Hospital

CAROLINAS MEDICAL CENTER/BEHAV HEALTH

Charlotte, NC · CCN 340113 · Rates published

14,625 distinct procedures filed

35 distinct payers

3,066,149 rate rows

2025-12-05 last MRF observed

Data quality

2,825,667 of 3,066,149 rate rows are consumer-grade (92.2%)

240,482 rows are marked excluded from the consumer medians — these stay visible in the raw drill-down with the same reason shown here, so nothing is silently hidden.

Excluded — reason	Rows
professional (physician) fee — not the facility price	233,184
no usable negotiated amount (only an out-of-band fallback) — excluded from medians	5,011
percent-of-charges filed in the dollar field — excluded from medians	1,489
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians	456
per-diem day rate — not a per-procedure price	164
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only	78
exceeds 10× this hospital's gross charge — excluded from medians	60
placeholder amount (≤ $0.02) — excluded from medians	40

Data source & audit trail ↓ Download audit trail (JSON)

Source MRF file	https://sthpiprd.blob.core.windows.net/machine-readable-files/11174/561398930-1790727550_carolinas-rehabilitation_standardcharges.csv
Found on page	https://atriumhealth.org/for-patients-visitors/financial-assistance/pricing
Discovered via	Discovered by HANK
Last fetch	not_modified · 2026-10-11
Content fingerprint	4858c624b3fccf7a… · 1,949,800,622 bytes · first seen 2026-05-05

Top 50 most expensive offerings

Outliers are flagged where this hospital's filed rate is ≥2× or ≤0.5× the national median for the same code.

Code	Description	Payers	Min $	Max $	Avg median	vs national
J3391 HCPCS	Inj, Atidarsagene Autotemcel	4	$4,595,100.00	$4,744,215.50	$4,696,462.50	nat. median $4,505,000 1.0× median
J1411 HCPCS	Etranacogene Dezaparvovec-drlb 1x10exp13 Gc/ml Intravenous Suspension	13	$3,758,972.00	$4,637,500.00	$3,880,954.33	nat. median $3,685,267 1.1× median
J1413 HCPCS	Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp	14	$3,382,791.84	$4,894,400.00	$3,537,600.00	nat. median $3,325,455 1.1× median
J3399 HCPCS	Onasemnogene Abeparvovec-xioi 2 X 10exp13 Vg/ml IV Suspension,kit	16	$27,261.82	$4,725,360.27	$3,445,333.32	nat. median $2,455,111 1.4× median
J3394 HCPCS	Inj, Lovotibeglogene Autotem	5	$3,313,414.63	$4,060,557.14	$3,410,868.00	nat. median $3,248,446 1.0× median
J3393 HCPCS	Inj, Betibeglogene Autotemce	5	$3,004,654.80	$3,682,175.00	$3,093,027.00	nat. median $2,968,000 1.0× median
J3392 HCPCS	Inj, Exagamglogene Autotem	5	$2,378,640.00	$2,915,000.00	$2,448,600.00	nat. median $2,332,000 1.1× median
Q2055 HCPCS	Idecabtagene Vicleucel 300 X 10exp6 To 510 X 10exp6 Cell IV Suspension	35	$568,464.29	$2,915,738.15	$1,885,721.96	nat. median $574,037 outlier · 3.3×
Q2056 HCPCS	Ciltacabtagene Autoleucel 0.5 X 10exp6 To 1x 10exp8 Cell IV Suspension	35	$577,186.32	$2,881,746.36	$1,863,738.14	nat. median $599,737 outlier · 3.1×
Q2054 HCPCS	Lisocabtagene Maraleucel 1.5 X 10exp6 To 70 X 10exp6 Cell/ml IV Susp	35	$573,788.95	$2,933,054.21	$1,853,881.54	nat. median $579,571 outlier · 3.2×
Q2041 HCPCS	Axicabtagene Ciloleucel Intravenous Suspension	35	$543,894.77	$2,779,761.60	$1,775,119.50	nat. median $562,501 outlier · 3.2×
Q2042 HCPCS	Tisagenlecleucel 0.2 X10exp6 To 2.5x10exp8 Cell Intravenous Suspension	35	$603,560.73	$3,276,304.05	$1,764,537.24	nat. median $621,313 outlier · 2.8×
Q2053 HCPCS	Brexucabtagene Autoleucel 1x 10exp6 To 1x 10exp8 Cell IV Suspension	35	$499,090.70	$2,340,480.00	$1,513,680.00	nat. median $513,770 outlier · 2.9×
Q2057 HCPCS	Afamitresgene Autoleucel	5	$786,032.40	$963,275.00	$809,151.00	nat. median $813,967 1.0× median
J2326 HCPCS	Nusinersen (pf) 12 Mg/5 Ml Intrathecal Solution	35	$1,241.34	$507,497.99	$331,390.67	nat. median $1,667 outlier · 198.8×
1 MS_DRG	Heart Transplant Or Implant Of Heart Assist System With Mcc	18	$197,959.00	$1,424,094.65	$323,575.00	nat. median $186,516 1.7× median
18 MS_DRG	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	16	$267,069.18	$1,897,457.10	$303,863.52	nat. median $168,055 1.8× median
Q2058 HCPCS	Obecbtge Autol Up To 400 Mil	5	$283,815.00	$347,812.50	$292,162.50	nat. median $286,598 1.0× median
0290 RC	Cardiac Device	1	$290,579.00	$290,579.00	$290,579.00	nat. median $53 outlier · 5481.6×
0294 RC	Cardiac Device	1	$290,579.00	$290,579.00	$290,579.00	nat. median $128 outlier · 2262.5×
J0225 HCPCS	Vutrisiran 25 Mg/0.5 Ml Subcutaneous Syringe	35	$5,103.71	$439,211.68	$287,158.51	nat. median $6,067 outlier · 47.3×
J3403 HCPCS	Revakinagene, Per Implant	5	$262,650.00	$321,875.00	$270,375.00	nat. median $264,195 1.0× median
14 MS_DRG	Allogeneic Bone Marrow Transplant	18	$109,206.58	$676,867.12	$253,915.67	nat. median $72,715 outlier · 3.5×
3 MS_DRG	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mo…	16	$175,089.86	$1,089,986.11	$227,668.82	nat. median $145,435 1.6× median
5 MS_DRG	Liver Transplant With Mcc Or Intestinal Transplant	18	$89,809.69	$555,239.69	$219,188.00	nat. median $69,922 outlier · 3.1×
J3402 HCPCS	Inj. Remestemcel-l-rknd/ Td	5	$209,752.80	$257,050.00	$215,922.00	nat. median $207,733 1.0× median
4 MS_DRG	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And…	16	$117,338.95	$727,861.05	$200,774.86	nat. median $97,418 outlier · 2.1×
2 MS_DRG	Heart Transplant Or Implant Of Heart Assist System Without Mcc	18	$92,738.51	$573,604.77	$197,959.00	nat. median $65,418 outlier · 3.0×
927 MS_DRG	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	16	$120,693.54	$1,203,618.83	$193,211.74	nat. median $131,925 1.5× median
7 MS_DRG	Lung Transplant	16	$108,945.56	$675,230.52	$178,701.47	nat. median $70,649 outlier · 2.5×
A9607 HCPCS	Lutetium Lu-177 Vipivotide Tetraxetan 27 Mci/ml (1,000 Mbq/ml) IV Soln	33	$234.43	$268,846.08	$175,553.57	nat. median $396 outlier · 443.4×
J9029 HCPCS	Nadofaragene Firadenovec-vncg 3x10exp11 Vp/ml Intravesical Suspension	35	$52,354.91	$220,846.00	$143,378.78	nat. median $66,211 outlier · 2.2×
77371 CPT	Hc Radiation Delivery Stereotactic Cranial Cobalt	34	$2,082.15	$204,204.12	$133,509.54	nat. median $7,491 outlier · 17.8×
17 MS_DRG	Autologous Bone Marrow Transplant Without Cc/mcc	18	$39,662.32	$326,431.78	$131,966.00	nat. median $29,295 outlier · 4.5×
16 MS_DRG	Autologous Bone Marrow Transplant With Cc/mcc	18	$39,662.32	$326,431.78	$131,966.00	nat. median $38,932 outlier · 3.4×
652 MS_DRG	Kidney Transplant	18	$29,872.66	$370,862.00	$119,165.00	nat. median $21,500 outlier · 5.5×
216 MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	16	$81,913.78	$505,728.67	$118,080.51	nat. median $69,822 1.7× median
Q0480 HCPCS	Driver Pneumatic Vad, Rep	5	$111,502.61	$136,645.35	$114,782.09	nat. median $108,243 1.1× median
J9226 HCPCS	Histrelin 50 Mg (65 Mcg/day) Implant Kit	35	$42,544.66	$179,463.94	$114,115.66	nat. median $57,036 outlier · 2.0×
850 MS_DRG	Acute Leukemia With Other Procedures	16	$78,440.00	$483,946.44	$113,242.36	nat. median $2,633 outlier · 43.0×
429 MS_DRG	Combined Anterior And Posterior Cervical Spinal Fusion With Mcc	16	$71,548.59	$440,734.12	$102,530.76	nat. median $2,596 outlier · 39.5×
J0223 HCPCS	Givosiran 189 Mg/ml Subcutaneous Solution	35	$119.23	$156,849.88	$102,421.27	nat. median $127 outlier · 806.7×
J1747 HCPCS	Spesolimab-sbzo 60 Mg/ml Intravenous Solution	33	$67.04	$154,026.12	$100,451.82	nat. median $76 outlier · 1328.9×
C9293 HCPCS	Glucarpidase 1,000 Unit Intravenous Solution	35	$35,925.65	$151,543.32	$99,079.68	nat. median $57,284 1.7× median
10 MS_DRG	Pancreas Transplant	17	$68,641.10	$422,502.78	$98,503.70	nat. median $23,080 outlier · 4.3×
K1007 HCPCS	Bil Hkaf Pc S/d Micro Sensor	5	$95,081.03	$116,520.88	$97,877.54	nat. median $95,583 1.0× median
19 MS_DRG	Simultaneous Pancreas And Kidney Transplant With Hemodialysis	16	$68,279.66	$420,236.23	$97,449.79	nat. median $45,605 outlier · 2.1×
834 MS_DRG	Acute Leukemia With Mcc	16	$49,297.23	$301,207.60	$95,698.13	nat. median $37,487 outlier · 2.6×
8 MS_DRG	Simultaneous Pancreas And Kidney Transplant	17	$48,615.44	$296,932.47	$95,375.05	nat. median $32,772 outlier · 2.9×
J0801 HCPCS	Corticotropin 80 Unit/ml Injection Gel	35	$4,545.23	$145,878.88	$95,340.57	nat. median $4,547 outlier · 21.0×

Other procedures at this hospital

Browse this hospital's 14,625 published procedures. Use the slice to choose what to show, then sort or filter any column.

Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
Code	Type	Description	Rate rows	Payers	Gross	Cash	Min $	Max $	Avg median	Last observed

J3391	HCPCS	Inj, Atidarsagene Autotemcel	8	4	—	—	$4,595,100.00	$4,744,215.50	$4,696,462.50	2025-12-05
J1411	HCPCS	Etranacogene Dezaparvovec-drlb 1x10exp13 Gc/ml Intravenous Suspension	19	13	—	—	$3,758,972.00	$4,637,500.00	$3,880,954.33	2025-12-05
J1413	HCPCS	Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp	22	14	—	—	$3,382,791.84	$4,894,400.00	$3,537,600.00	2025-12-05
J3399	HCPCS	Onasemnogene Abeparvovec-xioi 2 X 10exp13 Vg/ml IV Suspension,kit	42	16	—	—	$27,261.82	$4,725,360.27	$3,445,333.32	2025-12-05
J3394	HCPCS	Inj, Lovotibeglogene Autotem	9	5	—	—	$3,313,414.63	$4,060,557.14	$3,410,868.00	2025-12-05
J3393	HCPCS	Inj, Betibeglogene Autotemce	9	5	—	—	$3,004,654.80	$3,682,175.00	$3,093,027.00	2025-12-05
J3392	HCPCS	Inj, Exagamglogene Autotem	9	5	—	—	$2,378,640.00	$2,915,000.00	$2,448,600.00	2025-12-05
Q2055	HCPCS	Idecabtagene Vicleucel 300 X 10exp6 To 510 X 10exp6 Cell IV Suspension	138	35	$3,169,280.60	$1,584,640.30 50% off	$568,464.29	$2,915,738.15	$1,885,721.96	2025-12-05
Q2056	HCPCS	Ciltacabtagene Autoleucel 0.5 X 10exp6 To 1x 10exp8 Cell IV Suspension	138	35	$3,132,333.00	$1,566,166.50 50% off	$577,186.32	$2,881,746.36	$1,863,738.14	2025-12-05
Q2054	HCPCS	Lisocabtagene Maraleucel 1.5 X 10exp6 To 70 X 10exp6 Cell/ml IV Susp	138	35	$3,188,102.40	$1,594,051.20 50% off	$573,788.95	$2,933,054.21	$1,853,881.54	2025-12-05
Q2041	HCPCS	Axicabtagene Ciloleucel Intravenous Suspension	138	35	$3,021,480.00	$1,510,740.00 50% off	$543,894.77	$2,779,761.60	$1,775,119.50	2025-12-05
Q2042	HCPCS	Tisagenlecleucel 0.2 X10exp6 To 2.5x10exp8 Cell Intravenous Suspension	224	35	$3,247,380.77	$1,623,690.39 50% off	$603,560.73	$3,276,304.05	$1,764,537.24	2025-12-05
Q2053	HCPCS	Brexucabtagene Autoleucel 1x 10exp6 To 1x 10exp8 Cell IV Suspension	138	35	$2,544,000.00	$1,272,000.00 50% off	$499,090.70	$2,340,480.00	$1,513,680.00	2025-12-05
Q2057	HCPCS	Afamitresgene Autoleucel	9	5	—	—	$786,032.40	$963,275.00	$809,151.00	2025-12-05
J2326	HCPCS	Nusinersen (pf) 12 Mg/5 Ml Intrathecal Solution	134	35	$551,628.25	$275,814.13 50% off	$1,241.34	$507,497.99	$331,390.67	2025-12-05
1	MS_DRG	Heart Transplant Or Implant Of Heart Assist System With Mcc	37	18	—	—	$197,959.00	$1,424,094.65	$323,575.00	2025-12-05
18	MS_DRG	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	21	16	—	—	$267,069.18	$1,897,457.10	$303,863.52	2025-12-05
Q2058	HCPCS	Obecbtge Autol Up To 400 Mil	9	5	—	—	$283,815.00	$347,812.50	$292,162.50	2025-12-05
0294	RC	Cardiac Device	1	1	—	—	$290,579.00	$290,579.00	$290,579.00	2025-12-04
0290	RC	Cardiac Device	1	1	—	—	$290,579.00	$290,579.00	$290,579.00	2025-12-04
J0225	HCPCS	Vutrisiran 25 Mg/0.5 Ml Subcutaneous Syringe	135	35	$477,404.00	$238,702.00 50% off	$5,103.71	$439,211.68	$287,158.51	2025-12-05
J3403	HCPCS	Revakinagene, Per Implant	9	5	—	—	$262,650.00	$321,875.00	$270,375.00	2025-12-05
14	MS_DRG	Allogeneic Bone Marrow Transplant	54	18	—	—	$109,206.58	$676,867.12	$253,915.67	2025-12-05
3	MS_DRG	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mo…	21	16	—	—	$175,089.86	$1,089,986.11	$227,668.82	2025-12-05
5	MS_DRG	Liver Transplant With Mcc Or Intestinal Transplant	30	18	—	—	$89,809.69	$555,239.69	$219,188.00	2025-12-05
J3402	HCPCS	Inj. Remestemcel-l-rknd/ Td	9	5	—	—	$209,752.80	$257,050.00	$215,922.00	2025-12-05
4	MS_DRG	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And …	21	16	—	—	$117,338.95	$727,861.05	$200,774.86	2025-12-05
2	MS_DRG	Heart Transplant Or Implant Of Heart Assist System Without Mcc	37	18	—	—	$92,738.51	$573,604.77	$197,959.00	2025-12-05
927	MS_DRG	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	21	16	—	—	$120,693.54	$1,203,618.83	$193,211.74	2025-12-05
7	MS_DRG	Lung Transplant	21	16	—	—	$108,945.56	$675,230.52	$178,701.47	2025-12-05
A9607	HCPCS	Lutetium Lu-177 Vipivotide Tetraxetan 27 Mci/ml (1,000 Mbq/ml) IV Soln	132	33	$292,224.00	$146,112.00 50% off	$234.43	$268,846.08	$175,553.57	2025-12-05
J9029	HCPCS	Nadofaragene Firadenovec-vncg 3x10exp11 Vp/ml Intravesical Suspension	138	35	$240,050.00	$120,025.00 50% off	$52,354.91	$220,846.00	$143,378.78	2025-12-05
77371	CPT	Hc Radiation Delivery Stereotactic Cranial Cobalt	134	34	$221,961.00	$110,980.50 50% off	$2,082.15	$204,204.12	$133,509.54	2025-12-05
17	MS_DRG	Autologous Bone Marrow Transplant Without Cc/mcc	40	18	—	—	$39,662.32	$326,431.78	$131,966.00	2025-12-05
16	MS_DRG	Autologous Bone Marrow Transplant With Cc/mcc	40	18	—	—	$39,662.32	$326,431.78	$131,966.00	2025-12-05
652	MS_DRG	Kidney Transplant	31	18	—	—	$29,872.66	$370,862.00	$119,165.00	2025-12-05
216	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	21	16	—	—	$81,913.78	$505,728.67	$118,080.51	2025-12-05
Q0480	HCPCS	Driver Pneumatic Vad, Rep	9	5	—	—	$111,502.61	$136,645.35	$114,782.09	2025-12-05
J9226	HCPCS	Histrelin 50 Mg (65 Mcg/day) Implant Kit	139	35	$195,069.50	$97,534.75 50% off	$42,544.66	$179,463.94	$114,115.66	2025-12-05
850	MS_DRG	Acute Leukemia With Other Procedures	21	16	—	—	$78,440.00	$483,946.44	$113,242.36	2025-12-05
429	MS_DRG	Combined Anterior And Posterior Cervical Spinal Fusion With Mcc	21	16	—	—	$71,548.59	$440,734.12	$102,530.76	2025-12-05
J0223	HCPCS	Givosiran 189 Mg/ml Subcutaneous Solution	134	35	$170,489.00	$85,244.50 50% off	$119.23	$156,849.88	$102,421.27	2025-12-05
J1747	HCPCS	Spesolimab-sbzo 60 Mg/ml Intravenous Solution	131	33	$167,419.70	$83,709.85 50% off	$67.04	$154,026.12	$100,451.82	2025-12-05
C9293	HCPCS	Glucarpidase 1,000 Unit Intravenous Solution	129	35	$164,721.00	$82,360.50 50% off	$35,925.65	$151,543.32	$99,079.68	2025-12-05
10	MS_DRG	Pancreas Transplant	22	17	—	—	$68,641.10	$422,502.78	$98,503.70	2025-12-05
K1007	HCPCS	Bil Hkaf Pc S/d Micro Sensor	9	5	—	—	$95,081.03	$116,520.88	$97,877.54	2025-12-05
19	MS_DRG	Simultaneous Pancreas And Kidney Transplant With Hemodialysis	21	16	—	—	$68,279.66	$420,236.23	$97,449.79	2025-12-05
834	MS_DRG	Acute Leukemia With Mcc	21	16	—	—	$49,297.23	$301,207.60	$95,698.13	2025-12-05
8	MS_DRG	Simultaneous Pancreas And Kidney Transplant	22	17	—	—	$48,615.44	$296,932.47	$95,375.05	2025-12-05
J0801	HCPCS	Corticotropin 80 Unit/ml Injection Gel	124	35	$158,564.00	$79,282.00 50% off	$4,545.23	$145,878.88	$95,340.57	2025-12-05
212	MS_DRG	Concomitant Aortic And Mitral Valve Procedures	21	16	—	—	$88,622.75	$567,365.70	$94,958.89	2025-12-05
0795T	CPT	Hc Tcat Insert Perm Dual Chamber Leadls Pm Compl Sys	137	35	$151,770.35	$75,885.18 50% off	$261.30	$139,628.72	$91,289.87	2025-12-05
B0407	HCPCS	Traumatic Spinal Cord Injury M <24.50 And A >=61.50	3	3	—	—	$88,182.44	$90,776.04	$89,479.24	2025-12-05
215	MS_DRG	Other Heart Assist System Implant	21	16	—	—	$77,136.34	$552,531.85	$89,377.85	2025-12-05
426	MS_DRG	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	21	16	—	—	$76,014.89	$546,610.02	$88,433.47	2025-12-05
790	MS_DRG	Extreme Immaturity Or Respiratory Distress Syndrome, Neonate	15	13	—	—	$52,599.38	$321,913.68	$87,010.40	2025-12-05
6	MS_DRG	Liver Transplant Without Mcc	30	18	—	—	$43,933.90	$370,862.00	$84,003.04	2025-12-05
20	MS_DRG	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc	21	16	—	—	$69,337.94	$426,872.15	$83,086.34	2025-12-05
955	MS_DRG	Craniotomy For Multiple Significant Trauma	21	16	—	—	$59,587.27	$365,731.03	$81,177.68	2025-12-05
J9269	HCPCS	Tagraxofusp-erzs 1,000 Mcg/ml Intravenous Solution	133	35	$135,076.60	$67,538.30 50% off	$331.76	$124,270.47	$81,045.96	2025-12-05
228	MS_DRG	Other Cardiothoracic Procedures With Mcc	21	16	—	—	$44,994.54	$274,227.73	$79,968.57	2025-12-05
231	MS_DRG	Coronary Bypass With Ptca With Mcc	21	16	—	—	$72,602.90	$447,345.06	$79,611.80	2025-12-05
C0407	HCPCS	Traumatic Spinal Cord Injury M <24.50 And A >=61.50	3	3	—	—	$78,418.92	$80,725.35	$79,572.14	2025-12-05
456	MS_DRG	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	21	16	—	—	$72,565.74	$447,112.01	$78,200.84	2025-12-05
957	MS_DRG	Other O.r. Procedures For Multiple Significant Trauma With Mcc	21	16	—	—	$64,616.85	$397,268.74	$77,969.96	2025-12-05
275	MS_DRG	Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc	21	16	—	—	$61,475.26	$377,569.49	$77,569.90	2025-12-05
B1904	HCPCS	Guillain-barré M <38.50	3	3	—	—	$76,303.95	$78,548.18	$77,426.06	2025-12-05
D0407	HCPCS	Traumatic Spinal Cord Injury M <24.50 And A >=61.50	3	3	—	—	$76,124.57	$78,363.53	$77,244.05	2025-12-05
317	MS_DRG	Concomitant Left Atrial Appendage Closure And Cardiac Ablation	21	16	—	—	$54,510.27	$333,895.85	$76,049.97	2025-12-05
461	MS_DRG	Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc	21	16	—	—	$54,117.17	$331,430.98	$75,444.44	2025-12-05
23	MS_DRG	Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…	21	16	—	—	$50,703.52	$310,025.69	$75,191.46	2025-12-05
870	MS_DRG	Septicemia Or Severe Sepsis With Mv >96 Hours	21	16	—	—	$60,601.26	$372,089.14	$74,814.53	2025-12-05
233	MS_DRG	Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc	21	16	—	—	$67,402.52	$414,736.22	$72,998.26	2025-12-05
B1806	HCPCS	Major Multiple Trauma With Brain Or Spinal Cord Injury M <30.50	3	3	—	—	$71,775.73	$73,886.78	$72,831.25	2025-12-05
219	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	21	16	—	—	$66,652.61	$410,823.09	$71,417.99	2025-12-05
93656	CPT	Hc Ep Ephys Evl Trnsptl Tx Atrial Fib Isolat Pulm Vein	138	34	$121,044.20	$60,522.10 50% off	$261.30	$111,360.66	$71,113.47	2025-12-05
L8702	HCPCS	Ewhf S/d Uprt Micro Sensor	9	5	—	—	$68,801.71	$84,315.83	$70,825.29	2025-12-05
A0407	HCPCS	Traumatic Spinal Cord Injury M <24.50 And A >=61.50	3	3	—	—	$69,170.59	$71,205.02	$70,187.80	2025-12-05
207	MS_DRG	Respiratory System Diagnosis With Ventilator Support >96 Hours	21	16	—	—	$56,731.24	$347,822.25	$69,569.98	2025-12-05
266	MS_DRG	Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc	21	16	—	—	$52,963.21	$324,195.05	$67,801.14	2025-12-05
37	MS_DRG	Extracranial Procedures With Mcc	21	16	—	—	$31,846.04	$191,780.46	$67,261.70	2025-12-05
820	MS_DRG	Lymphoma And Leukemia With Major O.r. Procedures With Mcc	21	16	—	—	$51,630.48	$315,838.22	$66,847.13	2025-12-05
0915T	CPT	Hc Insert Perm Card Contract Mod-defib W/guide; Pulse Generator & Leads	137	35	$110,987.60	$55,493.80 50% off	$778.87	$102,108.59	$66,759.04	2025-12-05
0408T	CPT	Hc Insert Or Replace Perm Cardiac Cont Mod Gen+elect	136	34	$110,987.60	$55,493.80 50% off	$778.87	$102,108.59	$66,759.04	2025-12-05
J9359	HCPCS	Loncastuximab Tesirine-lpyl 10 Mg Intravenous Solution	134	34	$111,115.60	$55,557.80 50% off	$214.57	$102,226.35	$66,752.70	2025-12-05
576	MS_DRG	Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc	21	16	—	—	$48,253.19	$294,661.02	$66,324.91	2025-12-05
33288	CPT	Hc Rmvl&rplcmt Phrnc Nrv Stim Trnsvns Stim/snsg Ld	137	35	$109,284.20	$54,642.10 50% off	$778.87	$100,541.46	$65,570.52	2025-12-05
33287	CPT	Hc Rmvl&rplcmt Phrenic Nrv Stimulator Pls Generator	137	35	$109,005.70	$54,502.85 50% off	$778.87	$100,285.24	$65,566.93	2025-12-05
0414T	CPT	Hc Removal & Replace Permament Ccm Pulse Generator Only	136	34	$109,005.70	$54,502.85 50% off	$778.87	$100,285.24	$65,485.17	2025-12-05
B0406	HCPCS	Traumatic Spinal Cord Injury M >=24.50 And M <31.50 And A >=61.50	3	3	—	—	$64,502.63	$66,399.76	$65,451.20	2025-12-05
981	MS_DRG	Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc	16	14	—	—	$43,180.12	$262,850.65	$65,292.60	2025-12-05
0916T	CPT	Hc Insert Perm Card Contract Mod-defib W/guide; Pulse Generator Only	136	34	$109,005.70	$54,502.85 50% off	$778.87	$100,285.24	$64,858.39	2025-12-05
0409T	CPT	Hc Insert Or Replace Perm Ccm Pulse Generator Only	136	34	$109,005.70	$54,502.85 50% off	$778.87	$100,285.24	$64,858.39	2025-12-05
B0404	HCPCS	Traumatic Spinal Cord Injury M <31.50 And A <61.50	3	3	—	—	$63,566.11	$65,435.71	$64,500.91	2025-12-05
B0505	HCPCS	Non-traumatic Spinal Cord Injury M <39.50	3	3	—	—	$62,913.26	$64,763.65	$63,838.46	2025-12-05
427	MS_DRG	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	21	16	—	—	$59,284.22	$379,340.06	$63,761.72	2025-12-05
457	MS_DRG	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	21	16	—	—	$50,974.80	$311,726.71	$63,686.38	2025-12-05
450	MS_DRG	Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically …	21	16	—	—	$46,313.82	$282,500.24	$63,310.46	2025-12-05
650	MS_DRG	Kidney Transplant With Hemodialysis With Mcc	31	18	—	—	$42,020.63	$370,862.00	$63,155.57	2025-12-05
853	MS_DRG	Infectious And Parasitic Diseases With O.r. Procedures With Mcc	21	16	—	—	$45,136.91	$275,120.54	$62,806.53	2025-12-05
J9348	HCPCS	Naxitamab-gqgk 4 Mg/ml Intravenous Solution	135	35	$104,288.60	$52,144.30 50% off	$652.15	$95,945.51	$62,729.60	2025-12-05
270	MS_DRG	Other Major Cardiovascular Procedures With Mcc	21	16	—	—	$46,178.56	$281,652.18	$62,141.06	2025-12-05
B0106	HCPCS	Stroke M <41.50 And A <84.50	3	3	—	—	$60,621.00	$62,403.97	$61,512.48	2025-12-05
651	MS_DRG	Kidney Transplant With Hemodialysis Without Mcc	31	18	—	—	$33,045.10	$370,862.00	$61,192.09	2025-12-05
447	MS_DRG	Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall…	21	16	—	—	$55,756.13	$359,601.13	$60,334.03	2025-12-05
J9118	HCPCS	Calaspargase Pegol-mknl 750 Unit/ml Intravenous Solution	134	35	$100,182.50	$50,091.25 50% off	$77.95	$92,167.90	$60,184.64	2025-12-05
J2507	HCPCS	Pegloticase 8 Mg/ml Intravenous Solution	134	35	$99,415.25	$49,707.63 50% off	$3,476.20	$91,462.03	$59,723.71	2025-12-05
A9543	HCPCS	Y90 Ibritumomab, Rx	9	5	—	—	$57,961.04	$71,030.69	$59,665.78	2025-12-05
33266	CPT	Hc Maze Procedure Without Cardio By	131	34	$99,183.65	$49,591.83 50% off	$1,676.23	$91,248.96	$59,658.97	2025-12-05
C1904	HCPCS	Guillain-barré M <38.50	3	3	—	—	$58,662.45	$60,387.82	$59,525.14	2025-12-05
21	MS_DRG	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc	21	16	—	—	$49,297.23	$301,207.60	$59,509.64	2025-12-05
217	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	21	16	—	—	$55,358.69	$347,360.93	$59,316.60	2025-12-05
218	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	21	16	—	—	$52,634.96	$322,136.75	$59,316.60	2025-12-05
0811	RC	Hc Kidney Acquistion Live Donor	126	35	$98,460.75	$49,230.38 50% off	$311.55	$90,583.89	$59,224.14	2025-12-05
268	MS_DRG	Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc	21	16	—	—	$54,343.55	$357,761.12	$59,173.85	2025-12-05
276	MS_DRG	Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator	21	16	—	—	$54,573.55	$334,292.63	$59,113.42	2025-12-05
928	MS_DRG	Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc	21	16	—	—	$46,953.14	$358,321.57	$58,405.63	2025-12-05
C0406	HCPCS	Traumatic Spinal Cord Injury M >=24.50 And M <31.50 And A >=61.50	3	3	—	—	$57,360.92	$59,048.01	$58,204.47	2025-12-05
C1806	HCPCS	Major Multiple Trauma With Brain Or Spinal Cord Injury M <30.50	3	3	—	—	$57,258.72	$58,942.80	$58,100.76	2025-12-05
Q2043	HCPCS	Sipuleucel-t Auto Cd54+	10	6	—	—	$54,444.53	$69,090.41	$57,621.40	2025-12-05
C0404	HCPCS	Traumatic Spinal Cord Injury M <31.50 And A <61.50	3	3	—	—	$56,528.71	$58,191.32	$57,360.01	2025-12-05
33277	CPT	Hc Ins Phrenic Nrv Stimulator Transvns Sensing Ld	134	34	$94,209.80	$47,104.90 50% off	$259.77	$86,673.02	$56,667.19	2025-12-05
D0406	HCPCS	Traumatic Spinal Cord Injury M >=24.50 And M <31.50 And A >=61.50	3	3	—	—	$55,681.87	$57,319.57	$56,500.72	2025-12-05
232	MS_DRG	Coronary Bypass With Ptca Without Mcc	21	16	—	—	$52,422.45	$330,042.25	$56,170.42	2025-12-05
B0205	HCPCS	Traumatic Brain Injury M <35.50	3	3	—	—	$55,033.20	$56,651.83	$55,842.51	2025-12-05
234	MS_DRG	Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc	21	16	—	—	$47,659.20	$290,936.37	$55,689.16	2025-12-05
D0404	HCPCS	Traumatic Spinal Cord Injury M <31.50 And A <61.50	3	3	—	—	$54,874.68	$56,488.65	$55,681.66	2025-12-05
969	MS_DRG	HIV With Extensive O.r. Procedures With Mcc	21	16	—	—	$49,854.91	$340,735.06	$55,600.98	2025-12-05
D1904	HCPCS	Guillain-barré M <38.50	3	3	—	—	$54,739.11	$56,349.08	$55,544.09	2025-12-05
B1705	HCPCS	Major Multiple Trauma Without Brain Or Spinal Cord Injury M <36.50	3	3	—	—	$54,689.04	$56,297.55	$55,493.29	2025-12-05
D1806	HCPCS	Major Multiple Trauma With Brain Or Spinal Cord Injury M <30.50	3	3	—	—	$54,359.49	$55,958.30	$55,158.90	2025-12-05
J9229	HCPCS	Inotuzumab Ozogamicin 0.9 Mg(0.25 Mg/ml Initial Concentration) IV Soln	133	34	$91,682.00	$45,841.00 50% off	$2,752.01	$84,347.44	$55,146.72	2025-12-05
93653	CPT	Hc Ep Ephys Eval W/ablation Supravent Arrhythmia	139	35	$91,417.45	$45,708.73 50% off	$261.30	$84,104.05	$54,850.47	2025-12-05
J9600	HCPCS	Porfimer 75 Mg Intravenous Solution	139	35	$91,941.00	$45,970.50 50% off	$20,052.33	$84,585.72	$54,649.36	2025-12-05
A1904	HCPCS	Guillain-barré M <38.50	3	3	—	—	$53,792.17	$55,374.29	$54,583.23	2025-12-05
573	MS_DRG	Skin Graft For Skin Ulcer Or Cellulitis With Mcc	21	16	—	—	$31,952.04	$332,497.26	$54,287.23	2025-12-05
329	MS_DRG	Major Small And Large Bowel Procedures With Mcc	21	16	—	—	$41,898.82	$254,816.20	$54,089.33	2025-12-05
B0105	HCPCS	Stroke M <41.50 And A >=84.50	3	3	—	—	$53,297.84	$54,865.42	$54,081.63	2025-12-05
28	MS_DRG	Spinal Procedures With Mcc	21	16	—	—	$42,514.29	$328,594.17	$53,664.77	2025-12-05
J3316	HCPCS	Triptorelin Pamoate (pediatric) 22.5 Mg IM Suspension	134	35	$89,190.70	$44,595.35 50% off	$3,893.62	$82,055.44	$53,648.21	2025-12-05
C0106	HCPCS	Stroke M <41.50 And A <84.50	3	3	—	—	$52,574.07	$54,120.37	$53,347.22	2025-12-05
235	MS_DRG	Coronary Bypass Without Cardiac Catheterization With Mcc	21	16	—	—	$48,889.56	$318,908.19	$53,230.60	2025-12-05
933	MS_DRG	Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft	21	16	—	—	$39,802.84	$241,673.39	$53,192.21	2025-12-05
876	MS_DRG	O.r. Procedures With Principal Diagnosis Of Mental Illness	11	7	—	—	$36,660.48	$221,969.24	$53,167.49	2025-12-05
J9281	HCPCS	Mitomycin 40 Mg X 2 Intra-pyelocalyceal Kit	134	35	$88,490.00	$44,245.00 50% off	$324.90	$81,410.80	$53,160.37	2025-12-05
B1903	HCPCS	Guillain-barré M >=38.50 And M <51.50	3	3	—	—	$52,382.18	$53,922.83	$53,152.51	2025-12-05
0571T	CPT	Hc Insert/replace Icds W/substernal Electrode	137	35	$87,916.70	$43,958.35 50% off	$261.30	$80,883.36	$52,881.89	2025-12-05
B0604	HCPCS	Neurological M <43.50	3	3	—	—	$51,944.16	$53,471.93	$52,708.05	2025-12-05
956	MS_DRG	Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma	21	16	—	—	$35,812.58	$216,652.56	$52,548.02	2025-12-05
93591	CPT	Hc Cath Perq Transcath Cls Paravalvr Leak 1 Aortic Valve	137	35	$86,855.80	$43,427.90 50% off	$778.87	$79,907.34	$52,243.76	2025-12-05
93590	CPT	Hc Cath Perq Transcath Cls Paravalvr Leak 1 Mitral Valve	137	35	$86,855.80	$43,427.90 50% off	$778.87	$79,907.34	$52,243.76	2025-12-05
463	MS_DRG	Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …	21	16	—	—	$48,298.25	$294,943.67	$52,183.83	2025-12-05
11	MS_DRG	Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc	21	16	—	—	$48,232.60	$294,690.78	$51,681.02	2025-12-05
A0406	HCPCS	Traumatic Spinal Cord Injury M >=24.50 And M <31.50 And A >=61.50	3	3	—	—	$50,596.75	$52,084.89	$51,340.82	2025-12-05
B0405	HCPCS	Traumatic Spinal Cord Injury M >=31.50 And M <41.50	3	3	—	—	$50,550.86	$52,037.65	$51,294.26	2025-12-05
B1805	HCPCS	Major Multiple Trauma With Brain Or Spinal Cord Injury M >=30.50 And M <40.50	3	3	—	—	$50,540.44	$52,026.92	$51,283.68	2025-12-05
A1806	HCPCS	Major Multiple Trauma With Brain Or Spinal Cord Injury M <30.50	3	3	—	—	$50,400.69	$51,883.06	$51,141.88	2025-12-05
L7181	HCPCS	Electronic Elbo Simultaneous	9	5	—	—	$49,605.45	$60,790.99	$51,064.43	2025-12-05
356	MS_DRG	Other Digestive System O.r. Procedures With Mcc	21	16	—	—	$39,318.79	$238,638.14	$50,631.91	2025-12-05
A0404	HCPCS	Traumatic Spinal Cord Injury M <31.50 And A <61.50	3	3	—	—	$49,862.56	$51,329.10	$50,595.83	2025-12-05
428	MS_DRG	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	21	16	—	—	$46,648.59	$300,057.06	$50,558.25	2025-12-05
B0305	HCPCS	Non-traumatic Brain Injury M <42.50 And A <78.50	3	3	—	—	$49,735.33	$51,198.14	$50,466.73	2025-12-05
A5104	HCPCS	Expired, Not Orthopedic, Length Of Stay Is 16 Days Or More	3	3	—	—	$49,712.38	$51,174.51	$50,443.45	2025-12-05
25	MS_DRG	Craniotomy And Endovascular Intracranial Procedures With Mcc	21	16	—	—	$40,952.88	$248,884.57	$50,189.96	2025-12-05
B1604	HCPCS	Pain Syndrome M <43.50	3	3	—	—	$48,963.59	$50,403.70	$49,683.64	2025-12-05
653	MS_DRG	Major Bladder Procedures With Mcc	21	16	—	—	$35,546.21	$303,553.50	$49,671.35	2025-12-05
C0505	HCPCS	Non-traumatic Spinal Cord Injury M <39.50	3	3	—	—	$48,944.82	$50,384.38	$49,664.60	2025-12-05
J2350	HCPCS	Ocrelizumab 30 Mg/ml Intravenous Solution	134	35	$82,588.85	$41,294.43 50% off	$60.60	$75,981.74	$49,615.25	2025-12-05
B0704	HCPCS	Fracture Of Lower Extremity M <41.50	3	3	—	—	$48,542.27	$49,969.98	$49,256.13	2025-12-05
J9274	HCPCS	Tebentafusp-tebn 100 Mcg/0.5 Ml Intravenous Solution	133	34	$81,970.00	$40,985.00 50% off	$212.05	$75,412.40	$49,182.00	2025-12-05
B2102	HCPCS	Burns M <52.50	3	3	—	—	$48,339.94	$49,761.71	$49,050.82	2025-12-05
220	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	21	16	—	—	$45,585.57	$289,770.94	$49,013.89	2025-12-05
430	MS_DRG	Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc	21	16	—	—	$44,734.19	$298,390.58	$48,881.71	2025-12-05
D0106	HCPCS	Stroke M <41.50 And A <84.50	3	3	—	—	$48,043.76	$49,456.82	$48,750.29	2025-12-05
B1004	HCPCS	Amputation Lower Extremity M <47.50	3	3	—	—	$47,995.79	$49,407.44	$48,701.61	2025-12-05
J0638	HCPCS	Canakinumab (pf) 150 Mg/ml Subcutaneous Solution	135	35	$80,911.45	$40,455.73 50% off	$132.97	$74,438.53	$48,668.24	2025-12-05
277	MS_DRG	Cardiac Defibrillator Implant Without Mcc	21	16	—	—	$42,373.40	$257,791.88	$48,642.59	2025-12-05
405	MS_DRG	Pancreas, Liver And Shunt Procedures With Mcc	21	16	—	—	$41,796.99	$296,317.52	$48,517.36	2025-12-05
B1504	HCPCS	Pulmonary M <45.50	3	3	—	—	$47,438.89	$48,834.16	$48,136.53	2025-12-05
0812	RC	Hc Cadaver Donor - Liver	382	34	$85,226.70	$42,613.35 50% off	$311.55	$105,732.70	$48,009.06	2025-12-05
0914T	CPT	Hc Perq Transcath Thera Rx Balloon Angio, Separate Lesion, 1 Artery/branch	125	35	$79,223.25	$39,611.63 50% off	$778.87	$72,885.39	$47,652.79	2025-12-05
24	MS_DRG	Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…	21	16	—	—	$35,648.85	$215,625.95	$47,576.83	2025-12-05
264	MS_DRG	Other Circulatory System O.r. Procedures	21	16	—	—	$33,223.85	$200,420.05	$47,483.31	2025-12-05
326	MS_DRG	Stomach, Esophageal And Duodenal Procedures With Mcc	21	16	—	—	$44,305.15	$278,974.03	$47,472.78	2025-12-05
163	MS_DRG	Major Chest Procedures With Mcc	21	16	—	—	$42,035.65	$255,674.12	$47,384.53	2025-12-05
B1704	HCPCS	Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=36.50 And M <41.50	3	3	—	—	$46,602.49	$47,973.16	$47,287.83	2025-12-05
B2005	HCPCS	Miscellaneous M <46.50 And A <77.50	3	3	—	—	$46,329.26	$47,691.88	$47,010.57	2025-12-05
D0505	HCPCS	Non-traumatic Spinal Cord Injury M <39.50	3	3	—	—	$46,239.57	$47,599.56	$46,919.56	2025-12-05
C0105	HCPCS	Stroke M <41.50 And A >=84.50	3	3	—	—	$46,222.88	$47,582.38	$46,902.63	2025-12-05
239	MS_DRG	Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc	21	16	—	—	$43,530.39	$276,886.10	$46,892.37	2025-12-05
A0106	HCPCS	Stroke M <41.50 And A <84.50	3	3	—	—	$45,784.87	$47,131.49	$46,458.18	2025-12-05
B1204	HCPCS	Osteoarthritis M <49.50 And A <74.50	3	3	—	—	$45,547.09	$46,886.71	$46,216.90	2025-12-05
673	MS_DRG	Other Kidney And Urinary Tract Procedures With Mcc	21	16	—	—	$38,716.89	$234,864.00	$46,194.06	2025-12-05
267	MS_DRG	Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc	21	16	—	—	$42,791.01	$260,410.51	$46,144.94	2025-12-05
C0205	HCPCS	Traumatic Brain Injury M <35.50	3	3	—	—	$45,326.00	$46,659.11	$45,992.55	2025-12-05
B0504	HCPCS	Non-traumatic Spinal Cord Injury M >=39.50 And M <48.50	3	3	—	—	$45,275.94	$46,607.59	$45,941.77	2025-12-05
0266T	CPT	Apc	9	5	—	—	$43,655.98	$53,499.97	$45,900.51	2025-12-05
466	MS_DRG	Revision Of Hip Or Knee Replacement With Mcc	21	16	—	—	$37,310.26	$279,747.76	$45,874.86	2025-12-05
93654	CPT	Hc Ep Ephys Eval W/ablation Ventricular Tachycardia	136	34	$76,123.95	$38,061.98 50% off	$261.30	$70,034.03	$45,788.56	2025-12-05
B0304	HCPCS	Non-traumatic Brain Injury M <42.50 And A >=78.50	3	3	—	—	$45,096.57	$46,422.94	$45,759.75	2025-12-05
J7311	HCPCS	Fluocinolone 0.59 Mg Intravitreal Implant	133	34	$76,100.00	$38,050.00 50% off	$319.83	$70,012.00	$45,660.00	2025-12-05
33274	CPT	Hc Tcat Insj/rpl Perm Leadless Pacemaker Rv W/img	137	35	$75,885.15	$37,942.58 50% off	$400.74	$69,814.34	$45,644.92	2025-12-05
C0405	HCPCS	Traumatic Spinal Cord Injury M >=31.50 And M <41.50	3	3	—	—	$44,954.74	$46,276.93	$45,615.83	2025-12-05
B1404	HCPCS	Cardiac M <45.50	3	3	—	—	$44,756.58	$46,072.95	$45,414.77	2025-12-05
987	MS_DRG	Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc	21	16	—	—	$33,283.97	$200,797.00	$45,383.30	2025-12-05
B1304	HCPCS	Rheumatoid Other Arthritis M <44.50 And A >=64.50	3	3	—	—	$44,668.98	$45,982.78	$45,325.88	2025-12-05
B0904	HCPCS	Other Orthopedic M <44.5	3	3	—	—	$44,668.98	$45,982.78	$45,325.88	2025-12-05
458	MS_DRG	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	21	16	—	—	$39,732.45	$241,231.97	$45,312.73	2025-12-05
837	MS_DRG	Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot…	21	16	—	—	$40,113.38	$275,413.05	$45,183.58	2025-12-05
278	MS_DRG	Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures …	21	16	—	—	$40,044.43	$275,219.56	$45,152.71	2025-12-05
J9266	HCPCS	Pegaspargase 750 Unit/ml Injection Solution	139	35	$74,455.55	$37,227.78 50% off	$16,238.76	$68,499.11	$44,673.33	2025-12-05
B2004	HCPCS	Miscellaneous M <46.50 And A >=77.50	3	3	—	—	$43,953.55	$45,246.31	$44,599.93	2025-12-05
D0405	HCPCS	Traumatic Spinal Cord Injury M >=31.50 And M <41.50	3	3	—	—	$43,638.61	$44,922.10	$44,280.35	2025-12-05
245	MS_DRG	Aicd Generator Procedures	21	16	—	—	$37,884.86	$269,441.80	$44,231.29	2025-12-05
448	MS_DRG	Multiple Level Spinal Fusion Except Cervical Without Mcc	21	16	—	—	$37,877.70	$229,601.94	$44,176.30	2025-12-05
221	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	21	16	—	—	$41,168.75	$254,850.86	$44,112.14	2025-12-05
B1203	HCPCS	Osteoarthritis M <49.50 And A >=74.50	3	3	—	—	$43,434.20	$44,711.68	$44,072.94	2025-12-05
802	MS_DRG	Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc	21	16	—	—	$33,933.31	$204,868.72	$44,068.61	2025-12-05
856	MS_DRG	Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc	21	16	—	—	$41,126.61	$250,833.64	$44,066.99	2025-12-05
471	MS_DRG	Cervical Spinal Fusion With Mcc	21	16	—	—	$34,723.56	$267,978.74	$43,997.94	2025-12-05
94	MS_DRG	Bacterial And Tuberculous Infections Of Nervous System With Mcc	21	16	—	—	$34,438.73	$208,037.82	$43,899.96	2025-12-05
B0805	HCPCS	Replacement Of Lower-extremity Joint M <42.50	3	3	—	—	$42,994.10	$44,258.63	$43,626.37	2025-12-05
B0204	HCPCS	Traumatic Brain Injury M >=35.50 And M <49.50	3	3	—	—	$42,962.82	$44,226.43	$43,594.62	2025-12-05
B1305	HCPCS	Rheumatoid Other Arthritis M <51.50 And A <64.50	3	3	—	—	$42,777.18	$44,035.33	$43,406.25	2025-12-05
826	MS_DRG	Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. …	21	16	—	—	$36,306.61	$263,921.78	$43,350.97	2025-12-05
B0104	HCPCS	Stroke M >=41.50 And M <50.50	3	3	—	—	$42,622.83	$43,876.44	$43,249.64	2025-12-05
A0505	HCPCS	Non-traumatic Spinal Cord Injury M <39.50	3	3	—	—	$42,610.32	$43,863.56	$43,236.94	2025-12-05
799	MS_DRG	Splenic Procedures With Mcc	21	16	—	—	$33,900.91	$262,895.22	$43,187.24	2025-12-05
C1705	HCPCS	Major Multiple Trauma Without Brain Or Spinal Cord Injury M <36.50	3	3	—	—	$42,510.20	$43,760.50	$43,135.35	2025-12-05
949	MS_DRG	Aftercare With Cc/mcc	21	16	—	—	$11,594.93	$80,592.79	$43,106.13	2025-12-05
D0105	HCPCS	Stroke M <41.50 And A >=84.50	3	3	—	—	$42,239.05	$43,481.37	$42,860.21	2025-12-05
907	MS_DRG	Other O.r. Procedures For Injuries With Mcc	21	16	—	—	$37,088.37	$224,652.28	$42,808.84	2025-12-05
332	MS_DRG	Rectal Resection With Mcc	21	16	—	—	$33,015.04	$199,110.68	$42,641.14	2025-12-05
823	MS_DRG	Lymphoma And Non-acute Leukemia With Other Procedures With Mcc	21	16	—	—	$37,160.86	$259,160.71	$42,591.68	2025-12-05
B1103	HCPCS	Amputation Non-lower Extremity M <52.50	3	3	—	—	$41,832.32	$43,062.68	$42,447.50	2025-12-05
252	MS_DRG	Other Vascular Procedures With Mcc	21	16	—	—	$32,712.11	$197,211.27	$42,398.32	2025-12-05
B1804	HCPCS	Major Multiple Trauma With Brain Or Spinal Cord Injury M >=40.50 And M <45.50	3	3	—	—	$41,686.32	$42,912.39	$42,299.35	2025-12-05
665	MS_DRG	Prostatectomy With Mcc	21	16	—	—	$32,737.42	$197,369.93	$42,209.35	2025-12-05
J3241	HCPCS	Teprotumumab-trbw 500 Mg Intravenous Solution	134	34	$70,069.55	$35,034.78 50% off	$336.41	$64,463.99	$42,094.28	2025-12-05
236	MS_DRG	Coronary Bypass Without Cardiac Catheterization Without Mcc	21	16	—	—	$38,103.91	$231,020.37	$42,031.10	2025-12-05
B0603	HCPCS	Neurological M >=43.50 And M <52.50	3	3	—	—	$41,419.34	$42,637.56	$42,028.45	2025-12-05
B1703	HCPCS	Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=41.50 And M <50.50	3	3	—	—	$41,173.22	$42,384.20	$41,778.71	2025-12-05
D0205	HCPCS	Traumatic Brain Injury M <35.50	3	3	—	—	$41,169.05	$42,379.90	$41,774.47	2025-12-05
974	MS_DRG	HIV With Major Related Condition With Mcc	21	16	—	—	$29,198.78	$175,181.00	$41,752.11	2025-12-05
C9602	HCPCS	Hc Perc D-e Cor Stent Ather S	137	35	$68,873.40	$34,436.70 50% off	$778.87	$63,363.53	$41,427.35	2025-12-05
B0403	HCPCS	Traumatic Spinal Cord Injury M >=41.50 And M <47.50	3	3	—	—	$40,712.26	$41,909.68	$41,310.97	2025-12-05
L7180	HCPCS	Electronic Elbow Sequential	9	5	—	—	$39,992.59	$49,010.53	$41,168.84	2025-12-05
C9607	HCPCS	Hc Perc D-e Cor Revasc Chro Sing Ld	136	34	$68,873.40	$34,436.70 50% off	$778.87	$63,363.53	$41,081.87	2025-12-05
474	MS_DRG	Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc	21	16	—	—	$23,428.68	$249,499.52	$41,050.94	2025-12-05
C1805	HCPCS	Major Multiple Trauma With Brain Or Spinal Cord Injury M >=30.50 And M <40.50	3	3	—	—	$40,318.05	$41,503.88	$40,910.96	2025-12-05
C1903	HCPCS	Guillain-barré M >=38.50 And M <51.50	3	3	—	—	$40,270.08	$41,454.49	$40,862.29	2025-12-05
A0105	HCPCS	Stroke M <41.50 And A >=84.50	3	3	—	—	$40,255.47	$41,439.46	$40,847.47	2025-12-05
901	MS_DRG	Wound Debridements For Injuries With Mcc	21	16	—	—	$32,085.15	$246,811.51	$40,622.25	2025-12-05
L2006	HCPCS	Kaf Sng/dbl Swg/stn Mcpr Cus	9	5	—	—	$39,378.45	$48,257.90	$40,536.64	2025-12-05
C0305	HCPCS	Non-traumatic Brain Injury M <42.50 And A <78.50	3	3	—	—	$39,790.35	$40,960.66	$40,375.51	2025-12-05
319	MS_DRG	Other Endovascular Cardiac Valve Procedures With Mcc	21	16	—	—	$33,488.15	$244,941.75	$40,324.09	2025-12-05
B0703	HCPCS	Fracture Of Lower Extremity M >=41.50 And M <52.50	3	3	—	—	$39,736.12	$40,904.83	$40,320.47	2025-12-05
C1004	HCPCS	Amputation Lower Extremity M <47.50	3	3	—	—	$39,694.40	$40,861.88	$40,278.14	2025-12-05
A0405	HCPCS	Traumatic Spinal Cord Injury M >=31.50 And M <41.50	3	3	—	—	$39,652.68	$40,818.94	$40,235.81	2025-12-05
323	MS_DRG	Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc	21	16	—	—	$36,883.13	$238,325.79	$40,158.08	2025-12-05
B1603	HCPCS	Pain Syndrome M >=43.50 And M <58.50	3	3	—	—	$39,519.20	$40,681.53	$40,100.36	2025-12-05
D1705	HCPCS	Major Multiple Trauma Without Brain Or Spinal Cord Injury M <36.50	3	3	—	—	$39,369.02	$40,526.93	$39,947.98	2025-12-05
B0303	HCPCS	Non-traumatic Brain Injury M >=42.50 And M <52.50	3	3	—	—	$38,895.55	$40,039.53	$39,467.54	2025-12-05
C0604	HCPCS	Neurological M <43.50	3	3	—	—	$38,889.30	$40,033.10	$39,461.20	2025-12-05
A0205	HCPCS	Traumatic Brain Injury M <35.50	3	3	—	—	$38,759.98	$39,899.98	$39,329.98	2025-12-05
C1504	HCPCS	Pulmonary M <45.50	3	3	—	—	$38,503.43	$39,635.88	$39,069.66	2025-12-05
140	MS_DRG	Major Head And Neck Procedures With Mcc	21	16	—	—	$33,767.80	$236,828.00	$39,030.11	2025-12-05
12	MS_DRG	Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc	21	16	—	—	$35,712.84	$230,603.81	$38,883.89	2025-12-05
B1503	HCPCS	Pulmonary M >=45.50 And M <56.50	3	3	—	—	$38,307.36	$39,434.05	$38,870.71	2025-12-05
D1805	HCPCS	Major Multiple Trauma With Brain Or Spinal Cord Injury M >=30.50 And M <40.50	3	3	—	—	$38,276.07	$39,401.84	$38,838.95	2025-12-05
J1305	HCPCS	Evinacumab-dgnb 150 Mg/ml Intravenous Solution	220	34	$168,754.60	$84,377.30 50% off	$182.93	$155,254.23	$38,827.84	2025-12-05
31	MS_DRG	Ventricular Shunt Procedures With Mcc	21	16	—	—	$25,369.90	$234,913.60	$38,724.79	2025-12-05
271	MS_DRG	Other Major Cardiovascular Procedures With Cc	21	16	—	—	$32,822.85	$197,905.52	$38,722.46	2025-12-05
J9334	HCPCS	Efgartigimod Alfa 1008 Mg-hyaluron-qvfc 11,200 Unit/5.6 Ml Subcut Soln	135	35	$64,353.85	$32,176.93 50% off	$32.93	$59,205.54	$38,708.85	2025-12-05
B1803	HCPCS	Major Multiple Trauma With Brain Or Spinal Cord Injury M >=45.50 And M <55.50	3	3	—	—	$38,119.64	$39,240.81	$38,680.23	2025-12-05
B0503	HCPCS	Non-traumatic Spinal Cord Injury M >=48.50 And M <53.50	3	3	—	—	$38,088.36	$39,208.61	$38,648.48	2025-12-05
269	MS_DRG	Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc	21	16	—	—	$31,040.32	$233,430.69	$38,488.30	2025-12-05
33745	CPT	Hc Transcatheter Intracardiac Shunt Creation	134	35	$63,758.65	$31,879.33 50% off	$778.87	$58,657.96	$38,350.83	2025-12-05
958	MS_DRG	Other O.r. Procedures For Multiple Significant Trauma With Cc	21	16	—	—	$35,016.61	$230,906.18	$38,263.17	2025-12-05
D1903	HCPCS	Guillain-barré M >=38.50 And M <51.50	3	3	—	—	$37,577.34	$38,682.56	$38,129.95	2025-12-05
C0704	HCPCS	Fracture Of Lower Extremity M <41.50	3	3	—	—	$37,550.23	$38,654.65	$38,102.44	2025-12-05
B1003	HCPCS	Amputation Lower Extremity M >=47.50 And M <55.50	3	3	—	—	$37,489.74	$38,592.38	$38,041.06	2025-12-05
402	MS_DRG	Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical	21	16	—	—	$35,496.41	$221,106.24	$38,034.25	2025-12-05
B0903	HCPCS	Other Orthopedic M >=44.50 And M <51.50	3	3	—	—	$37,279.07	$38,375.52	$37,827.29	2025-12-05
423	MS_DRG	Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc	21	16	—	—	$30,690.77	$228,803.36	$37,750.35	2025-12-05
C2005	HCPCS	Miscellaneous M <46.50 And A <77.50	3	3	—	—	$37,005.83	$38,094.24	$37,550.04	2025-12-05
C0104	HCPCS	Stroke M >=41.50 And M <50.50	3	3	—	—	$36,964.13	$38,051.31	$37,507.72	2025-12-05
C1304	HCPCS	Rheumatoid Other Arthritis M <44.50 And A >=64.50	3	3	—	—	$36,932.83	$38,019.09	$37,475.96	2025-12-05
A1903	HCPCS	Guillain-barré M >=38.50 And M <51.50	3	3	—	—	$36,926.58	$38,012.66	$37,469.62	2025-12-05
229	MS_DRG	Other Cardiothoracic Procedures Without Mcc	21	16	—	—	$30,148.70	$181,137.36	$37,396.60	2025-12-05
56	MS_DRG	Degenerative Nervous System Disorders With Mcc	21	16	—	—	$25,385.69	$151,271.15	$37,378.27	2025-12-05
B2003	HCPCS	Miscellaneous M >=46.50 And M <55.50	3	3	—	—	$36,761.80	$37,843.03	$37,302.41	2025-12-05
904	MS_DRG	Skin Grafts For Injuries With Cc/mcc	21	16	—	—	$34,570.33	$218,571.92	$37,290.77	2025-12-05
C2102	HCPCS	Burns M <52.50	3	3	—	—	$36,732.60	$37,812.97	$37,272.78	2025-12-05
D2102	HCPCS	Burns M <52.50	3	3	—	—	$36,732.60	$37,812.97	$37,272.78	2025-12-05
D0305	HCPCS	Non-traumatic Brain Injury M <42.50 And A <78.50	3	3	—	—	$36,551.14	$37,626.17	$37,088.66	2025-12-05
739	MS_DRG	Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc…	21	16	—	—	$26,156.16	$224,513.47	$37,066.21	2025-12-05
B1403	HCPCS	Cardiac M >=45.50 And M <55.50	3	3	—	—	$36,526.11	$37,600.41	$37,063.26	2025-12-05
451	MS_DRG	Single Level Spinal Fusion Except Cervical Without Mcc	21	16	—	—	$29,988.12	$180,130.59	$36,902.83	2025-12-05
34	MS_DRG	Carotid Artery Stent Procedures With Mcc	21	16	—	—	$33,877.93	$219,940.81	$36,886.04	2025-12-05

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