Hospital

SOUTHWEST GENERAL HEALTH CENTER

Middleburg Heights, OH · CCN 360155 · Rates published

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You selected 27447 (HCPCS)

ARTHROPLASTY, KNEE/CONDYLE/PLATEAU; MEDI

This hospital’s price: $12,162 across 8 payers · range $11,363-$31,579

Source: https://southwestgeneral.pt.panaceainc.com/MRFDownload/southwestgeneral/southwestgeneral · observed 2026-07-01

This is the facility’s filed rate for this code. The comparison board’s estimate also adds the surgeon and anesthesia fees, so it is usually higher.

23,993 distinct procedures filed

40 distinct payers

779,461 rate rows

2026-07-01 last MRF observed

Data quality

407,282 of 779,461 rate rows are consumer-grade (52.3%)

372,179 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
no usable negotiated amount (only an out-of-band fallback) — excluded from medians	307,866
professional (physician) fee — not the facility price	36,986
per-diem day rate — not a per-procedure price	26,628
placeholder amount (≤ $0.02) — excluded from medians	317
exceeds 10× this hospital's gross charge — excluded from medians	265
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians	112
percent-of-charges filed in the dollar field — excluded from medians	5

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

Source MRF file	https://southwestgeneral.pt.panaceainc.com/MRFDownload/southwestgeneral/southwestgeneral
Found on page	https://www.swgeneral.com/financial-tools/price-transparency/
Discovered via	Discovered by HANK
Last fetch	not_modified · 2026-08-17
Content fingerprint	ca4619b9f888bcff… · 451,826,550 bytes · first seen 2026-07-31

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
J1411 HCPCS	Inj, Hemgenix, Per Tx Dose	12	$1,579,347.00	$4,958,415.00	$3,672,900.00	nat. median $3,710,000 1.0× median
J1414 HCPCS	Inj, Beqvez, Per Tx Dose	12	$1,550,150.00	$4,866,750.00	$3,605,000.00	nat. median $3,710,000 1.0× median
J1413 HCPCS	Inj Delandistrogene Mox Rokl	12	$1,429,945.55	$4,489,363.93	$3,325,454.76	nat. median $3,324,572 1.0× median
J3394 HCPCS	Inj, Lovotibeglogene Autotem	12	$1,412,980.00	$4,436,100.00	$3,286,000.00	nat. median $3,286,000 1.0× median
J3393 HCPCS	Inj, Betibeglogene Autotemce	12	$1,276,240.00	$4,006,800.00	$2,968,000.00	nat. median $2,997,086 1.0× median
J3399 HCPCS	Inj Onase Abepar-xioi Treat	14	$1,027,104.12	$4,967,207.52	$2,388,614.23	nat. median $2,460,273 1.0× median
J3392 HCPCS	Inj, Exagamglogene Autotem	14	$1,002,760.00	$4,477,440.00	$2,332,000.00	nat. median $2,405,851 1.0× median
Q2057 HCPCS	Afamitresgene Autoleucel	1	$1,479,590.40	$1,479,590.40	$1,479,590.40	nat. median $809,151 1.8× median
Q2058 HCPCS	Obecbtge Autol Up To 400 Mil	1	$534,240.00	$534,240.00	$534,240.00	nat. median $302,242 1.8× median
Q2042 HCPCS	Tisagenlecleucel Car-pos T	14	$227,552.93	$1,179,227.14	$529,192.86	nat. median $691,418 0.8× median
Q2056 HCPCS	Ciltacabtagene Car-pos T	14	$226,663.07	$1,129,910.02	$527,123.43	nat. median $631,793 0.8× median
Q2055 HCPCS	Idecabtagene Vicleucel Car	14	$226,432.66	$1,074,779.67	$526,587.59	nat. median $610,161 0.9× median
Q2054 HCPCS	Lisocabtagene Mara Car Pos T	14	$222,192.21	$1,079,540.79	$516,726.08	nat. median $624,417 0.8× median
J3403 HCPCS	Revakinagene, Per Implant	1	$503,488.84	$503,488.84	$503,488.84	nat. median $265,000 1.9× median
Q2041 HCPCS	Axicabtagene Ciloleucel Car+	14	$210,466.06	$1,021,150.29	$489,455.96	nat. median $588,565 0.8× median
Q2053 HCPCS	Brexucabtagene Car Pos T	14	$198,028.07	$939,437.95	$460,530.40	nat. median $577,541 0.8× median
90288 HCPCS	Botulism Ig IV	1	$420,747.88	$420,747.88	$420,747.88	nat. median $52,716 outlier · 8.0×
J3402 HCPCS	Inj. Remestemcel-l-rknd/ Td	1	$389,210.07	$389,210.07	$389,210.07	nat. median $209,736 1.9× median
Q0480 HCPCS	Driver Pneumatic Vad, Rep	1	$333,814.30	$333,814.30	$333,814.30	nat. median $111,503 outlier · 3.0×
18 MS_DRG	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	27	$108,221.06	$615,484.45	$292,489.36	nat. median $370,165 0.8× median
K1007 HCPCS	Bil Hkaf Pc S/d Micro Sensor	1	$286,193.90	$286,193.90	$286,193.90	nat. median $97,404 outlier · 2.9×
J3404 HCPCS	Inj Zopapogene Per Ther Dose	1	$234,048.00	$234,048.00	$234,048.00	nat. median $121,900 1.9× median
L8702 HCPCS	Ewhf S/d Uprt Micro Sensor	1	$207,093.15	$207,093.15	$207,093.15	nat. median $70,178 outlier · 3.0×
1 MS_DRG	Heart Transplant Or Implant Of Heart Assist System With Mcc	27	$70,232.48	$399,424.65	$189,817.50	nat. median $261,939 0.7× median
L7181 HCPCS	Electronic Elbo Simultaneous	1	$148,507.92	$148,507.92	$148,507.92	nat. median $50,449 outlier · 2.9×
J7310 HCPCS	Ganciclovir Long Act Implant	1	$146,512.35	$146,512.35	$146,512.35	nat. median $18,387 outlier · 8.0×
927 MS_DRG	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	27	$53,508.77	$304,308.68	$144,618.29	nat. median $205,166 0.7× median
L7180 HCPCS	Electronic Elbow Sequential	1	$144,239.17	$144,239.17	$144,239.17	nat. median $46,980 outlier · 3.1×
3 MS_DRG	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…	27	$53,194.76	$302,522.78	$143,769.63	nat. median $199,832 0.7× median
J9183 HCPCS	Gemcitabine Intravesical Sys	1	$140,329.46	$140,329.46	$140,329.46	nat. median $75,281 1.9× median
L2006 HCPCS	Kaf Sng/dbl Swg/stn Mcpr Cus	1	$119,009.05	$119,009.05	$119,009.05	nat. median $39,921 outlier · 3.0×
L8701 HCPCS	Ewh S/d Uprt Micro Sensor	1	$105,260.09	$105,260.09	$105,260.09	nat. median $35,670 outlier · 3.0×
4 MS_DRG	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…	27	$34,715.83	$197,424.00	$93,826.58	nat. median $132,706 0.7× median
L5856 HCPCS	Elec Knee-shin Swing/stance	1	$88,974.94	$88,974.94	$88,974.94	nat. median $30,017 outlier · 3.0×
L6700 HCPCS	Ue Add Ext Power Myoel	1	$88,825.67	$88,825.67	$88,825.67	nat. median $30,378 outlier · 2.9×
L6880 HCPCS	Elec Hand Ind Art Digits	1	$88,554.83	$88,554.83	$88,554.83	nat. median $30,016 outlier · 3.0×
7 MS_DRG	Lung Transplant	27	$32,457.40	$184,579.20	$87,722.71	nat. median $122,690 0.7× median
E2510NU OTHER	Sgd W Multi Methods Msg/accs	1	$81,692.39	$81,692.39	$81,692.39	nat. median $9,457 outlier · 8.6×
S2095 HCPCS	Transcath Emboliz Microspher	1	$81,512.03	$81,512.03	$81,512.03	nat. median $3,399 outlier · 24.0×
14 MS_DRG	Allogeneic Bone Marrow Transplant	27	$30,121.04	$171,291.13	$81,408.21	nat. median $114,305 0.7× median
64654 HCPCS	1st Opn Implt Bat Modulj Sys	1	$80,009.02	$80,009.02	$80,009.02	nat. median $44,598 1.8× median
2 MS_DRG	Heart Transplant Or Implant Of Heart Assist System Without Mcc	27	$28,401.65	$161,512.15	$76,761.22	nat. median $108,240 0.7× median
209 MS_DRG	Complex Aortic Arch Procedures	17	$28,369.07	$122,677.07	$76,673.17	nat. median $96,134 0.8× median
426 MS_DRG	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	17	$27,623.28	$119,452.03	$74,657.52	nat. median $96,835 0.8× median
212 MS_DRG	Concomitant Aortic And Mitral Valve Procedures	27	$27,254.64	$154,988.55	$73,661.20	nat. median $100,978 0.7× median
L8614 HCPCS	Cochlear Device	1	$72,570.53	$72,570.53	$72,570.53	nat. median $22,570 outlier · 3.2×
J9216 HCPCS	Interferon Gamma 1-b Inj	1	$71,743.89	$71,743.89	$71,743.89	nat. median $9,498 outlier · 7.6×
5 MS_DRG	Liver Transplant With Mcc Or Intestinal Transplant	27	$25,842.25	$146,955.56	$69,843.92	nat. median $99,646 0.7× median
Q0483 HCPCS	Monitor Elec Vad, Rep	1	$69,492.83	$69,492.83	$69,492.83	nat. median $23,335 outlier · 3.0×
L5858 HCPCS	Stance Phase Only	1	$68,884.00	$68,884.00	$68,884.00	nat. median $23,235 outlier · 3.0×

Other procedures at this hospital

Browse this hospital's 23,993 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

J1411	HCPCS	Inj, Hemgenix, Per Tx Dose	16	12	—	—	$1,579,347.00	$4,958,415.00	$3,672,900.00	2026-07-01
J1414	HCPCS	Inj, Beqvez, Per Tx Dose	16	12	—	—	$1,550,150.00	$4,866,750.00	$3,605,000.00	2026-07-01
J1413	HCPCS	Inj Delandistrogene Mox Rokl	16	12	—	—	$1,429,945.55	$4,489,363.93	$3,325,454.76	2026-07-01
J3394	HCPCS	Inj, Lovotibeglogene Autotem	16	12	—	—	$1,412,980.00	$4,436,100.00	$3,286,000.00	2026-07-01
J3393	HCPCS	Inj, Betibeglogene Autotemce	16	12	—	—	$1,276,240.00	$4,006,800.00	$2,968,000.00	2026-07-01
J3399	HCPCS	Inj Onase Abepar-xioi Treat	18	14	—	—	$1,027,104.12	$4,967,207.52	$2,388,614.23	2026-07-01
J3392	HCPCS	Inj, Exagamglogene Autotem	18	14	—	—	$1,002,760.00	$4,477,440.00	$2,332,000.00	2026-07-01
Q2057	HCPCS	Afamitresgene Autoleucel	1	1	—	—	$1,479,590.40	$1,479,590.40	$1,479,590.40	2026-07-01
Q2058	HCPCS	Obecbtge Autol Up To 400 Mil	1	1	—	—	$534,240.00	$534,240.00	$534,240.00	2026-07-01
Q2042	HCPCS	Tisagenlecleucel Car-pos T	18	14	—	—	$227,552.93	$1,179,227.14	$529,192.86	2026-07-01
Q2056	HCPCS	Ciltacabtagene Car-pos T	18	14	—	—	$226,663.07	$1,129,910.02	$527,123.43	2026-07-01
Q2055	HCPCS	Idecabtagene Vicleucel Car	18	14	—	—	$226,432.66	$1,074,779.67	$526,587.59	2026-07-01
Q2054	HCPCS	Lisocabtagene Mara Car Pos T	18	14	—	—	$222,192.21	$1,079,540.79	$516,726.08	2026-07-01
J3403	HCPCS	Revakinagene, Per Implant	1	1	—	—	$503,488.84	$503,488.84	$503,488.84	2026-07-01
Q2041	HCPCS	Axicabtagene Ciloleucel Car+	18	14	—	—	$210,466.06	$1,021,150.29	$489,455.96	2026-07-01
Q2053	HCPCS	Brexucabtagene Car Pos T	18	14	—	—	$198,028.07	$939,437.95	$460,530.40	2026-07-01
90288	HCPCS	Botulism Ig IV	1	1	—	—	$420,747.88	$420,747.88	$420,747.88	2026-07-01
J3402	HCPCS	Inj. Remestemcel-l-rknd/ Td	1	1	—	—	$389,210.07	$389,210.07	$389,210.07	2026-07-01
Q0480	HCPCS	Driver Pneumatic Vad, Rep	1	1	—	—	$333,814.30	$333,814.30	$333,814.30	2026-07-01
18	MS_DRG	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	33	27	—	—	$108,221.06	$615,484.45	$292,489.36	2026-07-01
K1007	HCPCS	Bil Hkaf Pc S/d Micro Sensor	1	1	—	—	$286,193.90	$286,193.90	$286,193.90	2026-07-01
J3404	HCPCS	Inj Zopapogene Per Ther Dose	1	1	—	—	$234,048.00	$234,048.00	$234,048.00	2026-07-01
L8702	HCPCS	Ewhf S/d Uprt Micro Sensor	1	1	—	—	$207,093.15	$207,093.15	$207,093.15	2026-07-01
1	MS_DRG	Heart Transplant Or Implant Of Heart Assist System With Mcc	33	27	—	—	$70,232.48	$399,424.65	$189,817.50	2026-07-01
L7181	HCPCS	Electronic Elbo Simultaneous	1	1	—	—	$148,507.92	$148,507.92	$148,507.92	2026-07-01
J7310	HCPCS	Ganciclovir Long Act Implant	1	1	—	—	$146,512.35	$146,512.35	$146,512.35	2026-07-01
927	MS_DRG	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	33	27	—	—	$53,508.77	$304,308.68	$144,618.29	2026-07-01
L7180	HCPCS	Electronic Elbow Sequential	1	1	—	—	$144,239.17	$144,239.17	$144,239.17	2026-07-01
3	MS_DRG	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…	33	27	—	—	$53,194.76	$302,522.78	$143,769.63	2026-07-01
J9183	HCPCS	Gemcitabine Intravesical Sys	1	1	—	—	$140,329.46	$140,329.46	$140,329.46	2026-07-01
L2006	HCPCS	Kaf Sng/dbl Swg/stn Mcpr Cus	1	1	—	—	$119,009.05	$119,009.05	$119,009.05	2026-07-01
L8701	HCPCS	Ewh S/d Uprt Micro Sensor	1	1	—	—	$105,260.09	$105,260.09	$105,260.09	2026-07-01
4	MS_DRG	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…	33	27	—	—	$34,715.83	$197,424.00	$93,826.58	2026-07-01
L5856	HCPCS	Elec Knee-shin Swing/stance	1	1	—	—	$88,974.94	$88,974.94	$88,974.94	2026-07-01
L6700	HCPCS	Ue Add Ext Power Myoel	1	1	—	—	$88,825.67	$88,825.67	$88,825.67	2026-07-01
L6880	HCPCS	Elec Hand Ind Art Digits	1	1	—	—	$88,554.83	$88,554.83	$88,554.83	2026-07-01
7	MS_DRG	Lung Transplant	33	27	—	—	$32,457.40	$184,579.20	$87,722.71	2026-07-01
E2510NU	OTHER	Sgd W Multi Methods Msg/accs	1	1	—	—	$81,692.39	$81,692.39	$81,692.39	2026-07-01
S2095	HCPCS	Transcath Emboliz Microspher	1	1	—	—	$81,512.03	$81,512.03	$81,512.03	2026-07-01
14	MS_DRG	Allogeneic Bone Marrow Transplant	33	27	—	—	$30,121.04	$171,291.13	$81,408.21	2026-07-01
64654	HCPCS	1st Opn Implt Bat Modulj Sys	1	1	—	—	$80,009.02	$80,009.02	$80,009.02	2026-07-01
2	MS_DRG	Heart Transplant Or Implant Of Heart Assist System Without Mcc	33	27	—	—	$28,401.65	$161,512.15	$76,761.22	2026-07-01
209	MS_DRG	Complex Aortic Arch Procedures	18	17	—	—	$28,369.07	$122,677.07	$76,673.17	2026-07-01
426	MS_DRG	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	18	17	—	—	$27,623.28	$119,452.03	$74,657.52	2026-07-01
212	MS_DRG	Concomitant Aortic And Mitral Valve Procedures	33	27	—	—	$27,254.64	$154,988.55	$73,661.20	2026-07-01
L8614	HCPCS	Cochlear Device	1	1	—	—	$72,570.53	$72,570.53	$72,570.53	2026-07-01
J9216	HCPCS	Interferon Gamma 1-b Inj	1	1	—	—	$71,743.89	$71,743.89	$71,743.89	2026-07-01
5	MS_DRG	Liver Transplant With Mcc Or Intestinal Transplant	33	27	—	—	$25,842.25	$146,955.56	$69,843.92	2026-07-01
Q0483	HCPCS	Monitor Elec Vad, Rep	1	1	—	—	$69,492.83	$69,492.83	$69,492.83	2026-07-01
L5858	HCPCS	Stance Phase Only	1	1	—	—	$68,884.00	$68,884.00	$68,884.00	2026-07-01
215	MS_DRG	Other Heart Assist System Implant	33	27	—	—	$24,956.37	$141,917.12	$67,449.65	2026-07-01
216	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	33	27	—	—	$24,519.82	$139,434.25	$66,269.78	2026-07-01
L6975	HCPCS	Interscap-thor Myoelectronic	1	1	—	—	$65,720.97	$65,720.97	$65,720.97	2026-07-01
L5973	HCPCS	Ank-foot Sys Dors-plant Flex	1	1	—	—	$65,435.96	$65,435.96	$65,435.96	2026-07-01
J9029	HCPCS	Instill Adstiladrin, Tx Dose	18	14	—	—	$27,242.55	$123,422.00	$63,354.77	2026-07-01
E0652NU	OTHER	Pneum Compres W/cal Pressure	1	1	—	—	$63,241.94	$63,241.94	$63,241.94	2026-07-01
0870T	OTHER	Imp Subq Prtl Ascts Pmp Sys	1	1	—	—	$62,229.43	$62,229.43	$62,229.43	2026-07-01
E2510UE	OTHER	Sgd W Multi Methods Msg/accs	1	1	—	—	$61,269.12	$61,269.12	$61,269.12	2026-07-01
429	MS_DRG	Combined Anterior And Posterior Cervical Spinal Fusion With Mcc	18	17	—	—	$22,582.16	$97,652.59	$61,032.87	2026-07-01
Q0489	HCPCS	Pwr Pck Base Combo Vad, Rep	1	1	—	—	$60,246.53	$60,246.53	$60,246.53	2026-07-01
L6970	HCPCS	Interscapular-thor Switch CT	1	1	—	—	$59,625.15	$59,625.15	$59,625.15	2026-07-01
850	MS_DRG	Acute Leukemia With Other Procedures	18	17	—	—	$21,704.80	$93,858.61	$58,661.63	2026-07-01
231	MS_DRG	Coronary Bypass With Ptca With Mcc	33	27	—	—	$21,129.42	$120,151.36	$57,106.53	2026-07-01
456	MS_DRG	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	33	27	—	—	$21,063.01	$119,773.66	$56,927.05	2026-07-01
C8007	HCPCS	Opn Mplnt Hpgls Ns Ary Ps Gn	1	1	—	—	$56,052.02	$56,052.02	$56,052.02	2026-07-01
0908T	OTHER	Opn Imp Int Nstm Sys Vgs Nrv	1	1	—	—	$56,052.02	$56,052.02	$56,052.02	2026-07-01
64656	HCPCS	Revj/rplcmt Bat Mod Sys Pg	1	1	—	—	$56,052.02	$56,052.02	$56,052.02	2026-07-01
0909T	OTHER	Rplcmt Int Nstim Sys Vgs Nrv	1	1	—	—	$56,052.02	$56,052.02	$56,052.02	2026-07-01
C8011	HCPCS	Opn Mplnt Hpgls Ns Ary Rec	1	1	—	—	$56,052.02	$56,052.02	$56,052.02	2026-07-01
L6965	HCPCS	Shldr Disartic Myoelectronic	1	1	—	—	$55,704.17	$55,704.17	$55,704.17	2026-07-01
L8687	HCPCS	Implt Nrostm Pls Gen Dua Rec	1	1	—	—	$55,449.80	$55,449.80	$55,449.80	2026-07-01
Q2043	HCPCS	Sipuleucel-t Auto Cd54+	18	14	—	—	$23,656.55	$108,036.84	$55,015.23	2026-07-01
38240	HCPCS	Transplt Allo Hct/donor	18	14	—	—	$23,575.74	$114,257.87	$54,827.31	2026-07-01
Q0481	HCPCS	Microprcsr Cu Elec Vad, Rep	1	1	—	—	$53,857.18	$53,857.18	$53,857.18	2026-07-01
L5859	HCPCS	Knee-shin Pro Flex/ext Cont	1	1	—	—	$53,777.08	$53,777.08	$53,777.08	2026-07-01
E0694NU	OTHER	Uvl Md Cabinet Sys 6 Ft	1	1	—	—	$53,437.79	$53,437.79	$53,437.79	2026-07-01
20	MS_DRG	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc	33	27	—	—	$19,723.29	$112,154.01	$53,306.18	2026-07-01
219	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	33	27	—	—	$19,245.89	$109,438.81	$52,015.92	2026-07-01
233	MS_DRG	Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc	33	27	—	—	$19,162.94	$108,967.04	$51,791.73	2026-07-01
957	MS_DRG	Other O.r. Procedures For Multiple Significant Trauma With Mcc	33	27	—	—	$19,099.54	$108,606.43	$51,620.37	2026-07-01
Q0224	HCPCS	Inj, Pemivibart, 4500 Mg	1	1	—	—	$50,887.63	$50,887.63	$50,887.63	2026-07-01
1013T	OTHER	Lap Srg Imp/rpl Eso Nea&pg/r	1	1	—	—	$50,735.13	$50,735.13	$50,735.13	2026-07-01
E0766	HCPCS	Elec Stim Cancer Treatment	1	1	—	—	$49,318.04	$49,318.04	$49,318.04	2026-07-01
0956T	OTHER	Prt Crn Ch Cr&tun Elt S-sclp	1	1	—	—	$49,288.08	$49,288.08	$49,288.08	2026-07-01
0960T	OTHER	Rpl S-sclp Eltr Ra Rcvr&tlmt	1	1	—	—	$49,288.08	$49,288.08	$49,288.08	2026-07-01
427	MS_DRG	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	18	17	—	—	$18,093.87	$78,243.76	$48,902.35	2026-07-01
0871T	OTHER	Rplcmt Subq Prtl Ascites Pmp	1	1	—	—	$48,894.74	$48,894.74	$48,894.74	2026-07-01
10	MS_DRG	Pancreas Transplant	33	27	—	—	$17,986.36	$102,275.25	$48,611.79	2026-07-01
928	MS_DRG	Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc	33	27	—	—	$17,978.84	$102,232.49	$48,591.47	2026-07-01
19	MS_DRG	Simultaneous Pancreas And Kidney Transplant With Hemodialysis	33	27	—	—	$17,883.36	$101,689.45	$48,333.41	2026-07-01
275	MS_DRG	Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc	33	27	—	—	$17,872.84	$101,629.59	$48,304.97	2026-07-01
E0652UE	OTHER	Pneum Compres W/cal Pressure	1	1	—	—	$47,431.55	$47,431.55	$47,431.55	2026-07-01
L6960	HCPCS	Shldr Disartic Switch Contro	1	1	—	—	$47,021.44	$47,021.44	$47,021.44	2026-07-01
870	MS_DRG	Septicemia Or Severe Sepsis With Mv >96 Hours	33	27	—	—	$17,325.02	$98,513.89	$46,824.38	2026-07-01
S4021	HCPCS	Ivf Canc Aftr Aspr Case Rate	1	1	—	—	$46,741.42	$46,741.42	$46,741.42	2026-07-01
268	MS_DRG	Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc	33	27	—	—	$17,240.07	$98,030.71	$46,594.78	2026-07-01
955	MS_DRG	Craniotomy For Multiple Significant Trauma	33	27	—	—	$16,872.18	$95,938.37	$45,600.49	2026-07-01
J9226	HCPCS	Supprelin La Implant	18	14	—	—	$19,500.59	$79,052.97	$45,350.22	2026-07-01
317	MS_DRG	Concomitant Left Atrial Appendage Closure And Cardiac Ablation	18	17	—	—	$16,760.41	$72,477.46	$45,298.41	2026-07-01
447	MS_DRG	Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall…	18	17	—	—	$16,748.14	$72,424.37	$45,265.23	2026-07-01
L6955	HCPCS	Above Elbow Myoelectronic CT	1	1	—	—	$44,698.80	$44,698.80	$44,698.80	2026-07-01
217	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	33	27	—	—	$16,481.74	$93,717.75	$44,545.25	2026-07-01
218	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	33	27	—	—	$16,481.74	$93,717.75	$44,545.25	2026-07-01
Q0479	HCPCS	Power Module Combo Vad, Rep	1	1	—	—	$44,490.48	$44,490.48	$44,490.48	2026-07-01
573	MS_DRG	Skin Graft For Skin Ulcer Or Cellulitis With Mcc	33	27	—	—	$16,421.85	$93,377.10	$44,383.38	2026-07-01
207	MS_DRG	Respiratory System Diagnosis With Ventilator Support >96 Hours	33	27	—	—	$16,129.40	$91,713.78	$43,592.96	2026-07-01
E2508NU	OTHER	Sgd Spelling Phys Contact	1	1	—	—	$43,169.39	$43,169.39	$43,169.39	2026-07-01
L6945	HCPCS	Elbow Disart Myoelectronic C	1	1	—	—	$43,080.63	$43,080.63	$43,080.63	2026-07-01
S4015	HCPCS	Complete Ivf Nos Case Rate	1	1	—	—	$42,573.56	$42,573.56	$42,573.56	2026-07-01
33276	HCPCS	Insj Phrnc Nrv Stim Sys	18	14	—	—	$17,938.42	$80,009.02	$41,717.26	2026-07-01
0266T	OTHER	Implt/rpl Crtd Sns Dev Total	17	13	—	—	$17,938.42	$70,919.35	$41,717.26	2026-07-01
J9219	HCPCS	Leuprolide Acetate Implant	1	1	—	—	$41,636.97	$41,636.97	$41,636.97	2026-07-01
266	MS_DRG	Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc	33	27	—	—	$15,361.80	$87,348.09	$41,518.38	2026-07-01
969	MS_DRG	HIV With Extensive O.r. Procedures With Mcc	33	27	—	—	$15,344.01	$87,246.89	$41,470.29	2026-07-01
L7191	HCPCS	Elbow Child Myoelectronic CT	1	1	—	—	$41,447.01	$41,447.01	$41,447.01	2026-07-01
L8044KM	OTHER	Hemi-facial Prosthesis	1	1	—	—	$41,243.41	$41,243.41	$41,243.41	2026-07-01
232	MS_DRG	Coronary Bypass With Ptca Without Mcc	33	27	—	—	$15,196.90	$86,410.24	$41,072.71	2026-07-01
28	MS_DRG	Spinal Procedures With Mcc	33	27	—	—	$15,060.83	$85,636.30	$40,704.94	2026-07-01
276	MS_DRG	Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator	33	27	—	—	$15,056.57	$85,612.07	$40,693.42	2026-07-01
457	MS_DRG	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	33	27	—	—	$14,947.56	$84,992.06	$40,398.80	2026-07-01
790	MS_DRG	Extreme Immaturity Or Respiratory Distress Syndrome, Neonate	26	23	—	—	$14,898.44	$84,118.36	$40,266.05	2026-07-01
16	MS_DRG	Autologous Bone Marrow Transplant With Cc/mcc	33	27	—	—	$14,863.85	$84,516.01	$40,172.58	2026-07-01
E0694UE	OTHER	Uvl Md Cabinet Sys 6 Ft	1	1	—	—	$40,078.63	$40,078.63	$40,078.63	2026-07-01
235	MS_DRG	Coronary Bypass Without Cardiac Catheterization With Mcc	33	27	—	—	$14,710.73	$83,645.16	$39,758.74	2026-07-01
820	MS_DRG	Lymphoma And Leukemia With Major O.r. Procedures With Mcc	33	27	—	—	$14,701.21	$83,590.99	$39,733.01	2026-07-01
L7186	HCPCS	Electron Elbow Child Switch	1	1	—	—	$39,404.24	$39,404.24	$39,404.24	2026-07-01
430	MS_DRG	Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc	18	17	—	—	$14,456.37	$62,514.05	$39,071.28	2026-07-01
23	MS_DRG	Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…	33	27	—	—	$14,364.15	$81,673.97	$38,822.03	2026-07-01
213	MS_DRG	Endovascular Abdominal Aorta With Iliac Branch Procedures	18	17	—	—	$14,305.51	$61,861.66	$38,663.54	2026-07-01
L6940	HCPCS	Elbow Disarticulation Switch	1	1	—	—	$38,615.53	$38,615.53	$38,615.53	2026-07-01
463	MS_DRG	Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …	33	27	—	—	$14,286.97	$81,234.97	$38,613.42	2026-07-01
L6950	HCPCS	Above Elbow Switch Control	1	1	—	—	$38,543.89	$38,543.89	$38,543.89	2026-07-01
S0317	HCPCS	Disease Mgmt Per Diem	1	1	—	—	$38,348.69	$38,348.69	$38,348.69	2026-07-01
428	MS_DRG	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	18	17	—	—	$14,092.75	$60,941.62	$38,088.51	2026-07-01
E2513NU	OTHER	Sgd Accessory, EMG Sensor	1	1	—	—	$38,035.68	$38,035.68	$38,035.68	2026-07-01
8	MS_DRG	Simultaneous Pancreas And Kidney Transplant	33	27	—	—	$14,049.14	$79,882.36	$37,970.66	2026-07-01
278	MS_DRG	Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures …	33	27	—	—	$13,952.91	$79,335.05	$37,710.58	2026-07-01
461	MS_DRG	Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc	33	27	—	—	$13,844.65	$78,719.32	$37,417.98	2026-07-01
S4025	HCPCS	Donor Serv Ivf Case Rate	1	1	—	—	$37,319.18	$37,319.18	$37,319.18	2026-07-01
L8043KM	OTHER	Upper Facial Prosthesis	1	1	—	—	$37,252.57	$37,252.57	$37,252.57	2026-07-01
33363	HCPCS	Tavr Open Axillary Appr	18	18	$68,914.00	$51,685.50 25% off	$2,459.59	$68,914.00	$37,213.56	2026-07-01
834	MS_DRG	Acute Leukemia With Mcc	33	27	—	—	$13,761.70	$78,247.54	$37,193.79	2026-07-01
405	MS_DRG	Pancreas, Liver And Shunt Procedures With Mcc	33	27	—	—	$13,713.09	$77,971.04	$37,062.40	2026-07-01
234	MS_DRG	Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc	33	27	—	—	$13,693.54	$77,859.86	$37,009.57	2026-07-01
11	MS_DRG	Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc	33	27	—	—	$13,671.99	$77,737.29	$36,951.32	2026-07-01
17	MS_DRG	Autologous Bone Marrow Transplant Without Cc/mcc	33	27	—	—	$13,617.36	$77,426.57	$36,803.67	2026-07-01
A0431	HCPCS	Rotary Wing Air Transport	1	1	—	—	$36,332.72	$36,332.72	$36,332.72	2026-07-01
220	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	33	27	—	—	$13,368.01	$76,008.40	$36,129.75	2026-07-01
450	MS_DRG	Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically …	18	17	—	—	$13,359.99	$57,772.93	$36,108.08	2026-07-01
E0194RR	OTHER	Air Fluidized Bed	1	1	—	—	$35,929.56	$35,929.56	$35,929.56	2026-07-01
21	MS_DRG	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc	33	27	—	—	$13,270.27	$75,452.53	$35,865.60	2026-07-01
270	MS_DRG	Other Major Cardiovascular Procedures With Mcc	33	27	—	—	$13,226.42	$75,203.10	$35,747.07	2026-07-01
33362	HCPCS	Tavr Open Fem Approach	18	18	$65,631.00	$49,223.25 25% off	$2,374.79	$65,631.00	$35,440.74	2026-07-01
L5991	HCPCS	Low Pros Ext Osseo Connector	1	1	—	—	$35,382.67	$35,382.67	$35,382.67	2026-07-01
466	MS_DRG	Revision Of Hip Or Knee Replacement With Mcc	33	27	—	—	$13,048.74	$74,192.57	$35,266.86	2026-07-01
K0808NU	OTHER	Pov Group 2 Vhd 451-600 Lbs	1	1	—	—	$35,241.32	$35,241.32	$35,241.32	2026-07-01
653	MS_DRG	Major Bladder Procedures With Mcc	33	27	—	—	$13,026.19	$74,064.29	$35,205.91	2026-07-01
33882	HCPCS	Evsc Rp Ta Dplmt Mlt Sys	18	18	$63,391.00	$47,543.25 25% off	$20,285.12	$63,391.00	$34,231.14	2026-07-01
37277	HCPCS	Rvscevsc Fpvt Stath Cpx1	18	18	$63,391.00	$47,543.25 25% off	$20,285.12	$63,391.00	$34,231.14	2026-07-01
35602	HCPCS	Bpg Crtd-clat Crtd	18	18	$63,391.00	$47,543.25 25% off	$20,285.12	$63,391.00	$34,231.14	2026-07-01
221	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	33	27	—	—	$12,634.75	$71,837.97	$34,147.96	2026-07-01
326	MS_DRG	Stomach, Esophageal And Duodenal Procedures With Mcc	33	27	—	—	$12,502.43	$71,085.41	$33,790.34	2026-07-01
33361	HCPCS	Transcatheter Aortic Valve Replacement	18	18	$2,220.00	$1,665.00 25% off	$2,175.74	$62,507.00	$33,753.78	2026-07-01
228	MS_DRG	Other Cardiothoracic Procedures With Mcc	33	27	—	—	$12,402.19	$70,515.29	$33,519.42	2026-07-01
853	MS_DRG	Infectious And Parasitic Diseases With O.r. Procedures With Mcc	33	27	—	—	$12,380.13	$70,389.87	$33,459.82	2026-07-01
239	MS_DRG	Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc	33	27	—	—	$12,337.78	$70,148.99	$33,345.35	2026-07-01
37182	HCPCS	Insert Hepatic Shunt (tips)	1	1	—	—	$33,298.83	$33,298.83	$33,298.83	2026-07-01
0981T	OTHER	Tcat Impl Wrls Ivc Snr	1	1	—	—	$33,298.83	$33,298.83	$33,298.83	2026-07-01
L8042KM	OTHER	Orbital Prosthesis	1	1	—	—	$33,261.07	$33,261.07	$33,261.07	2026-07-01
576	MS_DRG	Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc	33	27	—	—	$12,286.41	$69,856.80	$33,206.50	2026-07-01
L6925	HCPCS	Wrist Disart Myoelectronic C	1	1	—	—	$33,169.81	$33,169.81	$33,169.81	2026-07-01
5604568	CDM	Tavr Medtronic Valve/kit	23	18	$65,000.00	$48,750.00 25% off	$20,800.00	$65,000.00	$33,150.00	2026-07-01
5604569	CDM	Tavr Edwards Valve/kit	23	18	$65,000.00	$48,750.00 25% off	$20,800.00	$65,000.00	$33,150.00	2026-07-01
L6935	HCPCS	Below Elbow Myoelectronic CT	1	1	—	—	$33,013.92	$33,013.92	$33,013.92	2026-07-01
471	MS_DRG	Cervical Spinal Fusion With Mcc	33	27	—	—	$12,104.72	$68,823.46	$32,715.46	2026-07-01
837	MS_DRG	Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot…	33	27	—	—	$12,043.57	$68,475.69	$32,550.20	2026-07-01
33270	HCPCS	Insrt/repl Sub Defib Sys	34	28	$85,439.00	$64,079.25 25% off	$3,785.00	$85,439.00	$32,466.82	2026-07-01
0620T	OTHER	Evasc Ven Artlz Tibl/prnl Vn	18	14	—	—	$13,952.15	$80,009.02	$32,446.86	2026-07-01
E2508UE	OTHER	Sgd Spelling Phys Contact	1	1	—	—	$32,377.16	$32,377.16	$32,377.16	2026-07-01
L8045KM	OTHER	Auricular Prosthesis	1	1	—	—	$32,296.46	$32,296.46	$32,296.46	2026-07-01
267	MS_DRG	Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc	33	27	—	—	$11,934.56	$67,855.68	$32,255.57	2026-07-01
650	MS_DRG	Kidney Transplant With Hemodialysis With Mcc	33	27	—	—	$11,785.70	$67,009.05	$31,853.25	2026-07-01
22556	HCPCS	Arthrd Ant Ntrbd Min Dsc Thc	1	1	—	—	$31,849.62	$31,849.62	$31,849.62	2026-07-01
22838	HCPCS	Rev Rplc/rmv Thrc Vrt Tethrg	1	1	—	—	$31,849.62	$31,849.62	$31,849.62	2026-07-01
22837	HCPCS	Ant Thrc Vrt Body Tethrg 8+	1	1	—	—	$31,849.62	$31,849.62	$31,849.62	2026-07-01
22804	HCPCS	Arthrd Pst Dfrm 13+ Vrt Sgm	1	1	—	—	$31,849.62	$31,849.62	$31,849.62	2026-07-01
22810	HCPCS	Arthrd Ant Dfrm 4-7 Vrt Sgm	1	1	—	—	$31,849.62	$31,849.62	$31,849.62	2026-07-01
20838	HCPCS	Replantation Foot Complete	1	1	—	—	$31,849.62	$31,849.62	$31,849.62	2026-07-01
27703	HCPCS	Reconstruction Ankle Joint	1	1	—	—	$31,849.62	$31,849.62	$31,849.62	2026-07-01
0790T	OTHER	Revj Rplcmt/rmvl Vrt Tethrg	1	1	—	—	$31,849.62	$31,849.62	$31,849.62	2026-07-01
27280	HCPCS	Arthr Si Jt Opn B1grf Instrm	1	1	—	—	$31,849.62	$31,849.62	$31,849.62	2026-07-01
0656T	OTHER	Ant Lmbr Vrt Bdy Teth <7 Seg	1	1	—	—	$31,849.62	$31,849.62	$31,849.62	2026-07-01
0657T	OTHER	Ant Lmbr Vrt Bdy Teth 8+ Seg	1	1	—	—	$31,849.62	$31,849.62	$31,849.62	2026-07-01
22819	HCPCS	Kyphectomy 3 Or More	1	1	—	—	$31,849.62	$31,849.62	$31,849.62	2026-07-01
22836	HCPCS	Ant Thrc Vrt Body Tethrg <7	1	1	—	—	$31,849.62	$31,849.62	$31,849.62	2026-07-01
22808	HCPCS	Arthrd Ant Dfrm 2-3 Vrt Sgm	1	1	—	—	$31,849.62	$31,849.62	$31,849.62	2026-07-01
20808	HCPCS	Replantation Hand Complete	1	1	—	—	$31,849.62	$31,849.62	$31,849.62	2026-07-01
22812	HCPCS	Arthrd Ant Dfrm 8+ Vrt Sgm	1	1	—	—	$31,849.62	$31,849.62	$31,849.62	2026-07-01
27295	HCPCS	Amputation Of Leg At Hip	1	1	—	—	$31,849.62	$31,849.62	$31,849.62	2026-07-01
22586	HCPCS	Arthrd Pre-sac Ntrbdy L5-s1	1	1	—	—	$31,849.62	$31,849.62	$31,849.62	2026-07-01
20805	HCPCS	Replant Forearm Complete	1	1	—	—	$31,849.62	$31,849.62	$31,849.62	2026-07-01
22861	HCPCS	Rev Rplcm Arthrp 1ntrspc Crv	1	1	—	—	$31,849.62	$31,849.62	$31,849.62	2026-07-01
22800	HCPCS	Arthrd Pst Dfrm<6 Vrt Sgm	1	1	—	—	$31,849.62	$31,849.62	$31,849.62	2026-07-01
22818	HCPCS	Kyphectomy 1-2 Segments	1	1	—	—	$31,849.62	$31,849.62	$31,849.62	2026-07-01
22802	HCPCS	Arthrd Pst Dfrm 7-12 Vrt Sgm	1	1	—	—	$31,849.62	$31,849.62	$31,849.62	2026-07-01
20802	HCPCS	Replantation Arm Complete	1	1	—	—	$31,849.62	$31,849.62	$31,849.62	2026-07-01
27290	HCPCS	Amputation Of Leg At Hip	1	1	—	—	$31,849.62	$31,849.62	$31,849.62	2026-07-01
981	MS_DRG	Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc	33	27	—	—	$11,761.65	$66,872.23	$31,788.23	2026-07-01
L8679	HCPCS	Imp Neurosti Pls Gn Any Type	1	1	—	—	$31,758.63	$31,758.63	$31,758.63	2026-07-01
826	MS_DRG	Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. …	33	27	—	—	$11,726.56	$66,672.68	$31,693.41	2026-07-01
B9006NU	OTHER	Parenteral Infus Pump Statio	1	1	—	—	$31,624.63	$31,624.63	$31,624.63	2026-07-01
B9004NU	OTHER	Parenteral Infus Pump Portab	1	1	—	—	$31,624.63	$31,624.63	$31,624.63	2026-07-01
L5857	HCPCS	Elec Knee-shin Swing Only	1	1	—	—	$31,571.65	$31,571.65	$31,571.65	2026-07-01
6	MS_DRG	Liver Transplant Without Mcc	33	27	—	—	$11,624.32	$66,091.16	$31,417.07	2026-07-01
277	MS_DRG	Cardiac Defibrillator Implant Without Mcc	33	27	—	—	$11,577.95	$65,827.48	$31,291.77	2026-07-01
A0430	HCPCS	Fixed Wing Air Transport	1	1	—	—	$31,249.88	$31,249.88	$31,249.88	2026-07-01
L8619	HCPCS	Coch Imp Ext Proc/contr Rplc	1	1	—	—	$31,153.68	$31,153.68	$31,153.68	2026-07-01
329	MS_DRG	Major Small And Large Bowel Procedures With Mcc	33	27	—	—	$11,522.82	$65,513.91	$31,142.76	2026-07-01
C8005	HCPCS	Pef Bronch Ablt 3d Nav Ebus	1	1	—	—	$31,115.16	$31,115.16	$31,115.16	2026-07-01
L7190	HCPCS	Elbow Adolescent Myoelectron	1	1	—	—	$31,101.28	$31,101.28	$31,101.28	2026-07-01
823	MS_DRG	Lymphoma And Non-acute Leukemia With Other Procedures With Mcc	33	27	—	—	$11,493.50	$65,347.15	$31,063.51	2026-07-01
L6920	HCPCS	Wrist Disarticul Switch Ctrl	1	1	—	—	$31,048.18	$31,048.18	$31,048.18	2026-07-01
245	MS_DRG	Aicd Generator Procedures	33	27	—	—	$11,437.37	$65,027.89	$30,911.80	2026-07-01
856	MS_DRG	Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc	33	27	—	—	$11,403.03	$64,832.62	$30,819.01	2026-07-01
25	MS_DRG	Craniotomy And Endovascular Intracranial Procedures With Mcc	33	27	—	—	$11,398.02	$64,804.12	$30,805.46	2026-07-01
799	MS_DRG	Splenic Procedures With Mcc	33	27	—	—	$11,353.41	$64,550.41	$30,684.90	2026-07-01
163	MS_DRG	Major Chest Procedures With Mcc	33	27	—	—	$11,235.38	$63,879.10	$30,365.89	2026-07-01
31	MS_DRG	Ventricular Shunt Procedures With Mcc	33	27	—	—	$11,232.12	$63,860.57	$30,357.09	2026-07-01
319	MS_DRG	Other Endovascular Cardiac Valve Procedures With Mcc	33	27	—	—	$11,188.02	$63,609.71	$30,237.88	2026-07-01
93654	HCPCS	Eps W/3d Map Vt Ablation	34	28	$80,050.00	$60,037.50 25% off	$6,593.00	$80,050.00	$30,160.39	2026-07-01
L6930	HCPCS	Below Elbow Switch Control	1	1	—	—	$29,903.75	$29,903.75	$29,903.75	2026-07-01
37275	HCPCS	Rvscevsc Fpvt Stath Sf 1	18	18	$55,123.00	$41,342.25 25% off	$17,639.36	$55,123.00	$29,766.42	2026-07-01
356	MS_DRG	Other Digestive System O.r. Procedures With Mcc	33	27	—	—	$11,012.34	$62,610.58	$29,763.09	2026-07-01
33264	HCPCS	Rmvl & Rplcmt Dfb Gen Mlt Ld	54	28	$58,938.00	$44,203.50 25% off	$3,785.00	$82,088.09	$29,722.37	2026-07-01
0915T	OTHER	Insj Perm Ccm-d Sys Pg&eltrd	18	14	—	—	$12,780.62	$57,016.87	$29,722.37	2026-07-01
33231	HCPCS	Insrt Pulse Gen W/mult Leads	18	14	—	—	$12,780.62	$57,016.87	$29,722.37	2026-07-01
0408T	OTHER	Insj/rplc Cardiac Modulj Sys	18	14	—	—	$12,780.62	$57,016.87	$29,722.37	2026-07-01
0571T	OTHER	Insj/rplcmt Icds Ss Eltrd	18	14	—	—	$12,780.62	$57,016.87	$29,722.37	2026-07-01
L8041KM	OTHER	Midfacial Prosthesis	1	1	—	—	$29,601.88	$29,601.88	$29,601.88	2026-07-01
69930	HCPCS	Implant Cochlear Device	18	14	—	—	$12,679.46	$59,892.80	$29,487.12	2026-07-01
323	MS_DRG	Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc	33	27	—	—	$10,848.45	$61,678.43	$29,320.13	2026-07-01
1014T	OTHER	Lap Rv/rmv Eso Sph Nstm Eltr	1	1	—	—	$29,140.35	$29,140.35	$29,140.35	2026-07-01
33249	HCPCS	Insertion/repositioning Elect Lead Singl	55	28	$53,950.00	$40,462.50 25% off	$6,593.00	$82,088.09	$29,134.00	2026-07-01
474	MS_DRG	Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc	33	27	—	—	$10,761.99	$61,186.70	$29,086.46	2026-07-01
140	MS_DRG	Major Head And Neck Procedures With Mcc	33	27	—	—	$10,692.83	$60,793.32	$28,899.53	2026-07-01
448	MS_DRG	Multiple Level Spinal Fusion Except Cervical Without Mcc	18	17	—	—	$10,631.43	$45,973.74	$28,733.59	2026-07-01
269	MS_DRG	Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc	33	27	—	—	$10,587.32	$60,193.27	$28,614.38	2026-07-01
12	MS_DRG	Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc	33	27	—	—	$10,569.28	$60,090.65	$28,565.62	2026-07-01
958	MS_DRG	Other O.r. Procedures For Multiple Significant Trauma With Cc	33	27	—	—	$10,564.01	$60,060.72	$28,551.39	2026-07-01
E2513UE	OTHER	Sgd Accessory, EMG Sensor	1	1	—	—	$28,526.88	$28,526.88	$28,526.88	2026-07-01
673	MS_DRG	Other Kidney And Urinary Tract Procedures With Mcc	33	27	—	—	$10,533.19	$59,885.40	$28,468.08	2026-07-01
901	MS_DRG	Wound Debridements For Injuries With Mcc	33	27	—	—	$10,520.66	$59,814.14	$28,434.22	2026-07-01
236	MS_DRG	Coronary Bypass Without Cardiac Catheterization Without Mcc	33	27	—	—	$10,501.11	$59,702.97	$28,381.39	2026-07-01
458	MS_DRG	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	33	27	—	—	$10,460.52	$59,472.07	$28,271.67	2026-07-01
793	MS_DRG	Full Term Neonate With Major Problems	21	18	—	—	$10,453.00	$59,012.35	$28,251.35	2026-07-01
33287	HCPCS	Rmv&rplcmt Phrnc Nrv Stim Pg	18	14	—	—	$12,147.60	$56,052.02	$28,250.24	2026-07-01
0674T	OTHER	Laps Insj Nw/rpcmt Prm Isdss	18	14	—	—	$12,147.60	$56,052.02	$28,250.24	2026-07-01
63685	HCPCS	Incision/placement, Spinal Neurostimulat	35	28	$46,579.00	$34,934.25 25% off	$1,244.00	$80,699.00	$28,250.24	2026-07-01
0268T	OTHER	Implt/rpl Crtd Sns Dev Gen	17	13	—	—	$12,147.60	$48,025.40	$28,250.24	2026-07-01
423	MS_DRG	Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc	33	27	—	—	$10,411.40	$59,192.71	$28,138.92	2026-07-01
T1023	HCPCS	Program Intake Assessment	1	1	—	—	$27,999.68	$27,999.68	$27,999.68	2026-07-01
273	MS_DRG	Percutaneous And Other Intracardiac Procedures With Mcc	33	27	—	—	$10,342.48	$58,800.75	$27,952.66	2026-07-01
V5248	HCPCS	Hearing Aid, Binaural, Cic	1	1	—	—	$27,931.05	$27,931.05	$27,931.05	2026-07-01
E2506NU	OTHER	Sgd Prerec Msg > 40 Min	1	1	—	—	$27,917.18	$27,917.18	$27,917.18	2026-07-01
791	MS_DRG	Prematurity With Major Problems	21	18	—	—	$10,175.83	$57,447.03	$27,502.25	2026-07-01
402	MS_DRG	Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical	18	17	—	—	$10,079.35	$43,586.38	$27,241.49	2026-07-01
L8686	HCPCS	Implt Nrostm Pls Gen Sng Non	1	1	—	—	$27,187.07	$27,187.07	$27,187.07	2026-07-01
J9266	HCPCS	Pegaspargase Injection	18	14	—	—	$11,640.33	$54,574.18	$27,070.53	2026-07-01
802	MS_DRG	Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc	33	27	—	—	$9,988.13	$56,785.38	$26,994.95	2026-07-01
E1230NU	OTHER	Power Operated Vehicle	1	1	—	—	$26,736.36	$26,736.36	$26,736.36	2026-07-01
L5987	HCPCS	Shank Ft W Vert Load Pylon	1	1	—	—	$26,662.88	$26,662.88	$26,662.88	2026-07-01
L8046KM	OTHER	Partial Facial Prosthesis	1	1	—	—	$26,608.91	$26,608.91	$26,608.91	2026-07-01
24	MS_DRG	Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…	33	27	—	—	$9,807.19	$55,756.31	$26,505.93	2026-07-01
L8627	HCPCS	Cid Ext Speech Process Repl	1	1	—	—	$26,442.58	$26,442.58	$26,442.58	2026-07-01
K0808UE	OTHER	Pov Group 2 Vhd 451-600 Lbs	1	1	—	—	$26,430.96	$26,430.96	$26,430.96	2026-07-01
933	MS_DRG	Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft	33	27	—	—	$9,762.84	$55,504.03	$26,386.05	2026-07-01
34	MS_DRG	Carotid Artery Stent Procedures With Mcc	33	27	—	—	$9,703.95	$55,169.09	$26,226.89	2026-07-01
876	MS_DRG	O.r. Procedures With Principal Diagnosis Of Mental Illness	29	26	—	—	$9,689.41	$54,699.93	$26,187.60	2026-07-01
40	MS_DRG	Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc	33	27	—	—	$9,680.14	$55,033.68	$26,162.54	2026-07-01
907	MS_DRG	Other O.r. Procedures For Injuries With Mcc	33	27	—	—	$9,625.26	$54,721.54	$26,014.21	2026-07-01
956	MS_DRG	Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma	33	27	—	—	$9,434.05	$53,634.04	$25,497.43	2026-07-01
C9760	HCPCS	Non-blind Interatrial Shunt	18	14	—	—	$10,962.45	$48,894.74	$25,494.06	2026-07-01
C2624	HCPCS	Implantable Pap Sensor	23	18	$49,900.00	$37,425.00 25% off	$15,968.00	$49,900.00	$25,449.00	2026-07-01
143	MS_DRG	Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc	33	27	—	—	$9,392.95	$53,400.29	$25,386.35	2026-07-01
166	MS_DRG	Other Respiratory System O.r. Procedures With Mcc	33	27	—	—	$9,370.65	$53,273.44	$25,326.07	2026-07-01
518	MS_DRG	Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost…	33	27	—	—	$9,369.64	$53,267.74	$25,323.36	2026-07-01
628	MS_DRG	Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc	33	27	—	—	$9,343.33	$53,118.08	$25,252.24	2026-07-01
V5249	HCPCS	Hearing Aid, Binaural, Itc	1	1	—	—	$25,240.63	$25,240.63	$25,240.63	2026-07-01
651	MS_DRG	Kidney Transplant With Hemodialysis Without Mcc	33	27	—	—	$9,290.70	$52,818.77	$25,110.01	2026-07-01
904	MS_DRG	Skin Grafts For Injuries With Cc/mcc	33	27	—	—	$9,208.76	$52,352.69	$24,888.53	2026-07-01
492	MS_DRG	Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc	33	27	—	—	$9,205.00	$52,331.31	$24,878.37	2026-07-01
939	MS_DRG	O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc	33	27	—	—	$9,096.99	$51,717.01	$24,586.45	2026-07-01
495	MS_DRG	Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit…	33	27	—	—	$9,089.97	$51,677.10	$24,567.49	2026-07-01
L8040KM	OTHER	Nasal Prosthesis	1	1	—	—	$24,561.90	$24,561.90	$24,561.90	2026-07-01
332	MS_DRG	Rectal Resection With Mcc	33	27	—	—	$9,077.44	$51,605.84	$24,533.63	2026-07-01
265	MS_DRG	Aicd Lead Procedures	33	27	—	—	$9,071.18	$51,570.20	$24,516.69	2026-07-01
97	MS_DRG	Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc	33	27	—	—	$9,055.14	$51,478.99	$24,473.35	2026-07-01
279	MS_DRG	Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures …	33	27	—	—	$9,041.60	$51,402.02	$24,436.77	2026-07-01
739	MS_DRG	Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc…	33	27	—	—	$8,982.46	$51,065.65	$24,276.93	2026-07-01
736	MS_DRG	Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc	33	27	—	—	$8,961.66	$50,947.35	$24,220.71	2026-07-01

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