Price Transparencybeta Hospital negotiated rates

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

GRAND STRAND REGIONAL MEDICAL CENTER

Myrtle Beach, SC · CCN 420085 · Rates published

Your selected procedure

You selected 93458 (CPT)

Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with left heart catheterizat

This hospital’s price: $7,255 across 12 payers · range $2,500-$41,499

Source: https://www.hcadam.com/api/public/content/f2d8d6b1ce904dd3a542034572bc976a?download=true · observed 2024-10-01

This is the facility’s filed rate for this code. The comparison board’s estimate also adds the surgeon and anesthesia fees, so it is usually higher.

36,467 distinct procedures filed
51 distinct payers
975,575 rate rows
2024-10-01 last MRF observed · ⚠ 24 mo old
Data quality

922,264 of 975,575 rate rows are consumer-grade (94.5%)

53,311 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 29,160
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 14,090
per-diem day rate — not a per-procedure price 8,729
percent-of-charges filed in the dollar field — excluded from medians 651
below 25% of the Medicare reference for this DRG — likely a mislabeled per-diem; excluded from rankings 339
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 174
placeholder amount (≤ $0.02) — excluded from medians 135
exceeds 10× this hospital's gross charge — excluded from medians 33

⚠ Possibly outdated The most recent machine-readable file we have for this hospital is 24 months old.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://core.secure.ehc.com/src/util/json-detail-price-list/62-1768105_grand-strand-medical-center_standardcharges.json
Found on page https://mygrandstrandhealth.com/about/legal/pricing-transparency-cms-required-file-of-standard-charges.dot
Discovered viaCMS hospital list
Last fetch not_modified · 2026-10-03
Content fingerprint e956ebffb4055bd3… · 442,374,190 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
J3393
HCPCS 		Injection, Betibeglogene Autotemcel, Per Treatment 1 $4,897,200.00 $4,897,200.00 $4,897,200.00 nat. median
$2,968,000
1.6× median
9138
OTHER 		Inj, Hemgenix, Per Tx Dos 15 $3,672,900.00 $4,407,480.00 $3,746,358.00 nat. median
$3,765,001
1.0× median
773
OTHER 		Inj, Beqvez, Per Tx Dose 18 $3,605,000.00 $4,946,060.00 $3,677,100.00 nat. median
$3,677,100
1.0× median
09138
OTHER 		Inj, Hemgenix, Per Tx Dos 1 $3,562,713.00 $3,562,713.00 $3,562,713.00 nat. median
$3,562,713
1.0× median
00773
OTHER 		Inj, Beqvez, Per Tx Dose 1 $3,496,850.00 $3,496,850.00 $3,496,850.00 nat. median
$3,496,850
1.0× median
714
OTHER 		Inj Delandistrogene Mox R 20 $6,053.43 $4,888,418.85 $3,391,964.10 nat. median
$3,391,964
1.0× median
748
OTHER 		Inj, Lovotibeglogene Auto 20 $9,985.12 $4,830,420.00 $3,351,720.00 nat. median
$3,351,720
1.0× median
00714
OTHER 		Inj Delandistrogene Mox R 1 $3,225,691.35 $3,225,691.35 $3,225,691.35 nat. median
$3,225,691
1.0× median
00748
OTHER 		Inj, Lovotibeglogene Auto 1 $3,187,420.00 $3,187,420.00 $3,187,420.00 nat. median
$3,187,420
1.0× median
746
OTHER 		Inj, Betibeglogene Autote 20 $8,868.77 $4,362,960.00 $3,027,360.00 nat. median
$3,001,835
1.0× median
00746
OTHER 		Inj, Betibeglogene Autote 1 $2,878,960.00 $2,878,960.00 $2,878,960.00 nat. median
$2,878,960
1.0× median
9141
OTHER 		Inj Onase Abepar-xioi Tre 19 $2,388,614.00 $3,511,262.58 $2,436,386.28 nat. median
$2,508,045
1.0× median
09141
OTHER 		Inj Onase Abepar-xioi Tre 1 $2,316,955.58 $2,316,955.58 $2,316,955.58 nat. median
$2,316,956
1.0× median
J3399
HCPCS 		Injection, Onasemnogene Abeparvovec-xioi, Per Treatment, Up To 5x10°15 Vector Ge… 2 $31,607.91 $3,884,946.48 $1,958,277.19 nat. median
$2,455,111
0.8× median
Q2056
HCPCS 		Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige… 2 $492,271.12 $837,683.55 $837,683.55 nat. median
$599,737
1.4× median
Q2055
HCPCS 		Idecabtagene Vicleucel, Up To 510 Million Autologous B-cell Maturation Antigen (… 2 $470,149.30 $830,699.97 $830,699.97 nat. median
$574,037
1.4× median
Q2053
HCPCS 		Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V… 2 $435,956.80 $741,576.00 $741,576.00 nat. median
$513,770
1.4× median
Q2042
HCPCS 		Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka… 4 $502,693.77 $863,696.72 $566,461.89 nat. median
$621,313
0.9× median
9194
OTHER 		Tisagenlecleucel Car-pos 19 $529,192.90 $777,913.56 $539,776.76 nat. median
$555,653
1.0× median
9498
OTHER 		Ciltacabtagene Car-pos T 19 $527,123.40 $774,871.40 $537,665.87 nat. median
$553,480
1.0× median
9422
OTHER 		Idecabtagene Vicleucel Ca 19 $526,587.60 $774,083.77 $537,119.35 nat. median
$552,917
1.0× median
9413
OTHER 		Lisocabtagene Car Pos T 19 $516,726.10 $759,587.37 $527,060.62 nat. median
$542,562
1.0× median
09194
OTHER 		Tisagenlecleucel Car-pos 1 $513,317.11 $513,317.11 $513,317.11 nat. median
$513,317
1.0× median
09498
OTHER 		Ciltacabtagene Car-pos T 1 $511,309.70 $511,309.70 $511,309.70 nat. median
$511,310
1.0× median
09422
OTHER 		Idecabtagene Vicleucel Ca 1 $510,789.97 $510,789.97 $510,789.97 nat. median
$510,790
1.0× median
09413
OTHER 		Lisocabtagene Car Pos T 1 $501,224.32 $501,224.32 $501,224.32 nat. median
$501,224
1.0× median
9035
OTHER 		Axicabtagene Ciloleucel C 19 $489,456.00 $719,500.32 $499,245.12 nat. median
$513,929
1.0× median
09035
OTHER 		Axicabtagene Ciloleucel C 1 $474,772.32 $474,772.32 $474,772.32 nat. median
$474,772
1.0× median
9391
OTHER 		Brexucabtagene Car Pos T 19 $460,530.40 $676,979.69 $469,741.01 nat. median
$483,557
1.0× median
Q2054
HCPCS 		Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi… 3 $459,839.17 $819,043.85 $459,839.17 nat. median
$579,571
0.8× median
09391
OTHER 		Brexucabtagene Car Pos T 1 $446,714.49 $446,714.49 $446,714.49 nat. median
$446,714
1.0× median
Q2041
HCPCS 		Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via… 3 $445,599.57 $807,075.90 $445,599.57 nat. median
$562,501
0.8× median
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 26 $1,988.61 $1,432,271.11 $309,001.04 nat. median
$168,055
1.8× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 26 $1,988.61 $1,069,788.04 $230,975.43 nat. median
$186,516
1.2× median
5834
APR_DRG 		Neonate With Ecmo 3 $221,493.89 $232,568.58 $221,493.89 nat. median
$390,362
0.6× median
001
OTHER 		$9,069.04 1 $205,186.33 $205,186.33 $205,186.33 nat. median
$177,883
1.2× median
5884
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 3 $199,211.45 $209,172.02 $199,211.45 nat. median
$286,698
0.7× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 26 $1,988.61 $901,015.67 $194,646.70 nat. median
$131,925
1.5× median
1614
APR_DRG 		Implantable Heart Assist Systems 3 $183,748.72 $192,936.16 $183,748.72 nat. median
$202,242
0.9× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 28 $1,988.61 $813,940.43 $175,903.49 nat. median
$145,435
1.2× median
018
OTHER 		$9,069.03 1 $169,308.94 $169,308.94 $169,308.94 nat. median
$149,977
1.1× median
34
APR_DRG 		Bone Marrow Transplant 3 $167,492.49 $175,867.12 $167,492.49 nat. median
$187,752
0.9× median
24
APR_DRG 		Heart And/or Lung Transplant 3 $166,241.10 $174,553.15 $166,241.10 nat. median
$225,531
0.7× median
5833
APR_DRG 		Neonate With Ecmo 3 $159,293.58 $167,258.26 $159,293.58 nat. median
$268,208
0.6× median
8414
APR_DRG 		Extensive Third Degree Burns With Skin Graft 3 $146,336.41 $153,653.23 $146,336.41 nat. median
$173,018
0.8× median
5832
APR_DRG 		Neonate With Ecmo 3 $144,811.93 $152,052.52 $144,811.93 nat. median
$201,678
0.7× median
429019
CDM 		Tavr Cardio Bypass Supp 22 $39,253.50 $261,690.00 $143,929.50 nat. median
$136,864
1.1× median
1907
OTHER 		New Technology - Level 52 19 $139,315.30 $204,793.49 $142,101.61 nat. median
$149,948
0.9× median
1908
OTHER 		New Technology - Level 52 19 $139,315.30 $204,793.49 $142,101.61 nat. median
$149,948
0.9× median
14
APR_DRG 		Liver Transplant And/or Intestinal Transplant 3 $141,348.28 $148,415.70 $141,348.28 nat. median
$136,566
1.0× median

Other procedures at this hospital

Browse this hospital's 36,467 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
             
J3393 HCPCS Injection, Betibeglogene Autotemcel, Per Treatment 2 1 — — $4,897,200.00 $4,897,200.00 $4,897,200.00 2024-10-01
9138 OTHER Inj, Hemgenix, Per Tx Dos 22 15 — — $3,672,900.00 $4,407,480.00 $3,746,358.00 2024-10-01
773 OTHER Inj, Beqvez, Per Tx Dose 25 18 — — $3,605,000.00 $4,946,060.00 $3,677,100.00 2024-10-01
09138 OTHER Inj, Hemgenix, Per Tx Dos 1 1 — — $3,562,713.00 $3,562,713.00 $3,562,713.00 2024-10-01
00773 OTHER Inj, Beqvez, Per Tx Dose 1 1 — — $3,496,850.00 $3,496,850.00 $3,496,850.00 2024-10-01
714 OTHER Inj Delandistrogene Mox R 27 20 — — $6,053.43 $4,888,418.85 $3,391,964.10 2024-10-01
748 OTHER Inj, Lovotibeglogene Auto 27 20 — — $9,985.12 $4,830,420.00 $3,351,720.00 2024-10-01
00714 OTHER Inj Delandistrogene Mox R 1 1 — — $3,225,691.35 $3,225,691.35 $3,225,691.35 2024-10-01
00748 OTHER Inj, Lovotibeglogene Auto 1 1 — — $3,187,420.00 $3,187,420.00 $3,187,420.00 2024-10-01
746 OTHER Inj, Betibeglogene Autote 27 20 — — $8,868.77 $4,362,960.00 $3,027,360.00 2024-10-01
00746 OTHER Inj, Betibeglogene Autote 1 1 — — $2,878,960.00 $2,878,960.00 $2,878,960.00 2024-10-01
9141 OTHER Inj Onase Abepar-xioi Tre 26 19 — — $2,388,614.00 $3,511,262.58 $2,436,386.28 2024-10-01
09141 OTHER Inj Onase Abepar-xioi Tre 1 1 — — $2,316,955.58 $2,316,955.58 $2,316,955.58 2024-10-01
J3399 HCPCS Injection, Onasemnogene Abeparvovec-xioi, Per Treatment, Up To 5x10°15 Vector Ge… 4 2 — — $31,607.91 $3,884,946.48 $1,958,277.19 2024-10-01
Q2056 HCPCS Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige… 3 2 — — $492,271.12 $837,683.55 $837,683.55 2024-10-01
Q2055 HCPCS Idecabtagene Vicleucel, Up To 510 Million Autologous B-cell Maturation Antigen (… 3 2 — — $470,149.30 $830,699.97 $830,699.97 2024-10-01
Q2053 HCPCS Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V… 3 2 — — $435,956.80 $741,576.00 $741,576.00 2024-10-01
Q2042 HCPCS Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka… 9 4 — — $502,693.77 $863,696.72 $566,461.89 2024-10-01
9194 OTHER Tisagenlecleucel Car-pos 26 19 — — $529,192.90 $777,913.56 $539,776.76 2024-10-01
9498 OTHER Ciltacabtagene Car-pos T 26 19 — — $527,123.40 $774,871.40 $537,665.87 2024-10-01
9422 OTHER Idecabtagene Vicleucel Ca 26 19 — — $526,587.60 $774,083.77 $537,119.35 2024-10-01
9413 OTHER Lisocabtagene Car Pos T 26 19 — — $516,726.10 $759,587.37 $527,060.62 2024-10-01
09194 OTHER Tisagenlecleucel Car-pos 1 1 — — $513,317.11 $513,317.11 $513,317.11 2024-10-01
09498 OTHER Ciltacabtagene Car-pos T 1 1 — — $511,309.70 $511,309.70 $511,309.70 2024-10-01
09422 OTHER Idecabtagene Vicleucel Ca 1 1 — — $510,789.97 $510,789.97 $510,789.97 2024-10-01
09413 OTHER Lisocabtagene Car Pos T 1 1 — — $501,224.32 $501,224.32 $501,224.32 2024-10-01
9035 OTHER Axicabtagene Ciloleucel C 26 19 — — $489,456.00 $719,500.32 $499,245.12 2024-10-01
09035 OTHER Axicabtagene Ciloleucel C 1 1 — — $474,772.32 $474,772.32 $474,772.32 2024-10-01
9391 OTHER Brexucabtagene Car Pos T 26 19 — — $460,530.40 $676,979.69 $469,741.01 2024-10-01
Q2054 HCPCS Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi… 7 3 — — $459,839.17 $819,043.85 $459,839.17 2024-10-01
09391 OTHER Brexucabtagene Car Pos T 1 1 — — $446,714.49 $446,714.49 $446,714.49 2024-10-01
Q2041 HCPCS Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via… 7 3 — — $445,599.57 $807,075.90 $445,599.57 2024-10-01
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 43 26 — — $1,988.61 $1,432,271.11 $309,001.04 2024-10-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 46 26 — — $1,988.61 $1,069,788.04 $230,975.43 2024-10-01
5834 APR_DRG Neonate With Ecmo 3 3 — — $221,493.89 $232,568.58 $221,493.89 2024-10-01
001 OTHER $9,069.04 1 1 — — $205,186.33 $205,186.33 $205,186.33 2024-10-01
5884 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 3 3 — — $199,211.45 $209,172.02 $199,211.45 2024-10-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 46 26 — — $1,988.61 $901,015.67 $194,646.70 2024-10-01
1614 APR_DRG Implantable Heart Assist Systems 3 3 — — $183,748.72 $192,936.16 $183,748.72 2024-10-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 51 28 — — $1,988.61 $813,940.43 $175,903.49 2024-10-01
018 OTHER $9,069.03 1 1 — — $169,308.94 $169,308.94 $169,308.94 2024-10-01
34 APR_DRG Bone Marrow Transplant 3 3 — — $167,492.49 $175,867.12 $167,492.49 2024-10-01
24 APR_DRG Heart And/or Lung Transplant 3 3 — — $166,241.10 $174,553.15 $166,241.10 2024-10-01
5833 APR_DRG Neonate With Ecmo 3 3 — — $159,293.58 $167,258.26 $159,293.58 2024-10-01
8414 APR_DRG Extensive Third Degree Burns With Skin Graft 3 3 — — $146,336.41 $153,653.23 $146,336.41 2024-10-01
5832 APR_DRG Neonate With Ecmo 3 3 — — $144,811.93 $152,052.52 $144,811.93 2024-10-01
429019 CDM Tavr Cardio Bypass Supp 31 22 $261,690.00 $261,690.00 $39,253.50 $261,690.00 $143,929.50 2024-10-01
1908 OTHER New Technology - Level 52 26 19 — — $139,315.30 $204,793.49 $142,101.61 2024-10-01
1907 OTHER New Technology - Level 52 26 19 — — $139,315.30 $204,793.49 $142,101.61 2024-10-01
14 APR_DRG Liver Transplant And/or Intestinal Transplant 3 3 — — $141,348.28 $148,415.70 $141,348.28 2024-10-01
003 OTHER $9,069.04 1 1 — — $137,433.87 $137,433.87 $137,433.87 2024-10-01
01908 OTHER New Technology - Level 52 1 1 — — $135,135.84 $135,135.84 $135,135.84 2024-10-01
01907 OTHER New Technology - Level 52 1 1 — — $135,135.84 $135,135.84 $135,135.84 2024-10-01
5883 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 3 3 — — $131,395.02 $137,964.77 $131,395.02 2024-10-01
44 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 3 3 — — $130,196.95 $136,706.80 $130,196.95 2024-10-01
64 APR_DRG Pancreas Transplant 3 3 — — $128,488.58 $134,913.01 $128,488.58 2024-10-01
1905 OTHER New Technology - Level 51 26 19 — — $125,612.20 $184,649.93 $128,124.44 2024-10-01
1906 OTHER New Technology - Level 51 26 19 — — $125,612.20 $184,649.93 $128,124.44 2024-10-01
01905 OTHER New Technology - Level 51 1 1 — — $121,843.83 $121,843.83 $121,843.83 2024-10-01
01906 OTHER New Technology - Level 51 1 1 — — $121,843.83 $121,843.83 $121,843.83 2024-10-01
5914 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 3 3 — — $121,633.01 $127,714.66 $121,633.01 2024-10-01
J7330 HCPCS Autologous Cultured Chondrocytes, Implant 2 1 — — $120,116.70 $120,116.70 $120,116.70 2024-10-01
429021 CDM Tavr/tavi Transaortic 31 22 $217,934.00 $217,934.00 $32,690.10 $217,934.00 $119,863.70 2024-10-01
428992 CDM Tavr/tavi/trans Exposure 31 22 $217,873.00 $217,873.00 $32,680.95 $217,873.00 $119,830.15 2024-10-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 51 28 — — $1,988.61 $697,622.00 $116,213.09 2024-10-01
1903 OTHER New Technology - Level 50 26 19 — — $111,909.10 $164,506.38 $114,147.28 2024-10-01
1904 OTHER New Technology - Level 50 26 19 — — $111,909.10 $164,506.38 $114,147.28 2024-10-01
5934 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 3 3 — — $112,592.78 $118,222.42 $112,592.78 2024-10-01
23 APR_DRG Heart And/or Lung Transplant 3 3 — — $110,842.11 $116,384.21 $110,842.11 2024-10-01
930559 CDM Device Embl 25mm 3.50mm 21 17 $132,888.00 $132,888.00 $19,933.20 $132,888.00 $109,632.60 2024-10-01
6094 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 3 3 — — $109,540.14 $115,017.15 $109,540.14 2024-10-01
01903 OTHER New Technology - Level 50 1 1 — — $108,551.83 $108,551.83 $108,551.83 2024-10-01
01904 OTHER New Technology - Level 50 1 1 — — $108,551.83 $108,551.83 $108,551.83 2024-10-01
14 MS_DRG Allogeneic Bone Marrow Transplant 43 26 — — $1,988.61 $497,585.28 $107,807.06 2024-10-01
7 MS_DRG Lung Transplant 43 26 — — $1,988.61 $496,331.91 $107,537.27 2024-10-01
5891 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational 3 3 — — $106,168.44 $111,476.86 $106,168.44 2024-10-01
422028 CDM Insert Biv Gener Icd 31 22 $188,249.00 $188,249.00 $28,237.35 $188,249.00 $103,536.95 2024-10-01
6304 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 3 3 — — $103,045.92 $108,198.22 $103,045.92 2024-10-01
C1882 HCPCS Aicd Itrevia Hf-t Df-1 209 15 $149,233.25 $149,233.25 $39,650.06 $180,551.06 $102,821.71 2024-10-01
Q0480 HCPCS Driver For Use With Pneumatic Ventricular Assist Device, Replacement Only 31 21 — — $96,999.90 $146,999.85 $101,999.90 2024-10-01
429022 CDM Tavr/tavi Perc Fem Aprch 31 22 $183,845.00 $183,845.00 $27,576.75 $183,845.00 $101,114.75 2024-10-01
429018 CDM Tavr/tavi Op Axl Art Apr 31 22 $183,845.00 $183,845.00 $27,576.75 $183,845.00 $101,114.75 2024-10-01
432907 CDM Tmvi W/prosth Valve 31 22 $183,845.00 $183,845.00 $27,576.75 $183,845.00 $101,114.75 2024-10-01
429020 CDM Tavr/tavi Opn Ili Art 31 22 $183,845.00 $183,845.00 $27,576.75 $183,845.00 $101,114.75 2024-10-01
428541 CDM Tavr Pros Valve Faa 31 22 $183,845.00 $183,845.00 $27,576.75 $183,845.00 $101,114.75 2024-10-01
C2624 HCPCS Sensor Artery Impl Systm 33 23 $199,332.00 $199,332.00 $30,298.46 $189,365.40 $100,861.99 2024-10-01
930557 CDM Device Embl 3.25x16mm Pl 21 17 $121,497.50 $121,497.50 $18,224.63 $121,497.50 $100,235.44 2024-10-01
930556 CDM Device Embl 20x3mm Pipel 21 17 $121,497.50 $121,497.50 $18,224.63 $121,497.50 $100,235.44 2024-10-01
1901 OTHER New Technology - Level 49 26 19 — — $98,206.01 $144,362.83 $100,170.13 2024-10-01
1902 OTHER New Technology - Level 49 26 19 — — $98,206.01 $144,362.83 $100,170.13 2024-10-01
3034 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 3 3 — — $97,227.52 $102,088.89 $97,227.52 2024-10-01
004 OTHER $9,069.04 1 1 — — $96,633.05 $96,633.05 $96,633.05 2024-10-01
5892 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational 3 3 — — $96,517.69 $101,343.57 $96,517.69 2024-10-01
6024 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 3 3 — — $96,297.93 $101,112.83 $96,297.93 2024-10-01
01902 OTHER New Technology - Level 49 1 1 — — $95,259.83 $95,259.83 $95,259.83 2024-10-01
01901 OTHER New Technology - Level 49 1 1 — — $95,259.83 $95,259.83 $95,259.83 2024-10-01
33 APR_DRG Bone Marrow Transplant 3 3 — — $93,200.24 $97,860.25 $93,200.24 2024-10-01
K1007 HCPCS Bilateral Hip, Knee, Ankle, Foot Device, Powered, Includes Pelvic Component, Sin… 27 20 — — $88,300.94 $133,816.89 $92,852.54 2024-10-01
5831 APR_DRG Neonate With Ecmo 3 3 — — $91,707.94 $96,293.33 $91,707.94 2024-10-01
4404 APR_DRG Kidney Transplant 3 3 — — $91,184.76 $95,744.00 $91,184.76 2024-10-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 46 26 — — $1,988.61 $418,539.23 $90,792.11 2024-10-01
014 OTHER $9,069.04 1 1 — — $89,788.73 $89,788.73 $89,788.73 2024-10-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 46 28 — — $2,020.00 $413,730.83 $89,757.08 2024-10-01
1604 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 3 3 — — $89,490.18 $93,964.68 $89,490.18 2024-10-01
1624 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 3 3 — — $89,174.80 $93,633.54 $89,174.80 2024-10-01
22 APR_DRG Heart And/or Lung Transplant 3 3 — — $88,886.08 $93,330.39 $88,886.08 2024-10-01
6314 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 3 3 — — $88,567.03 $92,995.38 $88,567.03 2024-10-01
1585 OTHER New Technology - Level 48 26 19 — — $86,786.76 $127,576.54 $88,522.50 2024-10-01
1599 OTHER New Technology - Level 48 26 19 — — $86,786.76 $127,576.54 $88,522.50 2024-10-01
54 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 3 3 — — $88,192.80 $92,602.44 $88,192.80 2024-10-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 40 26 — — $2,020.00 $404,444.48 $87,758.17 2024-10-01
5893 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational 3 3 — — $87,744.10 $92,131.31 $87,744.10 2024-10-01
651 OTHER $15,384.00 1 1 — — $87,441.09 $87,441.09 $87,441.09 2024-10-01
8424 APR_DRG Burns With Skin Graft Except Extensive Third Degree Burns 3 3 — — $87,398.38 $91,768.30 $87,398.38 2024-10-01
215 MS_DRG Other Heart Assist System Implant 48 28 — — $1,988.61 $402,378.31 $87,313.42 2024-10-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 45 27 — — $2,020.00 $398,101.65 $86,392.86 2024-10-01
43 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 3 3 — — $85,031.67 $89,283.25 $85,031.67 2024-10-01
01585 OTHER New Technology - Level 48 1 1 — — $84,183.16 $84,183.16 $84,183.16 2024-10-01
01599 OTHER New Technology - Level 48 1 1 — — $84,183.16 $84,183.16 $84,183.16 2024-10-01
63 APR_DRG Pancreas Transplant 3 3 — — $83,656.14 $87,838.95 $83,656.14 2024-10-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 46 28 — — $56,861.50 $366,531.84 $83,499.18 2024-10-01
965753 CDM Occluder Cardiac Lt 16mm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
939549 CDM Valve Tavr 29mm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
936296 CDM Device Embl 10mm 3mm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
927422 CDM Graft Endo Aortc 3 Piece 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
965808 CDM Occluder Cardiac Lt 34mm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
936297 CDM Device Embl 12mm 3mm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
952486 CDM Valve Aor Tavr 34mm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
934624 CDM Implant Cranial Med 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
927440 CDM Valve Heart Xt 29mm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
936277 CDM Dev Embl 16x5mm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
965754 CDM Occluder Cardiac Lt 18mm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
927423 CDM Graft Endo Aortc 4 Piece 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
927439 CDM Valve Xt Sapien 26mm Ta 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
932522 CDM Kit Aor Vlv 14fr 29mm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
965755 CDM Occluder Cardiac Lt 20mm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
965758 CDM Occluder Cardiac Lt 28mm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
967172 CDM Device Embl 2.5mm 18mm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
967456 CDM Valve Aortic 29mm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
953244 CDM Valve Aor With Intro 27mm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
939548 CDM Valve Tavr 26mm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
975895 CDM Valve Tavr 26mm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
C1822 HCPCS Pulse Gen Imp 19 15 $99,999.00 $99,999.00 $43,799.56 $94,999.05 $82,499.18 2024-10-01
963522 CDM Device Embl 4.25mm 12mm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
954278 CDM Valve Aor Cndt 23mm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
967171 CDM Device Embl 3.5mm 18mm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
930523 CDM Dev Embl 20x4.25mm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
966993 CDM Valve Tavr Sz 23mm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
932521 CDM Valve 26mm Thv 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
972241 CDM Valve Tavr 29mm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
933595 CDM Device Embl Flx 4.5x14mm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
936578 CDM Valve Tavr 34mm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
975910 CDM Valve Tavr 29mm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
967619 CDM Valve Aortic 23mm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
966990 CDM Valve Tavr Size 34mm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
967167 CDM Device Embl 5mm 18mm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
932520 CDM Valve 23mm Thv 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
930522 CDM Device Embl Pipln 14x4mm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
936312 CDM Device Embl 14x3.5mm Pl 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
936298 CDM Dev Embl 16x3mm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
936282 CDM Dev Embl 18x3.5mm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
973222 CDM Valve Tavr 20mm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
934198 CDM Valve Aor Thv 14fr 20mm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
927441 CDM Valve Novaflx+ Trnfml 23 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
927421 CDM Graft Endo Aortc 2 Piece 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
936290 CDM Device Embl 18mm 2.5mm P 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
975108 CDM Valve Aor 23mm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
966992 CDM Valve Tavr Sz 26mm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
952484 CDM Valve Aor Tavr 26mm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
973904 CDM Valve Tavr 23mm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
967168 CDM Device Embl 3.75mm 25mm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
927443 CDM Valve Xt Sapien Nf 29mm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
952485 CDM Valve Aor Tavr 29mm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
973770 CDM Valve Aortic 20mm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
967169 CDM Device Embl 5mm 10mm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
975110 CDM Valve Aor 27mm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
936314 CDM Device Embl 35mm 3.5mm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
939547 CDM Valve Tavr 23mm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
973903 CDM Valve Tavr 26mm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
937574 CDM Strattice Reconst 20x30 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
975111 CDM Valve Aor 29mm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
953242 CDM Valve Aor With Intro 23mm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
965759 CDM Occluder Cardiac Lt 31mm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
936278 CDM Device Embl 5x35mm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
930525 CDM Device Embl Pl 4.75x20mm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
975509 CDM Pump Pain Infn 148gm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
936275 CDM Device Embl 5x18mm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
975109 CDM Valve Aor 25mm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
936319 CDM Device Embl 35mm 3.75mm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
966967 CDM Device Embl 3mm 10mm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
967170 CDM Device Embl 4mm 10mm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
966991 CDM Valve Tavr Sz 29mm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
975693 CDM Valve Aor 35mm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
951702 CDM Stent Thor 40x40mm 20cm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
927424 CDM Graft Endo Aortc Unl Pcs 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
949343 CDM Kit Impl Crnl Cstm Lg 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
927438 CDM Valve Xt Sapien 23mm Ta 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
936281 CDM Dev Embl 16x4.75mm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
953243 CDM Valve Aor With Intro 25mm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
965757 CDM Occluder Cardiac Lt 25mm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
927442 CDM Vlv 26mm Sapn Xt Trnscth 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
965756 CDM Occluder Cardiac Lt 22mm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
953864 CDM Valve Aor Tavr 23mm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
930521 CDM Device Embl Pipln 16x3.5 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
930553 CDM Device Embl 12mm 2.5mm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
933727 CDM Device Embl Flx 14x5mm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
968036 CDM Device Embl 3.75mm 18mm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
933726 CDM Device Embl 16x4.25mm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
930555 CDM Dev Embl Pipeln 14x3mm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
930526 CDM Device Embl 5x20mm Pipln 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
934585 CDM Implant Cust Cranial Lge 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
936320 CDM Device Embl 10mm 4mm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
936341 CDM Device Embl 10mm 5mm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
936336 CDM Device Embl Pl 4.75x14mm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
930558 CDM Device Embl 25mm 3.25mm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
956332 CDM Stent 20fr 31x31mm 10cm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
930554 CDM Device Embl 20mm 2.5mm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
956298 CDM Valve Aortic 25mm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
936324 CDM Device Embl 4.25mmx12mm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
966058 CDM Device Embl 3mm 18mm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
964953 CDM Device Embl 5mm 35mm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
964929 CDM Device Embl 3mm 12mm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
957464 CDM Graft Evas 40x40x10cm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
957467 CDM Graft Stnt 15cm 37mm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
964938 CDM Device Embl 4.75mm 16mm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
969591 CDM Device Embl 4.50x25mm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
955975 CDM Stnt Thorac 26x26mm 10cm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
976244 CDM Valve Tavr 23mm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
936627 CDM Valve Tavr 29mm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
936629 CDM Valve Tavr 23mm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
964952 CDM Device Embl 5mm 30mm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
975023 CDM Pump Pain Infn 20ml 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
930560 CDM Device Embl16x3.75mm Pip 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
957470 CDM Stent Gft Thor Act 37x37 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
964922 CDM Device Embl 3.25mm 16mm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
963331 CDM Valve Aortic 27mm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
957468 CDM Stent 34mmx34mmx15cm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
964944 CDM Device Embl 4mm 20mm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
957473 CDM Stent Thor 37x37mm 20cm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
957465 CDM Graft Evas 45x45mm 10cm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
964931 CDM Device Embl 4.25mm 20mm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
957449 CDM Stnt Thorac 28x28mm 10cm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
957463 CDM Graft Evas 34x34x10cm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
964886 CDM Device Embl 2.5mm 12mm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
936303 CDM Device Embl 10mm 3.25mm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
930561 CDM Device Embl 25mm 3.75mm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
934210 CDM Kit Implant Crnmxf Lg 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
964951 CDM Device Embl 5mm 25mm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
957471 CDM Stent Graft 15cm 31x31mm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
969594 CDM Device Embl 3.75mm 14mm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
964937 CDM Device Embl 4.75mm 14mm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
964926 CDM Device Embl 3.75mm 12mm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
957451 CDM Stent Thor 31x26mm 10cm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
964924 CDM Device Embl 3.5mm 14mm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
942982 CDM Kit Implant Crnmxf Med 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
964885 CDM Device Embl 2.5mm 14mm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
964920 CDM Device Embl 3.25mm 12mm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
955592 CDM Valve Heart Trnscth 23mm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
957474 CDM Stent Thor Act Cntrl 40x 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
955702 CDM Valve Heart Trnscth 26mm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
936628 CDM Valve Tavr 26mm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
930562 CDM Device Embl 25x4mm Pline 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
957447 CDM Stent Graft 10cm 21x21mm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
964939 CDM Device Embl 4.75mm 20mm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
962465 CDM Valve Aortic 21mm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
969592 CDM Device Emb 5mm 14mm 21 17 $99,999.00 $99,999.00 $14,999.85 $99,999.00 $82,499.18 2024-10-01
13 APR_DRG Liver Transplant And/or Intestinal Transplant 3 3 — — $81,277.47 $85,341.34 $81,277.47 2024-10-01
5913 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 3 3 — — $81,172.65 $85,231.28 $81,172.65 2024-10-01
1634 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis 3 3 — — $81,123.00 $85,179.15 $81,123.00 2024-10-01
964574 CDM Graft Evas 10cm 14.5mm 21 17 $97,720.25 $97,720.25 $14,658.04 $97,720.25 $80,619.21 2024-10-01
926928 CDM Graft Evas 14.5mm 18cm 21 17 $97,720.25 $97,720.25 $14,658.04 $97,720.25 $80,619.21 2024-10-01
934525 CDM Graft Evas 10cm 12mm 21 17 $97,720.25 $97,720.25 $14,658.04 $97,720.25 $80,619.21 2024-10-01
934934 CDM Graft Evas 10cm 10mm 21 17 $97,720.25 $97,720.25 $14,658.04 $97,720.25 $80,619.21 2024-10-01
1584 OTHER New Technology - Level 47 26 19 — — $77,651.36 $114,147.50 $79,204.39 2024-10-01
1598 OTHER New Technology - Level 47 26 19 — — $77,651.36 $114,147.50 $79,204.39 2024-10-01
926910 CDM Graft Evas 23x14.5m14cm 21 17 $94,872.75 $94,872.75 $14,230.91 $94,872.75 $78,270.02 2024-10-01
924971 CDM Graft Evas 31x14.5m 15cm 21 17 $94,872.75 $94,872.75 $14,230.91 $94,872.75 $78,270.02 2024-10-01
926926 CDM Graft Evas 14.5mm 14cm 21 17 $94,872.75 $94,872.75 $14,230.91 $94,872.75 $78,270.02 2024-10-01
925916 CDM Graft Evas 31x14.5m 13cm 21 17 $94,872.75 $94,872.75 $14,230.91 $94,872.75 $78,270.02 2024-10-01
926917 CDM Graft Evas 26x14.5m 12cm 21 17 $94,872.75 $94,872.75 $14,230.91 $94,872.75 $78,270.02 2024-10-01
924093 CDM Graft Evas 31x14.5m 17cm 21 17 $94,872.75 $94,872.75 $14,230.91 $94,872.75 $78,270.02 2024-10-01
900556 CDM Graft Evas 35x14.5m 16cm 21 17 $94,872.75 $94,872.75 $14,230.91 $94,872.75 $78,270.02 2024-10-01
937985 CDM Occluder Cv 35x18mm 21 17 $94,872.75 $94,872.75 $14,230.91 $94,872.75 $78,270.02 2024-10-01
937984 CDM Occluder Cv 18x18mm 21 17 $94,872.75 $94,872.75 $14,230.91 $94,872.75 $78,270.02 2024-10-01
937986 CDM Occluder Cv 25x18mm 21 17 $94,872.75 $94,872.75 $14,230.91 $94,872.75 $78,270.02 2024-10-01
62 APR_DRG Pancreas Transplant 3 3 — — $78,003.24 $81,903.40 $78,003.24 2024-10-01
C1772 HCPCS Pump Infs Pain 40ml 19 15 $93,971.00 $93,971.00 $41,159.30 $89,272.45 $77,526.07 2024-10-01
007 OTHER $9,069.04 1 1 — — $77,471.33 $77,471.33 $77,471.33 2024-10-01
002 OTHER $9,069.04 1 1 — — $77,330.79 $77,330.79 $77,330.79 2024-10-01
1613 APR_DRG Implantable Heart Assist Systems 3 3 — — $77,299.84 $81,164.84 $77,299.84 2024-10-01
A9699 HCPCS Radiopharmaceutical, Therapeutic, Not Otherwise Classified 2 1 — — $76,785.37 $76,785.37 $76,785.37 2024-10-01
C1721 HCPCS Icd Defib Card 7.68cm 266 15 $97,082.12 $97,082.12 $838.55 $144,278.40 $76,661.60 2024-10-01
C1722 HCPCS Defib Card .99cm Mini Sm 266 15 $95,088.75 $95,088.75 $34,868.96 $162,313.20 $76,139.60 2024-10-01
5933 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 3 3 — — $76,132.12 $79,938.72 $76,132.12 2024-10-01
850 MS_DRG Acute Leukemia With Other Procedures 45 27 — — $2,020.00 $349,854.39 $76,007.47 2024-10-01
G0448 HCPCS Insertion Or Replacement Of A Permanent Pacing Cardioverter-defibrillator System… 10 4 — — $8,000.00 $133,194.00 $75,445.50 2024-10-01
01584 OTHER New Technology - Level 47 1 1 — — $75,321.82 $75,321.82 $75,321.82 2024-10-01
01598 OTHER New Technology - Level 47 1 1 — — $75,321.82 $75,321.82 $75,321.82 2024-10-01
3044 APR_DRG Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back 3 3 — — $75,085.76 $78,840.05 $75,085.76 2024-10-01
21 APR_DRG Heart And/or Lung Transplant 3 3 — — $75,030.59 $78,782.12 $75,030.59 2024-10-01
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