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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

PENN HIGHLANDS HUNTINGDON

Huntingdon, PA · CCN 390056 · Rates published

305 distinct procedures filed
76 distinct payers
7,919 rate rows
2025-08-01 last MRF observed
Data quality

1,031 of 7,919 rate rows are consumer-grade (13.0%)

6,888 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 — reasonRows
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 6,290
professional (physician) fee — not the facility price 598
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://www.phhealthcare.org/download/?id=15373
Found on page https://www.phhealthcare.org/patients-visitors/patient-billing-services
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-05-18
Content fingerprint 0cdc7d561545124e… · 5,758,399 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
2033
OTHER 		Cath, Trans Intra Litho/coro 1 $67,625.40 $67,625.40 $67,625.40 nat. median
$2
outlier · 27944.4×
325
MS_DRG 		Coronary Intravascular Lithotripsy Without Intraluminal Device 1 $47,761.94 $47,761.94 $47,761.94 nat. median
$29,977
1.6× median
467
MS_DRG 		Revision Of Hip Or Knee Replacement With Cc 1 $45,093.58 $45,093.58 $45,093.58 nat. median
$34,720
1.3× median
9364
OTHER 		Inj Enfort Vedo-ejfv 0.25mg 1 $43,940.93 $43,940.93 $43,940.93 nat. median
$38
outlier · 1164.0×
322
MS_DRG 		Percutaneous Cardiovascular Procedures With Intraluminal Device Without Mcc 8 $39,612.33 $39,612.33 $39,612.33 nat. median
$19,070
outlier · 2.1×
9453
OTHER 		Injection, Nivolumab 1 $38,645.96 $38,645.96 $38,645.96 nat. median
$34
outlier · 1145.4×
9494
OTHER 		Injection, Ocrelizumab 1 $37,195.47 $37,195.47 $37,195.47 nat. median
$61
outlier · 608.8×
5465
OTHER 		Level 5 Neurostimulator And Related Procedures 2 $30,832.49 $30,832.49 $30,832.49 nat. median
$31,444
1.0× median
9284
OTHER 		Ipilimumab Injection 1 $28,664.84 $28,664.84 $28,664.84 nat. median
$188
outlier · 152.9×
853
MS_DRG 		Infectious And Parasitic Diseases With O.r. Procedures With Mcc 5 $27,955.45 $27,955.45 $27,955.45 nat. median
$48,170
0.6× median
260
MS_DRG 		Cardiac Pacemaker Revision Except Device Replacement With Mcc 1 $24,929.92 $24,929.92 $24,929.92 nat. median
$32,660
0.8× median
314
MS_DRG 		Other Circulatory System Diagnoses With Mcc 1 $24,106.09 $24,106.09 $24,106.09 nat. median
$20,752
1.2× median
9431
OTHER 		Inj, Dostarlimab-gxly, 10 Mg 1 $23,493.14 $23,493.14 $23,493.14 nat. median
$248
outlier · 94.6×
321
MS_DRG 		Percutaneous Cardiovascular Procedures With Intraluminal Device With Mcc Or 4+ A… 7 $23,197.47 $23,197.47 $23,197.47 nat. median
$28,170
0.8× median
1490
OTHER 		Inj Pembrolizumab 3 $22,471.46 $22,471.46 $22,471.46 nat. median
$61
outlier · 367.6×
5116
OTHER 		Level 6 Musculoskeletal Procedures 8 $22,430.83 $22,430.83 $22,430.83 nat. median
$18,574
1.2× median
553
MS_DRG 		Bone Diseases And Arthropathies With Mcc 1 $22,002.72 $22,002.72 $22,002.72 nat. median
$13,586
1.6× median
466
MS_DRG 		Revision Of Hip Or Knee Replacement With Mcc 1 $20,578.31 $20,578.31 $20,578.31 nat. median
$49,191
outlier · 0.4×
5194
OTHER 		Level 4 Endovascular Procedures 2 $20,536.51 $20,536.51 $20,536.51 nat. median
$18,909
1.1× median
398
MS_DRG 		Appendix Procedures With Cc 1 $20,172.22 $20,172.22 $20,172.22 nat. median
$15,921
1.3× median
981
MS_DRG 		Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 1 $19,800.09 $19,800.09 $19,800.09 nat. median
$46,084
outlier · 0.4×
486
MS_DRG 		Knee Procedures With Principal Diagnosis Of Infection With Cc 2 $18,405.53 $18,405.53 $18,405.53 nat. median
$21,377
0.9× median
483
MS_DRG 		Major Joint Or Limb Reattachment Procedures Of Upper Extremities 1 $18,353.91 $18,353.91 $18,353.91 nat. median
$26,699
0.7× median
468
MS_DRG 		Revision Of Hip Or Knee Replacement Without Cc/Mcc 2 $17,904.65 $17,904.65 $17,904.65 nat. median
$27,218
0.7× median
286
MS_DRG 		Circulatory Disorders Except Ami, With Cardiac Catheterization With Mcc 3 $16,328.20 $16,328.20 $16,328.20 nat. median
$22,019
0.7× median
418
MS_DRG 		Laparoscopic Cholecystectomy Without C.d.e. With Cc 3 $15,872.42 $15,872.42 $15,872.42 nat. median
$17,482
0.9× median
438
MS_DRG 		Disorders Of Pancreas Except Malignancy With Mcc 2 $15,585.31 $15,585.31 $15,585.31 nat. median
$16,971
0.9× median
250
MS_DRG 		Percutaneous Cardiovascular Procedures Without Intraluminal Device With Mcc 1 $15,501.05 $15,501.05 $15,501.05 nat. median
$23,306
0.7× median
871
MS_DRG 		Septicemia Or Severe Sepsis Without Mv >96 Hours With Mcc 18 $15,396.62 $15,396.62 $15,396.62 nat. median
$19,634
0.8× median
940
MS_DRG 		O.r. Procedures With Diagnoses Of Other Contact With Health Services With Cc 1 $15,279.43 $15,279.43 $15,279.43 nat. median
$22,721
0.7× median
417
MS_DRG 		Laparoscopic Cholecystectomy Without C.d.e. With Mcc 1 $15,250.02 $15,250.02 $15,250.02 nat. median
$23,829
0.6× median
808
MS_DRG 		Major Hematological And Immunological Diagnoses Except Sickle Cell Crisis And Co… 1 $15,035.93 $15,035.93 $15,035.93 nat. median
$22,208
0.7× median
125
MS_DRG 		Other Disorders Of The Eye Without Mcc 1 $14,998.93 $14,998.93 $14,998.93 nat. median
$8,775
1.7× median
432
MS_DRG 		Cirrhosis And Alcoholic Hepatitis With Mcc 1 $14,894.06 $14,894.06 $14,894.06 nat. median
$19,681
0.8× median
559
MS_DRG 		Aftercare, Musculoskeletal System And Connective Tissue With Mcc 1 $14,750.28 $14,750.28 $14,750.28 nat. median
$19,047
0.8× median
571
MS_DRG 		Skin Debridement With Cc 1 $14,557.52 $14,557.52 $14,557.52 nat. median
$17,260
0.8× median
698
MS_DRG 		Other Kidney And Urinary Tract Diagnoses With Mcc 4 $14,548.75 $14,548.75 $14,548.75 nat. median
$16,676
0.9× median
64
MS_DRG 		Intracranial Hemorrhage Or Cerebral Infarction With Mcc 1 $14,372.60 $14,372.60 $14,372.60 nat. median
$20,254
0.7× median
205
MS_DRG 		Other Respiratory System Diagnoses With Mcc 1 $14,210.39 $14,210.39 $14,210.39 nat. median
$18,292
0.8× median
9357
OTHER 		Inj. Eptinezumab-jjmr 1 Mg 1 $14,067.30 $14,067.30 $14,067.30 nat. median
$20
outlier · 686.2×
435
MS_DRG 		Malignancy Of Hepatobiliary System Or Pancreas With Mcc 1 $13,584.52 $13,584.52 $13,584.52 nat. median
$18,498
0.7× median
299
MS_DRG 		Peripheral Vascular Disorders With Mcc 1 $13,388.40 $13,388.40 $13,388.40 nat. median
$16,470
0.8× median
196
MS_DRG 		Interstitial Lung Disease With Mcc 2 $13,262.81 $13,262.81 $13,262.81 nat. median
$18,723
0.7× median
854
MS_DRG 		Infectious And Parasitic Diseases With O.r. Procedures With Cc 8 $13,183.37 $13,183.37 $13,183.37 nat. median
$20,421
0.6× median
377
MS_DRG 		Gastrointestinal Hemorrhage With Mcc 2 $12,828.32 $12,828.32 $12,828.32 nat. median
$18,249
0.7× median
982
MS_DRG 		Extensive O.r. Procedures Unrelated To Principal Diagnosis With Cc 2 $12,661.65 $12,661.65 $12,661.65 nat. median
$24,493
0.5× median
637
MS_DRG 		Diabetes With Mcc 6 $12,224.01 $12,224.01 $12,224.01 nat. median
$14,787
0.8× median
306
MS_DRG 		Cardiac Congenital And Valvular Disorders With Mcc 1 $12,137.95 $12,137.95 $12,137.95 nat. median
$15,865
0.8× median
9347
OTHER 		Inj Luspatercept-aamt 0.25mg 1 $12,043.05 $12,043.05 $12,043.05 nat. median
$43
outlier · 277.1×
470
MS_DRG 		Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity Without… 1 $11,957.43 $11,957.43 $11,957.43 nat. median
$20,055
0.6× median

Other procedures at this hospital

Browse this hospital's 305 published procedures. Use the slice to choose what to show, then sort or filter any column.

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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
             
2033 OTHER Cath, Trans Intra Litho/coro 1 1 — — $67,625.40 $67,625.40 $67,625.40 2025-08-01
325 MS_DRG Coronary Intravascular Lithotripsy Without Intraluminal Device 1 1 — — $47,761.94 $47,761.94 $47,761.94 2025-08-01
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 1 1 — — $45,093.58 $45,093.58 $45,093.58 2025-08-01
9364 OTHER Inj Enfort Vedo-ejfv 0.25mg 1 1 — — $43,940.93 $43,940.93 $43,940.93 2025-08-01
322 MS_DRG Percutaneous Cardiovascular Procedures With Intraluminal Device Without Mcc 8 8 — — $39,612.33 $39,612.33 $39,612.33 2025-08-01
9453 OTHER Injection, Nivolumab 1 1 — — $38,645.96 $38,645.96 $38,645.96 2025-08-01
9494 OTHER Injection, Ocrelizumab 1 1 — — $37,195.47 $37,195.47 $37,195.47 2025-08-01
5465 OTHER Level 5 Neurostimulator And Related Procedures 2 2 — — $30,832.49 $30,832.49 $30,832.49 2025-08-01
9284 OTHER Ipilimumab Injection 1 1 — — $28,664.84 $28,664.84 $28,664.84 2025-08-01
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 5 5 — — $27,955.45 $27,955.45 $27,955.45 2025-08-01
260 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Mcc 1 1 — — $24,929.92 $24,929.92 $24,929.92 2025-08-01
314 MS_DRG Other Circulatory System Diagnoses With Mcc 1 1 — — $24,106.09 $24,106.09 $24,106.09 2025-08-01
9431 OTHER Inj, Dostarlimab-gxly, 10 Mg 1 1 — — $23,493.14 $23,493.14 $23,493.14 2025-08-01
321 MS_DRG Percutaneous Cardiovascular Procedures With Intraluminal Device With Mcc Or 4+ A… 7 7 — — $23,197.47 $23,197.47 $23,197.47 2025-08-01
1490 OTHER Inj Pembrolizumab 3 3 — — $22,471.46 $22,471.46 $22,471.46 2025-08-01
5116 OTHER Level 6 Musculoskeletal Procedures 8 8 — — $22,430.83 $22,430.83 $22,430.83 2025-08-01
553 MS_DRG Bone Diseases And Arthropathies With Mcc 1 1 — — $22,002.72 $22,002.72 $22,002.72 2025-08-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 1 1 — — $20,578.31 $20,578.31 $20,578.31 2025-08-01
5194 OTHER Level 4 Endovascular Procedures 2 2 — — $20,536.51 $20,536.51 $20,536.51 2025-08-01
398 MS_DRG Appendix Procedures With Cc 1 1 — — $20,172.22 $20,172.22 $20,172.22 2025-08-01
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 1 1 — — $19,800.09 $19,800.09 $19,800.09 2025-08-01
486 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Cc 2 2 — — $18,405.53 $18,405.53 $18,405.53 2025-08-01
483 MS_DRG Major Joint Or Limb Reattachment Procedures Of Upper Extremities 1 1 — — $18,353.91 $18,353.91 $18,353.91 2025-08-01
468 MS_DRG Revision Of Hip Or Knee Replacement Without Cc/Mcc 2 2 — — $17,904.65 $17,904.65 $17,904.65 2025-08-01
286 MS_DRG Circulatory Disorders Except Ami, With Cardiac Catheterization With Mcc 3 3 — — $16,328.20 $16,328.20 $16,328.20 2025-08-01
418 MS_DRG Laparoscopic Cholecystectomy Without C.d.e. With Cc 3 3 — — $15,872.42 $15,872.42 $15,872.42 2025-08-01
438 MS_DRG Disorders Of Pancreas Except Malignancy With Mcc 2 2 — — $15,585.31 $15,585.31 $15,585.31 2025-08-01
250 MS_DRG Percutaneous Cardiovascular Procedures Without Intraluminal Device With Mcc 1 1 — — $15,501.05 $15,501.05 $15,501.05 2025-08-01
871 MS_DRG Septicemia Or Severe Sepsis Without Mv >96 Hours With Mcc 18 18 — — $15,396.62 $15,396.62 $15,396.62 2025-08-01
940 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Cc 1 1 — — $15,279.43 $15,279.43 $15,279.43 2025-08-01
417 MS_DRG Laparoscopic Cholecystectomy Without C.d.e. With Mcc 1 1 — — $15,250.02 $15,250.02 $15,250.02 2025-08-01
808 MS_DRG Major Hematological And Immunological Diagnoses Except Sickle Cell Crisis And Co… 1 1 — — $15,035.93 $15,035.93 $15,035.93 2025-08-01
125 MS_DRG Other Disorders Of The Eye Without Mcc 1 1 — — $14,998.93 $14,998.93 $14,998.93 2025-08-01
432 MS_DRG Cirrhosis And Alcoholic Hepatitis With Mcc 1 1 — — $14,894.06 $14,894.06 $14,894.06 2025-08-01
559 MS_DRG Aftercare, Musculoskeletal System And Connective Tissue With Mcc 1 1 — — $14,750.28 $14,750.28 $14,750.28 2025-08-01
571 MS_DRG Skin Debridement With Cc 1 1 — — $14,557.52 $14,557.52 $14,557.52 2025-08-01
698 MS_DRG Other Kidney And Urinary Tract Diagnoses With Mcc 4 4 — — $14,548.75 $14,548.75 $14,548.75 2025-08-01
64 MS_DRG Intracranial Hemorrhage Or Cerebral Infarction With Mcc 1 1 — — $14,372.60 $14,372.60 $14,372.60 2025-08-01
205 MS_DRG Other Respiratory System Diagnoses With Mcc 1 1 — — $14,210.39 $14,210.39 $14,210.39 2025-08-01
9357 OTHER Inj. Eptinezumab-jjmr 1 Mg 1 1 — — $14,067.30 $14,067.30 $14,067.30 2025-08-01
435 MS_DRG Malignancy Of Hepatobiliary System Or Pancreas With Mcc 1 1 — — $13,584.52 $13,584.52 $13,584.52 2025-08-01
299 MS_DRG Peripheral Vascular Disorders With Mcc 1 1 — — $13,388.40 $13,388.40 $13,388.40 2025-08-01
196 MS_DRG Interstitial Lung Disease With Mcc 2 2 — — $13,262.81 $13,262.81 $13,262.81 2025-08-01
854 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Cc 8 8 — — $13,183.37 $13,183.37 $13,183.37 2025-08-01
377 MS_DRG Gastrointestinal Hemorrhage With Mcc 2 2 — — $12,828.32 $12,828.32 $12,828.32 2025-08-01
982 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Cc 2 2 — — $12,661.65 $12,661.65 $12,661.65 2025-08-01
637 MS_DRG Diabetes With Mcc 6 6 — — $12,224.01 $12,224.01 $12,224.01 2025-08-01
306 MS_DRG Cardiac Congenital And Valvular Disorders With Mcc 1 1 — — $12,137.95 $12,137.95 $12,137.95 2025-08-01
9347 OTHER Inj Luspatercept-aamt 0.25mg 1 1 — — $12,043.05 $12,043.05 $12,043.05 2025-08-01
470 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity Without … 1 1 — — $11,957.43 $11,957.43 $11,957.43 2025-08-01
251 MS_DRG Percutaneous Cardiovascular Procedures Without Intraluminal Device Without Mcc 1 1 — — $11,910.76 $11,910.76 $11,910.76 2025-08-01
446 MS_DRG Disorders Of The Biliary Tract Without Cc/Mcc 1 1 — — $11,698.39 $11,698.39 $11,698.39 2025-08-01
882 MS_DRG Neuroses Except Depressive 2 2 — — $11,456.83 $11,456.83 $11,456.83 2025-08-01
336 MS_DRG Peritoneal Adhesiolysis With Cc 1 1 — — $11,010.43 $11,010.43 $11,010.43 2025-08-01
202 MS_DRG Bronchitis And Asthma With Cc/Mcc 3 3 — — $10,650.89 $10,650.89 $10,650.89 2025-08-01
617 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 4 4 — — $10,430.90 $10,430.90 $10,430.90 2025-08-01
5223 OTHER Level 3 Pacemaker And Similar Procedures 1 1 — — $10,394.08 $10,394.08 $10,394.08 2025-08-01
885 MS_DRG Psychoses 21 21 — — $10,199.65 $10,199.65 $10,199.65 2025-08-01
308 MS_DRG Cardiac Arrhythmia And Conduction Disorders With Mcc 2 2 — — $10,171.04 $10,171.04 $10,171.04 2025-08-01
92 MS_DRG Other Disorders Of Nervous System With Cc 2 2 — — $10,144.98 $10,144.98 $10,144.98 2025-08-01
564 MS_DRG Other Musculoskeletal System And Connective Tissue Diagnoses With Mcc 1 1 — — $10,065.48 $10,065.48 $10,065.48 2025-08-01
9304 OTHER Inj., Cemiplimab-rwlc, 1 Mg 1 1 — — $9,989.25 $9,989.25 $9,989.25 2025-08-01
9418 OTHER Inj. Margetuximab-cmkb, 5 Mg 1 1 — — $9,903.68 $9,903.68 $9,903.68 2025-08-01
177 MS_DRG Respiratory Infections And Inflammations With Mcc 6 6 — — $9,897.17 $9,897.17 $9,897.17 2025-08-01
280 MS_DRG Acute Myocardial Infarction, Discharged Alive With Mcc 7 7 — — $9,643.45 $9,643.45 $9,643.45 2025-08-01
352 MS_DRG Inguinal And Femoral Hernia Procedures Without Cc/Mcc 1 1 — — $9,467.52 $9,467.52 $9,467.52 2025-08-01
809 MS_DRG Major Hematological And Immunological Diagnoses Except Sickle Cell Crisis And Co… 1 1 — — $9,378.49 $9,378.49 $9,378.49 2025-08-01
947 MS_DRG Signs And Symptoms With Mcc 1 1 — — $9,353.00 $9,353.00 $9,353.00 2025-08-01
5165 OTHER Level 5 ENT Procedures 2 2 — — $9,329.64 $9,329.64 $9,329.64 2025-08-01
884 MS_DRG Organic Disturbances And Intellectual Disability 1 1 — — $9,239.14 $9,239.14 $9,239.14 2025-08-01
300 MS_DRG Peripheral Vascular Disorders With Cc 1 1 — — $8,941.69 $8,941.69 $8,941.69 2025-08-01
287 MS_DRG Circulatory Disorders Except Ami, With Cardiac Catheterization Without Mcc 4 4 — — $8,862.44 $8,862.44 $8,862.44 2025-08-01
5114 OTHER Level 4 Musculoskeletal Procedures 16 16 — — $8,773.43 $8,773.43 $8,773.43 2025-08-01
638 MS_DRG Diabetes With Cc 2 2 — — $8,756.43 $8,756.43 $8,756.43 2025-08-01
9492 OTHER Inj., Durvalumab, 10 Mg 4 4 — — $8,738.81 $8,738.81 $8,738.81 2025-08-01
378 MS_DRG Gastrointestinal Hemorrhage With Cc 4 4 — — $8,703.82 $8,703.82 $8,703.82 2025-08-01
291 MS_DRG Heart Failure And Shock With Mcc 8 8 — — $8,549.22 $8,549.22 $8,549.22 2025-08-01
175 MS_DRG Pulmonary Embolism With Mcc Or Acute Cor Pulmonale 1 1 — — $8,524.78 $8,524.78 $8,524.78 2025-08-01
9213 OTHER Inj. Pemetrexed Nos 10mg 2 2 — — $8,470.42 $8,470.42 $8,470.42 2025-08-01
9274 OTHER Crotalidae Poly Immune Fab 1 1 — — $8,448.56 $8,448.56 $8,448.56 2025-08-01
445 MS_DRG Disorders Of The Biliary Tract With Cc 1 1 — — $8,308.98 $8,308.98 $8,308.98 2025-08-01
863 MS_DRG Postoperative And Post-traumatic Infections Without Mcc 1 1 — — $8,308.27 $8,308.27 $8,308.27 2025-08-01
920 MS_DRG Complications Of Treatment With Cc 1 1 — — $8,294.56 $8,294.56 $8,294.56 2025-08-01
489 MS_DRG Knee Procedures Without Principal Diagnosis Of Infection Without Cc/Mcc 1 1 — — $8,228.80 $8,228.80 $8,228.80 2025-08-01
602 MS_DRG Cellulitis With Mcc 1 1 — — $8,150.69 $8,150.69 $8,150.69 2025-08-01
5626 OTHER Level 6 Radiation Therapy 6 6 — — $8,110.00 $8,110.00 $8,110.00 2025-08-01
696 MS_DRG Kidney And Urinary Tract Signs And Symptoms Without Mcc 1 1 — — $8,080.36 $8,080.36 $8,080.36 2025-08-01
355 MS_DRG Hernia Procedures Except Inguinal And Femoral Without Cc/Mcc 1 1 — — $7,951.49 $7,951.49 $7,951.49 2025-08-01
554 MS_DRG Bone Diseases And Arthropathies Without Mcc 1 1 — — $7,902.54 $7,902.54 $7,902.54 2025-08-01
389 MS_DRG Gastrointestinal Obstruction With Cc 1 1 — — $7,787.33 $7,787.33 $7,787.33 2025-08-01
309 MS_DRG Cardiac Arrhythmia And Conduction Disorders With Cc 1 1 — — $7,727.16 $7,727.16 $7,727.16 2025-08-01
560 MS_DRG Aftercare, Musculoskeletal System And Connective Tissue With Cc 2 2 — — $7,625.02 $7,625.02 $7,625.02 2025-08-01
59 MS_DRG Multiple Sclerosis And Cerebellar Ataxia With Cc 1 1 — — $7,600.46 $7,600.46 $7,600.46 2025-08-01
897 MS_DRG Alcohol, Drug Abuse Or Dependence Without Rehabilitation Therapy Without Mcc 10 10 — — $7,506.69 $7,506.69 $7,506.69 2025-08-01
391 MS_DRG Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders With Mcc 4 4 — — $7,490.16 $7,490.16 $7,490.16 2025-08-01
5491 OTHER Level 1 Intraocular Procedures 10 10 — — $7,472.31 $7,472.31 $7,472.31 2025-08-01
689 MS_DRG Kidney And Urinary Tract Infections With Mcc 2 2 — — $7,458.36 $7,458.36 $7,458.36 2025-08-01
5183 OTHER Level 3 Vascular Procedures 13 13 — — $7,385.80 $7,385.80 $7,385.80 2025-08-01
9132 OTHER Prothrombin Complex Kcentra 5 5 — — $7,336.65 $7,336.65 $7,336.65 2025-08-01
151 MS_DRG Epistaxis Without Mcc 1 1 — — $7,325.43 $7,325.43 $7,325.43 2025-08-01
5164 OTHER Level 4 ENT Procedures 4 4 — — $7,317.49 $7,317.49 $7,317.49 2025-08-01
419 MS_DRG Laparoscopic Cholecystectomy Without C.d.e. Without Cc/Mcc 2 2 — — $7,256.20 $7,256.20 $7,256.20 2025-08-01
815 MS_DRG Reticuloendothelial And Immunity Disorders With Cc 1 1 — — $7,239.73 $7,239.73 $7,239.73 2025-08-01
917 MS_DRG Poisoning And Toxic Effects Of Drugs With Mcc 1 1 — — $7,231.03 $7,231.03 $7,231.03 2025-08-01
872 MS_DRG Septicemia Or Severe Sepsis Without Mv >96 Hours Without Mcc 12 12 — — $7,219.20 $7,219.20 $7,219.20 2025-08-01
195 MS_DRG Simple Pneumonia And Pleurisy Without Cc/Mcc 1 1 — — $7,190.04 $7,190.04 $7,190.04 2025-08-01
908 MS_DRG Other O.r. Procedures For Injuries With Cc 1 1 — — $7,022.21 $7,022.21 $7,022.21 2025-08-01
629 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Cc 1 1 — — $6,955.37 $6,955.37 $6,955.37 2025-08-01
603 MS_DRG Cellulitis Without Mcc 6 6 — — $6,891.76 $6,891.76 $6,891.76 2025-08-01
605 MS_DRG Trauma To The Skin, Subcutaneous Tissue And Breast Without Mcc 1 1 — — $6,877.81 $6,877.81 $6,877.81 2025-08-01
9008 OTHER Inj Tezepelumab-ekko, 1mg 3 3 — — $6,858.16 $6,858.16 $6,858.16 2025-08-01
699 MS_DRG Other Kidney And Urinary Tract Diagnoses With Cc 1 1 — — $6,795.97 $6,795.97 $6,795.97 2025-08-01
552 MS_DRG Medical Back Problems Without Mcc 1 1 — — $6,773.29 $6,773.29 $6,773.29 2025-08-01
5361 OTHER Level 1 Laparoscopy And Related Services 19 19 — — $6,714.24 $6,714.24 $6,714.24 2025-08-01
5341 OTHER Level 1 Abdominal/Peritoneal/Biliary And Related Procedures 11 11 — — $6,707.81 $6,707.81 $6,707.81 2025-08-01
372 MS_DRG Major Gastrointestinal Disorders And Peritoneal Infections With Cc 2 2 — — $6,694.60 $6,694.60 $6,694.60 2025-08-01
694 MS_DRG Urinary Stones Without Mcc 1 1 — — $6,673.30 $6,673.30 $6,673.30 2025-08-01
315 MS_DRG Other Circulatory System Diagnoses With Cc 1 1 — — $6,627.16 $6,627.16 $6,627.16 2025-08-01
690 MS_DRG Kidney And Urinary Tract Infections Without Mcc 4 4 — — $6,457.31 $6,457.31 $6,457.31 2025-08-01
187 MS_DRG Pleural Effusion With Cc 1 1 — — $6,442.73 $6,442.73 $6,442.73 2025-08-01
5432 OTHER Level 2 Nerve Procedures 1 1 — — $6,369.30 $6,369.30 $6,369.30 2025-08-01
282 MS_DRG Acute Myocardial Infarction, Discharged Alive Without Cc/Mcc 3 3 — — $6,269.78 $6,269.78 $6,269.78 2025-08-01
68 MS_DRG Precerebral Occlusion Without Infarction Without Mcc 1 1 — — $6,248.47 $6,248.47 $6,248.47 2025-08-01
386 MS_DRG Inflammatory Bowel Disease With Cc 1 1 — — $6,239.78 $6,239.78 $6,239.78 2025-08-01
191 MS_DRG Chronic Obstructive Pulmonary Disease With Cc 2 2 — — $6,226.45 $6,226.45 $6,226.45 2025-08-01
281 MS_DRG Acute Myocardial Infarction, Discharged Alive With Cc 4 4 — — $6,128.31 $6,128.31 $6,128.31 2025-08-01
9300 OTHER Omalizumab Injection 1 1 — — $6,083.80 $6,083.80 $6,083.80 2025-08-01
176 MS_DRG Pulmonary Embolism Without Mcc 2 2 — — $6,071.74 $6,071.74 $6,071.74 2025-08-01
189 MS_DRG Pulmonary Edema And Respiratory Failure 5 5 — — $6,021.89 $6,021.89 $6,021.89 2025-08-01
433 MS_DRG Cirrhosis And Alcoholic Hepatitis With Cc 2 2 — — $5,998.69 $5,998.69 $5,998.69 2025-08-01
310 MS_DRG Cardiac Arrhythmia And Conduction Disorders Without Cc/Mcc 4 4 — — $5,877.03 $5,877.03 $5,877.03 2025-08-01
312 MS_DRG Syncope And Collapse 1 1 — — $5,837.01 $5,837.01 $5,837.01 2025-08-01
682 MS_DRG Renal Failure With Mcc 2 2 — — $5,793.77 $5,793.77 $5,793.77 2025-08-01
439 MS_DRG Disorders Of Pancreas Except Malignancy With Cc 4 4 — — $5,774.16 $5,774.16 $5,774.16 2025-08-01
880 MS_DRG Acute Adjustment Reaction And Psychosocial Dysfunction 3 3 — — $5,732.50 $5,732.50 $5,732.50 2025-08-01
179 MS_DRG Respiratory Infections And Inflammations Without Cc/Mcc 1 1 — — $5,687.28 $5,687.28 $5,687.28 2025-08-01
5362 OTHER Level 2 Laparoscopy And Related Services 2 2 — — $5,682.99 $5,682.99 $5,682.99 2025-08-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 1 1 — — $5,644.12 $5,644.12 $5,644.12 2025-08-01
5594 OTHER Level 4 Nuclear Medicine And Related Services 17 17 — — $5,643.74 $5,643.74 $5,643.74 2025-08-01
683 MS_DRG Renal Failure With Cc 5 5 — — $5,539.81 $5,539.81 $5,539.81 2025-08-01
101 MS_DRG Seizures Without Mcc 2 2 — — $5,520.69 $5,520.69 $5,520.69 2025-08-01
5091 OTHER Level 1 Breast/Lymphatic Surgery And Related Procedures 4 4 — — $5,492.96 $5,492.96 $5,492.96 2025-08-01
190 MS_DRG Chronic Obstructive Pulmonary Disease With Mcc 5 5 — — $5,487.07 $5,487.07 $5,487.07 2025-08-01
640 MS_DRG Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes With M… 4 4 — — $5,473.28 $5,473.28 $5,473.28 2025-08-01
5192 OTHER Level 2 Endovascular Procedures 9 9 — — $5,424.48 $5,424.48 $5,424.48 2025-08-01
311 MS_DRG Angina Pectoris 1 1 — — $5,374.82 $5,374.82 $5,374.82 2025-08-01
293 MS_DRG Heart Failure And Shock Without Cc/Mcc 2 2 — — $5,351.14 $5,351.14 $5,351.14 2025-08-01
203 MS_DRG Bronchitis And Asthma Without Cc/Mcc 1 1 — — $5,213.15 $5,213.15 $5,213.15 2025-08-01
442 MS_DRG Disorders Of Liver Except Malignancy, Cirrhosis Or Alcoholic Hepatitis With Cc 1 1 — — $5,204.08 $5,204.08 $5,204.08 2025-08-01
394 MS_DRG Other Digestive System Diagnoses With Cc 3 3 — — $5,088.52 $5,088.52 $5,088.52 2025-08-01
536 MS_DRG Fractures Of Hip And Pelvis Without Mcc 1 1 — — $4,953.62 $4,953.62 $4,953.62 2025-08-01
193 MS_DRG Simple Pneumonia And Pleurisy With Mcc 5 5 — — $4,903.94 $4,903.94 $4,903.94 2025-08-01
316 MS_DRG Other Circulatory System Diagnoses Without Cc/Mcc 1 1 — — $4,831.66 $4,831.66 $4,831.66 2025-08-01
918 MS_DRG Poisoning And Toxic Effects Of Drugs Without Mcc 2 2 — — $4,809.64 $4,809.64 $4,809.64 2025-08-01
122 MS_DRG Acute Major Eye Infections Without Cc/Mcc 1 1 — — $4,729.22 $4,729.22 $4,729.22 2025-08-01
5313 OTHER Level 3 Lower Gi Procedures 6 6 — — $4,566.41 $4,566.41 $4,566.41 2025-08-01
641 MS_DRG Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes Withou… 3 3 — — $4,432.46 $4,432.46 $4,432.46 2025-08-01
7043 OTHER Infliximab Not Biosimil 10mg 3 3 — — $4,428.27 $4,428.27 $4,428.27 2025-08-01
1433 OTHER Calcitonin Salmon Injection 1 1 — — $4,421.03 $4,421.03 $4,421.03 2025-08-01
1207 OTHER Octreotide Injection, Depot 2 2 — — $4,357.89 $4,357.89 $4,357.89 2025-08-01
9327 OTHER Inj. Romosozumab-aqqg 1 Mg 3 3 — — $4,015.30 $4,015.30 $4,015.30 2025-08-01
896 MS_DRG Alcohol, Drug Abuse Or Dependence Without Rehabilitation Therapy With Mcc 1 1 — — $3,965.07 $3,965.07 $3,965.07 2025-08-01
194 MS_DRG Simple Pneumonia And Pleurisy With Cc 2 2 — — $3,770.41 $3,770.41 $3,770.41 2025-08-01
894 MS_DRG Alcohol, Drug Abuse Or Dependence, Left Ama 1 1 — — $3,739.80 $3,739.80 $3,739.80 2025-08-01
881 MS_DRG Depressive Neuroses 2 2 — — $3,690.72 $3,690.72 $3,690.72 2025-08-01
313 MS_DRG Chest Pain 1 1 — — $3,680.26 $3,680.26 $3,680.26 2025-08-01
5054 OTHER Level 4 Skin Procedures 11 11 — — $3,678.26 $3,678.26 $3,678.26 2025-08-01
9264 OTHER Tocilizumab Injection 1 1 — — $3,580.45 $3,580.45 $3,580.45 2025-08-01
5303 OTHER Level 3 Upper Gi Procedures 3 3 — — $3,579.20 $3,579.20 $3,579.20 2025-08-01
440 MS_DRG Disorders Of Pancreas Except Malignancy Without Cc/Mcc 1 1 — — $3,495.44 $3,495.44 $3,495.44 2025-08-01
5373 OTHER Level 3 Urology And Related Services 1 1 — — $3,441.32 $3,441.32 $3,441.32 2025-08-01
305 MS_DRG Hypertension Without Mcc 3 3 — — $3,363.84 $3,363.84 $3,363.84 2025-08-01
948 MS_DRG Signs And Symptoms Without Mcc 2 2 — — $3,355.36 $3,355.36 $3,355.36 2025-08-01
9512 OTHER Rbc Leukocytes Reduced 2 2 — — $3,312.14 $3,312.14 $3,312.14 2025-08-01
639 MS_DRG Diabetes Without Cc/Mcc 2 2 — — $3,281.53 $3,281.53 $3,281.53 2025-08-01
392 MS_DRG Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders Without Mcc 5 5 — — $3,278.62 $3,278.62 $3,278.62 2025-08-01
493 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Cc 1 1 — — $3,272.40 $3,272.40 $3,272.40 2025-08-01
1712 OTHER Paclitaxel Protein Bound 1 1 — — $3,121.50 $3,121.50 $3,121.50 2025-08-01
9473 OTHER Injection, Mepolizumab, 1mg 1 1 — — $3,052.09 $3,052.09 $3,052.09 2025-08-01
0943 OTHER Octagam Injection 1 1 — — $2,844.48 $2,844.48 $2,844.48 2025-08-01
5112 OTHER Level 2 Musculoskeletal Procedures 14 14 — — $2,715.57 $2,715.57 $2,715.57 2025-08-01
886 MS_DRG Behavioral And Developmental Disorders 1 1 — — $2,700.00 $2,700.00 $2,700.00 2025-08-01
9272 OTHER Inj, Denosumab 8 8 — — $2,548.57 $2,548.57 $2,548.57 2025-08-01
642 MS_DRG Inborn And Other Disorders Of Metabolism 1 1 — — $2,532.81 $2,532.81 $2,532.81 2025-08-01
66 MS_DRG Intracranial Hemorrhage Or Cerebral Infarction Without Cc/Mcc 1 1 — — $2,506.10 $2,506.10 $2,506.10 2025-08-01
9219 OTHER Procainamide Hcl Injection 1 1 — — $2,498.22 $2,498.22 $2,498.22 2025-08-01
7046 OTHER Doxorubicin Inj 10mg 1 1 — — $2,397.26 $2,397.26 $2,397.26 2025-08-01
5623 OTHER Level 3 Radiation Therapy 10 10 — — $2,339.93 $2,339.93 $2,339.93 2025-08-01
5592 OTHER Level 2 Nuclear Medicine And Related Services 18 18 — — $1,998.19 $1,998.19 $1,998.19 2025-08-01
983 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis Without Cc/Mcc 1 1 — — $1,945.83 $1,945.83 $1,945.83 2025-08-01
9042 OTHER Glucagon Hydrochloride 1 1 — — $1,924.00 $1,924.00 $1,924.00 2025-08-01
5781 OTHER Resuscitation And Cardioversion 5 5 — — $1,919.29 $1,919.29 $1,919.29 2025-08-01
5573 OTHER Level 3 Imaging With Contrast 8 8 — — $1,908.79 $1,908.79 $1,908.79 2025-08-01
0800 OTHER Leuprolide Acetate 1 1 — — $1,852.86 $1,852.86 $1,852.86 2025-08-01
776 MS_DRG Postpartum And Post Abortion Diagnoses Without O.r. Procedures 1 1 — — $1,691.45 $1,691.45 $1,691.45 2025-08-01
69 MS_DRG Transient Ischemia Without Thrombolytic 1 1 — — $1,546.56 $1,546.56 $1,546.56 2025-08-01
1297 OTHER Ferumoxytol, Non-esrd 1 1 — — $1,542.00 $1,542.00 $1,542.00 2025-08-01
9329 OTHER Inj Mvasi 10 Mg 3 3 — — $1,447.85 $1,447.85 $1,447.85 2025-08-01
5771 OTHER Cardiac Rehabilitation 12 12 — — $1,406.03 $1,406.03 $1,406.03 2025-08-01
5523 OTHER Level 3 Imaging Without Contrast 30 30 — — $1,307.46 $1,307.46 $1,307.46 2025-08-01
9501 OTHER Platelet Pheres Leukoreduced 2 2 — — $1,299.83 $1,299.83 $1,299.83 2025-08-01
9436 OTHER Inj Pegfilgrast Ex Bio 0.5mg 5 5 — — $1,139.62 $1,139.62 $1,139.62 2025-08-01
0763 OTHER Inj, Bupivacaine Liposome 2 2 — — $1,111.07 $1,111.07 $1,111.07 2025-08-01
9536 OTHER Platelets Pheresis Path Redu 1 1 — — $992.18 $992.18 $992.18 2025-08-01
9522 OTHER Rbc Leukoreduced Irradiated 1 1 — — $946.56 $946.56 $946.56 2025-08-01
5591 OTHER Level 1 Nuclear Medicine And Related Services 13 13 — — $935.99 $935.99 $935.99 2025-08-01
5723 OTHER Level 3 Diagnostic Tests And Related Services 4 4 — — $932.97 $932.97 $932.97 2025-08-01
5181 OTHER Level 1 Vascular Procedures 6 6 — — $905.15 $905.15 $905.15 2025-08-01
9350 OTHER Inj., Trazimera, 10 Mg 1 1 — — $887.58 $887.58 $887.58 2025-08-01
5342 OTHER Level 2 Abdominal/Peritoneal/Biliary And Related Procedures 1 1 — — $853.60 $853.60 $853.60 2025-08-01
5412 OTHER Level 2 Gynecologic Procedures 4 4 — — $818.90 $818.90 $818.90 2025-08-01
7048 OTHER Alteplase Recombinant 5 5 — — $605.69 $605.69 $605.69 2025-08-01
5501 OTHER Level 1 Extraocular, Repair, And Plastic Eye Procedures 1 1 — — $531.62 $531.62 $531.62 2025-08-01
N809 OTHER Other Medicine 3 3 — — $492.14 $492.14 $492.14 2025-08-01
5021 OTHER Level 1 Type A Ed Visits 10 10 — — $476.65 $476.65 $476.65 2025-08-01
5722 OTHER Level 2 Diagnostic Tests And Related Services 25 25 — — $473.42 $473.42 $473.42 2025-08-01
1469 OTHER Inj Filgrastim Excl Biosimil 1 1 — — $456.54 $456.54 $456.54 2025-08-01
5693 OTHER Level 3 Drug Administration 21 21 — — $440.25 $440.25 $440.25 2025-08-01
0764 OTHER Ketorolac Tromethamine Inj 1 1 — — $430.26 $430.26 $430.26 2025-08-01
N804 OTHER Mammography Services 33 33 — — $416.64 $416.64 $416.64 2025-08-01
9120 OTHER Injection, Fulvestrant 3 3 — — $392.97 $392.97 $392.97 2025-08-01
5102 OTHER Level 2 Strapping And Cast Application 11 11 — — $388.88 $388.88 $388.88 2025-08-01
1822 OTHER Injection, Zarxio 7 7 — — $386.38 $386.38 $386.38 2025-08-01
5622 OTHER Level 2 Radiation Therapy 10 10 — — $382.24 $382.24 $382.24 2025-08-01
5101 OTHER Level 1 Strapping And Cast Application 10 10 — — $380.50 $380.50 $380.50 2025-08-01
5522 OTHER Level 2 Imaging Without Contrast 39 39 — — $366.03 $366.03 $366.03 2025-08-01
1686 OTHER Epoetin Alfa, Non-esrd 1 1 — — $362.21 $362.21 $362.21 2025-08-01
5721 OTHER Level 1 Diagnostic Tests And Related Services 18 18 — — $357.16 $357.16 $357.16 2025-08-01
5162 OTHER Level 2 ENT Procedures 3 3 — — $325.22 $325.22 $325.22 2025-08-01
5672 OTHER Level 2 Pathology 9 9 — — $272.79 $272.79 $272.79 2025-08-01
9200 OTHER Inj, Remdesivir, 1 Mg 1 1 — — $266.40 $266.40 $266.40 2025-08-01
5671 OTHER Level 1 Pathology 7 7 — — $249.55 $249.55 $249.55 2025-08-01
5161 OTHER Level 1 ENT Procedures 3 3 — — $216.61 $216.61 $216.61 2025-08-01
5151 OTHER Level 1 Airway Endoscopy 15 15 — — $200.27 $200.27 $200.27 2025-08-01
5012 OTHER Clinic Visits And Related Services 27 27 — — $180.76 $180.76 $180.76 2025-08-01
N907 OTHER Not Billable To Fi 10 10 — — $170.97 $170.97 $170.97 2025-08-01
5111 OTHER Level 1 Musculoskeletal Procedures 10 10 — — $159.82 $159.82 $159.82 2025-08-01
1415 OTHER Glassia Injection 2 2 — — $147.23 $147.23 $147.23 2025-08-01
5741 OTHER Level 1 Electronic Analysis Of Devices 15 15 — — $143.32 $143.32 $143.32 2025-08-01
5822 OTHER Level 2 Health And Behavior Services 2 2 — — $113.36 $113.36 $113.36 2025-08-01
5692 OTHER Level 2 Drug Administration 17 17 — — $96.78 $96.78 $96.78 2025-08-01
5732 OTHER Level 2 Minor Procedures 10 10 — — $95.53 $95.53 $95.53 2025-08-01
N902 OTHER Packaged Services 9 9 — — $82.50 $82.50 $82.50 2025-08-01
1685 OTHER Darbepoetin Alfa, Non-esrd 1 1 — — $68.45 $68.45 $68.45 2025-08-01
N903 OTHER Influenza Vaccines & Pneumococcal Pneumonia Vaccines 1 1 — — $68.19 $68.19 $68.19 2025-08-01
5821 OTHER Level 1 Health And Behavior Services 1 1 — — $66.00 $66.00 $66.00 2025-08-01
0790 OTHER Inj, Methylpred Acetate 1 Mg 2 2 — — $37.80 $37.80 $37.80 2025-08-01
N905 OTHER Not Recognized By Opps 2 2 — — $34.72 $34.72 $34.72 2025-08-01
9507 OTHER Platelets, Pheresis 1 1 — — $5.00 $5.00 $5.00 2025-08-01
5791 OTHER Pulmonary Treatment 0 0 — — — — — 2025-08-01
5571 OTHER Level 1 Imaging With Contrast 0 0 — — — — — 2025-08-01
5193 OTHER Level 3 Endovascular Procedures 0 0 — — — — — 2025-08-01
5191 OTHER Level 1 Endovascular Procedures 0 0 — — — — — 2025-08-01
5184 OTHER Level 4 Vascular Procedures 0 0 — — — — — 2025-08-01
9002 OTHER Tenecteplase Injection 0 0 — — — — — 2025-08-01
5182 OTHER Level 2 Vascular Procedures 0 0 — — — — — 2025-08-01
9013 OTHER Inj Risankizumab-rzaa?1 Mg 0 0 — — — — — 2025-08-01
5163 OTHER Level 3 ENT Procedures 0 0 — — — — — 2025-08-01
9097 OTHER Inj Retacrit Non-esrd Use 0 0 — — — — — 2025-08-01
5691 OTHER Level 1 Drug Administration 0 0 — — — — — 2025-08-01
9126 OTHER Natalizumab Injection 0 0 — — — — — 2025-08-01
5673 OTHER Level 3 Pathology 0 0 — — — — — 2025-08-01
9133 OTHER Rabies Ig, Im/sc 0 0 — — — — — 2025-08-01
9139 OTHER Rabies Vaccine, IM 0 0 — — — — — 2025-08-01
5431 OTHER Level 1 Nerve Procedures 0 0 — — — — — 2025-08-01
5155 OTHER Level 5 Airway Endoscopy 0 0 — — — — — 2025-08-01
5153 OTHER Level 3 Airway Endoscopy 0 0 — — — — — 2025-08-01
5441 OTHER Level 1 Nerve Injections 0 0 — — — — — 2025-08-01
5115 OTHER Level 5 Musculoskeletal Procedures 0 0 — — — — — 2025-08-01
5113 OTHER Level 3 Musculoskeletal Procedures 0 0 — — — — — 2025-08-01
5613 OTHER Level 3 Therapeutic Radiation Treatment Preparation 0 0 — — — — — 2025-08-01
5612 OTHER Level 2 Therapeutic Radiation Treatment Preparation 0 0 — — — — — 2025-08-01
5611 OTHER Level 1 Therapeutic Radiation Treatment Preparation 0 0 — — — — — 2025-08-01
5073 OTHER Level 3 Excision/ Biopsy/ Incision And Drainage 0 0 — — — — — 2025-08-01
5072 OTHER Level 2 Excision/ Biopsy/ Incision And Drainage 0 0 — — — — — 2025-08-01
5071 OTHER Level 1 Excision/ Biopsy/ Incision And Drainage 0 0 — — — — — 2025-08-01
5053 OTHER Level 3 Skin Procedures 0 0 — — — — — 2025-08-01
5052 OTHER Level 2 Skin Procedures 0 0 — — — — — 2025-08-01
5051 OTHER Level 1 Skin Procedures 0 0 — — — — — 2025-08-01
9367 OTHER Inj Ruxience, 10 Mg 0 0 — — — — — 2025-08-01
5041 OTHER Critical Care 0 0 — — — — — 2025-08-01
5025 OTHER Level 5 Type A Ed Visits 0 0 — — — — — 2025-08-01
5024 OTHER Level 4 Type A Ed Visits 0 0 — — — — — 2025-08-01
9441 OTHER Inj Ferric Carboxymaltos 1mg 0 0 — — — — — 2025-08-01
5023 OTHER Level 3 Type A Ed Visits 0 0 — — — — — 2025-08-01
5022 OTHER Level 2 Type A Ed Visits 0 0 — — — — — 2025-08-01
5442 OTHER Level 2 Nerve Injections 0 0 — — — — — 2025-08-01
1823 OTHER Injection, Dalbavancin 0 0 — — — — — 2025-08-01
5593 OTHER Level 3 Nuclear Medicine And Related Services 0 0 — — — — — 2025-08-01
5521 OTHER Level 1 Imaging Without Contrast 0 0 — — — — — 2025-08-01
5524 OTHER Level 4 Imaging Without Contrast 0 0 — — — — — 2025-08-01
N800 OTHER Clinical Diagnostic Lab Services 0 0 — — — — — 2025-08-01
N801 OTHER Therapy Services 0 0 — — — — — 2025-08-01
1214 OTHER Inj Ivig Privigen 500 Mg 0 0 — — — — — 2025-08-01
N900 OTHER Non-covered Services 0 0 — — — — — 2025-08-01
5694 OTHER Level 4 Drug Administration 0 0 — — — — — 2025-08-01
5572 OTHER Level 2 Imaging With Contrast 0 0 — — — — — 2025-08-01
5312 OTHER Level 2 Lower Gi Procedures 0 0 — — — — — 2025-08-01
5311 OTHER Level 1 Lower Gi Procedures 0 0 — — — — — 2025-08-01
5302 OTHER Level 2 Upper Gi Procedures 0 0 — — — — — 2025-08-01
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