|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
Q2057
|
HCPCS
|
Afamitresgene Autoleucel
|
9
|
5
|
—
|
—
|
$786,032.40
|
$963,275.00
|
$809,151.00
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
212
|
MS_DRG
|
Concomitant Aortic And Mitral Valve Procedures
|
21
|
16
|
—
|
—
|
$88,622.75
|
$567,365.70
|
$94,958.89
|
2025-12-05
|
|
B0407
|
LOCAL
|
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
|
|
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
|
|
790
|
MS_DRG
|
Extreme Immaturity Or Respiratory Distress Syndrome, Neonate
|
21
|
16
|
—
|
—
|
$52,599.38
|
$321,913.68
|
$82,016.67
|
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
|
|
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
|
LOCAL
|
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
|
LOCAL
|
Guillain-barré M <38.50
|
3
|
3
|
—
|
—
|
$76,303.95
|
$78,548.18
|
$77,426.06
|
2025-12-05
|
|
D0407
|
LOCAL
|
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
|
LOCAL
|
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
|
|
L8702
|
HCPCS
|
Ewhf S/d Uprt Micro Sensor
|
9
|
5
|
—
|
—
|
$68,801.71
|
$84,315.83
|
$70,825.29
|
2025-12-05
|
|
A0407
|
LOCAL
|
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
|
|
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
|
|
B0406
|
LOCAL
|
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
|
|
B0404
|
LOCAL
|
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
|
|
981
|
MS_DRG
|
Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc
|
21
|
16
|
—
|
—
|
$43,180.12
|
$262,850.65
|
$64,133.18
|
2025-12-05
|
|
B0505
|
LOCAL
|
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
|
|
270
|
MS_DRG
|
Other Major Cardiovascular Procedures With Mcc
|
21
|
16
|
—
|
—
|
$46,178.56
|
$281,652.18
|
$62,141.06
|
2025-12-05
|
|
B0106
|
LOCAL
|
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
|
|
A9543
|
HCPCS
|
Y90 Ibritumomab, Rx
|
9
|
5
|
—
|
—
|
$57,961.04
|
$71,030.69
|
$59,665.78
|
2025-12-05
|
|
C1904
|
LOCAL
|
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
|
|
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
|
LOCAL
|
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
|
LOCAL
|
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
|
LOCAL
|
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
|
|
D0406
|
LOCAL
|
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
|
LOCAL
|
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
|
LOCAL
|
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
|
LOCAL
|
Guillain-barré M <38.50
|
3
|
3
|
—
|
—
|
$54,739.11
|
$56,349.08
|
$55,544.09
|
2025-12-05
|
|
B1705
|
LOCAL
|
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
|
LOCAL
|
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
|
|
A1904
|
LOCAL
|
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
|
LOCAL
|
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
|
|
C0106
|
LOCAL
|
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
|
|
B1903
|
LOCAL
|
Guillain-barré M >=38.50 And M <51.50
|
3
|
3
|
—
|
—
|
$52,382.18
|
$53,922.83
|
$53,152.51
|
2025-12-05
|
|
B0604
|
LOCAL
|
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
|
|
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
|
LOCAL
|
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
|
LOCAL
|
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
|
LOCAL
|
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
|
LOCAL
|
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
|
LOCAL
|
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
|
LOCAL
|
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
|
LOCAL
|
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
|
LOCAL
|
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
|
LOCAL
|
Non-traumatic Spinal Cord Injury M <39.50
|
3
|
3
|
—
|
—
|
$48,944.82
|
$50,384.38
|
$49,664.60
|
2025-12-05
|
|
B0704
|
LOCAL
|
Fracture Of Lower Extremity M <41.50
|
3
|
3
|
—
|
—
|
$48,542.27
|
$49,969.98
|
$49,256.13
|
2025-12-05
|
|
B2102
|
LOCAL
|
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
|
LOCAL
|
Stroke M <41.50 And A <84.50
|
3
|
3
|
—
|
—
|
$48,043.76
|
$49,456.82
|
$48,750.29
|
2025-12-05
|
|
B1004
|
LOCAL
|
Amputation Lower Extremity M <47.50
|
3
|
3
|
—
|
—
|
$47,995.79
|
$49,407.44
|
$48,701.61
|
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
|
LOCAL
|
Pulmonary M <45.50
|
3
|
3
|
—
|
—
|
$47,438.89
|
$48,834.16
|
$48,136.53
|
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
|
LOCAL
|
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
|
LOCAL
|
Miscellaneous M <46.50 And A <77.50
|
3
|
3
|
—
|
—
|
$46,329.26
|
$47,691.88
|
$47,010.57
|
2025-12-05
|
|
D0505
|
LOCAL
|
Non-traumatic Spinal Cord Injury M <39.50
|
3
|
3
|
—
|
—
|
$46,239.57
|
$47,599.56
|
$46,919.56
|
2025-12-05
|
|
C0105
|
LOCAL
|
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
|
LOCAL
|
Stroke M <41.50 And A <84.50
|
3
|
3
|
—
|
—
|
$45,784.87
|
$47,131.49
|
$46,458.18
|
2025-12-05
|
|
B1204
|
LOCAL
|
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
|
LOCAL
|
Traumatic Brain Injury M <35.50
|
3
|
3
|
—
|
—
|
$45,326.00
|
$46,659.11
|
$45,992.55
|
2025-12-05
|
|
B0504
|
LOCAL
|
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
|
|
B0304
|
LOCAL
|
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
|
|
C0405
|
LOCAL
|
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
|
LOCAL
|
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
|
|
B0904
|
LOCAL
|
Other Orthopedic M <44.5
|
3
|
3
|
—
|
—
|
$44,668.98
|
$45,982.78
|
$45,325.88
|
2025-12-05
|
|
B1304
|
LOCAL
|
Rheumatoid Other Arthritis M <44.50 And A >=64.50
|
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
|
|
B2004
|
LOCAL
|
Miscellaneous M <46.50 And A >=77.50
|
3
|
3
|
—
|
—
|
$43,953.55
|
$45,246.31
|
$44,599.93
|
2025-12-05
|
|
D0405
|
LOCAL
|
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
|
LOCAL
|
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
|
LOCAL
|
Replacement Of Lower-extremity Joint M <42.50
|
3
|
3
|
—
|
—
|
$42,994.10
|
$44,258.63
|
$43,626.37
|
2025-12-05
|
|
B0204
|
LOCAL
|
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
|
LOCAL
|
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
|
LOCAL
|
Stroke M >=41.50 And M <50.50
|
3
|
3
|
—
|
—
|
$42,622.83
|
$43,876.44
|
$43,249.64
|
2025-12-05
|
|
A0505
|
LOCAL
|
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
|
LOCAL
|
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
|
LOCAL
|
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
|
LOCAL
|
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
|
LOCAL
|
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
|
|
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
|
LOCAL
|
Neurological M >=43.50 And M <52.50
|
3
|
3
|
—
|
—
|
$41,419.34
|
$42,637.56
|
$42,028.45
|
2025-12-05
|
|
B1703
|
LOCAL
|
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
|
LOCAL
|
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
|
|
B0403
|
LOCAL
|
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
|
|
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
|
LOCAL
|
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
|
LOCAL
|
Guillain-barré M >=38.50 And M <51.50
|
3
|
3
|
—
|
—
|
$40,270.08
|
$41,454.49
|
$40,862.29
|
2025-12-05
|
|
A0105
|
LOCAL
|
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
|
LOCAL
|
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
|
LOCAL
|
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
|
LOCAL
|
Amputation Lower Extremity M <47.50
|
3
|
3
|
—
|
—
|
$39,694.40
|
$40,861.88
|
$40,278.14
|
2025-12-05
|
|
A0405
|
LOCAL
|
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
|
LOCAL
|
Pain Syndrome M >=43.50 And M <58.50
|
3
|
3
|
—
|
—
|
$39,519.20
|
$40,681.53
|
$40,100.36
|
2025-12-05
|
|
D1705
|
LOCAL
|
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
|
LOCAL
|
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
|
LOCAL
|
Neurological M <43.50
|
3
|
3
|
—
|
—
|
$38,889.30
|
$40,033.10
|
$39,461.20
|
2025-12-05
|
|
A0205
|
LOCAL
|
Traumatic Brain Injury M <35.50
|
3
|
3
|
—
|
—
|
$38,759.98
|
$39,899.98
|
$39,329.98
|
2025-12-05
|
|
C1504
|
LOCAL
|
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
|
LOCAL
|
Pulmonary M >=45.50 And M <56.50
|
3
|
3
|
—
|
—
|
$38,307.36
|
$39,434.05
|
$38,870.71
|
2025-12-05
|
|
D1805
|
LOCAL
|
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
|
|
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
|
|
B1803
|
LOCAL
|
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
|
LOCAL
|
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
|
|
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
|
LOCAL
|
Guillain-barré M >=38.50 And M <51.50
|
3
|
3
|
—
|
—
|
$37,577.34
|
$38,682.56
|
$38,129.95
|
2025-12-05
|
|
C0704
|
LOCAL
|
Fracture Of Lower Extremity M <41.50
|
3
|
3
|
—
|
—
|
$37,550.23
|
$38,654.65
|
$38,102.44
|
2025-12-05
|
|
B1003
|
LOCAL
|
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
|
|
A5102
|
LOCAL
|
Expired, Orthopedic, Length Of Stay Is 14 Days Or More
|
3
|
3
|
—
|
—
|
$37,389.62
|
$38,489.31
|
$37,939.47
|
2025-12-05
|
|
B0903
|
LOCAL
|
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
|
LOCAL
|
Miscellaneous M <46.50 And A <77.50
|
3
|
3
|
—
|
—
|
$37,005.83
|
$38,094.24
|
$37,550.04
|
2025-12-05
|
|
C0104
|
LOCAL
|
Stroke M >=41.50 And M <50.50
|
3
|
3
|
—
|
—
|
$36,964.13
|
$38,051.31
|
$37,507.72
|
2025-12-05
|
|
C1304
|
LOCAL
|
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
|
LOCAL
|
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
|
LOCAL
|
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
|
LOCAL
|
Burns M <52.50
|
3
|
3
|
—
|
—
|
$36,732.60
|
$37,812.97
|
$37,272.78
|
2025-12-05
|
|
D2102
|
LOCAL
|
Burns M <52.50
|
3
|
3
|
—
|
—
|
$36,732.60
|
$37,812.97
|
$37,272.78
|
2025-12-05
|
|
D0305
|
LOCAL
|
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
|
LOCAL
|
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
|