|
J3391
|
HCPCS
|
Inj, Atidarsagene Autotemcel
|
16
|
15
|
—
|
—
|
$9,509.28
|
$4,955,500.00
|
$4,505,000.00
|
2026-06-15
|
|
J1411
|
HCPCS
|
Inj, Hemgenix, Per Tx Dose
|
24
|
19
|
—
|
—
|
$15,391.98
|
$4,053,793.33
|
$3,685,266.66
|
2026-06-15
|
|
J1414
|
HCPCS
|
Inj, Beqvez, Per Tx Dose
|
13
|
10
|
—
|
—
|
$15,391.98
|
$3,893,400.00
|
$3,605,000.00
|
2026-06-15
|
|
J3389
|
HCPCS
|
Topi Adm Prad Zami Per Treat
|
16
|
15
|
—
|
—
|
$9,509.28
|
$3,669,402.00
|
$3,335,820.00
|
2026-06-15
|
|
J1413
|
HCPCS
|
Inj Delandistrogene Mox Rokl
|
24
|
19
|
—
|
—
|
$15,391.98
|
$3,660,645.69
|
$3,327,859.72
|
2026-06-15
|
|
J3394
|
HCPCS
|
Lyfgenia 1.7 X To 20 X 10exp6 Cell/ml Intravenous Suspension
|
27
|
22
|
—
|
—
|
$9,509.28
|
$4,761,600.00
|
$3,286,000.00
|
2026-06-15
|
|
J3387
|
HCPCS
|
Inj Elivaldogene Autotemecel
|
16
|
15
|
—
|
—
|
$9,509.28
|
$3,498,000.00
|
$3,180,000.00
|
2026-06-15
|
|
J3393
|
HCPCS
|
Zynteglo 2 X 10exp6 To 20 X 10exp6 Cell/ml Intravenous Suspension
|
31
|
23
|
—
|
—
|
$9,509.28
|
$4,850,496.00
|
$2,968,000.00
|
2026-06-15
|
|
J3399
|
HCPCS
|
Zolgensma 2 X 10exp13 Vg/ml Intravenous Suspension Kit
|
48
|
27
|
—
|
$4,972,500.00
|
$12,141.80
|
$4,911,300.00
|
$2,637,650.33
|
2026-06-15
|
|
J3392
|
HCPCS
|
Casgevy 4x10exp6 To 13x10exp6 Cell/ml Intravenous Suspension
|
34
|
24
|
—
|
—
|
$9,509.28
|
$4,984,320.00
|
$2,332,000.00
|
2026-06-15
|
|
Q205700
|
OTHER
|
Afamitresgene Autoleucel
|
2
|
1
|
—
|
—
|
$1,371,703.60
|
$1,757,013.60
|
$1,564,358.60
|
2026-06-15
|
|
Q2057
|
HCPCS
|
Tecelra 2.68x 10exp9 To 10x 10exp9 Cell Intravenous Suspension
|
52
|
33
|
$3,489,600.00
|
$2,268,240.00
35% off
|
$9,509.28
|
$3,489,600.00
|
$1,471,884.20
|
2026-06-15
|
|
C9301
|
HCPCS
|
Aucatzyl Intravenous Suspension
|
41
|
28
|
$2,520,000.00
|
$1,638,000.00
35% off
|
$9,509.28
|
$2,520,000.00
|
$1,260,000.00
|
2026-06-15
|
|
Q2042
|
HCPCS
|
Kymriah 0.2 X 10exp6 To 2.5 X 10exp8 Cell Intravenous Suspension
|
89
|
34
|
$2,905,939.24
|
$1,888,860.51
35% off
|
$9,509.28
|
$2,905,939.24
|
$1,203,058.85
|
2026-06-15
|
|
Q205600
|
OTHER
|
Ciltacabtagene Car-pos T
|
2
|
1
|
—
|
—
|
$1,046,016.23
|
$1,339,841.02
|
$1,192,928.62
|
2026-06-15
|
|
Q204200
|
OTHER
|
Tisagenlecleucel Car-pos T
|
2
|
1
|
—
|
—
|
$1,008,425.71
|
$1,291,691.36
|
$1,150,058.54
|
2026-06-15
|
|
Q205400
|
OTHER
|
Lisocabtagene Mara Car Pos T
|
2
|
1
|
—
|
—
|
$1,000,718.21
|
$1,281,818.83
|
$1,141,268.52
|
2026-06-15
|
|
Q205500
|
OTHER
|
Idecabtagene Vicleucel Car
|
2
|
1
|
—
|
—
|
$993,385.48
|
$1,272,426.34
|
$1,132,905.91
|
2026-06-15
|
|
Q204100
|
OTHER
|
Axicabtagene Ciloleucel Car+
|
2
|
1
|
—
|
—
|
$947,302.19
|
$1,213,398.31
|
$1,080,350.25
|
2026-06-15
|
|
Q205300
|
OTHER
|
Brexucabtagene Car Pos T
|
2
|
1
|
—
|
—
|
$871,221.36
|
$1,115,946.46
|
$993,583.91
|
2026-06-15
|
|
Q2054
|
HCPCS
|
Breyanzi 1.5x To 70x10exp6 Cell/ml Intravenous Suspension
|
60
|
34
|
$2,678,006.00
|
$1,740,703.90
35% off
|
$9,509.28
|
$2,678,006.00
|
$951,897.23
|
2026-06-15
|
|
Q2056
|
HCPCS
|
Carvykti 0.5x 10exp6 To 1x 10exp8 Cell Intravenous Suspension
|
60
|
34
|
$2,665,490.12
|
$1,732,568.58
35% off
|
$9,509.28
|
$2,665,490.12
|
$947,448.46
|
2026-06-15
|
|
Q2041
|
HCPCS
|
Yescarta Intravenous Suspension
|
60
|
34
|
$2,417,184.00
|
$1,571,169.60
35% off
|
$9,509.28
|
$2,417,184.00
|
$859,188.05
|
2026-06-15
|
|
Q2053
|
HCPCS
|
Tecartus 2x10exp6 To 2x10exp8 Cell Intravenous Suspension
|
60
|
34
|
$2,217,600.00
|
$1,441,440.00
35% off
|
$9,509.28
|
$2,217,600.00
|
$788,245.92
|
2026-06-15
|
|
005-P
|
OTHER
|
Liver/Intestinal - Pediatric
|
1
|
1
|
—
|
—
|
$696,055.00
|
$696,055.00
|
$696,055.00
|
2026-06-15
|
|
Q205800
|
OTHER
|
Obecbtge Autol Up To 400 Mil
|
2
|
1
|
—
|
—
|
$560,700.00
|
$718,200.00
|
$639,450.00
|
2026-06-15
|
|
005-A
|
OTHER
|
Liver/Intestinal - Adult
|
1
|
1
|
—
|
—
|
$603,170.00
|
$603,170.00
|
$603,170.00
|
2026-06-15
|
|
005-I
|
OTHER
|
Intestinal - Adult
|
2
|
2
|
—
|
—
|
$563,700.00
|
$563,700.00
|
$563,700.00
|
2026-06-15
|
|
006-LA
|
OTHER
|
Liver (Live Donor) - Adult
|
3
|
3
|
—
|
—
|
$374,196.00
|
$561,500.00
|
$561,500.00
|
2026-06-15
|
|
005-LA
|
OTHER
|
Liver (Live Donor) - Adult
|
2
|
2
|
—
|
—
|
$561,500.00
|
$561,500.00
|
$561,500.00
|
2026-06-15
|
|
006-LP
|
OTHER
|
Liver (Live Donor) - Pediatric
|
2
|
2
|
—
|
—
|
$560,500.00
|
$560,500.00
|
$560,500.00
|
2026-06-15
|
|
005-LP
|
OTHER
|
Liver (Live Donor) - Pediatric
|
2
|
2
|
—
|
—
|
$560,500.00
|
$560,500.00
|
$560,500.00
|
2026-06-15
|
|
014-UP
|
OTHER
|
Allogeneic Unrelated Bmt - Pediatric
|
1
|
1
|
—
|
—
|
$540,638.00
|
$540,638.00
|
$540,638.00
|
2026-06-15
|
|
J340300
|
OTHER
|
Revakinagene, Per Implant
|
2
|
1
|
—
|
—
|
$471,700.00
|
$604,200.00
|
$537,950.00
|
2026-06-15
|
|
001-P
|
OTHER
|
Heart - Pediatric
|
1
|
1
|
—
|
—
|
$535,426.00
|
$535,426.00
|
$535,426.00
|
2026-06-15
|
|
006-DA
|
OTHER
|
Liver (Deceased Donor) - Adult
|
3
|
3
|
—
|
—
|
$358,735.00
|
$486,600.00
|
$486,600.00
|
2026-06-15
|
|
005-DA
|
OTHER
|
Liver (Deceased Donor) - Adult
|
2
|
2
|
—
|
—
|
$486,600.00
|
$486,600.00
|
$486,600.00
|
2026-06-15
|
|
014-U
|
OTHER
|
Allogeneic Unrelated Bmt ? Adult & Pediatric
|
2
|
2
|
—
|
—
|
$481,200.00
|
$481,200.00
|
$481,200.00
|
2026-06-15
|
|
005-DP
|
OTHER
|
Liver (Deceased Donor) -pediatric
|
2
|
2
|
—
|
—
|
$471,700.00
|
$471,700.00
|
$471,700.00
|
2026-06-15
|
|
006-DP
|
OTHER
|
Liver (Deceased Donor) -pediatric
|
2
|
2
|
—
|
—
|
$471,700.00
|
$471,700.00
|
$471,700.00
|
2026-06-15
|
|
006-P
|
OTHER
|
Liver (Live & Deceased Donor) - Pediatric
|
1
|
1
|
—
|
—
|
$449,447.00
|
$449,447.00
|
$449,447.00
|
2026-06-15
|
|
002-P
|
OTHER
|
Heart - Pediatric
|
3
|
3
|
—
|
—
|
$444,900.00
|
$535,426.00
|
$444,900.00
|
2026-06-15
|
|
003-P
|
OTHER
|
Heart - Pediatric
|
2
|
2
|
—
|
—
|
$444,900.00
|
$444,900.00
|
$444,900.00
|
2026-06-15
|
|
014-RP
|
OTHER
|
Allogeneic Related Bmt - Pediatric
|
1
|
1
|
—
|
—
|
$440,327.00
|
$440,327.00
|
$440,327.00
|
2026-06-15
|
|
007-D
|
OTHER
|
Lung (Double) - Adult
|
3
|
3
|
—
|
—
|
$433,900.00
|
$479,141.00
|
$433,900.00
|
2026-06-15
|
|
014-UA
|
OTHER
|
Allogeneic Unrelated Bmt - Adult
|
1
|
1
|
—
|
—
|
$430,092.00
|
$430,092.00
|
$430,092.00
|
2026-06-15
|
|
007-S
|
OTHER
|
Lung (Single) - Adult
|
3
|
3
|
—
|
—
|
$428,300.00
|
$451,839.00
|
$428,300.00
|
2026-06-15
|
|
014-R
|
OTHER
|
Allogeneic Related Bmt ? Adult & Pediatric
|
2
|
2
|
—
|
—
|
$428,000.00
|
$428,000.00
|
$428,000.00
|
2026-06-15
|
|
J3402
|
HCPCS
|
Ryoncil 6.68 X 10exp6 Cell/ml Intravenous Suspension
|
53
|
33
|
$931,200.00
|
$605,280.00
35% off
|
$9,509.28
|
$931,200.00
|
$419,040.00
|
2026-06-15
|
|
J340200
|
OTHER
|
Inj. Remestemcel-l-rknd/ Td
|
2
|
1
|
—
|
—
|
$358,970.86
|
$459,805.37
|
$409,388.11
|
2026-06-15
|
|
014-RA
|
OTHER
|
Allogeneic Related Bmt - Adult
|
1
|
1
|
—
|
—
|
$366,514.00
|
$366,514.00
|
$366,514.00
|
2026-06-15
|
|
001-A
|
OTHER
|
Heart - Adult
|
4
|
4
|
—
|
—
|
$36,400.00
|
$446,380.00
|
$361,500.00
|
2026-06-15
|
|
002-A
|
OTHER
|
Heart - Adult
|
3
|
3
|
—
|
—
|
$361,500.00
|
$446,380.00
|
$361,500.00
|
2026-06-15
|
|
18
|
MS_DRG
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
27
|
16
|
—
|
—
|
$292,570.60
|
$736,266.74
|
$307,199.13
|
2026-06-15
|
|
Q2058
|
HCPCS
|
Obecbtge Autol Up To 400 Mil
|
17
|
15
|
—
|
—
|
$9,509.28
|
$602,383.43
|
$278,250.00
|
2026-06-15
|
|
J3403
|
HCPCS
|
Revakinagene, Per Implant
|
17
|
15
|
—
|
—
|
$9,509.28
|
$573,698.50
|
$265,000.00
|
2026-06-15
|
|
017-P
|
OTHER
|
Autologous Bmt - Pediatric
|
1
|
1
|
—
|
—
|
$247,521.00
|
$247,521.00
|
$247,521.00
|
2026-06-15
|
|
016-P
|
OTHER
|
Autologous Bmt - Pediatric
|
1
|
1
|
—
|
—
|
$247,521.00
|
$247,521.00
|
$247,521.00
|
2026-06-15
|
|
5884
|
APR_DRG
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
5
|
5
|
—
|
—
|
$215,557.62
|
$223,769.34
|
$219,663.48
|
2026-06-15
|
|
5834
|
APR_DRG
|
Neonate With Ecmo
|
5
|
5
|
—
|
—
|
$208,520.11
|
$216,463.73
|
$212,491.92
|
2026-06-15
|
|
5833
|
APR_DRG
|
Neonate With Ecmo
|
5
|
5
|
—
|
—
|
$208,520.11
|
$216,463.73
|
$212,491.92
|
2026-06-15
|
|
016-A
|
OTHER
|
Autologous Bmt - Adult
|
1
|
1
|
—
|
—
|
$205,695.00
|
$205,695.00
|
$205,695.00
|
2026-06-15
|
|
017-A
|
OTHER
|
Autologous Bmt - Adult
|
1
|
1
|
—
|
—
|
$205,695.00
|
$205,695.00
|
$205,695.00
|
2026-06-15
|
|
5831
|
APR_DRG
|
Neonate With Ecmo
|
5
|
5
|
—
|
—
|
$198,345.35
|
$205,901.36
|
$202,123.35
|
2026-06-15
|
|
5832
|
APR_DRG
|
Neonate With Ecmo
|
5
|
5
|
—
|
—
|
$198,345.35
|
$205,901.36
|
$202,123.35
|
2026-06-15
|
|
1
|
MS_DRG
|
Heart Transplant Or Implant Of Heart Assist System With Mcc
|
27
|
16
|
—
|
—
|
$189,866.54
|
$477,807.50
|
$199,359.87
|
2026-06-15
|
|
651-C
|
OTHER
|
Kidney Transplant With Hemodialysis Without Mcc - Cadaveric
|
1
|
1
|
—
|
—
|
$185,100.00
|
$185,100.00
|
$185,100.00
|
2026-06-15
|
|
650-C
|
OTHER
|
Kidney Transplant With Hemodialysis With Mcc - Cadaveric
|
1
|
1
|
—
|
—
|
$185,100.00
|
$185,100.00
|
$185,100.00
|
2026-06-15
|
|
652-C
|
OTHER
|
Kidney Transplant - Cadaveric
|
1
|
1
|
—
|
—
|
$185,100.00
|
$185,100.00
|
$185,100.00
|
2026-06-15
|
|
1614
|
APR_DRG
|
Implantable Heart Assist Systems
|
5
|
5
|
—
|
—
|
$175,483.62
|
$182,168.71
|
$178,826.17
|
2026-06-15
|
|
650-P
|
OTHER
|
Kidney (Deceased & Live Donor) - Pediatric
|
1
|
1
|
—
|
—
|
$175,870.00
|
$175,870.00
|
$175,870.00
|
2026-06-15
|
|
652-P
|
OTHER
|
Kidney (Deceased & Live Donor) - Pediatric
|
1
|
1
|
—
|
—
|
$175,870.00
|
$175,870.00
|
$175,870.00
|
2026-06-15
|
|
651-P
|
OTHER
|
Kidney (Deceased & Live Donor) - Pediatric
|
1
|
1
|
—
|
—
|
$175,870.00
|
$175,870.00
|
$175,870.00
|
2026-06-15
|
|
651-D
|
OTHER
|
Kidney (Deceased) - Adult & Pediatric
|
2
|
2
|
—
|
—
|
$175,300.00
|
$175,300.00
|
$175,300.00
|
2026-06-15
|
|
650-D
|
OTHER
|
Kidney (Deceased) - Adult & Pediatric
|
2
|
2
|
—
|
—
|
$175,300.00
|
$175,300.00
|
$175,300.00
|
2026-06-15
|
|
652-D
|
OTHER
|
Kidney (Deceased) - Adult & Pediatric
|
2
|
2
|
—
|
—
|
$175,300.00
|
$175,300.00
|
$175,300.00
|
2026-06-15
|
|
650-LD
|
OTHER
|
Kidney Transplant With Hemodialysis With Mcc - Live Donor
|
1
|
1
|
—
|
—
|
$170,100.00
|
$170,100.00
|
$170,100.00
|
2026-06-15
|
|
651-LD
|
OTHER
|
Kidney Transplant With Hemodialysis Without Mcc - Live Donor
|
1
|
1
|
—
|
—
|
$170,100.00
|
$170,100.00
|
$170,100.00
|
2026-06-15
|
|
652-LD
|
OTHER
|
Kidney Transplant - Live Donor
|
1
|
1
|
—
|
—
|
$170,100.00
|
$170,100.00
|
$170,100.00
|
2026-06-15
|
|
J733000
|
OTHER
|
Cultured Chondrocytes Implnt
|
2
|
1
|
—
|
—
|
$149,032.28
|
$190,895.28
|
$169,963.78
|
2026-06-15
|
|
A954300
|
OTHER
|
Y90 Ibritumomab, Rx
|
2
|
1
|
—
|
—
|
$144,835.13
|
$185,519.15
|
$165,177.14
|
2026-06-15
|
|
651-L
|
OTHER
|
Kidney ( Live Donor) - Adult & Pediatric
|
2
|
2
|
—
|
—
|
$161,100.00
|
$161,100.00
|
$161,100.00
|
2026-06-15
|
|
652-L
|
OTHER
|
Kidney (Live Donor) - Adult & Pediatric
|
2
|
2
|
—
|
—
|
$161,100.00
|
$161,100.00
|
$161,100.00
|
2026-06-15
|
|
650-L
|
OTHER
|
Kidney ( Live Donor) - Adult & Pediatric
|
2
|
2
|
—
|
—
|
$161,100.00
|
$161,100.00
|
$161,100.00
|
2026-06-15
|
|
650-A
|
OTHER
|
Kidney (Deceased & Live Donor) - Adult
|
1
|
1
|
—
|
—
|
$158,573.00
|
$158,573.00
|
$158,573.00
|
2026-06-15
|
|
652-A
|
OTHER
|
Kidney (Deceased & Live Donor) - Adult
|
1
|
1
|
—
|
—
|
$158,573.00
|
$158,573.00
|
$158,573.00
|
2026-06-15
|
|
651-A
|
OTHER
|
Kidney (Deceased & Live Donor) - Adult
|
1
|
1
|
—
|
—
|
$158,573.00
|
$158,573.00
|
$158,573.00
|
2026-06-15
|
|
24
|
APR_DRG
|
Heart And/or Lung Transplant
|
5
|
5
|
—
|
—
|
$154,335.55
|
$160,215.00
|
$157,275.28
|
2026-06-15
|
|
927
|
MS_DRG
|
Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft
|
27
|
16
|
—
|
—
|
$144,653.16
|
$364,026.03
|
$151,885.82
|
2026-06-15
|
|
3
|
MS_DRG
|
Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…
|
28
|
17
|
—
|
—
|
$41,100.00
|
$361,889.66
|
$149,556.40
|
2026-06-15
|
|
6094
|
APR_DRG
|
Neonate Birth Weight 1500-2499 Grams With Major Procedure
|
5
|
5
|
—
|
—
|
$138,253.70
|
$143,520.51
|
$140,887.10
|
2026-06-15
|
|
1612
|
APR_DRG
|
Implantable Heart Assist Systems
|
5
|
5
|
—
|
—
|
$135,811.53
|
$140,985.30
|
$138,398.41
|
2026-06-15
|
|
1611
|
APR_DRG
|
Implantable Heart Assist Systems
|
5
|
5
|
—
|
—
|
$135,811.53
|
$140,985.30
|
$138,398.41
|
2026-06-15
|
|
1613
|
APR_DRG
|
Implantable Heart Assist Systems
|
5
|
5
|
—
|
—
|
$135,811.53
|
$140,985.30
|
$138,398.41
|
2026-06-15
|
|
6304
|
APR_DRG
|
Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure
|
5
|
5
|
—
|
—
|
$134,174.18
|
$139,285.57
|
$136,729.88
|
2026-06-15
|
|
74
|
APR_DRG
|
Allogeneic Bone Marrow Transplant
|
5
|
5
|
—
|
—
|
$131,927.99
|
$136,953.81
|
$134,440.90
|
2026-06-15
|
|
J902900
|
OTHER
|
Instill Adstiladrin, Tx Dose
|
2
|
1
|
—
|
—
|
$114,409.13
|
$146,546.52
|
$130,477.82
|
2026-06-15
|
|
J0225
|
HCPCS
|
Amvuttra 25 Mg/0.5 Ml Subcutaneous Syringe
|
62
|
34
|
$859,327.20
|
$558,562.68
35% off
|
$4,926.00
|
$859,327.20
|
$130,334.96
|
2026-06-15
|
|
8412
|
APR_DRG
|
Extensive Third Degree Burns With Skin Graft
|
5
|
5
|
—
|
—
|
$122,803.16
|
$127,481.38
|
$125,142.27
|
2026-06-15
|
|
8413
|
APR_DRG
|
Extensive Third Degree Burns With Skin Graft
|
5
|
5
|
—
|
—
|
$122,803.16
|
$127,481.38
|
$125,142.27
|
2026-06-15
|
|
8411
|
APR_DRG
|
Extensive Third Degree Burns With Skin Graft
|
5
|
5
|
—
|
—
|
$122,803.16
|
$127,481.38
|
$125,142.27
|
2026-06-15
|
|
8414
|
APR_DRG
|
Extensive Third Degree Burns With Skin Graft
|
5
|
5
|
—
|
—
|
$122,803.16
|
$127,481.38
|
$125,142.27
|
2026-06-15
|
|
6314
|
APR_DRG
|
Neonate Birth Weight > 2499 Grams With Other Major Procedure
|
5
|
5
|
—
|
—
|
$118,433.06
|
$122,944.80
|
$120,688.93
|
2026-06-15
|
|
9028800
|
OTHER
|
Botulism Ig IV
|
2
|
1
|
—
|
—
|
$104,850.90
|
$134,303.40
|
$119,577.15
|
2026-06-15
|
|
5883
|
APR_DRG
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
5
|
5
|
—
|
—
|
$108,889.62
|
$113,037.80
|
$110,963.71
|
2026-06-15
|
|
Q204300
|
OTHER
|
Sipuleucel-t Auto Cd54+
|
2
|
1
|
—
|
—
|
$96,839.32
|
$124,041.37
|
$110,440.35
|
2026-06-15
|
|
5882
|
APR_DRG
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
5
|
5
|
—
|
—
|
$103,576.21
|
$107,521.97
|
$105,549.09
|
2026-06-15
|
|
5881
|
APR_DRG
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
5
|
5
|
—
|
—
|
$103,576.21
|
$107,521.97
|
$105,549.09
|
2026-06-15
|
|
5934
|
APR_DRG
|
Neonate Birth Weight 750-999 Grams Without Major Procedure
|
5
|
5
|
—
|
—
|
$100,377.29
|
$104,201.19
|
$102,289.24
|
2026-06-15
|
|
4
|
MS_DRG
|
Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…
|
28
|
17
|
—
|
—
|
$28,700.00
|
$236,166.37
|
$97,599.35
|
2026-06-15
|
|
5914
|
APR_DRG
|
Neonate Birth Weight 500-749 Grams Without Major Procedure
|
5
|
5
|
—
|
—
|
$93,184.57
|
$96,734.46
|
$94,959.51
|
2026-06-15
|
|
A9699
|
HCPCS
|
Radiopharm Rx Agent Noc
|
2
|
2
|
—
|
—
|
$85,767.37
|
$97,225.26
|
$91,496.32
|
2026-06-15
|
|
7
|
MS_DRG
|
Lung Transplant
|
28
|
17
|
—
|
—
|
$26,000.00
|
$220,800.91
|
$91,249.33
|
2026-06-15
|
|
J922600
|
OTHER
|
Supprelin La Implant
|
2
|
1
|
—
|
—
|
$76,869.91
|
$98,462.58
|
$87,666.24
|
2026-06-15
|
|
14
|
MS_DRG
|
Allogeneic Bone Marrow Transplant
|
29
|
18
|
—
|
—
|
$12,900.00
|
$254,000.00
|
$85,494.41
|
2026-06-15
|
|
L8702
|
HCPCS
|
Ewhf S/d Uprt Micro Sensor
|
1
|
1
|
—
|
—
|
$84,419.70
|
$84,419.70
|
$84,419.70
|
2026-06-15
|
|
2
|
MS_DRG
|
Heart Transplant Or Implant Of Heart Assist System Without Mcc
|
27
|
16
|
—
|
—
|
$76,774.81
|
$193,207.19
|
$80,613.55
|
2026-06-15
|
|
1604
|
APR_DRG
|
Major Cardiothoracic Repair Of Heart Anomaly
|
5
|
5
|
—
|
—
|
$76,133.26
|
$79,033.58
|
$77,583.42
|
2026-06-15
|
|
426
|
MS_DRG
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
27
|
16
|
—
|
—
|
$19,648.00
|
$187,911.46
|
$76,910.55
|
2026-06-15
|
|
209
|
MS_DRG
|
Complex Aortic Arch Procedures
|
23
|
16
|
—
|
—
|
$19,648.00
|
$192,985.54
|
$76,686.73
|
2026-06-15
|
|
212
|
MS_DRG
|
Concomitant Aortic And Mitral Valve Procedures
|
27
|
16
|
—
|
—
|
$16,743.00
|
$185,403.41
|
$75,884.03
|
2026-06-15
|
|
5
|
MS_DRG
|
Liver Transplant With Mcc Or Intestinal Transplant
|
28
|
17
|
—
|
—
|
$27,200.00
|
$175,794.03
|
$72,649.55
|
2026-06-15
|
|
J9226
|
HCPCS
|
Supprelin La 50 Mg (65 Mcg/day) Implant Kit
|
62
|
34
|
$180,653.82
|
$117,424.98
35% off
|
$15,391.98
|
$180,653.82
|
$71,809.89
|
2026-06-15
|
|
215
|
MS_DRG
|
Other Heart Assist System Implant
|
27
|
16
|
—
|
—
|
$67,460.31
|
$169,766.85
|
$70,833.33
|
2026-06-15
|
|
27879075_IP
|
CDM
|
Tavr Device Kit
|
1
|
1
|
$105,000.00
|
$68,250.00
35% off
|
$70,245.00
|
$70,245.00
|
$70,245.00
|
2026-06-15
|
|
6024
|
APR_DRG
|
Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…
|
5
|
5
|
—
|
—
|
$68,702.75
|
$71,320.00
|
$70,011.37
|
2026-06-15
|
|
22
|
APR_DRG
|
Heart And/or Lung Transplant
|
5
|
5
|
—
|
—
|
$68,409.56
|
$71,015.64
|
$69,712.60
|
2026-06-15
|
|
23
|
APR_DRG
|
Heart And/or Lung Transplant
|
5
|
5
|
—
|
—
|
$68,409.56
|
$71,015.64
|
$69,712.60
|
2026-06-15
|
|
21
|
APR_DRG
|
Heart And/or Lung Transplant
|
5
|
5
|
—
|
—
|
$68,409.56
|
$71,015.64
|
$69,712.60
|
2026-06-15
|
|
94
|
APR_DRG
|
Extracorporeal Membrane Oxygenation (ecmo)
|
5
|
5
|
—
|
—
|
$68,299.81
|
$70,901.71
|
$69,600.76
|
2026-06-15
|
|
6074
|
APR_DRG
|
Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…
|
5
|
5
|
—
|
—
|
$67,946.00
|
$70,534.42
|
$69,240.21
|
2026-06-15
|
|
001-C
|
OTHER
|
Deep Brain Stimulation Bilateral
|
1
|
1
|
—
|
—
|
$69,100.00
|
$69,100.00
|
$69,100.00
|
2026-06-15
|
|
64654
|
HCPCS
|
Initial Open Implantation Bat Modulation System
|
49
|
33
|
$180,002.00
|
$117,001.30
35% off
|
$1,128.93
|
$180,002.00
|
$68,580.76
|
2026-06-15
|
|
216
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
28
|
17
|
—
|
—
|
$16,743.00
|
$283,600.00
|
$67,274.28
|
2026-06-15
|
|
C9293
|
HCPCS
|
Voraxaze 1000 Unit Intravenous Solution
|
52
|
33
|
$155,638.80
|
$101,165.22
35% off
|
$448.69
|
$155,638.80
|
$67,235.96
|
2026-06-15
|
|
27879075_OP
|
CDM
|
Tavr Device Kit
|
1
|
1
|
$105,000.00
|
$68,250.00
35% off
|
$66,675.00
|
$66,675.00
|
$66,675.00
|
2026-06-15
|
|
73
|
APR_DRG
|
Allogeneic Bone Marrow Transplant
|
5
|
5
|
—
|
—
|
$64,388.05
|
$66,840.93
|
$65,614.49
|
2026-06-15
|
|
27882225_IP
|
CDM
|
Sapien 3 Transcatheter Heart Valve
|
1
|
1
|
$97,500.00
|
$63,375.00
35% off
|
$65,227.50
|
$65,227.50
|
$65,227.50
|
2026-06-15
|
|
5933
|
APR_DRG
|
Neonate Birth Weight 750-999 Grams Without Major Procedure
|
5
|
5
|
—
|
—
|
$62,808.19
|
$65,200.88
|
$64,004.53
|
2026-06-15
|
|
J9029
|
HCPCS
|
Adstiladrin 3x10exp11 Vp/ml Intravesical Suspension
|
62
|
34
|
$73,080.00
|
$47,502.00
35% off
|
$15,391.98
|
$226,485.08
|
$63,354.77
|
2026-06-15
|
|
44
|
APR_DRG
|
Tracheostomy With Mv >96 Hours With Extensive Procedure
|
5
|
5
|
—
|
—
|
$62,024.79
|
$64,387.64
|
$63,206.22
|
2026-06-15
|
|
429
|
MS_DRG
|
Combined Anterior And Posterior Cervical Spinal Fusion With Mcc
|
27
|
16
|
—
|
—
|
$19,648.00
|
$153,613.68
|
$62,872.77
|
2026-06-15
|
|
A9543
|
HCPCS
|
Zevalin (y-90) 3.2 Mg/2 Ml Intravenous Kit
|
61
|
34
|
$148,248.86
|
$96,361.76
35% off
|
$14,774.74
|
$148,248.86
|
$62,506.99
|
2026-06-15
|
|
27882225_OP
|
CDM
|
Sapien 3 Transcatheter Heart Valve
|
1
|
1
|
$97,500.00
|
$63,375.00
35% off
|
$61,912.50
|
$61,912.50
|
$61,912.50
|
2026-06-15
|
|
850
|
MS_DRG
|
Acute Leukemia With Other Procedures
|
27
|
16
|
—
|
—
|
$48,143.00
|
$147,644.48
|
$60,429.63
|
2026-06-15
|
|
6303
|
APR_DRG
|
Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure
|
5
|
5
|
—
|
—
|
$59,265.92
|
$61,523.67
|
$60,394.79
|
2026-06-15
|
|
27881015_IP
|
CDM
|
Mitraclip System
|
1
|
1
|
$90,000.00
|
$58,500.00
35% off
|
$60,210.00
|
$60,210.00
|
$60,210.00
|
2026-06-15
|
|
8504
|
APR_DRG
|
Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal…
|
5
|
5
|
—
|
—
|
$58,435.48
|
$60,661.60
|
$59,548.54
|
2026-06-15
|
|
38240
|
HCPCS
|
Trnsplj Allogeneic Hematopoietic Cells Per Donor
|
58
|
34
|
$131,220.00
|
$85,293.00
35% off
|
$426.26
|
$131,220.00
|
$59,509.30
|
2026-06-15
|
|
27879075
|
CDM
|
Tavr Device Kit
|
36
|
24
|
$105,000.00
|
$68,250.00
35% off
|
$17,892.00
|
$105,000.00
|
$59,482.50
|
2026-06-15
|
|
6334
|
APR_DRG
|
Neonate Birth Weight > 2499 Grams With Major Anomaly
|
5
|
5
|
—
|
—
|
$57,784.30
|
$59,985.61
|
$58,884.96
|
2026-06-15
|
|
0451T
|
OTHER
|
Insj/rplcmt Aortic Ventr Sys
|
5
|
5
|
—
|
—
|
$58,057.97
|
$59,163.83
|
$58,057.97
|
2026-06-15
|
|
0454T
|
OTHER
|
Insj/rplcmt Subq Electrode
|
5
|
5
|
—
|
—
|
$58,057.97
|
$59,163.83
|
$58,057.97
|
2026-06-15
|
|
33981
|
HCPCS
|
Replace Vad Pump Ext
|
5
|
5
|
—
|
—
|
$58,057.97
|
$59,163.83
|
$58,057.97
|
2026-06-15
|
|
33975
|
HCPCS
|
Implant Ventricular Device
|
5
|
5
|
—
|
—
|
$58,057.97
|
$59,163.83
|
$58,057.97
|
2026-06-15
|
|
33983
|
HCPCS
|
Replace Vad Intra W/bp
|
5
|
5
|
—
|
—
|
$58,057.97
|
$59,163.83
|
$58,057.97
|
2026-06-15
|
|
0459T
|
OTHER
|
Relocaj Rplcmt Aortic Ventr
|
5
|
5
|
—
|
—
|
$58,057.97
|
$59,163.83
|
$58,057.97
|
2026-06-15
|
|
33976
|
HCPCS
|
Implant Ventricular Device
|
5
|
5
|
—
|
—
|
$58,057.97
|
$59,163.83
|
$58,057.97
|
2026-06-15
|
|
33991
|
HCPCS
|
Insj Perq Vad L Hrt Artl&ven
|
5
|
5
|
—
|
—
|
$58,057.97
|
$59,163.83
|
$58,057.97
|
2026-06-15
|
|
0452T
|
OTHER
|
Insj/rplcmt Dev Vasc Seal
|
5
|
5
|
—
|
—
|
$58,057.97
|
$59,163.83
|
$58,057.97
|
2026-06-15
|
|
33979
|
HCPCS
|
Insert Intracorporeal Device
|
5
|
5
|
—
|
—
|
$58,057.97
|
$59,163.83
|
$58,057.97
|
2026-06-15
|
|
33982
|
HCPCS
|
Replace Vad Intra Without Bp
|
5
|
5
|
—
|
—
|
$58,057.97
|
$59,163.83
|
$58,057.97
|
2026-06-15
|
|
0453T
|
OTHER
|
Insj/rplcmt Mech-elec Ntrfce
|
5
|
5
|
—
|
—
|
$58,057.97
|
$59,163.83
|
$58,057.97
|
2026-06-15
|
|
456
|
MS_DRG
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
28
|
17
|
—
|
—
|
$16,743.00
|
$212,600.00
|
$57,788.43
|
2026-06-15
|
|
3034
|
APR_DRG
|
Dorsal And Lumbar Fusion Procedure For Curvature Of Back
|
5
|
5
|
—
|
—
|
$56,663.83
|
$58,822.45
|
$57,743.14
|
2026-06-15
|
|
J926600
|
OTHER
|
Pegaspargase Injection
|
2
|
1
|
—
|
—
|
$50,594.83
|
$64,806.86
|
$57,700.85
|
2026-06-15
|
|
8514
|
APR_DRG
|
Gender Related Procedures
|
5
|
5
|
—
|
—
|
$56,551.47
|
$58,705.81
|
$57,628.64
|
2026-06-15
|
|
6093
|
APR_DRG
|
Neonate Birth Weight 1500-2499 Grams With Major Procedure
|
5
|
5
|
—
|
—
|
$56,189.82
|
$58,330.38
|
$57,260.10
|
2026-06-15
|
|
27881015_OP
|
CDM
|
Mitraclip System
|
1
|
1
|
$90,000.00
|
$58,500.00
35% off
|
$57,150.00
|
$57,150.00
|
$57,150.00
|
2026-06-15
|
|
231
|
MS_DRG
|
Coronary Bypass With Ptca With Mcc
|
27
|
16
|
—
|
—
|
$16,743.00
|
$143,729.80
|
$57,113.96
|
2026-06-15
|
|
J960000
|
OTHER
|
Porfimer Sodium Injection
|
2
|
1
|
—
|
—
|
$49,817.93
|
$63,811.73
|
$56,814.83
|
2026-06-15
|
|
6023
|
APR_DRG
|
Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…
|
5
|
5
|
—
|
—
|
$55,542.82
|
$57,658.73
|
$56,600.77
|
2026-06-15
|
|
14
|
APR_DRG
|
Liver Transplant And/or Intestinal Transplant
|
5
|
5
|
—
|
—
|
$54,437.49
|
$56,511.30
|
$55,474.40
|
2026-06-15
|
|
27882225
|
CDM
|
Sapien 3 Transcatheter Heart Valve
|
36
|
24
|
$97,500.00
|
$63,375.00
35% off
|
$16,614.00
|
$97,500.00
|
$55,233.75
|
2026-06-15
|
|
6092
|
APR_DRG
|
Neonate Birth Weight 1500-2499 Grams With Major Procedure
|
5
|
5
|
—
|
—
|
$53,447.67
|
$55,483.77
|
$54,465.72
|
2026-06-15
|
|
6091
|
APR_DRG
|
Neonate Birth Weight 1500-2499 Grams With Major Procedure
|
5
|
5
|
—
|
—
|
$53,447.67
|
$55,483.77
|
$54,465.72
|
2026-06-15
|
|
6114
|
APR_DRG
|
Neonate Birth Weight 1500-1999 Grams With Major Anomaly
|
5
|
5
|
—
|
—
|
$53,265.27
|
$55,294.42
|
$54,279.85
|
2026-06-15
|
|
957
|
MS_DRG
|
Other O.r. Procedures For Multiple Significant Trauma With Mcc
|
27
|
16
|
—
|
—
|
$51,626.08
|
$129,919.30
|
$54,207.38
|
2026-06-15
|
|
20
|
MS_DRG
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc
|
28
|
17
|
—
|
—
|
$16,743.00
|
$289,300.00
|
$54,112.10
|
2026-06-15
|
|
6214
|
APR_DRG
|
Neonate Birth Weight 2000-2499 Grams With Major Anomaly
|
5
|
5
|
—
|
—
|
$52,303.14
|
$54,295.64
|
$53,299.39
|
2026-06-15
|
|
37295
|
HCPCS
|
Revsc Evsc Tpvt St Athrc Uni Cplx Les Ea Add Vsl
|
40
|
28
|
$107,690.00
|
$69,998.50
35% off
|
$781.49
|
$107,690.00
|
$53,091.17
|
2026-06-15
|
|
37289
|
HCPCS
|
Revsc Evasc Tpvt Athrc Uni Sf Les Ea Addl Vsl
|
40
|
28
|
$107,690.00
|
$69,998.50
35% off
|
$447.27
|
$107,690.00
|
$53,091.17
|
2026-06-15
|
|
37272
|
HCPCS
|
Revsc Evasc Fpvt Athrc Uni Sf Les Ea Addl Vsl
|
40
|
28
|
$107,690.00
|
$69,998.50
35% off
|
$376.43
|
$107,690.00
|
$53,091.17
|
2026-06-15
|
|
37274
|
HCPCS
|
Revsc Evasc Fpvt Athrc Uni Cplx Les Ea Addl Vsl
|
40
|
28
|
$107,690.00
|
$69,998.50
35% off
|
$518.20
|
$107,690.00
|
$53,091.17
|
2026-06-15
|
|
37287
|
HCPCS
|
Revsc Evasc Tpvt St Plmt Uni Cplx Les Ea Add Vsl
|
40
|
28
|
$107,690.00
|
$69,998.50
35% off
|
$474.45
|
$107,690.00
|
$53,091.17
|
2026-06-15
|
|
37285
|
HCPCS
|
Revsc Evasc Tpvt St Plmt Uni Sf Les Ea Addl Vsl
|
40
|
28
|
$107,690.00
|
$69,998.50
35% off
|
$316.15
|
$107,690.00
|
$53,091.17
|
2026-06-15
|
|
37291
|
HCPCS
|
Revsc Evasc Tpvt Athrc Uni Cplx Les Ea Addl Vsl
|
40
|
28
|
$107,690.00
|
$69,998.50
35% off
|
$611.29
|
$107,690.00
|
$53,091.17
|
2026-06-15
|
|
37278
|
HCPCS
|
Revsc Evsc Fpvt St Athrc Uni Cplx Les Ea Add Vsl
|
40
|
28
|
$107,690.00
|
$69,998.50
35% off
|
$562.26
|
$107,690.00
|
$53,091.17
|
2026-06-15
|
|
37276
|
HCPCS
|
Revsc Evasc Fpvt St Athrc Uni Sf Les Ea Addl Vsl
|
40
|
28
|
$107,690.00
|
$69,998.50
35% off
|
$399.06
|
$107,690.00
|
$53,091.17
|
2026-06-15
|
|
37293
|
HCPCS
|
Revsc Evasc Tpvt St Athrc Uni Sf Les Ea Addl Vsl
|
40
|
28
|
$107,690.00
|
$69,998.50
35% off
|
$621.21
|
$107,690.00
|
$53,091.17
|
2026-06-15
|
|
219
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
28
|
17
|
—
|
—
|
$16,743.00
|
$193,600.00
|
$52,802.07
|
2026-06-15
|
|
84
|
APR_DRG
|
Autologous Bone Marrow Transplant
|
5
|
5
|
—
|
—
|
$51,671.82
|
$53,640.27
|
$52,656.05
|
2026-06-15
|
|
5913
|
APR_DRG
|
Neonate Birth Weight 500-749 Grams Without Major Procedure
|
5
|
5
|
—
|
—
|
$51,619.04
|
$53,585.48
|
$52,602.26
|
2026-06-15
|
|
233
|
MS_DRG
|
Coronary Bypass With Cardiac Catheterization With Mcc
|
28
|
17
|
—
|
—
|
$16,743.00
|
$217,200.00
|
$52,574.45
|
2026-06-15
|
|
72
|
APR_DRG
|
Allogeneic Bone Marrow Transplant
|
5
|
5
|
—
|
—
|
$51,543.26
|
$53,506.81
|
$52,525.04
|
2026-06-15
|
|
71
|
APR_DRG
|
Allogeneic Bone Marrow Transplant
|
5
|
5
|
—
|
—
|
$51,543.26
|
$53,506.81
|
$52,525.04
|
2026-06-15
|
|
10
|
MS_DRG
|
Pancreas Transplant
|
32
|
20
|
—
|
—
|
$10,700.00
|
$240,800.00
|
$52,505.87
|
2026-06-15
|
|
8424
|
APR_DRG
|
Burns With Skin Graft Except Extensive Third Degree Burns
|
5
|
5
|
—
|
—
|
$51,274.64
|
$53,227.96
|
$52,251.30
|
2026-06-15
|
|
19
|
MS_DRG
|
Simultaneous Pancreas And Kidney Transplant With Hemodialysis
|
30
|
18
|
—
|
—
|
$48,338.09
|
$292,000.00
|
$52,205.14
|
2026-06-15
|
|
27880805
|
CDM
|
Pascal Precision Ace Implant System
|
38
|
25
|
$91,800.00
|
$59,670.00
35% off
|
$15,642.72
|
$91,800.00
|
$52,004.70
|
2026-06-15
|
|
27882245
|
CDM
|
Pascal Precision Transcatheter Valve System
|
38
|
25
|
$91,800.00
|
$59,670.00
35% off
|
$15,642.72
|
$91,800.00
|
$52,004.70
|
2026-06-15
|
|
928
|
MS_DRG
|
Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc
|
27
|
16
|
—
|
—
|
$48,596.22
|
$122,294.54
|
$51,026.03
|
2026-06-15
|
|
J3357
|
HCPCS
|
Stelara 45 Mg/0.5 Ml Subcutaneous Solution
|
86
|
30
|
$104,945.34
|
$68,214.47
35% off
|
$159.91
|
$104,945.34
|
$51,003.42
|
2026-06-15
|
|
27881015
|
CDM
|
Mitraclip System
|
36
|
24
|
$90,000.00
|
$58,500.00
35% off
|
$15,336.00
|
$90,000.00
|
$50,985.00
|
2026-06-15
|
|
427
|
MS_DRG
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
28
|
17
|
—
|
—
|
$19,648.00
|
$269,394.00
|
$50,863.49
|
2026-06-15
|
|
6124
|
APR_DRG
|
Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other…
|
5
|
5
|
—
|
—
|
$49,791.98
|
$51,688.81
|
$50,740.40
|
2026-06-15
|
|
92930
|
HCPCS
|
Perq Tcat Plmt Ntrac St 2+les 2+st 2+c Segments
|
49
|
33
|
$129,228.00
|
$83,998.20
35% off
|
$1,113.04
|
$129,228.00
|
$49,235.87
|
2026-06-15
|
|
870
|
MS_DRG
|
Septicemia Or Severe Sepsis With Mv >96 Hours
|
28
|
17
|
—
|
—
|
$14,369.00
|
$194,500.00
|
$48,701.73
|
2026-06-15
|
|
6073
|
APR_DRG
|
Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…
|
5
|
5
|
—
|
—
|
$47,747.52
|
$49,566.47
|
$48,657.00
|
2026-06-15
|
|
L2006
|
HCPCS
|
Kaf Sng/dbl Swg/stn Mcpr Cus
|
1
|
1
|
—
|
—
|
$48,512.99
|
$48,512.99
|
$48,512.99
|
2026-06-15
|
|
275
|
MS_DRG
|
Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc
|
27
|
16
|
—
|
—
|
$16,743.00
|
$121,573.32
|
$48,309.63
|
2026-06-15
|
|
5893
|
APR_DRG
|
Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …
|
5
|
5
|
—
|
—
|
$47,093.20
|
$48,887.23
|
$47,990.22
|
2026-06-15
|
|
5894
|
APR_DRG
|
Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …
|
5
|
5
|
—
|
—
|
$47,093.20
|
$48,887.23
|
$47,990.22
|
2026-06-15
|
|
1834
|
APR_DRG
|
Percutaneous Structural Cardiac Procedures
|
5
|
5
|
—
|
—
|
$47,089.55
|
$48,883.44
|
$47,986.49
|
2026-06-15
|
|
43
|
APR_DRG
|
Tracheostomy With Mv >96 Hours With Extensive Procedure
|
5
|
5
|
—
|
—
|
$46,998.61
|
$48,789.03
|
$47,893.82
|
2026-06-15
|
|
955
|
MS_DRG
|
Craniotomy For Multiple Significant Trauma
|
27
|
16
|
—
|
—
|
$45,604.31
|
$114,765.26
|
$47,884.53
|
2026-06-15
|
|
8634
|
APR_DRG
|
Neonatal Aftercare
|
5
|
5
|
—
|
—
|
$46,930.15
|
$48,717.96
|
$47,824.06
|
2026-06-15
|
|
1784
|
APR_DRG
|
External Heart Assist Devices
|
5
|
5
|
—
|
—
|
$46,914.47
|
$48,701.69
|
$47,808.08
|
2026-06-15
|
|
J9028
|
HCPCS
|
Anktiva 400 Mcg/0.4 Ml Intravesical Solution
|
62
|
34
|
$322,200.00
|
$209,430.00
35% off
|
$92.19
|
$322,200.00
|
$47,676.99
|
2026-06-15
|
|
6904
|
APR_DRG
|
Acute Leukemia
|
5
|
5
|
—
|
—
|
$46,731.04
|
$48,511.27
|
$47,621.15
|
2026-06-15
|
|
317
|
MS_DRG
|
Concomitant Left Atrial Appendage Closure And Cardiac Ablation
|
27
|
16
|
—
|
—
|
$19,648.00
|
$114,004.83
|
$46,661.20
|
2026-06-15
|
|
447
|
MS_DRG
|
Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall…
|
27
|
16
|
—
|
—
|
$16,471.00
|
$113,921.28
|
$46,627.01
|
2026-06-15
|
|
573
|
MS_DRG
|
Skin Graft For Skin Ulcer Or Cellulitis With Mcc
|
27
|
16
|
—
|
—
|
$44,386.81
|
$111,701.37
|
$46,606.15
|
2026-06-15
|
|
268
|
MS_DRG
|
Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc
|
27
|
16
|
—
|
—
|
$16,743.00
|
$151,598.00
|
$46,598.90
|
2026-06-15
|
|
207
|
MS_DRG
|
Respiratory System Diagnosis With Ventilator Support >96 Hours
|
28
|
17
|
—
|
—
|
$43,596.15
|
$148,400.00
|
$46,429.90
|
2026-06-15
|
|
6313
|
APR_DRG
|
Neonate Birth Weight > 2499 Grams With Other Major Procedure
|
5
|
5
|
—
|
—
|
$44,947.36
|
$46,659.64
|
$45,803.50
|
2026-06-15
|
|
5891
|
APR_DRG
|
Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …
|
5
|
5
|
—
|
—
|
$44,795.79
|
$46,502.30
|
$45,649.05
|
2026-06-15
|
|
5892
|
APR_DRG
|
Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …
|
5
|
5
|
—
|
—
|
$44,795.79
|
$46,502.30
|
$45,649.05
|
2026-06-15
|
|
J2778
|
HCPCS
|
Darvocet-n 50 50 Mg-325 Mg Tab
|
93
|
34
|
$140,400.00
|
$91,260.00
35% off
|
$65.44
|
$140,400.00
|
$45,489.60
|
2026-06-15
|
|
001-B
|
OTHER
|
Deep Brain Stimulation Unilateral
|
1
|
1
|
—
|
—
|
$45,300.00
|
$45,300.00
|
$45,300.00
|
2026-06-15
|
|
217
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
28
|
17
|
—
|
—
|
$16,743.00
|
$223,200.00
|
$45,216.97
|
2026-06-15
|
|
54
|
APR_DRG
|
Tracheostomy With Mv >96 Hours Without Extensive Procedure
|
5
|
5
|
—
|
—
|
$43,787.15
|
$45,455.23
|
$44,621.19
|
2026-06-15
|
|
218
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
27
|
16
|
—
|
—
|
$16,743.00
|
$112,108.87
|
$44,548.74
|
2026-06-15
|
|
471A
|
OTHER
|
Bilateral Total Hip Replacement Proc. Of Lower Extremitv
|
1
|
1
|
—
|
—
|
$43,800.00
|
$43,800.00
|
$43,800.00
|
2026-06-15
|
|
969
|
MS_DRG
|
HIV With Extensive O.r. Procedures With Mcc
|
27
|
16
|
—
|
—
|
$41,472.81
|
$104,368.17
|
$43,546.45
|
2026-06-15
|
|
16
|
MS_DRG
|
Autologous Bone Marrow Transplant With Cc/mcc
|
29
|
18
|
—
|
—
|
$40,174.69
|
$240,500.00
|
$43,388.67
|
2026-06-15
|
|
3033
|
APR_DRG
|
Dorsal And Lumbar Fusion Procedure For Curvature Of Back
|
5
|
5
|
—
|
—
|
$42,499.96
|
$44,119.00
|
$43,309.48
|
2026-06-15
|
|
L8701
|
HCPCS
|
Ewh S/d Uprt Micro Sensor
|
1
|
1
|
—
|
—
|
$42,908.35
|
$42,908.35
|
$42,908.35
|
2026-06-15
|
|
J2779
|
HCPCS
|
Susvimo 10 Mg/0.1 Ml Intravitreal Solution
|
62
|
34
|
$288,000.00
|
$187,200.00
35% off
|
$76.22
|
$288,000.00
|
$42,808.08
|
2026-06-15
|
|
J9600
|
HCPCS
|
Photofrin 75 Mg Intravenous Solution
|
61
|
34
|
$111,950.40
|
$72,767.76
35% off
|
$15,391.98
|
$111,950.40
|
$42,653.10
|
2026-06-15
|
|
J1930
|
HCPCS
|
Somatuline Depot 60 Mg/0.2 Ml Subcutaneous Syringe
|
124
|
34
|
$113,976.00
|
$74,084.40
35% off
|
$35.38
|
$113,976.00
|
$42,424.13
|
2026-06-15
|
|
820
|
MS_DRG
|
Lymphoma And Leukemia With Major O.r. Procedures With Mcc
|
28
|
17
|
—
|
—
|
$39,734.98
|
$207,900.00
|
$42,317.76
|
2026-06-15
|
|
6814
|
APR_DRG
|
Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms
|
5
|
5
|
—
|
—
|
$41,141.69
|
$42,708.99
|
$41,925.34
|
2026-06-15
|
|
0266T
|
OTHER
|
Implt/rpl Crtd Sns Dev Total
|
13
|
10
|
—
|
—
|
$16,323.77
|
$45,054.64
|
$41,717.26
|
2026-06-15
|
|
33276
|
HCPCS
|
Insj Phrnc Nrv Stim Sys
|
25
|
19
|
—
|
—
|
$16,323.77
|
$90,214.33
|
$41,717.26
|
2026-06-15
|
|
6954
|
APR_DRG
|
Chemotherapy For Acute Leukemia
|
5
|
5
|
—
|
—
|
$40,907.03
|
$42,465.40
|
$41,686.22
|
2026-06-15
|
|
3004
|
APR_DRG
|
Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical
|
5
|
5
|
—
|
—
|
$40,751.30
|
$42,303.73
|
$41,527.51
|
2026-06-15
|
|
266
|
MS_DRG
|
Endovascular Cardiac Valve Replacement W Mcc
|
29
|
18
|
—
|
—
|
$16,743.00
|
$173,600.00
|
$41,520.92
|
2026-06-15
|
|
6022
|
APR_DRG
|
Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…
|
5
|
5
|
—
|
—
|
$40,637.89
|
$42,186.00
|
$41,411.94
|
2026-06-15
|
|
1634
|
APR_DRG
|
Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis
|
5
|
5
|
—
|
—
|
$40,572.04
|
$42,117.64
|
$41,344.84
|
2026-06-15
|
|
28
|
MS_DRG
|
Spinal Procedures With Mcc
|
28
|
17
|
—
|
—
|
$16,743.00
|
$108,100.00
|
$41,317.83
|
2026-06-15
|
|
463
|
MS_DRG
|
Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …
|
28
|
17
|
—
|
—
|
$38,615.05
|
$188,200.00
|
$41,125.03
|
2026-06-15
|
|
232
|
MS_DRG
|
Coronary Bypass With Ptca Without Mcc
|
27
|
16
|
—
|
—
|
$16,743.00
|
$103,367.33
|
$41,075.11
|
2026-06-15
|
|
37292
|
HCPCS
|
Revsc Evasc Tpvt St Athrc Uni Sf Les 1st Vsl
|
49
|
33
|
$107,690.00
|
$69,998.50
35% off
|
$1,417.93
|
$107,690.00
|
$41,029.89
|
2026-06-15
|
|
37290
|
HCPCS
|
Revsc Evasc Tpvt Athrc Uni Cplx Les 1st Vsl
|
49
|
33
|
$107,690.00
|
$69,998.50
35% off
|
$1,598.72
|
$107,690.00
|
$41,029.89
|
2026-06-15
|
|
37271
|
HCPCS
|
Revsc Evasc Fpvt Athrc Uni Sf Les 1st Vsl
|
49
|
33
|
$107,690.00
|
$69,998.50
35% off
|
$852.85
|
$107,690.00
|
$41,029.89
|
2026-06-15
|
|
37294
|
HCPCS
|
Revsc Evasc Tpvt St Athrc Uni Cplx Les 1st Vsl
|
49
|
33
|
$107,690.00
|
$69,998.50
35% off
|
$1,699.98
|
$107,690.00
|
$41,029.89
|
2026-06-15
|
|
37273
|
HCPCS
|
Revsc Evasc Fpvt Athrc Uni Cplx Les 1st Vsl
|
49
|
33
|
$107,690.00
|
$69,998.50
35% off
|
$1,194.54
|
$107,690.00
|
$41,029.89
|
2026-06-15
|
|
37288
|
HCPCS
|
Revsc Evasc Tpvt Athrc Uni Sf Les 1st Vsl
|
49
|
33
|
$107,690.00
|
$69,998.50
35% off
|
$1,270.62
|
$107,690.00
|
$41,029.89
|
2026-06-15
|
|
37284
|
HCPCS
|
Revsc Evasc Tpvt St Plmt Uni Sf Les 1st Vsl
|
49
|
33
|
$107,690.00
|
$69,998.50
35% off
|
$952.93
|
$107,690.00
|
$41,029.89
|
2026-06-15
|
|
37277
|
HCPCS
|
Revsc Evasc Fpvt St Athrc Uni Cplx Les 1st Vsl
|
49
|
33
|
$107,690.00
|
$69,998.50
35% off
|
$1,412.33
|
$107,690.00
|
$41,029.89
|
2026-06-15
|
|
37286
|
HCPCS
|
Revsc Evasc Tpvt St Plmt Uni Cplx Les 1st Vsl
|
49
|
33
|
$107,690.00
|
$69,998.50
35% off
|
$1,279.29
|
$107,690.00
|
$41,029.89
|
2026-06-15
|
|
37275
|
HCPCS
|
Revsc Evasc Fpvt St Athrc Uni Sf Les 1st Vsl
|
49
|
33
|
$107,690.00
|
$69,998.50
35% off
|
$1,037.88
|
$107,690.00
|
$41,029.89
|
2026-06-15
|
|
8
|
MS_DRG
|
Simultaneous Pancreas And Kidney Transplant
|
32
|
20
|
—
|
—
|
$26,000.00
|
$308,400.00
|
$41,009.86
|
2026-06-15
|
|
457
|
MS_DRG
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
28
|
17
|
—
|
—
|
$16,743.00
|
$158,200.00
|
$41,007.00
|
2026-06-15
|
|
1624
|
APR_DRG
|
Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis
|
5
|
5
|
—
|
—
|
$40,114.23
|
$41,642.39
|
$40,878.31
|
2026-06-15
|
|
790
|
MS_DRG
|
Extreme Immaturity Or Respiratory Distress Syndrome, Neonate
|
24
|
16
|
—
|
—
|
$5,351.00
|
$101,336.68
|
$40,872.21
|
2026-06-15
|
|
6034
|
APR_DRG
|
Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition
|
5
|
5
|
—
|
—
|
$39,989.32
|
$41,512.73
|
$40,751.02
|
2026-06-15
|
|
6033
|
APR_DRG
|
Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition
|
5
|
5
|
—
|
—
|
$39,989.32
|
$41,512.73
|
$40,751.02
|
2026-06-15
|
|
276
|
MS_DRG
|
Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator
|
27
|
16
|
—
|
—
|
$16,743.00
|
$102,412.53
|
$40,695.70
|
2026-06-15
|
|
430
|
MS_DRG
|
Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc
|
28
|
17
|
—
|
—
|
$19,648.00
|
$228,300.00
|
$40,635.97
|
2026-06-15
|
|
5931
|
APR_DRG
|
Neonate Birth Weight 750-999 Grams Without Major Procedure
|
5
|
5
|
—
|
—
|
$39,734.29
|
$41,247.98
|
$40,491.13
|
2026-06-15
|
|
5932
|
APR_DRG
|
Neonate Birth Weight 750-999 Grams Without Major Procedure
|
5
|
5
|
—
|
—
|
$39,734.29
|
$41,247.98
|
$40,491.13
|
2026-06-15
|
|
235
|
MS_DRG
|
Coronary Bypass Without Cardiac Catheterization With Mcc
|
28
|
17
|
—
|
—
|
$16,743.00
|
$168,400.00
|
$40,357.14
|
2026-06-15
|
|
224
|
APR_DRG
|
Ventricular Shunt Procedures
|
5
|
5
|
—
|
—
|
$39,011.51
|
$40,497.66
|
$39,754.59
|
2026-06-15
|
|
17
|
MS_DRG
|
Autologous Bone Marrow Transplant Without Cc/mcc
|
29
|
18
|
—
|
—
|
$36,804.72
|
$240,500.00
|
$39,749.10
|
2026-06-15
|
|
5911
|
APR_DRG
|
Neonate Birth Weight 500-749 Grams Without Major Procedure
|
5
|
5
|
—
|
—
|
$38,942.00
|
$40,425.51
|
$39,683.75
|
2026-06-15
|
|
5912
|
APR_DRG
|
Neonate Birth Weight 500-749 Grams Without Major Procedure
|
5
|
5
|
—
|
—
|
$38,942.00
|
$40,425.51
|
$39,683.75
|
2026-06-15
|
|
A960400
|
OTHER
|
Sm 153 Lexidronam
|
2
|
1
|
—
|
—
|
$34,780.24
|
$44,549.97
|
$39,665.10
|
2026-06-15
|
|
428
|
MS_DRG
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
28
|
17
|
—
|
—
|
$19,648.00
|
$203,786.00
|
$39,613.57
|
2026-06-15
|
|
834
|
MS_DRG
|
Acute Leukemia Without Major O.r. Procedures With Mcc
|
28
|
17
|
—
|
—
|
$37,194.97
|
$152,300.00
|
$39,612.65
|
2026-06-15
|
|
6302
|
APR_DRG
|
Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure
|
5
|
5
|
—
|
—
|
$38,833.31
|
$40,312.67
|
$39,572.99
|
2026-06-15
|
|
6301
|
APR_DRG
|
Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure
|
5
|
5
|
—
|
—
|
$38,833.31
|
$40,312.67
|
$39,572.99
|
2026-06-15
|
|
83
|
APR_DRG
|
Autologous Bone Marrow Transplant
|
5
|
5
|
—
|
—
|
$38,812.92
|
$40,291.51
|
$39,552.22
|
2026-06-15
|
|
405
|
MS_DRG
|
Pancreas, Liver And Shunt Procedures With Mcc
|
28
|
17
|
—
|
—
|
$37,063.54
|
$128,400.00
|
$39,472.67
|
2026-06-15
|
|
23
|
MS_DRG
|
Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…
|
28
|
17
|
—
|
—
|
$16,743.00
|
$139,200.00
|
$39,406.07
|
2026-06-15
|
|
114
|
APR_DRG
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
5
|
5
|
—
|
—
|
$38,444.48
|
$39,909.03
|
$39,176.76
|
2026-06-15
|
|
111
|
APR_DRG
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
5
|
5
|
—
|
—
|
$38,444.48
|
$39,909.03
|
$39,176.76
|
2026-06-15
|
|
113
|
APR_DRG
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
5
|
5
|
—
|
—
|
$38,444.48
|
$39,909.03
|
$39,176.76
|
2026-06-15
|
|
112
|
APR_DRG
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
5
|
5
|
—
|
—
|
$38,444.48
|
$39,909.03
|
$39,176.76
|
2026-06-15
|
|
11
|
MS_DRG
|
Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc
|
27
|
16
|
—
|
—
|
$36,952.42
|
$92,992.41
|
$38,800.04
|
2026-06-15
|
|
213
|
MS_DRG
|
Endovascular Abdominal Aorta With Iliac Branch Procedures
|
23
|
16
|
—
|
—
|
$19,648.00
|
$97,302.65
|
$38,665.18
|
2026-06-15
|
|
7924
|
APR_DRG
|
Extensive O.r. Procedures For Other Complications Of Treatment
|
5
|
5
|
—
|
—
|
$37,757.77
|
$39,196.16
|
$38,476.96
|
2026-06-15
|
|
461
|
MS_DRG
|
Bilateral Or Multiple Major Joint Procs Of Lower Extremity W Mcc
|
28
|
17
|
—
|
—
|
$16,743.00
|
$116,800.00
|
$37,980.52
|
2026-06-15
|
|
278
|
MS_DRG
|
Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures …
|
27
|
16
|
—
|
—
|
$16,743.00
|
$94,903.71
|
$37,711.92
|
2026-06-15
|
|
234
|
MS_DRG
|
Coronary Bypass With Cardiac Catheterization Without Mcc
|
28
|
17
|
—
|
—
|
$16,743.00
|
$158,100.00
|
$37,565.85
|
2026-06-15
|
|
653
|
MS_DRG
|
Major Bladder Procedures With Mcc
|
28
|
17
|
—
|
—
|
$35,206.46
|
$144,700.00
|
$37,494.88
|
2026-06-15
|
|
9504
|
APR_DRG
|
Extensive O.r. Procedure Unrelated To Principal Diagnosis
|
5
|
5
|
—
|
—
|
$36,693.21
|
$38,091.04
|
$37,392.12
|
2026-06-15
|
|
450
|
MS_DRG
|
Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically …
|
27
|
16
|
—
|
—
|
$16,471.00
|
$91,148.00
|
$37,192.19
|
2026-06-15
|
|
471B
|
OTHER
|
Bilateral Total Knee Replacement Proc. Of Low Extr
|
1
|
1
|
—
|
—
|
$36,700.00
|
$36,700.00
|
$36,700.00
|
2026-06-15
|