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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

LEHIGH VALLEY HOSPITAL - HAZLETON

Hazleton, PA · CCN 390185 · Rates published

21,600 distinct procedures filed
19 distinct payers
838,032 rate rows
2025-08-01 last MRF observed · ⚠ 14 mo old
Data quality

783,549 of 838,032 rate rows are consumer-grade (93.5%)

54,483 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 46,292
template filing: same amount across many unrelated codes — excluded 4,147
placeholder amount (≤ $0.02) — excluded from medians 2,162
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 771
exceeds 10× this hospital's gross charge — excluded from medians 681
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 165
per-diem day rate — not a per-procedure price 137
percent-of-charges filed in the dollar field — excluded from medians 128

⚠ Possibly outdated The most recent machine-readable file we have for this hospital is 14 months old.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://lvhn.pt.panaceainc.com/MRFDownload/lvhn/hazleton
Found on page https://www.lvhn.org/get-price-quote
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-10-14
Content fingerprint 59bc23b6c4b70e13… · 412,319,224 bytes · first seen 2026-05-05

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
J1414
HCPCS 		Inj, Beqvez, Per Tx Dose 14 $3,570,000.00 $4,683,875.00 $3,895,500.00 nat. median
$3,508,750
1.1× median
J1411
HCPCS 		Inj, Hemgenix, Per Tx Dose 14 $3,570,000.00 $4,652,649.17 $3,869,530.00 nat. median
$3,685,267
1.0× median
J1413
HCPCS 		Inj Delandistrogene Mox Rokl 14 $3,264,000.00 $4,194,622.54 $3,488,596.97 nat. median
$3,325,455
1.0× median
J3394
HCPCS 		Inj, Lovotibeglogene Autotem 14 $3,162,000.00 $4,148,575.00 $3,450,300.00 nat. median
$3,248,446
1.1× median
J3393
HCPCS 		Inj, Betibeglogene Autotemce 14 $2,856,000.00 $3,722,119.33 $3,095,624.00 nat. median
$2,968,000
1.0× median
J3399
HCPCS 		Inj Onase Abepar-xioi Treat 14 $2,368,485.25 $4,846,262.46 $2,556,403.45 nat. median
$2,455,111
1.0× median
J3392
HCPCS 		Inj, Exagamglogene Autotem 14 $2,244,000.00 $4,664,000.00 $2,460,260.00 nat. median
$2,332,000
1.1× median
Q2057
HCPCS 		Afamitresgene Autoleucel 15 $770,620.00 $4,438,595.90 $899,098.24 nat. median
$813,967
1.1× median
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 16 $565,623.84 $3,375,103.79 $636,648.23 nat. median
$621,313
1.0× median
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell Immunotherapy 7 $417,151.84 $793,701.15 $621,431.52 nat. median
$168,055
outlier · 3.7×
Q2056
HCPCS 		Ciltacabtagene Car-pos T 16 $551,318.34 $3,225,806.77 $608,486.23 nat. median
$599,737
1.0× median
5957251501
NDC 		Idecabtagene Vicleucel 300 X 10exp6 To 460 X 10exp6 Cell IV Suspension 19 $481,424.70 $3,076,830.38 $580,384.71 —
7315390001
NDC 		Lisocabtagene Maraleucel 1.5 X 10exp6 To 70 X 10exp6 Cell/ml IV Susp 19 $484,193.05 $3,011,633.21 $568,086.52 —
7128711901
NDC 		Axicabtagene Ciloleucel Intravenous Suspension 19 $458,887.28 $2,932,315.72 $553,124.80 —
7128722001
NDC 		Brexucabtagene Autoleucel 1x 10exp6 To 1x 10exp8 Cell IV Suspension 19 $420,997.50 $2,853,931.20 $538,339.08 —
7128721901
NDC 		Brexucabtagene Autoleucel 2x 10exp6 To 2x 10exp8 Cell IV Suspension 19 $420,997.50 $2,853,931.20 $538,339.08 —
C9098
HCPCS 		Ciltacabtagene Car Pos T 1 $335,983.43 $335,983.43 $335,983.43 nat. median
$2,313,353
outlier · 0.1×
C9301
HCPCS 		Obecabtagene Car Pos T 15 $278,250.00 $1,622,614.88 $328,682.82 nat. median
$377,029
0.9× median
5831
APR_DRG 		Neonate With Ecmo 8 $141,506.98 $499,958.53 $251,119.46 nat. median
$173,909
1.4× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 15 $205,104.67 $481,368.08 $239,971.30 nat. median
$186,516
1.3× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 14 $172,796.80 $453,284.74 $226,057.44 nat. median
$131,925
1.7× median
0-D
OTHER 		Kidney Transplant With Hemodialysis With Mcc - Deceased Donor 2 $145,141.00 $291,282.00 $218,211.50 —
1-D
OTHER 		Kidney Transplant With Hemodialysis Without Mcc - Deceased Donor 2 $145,141.00 $238,389.00 $191,765.00 —
0-L
OTHER 		Kidney Transplant With Hemodialysis With Mcc - Living Donor 2 $122,004.00 $243,226.00 $182,615.00 —
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 15 $22,511.00 $377,753.38 $181,960.62 nat. median
$145,435
1.3× median
2-D
OTHER 		Kidney Transplant - Deceased Donor 2 $145,141.00 $201,892.00 $173,516.50 —
5881
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 8 $124,900.26 $326,165.98 $170,016.21 nat. median
$130,862
1.3× median
1-L
OTHER 		Kidney Transplant With Hemodialysis Without Mcc - Living Donor 2 $122,004.00 $199,061.00 $160,532.50 —
J7330
HCPCS 		Cultured Chondrocytes Implnt 2 $61,878.30 $232,043.63 $146,960.97 nat. median
$92,809
1.6× median
2-L
OTHER 		Kidney Transplant - Living Donor 2 $122,004.00 $171,483.00 $146,743.50 —
K1007
HCPCS 		Bil Hkaf Pc S/d Micro Sensor 14 $95,081.03 $543,593.19 $145,926.08 nat. median
$95,583
1.5× median
1611
APR_DRG 		Implantable Heart Assist Systems 8 $100,280.52 $247,543.19 $132,785.23 nat. median
$108,954
1.2× median
Q0480
HCPCS 		Driver Pneumatic Vad, Rep 14 $101,999.91 $583,149.48 $126,249.89 nat. median
$108,243
1.2× median
21
APR_DRG 		Heart And/or Lung Transplant 8 $84,974.85 $288,849.81 $122,499.17 nat. median
$77,825
1.6× median
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 15 $22,511.00 $249,055.38 $120,428.82 nat. median
$97,418
1.2× median
426
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 14 $76,520.75 $225,896.24 $118,726.09 nat. median
$2,736
outlier · 43.4×
5911
APR_DRG 		Neonate Birth Weight 500-749 Grams Without Major Procedure 8 $54,880.49 $207,201.38 $118,509.21 nat. median
$30,994
outlier · 3.8×
7
MS_DRG 		Lung Transplant 14 $95,368.40 $259,010.61 $118,041.77 nat. median
$70,649
1.7× median
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 15 $80,476.47 $285,815.22 $115,647.39 nat. median
$65,418
1.8× median
212
MS_DRG 		Concomitant Aortic And Mitral Valve?procedures 15 $79,562.21 $232,270.69 $114,661.18 nat. median
$74,509
1.5× median
111
APR_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 17 $35,223.87 $620,274.70 $108,670.51 nat. median
$30,753
outlier · 3.5×
5931
APR_DRG 		Neonate Birth Weight 750-999 Grams Without Major Procedure 8 $18,489.11 $192,128.31 $106,724.01 nat. median
$33,329
outlier · 3.2×
L8702
HCPCS 		Ewhf S/d Uprt Micro Sensor 14 $68,801.71 $393,350.19 $105,593.76 nat. median
$68,802
1.5× median
850
MS_DRG 		Acute Leukemia With Other Procedures 14 $67,338.21 $198,649.56 $104,405.83 nat. median
$2,633
outlier · 39.7×
5891
APR_DRG 		Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational… 8 $14,791.42 $127,413.47 $103,254.71 nat. median
$99,483
1.0× median
71
APR_DRG 		Allogeneic Bone Marrow Transplant 17 $57,323.70 $230,932.33 $97,482.89 nat. median
$55,310
1.8× median
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 14 $77,785.30 $228,712.56 $96,278.38 nat. median
$69,922
1.4× median
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 15 $70,530.11 $170,110.29 $95,604.36 nat. median
$69,822
1.4× median
429
MS_DRG 		Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 14 $61,006.00 $179,860.45 $94,530.69 nat. median
$2,596
outlier · 36.4×
270006206-10806601-20758
CDM 		Hb Kit Protek Duo Dl31 19 $30,011.11 $149,438.03 $89,724.57 —

Other procedures at this hospital

Browse this hospital's 21,600 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
             
J1414 HCPCS Inj, Beqvez, Per Tx Dose 16 14 — — $3,570,000.00 $4,683,875.00 $3,895,500.00 2025-08-01
J1411 HCPCS Inj, Hemgenix, Per Tx Dose 16 14 — — $3,570,000.00 $4,652,649.17 $3,869,530.00 2025-08-01
J1413 HCPCS Inj Delandistrogene Mox Rokl 16 14 — — $3,264,000.00 $4,194,622.54 $3,488,596.97 2025-08-01
J3394 HCPCS Inj, Lovotibeglogene Autotem 16 14 — — $3,162,000.00 $4,148,575.00 $3,450,300.00 2025-08-01
J3393 HCPCS Inj, Betibeglogene Autotemce 16 14 — — $2,856,000.00 $3,722,119.33 $3,095,624.00 2025-08-01
J3399 HCPCS Inj Onase Abepar-xioi Treat 18 14 — — $2,368,485.25 $4,846,262.46 $2,556,403.45 2025-08-01
J3392 HCPCS Inj, Exagamglogene Autotem 18 14 — — $2,244,000.00 $4,664,000.00 $2,460,260.00 2025-08-01
Q2057 HCPCS Afamitresgene Autoleucel 28 15 — — $770,620.00 $4,438,595.90 $899,098.24 2025-08-01
Q2042 HCPCS Tisagenlecleucel Car-pos T 36 16 — — $565,623.84 $3,375,103.79 $636,648.23 2025-08-01
18 MS_DRG Chimeric Antigen Receptor (car) T-cell Immunotherapy 13 7 — — $417,151.84 $793,701.15 $621,431.52 2025-08-01
Q2056 HCPCS Ciltacabtagene Car-pos T 36 16 — — $551,318.34 $3,225,806.77 $608,486.23 2025-08-01
5957251501 NDC Idecabtagene Vicleucel 300 X 10exp6 To 460 X 10exp6 Cell IV Suspension 41 19 $3,962,343.23 $1,981,171.62 50% off $481,424.70 $3,076,830.38 $580,384.71 2025-08-01
7315390001 NDC Lisocabtagene Maraleucel 1.5 X 10exp6 To 70 X 10exp6 Cell/ml IV Susp 41 19 $3,985,128.00 $1,992,564.00 50% off $484,193.05 $3,011,633.21 $568,086.52 2025-08-01
7128711901 NDC Axicabtagene Ciloleucel Intravenous Suspension 41 19 $3,776,850.00 $1,888,425.00 50% off $458,887.28 $2,932,315.72 $553,124.80 2025-08-01
7128722001 NDC Brexucabtagene Autoleucel 1x 10exp6 To 1x 10exp8 Cell IV Suspension 41 19 $3,465,000.00 $1,732,500.00 50% off $420,997.50 $2,853,931.20 $538,339.08 2025-08-01
7128721901 NDC Brexucabtagene Autoleucel 2x 10exp6 To 2x 10exp8 Cell IV Suspension 41 19 $3,465,000.00 $1,732,500.00 50% off $420,997.50 $2,853,931.20 $538,339.08 2025-08-01
C9098 HCPCS Ciltacabtagene Car Pos T 2 1 — — $335,983.43 $335,983.43 $335,983.43 2025-08-01
C9301 HCPCS Obecabtagene Car Pos T 28 15 — — $278,250.00 $1,622,614.88 $328,682.82 2025-08-01
5831 APR_DRG Neonate With Ecmo 36 8 — — $141,506.98 $499,958.53 $251,119.46 2025-08-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 28 15 — — $205,104.67 $481,368.08 $239,971.30 2025-08-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 28 14 — — $172,796.80 $453,284.74 $226,057.44 2025-08-01
0-D OTHER Kidney Transplant With Hemodialysis With Mcc - Deceased Donor 2 2 — — $145,141.00 $291,282.00 $218,211.50 2025-08-01
1-D OTHER Kidney Transplant With Hemodialysis Without Mcc - Deceased Donor 2 2 — — $145,141.00 $238,389.00 $191,765.00 2025-08-01
0-L OTHER Kidney Transplant With Hemodialysis With Mcc - Living Donor 2 2 — — $122,004.00 $243,226.00 $182,615.00 2025-08-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 30 15 — — $22,511.00 $377,753.38 $181,960.62 2025-08-01
2-D OTHER Kidney Transplant - Deceased Donor 2 2 — — $145,141.00 $201,892.00 $173,516.50 2025-08-01
5881 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 36 8 — — $124,900.26 $326,165.98 $170,016.21 2025-08-01
1-L OTHER Kidney Transplant With Hemodialysis Without Mcc - Living Donor 2 2 — — $122,004.00 $199,061.00 $160,532.50 2025-08-01
J7330 HCPCS Cultured Chondrocytes Implnt 2 2 — — $61,878.30 $232,043.63 $146,960.97 2025-08-01
2-L OTHER Kidney Transplant - Living Donor 2 2 — — $122,004.00 $171,483.00 $146,743.50 2025-08-01
K1007 HCPCS Bil Hkaf Pc S/d Micro Sensor 26 14 — — $95,081.03 $543,593.19 $145,926.08 2025-08-01
1611 APR_DRG Implantable Heart Assist Systems 36 8 — — $100,280.52 $247,543.19 $132,785.23 2025-08-01
Q0480 HCPCS Driver Pneumatic Vad, Rep 27 14 — — $101,999.91 $583,149.48 $126,249.89 2025-08-01
21 APR_DRG Heart And/or Lung Transplant 36 8 — — $84,974.85 $288,849.81 $122,499.17 2025-08-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 30 15 — — $22,511.00 $249,055.38 $120,428.82 2025-08-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 29 14 — — $76,520.75 $225,896.24 $118,726.09 2025-08-01
5911 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 36 8 — — $54,880.49 $207,201.38 $118,509.21 2025-08-01
7 MS_DRG Lung Transplant 27 14 — — $95,368.40 $259,010.61 $118,041.77 2025-08-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 28 15 — — $80,476.47 $285,815.22 $115,647.39 2025-08-01
212 MS_DRG Concomitant Aortic And Mitral Valve?procedures 30 15 — — $79,562.21 $232,270.69 $114,661.18 2025-08-01
111 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 52 17 — — $35,223.87 $620,274.70 $108,670.51 2025-08-01
5931 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 36 8 — — $18,489.11 $192,128.31 $106,724.01 2025-08-01
L8702 HCPCS Ewhf S/d Uprt Micro Sensor 26 14 — — $68,801.71 $393,350.19 $105,593.76 2025-08-01
850 MS_DRG Acute Leukemia With Other Procedures 29 14 — — $67,338.21 $198,649.56 $104,405.83 2025-08-01
5891 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 36 8 — — $14,791.42 $127,413.47 $103,254.71 2025-08-01
71 APR_DRG Allogeneic Bone Marrow Transplant 65 17 — — $57,323.70 $230,932.33 $97,482.89 2025-08-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 27 14 — — $77,785.30 $228,712.56 $96,278.38 2025-08-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 30 15 — — $70,530.11 $170,110.29 $95,604.36 2025-08-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 29 14 — — $61,006.00 $179,860.45 $94,530.69 2025-08-01
270006206-10806601-20758 CDM Hb Kit Protek Duo Dl31 41 19 $247,005.00 $123,502.50 50% off $30,011.11 $149,438.03 $89,724.57 2025-08-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 30 15 — — $58,002.32 $338,268.00 $89,578.36 2025-08-01
8 MS_DRG Simultaneous Pancreas/kidney Transplant 12 7 — — $61,077.85 $275,556.00 $89,458.92 2025-08-01
215 MS_DRG Other Heart Assist System Implant 30 15 — — $63,299.27 $186,743.94 $85,993.61 2025-08-01
270006205-10806601-20759 CDM Hb Kit Protek Duo Dl29 41 19 $233,020.00 $116,510.00 50% off $28,311.93 $140,977.10 $84,644.51 2025-08-01
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 29 14 — — $52,009.50 $153,165.82 $80,500.58 2025-08-01
6021 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 36 8 — — $18,804.79 $142,670.23 $80,077.71 2025-08-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 30 15 — — $22,511.00 $164,687.70 $79,775.95 2025-08-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 30 15 — — $51,750.06 $135,101.28 $77,728.45 2025-08-01
6301 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 36 8 — — $24,284.20 $237,926.58 $76,976.10 2025-08-01
41 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 36 8 — — $46,694.22 $173,709.45 $76,243.84 2025-08-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 30 15 — — $22,511.00 $149,278.12 $76,018.23 2025-08-01
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 29 14 — — $49,117.02 $144,583.17 $75,989.73 2025-08-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 30 15 — — $61,974.76 $149,360.96 $75,858.02 2025-08-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 30 15 — — $55,070.93 $137,771.87 $71,907.75 2025-08-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 30 15 — — $54,107.56 $136,381.18 $71,620.20 2025-08-01
A0407 HCPCS Traumatic Spinal Cord Injury M <24.50 And A >=61.50 28 7 — — $63,119.61 $82,812.05 $71,523.71 2025-08-01
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 29 14 — — $45,350.25 $133,406.31 $70,115.42 2025-08-01
J9029 HCPCS Instill Adstiladrin, Tx Dose 38 17 — — $56,912.05 $368,758.46 $69,559.17 2025-08-01
810000001-10806601-16112 CDM Hb Organ Processing 41 19 $191,370.00 $95,685.00 50% off $23,251.46 $115,778.85 $69,515.15 2025-08-01
810000002-10806601-16111 CDM Hb Organ Processing - Lrd 41 19 $191,370.00 $95,685.00 50% off $23,251.46 $115,778.85 $69,515.15 2025-08-01
61 APR_DRG Pancreas Transplant 66 18 — — $41,902.30 $171,123.00 $68,868.54 2025-08-01
810000003-10806601-16110 CDM Hb Pancreas Organ Processing 41 19 $184,995.00 $92,497.50 50% off $22,476.89 $111,921.98 $67,199.43 2025-08-01
A9543 HCPCS Y90 Ibritumomab, Rx 32 15 — — $41,945.39 $331,372.36 $67,124.00 2025-08-01
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 30 15 — — $22,511.00 $144,503.38 $66,473.96 2025-08-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc 30 15 — — $45,408.39 $111,401.95 $66,286.74 2025-08-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 30 15 — — $22,511.00 $131,563.99 $66,273.17 2025-08-01
11 APR_DRG Liver Transplant And/or Intestinal Transplant 36 8 — — $44,740.62 $174,907.81 $64,891.93 2025-08-01
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 30 15 — — $22,511.00 $139,543.56 $64,509.28 2025-08-01
560000237-10806601-18127 CDM Hb Trnsplj Allogeneic Hematopoietic Cells Per Donor 35 16 $180,430.00 $90,215.00 50% off $130.04 $340,646.37 $64,256.37 2025-08-01
J7310 HCPCS Ganciclovir Long Act Implant 1 1 — — $63,600.00 $63,600.00 $63,600.00 2025-08-01
481000211-10806601-18807 CDM Hb 33270 Insert Subq Defib W/eltrd 41 19 $157,220.00 $78,610.00 50% off $19,102.23 $184,667.39 $63,334.44 2025-08-01
481000370-10806601-18682 CDM Hb 0915t Insj Perm Ccm-d Sys Pg&dual Transvns Eltrds/lds 41 19 $161,270.00 $80,635.00 50% off $19,594.31 $184,667.39 $63,334.44 2025-08-01
8411 APR_DRG Extensive Third Degree Burns With Skin Graft 27 8 — — $39,888.43 $234,667.40 $63,268.98 2025-08-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 30 15 — — $44,785.57 $107,671.95 $63,145.10 2025-08-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 30 15 — — $47,323.39 $113,826.95 $63,137.33 2025-08-01
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 29 14 — — $40,391.61 $118,692.89 $62,382.37 2025-08-01
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 29 14 — — $40,147.42 $117,968.32 $62,001.55 2025-08-01
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 29 15 — — $43,594.41 $134,454.35 $61,999.00 2025-08-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 30 15 — — $14,754.00 $122,852.67 $61,613.31 2025-08-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 30 15 — — $22,511.00 $118,690.73 $61,420.93 2025-08-01
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 30 15 — — $43,928.73 $107,246.00 $61,358.27 2025-08-01
3023789006 NDC Sipuleucel-t In Lactated Ringers 50 Million Cell/250 Ml IV Suspension 39 17 $73,946.00 $36,973.00 50% off $8,984.44 $332,495.22 $61,008.30 2025-08-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 30 15 — — $14,754.00 $122,615.27 $60,804.90 2025-08-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 30 15 — — $22,511.00 $124,103.41 $60,552.21 2025-08-01
L7181 HCPCS Electronic Elbo Simultaneous 27 14 — — $48,001.22 $275,312.52 $59,604.23 2025-08-01
L2006 HCPCS Kaf Sng/dbl Swg/stn Mcpr Cus 26 14 — — $38,584.77 $220,595.21 $59,218.18 2025-08-01
91 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 36 8 — — $37,839.64 $195,690.14 $58,450.15 2025-08-01
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 29 14 — — $37,818.90 $111,059.07 $58,370.20 2025-08-01
270006137-10806601-20827 CDM Hb Set Usa Hls Advanced 7.0 41 19 $160,030.00 $80,015.00 50% off $19,443.65 $96,818.15 $58,130.90 2025-08-01
834 MS_DRG Acute Leukemia Without Major O.r. Procedures With Mcc 30 15 — — $22,511.00 $151,813.73 $58,127.23 2025-08-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 30 15 — — $22,511.00 $123,693.69 $57,606.94 2025-08-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 30 15 — — $43,627.12 $107,246.00 $57,585.85 2025-08-01
6071 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 36 8 — — $24,260.92 $109,339.25 $57,576.94 2025-08-01
228 MS_DRG Other Cardiothoracic Procedures With Mcc 30 15 — — $36,606.67 $104,587.58 $57,259.68 2025-08-01
51 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 36 8 — — $31,411.15 $113,306.08 $56,474.81 2025-08-01
653 MS_DRG Major Bladder Procedures With Mcc 30 15 — — $22,511.00 $117,439.99 $56,176.28 2025-08-01
481000292-10806601-18752 CDM Hb Tcat Impl Wrls P-art Prs Snr 41 19 $138,070.00 $69,035.00 50% off $16,775.51 $163,740.71 $56,157.32 2025-08-01
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 30 15 — — $22,511.00 $118,582.91 $55,670.19 2025-08-01
270006273-10806601-20691 CDM Hb Protek Duo Cannula Veno-venous 31fr 41 19 $152,290.00 $76,145.00 50% off $18,503.24 $92,135.45 $55,319.35 2025-08-01
270006272-10806601-20692 CDM Hb Protek Duo Cannula Veno-venous 29fr 41 19 $152,290.00 $76,145.00 50% off $18,503.24 $92,135.45 $55,319.35 2025-08-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 30 15 — — $42,229.74 $103,714.91 $55,255.00 2025-08-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 30 15 — — $22,511.00 $106,291.17 $53,987.71 2025-08-01
L8701 HCPCS Ewh S/d Uprt Micro Sensor 26 14 — — $34,970.13 $199,929.71 $53,670.58 2025-08-01
6091 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 36 8 — — $32,855.30 $214,455.38 $53,431.14 2025-08-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 30 15 — — $39,055.11 $93,773.85 $53,193.33 2025-08-01
L7180 HCPCS Electronic Elbow Sequential 27 14 — — $42,745.35 $244,381.90 $52,907.85 2025-08-01
6031 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 36 8 — — $15,795.28 $177,713.02 $52,609.84 2025-08-01
33276 HCPCS Insj Phrnc Nrv Stim Sys 28 15 — — $45,000.50 $259,192.62 $52,503.01 2025-08-01
3031 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 36 8 — — $30,914.02 $103,729.71 $52,469.82 2025-08-01
A1904 HCPCS Guillain-barr? M <38.50 28 7 — — $49,086.47 $71,656.96 $52,468.07 2025-08-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 30 15 — — $38,884.32 $107,246.00 $52,451.70 2025-08-01
A0406 HCPCS Traumatic Spinal Cord Injury M >=24.50 And M <31.50 And A >=61.50 28 7 — — $46,170.59 $60,574.36 $52,316.93 2025-08-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 30 15 — — $22,511.00 $102,623.86 $52,173.15 2025-08-01
A1806 HCPCS Major Multiple Trauma With Brain Or Spinal Cord Injury M <30.50 28 7 — — $45,991.68 $67,404.52 $51,649.36 2025-08-01
A0404 HCPCS Traumatic Spinal Cord Injury M <31.50 And A <61.50 28 7 — — $45,500.63 $59,694.88 $51,558.19 2025-08-01
28 MS_DRG Spinal Procedures With Mcc 30 15 — — $22,511.00 $107,157.27 $51,182.88 2025-08-01
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 30 15 — — $34,581.94 $107,246.00 $51,180.54 2025-08-01
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 30 15 — — $34,198.21 $107,246.00 $51,148.40 2025-08-01
9101 APR_DRG Craniotomy For Multiple Significant Trauma 66 18 — — $19,882.59 $123,499.61 $50,750.81 2025-08-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 28 14 — — $26,770.44 $114,135.72 $50,608.48 2025-08-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 30 15 — — $22,511.00 $100,558.09 $50,257.62 2025-08-01
245 MS_DRG Aicd Generator Procedures 30 15 — — $35,905.36 $103,315.28 $49,370.96 2025-08-01
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 30 15 — — $22,511.00 $104,566.02 $49,199.04 2025-08-01
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 30 15 — — $22,511.00 $95,686.27 $49,127.81 2025-08-01
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 30 15 — — $31,345.70 $89,276.82 $48,910.88 2025-08-01
6797900201 NDC Histrelin 50 Mg (65 Mcg/day) Implant Kit 40 18 $48,781.77 $24,390.89 50% off $9,790.50 $263,654.01 $48,579.32 2025-08-01
0266T OTHER Implt/rpl Crtd Sns Dev Total 30 15 — — $21,089.53 $259,192.62 $48,521.12 2025-08-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 29 14 — — $35,690.14 $106,388.77 $48,254.52 2025-08-01
1781 APR_DRG External Heart Assist Systems 36 8 — — $37,012.46 $78,705.02 $48,096.59 2025-08-01
1621 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 36 8 — — $31,547.42 $98,596.01 $48,079.60 2025-08-01
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 30 15 — — $36,752.03 $96,177.45 $48,019.19 2025-08-01
481000031-10806601-18971 CDM Hb Icd Insert Generator, Leads Single/dual 33249 35 16 $266,370.00 $133,185.00 50% off $892.40 $184,667.39 $47,946.60 2025-08-01
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 30 15 — — $22,511.00 $95,108.13 $47,886.57 2025-08-01
0674T OTHER Laps Insj Nw/rpcmt Prm Isdss 28 15 — — $30,700.74 $175,520.92 $47,118.10 2025-08-01
33287 HCPCS Rmv&rplcmt Phrnc Nrv Stim Pg 28 15 — — $30,700.74 $175,520.92 $47,118.10 2025-08-01
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 28 14 — — $33,874.08 $97,902.60 $46,691.46 2025-08-01
A0106 HCPCS Stroke M <41.50 And A <84.50 28 7 — — $41,779.64 $56,929.12 $46,546.40 2025-08-01
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 29 14 — — $30,067.34 $88,058.43 $46,281.57 2025-08-01
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 29 14 — — $28,028.49 $106,388.77 $45,992.03 2025-08-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 30 15 — — $22,511.00 $95,198.03 $45,520.67 2025-08-01
L6700 HCPCS Ue Add Ext Power Myoel 26 14 — — $29,510.19 $168,714.39 $45,290.91 2025-08-01
6311 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 36 8 — — $6,325.78 $210,541.91 $45,273.96 2025-08-01
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 30 15 — — $21,439.00 $93,244.68 $44,502.66 2025-08-01
4401 APR_DRG Kidney Transplant 64 17 — — $22,711.86 $92,139.75 $44,369.35 2025-08-01
481000371-10806601-18681 CDM Hb 0916t Insertion Perm Ccm-d System Pulse Generator Only 41 19 $112,905.00 $56,452.50 50% off $13,717.96 $129,284.94 $44,340.20 2025-08-01
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 29 14 — — $28,822.41 $84,364.44 $44,340.09 2025-08-01
5063321011 NDC Glucarpidase 1000 Unit Intravenous Solution 14 8 $160,331.12 $80,165.56 50% off $1,574.93 $89,785.43 $44,147.18 2025-08-01
6 MS_DRG Liver Transplant Without Mcc 27 14 — — $35,632.10 $103,595.62 $44,103.46 2025-08-01
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 30 15 — — $22,511.00 $92,985.91 $44,098.23 2025-08-01
A0505 HCPCS Non-traumatic Spinal Cord Injury M <39.50 28 7 — — $38,882.80 $59,081.79 $44,043.35 2025-08-01
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 30 15 — — $22,511.00 $89,522.45 $44,024.49 2025-08-01
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 30 15 — — $22,511.00 $85,093.32 $43,984.68 2025-08-01
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 30 15 — — $33,718.06 $107,246.00 $43,691.71 2025-08-01
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 30 15 — — $28,808.59 $80,929.00 $43,555.21 2025-08-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 30 15 — — $22,511.00 $90,474.26 $43,284.14 2025-08-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 30 15 — — $34,012.73 $89,797.42 $42,801.53 2025-08-01
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 30 15 — — $22,511.00 $88,780.40 $42,482.18 2025-08-01
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 30 15 — — $14,754.00 $88,256.91 $42,234.31 2025-08-01
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 30 15 — — $22,511.00 $88,152.91 $42,185.08 2025-08-01
6081 APR_DRG Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 36 8 — — $13,876.59 $69,081.41 $42,128.66 2025-08-01
140 MS_DRG Major Head And Neck Procedures With Mcc 30 15 — — $22,511.00 $84,597.34 $41,494.41 2025-08-01
1601 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 36 8 — — $22,522.32 $144,424.90 $41,188.85 2025-08-01
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 30 15 — — $30,275.19 $73,021.00 $41,001.91 2025-08-01
A0405 HCPCS Traumatic Spinal Cord Injury M >=31.50 And M <41.50 28 7 — — $36,183.90 $47,472.28 $41,001.56 2025-08-01
471 MS_DRG Cervical Spinal Fusion With Mcc 30 15 — — $22,511.00 $85,614.77 $40,983.37 2025-08-01
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 30 15 — — $22,511.00 $87,594.80 $40,970.59 2025-08-01
A0105 HCPCS Stroke M <41.50 And A >=84.50 28 7 — — $36,733.96 $50,051.95 $40,922.99 2025-08-01
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 30 15 — — $22,511.00 $82,480.87 $40,720.27 2025-08-01
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 30 15 — — $22,511.00 $102,193.93 $40,272.35 2025-08-01
1631 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis 36 8 — — $27,030.76 $82,129.52 $40,192.53 2025-08-01
1651 APR_DRG Coronary Bypass With Ami Or Complex Principal Diagnosis 36 8 — — $27,999.01 $76,701.05 $40,159.47 2025-08-01
799 MS_DRG Splenic Procedures With Mcc 30 15 — — $22,511.00 $83,808.10 $40,127.99 2025-08-01
A0205 HCPCS Traumatic Brain Injury M <35.50 28 7 — — $35,369.28 $51,681.64 $40,011.36 2025-08-01
34 MS_DRG Carotid Artery Stent Procedures With Mcc 30 15 — — $22,511.00 $84,769.85 $40,008.29 2025-08-01
81 APR_DRG Autologous Bone Marrow Transplant 36 8 — — $23,009.87 $97,480.75 $39,863.69 2025-08-01
163 MS_DRG Major Chest Procedures With Mcc 30 15 — — $22,511.00 $81,241.76 $39,656.06 2025-08-01
265 MS_DRG Aicd Lead Procedures 30 15 — — $26,315.10 $74,203.27 $39,494.81 2025-08-01
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 30 15 — — $22,511.00 $80,413.83 $39,278.25 2025-08-01
901 MS_DRG Wound Debridements For Injuries With Mcc 30 15 — — $22,511.00 $78,091.99 $39,027.99 2025-08-01
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 30 15 — — $22,511.00 $77,286.99 $38,845.61 2025-08-01
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 30 15 — — $22,511.00 $80,936.83 $38,768.55 2025-08-01
6121 APR_DRG Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other… 36 8 — — $19,579.93 $78,101.46 $38,270.03 2025-08-01
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 30 15 — — $22,511.00 $79,521.46 $38,098.43 2025-08-01
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 30 15 — — $22,511.00 $78,828.76 $37,929.60 2025-08-01
A1705 HCPCS Major Multiple Trauma Without Brain Or Spinal Cord Injury M <36.50 28 7 — — $32,592.35 $51,358.44 $37,881.43 2025-08-01
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 30 15 — — $22,511.00 $79,047.32 $37,873.95 2025-08-01
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 30 15 — — $22,511.00 $72,542.81 $37,762.15 2025-08-01
0620T OTHER Evasc Ven Artlz Tibl/prnl Vn 30 15 — — $11,506.22 $201,594.90 $37,738.76 2025-08-01
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 30 15 — — $22,511.00 $75,410.88 $37,732.81 2025-08-01
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 30 15 — — $22,511.00 $72,439.33 $37,540.25 2025-08-01
0571T OTHER Insj/rplcmt Icds Ss Eltrd 30 15 — — $23,533.24 $184,667.39 $37,406.90 2025-08-01
0408T OTHER Insj/rplc Cardiac Modulj Sys 30 15 — — $16,520.92 $184,667.39 $37,406.90 2025-08-01
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 30 15 — — $23,678.44 $69,027.80 $37,286.04 2025-08-01
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 30 15 — — $22,511.00 $92,123.33 $37,214.32 2025-08-01
6111 APR_DRG Neonate Birth Weight 1500-1999 Grams With Major Anomaly 36 8 — — $12,242.76 $88,618.15 $36,940.22 2025-08-01
1791 APR_DRG Defibrillator Implants 36 8 — — $25,884.47 $63,785.02 $36,883.04 2025-08-01
1831 APR_DRG Percutaneous Structural Cardiac Procedures 36 8 — — $28,233.20 $68,589.82 $36,868.85 2025-08-01
332 MS_DRG Rectal Resection With Mcc 30 15 — — $22,511.00 $83,152.52 $36,568.16 2025-08-01
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 30 15 — — $22,511.00 $76,877.26 $36,567.35 2025-08-01
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 28 14 — — $31,836.26 $73,942.39 $36,557.08 2025-08-01
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 30 15 — — $22,511.00 $77,524.20 $36,448.61 2025-08-01
A1805 HCPCS Major Multiple Trauma With Brain Or Spinal Cord Injury M >=30.50 And M <40.50 28 7 — — $32,384.89 $47,462.49 $36,368.04 2025-08-01
324 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc 30 15 — — $23,610.85 $64,822.74 $36,125.43 2025-08-01
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 30 15 — — $22,511.00 $75,187.23 $36,046.35 2025-08-01
A1903 HCPCS Guillain-barr? M >=38.50 And M <51.50 28 7 — — $33,696.27 $49,192.06 $36,018.06 2025-08-01
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 28 14 — — $25,626.87 $76,338.15 $35,920.59 2025-08-01
L5856 HCPCS Elec Knee-shin Swing/stance 27 14 — — $28,800.44 $164,947.01 $35,710.47 2025-08-01
64582 HCPCS Opn Mpltj Hpglsl Nstm Ary Pg 30 15 — — $21,089.53 $175,520.92 $35,554.16 2025-08-01
0268T OTHER Implt/rpl Crtd Sns Dev Gen 30 15 — — $21,089.53 $175,520.92 $35,554.16 2025-08-01
L6880 HCPCS Elec Hand Ind Art Digits 27 14 — — $28,630.16 $164,168.15 $35,541.85 2025-08-01
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 30 15 — — $25,041.83 $59,787.39 $35,492.70 2025-08-01
761001931-10806601-16134 CDM Hb C9797 Vasc Emb/occ W/prs Cath 41 19 $90,325.00 $45,162.50 50% off $10,974.49 $103,426.61 $35,471.70 2025-08-01
A0305 HCPCS Non-traumatic Brain Injury M <42.50 And A <78.50 28 7 — — $31,437.04 $46,706.41 $35,317.33 2025-08-01
6131 APR_DRG Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection 36 8 — — $16,192.44 $89,033.64 $35,310.63 2025-08-01
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 30 15 — — $22,511.00 $73,336.50 $35,213.40 2025-08-01
481000351-10806601-18700 CDM Hb 0823t Tcat Ins 1chmbr Ldls Pm Ra 41 19 $79,665.00 $39,832.50 50% off $9,679.30 $109,845.52 $35,194.27 2025-08-01
481000262-10806601-18780 CDM Hb Transcath Insert Or Replace Leadless Pacemaker Ventr 33274 41 19 $76,875.00 $38,437.50 50% off $9,340.31 $109,845.52 $35,194.27 2025-08-01
481000353-10806601-18698 CDM Hb 0825t Tcat Rmv&rpl 1chmb Ldls Pm Ra 41 19 $79,665.00 $39,832.50 50% off $9,679.30 $109,845.52 $35,194.27 2025-08-01
A1004 HCPCS Amputation Lower Extremity M <47.50 28 7 — — $29,644.11 $45,072.80 $35,136.44 2025-08-01
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 30 15 — — $14,754.00 $71,270.51 $35,093.06 2025-08-01
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 30 15 — — $22,511.00 $72,650.63 $35,081.08 2025-08-01
451 MS_DRG Single Level Spinal Fusion Except Cervical Without Mcc 29 14 — — $22,817.96 $66,547.89 $34,976.11 2025-08-01
481000024-10806601-18978 CDM Hb Icd Gen Insertion With Multiple Lead 33231 35 16 $144,090.00 $72,045.00 50% off $892.40 $184,667.39 $34,833.94 2025-08-01
481000034-10806601-18968 CDM Hb Icd Removal/rplcmnt Pace With Mult Lead 33264 35 16 $157,220.00 $78,610.00 50% off $892.40 $184,667.39 $34,833.94 2025-08-01
A0604 HCPCS Neurological M <43.50 28 7 — — $29,878.22 $48,780.72 $34,790.65 2025-08-01
0923T OTHER Rmvl&rplcmt Perm Ccm-d Pg 28 15 — — $22,613.50 $129,284.94 $34,706.18 2025-08-01
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 30 15 — — $22,511.00 $70,731.40 $34,703.57 2025-08-01
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 30 15 — — $22,511.00 $67,008.76 $34,579.11 2025-08-01
A1504 HCPCS Pulmonary M <45.50 28 7 — — $30,909.82 $44,549.82 $34,570.51 2025-08-01
904 MS_DRG Skin Grafts For Injuries With Cc/mcc 30 15 — — $22,511.00 $68,055.75 $34,432.59 2025-08-01
3041 APR_DRG Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back 36 8 — — $20,288.65 $72,727.22 $34,288.97 2025-08-01
A2102 HCPCS Burns M <52.50 21 7 — — $28,625.84 $45,395.99 $34,170.12 2025-08-01
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 30 15 — — $22,965.49 $80,929.00 $34,030.78 2025-08-01
1661 APR_DRG Coronary Bypass Without Ami Or Complex Principal Diagnosis 36 8 — — $23,251.59 $67,168.41 $34,024.92 2025-08-01
1671 APR_DRG Other Cardiothoracic And Thoracic Vascular Procedures 36 8 — — $23,244.74 $82,687.59 $33,970.21 2025-08-01
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 30 15 — — $22,511.00 $68,682.77 $33,874.66 2025-08-01
A0704 HCPCS Fracture Of Lower Extremity M <41.50 28 7 — — $29,988.61 $45,586.00 $33,834.94 2025-08-01
31 MS_DRG Ventricular Shunt Procedures With Mcc 30 15 — — $22,511.00 $73,863.52 $33,776.17 2025-08-01
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 30 15 — — $22,511.00 $70,216.70 $33,693.00 2025-08-01
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 30 15 — — $22,511.00 $73,845.89 $33,634.41 2025-08-01
485 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Mcc 30 15 — — $22,511.00 $71,205.81 $33,433.06 2025-08-01
A1304 HCPCS Rheumatoid Other Arthritis M <44.50 And A >=64.50 28 7 — — $29,927.71 $41,948.60 $33,404.39 2025-08-01
560000345-10806601-18021 CDM Hb Nmdp Unreltd Donr Marrow Fee & Cryo 41 19 $91,695.00 $45,847.50 50% off $11,140.94 $55,475.48 $33,308.21 2025-08-01
69930 HCPCS Implant Cochlear Device 37 18 — — $892.40 $183,205.79 $33,301.57 2025-08-01
274 MS_DRG Percutaneous And Other Intracardiac Procedures Without Mcc 30 15 — — $23,072.33 $80,929.00 $33,251.57 2025-08-01
0816T OTHER Opn Insj/rplcmt Ins Ptn Subq 28 15 — — $21,604.23 $123,514.79 $33,157.20 2025-08-01
0680T OTHER Insj/rplcmt Pg Only Isdss 28 15 — — $21,604.23 $123,514.79 $33,157.20 2025-08-01
0817T OTHER Opn Insj/rplcmt Ins Ptn Subf 28 15 — — $21,604.23 $123,514.79 $33,157.20 2025-08-01
481000294-10806601-18750 CDM Hb Revasc Lithotr-stent Tib/per 41 19 $71,155.00 $35,577.50 50% off $8,645.33 $103,426.61 $33,137.66 2025-08-01
481000296-10806601-18748 CDM Hb Revasc Lith-sten-ath Tib/per 41 19 $71,155.00 $35,577.50 50% off $8,645.33 $103,426.61 $33,137.66 2025-08-01
481000286-10806601-18757 CDM Hb Revasc Lithotrip-stent-ather 41 19 $74,375.00 $37,187.50 50% off $9,036.56 $103,426.61 $33,137.66 2025-08-01
481000295-10806601-18749 CDM Hb Revasc Lithotr-ather Tib/per 41 19 $71,155.00 $35,577.50 50% off $8,645.33 $103,426.61 $33,137.66 2025-08-01
481000253-10806601-18784 CDM Hb Perq Transcath Cls Aortic 93591 41 19 $74,560.00 $37,280.00 50% off $9,059.04 $103,426.61 $33,137.66 2025-08-01
481000252-10806601-18785 CDM Hb Perq Transcath Cls Mitral 93590 41 19 $76,875.00 $38,437.50 50% off $9,340.31 $103,426.61 $33,137.66 2025-08-01
481000210-10806601-18808 CDM Hb 0238t Trluml Perip Athrc Iliac Art 41 19 $74,560.00 $37,280.00 50% off $9,059.04 $103,426.61 $33,137.66 2025-08-01
A2005 HCPCS Miscellaneous M <46.50 And A <77.50 28 7 — — $28,713.39 $43,507.76 $33,116.46 2025-08-01
665 MS_DRG Prostatectomy With Mcc 30 15 — — $22,511.00 $66,224.43 $33,087.86 2025-08-01
A0403 HCPCS Traumatic Spinal Cord Injury M >=41.50 And M <47.50 28 7 — — $29,141.64 $38,232.85 $33,021.33 2025-08-01
840 MS_DRG Lymphoma And Non-acute Leukemia With Mcc 30 15 — — $22,511.00 $69,890.38 $32,951.10 2025-08-01
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 30 15 — — $22,511.00 $69,546.91 $32,895.21 2025-08-01
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 30 15 — — $22,511.00 $69,739.43 $32,843.96 2025-08-01
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 30 15 — — $22,511.00 $64,003.29 $32,819.90 2025-08-01
A0104 HCPCS Stroke M >=41.50 And M <50.50 28 7 — — $29,375.74 $40,027.06 $32,726.24 2025-08-01
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 30 15 — — $22,511.00 $67,865.39 $32,683.94 2025-08-01
252 MS_DRG Other Vascular Procedures With Mcc 30 15 — — $22,511.00 $64,693.35 $32,671.12 2025-08-01
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 30 15 — — $22,511.00 $68,124.49 $32,592.38 2025-08-01
A1704 HCPCS Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=36.50 And M <41.50 28 7 — — $27,773.16 $43,764.36 $32,279.69 2025-08-01
325 MS_DRG Coronary Intravascular Lithotripsy Without Intraluminal Device 30 15 — — $21,190.76 $57,016.41 $32,084.33 2025-08-01
A1604 HCPCS Pain Syndrome M <43.50 28 7 — — $27,767.45 $45,981.67 $32,028.05 2025-08-01
A0304 HCPCS Non-traumatic Brain Injury M <42.50 And A >=78.50 28 7 — — $28,505.93 $42,350.14 $32,024.04 2025-08-01
271 MS_DRG Other Major Cardiovascular Procedures With Cc 30 15 — — $22,511.00 $61,976.23 $32,020.05 2025-08-01
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 30 15 — — $14,754.00 $64,311.99 $31,992.56 2025-08-01
A1305 HCPCS Rheumatoid Other Arthritis M <51.50 And A <64.50 28 7 — — $28,660.10 $40,172.01 $31,989.42 2025-08-01
1301 APR_DRG Respiratory System Diagnosis With Ventilator Support > 96 Hours 36 8 — — $23,142.03 $52,307.90 $31,983.07 2025-08-01
A0904 HCPCS Other Orthopedic M <44.5 28 7 — — $27,841.67 $41,948.60 $31,982.03 2025-08-01
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 30 15 — — $22,511.00 $66,487.03 $31,927.15 2025-08-01
64568 HCPCS Opn Impltj Crnl Nrv Nea&pg 37 18 — — $892.40 $175,520.92 $31,904.69 2025-08-01
61886 HCPCS Implant Neurostim Arrays 39 18 — — $892.40 $175,520.92 $31,904.69 2025-08-01
761001320-10806601-16531 CDM Hb 63685 Insj/rplcmt Spi Npg Rcvr With Pocket 41 19 $136,325.00 $68,162.50 50% off $346.15 $175,520.92 $31,904.69 2025-08-01
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 30 15 — — $23,993.65 $60,372.58 $31,867.22 2025-08-01
A0504 HCPCS Non-traumatic Spinal Cord Injury M >=39.50 And M <48.50 28 7 — — $27,982.53 $42,518.59 $31,695.58 2025-08-01
793 MS_DRG Full Term Neonate With Major Problems 29 15 — — $8,743.00 $73,509.23 $31,602.54 2025-08-01
469 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc… 30 15 — — $24,145.75 $57,614.11 $31,600.06 2025-08-01
A1404 HCPCS Cardiac M <45.50 28 7 — — $27,525.73 $42,030.87 $31,479.65 2025-08-01
662 MS_DRG Minor Bladder Procedures With Mcc 30 15 — — $22,511.00 $64,758.04 $31,290.23 2025-08-01
A1103 HCPCS Amputation Non-lower Extremity M <52.50 21 7 — — $30,064.75 $39,284.70 $31,281.05 2025-08-01
A0204 HCPCS Traumatic Brain Injury M >=35.50 And M <49.50 28 7 — — $27,613.28 $40,346.35 $31,237.00 2025-08-01
560000344-10806601-18022 CDM Hb Nmdp Unreltd Donr Marrow Fee 41 19 $85,695.00 $42,847.50 50% off $10,411.94 $51,845.48 $31,128.71 2025-08-01
560000347-10806601-18019 CDM Hb Nmdp Unreltd Donr Primary Pbsc Fee &cryo 41 19 $85,685.00 $42,842.50 50% off $10,410.73 $51,839.43 $31,125.08 2025-08-01
791 MS_DRG Prematurity With Major Problems 29 15 — — $22,236.92 $71,559.80 $31,068.21 2025-08-01
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