|
18
|
MS_DRG
|
Chimeric Antigen Receptor (car) T-cell Immunotherapy
|
22
|
13
|
—
|
—
|
$296,198.25
|
$1,528,161.51
|
$339,848.52
|
2025-01-01
|
|
J2326
|
HCPCS
|
Inj Nusinersen 0.1mg
|
38
|
22
|
$413,702.43
|
$351,647.07
|
$89.00
|
$372,332.19
|
$299,934.26
|
2025-01-01
|
|
426
|
MS_DRG
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
1
|
1
|
—
|
—
|
$259,109.02
|
$259,109.02
|
$259,109.02
|
2025-01-01
|
|
1
|
MS_DRG
|
Heart Transplant Or Implant Of Heart Assist System With Mcc
|
22
|
13
|
—
|
—
|
$217,906.47
|
$1,123,995.73
|
$250,019.00
|
2025-01-01
|
|
927
|
MS_DRG
|
Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft
|
22
|
13
|
—
|
—
|
$211,961.53
|
$1,093,306.16
|
$243,197.97
|
2025-01-01
|
|
'002-4
|
APR_DRG
|
Heart &/or Lung Transplant
|
17
|
6
|
—
|
—
|
$214,129.69
|
$481,791.80
|
$235,542.66
|
2025-01-01
|
|
850
|
MS_DRG
|
Acute Leukemia With Other Procedures
|
1
|
1
|
—
|
—
|
$227,856.35
|
$227,856.35
|
$227,856.35
|
2025-01-01
|
|
429
|
MS_DRG
|
Combined Anterior And Posterior Cervical Spinal Fusion With Mcc
|
1
|
1
|
—
|
—
|
$206,304.74
|
$206,304.74
|
$206,304.74
|
2025-01-01
|
|
3
|
MS_DRG
|
Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…
|
22
|
13
|
—
|
—
|
$171,479.06
|
$884,323.40
|
$196,749.65
|
2025-01-01
|
|
427
|
MS_DRG
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
1
|
1
|
—
|
—
|
$175,685.28
|
$175,685.28
|
$175,685.28
|
2025-01-01
|
|
'583-4
|
APR_DRG
|
Neonate W Ecmo
|
17
|
6
|
—
|
—
|
$157,748.92
|
$354,935.07
|
$173,523.81
|
2025-01-01
|
|
'588-4
|
APR_DRG
|
Neonate Bwt <1500g W Major Procedure
|
17
|
6
|
—
|
—
|
$154,984.28
|
$348,714.63
|
$170,482.71
|
2025-01-01
|
|
'588-3
|
APR_DRG
|
Neonate Bwt <1500g W Major Procedure
|
17
|
6
|
—
|
—
|
$154,984.28
|
$348,714.63
|
$170,482.71
|
2025-01-01
|
|
447
|
MS_DRG
|
Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall…
|
1
|
1
|
—
|
—
|
$165,840.75
|
$165,840.75
|
$165,840.75
|
2025-01-01
|
|
'161-4
|
APR_DRG
|
Cardiac Defibrillator & Heart Assist Implant
|
17
|
6
|
—
|
—
|
$141,798.54
|
$319,046.72
|
$155,978.39
|
2025-01-01
|
|
317
|
MS_DRG
|
Concomitant Left Atrial Appendage Closure And Cardiac Ablation
|
1
|
1
|
—
|
—
|
$153,020.60
|
$153,020.60
|
$153,020.60
|
2025-01-01
|
|
'003-4
|
APR_DRG
|
Bone Marrow Transplant
|
17
|
6
|
—
|
—
|
$137,692.92
|
$309,809.07
|
$151,462.21
|
2025-01-01
|
|
428
|
MS_DRG
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
1
|
1
|
—
|
—
|
$136,143.91
|
$136,143.91
|
$136,143.91
|
2025-01-01
|
|
4
|
MS_DRG
|
Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…
|
22
|
13
|
—
|
—
|
$118,286.35
|
$609,726.60
|
$135,718.03
|
2025-01-01
|
|
430
|
MS_DRG
|
Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc
|
1
|
1
|
—
|
—
|
$135,312.82
|
$135,312.82
|
$135,312.82
|
2025-01-01
|
|
'591-4
|
APR_DRG
|
Neonate Birthwt 500-749g Without Major Procedure
|
17
|
6
|
—
|
—
|
$119,104.05
|
$267,984.11
|
$131,014.46
|
2025-01-01
|
|
'588-1
|
APR_DRG
|
Neonate Bwt <1500g W Major Procedure
|
17
|
6
|
—
|
—
|
$118,675.43
|
$267,019.72
|
$130,542.97
|
2025-01-01
|
|
'588-2
|
APR_DRG
|
Neonate Bwt <1500g W Major Procedure
|
17
|
6
|
—
|
—
|
$118,675.43
|
$267,019.72
|
$130,542.97
|
2025-01-01
|
|
450
|
MS_DRG
|
Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically …
|
1
|
1
|
—
|
—
|
$127,387.72
|
$127,387.72
|
$127,387.72
|
2025-01-01
|
|
'841-4
|
APR_DRG
|
Extensive 3rd Degree Burns W Skin Graft
|
17
|
6
|
—
|
—
|
$115,209.07
|
$259,220.41
|
$126,729.98
|
2025-01-01
|
|
'004-4
|
APR_DRG
|
Tracheostomy W Mv 96+ Hours W Extensive Procedure Or Ecmo
|
17
|
6
|
—
|
—
|
$111,129.17
|
$250,040.63
|
$122,242.09
|
2025-01-01
|
|
'001-4
|
APR_DRG
|
Liver Transplant &/or Intestinal Transplant
|
17
|
6
|
—
|
—
|
$107,659.14
|
$242,233.07
|
$118,425.05
|
2025-01-01
|
|
'593-4
|
APR_DRG
|
Neonate Birthwt 750-999g Without Major Procedure
|
17
|
6
|
—
|
—
|
$107,233.58
|
$241,275.56
|
$117,956.94
|
2025-01-01
|
|
7
|
MS_DRG
|
Lung Transplant
|
21
|
12
|
—
|
—
|
$98,732.90
|
$508,785.74
|
$114,322.31
|
2025-01-01
|
|
J1747
|
HCPCS
|
Injection Spesolimab-sbzo 1 Mg
|
38
|
22
|
$156,466.98
|
$132,996.93
|
$60.15
|
$140,820.28
|
$113,438.57
|
2025-01-01
|
|
2
|
MS_DRG
|
Heart Transplant Or Implant Of Heart Assist System Without Mcc
|
22
|
13
|
—
|
—
|
$98,553.72
|
$507,860.78
|
$113,077.43
|
2025-01-01
|
|
'609-4
|
APR_DRG
|
Neonate Bwt 1500-2499g W Major Procedure
|
17
|
6
|
—
|
—
|
$98,222.03
|
$220,999.57
|
$108,044.23
|
2025-01-01
|
|
14
|
MS_DRG
|
Allogeneic Bone Marrow Transplant
|
21
|
12
|
—
|
—
|
$92,260.87
|
$475,375.21
|
$106,828.38
|
2025-01-01
|
|
'602-4
|
APR_DRG
|
Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom
|
17
|
6
|
—
|
—
|
$93,062.61
|
$209,390.87
|
$102,368.87
|
2025-01-01
|
|
'002-3
|
APR_DRG
|
Heart &/or Lung Transplant
|
17
|
6
|
—
|
—
|
$92,739.30
|
$208,663.43
|
$102,013.23
|
2025-01-01
|
|
448
|
MS_DRG
|
Multiple Level Spinal Fusion Except Cervical Without Mcc
|
1
|
1
|
—
|
—
|
$101,005.37
|
$101,005.37
|
$101,005.37
|
2025-01-01
|
|
212
|
MS_DRG
|
Concomitant Aortic And Mitral Valve Procedures
|
22
|
13
|
—
|
—
|
$86,715.27
|
$446,747.09
|
$99,494.36
|
2025-01-01
|
|
'841-3
|
APR_DRG
|
Extensive 3rd Degree Burns W Skin Graft
|
17
|
6
|
—
|
—
|
$90,131.42
|
$202,795.70
|
$99,144.56
|
2025-01-01
|
|
'583-3
|
APR_DRG
|
Neonate W Ecmo
|
17
|
6
|
—
|
—
|
$89,822.20
|
$202,099.95
|
$98,804.42
|
2025-01-01
|
|
2433805008
|
NDC
|
Carmustine In Polifeprosan 7.7 Mg Wafer 8 Each Box
|
26
|
16
|
$116,256.79
|
$98,818.27
|
$89.00
|
$108,118.81
|
$97,655.71
|
2025-01-01
|
|
'583-1
|
APR_DRG
|
Neonate W Ecmo
|
17
|
6
|
—
|
—
|
$88,151.17
|
$198,340.13
|
$96,966.29
|
2025-01-01
|
|
'583-2
|
APR_DRG
|
Neonate W Ecmo
|
17
|
6
|
—
|
—
|
$88,151.17
|
$198,340.13
|
$96,966.29
|
2025-01-01
|
|
402
|
MS_DRG
|
Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical
|
1
|
1
|
—
|
—
|
$96,768.27
|
$96,768.27
|
$96,768.27
|
2025-01-01
|
|
5
|
MS_DRG
|
Liver Transplant With Mcc Or Intestinal Transplant
|
21
|
12
|
—
|
—
|
$83,335.04
|
$429,297.30
|
$96,493.20
|
2025-01-01
|
|
215
|
MS_DRG
|
Other Heart Assist System Implant
|
22
|
13
|
—
|
—
|
$82,248.73
|
$423,689.47
|
$94,369.60
|
2025-01-01
|
|
'603-4
|
APR_DRG
|
Neonate Birthwt 1000-1249g W Or Without Other Significant Condition
|
17
|
6
|
—
|
—
|
$85,764.95
|
$192,971.14
|
$94,341.45
|
2025-01-01
|
|
'005-4
|
APR_DRG
|
Tracheostomy W Mv 96+ Hours Without Extensive Procedure
|
17
|
6
|
—
|
—
|
$84,905.87
|
$191,038.21
|
$93,396.46
|
2025-01-01
|
|
27800000002-43
|
CDM
|
Device Impella 5.5 Smartassist
|
26
|
16
|
$112,500.00
|
$95,625.00
|
$89.00
|
$104,625.00
|
$92,812.50
|
2025-01-01
|
|
'593-3
|
APR_DRG
|
Neonate Birthwt 750-999g Without Major Procedure
|
17
|
6
|
—
|
—
|
$83,855.73
|
$188,675.39
|
$92,241.30
|
2025-01-01
|
|
216
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
22
|
13
|
—
|
—
|
$78,155.00
|
$402,556.43
|
$89,672.57
|
2025-01-01
|
|
'002-2
|
APR_DRG
|
Heart &/or Lung Transplant
|
17
|
6
|
—
|
—
|
$79,127.38
|
$178,036.61
|
$87,040.12
|
2025-01-01
|
|
'607-4
|
APR_DRG
|
Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom
|
17
|
6
|
—
|
—
|
$76,064.55
|
$171,145.24
|
$83,671.01
|
2025-01-01
|
|
'630-4
|
APR_DRG
|
Neonate Birthwt >2499g W Major Cardiovascular Procedure
|
17
|
6
|
—
|
—
|
$75,353.64
|
$169,545.69
|
$82,889.00
|
2025-01-01
|
|
27800000002-42
|
CDM
|
Device Impella 5.5 Smartassist
|
26
|
16
|
$100,000.00
|
$85,000.00
|
$89.00
|
$93,000.00
|
$82,500.00
|
2025-01-01
|
|
'589-2
|
APR_DRG
|
Neonate Bwt <500g Or Ga <24 Weeks
|
17
|
6
|
—
|
—
|
$74,798.88
|
$168,297.48
|
$82,278.77
|
2025-01-01
|
|
'589-1
|
APR_DRG
|
Neonate Bwt <500g Or Ga <24 Weeks
|
17
|
6
|
—
|
—
|
$74,798.88
|
$168,297.48
|
$82,278.77
|
2025-01-01
|
|
A9542
|
HCPCS
|
Indium In-111 Ibritumomab Tiuxetan Diagnostic Per Study Dose Up To 5 Millicuries
|
26
|
16
|
$97,800.00
|
$83,130.00
|
$89.00
|
$90,954.00
|
$82,152.00
|
2025-01-01
|
|
'002-1
|
APR_DRG
|
Heart &/or Lung Transplant
|
17
|
6
|
—
|
—
|
$74,561.30
|
$167,762.93
|
$82,017.43
|
2025-01-01
|
|
'003-3
|
APR_DRG
|
Bone Marrow Transplant
|
17
|
6
|
—
|
—
|
$72,865.17
|
$163,946.63
|
$80,151.69
|
2025-01-01
|
|
'591-3
|
APR_DRG
|
Neonate Birthwt 500-749g Without Major Procedure
|
17
|
6
|
—
|
—
|
$72,814.34
|
$163,832.27
|
$80,095.77
|
2025-01-01
|
|
453
|
MS_DRG
|
Combined Anterior And Posterior Spinal Fusion With Mcc
|
17
|
12
|
—
|
—
|
$71,374.45
|
$367,553.15
|
$79,638.86
|
2025-01-01
|
|
27800000002-547
|
CDM
|
Coil Azur Cx Detach 13mmx24cm .035in Periph 1/bx
|
26
|
16
|
$96,382.50
|
$81,925.13
|
$89.00
|
$89,635.73
|
$79,515.57
|
2025-01-01
|
|
20
|
MS_DRG
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc
|
22
|
13
|
—
|
—
|
$68,088.22
|
$350,588.65
|
$78,122.27
|
2025-01-01
|
|
456
|
MS_DRG
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
22
|
13
|
—
|
—
|
$67,903.42
|
$349,634.65
|
$77,910.24
|
2025-01-01
|
|
451
|
MS_DRG
|
Single Level Spinal Fusion Except Cervical Without Mcc
|
1
|
1
|
—
|
—
|
$76,332.21
|
$76,332.21
|
$76,332.21
|
2025-01-01
|
|
'090-4
|
APR_DRG
|
Major Larynx & Trachea Procedures
|
17
|
6
|
—
|
—
|
$69,235.93
|
$155,780.84
|
$76,159.52
|
2025-01-01
|
|
'602-3
|
APR_DRG
|
Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom
|
17
|
6
|
—
|
—
|
$68,817.72
|
$154,839.87
|
$75,699.49
|
2025-01-01
|
|
'593-2
|
APR_DRG
|
Neonate Birthwt 750-999g Without Major Procedure
|
17
|
6
|
—
|
—
|
$68,695.25
|
$154,564.31
|
$75,564.78
|
2025-01-01
|
|
231
|
MS_DRG
|
Coronary Bypass With Ptca With Mcc
|
22
|
13
|
—
|
—
|
$65,378.89
|
$336,602.27
|
$75,013.67
|
2025-01-01
|
|
'591-2
|
APR_DRG
|
Neonate Birthwt 500-749g Without Major Procedure
|
17
|
6
|
—
|
—
|
$67,959.24
|
$152,908.29
|
$74,755.16
|
2025-01-01
|
|
'303-4
|
APR_DRG
|
Dorsal & Lumbar Fusion Proc For Curvature Of Back
|
17
|
6
|
—
|
—
|
$67,179.15
|
$151,153.09
|
$73,897.07
|
2025-01-01
|
|
19
|
MS_DRG
|
Simultaneous Pancreas And Kidney Transplant With Hemodialysis
|
22
|
13
|
—
|
—
|
$64,401.05
|
$331,554.39
|
$73,891.74
|
2025-01-01
|
|
A9596
|
HCPCS
|
Gallium Ga-68 Gozetotide Diagnostic 1 Millicurie
|
38
|
22
|
$147,600.00
|
$125,460.00
|
$89.00
|
$132,840.00
|
$73,800.00
|
2025-01-01
|
|
'593-1
|
APR_DRG
|
Neonate Birthwt 750-999g Without Major Procedure
|
17
|
6
|
—
|
—
|
$66,617.65
|
$149,889.71
|
$73,279.42
|
2025-01-01
|
|
233
|
MS_DRG
|
Coronary Bypass With Cardiac Catheterization With Mcc
|
22
|
13
|
—
|
—
|
$62,843.11
|
$323,511.81
|
$72,104.20
|
2025-01-01
|
|
'631-4
|
APR_DRG
|
Neonate Birthwt >2499g W Other Major Procedure
|
17
|
6
|
—
|
—
|
$64,845.59
|
$145,902.58
|
$71,330.15
|
2025-01-01
|
|
219
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
22
|
13
|
—
|
—
|
$62,132.83
|
$319,845.15
|
$71,289.25
|
2025-01-01
|
|
'440-4
|
APR_DRG
|
Kidney Transplant
|
17
|
6
|
—
|
—
|
$64,053.85
|
$144,121.16
|
$70,459.24
|
2025-01-01
|
|
27800000002-85
|
CDM
|
Valve Sapien Thv Edwards Resilia 20mm
|
26
|
16
|
$85,000.00
|
$72,250.00
|
$89.00
|
$79,050.00
|
$70,125.00
|
2025-01-01
|
|
27800000002-83
|
CDM
|
Valve Sapien Thv Edwards Resilia 29mm
|
26
|
16
|
$85,000.00
|
$72,250.00
|
$89.00
|
$79,050.00
|
$70,125.00
|
2025-01-01
|
|
27800000002-84
|
CDM
|
Valve Sapien Thv Edwards Resilia 26mm
|
26
|
16
|
$85,000.00
|
$72,250.00
|
$89.00
|
$79,050.00
|
$70,125.00
|
2025-01-01
|
|
27800000002-82
|
CDM
|
Valve Sapien Thv Edwards Resilia 23mm
|
26
|
16
|
$85,000.00
|
$72,250.00
|
$89.00
|
$79,050.00
|
$70,125.00
|
2025-01-01
|
|
'004-3
|
APR_DRG
|
Tracheostomy W Mv 96+ Hours W Extensive Procedure Or Ecmo
|
17
|
6
|
—
|
—
|
$62,134.22
|
$139,802.00
|
$68,347.64
|
2025-01-01
|
|
'160-4
|
APR_DRG
|
Major Cardiothoracic Repair Of Heart Anomaly
|
17
|
6
|
—
|
—
|
$61,358.41
|
$138,056.42
|
$67,494.25
|
2025-01-01
|
|
27800000002-601
|
CDM
|
Valve Sapien 3 Ultra Thv 20mm W/command System
|
26
|
16
|
$81,250.00
|
$69,062.50
|
$89.00
|
$75,562.50
|
$67,031.25
|
2025-01-01
|
|
27800000002-428
|
CDM
|
Valve Sapien 3 Thv 29mm W/command System
|
26
|
16
|
$81,250.00
|
$69,062.50
|
$89.00
|
$75,562.50
|
$67,031.25
|
2025-01-01
|
|
27800000002-604
|
CDM
|
Valve Sapien 3 Ultra Thv 26mm W/command System
|
26
|
16
|
$81,250.00
|
$69,062.50
|
$89.00
|
$75,562.50
|
$67,031.25
|
2025-01-01
|
|
27800000002-605
|
CDM
|
Valve Sapien 3 Ultra Thv 26mm W/command System
|
26
|
16
|
$81,250.00
|
$69,062.50
|
$89.00
|
$75,562.50
|
$67,031.25
|
2025-01-01
|
|
27800000002-430
|
CDM
|
Valve Thv Sapien 3 26mm W/certitudesystem
|
26
|
16
|
$81,250.00
|
$69,062.50
|
$89.00
|
$75,562.50
|
$67,031.25
|
2025-01-01
|
|
27800000002-603
|
CDM
|
Valve Sapien 3 Ultra Thv 23mm W/command System
|
26
|
16
|
$81,250.00
|
$69,062.50
|
$89.00
|
$75,562.50
|
$67,031.25
|
2025-01-01
|
|
27800000002-425
|
CDM
|
Valve Sapien 3 Thv 23mm W/command System
|
26
|
16
|
$81,250.00
|
$69,062.50
|
$89.00
|
$75,562.50
|
$67,031.25
|
2025-01-01
|
|
27800000002-427
|
CDM
|
Valve Sapien 3 Thv 29mm W/command System
|
26
|
16
|
$81,250.00
|
$69,062.50
|
$89.00
|
$75,562.50
|
$67,031.25
|
2025-01-01
|
|
27800000002-429
|
CDM
|
Valve Thv Sapien 3 23mm W/certitudesystem
|
26
|
16
|
$81,250.00
|
$69,062.50
|
$89.00
|
$75,562.50
|
$67,031.25
|
2025-01-01
|
|
27800000002-602
|
CDM
|
Valve Sapien 3 Ultra Thv 23mm W/command System
|
26
|
16
|
$81,250.00
|
$69,062.50
|
$89.00
|
$75,562.50
|
$67,031.25
|
2025-01-01
|
|
27800000002-431
|
CDM
|
Valve Thv Sapien 3 29mm W/certitudesystem
|
26
|
16
|
$81,250.00
|
$69,062.50
|
$89.00
|
$75,562.50
|
$67,031.25
|
2025-01-01
|
|
27800000002-426
|
CDM
|
Valve Sapien 3 Thv 26mm W/command System
|
26
|
16
|
$81,250.00
|
$69,062.50
|
$89.00
|
$75,562.50
|
$67,031.25
|
2025-01-01
|
|
27800000002-424
|
CDM
|
Valve Sapien 3 Thv 20mm W/command System
|
26
|
16
|
$81,250.00
|
$69,062.50
|
$89.00
|
$75,562.50
|
$67,031.25
|
2025-01-01
|
|
957
|
MS_DRG
|
Other O.r. Procedures For Multiple Significant Trauma With Mcc
|
22
|
13
|
—
|
—
|
$58,286.59
|
$299,989.64
|
$66,876.18
|
2025-01-01
|
|
'161-3
|
APR_DRG
|
Cardiac Defibrillator & Heart Assist Implant
|
17
|
6
|
—
|
—
|
$60,719.76
|
$136,619.46
|
$66,791.74
|
2025-01-01
|
|
'361-4
|
APR_DRG
|
Skin Graft For Skin & Subcutaneous Tissue Diagnoses
|
17
|
6
|
—
|
—
|
$59,255.70
|
$133,325.33
|
$65,181.27
|
2025-01-01
|
|
275
|
MS_DRG
|
Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc
|
22
|
13
|
—
|
—
|
$56,706.14
|
$291,830.91
|
$65,062.83
|
2025-01-01
|
|
870
|
MS_DRG
|
Septicemia Or Severe Sepsis With Mv >96 Hours
|
22
|
13
|
—
|
—
|
$56,136.47
|
$288,890.12
|
$64,409.21
|
2025-01-01
|
|
'602-2
|
APR_DRG
|
Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom
|
17
|
6
|
—
|
—
|
$58,542.34
|
$131,720.27
|
$64,396.57
|
2025-01-01
|
|
928
|
MS_DRG
|
Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc
|
22
|
13
|
—
|
—
|
$55,773.30
|
$287,015.32
|
$63,992.53
|
2025-01-01
|
|
207
|
MS_DRG
|
Respiratory System Diagnosis With Ventilator Support >96 Hours
|
22
|
13
|
—
|
—
|
$55,679.29
|
$286,530.02
|
$63,884.66
|
2025-01-01
|
|
'162-4
|
APR_DRG
|
Cardiac Valve Procedures W Ami Or Complex Pdx
|
17
|
6
|
—
|
—
|
$57,934.31
|
$130,352.20
|
$63,727.74
|
2025-01-01
|
|
969
|
MS_DRG
|
HIV With Extensive O.r. Procedures With Mcc
|
22
|
13
|
—
|
—
|
$55,394.86
|
$285,061.70
|
$63,558.32
|
2025-01-01
|
|
268
|
MS_DRG
|
Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc
|
22
|
13
|
—
|
—
|
$55,251.04
|
$284,319.25
|
$63,393.30
|
2025-01-01
|
|
J9298
|
HCPCS
|
Opdualag Per 1 Each
|
38
|
22
|
$87,194.88
|
$74,115.65
|
$89.00
|
$78,475.39
|
$63,216.29
|
2025-01-01
|
|
461
|
MS_DRG
|
Bilateral Or Multiple Major Joint Procs Of Lower Extremity W Mcc
|
22
|
13
|
—
|
—
|
$54,960.18
|
$282,817.74
|
$63,059.57
|
2025-01-01
|
|
'005-3
|
APR_DRG
|
Tracheostomy W Mv 96+ Hours Without Extensive Procedure
|
17
|
6
|
—
|
—
|
$57,003.58
|
$128,258.06
|
$62,703.94
|
2025-01-01
|
|
'304-4
|
APR_DRG
|
Dorsal & Lumbar Fusion Proc Except For Curvature Of Back
|
17
|
6
|
—
|
—
|
$56,694.36
|
$127,562.31
|
$62,363.80
|
2025-01-01
|
|
'607-3
|
APR_DRG
|
Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom
|
17
|
6
|
—
|
—
|
$56,491.68
|
$127,106.28
|
$62,140.85
|
2025-01-01
|
|
27800000002-75
|
CDM
|
Valve Aortic 34mm Evolut Fx
|
26
|
16
|
$75,000.00
|
$63,750.00
|
$89.00
|
$69,750.00
|
$61,875.00
|
2025-01-01
|
|
27800000002-292
|
CDM
|
Kit Mitraclip 2 Mbr0302
|
26
|
16
|
$75,000.00
|
$63,750.00
|
$89.00
|
$69,750.00
|
$61,875.00
|
2025-01-01
|
|
27800000002-73
|
CDM
|
Valve Aortic 26mm Evolut Fx
|
26
|
16
|
$75,000.00
|
$63,750.00
|
$89.00
|
$69,750.00
|
$61,875.00
|
2025-01-01
|
|
27800000002-76
|
CDM
|
Valve Aortic 23mm Evolut Fx
|
26
|
16
|
$75,000.00
|
$63,750.00
|
$89.00
|
$69,750.00
|
$61,875.00
|
2025-01-01
|
|
27800000002-290
|
CDM
|
Kit Mitraclip 1 Mbr0301
|
26
|
16
|
$75,000.00
|
$63,750.00
|
$89.00
|
$69,750.00
|
$61,875.00
|
2025-01-01
|
|
27800000002-394
|
CDM
|
Valve Aort 29mm Pro Perc
|
26
|
16
|
$75,000.00
|
$63,750.00
|
$89.00
|
$69,750.00
|
$61,875.00
|
2025-01-01
|
|
27800000002-74
|
CDM
|
Valve Aortic 29mm Evolut Fx
|
26
|
16
|
$75,000.00
|
$63,750.00
|
$89.00
|
$69,750.00
|
$61,875.00
|
2025-01-01
|
|
27800000002-470
|
CDM
|
Valve Aortic Evolut Tm Pro 26mm
|
26
|
16
|
$75,000.00
|
$63,750.00
|
$89.00
|
$69,750.00
|
$61,875.00
|
2025-01-01
|
|
27800000002-609
|
CDM
|
Kit Mitraclip G4 Syst Cds0701nt/ntw/xt/xtw
|
26
|
16
|
$75,000.00
|
$63,750.00
|
$89.00
|
$69,750.00
|
$61,875.00
|
2025-01-01
|
|
27800000002-289
|
CDM
|
Kit Mitraclip 1 Mbr0101
|
26
|
16
|
$75,000.00
|
$63,750.00
|
$89.00
|
$69,750.00
|
$61,875.00
|
2025-01-01
|
|
27800000002-713
|
CDM
|
Kit Mitraclip 1 Mbr0303
|
26
|
16
|
$75,000.00
|
$63,750.00
|
$89.00
|
$69,750.00
|
$61,875.00
|
2025-01-01
|
|
27800000002-393
|
CDM
|
Valve Aort 26mm Pro Perc
|
26
|
16
|
$75,000.00
|
$63,750.00
|
$89.00
|
$69,750.00
|
$61,875.00
|
2025-01-01
|
|
27800000002-472
|
CDM
|
Valve Aortic Evolut Tm Pro 34mm
|
26
|
16
|
$75,000.00
|
$63,750.00
|
$89.00
|
$69,750.00
|
$61,875.00
|
2025-01-01
|
|
27800000002-471
|
CDM
|
Valve Aortic Evolut Tm Pro 29mm
|
26
|
16
|
$75,000.00
|
$63,750.00
|
$89.00
|
$69,750.00
|
$61,875.00
|
2025-01-01
|
|
27800000002-745
|
CDM
|
Kit Mitraclip 3 Mbr0103
|
26
|
16
|
$75,000.00
|
$63,750.00
|
$89.00
|
$69,750.00
|
$61,875.00
|
2025-01-01
|
|
27800000002-291
|
CDM
|
Kit Mitraclip 2 Mbr0102
|
26
|
16
|
$75,000.00
|
$63,750.00
|
$89.00
|
$69,750.00
|
$61,875.00
|
2025-01-01
|
|
27800000002-807
|
CDM
|
Valve Aortic Evolut Tm Pro 23mm
|
26
|
16
|
$75,000.00
|
$63,750.00
|
$89.00
|
$69,750.00
|
$61,875.00
|
2025-01-01
|
|
'312-4
|
APR_DRG
|
Skin Graft, Except Hand, For Musculoskeletal & Connective Tissue Diagnoses
|
17
|
6
|
—
|
—
|
$55,592.79
|
$125,083.78
|
$61,152.07
|
2025-01-01
|
|
'603-3
|
APR_DRG
|
Neonate Birthwt 1000-1249g W Or Without Other Significant Condition
|
17
|
6
|
—
|
—
|
$55,447.06
|
$124,755.89
|
$60,991.77
|
2025-01-01
|
|
'681-4
|
APR_DRG
|
Other O.r. Procedures For Lymphatic/hematopoietic/other Neoplasms
|
17
|
6
|
—
|
—
|
$55,402.36
|
$124,655.31
|
$60,942.60
|
2025-01-01
|
|
'680-4
|
APR_DRG
|
Major O.r. Procedures For Lymphatic/hematopoietic/other Neoplasms
|
17
|
6
|
—
|
—
|
$55,249.89
|
$124,312.25
|
$60,774.88
|
2025-01-01
|
|
'591-1
|
APR_DRG
|
Neonate Birthwt 500-749g Without Major Procedure
|
17
|
6
|
—
|
—
|
$54,901.48
|
$123,528.33
|
$60,391.63
|
2025-01-01
|
|
459
|
MS_DRG
|
Spinal Fusion Except Cervical With Mcc
|
17
|
12
|
—
|
—
|
$53,464.10
|
$275,094.54
|
$59,654.68
|
2025-01-01
|
|
'690-4
|
APR_DRG
|
Acute Leukemia
|
17
|
6
|
—
|
—
|
$54,066.88
|
$121,650.48
|
$59,473.57
|
2025-01-01
|
|
217
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
22
|
13
|
—
|
—
|
$51,318.81
|
$264,019.91
|
$58,881.58
|
2025-01-01
|
|
'842-4
|
APR_DRG
|
Burns With Skin Graft Except Extensive 3rd Degree Burns
|
17
|
6
|
—
|
—
|
$53,360.26
|
$120,060.59
|
$58,696.29
|
2025-01-01
|
|
266
|
MS_DRG
|
Endovascular Cardiac Valve Replacement W Mcc
|
22
|
13
|
—
|
—
|
$50,361.07
|
$259,075.74
|
$57,782.70
|
2025-01-01
|
|
16
|
MS_DRG
|
Autologous Bone Marrow Transplant With Cc/mcc
|
21
|
12
|
—
|
—
|
$49,805.86
|
$256,209.61
|
$57,669.94
|
2025-01-01
|
|
17
|
MS_DRG
|
Autologous Bone Marrow Transplant Without Cc/mcc
|
21
|
12
|
—
|
—
|
$49,805.86
|
$256,209.61
|
$57,669.94
|
2025-01-01
|
|
'612-4
|
APR_DRG
|
Neonate Bwt 1500-1999g W Resp Dist Synd/oth Maj Resp Cond
|
17
|
6
|
—
|
—
|
$52,355.44
|
$117,799.74
|
$57,590.98
|
2025-01-01
|
|
573
|
MS_DRG
|
Skin Graft For Skin Ulcer Or Cellulitis With Mcc
|
22
|
13
|
—
|
—
|
$50,136.09
|
$257,914.35
|
$57,524.57
|
2025-01-01
|
|
276
|
MS_DRG
|
Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator
|
22
|
13
|
—
|
—
|
$50,072.62
|
$257,586.68
|
$57,451.74
|
2025-01-01
|
|
J9359
|
HCPCS
|
Loncastuximab-lpyl 0.1 Mg
|
38
|
22
|
$78,900.03
|
$67,065.03
|
$89.00
|
$71,010.03
|
$57,202.52
|
2025-01-01
|
|
'405-4
|
APR_DRG
|
Other Procedures For Endocrine, Nutritional & Metabolic Disorders
|
17
|
6
|
—
|
—
|
$51,831.91
|
$116,621.80
|
$57,015.10
|
2025-01-01
|
|
'001-3
|
APR_DRG
|
Liver Transplant &/or Intestinal Transplant
|
17
|
6
|
—
|
—
|
$51,699.65
|
$116,324.21
|
$56,869.62
|
2025-01-01
|
|
21
|
MS_DRG
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc
|
22
|
13
|
—
|
—
|
$49,519.82
|
$254,732.99
|
$56,817.48
|
2025-01-01
|
|
955
|
MS_DRG
|
Craniotomy For Multiple Significant Trauma
|
22
|
13
|
—
|
—
|
$49,108.45
|
$252,609.32
|
$56,345.48
|
2025-01-01
|
|
457
|
MS_DRG
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
22
|
13
|
—
|
—
|
$48,988.73
|
$251,991.29
|
$56,208.12
|
2025-01-01
|
|
820
|
MS_DRG
|
Lymphoma And Leukemia With Major O.r. Procedures With Mcc
|
22
|
13
|
—
|
—
|
$48,758.93
|
$250,805.02
|
$55,944.46
|
2025-01-01
|
|
'611-4
|
APR_DRG
|
Neonate Birthwt 1500-1999g W Major Anomaly
|
17
|
6
|
—
|
—
|
$50,764.02
|
$114,219.05
|
$55,840.42
|
2025-01-01
|
|
28
|
MS_DRG
|
Spinal Procedures With Mcc
|
22
|
13
|
—
|
—
|
$48,593.41
|
$249,950.58
|
$55,754.55
|
2025-01-01
|
|
'950-4
|
APR_DRG
|
Extensive Procedure Unrelated To Principal Diagnosis
|
17
|
6
|
—
|
—
|
$50,155.37
|
$112,849.58
|
$55,170.91
|
2025-01-01
|
|
232
|
MS_DRG
|
Coronary Bypass With Ptca Without Mcc
|
22
|
13
|
—
|
—
|
$47,970.72
|
$246,736.03
|
$55,040.08
|
2025-01-01
|
|
454
|
MS_DRG
|
Combined Anterior And Posterior Spinal Fusion With Cc
|
17
|
12
|
—
|
—
|
$49,318.15
|
$253,691.89
|
$55,028.67
|
2025-01-01
|
|
'023-4
|
APR_DRG
|
Spinal Procedures
|
17
|
6
|
—
|
—
|
$49,958.20
|
$112,405.95
|
$54,954.02
|
2025-01-01
|
|
235
|
MS_DRG
|
Coronary Bypass Without Cardiac Catheterization With Mcc
|
22
|
13
|
—
|
—
|
$47,424.35
|
$243,915.53
|
$54,413.21
|
2025-01-01
|
|
790
|
MS_DRG
|
Extreme Immaturity Or Respiratory Distress Syndrome, Neonate
|
16
|
12
|
—
|
—
|
$48,384.51
|
$248,872.15
|
$53,986.92
|
2025-01-01
|
|
27200000002-6085
|
CDM
|
Set Pump Cath Sys Rp Flex W/smart Assist
|
21
|
15
|
$62,500.00
|
$53,125.00
|
$89.00
|
$58,125.00
|
$53,125.00
|
2025-01-01
|
|
'003-2
|
APR_DRG
|
Bone Marrow Transplant
|
17
|
6
|
—
|
—
|
$47,989.59
|
$107,976.58
|
$52,788.55
|
2025-01-01
|
|
218
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
22
|
13
|
—
|
—
|
$45,946.75
|
$236,287.72
|
$52,717.85
|
2025-01-01
|
|
576
|
MS_DRG
|
Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc
|
22
|
13
|
—
|
—
|
$45,837.48
|
$235,723.62
|
$52,592.48
|
2025-01-01
|
|
23
|
MS_DRG
|
Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…
|
22
|
13
|
—
|
—
|
$45,722.59
|
$235,130.49
|
$52,460.65
|
2025-01-01
|
|
463
|
MS_DRG
|
Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …
|
22
|
13
|
—
|
—
|
$45,681.61
|
$234,918.95
|
$52,413.63
|
2025-01-01
|
|
'006-4
|
APR_DRG
|
Pancreas Transplant
|
17
|
6
|
—
|
—
|
$47,244.39
|
$106,299.88
|
$51,968.83
|
2025-01-01
|
|
'447-4
|
APR_DRG
|
Other Kidney, Urinary Tract & Related Procedures
|
17
|
6
|
—
|
—
|
$47,193.57
|
$106,185.53
|
$51,912.93
|
2025-01-01
|
|
'850-4
|
APR_DRG
|
Procedure W Diag Of Rehab, Aftercare Or Oth Contact W Health Service
|
17
|
6
|
—
|
—
|
$47,169.69
|
$106,131.80
|
$51,886.66
|
2025-01-01
|
|
834
|
MS_DRG
|
Acute Leukemia Without Major O.r. Procedures With Mcc
|
22
|
13
|
—
|
—
|
$45,161.76
|
$232,235.32
|
$51,817.18
|
2025-01-01
|
|
27800000002-77
|
CDM
|
Impella Rp With Smart Assist
|
26
|
16
|
$62,500.00
|
$53,125.00
|
$89.00
|
$58,125.00
|
$51,562.50
|
2025-01-01
|
|
27800000002-335
|
CDM
|
Set Pump Impella Rp
|
26
|
16
|
$62,500.00
|
$53,125.00
|
$89.00
|
$58,125.00
|
$51,562.50
|
2025-01-01
|
|
27800000002-332
|
CDM
|
Set Pump Impella Cp
|
26
|
16
|
$62,500.00
|
$53,125.00
|
$89.00
|
$58,125.00
|
$51,562.50
|
2025-01-01
|
|
27800000002-334
|
CDM
|
Set Pump Impella Rp
|
26
|
16
|
$62,500.00
|
$53,125.00
|
$89.00
|
$58,125.00
|
$51,562.50
|
2025-01-01
|
|
27800000002-331
|
CDM
|
Set Pump Impella Cp
|
26
|
16
|
$62,500.00
|
$53,125.00
|
$89.00
|
$58,125.00
|
$51,562.50
|
2025-01-01
|
|
27800000002-825
|
CDM
|
Set Pump Aic Impella 5.0
|
26
|
16
|
$62,500.00
|
$53,125.00
|
$89.00
|
$58,125.00
|
$51,562.50
|
2025-01-01
|
|
27800000002-824
|
CDM
|
Set Pump Aic Impella 5.0
|
26
|
16
|
$62,500.00
|
$53,125.00
|
$89.00
|
$58,125.00
|
$51,562.50
|
2025-01-01
|
|
'912-4
|
APR_DRG
|
Musculoskeletal & Other Procedures For Multiple Significant Trauma
|
17
|
6
|
—
|
—
|
$46,862.91
|
$105,441.55
|
$51,549.20
|
2025-01-01
|
|
'512-4
|
APR_DRG
|
Uterine & Adnexa Procedures For Non-ovarian & Non-adnexal Malig
|
17
|
6
|
—
|
—
|
$46,414.69
|
$104,433.05
|
$51,056.16
|
2025-01-01
|
|
405
|
MS_DRG
|
Pancreas, Liver And Shunt Procedures With Mcc
|
22
|
13
|
—
|
—
|
$44,408.09
|
$228,344.69
|
$50,952.44
|
2025-01-01
|
|
'607-2
|
APR_DRG
|
Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom
|
17
|
6
|
—
|
—
|
$46,261.61
|
$104,088.62
|
$50,887.77
|
2025-01-01
|
|
'260-4
|
APR_DRG
|
Major Pancreas, Liver & Shunt Procedures
|
17
|
6
|
—
|
—
|
$45,943.82
|
$103,373.60
|
$50,538.20
|
2025-01-01
|
|
'695-4
|
APR_DRG
|
Chemotherapy For Acute Leukemia #
|
17
|
6
|
—
|
—
|
$45,700.73
|
$102,826.64
|
$50,270.80
|
2025-01-01
|
|
653
|
MS_DRG
|
Major Bladder Procedures With Mcc
|
22
|
13
|
—
|
—
|
$43,672.11
|
$224,545.30
|
$50,107.99
|
2025-01-01
|
|
'092-4
|
APR_DRG
|
Facial Bone Procedures Except Major Cranial/facial Bone Procedures
|
17
|
6
|
—
|
—
|
$45,496.21
|
$102,366.47
|
$50,045.83
|
2025-01-01
|
|
'006-3
|
APR_DRG
|
Pancreas Transplant
|
17
|
6
|
—
|
—
|
$45,256.18
|
$101,826.41
|
$49,781.80
|
2025-01-01
|
|
'609-3
|
APR_DRG
|
Neonate Bwt 1500-2499g W Major Procedure
|
17
|
6
|
—
|
—
|
$45,065.75
|
$101,397.94
|
$49,572.33
|
2025-01-01
|
|
'021-4
|
APR_DRG
|
Craniotomy Except For Trauma
|
17
|
6
|
—
|
—
|
$44,810.41
|
$100,823.42
|
$49,291.45
|
2025-01-01
|
|
8
|
MS_DRG
|
Simultaneous Pancreas/kidney Transplant
|
21
|
12
|
—
|
—
|
$42,451.62
|
$218,244.79
|
$49,154.51
|
2025-01-01
|
|
A9543
|
HCPCS
|
Yttrium Y-90 Ibritumomab Tiuxetan Therapeutic Per Treatment Dose Up To 40 Millic…
|
38
|
22
|
$55,035.00
|
$46,779.75
|
$89.00
|
$91,667.21
|
$48,981.15
|
2025-01-01
|
|
'004-1
|
APR_DRG
|
Tracheostomy W Mv 96+ Hours W Extensive Procedure Or Ecmo
|
17
|
6
|
—
|
—
|
$44,487.10
|
$100,095.98
|
$48,935.81
|
2025-01-01
|
|
'004-2
|
APR_DRG
|
Tracheostomy W Mv 96+ Hours W Extensive Procedure Or Ecmo
|
17
|
6
|
—
|
—
|
$44,487.10
|
$100,095.98
|
$48,935.81
|
2025-01-01
|
|
'169-4
|
APR_DRG
|
Major Abdominal Vascular Procedures
|
17
|
6
|
—
|
—
|
$44,452.20
|
$100,017.45
|
$48,897.42
|
2025-01-01
|
|
'910-4
|
APR_DRG
|
Craniotomy For Multiple Significant Trauma
|
17
|
6
|
—
|
—
|
$44,449.75
|
$100,011.94
|
$48,894.73
|
2025-01-01
|
|
'608-4
|
APR_DRG
|
Neonate Bwt 1250-1499g W Or Without Other Significant Condition
|
17
|
6
|
—
|
—
|
$44,449.14
|
$100,010.57
|
$48,894.05
|
2025-01-01
|
|
220
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
22
|
13
|
—
|
—
|
$42,314.23
|
$217,535.52
|
$48,550.00
|
2025-01-01
|
|
'220-4
|
APR_DRG
|
Major Stomach, Esophageal & Duodenal Procedures
|
17
|
6
|
—
|
—
|
$43,869.27
|
$98,705.86
|
$48,256.20
|
2025-01-01
|
|
'841-2
|
APR_DRG
|
Extensive 3rd Degree Burns W Skin Graft
|
17
|
6
|
—
|
—
|
$43,833.76
|
$98,625.96
|
$48,217.14
|
2025-01-01
|
|
'165-4
|
APR_DRG
|
Coronary Bypass W Ami Or Complex Pdx
|
17
|
6
|
—
|
—
|
$43,801.30
|
$98,552.93
|
$48,181.43
|
2025-01-01
|
|
234
|
MS_DRG
|
Coronary Bypass With Cardiac Catheterization Without Mcc
|
22
|
13
|
—
|
—
|
$41,939.00
|
$215,598.50
|
$48,119.49
|
2025-01-01
|
|
'321-4
|
APR_DRG
|
Cervical Spinal Fusion & Other Back/neck Proc Exc Disc Excis/decomp
|
17
|
6
|
—
|
—
|
$43,725.38
|
$98,382.11
|
$48,097.92
|
2025-01-01
|
|
J9281
|
HCPCS
|
mitoMYcin 40 Mg X 2 Kit 1 Each Kit
|
38
|
22
|
$66,330.00
|
$56,380.50
|
$89.00
|
$59,697.00
|
$48,089.25
|
2025-01-01
|
|
466
|
MS_DRG
|
Revision Of Hip Or Knee Replacement With Mcc
|
22
|
13
|
—
|
—
|
$41,848.21
|
$215,129.79
|
$48,015.32
|
2025-01-01
|
|
'163-4
|
APR_DRG
|
Cardiac Valve Procedures Without Ami Or Complex Pdx
|
17
|
6
|
—
|
—
|
$43,620.06
|
$98,145.14
|
$47,982.07
|
2025-01-01
|
|
11
|
MS_DRG
|
Tracheostomy For Face,mouth & Neck Diagnoses W Mcc
|
22
|
13
|
—
|
—
|
$41,604.76
|
$213,873.01
|
$47,735.99
|
2025-01-01
|
|
'303-3
|
APR_DRG
|
Dorsal & Lumbar Fusion Proc For Curvature Of Back
|
17
|
6
|
—
|
—
|
$43,258.79
|
$97,332.28
|
$47,584.67
|
2025-01-01
|
|
'401-4
|
APR_DRG
|
Pituitary & Adrenal Procedures
|
17
|
6
|
—
|
—
|
$43,256.95
|
$97,328.14
|
$47,582.65
|
2025-01-01
|
|
326
|
MS_DRG
|
Stomach, Esophageal And Duodenal Procedures With Mcc
|
22
|
13
|
—
|
—
|
$40,983.67
|
$210,666.76
|
$47,023.36
|
2025-01-01
|
|
'603-2
|
APR_DRG
|
Neonate Birthwt 1000-1249g W Or Without Other Significant Condition
|
17
|
6
|
—
|
—
|
$42,710.76
|
$96,099.21
|
$46,981.84
|
2025-01-01
|
|
J2507
|
HCPCS
|
Pegloticase Per 1 Mg
|
38
|
22
|
$64,638.66
|
$54,942.86
|
$89.00
|
$58,174.79
|
$46,863.03
|
2025-01-01
|
|
270
|
MS_DRG
|
Other Major Cardiovascular Procedures With Mcc
|
22
|
13
|
—
|
—
|
$40,806.10
|
$209,750.10
|
$46,819.63
|
2025-01-01
|
|
228
|
MS_DRG
|
Other Cardiothoracic Procedures With Mcc
|
22
|
13
|
—
|
—
|
$40,659.87
|
$208,995.20
|
$46,651.85
|
2025-01-01
|
|
'310-4
|
APR_DRG
|
Intervertebral Disc Excision & Decompression
|
17
|
6
|
—
|
—
|
$42,366.02
|
$95,323.55
|
$46,602.62
|
2025-01-01
|
|
'608-3
|
APR_DRG
|
Neonate Bwt 1250-1499g W Or Without Other Significant Condition
|
17
|
6
|
—
|
—
|
$42,252.13
|
$95,067.29
|
$46,477.34
|
2025-01-01
|
|
'089-4
|
APR_DRG
|
Major Cranial/facial Bone Procedures
|
17
|
6
|
—
|
—
|
$42,221.51
|
$94,998.40
|
$46,443.66
|
2025-01-01
|
|
853
|
MS_DRG
|
Infectious And Parasitic Diseases With O.r. Procedures With Mcc
|
22
|
13
|
—
|
—
|
$40,343.29
|
$207,360.97
|
$46,288.61
|
2025-01-01
|
|
'024-4
|
APR_DRG
|
Extracranial Vascular Procedures
|
17
|
6
|
—
|
—
|
$42,068.43
|
$94,653.97
|
$46,275.27
|
2025-01-01
|
|
'621-4
|
APR_DRG
|
Neonate Bwt 2000-2499g W Major Anomaly
|
17
|
6
|
—
|
—
|
$42,059.25
|
$94,633.31
|
$46,265.18
|
2025-01-01
|
|
'441-4
|
APR_DRG
|
Major Bladder Procedures
|
17
|
6
|
—
|
—
|
$41,882.90
|
$94,236.53
|
$46,071.19
|
2025-01-01
|
|
799
|
MS_DRG
|
Splenic Procedures With Mcc
|
22
|
13
|
—
|
—
|
$39,984.14
|
$205,506.90
|
$45,876.54
|
2025-01-01
|
|
J9600
|
HCPCS
|
Porfimer Per 75 Mg
|
38
|
22
|
$63,119.97
|
$53,651.97
|
$89.00
|
$56,807.97
|
$45,761.98
|
2025-01-01
|
|
'020-4
|
APR_DRG
|
Craniotomy For Trauma
|
17
|
6
|
—
|
—
|
$41,434.07
|
$93,226.66
|
$45,577.48
|
2025-01-01
|
|
471
|
MS_DRG
|
Cervical Spinal Fusion With Mcc
|
22
|
13
|
—
|
—
|
$39,698.10
|
$204,030.28
|
$45,548.35
|
2025-01-01
|
|
6
|
MS_DRG
|
Liver Transplant Without Mcc
|
21
|
12
|
—
|
—
|
$39,038.45
|
$200,624.94
|
$45,202.41
|
2025-01-01
|
|
267
|
MS_DRG
|
Endovascular Cardiac Valve Replacement Without Mcc
|
22
|
13
|
—
|
—
|
$39,386.35
|
$202,420.94
|
$45,190.66
|
2025-01-01
|
|
'167-4
|
APR_DRG
|
Other Cardiothoracic & Thoracic Vascular Procedures
|
17
|
6
|
—
|
—
|
$41,074.02
|
$92,416.55
|
$45,181.42
|
2025-01-01
|
|
'003-1
|
APR_DRG
|
Bone Marrow Transplant
|
17
|
6
|
—
|
—
|
$41,039.73
|
$92,339.39
|
$45,143.70
|
2025-01-01
|
|
'181-4
|
APR_DRG
|
Lower Extremity Arterial Procedures #
|
17
|
6
|
—
|
—
|
$40,984.01
|
$92,214.02
|
$45,082.41
|
2025-01-01
|
|
'791-4
|
APR_DRG
|
O.r. Procedure For Other Complications Of Treatment
|
17
|
6
|
—
|
—
|
$40,948.50
|
$92,134.13
|
$45,043.35
|
2025-01-01
|
|
'221-4
|
APR_DRG
|
Major Small & Large Bowel Procedures
|
17
|
6
|
—
|
—
|
$40,933.80
|
$92,101.05
|
$45,027.18
|
2025-01-01
|
|
10
|
MS_DRG
|
Pancreas Transplant
|
21
|
12
|
—
|
—
|
$38,851.24
|
$199,658.50
|
$44,985.64
|
2025-01-01
|
|
'403-4
|
APR_DRG
|
Procedures For Obesity
|
17
|
6
|
—
|
—
|
$40,740.31
|
$91,665.70
|
$44,814.34
|
2025-01-01
|
|
239
|
MS_DRG
|
Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc
|
22
|
13
|
—
|
—
|
$38,796.59
|
$199,376.45
|
$44,513.99
|
2025-01-01
|
|
277
|
MS_DRG
|
Cardiac Defibrillator Implant Without Mcc
|
22
|
13
|
—
|
—
|
$38,600.55
|
$198,364.39
|
$44,289.06
|
2025-01-01
|
|
'602-1
|
APR_DRG
|
Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom
|
17
|
6
|
—
|
—
|
$40,225.96
|
$90,508.41
|
$44,248.56
|
2025-01-01
|
|
'911-4
|
APR_DRG
|
Extensive Abdominal/thoracic Procedures For Mult Significant Trauma
|
17
|
6
|
—
|
—
|
$40,211.26
|
$90,475.34
|
$44,232.39
|
2025-01-01
|
|
'313-4
|
APR_DRG
|
Knee & Lower Leg Procedures Except Foot
|
17
|
6
|
—
|
—
|
$40,094.92
|
$90,213.57
|
$44,104.41
|
2025-01-01
|
|
837
|
MS_DRG
|
Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot…
|
22
|
13
|
—
|
—
|
$38,393.25
|
$200,919.43
|
$44,051.21
|
2025-01-01
|
|
981
|
MS_DRG
|
Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc
|
22
|
13
|
—
|
—
|
$38,263.08
|
$196,622.31
|
$43,901.85
|
2025-01-01
|
|
'510-4
|
APR_DRG
|
Pelvic Evisceration, Radical Hysterectomy & Other Radical GYN Procs
|
17
|
6
|
—
|
—
|
$39,715.28
|
$89,359.38
|
$43,686.81
|
2025-01-01
|
|
163
|
MS_DRG
|
Major Chest Procedures With Mcc
|
22
|
13
|
—
|
—
|
$38,047.76
|
$195,510.70
|
$43,654.79
|
2025-01-01
|
|
'442-4
|
APR_DRG
|
Kidney & Urinary Tract Procedures For Malignancy
|
17
|
6
|
—
|
—
|
$39,510.76
|
$88,899.21
|
$43,461.84
|
2025-01-01
|
|
'612-3
|
APR_DRG
|
Neonate Bwt 1500-1999g W Resp Dist Synd/oth Maj Resp Cond
|
17
|
6
|
—
|
—
|
$39,309.31
|
$88,445.95
|
$43,240.24
|
2025-01-01
|
|
'177-4
|
APR_DRG
|
Cardiac Pacemaker & Defibrillator Revision Except Device Replacement
|
17
|
6
|
—
|
—
|
$39,257.87
|
$88,330.21
|
$43,183.66
|
2025-01-01
|
|
'691-4
|
APR_DRG
|
Lymphoma, Myeloma & Non-acute Leukemia
|
17
|
6
|
—
|
—
|
$39,246.85
|
$88,305.41
|
$43,171.54
|
2025-01-01
|
|
'710-4
|
APR_DRG
|
Infectious & Parasitic Diseases Including HIV W O.r. Procedure
|
17
|
6
|
—
|
—
|
$39,170.92
|
$88,134.57
|
$43,088.01
|
2025-01-01
|
|
'317-4
|
APR_DRG
|
Tendon, Muscle & Other Soft Tissue Procedures
|
17
|
6
|
—
|
—
|
$39,156.23
|
$88,101.52
|
$43,071.85
|
2025-01-01
|
|
221
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
22
|
13
|
—
|
—
|
$37,525.49
|
$192,814.63
|
$43,055.57
|
2025-01-01
|
|
'305-4
|
APR_DRG
|
Amputation Of Lower Limb Except Toes
|
17
|
6
|
—
|
—
|
$39,057.03
|
$87,878.32
|
$42,962.73
|
2025-01-01
|
|
'026-4
|
APR_DRG
|
Other Nervous System & Related Procedures
|
17
|
6
|
—
|
—
|
$38,898.44
|
$87,521.49
|
$42,788.28
|
2025-01-01
|
|
'951-4
|
APR_DRG
|
Moderately Extensive Procedure Unrelated To Principal Diagnosis
|
17
|
6
|
—
|
—
|
$38,893.54
|
$87,510.47
|
$42,782.89
|
2025-01-01
|
|
'182-4
|
APR_DRG
|
Other Peripheral Vascular Procedures #
|
17
|
6
|
—
|
—
|
$38,874.56
|
$87,467.76
|
$42,762.02
|
2025-01-01
|
|
'611-3
|
APR_DRG
|
Neonate Birthwt 1500-1999g W Major Anomaly
|
17
|
6
|
—
|
—
|
$38,836.60
|
$87,382.35
|
$42,720.26
|
2025-01-01
|
|
'166-4
|
APR_DRG
|
Coronary Bypass Without Ami Or Complex Pdx
|
17
|
6
|
—
|
—
|
$38,624.73
|
$86,905.64
|
$42,487.20
|
2025-01-01
|
|
'511-4
|
APR_DRG
|
Uterine & Adnexa Procedures For Ovarian & Adnexal Malignancy
|
17
|
6
|
—
|
—
|
$38,595.34
|
$86,839.52
|
$42,454.87
|
2025-01-01
|
|
'444-4
|
APR_DRG
|
Renal Dialysis Access Device Procedure Only
|
17
|
6
|
—
|
—
|
$38,347.35
|
$86,281.54
|
$42,182.09
|
2025-01-01
|
|
'001-1
|
APR_DRG
|
Liver Transplant &/or Intestinal Transplant
|
17
|
6
|
—
|
—
|
$38,208.97
|
$85,970.18
|
$42,029.87
|
2025-01-01
|
|
'001-2
|
APR_DRG
|
Liver Transplant &/or Intestinal Transplant
|
17
|
6
|
—
|
—
|
$38,208.97
|
$85,970.18
|
$42,029.87
|
2025-01-01
|
|
245
|
MS_DRG
|
Aicd Generator Procedures
|
22
|
13
|
—
|
—
|
$36,583.82
|
$187,953.41
|
$41,975.11
|
2025-01-01
|
|
458
|
MS_DRG
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
22
|
13
|
—
|
—
|
$36,580.61
|
$187,936.82
|
$41,971.43
|
2025-01-01
|
|
'264-4
|
APR_DRG
|
Other Hepatobiliary, Pancreas & Abdominal Procedures
|
17
|
6
|
—
|
—
|
$38,155.69
|
$85,850.30
|
$41,971.26
|
2025-01-01
|
|
'261-4
|
APR_DRG
|
Major Biliary Tract Procedures
|
17
|
6
|
—
|
—
|
$38,069.97
|
$85,657.43
|
$41,876.97
|
2025-01-01
|
|
329
|
MS_DRG
|
Major Small And Large Bowel Procedures With Mcc
|
22
|
13
|
—
|
—
|
$36,466.51
|
$187,347.83
|
$41,840.52
|
2025-01-01
|
|
'161-2
|
APR_DRG
|
Cardiac Defibrillator & Heart Assist Implant
|
17
|
6
|
—
|
—
|
$37,990.37
|
$85,478.33
|
$41,789.41
|
2025-01-01
|
|
823
|
MS_DRG
|
Lymphoma And Non-acute Leukemia With Other Procedures With Mcc
|
22
|
13
|
—
|
—
|
$36,346.79
|
$186,729.81
|
$41,703.16
|
2025-01-01
|
|
650
|
MS_DRG
|
Kidney Transplant With Hemodialysis With Mcc
|
22
|
13
|
—
|
—
|
$36,311.44
|
$186,547.31
|
$41,662.60
|
2025-01-01
|
|
'120-4
|
APR_DRG
|
Major Respiratory & Chest Procedures
|
17
|
6
|
—
|
—
|
$37,765.03
|
$84,971.32
|
$41,541.53
|
2025-01-01
|
|
455
|
MS_DRG
|
Combined Anterior And Posterior Spinal Fusion Without Cc/mcc
|
17
|
12
|
—
|
—
|
$37,180.00
|
$191,031.08
|
$41,485.05
|
2025-01-01
|
|
'130-4
|
APR_DRG
|
Respiratory System Diagnosis W Ventilator Support 96+ Hours
|
17
|
6
|
—
|
—
|
$37,654.82
|
$84,723.35
|
$41,420.30
|
2025-01-01
|
|
'690-3
|
APR_DRG
|
Acute Leukemia
|
17
|
6
|
—
|
—
|
$37,594.20
|
$84,586.95
|
$41,353.62
|
2025-01-01
|
|
278
|
MS_DRG
|
Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures …
|
22
|
13
|
—
|
—
|
$36,013.35
|
$185,008.47
|
$41,320.58
|
2025-01-01
|
|
'121-4
|
APR_DRG
|
Other Respiratory & Chest Procedures
|
17
|
6
|
—
|
—
|
$37,558.68
|
$84,507.03
|
$41,314.55
|
2025-01-01
|
|
'301-4
|
APR_DRG
|
Hip Joint Replacement
|
17
|
6
|
—
|
—
|
$37,537.86
|
$84,460.19
|
$41,291.65
|
2025-01-01
|
|
'262-4
|
APR_DRG
|
Cholecystectomy Except Laparoscopic
|
17
|
6
|
—
|
—
|
$37,537.25
|
$84,458.81
|
$41,290.98
|
2025-01-01
|
|
'519-4
|
APR_DRG
|
Uterine & Adnexa Procedures For Leiomyoma
|
17
|
6
|
—
|
—
|
$37,507.86
|
$84,392.69
|
$41,258.65
|
2025-01-01
|
|
27800000002-333
|
CDM
|
Set Pump Impella Cp
|
26
|
16
|
$50,000.00
|
$42,500.00
|
$89.00
|
$46,500.00
|
$41,250.00
|
2025-01-01
|
|
'607-1
|
APR_DRG
|
Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom
|
17
|
6
|
—
|
—
|
$37,461.32
|
$84,287.97
|
$41,207.45
|
2025-01-01
|
|
'711-4
|
APR_DRG
|
Post-op, Post-trauma, Other Device Infections W O.r. Procedure
|
17
|
6
|
—
|
—
|
$37,428.87
|
$84,214.96
|
$41,171.76
|
2025-01-01
|
|
856
|
MS_DRG
|
Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc
|
22
|
13
|
—
|
—
|
$35,756.23
|
$183,681.18
|
$41,025.57
|
2025-01-01
|
|
25
|
MS_DRG
|
Craniotomy And Endovascular Intracranial Procedures With Mcc
|
22
|
13
|
—
|
—
|
$35,656.61
|
$183,166.85
|
$40,911.26
|
2025-01-01
|
|
'518-4
|
APR_DRG
|
Other Female Reproductive System & Related Procedures
|
17
|
6
|
—
|
—
|
$37,073.72
|
$83,415.87
|
$40,781.09
|
2025-01-01
|
|
'049-4
|
APR_DRG
|
Bacterial & Tuberculous Infections Of Nervous System
|
17
|
6
|
—
|
—
|
$37,010.04
|
$83,272.59
|
$40,711.04
|
2025-01-01
|
|
'171-4
|
APR_DRG
|
Perm Cardiac Pacemaker Implant Without Ami, Heart Failure Or Shock
|
17
|
6
|
—
|
—
|
$36,987.38
|
$83,221.61
|
$40,686.12
|
2025-01-01
|
|
826
|
MS_DRG
|
Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. …
|
22
|
13
|
—
|
—
|
$35,438.06
|
$191,947.74
|
$40,660.51
|
2025-01-01
|
|
'952-4
|
APR_DRG
|
Nonextensive Procedure Unrelated To Principal Diagnosis
|
17
|
6
|
—
|
—
|
$36,790.22
|
$82,778.00
|
$40,469.24
|
2025-01-01
|
|
'630-3
|
APR_DRG
|
Neonate Birthwt >2499g W Major Cardiovascular Procedure
|
17
|
6
|
—
|
—
|
$36,752.87
|
$82,693.96
|
$40,428.16
|
2025-01-01
|
|
319
|
MS_DRG
|
Other Endovascular Cardiac Valve Procedures With Mcc
|
22
|
13
|
—
|
—
|
$35,221.92
|
$180,922.89
|
$40,412.52
|
2025-01-01
|
|
'043-4
|
APR_DRG
|
Multiple Sclerosis & Other Demyelinating Diseases
|
17
|
6
|
—
|
—
|
$36,705.10
|
$82,586.48
|
$40,375.61
|
2025-01-01
|
|
'381-4
|
APR_DRG
|
Major Skin Disorders
|
17
|
6
|
—
|
—
|
$36,613.87
|
$82,381.21
|
$40,275.26
|
2025-01-01
|
|
901
|
MS_DRG
|
Wound Debridements For Injuries With Mcc
|
22
|
13
|
—
|
—
|
$34,947.94
|
$179,508.49
|
$40,098.15
|
2025-01-01
|
|
'005-2
|
APR_DRG
|
Tracheostomy W Mv 96+ Hours Without Extensive Procedure
|
17
|
6
|
—
|
—
|
$36,251.37
|
$81,565.58
|
$39,876.51
|
2025-01-01
|
|
474
|
MS_DRG
|
Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc
|
22
|
13
|
—
|
—
|
$34,747.07
|
$178,471.54
|
$39,867.69
|
2025-01-01
|
|
356
|
MS_DRG
|
Other Digestive System O.r. Procedures With Mcc
|
22
|
13
|
—
|
—
|
$34,553.43
|
$177,471.92
|
$39,645.51
|
2025-01-01
|
|
'229-4
|
APR_DRG
|
Other Digestive System & Abdominal Procedures
|
17
|
6
|
—
|
—
|
$35,903.57
|
$80,783.03
|
$39,493.93
|
2025-01-01
|
|
'308-4
|
APR_DRG
|
Hip And Femur Fracture Repair
|
17
|
6
|
—
|
—
|
$35,793.36
|
$80,535.06
|
$39,372.70
|
2025-01-01
|
|
'309-4
|
APR_DRG
|
Other Significant Hip And Femur Surgery
|
17
|
6
|
—
|
—
|
$35,648.24
|
$80,208.54
|
$39,213.06
|
2025-01-01
|
|
'162-3
|
APR_DRG
|
Cardiac Valve Procedures W Ami Or Complex Pdx
|
17
|
6
|
—
|
—
|
$35,596.80
|
$80,092.80
|
$39,156.48
|
2025-01-01
|
|
'650-4
|
APR_DRG
|
Splenectomy
|
17
|
6
|
—
|
—
|
$35,390.45
|
$79,628.51
|
$38,929.50
|
2025-01-01
|
|
'005-1
|
APR_DRG
|
Tracheostomy W Mv 96+ Hours Without Extensive Procedure
|
17
|
6
|
—
|
—
|
$35,348.20
|
$79,533.45
|
$38,883.02
|
2025-01-01
|
|
'608-2
|
APR_DRG
|
Neonate Bwt 1250-1499g W Or Without Other Significant Condition
|
17
|
6
|
—
|
—
|
$35,286.35
|
$79,394.29
|
$38,814.99
|
2025-01-01
|