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Hospital facility prices. What the hospital charges for the facility side of care — the surgeon’s and anesthesiologist’s fees are billed separately and are not included. How we scope prices →

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Hospital

MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL

New Albany, OH · CCN 360266 · Rates published

39,515 distinct procedures filed
116 distinct payers
10,120,454 rate rows
2025-01-01 last MRF observed · ⚠ 21 mo old

⚠ Possibly outdated The most recent machine-readable file we have for this hospital is 21 months old. CMS requires hospitals to refresh these files at least annually, so newer rates may exist that we haven't ingested yet. The prices below are exactly as last filed.

Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://trinityhealth.pt.panaceainc.com/MRFDownload/trinityhealth/mountcarmel-newalbany-surgicalhospital
Found on page https://www.mountcarmelhealth.com/for-patients/billing-and-insurance/pricing-information/price-estimates
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-10-15
Content fingerprint ba491a25e2c186d3… · 193,044,124 bytes · first seen 2026-05-09

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
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell Immunotherapy 21 $234,161.82 $797,902.35 $257,814.93 nat. median
$168,055
1.5× median
'588-4
OTHER 		Neonate Birth Weight < 1500 Grams With Major Procedure 11 $189,088.32 $206,106.27 $202,324.50 —
'583-3
OTHER 		Neonate With Ecmo 11 $182,938.54 $199,403.01 $195,744.24 —
'583-4
OTHER 		Neonate With Ecmo 11 $182,938.54 $199,403.01 $195,744.24 —
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 20 $180,598.51 $586,874.38 $189,628.44 nat. median
$186,516
1.0× median
'583-2
OTHER 		Neonate With Ecmo 11 $174,047.09 $189,711.33 $186,230.39 —
'583-1
OTHER 		Neonate With Ecmo 11 $174,047.09 $189,711.33 $186,230.39 —
'161-4
OTHER 		Implantable Heart Assist Systems 11 $173,375.55 $188,979.35 $185,511.84 —
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 21 $131,925.09 $570,850.37 $184,450.82 nat. median
$131,925
1.4× median
'002-4
OTHER 		Heart And/or Lung Transplant 11 $152,568.13 $166,299.26 $163,247.90 —
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 21 $97,079.83 $461,733.74 $149,193.50 nat. median
$145,435
1.0× median
'161-1
OTHER 		Implantable Heart Assist Systems 11 $134,342.49 $146,433.31 $143,746.46 —
'161-2
OTHER 		Implantable Heart Assist Systems 11 $134,342.49 $146,433.31 $143,746.46 —
'161-3
OTHER 		Implantable Heart Assist Systems 11 $134,342.49 $146,433.31 $143,746.46 —
'007-4
OTHER 		Allogeneic Bone Marrow Transplant 11 $130,521.51 $142,268.45 $139,658.02 —
'841-4
OTHER 		Extensive Third Degree Burns With Skin Graft 11 $121,543.66 $132,482.59 $130,051.72 —
'841-1
OTHER 		Extensive Third Degree Burns With Skin Graft 11 $121,543.66 $132,482.59 $130,051.72 —
'841-3
OTHER 		Extensive Third Degree Burns With Skin Graft 11 $121,543.66 $132,482.59 $130,051.72 —
'841-2
OTHER 		Extensive Third Degree Burns With Skin Graft 11 $121,543.66 $132,482.59 $130,051.72 —
'609-4
OTHER 		Neonate Birth Weight 1500-2499 Grams With Major Procedure 11 $121,534.41 $132,472.51 $130,041.82 —
'630-4
OTHER 		Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 11 $117,969.49 $128,586.74 $126,227.35 —
'631-4
OTHER 		Neonate Birth Weight > 2499 Grams With Other Major Procedure 11 $104,213.75 $113,592.99 $111,508.71 —
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 21 $63,636.83 $318,357.90 $102,866.49 nat. median
$97,418
1.1× median
'588-3
OTHER 		Neonate Birth Weight < 1500 Grams With Major Procedure 11 $95,874.02 $104,502.68 $102,585.20 —
'588-1
OTHER 		Neonate Birth Weight < 1500 Grams With Major Procedure 11 $91,230.84 $99,441.62 $97,617.00 —
'588-2
OTHER 		Neonate Birth Weight < 1500 Grams With Major Procedure 11 $91,230.84 $99,441.62 $97,617.00 —
7
MS_DRG 		Lung Transplant 20 $81,749.37 $265,653.42 $96,137.12 nat. median
$70,649
1.4× median
'593-4
OTHER 		Neonate Birth Weight 750-999 Grams Without Major Procedure 11 $88,435.67 $96,394.88 $94,626.17 —
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 20 $68,977.53 $224,149.95 $90,967.54 nat. median
$69,922
1.3× median
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 20 $81,600.75 $265,170.47 $88,578.60 nat. median
$65,418
1.4× median
'591-4
OTHER 		Neonate Birth Weight 500-749 Grams Without Major Procedure 11 $82,150.15 $89,543.66 $87,900.66 —
14
MS_DRG 		Allogeneic Bone Marrow Transplant 19 $76,381.12 $248,208.71 $87,839.05 nat. median
$72,715
1.2× median
'160-4
OTHER 		Major Cardiothoracic Repair Of Heart Anomaly 11 $75,625.53 $82,431.83 $80,919.32 —
27100000002-816
CDM 		Glove Vinyl Powder Free Lg 96 $71,586.19 $166,479.51 $77,745.93 —
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 20 $71,781.28 $233,261.05 $75,370.34 nat. median
$74,509
1.0× median
'002-3
OTHER 		Heart And/or Lung Transplant 11 $68,026.25 $74,148.61 $72,788.09 —
'002-1
OTHER 		Heart And/or Lung Transplant 11 $68,026.25 $74,148.61 $72,788.09 —
'002-2
OTHER 		Heart And/or Lung Transplant 11 $68,026.25 $74,148.61 $72,788.09 —
'009-4
OTHER 		Extracorporeal Membrane Oxygenation (ecmo) 11 $67,918.27 $74,030.91 $72,672.55 —
215
MS_DRG 		Other Heart Assist System Implant 21 $51,613.48 $221,221.92 $71,480.31 nat. median
$73,023
1.0× median
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 21 $64,680.93 $210,187.68 $70,044.23 nat. median
$69,822
1.0× median
'007-3
OTHER 		Allogeneic Bone Marrow Transplant 11 $64,069.52 $69,835.78 $68,554.39 —
27800000002-88968
CDM 		Device Impella 5.5 Smartassist 96 $62,887.50 $146,250.00 $68,298.75 —
27800000002-88967
CDM 		Device Impella 5.5 Smartassist 96 $62,887.50 $146,250.00 $68,298.75 —
'004-4
OTHER 		Tracheostomy With Mv >96 Hours With Extensive Procedure 11 $61,744.33 $67,301.32 $66,066.43 —
'602-4
OTHER 		Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 11 $60,756.04 $66,224.08 $65,008.96 —
27200000002-30479
CDM 		Stylet Steerable 30cm 96 $59,761.21 $138,979.55 $64,903.45 —
27800000002-91547
CDM 		Graft Bn Canc Crsh Frzdr 30ml 96 $59,505.55 $138,385.00 $64,625.80 —
'607-4
OTHER 		Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 11 $60,094.79 $65,503.32 $64,301.43 —
'850-4
OTHER 		Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal… 11 $58,212.83 $63,451.98 $62,287.73 —

Other procedures at this hospital

Browse this hospital's 39,515 published procedures. Use the slice to choose what to show, then sort or filter any column.

Slice
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
             
'001-4 OTHER Liver Transplant And/or Intestinal Transplant 22 11 — — $54,279.24 $59,164.37 $58,078.79 2025-01-01
'002-1 OTHER Heart And/or Lung Transplant 22 11 — — $68,026.25 $74,148.61 $72,788.09 2025-01-01
'002-2 OTHER Heart And/or Lung Transplant 22 11 — — $68,026.25 $74,148.61 $72,788.09 2025-01-01
'002-3 OTHER Heart And/or Lung Transplant 22 11 — — $68,026.25 $74,148.61 $72,788.09 2025-01-01
'002-4 OTHER Heart And/or Lung Transplant 22 11 — — $152,568.13 $166,299.26 $163,247.90 2025-01-01
'004-3 OTHER Tracheostomy With Mv >96 Hours With Extensive Procedure 22 11 — — $46,960.19 $51,186.61 $50,247.40 2025-01-01
'004-4 OTHER Tracheostomy With Mv >96 Hours With Extensive Procedure 22 11 — — $61,744.33 $67,301.32 $66,066.43 2025-01-01
'005-3 OTHER Tracheostomy With Mv >96 Hours Without Extensive Procedure 22 11 — — $31,897.88 $34,768.69 $34,130.73 2025-01-01
'005-4 OTHER Tracheostomy With Mv >96 Hours Without Extensive Procedure 22 11 — — $43,800.46 $47,742.50 $46,866.49 2025-01-01
'007-1 OTHER Allogeneic Bone Marrow Transplant 22 11 — — $51,431.63 $56,060.48 $55,031.84 2025-01-01
'007-2 OTHER Allogeneic Bone Marrow Transplant 22 11 — — $51,431.63 $56,060.48 $55,031.84 2025-01-01
'007-3 OTHER Allogeneic Bone Marrow Transplant 22 11 — — $64,069.52 $69,835.78 $68,554.39 2025-01-01
'007-4 OTHER Allogeneic Bone Marrow Transplant 22 11 — — $130,521.51 $142,268.45 $139,658.02 2025-01-01
'008-3 OTHER Autologous Bone Marrow Transplant 22 11 — — $38,906.36 $42,407.93 $41,629.81 2025-01-01
'008-4 OTHER Autologous Bone Marrow Transplant 22 11 — — $51,558.12 $56,198.35 $55,167.19 2025-01-01
'009-1 OTHER Extracorporeal Membrane Oxygenation (ecmo) 22 11 — — $28,274.86 $30,819.60 $30,254.10 2025-01-01
'009-2 OTHER Extracorporeal Membrane Oxygenation (ecmo) 22 11 — — $28,274.86 $30,819.60 $30,254.10 2025-01-01
'009-3 OTHER Extracorporeal Membrane Oxygenation (ecmo) 22 11 — — $28,274.86 $30,819.60 $30,254.10 2025-01-01
'009-4 OTHER Extracorporeal Membrane Oxygenation (ecmo) 22 11 — — $67,918.27 $74,030.91 $72,672.55 2025-01-01
'011-1 OTHER Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 22 11 — — $38,543.85 $42,012.80 $41,241.92 2025-01-01
'011-2 OTHER Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 22 11 — — $38,543.85 $42,012.80 $41,241.92 2025-01-01
'011-3 OTHER Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 22 11 — — $38,543.85 $42,012.80 $41,241.92 2025-01-01
'011-4 OTHER Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 22 11 — — $38,543.85 $42,012.80 $41,241.92 2025-01-01
'021-4 OTHER Open Craniotomy Except Trauma 22 11 — — $32,156.52 $35,050.61 $34,407.48 2025-01-01
'022-4 OTHER Ventricular Shunt Procedures 22 11 — — $39,101.75 $42,620.91 $41,838.87 2025-01-01
'023-4 OTHER Spinal Procedures 22 11 — — $28,156.08 $30,690.13 $30,127.01 2025-01-01
'026-4 OTHER Other Nervous System And Related Procedures 22 11 — — $28,731.46 $31,317.29 $30,742.66 2025-01-01
'091-4 OTHER Other Major Head And Neck Procedures 22 11 — — $34,813.88 $37,947.13 $37,250.85 2025-01-01
'120-4 OTHER Major Respiratory And Chest Procedures 22 11 — — $31,978.09 $34,856.12 $34,216.56 2025-01-01
'130-4 OTHER Respiratory System Diagnosis With Ventilator Support > 96 Hours 22 11 — — $28,133.97 $30,666.03 $30,103.35 2025-01-01
'160-3 OTHER Major Cardiothoracic Repair Of Heart Anomaly 22 11 — — $31,427.39 $34,255.86 $33,627.31 2025-01-01
'160-4 OTHER Major Cardiothoracic Repair Of Heart Anomaly 22 11 — — $75,625.53 $82,431.83 $80,919.32 2025-01-01
'161-1 OTHER Implantable Heart Assist Systems 22 11 — — $134,342.49 $146,433.31 $143,746.46 2025-01-01
'161-2 OTHER Implantable Heart Assist Systems 22 11 — — $134,342.49 $146,433.31 $143,746.46 2025-01-01
'161-3 OTHER Implantable Heart Assist Systems 22 11 — — $134,342.49 $146,433.31 $143,746.46 2025-01-01
'161-4 OTHER Implantable Heart Assist Systems 22 11 — — $173,375.55 $188,979.35 $185,511.84 2025-01-01
'162-3 OTHER Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 22 11 — — $29,328.44 $31,968.00 $31,381.43 2025-01-01
'162-4 OTHER Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 22 11 — — $40,186.70 $43,803.50 $42,999.77 2025-01-01
'163-4 OTHER Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis 22 11 — — $40,637.14 $44,294.48 $43,481.74 2025-01-01
'165-4 OTHER Coronary Bypass With Ami Or Complex Principal Diagnosis 22 11 — — $29,278.57 $31,913.64 $31,328.07 2025-01-01
'167-4 OTHER Other Cardiothoracic And Thoracic Vascular Procedures 22 11 — — $32,213.08 $35,112.26 $34,468.00 2025-01-01
'178-1 OTHER External Heart Assist Systems 22 11 — — $28,100.55 $30,629.60 $30,067.59 2025-01-01
'178-2 OTHER External Heart Assist Systems 22 11 — — $28,100.55 $30,629.60 $30,067.59 2025-01-01
'178-3 OTHER External Heart Assist Systems 22 11 — — $28,100.55 $30,629.60 $30,067.59 2025-01-01
'178-4 OTHER External Heart Assist Systems 22 11 — — $46,877.41 $51,096.38 $50,158.83 2025-01-01
'179-4 OTHER Defibrillator Implants 22 11 — — $32,420.81 $35,338.68 $34,690.27 2025-01-01
'183-1 OTHER Percutaneous Structural Cardiac Procedures 22 11 — — $29,153.62 $31,777.45 $31,194.37 2025-01-01
'183-2 OTHER Percutaneous Structural Cardiac Procedures 22 11 — — $29,975.82 $32,673.64 $32,074.13 2025-01-01
'183-3 OTHER Percutaneous Structural Cardiac Procedures 22 11 — — $33,303.17 $36,300.46 $35,634.39 2025-01-01
'183-4 OTHER Percutaneous Structural Cardiac Procedures 22 11 — — $47,049.66 $51,284.13 $50,343.14 2025-01-01
'200-4 OTHER Cardiac Structural And Valvular Disorders 22 11 — — $33,982.42 $37,040.84 $36,361.19 2025-01-01
'220-4 OTHER Major Stomach, Esophageal And Duodenal Procedures 22 11 — — $30,032.38 $32,735.29 $32,134.65 2025-01-01
'303-2 OTHER Dorsal And Lumbar Fusion Procedure For Curvature Of Back 22 11 — — $29,494.53 $32,149.04 $31,559.15 2025-01-01
'303-3 OTHER Dorsal And Lumbar Fusion Procedure For Curvature Of Back 22 11 — — $42,534.00 $46,362.06 $45,511.38 2025-01-01
'303-4 OTHER Dorsal And Lumbar Fusion Procedure For Curvature Of Back 22 11 — — $56,469.71 $61,551.98 $60,422.59 2025-01-01
'304-4 OTHER Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back 22 11 — — $33,746.92 $36,784.14 $36,109.20 2025-01-01
'312-4 OTHER Skin Graft, Except Hand, For Musculoskeletal And Connective Tissue Diagnoses 22 11 — — $30,824.24 $33,598.42 $32,981.94 2025-01-01
'583-1 OTHER Neonate With Ecmo 22 11 — — $174,047.09 $189,711.33 $186,230.39 2025-01-01
'583-2 OTHER Neonate With Ecmo 22 11 — — $174,047.09 $189,711.33 $186,230.39 2025-01-01
'583-3 OTHER Neonate With Ecmo 22 11 — — $182,938.54 $199,403.01 $195,744.24 2025-01-01
'583-4 OTHER Neonate With Ecmo 22 11 — — $182,938.54 $199,403.01 $195,744.24 2025-01-01
'588-1 OTHER Neonate Birth Weight < 1500 Grams With Major Procedure 22 11 — — $91,230.84 $99,441.62 $97,617.00 2025-01-01
'588-2 OTHER Neonate Birth Weight < 1500 Grams With Major Procedure 22 11 — — $91,230.84 $99,441.62 $97,617.00 2025-01-01
'588-3 OTHER Neonate Birth Weight < 1500 Grams With Major Procedure 22 11 — — $95,874.02 $104,502.68 $102,585.20 2025-01-01
'588-4 OTHER Neonate Birth Weight < 1500 Grams With Major Procedure 22 11 — — $189,088.32 $206,106.27 $202,324.50 2025-01-01
'589-1 OTHER Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 22 11 — — $39,864.30 $43,452.09 $42,654.80 2025-01-01
'589-2 OTHER Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 22 11 — — $39,864.30 $43,452.09 $42,654.80 2025-01-01
'589-3 OTHER Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 22 11 — — $41,872.23 $45,640.73 $44,803.29 2025-01-01
'589-4 OTHER Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 22 11 — — $41,872.23 $45,640.73 $44,803.29 2025-01-01
'591-1 OTHER Neonate Birth Weight 500-749 Grams Without Major Procedure 22 11 — — $34,749.09 $37,876.51 $37,181.53 2025-01-01
'591-2 OTHER Neonate Birth Weight 500-749 Grams Without Major Procedure 22 11 — — $34,749.09 $37,876.51 $37,181.53 2025-01-01
'591-3 OTHER Neonate Birth Weight 500-749 Grams Without Major Procedure 22 11 — — $45,826.91 $49,951.33 $49,034.79 2025-01-01
'591-4 OTHER Neonate Birth Weight 500-749 Grams Without Major Procedure 22 11 — — $82,150.15 $89,543.66 $87,900.66 2025-01-01
'593-1 OTHER Neonate Birth Weight 750-999 Grams Without Major Procedure 22 11 — — $35,441.19 $38,630.90 $37,922.07 2025-01-01
'593-2 OTHER Neonate Birth Weight 750-999 Grams Without Major Procedure 22 11 — — $35,441.19 $38,630.90 $37,922.07 2025-01-01
'593-3 OTHER Neonate Birth Weight 750-999 Grams Without Major Procedure 22 11 — — $55,604.84 $60,609.28 $59,497.18 2025-01-01
'593-4 OTHER Neonate Birth Weight 750-999 Grams Without Major Procedure 22 11 — — $88,435.67 $96,394.88 $94,626.17 2025-01-01
'602-2 OTHER Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 22 11 — — $36,231.00 $39,491.79 $38,767.17 2025-01-01
'602-3 OTHER Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 22 11 — — $49,256.07 $53,689.12 $52,703.99 2025-01-01
'602-4 OTHER Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 22 11 — — $60,756.04 $66,224.08 $65,008.96 2025-01-01
'603-3 OTHER Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 22 11 — — $35,664.36 $38,874.15 $38,160.87 2025-01-01
'603-4 OTHER Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 22 11 — — $35,664.36 $38,874.15 $38,160.87 2025-01-01
'607-2 OTHER Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 22 11 — — $29,877.09 $32,566.03 $31,968.49 2025-01-01
'607-3 OTHER Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 22 11 — — $42,444.02 $46,263.98 $45,415.10 2025-01-01
'607-4 OTHER Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 22 11 — — $60,094.79 $65,503.32 $64,301.43 2025-01-01
'608-3 OTHER Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 22 11 — — $30,122.36 $32,833.37 $32,230.93 2025-01-01
'608-4 OTHER Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 22 11 — — $30,122.36 $32,833.37 $32,230.93 2025-01-01
'609-1 OTHER Neonate Birth Weight 1500-2499 Grams With Major Procedure 22 11 — — $47,425.02 $51,693.27 $50,744.77 2025-01-01
'609-2 OTHER Neonate Birth Weight 1500-2499 Grams With Major Procedure 22 11 — — $47,425.02 $51,693.27 $50,744.77 2025-01-01
'609-3 OTHER Neonate Birth Weight 1500-2499 Grams With Major Procedure 22 11 — — $49,821.17 $54,305.08 $53,308.65 2025-01-01
'609-4 OTHER Neonate Birth Weight 1500-2499 Grams With Major Procedure 22 11 — — $121,534.41 $132,472.51 $130,041.82 2025-01-01
'611-4 OTHER Neonate Birth Weight 1500-1999 Grams With Major Anomaly 22 11 — — $47,265.62 $51,519.53 $50,574.21 2025-01-01
'612-4 OTHER Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other… 22 11 — — $44,230.33 $48,211.06 $47,326.45 2025-01-01
'621-4 OTHER Neonate Birth Weight 2000-2499 Grams With Major Anomaly 22 11 — — $46,424.91 $50,603.15 $49,674.65 2025-01-01
'622-4 OTHER Neonate Birth Weight 2000-2499 Grams With Respiratory Distress Syndrome Or Other… 22 11 — — $29,687.35 $32,359.21 $31,765.46 2025-01-01
'630-1 OTHER Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 22 11 — — $34,653.96 $37,772.82 $37,079.74 2025-01-01
'630-2 OTHER Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 22 11 — — $34,653.96 $37,772.82 $37,079.74 2025-01-01
'630-3 OTHER Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 22 11 — — $52,509.38 $57,235.22 $56,185.04 2025-01-01
'630-4 OTHER Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 22 11 — — $117,969.49 $128,586.74 $126,227.35 2025-01-01
'631-3 OTHER Neonate Birth Weight > 2499 Grams With Other Major Procedure 22 11 — — $39,996.96 $43,596.69 $42,796.75 2025-01-01
'631-4 OTHER Neonate Birth Weight > 2499 Grams With Other Major Procedure 22 11 — — $104,213.75 $113,592.99 $111,508.71 2025-01-01
'633-4 OTHER Neonate Birth Weight > 2499 Grams With Major Anomaly 22 11 — — $51,214.64 $55,823.96 $54,799.66 2025-01-01
'634-4 OTHER Neonate Birth Weight > 2499 Grams With Respiratory Distress Syndrome Or Other Ma… 22 11 — — $30,034.95 $32,738.10 $32,137.40 2025-01-01
'660-4 OTHER Major Hematologic Or Immunologic Diagnoses Except Sickle Cell Crisis And Coagula… 22 11 — — $31,887.08 $34,756.92 $34,119.18 2025-01-01
'681-4 OTHER Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 22 11 — — $41,197.61 $44,905.39 $44,081.44 2025-01-01
'690-3 OTHER Acute Leukemia 22 11 — — $29,850.87 $32,537.45 $31,940.43 2025-01-01
'690-4 OTHER Acute Leukemia 22 11 — — $46,696.92 $50,899.64 $49,965.70 2025-01-01
'695-4 OTHER Chemotherapy For Acute Leukemia 22 11 — — $40,966.73 $44,653.74 $43,834.40 2025-01-01
'792-4 OTHER Extensive O.r. Procedures For Other Complications Of Treatment 22 11 — — $37,868.20 $41,276.34 $40,518.97 2025-01-01
'841-1 OTHER Extensive Third Degree Burns With Skin Graft 22 11 — — $121,543.66 $132,482.59 $130,051.72 2025-01-01
'841-2 OTHER Extensive Third Degree Burns With Skin Graft 22 11 — — $121,543.66 $132,482.59 $130,051.72 2025-01-01
'841-3 OTHER Extensive Third Degree Burns With Skin Graft 22 11 — — $121,543.66 $132,482.59 $130,051.72 2025-01-01
'841-4 OTHER Extensive Third Degree Burns With Skin Graft 22 11 — — $121,543.66 $132,482.59 $130,051.72 2025-01-01
'842-4 OTHER Burns With Skin Graft Except Extensive Third Degree Burns 22 11 — — $51,167.33 $55,772.39 $54,749.04 2025-01-01
'850-4 OTHER Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal… 22 11 — — $58,212.83 $63,451.98 $62,287.73 2025-01-01
'851-4 OTHER Gender Related Procedures 22 11 — — $56,359.16 $61,431.48 $60,304.30 2025-01-01
'863-3 OTHER Neonatal Aftercare 22 11 — — $35,603.68 $38,808.01 $38,095.94 2025-01-01
'863-4 OTHER Neonatal Aftercare 22 11 — — $46,892.83 $51,113.18 $50,175.33 2025-01-01
'910-4 OTHER Craniotomy For Multiple Significant Trauma 22 11 — — $33,544.84 $36,563.88 $35,892.98 2025-01-01
'911-4 OTHER Extensive Abdominal Or Thoracic Procedures For Multiple Significant Trauma 22 11 — — $28,923.77 $31,526.91 $30,948.43 2025-01-01
'950-4 OTHER Extensive O.r. Procedure Unrelated To Principal Diagnosis 22 11 — — $36,820.78 $40,134.65 $39,398.23 2025-01-01
0451T OTHER Insj/rplcmt Aortic Ventr Sys 22 11 — — $44,455.93 $48,456.96 $47,567.85 2025-01-01
0452T OTHER Insj/rplcmt Dev Vasc Seal 22 11 — — $44,455.93 $48,456.96 $47,567.85 2025-01-01
0453T OTHER Insj/rplcmt Mech-elec Ntrfce 22 11 — — $44,455.93 $48,456.96 $47,567.85 2025-01-01
0454T OTHER Insj/rplcmt Subq Electrode 22 11 — — $44,455.93 $48,456.96 $47,567.85 2025-01-01
0459T OTHER Relocaj Rplcmt Aortic Ventr 22 11 — — $44,455.93 $48,456.96 $47,567.85 2025-01-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 52 20 — — $180,598.51 $586,874.38 $189,628.44 2025-01-01
10 MS_DRG Pancreas Transplant 50 19 — — $22,693.35 $104,248.14 $33,684.22 2025-01-01
11 MS_DRG Tracheostomy For Face,mouth & Neck Diagnoses W Mcc 54 21 — — $22,128.31 $111,669.99 $36,082.35 2025-01-01
14 MS_DRG Allogeneic Bone Marrow Transplant 50 19 — — $76,381.12 $248,208.71 $87,839.05 2025-01-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 50 19 — — $40,567.83 $133,775.29 $43,224.92 2025-01-01
163 MS_DRG Major Chest Procedures With Mcc 54 21 — — $25,560.59 $102,082.44 $32,984.45 2025-01-01
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 50 19 — — $24,745.32 $133,775.29 $43,224.92 2025-01-01
18 MS_DRG Chimeric Antigen Receptor (car) T-cell Immunotherapy 54 21 — — $234,161.82 $797,902.35 $257,814.93 2025-01-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 54 21 — — $41,789.48 $173,115.23 $55,936.28 2025-01-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 52 20 — — $81,600.75 $265,170.47 $88,578.60 2025-01-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 54 21 — — $53,497.38 $183,053.63 $59,147.53 2025-01-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 54 21 — — $34,410.66 $149,606.56 $48,340.26 2025-01-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 54 21 — — $40,929.33 $133,004.30 $42,975.80 2025-01-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 50 20 — — $71,781.28 $233,261.05 $75,370.34 2025-01-01
215 MS_DRG Other Heart Assist System Implant 54 21 — — $51,613.48 $221,221.92 $71,480.31 2025-01-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 54 21 — — $64,680.93 $210,187.68 $70,044.23 2025-01-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 54 21 — — $36,204.88 $137,853.30 $44,542.59 2025-01-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 54 21 — — $32,885.48 $123,373.43 $39,863.91 2025-01-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 54 21 — — $36,789.37 $167,001.46 $53,960.82 2025-01-01
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 54 21 — — $23,170.45 $84,953.91 $30,484.20 2025-01-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 54 21 — — $29,660.77 $113,582.30 $36,700.24 2025-01-01
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 54 21 — — $25,326.05 $100,674.73 $32,529.60 2025-01-01
222 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 4 2 — — $46,663.54 $47,304.02 $46,983.78 2025-01-01
224 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 4 2 — — $50,551.75 $51,245.60 $50,898.68 2025-01-01
225 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 4 2 — — $31,643.13 $32,077.45 $31,860.29 2025-01-01
226 MS_DRG Cardiac Defibrillator Implant Without Cardiac Catheterization With Mcc 4 2 — — $37,490.50 $38,005.07 $37,747.79 2025-01-01
228 MS_DRG Other Cardiothoracic Procedures With Mcc 54 21 — — $33,147.62 $109,123.13 $35,259.41 2025-01-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 54 21 — — $33,676.29 $122,769.20 $39,668.67 2025-01-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 54 21 — — $39,893.67 $175,750.89 $56,787.91 2025-01-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 54 21 — — $38,879.60 $128,828.83 $41,626.64 2025-01-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization With Mcc 54 21 — — $33,933.41 $168,915.94 $54,579.42 2025-01-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Without Mcc 54 21 — — $29,872.12 $112,570.92 $36,373.45 2025-01-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 54 21 — — $28,050.93 $127,356.15 $41,150.79 2025-01-01
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 54 21 — — $28,195.80 $104,100.87 $33,636.65 2025-01-01
245 MS_DRG Aicd Generator Procedures 54 21 — — $28,196.42 $98,136.53 $31,709.46 2025-01-01
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 54 21 — — $23,627.15 $95,637.31 $30,901.93 2025-01-01
266 MS_DRG Endovascular Cardiac Valve Replacement W Mcc 54 21 — — $38,878.96 $135,271.79 $43,708.47 2025-01-01
267 MS_DRG Endovascular Cardiac Valve Replacement Without Mcc 54 21 — — $32,524.07 $105,690.49 $34,150.27 2025-01-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 54 21 — — $32,732.46 $148,452.24 $47,967.28 2025-01-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 54 21 — — $29,773.02 $109,517.28 $35,386.77 2025-01-01
27000000004-1176 CDM Drape Surg W/17 5/8x11.75in Towl Ster 232 96 $66,068.70 $42,944.66 35% off $28,409.54 $66,068.70 $30,854.08 2025-01-01
27100000002-816 CDM Glove Vinyl Powder Free Lg 232 96 $166,479.51 $108,211.68 35% off $71,586.19 $166,479.51 $77,745.93 2025-01-01
27200000002-21145 CDM Glv Surg Orth Ltx Maxxus 8.5 232 96 $74,258.59 $48,268.08 35% off $31,931.19 $74,258.59 $34,678.76 2025-01-01
27200000002-21552 CDM Hemostat D Stat Flowable 0330 232 96 $87,500.00 $56,875.00 35% off $37,625.00 $87,500.00 $40,862.50 2025-01-01
27200000002-28034 CDM Clip Lig Ti Horizon Sm 6/cq 232 96 $71,250.00 $46,312.50 35% off $30,637.50 $71,250.00 $33,273.75 2025-01-01
27200000002-30479 CDM Stylet Steerable 30cm 232 96 $138,979.55 $90,336.71 35% off $59,761.21 $138,979.55 $64,903.45 2025-01-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 50 20 — — $46,890.06 $152,374.32 $49,234.56 2025-01-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 50 20 — — $41,387.85 $134,494.30 $43,457.24 2025-01-01
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 50 20 — — $31,872.28 $103,572.44 $33,465.89 2025-01-01
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 50 20 — — $29,726.31 $96,598.88 $31,212.63 2025-01-01
27800000002-88967 CDM Device Impella 5.5 Smartassist 232 96 $146,250.00 $95,062.50 35% off $62,887.50 $146,250.00 $68,298.75 2025-01-01
27800000002-88968 CDM Device Impella 5.5 Smartassist 232 96 $146,250.00 $95,062.50 35% off $62,887.50 $146,250.00 $68,298.75 2025-01-01
27800000002-88987 CDM Valve Hrt Sapien 3 Ultra 23mm 232 96 $105,625.00 $68,656.25 35% off $45,418.75 $105,625.00 $49,326.88 2025-01-01
27800000002-88988 CDM Valve Hrt Sapien 3 Ultra 26mm 232 96 $105,625.00 $68,656.25 35% off $45,418.75 $105,625.00 $49,326.88 2025-01-01
27800000002-89069 CDM Watchman Flx Procedure - Device 232 96 $65,100.00 $42,315.00 35% off $27,993.00 $65,100.00 $30,401.70 2025-01-01
27800000002-89075 CDM Valve Aortic 26mm Evolut Fx 232 96 $97,500.00 $63,375.00 35% off $41,925.00 $97,500.00 $45,532.50 2025-01-01
27800000002-89076 CDM Valve Aortic 29mm Evolut Fx 232 96 $97,500.00 $63,375.00 35% off $41,925.00 $97,500.00 $45,532.50 2025-01-01
27800000002-89077 CDM Valve Aortic 34mm Evolut Fx 232 96 $75,000.00 $48,750.00 35% off $32,250.00 $75,000.00 $35,025.00 2025-01-01
27800000002-89078 CDM Valve Aortic 34mm Evolut Fx 232 96 $97,987.50 $63,691.88 35% off $42,134.63 $97,987.50 $45,760.16 2025-01-01
27800000002-89079 CDM Valve Aortic 23mm Evolut Fx 232 96 $75,000.00 $48,750.00 35% off $32,250.00 $75,000.00 $35,025.00 2025-01-01
27800000002-89080 CDM Valve Aortic 23mm Evolut Fx 232 96 $97,500.00 $63,375.00 35% off $41,925.00 $97,500.00 $45,532.50 2025-01-01
27800000002-89096 CDM Valve Sapien Thv Edwards Resilia 23mm 232 96 $110,500.00 $71,825.00 35% off $47,515.00 $110,500.00 $51,603.50 2025-01-01
27800000002-89097 CDM Valve Sapien Thv Edwards Resilia 29mm 232 96 $110,500.00 $71,825.00 35% off $47,515.00 $110,500.00 $51,603.50 2025-01-01
27800000002-89098 CDM Valve Sapien Thv Edwards Resilia 26mm 232 96 $110,500.00 $71,825.00 35% off $47,515.00 $110,500.00 $51,603.50 2025-01-01
27800000002-89099 CDM Valve Sapien Thv Edwards Resilia 20mm 232 96 $110,500.00 $71,825.00 35% off $47,515.00 $110,500.00 $51,603.50 2025-01-01
27800000002-90151 CDM Kit Mitraclip 1 Mbr0101 232 96 $97,500.00 $63,375.00 35% off $41,925.00 $97,500.00 $45,532.50 2025-01-01
27800000002-90152 CDM Kit Mitraclip 1 Mbr0201 232 96 $97,500.00 $63,375.00 35% off $41,925.00 $97,500.00 $45,532.50 2025-01-01
27800000002-90153 CDM Kit Mitraclip 1 Mbr0301 232 96 $97,500.00 $63,375.00 35% off $41,925.00 $97,500.00 $45,532.50 2025-01-01
27800000002-90154 CDM Kit Mitraclip 1 Mbr0301 232 96 $97,500.00 $63,375.00 35% off $41,925.00 $97,500.00 $45,532.50 2025-01-01
27800000002-90155 CDM Kit Mitraclip 3 Mbr0203 232 96 $97,500.00 $63,375.00 35% off $41,925.00 $97,500.00 $45,532.50 2025-01-01
27800000002-90156 CDM Kit Mitraclp 1 Sgc0301 Cds0501 232 96 $97,500.00 $63,375.00 35% off $41,925.00 $97,500.00 $45,532.50 2025-01-01
27800000002-90157 CDM Kit Mitraclp 2 Sgc0301 Cds0501 232 96 $97,500.00 $63,375.00 35% off $41,925.00 $97,500.00 $45,532.50 2025-01-01
27800000002-90158 CDM Kit Mitraclp 3 Sgc0301 Cds0501 232 96 $97,500.00 $63,375.00 35% off $41,925.00 $97,500.00 $45,532.50 2025-01-01
27800000002-90267 CDM Set Pump Impella Cp 232 96 $81,250.00 $52,812.50 35% off $34,937.50 $81,250.00 $37,943.75 2025-01-01
27800000002-90268 CDM Set Pump Impella Cp 232 96 $81,250.00 $52,812.50 35% off $34,937.50 $81,250.00 $37,943.75 2025-01-01
27800000002-90269 CDM Set Pump Impella Cp 232 96 $81,250.00 $52,812.50 35% off $34,937.50 $81,250.00 $37,943.75 2025-01-01
27800000002-90270 CDM Set Pump Impella Cp 232 96 $81,250.00 $52,812.50 35% off $34,937.50 $81,250.00 $37,943.75 2025-01-01
27800000002-90271 CDM Set Pump Impella Cp 232 96 $81,250.00 $52,812.50 35% off $34,937.50 $81,250.00 $37,943.75 2025-01-01
27800000002-90555 CDM Valve Aort 26mm Evolutr 232 96 $107,250.00 $69,712.50 35% off $46,117.50 $107,250.00 $50,085.75 2025-01-01
27800000002-90556 CDM Valve Aort 26mm Pro Perc 232 96 $97,500.00 $63,375.00 35% off $41,925.00 $97,500.00 $45,532.50 2025-01-01
27800000002-90558 CDM Valve Aort 29mm Pro Perc 232 96 $97,500.00 $63,375.00 35% off $41,925.00 $97,500.00 $45,532.50 2025-01-01
27800000002-90559 CDM Valve Aort 34mm Evolutr 232 96 $97,500.00 $63,375.00 35% off $41,925.00 $97,500.00 $45,532.50 2025-01-01
27800000002-90653 CDM Valve Sapien 3 Thv 20mm W/command System 232 96 $105,625.00 $68,656.25 35% off $45,418.75 $105,625.00 $49,326.88 2025-01-01
27800000002-90654 CDM Valve Sapien 3 Thv 23mm W/command System 232 96 $81,250.00 $52,812.50 35% off $34,937.50 $81,250.00 $37,943.75 2025-01-01
27800000002-90655 CDM Valve Sapien 3 Thv 23mm W/command System 232 96 $105,625.00 $68,656.25 35% off $45,418.75 $105,625.00 $49,326.88 2025-01-01
27800000002-90656 CDM Valve Sapien 3 Thv 26mm W/command System 232 96 $81,250.00 $52,812.50 35% off $34,937.50 $81,250.00 $37,943.75 2025-01-01
27800000002-90657 CDM Valve Sapien 3 Thv 26mm W/command System 232 96 $105,625.00 $68,656.25 35% off $45,418.75 $105,625.00 $49,326.88 2025-01-01
27800000002-90658 CDM Valve Sapien 3 Thv 29mm W/command System 232 96 $81,250.00 $52,812.50 35% off $34,937.50 $81,250.00 $37,943.75 2025-01-01
27800000002-90659 CDM Valve Sapien 3 Thv 29mm W/command System 232 96 $105,625.00 $68,656.25 35% off $45,418.75 $105,625.00 $49,326.88 2025-01-01
27800000002-90836 CDM Valve Aortic Evolut Tm Pro 26mm 232 96 $75,000.00 $48,750.00 35% off $32,250.00 $75,000.00 $35,025.00 2025-01-01
27800000002-90837 CDM Valve Aortic Evolut Tm Pro 29mm 232 96 $97,500.00 $63,375.00 35% off $41,925.00 $97,500.00 $45,532.50 2025-01-01
27800000002-90838 CDM Valve Aortic Evolut Tm Pro 34mm 232 96 $75,000.00 $48,750.00 35% off $32,250.00 $75,000.00 $35,025.00 2025-01-01
27800000002-91231 CDM Valve Sapien 3 Ultra Thv 20mm W/command System 232 96 $105,625.00 $68,656.25 35% off $45,418.75 $105,625.00 $49,326.88 2025-01-01
27800000002-91232 CDM Valve Sapien 3 Ultra Thv 23mm W/command System 232 96 $81,250.00 $52,812.50 35% off $34,937.50 $81,250.00 $37,943.75 2025-01-01
27800000002-91233 CDM Valve Sapien 3 Ultra Thv 23mm W/command System 232 96 $105,625.00 $68,656.25 35% off $45,418.75 $105,625.00 $49,326.88 2025-01-01
27800000002-91234 CDM Valve Sapien 3 Ultra Thv 23mm W/command System 232 96 $105,625.00 $68,656.25 35% off $45,418.75 $105,625.00 $49,326.88 2025-01-01
27800000002-91235 CDM Valve Sapien 3 Ultra Thv 26mm W/command System 232 96 $81,250.00 $52,812.50 35% off $34,937.50 $81,250.00 $37,943.75 2025-01-01
27800000002-91236 CDM Valve Sapien 3 Ultra Thv 26mm W/command System 232 96 $105,625.00 $68,656.25 35% off $45,418.75 $105,625.00 $49,326.88 2025-01-01
27800000002-91237 CDM Valve Sapien 3 Ultra Thv 26mm W/command System 232 96 $105,625.00 $68,656.25 35% off $45,418.75 $105,625.00 $49,326.88 2025-01-01
27800000002-91247 CDM Kit Mitraclip G4 Syst Cds0701nt/ntw/xt/xtw 232 96 $97,500.00 $63,375.00 35% off $41,925.00 $97,500.00 $45,532.50 2025-01-01
27800000002-91435 CDM Kit Mitraclip 1 Mbr0303 232 96 $97,500.00 $63,375.00 35% off $41,925.00 $97,500.00 $45,532.50 2025-01-01
27800000002-91487 CDM Stent Graft Confrm Thor 37x37x10 22f 232 96 $64,015.00 $41,609.75 35% off $27,526.45 $64,015.00 $29,895.01 2025-01-01
27800000002-91492 CDM Stent Graft Confrm Thor 28x28x10 20f 232 96 $64,015.00 $41,609.75 35% off $27,526.45 $64,015.00 $29,895.01 2025-01-01
27800000002-91494 CDM Stent Graft Confrm Thor 34x34x10 22f 232 96 $64,015.00 $41,609.75 35% off $27,526.45 $64,015.00 $29,895.01 2025-01-01
27800000002-91511 CDM Kit Mitraclip G4 Delivery Sys Xtw 232 96 $97,500.00 $63,375.00 35% off $41,925.00 $97,500.00 $45,532.50 2025-01-01
27800000002-91517 CDM Kit Mitraclip G4 Delivery Sys Nt 232 96 $97,500.00 $63,375.00 35% off $41,925.00 $97,500.00 $45,532.50 2025-01-01
27800000002-91547 CDM Graft Bn Canc Crsh Frzdr 30ml 232 96 $138,385.00 $89,950.25 35% off $59,505.55 $138,385.00 $64,625.80 2025-01-01
27800000002-91555 CDM Kit Mitraclip 2 Mbr0202 232 96 $97,500.00 $63,375.00 35% off $41,925.00 $97,500.00 $45,532.50 2025-01-01
27800000002-91556 CDM Kit Mitraclip 2 Mbr0202 232 96 $97,500.00 $63,375.00 35% off $41,925.00 $97,500.00 $45,532.50 2025-01-01
27800000002-91577 CDM Implant Gammatile Therapy Device 4pk 232 96 $84,500.00 $54,925.00 35% off $36,335.00 $84,500.00 $39,461.50 2025-01-01
27800000002-91990 CDM Set Pump Aic Impella 5.0 232 96 $81,250.00 $52,812.50 35% off $34,937.50 $81,250.00 $37,943.75 2025-01-01
27800000002-91991 CDM Set Pump Aic Impella 5.0 232 96 $81,250.00 $52,812.50 35% off $34,937.50 $81,250.00 $37,943.75 2025-01-01
28 MS_DRG Spinal Procedures With Mcc 54 21 — — $23,216.37 $130,507.25 $42,168.97 2025-01-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 54 21 — — $97,079.83 $461,733.74 $149,193.50 2025-01-01
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 54 21 — — $27,072.61 $94,465.67 $30,523.35 2025-01-01
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 54 21 — — $21,028.94 $109,995.90 $35,541.42 2025-01-01
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 54 21 — — $21,162.52 $97,820.34 $31,607.30 2025-01-01
33975 HCPCS Implant Ventricular Device 22 11 — — $44,455.93 $48,456.96 $47,567.85 2025-01-01
33976 HCPCS Implant Ventricular Device 22 11 — — $44,455.93 $48,456.96 $47,567.85 2025-01-01
33979 HCPCS Insert Intracorporeal Device 22 11 — — $44,455.93 $48,456.96 $47,567.85 2025-01-01
33981 HCPCS Replace Vad Pump Ext 22 11 — — $44,455.93 $48,456.96 $47,567.85 2025-01-01
33982 HCPCS Replace Vad Intra Without Bp 22 11 — — $44,455.93 $48,456.96 $47,567.85 2025-01-01
33983 HCPCS Replace Vad Intra W/bp 22 11 — — $44,455.93 $48,456.96 $47,567.85 2025-01-01
33990 HCPCS Insj Perq Vad L Hrt Arterial 22 11 — — $44,455.93 $48,456.96 $47,567.85 2025-01-01
33991 HCPCS Insj Perq Vad L Hrt Artl&ven 22 11 — — $44,455.93 $48,456.96 $47,567.85 2025-01-01
33995 HCPCS Insj Perq Vad R Hrt Venous 22 11 — — $44,455.93 $48,456.96 $47,567.85 2025-01-01
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 54 21 — — $20,039.34 $92,663.81 $29,941.15 2025-01-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 54 21 — — $63,636.83 $318,357.90 $102,866.49 2025-01-01
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 54 21 — — $25,663.44 $119,226.12 $38,523.85 2025-01-01
453 MS_DRG Combined Anterior/posterior Spinal Fusion W Mcc 54 21 — — $40,574.72 $191,911.34 $62,009.60 2025-01-01
454 MS_DRG Combined Anterior/posterior Spinal Fusion W Cc 54 21 — — $27,254.47 $132,460.71 $42,800.15 2025-01-01
455 MS_DRG Combined Anterior/posterior Spinal Fusion Without Cc/mcc 54 21 — — $22,280.07 $112,620.00 $32,228.70 2025-01-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 54 21 — — $45,376.04 $182,555.52 $58,986.59 2025-01-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 54 21 — — $33,524.52 $131,572.77 $42,513.25 2025-01-01
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 54 21 — — $30,196.83 $98,127.87 $32,953.83 2025-01-01
459 MS_DRG Spinal Fusion Except Cervical With Mcc 54 21 — — $29,667.67 $143,635.72 $46,410.98 2025-01-01
461 MS_DRG Bilateral Or Multiple Major Joint Procs Of Lower Extremity W Mcc 54 21 — — $38,105.71 $147,668.25 $47,713.95 2025-01-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 54 21 — — $21,012.64 $122,658.75 $39,632.99 2025-01-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 54 21 — — $21,741.99 $112,326.20 $36,294.37 2025-01-01
471 MS_DRG Cervical Spinal Fusion With Mcc 54 21 — — $25,581.92 $106,530.78 $34,421.78 2025-01-01
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 54 21 — — $15,473.20 $93,185.74 $30,109.79 2025-01-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 52 20 — — $68,977.53 $224,149.95 $90,967.54 2025-01-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 54 21 — — $34,734.89 $134,665.39 $43,512.53 2025-01-01
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 54 21 — — $31,741.59 $123,078.90 $39,768.74 2025-01-01
6 MS_DRG Liver Transplant Without Mcc 52 20 — — $32,235.50 $104,752.74 $47,328.43 2025-01-01
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 54 21 — — $29,973.57 $97,402.36 $35,080.50 2025-01-01
652 MS_DRG Kidney Transplant 52 20 — — $20,022.81 $86,606.64 $30,665.91 2025-01-01
653 MS_DRG Major Bladder Procedures With Mcc 54 21 — — $21,088.52 $117,242.34 $37,882.86 2025-01-01
7 MS_DRG Lung Transplant 52 20 — — $81,749.37 $265,653.42 $96,137.12 2025-01-01
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 40 19 — — $24,114.43 $109,801.83 $40,847.38 2025-01-01
7907 OTHER Level 3: Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 4 2 — — $53,352.52 $54,084.81 $53,718.66 2025-01-01
799 MS_DRG Splenic Procedures With Mcc 54 21 — — $21,016.41 $107,301.77 $34,670.91 2025-01-01
8 MS_DRG Simultaneous Pancreas/kidney Transplant 52 20 — — $35,066.57 $113,952.64 $53,706.17 2025-01-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 54 21 — — $35,676.21 $130,953.38 $42,313.11 2025-01-01
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 54 21 — — $26,129.40 $97,497.65 $31,503.03 2025-01-01
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 54 21 — — $29,249.14 $100,222.10 $31,595.47 2025-01-01
834 MS_DRG Acute Leukemia Without Major O.r. Procedures With Mcc 54 21 — — $37,314.51 $121,257.54 $39,180.24 2025-01-01
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 54 21 — — $19,283.02 $104,906.51 $33,285.36 2025-01-01
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 54 21 — — $23,050.18 $108,269.84 $34,983.70 2025-01-01
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 54 21 — — $16,004.37 $95,905.86 $30,988.70 2025-01-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 54 21 — — $39,357.47 $150,838.84 $48,738.43 2025-01-01
901 MS_DRG Wound Debridements For Injuries With Mcc 54 21 — — $26,736.46 $93,727.16 $30,284.73 2025-01-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 54 21 — — $131,925.09 $570,850.37 $184,450.82 2025-01-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 54 21 — — $20,373.59 $149,859.94 $48,422.13 2025-01-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 54 21 — — $34,874.74 $131,895.46 $42,617.52 2025-01-01
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 54 21 — — $25,846.24 $83,990.18 $30,249.96 2025-01-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 54 21 — — $37,121.75 $156,634.25 $50,611.01 2025-01-01
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 54 21 — — $36,303.97 $148,839.90 $48,092.53 2025-01-01
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 54 21 — — $26,008.99 $102,662.84 $33,171.99 2025-01-01
A9542 HCPCS Indium In-111 Ibritumomab Tiuxetan Diagnostic Per Study Dose Up To 5 Millicuries 256 105 $97,800.00 $63,570.00 35% off $98.80 $97,800.00 $45,672.60 2025-01-01
A9606 HCPCS Radium Ra-223 Dichloride Therapeutic Per Microcurie 292 115 $85,076.88 $55,299.97 35% off $145.12 $85,076.88 $39,730.90 2025-01-01
C1822 HCPCS Kit Ipg Omnia 1,160 96 $65,000.00 $42,250.00 35% off $6,281.23 $84,500.00 $32,690.00 2025-01-01
C1824 HCPCS Kit Ipg Optimizer Smart Mini 232 96 $84,500.00 $54,925.00 35% off $36,335.00 $84,500.00 $39,461.50 2025-01-01
J7330 HCPCS Membrane Collgn Porcine Maci W/autologous Cult Chondrocytes 256 105 $114,240.00 $74,256.00 35% off $732.20 $114,240.00 $53,350.08 2025-01-01
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