|
397
|
MS_DRG
|
Appendix Procedures With Mcc
|
1
|
1
|
—
|
—
|
$60,913.00
|
$60,913.00
|
$60,913.00
|
2025-07-01
|
|
5232
|
OTHER
|
Level 2 Icd And Similar Procedures
|
1
|
1
|
—
|
—
|
$44,419.58
|
$44,419.58
|
$44,419.58
|
2025-07-01
|
|
329
|
MS_DRG
|
Major Small And Large Bowel Procedures With Mcc
|
1
|
1
|
—
|
—
|
$42,788.71
|
$42,788.71
|
$42,788.71
|
2025-07-01
|
|
853
|
MS_DRG
|
Infectious And Parasitic Diseases With O.r. Procedures With Mcc
|
4
|
3
|
—
|
—
|
$37,193.17
|
$37,193.17
|
$37,193.17
|
2025-07-01
|
|
628
|
MS_DRG
|
Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc
|
1
|
1
|
—
|
—
|
$31,401.39
|
$31,401.39
|
$31,401.39
|
2025-07-01
|
|
371
|
MS_DRG
|
Major Gastrointestinal Disorders And Peritoneal Infections With Mcc
|
1
|
1
|
—
|
—
|
$30,031.08
|
$30,031.08
|
$30,031.08
|
2025-07-01
|
|
273
|
MS_DRG
|
Percutaneous And Other Intracardiac Procedures With Mcc
|
1
|
1
|
—
|
—
|
$29,687.99
|
$29,687.99
|
$29,687.99
|
2025-07-01
|
|
243
|
MS_DRG
|
Permanent Cardiac Pacemaker Implant With Cc
|
1
|
1
|
—
|
—
|
$27,738.15
|
$27,738.15
|
$27,738.15
|
2025-07-01
|
|
264
|
MS_DRG
|
Other Circulatory System O.r. Procedures
|
1
|
1
|
—
|
—
|
$25,352.16
|
$25,352.16
|
$25,352.16
|
2025-07-01
|
|
330
|
MS_DRG
|
Major Small And Large Bowel Procedures With Cc
|
1
|
1
|
—
|
—
|
$25,035.90
|
$25,035.90
|
$25,035.90
|
2025-07-01
|
|
617
|
MS_DRG
|
Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With…
|
2
|
2
|
—
|
—
|
$24,770.74
|
$24,770.74
|
$24,770.74
|
2025-07-01
|
|
580
|
MS_DRG
|
Other Skin, Subcutaneous Tissue And Breast Procedures With Cc
|
1
|
1
|
—
|
—
|
$24,258.25
|
$24,258.25
|
$24,258.25
|
2025-07-01
|
|
300
|
MS_DRG
|
Peripheral Vascular Disorders With Cc
|
1
|
1
|
—
|
—
|
$21,167.35
|
$21,167.35
|
$21,167.35
|
2025-07-01
|
|
5361
|
OTHER
|
Level 1 Laparoscopy And Related Services
|
15
|
9
|
—
|
—
|
$21,106.30
|
$21,106.30
|
$21,106.30
|
2025-07-01
|
|
579
|
MS_DRG
|
Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc
|
3
|
3
|
—
|
—
|
$19,664.06
|
$19,664.06
|
$19,664.06
|
2025-07-01
|
|
357
|
MS_DRG
|
Other Digestive System O.r. Procedures With Cc
|
1
|
1
|
—
|
—
|
$19,041.73
|
$19,041.73
|
$19,041.73
|
2025-07-01
|
|
345
|
MS_DRG
|
Minor Small And Large Bowel Procedures With Cc
|
1
|
1
|
—
|
—
|
$17,377.76
|
$17,377.76
|
$17,377.76
|
2025-07-01
|
|
5054
|
OTHER
|
Level 4 Skin Procedures
|
9
|
6
|
—
|
—
|
$16,950.62
|
$16,950.62
|
$16,950.62
|
2025-07-01
|
|
5165
|
OTHER
|
Level 5 ENT Procedures
|
2
|
2
|
—
|
—
|
$16,724.72
|
$16,724.72
|
$16,724.72
|
2025-07-01
|
|
261
|
MS_DRG
|
Cardiac Pacemaker Revision Except Device Replacement With Cc
|
1
|
1
|
—
|
—
|
$16,495.24
|
$16,495.24
|
$16,495.24
|
2025-07-01
|
|
441
|
MS_DRG
|
Disorders Of Liver Except Malignancy, Cirrhosis Or Alcoholic Hepatitis With Mcc
|
1
|
1
|
—
|
—
|
$16,428.42
|
$16,428.42
|
$16,428.42
|
2025-07-01
|
|
689
|
MS_DRG
|
Kidney And Urinary Tract Infections With Mcc
|
4
|
4
|
—
|
—
|
$16,141.62
|
$16,141.62
|
$16,141.62
|
2025-07-01
|
|
554
|
MS_DRG
|
Bone Diseases And Arthropathies Without Mcc
|
1
|
1
|
—
|
—
|
$16,043.12
|
$16,043.12
|
$16,043.12
|
2025-07-01
|
|
41
|
MS_DRG
|
Peripheral, Cranial Nerve And Other Nervous System Procedures With Cc Or Periphe…
|
2
|
2
|
—
|
—
|
$15,912.34
|
$15,912.34
|
$15,912.34
|
2025-07-01
|
|
974
|
MS_DRG
|
HIV With Major Related Condition With Mcc
|
1
|
1
|
—
|
—
|
$15,733.89
|
$15,733.89
|
$15,733.89
|
2025-07-01
|
|
637
|
MS_DRG
|
Diabetes With Mcc
|
3
|
3
|
—
|
—
|
$15,413.66
|
$15,413.66
|
$15,413.66
|
2025-07-01
|
|
623
|
MS_DRG
|
Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor…
|
1
|
1
|
—
|
—
|
$14,935.84
|
$14,935.84
|
$14,935.84
|
2025-07-01
|
|
981
|
MS_DRG
|
Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc
|
1
|
1
|
—
|
—
|
$14,248.63
|
$14,248.63
|
$14,248.63
|
2025-07-01
|
|
616
|
MS_DRG
|
Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With…
|
2
|
2
|
—
|
—
|
$14,197.02
|
$14,197.02
|
$14,197.02
|
2025-07-01
|
|
884
|
MS_DRG
|
Organic Disturbances And Intellectual Disability
|
1
|
1
|
—
|
—
|
$14,099.53
|
$14,099.53
|
$14,099.53
|
2025-07-01
|
|
189
|
MS_DRG
|
Pulmonary Edema And Respiratory Failure
|
6
|
5
|
—
|
—
|
$13,938.20
|
$13,938.20
|
$13,938.20
|
2025-07-01
|
|
896
|
MS_DRG
|
Alcohol, Drug Abuse Or Dependence Without Rehabilitation Therapy With Mcc
|
2
|
2
|
—
|
—
|
$13,874.25
|
$13,874.25
|
$13,874.25
|
2025-07-01
|
|
291
|
MS_DRG
|
Heart Failure And Shock With Mcc
|
9
|
7
|
—
|
—
|
$13,837.58
|
$13,837.58
|
$13,837.58
|
2025-07-01
|
|
244
|
MS_DRG
|
Permanent Cardiac Pacemaker Implant Without Cc/Mcc
|
1
|
1
|
—
|
—
|
$13,629.57
|
$13,629.57
|
$13,629.57
|
2025-07-01
|
|
871
|
MS_DRG
|
Septicemia Or Severe Sepsis Without Mv >96 Hours With Mcc
|
14
|
8
|
—
|
—
|
$13,500.75
|
$13,500.75
|
$13,500.75
|
2025-07-01
|
|
5375
|
OTHER
|
Level 5 Urology And Related Services
|
8
|
4
|
—
|
—
|
$13,425.53
|
$13,425.53
|
$13,425.53
|
2025-07-01
|
|
377
|
MS_DRG
|
Gastrointestinal Hemorrhage With Mcc
|
2
|
2
|
—
|
—
|
$13,399.66
|
$13,399.66
|
$13,399.66
|
2025-07-01
|
|
843
|
MS_DRG
|
Other Myeloproliferative Disorders Or Poorly Differentiated Neoplastic Diagnoses…
|
1
|
1
|
—
|
—
|
$13,018.91
|
$13,018.91
|
$13,018.91
|
2025-07-01
|
|
565
|
MS_DRG
|
Other Musculoskeletal System And Connective Tissue Diagnoses With Cc
|
2
|
2
|
—
|
—
|
$12,689.36
|
$12,689.36
|
$12,689.36
|
2025-07-01
|
|
368
|
MS_DRG
|
Major Esophageal Disorders With Mcc
|
1
|
1
|
—
|
—
|
$12,620.51
|
$12,620.51
|
$12,620.51
|
2025-07-01
|
|
501
|
MS_DRG
|
Soft Tissue Procedures With Cc
|
1
|
1
|
—
|
—
|
$12,483.82
|
$12,483.82
|
$12,483.82
|
2025-07-01
|
|
604
|
MS_DRG
|
Trauma To The Skin, Subcutaneous Tissue And Breast With Mcc
|
1
|
1
|
—
|
—
|
$12,481.55
|
$12,481.55
|
$12,481.55
|
2025-07-01
|
|
77
|
MS_DRG
|
Hypertensive Encephalopathy With Mcc
|
1
|
1
|
—
|
—
|
$12,310.67
|
$12,310.67
|
$12,310.67
|
2025-07-01
|
|
660
|
MS_DRG
|
Kidney And Ureter Procedures For Non-neoplasm With Cc
|
1
|
1
|
—
|
—
|
$12,147.13
|
$12,147.13
|
$12,147.13
|
2025-07-01
|
|
5694
|
OTHER
|
Level 4 Drug Administration
|
1
|
1
|
—
|
—
|
$12,090.36
|
$12,090.36
|
$12,090.36
|
2025-07-01
|
|
416
|
MS_DRG
|
Cholecystectomy Except By Laparoscope Without C.d.e. Without Cc/Mcc
|
1
|
1
|
—
|
—
|
$11,920.07
|
$11,920.07
|
$11,920.07
|
2025-07-01
|
|
564
|
MS_DRG
|
Other Musculoskeletal System And Connective Tissue Diagnoses With Mcc
|
1
|
1
|
—
|
—
|
$11,748.11
|
$11,748.11
|
$11,748.11
|
2025-07-01
|
|
629
|
MS_DRG
|
Other Endocrine, Nutritional And Metabolic O.r. Procedures With Cc
|
2
|
2
|
—
|
—
|
$11,743.49
|
$11,743.49
|
$11,743.49
|
2025-07-01
|
|
314
|
MS_DRG
|
Other Circulatory System Diagnoses With Mcc
|
3
|
3
|
—
|
—
|
$11,633.17
|
$11,633.17
|
$11,633.17
|
2025-07-01
|
|
917
|
MS_DRG
|
Poisoning And Toxic Effects Of Drugs With Mcc
|
1
|
1
|
—
|
—
|
$11,472.61
|
$11,472.61
|
$11,472.61
|
2025-07-01
|
|
355
|
MS_DRG
|
Hernia Procedures Except Inguinal And Femoral Without Cc/Mcc
|
1
|
1
|
—
|
—
|
$11,466.13
|
$11,466.13
|
$11,466.13
|
2025-07-01
|
|
5222
|
OTHER
|
Level 2 Pacemaker And Similar Procedures
|
4
|
4
|
—
|
—
|
$11,280.75
|
$11,280.75
|
$11,280.75
|
2025-07-01
|
|
5091
|
OTHER
|
Level 1 Breast/Lymphatic Surgery And Related Procedures
|
11
|
6
|
—
|
—
|
$11,226.19
|
$11,226.19
|
$11,226.19
|
2025-07-01
|
|
399
|
MS_DRG
|
Appendix Procedures Without Cc/Mcc
|
3
|
2
|
—
|
—
|
$10,808.71
|
$10,808.71
|
$10,808.71
|
2025-07-01
|
|
630
|
MS_DRG
|
Other Endocrine, Nutritional And Metabolic O.r. Procedures Without Cc/Mcc
|
1
|
1
|
—
|
—
|
$10,774.43
|
$10,774.43
|
$10,774.43
|
2025-07-01
|
|
65
|
MS_DRG
|
Intracranial Hemorrhage Or Cerebral Infarction With Cc Or Tpa In 24 Hours
|
8
|
6
|
—
|
—
|
$10,774.41
|
$10,774.41
|
$10,774.41
|
2025-07-01
|
|
70
|
MS_DRG
|
Nonspecific Cerebrovascular Disorders With Mcc
|
3
|
3
|
—
|
—
|
$10,745.25
|
$10,745.25
|
$10,745.25
|
2025-07-01
|
|
183
|
MS_DRG
|
Major Chest Trauma With Mcc
|
1
|
1
|
—
|
—
|
$10,717.97
|
$10,717.97
|
$10,717.97
|
2025-07-01
|
|
306
|
MS_DRG
|
Cardiac Congenital And Valvular Disorders With Mcc
|
1
|
1
|
—
|
—
|
$10,685.59
|
$10,685.59
|
$10,685.59
|
2025-07-01
|
|
176
|
MS_DRG
|
Pulmonary Embolism Without Mcc
|
4
|
4
|
—
|
—
|
$10,669.72
|
$10,669.72
|
$10,669.72
|
2025-07-01
|
|
723
|
MS_DRG
|
Malignancy, Male Reproductive System With Cc
|
1
|
1
|
—
|
—
|
$10,419.50
|
$10,419.50
|
$10,419.50
|
2025-07-01
|
|
556
|
MS_DRG
|
Signs And Symptoms Of Musculoskeletal System And Connective Tissue Without Mcc
|
1
|
1
|
—
|
—
|
$10,200.00
|
$10,200.00
|
$10,200.00
|
2025-07-01
|
|
288
|
MS_DRG
|
Acute And Subacute Endocarditis With Mcc
|
1
|
1
|
—
|
—
|
$10,161.00
|
$10,161.00
|
$10,161.00
|
2025-07-01
|
|
854
|
MS_DRG
|
Infectious And Parasitic Diseases With O.r. Procedures With Cc
|
3
|
3
|
—
|
—
|
$10,105.28
|
$10,105.28
|
$10,105.28
|
2025-07-01
|
|
378
|
MS_DRG
|
Gastrointestinal Hemorrhage With Cc
|
4
|
3
|
—
|
—
|
$10,034.98
|
$10,034.98
|
$10,034.98
|
2025-07-01
|
|
698
|
MS_DRG
|
Other Kidney And Urinary Tract Diagnoses With Mcc
|
2
|
2
|
—
|
—
|
$9,735.60
|
$9,735.60
|
$9,735.60
|
2025-07-01
|
|
432
|
MS_DRG
|
Cirrhosis And Alcoholic Hepatitis With Mcc
|
1
|
1
|
—
|
—
|
$9,674.00
|
$9,674.00
|
$9,674.00
|
2025-07-01
|
|
868
|
MS_DRG
|
Other Infectious And Parasitic Diseases Diagnoses With Cc
|
1
|
1
|
—
|
—
|
$9,655.62
|
$9,655.62
|
$9,655.62
|
2025-07-01
|
|
535
|
MS_DRG
|
Fractures Of Hip And Pelvis With Mcc
|
1
|
1
|
—
|
—
|
$9,646.38
|
$9,646.38
|
$9,646.38
|
2025-07-01
|
|
438
|
MS_DRG
|
Disorders Of Pancreas Except Malignancy With Mcc
|
2
|
2
|
—
|
—
|
$9,635.16
|
$9,635.16
|
$9,635.16
|
2025-07-01
|
|
446
|
MS_DRG
|
Disorders Of The Biliary Tract Without Cc/Mcc
|
1
|
1
|
—
|
—
|
$9,633.28
|
$9,633.28
|
$9,633.28
|
2025-07-01
|
|
863
|
MS_DRG
|
Postoperative And Post-traumatic Infections Without Mcc
|
2
|
2
|
—
|
—
|
$9,532.74
|
$9,532.74
|
$9,532.74
|
2025-07-01
|
|
94
|
MS_DRG
|
Bacterial And Tuberculous Infections Of Nervous System With Mcc
|
1
|
1
|
—
|
—
|
$9,385.46
|
$9,385.46
|
$9,385.46
|
2025-07-01
|
|
5073
|
OTHER
|
Level 3 Excision/ Biopsy/ Incision And Drainage
|
16
|
7
|
—
|
—
|
$9,125.45
|
$9,125.45
|
$9,125.45
|
2025-07-01
|
|
640
|
MS_DRG
|
Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes With M…
|
6
|
5
|
—
|
—
|
$9,082.10
|
$9,082.10
|
$9,082.10
|
2025-07-01
|
|
315
|
MS_DRG
|
Other Circulatory System Diagnoses With Cc
|
2
|
2
|
—
|
—
|
$9,004.00
|
$9,004.00
|
$9,004.00
|
2025-07-01
|
|
389
|
MS_DRG
|
Gastrointestinal Obstruction With Cc
|
8
|
6
|
—
|
—
|
$8,958.97
|
$8,958.97
|
$8,958.97
|
2025-07-01
|
|
5341
|
OTHER
|
Level 1 Abdominal/Peritoneal/Biliary And Related Procedures
|
9
|
5
|
—
|
—
|
$8,746.89
|
$8,746.89
|
$8,746.89
|
2025-07-01
|
|
74
|
MS_DRG
|
Cranial And Peripheral Nerve Disorders Without Mcc
|
1
|
1
|
—
|
—
|
$8,712.16
|
$8,712.16
|
$8,712.16
|
2025-07-01
|
|
394
|
MS_DRG
|
Other Digestive System Diagnoses With Cc
|
1
|
1
|
—
|
—
|
$8,674.69
|
$8,674.69
|
$8,674.69
|
2025-07-01
|
|
549
|
MS_DRG
|
Septic Arthritis With Cc
|
1
|
1
|
—
|
—
|
$8,579.87
|
$8,579.87
|
$8,579.87
|
2025-07-01
|
|
373
|
MS_DRG
|
Major Gastrointestinal Disorders And Peritoneal Infections Without Cc/Mcc
|
3
|
3
|
—
|
—
|
$8,447.77
|
$8,447.77
|
$8,447.77
|
2025-07-01
|
|
5313
|
OTHER
|
Level 3 Lower Gi Procedures
|
9
|
4
|
—
|
—
|
$8,439.25
|
$8,439.25
|
$8,439.25
|
2025-07-01
|
|
555
|
MS_DRG
|
Signs And Symptoms Of Musculoskeletal System And Connective Tissue With Mcc
|
1
|
1
|
—
|
—
|
$8,410.82
|
$8,410.82
|
$8,410.82
|
2025-07-01
|
|
760
|
MS_DRG
|
Menstrual And Other Female Reproductive System Disorders With Cc/Mcc
|
1
|
1
|
—
|
—
|
$8,208.77
|
$8,208.77
|
$8,208.77
|
2025-07-01
|
|
177
|
MS_DRG
|
Respiratory Infections And Inflammations With Mcc
|
7
|
5
|
—
|
—
|
$8,198.18
|
$8,198.18
|
$8,198.18
|
2025-07-01
|
|
812
|
MS_DRG
|
Red Blood Cell Disorders Without Mcc
|
4
|
3
|
—
|
—
|
$8,115.45
|
$8,115.45
|
$8,115.45
|
2025-07-01
|
|
682
|
MS_DRG
|
Renal Failure With Mcc
|
3
|
3
|
—
|
—
|
$8,113.90
|
$8,113.90
|
$8,113.90
|
2025-07-01
|
|
811
|
MS_DRG
|
Red Blood Cell Disorders With Mcc
|
5
|
5
|
—
|
—
|
$8,101.98
|
$8,101.98
|
$8,101.98
|
2025-07-01
|
|
866
|
MS_DRG
|
Viral Illness Without Mcc
|
1
|
1
|
—
|
—
|
$8,056.09
|
$8,056.09
|
$8,056.09
|
2025-07-01
|
|
202
|
MS_DRG
|
Bronchitis And Asthma With Cc/Mcc
|
2
|
2
|
—
|
—
|
$8,053.47
|
$8,053.47
|
$8,053.47
|
2025-07-01
|
|
308
|
MS_DRG
|
Cardiac Arrhythmia And Conduction Disorders With Mcc
|
3
|
3
|
—
|
—
|
$7,798.34
|
$7,798.34
|
$7,798.34
|
2025-07-01
|
|
71
|
MS_DRG
|
Nonspecific Cerebrovascular Disorders With Cc
|
4
|
4
|
—
|
—
|
$7,745.16
|
$7,745.16
|
$7,745.16
|
2025-07-01
|
|
302
|
MS_DRG
|
Atherosclerosis With Mcc
|
1
|
1
|
—
|
—
|
$7,730.36
|
$7,730.36
|
$7,730.36
|
2025-07-01
|
|
442
|
MS_DRG
|
Disorders Of Liver Except Malignancy, Cirrhosis Or Alcoholic Hepatitis With Cc
|
1
|
1
|
—
|
—
|
$7,707.00
|
$7,707.00
|
$7,707.00
|
2025-07-01
|
|
93
|
MS_DRG
|
Other Disorders Of Nervous System Without Cc/Mcc
|
1
|
1
|
—
|
—
|
$7,660.83
|
$7,660.83
|
$7,660.83
|
2025-07-01
|
|
101
|
MS_DRG
|
Seizures Without Mcc
|
1
|
1
|
—
|
—
|
$7,611.06
|
$7,611.06
|
$7,611.06
|
2025-07-01
|
|
69
|
MS_DRG
|
Transient Ischemia Without Thrombolytic
|
2
|
2
|
—
|
—
|
$7,531.52
|
$7,531.52
|
$7,531.52
|
2025-07-01
|
|
398
|
MS_DRG
|
Appendix Procedures With Cc
|
1
|
1
|
—
|
—
|
$7,296.57
|
$7,296.57
|
$7,296.57
|
2025-07-01
|
|
605
|
MS_DRG
|
Trauma To The Skin, Subcutaneous Tissue And Breast Without Mcc
|
1
|
1
|
—
|
—
|
$7,289.90
|
$7,289.90
|
$7,289.90
|
2025-07-01
|
|
638
|
MS_DRG
|
Diabetes With Cc
|
3
|
3
|
—
|
—
|
$7,221.70
|
$7,221.70
|
$7,221.70
|
2025-07-01
|
|
948
|
MS_DRG
|
Signs And Symptoms Without Mcc
|
1
|
1
|
—
|
—
|
$7,216.39
|
$7,216.39
|
$7,216.39
|
2025-07-01
|
|
190
|
MS_DRG
|
Chronic Obstructive Pulmonary Disease With Mcc
|
3
|
3
|
—
|
—
|
$7,182.69
|
$7,182.69
|
$7,182.69
|
2025-07-01
|
|
372
|
MS_DRG
|
Major Gastrointestinal Disorders And Peritoneal Infections With Cc
|
2
|
1
|
—
|
—
|
$7,177.23
|
$7,177.23
|
$7,177.23
|
2025-07-01
|
|
433
|
MS_DRG
|
Cirrhosis And Alcoholic Hepatitis With Cc
|
1
|
1
|
—
|
—
|
$7,088.43
|
$7,088.43
|
$7,088.43
|
2025-07-01
|
|
204
|
MS_DRG
|
Respiratory Signs And Symptoms
|
1
|
1
|
—
|
—
|
$7,062.34
|
$7,062.34
|
$7,062.34
|
2025-07-01
|
|
919
|
MS_DRG
|
Complications Of Treatment With Mcc
|
1
|
1
|
—
|
—
|
$7,060.07
|
$7,060.07
|
$7,060.07
|
2025-07-01
|
|
560
|
MS_DRG
|
Aftercare, Musculoskeletal System And Connective Tissue With Cc
|
5
|
5
|
—
|
—
|
$6,769.95
|
$6,769.95
|
$6,769.95
|
2025-07-01
|
|
303
|
MS_DRG
|
Atherosclerosis Without Mcc
|
1
|
1
|
—
|
—
|
$6,767.76
|
$6,767.76
|
$6,767.76
|
2025-07-01
|
|
57
|
MS_DRG
|
Degenerative Nervous System Disorders Without Mcc
|
1
|
1
|
—
|
—
|
$6,688.00
|
$6,688.00
|
$6,688.00
|
2025-07-01
|
|
872
|
MS_DRG
|
Septicemia Or Severe Sepsis Without Mv >96 Hours Without Mcc
|
13
|
7
|
—
|
—
|
$6,635.09
|
$6,635.09
|
$6,635.09
|
2025-07-01
|
|
440
|
MS_DRG
|
Disorders Of Pancreas Except Malignancy Without Cc/Mcc
|
4
|
4
|
—
|
—
|
$6,574.86
|
$6,574.86
|
$6,574.86
|
2025-07-01
|
|
5072
|
OTHER
|
Level 2 Excision/ Biopsy/ Incision And Drainage
|
15
|
8
|
—
|
—
|
$6,532.17
|
$6,532.17
|
$6,532.17
|
2025-07-01
|
|
602
|
MS_DRG
|
Cellulitis With Mcc
|
2
|
2
|
—
|
—
|
$6,505.04
|
$6,505.04
|
$6,505.04
|
2025-07-01
|
|
5223
|
OTHER
|
Level 3 Pacemaker And Similar Procedures
|
2
|
2
|
—
|
—
|
$6,503.15
|
$6,503.15
|
$6,503.15
|
2025-07-01
|
|
280
|
MS_DRG
|
Acute Myocardial Infarction, Discharged Alive With Mcc
|
3
|
3
|
—
|
—
|
$6,306.70
|
$6,306.70
|
$6,306.70
|
2025-07-01
|
|
309
|
MS_DRG
|
Cardiac Arrhythmia And Conduction Disorders With Cc
|
2
|
2
|
—
|
—
|
$6,302.93
|
$6,302.93
|
$6,302.93
|
2025-07-01
|
|
683
|
MS_DRG
|
Renal Failure With Cc
|
8
|
4
|
—
|
—
|
$6,275.87
|
$6,275.87
|
$6,275.87
|
2025-07-01
|
|
639
|
MS_DRG
|
Diabetes Without Cc/Mcc
|
2
|
2
|
—
|
—
|
$6,070.79
|
$6,070.79
|
$6,070.79
|
2025-07-01
|
|
59
|
MS_DRG
|
Multiple Sclerosis And Cerebellar Ataxia With Cc
|
1
|
1
|
—
|
—
|
$6,030.36
|
$6,030.36
|
$6,030.36
|
2025-07-01
|
|
439
|
MS_DRG
|
Disorders Of Pancreas Except Malignancy With Cc
|
5
|
4
|
—
|
—
|
$5,920.40
|
$5,920.40
|
$5,920.40
|
2025-07-01
|
|
390
|
MS_DRG
|
Gastrointestinal Obstruction Without Cc/Mcc
|
4
|
4
|
—
|
—
|
$5,903.82
|
$5,903.82
|
$5,903.82
|
2025-07-01
|
|
66
|
MS_DRG
|
Intracranial Hemorrhage Or Cerebral Infarction Without Cc/Mcc
|
6
|
4
|
—
|
—
|
$5,883.48
|
$5,883.48
|
$5,883.48
|
2025-07-01
|
|
557
|
MS_DRG
|
Tendonitis, Myositis And Bursitis With Mcc
|
1
|
1
|
—
|
—
|
$5,815.54
|
$5,815.54
|
$5,815.54
|
2025-07-01
|
|
445
|
MS_DRG
|
Disorders Of The Biliary Tract With Cc
|
1
|
1
|
—
|
—
|
$5,764.61
|
$5,764.61
|
$5,764.61
|
2025-07-01
|
|
391
|
MS_DRG
|
Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders With Mcc
|
1
|
1
|
—
|
—
|
$5,699.72
|
$5,699.72
|
$5,699.72
|
2025-07-01
|
|
419
|
MS_DRG
|
Laparoscopic Cholecystectomy Without C.d.e. Without Cc/Mcc
|
2
|
1
|
—
|
—
|
$5,666.81
|
$5,666.81
|
$5,666.81
|
2025-07-01
|
|
304
|
MS_DRG
|
Hypertension With Mcc
|
2
|
2
|
—
|
—
|
$5,666.56
|
$5,666.56
|
$5,666.56
|
2025-07-01
|
|
92
|
MS_DRG
|
Other Disorders Of Nervous System With Cc
|
1
|
1
|
—
|
—
|
$5,653.42
|
$5,653.42
|
$5,653.42
|
2025-07-01
|
|
281
|
MS_DRG
|
Acute Myocardial Infarction, Discharged Alive With Cc
|
3
|
3
|
—
|
—
|
$5,619.13
|
$5,619.13
|
$5,619.13
|
2025-07-01
|
|
5801
|
OTHER
|
Ventilation Initiation And Management
|
1
|
1
|
—
|
—
|
$5,551.52
|
$5,551.52
|
$5,551.52
|
2025-07-01
|
|
5113
|
OTHER
|
Level 3 Musculoskeletal Procedures
|
3
|
3
|
—
|
—
|
$5,503.68
|
$5,503.68
|
$5,503.68
|
2025-07-01
|
|
311
|
MS_DRG
|
Angina Pectoris
|
1
|
1
|
—
|
—
|
$5,421.29
|
$5,421.29
|
$5,421.29
|
2025-07-01
|
|
8011
|
OTHER
|
Comprehensive Observation Services
|
18
|
8
|
—
|
—
|
$5,409.47
|
$5,409.47
|
$5,409.47
|
2025-07-01
|
|
603
|
MS_DRG
|
Cellulitis Without Mcc
|
3
|
3
|
—
|
—
|
$5,391.12
|
$5,391.12
|
$5,391.12
|
2025-07-01
|
|
561
|
MS_DRG
|
Aftercare, Musculoskeletal System And Connective Tissue Without Cc/Mcc
|
5
|
5
|
—
|
—
|
$5,389.29
|
$5,389.29
|
$5,389.29
|
2025-07-01
|
|
194
|
MS_DRG
|
Simple Pneumonia And Pleurisy With Cc
|
4
|
4
|
—
|
—
|
$5,364.73
|
$5,364.73
|
$5,364.73
|
2025-07-01
|
|
536
|
MS_DRG
|
Fractures Of Hip And Pelvis Without Mcc
|
1
|
1
|
—
|
—
|
$5,304.51
|
$5,304.51
|
$5,304.51
|
2025-07-01
|
|
292
|
MS_DRG
|
Heart Failure And Shock With Cc
|
4
|
3
|
—
|
—
|
$5,179.29
|
$5,179.29
|
$5,179.29
|
2025-07-01
|
|
178
|
MS_DRG
|
Respiratory Infections And Inflammations With Cc
|
1
|
1
|
—
|
—
|
$5,077.50
|
$5,077.50
|
$5,077.50
|
2025-07-01
|
|
179
|
MS_DRG
|
Respiratory Infections And Inflammations Without Cc/Mcc
|
1
|
1
|
—
|
—
|
$5,077.50
|
$5,077.50
|
$5,077.50
|
2025-07-01
|
|
313
|
MS_DRG
|
Chest Pain
|
2
|
2
|
—
|
—
|
$4,943.99
|
$4,943.99
|
$4,943.99
|
2025-07-01
|
|
5183
|
OTHER
|
Level 3 Vascular Procedures
|
13
|
7
|
—
|
—
|
$4,930.79
|
$4,930.79
|
$4,930.79
|
2025-07-01
|
|
559
|
MS_DRG
|
Aftercare, Musculoskeletal System And Connective Tissue With Mcc
|
2
|
2
|
—
|
—
|
$4,720.46
|
$4,720.46
|
$4,720.46
|
2025-07-01
|
|
201
|
MS_DRG
|
Pneumothorax Without Cc/Mcc
|
1
|
1
|
—
|
—
|
$4,671.63
|
$4,671.63
|
$4,671.63
|
2025-07-01
|
|
388
|
MS_DRG
|
Gastrointestinal Obstruction With Mcc
|
1
|
1
|
—
|
—
|
$4,663.39
|
$4,663.39
|
$4,663.39
|
2025-07-01
|
|
641
|
MS_DRG
|
Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes Withou…
|
7
|
7
|
—
|
—
|
$4,576.30
|
$4,576.30
|
$4,576.30
|
2025-07-01
|
|
558
|
MS_DRG
|
Tendonitis, Myositis And Bursitis Without Mcc
|
3
|
3
|
—
|
—
|
$4,536.77
|
$4,536.77
|
$4,536.77
|
2025-07-01
|
|
392
|
MS_DRG
|
Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders Without Mcc
|
6
|
4
|
—
|
—
|
$4,535.12
|
$4,535.12
|
$4,535.12
|
2025-07-01
|
|
376
|
MS_DRG
|
Digestive Malignancy Without Cc/Mcc
|
1
|
1
|
—
|
—
|
$4,505.94
|
$4,505.94
|
$4,505.94
|
2025-07-01
|
|
540
|
MS_DRG
|
Osteomyelitis With Cc
|
3
|
3
|
—
|
—
|
$4,251.24
|
$4,251.24
|
$4,251.24
|
2025-07-01
|
|
5415
|
OTHER
|
Level 5 Gynecologic Procedures
|
1
|
1
|
—
|
—
|
$4,250.97
|
$4,250.97
|
$4,250.97
|
2025-07-01
|
|
192
|
MS_DRG
|
Chronic Obstructive Pulmonary Disease Without Cc/Mcc
|
1
|
1
|
—
|
—
|
$4,146.72
|
$4,146.72
|
$4,146.72
|
2025-07-01
|
|
594
|
MS_DRG
|
Skin Ulcers Without Cc/Mcc
|
1
|
1
|
—
|
—
|
$4,145.42
|
$4,145.42
|
$4,145.42
|
2025-07-01
|
|
191
|
MS_DRG
|
Chronic Obstructive Pulmonary Disease With Cc
|
1
|
1
|
—
|
—
|
$4,080.47
|
$4,080.47
|
$4,080.47
|
2025-07-01
|
|
761
|
MS_DRG
|
Menstrual And Other Female Reproductive System Disorders Without Cc/Mcc
|
1
|
1
|
—
|
—
|
$4,044.97
|
$4,044.97
|
$4,044.97
|
2025-07-01
|
|
195
|
MS_DRG
|
Simple Pneumonia And Pleurisy Without Cc/Mcc
|
1
|
1
|
—
|
—
|
$4,038.06
|
$4,038.06
|
$4,038.06
|
2025-07-01
|
|
5791
|
OTHER
|
Pulmonary Treatment
|
1
|
1
|
—
|
—
|
$4,019.37
|
$4,019.37
|
$4,019.37
|
2025-07-01
|
|
622
|
MS_DRG
|
Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor…
|
1
|
1
|
—
|
—
|
$4,015.15
|
$4,015.15
|
$4,015.15
|
2025-07-01
|
|
593
|
MS_DRG
|
Skin Ulcers With Cc
|
2
|
2
|
—
|
—
|
$3,981.73
|
$3,981.73
|
$3,981.73
|
2025-07-01
|
|
684
|
MS_DRG
|
Renal Failure Without Cc/Mcc
|
2
|
2
|
—
|
—
|
$3,970.36
|
$3,970.36
|
$3,970.36
|
2025-07-01
|
|
312
|
MS_DRG
|
Syncope And Collapse
|
2
|
2
|
—
|
—
|
$3,969.86
|
$3,969.86
|
$3,969.86
|
2025-07-01
|
|
699
|
MS_DRG
|
Other Kidney And Urinary Tract Diagnoses With Cc
|
1
|
1
|
—
|
—
|
$3,841.56
|
$3,841.56
|
$3,841.56
|
2025-07-01
|
|
690
|
MS_DRG
|
Kidney And Urinary Tract Infections Without Mcc
|
4
|
4
|
—
|
—
|
$3,807.22
|
$3,807.22
|
$3,807.22
|
2025-07-01
|
|
64
|
MS_DRG
|
Intracranial Hemorrhage Or Cerebral Infarction With Mcc
|
2
|
2
|
—
|
—
|
$3,771.51
|
$3,771.51
|
$3,771.51
|
2025-07-01
|
|
310
|
MS_DRG
|
Cardiac Arrhythmia And Conduction Disorders Without Cc/Mcc
|
3
|
2
|
—
|
—
|
$3,716.72
|
$3,716.72
|
$3,716.72
|
2025-07-01
|
|
8008
|
OTHER
|
MRI And MRA With Contrast Composite
|
10
|
7
|
—
|
—
|
$3,169.87
|
$3,169.87
|
$3,169.87
|
2025-07-01
|
|
379
|
MS_DRG
|
Gastrointestinal Hemorrhage Without Cc/Mcc
|
1
|
1
|
—
|
—
|
$3,120.36
|
$3,120.36
|
$3,120.36
|
2025-07-01
|
|
864
|
MS_DRG
|
Fever And Inflammatory Conditions
|
1
|
1
|
—
|
—
|
$3,069.48
|
$3,069.48
|
$3,069.48
|
2025-07-01
|
|
5374
|
OTHER
|
Level 4 Urology And Related Services
|
6
|
5
|
—
|
—
|
$3,067.05
|
$3,067.05
|
$3,067.05
|
2025-07-01
|
|
5025
|
OTHER
|
Level 5 Type A Ed Visits
|
23
|
10
|
—
|
—
|
$3,015.85
|
$3,015.85
|
$3,015.85
|
2025-07-01
|
|
91
|
MS_DRG
|
Other Disorders Of Nervous System With Mcc
|
1
|
1
|
—
|
—
|
$3,005.99
|
$3,005.99
|
$3,005.99
|
2025-07-01
|
|
2040
|
OTHER
|
Endo, Single, Urinary Tract
|
1
|
1
|
—
|
—
|
$2,899.45
|
$2,899.45
|
$2,899.45
|
2025-07-01
|
|
5112
|
OTHER
|
Level 2 Musculoskeletal Procedures
|
6
|
4
|
—
|
—
|
$2,872.48
|
$2,872.48
|
$2,872.48
|
2025-07-01
|
|
5055
|
OTHER
|
Level 5 Skin Procedures
|
1
|
1
|
—
|
—
|
$2,859.91
|
$2,859.91
|
$2,859.91
|
2025-07-01
|
|
5302
|
OTHER
|
Level 2 Upper Gi Procedures
|
4
|
3
|
—
|
—
|
$2,807.84
|
$2,807.84
|
$2,807.84
|
2025-07-01
|
|
5191
|
OTHER
|
Level 1 Endovascular Procedures
|
1
|
1
|
—
|
—
|
$2,734.67
|
$2,734.67
|
$2,734.67
|
2025-07-01
|
|
5731
|
OTHER
|
Level 1 Minor Procedures
|
4
|
4
|
—
|
—
|
$2,701.39
|
$2,701.39
|
$2,701.39
|
2025-07-01
|
|
5781
|
OTHER
|
Resuscitation And Cardioversion
|
3
|
2
|
—
|
—
|
$2,564.78
|
$2,564.78
|
$2,564.78
|
2025-07-01
|
|
149
|
MS_DRG
|
Dysequilibrium
|
1
|
1
|
—
|
—
|
$2,391.15
|
$2,391.15
|
$2,391.15
|
2025-07-01
|
|
8007
|
OTHER
|
MRI And MRA Without Contrast Composite
|
10
|
6
|
—
|
—
|
$2,310.64
|
$2,310.64
|
$2,310.64
|
2025-07-01
|
|
5594
|
OTHER
|
Level 4 Nuclear Medicine And Related Services
|
1
|
1
|
—
|
—
|
$2,282.51
|
$2,282.51
|
$2,282.51
|
2025-07-01
|
|
949
|
MS_DRG
|
Aftercare With Cc/Mcc
|
1
|
1
|
—
|
—
|
$2,280.36
|
$2,280.36
|
$2,280.36
|
2025-07-01
|
|
897
|
MS_DRG
|
Alcohol, Drug Abuse Or Dependence Without Rehabilitation Therapy Without Mcc
|
3
|
2
|
—
|
—
|
$2,124.60
|
$2,124.60
|
$2,124.60
|
2025-07-01
|
|
916
|
MS_DRG
|
Allergic Reactions Without Mcc
|
1
|
1
|
—
|
—
|
$1,998.96
|
$1,998.96
|
$1,998.96
|
2025-07-01
|
|
5182
|
OTHER
|
Level 2 Vascular Procedures
|
9
|
6
|
—
|
—
|
$1,996.57
|
$1,996.57
|
$1,996.57
|
2025-07-01
|
|
539
|
MS_DRG
|
Osteomyelitis With Mcc
|
1
|
1
|
—
|
—
|
$1,907.01
|
$1,907.01
|
$1,907.01
|
2025-07-01
|
|
5573
|
OTHER
|
Level 3 Imaging With Contrast
|
2
|
1
|
—
|
—
|
$1,790.55
|
$1,790.55
|
$1,790.55
|
2025-07-01
|
|
299
|
MS_DRG
|
Peripheral Vascular Disorders With Mcc
|
1
|
1
|
—
|
—
|
$1,660.41
|
$1,660.41
|
$1,660.41
|
2025-07-01
|
|
5041
|
OTHER
|
Critical Care
|
12
|
7
|
—
|
—
|
$1,620.24
|
$1,620.24
|
$1,620.24
|
2025-07-01
|
|
9290
|
OTHER
|
Inj, Bupivacaine, Nos, 0.5mg
|
2
|
2
|
—
|
—
|
$1,565.56
|
$1,565.56
|
$1,565.56
|
2025-07-01
|
|
5241
|
OTHER
|
Level 1 Blood Product Exchange And Related Services
|
6
|
4
|
—
|
—
|
$1,475.24
|
$1,475.24
|
$1,475.24
|
2025-07-01
|
|
951
|
MS_DRG
|
Other Factors Influencing Health Status
|
1
|
1
|
—
|
—
|
$1,373.82
|
$1,373.82
|
$1,373.82
|
2025-07-01
|
|
5524
|
OTHER
|
Level 4 Imaging Without Contrast
|
24
|
10
|
—
|
—
|
$1,303.81
|
$1,303.81
|
$1,303.81
|
2025-07-01
|
|
5592
|
OTHER
|
Level 2 Nuclear Medicine And Related Services
|
15
|
7
|
—
|
—
|
$1,286.82
|
$1,286.82
|
$1,286.82
|
2025-07-01
|
|
5623
|
OTHER
|
Level 3 Radiation Therapy
|
2
|
2
|
—
|
—
|
$1,226.99
|
$1,226.99
|
$1,226.99
|
2025-07-01
|
|
5024
|
OTHER
|
Level 4 Type A Ed Visits
|
24
|
10
|
—
|
—
|
$1,218.94
|
$1,218.94
|
$1,218.94
|
2025-07-01
|
|
5442
|
OTHER
|
Level 2 Nerve Injections
|
4
|
4
|
—
|
—
|
$1,213.28
|
$1,213.28
|
$1,213.28
|
2025-07-01
|
|
5372
|
OTHER
|
Level 2 Urology And Related Services
|
3
|
3
|
—
|
—
|
$1,209.64
|
$1,209.64
|
$1,209.64
|
2025-07-01
|
|
5722
|
OTHER
|
Level 2 Diagnostic Tests And Related Services
|
15
|
8
|
—
|
—
|
$1,087.32
|
$1,087.32
|
$1,087.32
|
2025-07-01
|
|
5051
|
OTHER
|
Level 1 Skin Procedures
|
11
|
5
|
—
|
—
|
$1,070.26
|
$1,070.26
|
$1,070.26
|
2025-07-01
|
|
918
|
MS_DRG
|
Poisoning And Toxic Effects Of Drugs Without Mcc
|
1
|
1
|
—
|
—
|
$1,049.88
|
$1,049.88
|
$1,049.88
|
2025-07-01
|
|
5673
|
OTHER
|
Level 3 Pathology
|
4
|
4
|
—
|
—
|
$1,029.84
|
$1,029.84
|
$1,029.84
|
2025-07-01
|
|
5693
|
OTHER
|
Level 3 Drug Administration
|
15
|
7
|
—
|
—
|
$1,010.95
|
$1,010.95
|
$1,010.95
|
2025-07-01
|
|
5053
|
OTHER
|
Level 3 Skin Procedures
|
17
|
8
|
—
|
—
|
$797.80
|
$797.80
|
$797.80
|
2025-07-01
|
|
5412
|
OTHER
|
Level 2 Gynecologic Procedures
|
2
|
2
|
—
|
—
|
$761.79
|
$761.79
|
$761.79
|
2025-07-01
|
|
5023
|
OTHER
|
Level 3 Type A Ed Visits
|
24
|
10
|
—
|
—
|
$746.62
|
$746.62
|
$746.62
|
2025-07-01
|
|
5721
|
OTHER
|
Level 1 Diagnostic Tests And Related Services
|
13
|
7
|
—
|
—
|
$732.92
|
$732.92
|
$732.92
|
2025-07-01
|
|
5162
|
OTHER
|
Level 2 ENT Procedures
|
1
|
1
|
—
|
—
|
$715.13
|
$715.13
|
$715.13
|
2025-07-01
|
|
9139
|
OTHER
|
Rabies Vaccine, IM
|
5
|
3
|
—
|
—
|
$582.45
|
$582.45
|
$582.45
|
2025-07-01
|
|
8004
|
OTHER
|
Ultrasound Composite
|
5
|
2
|
—
|
—
|
$553.13
|
$553.13
|
$553.13
|
2025-07-01
|
|
5441
|
OTHER
|
Level 1 Nerve Injections
|
1
|
1
|
—
|
—
|
$544.11
|
$544.11
|
$544.11
|
2025-07-01
|
|
N804
|
OTHER
|
Mammography Services
|
25
|
10
|
—
|
—
|
$486.65
|
$486.65
|
$486.65
|
2025-07-01
|
|
5733
|
OTHER
|
Level 3 Minor Procedures
|
21
|
9
|
—
|
—
|
$442.38
|
$442.38
|
$442.38
|
2025-07-01
|
|
5671
|
OTHER
|
Level 1 Pathology
|
2
|
1
|
—
|
—
|
$416.33
|
$416.33
|
$416.33
|
2025-07-01
|
|
5692
|
OTHER
|
Level 2 Drug Administration
|
5
|
5
|
—
|
—
|
$407.94
|
$407.94
|
$407.94
|
2025-07-01
|
|
5101
|
OTHER
|
Level 1 Strapping And Cast Application
|
13
|
7
|
—
|
—
|
$381.46
|
$381.46
|
$381.46
|
2025-07-01
|
|
5522
|
OTHER
|
Level 2 Imaging Without Contrast
|
25
|
10
|
—
|
—
|
$309.11
|
$309.11
|
$309.11
|
2025-07-01
|
|
5411
|
OTHER
|
Level 1 Gynecologic Procedures
|
1
|
1
|
—
|
—
|
$307.16
|
$307.16
|
$307.16
|
2025-07-01
|
|
5734
|
OTHER
|
Level 4 Minor Procedures
|
13
|
6
|
—
|
—
|
$283.08
|
$283.08
|
$283.08
|
2025-07-01
|
|
5021
|
OTHER
|
Level 1 Type A Ed Visits
|
15
|
7
|
—
|
—
|
$260.75
|
$260.75
|
$260.75
|
2025-07-01
|
|
5371
|
OTHER
|
Level 1 Urology And Related Services
|
2
|
2
|
—
|
—
|
$255.84
|
$255.84
|
$255.84
|
2025-07-01
|
|
5022
|
OTHER
|
Level 2 Type A Ed Visits
|
22
|
9
|
—
|
—
|
$253.88
|
$253.88
|
$253.88
|
2025-07-01
|
|
5741
|
OTHER
|
Level 1 Electronic Analysis Of Devices
|
5
|
4
|
—
|
—
|
$217.45
|
$217.45
|
$217.45
|
2025-07-01
|
|
5521
|
OTHER
|
Level 1 Imaging Without Contrast
|
24
|
10
|
—
|
—
|
$209.96
|
$209.96
|
$209.96
|
2025-07-01
|
|
N801
|
OTHER
|
Therapy Services
|
22
|
10
|
—
|
—
|
$203.24
|
$203.24
|
$203.24
|
2025-07-01
|
|
N700
|
OTHER
|
Non-opps Clinic Services
|
18
|
8
|
—
|
—
|
$149.77
|
$149.77
|
$149.77
|
2025-07-01
|
|
5672
|
OTHER
|
Level 2 Pathology
|
1
|
1
|
—
|
—
|
$148.67
|
$148.67
|
$148.67
|
2025-07-01
|
|
N905
|
OTHER
|
Not Recognized By Opps
|
3
|
2
|
—
|
—
|
$140.57
|
$140.57
|
$140.57
|
2025-07-01
|
|
5732
|
OTHER
|
Level 2 Minor Procedures
|
12
|
7
|
—
|
—
|
$90.60
|
$90.60
|
$90.60
|
2025-07-01
|
|
N902
|
OTHER
|
Packaged Services
|
1
|
1
|
—
|
—
|
$78.69
|
$78.69
|
$78.69
|
2025-07-01
|
|
5373
|
OTHER
|
Level 3 Urology And Related Services
|
0
|
0
|
—
|
—
|
—
|
—
|
—
|
2025-07-01
|
|
L1830
|
HCPCS
|
"Hb Immobilizer Mln Ort2431018 Knee
|
0
|
0
|
—
|
—
|
—
|
—
|
—
|
2025-07-01
|
|
193
|
MS_DRG
|
Simple Pneumonia And Pleurisy With Mcc
|
0
|
0
|
—
|
—
|
—
|
—
|
—
|
2025-07-01
|
|
5312
|
OTHER
|
Level 2 Lower Gi Procedures
|
0
|
0
|
—
|
—
|
—
|
—
|
—
|
2025-07-01
|
|
8005
|
OTHER
|
CT And CTA Without Contrast Composite
|
0
|
0
|
—
|
—
|
—
|
—
|
—
|
2025-07-01
|
|
8006
|
OTHER
|
CT And CTA With Contrast Composite
|
0
|
0
|
—
|
—
|
—
|
—
|
—
|
2025-07-01
|
|
5311
|
OTHER
|
Level 1 Lower Gi Procedures
|
0
|
0
|
—
|
—
|
—
|
—
|
—
|
2025-07-01
|
|
5301
|
OTHER
|
Level 1 Upper Gi Procedures
|
0
|
0
|
—
|
—
|
—
|
—
|
—
|
2025-07-01
|
|
5092
|
OTHER
|
Level 2 Breast/Lymphatic Surgery And Related Procedures
|
0
|
0
|
—
|
—
|
—
|
—
|
—
|
2025-07-01
|
|
40"""" To 42"""" (27.07)"""
|
OTHER
|
"Hb Bra Mln Medmamcomp5 Post Surgical Compression 2Xl
|
0
|
0
|
—
|
$145.27
|
—
|
—
|
—
|
2025-07-01
|
|
5071
|
OTHER
|
Level 1 Excision/ Biopsy/ Incision And Drainage
|
0
|
0
|
—
|
—
|
—
|
—
|
—
|
2025-07-01
|
|
Micro Allig Serr 2 3/4"""" Sklar (63.31"""
|
OTHER
|
"Hb Forcep Mck 275418 Forcep
|
0
|
0
|
—
|
$320.20
|
—
|
—
|
—
|
2025-07-01
|
|
Micro Alligator Serr 23/4"""" (42.50)"""
|
OTHER
|
"Hb Forcep Mck 1084525 Forcep
|
0
|
0
|
—
|
$228.13
|
—
|
—
|
—
|
2025-07-01
|
|
5572
|
OTHER
|
Level 2 Imaging With Contrast
|
0
|
0
|
—
|
—
|
—
|
—
|
—
|
2025-07-01
|
|
N800
|
OTHER
|
Clinical Diagnostic Lab Services
|
0
|
0
|
—
|
—
|
—
|
—
|
—
|
2025-07-01
|
|
5591
|
OTHER
|
Level 1 Nuclear Medicine And Related Services
|
0
|
0
|
—
|
—
|
—
|
—
|
—
|
2025-07-01
|
|
5052
|
OTHER
|
Level 2 Skin Procedures
|
0
|
0
|
—
|
—
|
—
|
—
|
—
|
2025-07-01
|
|
5523
|
OTHER
|
Level 3 Imaging Without Contrast
|
0
|
0
|
—
|
—
|
—
|
—
|
—
|
2025-07-01
|
|
5593
|
OTHER
|
Level 3 Nuclear Medicine And Related Services
|
0
|
0
|
—
|
—
|
—
|
—
|
—
|
2025-07-01
|
|
5571
|
OTHER
|
Level 1 Imaging With Contrast
|
0
|
0
|
—
|
—
|
—
|
—
|
—
|
2025-07-01
|