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

EAST COOPER MEDICAL CENTER

Mount Pleasant, SC · CCN 420089 · Rates published

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You selected 93350 (CPT)

STRESS TTE ONLY

This hospital’s price: $529 across 13 payers · range $50-$1,891

Source: https://www2.novanthealth.org/Public_Files/regulatory/934555562_east-cooper-medical-center-llc-dba-east-cooper-medical-center_standardcharges.json · observed 2026-03-12

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.

24,748 distinct procedures filed
33 distinct payers
1,979,401 rate rows
2026-03-12 last MRF observed
Data quality

1,061,382 of 1,979,401 rate rows are consumer-grade (53.6%)

918,019 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 803,772
template filing: same amount across many unrelated codes — excluded 91,002
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 14,618
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 4,315
per-diem day rate — not a per-procedure price 1,892
placeholder amount (≤ $0.02) — excluded from medians 1,564
below 25% of the Medicare reference for this DRG — likely a mislabeled per-diem; excluded from rankings 832
exceeds 10× this hospital's gross charge — excluded from medians 24
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://www2.novanthealth.org/Public_Files/regulatory/934555562_EastCooperMedicalCenter_standardcharges.json
Found on page https://www.novanthealth.org/for-patients/billing--insurance/price-transparency/
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-10-20
Content fingerprint 98044a8049223980… · 474,086,093 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
J3391
HCPCS 		Injection, Atidarsagene Autotemcel, Per Treatment 9 $4,101,171.80 $4,306,230.39 $4,162,689.38 nat. median
$4,505,000
0.9× median
J1414
HCPCS 		Injection, Fidanacogene Elaparvovec-dzkt, Per Therapeutic Dose 1 $3,710,000.00 $3,710,000.00 $3,710,000.00 nat. median
$3,710,000
1.0× median
J1411
HCPCS 		Injection, Etranacogene Dezaparvovec-drlb, Per Therapeutic Dose 10 $34.60 $4,864,633.09 $3,438,792.35 nat. median
$3,705,478
0.9× median
J3392
HCPCS 		Injection, Exagamglogene Autotemcel, Per Treatment 14 $2,122,959.52 $4,054,852.68 $3,088,906.10 nat. median
$2,401,965
1.3× median
J3394
HCPCS 		Injection, Lovotibeglogene Autotemcel, Per Treatment 9 $2,957,255.05 $4,879,470.83 $3,045,972.70 nat. median
$3,286,000
0.9× median
J3393
HCPCS 		Injection, Betibeglogene Autotemcel, Per Treatment 9 $2,681,683.87 $4,424,778.39 $2,762,134.39 nat. median
$2,994,107
0.9× median
J3399
HCPCS 		Injection, Onasemnogene Abeparvovec-xioi, Per Treatment, Up To 5x10^15 Vector Ge… 10 $34.60 $4,268,915.88 $2,279,735.18 nat. median
$2,467,386
0.9× median
Q2057
HCPCS 		Afamitresgene Autoleucel, Including Leukapheresis And Dose Preparation Procedure… 9 $7,342.70 $1,339,944.49 $708,557.04 nat. median
$813,967
0.9× median
Q2042
HCPCS 		Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka… 15 $34.60 $1,028,886.17 $578,771.00 nat. median
$739,258
0.8× median
Q2054
HCPCS 		Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi… 15 $34.60 $978,134.44 $535,157.32 nat. median
$640,950
0.8× median
Q2055
HCPCS 		Idecabtagene Vicleucel, Up To 460 Million Autologous B-cell Maturation Antigen (… 15 $34.60 $969,057.50 $530,520.19 nat. median
$622,450
0.9× median
Q2056
HCPCS 		Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige… 10 $34.60 $983,925.92 $515,144.46 nat. median
$646,415
0.8× median
Q2041
HCPCS 		Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via… 15 $34.60 $927,174.01 $507,275.83 nat. median
$608,239
0.8× median
Q2053
HCPCS 		Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V… 15 $34.60 $850,796.78 $489,399.00 nat. median
$591,721
0.8× median
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell Immunotherapy 12 $12.90 $1,430,430.25 $323,539.97 nat. median
$359,454
0.9× median
Q2058
HCPCS 		Obecabtagene Autoleucel, 10 Up To 400 Million Cd19 Car-positive Viable T Cells,… 9 $5,254.90 $483,817.65 $255,840.75 nat. median
$319,951
0.8× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 13 $30.00 $928,291.69 $210,998.73 nat. median
$249,036
0.8× median
Q0480
HCPCS 		Driver For Use With Pneumatic Ventricular Assist Device, Replacement Only 16 $34.60 $212,969.99 $162,236.30 nat. median
$111,503
1.5× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 13 $26.00 $707,235.31 $160,753.08 nat. median
$198,418
0.8× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 14 $26.70 $703,084.75 $159,026.29 nat. median
$190,559
0.8× median
K1007
HCPCS 		Bilateral Hip, Knee, Ankle, Foot Device, Powered, Includes Pelvic Component, Sin… 14 $34.60 $181,604.77 $138,342.90 nat. median
$96,983
1.4× median
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 14 $26.00 $458,827.63 $103,779.32 nat. median
$126,695
0.8× median
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 14 $17,633.00 $324,055.25 $101,274.53 nat. median
$90,551
1.1× median
7
MS_DRG 		Lung Transplant 13 $18.50 $428,975.38 $97,505.20 nat. median
$117,974
0.8× median
231
MS_DRG 		Coronary Bypass With Ptca With Mcc 14 $17,633.00 $279,240.44 $90,228.03 nat. median
$77,028
1.2× median
14
MS_DRG 		Allogeneic Bone Marrow Transplant 12 $25.60 $398,092.94 $90,042.12 nat. median
$110,307
0.8× median
426
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 10 $81,354.20 $365,077.25 $85,421.91 nat. median
$93,276
0.9× median
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 13 $9.60 $375,365.88 $85,319.87 nat. median
$104,013
0.8× median
5834
APR_DRG 		Neonate With Ecmo, Severe 4 $80,554.54 $822,310.92 $82,568.48 nat. median
$307,206
outlier · 0.3×
212
MS_DRG 		Concomitant Aortic And Mitral Valve�procedures 14 $12.60 $360,204.56 $82,088.40 nat. median
$97,323
0.8× median
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 13 $14.80 $341,535.31 $77,630.25 nat. median
$95,038
0.8× median
456
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 15 $13,783.00 $278,362.63 $77,199.74 nat. median
$77,632
1.0× median
215
MS_DRG 		Other Heart Assist System Implant 14 $5.00 $329,825.63 $74,968.66 nat. median
$93,901
0.8× median
A9543
HCPCS 		Yttrium Y-90 Ibritumomab Tiuxetan, Therapeutic, Per Treatment Dose, Up To 40 Mil… 14 $34.60 $98,805.83 $74,504.35 nat. median
$63,528
1.2× median
233
MS_DRG 		Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 14 $15,117.00 $253,247.25 $72,947.36 nat. median
$71,748
1.0× median
L7181
HCPCS 		Electronic Elbow, Microprocessor Simultaneous Control Of Elbow And Terminal Devi… 15 $34.60 $94,746.41 $72,175.93 nat. median
$50,516
1.4× median
429
MS_DRG 		Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 10 $66,505.35 $298,443.00 $69,830.62 nat. median
$78,049
0.9× median
C1831
HCPCS 		Dvc Spinal Interbody Aprevo 14 $34.60 $219,978.90 $67,215.77 nat. median
$7,520
outlier · 8.9×
850
MS_DRG 		Acute Leukemia With Other Procedures 10 $63,921.05 $286,845.94 $67,117.10 nat. median
$78,268
0.9× median
219
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 15 $13,783.00 $254,343.69 $66,339.51 nat. median
$72,398
0.9× median
C1820
HCPCS 		Imp Nstim Precision Montage 15 $34.60 $317,275.20 $63,974.93 nat. median
$22,986
outlier · 2.8×
J9029
HCPCS 		Injection, Nadofaragene Firadenovec-vncg, Per Therapeutic Dose 14 $34.60 $110,138.77 $63,402.04 nat. median
$68,423
0.9× median
20
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 15 $10.00 $260,654.00 $60,407.79 nat. median
$74,370
0.8× median
620T
OTHER 		Evasc Ven Artlz Tibl/prnl Vn 15 $9,830.00 $78,246.32 $59,606.49 nat. median
$33,425
1.8× median
957
MS_DRG 		Other O.r. Procedures For Multiple Significant Trauma With Mcc 15 $10.00 $252,409.19 $58,497.02 nat. median
$67,976
0.9× median
L7180
HCPCS 		Electronic Elbow, Microprocessor Sequential Control Of Elbow And Terminal Device 15 $34.60 $76,385.85 $58,189.22 nat. median
$46,980
1.2× median
217
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 15 $13,783.00 $217,806.81 $57,709.81 nat. median
$62,031
0.9× median
427
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 10 $53,284.89 $239,116.13 $55,949.13 nat. median
$63,648
0.9× median
C1767
HCPCS 		Gen Nstim Osa Inspire 3028 15 $34.60 $210,900.60 $55,858.74 nat. median
$23,896
outlier · 2.3×
J7330
HCPCS 		Autologous Cultured Chondrocytes, Implant 14 $34.60 $55,272.26 $55,272.26 nat. median
$75,000
0.7× median

Other procedures at this hospital

Browse this hospital's 24,748 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
             
J3391 HCPCS Injection, Atidarsagene Autotemcel, Per Treatment 14 9 — — $4,101,171.80 $4,306,230.39 $4,162,689.38 2026-03-12
J1414 HCPCS Injection, Fidanacogene Elaparvovec-dzkt, Per Therapeutic Dose 3 1 — — $3,710,000.00 $3,710,000.00 $3,710,000.00 2026-03-12
J1411 HCPCS Injection, Etranacogene Dezaparvovec-drlb, Per Therapeutic Dose 24 10 — — $34.60 $4,864,633.09 $3,438,792.35 2026-03-12
J3392 HCPCS Injection, Exagamglogene Autotemcel, Per Treatment 42 14 — — $2,122,959.52 $4,054,852.68 $3,088,906.10 2026-03-12
J3394 HCPCS Injection, Lovotibeglogene Autotemcel, Per Treatment 19 9 — — $2,957,255.05 $4,879,470.83 $3,045,972.70 2026-03-12
J3393 HCPCS Injection, Betibeglogene Autotemcel, Per Treatment 19 9 — — $2,681,683.87 $4,424,778.39 $2,762,134.39 2026-03-12
J3399 HCPCS Injection, Onasemnogene Abeparvovec-xioi, Per Treatment, Up To 5x10^15 Vector Ge… 30 10 — — $34.60 $4,268,915.88 $2,279,735.18 2026-03-12
Q2057 HCPCS Afamitresgene Autoleucel, Including Leukapheresis And Dose Preparation Procedure… 21 9 — — $7,342.70 $1,339,944.49 $708,557.04 2026-03-12
Q2042 HCPCS Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka… 48 15 — — $34.60 $1,028,886.17 $578,771.00 2026-03-12
Q2054 HCPCS Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi… 48 15 — — $34.60 $978,134.44 $535,157.32 2026-03-12
Q2055 HCPCS Idecabtagene Vicleucel, Up To 460 Million Autologous B-cell Maturation Antigen (… 48 15 — — $34.60 $969,057.50 $530,520.19 2026-03-12
Q2056 HCPCS Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige… 30 10 — — $34.60 $983,925.92 $515,144.46 2026-03-12
Q2041 HCPCS Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via… 48 15 — — $34.60 $927,174.01 $507,275.83 2026-03-12
Q2053 HCPCS Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V… 48 15 — — $34.60 $850,796.78 $489,399.00 2026-03-12
18 MS_DRG Chimeric Antigen Receptor (car) T-cell Immunotherapy 38 12 — — $12.90 $1,430,430.25 $323,539.97 2026-03-12
Q2058 HCPCS Obecabtagene Autoleucel, 10 Up To 400 Million Cd19 Car-positive Viable T Cells, … 21 9 — — $5,254.90 $483,817.65 $255,840.75 2026-03-12
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 39 13 — — $30.00 $928,291.69 $210,998.73 2026-03-12
Q0480 HCPCS Driver For Use With Pneumatic Ventricular Assist Device, Replacement Only 46 16 — — $34.60 $212,969.99 $162,236.30 2026-03-12
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 39 13 — — $26.00 $707,235.31 $160,753.08 2026-03-12
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 40 14 — $11,788.78 $26.70 $703,084.75 $159,026.29 2026-03-12
K1007 HCPCS Bilateral Hip, Knee, Ankle, Foot Device, Powered, Includes Pelvic Component, Sin… 40 14 — — $34.60 $181,604.77 $138,342.90 2026-03-12
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 40 14 — $7,118.38 $26.00 $458,827.63 $103,779.32 2026-03-12
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 39 14 — $146,796.18 $17,633.00 $324,055.25 $101,274.53 2026-03-12
7 MS_DRG Lung Transplant 39 13 — — $18.50 $428,975.38 $97,505.20 2026-03-12
231 MS_DRG Coronary Bypass With Ptca With Mcc 39 14 — $122,813.54 $17,633.00 $279,240.44 $90,228.03 2026-03-12
14 MS_DRG Allogeneic Bone Marrow Transplant 38 12 — — $25.60 $398,092.94 $90,042.12 2026-03-12
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 27 10 — $162,178.97 $81,354.20 $365,077.25 $85,421.91 2026-03-12
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 39 13 — — $9.60 $375,365.88 $85,319.87 2026-03-12
5834 APR_DRG Neonate With Ecmo, Severe 4 4 — — $80,554.54 $822,310.92 $82,568.48 2026-03-12
212 MS_DRG Concomitant Aortic And Mitral Valve�procedures 46 14 — $176,224.13 $12.60 $360,204.56 $82,088.40 2026-03-12
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 39 13 — — $14.80 $341,535.31 $77,630.25 2026-03-12
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 42 15 — $113,120.54 $13,783.00 $278,362.63 $77,199.74 2026-03-12
215 MS_DRG Other Heart Assist System Implant 39 14 — $128,686.42 $5.00 $329,825.63 $74,968.66 2026-03-12
A9543 HCPCS Yttrium Y-90 Ibritumomab Tiuxetan, Therapeutic, Per Treatment Dose, Up To 40 Mil… 48 14 — $84,429.31 $34.60 $98,805.83 $74,504.35 2026-03-12
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 40 14 — $112,537.88 $15,117.00 $253,247.25 $72,947.36 2026-03-12
L7181 HCPCS Electronic Elbow, Microprocessor Simultaneous Control Of Elbow And Terminal Devi… 42 15 — — $34.60 $94,746.41 $72,175.93 2026-03-12
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 27 10 — $104,154.52 $66,505.35 $298,443.00 $69,830.62 2026-03-12
C1831 HCPCS Dvc Spinal Interbody Aprevo 28 14 $209,552.00 $157,164.00 25% off $34.60 $219,978.90 $67,215.77 2026-03-12
850 MS_DRG Acute Leukemia With Other Procedures 27 10 — $105,857.25 $63,921.05 $286,845.94 $67,117.10 2026-03-12
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 42 15 — $108,591.76 $13,783.00 $254,343.69 $66,339.51 2026-03-12
C1820 HCPCS Imp Nstim Precision Montage 228 15 $235,052.00 $226,677.00 $34.60 $317,275.20 $63,974.93 2026-03-12
J9029 HCPCS Injection, Nadofaragene Firadenovec-vncg, Per Therapeutic Dose 44 14 — $88,088.18 $34.60 $110,138.77 $63,402.04 2026-03-12
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 47 15 — $122,398.90 $10.00 $260,654.00 $60,407.79 2026-03-12
620T OTHER Evasc Ven Artlz Tibl/prnl Vn 43 15 — — $9,830.00 $78,246.32 $59,606.49 2026-03-12
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 47 15 — $115,884.12 $10.00 $252,409.19 $58,497.02 2026-03-12
L7180 HCPCS Electronic Elbow, Microprocessor Sequential Control Of Elbow And Terminal Device 42 15 — — $34.60 $76,385.85 $58,189.22 2026-03-12
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 42 15 — $98,094.24 $13,783.00 $217,806.81 $57,709.81 2026-03-12
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 27 10 — $92,133.04 $53,284.89 $239,116.13 $55,949.13 2026-03-12
C1767 HCPCS Gen Nstim Osa Inspire 3028 172 15 $200,966.00 $129,222.00 36% off $34.60 $210,900.60 $55,858.74 2026-03-12
J7330 HCPCS Autologous Cultured Chondrocytes, Implant 30 14 — — $34.60 $55,272.26 $55,272.26 2026-03-12
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 41 14 — $112,923.45 $13,783.00 $236,194.50 $55,265.52 2026-03-12
232 MS_DRG Coronary Bypass With Ptca Without Mcc 42 15 — $96,988.16 $13,783.00 $200,823.63 $54,992.51 2026-03-12
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 42 15 — $118,644.47 $13,783.00 $217,806.81 $54,861.93 2026-03-12
C1826 HCPCS Sys Gen Nstim Evoke Rechg 33 15 $153,818.00 $115,363.50 25% off $34.60 $161,471.70 $53,823.90 2026-03-12
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 40 14 — $5,078.06 $12.60 $237,595.69 $53,740.26 2026-03-12
10 MS_DRG Pancreas Transplant 39 13 — — $9.50 $237,695.06 $53,497.90 2026-03-12
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 38 12 — — $11.60 $236,333.63 $53,454.81 2026-03-12
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 41 14 — $216,106.50 $13,783.00 $227,830.44 $53,308.48 2026-03-12
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 47 15 — $75,696.95 $13.50 $228,953.38 $53,061.02 2026-03-12
Q2043 HCPCS Sipuleucel-t, Minimum Of 50 Million Autologous Cd54+ Cells Activated With Pap-gm… 56 17 — $58,002.43 $34.60 $96,106.83 $52,497.78 2026-03-12
5884 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure, Severe 4 4 — — $50,913.49 $519,731.33 $52,186.38 2026-03-12
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 27 10 — $114,415.10 $49,320.97 $221,328.00 $51,787.02 2026-03-12
955 MS_DRG Craniotomy For Multiple Significant Trauma 47 15 — $123,322.96 $8.00 $222,967.69 $51,673.81 2026-03-12
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 27 10 — $102,302.08 $39,194.21 $221,490.31 $51,331.43 2026-03-12
L8701 HCPCS Powered Upper Extremity Range Of Motion Assist Device, Elbow, Wrist, Hand With S… 42 15 — — $34.60 $66,792.95 $50,881.54 2026-03-12
C1840 HCPCS Pros Oculr Telescop Mini 25 13 $143,206.00 $107,404.50 25% off $34.60 $150,331.50 $50,110.50 2026-03-12
5833 APR_DRG Neonate With Ecmo, Major 4 4 — — $48,636.75 $496,490.10 $49,852.71 2026-03-12
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 47 15 — $244,730.30 $14.80 $213,149.44 $49,398.39 2026-03-12
33270 CPT Insertion Or Replacement Of Defibrillator With Electrode 55 16 — $65,810.75 $34.60 $92,678.98 $49,217.53 2026-03-12
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 42 15 — $118,212.60 $13,783.00 $217,015.13 $48,769.03 2026-03-12
90288 CPT Botulinum Human Antitoxin For Infusion Into Vein 30 14 — — $34.60 $48,705.00 $48,705.00 2026-03-12
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 42 14 — $65,925.32 $10,590.00 $203,003.25 $47,499.33 2026-03-12
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 47 15 — $131,626.63 $13.00 $202,768.06 $46,992.45 2026-03-12
276 MS_DRG Cardiac Defibrillator Implant With Mcc 41 14 — $83,424.42 $13,783.00 $198,968.63 $46,555.30 2026-03-12
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 43 15 — $172,761.86 $10,590.00 $197,527.69 $46,218.14 2026-03-12
28 MS_DRG Spinal Procedures With Mcc 47 15 — $119,474.25 $10.00 $199,024.94 $46,124.97 2026-03-12
0333 RC Radiology Therapeutic And/of Chemotherapy Administration Radiation Therapy 4 2 — — $300.00 $74,138.00 $45,752.00 2024-12-08
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 43 15 — $99,904.67 $10,590.00 $194,397.38 $45,485.71 2026-03-12
J9226 HCPCS Histrelin Implant (supprelin La), 50 Mg 45 14 — $29,206.15 $34.60 $78,281.35 $45,261.80 2026-03-12
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 47 15 — $50,869.94 $11.90 $194,271.50 $45,023.34 2026-03-12
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 27 10 — $66,243.04 $42,570.48 $191,035.19 $44,699.00 2026-03-12
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 38 12 — — $16.60 $196,421.31 $44,427.29 2026-03-12
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 47 15 — $76,635.01 $7.50 $189,816.19 $43,990.79 2026-03-12
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 37 14 — $152,994.00 $17.90 $123,002.05 $43,872.60 2026-03-12
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 47 15 — $96,854.61 $11.00 $188,795.94 $43,754.35 2026-03-12
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 27 10 — $77,516.00 $41,499.41 $186,228.75 $43,574.38 2026-03-12
L5856 HCPCS Addition To Lower Extremity Prosthesis, Endoskeletal Knee-shin System, Microproc… 42 15 — — $34.60 $56,765.12 $43,242.54 2026-03-12
L6880 HCPCS Electric Hand, Switch Or Myoelectric Controlled, Independently Articulating Digi… 42 15 — — $34.60 $56,497.17 $43,038.42 2026-03-12
L6700 HCPCS Upper Extremity Addition, External Powered Feature, Myoelectronic Control Module… 37 13 — — $29,510.19 $56,364.46 $42,937.32 2026-03-12
915T OTHER Insertion Of Permanent Cardiac Contractility Modulation-defibrillation System Co… 37 13 — — $18,409.00 $55,760.71 $42,477.40 2026-03-12
24 APR_DRG Heart And/Or Lung Transplant, Severe 4 4 — — $41,431.77 $422,940.74 $42,467.60 2026-03-12
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 43 15 — $61,593.63 $10,590.00 $181,210.31 $42,400.16 2026-03-12
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 47 15 — $96,726.45 $7.00 $182,949.38 $42,399.38 2026-03-12
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 43 15 — $83,412.57 $10,590.00 $180,951.94 $42,339.70 2026-03-12
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 39 13 — — $8.70 $185,652.38 $42,198.39 2026-03-12
834 MS_DRG Acute Leukemia Without Major O.r. Procedures With Mcc 47 15 — $76,003.89 $9.90 $207,932.65 $42,145.27 2026-03-12
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 46 14 — $100,435.64 $6.00 $184,380.38 $41,909.27 2026-03-12
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 47 15 — $95,549.29 $11.50 $180,667.06 $41,870.44 2026-03-12
908T OTHER Open Implantation Of Integrated Neurostimulation System, Vagus Nerve, Including … 37 13 — — $4,985.00 $54,817.11 $41,758.58 2026-03-12
674T OTHER Laps Insj Nw/rpcmt Prm Isdss 43 15 — — $15,339.00 $54,817.11 $41,758.58 2026-03-12
909T OTHER Replacement Of Integrated Neurostimulation System, Vagus Nerve, Including Analys… 37 13 — — $4,985.00 $54,817.11 $41,758.58 2026-03-12
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 43 15 — $83,022.70 $10,590.00 $176,649.00 $41,332.88 2026-03-12
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 27 10 — $73,945.74 $39,341.03 $176,543.00 $41,308.08 2026-03-12
64568 CPT Implantation Of Cranial Nerve Neurostimulator Electrodes And Generator 54 19 — $42,199.70 $34.60 $78,246.32 $41,171.50 2026-03-12
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 42 14 — $154,758.75 $10,590.00 $174,777.44 $40,894.97 2026-03-12
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 38 12 — — $16.60 $179,944.94 $40,700.60 2026-03-12
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 47 15 — $85,654.89 $6.00 $175,357.13 $40,639.84 2026-03-12
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 47 15 — $166,220.58 $7.00 $172,428.88 $39,961.20 2026-03-12
653 MS_DRG Major Bladder Procedures With Mcc 36 14 — $62,445.54 $10,590.00 $172,130.75 $39,700.32 2026-03-12
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 43 15 — $70,678.13 $10,590.00 $166,956.63 $39,065.03 2026-03-12
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 43 15 — $101,130.98 $10,590.00 $165,207.63 $38,655.79 2026-03-12
228 MS_DRG Other Cardiothoracic Procedures With Mcc 47 15 — $62,518.77 $6.50 $163,882.63 $37,980.57 2026-03-12
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 47 15 — $234,559.50 $9.90 $163,591.13 $37,913.01 2026-03-12
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 47 15 — $47,177.99 $11.00 $163,031.31 $37,783.27 2026-03-12
C1721 HCPCS Dfb Fortfy Asr Dr235740c 29 14 $107,965.00 $80,973.75 25% off $34.60 $113,337.00 $37,779.00 2026-03-12
471 MS_DRG Cervical Spinal Fusion With Mcc 44 15 — $228,939.93 $10,590.00 $159,950.69 $37,425.76 2026-03-12
408T OTHER Insj/rplc Cardiac Modulj Sys 42 14 — $33,021.13 $18,409.00 $55,760.71 $37,156.86 2026-03-12
571T OTHER Insj/rplcmt Icds Ss Eltrd 43 15 — — $18,409.00 $55,760.71 $37,156.86 2026-03-12
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 47 15 — $88,436.78 $9.00 $162,352.25 $36,902.33 2026-03-12
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 42 14 — $62,695.40 $10,590.00 $157,701.50 $36,899.49 2026-03-12
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 47 15 — $52,909.78 $10.90 $168,614.41 $36,882.01 2026-03-12
956T OTHER Partial Craniectomy, Channel Creation, And Tunneling Of Electrode For Sub-scalp … 42 14 — $42,188.44 $25,236.75 $48,202.19 $36,719.47 2026-03-12
960T OTHER Replacement Of Sub-scalp Implanted Electrode Array, Receiver, And Telemetry Unit… 42 14 — $42,188.44 $25,236.75 $48,202.19 $36,719.47 2026-03-12
6094 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure, Severe 4 4 — — $35,802.61 $365,477.54 $36,697.71 2026-03-12
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 47 15 — $73,824.75 $9.00 $155,415.88 $36,018.36 2026-03-12
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 47 15 — $61,963.04 $8.70 $154,952.13 $35,910.89 2026-03-12
5914 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure, Severe 4 4 — — $35,031.56 $357,606.65 $35,907.38 2026-03-12
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 42 14 — $76,255.91 $10,590.00 $152,987.81 $35,796.57 2026-03-12
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 43 15 — $77,798.78 $10,590.00 $152,259.06 $35,626.05 2026-03-12
1614 APR_DRG Implantable Heart Assist Systems, Severe 4 4 — — $34,449.67 $351,666.64 $35,310.95 2026-03-12
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 38 12 — — $6.00 $155,733.88 $35,224.46 2026-03-12
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 47 15 — $58,252.78 $10.50 $151,871.50 $35,196.94 2026-03-12
799 MS_DRG Splenectomy With Mcc 43 15 — $81,718.45 $10,590.00 $150,019.81 $35,102.10 2026-03-12
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 47 15 — $39,532.99 $9.00 $150,675.69 $34,919.80 2026-03-12
6 MS_DRG Liver Transplant Without Mcc 39 13 — — $7.80 $153,600.63 $34,913.10 2026-03-12
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 47 15 — $55,291.03 $6.60 $150,609.44 $34,904.45 2026-03-12
245 MS_DRG Aicd Generator Procedures 46 15 — $82,323.73 $4.10 $151,129.50 $34,519.81 2026-03-12
C7532 HCPCS Transluminal Balloon Angioplasty (except Lower Extremity Artery(ies) For Occlusi… 37 16 — — $34.60 $39,758.00 $34,442.50 2026-03-12
C7535 HCPCS Revascularization, Endovascular, Open Or Percutaneous, Femoral, Popliteal Artery… 37 16 — — $34.60 $39,758.00 $34,442.50 2026-03-12
C7531 HCPCS Revascularization, Endovascular, Open Or Percutaneous, Femoral, Popliteal Artery… 37 16 — — $34.60 $39,758.00 $34,442.50 2026-03-12
C7533 HCPCS Percutaneous Transluminal Coronary Angioplasty, Single Major Coronary Artery Or … 37 16 — — $34.60 $39,758.00 $34,442.50 2026-03-12
C7534 HCPCS Revascularization, Endovascular, Open Or Percutaneous, Femoral, Popliteal Artery… 37 16 — — $34.60 $39,758.00 $34,442.50 2026-03-12
163 MS_DRG Major Chest Procedures With Mcc 47 15 — $48,143.25 $7.50 $148,459.63 $34,406.22 2026-03-12
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 46 14 — $80,528.37 $7.80 $181,525.26 $34,261.13 2026-03-12
L8614 HCPCS Cochlear Device, Includes All Internal And External Components 36 13 — — $34.60 $44,766.33 $34,043.51 2026-03-12
94 APR_DRG Extracorporeal Membrane Oxygenation (Ecmo), Severe 4 4 — — $33,154.49 $338,445.23 $33,983.38 2026-03-12
C9760 HCPCS Non-randomized, Non-blinded Procedure For Nyha Class Ii, Iii, IV Heart Failure; … 49 15 — $35,323.61 $34.60 $47,817.54 $33,980.77 2026-03-12
5883 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure, Major 4 4 — — $32,958.12 $336,440.66 $33,782.10 2026-03-12
Q0483 HCPCS Monitor/display Module For Use With Electric Ventricular Assist Device, Replacem… 46 16 — — $34.60 $44,335.68 $33,774.04 2026-03-12
31 MS_DRG Ventricular Shunt Procedures With Mcc 47 15 — $50,326.06 $7.00 $148,416.56 $33,734.77 2026-03-12
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 43 15 — $64,282.90 $10,590.00 $118,011.13 $33,732.00 2026-03-12
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 43 15 — $53,533.36 $10,590.00 $105,761.50 $33,732.00 2026-03-12
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 43 15 — $240,353.93 $10,590.00 $138,217.38 $33,732.00 2026-03-12
500 MS_DRG Soft Tissue Procedures With Mcc 43 15 — $38,882.93 $10,590.00 $104,834.00 $33,732.00 2026-03-12
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 43 15 — $69,875.76 $10,590.00 $138,754.00 $33,732.00 2026-03-12
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 47 15 — $47,859.73 $8.00 $145,511.50 $33,732.00 2026-03-12
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 43 15 — $43,604.50 $10,590.00 $123,811.31 $33,732.00 2026-03-12
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 43 15 — $65,421.29 $10,590.00 $120,101.31 $33,732.00 2026-03-12
252 MS_DRG Other Vascular Procedures With Mcc 43 15 — $98,764.55 $10,590.00 $115,549.94 $33,631.66 2026-03-12
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 43 15 — $100,913.30 $10,590.00 $107,275.31 $33,482.52 2026-03-12
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 43 15 — $137,796.75 $10,590.00 $105,566.06 $33,480.29 2026-03-12
L5858 HCPCS Addition To Lower Extremity Prosthesis, Endoskeletal Knee Shin System, Microproc… 42 15 — — $34.60 $43,947.29 $33,478.17 2026-03-12
69930 CPT Implantation Of Cochlear Device 64 19 — $59,042.04 $34.60 $116,169.36 $33,308.06 2026-03-12
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 47 15 — $40,097.79 $10.00 $142,202.31 $33,272.94 2026-03-12
656 MS_DRG Kidney And Ureter Procedures For Neoplasm With Mcc 43 15 — $44,549.03 $10,590.00 $105,463.38 $33,227.18 2026-03-12
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 43 15 — $60,991.59 $10,590.00 $137,568.13 $33,126.43 2026-03-12
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 45 14 — $74,727.65 $4.60 $143,345.13 $32,901.48 2026-03-12
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 27 10 — $68,867.69 $31,303.93 $140,476.50 $32,869.13 2026-03-12
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 42 14 — $60,266.77 $10,590.00 $136,657.19 $32,853.74 2026-03-12
469 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc… 46 17 — $120,590.25 $10,590.00 $100,474.75 $32,732.68 2026-03-12
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 47 15 — $112,673.59 $8.50 $139,655.00 $32,676.91 2026-03-12
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 47 15 — $63,483.77 $6.70 $139,585.44 $32,660.64 2026-03-12
5882 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure, Moderate 4 4 — — $31,786.09 $324,476.43 $32,580.78 2026-03-12
901 MS_DRG Wound Debridements For Injuries With Mcc 47 15 — $83,705.25 $9.00 $139,012.38 $32,526.54 2026-03-12
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 42 14 — $216,106.50 $10,590.00 $139,893.50 $32,420.98 2026-03-12
266T OTHER Implt/rpl Crtd Sns Dev Total 9 3 — $44,601.24 $107.83 $60,686.40 $32,227.75 2026-03-12
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 47 15 — $133,751.36 $8.80 $139,178.00 $31,945.01 2026-03-12
5934 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure, Severe 4 4 — — $30,922.68 $315,662.66 $31,695.78 2026-03-12
140 MS_DRG Major Head And Neck Procedures With Mcc 46 14 — $56,774.06 $7.00 $141,288.06 $31,484.78 2026-03-12
6314 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure, Severe 4 4 — — $30,557.34 $311,933.23 $31,321.31 2026-03-12
5832 APR_DRG Neonate With Ecmo, Moderate 4 4 — — $30,520.66 $311,558.79 $31,283.71 2026-03-12
480 MS_DRG Hip And Femur Procedures Except Major Joint With Mcc 43 15 — $141,650.55 $10,590.00 $96,469.94 $31,171.32 2026-03-12
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 27 10 — $65,149.88 $29,677.76 $133,179.06 $31,161.65 2026-03-12
662 MS_DRG Minor Bladder Procedures With Mcc 43 15 — $55,241.48 $10,590.00 $101,412.19 $31,064.46 2026-03-12
L5973 HCPCS Endoskeletal Ankle Foot System, Microprocessor Controlled Feature, Dorsiflexion … 42 15 — — $34.60 $40,682.89 $30,991.42 2026-03-12
793 MS_DRG Full Term Neonate With Major Problems 34 14 — $7,289.25 $4.70 $86,290.65 $30,932.25 2026-03-12
C1772 HCPCS Imp Pmp Inf Programmable 28 14 $105,952.00 $79,464.00 25% off $34.60 $111,223.80 $30,895.50 2026-03-12
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 47 15 — $71,888.67 $7.70 $131,973.31 $30,879.52 2026-03-12
406 MS_DRG Pancreas, Liver And Shunt Procedures With Cc 43 15 — $42,242.09 $10,590.00 $96,069.13 $30,577.57 2026-03-12
411 MS_DRG Cholecystectomy With C.d.e. With Mcc 43 15 — $59,604.41 $10,590.00 $109,421.81 $30,504.49 2026-03-12
33264 CPT Removal And Replacement Of Defibrillator Pulse Generator, Multiple Wires (leads) 60 19 $107,721.00 $68,114.81 37% off $34.60 $96,948.90 $30,361.85 2026-03-12
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 46 15 — $53,040.10 $4.00 $129,581.69 $30,319.93 2026-03-12
791 MS_DRG Prematurity With Major Problems 37 14 — $37,871.25 $13.00 $84,002.85 $30,261.58 2026-03-12
8414 APR_DRG Extensive Third Degree Burns With Skin Graft, Severe 4 4 — — $29,471.64 $300,850.23 $30,208.46 2026-03-12
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 44 15 — $131,598.93 $10,590.00 $121,621.75 $30,157.25 2026-03-12
C1822 HCPCS Imp Gen Nstim Senza Hf/hfx 32 15 $103,333.33 $77,500.00 25% off $34.60 $108,475.20 $30,132.00 2026-03-12
923T OTHER Removal And Replacement Of Permanent Cardiac Contractility Modulation-defibrilla… 37 13 — — $18,409.00 $40,994.00 $30,101.42 2026-03-12
916T OTHER Insertion Of Permanent Cardiac Contractility Modulation-defibrillation System Co… 37 13 — — $18,409.00 $40,994.00 $30,101.42 2026-03-12
33249 CPT Insertion Or Replacement Of Single Or Dual Chamber Pacing Defibrillator Leads 63 19 $106,663.00 $91,025.78 $278.00 $123,853.13 $30,069.91 2026-03-12
34 MS_DRG Carotid Artery Stent Procedures With Mcc 46 15 — $52,424.05 $4.90 $128,216.94 $30,000.60 2026-03-12
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 47 15 — $57,869.36 $7.00 $127,902.25 $29,926.96 2026-03-12
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 47 15 — $49,034.73 $6.90 $127,176.81 $29,757.23 2026-03-12
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 39 14 — $68,867.69 $2.50 $128,995.38 $29,607.83 2026-03-12
800 MS_DRG Splenectomy With Cc 43 15 — $50,692.24 $10,590.00 $93,061.38 $29,363.61 2026-03-12
0D160JL OTHER Bypass Stomach To Transverse Colon With Synthetic Substitute, Open Approach 2 1 — — $24,808.00 $33,860.00 $29,334.00 2024-12-08
0DL60CZ OTHER Occlusion Of Stomach With Extraluminal Device, Open Approach 2 1 — — $24,808.00 $33,860.00 $29,334.00 2024-12-08
0DL67DZ OTHER Occlusion Of Stomach With Intraluminal Device, Via Natural Or Artificial Opening 2 1 — — $24,808.00 $33,860.00 $29,334.00 2024-12-08
0D16479 OTHER Bypass Stomach To Duodenum With Autologous Tissue Substitute, Percutaneous Endos… 2 1 — — $24,808.00 $33,860.00 $29,334.00 2024-12-08
0DL73CZ OTHER Occlusion Of Stomach, Pylorus With Extraluminal Device, Percutaneous Approach 2 1 — — $24,808.00 $33,860.00 $29,334.00 2024-12-08
0DL63ZZ OTHER Occlusion Of Stomach, Percutaneous Approach 2 1 — — $24,808.00 $33,860.00 $29,334.00 2024-12-08
0D164Z9 OTHER Bypass Stomach To Duodenum, Percutaneous Endoscopic Approach 2 1 — — $24,808.00 $33,860.00 $29,334.00 2024-12-08
0D168KL OTHER Bypass Stomach To Transverse Colon With Nonautologous Tissue Substitute, Via Nat… 2 1 — — $24,808.00 $33,860.00 $29,334.00 2024-12-08
0DL68DZ OTHER Occlusion Of Stomach With Intraluminal Device, Via Natural Or Artificial Opening… 2 1 — — $24,808.00 $33,860.00 $29,334.00 2024-12-08
0DV64ZZ OTHER Restriction Of Stomach, Percutaneous Endoscopic Approach 2 1 — — $24,808.00 $33,860.00 $29,334.00 2024-12-08
0D160JB OTHER Bypass Stomach To Ileum With Synthetic Substitute, Open Approach 2 1 — — $24,808.00 $33,860.00 $29,334.00 2024-12-08
0DB60ZZ OTHER Excision Of Stomach, Open Approach 2 1 — — $24,808.00 $33,860.00 $29,334.00 2024-12-08
0D160ZL OTHER Bypass Stomach To Transverse Colon, Open Approach 2 1 — — $24,808.00 $33,860.00 $29,334.00 2024-12-08
0D164JB OTHER Bypass Stomach To Ileum With Synthetic Substitute, Percutaneous Endoscopic Appro… 2 1 — — $24,808.00 $33,860.00 $29,334.00 2024-12-08
0D164KB OTHER Bypass Stomach To Ileum With Nonautologous Tissue Substitute, Percutaneous Endos… 2 1 — — $24,808.00 $33,860.00 $29,334.00 2024-12-08
0DL64CZ OTHER Occlusion Of Stomach With Extraluminal Device, Percutaneous Endoscopic Approach 2 1 — — $24,808.00 $33,860.00 $29,334.00 2024-12-08
0D168ZL OTHER Bypass Stomach To Transverse Colon, Via Natural Or Artificial Opening Endoscopic 2 1 — — $24,808.00 $33,860.00 $29,334.00 2024-12-08
0DP64CZ OTHER Removal Of Extraluminal Device From Stomach, Percutaneous Endoscopic Approach 2 1 — — $24,808.00 $33,860.00 $29,334.00 2024-12-08
0DV68DZ OTHER Restriction Of Stomach With Intraluminal Device, Via Natural Or Artificial Openi… 2 1 — — $24,808.00 $33,860.00 $29,334.00 2024-12-08
0D164ZL OTHER Bypass Stomach To Transverse Colon, Percutaneous Endoscopic Approach 2 1 — — $24,808.00 $33,860.00 $29,334.00 2024-12-08
0DH67DZ OTHER Insertion Of Intraluminal Device Into Stomach, Via Natural Or Artificial Opening 2 1 — — $24,808.00 $33,860.00 $29,334.00 2024-12-08
0D160ZB OTHER Bypass Stomach To Ileum, Open Approach 2 1 — — $24,808.00 $33,860.00 $29,334.00 2024-12-08
0D164K9 OTHER Bypass Stomach To Duodenum With Nonautologous Tissue Substitute, Percutaneous En… 2 1 — — $24,808.00 $33,860.00 $29,334.00 2024-12-08
0DL68ZZ OTHER Occlusion Of Stomach, Via Natural Or Artificial Opening Endoscopic 2 1 — — $24,808.00 $33,860.00 $29,334.00 2024-12-08
0D160KA OTHER Bypass Stomach To Jejunum With Nonautologous Tissue Substitute, Open Approach 2 1 — — $24,808.00 $33,860.00 $29,334.00 2024-12-08
0D164JL OTHER Bypass Stomach To Transverse Colon With Synthetic Substitute, Percutaneous Endos… 2 1 — — $24,808.00 $33,860.00 $29,334.00 2024-12-08
0D168J9 OTHER Bypass Stomach To Duodenum With Synthetic Substitute, Via Natural Or Artificial … 2 1 — — $24,808.00 $33,860.00 $29,334.00 2024-12-08
0DL74DZ OTHER Occlusion Of Stomach, Pylorus With Intraluminal Device, Percutaneous Endoscopic … 2 1 — — $24,808.00 $33,860.00 $29,334.00 2024-12-08
0DH64DZ OTHER Insertion Of Intraluminal Device Into Stomach, Percutaneous Endoscopic Approach 2 1 — — $24,808.00 $33,860.00 $29,334.00 2024-12-08
0D164KA OTHER Bypass Stomach To Jejunum With Nonautologous Tissue Substitute, Percutaneous End… 2 1 — — $24,808.00 $33,860.00 $29,334.00 2024-12-08
0D168JB OTHER Bypass Stomach To Ileum With Synthetic Substitute, Via Natural Or Artificial Ope… 2 1 — — $24,808.00 $33,860.00 $29,334.00 2024-12-08
0DL77ZZ OTHER Occlusion Of Stomach, Pylorus, Via Natural Or Artificial Opening 2 1 — — $24,808.00 $33,860.00 $29,334.00 2024-12-08
0D160KB OTHER Bypass Stomach To Ileum With Nonautologous Tissue Substitute, Open Approach 2 1 — — $24,808.00 $33,860.00 $29,334.00 2024-12-08
0DQ60ZZ OTHER Repair Stomach, Open Approach 2 1 — — $24,808.00 $33,860.00 $29,334.00 2024-12-08
0D168JA OTHER Bypass Stomach To Jejunum With Synthetic Substitute, Via Natural Or Artificial O… 2 1 — — $24,808.00 $33,860.00 $29,334.00 2024-12-08
0DB67ZZ OTHER Excision Of Stomach, Via Natural Or Artificial Opening 2 1 — — $24,808.00 $33,860.00 $29,334.00 2024-12-08
0DV63DZ OTHER Restriction Of Stomach With Intraluminal Device, Percutaneous Approach 2 1 — — $24,808.00 $33,860.00 $29,334.00 2024-12-08
0DV63ZZ OTHER Restriction Of Stomach, Percutaneous Approach 2 1 — — $24,808.00 $33,860.00 $29,334.00 2024-12-08
0DV67ZZ OTHER Restriction Of Stomach, Via Natural Or Artificial Opening 2 1 — — $24,808.00 $33,860.00 $29,334.00 2024-12-08
0DW64CZ OTHER Revision Of Extraluminal Device In Stomach, Percutaneous Endoscopic Approach 2 1 — — $24,808.00 $33,860.00 $29,334.00 2024-12-08
0D1607L OTHER Bypass Stomach To Transverse Colon With Autologous Tissue Substitute, Open Appro… 2 1 — — $24,808.00 $33,860.00 $29,334.00 2024-12-08
0D164KL OTHER Bypass Stomach To Transverse Colon With Nonautologous Tissue Substitute, Percuta… 2 1 — — $24,808.00 $33,860.00 $29,334.00 2024-12-08
0D168ZB OTHER Bypass Stomach To Ileum, Via Natural Or Artificial Opening Endoscopic 2 1 — — $24,808.00 $33,860.00 $29,334.00 2024-12-08
0DB63Z3 OTHER Excision Of Stomach, Percutaneous Approach, Vertical 2 1 — — $24,808.00 $33,860.00 $29,334.00 2024-12-08
0D160ZA OTHER Bypass Stomach To Jejunum, Open Approach 2 1 — — $24,808.00 $33,860.00 $29,334.00 2024-12-08
0D164JA OTHER Bypass Stomach To Jejunum With Synthetic Substitute, Percutaneous Endoscopic App… 2 1 — — $24,808.00 $33,860.00 $29,334.00 2024-12-08
0D1647B OTHER Bypass Stomach To Ileum With Autologous Tissue Substitute, Percutaneous Endoscop… 2 1 — — $24,808.00 $33,860.00 $29,334.00 2024-12-08
0DL70CZ OTHER Occlusion Of Stomach, Pylorus With Extraluminal Device, Open Approach 2 1 — — $24,808.00 $33,860.00 $29,334.00 2024-12-08
0D164J9 OTHER Bypass Stomach To Duodenum With Synthetic Substitute, Percutaneous Endoscopic Ap… 2 1 — — $24,808.00 $33,860.00 $29,334.00 2024-12-08
0D168K9 OTHER Bypass Stomach To Duodenum With Nonautologous Tissue Substitute, Via Natural Or … 2 1 — — $24,808.00 $33,860.00 $29,334.00 2024-12-08
0D168Z9 OTHER Bypass Stomach To Duodenum, Via Natural Or Artificial Opening Endoscopic 2 1 — — $24,808.00 $33,860.00 $29,334.00 2024-12-08
0DB64Z3 OTHER Excision Of Stomach, Percutaneous Endoscopic Approach, Vertical 2 1 — — $24,808.00 $33,860.00 $29,334.00 2024-12-08
0D1607B OTHER Bypass Stomach To Ileum With Autologous Tissue Substitute, Open Approach 2 1 — — $24,808.00 $33,860.00 $29,334.00 2024-12-08
0D1687B OTHER Bypass Stomach To Ileum With Autologous Tissue Substitute, Via Natural Or Artifi… 2 1 — — $24,808.00 $33,860.00 $29,334.00 2024-12-08
0DQ64ZZ OTHER Repair Stomach, Percutaneous Endoscopic Approach 2 1 — — $24,808.00 $33,860.00 $29,334.00 2024-12-08
0DV60ZZ OTHER Restriction Of Stomach, Open Approach 2 1 — — $24,808.00 $33,860.00 $29,334.00 2024-12-08
0D160K9 OTHER Bypass Stomach To Duodenum With Nonautologous Tissue Substitute, Open Approach 2 1 — — $24,808.00 $33,860.00 $29,334.00 2024-12-08
0DL74ZZ OTHER Occlusion Of Stomach, Pylorus, Percutaneous Endoscopic Approach 2 1 — — $24,808.00 $33,860.00 $29,334.00 2024-12-08
0DL78ZZ OTHER Occlusion Of Stomach, Pylorus, Via Natural Or Artificial Opening Endoscopic 2 1 — — $24,808.00 $33,860.00 $29,334.00 2024-12-08
0DQ67ZZ OTHER Repair Stomach, Via Natural Or Artificial Opening 2 1 — — $24,808.00 $33,860.00 $29,334.00 2024-12-08
0D168ZA OTHER Bypass Stomach To Jejunum, Via Natural Or Artificial Opening Endoscopic 2 1 — — $24,808.00 $33,860.00 $29,334.00 2024-12-08
0DL63DZ OTHER Occlusion Of Stomach With Intraluminal Device, Percutaneous Approach 2 1 — — $24,808.00 $33,860.00 $29,334.00 2024-12-08
0D160J9 OTHER Bypass Stomach To Duodenum With Synthetic Substitute, Open Approach 2 1 — — $24,808.00 $33,860.00 $29,334.00 2024-12-08
0DL78DZ OTHER Occlusion Of Stomach, Pylorus With Intraluminal Device, Via Natural Or Artificia… 2 1 — — $24,808.00 $33,860.00 $29,334.00 2024-12-08
0DV60CZ OTHER Restriction Of Stomach With Extraluminal Device, Open Approach 2 1 — — $24,808.00 $33,860.00 $29,334.00 2024-12-08
0DV64DZ OTHER Restriction Of Stomach With Intraluminal Device, Percutaneous Endoscopic Approac… 2 1 — — $24,808.00 $33,860.00 $29,334.00 2024-12-08
0DV68ZZ OTHER Restriction Of Stomach, Via Natural Or Artificial Opening Endoscopic 2 1 — — $24,808.00 $33,860.00 $29,334.00 2024-12-08
0D16879 OTHER Bypass Stomach To Duodenum With Autologous Tissue Substitute, Via Natural Or Art… 2 1 — — $24,808.00 $33,860.00 $29,334.00 2024-12-08
0D16079 OTHER Bypass Stomach To Duodenum With Autologous Tissue Substitute, Open Approach 2 1 — — $24,808.00 $33,860.00 $29,334.00 2024-12-08
0D164ZB OTHER Bypass Stomach To Ileum, Percutaneous Endoscopic Approach 2 1 — — $24,808.00 $33,860.00 $29,334.00 2024-12-08
0DL60ZZ OTHER Occlusion Of Stomach, Open Approach 2 1 — — $24,808.00 $33,860.00 $29,334.00 2024-12-08
0D1687A OTHER Bypass Stomach To Jejunum With Autologous Tissue Substitute, Via Natural Or Arti… 2 1 — — $24,808.00 $33,860.00 $29,334.00 2024-12-08
0D1647L OTHER Bypass Stomach To Transverse Colon With Autologous Tissue Substitute, Percutaneo… 2 1 — — $24,808.00 $33,860.00 $29,334.00 2024-12-08
0D1607A OTHER Bypass Stomach To Jejunum With Autologous Tissue Substitute, Open Approach 2 1 — — $24,808.00 $33,860.00 $29,334.00 2024-12-08
0D164ZA OTHER Bypass Stomach To Jejunum, Percutaneous Endoscopic Approach 2 1 — — $24,808.00 $33,860.00 $29,334.00 2024-12-08
0DL77DZ OTHER Occlusion Of Stomach, Pylorus With Intraluminal Device, Via Natural Or Artificia… 2 1 — — $24,808.00 $33,860.00 $29,334.00 2024-12-08
0D160JA OTHER Bypass Stomach To Jejunum With Synthetic Substitute, Open Approach 2 1 — — $24,808.00 $33,860.00 $29,334.00 2024-12-08
0DL74CZ OTHER Occlusion Of Stomach, Pylorus With Extraluminal Device, Percutaneous Endoscopic … 2 1 — — $24,808.00 $33,860.00 $29,334.00 2024-12-08
0D160KL OTHER Bypass Stomach To Transverse Colon With Nonautologous Tissue Substitute, Open Ap… 2 1 — — $24,808.00 $33,860.00 $29,334.00 2024-12-08
0D168KA OTHER Bypass Stomach To Jejunum With Nonautologous Tissue Substitute, Via Natural Or A… 2 1 — — $24,808.00 $33,860.00 $29,334.00 2024-12-08
0DL64DZ OTHER Occlusion Of Stomach With Intraluminal Device, Percutaneous Endoscopic Approach 2 1 — — $24,808.00 $33,860.00 $29,334.00 2024-12-08
0DL70ZZ OTHER Occlusion Of Stomach, Pylorus, Open Approach 2 1 — — $24,808.00 $33,860.00 $29,334.00 2024-12-08
0DQ63ZZ OTHER Repair Stomach, Percutaneous Approach 2 1 — — $24,808.00 $33,860.00 $29,334.00 2024-12-08
0DQ68ZZ OTHER Repair Stomach, Via Natural Or Artificial Opening Endoscopic 2 1 — — $24,808.00 $33,860.00 $29,334.00 2024-12-08
0DV63CZ OTHER Restriction Of Stomach With Extraluminal Device, Percutaneous Approach 2 1 — — $24,808.00 $33,860.00 $29,334.00 2024-12-08
0DH63DZ OTHER Insertion Of Intraluminal Device Into Stomach, Percutaneous Approach 2 1 — — $24,808.00 $33,860.00 $29,334.00 2024-12-08
0DL63CZ OTHER Occlusion Of Stomach With Extraluminal Device, Percutaneous Approach 2 1 — — $24,808.00 $33,860.00 $29,334.00 2024-12-08
0DL70DZ OTHER Occlusion Of Stomach, Pylorus With Intraluminal Device, Open Approach 2 1 — — $24,808.00 $33,860.00 $29,334.00 2024-12-08
0DB67Z3 OTHER Excision Of Stomach, Via Natural Or Artificial Opening, Vertical 2 1 — — $24,808.00 $33,860.00 $29,334.00 2024-12-08
0DH68DZ OTHER Insertion Of Intraluminal Device Into Stomach, Via Natural Or Artificial Opening… 2 1 — — $24,808.00 $33,860.00 $29,334.00 2024-12-08
0D168KB OTHER Bypass Stomach To Ileum With Nonautologous Tissue Substitute, Via Natural Or Art… 2 1 — — $24,808.00 $33,860.00 $29,334.00 2024-12-08
0DB63ZZ OTHER Excision Of Stomach, Percutaneous Approach 2 1 — — $24,808.00 $33,860.00 $29,334.00 2024-12-08
0DH60DZ OTHER Insertion Of Intraluminal Device Into Stomach, Open Approach 2 1 — — $24,808.00 $33,860.00 $29,334.00 2024-12-08
0DL73DZ OTHER Occlusion Of Stomach, Pylorus With Intraluminal Device, Percutaneous Approach 2 1 — — $24,808.00 $33,860.00 $29,334.00 2024-12-08
0DL73ZZ OTHER Occlusion Of Stomach, Pylorus, Percutaneous Approach 2 1 — — $24,808.00 $33,860.00 $29,334.00 2024-12-08
0D160Z9 OTHER Bypass Stomach To Duodenum, Open Approach 2 1 — — $24,808.00 $33,860.00 $29,334.00 2024-12-08
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