|
J3391
|
HCPCS
|
Inj, Atidarsagene Autotemcel
|
3
|
3
|
—
|
—
|
$3,020,475.00
|
$4,421,275.00
|
$4,377,500.00
|
2025-12-31
|
|
C9172
|
HCPCS
|
Inj, Beqvez, Per Tx Dose
|
3
|
1
|
—
|
—
|
$4,200,000.00
|
$4,200,000.00
|
$4,200,000.00
|
2025-12-31
|
|
J1413
|
HCPCS
|
Inj Delandistrogene Mox Rokl
|
9
|
6
|
—
|
—
|
$2,293,954.61
|
$4,887,120.69
|
$3,840,000.00
|
2025-12-31
|
|
J1414
|
HCPCS
|
Inj, Beqvez, Per Tx Dose
|
7
|
5
|
—
|
—
|
$2,559,900.00
|
$4,200,000.00
|
$3,747,100.00
|
2025-12-31
|
|
J3394
|
HCPCS
|
Inj, Lovotibeglogene Autotem
|
9
|
6
|
—
|
—
|
$2,250,334.95
|
$4,794,191.85
|
$3,720,000.00
|
2025-12-31
|
|
J1411
|
HCPCS
|
Inj, Hemgenix, Per Tx Dose
|
4
|
4
|
—
|
—
|
$2,542,834.00
|
$3,722,119.34
|
$3,679,083.33
|
2025-12-31
|
|
J3393
|
HCPCS
|
Inj, Betibeglogene Autotemce
|
9
|
6
|
—
|
—
|
$2,035,973.80
|
$4,337,509.40
|
$3,360,000.00
|
2025-12-31
|
|
J3399
|
HCPCS
|
Inj Onase Abepar-xioi Treat
|
9
|
6
|
—
|
—
|
$1,691,959.76
|
$3,604,609.93
|
$2,786,453.23
|
2025-12-31
|
|
J3392
|
HCPCS
|
Inj, Exagamglogene Autotem
|
9
|
6
|
—
|
—
|
$1,609,080.00
|
$3,428,040.00
|
$2,640,000.00
|
2025-12-31
|
|
Q2057
|
HCPCS
|
Afamitresgene Autoleucel
|
8
|
6
|
—
|
—
|
$531,727.80
|
$1,960,629.90
|
$1,132,811.40
|
2025-12-31
|
|
Q2042
|
HCPCS
|
Tisagenlecleucel Car-pos T
|
9
|
7
|
—
|
—
|
$399,043.96
|
$1,471,387.28
|
$850,137.13
|
2025-12-31
|
|
24
|
APR_DRG
|
Heart &/or Lung Transplant
|
23
|
8
|
—
|
—
|
$204,348.46
|
$1,218,721.78
|
$659,485.26
|
2025-12-31
|
|
Q2054
|
HCPCS
|
Lisocabtagene Mara Car Pos T
|
12
|
8
|
—
|
—
|
$373,728.61
|
$1,378,042.45
|
$637,620.48
|
2025-12-31
|
|
Q2055
|
HCPCS
|
Idecabtagene Vicleucel Car
|
12
|
8
|
—
|
—
|
$373,469.71
|
$1,377,087.83
|
$633,974.92
|
2025-12-31
|
|
Q2056
|
HCPCS
|
Ciltacabtagene Car-pos T
|
12
|
8
|
—
|
—
|
$381,831.39
|
$1,407,919.70
|
$626,466.60
|
2025-12-31
|
|
Q2041
|
HCPCS
|
Axicabtagene Ciloleucel Car+
|
12
|
8
|
—
|
—
|
$367,822.77
|
$1,356,265.97
|
$604,296.00
|
2025-12-31
|
|
C9098
|
HCPCS
|
Ciltacabtagene Car Pos T
|
3
|
1
|
—
|
—
|
$558,000.00
|
$558,000.00
|
$558,000.00
|
2025-12-31
|
|
Q2053
|
HCPCS
|
Brexucabtagene Car Pos T
|
12
|
8
|
—
|
—
|
$337,906.80
|
$1,245,957.38
|
$554,400.00
|
2025-12-31
|
|
5834
|
APR_DRG
|
Neonate W Ecmo
|
23
|
8
|
—
|
—
|
$150,509.29
|
$897,124.44
|
$485,459.73
|
2025-12-31
|
|
5883
|
APR_DRG
|
Neonate Bwt <1500g W Major Procedure
|
23
|
8
|
—
|
—
|
$147,869.29
|
$881,354.90
|
$476,926.38
|
2025-12-31
|
|
5884
|
APR_DRG
|
Neonate Bwt <1500g W Major Procedure
|
23
|
8
|
—
|
—
|
$147,869.29
|
$881,354.90
|
$476,926.38
|
2025-12-31
|
|
1614
|
APR_DRG
|
Cardiac Defibrillator & Heart Assist Implant
|
23
|
8
|
—
|
—
|
$135,277.95
|
$806,143.10
|
$436,227.12
|
2025-12-31
|
|
34
|
APR_DRG
|
Bone Marrow Transplant
|
23
|
8
|
—
|
—
|
$131,357.41
|
$782,724.55
|
$423,554.67
|
2025-12-31
|
|
5914
|
APR_DRG
|
Neonate Birthwt 500-749g Without Major Procedure
|
23
|
8
|
—
|
—
|
$113,606.51
|
$676,693.16
|
$366,178.05
|
2025-12-31
|
|
5881
|
APR_DRG
|
Neonate Bwt <1500g W Major Procedure
|
23
|
8
|
—
|
—
|
$113,197.20
|
$674,248.27
|
$364,855.05
|
2025-12-31
|
|
5882
|
APR_DRG
|
Neonate Bwt <1500g W Major Procedure
|
23
|
8
|
—
|
—
|
$113,197.20
|
$674,248.27
|
$364,855.05
|
2025-12-31
|
|
J3402
|
HCPCS
|
Inj. Remestemcel-l-rknd/ Td
|
2
|
1
|
—
|
—
|
$361,288.92
|
$361,288.92
|
$361,288.92
|
2025-12-31
|
|
8414
|
APR_DRG
|
Extensive 3rd Degree Burns W Skin Graft
|
23
|
8
|
—
|
—
|
$109,887.11
|
$654,476.10
|
$354,155.76
|
2025-12-31
|
|
44
|
APR_DRG
|
Tracheostomy W Mv 96+ Hours W Extensive Procedure Or Ecmo
|
23
|
8
|
—
|
—
|
$105,991.13
|
$631,204.24
|
$341,562.69
|
2025-12-31
|
|
18
|
MS_DRG
|
Chimeric Antigen Receptor (car) T-cell Immunotherapy
|
10
|
9
|
—
|
—
|
$304,757.14
|
$693,915.52
|
$335,629.58
|
2025-12-31
|
|
Q2058
|
HCPCS
|
Obecbtge Autol Up To 400 Mil
|
6
|
5
|
—
|
—
|
$186,558.75
|
$687,894.56
|
$335,265.00
|
2025-12-31
|
|
14
|
APR_DRG
|
Liver Transplant &/or Intestinal Transplant
|
23
|
8
|
—
|
—
|
$102,677.52
|
$611,411.11
|
$330,852.06
|
2025-12-31
|
|
5934
|
APR_DRG
|
Neonate Birthwt 750-999g Without Major Procedure
|
23
|
8
|
—
|
—
|
$102,271.15
|
$608,983.68
|
$329,538.51
|
2025-12-31
|
|
6094
|
APR_DRG
|
Neonate Bwt 1500-2499g W Major Procedure
|
23
|
8
|
—
|
—
|
$93,665.84
|
$557,581.61
|
$301,723.38
|
2025-12-31
|
|
6024
|
APR_DRG
|
Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom
|
23
|
8
|
—
|
—
|
$88,738.99
|
$528,152.12
|
$285,798.24
|
2025-12-31
|
|
23
|
APR_DRG
|
Heart &/or Lung Transplant
|
23
|
8
|
—
|
—
|
$88,430.26
|
$526,307.98
|
$284,800.32
|
2025-12-31
|
|
8413
|
APR_DRG
|
Extensive 3rd Degree Burns W Skin Graft
|
23
|
8
|
—
|
—
|
$85,939.94
|
$511,432.57
|
$276,750.81
|
2025-12-31
|
|
5833
|
APR_DRG
|
Neonate W Ecmo
|
23
|
8
|
—
|
—
|
$85,644.66
|
$509,668.75
|
$275,796.36
|
2025-12-31
|
|
5831
|
APR_DRG
|
Neonate W Ecmo
|
23
|
8
|
—
|
—
|
$84,048.96
|
$500,137.18
|
$270,638.55
|
2025-12-31
|
|
5832
|
APR_DRG
|
Neonate W Ecmo
|
23
|
8
|
—
|
—
|
$84,048.96
|
$500,137.18
|
$270,638.55
|
2025-12-31
|
|
6034
|
APR_DRG
|
Neonate Birthwt 1000-1249g W Or Without Other Significant Condition
|
23
|
8
|
—
|
—
|
$81,770.31
|
$486,526.12
|
$263,273.22
|
2025-12-31
|
|
54
|
APR_DRG
|
Tracheostomy W Mv 96+ Hours Without Extensive Procedure
|
23
|
8
|
—
|
—
|
$80,949.95
|
$481,625.87
|
$260,621.55
|
2025-12-31
|
|
5933
|
APR_DRG
|
Neonate Birthwt 750-999g Without Major Procedure
|
23
|
8
|
—
|
—
|
$79,947.16
|
$475,635.89
|
$257,380.20
|
2025-12-31
|
|
1
|
MS_DRG
|
Heart Transplant Or Implant Of Heart Assist System With Mcc
|
9
|
8
|
—
|
—
|
$227,628.03
|
$518,296.72
|
$249,523.74
|
2025-12-31
|
|
22
|
APR_DRG
|
Heart &/or Lung Transplant
|
23
|
8
|
—
|
—
|
$75,431.96
|
$448,665.26
|
$242,785.62
|
2025-12-31
|
|
6074
|
APR_DRG
|
Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom
|
23
|
8
|
—
|
—
|
$72,507.19
|
$431,194.77
|
$233,331.84
|
2025-12-31
|
|
6304
|
APR_DRG
|
Neonate Birthwt >2499g W Major Cardiovascular Procedure
|
23
|
8
|
—
|
—
|
$71,828.34
|
$427,139.75
|
$231,137.55
|
2025-12-31
|
|
5891
|
APR_DRG
|
Neonate Bwt <500g Or Ga <24 Weeks
|
23
|
8
|
—
|
—
|
$71,298.58
|
$423,975.36
|
$229,425.21
|
2025-12-31
|
|
5892
|
APR_DRG
|
Neonate Bwt <500g Or Ga <24 Weeks
|
23
|
8
|
—
|
—
|
$71,298.58
|
$423,975.36
|
$229,425.21
|
2025-12-31
|
|
21
|
APR_DRG
|
Heart &/or Lung Transplant
|
23
|
8
|
—
|
—
|
$71,071.71
|
$422,620.19
|
$228,691.89
|
2025-12-31
|
|
33
|
APR_DRG
|
Bone Marrow Transplant
|
23
|
8
|
—
|
—
|
$69,452.04
|
$412,945.41
|
$223,456.59
|
2025-12-31
|
|
5913
|
APR_DRG
|
Neonate Birthwt 500-749g Without Major Procedure
|
23
|
8
|
—
|
—
|
$69,403.51
|
$412,655.52
|
$223,299.72
|
2025-12-31
|
|
904
|
APR_DRG
|
Major Larynx & Trachea Procedures
|
23
|
8
|
—
|
—
|
$65,986.41
|
$392,244.18
|
$212,254.56
|
2025-12-31
|
|
927
|
MS_DRG
|
Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft
|
10
|
9
|
—
|
—
|
$191,703.95
|
$436,499.52
|
$211,247.31
|
2025-12-31
|
|
6023
|
APR_DRG
|
Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom
|
23
|
8
|
—
|
—
|
$65,587.04
|
$389,858.67
|
$210,963.69
|
2025-12-31
|
|
5932
|
APR_DRG
|
Neonate Birthwt 750-999g Without Major Procedure
|
23
|
8
|
—
|
—
|
$65,470.10
|
$389,160.13
|
$210,585.69
|
2025-12-31
|
|
5912
|
APR_DRG
|
Neonate Birthwt 500-749g Without Major Procedure
|
23
|
8
|
—
|
—
|
$64,767.27
|
$384,961.90
|
$208,313.91
|
2025-12-31
|
|
3034
|
APR_DRG
|
Dorsal & Lumbar Fusion Proc For Curvature Of Back
|
23
|
8
|
—
|
—
|
$64,022.34
|
$380,512.20
|
$205,906.05
|
2025-12-31
|
|
5931
|
APR_DRG
|
Neonate Birthwt 750-999g Without Major Procedure
|
23
|
8
|
—
|
—
|
$63,486.15
|
$377,309.40
|
$204,172.92
|
2025-12-31
|
|
6314
|
APR_DRG
|
Neonate Birthwt >2499g W Other Major Procedure
|
23
|
8
|
—
|
—
|
$61,793.97
|
$367,201.52
|
$198,703.26
|
2025-12-31
|
|
4404
|
APR_DRG
|
Kidney Transplant
|
23
|
8
|
—
|
—
|
$61,037.93
|
$362,685.46
|
$196,259.49
|
2025-12-31
|
|
3
|
MS_DRG
|
Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…
|
10
|
9
|
—
|
—
|
$173,188.76
|
$394,341.44
|
$190,876.71
|
2025-12-31
|
|
43
|
APR_DRG
|
Tracheostomy W Mv 96+ Hours W Extensive Procedure Or Ecmo
|
23
|
8
|
—
|
—
|
$59,204.84
|
$351,735.85
|
$190,334.34
|
2025-12-31
|
|
1604
|
APR_DRG
|
Major Cardiothoracic Repair Of Heart Anomaly
|
23
|
8
|
—
|
—
|
$58,464.00
|
$347,310.60
|
$187,939.71
|
2025-12-31
|
|
8504
|
APR_DRG
|
Procedure W Diag Of Rehab, Aftercare Or Oth Contact W Health Service
|
17
|
8
|
—
|
—
|
$44,914.89
|
$266,377.75
|
$187,014.31
|
2025-12-31
|
|
1613
|
APR_DRG
|
Cardiac Defibrillator & Heart Assist Implant
|
23
|
8
|
—
|
—
|
$57,854.14
|
$343,667.71
|
$185,968.44
|
2025-12-31
|
|
3614
|
APR_DRG
|
Skin Graft For Skin & Subcutaneous Tissue Diagnoses
|
23
|
8
|
—
|
—
|
$56,456.07
|
$335,316.66
|
$181,449.45
|
2025-12-31
|
|
6022
|
APR_DRG
|
Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom
|
23
|
8
|
—
|
—
|
$55,774.87
|
$331,247.67
|
$179,247.60
|
2025-12-31
|
|
1624
|
APR_DRG
|
Cardiac Valve Procedures W Ami Or Complex Pdx
|
23
|
8
|
—
|
—
|
$55,194.25
|
$327,779.42
|
$177,370.83
|
2025-12-31
|
|
53
|
APR_DRG
|
Tracheostomy W Mv 96+ Hours Without Extensive Procedure
|
23
|
8
|
—
|
—
|
$54,305.48
|
$322,470.51
|
$174,498.03
|
2025-12-31
|
|
3044
|
APR_DRG
|
Dorsal & Lumbar Fusion Proc Except For Curvature Of Back
|
23
|
8
|
—
|
—
|
$54,010.19
|
$320,706.70
|
$173,543.58
|
2025-12-31
|
|
6073
|
APR_DRG
|
Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom
|
23
|
8
|
—
|
—
|
$53,816.65
|
$319,550.62
|
$172,917.99
|
2025-12-31
|
|
3124
|
APR_DRG
|
Skin Graft, Except Hand, For Musculoskeletal & Connective Tissue Diagnoses
|
23
|
8
|
—
|
—
|
$52,958.28
|
$314,423.33
|
$170,143.47
|
2025-12-31
|
|
6033
|
APR_DRG
|
Neonate Birthwt 1000-1249g W Or Without Other Significant Condition
|
23
|
8
|
—
|
—
|
$52,819.12
|
$313,592.07
|
$169,693.65
|
2025-12-31
|
|
6814
|
APR_DRG
|
Other O.r. Procedures For Lymphatic/hematopoietic/other Neoplasms
|
23
|
8
|
—
|
—
|
$52,776.44
|
$313,337.10
|
$169,555.68
|
2025-12-31
|
|
6804
|
APR_DRG
|
Major O.r. Procedures For Lymphatic/hematopoietic/other Neoplasms
|
23
|
8
|
—
|
—
|
$52,630.84
|
$312,467.42
|
$169,085.07
|
2025-12-31
|
|
5911
|
APR_DRG
|
Neonate Birthwt 500-749g Without Major Procedure
|
23
|
8
|
—
|
—
|
$52,298.14
|
$310,480.07
|
$168,009.66
|
2025-12-31
|
|
6904
|
APR_DRG
|
Acute Leukemia
|
23
|
8
|
—
|
—
|
$51,501.16
|
$305,719.52
|
$165,433.59
|
2025-12-31
|
|
8424
|
APR_DRG
|
Burns With Skin Graft Except Extensive 3rd Degree Burns
|
23
|
8
|
—
|
—
|
$50,826.40
|
$301,688.95
|
$163,252.53
|
2025-12-31
|
|
6124
|
APR_DRG
|
Neonate Bwt 1500-1999g W Resp Dist Synd/oth Maj Resp Cond
|
23
|
8
|
—
|
—
|
$49,866.87
|
$295,957.43
|
$160,151.04
|
2025-12-31
|
|
4054
|
APR_DRG
|
Other Procedures For Endocrine, Nutritional & Metabolic Disorders
|
23
|
8
|
—
|
—
|
$49,366.94
|
$292,971.17
|
$158,535.09
|
2025-12-31
|
|
13
|
APR_DRG
|
Liver Transplant &/or Intestinal Transplant
|
23
|
8
|
—
|
—
|
$49,240.64
|
$292,216.75
|
$158,126.85
|
2025-12-31
|
|
6114
|
APR_DRG
|
Neonate Birthwt 1500-1999g W Major Anomaly
|
23
|
8
|
—
|
—
|
$48,347.19
|
$286,879.90
|
$155,238.93
|
2025-12-31
|
|
9504
|
APR_DRG
|
Extensive Procedure Unrelated To Principal Diagnosis
|
23
|
8
|
—
|
—
|
$47,765.98
|
$283,408.16
|
$153,360.27
|
2025-12-31
|
|
234
|
APR_DRG
|
Spinal Procedures
|
23
|
8
|
—
|
—
|
$47,577.70
|
$282,283.51
|
$152,751.69
|
2025-12-31
|
|
32
|
APR_DRG
|
Bone Marrow Transplant
|
23
|
8
|
—
|
—
|
$45,697.83
|
$271,054.48
|
$146,675.34
|
2025-12-31
|
|
64
|
APR_DRG
|
Pancreas Transplant
|
23
|
8
|
—
|
—
|
$44,986.22
|
$266,803.86
|
$144,375.21
|
2025-12-31
|
|
4474
|
APR_DRG
|
Other Kidney, Urinary Tract & Related Procedures
|
23
|
8
|
—
|
—
|
$44,937.69
|
$266,513.97
|
$144,218.34
|
2025-12-31
|
|
9124
|
APR_DRG
|
Musculoskeletal & Other Procedures For Multiple Significant Trauma
|
23
|
8
|
—
|
—
|
$44,621.94
|
$264,627.91
|
$143,197.74
|
2025-12-31
|
|
5124
|
APR_DRG
|
Uterine & Adnexa Procedures For Non-ovarian & Non-adnexal Malig
|
23
|
8
|
—
|
—
|
$44,193.93
|
$262,071.25
|
$141,814.26
|
2025-12-31
|
|
6072
|
APR_DRG
|
Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom
|
23
|
8
|
—
|
—
|
$44,047.75
|
$261,198.08
|
$141,341.76
|
2025-12-31
|
|
2604
|
APR_DRG
|
Major Pancreas, Liver & Shunt Procedures
|
23
|
8
|
—
|
—
|
$43,744.28
|
$259,385.37
|
$140,360.85
|
2025-12-31
|
|
6954
|
APR_DRG
|
Chemotherapy For Acute Leukemia #
|
23
|
8
|
—
|
—
|
$43,512.15
|
$257,998.76
|
$139,610.52
|
2025-12-31
|
|
924
|
APR_DRG
|
Facial Bone Procedures Except Major Cranial/facial Bone Procedures
|
23
|
8
|
—
|
—
|
$43,316.85
|
$256,832.20
|
$138,979.26
|
2025-12-31
|
|
63
|
APR_DRG
|
Pancreas Transplant
|
23
|
8
|
—
|
—
|
$43,087.64
|
$255,463.06
|
$138,238.38
|
2025-12-31
|
|
6093
|
APR_DRG
|
Neonate Bwt 1500-2499g W Major Procedure
|
23
|
8
|
—
|
—
|
$42,905.79
|
$254,376.83
|
$137,650.59
|
2025-12-31
|
|
214
|
APR_DRG
|
Craniotomy Except For Trauma
|
23
|
8
|
—
|
—
|
$42,661.97
|
$252,920.38
|
$136,862.46
|
2025-12-31
|
|
42
|
APR_DRG
|
Tracheostomy W Mv 96+ Hours W Extensive Procedure Or Ecmo
|
23
|
8
|
—
|
—
|
$42,353.24
|
$251,076.23
|
$135,864.54
|
2025-12-31
|
|
41
|
APR_DRG
|
Tracheostomy W Mv 96+ Hours W Extensive Procedure Or Ecmo
|
23
|
8
|
—
|
—
|
$42,353.24
|
$251,076.23
|
$135,864.54
|
2025-12-31
|
|
1694
|
APR_DRG
|
Major Abdominal Vascular Procedures
|
23
|
8
|
—
|
—
|
$42,319.91
|
$250,877.15
|
$135,756.81
|
2025-12-31
|
|
9104
|
APR_DRG
|
Craniotomy For Multiple Significant Trauma
|
23
|
8
|
—
|
—
|
$42,317.57
|
$250,863.18
|
$135,749.25
|
2025-12-31
|
|
6084
|
APR_DRG
|
Neonate Bwt 1250-1499g W Or Without Other Significant Condition
|
23
|
8
|
—
|
—
|
$42,316.98
|
$250,859.68
|
$135,747.36
|
2025-12-31
|
|
2204
|
APR_DRG
|
Major Stomach, Esophageal & Duodenal Procedures
|
23
|
8
|
—
|
—
|
$41,763.25
|
$247,552.10
|
$133,957.53
|
2025-12-31
|
|
8412
|
APR_DRG
|
Extensive 3rd Degree Burns W Skin Graft
|
23
|
8
|
—
|
—
|
$41,729.34
|
$247,349.52
|
$133,847.91
|
2025-12-31
|
|
1654
|
APR_DRG
|
Coronary Bypass W Ami Or Complex Pdx
|
23
|
8
|
—
|
—
|
$41,698.35
|
$247,164.41
|
$133,747.74
|
2025-12-31
|
|
3214
|
APR_DRG
|
Cervical Spinal Fusion & Other Back/neck Proc Exc Disc Excis/decomp
|
23
|
8
|
—
|
—
|
$41,625.84
|
$246,731.31
|
$133,513.38
|
2025-12-31
|
|
1634
|
APR_DRG
|
Cardiac Valve Procedures Without Ami Or Complex Pdx
|
23
|
8
|
—
|
—
|
$41,525.27
|
$246,130.57
|
$133,188.30
|
2025-12-31
|
|
3033
|
APR_DRG
|
Dorsal & Lumbar Fusion Proc For Curvature Of Back
|
23
|
8
|
—
|
—
|
$41,180.29
|
$244,069.88
|
$132,073.20
|
2025-12-31
|
|
4014
|
APR_DRG
|
Pituitary & Adrenal Procedures
|
23
|
8
|
—
|
—
|
$41,178.53
|
$244,059.40
|
$132,067.53
|
2025-12-31
|
|
6032
|
APR_DRG
|
Neonate Birthwt 1000-1249g W Or Without Other Significant Condition
|
23
|
8
|
—
|
—
|
$40,656.97
|
$240,943.91
|
$130,381.65
|
2025-12-31
|
|
3104
|
APR_DRG
|
Intervertebral Disc Excision & Decompression
|
23
|
8
|
—
|
—
|
$40,327.77
|
$238,977.52
|
$129,317.58
|
2025-12-31
|
|
6083
|
APR_DRG
|
Neonate Bwt 1250-1499g W Or Without Other Significant Condition
|
23
|
8
|
—
|
—
|
$40,219.01
|
$238,327.88
|
$128,966.04
|
2025-12-31
|
|
894
|
APR_DRG
|
Major Cranial/facial Bone Procedures
|
23
|
8
|
—
|
—
|
$40,189.77
|
$238,153.24
|
$128,871.54
|
2025-12-31
|
|
244
|
APR_DRG
|
Extracranial Vascular Procedures
|
23
|
8
|
—
|
—
|
$40,043.59
|
$237,280.07
|
$128,399.04
|
2025-12-31
|
|
6214
|
APR_DRG
|
Neonate Bwt 2000-2499g W Major Anomaly
|
23
|
8
|
—
|
—
|
$40,034.82
|
$237,227.68
|
$128,370.69
|
2025-12-31
|
|
4414
|
APR_DRG
|
Major Bladder Procedures
|
23
|
8
|
—
|
—
|
$39,866.43
|
$236,221.78
|
$127,826.37
|
2025-12-31
|
|
204
|
APR_DRG
|
Craniotomy For Trauma
|
23
|
8
|
—
|
—
|
$39,437.83
|
$233,661.63
|
$126,441.00
|
2025-12-31
|
|
4
|
MS_DRG
|
Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…
|
10
|
9
|
—
|
—
|
$114,184.53
|
$259,992.00
|
$125,959.65
|
2025-12-31
|
|
1674
|
APR_DRG
|
Other Cardiothoracic & Thoracic Vascular Procedures
|
23
|
8
|
—
|
—
|
$39,094.01
|
$231,607.92
|
$125,329.68
|
2025-12-31
|
|
31
|
APR_DRG
|
Bone Marrow Transplant
|
23
|
8
|
—
|
—
|
$39,061.27
|
$231,412.33
|
$125,223.84
|
2025-12-31
|
|
1814
|
APR_DRG
|
Lower Extremity Arterial Procedures #
|
23
|
8
|
—
|
—
|
$39,008.06
|
$231,094.50
|
$125,051.85
|
2025-12-31
|
|
7914
|
APR_DRG
|
O.r. Procedure For Other Complications Of Treatment
|
23
|
8
|
—
|
—
|
$38,974.14
|
$230,891.92
|
$124,942.23
|
2025-12-31
|
|
2214
|
APR_DRG
|
Major Small & Large Bowel Procedures
|
23
|
8
|
—
|
—
|
$38,960.11
|
$230,808.09
|
$124,896.87
|
2025-12-31
|
|
4034
|
APR_DRG
|
Procedures For Obesity
|
23
|
8
|
—
|
—
|
$38,775.34
|
$229,704.40
|
$124,299.63
|
2025-12-31
|
|
6021
|
APR_DRG
|
Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom
|
23
|
8
|
—
|
—
|
$38,284.18
|
$226,770.53
|
$122,712.03
|
2025-12-31
|
|
9114
|
APR_DRG
|
Extensive Abdominal/thoracic Procedures For Mult Significant Trauma
|
23
|
8
|
—
|
—
|
$38,270.14
|
$226,686.71
|
$122,666.67
|
2025-12-31
|
|
3134
|
APR_DRG
|
Knee & Lower Leg Procedures Except Foot
|
23
|
8
|
—
|
—
|
$38,159.05
|
$226,023.10
|
$122,307.57
|
2025-12-31
|
|
Q2043
|
HCPCS
|
Sipuleucel-t 50000000 Cells IV Susp
|
25
|
13
|
$187,808.70
|
$93,904.35
50% off
|
$55,945.97
|
$187,808.70
|
$122,075.66
|
2025-12-31
|
|
5104
|
APR_DRG
|
Pelvic Evisceration, Radical Hysterectomy & Other Radical GYN Procs
|
23
|
8
|
—
|
—
|
$37,796.52
|
$223,857.62
|
$121,135.77
|
2025-12-31
|
|
4424
|
APR_DRG
|
Kidney & Urinary Tract Procedures For Malignancy
|
23
|
8
|
—
|
—
|
$37,601.22
|
$222,691.06
|
$120,504.51
|
2025-12-31
|
|
6123
|
APR_DRG
|
Neonate Bwt 1500-1999g W Resp Dist Synd/oth Maj Resp Cond
|
23
|
8
|
—
|
—
|
$37,408.85
|
$221,541.96
|
$119,882.70
|
2025-12-31
|
|
1774
|
APR_DRG
|
Cardiac Pacemaker & Defibrillator Revision Except Device Replacement
|
23
|
8
|
—
|
—
|
$37,359.73
|
$221,248.57
|
$119,723.94
|
2025-12-31
|
|
6914
|
APR_DRG
|
Lymphoma, Myeloma & Non-acute Leukemia
|
23
|
8
|
—
|
—
|
$37,349.21
|
$221,185.71
|
$119,689.92
|
2025-12-31
|
|
7104
|
APR_DRG
|
Infectious & Parasitic Diseases Including HIV W O.r. Procedure
|
23
|
8
|
—
|
—
|
$37,276.70
|
$220,752.61
|
$119,455.56
|
2025-12-31
|
|
3174
|
APR_DRG
|
Tendon, Muscle & Other Soft Tissue Procedures
|
23
|
8
|
—
|
—
|
$37,262.67
|
$220,668.79
|
$119,410.20
|
2025-12-31
|
|
3054
|
APR_DRG
|
Amputation Of Lower Limb Except Toes
|
23
|
8
|
—
|
—
|
$37,167.95
|
$220,102.97
|
$119,104.02
|
2025-12-31
|
|
A9513
|
HCPCS
|
Lutetium Lu 177 Dotatate 370 Mbq/ml IV Soln
|
19
|
12
|
$183,026.68
|
$91,513.34
50% off
|
$312.69
|
$155,572.68
|
$118,967.34
|
2025-12-31
|
|
264
|
APR_DRG
|
Other Nervous System & Related Procedures
|
23
|
8
|
—
|
—
|
$37,016.50
|
$219,198.36
|
$118,614.51
|
2025-12-31
|
|
9514
|
APR_DRG
|
Moderately Extensive Procedure Unrelated To Principal Diagnosis
|
23
|
8
|
—
|
—
|
$37,011.83
|
$219,170.42
|
$118,599.39
|
2025-12-31
|
|
1824
|
APR_DRG
|
Other Peripheral Vascular Procedures #
|
23
|
8
|
—
|
—
|
$36,993.70
|
$219,062.14
|
$118,540.80
|
2025-12-31
|
|
6113
|
APR_DRG
|
Neonate Birthwt 1500-1999g W Major Anomaly
|
23
|
8
|
—
|
—
|
$36,957.45
|
$218,845.60
|
$118,423.62
|
2025-12-31
|
|
1664
|
APR_DRG
|
Coronary Bypass Without Ami Or Complex Pdx
|
23
|
8
|
—
|
—
|
$36,755.14
|
$217,637.12
|
$117,769.68
|
2025-12-31
|
|
5114
|
APR_DRG
|
Uterine & Adnexa Procedures For Ovarian & Adnexal Malignancy
|
23
|
8
|
—
|
—
|
$36,727.07
|
$217,469.47
|
$117,678.96
|
2025-12-31
|
|
4444
|
APR_DRG
|
Renal Dialysis Access Device Procedure Only
|
23
|
8
|
—
|
—
|
$36,490.26
|
$216,054.93
|
$116,913.51
|
2025-12-31
|
|
12
|
APR_DRG
|
Liver Transplant &/or Intestinal Transplant
|
23
|
8
|
—
|
—
|
$36,358.11
|
$215,265.58
|
$116,486.37
|
2025-12-31
|
|
11
|
APR_DRG
|
Liver Transplant &/or Intestinal Transplant
|
23
|
8
|
—
|
—
|
$36,358.11
|
$215,265.58
|
$116,486.37
|
2025-12-31
|
|
2644
|
APR_DRG
|
Other Hepatobiliary, Pancreas & Abdominal Procedures
|
23
|
8
|
—
|
—
|
$36,307.24
|
$214,961.71
|
$116,321.94
|
2025-12-31
|
|
14
|
MS_DRG
|
Allogeneic Bone Marrow Transplant
|
9
|
8
|
—
|
—
|
$105,875.65
|
$241,073.12
|
$116,236.95
|
2025-12-31
|
|
2614
|
APR_DRG
|
Major Biliary Tract Procedures
|
23
|
8
|
—
|
—
|
$36,225.38
|
$214,472.74
|
$116,057.34
|
2025-12-31
|
|
7
|
MS_DRG
|
Lung Transplant
|
9
|
8
|
—
|
—
|
$105,608.97
|
$240,465.92
|
$115,945.02
|
2025-12-31
|
|
1612
|
APR_DRG
|
Cardiac Defibrillator & Heart Assist Implant
|
23
|
8
|
—
|
—
|
$36,149.37
|
$214,018.69
|
$115,811.64
|
2025-12-31
|
|
1204
|
APR_DRG
|
Major Respiratory & Chest Procedures
|
23
|
8
|
—
|
—
|
$35,934.19
|
$212,733.37
|
$115,116.12
|
2025-12-31
|
|
1304
|
APR_DRG
|
Respiratory System Diagnosis W Ventilator Support 96+ Hours
|
23
|
8
|
—
|
—
|
$35,828.94
|
$212,104.69
|
$114,775.92
|
2025-12-31
|
|
6903
|
APR_DRG
|
Acute Leukemia
|
23
|
8
|
—
|
—
|
$35,771.05
|
$211,758.91
|
$114,588.81
|
2025-12-31
|
|
1214
|
APR_DRG
|
Other Respiratory & Chest Procedures
|
23
|
8
|
—
|
—
|
$35,737.14
|
$211,556.33
|
$114,479.19
|
2025-12-31
|
|
3014
|
APR_DRG
|
Hip Joint Replacement
|
23
|
8
|
—
|
—
|
$35,717.26
|
$211,437.58
|
$114,414.93
|
2025-12-31
|
|
2624
|
APR_DRG
|
Cholecystectomy Except Laparoscopic
|
23
|
8
|
—
|
—
|
$35,716.67
|
$211,434.09
|
$114,413.04
|
2025-12-31
|
|
5194
|
APR_DRG
|
Uterine & Adnexa Procedures For Leiomyoma
|
23
|
8
|
—
|
—
|
$35,688.61
|
$211,266.44
|
$114,322.32
|
2025-12-31
|
|
6071
|
APR_DRG
|
Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom
|
23
|
8
|
—
|
—
|
$35,644.17
|
$211,000.99
|
$114,178.68
|
2025-12-31
|
|
7114
|
APR_DRG
|
Post-op, Post-trauma, Other Device Infections W O.r. Procedure
|
23
|
8
|
—
|
—
|
$35,613.18
|
$210,815.88
|
$114,078.51
|
2025-12-31
|
|
5184
|
APR_DRG
|
Other Female Reproductive System & Related Procedures
|
23
|
8
|
—
|
—
|
$35,274.04
|
$208,790.11
|
$112,982.31
|
2025-12-31
|
|
494
|
APR_DRG
|
Bacterial & Tuberculous Infections Of Nervous System
|
23
|
8
|
—
|
—
|
$35,213.23
|
$208,426.87
|
$112,785.75
|
2025-12-31
|
|
1714
|
APR_DRG
|
Perm Cardiac Pacemaker Implant Without Ami, Heart Failure Or Shock
|
23
|
8
|
—
|
—
|
$35,191.60
|
$208,297.64
|
$112,715.82
|
2025-12-31
|
|
9524
|
APR_DRG
|
Nonextensive Procedure Unrelated To Principal Diagnosis
|
23
|
8
|
—
|
—
|
$35,003.32
|
$207,172.99
|
$112,107.24
|
2025-12-31
|
|
6303
|
APR_DRG
|
Neonate Birthwt >2499g W Major Cardiovascular Procedure
|
23
|
8
|
—
|
—
|
$34,967.65
|
$206,959.94
|
$111,991.95
|
2025-12-31
|
|
434
|
APR_DRG
|
Multiple Sclerosis & Other Demyelinating Diseases
|
23
|
8
|
—
|
—
|
$34,922.04
|
$206,687.51
|
$111,844.53
|
2025-12-31
|
|
3814
|
APR_DRG
|
Major Skin Disorders
|
23
|
8
|
—
|
—
|
$34,834.92
|
$206,167.10
|
$111,562.92
|
2025-12-31
|
|
52
|
APR_DRG
|
Tracheostomy W Mv 96+ Hours Without Extensive Procedure
|
23
|
8
|
—
|
—
|
$34,488.76
|
$204,099.42
|
$110,444.04
|
2025-12-31
|
|
2294
|
APR_DRG
|
Other Digestive System & Abdominal Procedures
|
23
|
8
|
—
|
—
|
$34,156.64
|
$202,115.56
|
$109,370.52
|
2025-12-31
|
|
3084
|
APR_DRG
|
Hip And Femur Fracture Repair
|
23
|
8
|
—
|
—
|
$34,051.39
|
$201,486.88
|
$109,030.32
|
2025-12-31
|
|
3094
|
APR_DRG
|
Other Significant Hip And Femur Surgery
|
23
|
8
|
—
|
—
|
$33,912.82
|
$200,659.11
|
$108,582.39
|
2025-12-31
|
|
1623
|
APR_DRG
|
Cardiac Valve Procedures W Ami Or Complex Pdx
|
23
|
8
|
—
|
—
|
$33,863.70
|
$200,365.72
|
$108,423.63
|
2025-12-31
|
|
Q0480
|
HCPCS
|
Driver Pneumatic Vad, Rep
|
2
|
2
|
—
|
—
|
$106,120.93
|
$110,365.77
|
$108,243.35
|
2025-12-31
|
|
6504
|
APR_DRG
|
Splenectomy
|
23
|
8
|
—
|
—
|
$33,666.65
|
$199,188.68
|
$107,786.70
|
2025-12-31
|
|
51
|
APR_DRG
|
Tracheostomy W Mv 96+ Hours Without Extensive Procedure
|
23
|
8
|
—
|
—
|
$33,626.30
|
$198,947.68
|
$107,656.29
|
2025-12-31
|
|
6082
|
APR_DRG
|
Neonate Bwt 1250-1499g W Or Without Other Significant Condition
|
23
|
8
|
—
|
—
|
$33,567.25
|
$198,594.92
|
$107,465.40
|
2025-12-31
|
|
4403
|
APR_DRG
|
Kidney Transplant
|
23
|
8
|
—
|
—
|
$33,487.73
|
$198,119.91
|
$107,208.36
|
2025-12-31
|
|
2234
|
APR_DRG
|
Other Small & Large Bowel Procedures
|
23
|
8
|
—
|
—
|
$32,938.67
|
$194,840.27
|
$105,433.65
|
2025-12-31
|
|
2244
|
APR_DRG
|
Peritoneal Adhesiolysis
|
23
|
8
|
—
|
—
|
$32,880.79
|
$194,494.49
|
$105,246.54
|
2025-12-31
|
|
2224
|
APR_DRG
|
Other Stomach, Esophageal & Duodenal Procedures
|
23
|
8
|
—
|
—
|
$32,678.47
|
$193,286.02
|
$104,592.60
|
2025-12-31
|
|
3024
|
APR_DRG
|
Knee Joint Replacement
|
23
|
8
|
—
|
—
|
$32,145.21
|
$190,100.68
|
$102,868.92
|
2025-12-31
|
|
4234
|
APR_DRG
|
Inborn Errors Of Metabolism
|
23
|
8
|
—
|
—
|
$32,118.90
|
$189,943.50
|
$102,783.87
|
2025-12-31
|
|
224
|
APR_DRG
|
Ventricular Shunt Procedures
|
23
|
8
|
—
|
—
|
$31,821.86
|
$188,169.21
|
$101,823.75
|
2025-12-31
|
|
8411
|
APR_DRG
|
Extensive 3rd Degree Burns W Skin Graft
|
23
|
8
|
—
|
—
|
$31,700.82
|
$187,446.22
|
$101,432.52
|
2025-12-31
|
|
6334
|
APR_DRG
|
Neonate Birthwt >2499g W Major Anomaly
|
23
|
8
|
—
|
—
|
$31,625.40
|
$186,995.67
|
$101,188.71
|
2025-12-31
|
|
504
|
APR_DRG
|
Non-bacterial Infections Of Nervous System Exc Viral Meningitis
|
23
|
8
|
—
|
—
|
$31,582.13
|
$186,737.21
|
$101,048.85
|
2025-12-31
|
|
3043
|
APR_DRG
|
Dorsal & Lumbar Fusion Proc Except For Curvature Of Back
|
23
|
8
|
—
|
—
|
$31,471.61
|
$186,077.09
|
$100,691.64
|
2025-12-31
|
|
3644
|
APR_DRG
|
Other Skin, Subcutaneous Tissue & Related Procedures
|
23
|
8
|
—
|
—
|
$31,364.61
|
$185,437.92
|
$100,345.77
|
2025-12-31
|
|
8634
|
APR_DRG
|
Neonatal Aftercare
|
23
|
8
|
—
|
—
|
$31,304.38
|
$185,078.17
|
$100,151.10
|
2025-12-31
|
|
3032
|
APR_DRG
|
Dorsal & Lumbar Fusion Proc For Curvature Of Back
|
23
|
8
|
—
|
—
|
$31,242.40
|
$184,707.95
|
$99,950.76
|
2025-12-31
|
|
2274
|
APR_DRG
|
Hernia Procedures Except Inguinal, Femoral & Umbilical
|
23
|
8
|
—
|
—
|
$31,156.45
|
$184,194.52
|
$99,672.93
|
2025-12-31
|
|
6134
|
APR_DRG
|
Neonate Birthwt 1500-1999g W Congenital/perinatal Infection
|
23
|
8
|
—
|
—
|
$30,597.46
|
$180,855.50
|
$97,866.09
|
2025-12-31
|
|
2
|
MS_DRG
|
Heart Transplant Or Implant Of Heart Assist System Without Mcc
|
9
|
8
|
—
|
—
|
$89,050.20
|
$202,762.48
|
$97,817.52
|
2025-12-31
|
|
6031
|
APR_DRG
|
Neonate Birthwt 1000-1249g W Or Without Other Significant Condition
|
23
|
8
|
—
|
—
|
$30,574.66
|
$180,719.28
|
$97,792.38
|
2025-12-31
|
|
6224
|
APR_DRG
|
Neonate Bwt 2000-2499g W Resp Dist Synd/oth Maj Resp Cond
|
23
|
8
|
—
|
—
|
$30,544.25
|
$180,537.66
|
$97,694.10
|
2025-12-31
|
|
212
|
MS_DRG
|
Concomitant Aortic And Mitral Valve Procedures
|
10
|
9
|
—
|
—
|
$88,033.61
|
$200,447.76
|
$97,188.14
|
2025-12-31
|
|
3154
|
APR_DRG
|
Shoulder, Upper Arm & Forearm Procedures Except Joint Replacement
|
23
|
8
|
—
|
—
|
$30,336.09
|
$179,294.26
|
$97,021.26
|
2025-12-31
|
|
8444
|
APR_DRG
|
Partial Thickness Burns Without Skin Graft
|
23
|
8
|
—
|
—
|
$30,022.10
|
$177,418.68
|
$96,006.33
|
2025-12-31
|
|
4434
|
APR_DRG
|
Kidney & Urinary Tract Procedures For Nonmalignancy
|
23
|
8
|
—
|
—
|
$29,952.51
|
$177,003.05
|
$95,781.42
|
2025-12-31
|
|
62
|
APR_DRG
|
Pancreas Transplant
|
23
|
8
|
—
|
—
|
$29,880.01
|
$176,569.96
|
$95,547.06
|
2025-12-31
|
|
61
|
APR_DRG
|
Pancreas Transplant
|
23
|
8
|
—
|
—
|
$29,880.01
|
$176,569.96
|
$95,547.06
|
2025-12-31
|
|
6133
|
APR_DRG
|
Neonate Birthwt 1500-1999g W Congenital/perinatal Infection
|
23
|
8
|
—
|
—
|
$29,834.99
|
$176,301.02
|
$95,401.53
|
2025-12-31
|
|
6144
|
APR_DRG
|
Neonate Bwt 1500-1999g W Or Without Other Significant Condition
|
23
|
8
|
—
|
—
|
$29,767.16
|
$175,895.86
|
$95,182.29
|
2025-12-31
|
|
6143
|
APR_DRG
|
Neonate Bwt 1500-1999g W Or Without Other Significant Condition
|
23
|
8
|
—
|
—
|
$29,767.16
|
$175,895.86
|
$95,182.29
|
2025-12-31
|
|
K1007
|
HCPCS
|
Bil Hkaf Pc S/d Micro Sensor
|
2
|
2
|
—
|
—
|
$93,216.70
|
$96,945.37
|
$95,081.04
|
2025-12-31
|
|
3204
|
APR_DRG
|
Other Musculoskeletal System & Connective Tissue Procedures
|
23
|
8
|
—
|
—
|
$29,577.12
|
$174,760.74
|
$94,568.04
|
2025-12-31
|
|
5
|
MS_DRG
|
Liver Transplant With Mcc Or Intestinal Transplant
|
9
|
8
|
—
|
—
|
$86,057.80
|
$195,948.96
|
$94,541.64
|
2025-12-31
|
|
215
|
MS_DRG
|
Other Heart Assist System Implant
|
10
|
9
|
—
|
—
|
$85,616.58
|
$194,944.32
|
$94,528.90
|
2025-12-31
|
|
6604
|
APR_DRG
|
Major Hematologic/immunologic Diag Exc Sickle Cell Crisis & Coagul
|
23
|
8
|
—
|
—
|
$29,427.44
|
$173,866.61
|
$94,084.20
|
2025-12-31
|
|
1754
|
APR_DRG
|
Percutaneous Coronary Intervention Without Ami
|
23
|
8
|
—
|
—
|
$29,033.92
|
$171,516.02
|
$92,812.23
|
2025-12-31
|
|
6313
|
APR_DRG
|
Neonate Birthwt >2499g W Other Major Procedure
|
23
|
8
|
—
|
—
|
$28,831.02
|
$170,304.05
|
$92,156.40
|
2025-12-31
|
|
3464
|
APR_DRG
|
Connective Tissue Disorders
|
23
|
8
|
—
|
—
|
$28,822.25
|
$170,251.66
|
$92,128.05
|
2025-12-31
|
|
1653
|
APR_DRG
|
Coronary Bypass W Ami Or Complex Pdx
|
23
|
8
|
—
|
—
|
$28,745.65
|
$169,794.12
|
$91,880.46
|
2025-12-31
|
|
1804
|
APR_DRG
|
Other Circulatory System Procedures
|
23
|
8
|
—
|
—
|
$28,498.32
|
$168,316.71
|
$91,080.99
|
2025-12-31
|
|
1704
|
APR_DRG
|
Permanent Cardiac Pacemaker Implant W Ami, Heart Failure Or Shock
|
23
|
8
|
—
|
—
|
$28,459.73
|
$168,086.19
|
$90,956.25
|
2025-12-31
|
|
5134
|
APR_DRG
|
Uterine & Adnexa Procedures For Non-malignancy Except Leiomyoma
|
23
|
8
|
—
|
—
|
$28,395.99
|
$167,705.48
|
$90,750.24
|
2025-12-31
|
|
1603
|
APR_DRG
|
Major Cardiothoracic Repair Of Heart Anomaly
|
23
|
8
|
—
|
—
|
$28,270.28
|
$166,954.55
|
$90,343.89
|
2025-12-31
|
|
4402
|
APR_DRG
|
Kidney Transplant
|
23
|
8
|
—
|
—
|
$27,482.66
|
$162,249.89
|
$87,798.06
|
2025-12-31
|
|
6614
|
APR_DRG
|
Coagulation & Platelet Disorders
|
23
|
8
|
—
|
—
|
$27,018.98
|
$159,480.17
|
$86,299.29
|
2025-12-31
|
|
216
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
10
|
9
|
—
|
—
|
$77,990.54
|
$177,580.24
|
$86,138.66
|
2025-12-31
|
|
6122
|
APR_DRG
|
Neonate Bwt 1500-1999g W Resp Dist Synd/oth Maj Resp Cond
|
23
|
8
|
—
|
—
|
$26,925.42
|
$158,921.34
|
$85,996.89
|
2025-12-31
|
|
1633
|
APR_DRG
|
Cardiac Valve Procedures Without Ami Or Complex Pdx
|
23
|
8
|
—
|
—
|
$26,899.11
|
$158,764.17
|
$85,911.84
|
2025-12-31
|
|
3123
|
APR_DRG
|
Skin Graft, Except Hand, For Musculoskeletal & Connective Tissue Diagnoses
|
23
|
8
|
—
|
—
|
$26,794.45
|
$158,138.98
|
$85,573.53
|
2025-12-31
|
|
1622
|
APR_DRG
|
Cardiac Valve Procedures W Ami Or Complex Pdx
|
23
|
8
|
—
|
—
|
$26,527.82
|
$156,546.31
|
$84,711.69
|
2025-12-31
|
|
426
|
MS_DRG
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
5
|
4
|
—
|
—
|
$84,651.71
|
$192,747.36
|
$84,651.71
|
2025-12-31
|
|
1934
|
APR_DRG
|
Acute & Subacute Endocarditis
|
23
|
8
|
—
|
—
|
$26,423.15
|
$155,921.11
|
$84,373.38
|
2025-12-31
|
|
2284
|
APR_DRG
|
Inguinal, Femoral & Umbilical Hernia Procedures
|
23
|
8
|
—
|
—
|
$26,374.03
|
$155,627.73
|
$84,214.62
|
2025-12-31
|
|
3031
|
APR_DRG
|
Dorsal & Lumbar Fusion Proc For Curvature Of Back
|
23
|
8
|
—
|
—
|
$26,163.54
|
$154,370.35
|
$83,534.22
|
2025-12-31
|
|
5893
|
APR_DRG
|
Neonate Bwt <500g Or Ga <24 Weeks
|
23
|
8
|
—
|
—
|
$26,047.18
|
$153,675.31
|
$83,158.11
|
2025-12-31
|
|
6964
|
APR_DRG
|
Other Chemotherapy #
|
23
|
8
|
—
|
—
|
$26,015.02
|
$153,483.21
|
$83,054.16
|
2025-12-31
|
|
8423
|
APR_DRG
|
Burns With Skin Graft Except Extensive 3rd Degree Burns
|
23
|
8
|
—
|
—
|
$25,834.34
|
$152,403.96
|
$82,470.15
|
2025-12-31
|
|
213
|
APR_DRG
|
Craniotomy Except For Trauma
|
23
|
8
|
—
|
—
|
$25,649.57
|
$151,300.27
|
$81,872.91
|
2025-12-31
|
|
C9293
|
HCPCS
|
Glucarpidase 1000 Units/ml Intrathecal Syringe
|
21
|
11
|
$129,700.20
|
$64,850.10
50% off
|
$494.09
|
$110,245.17
|
$81,711.13
|
2025-12-31
|
|
5464
|
APR_DRG
|
Other O.r. Proc For Obstetric Diagnoses Except Delivery Diagnoses
|
23
|
8
|
—
|
—
|
$25,508.07
|
$150,455.04
|
$81,415.53
|
2025-12-31
|
|
233
|
APR_DRG
|
Spinal Procedures
|
23
|
8
|
—
|
—
|
$25,441.99
|
$150,060.36
|
$81,201.96
|
2025-12-31
|
|
1303
|
APR_DRG
|
Respiratory System Diagnosis W Ventilator Support 96+ Hours
|
23
|
8
|
—
|
—
|
$25,342.59
|
$149,466.60
|
$80,880.66
|
2025-12-31
|
|
4834
|
APR_DRG
|
Testes & Scrotal Procedures
|
23
|
8
|
—
|
—
|
$25,334.40
|
$149,417.71
|
$80,854.20
|
2025-12-31
|
|
6081
|
APR_DRG
|
Neonate Bwt 1250-1499g W Or Without Other Significant Condition
|
23
|
8
|
—
|
—
|
$25,137.94
|
$148,244.16
|
$80,219.16
|
2025-12-31
|
|
8503
|
APR_DRG
|
Procedure W Diag Of Rehab, Aftercare Or Oth Contact W Health Service
|
17
|
8
|
—
|
—
|
$19,249.23
|
$113,069.18
|
$79,381.83
|
2025-12-31
|
|
984
|
APR_DRG
|
Other Ear, Nose, Mouth & Throat Procedures
|
23
|
8
|
—
|
—
|
$24,653.21
|
$145,348.71
|
$78,652.35
|
2025-12-31
|
|
8633
|
APR_DRG
|
Neonatal Aftercare
|
23
|
8
|
—
|
—
|
$24,594.73
|
$144,999.44
|
$78,463.35
|
2025-12-31
|
|
914
|
APR_DRG
|
Other Major Head & Neck Procedures
|
23
|
8
|
—
|
—
|
$24,543.28
|
$144,692.08
|
$78,297.03
|
2025-12-31
|
|
A9543
|
HCPCS
|
Y90 Ibritumomab, Rx
|
10
|
7
|
—
|
—
|
$14,774.74
|
$144,574.38
|
$77,830.66
|
2025-12-31
|
|
1924
|
APR_DRG
|
Cardiac Catheterization For Other Non-coronary Conditions
|
23
|
8
|
—
|
—
|
$24,394.76
|
$143,804.94
|
$77,816.97
|
2025-12-31
|
|
1813
|
APR_DRG
|
Lower Extremity Arterial Procedures #
|
23
|
8
|
—
|
—
|
$24,236.89
|
$142,861.91
|
$77,306.67
|
2025-12-31
|
|
903
|
APR_DRG
|
Major Larynx & Trachea Procedures
|
23
|
8
|
—
|
—
|
$24,215.25
|
$142,732.68
|
$77,236.74
|
2025-12-31
|
|
2254
|
APR_DRG
|
Appendectomy
|
23
|
8
|
—
|
—
|
$24,072.58
|
$141,880.46
|
$76,775.58
|
2025-12-31
|
|
6112
|
APR_DRG
|
Neonate Birthwt 1500-1999g W Major Anomaly
|
23
|
8
|
—
|
—
|
$23,912.95
|
$140,926.95
|
$76,259.61
|
2025-12-31
|
|
6344
|
APR_DRG
|
Neonate, Birthwt >2499g W Resp Dist Synd/oth Maj Resp Cond
|
23
|
8
|
—
|
—
|
$23,904.77
|
$140,878.05
|
$76,233.15
|
2025-12-31
|
|
6132
|
APR_DRG
|
Neonate Birthwt 1500-1999g W Congenital/perinatal Infection
|
23
|
8
|
—
|
—
|
$23,870.27
|
$140,671.99
|
$76,121.64
|
2025-12-31
|
|
4624
|
APR_DRG
|
Nephritis & Nephrosis
|
23
|
8
|
—
|
—
|
$23,814.72
|
$140,340.18
|
$75,942.09
|
2025-12-31
|
|
1663
|
APR_DRG
|
Coronary Bypass Without Ami Or Complex Pdx
|
23
|
8
|
—
|
—
|
$23,801.27
|
$140,259.85
|
$75,898.62
|
2025-12-31
|
|
1611
|
APR_DRG
|
Cardiac Defibrillator & Heart Assist Implant
|
23
|
8
|
—
|
—
|
$23,792.50
|
$140,207.46
|
$75,870.27
|
2025-12-31
|
|
231
|
MS_DRG
|
Coronary Bypass With Ptca With Mcc
|
10
|
9
|
—
|
—
|
$68,477.59
|
$155,919.76
|
$75,672.41
|
2025-12-31
|
|
456
|
MS_DRG
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
10
|
9
|
—
|
—
|
$68,439.61
|
$155,833.28
|
$75,630.62
|
2025-12-31
|
|
9503
|
APR_DRG
|
Extensive Procedure Unrelated To Principal Diagnosis
|
23
|
8
|
—
|
—
|
$23,676.14
|
$139,512.41
|
$75,494.16
|
2025-12-31
|
|
6213
|
APR_DRG
|
Neonate Bwt 2000-2499g W Major Anomaly
|
23
|
8
|
—
|
—
|
$23,582.00
|
$138,950.08
|
$75,189.87
|
2025-12-31
|
|
974
|
APR_DRG
|
Tonsil & Adenoid Procedures
|
23
|
8
|
—
|
—
|
$23,558.03
|
$138,806.88
|
$75,112.38
|
2025-12-31
|
|
1652
|
APR_DRG
|
Coronary Bypass W Ami Or Complex Pdx
|
23
|
8
|
—
|
—
|
$23,398.98
|
$137,856.87
|
$74,598.30
|
2025-12-31
|
|
2004
|
APR_DRG
|
Cardiac Structural & Valvular Disorders
|
23
|
8
|
—
|
—
|
$23,355.13
|
$137,594.92
|
$74,456.55
|
2025-12-31
|
|
850
|
MS_DRG
|
Acute Leukemia With Other Procedures
|
5
|
4
|
—
|
—
|
$74,441.36
|
$169,498.96
|
$74,441.36
|
2025-12-31
|
|
9123
|
APR_DRG
|
Musculoskeletal & Other Procedures For Multiple Significant Trauma
|
23
|
8
|
—
|
—
|
$23,331.74
|
$137,455.21
|
$74,380.95
|
2025-12-31
|
|
1651
|
APR_DRG
|
Coronary Bypass W Ami Or Complex Pdx
|
23
|
8
|
—
|
—
|
$23,320.05
|
$137,385.35
|
$74,343.15
|
2025-12-31
|
|
7754
|
APR_DRG
|
Alcohol Abuse & Dependence
|
23
|
8
|
—
|
—
|
$23,237.02
|
$136,889.39
|
$74,074.77
|
2025-12-31
|
|
9103
|
APR_DRG
|
Craniotomy For Multiple Significant Trauma
|
23
|
8
|
—
|
—
|
$22,990.27
|
$135,415.47
|
$73,277.19
|
2025-12-31
|
|
6803
|
APR_DRG
|
Major O.r. Procedures For Lymphatic/hematopoietic/other Neoplasms
|
23
|
8
|
—
|
—
|
$22,941.15
|
$135,122.08
|
$73,118.43
|
2025-12-31
|
|
3434
|
APR_DRG
|
Musculoskeletal Malignancy & Pathol Fracture D/t Muscskel Malig
|
23
|
8
|
—
|
—
|
$22,842.33
|
$134,531.82
|
$72,799.02
|
2025-12-31
|
|
3144
|
APR_DRG
|
Foot & Toe Procedures
|
23
|
8
|
—
|
—
|
$22,802.57
|
$134,294.32
|
$72,670.50
|
2025-12-31
|
|
6394
|
APR_DRG
|
Neonate Birthwt >2499g W Other Significant Condition
|
23
|
8
|
—
|
—
|
$22,740.01
|
$133,920.60
|
$72,468.27
|
2025-12-31
|
|
1744
|
APR_DRG
|
Percutaneous Coronary Intervention W Ami
|
23
|
8
|
—
|
—
|
$22,707.85
|
$133,728.50
|
$72,364.32
|
2025-12-31
|
|
6813
|
APR_DRG
|
Other O.r. Procedures For Lymphatic/hematopoietic/other Neoplasms
|
23
|
8
|
—
|
—
|
$22,652.30
|
$133,396.69
|
$72,184.77
|
2025-12-31
|
|
893
|
APR_DRG
|
Major Cranial/facial Bone Procedures
|
23
|
8
|
—
|
—
|
$22,597.92
|
$133,071.87
|
$72,009.00
|
2025-12-31
|
|
20
|
MS_DRG
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc
|
10
|
9
|
—
|
—
|
$65,141.75
|
$148,324.24
|
$72,002.29
|
2025-12-31
|
|
564
|
APR_DRG
|
Brain Contusion/laceration & Complicated Skull Fx, Coma < 1 Hr Or No Coma
|
23
|
8
|
—
|
—
|
$22,562.84
|
$132,862.31
|
$71,895.60
|
2025-12-31
|
|
8904
|
APR_DRG
|
HIV W Multiple Major HIV Related Conditions
|
23
|
8
|
—
|
—
|
$22,460.51
|
$132,251.09
|
$71,564.85
|
2025-12-31
|
|
6514
|
APR_DRG
|
Other Procedures Of Blood & Blood-forming Organs
|
23
|
8
|
—
|
—
|
$22,375.14
|
$131,741.15
|
$71,288.91
|
2025-12-31
|
|
9102
|
APR_DRG
|
Craniotomy For Multiple Significant Trauma
|
23
|
8
|
—
|
—
|
$22,302.05
|
$131,304.56
|
$71,052.66
|
2025-12-31
|
|
9101
|
APR_DRG
|
Craniotomy For Multiple Significant Trauma
|
23
|
8
|
—
|
—
|
$22,302.05
|
$131,304.56
|
$71,052.66
|
2025-12-31
|
|
10
|
MS_DRG
|
Pancreas Transplant
|
9
|
8
|
—
|
—
|
$64,429.81
|
$146,703.20
|
$70,864.69
|
2025-12-31
|
|
3042
|
APR_DRG
|
Dorsal & Lumbar Fusion Proc Except For Curvature Of Back
|
23
|
8
|
—
|
—
|
$22,158.21
|
$130,445.36
|
$70,587.72
|
2025-12-31
|
|
19
|
MS_DRG
|
Simultaneous Pancreas And Kidney Transplant With Hemodialysis
|
9
|
8
|
—
|
—
|
$64,060.51
|
$145,862.32
|
$70,460.40
|
2025-12-31
|
|
1693
|
APR_DRG
|
Major Abdominal Vascular Procedures
|
23
|
8
|
—
|
—
|
$22,044.77
|
$129,767.78
|
$70,221.06
|
2025-12-31
|
|
4401
|
APR_DRG
|
Kidney Transplant
|
23
|
8
|
—
|
—
|
$21,989.81
|
$129,439.46
|
$70,043.40
|
2025-12-31
|
|
2794
|
APR_DRG
|
Hepatic Coma & Other Major Acute Liver Disorders
|
23
|
8
|
—
|
—
|
$21,983.96
|
$129,404.54
|
$70,024.50
|
2025-12-31
|
|
3213
|
APR_DRG
|
Cervical Spinal Fusion & Other Back/neck Proc Exc Disc Excis/decomp
|
23
|
8
|
—
|
—
|
$21,969.93
|
$129,320.71
|
$69,979.14
|
2025-12-31
|
|
1632
|
APR_DRG
|
Cardiac Valve Procedures Without Ami Or Complex Pdx
|
23
|
8
|
—
|
—
|
$21,955.31
|
$129,233.39
|
$69,931.89
|
2025-12-31
|
|
233
|
MS_DRG
|
Coronary Bypass With Cardiac Catheterization With Mcc
|
10
|
9
|
—
|
—
|
$63,164.33
|
$143,821.76
|
$69,826.71
|
2025-12-31
|
|
243
|
APR_DRG
|
Extracranial Vascular Procedures
|
23
|
8
|
—
|
—
|
$21,898.01
|
$128,891.11
|
$69,746.67
|
2025-12-31
|
|
913
|
APR_DRG
|
Other Major Head & Neck Procedures
|
23
|
8
|
—
|
—
|
$21,864.68
|
$128,692.02
|
$69,638.94
|
2025-12-31
|
|
1673
|
APR_DRG
|
Other Cardiothoracic & Thoracic Vascular Procedures
|
23
|
8
|
—
|
—
|
$21,844.80
|
$128,573.27
|
$69,574.68
|
2025-12-31
|
|
2634
|
APR_DRG
|
Laparoscopic Cholecystectomy
|
23
|
8
|
—
|
—
|
$21,777.56
|
$128,171.61
|
$69,357.33
|
2025-12-31
|
|
219
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
10
|
9
|
—
|
—
|
$62,526.74
|
$142,370.00
|
$69,125.23
|
2025-12-31
|
|
9304
|
APR_DRG
|
Multiple Significant Trauma Without O.r. Procedure
|
23
|
8
|
—
|
—
|
$21,685.76
|
$127,623.26
|
$69,060.60
|
2025-12-31
|
|
L8702
|
HCPCS
|
Ewhf S/d Uprt Micro Sensor
|
2
|
2
|
—
|
—
|
$67,452.66
|
$70,150.77
|
$68,801.71
|
2025-12-31
|
|
2264
|
APR_DRG
|
Anal Procedures
|
23
|
8
|
—
|
—
|
$21,538.99
|
$126,746.59
|
$68,586.21
|
2025-12-31
|
|
1104
|
APR_DRG
|
Ear, Nose, Mouth, Throat, Cranial/facial Malignancies
|
23
|
8
|
—
|
—
|
$21,531.98
|
$126,704.68
|
$68,563.53
|
2025-12-31
|
|
7244
|
APR_DRG
|
Other Infectious & Parasitic Diseases
|
23
|
8
|
—
|
—
|
$21,490.46
|
$126,456.70
|
$68,429.34
|
2025-12-31
|
|
6223
|
APR_DRG
|
Neonate Bwt 2000-2499g W Resp Dist Synd/oth Maj Resp Cond
|
23
|
8
|
—
|
—
|
$21,403.92
|
$125,939.78
|
$68,149.62
|
2025-12-31
|
|
1703
|
APR_DRG
|
Permanent Cardiac Pacemaker Implant W Ami, Heart Failure Or Shock
|
23
|
8
|
—
|
—
|
$21,387.55
|
$125,841.98
|
$68,096.70
|
2025-12-31
|
|
6092
|
APR_DRG
|
Neonate Bwt 1500-2499g W Major Procedure
|
23
|
8
|
—
|
—
|
$21,341.36
|
$125,566.06
|
$67,947.39
|
2025-12-31
|