|
J1411
|
HCPCS
|
Inj, Hemgenix, Per Tx Dose
|
6
|
6
|
—
|
—
|
$3,672,900.00
|
$3,801,451.50
|
$3,746,358.00
|
2024-11-21
|
|
C9172
|
HCPCS
|
Inj, Beqvez, Per Tx Dose
|
6
|
6
|
—
|
—
|
$3,605,000.00
|
$3,731,175.00
|
$3,677,100.00
|
2024-11-21
|
|
J1413
|
HCPCS
|
Inj Delandistrogene Mox Rokl
|
6
|
6
|
—
|
—
|
$3,325,454.76
|
$3,441,845.67
|
$3,391,963.85
|
2024-11-21
|
|
J3394
|
HCPCS
|
Inj, Lovotibeglogene Autotem
|
6
|
6
|
—
|
—
|
$3,286,000.00
|
$3,401,010.00
|
$3,351,720.00
|
2024-11-21
|
|
J3393
|
HCPCS
|
Inj, Betibeglogene Autotemce
|
6
|
6
|
—
|
—
|
$2,968,000.00
|
$3,071,880.00
|
$3,027,360.00
|
2024-11-21
|
|
J3399
|
HCPCS
|
Inj Onase Abepar-xioi Treat
|
11
|
7
|
—
|
—
|
$85,647.24
|
$4,418,936.33
|
$2,436,386.51
|
2024-11-21
|
|
Q2042
|
HCPCS
|
Tisagenlecleucel Car-pos T
|
11
|
7
|
—
|
—
|
$529,192.86
|
$1,793,106.00
|
$547,714.60
|
2024-11-21
|
|
Q2056
|
HCPCS
|
Ciltacabtagene Car-pos T
|
8
|
7
|
—
|
—
|
$527,123.43
|
$975,178.35
|
$540,301.52
|
2024-11-21
|
|
Q2055
|
HCPCS
|
Idecabtagene Vicleucel Car
|
8
|
7
|
—
|
—
|
$526,587.59
|
$974,187.05
|
$539,752.28
|
2024-11-21
|
|
Q2054
|
HCPCS
|
Lisocabtagene Mara Car Pos T
|
8
|
7
|
—
|
—
|
$516,726.08
|
$955,943.24
|
$529,644.23
|
2024-11-21
|
|
Q2041
|
HCPCS
|
Axicabtagene Ciloleucel Car+
|
8
|
7
|
—
|
—
|
$489,455.96
|
$905,493.52
|
$501,692.36
|
2024-11-21
|
|
Q2053
|
HCPCS
|
Brexucabtagene Car Pos T
|
8
|
7
|
—
|
—
|
$460,530.40
|
$851,981.24
|
$472,043.66
|
2024-11-21
|
|
5834
|
APR_DRG
|
Neonate W Ecmo
|
3
|
3
|
—
|
—
|
$230,820.30
|
$261,648.82
|
$261,648.82
|
2024-11-21
|
|
18
|
MS_DRG
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
8
|
7
|
—
|
—
|
$243,404.16
|
$662,059.32
|
$249,489.26
|
2024-11-21
|
|
5884
|
APR_DRG
|
Neonate Bwt <1500g W Major Procedure
|
3
|
3
|
—
|
—
|
$207,599.62
|
$235,326.77
|
$235,326.77
|
2024-11-21
|
|
1614
|
APR_DRG
|
Cardiac Defibrillator & Heart Assist Implant
|
3
|
3
|
—
|
—
|
$191,485.81
|
$217,060.79
|
$217,060.79
|
2024-11-21
|
|
34
|
APR_DRG
|
Bone Marrow Transplant
|
3
|
3
|
—
|
—
|
$174,545.08
|
$197,857.44
|
$197,857.44
|
2024-11-21
|
|
24
|
APR_DRG
|
Heart &/or Lung Transplant
|
3
|
3
|
—
|
—
|
$173,240.99
|
$196,379.18
|
$196,379.18
|
2024-11-21
|
|
5833
|
APR_DRG
|
Neonate W Ecmo
|
3
|
3
|
—
|
—
|
$166,000.93
|
$188,172.14
|
$188,172.14
|
2024-11-21
|
|
1
|
MS_DRG
|
Heart Transplant Or Implant Of Heart Assist System With Mcc
|
8
|
7
|
—
|
—
|
$181,802.51
|
$494,502.83
|
$186,347.58
|
2024-11-21
|
|
8414
|
APR_DRG
|
Extensive 3rd Degree Burns W Skin Graft
|
3
|
3
|
—
|
—
|
$152,498.18
|
$172,865.94
|
$172,865.94
|
2024-11-21
|
|
5832
|
APR_DRG
|
Neonate W Ecmo
|
3
|
3
|
—
|
—
|
$150,909.50
|
$171,065.08
|
$171,065.08
|
2024-11-21
|
|
14
|
APR_DRG
|
Liver Transplant &/or Intestinal Transplant
|
3
|
3
|
—
|
—
|
$147,300.02
|
$166,973.51
|
$166,973.51
|
2024-11-21
|
|
927
|
MS_DRG
|
Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft
|
8
|
7
|
—
|
—
|
$153,110.57
|
$416,460.75
|
$156,938.34
|
2024-11-21
|
|
5883
|
APR_DRG
|
Neonate Bwt <1500g W Major Procedure
|
3
|
3
|
—
|
—
|
$136,927.65
|
$155,215.81
|
$155,215.81
|
2024-11-21
|
|
44
|
APR_DRG
|
Ecmo Or Tracheostomy W Long Term Mechanical Ventilation W Extensive Procedure
|
3
|
3
|
—
|
—
|
$135,679.14
|
$153,800.54
|
$153,800.54
|
2024-11-21
|
|
64
|
APR_DRG
|
Pancreas Transplant
|
3
|
3
|
—
|
—
|
$133,898.83
|
$151,782.45
|
$151,782.45
|
2024-11-21
|
|
5914
|
APR_DRG
|
Neonate Birthwt 500-749g Without Major Procedure
|
3
|
3
|
—
|
—
|
$126,754.59
|
$143,684.03
|
$143,684.03
|
2024-11-21
|
|
26140
|
CDM
|
Impella 5.5 With Smartassist S2 Set
|
29
|
11
|
$298,800.00
|
$149,400.00
50% off
|
$83,664.00
|
$201,092.40
|
$142,378.20
|
2024-11-21
|
|
3
|
MS_DRG
|
Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mo…
|
8
|
7
|
—
|
—
|
$138,322.82
|
$376,238.07
|
$141,780.89
|
2024-11-21
|
|
5934
|
APR_DRG
|
Neonate Birthwt 750-999g Without Major Procedure
|
3
|
3
|
—
|
—
|
$117,333.71
|
$133,004.88
|
$133,004.88
|
2024-11-21
|
|
23
|
APR_DRG
|
Heart &/or Lung Transplant
|
3
|
3
|
—
|
—
|
$115,509.32
|
$130,936.83
|
$130,936.83
|
2024-11-21
|
|
6094
|
APR_DRG
|
Neonate Bwt 1500-2499g W Major Procedure
|
3
|
3
|
—
|
—
|
$114,152.53
|
$129,398.82
|
$129,398.82
|
2024-11-21
|
|
5891
|
APR_DRG
|
Neonate Bwt <500g
|
3
|
3
|
—
|
—
|
$110,638.86
|
$125,415.87
|
$125,415.87
|
2024-11-21
|
|
6304
|
APR_DRG
|
Neonate Birthwt >2499g W Major Cardiovascular Procedure
|
3
|
3
|
—
|
—
|
$107,384.86
|
$121,727.26
|
$121,727.26
|
2024-11-21
|
|
3034
|
APR_DRG
|
Dorsal & Lumbar Fusion Proc For Curvature Of Back
|
3
|
3
|
—
|
—
|
$101,321.46
|
$114,854.03
|
$114,854.03
|
2024-11-21
|
|
5892
|
APR_DRG
|
Neonate Bwt <500g
|
3
|
3
|
—
|
—
|
$100,581.74
|
$114,015.51
|
$114,015.51
|
2024-11-21
|
|
6024
|
APR_DRG
|
Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom
|
3
|
3
|
—
|
—
|
$100,352.74
|
$113,755.92
|
$113,755.92
|
2024-11-21
|
|
33
|
APR_DRG
|
Bone Marrow Transplant
|
3
|
3
|
—
|
—
|
$97,124.61
|
$110,096.64
|
$110,096.64
|
2024-11-21
|
|
5831
|
APR_DRG
|
Neonate W Ecmo
|
3
|
3
|
—
|
—
|
$95,569.47
|
$108,333.80
|
$108,333.80
|
2024-11-21
|
|
4404
|
APR_DRG
|
Kidney Transplant
|
3
|
3
|
—
|
—
|
$95,024.26
|
$107,715.77
|
$107,715.77
|
2024-11-21
|
|
28989
|
CDM
|
Tavr Edwards Sapien 3 Resilia With Commander System 23mm S3urcm23a
|
29
|
11
|
$225,760.00
|
$112,880.00
50% off
|
$63,212.80
|
$151,936.48
|
$107,574.64
|
2024-11-21
|
|
29142
|
CDM
|
Tavr Edwards Sapien 3 Resilia With Commander System 20mm 9755rsl20a
|
29
|
11
|
$225,760.00
|
$112,880.00
50% off
|
$63,212.80
|
$151,936.48
|
$107,574.64
|
2024-11-21
|
|
29511
|
CDM
|
Tavr Edwards Sapien 3 Resilia With Commander System 29mm S3urcm29a
|
29
|
11
|
$225,760.00
|
$112,880.00
50% off
|
$63,212.80
|
$151,936.48
|
$107,574.64
|
2024-11-21
|
|
29331
|
CDM
|
Tavr Edwards Sapien 3 Resilia With Commander System 26mm S3urcm26a
|
29
|
11
|
$225,760.00
|
$112,880.00
50% off
|
$63,212.80
|
$151,936.48
|
$107,574.64
|
2024-11-21
|
|
19471
|
CDM
|
Edwards Sapien 3 Ultra Transcather Heart Valve With Commander Delivery System 23 M…
|
29
|
11
|
$215,800.00
|
$107,900.00
50% off
|
$60,424.00
|
$145,233.40
|
$106,180.24
|
2024-11-21
|
|
23612
|
CDM
|
Edwards Sapien 3 Ultra Transcather Heart Valve With Commander Delivery System 23 M…
|
29
|
11
|
$215,800.00
|
$107,900.00
50% off
|
$60,424.00
|
$145,233.40
|
$106,180.24
|
2024-11-21
|
|
29143
|
CDM
|
Edwards Sapien 3 Ultra Transcather Heart Valve With Commander Delivery System 23 M…
|
29
|
11
|
$225,760.00
|
$112,880.00
50% off
|
$63,212.80
|
$151,936.48
|
$106,180.24
|
2024-11-21
|
|
1604
|
APR_DRG
|
Major Cardiothoracic Repair Of Heart Anomaly
|
3
|
3
|
—
|
—
|
$93,258.33
|
$105,713.98
|
$105,713.98
|
2024-11-21
|
|
1624
|
APR_DRG
|
Cardiac Valve Procedures W Cardiac Catheterization
|
3
|
3
|
—
|
—
|
$92,929.67
|
$105,341.42
|
$105,341.42
|
2024-11-21
|
|
22
|
APR_DRG
|
Heart &/or Lung Transplant
|
3
|
3
|
—
|
—
|
$92,628.80
|
$105,000.37
|
$105,000.37
|
2024-11-21
|
|
6314
|
APR_DRG
|
Neonate Birthwt >2499g W Other Major Procedure
|
3
|
3
|
—
|
—
|
$92,296.31
|
$104,623.47
|
$104,623.47
|
2024-11-21
|
|
54
|
APR_DRG
|
Tracheostomy W Long Term Mechanical Ventilation Without Extensive Procedure
|
3
|
3
|
—
|
—
|
$91,906.33
|
$104,181.40
|
$104,181.40
|
2024-11-21
|
|
5893
|
APR_DRG
|
Neonate Bwt <500g
|
3
|
3
|
—
|
—
|
$91,438.73
|
$103,651.35
|
$103,651.35
|
2024-11-21
|
|
8424
|
APR_DRG
|
Full Thickness Burns W Skin Graft
|
3
|
3
|
—
|
—
|
$91,078.45
|
$103,242.96
|
$103,242.96
|
2024-11-21
|
|
13012
|
CDM
|
Tavr Heart Valve W/commander Del 23mm Sapien 3 Tavr 9600cm23a(supply Chain Foll…
|
28
|
11
|
$215,800.00
|
$107,900.00
50% off
|
$60,424.00
|
$145,233.40
|
$102,828.70
|
2024-11-21
|
|
13014
|
CDM
|
Tavr Heart Valve W/commander Del 29mm Sapien 3 Tavr 9600cm29a(supply Chain Fol…
|
29
|
11
|
$215,800.00
|
$107,900.00
50% off
|
$60,424.00
|
$145,233.40
|
$102,828.70
|
2024-11-21
|
|
17938
|
CDM
|
Tavr Heart Valve Certitude Kits 23mm Sapien 3 Valve (supply Chain Follow Tavr Pr…
|
29
|
11
|
$215,800.00
|
$107,900.00
50% off
|
$60,424.00
|
$145,233.40
|
$102,828.70
|
2024-11-21
|
|
19470
|
CDM
|
Tavr Edwards Sapien 3 Ultra Thv With Commander System S3ucm226a
|
29
|
11
|
$215,800.00
|
$107,900.00
50% off
|
$60,424.00
|
$145,233.40
|
$102,828.70
|
2024-11-21
|
|
17939
|
CDM
|
Tavr Heart Valve Certitude Kits 26mm Sapien 3 Valve (supply Chain Follow Tavr Pr…
|
29
|
11
|
$215,800.00
|
$107,900.00
50% off
|
$60,424.00
|
$145,233.40
|
$102,828.70
|
2024-11-21
|
|
30664
|
CDM
|
Tavr Edwards Sapien 3 Ultra With Commander System 23mm S3usta123a
|
29
|
11
|
$215,800.00
|
$107,900.00
50% off
|
$60,424.00
|
$145,233.40
|
$102,828.70
|
2024-11-21
|
|
13811
|
CDM
|
Tavr Heart Valve W/commander Del 20mm Sapien 3 Tavr 9600cm20a(supply Chain Foll…
|
29
|
11
|
$215,800.00
|
$107,900.00
50% off
|
$60,424.00
|
$145,233.40
|
$102,828.70
|
2024-11-21
|
|
13013
|
CDM
|
Tavr Heart Valve W/commander Del 26mm Sapien 3 Tavr 9600cm26a(supply Chain Fol…
|
29
|
11
|
$215,800.00
|
$107,900.00
50% off
|
$60,424.00
|
$145,233.40
|
$102,828.70
|
2024-11-21
|
|
23132
|
CDM
|
Tavr Edwards Sapien 3 Ultra Thv With Commander System 20mm S3ucm220a
|
29
|
11
|
$215,800.00
|
$107,900.00
50% off
|
$60,424.00
|
$145,233.40
|
$102,828.70
|
2024-11-21
|
|
Q0480
|
HCPCS
|
Driver Pneumatic Vad, Rep
|
8
|
7
|
—
|
—
|
$99,999.92
|
$184,999.85
|
$102,499.92
|
2024-11-21
|
|
J9247
|
HCPCS
|
Hc Rx Rev Code 636 W/Hcpcs
|
15
|
9
|
$190,000.00
|
$95,000.00
50% off
|
$1,611.96
|
$127,870.00
|
$101,080.00
|
2024-11-21
|
|
43
|
APR_DRG
|
Ecmo Or Tracheostomy W Long Term Mechanical Ventilation W Extensive Procedure
|
3
|
3
|
—
|
—
|
$88,612.08
|
$100,447.18
|
$100,447.18
|
2024-11-21
|
|
63
|
APR_DRG
|
Pancreas Transplant
|
3
|
3
|
—
|
—
|
$87,178.64
|
$98,822.28
|
$98,822.28
|
2024-11-21
|
|
13
|
APR_DRG
|
Liver Transplant &/or Intestinal Transplant
|
3
|
3
|
—
|
—
|
$84,699.81
|
$96,012.38
|
$96,012.38
|
2024-11-21
|
|
5913
|
APR_DRG
|
Neonate Birthwt 500-749g Without Major Procedure
|
3
|
3
|
—
|
—
|
$84,590.58
|
$95,888.55
|
$95,888.55
|
2024-11-21
|
|
1634
|
APR_DRG
|
Cardiac Valve Procedures Without Cardiac Catheterization
|
3
|
3
|
—
|
—
|
$84,538.83
|
$95,829.90
|
$95,829.90
|
2024-11-21
|
|
19147
|
CDM
|
Tavr Evolutproplus 26mm
|
29
|
11
|
$199,200.00
|
$99,600.00
50% off
|
$55,776.00
|
$134,061.60
|
$94,918.80
|
2024-11-21
|
|
18046
|
CDM
|
Tavr Evolutpro-23-US (medtronic)
|
29
|
11
|
$199,200.00
|
$99,600.00
50% off
|
$55,776.00
|
$134,061.60
|
$94,918.80
|
2024-11-21
|
|
17302
|
CDM
|
Tavr Evolutr-26-US (medtronic)
|
29
|
11
|
$199,200.00
|
$99,600.00
50% off
|
$55,776.00
|
$134,061.60
|
$94,918.80
|
2024-11-21
|
|
16807
|
CDM
|
Tavr Evolutpro-29-US (medtronic)
|
29
|
11
|
$199,200.00
|
$99,600.00
50% off
|
$55,776.00
|
$134,061.60
|
$94,918.80
|
2024-11-21
|
|
18979
|
CDM
|
Tavr Evolutproplus 26mm Evproplus-26us
|
29
|
11
|
$199,200.00
|
$99,600.00
50% off
|
$55,776.00
|
$134,061.60
|
$94,918.80
|
2024-11-21
|
|
17774
|
CDM
|
Tavr Evolutfx-34 (medtronic)
|
29
|
11
|
$199,200.00
|
$99,600.00
50% off
|
$55,776.00
|
$134,061.60
|
$94,918.80
|
2024-11-21
|
|
16808
|
CDM
|
Tavr Evolutpro-34-US (medtronic)
|
29
|
11
|
$199,200.00
|
$99,600.00
50% off
|
$55,776.00
|
$134,061.60
|
$94,918.80
|
2024-11-21
|
|
18044
|
CDM
|
Tavr (medtronic) Evolutfx-29 (supply Chain Follow Tavr Proc)
|
29
|
11
|
$199,200.00
|
$99,600.00
50% off
|
$55,776.00
|
$134,061.60
|
$94,918.80
|
2024-11-21
|
|
19146
|
CDM
|
Tavr Evolutproplus 23mm
|
29
|
11
|
$199,200.00
|
$99,600.00
50% off
|
$55,776.00
|
$134,061.60
|
$94,918.80
|
2024-11-21
|
|
17301
|
CDM
|
Tavr Evolutr-29-US (medtronic)
|
28
|
11
|
$199,200.00
|
$99,600.00
50% off
|
$55,776.00
|
$134,061.60
|
$94,918.80
|
2024-11-21
|
|
16806
|
CDM
|
Tavr Evolutproplus-26-US (medtronic)
|
29
|
11
|
$199,200.00
|
$99,600.00
50% off
|
$55,776.00
|
$134,061.60
|
$94,918.80
|
2024-11-21
|
|
4
|
MS_DRG
|
Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And …
|
8
|
7
|
—
|
—
|
$91,197.18
|
$248,056.33
|
$93,477.11
|
2024-11-21
|
|
K1007
|
HCPCS
|
Bil Hkaf Pc S/d Micro Sensor
|
8
|
7
|
—
|
—
|
$91,031.93
|
$168,409.07
|
$93,307.73
|
2024-11-21
|
|
62
|
APR_DRG
|
Pancreas Transplant
|
3
|
3
|
—
|
—
|
$81,287.71
|
$92,144.55
|
$92,144.55
|
2024-11-21
|
|
1613
|
APR_DRG
|
Cardiac Defibrillator & Heart Assist Implant
|
3
|
3
|
—
|
—
|
$80,554.70
|
$91,313.64
|
$91,313.64
|
2024-11-21
|
|
5933
|
APR_DRG
|
Neonate Birthwt 750-999g Without Major Procedure
|
3
|
3
|
—
|
—
|
$79,337.80
|
$89,934.21
|
$89,934.21
|
2024-11-21
|
|
3044
|
APR_DRG
|
Dorsal & Lumbar Fusion Proc Except For Curvature Of Back
|
3
|
3
|
—
|
—
|
$78,247.39
|
$88,698.16
|
$88,698.16
|
2024-11-21
|
|
21
|
APR_DRG
|
Heart &/or Lung Transplant
|
3
|
3
|
—
|
—
|
$78,189.89
|
$88,632.99
|
$88,632.99
|
2024-11-21
|
|
1654
|
APR_DRG
|
Coronary Bypass W Cardiac Cath Or Percutaneous Cardiac Procedure
|
3
|
3
|
—
|
—
|
$76,987.37
|
$87,269.86
|
$87,269.86
|
2024-11-21
|
|
14
|
MS_DRG
|
Allogeneic Bone Marrow Transplant
|
8
|
7
|
—
|
—
|
$84,561.02
|
$230,005.97
|
$86,675.05
|
2024-11-21
|
|
7
|
MS_DRG
|
Lung Transplant
|
8
|
7
|
—
|
—
|
$84,348.03
|
$229,426.64
|
$86,456.73
|
2024-11-21
|
|
6074
|
APR_DRG
|
Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom
|
3
|
3
|
—
|
—
|
$76,183.45
|
$86,358.57
|
$86,358.57
|
2024-11-21
|
|
6023
|
APR_DRG
|
Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom
|
3
|
3
|
—
|
—
|
$74,347.57
|
$84,277.48
|
$84,277.48
|
2024-11-21
|
|
3033
|
APR_DRG
|
Dorsal & Lumbar Fusion Proc For Curvature Of Back
|
3
|
3
|
—
|
—
|
$74,306.37
|
$84,230.78
|
$84,230.78
|
2024-11-21
|
|
61
|
APR_DRG
|
Pancreas Transplant
|
3
|
3
|
—
|
—
|
$72,189.73
|
$81,831.45
|
$81,831.45
|
2024-11-21
|
|
12
|
APR_DRG
|
Liver Transplant &/or Intestinal Transplant
|
3
|
3
|
—
|
—
|
$72,110.20
|
$81,741.29
|
$81,741.29
|
2024-11-21
|
|
11
|
APR_DRG
|
Liver Transplant &/or Intestinal Transplant
|
3
|
3
|
—
|
—
|
$71,709.68
|
$81,287.28
|
$81,287.28
|
2024-11-21
|
|
1674
|
APR_DRG
|
Other Cardiothoracic Procedures
|
3
|
3
|
—
|
—
|
$69,567.18
|
$78,858.62
|
$78,858.62
|
2024-11-21
|
|
9104
|
APR_DRG
|
Craniotomy For Multiple Significant Trauma
|
3
|
3
|
—
|
—
|
$69,098.63
|
$78,327.49
|
$78,327.49
|
2024-11-21
|
|
4014
|
APR_DRG
|
Pituitary & Adrenal Procedures
|
3
|
3
|
—
|
—
|
$68,906.03
|
$78,109.17
|
$78,109.17
|
2024-11-21
|
|
904
|
APR_DRG
|
Major Larynx & Trachea Procedures
|
3
|
3
|
—
|
—
|
$68,455.68
|
$77,598.67
|
$77,598.67
|
2024-11-21
|
|
1664
|
APR_DRG
|
Coronary Bypass Without Cardiac Cath Or Percutaneous Cardiac Procedure
|
3
|
3
|
—
|
—
|
$68,295.67
|
$77,417.28
|
$77,417.28
|
2024-11-21
|
|
3124
|
APR_DRG
|
Skin Graft, Except Hand, For Musculoskeletal & Connective Tissue Diagnoses
|
3
|
3
|
—
|
—
|
$68,172.06
|
$77,277.17
|
$77,277.17
|
2024-11-21
|
|
6034
|
APR_DRG
|
Neonate Birthwt 1000-1249g W Or Without Other Significant Condition
|
3
|
3
|
—
|
—
|
$67,790.70
|
$76,844.88
|
$76,844.88
|
2024-11-21
|
|
5882
|
APR_DRG
|
Neonate Bwt <1500g W Major Procedure
|
3
|
3
|
—
|
—
|
$67,105.60
|
$76,068.27
|
$76,068.27
|
2024-11-21
|
|
9124
|
APR_DRG
|
Musculoskeletal & Other Procedures For Multiple Significant Trauma
|
3
|
3
|
—
|
—
|
$66,003.68
|
$74,819.18
|
$74,819.18
|
2024-11-21
|
|
42
|
APR_DRG
|
Ecmo Or Tracheostomy W Long Term Mechanical Ventilation W Extensive Procedure
|
3
|
3
|
—
|
—
|
$64,679.47
|
$73,318.11
|
$73,318.11
|
2024-11-21
|
|
53
|
APR_DRG
|
Tracheostomy W Long Term Mechanical Ventilation Without Extensive Procedure
|
3
|
3
|
—
|
—
|
$64,327.82
|
$72,919.49
|
$72,919.49
|
2024-11-21
|
|
2
|
MS_DRG
|
Heart Transplant Or Implant Of Heart Assist System Without Mcc
|
8
|
7
|
—
|
—
|
$71,122.82
|
$193,454.07
|
$72,900.89
|
2024-11-21
|
|
212
|
MS_DRG
|
Concomitant Aortic And Mitral Valve Procedures
|
9
|
7
|
—
|
—
|
$70,310.89
|
$279,751.00
|
$72,420.22
|
2024-11-21
|
|
6804
|
APR_DRG
|
Major O.r. Procedures For Lymphatic/hematopoietic/other Neoplasms
|
3
|
3
|
—
|
—
|
$63,516.23
|
$71,999.51
|
$71,999.51
|
2024-11-21
|
|
6093
|
APR_DRG
|
Neonate Bwt 1500-2499g W Major Procedure
|
3
|
3
|
—
|
—
|
$62,890.54
|
$71,290.24
|
$71,290.24
|
2024-11-21
|
|
6033
|
APR_DRG
|
Neonate Birthwt 1000-1249g W Or Without Other Significant Condition
|
3
|
3
|
—
|
—
|
$62,844.55
|
$71,238.11
|
$71,238.11
|
2024-11-21
|
|
3214
|
APR_DRG
|
Cervical Spinal Fusion & Other Back/neck Proc Exc Disc Excis/decomp
|
3
|
3
|
—
|
—
|
$62,695.07
|
$71,068.67
|
$71,068.67
|
2024-11-21
|
|
41
|
APR_DRG
|
Ecmo Or Tracheostomy W Long Term Mechanical Ventilation W Extensive Procedure
|
3
|
3
|
—
|
—
|
$62,201.60
|
$70,509.29
|
$70,509.29
|
2024-11-21
|
|
5
|
MS_DRG
|
Liver Transplant With Mcc Or Intestinal Transplant
|
8
|
7
|
—
|
—
|
$68,732.86
|
$186,953.38
|
$70,451.18
|
2024-11-21
|
|
215
|
MS_DRG
|
Other Heart Assist System Implant
|
9
|
7
|
—
|
—
|
$68,380.46
|
$208,182.00
|
$70,431.87
|
2024-11-21
|
|
234
|
APR_DRG
|
Spinal Procedures
|
3
|
3
|
—
|
—
|
$61,570.16
|
$69,793.51
|
$69,793.51
|
2024-11-21
|
|
426
|
MS_DRG
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
9
|
7
|
—
|
—
|
$67,609.83
|
$183,898.74
|
$69,638.12
|
2024-11-21
|
|
8413
|
APR_DRG
|
Extensive 3rd Degree Burns W Skin Graft
|
3
|
3
|
—
|
—
|
$61,388.10
|
$69,587.14
|
$69,587.14
|
2024-11-21
|
|
2604
|
APR_DRG
|
Major Pancreas, Liver & Shunt Procedures
|
3
|
3
|
—
|
—
|
$61,154.31
|
$69,322.12
|
$69,322.12
|
2024-11-21
|
|
1694
|
APR_DRG
|
Major Thoracic & Abdominal Vascular Procedures
|
3
|
3
|
—
|
—
|
$60,933.92
|
$69,072.30
|
$69,072.30
|
2024-11-21
|
|
1623
|
APR_DRG
|
Cardiac Valve Procedures W Cardiac Catheterization
|
3
|
3
|
—
|
—
|
$60,689.58
|
$68,795.33
|
$68,795.33
|
2024-11-21
|
|
914
|
APR_DRG
|
Other Major Head & Neck Procedures
|
3
|
3
|
—
|
—
|
$60,594.72
|
$68,687.80
|
$68,687.80
|
2024-11-21
|
|
214
|
APR_DRG
|
Craniotomy Except For Trauma
|
3
|
3
|
—
|
—
|
$60,346.55
|
$68,406.48
|
$68,406.48
|
2024-11-21
|
|
32
|
APR_DRG
|
Bone Marrow Transplant
|
3
|
3
|
—
|
—
|
$60,043.77
|
$68,063.26
|
$68,063.26
|
2024-11-21
|
|
4032
|
CDM
|
Bifurcated 4 Piece Capped Case Medtronic Aaa4
|
29
|
11
|
$142,760.00
|
$71,380.00
50% off
|
$39,972.80
|
$96,077.48
|
$68,025.14
|
2024-11-21
|
|
6124
|
APR_DRG
|
Neonate Bwt 1500-1999g W Resp Dist Synd/oth Maj Resp Cond
|
3
|
3
|
—
|
—
|
$59,691.16
|
$67,663.55
|
$67,663.55
|
2024-11-21
|
|
L8702
|
HCPCS
|
Ewhf S/d Uprt Micro Sensor
|
8
|
7
|
—
|
—
|
$65,871.74
|
$121,862.72
|
$67,518.53
|
2024-11-21
|
|
6073
|
APR_DRG
|
Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom
|
3
|
3
|
—
|
—
|
$59,295.42
|
$67,214.96
|
$67,214.96
|
2024-11-21
|
|
4414
|
APR_DRG
|
Major Bladder Procedures
|
3
|
3
|
—
|
—
|
$59,255.18
|
$67,169.34
|
$67,169.34
|
2024-11-21
|
|
A9543
|
HCPCS
|
Y90 Ibritumomab, Rx
|
8
|
7
|
—
|
—
|
$65,476.58
|
$121,131.68
|
$67,113.49
|
2024-11-21
|
|
8634
|
APR_DRG
|
Neonatal Aftercare
|
3
|
3
|
—
|
—
|
$58,875.74
|
$66,739.22
|
$66,739.22
|
2024-11-21
|
|
4034
|
APR_DRG
|
Procedures For Obesity
|
3
|
3
|
—
|
—
|
$58,594.03
|
$66,419.89
|
$66,419.89
|
2024-11-21
|
|
29898
|
CDM
|
Tag Conform Thoracic Sg Tgmr404015
|
28
|
11
|
$138,623.28
|
$69,311.64
50% off
|
$38,814.52
|
$93,293.47
|
$66,053.99
|
2024-11-21
|
|
29189
|
CDM
|
Ctag Cmds Thoracic 24fr Tgm454515
|
29
|
11
|
$138,623.28
|
$69,311.64
50% off
|
$38,814.52
|
$93,293.47
|
$66,053.99
|
2024-11-21
|
|
29897
|
CDM
|
Tag Conform Thoracic Sg Tgmr373720
|
29
|
11
|
$138,623.28
|
$69,311.64
50% off
|
$38,814.52
|
$93,293.47
|
$66,053.99
|
2024-11-21
|
|
4403
|
APR_DRG
|
Kidney Transplant
|
3
|
3
|
—
|
—
|
$58,028.70
|
$65,779.06
|
$65,779.06
|
2024-11-21
|
|
6084
|
APR_DRG
|
Neonate Bwt 1250-1499g W Or Without Other Significant Condition
|
3
|
3
|
—
|
—
|
$57,897.43
|
$65,630.25
|
$65,630.25
|
2024-11-21
|
|
J9029
|
HCPCS
|
Instill Adstiladrin, Tx Dose
|
11
|
7
|
—
|
—
|
$63,354.77
|
$224,047.05
|
$65,572.19
|
2024-11-21
|
|
9504
|
APR_DRG
|
Extensive Procedure Unrelated To Principal Diagnosis
|
3
|
3
|
—
|
—
|
$57,579.31
|
$65,269.65
|
$65,269.65
|
2024-11-21
|
|
2204
|
APR_DRG
|
Major Stomach, Esophageal & Duodenal Procedures
|
3
|
3
|
—
|
—
|
$57,114.59
|
$64,742.86
|
$64,742.86
|
2024-11-21
|
|
6514
|
APR_DRG
|
Other Procedures Of Blood & Blood-forming Organs
|
3
|
3
|
—
|
—
|
$57,050.39
|
$64,670.09
|
$64,670.09
|
2024-11-21
|
|
6814
|
APR_DRG
|
Other O.r. Procedures For Lymphatic/hematopoietic/other Neoplasms
|
3
|
3
|
—
|
—
|
$56,694.91
|
$64,267.12
|
$64,267.12
|
2024-11-21
|
|
216
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
9
|
7
|
—
|
—
|
$62,289.67
|
$193,187.00
|
$64,158.36
|
2024-11-21
|
|
6022
|
APR_DRG
|
Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom
|
3
|
3
|
—
|
—
|
$56,251.27
|
$63,764.23
|
$63,764.23
|
2024-11-21
|
|
24511
|
CDM
|
Tag Conform Thoracic Sg Tgmr404020
|
29
|
11
|
$133,762.80
|
$66,881.40
50% off
|
$37,453.58
|
$90,022.36
|
$63,737.97
|
2024-11-21
|
|
9114
|
APR_DRG
|
Extensive Abdominal/thoracic Procedures For Mult Significant Trauma
|
3
|
3
|
—
|
—
|
$55,611.20
|
$63,038.67
|
$63,038.67
|
2024-11-21
|
|
204
|
APR_DRG
|
Craniotomy For Trauma
|
3
|
3
|
—
|
—
|
$55,487.59
|
$62,898.56
|
$62,898.56
|
2024-11-21
|
|
C9293
|
HCPCS
|
Hc Rx Rev Code 636 W/Hcpcs
|
12
|
7
|
$109,388.00
|
$54,694.00
50% off
|
$30,628.64
|
$73,618.12
|
$62,624.63
|
2024-11-21
|
|
894
|
APR_DRG
|
Major Cranial/facial Bone Procedures
|
3
|
3
|
—
|
—
|
$55,206.84
|
$62,580.31
|
$62,580.31
|
2024-11-21
|
|
1204
|
APR_DRG
|
Major Respiratory & Chest Procedures
|
3
|
3
|
—
|
—
|
$55,003.71
|
$62,350.04
|
$62,350.04
|
2024-11-21
|
|
850
|
MS_DRG
|
Acute Leukemia With Other Procedures
|
9
|
7
|
—
|
—
|
$59,455.01
|
$161,717.63
|
$61,238.66
|
2024-11-21
|
|
3808
|
CDM
|
Bifurcated 3 Piece Capped Case Medtronic Aaa3
|
29
|
11
|
$127,156.00
|
$63,578.00
50% off
|
$35,603.68
|
$85,575.99
|
$60,589.83
|
2024-11-21
|
|
5912
|
APR_DRG
|
Neonate Birthwt 500-749g Without Major Procedure
|
3
|
3
|
—
|
—
|
$53,344.13
|
$60,468.81
|
$60,468.81
|
2024-11-21
|
|
3032
|
APR_DRG
|
Dorsal & Lumbar Fusion Proc For Curvature Of Back
|
3
|
3
|
—
|
—
|
$53,104.58
|
$60,197.27
|
$60,197.27
|
2024-11-21
|
|
2214
|
APR_DRG
|
Major Small & Large Bowel Procedures
|
3
|
3
|
—
|
—
|
$53,035.60
|
$60,119.07
|
$60,119.07
|
2024-11-21
|
|
1653
|
APR_DRG
|
Coronary Bypass W Cardiac Cath Or Percutaneous Cardiac Procedure
|
3
|
3
|
—
|
—
|
$51,026.28
|
$57,841.38
|
$57,841.38
|
2024-11-21
|
|
1612
|
APR_DRG
|
Cardiac Defibrillator & Heart Assist Implant
|
3
|
3
|
—
|
—
|
$50,796.31
|
$57,580.71
|
$57,580.71
|
2024-11-21
|
|
244
|
APR_DRG
|
Extracranial Vascular Procedures
|
3
|
3
|
—
|
—
|
$50,559.64
|
$57,312.42
|
$57,312.42
|
2024-11-21
|
|
6083
|
APR_DRG
|
Neonate Bwt 1250-1499g W Or Without Other Significant Condition
|
3
|
3
|
—
|
—
|
$50,481.07
|
$57,223.36
|
$57,223.36
|
2024-11-21
|
|
1734
|
APR_DRG
|
Other Vascular Procedures
|
3
|
3
|
—
|
—
|
$50,345.01
|
$57,069.12
|
$57,069.12
|
2024-11-21
|
|
6904
|
APR_DRG
|
Acute Leukemia
|
3
|
3
|
—
|
—
|
$50,307.64
|
$57,026.76
|
$57,026.76
|
2024-11-21
|
|
6114
|
APR_DRG
|
Neonate Birthwt 1500-1999g W Major Anomaly
|
3
|
3
|
—
|
—
|
$50,248.23
|
$56,959.42
|
$56,959.42
|
2024-11-21
|
|
Q2043
|
HCPCS
|
Sipuleucel-t Auto Cd54+
|
11
|
7
|
—
|
—
|
$55,015.23
|
$186,411.86
|
$56,940.76
|
2024-11-21
|
|
52
|
APR_DRG
|
Tracheostomy W Long Term Mechanical Ventilation Without Extensive Procedure
|
3
|
3
|
—
|
—
|
$50,138.04
|
$56,834.51
|
$56,834.51
|
2024-11-21
|
|
5104
|
APR_DRG
|
Pelvic Evisceration, Radical Hysterectomy & Other Radical GYN Procs
|
3
|
3
|
—
|
—
|
$50,129.42
|
$56,824.74
|
$56,824.74
|
2024-11-21
|
|
6303
|
APR_DRG
|
Neonate Birthwt >2499g W Major Cardiovascular Procedure
|
3
|
3
|
—
|
—
|
$50,064.26
|
$56,750.88
|
$56,750.88
|
2024-11-21
|
|
5932
|
APR_DRG
|
Neonate Birthwt 750-999g Without Major Procedure
|
3
|
3
|
—
|
—
|
$49,742.31
|
$56,385.93
|
$56,385.93
|
2024-11-21
|
|
2644
|
APR_DRG
|
Other Hepatobiliary, Pancreas & Abdominal Procedures
|
3
|
3
|
—
|
—
|
$49,729.85
|
$56,371.81
|
$56,371.81
|
2024-11-21
|
|
231
|
MS_DRG
|
Coronary Bypass With Ptca With Mcc
|
9
|
7
|
—
|
—
|
$54,691.85
|
$205,052.00
|
$56,332.61
|
2024-11-21
|
|
456
|
MS_DRG
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
9
|
7
|
—
|
—
|
$54,661.50
|
$172,337.00
|
$56,301.35
|
2024-11-21
|
|
1633
|
APR_DRG
|
Cardiac Valve Procedures Without Cardiac Catheterization
|
3
|
3
|
—
|
—
|
$49,628.29
|
$56,256.67
|
$56,256.67
|
2024-11-21
|
|
224
|
APR_DRG
|
Ventricular Shunt Procedures
|
3
|
3
|
—
|
—
|
$49,451.98
|
$56,056.82
|
$56,056.82
|
2024-11-21
|
|
429
|
MS_DRG
|
Combined Anterior And Posterior Cervical Spinal Fusion With Mcc
|
9
|
7
|
—
|
—
|
$53,831.51
|
$151,174.00
|
$55,446.46
|
2024-11-21
|
|
C1820
|
HCPCS
|
Battery Spinal Cord Stimulator 37712
|
197
|
11
|
$108,232.00
|
$54,116.00
50% off
|
$400.40
|
$153,344.13
|
$55,369.30
|
2024-11-21
|
|
6504
|
APR_DRG
|
Splenectomy
|
3
|
3
|
—
|
—
|
$48,699.80
|
$55,204.18
|
$55,204.18
|
2024-11-21
|
|
6144
|
APR_DRG
|
Neonate Bwt 1500-1999g W Or Without Other Significant Condition
|
3
|
3
|
—
|
—
|
$48,677.77
|
$55,179.20
|
$55,179.20
|
2024-11-21
|
|
7114
|
APR_DRG
|
Post-op, Post-trauma, Other Device Infections W O.r. Procedure
|
3
|
3
|
—
|
—
|
$48,459.30
|
$54,931.56
|
$54,931.56
|
2024-11-21
|
|
1214
|
APR_DRG
|
Other Respiratory & Chest Procedures
|
3
|
3
|
—
|
—
|
$48,237.00
|
$54,679.57
|
$54,679.57
|
2024-11-21
|
|
2614
|
APR_DRG
|
Major Biliary Tract Procedures
|
3
|
3
|
—
|
—
|
$48,140.22
|
$54,569.87
|
$54,569.87
|
2024-11-21
|
|
4402
|
APR_DRG
|
Kidney Transplant
|
3
|
3
|
—
|
—
|
$47,983.08
|
$54,391.73
|
$54,391.73
|
2024-11-21
|
|
1603
|
APR_DRG
|
Major Cardiothoracic Repair Of Heart Anomaly
|
3
|
3
|
—
|
—
|
$47,922.71
|
$54,323.31
|
$54,323.31
|
2024-11-21
|
|
5114
|
APR_DRG
|
Uterine & Adnexa Procedures For Ovarian & Adnexal Malignancy
|
3
|
3
|
—
|
—
|
$47,801.02
|
$54,185.36
|
$54,185.36
|
2024-11-21
|
|
3043
|
APR_DRG
|
Dorsal & Lumbar Fusion Proc Except For Curvature Of Back
|
3
|
3
|
—
|
—
|
$47,568.19
|
$53,921.43
|
$53,921.43
|
2024-11-21
|
|
20409
|
CDM
|
35 Mm Watchman Closure Device
|
29
|
11
|
$112,880.00
|
$56,440.00
50% off
|
$31,606.40
|
$75,968.24
|
$53,787.32
|
2024-11-21
|
|
29951
|
CDM
|
35 Mm Watchman Flx Pro Closure Device
|
29
|
11
|
$112,880.00
|
$56,440.00
50% off
|
$31,606.40
|
$75,968.24
|
$53,787.32
|
2024-11-21
|
|
29949
|
CDM
|
27 Mm Watchman Closure Device
|
29
|
11
|
$112,880.00
|
$56,440.00
50% off
|
$31,606.40
|
$75,968.24
|
$53,787.32
|
2024-11-21
|
|
20407
|
CDM
|
24 Mm Watchman Closure Device
|
29
|
11
|
$112,880.00
|
$56,440.00
50% off
|
$31,606.40
|
$75,968.24
|
$53,787.32
|
2024-11-21
|
|
20404
|
CDM
|
20 Mm Watchman Closure Device
|
29
|
11
|
$112,880.00
|
$56,440.00
50% off
|
$31,606.40
|
$75,968.24
|
$53,787.32
|
2024-11-21
|
|
29952
|
CDM
|
40 Mm Watchman Flx Pro Closure Device
|
29
|
11
|
$112,880.00
|
$56,440.00
50% off
|
$31,606.40
|
$75,968.24
|
$53,787.32
|
2024-11-21
|
|
29947
|
CDM
|
20 Mm Watchman Flx Pro Closure Device
|
29
|
11
|
$112,880.00
|
$56,440.00
50% off
|
$31,606.40
|
$75,968.24
|
$53,787.32
|
2024-11-21
|
|
29948
|
CDM
|
24 Mm Watchman Flx Pro Closure Device
|
29
|
11
|
$112,880.00
|
$56,440.00
50% off
|
$31,606.40
|
$75,968.24
|
$53,787.32
|
2024-11-21
|
|
20408
|
CDM
|
31 Mm Watchman Closure Device
|
29
|
11
|
$112,880.00
|
$56,440.00
50% off
|
$31,606.40
|
$75,968.24
|
$53,787.32
|
2024-11-21
|
|
29950
|
CDM
|
31 Mm Watchman Flx Pro Closure Device
|
29
|
11
|
$112,880.00
|
$56,440.00
50% off
|
$31,606.40
|
$75,968.24
|
$53,787.32
|
2024-11-21
|
|
20405
|
CDM
|
27 Mm Watchman Closure Device
|
28
|
11
|
$112,880.00
|
$56,440.00
50% off
|
$31,606.40
|
$75,968.24
|
$53,787.32
|
2024-11-21
|
|
1622
|
APR_DRG
|
Cardiac Valve Procedures W Cardiac Catheterization
|
3
|
3
|
—
|
—
|
$47,431.17
|
$53,766.11
|
$53,766.11
|
2024-11-21
|
|
7104
|
APR_DRG
|
Infectious & Parasitic Diseases Including HIV W O.r. Procedure
|
3
|
3
|
—
|
—
|
$47,316.18
|
$53,635.77
|
$53,635.77
|
2024-11-21
|
|
20
|
MS_DRG
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc
|
9
|
7
|
—
|
—
|
$52,027.57
|
$167,310.00
|
$53,588.40
|
2024-11-21
|
|
7914
|
APR_DRG
|
O.r. Procedure For Other Complications Of Treatment
|
3
|
3
|
—
|
—
|
$47,249.11
|
$53,559.73
|
$53,559.73
|
2024-11-21
|
|
924
|
APR_DRG
|
Facial Bone Procedures Except Major Cranial/facial Bone Procedures
|
3
|
3
|
—
|
—
|
$47,243.36
|
$53,553.22
|
$53,553.22
|
2024-11-21
|
|
4424
|
APR_DRG
|
Kidney & Urinary Tract Procedures For Malignancy
|
3
|
3
|
—
|
—
|
$47,166.71
|
$53,466.32
|
$53,466.32
|
2024-11-21
|
|
2234
|
APR_DRG
|
Other Small & Large Bowel Procedures
|
3
|
3
|
—
|
—
|
$47,050.77
|
$53,334.90
|
$53,334.90
|
2024-11-21
|
|
6934
|
APR_DRG
|
Chemotherapy
|
3
|
3
|
—
|
—
|
$47,030.64
|
$53,312.09
|
$53,312.09
|
2024-11-21
|
|
51
|
APR_DRG
|
Tracheostomy W Long Term Mechanical Ventilation Without Extensive Procedure
|
3
|
3
|
—
|
—
|
$46,953.99
|
$53,225.20
|
$53,225.20
|
2024-11-21
|
|
1704
|
APR_DRG
|
Permanent Cardiac Pacemaker Implant W Ami, Heart Failure Or Shock
|
3
|
3
|
—
|
—
|
$46,808.34
|
$53,060.10
|
$53,060.10
|
2024-11-21
|
|
6134
|
APR_DRG
|
Neonate Birthwt 1500-1999g W Congenital/perinatal Infection
|
3
|
3
|
—
|
—
|
$46,785.35
|
$53,034.03
|
$53,034.03
|
2024-11-21
|
|
4054
|
APR_DRG
|
Other Procedures For Endocrine, Nutritional & Metabolic Disorders
|
3
|
3
|
—
|
—
|
$46,755.64
|
$53,000.36
|
$53,000.36
|
2024-11-21
|
|
264
|
APR_DRG
|
Other Nervous System & Related Procedures
|
3
|
3
|
—
|
—
|
$46,682.82
|
$52,917.81
|
$52,917.81
|
2024-11-21
|
|
10
|
MS_DRG
|
Pancreas Transplant
|
8
|
7
|
—
|
—
|
$51,458.95
|
$139,968.34
|
$52,745.43
|
2024-11-21
|
|
5881
|
APR_DRG
|
Neonate Bwt <1500g W Major Procedure
|
3
|
3
|
—
|
—
|
$46,384.83
|
$52,580.02
|
$52,580.02
|
2024-11-21
|
|
19
|
MS_DRG
|
Simultaneous Pancreas And Kidney Transplant With Hemodialysis
|
8
|
7
|
—
|
—
|
$51,164.00
|
$139,166.08
|
$52,443.10
|
2024-11-21
|
|
1304
|
APR_DRG
|
Respiratory System Diagnosis W Ventilator Support 96+ Hours
|
3
|
3
|
—
|
—
|
$46,130.91
|
$52,292.18
|
$52,292.18
|
2024-11-21
|
|
8444
|
APR_DRG
|
Partial Thickness Burns W Or Without Skin Graft
|
3
|
3
|
—
|
—
|
$46,012.09
|
$52,157.50
|
$52,157.50
|
2024-11-21
|
|
C1767
|
HCPCS
|
Lead 2.00mm Model 304-20
|
209
|
11
|
$108,232.00
|
$54,116.00
50% off
|
$12,119.57
|
$136,735.23
|
$52,124.00
|
2024-11-21
|
|
233
|
MS_DRG
|
Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc
|
9
|
7
|
—
|
—
|
$50,448.23
|
$147,868.00
|
$51,961.68
|
2024-11-21
|
|
6072
|
APR_DRG
|
Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom
|
3
|
3
|
—
|
—
|
$45,499.46
|
$51,576.40
|
$51,576.40
|
2024-11-21
|
|
219
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
9
|
7
|
—
|
—
|
$49,939.01
|
$154,856.00
|
$51,437.18
|
2024-11-21
|
|
6224
|
APR_DRG
|
Neonate Bwt 2000-2499g W Resp Dist Synd/oth Maj Resp Cond
|
3
|
3
|
—
|
—
|
$45,228.30
|
$51,269.02
|
$51,269.02
|
2024-11-21
|
|
J1823
|
HCPCS
|
Hc Rx Rev Code 636 W/Hcpcs
|
23
|
11
|
$182,793.72
|
$91,396.86
50% off
|
$484.40
|
$123,020.17
|
$51,182.24
|
2024-11-21
|
|
3031
|
APR_DRG
|
Dorsal & Lumbar Fusion Proc For Curvature Of Back
|
3
|
3
|
—
|
—
|
$45,072.11
|
$51,091.97
|
$51,091.97
|
2024-11-21
|
|
6344
|
APR_DRG
|
Neonate, Birthwt >2499g W Resp Dist Synd/oth Maj Resp Cond
|
3
|
3
|
—
|
—
|
$44,970.54
|
$50,976.84
|
$50,976.84
|
2024-11-21
|
|
9514
|
APR_DRG
|
Moderately Extensive Procedure Unrelated To Principal Diagnosis
|
3
|
3
|
—
|
—
|
$44,914.97
|
$50,913.84
|
$50,913.84
|
2024-11-21
|
|
6123
|
APR_DRG
|
Neonate Bwt 1500-1999g W Resp Dist Synd/oth Maj Resp Cond
|
3
|
3
|
—
|
—
|
$44,845.98
|
$50,835.64
|
$50,835.64
|
2024-11-21
|
|
26787
|
CDM
|
Conduit Aortic Valved Konect Resilia 11060a
|
29
|
11
|
$106,240.00
|
$53,120.00
50% off
|
$29,747.20
|
$71,499.52
|
$50,623.36
|
2024-11-21
|
|
8504
|
APR_DRG
|
Procedure W Diag Of Rehab, Aftercare Or Oth Contact W Health Service
|
3
|
3
|
—
|
—
|
$44,574.81
|
$50,528.26
|
$50,528.26
|
2024-11-21
|
|
2624
|
APR_DRG
|
Cholecystectomy Except Laparoscopic
|
3
|
3
|
—
|
—
|
$44,423.42
|
$50,356.64
|
$50,356.64
|
2024-11-21
|
|
5354
|
CDM
|
Thoracic Endoprosthesis Tgu313115
|
29
|
11
|
$105,410.00
|
$52,705.00
50% off
|
$29,514.80
|
$70,940.93
|
$50,227.86
|
2024-11-21
|
|
5682
|
CDM
|
Endoprosthesis Thoracic Tgu454510
|
29
|
11
|
$105,410.00
|
$52,705.00
50% off
|
$29,514.80
|
$70,940.93
|
$50,227.86
|
2024-11-21
|
|
5124
|
APR_DRG
|
Uterine & Adnexa Procedures For Non-ovarian & Non-adnexal Malig
|
3
|
3
|
—
|
—
|
$43,791.02
|
$49,639.78
|
$49,639.78
|
2024-11-21
|
|
957
|
MS_DRG
|
Other O.r. Procedures For Multiple Significant Trauma With Mcc
|
9
|
7
|
—
|
—
|
$48,175.08
|
$156,032.00
|
$49,620.33
|
2024-11-21
|
|
4572
|
CDM
|
Thoracic Endoprosthesis Tgu343415
|
29
|
11
|
$105,410.00
|
$52,705.00
50% off
|
$29,514.80
|
$70,940.93
|
$49,593.88
|
2024-11-21
|
|
38240
|
CPT
|
Trnsplj Allogeneic Hematopoietic Cells Per Donor
|
11
|
7
|
—
|
—
|
$47,901.92
|
$331,522.56
|
$49,578.48
|
2024-11-21
|
|
3614
|
APR_DRG
|
Skin Graft For Skin & Subcutaneous Tissue Diagnoses
|
3
|
3
|
—
|
—
|
$43,512.18
|
$49,323.70
|
$49,323.70
|
2024-11-21
|
|
4804
|
APR_DRG
|
Major Male Pelvic Procedures
|
3
|
3
|
—
|
—
|
$43,365.58
|
$49,157.52
|
$49,157.52
|
2024-11-21
|
|
4861
|
CDM
|
Thoracic Endoprosthesis Tgu262610
|
29
|
11
|
$102,920.00
|
$51,460.00
50% off
|
$28,817.60
|
$69,265.16
|
$49,041.38
|
2024-11-21
|
|
1764
|
APR_DRG
|
Cardiac Pacemaker & Defibrillator Device Replacement
|
3
|
3
|
—
|
—
|
$43,185.44
|
$48,953.32
|
$48,953.32
|
2024-11-21
|
|
L7181
|
HCPCS
|
Electronic Elbo Simultaneous
|
8
|
7
|
—
|
—
|
$47,492.96
|
$87,861.98
|
$48,680.29
|
2024-11-21
|
|
4401
|
APR_DRG
|
Kidney Transplant
|
3
|
3
|
—
|
—
|
$42,799.29
|
$48,515.60
|
$48,515.60
|
2024-11-21
|
|
5184
|
APR_DRG
|
Other Female Reproductive System & Related Procedures
|
3
|
3
|
—
|
—
|
$42,691.98
|
$48,393.95
|
$48,393.95
|
2024-11-21
|
|
17999
|
CDM
|
Stent Graft Thoracic System Valiant Navion Vnmf3434c97tu
|
29
|
11
|
$101,558.80
|
$50,779.40
50% off
|
$28,436.46
|
$68,349.07
|
$48,392.76
|
2024-11-21
|
|
3154
|
APR_DRG
|
Shoulder, Upper Arm & Forearm Procedures
|
3
|
3
|
—
|
—
|
$42,679.52
|
$48,379.83
|
$48,379.83
|
2024-11-21
|
|
15387
|
CDM
|
Endoprosthesis Thoracic Tgu454515
|
29
|
11
|
$100,881.52
|
$50,440.76
50% off
|
$28,246.83
|
$67,893.26
|
$48,070.04
|
2024-11-21
|
|
14011
|
CDM
|
Thoracic Endoprosthesis Tgu313110
|
28
|
11
|
$100,881.52
|
$50,440.76
50% off
|
$28,246.83
|
$67,893.26
|
$48,070.04
|
2024-11-21
|
|
3139
|
CDM
|
Thoracis Endoprosthesis Tgu343420
|
29
|
11
|
$100,881.52
|
$50,440.76
50% off
|
$28,246.83
|
$67,893.26
|
$48,070.04
|
2024-11-21
|
|
2224
|
APR_DRG
|
Other Stomach, Esophageal & Duodenal Procedures
|
3
|
3
|
—
|
—
|
$42,397.81
|
$48,060.50
|
$48,060.50
|
2024-11-21
|
|
4834
|
APR_DRG
|
Testes & Scrotal Procedures
|
3
|
3
|
—
|
—
|
$42,393.02
|
$48,055.07
|
$48,055.07
|
2024-11-21
|
|
1621
|
APR_DRG
|
Cardiac Valve Procedures W Cardiac Catheterization
|
3
|
3
|
—
|
—
|
$42,369.07
|
$48,027.91
|
$48,027.91
|
2024-11-21
|
|
2244
|
APR_DRG
|
Peritoneal Adhesiolysis
|
3
|
3
|
—
|
—
|
$42,271.33
|
$47,917.12
|
$47,917.12
|
2024-11-21
|
|
4474
|
APR_DRG
|
Other Kidney, Urinary Tract & Related Procedures
|
3
|
3
|
—
|
—
|
$42,095.03
|
$47,717.27
|
$47,717.27
|
2024-11-21
|
|
1652
|
APR_DRG
|
Coronary Bypass W Cardiac Cath Or Percutaneous Cardiac Procedure
|
3
|
3
|
—
|
—
|
$42,026.04
|
$47,639.07
|
$47,639.07
|
2024-11-21
|
|
427
|
MS_DRG
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
9
|
7
|
—
|
—
|
$45,841.90
|
$124,689.97
|
$47,217.16
|
2024-11-21
|
|
3024
|
APR_DRG
|
Knee Joint Replacement
|
3
|
3
|
—
|
—
|
$41,650.43
|
$47,213.29
|
$47,213.29
|
2024-11-21
|
|
3174
|
APR_DRG
|
Tendon, Muscle & Other Soft Tissue Procedures
|
3
|
3
|
—
|
—
|
$41,563.23
|
$47,114.45
|
$47,114.45
|
2024-11-21
|
|
5464
|
APR_DRG
|
Other O.r. Proc For Obstetric Diagnoses Except Delivery Diagnoses
|
3
|
3
|
—
|
—
|
$41,563.23
|
$47,114.45
|
$47,114.45
|
2024-11-21
|
|
3134
|
APR_DRG
|
Knee & Lower Leg Procedures Except Foot
|
3
|
3
|
—
|
—
|
$41,536.40
|
$47,084.04
|
$47,084.04
|
2024-11-21
|
|
275
|
MS_DRG
|
Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc
|
9
|
7
|
—
|
—
|
$45,611.50
|
$154,377.00
|
$46,979.85
|
2024-11-21
|
|
J9226
|
HCPCS
|
Supprelin La Implant
|
11
|
7
|
—
|
—
|
$45,350.22
|
$157,273.83
|
$46,937.47
|
2024-11-21
|
|
2274
|
APR_DRG
|
Hernia Procedures Except Inguinal, Femoral & Umbilical
|
3
|
3
|
—
|
—
|
$41,283.44
|
$46,797.29
|
$46,797.29
|
2024-11-21
|
|
3138
|
CDM
|
Thoracic Endoprosthesis Tgu373715
|
29
|
11
|
$97,940.00
|
$48,970.00
50% off
|
$27,423.20
|
$65,913.62
|
$46,668.41
|
2024-11-21
|
|
2983
|
CDM
|
Bifurcated 2 Piece Capped Case Medtronic Aaa 2
|
28
|
11
|
$97,282.64
|
$48,641.32
50% off
|
$27,239.14
|
$65,471.22
|
$46,355.18
|
2024-11-21
|
|
870
|
MS_DRG
|
Septicemia Or Severe Sepsis With Mv >96 Hours
|
9
|
7
|
—
|
—
|
$44,898.31
|
$137,544.00
|
$46,245.26
|
2024-11-21
|
|
2294
|
APR_DRG
|
Other Digestive System & Abdominal Procedures
|
3
|
3
|
—
|
—
|
$40,790.94
|
$46,239.00
|
$46,239.00
|
2024-11-21
|
|
1663
|
APR_DRG
|
Coronary Bypass Without Cardiac Cath Or Percutaneous Cardiac Procedure
|
3
|
3
|
—
|
—
|
$40,786.15
|
$46,233.57
|
$46,233.57
|
2024-11-21
|
|
6032
|
APR_DRG
|
Neonate Birthwt 1000-1249g W Or Without Other Significant Condition
|
3
|
3
|
—
|
—
|
$40,746.86
|
$46,189.04
|
$46,189.04
|
2024-11-21
|
|
4044
|
APR_DRG
|
Thyroid, Parathyroid & Thyroglossal Procedures
|
3
|
3
|
—
|
—
|
$40,741.11
|
$46,182.52
|
$46,182.52
|
2024-11-21
|
|
29191
|
CDM
|
6 X 100 Zilver Stent
|
29
|
11
|
$111,487.59
|
$55,743.80
50% off
|
$31,216.53
|
$75,031.15
|
$46,105.97
|
2024-11-21
|
|
29190
|
CDM
|
6 X 100 Zilver Stent
|
29
|
11
|
$111,487.59
|
$55,743.80
50% off
|
$31,216.53
|
$75,031.15
|
$46,105.97
|
2024-11-21
|
|
3094
|
APR_DRG
|
Hip & Femur Procedures For Non-trauma Except Joint Replacement
|
3
|
3
|
—
|
—
|
$40,634.75
|
$46,061.96
|
$46,061.96
|
2024-11-21
|
|
31
|
APR_DRG
|
Bone Marrow Transplant
|
3
|
3
|
—
|
—
|
$40,629.00
|
$46,055.44
|
$46,055.44
|
2024-11-21
|
|
J1640
|
HCPCS
|
Hc Rx Rev Code 636 W/Hcpcs
|
20
|
11
|
$117,640.60
|
$58,820.30
50% off
|
$32.20
|
$79,172.12
|
$45,997.47
|
2024-11-21
|
|
3054
|
APR_DRG
|
Amputation Of Lower Limb Except Toes
|
3
|
3
|
—
|
—
|
$40,392.33
|
$45,787.16
|
$45,787.16
|
2024-11-21
|
|
1754
|
APR_DRG
|
Percutaneous Cardiovascular Procedures Without Ami
|
3
|
3
|
—
|
—
|
$40,359.75
|
$45,750.23
|
$45,750.23
|
2024-11-21
|
|
1714
|
APR_DRG
|
Perm Cardiac Pacemaker Implant Without Ami, Heart Failure Or Shock
|
3
|
3
|
—
|
—
|
$40,350.17
|
$45,739.37
|
$45,739.37
|
2024-11-21
|
|
1632
|
APR_DRG
|
Cardiac Valve Procedures Without Cardiac Catheterization
|
3
|
3
|
—
|
—
|
$40,330.05
|
$45,716.56
|
$45,716.56
|
2024-11-21
|
|
955
|
MS_DRG
|
Craniotomy For Multiple Significant Trauma
|
9
|
7
|
—
|
—
|
$44,070.89
|
$119,872.82
|
$45,393.02
|
2024-11-21
|
|
3104
|
APR_DRG
|
Intervertebral Disc Excision & Decompression
|
3
|
3
|
—
|
—
|
$39,918.99
|
$45,250.60
|
$45,250.60
|
2024-11-21
|
|
9103
|
APR_DRG
|
Craniotomy For Multiple Significant Trauma
|
3
|
3
|
—
|
—
|
$39,886.41
|
$45,213.67
|
$45,213.67
|
2024-11-21
|
|
1673
|
APR_DRG
|
Other Cardiothoracic Procedures
|
3
|
3
|
—
|
—
|
$39,843.29
|
$45,164.79
|
$45,164.79
|
2024-11-21
|
|
704
|
APR_DRG
|
Orbital Procedures
|
3
|
3
|
—
|
—
|
$39,428.40
|
$44,694.48
|
$44,694.48
|
2024-11-21
|
|
4814
|
APR_DRG
|
Penis Procedures
|
3
|
3
|
—
|
—
|
$39,422.65
|
$44,687.96
|
$44,687.96
|
2024-11-21
|
|
447
|
MS_DRG
|
Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall…
|
9
|
7
|
—
|
—
|
$43,273.16
|
$133,569.00
|
$44,571.35
|
2024-11-21
|
|
3204
|
APR_DRG
|
Other Musculoskeletal System & Connective Tissue Procedures
|
3
|
3
|
—
|
—
|
$39,230.05
|
$44,469.64
|
$44,469.64
|
2024-11-21
|
|
268
|
MS_DRG
|
Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc
|
9
|
7
|
—
|
—
|
$43,033.72
|
$192,867.00
|
$44,324.73
|
2024-11-21
|
|
4434
|
APR_DRG
|
Kidney & Urinary Tract Procedures For Nonmalignancy
|
3
|
3
|
—
|
—
|
$39,038.41
|
$44,252.41
|
$44,252.41
|
2024-11-21
|
|
5144
|
APR_DRG
|
Female Reproductive System Reconstructive Procedures
|
3
|
3
|
—
|
—
|
$38,988.59
|
$44,195.93
|
$44,195.93
|
2024-11-21
|
|
928
|
MS_DRG
|
Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc
|
8
|
7
|
—
|
—
|
$43,106.64
|
$117,250.06
|
$44,184.30
|
2024-11-21
|
|
1744
|
APR_DRG
|
Percutaneous Cardiovascular Procedures W Ami
|
3
|
3
|
—
|
—
|
$38,968.47
|
$44,173.12
|
$44,173.12
|
2024-11-21
|
|
6113
|
APR_DRG
|
Neonate Birthwt 1500-1999g W Major Anomaly
|
3
|
3
|
—
|
—
|
$38,860.19
|
$44,050.39
|
$44,050.39
|
2024-11-21
|
|
5134
|
APR_DRG
|
Uterine & Adnexa Procedures For Non-malignancy Except Leiomyoma
|
3
|
3
|
—
|
—
|
$38,698.26
|
$43,866.82
|
$43,866.82
|
2024-11-21
|
|
1774
|
APR_DRG
|
Cardiac Pacemaker & Defibrillator Revision Except Device Replacement
|
3
|
3
|
—
|
—
|
$38,543.03
|
$43,690.87
|
$43,690.87
|
2024-11-21
|
|
1611
|
APR_DRG
|
Cardiac Defibrillator & Heart Assist Implant
|
3
|
3
|
—
|
—
|
$38,421.34
|
$43,552.92
|
$43,552.92
|
2024-11-21
|
|
3014
|
APR_DRG
|
Hip Joint Replacement
|
3
|
3
|
—
|
—
|
$38,317.86
|
$43,435.62
|
$43,435.62
|
2024-11-21
|
|
1804
|
APR_DRG
|
Other Circulatory System Procedures
|
3
|
3
|
—
|
—
|
$38,101.31
|
$43,190.15
|
$43,190.15
|
2024-11-21
|
|
6334
|
APR_DRG
|
Neonate Birthwt >2499g W Major Anomaly
|
3
|
3
|
—
|
—
|
$38,065.86
|
$43,149.96
|
$43,149.96
|
2024-11-21
|
|
207
|
MS_DRG
|
Respiratory System Diagnosis With Ventilator Support >96 Hours
|
9
|
7
|
—
|
—
|
$41,740.30
|
$121,453.00
|
$42,992.51
|
2024-11-21
|
|
217
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
9
|
7
|
—
|
—
|
$41,680.28
|
$139,862.00
|
$42,930.69
|
2024-11-21
|
|
5194
|
APR_DRG
|
Uterine & Adnexa Procedures For Leiomyoma
|
3
|
3
|
—
|
—
|
$37,783.19
|
$42,829.54
|
$42,829.54
|
2024-11-21
|
|
9524
|
APR_DRG
|
Nonextensive Procedure Unrelated To Principal Diagnosis
|
3
|
3
|
—
|
—
|
$37,537.89
|
$42,551.48
|
$42,551.48
|
2024-11-21
|