|
1
|
OTHER
|
Heart Transplant Or Implant Of Heart Assist System With Mcc
|
29
|
24
|
—
|
—
|
$481,216.94
|
$677,273.62
|
$579,245.28
|
2026-05-06
|
|
10
|
OTHER
|
Pancreas Transplant
|
29
|
24
|
—
|
—
|
$85,479.90
|
$291,126.68
|
$188,303.29
|
2026-05-06
|
|
11
|
OTHER
|
Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc
|
49
|
39
|
—
|
—
|
$65,665.05
|
$180,115.88
|
$122,890.46
|
2026-05-06
|
|
114
|
OTHER
|
Orbital Procedures Without Cc/mcc
|
49
|
39
|
—
|
—
|
$21,874.30
|
$108,749.49
|
$65,311.89
|
2026-05-06
|
|
12
|
OTHER
|
Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc
|
49
|
39
|
—
|
—
|
$49,765.64
|
$136,091.66
|
$92,928.65
|
2026-05-06
|
|
13
|
OTHER
|
Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy Without Cc/mcc
|
49
|
39
|
—
|
—
|
$37,841.73
|
$103,321.11
|
$70,581.42
|
2026-05-06
|
|
140
|
OTHER
|
Major Head And Neck Procedures With Mcc
|
49
|
39
|
—
|
—
|
$54,116.89
|
$147,696.34
|
$100,906.62
|
2026-05-06
|
|
143
|
OTHER
|
Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc
|
49
|
39
|
—
|
—
|
$35,650.84
|
$96,908.74
|
$66,279.79
|
2026-05-06
|
|
16
|
OTHER
|
Autologous Bone Marrow Transplant With Cc/mcc
|
46
|
37
|
—
|
—
|
$51,595.58
|
$141,557.60
|
$96,576.59
|
2026-05-06
|
|
163
|
OTHER
|
Major Chest Procedures With Mcc
|
49
|
39
|
—
|
—
|
$83,704.11
|
$368,003.46
|
$225,853.79
|
2026-05-06
|
|
18
|
OTHER
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
47
|
38
|
—
|
—
|
$654,252.67
|
$2,288,048.80
|
$1,471,150.74
|
2026-05-06
|
|
19
|
OTHER
|
Simultaneous Pancreas And Kidney Transplant With Hemodialysis
|
29
|
24
|
—
|
—
|
$9,821.34
|
$154,582.35
|
$82,201.85
|
2026-05-06
|
|
197
|
OTHER
|
Interstitial Lung Disease With Cc
|
49
|
39
|
—
|
—
|
$17,713.61
|
$236,933.53
|
$127,323.57
|
2026-05-06
|
|
198
|
OTHER
|
Interstitial Lung Disease Without Cc/mcc
|
49
|
39
|
—
|
—
|
$13,307.60
|
$119,097.60
|
$66,202.60
|
2026-05-06
|
|
2
|
OTHER
|
Heart Transplant Or Implant Of Heart Assist System Without Mcc
|
29
|
24
|
—
|
—
|
$214,884.15
|
$602,309.54
|
$408,596.84
|
2026-05-06
|
|
20
|
OTHER
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc
|
49
|
39
|
—
|
—
|
$113,008.09
|
$309,746.98
|
$211,377.54
|
2026-05-06
|
|
207
|
OTHER
|
Respiratory System Diagnosis With Ventilator Support >96 Hours
|
49
|
39
|
—
|
—
|
$122,672.27
|
$446,384.20
|
$284,528.23
|
2026-05-06
|
|
21
|
OTHER
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc
|
49
|
39
|
—
|
—
|
$105,018.70
|
$295,555.84
|
$200,287.27
|
2026-05-06
|
|
212
|
OTHER
|
Hip & Femur Procedures Except Major Joint Age 0-17
|
49
|
39
|
—
|
—
|
$44,092.50
|
$259,819.52
|
$151,956.01
|
2026-05-06
|
|
215
|
OTHER
|
Other Heart Assist System Implant
|
49
|
39
|
—
|
—
|
$99,456.19
|
$268,102.88
|
$183,779.54
|
2026-05-06
|
|
216
|
OTHER
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
49
|
39
|
—
|
—
|
$88,953.56
|
$243,046.92
|
$166,000.24
|
2026-05-06
|
|
217
|
OTHER
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
49
|
39
|
—
|
—
|
$48,353.99
|
$154,020.92
|
$101,187.46
|
2026-05-06
|
|
218
|
OTHER
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
49
|
39
|
—
|
—
|
$18,310.56
|
$141,890.81
|
$80,100.68
|
2026-05-06
|
|
219
|
OTHER
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
49
|
39
|
—
|
—
|
$88,565.53
|
$241,945.65
|
$165,255.59
|
2026-05-06
|
|
22
|
OTHER
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/…
|
49
|
39
|
—
|
—
|
$67,077.60
|
$286,082.92
|
$176,580.26
|
2026-05-06
|
|
220
|
OTHER
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
49
|
39
|
—
|
—
|
$33,253.37
|
$126,326.30
|
$79,789.84
|
2026-05-06
|
|
221
|
OTHER
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
49
|
39
|
—
|
—
|
$39,341.61
|
$109,533.51
|
$74,437.56
|
2026-05-06
|
|
228
|
OTHER
|
Other Cardiothoracic Procedures With Mcc
|
49
|
39
|
—
|
—
|
$29,829.26
|
$118,851.70
|
$74,340.48
|
2026-05-06
|
|
23
|
OTHER
|
Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…
|
49
|
39
|
—
|
—
|
$83,918.13
|
$229,530.84
|
$156,724.48
|
2026-05-06
|
|
231
|
OTHER
|
Coronary Bypass With Ptca With Mcc
|
49
|
39
|
—
|
—
|
$91,341.43
|
$250,048.24
|
$170,694.83
|
2026-05-06
|
|
232
|
OTHER
|
Coronary Bypass With Ptca Without Mcc
|
49
|
39
|
—
|
—
|
$57,137.54
|
$155,398.09
|
$106,267.82
|
2026-05-06
|
|
233
|
OTHER
|
Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc
|
49
|
39
|
—
|
—
|
$63,124.92
|
$186,421.14
|
$124,773.03
|
2026-05-06
|
|
234
|
OTHER
|
Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc
|
49
|
39
|
—
|
—
|
$44,546.13
|
$126,886.77
|
$85,716.45
|
2026-05-06
|
|
235
|
OTHER
|
Coronary Bypass Without Cardiac Catheterization With Mcc
|
49
|
39
|
—
|
—
|
$35,682.60
|
$140,338.17
|
$88,010.38
|
2026-05-06
|
|
236
|
OTHER
|
Coronary Bypass Without Cardiac Catheterization Without Mcc
|
49
|
39
|
—
|
—
|
$29,663.65
|
$98,073.58
|
$63,868.61
|
2026-05-06
|
|
239
|
OTHER
|
Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc
|
49
|
39
|
—
|
—
|
$57,183.03
|
$156,738.40
|
$106,960.71
|
2026-05-06
|
|
242
|
OTHER
|
Permanent Cardiac Pacemaker Implant With Mcc
|
49
|
39
|
—
|
—
|
$48,635.55
|
$132,312.54
|
$90,474.04
|
2026-05-06
|
|
245
|
OTHER
|
Aicd Generator Procedures
|
49
|
39
|
—
|
—
|
$29,516.71
|
$116,550.18
|
$73,033.45
|
2026-05-06
|
|
25
|
OTHER
|
Craniotomy And Endovascular Intracranial Procedures With Mcc
|
49
|
39
|
—
|
—
|
$27,304.41
|
$106,664.35
|
$66,984.38
|
2026-05-06
|
|
250
|
OTHER
|
Percutaneous Cardiovascular Procedures Without Coronary Artery Stent With Mcc
|
49
|
39
|
—
|
—
|
$36,771.26
|
$99,427.88
|
$68,099.57
|
2026-05-06
|
|
252
|
OTHER
|
Other Vascular Procedures With Mcc
|
49
|
39
|
—
|
—
|
$36,372.64
|
$98,587.04
|
$67,479.84
|
2026-05-06
|
|
253
|
OTHER
|
Other Vascular Procedures With Cc
|
49
|
39
|
—
|
—
|
$34,990.40
|
$94,601.40
|
$64,795.90
|
2026-05-06
|
|
266
|
OTHER
|
Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc
|
49
|
39
|
—
|
—
|
$56,992.29
|
$149,906.89
|
$103,449.59
|
2026-05-06
|
|
267
|
OTHER
|
Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc
|
49
|
39
|
—
|
—
|
$52,625.50
|
$133,371.04
|
$92,998.27
|
2026-05-06
|
|
268
|
OTHER
|
Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc
|
49
|
39
|
—
|
—
|
$121,725.76
|
$432,603.33
|
$277,164.54
|
2026-05-06
|
|
269
|
OTHER
|
Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc
|
49
|
39
|
—
|
—
|
$63,827.22
|
$167,214.62
|
$115,520.92
|
2026-05-06
|
|
270
|
OTHER
|
Other Major Cardiovascular Procedures With Mcc
|
49
|
39
|
—
|
—
|
$29,228.83
|
$122,422.05
|
$75,825.44
|
2026-05-06
|
|
271
|
OTHER
|
Other Major Cardiovascular Procedures With Cc
|
49
|
39
|
—
|
—
|
$38,593.71
|
$103,686.92
|
$71,140.32
|
2026-05-06
|
|
273
|
OTHER
|
Percutaneous And Other Intracardiac Procedures With Mcc
|
49
|
39
|
—
|
—
|
$35,292.29
|
$93,813.92
|
$64,553.11
|
2026-05-06
|
|
275
|
OTHER
|
Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc
|
49
|
39
|
—
|
—
|
$44,112.31
|
$168,547.95
|
$106,330.13
|
2026-05-06
|
|
276
|
OTHER
|
Non-maligant Breast Disorders
|
49
|
39
|
—
|
—
|
$21,516.97
|
$147,736.44
|
$84,626.71
|
2026-05-06
|
|
277
|
OTHER
|
Cellulitis Age >17 W Cc
|
49
|
39
|
—
|
—
|
$69,054.62
|
$186,329.60
|
$127,692.11
|
2026-05-06
|
|
28
|
OTHER
|
Spinal Procedures With Mcc
|
49
|
39
|
—
|
—
|
$22,972.40
|
$144,996.08
|
$83,984.24
|
2026-05-06
|
|
288
|
OTHER
|
Acute And Subacute Endocarditis With Mcc
|
49
|
39
|
—
|
—
|
$46,046.49
|
$150,178.87
|
$98,112.68
|
2026-05-06
|
|
3
|
OTHER
|
Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…
|
49
|
39
|
—
|
—
|
$187,683.29
|
$516,079.53
|
$351,881.41
|
2026-05-06
|
|
31
|
OTHER
|
Ventricular Shunt Procedures With Mcc
|
49
|
39
|
—
|
—
|
$36,346.55
|
$99,945.81
|
$68,146.18
|
2026-05-06
|
|
314
|
OTHER
|
Other Circulatory System Diagnoses With Mcc
|
49
|
39
|
—
|
—
|
$37,176.37
|
$156,411.64
|
$96,794.01
|
2026-05-06
|
|
319
|
OTHER
|
Other Endovascular Cardiac Valve Procedures With Mcc
|
49
|
39
|
—
|
—
|
$36,561.69
|
$104,768.28
|
$70,664.99
|
2026-05-06
|
|
326
|
OTHER
|
Stomach, Esophageal And Duodenal Procedures With Mcc
|
49
|
39
|
—
|
—
|
$90,192.88
|
$304,865.89
|
$197,529.39
|
2026-05-06
|
|
327
|
OTHER
|
Stomach, Esophageal And Duodenal Procedures With Cc
|
49
|
39
|
—
|
—
|
$44,348.83
|
$172,324.25
|
$108,336.54
|
2026-05-06
|
|
329
|
OTHER
|
Major Small And Large Bowel Procedures With Mcc
|
49
|
39
|
—
|
—
|
$47,428.87
|
$129,654.39
|
$88,541.63
|
2026-05-06
|
|
347
|
OTHER
|
Anal And Stomal Procedures With Mcc
|
49
|
39
|
—
|
—
|
$44,969.20
|
$235,994.58
|
$140,481.89
|
2026-05-06
|
|
356
|
OTHER
|
Other Digestive System O.r. Procedures With Mcc
|
49
|
39
|
—
|
—
|
$75,981.16
|
$264,271.64
|
$170,126.40
|
2026-05-06
|
|
38240
|
CPT
|
Hc Hpc Allogeneic
|
101
|
81
|
$147,856.00
|
$96,106.40
35% off
|
$4,977.46
|
$137,506.08
|
$63,270.20
|
2026-03-01
|
|
385
|
OTHER
|
Inflammatory Bowel Disease With Mcc
|
49
|
39
|
—
|
—
|
$27,825.01
|
$104,566.00
|
$66,195.51
|
2026-05-06
|
|
399
|
OTHER
|
Reticuloendothelial & Immunity Disorders Without Cc
|
49
|
39
|
—
|
—
|
$19,766.43
|
$144,306.11
|
$82,036.27
|
2026-05-06
|
|
4
|
OTHER
|
Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…
|
49
|
39
|
—
|
—
|
$261,042.60
|
$759,369.02
|
$510,205.81
|
2026-05-06
|
|
40
|
OTHER
|
Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc
|
49
|
39
|
—
|
—
|
$61,062.08
|
$167,148.60
|
$114,105.34
|
2026-05-06
|
|
405
|
OTHER
|
Pancreas, Liver And Shunt Procedures With Mcc
|
49
|
39
|
—
|
—
|
$46,276.76
|
$129,474.49
|
$87,875.62
|
2026-05-06
|
|
406
|
OTHER
|
Pancreas, Liver And Shunt Procedures With Cc
|
49
|
39
|
—
|
—
|
$38,312.96
|
$104,069.98
|
$71,191.47
|
2026-05-06
|
|
423
|
OTHER
|
Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc
|
49
|
39
|
—
|
—
|
$38,013.02
|
$103,535.60
|
$70,774.31
|
2026-05-06
|
|
424
|
OTHER
|
Other Hepatobiliary Or Pancreas O.r. Procedures With Cc
|
49
|
39
|
—
|
—
|
$37,854.73
|
$105,028.79
|
$71,441.76
|
2026-05-06
|
|
432
|
OTHER
|
Cirrhosis And Alcoholic Hepatitis With Mcc
|
49
|
39
|
—
|
—
|
$34,024.32
|
$191,792.42
|
$112,908.37
|
2026-05-06
|
|
453
|
OTHER
|
Combined Anterior And Posterior Spinal Fusion With Mcc
|
24
|
22
|
—
|
—
|
$5,600.00
|
$218,924.50
|
$82,240.44
|
2026-05-06
|
|
456
|
OTHER
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
49
|
39
|
—
|
—
|
$95,135.23
|
$260,402.15
|
$177,768.69
|
2026-05-06
|
|
457
|
OTHER
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
49
|
39
|
—
|
—
|
$22,691.65
|
$136,884.69
|
$79,788.17
|
2026-05-06
|
|
458
|
OTHER
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
49
|
39
|
—
|
—
|
$32,960.35
|
$102,984.30
|
$67,972.32
|
2026-05-06
|
|
461
|
OTHER
|
Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc
|
49
|
39
|
—
|
—
|
$109,199.59
|
$299,185.13
|
$204,192.36
|
2026-05-06
|
|
463
|
OTHER
|
Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …
|
49
|
39
|
—
|
—
|
$37,228.07
|
$128,813.85
|
$83,020.96
|
2026-05-06
|
|
466
|
OTHER
|
Revision Of Hip Or Knee Replacement With Mcc
|
49
|
39
|
—
|
—
|
$21,292.35
|
$121,506.21
|
$71,399.28
|
2026-05-06
|
|
468
|
OTHER
|
Revision Of Hip Or Knee Replacement Without Cc/mcc
|
49
|
39
|
—
|
—
|
$35,467.73
|
$92,478.78
|
$63,973.25
|
2026-05-06
|
|
471
|
OTHER
|
Cervical Spinal Fusion With Mcc
|
49
|
39
|
—
|
—
|
$87,351.60
|
$311,469.55
|
$199,410.58
|
2026-05-06
|
|
474
|
OTHER
|
Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc
|
49
|
39
|
—
|
—
|
$19,993.22
|
$106,960.10
|
$63,476.66
|
2026-05-06
|
|
485
|
OTHER
|
Knee Procedures With Principal Diagnosis Of Infection With Mcc
|
49
|
39
|
—
|
—
|
$58,494.86
|
$187,111.74
|
$122,803.30
|
2026-05-06
|
|
495
|
OTHER
|
Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit…
|
49
|
39
|
—
|
—
|
$37,362.45
|
$101,709.13
|
$69,535.79
|
2026-05-06
|
|
499
|
OTHER
|
Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur Without…
|
49
|
39
|
—
|
—
|
$22,055.20
|
$104,737.30
|
$63,396.25
|
2026-05-06
|
|
5
|
OTHER
|
Liver Transplant With Mcc Or Intestinal Transplant
|
29
|
24
|
—
|
—
|
$183,795.30
|
$378,849.96
|
$281,322.63
|
2026-05-06
|
|
500
|
OTHER
|
Soft Tissue Procedures With Mcc
|
49
|
39
|
—
|
—
|
$51,655.43
|
$141,551.58
|
$96,603.51
|
2026-05-06
|
|
503
|
OTHER
|
Foot Procedures With Mcc
|
49
|
39
|
—
|
—
|
$47,625.18
|
$163,349.95
|
$105,487.57
|
2026-05-06
|
|
509
|
OTHER
|
Arthroscopy
|
49
|
39
|
—
|
—
|
$24,259.20
|
$109,002.14
|
$66,630.67
|
2026-05-06
|
|
541-4
|
OTHER
|
Vaginal Delivery With Sterilization And/or D&c
|
8
|
8
|
—
|
—
|
$57,142.51
|
$69,609.96
|
$67,289.63
|
2026-05-06
|
|
570
|
OTHER
|
Skin Debridement With Mcc
|
49
|
39
|
—
|
—
|
$51,892.42
|
$449,415.11
|
$250,653.77
|
2026-05-06
|
|
573
|
OTHER
|
Skin Graft For Skin Ulcer Or Cellulitis With Mcc
|
49
|
39
|
—
|
—
|
$17,841.47
|
$146,873.07
|
$82,357.27
|
2026-05-06
|
|
598
|
OTHER
|
Malignant Breast Disorders With Cc
|
49
|
39
|
—
|
—
|
$20,499.10
|
$144,877.60
|
$82,688.35
|
2026-05-06
|
|
6
|
OTHER
|
Liver Transplant Without Mcc
|
29
|
24
|
—
|
—
|
$85,893.68
|
$490,405.16
|
$288,149.42
|
2026-05-06
|
|
616
|
OTHER
|
Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With…
|
49
|
39
|
—
|
—
|
$37,672.51
|
$102,990.88
|
$70,331.70
|
2026-05-06
|
|
630
|
OTHER
|
Other Endocrine, Nutritional And Metabolic O.r. Procedures Without Cc/mcc
|
49
|
39
|
—
|
—
|
$24,795.50
|
$118,481.36
|
$71,638.43
|
2026-05-06
|
|
650
|
OTHER
|
Kidney Transplant With Hemodialysis With Mcc
|
29
|
24
|
—
|
—
|
$89,842.35
|
$189,318.00
|
$139,580.17
|
2026-05-06
|
|
651
|
OTHER
|
Kidney Transplant With Hemodialysis Without Mcc
|
29
|
24
|
—
|
—
|
$67,713.75
|
$175,317.80
|
$121,515.77
|
2026-05-06
|
|
652
|
OTHER
|
Kidney Transplant
|
29
|
24
|
—
|
—
|
$59,892.30
|
$141,711.22
|
$100,801.76
|
2026-05-06
|
|
653
|
OTHER
|
Major Bladder Procedures With Mcc
|
49
|
39
|
—
|
—
|
$96,134.71
|
$346,102.22
|
$221,118.46
|
2026-05-06
|
|
656
|
OTHER
|
Kidney And Ureter Procedures For Neoplasm With Mcc
|
49
|
39
|
—
|
—
|
$38,822.23
|
$105,321.07
|
$72,071.65
|
2026-05-06
|
|
665
|
OTHER
|
Prostatectomy With Mcc
|
49
|
39
|
—
|
—
|
$34,341.15
|
$93,608.17
|
$63,974.66
|
2026-05-06
|
|
668
|
OTHER
|
Transurethral Procedures With Mcc
|
49
|
39
|
—
|
—
|
$37,306.79
|
$101,917.14
|
$69,611.96
|
2026-05-06
|
|
673
|
OTHER
|
Other Kidney And Urinary Tract Procedures With Mcc
|
49
|
39
|
—
|
—
|
$50,990.57
|
$139,756.90
|
$95,373.74
|
2026-05-06
|
|
675
|
OTHER
|
Other Kidney And Urinary Tract Procedures Without Cc/mcc
|
49
|
39
|
—
|
—
|
$28,173.07
|
$109,020.16
|
$68,596.62
|
2026-05-06
|
|
7
|
OTHER
|
Lung Transplant
|
29
|
24
|
—
|
—
|
$217,826.73
|
$1,730,277.76
|
$974,052.24
|
2026-05-06
|
|
70
|
OTHER
|
Nonspecific Cerebrovascular Disorders With Mcc
|
49
|
39
|
—
|
—
|
$31,777.94
|
$138,654.14
|
$85,216.04
|
2026-05-06
|
|
736
|
OTHER
|
Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc
|
49
|
39
|
—
|
—
|
$40,300.92
|
$109,784.82
|
$75,042.87
|
2026-05-06
|
|
739
|
OTHER
|
Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc…
|
49
|
39
|
—
|
—
|
$31,035.20
|
$94,944.46
|
$62,989.83
|
2026-05-06
|
|
741
|
OTHER
|
Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy Without…
|
49
|
39
|
—
|
—
|
$23,072.97
|
$116,941.76
|
$70,007.37
|
2026-05-06
|
|
745
|
OTHER
|
D&c, Conization, Laparoscopy And Tubal Interruption Without Cc/mcc
|
49
|
39
|
—
|
—
|
$18,395.51
|
$194,587.44
|
$106,491.48
|
2026-05-06
|
|
783
|
OTHER
|
Cesarean Section With Sterilization With Mcc
|
49
|
39
|
—
|
—
|
$13,000.00
|
$149,036.20
|
$81,018.10
|
2026-05-06
|
|
799
|
OTHER
|
Splenectomy With Mcc
|
49
|
39
|
—
|
—
|
$30,141.40
|
$113,401.98
|
$71,771.69
|
2026-05-06
|
|
8
|
OTHER
|
Simultaneous Pancreas And Kidney Transplant
|
29
|
24
|
—
|
—
|
$93,437.27
|
$473,552.32
|
$283,494.79
|
2026-05-06
|
|
800
|
OTHER
|
Splenectomy With Cc
|
49
|
39
|
—
|
—
|
$42,196.69
|
$114,594.32
|
$78,395.51
|
2026-05-06
|
|
802
|
OTHER
|
Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc
|
49
|
39
|
—
|
—
|
$60,924.15
|
$184,119.26
|
$122,521.71
|
2026-05-06
|
|
809
|
OTHER
|
Major Hematological And Immunological Diagnoses Except Sickle Cell Crisis And Co…
|
49
|
39
|
—
|
—
|
$21,387.74
|
$114,298.48
|
$67,843.11
|
2026-05-06
|
|
820
|
OTHER
|
Lymphoma And Leukemia With Major O.r. Procedures With Mcc
|
49
|
39
|
—
|
—
|
$46,784.11
|
$138,861.86
|
$92,822.99
|
2026-05-06
|
|
823
|
OTHER
|
Lymphoma And Non-acute Leukemia With Other Procedures With Mcc
|
49
|
39
|
—
|
—
|
$49,808.00
|
$136,344.24
|
$93,076.12
|
2026-05-06
|
|
826
|
OTHER
|
Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. …
|
49
|
39
|
—
|
—
|
$43,988.65
|
$119,963.66
|
$81,976.15
|
2026-05-06
|
|
834
|
OTHER
|
Acute Leukemia Without Major O.r. Procedures With Mcc
|
49
|
39
|
—
|
—
|
$12,186.20
|
$131,826.11
|
$72,006.15
|
2026-05-06
|
|
837
|
OTHER
|
Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot…
|
49
|
39
|
—
|
—
|
$86,019.76
|
$374,649.90
|
$230,334.83
|
2026-05-06
|
|
841
|
OTHER
|
Lymphoma And Non-acute Leukemia With Cc
|
49
|
39
|
—
|
—
|
$27,942.22
|
$158,810.44
|
$93,376.33
|
2026-05-06
|
|
849
|
OTHER
|
Radiotherapy
|
49
|
39
|
—
|
—
|
$47,793.88
|
$212,886.40
|
$130,340.14
|
2026-05-06
|
|
853
|
OTHER
|
Infectious And Parasitic Diseases With O.r. Procedures With Mcc
|
49
|
39
|
—
|
—
|
$25,077.23
|
$119,281.01
|
$72,179.12
|
2026-05-06
|
|
856
|
OTHER
|
Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc
|
49
|
39
|
—
|
—
|
$19,819.29
|
$107,601.66
|
$63,710.47
|
2026-05-06
|
|
867
|
OTHER
|
Other Infectious And Parasitic Diseases Diagnoses With Mcc
|
49
|
39
|
—
|
—
|
$37,155.06
|
$131,462.90
|
$84,308.98
|
2026-05-06
|
|
870
|
OTHER
|
Septicemia Or Severe Sepsis With Mv >96 Hours
|
49
|
39
|
—
|
—
|
$60,042.95
|
$165,912.52
|
$112,977.74
|
2026-05-06
|
|
876
|
OTHER
|
O.r. Procedures With Principal Diagnosis Of Mental Illness
|
4
|
4
|
—
|
—
|
$51,780.26
|
$93,720.96
|
$75,644.80
|
2026-05-06
|
|
901
|
OTHER
|
Wound Debridements For Injuries With Mcc
|
49
|
39
|
—
|
—
|
$26,424.28
|
$105,667.43
|
$66,045.85
|
2026-05-06
|
|
904
|
OTHER
|
Skin Grafts For Injuries With Cc/mcc
|
49
|
39
|
—
|
—
|
$37,715.63
|
$102,554.56
|
$70,135.10
|
2026-05-06
|
|
908
|
OTHER
|
Other O.r. Procedures For Injuries With Cc
|
49
|
39
|
—
|
—
|
$35,588.81
|
$159,216.24
|
$97,402.52
|
2026-05-06
|
|
927
|
OTHER
|
Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft
|
49
|
39
|
—
|
—
|
$135,877.24
|
$565,788.78
|
$350,833.01
|
2026-05-06
|
|
928
|
OTHER
|
Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc
|
49
|
39
|
—
|
—
|
$17,476.54
|
$159,291.76
|
$88,384.15
|
2026-05-06
|
|
929
|
OTHER
|
Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/mcc
|
49
|
39
|
—
|
—
|
$47,483.56
|
$129,608.30
|
$88,545.93
|
2026-05-06
|
|
933
|
OTHER
|
Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft
|
49
|
39
|
—
|
—
|
$41,908.71
|
$110,486.12
|
$76,197.41
|
2026-05-06
|
|
939
|
OTHER
|
O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc
|
49
|
39
|
—
|
—
|
$40,727.09
|
$111,036.70
|
$75,881.90
|
2026-05-06
|
|
955
|
OTHER
|
Craniotomy For Multiple Significant Trauma
|
49
|
39
|
—
|
—
|
$59,745.43
|
$162,854.95
|
$111,300.19
|
2026-05-06
|
|
957
|
OTHER
|
Other O.r. Procedures For Multiple Significant Trauma With Mcc
|
49
|
39
|
—
|
—
|
$52,810.42
|
$178,021.17
|
$115,415.79
|
2026-05-06
|
|
959
|
OTHER
|
Other O.r. Procedures For Multiple Significant Trauma Without Cc/mcc
|
49
|
39
|
—
|
—
|
$44,970.36
|
$157,666.97
|
$101,318.66
|
2026-05-06
|
|
963
|
OTHER
|
Other Multiple Significant Trauma With Mcc
|
49
|
39
|
—
|
—
|
$36,986.33
|
$100,693.23
|
$68,839.78
|
2026-05-06
|
|
969
|
OTHER
|
HIV With Extensive O.r. Procedures With Mcc
|
49
|
39
|
—
|
—
|
$120,161.70
|
$592,708.51
|
$356,435.10
|
2026-05-06
|
|
970
|
OTHER
|
HIV With Extensive O.r. Procedures Without Mcc
|
49
|
39
|
—
|
—
|
$49,360.14
|
$232,256.88
|
$140,808.51
|
2026-05-06
|
|
981
|
OTHER
|
Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc
|
49
|
39
|
—
|
—
|
$26,188.94
|
$113,380.51
|
$69,784.73
|
2026-05-06
|
|
APR-DRG 003-2
|
OTHER
|
Bone Marrow Transplant
|
16
|
16
|
$876,743.76
|
$569,883.00
35% off
|
$3,043.09
|
$745,232.20
|
$116,432.23
|
2026-05-28
|
|
APR-DRG 003-3
|
OTHER
|
Bone Marrow Transplant
|
16
|
16
|
$777,830.26
|
$505,590.00
35% off
|
$3,373.42
|
$661,155.72
|
$102,356.90
|
2026-05-28
|
|
APR-DRG 003-4
|
OTHER
|
Bone Marrow Transplant
|
16
|
16
|
$3,877,567.58
|
$2,520,419.00
35% off
|
$4,323.71
|
$3,295,932.44
|
$169,969.06
|
2026-05-28
|
|
APR-DRG 004-2
|
OTHER
|
Tracheostomy With Mv >96 Hours With Extensive Procedure
|
16
|
16
|
—
|
$3,782,003.00
|
$4,256.22
|
$4,945,695.78
|
$106,848.24
|
2026-05-28
|
|
APR-DRG 004-3
|
OTHER
|
Tracheostomy With Mv >96 Hours With Extensive Procedure
|
16
|
16
|
$2,472,853.65
|
$1,607,355.00
35% off
|
$4,458.34
|
$2,101,925.60
|
$107,138.75
|
2026-05-28
|
|
APR-DRG 004-4
|
OTHER
|
Tracheostomy With Mv >96 Hours With Extensive Procedure
|
16
|
16
|
$795,413.19
|
$517,019.00
35% off
|
$4,458.34
|
$676,101.21
|
$105,245.04
|
2026-05-28
|
|
APR-DRG 583-2
|
OTHER
|
Neonate With Ecmo
|
8
|
8
|
$753,940.60
|
$490,061.00
35% off
|
$27,002.45
|
$640,849.51
|
$196,226.57
|
2026-05-28
|
|
APR-DRG 588-2
|
OTHER
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
1
|
1
|
$926,362.89
|
$602,136.00
35% off
|
$787,408.46
|
$787,408.46
|
$787,408.46
|
2026-05-28
|
|
APR-DRG 588-3
|
OTHER
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
1
|
1
|
$1,165,605.86
|
$757,644.00
35% off
|
$990,764.98
|
$990,764.98
|
$990,764.98
|
2026-05-28
|
|
APR-DRG 588-4
|
OTHER
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
1
|
1
|
$1,203,010.60
|
$781,957.00
35% off
|
$1,022,559.01
|
$1,022,559.01
|
$1,022,559.01
|
2026-05-28
|
|
APR-DRG 589-1
|
OTHER
|
Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …
|
1
|
1
|
$207,541.00
|
$134,902.00
35% off
|
$176,409.85
|
$176,409.85
|
$176,409.85
|
2026-05-28
|
|
APR-DRG 589-3
|
OTHER
|
Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …
|
1
|
1
|
$2,588,272.66
|
$1,682,377.00
35% off
|
$2,200,031.76
|
$2,200,031.76
|
$2,200,031.76
|
2026-05-28
|
|
APR-DRG 591-2
|
OTHER
|
Neonate Birth Weight 500-749 Grams Without Major Procedure
|
1
|
1
|
$588,987.01
|
$382,842.00
35% off
|
$500,638.96
|
$500,638.96
|
$500,638.96
|
2026-05-28
|
|
APR-DRG 591-3
|
OTHER
|
Neonate Birth Weight 500-749 Grams Without Major Procedure
|
1
|
1
|
$1,675,014.64
|
$1,088,760.00
35% off
|
$1,423,762.44
|
$1,423,762.44
|
$1,423,762.44
|
2026-05-28
|
|
APR-DRG 591-4
|
OTHER
|
Neonate Birth Weight 500-749 Grams Without Major Procedure
|
1
|
1
|
$1,500,105.00
|
$975,068.00
35% off
|
$1,275,089.25
|
$1,275,089.25
|
$1,275,089.25
|
2026-05-28
|
|
APR-DRG 593-2
|
OTHER
|
Neonate Birth Weight 750-999 Grams Without Major Procedure
|
8
|
8
|
$403,301.00
|
$262,146.00
35% off
|
$19,979.89
|
$342,805.85
|
$92,521.38
|
2026-05-28
|
|
APR-DRG 593-3
|
OTHER
|
Neonate Birth Weight 750-999 Grams Without Major Procedure
|
8
|
8
|
$752,808.00
|
$489,325.00
35% off
|
$19,979.89
|
$639,886.80
|
$195,179.97
|
2026-05-28
|
|
APR-DRG 593-4
|
OTHER
|
Neonate Birth Weight 750-999 Grams Without Major Procedure
|
8
|
8
|
$990,884.00
|
$644,075.00
35% off
|
$19,979.89
|
$842,251.40
|
$265,108.60
|
2026-05-28
|
|
APR-DRG 602-1
|
OTHER
|
Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…
|
8
|
8
|
$385,006.00
|
$250,254.00
35% off
|
$25,399.65
|
$327,255.10
|
$87,193.11
|
2026-05-28
|
|
APR-DRG 602-2
|
OTHER
|
Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…
|
8
|
8
|
$713,583.00
|
$463,829.00
35% off
|
$25,399.65
|
$606,545.55
|
$183,704.07
|
2026-05-28
|
|
APR-DRG 602-4
|
OTHER
|
Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…
|
8
|
8
|
$861,472.00
|
$559,957.00
35% off
|
$25,399.65
|
$732,251.20
|
$227,142.61
|
2026-05-28
|
|
APR-DRG 603-2
|
OTHER
|
Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition
|
8
|
8
|
$591,272.21
|
$384,327.00
35% off
|
$14,952.51
|
$502,581.38
|
$147,719.74
|
2026-05-28
|
|
APR-DRG 603-3
|
OTHER
|
Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition
|
8
|
8
|
$463,918.66
|
$301,547.00
35% off
|
$14,952.51
|
$394,330.86
|
$110,312.96
|
2026-05-28
|
|
APR-DRG 603-4
|
OTHER
|
Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition
|
8
|
8
|
$693,353.30
|
$450,680.00
35% off
|
$14,952.51
|
$589,350.31
|
$177,703.40
|
2026-05-28
|
|
APR-DRG 607-2
|
OTHER
|
Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…
|
8
|
8
|
$480,104.00
|
$312,068.00
35% off
|
$14,507.58
|
$408,088.40
|
$115,091.71
|
2026-05-28
|
|
APR-DRG 607-3
|
OTHER
|
Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…
|
8
|
8
|
$715,283.00
|
$464,934.00
35% off
|
$14,507.58
|
$607,990.55
|
$184,169.42
|
2026-05-28
|
|
APR-DRG 607-4
|
OTHER
|
Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…
|
8
|
8
|
$1,365,907.92
|
$887,840.00
35% off
|
$14,507.58
|
$1,161,021.73
|
$375,273.58
|
2026-05-28
|
|
APR-DRG 608-1
|
OTHER
|
Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition
|
1
|
1
|
$495,276.00
|
$321,929.00
35% off
|
$420,984.60
|
$420,984.60
|
$420,984.60
|
2026-05-28
|
|
APR-DRG 608-2
|
OTHER
|
Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition
|
1
|
1
|
$303,433.00
|
$197,231.00
35% off
|
$257,918.05
|
$257,918.05
|
$257,918.05
|
2026-05-28
|
|
APR-DRG 608-3
|
OTHER
|
Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition
|
1
|
1
|
$754,926.86
|
$490,702.00
35% off
|
$641,687.83
|
$641,687.83
|
$641,687.83
|
2026-05-28
|
|
APR-DRG 608-4
|
OTHER
|
Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition
|
1
|
1
|
$356,791.00
|
$231,914.00
35% off
|
$303,272.35
|
$303,272.35
|
$303,272.35
|
2026-05-28
|
|
APR-DRG 609-2
|
OTHER
|
Neonate Birth Weight 1500-2499 Grams With Major Procedure
|
1
|
1
|
$97,811.25
|
$63,577.00
35% off
|
$83,139.56
|
$83,139.56
|
$83,139.56
|
2026-05-28
|
|
APR-DRG 609-3
|
OTHER
|
Neonate Birth Weight 1500-2499 Grams With Major Procedure
|
1
|
1
|
$269,569.61
|
$175,220.00
35% off
|
$229,134.17
|
$229,134.17
|
$229,134.17
|
2026-05-28
|
|
APR-DRG 609-4
|
OTHER
|
Neonate Birth Weight 1500-2499 Grams With Major Procedure
|
1
|
1
|
$1,232,236.05
|
$800,953.00
35% off
|
$1,047,400.64
|
$1,047,400.64
|
$1,047,400.64
|
2026-05-28
|
|
APR-DRG 611-1
|
OTHER
|
Neonate Birth Weight 1500-1999 Grams With Major Anomaly
|
1
|
1
|
$307,680.00
|
$199,992.00
35% off
|
$261,528.00
|
$261,528.00
|
$261,528.00
|
2026-05-28
|
|
APR-DRG 611-4
|
OTHER
|
Neonate Birth Weight 1500-1999 Grams With Major Anomaly
|
1
|
1
|
$1,467,012.67
|
$953,558.00
35% off
|
$1,246,960.77
|
$1,246,960.77
|
$1,246,960.77
|
2026-05-28
|
|
APR-DRG 612-1
|
OTHER
|
Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other…
|
1
|
1
|
$335,158.00
|
$217,853.00
35% off
|
$284,884.30
|
$284,884.30
|
$284,884.30
|
2026-05-28
|
|
APR-DRG 612-2
|
OTHER
|
Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other…
|
1
|
1
|
$351,791.00
|
$228,664.00
35% off
|
$299,022.35
|
$299,022.35
|
$299,022.35
|
2026-05-28
|
|
APR-DRG 612-3
|
OTHER
|
Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other…
|
1
|
1
|
$757,447.00
|
$492,341.00
35% off
|
$643,829.95
|
$643,829.95
|
$643,829.95
|
2026-05-28
|
|
APR-DRG 612-4
|
OTHER
|
Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other…
|
1
|
1
|
$625,748.92
|
$406,737.00
35% off
|
$531,886.58
|
$531,886.58
|
$531,886.58
|
2026-05-28
|
|
APR-DRG 614-3
|
OTHER
|
Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition
|
8
|
8
|
$521,161.00
|
$338,755.00
35% off
|
$41,860.38
|
$442,986.85
|
$127,680.34
|
2026-05-28
|
|
APR-DRG 621-4
|
OTHER
|
Neonate Birth Weight 2000-2499 Grams With Major Anomaly
|
8
|
8
|
$1,331,706.75
|
$865,609.00
35% off
|
$27,976.40
|
$1,131,950.74
|
$366,209.19
|
2026-05-28
|
|
APR-DRG 622-4
|
OTHER
|
Neonate Birth Weight 2000-2499 Grams With Respiratory Distress Syndrome Or Other…
|
8
|
8
|
$769,040.26
|
$499,876.00
35% off
|
$63,322.21
|
$653,684.22
|
$200,134.61
|
2026-05-28
|
|
APR-DRG 623-3
|
OTHER
|
Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection
|
8
|
8
|
$326,803.00
|
$212,422.00
35% off
|
$32,783.06
|
$277,782.55
|
$70,141.49
|
2026-05-28
|
|
APR-DRG 630-1
|
OTHER
|
Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure
|
8
|
8
|
$619,098.30
|
$402,414.00
35% off
|
$24,686.71
|
$526,233.56
|
$156,292.70
|
2026-05-28
|
|
APR-DRG 630-3
|
OTHER
|
Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure
|
8
|
8
|
$336,744.30
|
$218,884.00
35% off
|
$24,686.71
|
$286,232.65
|
$73,358.55
|
2026-05-28
|
|
APR-DRG 630-4
|
OTHER
|
Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure
|
8
|
8
|
$356,448.67
|
$231,692.00
35% off
|
$24,686.71
|
$302,981.37
|
$79,146.20
|
2026-05-28
|
|
APR-DRG 631-2
|
OTHER
|
Neonate Birth Weight > 2499 Grams With Other Major Procedure
|
1
|
1
|
$226,378.40
|
$147,146.00
35% off
|
$192,421.64
|
$192,421.64
|
$192,421.64
|
2026-05-28
|
|
APR-DRG 631-3
|
OTHER
|
Neonate Birth Weight > 2499 Grams With Other Major Procedure
|
1
|
1
|
$120,175.80
|
$78,114.00
35% off
|
$102,149.43
|
$102,149.43
|
$102,149.43
|
2026-05-28
|
|
APR-DRG 631-4
|
OTHER
|
Neonate Birth Weight > 2499 Grams With Other Major Procedure
|
1
|
1
|
$404,587.75
|
$262,982.00
35% off
|
$343,899.59
|
$343,899.59
|
$343,899.59
|
2026-05-28
|
|
APR-DRG 633-4
|
OTHER
|
Neonate Birth Weight > 2499 Grams With Major Anomaly
|
1
|
1
|
$179,679.00
|
$116,791.00
35% off
|
$152,727.15
|
$152,727.15
|
$152,727.15
|
2026-05-28
|
|
APR-DRG 636-4
|
OTHER
|
Neonate Birth Weight > 2499 Grams With Congenital Or Perinatal Infection
|
1
|
1
|
$193,245.48
|
$125,610.00
35% off
|
$164,258.66
|
$164,258.66
|
$164,258.66
|
2026-05-28
|
|
C1605
|
HCPCS
|
Hc Aveir Ntap C1605
|
50
|
42
|
$118,705.00
|
$77,158.25
35% off
|
$18,280.57
|
$110,395.65
|
$71,223.00
|
2026-03-01
|
|
C1823
|
HCPCS
|
Hc Remede System 1001
|
78
|
31
|
$151,250.00
|
$98,312.50
35% off
|
$22,233.75
|
$147,056.25
|
$101,200.00
|
2026-03-01
|
|
MS-DRG 001
|
OTHER
|
Heart Transplant Or Implant Of Heart Assist System With Mcc
|
14
|
14
|
$846,592.03
|
$550,285.00
35% off
|
$296,307.21
|
$846,592.03
|
$698,438.43
|
2026-05-28
|
|
MS-DRG 002
|
OTHER
|
Heart Transplant Or Implant Of Heart Assist System Without Mcc
|
14
|
14
|
$752,886.92
|
$489,376.00
35% off
|
$49,022.11
|
$752,886.92
|
$602,309.54
|
2026-05-28
|
|
MS-DRG 003
|
OTHER
|
Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…
|
23
|
23
|
$645,099.41
|
$419,315.00
35% off
|
$9,987.87
|
$645,099.41
|
$233,851.32
|
2026-05-28
|
|
MS-DRG 004
|
OTHER
|
Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…
|
23
|
23
|
$949,211.27
|
$616,987.00
35% off
|
$83,492.06
|
$949,211.27
|
$254,515.89
|
2026-05-28
|
|
MS-DRG 005
|
OTHER
|
Liver Transplant With Mcc Or Intestinal Transplant
|
14
|
14
|
$473,562.45
|
$307,816.00
35% off
|
$165,746.86
|
$473,562.45
|
$390,689.02
|
2026-05-28
|
|
MS-DRG 006
|
OTHER
|
Liver Transplant Without Mcc
|
14
|
14
|
$613,006.45
|
$398,454.00
35% off
|
$76,871.66
|
$613,006.45
|
$490,405.16
|
2026-05-28
|
|
MS-DRG 007
|
OTHER
|
Lung Transplant
|
14
|
14
|
$2,162,847.20
|
$1,405,851.00
35% off
|
$756,996.52
|
$2,162,847.20
|
$1,784,348.94
|
2026-05-28
|
|
MS-DRG 008
|
OTHER
|
Simultaneous Pancreas And Kidney Transplant
|
14
|
14
|
$591,940.40
|
$384,761.00
35% off
|
$207,179.14
|
$591,940.40
|
$488,350.83
|
2026-05-28
|
|
MS-DRG 010
|
OTHER
|
Pancreas Transplant
|
14
|
14
|
$363,908.35
|
$236,540.00
35% off
|
$127,367.92
|
$363,908.35
|
$300,224.39
|
2026-05-28
|
|
MS-DRG 011
|
OTHER
|
Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc
|
23
|
23
|
$225,144.85
|
$146,344.00
35% off
|
$40,205.58
|
$225,144.85
|
$78,800.70
|
2026-05-28
|
|
MS-DRG 016
|
OTHER
|
Autologous Bone Marrow Transplant With Cc/mcc
|
22
|
22
|
$176,947.00
|
$115,016.00
35% off
|
$26,041.64
|
$176,947.00
|
$118,554.49
|
2026-05-28
|
|
MS-DRG 018
|
OTHER
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
23
|
23
|
$2,860,061.00
|
$1,859,040.00
35% off
|
$458,389.23
|
$2,860,061.00
|
$1,001,021.35
|
2026-05-28
|
|
MS-DRG 020
|
OTHER
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc
|
23
|
23
|
$387,183.73
|
$251,669.00
35% off
|
$87,970.74
|
$387,183.73
|
$159,516.25
|
2026-05-28
|
|
MS-DRG 021
|
OTHER
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc
|
23
|
23
|
$369,444.80
|
$240,139.00
35% off
|
$82,718.36
|
$369,444.80
|
$129,305.68
|
2026-05-28
|
|
MS-DRG 022
|
OTHER
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/…
|
23
|
23
|
$357,603.65
|
$232,442.00
35% off
|
$33,125.01
|
$357,603.65
|
$80,570.45
|
2026-05-28
|
|
MS-DRG 023
|
OTHER
|
Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…
|
23
|
23
|
$286,913.55
|
$186,494.00
35% off
|
$9,596.95
|
$286,913.55
|
$87,526.38
|
2026-05-28
|
|
MS-DRG 045
|
OTHER
|
Neurological Eye Disorders
|
14
|
14
|
$79,098.57
|
$51,414.00
35% off
|
$27,684.50
|
$79,098.57
|
$65,256.32
|
2026-05-28
|
|
MS-DRG 104
|
OTHER
|
Cardiac Valve & Oth Major Cardiothoracic Proc W Card Cath
|
14
|
14
|
$599,559.59
|
$389,714.00
35% off
|
$209,845.86
|
$599,559.59
|
$494,636.66
|
2026-05-28
|
|
MS-DRG 105
|
OTHER
|
Cardiac Valve & Oth Major Cardiothoracic Proc Without Card Cath
|
14
|
14
|
$372,415.27
|
$242,070.00
35% off
|
$22,615.75
|
$372,415.27
|
$297,932.22
|
2026-05-28
|
|
MS-DRG 107
|
OTHER
|
No Longer Valid
|
14
|
14
|
$131,788.55
|
$85,663.00
35% off
|
$10,918.20
|
$131,788.55
|
$105,430.84
|
2026-05-28
|
|
MS-DRG 110
|
OTHER
|
Major Cardiovascular Procedures W Cc
|
14
|
14
|
$85,727.51
|
$55,723.00
35% off
|
$30,004.63
|
$85,727.51
|
$70,725.20
|
2026-05-28
|
|
MS-DRG 112
|
OTHER
|
No Longer Valid
|
14
|
14
|
$137,461.40
|
$89,350.00
35% off
|
$48,111.49
|
$137,461.40
|
$113,405.65
|
2026-05-28
|
|
MS-DRG 120
|
OTHER
|
Other Circulatory System O.r. Procedures
|
14
|
14
|
$122,985.83
|
$79,941.00
35% off
|
$4,541.36
|
$122,985.83
|
$98,388.66
|
2026-05-28
|
|
MS-DRG 129
|
OTHER
|
Major Head & Neck Procedures W Cc/mcc Or Major Device
|
23
|
23
|
$309,506.05
|
$201,179.00
35% off
|
$37,864.00
|
$309,506.05
|
$157,848.09
|
2026-05-28
|
|
MS-DRG 131
|
OTHER
|
Cranial/facial Procedures W Cc/mcc
|
23
|
23
|
$134,149.40
|
$87,197.00
35% off
|
$13,861.69
|
$134,149.40
|
$80,489.64
|
2026-05-28
|
|
MS-DRG 163
|
OTHER
|
Major Chest Procedures With Mcc
|
23
|
23
|
$460,004.33
|
$299,003.00
35% off
|
$61,283.23
|
$460,004.33
|
$161,001.52
|
2026-05-28
|
|
MS-DRG 197
|
OTHER
|
Interstitial Lung Disease With Cc
|
23
|
23
|
$296,166.91
|
$192,508.00
35% off
|
$12,325.68
|
$296,166.91
|
$103,658.42
|
2026-05-28
|
|
MS-DRG 207
|
OTHER
|
Respiratory System Diagnosis With Ventilator Support >96 Hours
|
23
|
23
|
$557,980.25
|
$362,687.00
35% off
|
$70,209.86
|
$557,980.25
|
$195,293.09
|
2026-05-28
|
|
MS-DRG 212
|
OTHER
|
Hip & Femur Procedures Except Major Joint Age 0-17
|
14
|
14
|
$148,868.05
|
$96,764.00
35% off
|
$52,103.82
|
$148,868.05
|
$122,816.14
|
2026-05-28
|
|
MS-DRG 213
|
OTHER
|
Amputation For Musculoskeletal System & Conn Tissue Disorders
|
14
|
14
|
$382,425.60
|
$248,577.00
35% off
|
$133,848.96
|
$382,425.60
|
$315,501.12
|
2026-05-28
|
|
MS-DRG 215
|
OTHER
|
Other Heart Assist System Implant
|
23
|
23
|
$335,128.60
|
$217,834.00
35% off
|
$74,221.35
|
$335,128.60
|
$162,932.79
|
2026-05-28
|
|
MS-DRG 216
|
OTHER
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
23
|
23
|
$303,808.65
|
$197,476.00
35% off
|
$63,676.96
|
$303,808.65
|
$154,922.26
|
2026-05-28
|
|
MS-DRG 217
|
OTHER
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
23
|
23
|
$162,028.05
|
$105,318.00
35% off
|
$22,450.01
|
$162,028.05
|
$82,634.31
|
2026-05-28
|
|
MS-DRG 219
|
OTHER
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
23
|
23
|
$302,432.06
|
$196,581.00
35% off
|
$63,320.71
|
$302,432.06
|
$124,341.50
|
2026-05-28
|
|
MS-DRG 220
|
OTHER
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
23
|
23
|
$111,085.61
|
$72,206.00
35% off
|
$7,412.57
|
$111,085.61
|
$66,160.88
|
2026-05-28
|
|
MS-DRG 221
|
OTHER
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
23
|
23
|
$129,859.38
|
$84,409.00
35% off
|
$13,232.97
|
$129,859.38
|
$66,228.28
|
2026-05-28
|
|
MS-DRG 222
|
OTHER
|
Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock…
|
23
|
23
|
$159,375.10
|
$103,594.00
35% off
|
$21,506.63
|
$159,375.10
|
$95,625.06
|
2026-05-28
|
|
MS-DRG 223
|
OTHER
|
Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock…
|
23
|
23
|
$290,106.23
|
$188,569.00
35% off
|
$60,093.85
|
$290,106.23
|
$101,537.18
|
2026-05-28
|
|
MS-DRG 225
|
OTHER
|
Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh…
|
23
|
23
|
$165,498.01
|
$107,574.00
35% off
|
$23,785.17
|
$165,498.01
|
$84,403.99
|
2026-05-28
|
|
MS-DRG 226
|
OTHER
|
Cardiac Defibrillator Implant Without Cardiac Catheterization With Mcc
|
23
|
23
|
$197,034.50
|
$128,072.00
35% off
|
$32,702.27
|
$197,034.50
|
$100,487.60
|
2026-05-28
|
|
MS-DRG 227
|
OTHER
|
Cardiac Defibrillator Implant Without Cardiac Catheterization Without Mcc
|
23
|
23
|
$125,713.88
|
$81,714.00
35% off
|
$12,616.33
|
$125,713.88
|
$64,114.08
|
2026-05-28
|
|
MS-DRG 230
|
OTHER
|
Other Cardiothoracic Procedures Without Cc/mcc
|
23
|
23
|
$288,760.15
|
$187,694.00
35% off
|
$59,424.84
|
$288,760.15
|
$173,256.09
|
2026-05-28
|
|
MS-DRG 231
|
OTHER
|
Coronary Bypass With Ptca With Mcc
|
23
|
23
|
$312,560.30
|
$203,164.00
35% off
|
$66,167.14
|
$312,560.30
|
$134,500.11
|
2026-05-28
|
|
MS-DRG 232
|
OTHER
|
Coronary Bypass With Ptca Without Mcc
|
23
|
23
|
$194,247.61
|
$126,261.00
35% off
|
$10,860.26
|
$194,247.61
|
$72,874.51
|
2026-05-28
|
|
MS-DRG 233
|
OTHER
|
Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc
|
23
|
23
|
$215,419.13
|
$140,022.00
35% off
|
$37,648.40
|
$215,419.13
|
$109,863.76
|
2026-05-28
|
|
MS-DRG 234
|
OTHER
|
Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc
|
23
|
23
|
$151,346.44
|
$98,375.00
35% off
|
$18,881.51
|
$151,346.44
|
$77,186.68
|
2026-05-28
|
|
MS-DRG 237
|
OTHER
|
Major Cardiovasc Procedures W Mcc
|
23
|
23
|
$715,523.45
|
$465,090.00
35% off
|
$183,872.79
|
$715,523.45
|
$429,314.07
|
2026-05-28
|
|
MS-DRG 238
|
OTHER
|
Major Cardiovasc Procedures Without Mcc
|
23
|
23
|
$300,874.70
|
$195,569.00
35% off
|
$63,316.41
|
$300,874.70
|
$180,524.82
|
2026-05-28
|
|
MS-DRG 239
|
OTHER
|
Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc
|
23
|
23
|
$195,923.00
|
$127,350.00
35% off
|
$4,889.98
|
$195,923.00
|
$68,573.05
|
2026-05-28
|
|
MS-DRG 266
|
OTHER
|
Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc
|
23
|
23
|
$187,383.61
|
$121,799.00
35% off
|
$23,672.55
|
$187,383.61
|
$86,266.29
|
2026-05-28
|
|
MS-DRG 267
|
OTHER
|
Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc
|
23
|
23
|
$166,713.80
|
$108,364.00
35% off
|
$26,408.29
|
$166,713.80
|
$85,024.04
|
2026-05-28
|
|
MS-DRG 268
|
OTHER
|
Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc
|
23
|
23
|
$540,754.16
|
$351,490.00
35% off
|
$85,230.79
|
$540,754.16
|
$189,263.96
|
2026-05-28
|
|
MS-DRG 269
|
OTHER
|
Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc
|
23
|
23
|
$209,018.27
|
$135,862.00
35% off
|
$38,015.38
|
$209,018.27
|
$73,156.39
|
2026-05-28
|
|
MS-DRG 277
|
OTHER
|
Cellulitis Age >17 W Cc
|
14
|
14
|
$232,912.00
|
$151,393.00
35% off
|
$21,378.23
|
$232,912.00
|
$186,329.60
|
2026-05-28
|
|
MS-DRG 326
|
OTHER
|
Stomach, Esophageal And Duodenal Procedures With Mcc
|
23
|
23
|
$381,082.36
|
$247,704.00
35% off
|
$36,624.59
|
$381,082.36
|
$86,755.01
|
2026-05-28
|
|
MS-DRG 356
|
OTHER
|
Other Digestive System O.r. Procedures With Mcc
|
23
|
23
|
$330,339.55
|
$214,721.00
35% off
|
$52,727.47
|
$330,339.55
|
$115,618.84
|
2026-05-28
|
|
MS-DRG 360
|
OTHER
|
Vagina, Cervix & Vulva Procedures
|
14
|
14
|
$99,949.81
|
$64,967.00
35% off
|
$7,677.90
|
$99,949.81
|
$79,959.85
|
2026-05-28
|
|
MS-DRG 398
|
OTHER
|
Reticuloendothelial & Immunity Disorders W Cc
|
14
|
14
|
$82,456.32
|
$53,597.00
35% off
|
$4,045.30
|
$82,456.32
|
$65,965.06
|
2026-05-28
|
|
MS-DRG 399
|
OTHER
|
Reticuloendothelial & Immunity Disorders Without Cc
|
14
|
14
|
$180,382.64
|
$117,249.00
35% off
|
$14,840.36
|
$180,382.64
|
$144,306.11
|
2026-05-28
|
|
MS-DRG 402
|
OTHER
|
Lymphoma & Non-acute Leukemia W Other O.r. Proc Without Cc
|
14
|
14
|
$253,839.77
|
$164,996.00
35% off
|
$23,444.20
|
$253,839.77
|
$203,071.82
|
2026-05-28
|
|
MS-DRG 405
|
OTHER
|
Pancreas, Liver And Shunt Procedures With Mcc
|
23
|
23
|
$157,405.59
|
$102,314.00
35% off
|
$5,900.12
|
$157,405.59
|
$70,228.23
|
2026-05-28
|
|
MS-DRG 451
|
OTHER
|
Poisoning & Toxic Effects Of Drugs Age 0-17
|
14
|
14
|
$78,978.04
|
$51,336.00
35% off
|
$3,033.80
|
$78,978.04
|
$63,182.43
|
2026-05-28
|
|
MS-DRG 453
|
OTHER
|
Combined Anterior And Posterior Spinal Fusion With Mcc
|
23
|
23
|
$273,655.62
|
$177,876.00
35% off
|
$14,087.73
|
$273,655.62
|
$112,461.12
|
2026-05-28
|
|
MS-DRG 456
|
OTHER
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
23
|
23
|
$325,502.69
|
$211,577.00
35% off
|
$12,552.35
|
$325,502.69
|
$113,925.94
|
2026-05-28
|
|
MS-DRG 459
|
OTHER
|
Spinal Fusion Except Cervical With Mcc
|
23
|
23
|
$176,973.88
|
$115,033.00
35% off
|
$11,754.77
|
$176,973.88
|
$82,418.04
|
2026-05-28
|
|
MS-DRG 461
|
OTHER
|
Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc
|
23
|
23
|
$373,981.41
|
$243,088.00
35% off
|
$74,440.01
|
$373,981.41
|
$130,893.49
|
2026-05-28
|
|
MS-DRG 463
|
OTHER
|
Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …
|
23
|
23
|
$126,655.08
|
$82,326.00
35% off
|
$6,288.52
|
$126,655.08
|
$64,594.09
|
2026-05-28
|
|
MS-DRG 471
|
OTHER
|
Cervical Spinal Fusion With Mcc
|
23
|
23
|
$389,336.94
|
$253,069.00
35% off
|
$45,154.18
|
$389,336.94
|
$89,393.23
|
2026-05-28
|
|
MS-DRG 490
|
OTHER
|
Back & Neck Proc Exc Spinal Fusion W Cc/mcc Or Disc Device/neurostim
|
23
|
23
|
$158,640.20
|
$103,116.00
35% off
|
$9,081.50
|
$158,640.20
|
$80,906.50
|
2026-05-28
|
|
MS-DRG 503
|
OTHER
|
Foot Procedures With Mcc
|
23
|
23
|
$204,187.44
|
$132,722.00
35% off
|
$32,320.95
|
$204,187.44
|
$71,465.60
|
2026-05-28
|
|
MS-DRG 531
|
OTHER
|
Spinal Procedures W Cc
|
14
|
14
|
$152,879.40
|
$99,372.00
35% off
|
$7,937.19
|
$152,879.40
|
$122,303.52
|
2026-05-28
|
|
MS-DRG 567
|
OTHER
|
Stomach, Esophageal & Duodenal Proc Age > 17 W Cc W Major Gi Dx
|
14
|
14
|
$92,298.76
|
$59,994.00
35% off
|
$6,345.63
|
$92,298.76
|
$73,839.01
|
2026-05-28
|
|
MS-DRG 570
|
OTHER
|
Skin Debridement With Mcc
|
23
|
23
|
$561,768.89
|
$365,150.00
35% off
|
$34,782.41
|
$561,768.89
|
$139,892.87
|
2026-05-28
|
|
MS-DRG 650
|
OTHER
|
Kidney Transplant With Hemodialysis With Mcc
|
14
|
14
|
$236,647.50
|
$153,821.00
35% off
|
$10,316.12
|
$236,647.50
|
$189,318.00
|
2026-05-28
|
|
MS-DRG 651
|
OTHER
|
Kidney Transplant With Hemodialysis Without Mcc
|
14
|
14
|
$219,147.25
|
$142,446.00
35% off
|
$9,264.96
|
$219,147.25
|
$175,317.80
|
2026-05-28
|
|
MS-DRG 652
|
OTHER
|
Kidney Transplant
|
14
|
14
|
$177,139.02
|
$115,140.00
35% off
|
$10,209.57
|
$177,139.02
|
$141,711.22
|
2026-05-28
|
|
MS-DRG 653
|
OTHER
|
Major Bladder Procedures With Mcc
|
23
|
23
|
$432,627.77
|
$281,208.00
35% off
|
$40,662.81
|
$432,627.77
|
$101,935.14
|
2026-05-28
|
|
MS-DRG 820
|
OTHER
|
Lymphoma And Leukemia With Major O.r. Procedures With Mcc
|
23
|
23
|
$159,643.33
|
$103,768.00
35% off
|
$7,329.78
|
$159,643.33
|
$69,666.41
|
2026-05-28
|
|
MS-DRG 837
|
OTHER
|
Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot…
|
23
|
23
|
$468,312.38
|
$304,403.00
35% off
|
$2,028.00
|
$468,312.38
|
$112,518.73
|
2026-05-28
|
|
MS-DRG 870
|
OTHER
|
Septicemia Or Severe Sepsis With Mv >96 Hours
|
23
|
23
|
$205,349.01
|
$133,477.00
35% off
|
$6,406.39
|
$205,349.01
|
$78,813.36
|
2026-05-28
|
|
MS-DRG 927
|
OTHER
|
Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft
|
23
|
23
|
$465,667.50
|
$302,684.00
35% off
|
$110,913.37
|
$465,667.50
|
$258,157.52
|
2026-05-28
|
|
MS-DRG 955
|
OTHER
|
Craniotomy For Multiple Significant Trauma
|
23
|
23
|
$203,377.17
|
$132,195.00
35% off
|
$34,309.97
|
$203,377.17
|
$97,053.84
|
2026-05-28
|
|
MS-DRG 957
|
OTHER
|
Other O.r. Procedures For Multiple Significant Trauma With Mcc
|
23
|
23
|
$179,465.74
|
$116,653.00
35% off
|
$27,269.13
|
$179,465.74
|
$91,527.53
|
2026-05-28
|
|
MS-DRG 959
|
OTHER
|
Other O.r. Procedures For Multiple Significant Trauma Without Cc/mcc
|
23
|
23
|
$197,083.71
|
$128,104.00
35% off
|
$32,230.04
|
$197,083.71
|
$68,979.30
|
2026-05-28
|
|
MS-DRG 969
|
OTHER
|
HIV With Extensive O.r. Procedures With Mcc
|
23
|
23
|
$740,885.64
|
$481,576.00
35% off
|
$71,627.25
|
$740,885.64
|
$192,931.13
|
2026-05-28
|
|
MS-DRG 970
|
OTHER
|
HIV With Extensive O.r. Procedures Without Mcc
|
23
|
23
|
$290,321.10
|
$188,709.00
35% off
|
$36,581.68
|
$290,321.10
|
$101,612.39
|
2026-05-28
|
|
PX-8110000000
|
CDM
|
Hc Living Donor Sac- Kidney
|
38
|
32
|
$165,000.00
|
$107,250.00
35% off
|
$25,410.00
|
$153,450.00
|
$114,510.00
|
2026-03-01
|
|
PX-8120000000
|
CDM
|
Hc Cadaver Donor Sac- Kidney
|
38
|
32
|
$194,370.00
|
$126,340.50
35% off
|
$29,932.98
|
$180,764.10
|
$134,892.78
|
2026-03-01
|
|
PX-8120000001
|
CDM
|
Hc Cadaver Donor Sac- Liver
|
38
|
32
|
$269,900.00
|
$175,435.00
35% off
|
$41,564.60
|
$251,007.00
|
$187,310.60
|
2026-03-01
|
|
PX-8130000000
|
CDM
|
Hc Cadaver Donor Sac-pancreas
|
38
|
32
|
$121,000.00
|
$78,650.00
35% off
|
$18,634.00
|
$112,530.00
|
$83,974.00
|
2026-03-01
|
|
Q2041
|
HCPCS
|
Hc Axicabtagene Ciloleucel Car+ (Yescarta)
|
112
|
95
|
$2,909,170.00
|
$1,890,960.50
35% off
|
$448,012.18
|
$2,705,528.10
|
$553,479.93
|
2026-03-01
|
|
Q2042
|
HCPCS
|
Tisagenlecleucel IV Up To 600 Million Car Pos
|
112
|
95
|
$2,591,313.00
|
$1,684,353.45
35% off
|
$399,062.20
|
$2,409,921.09
|
$589,192.56
|
2026-03-01
|
|
Q2053
|
HCPCS
|
Hc Brexucabtagene Autoleucel Up To 100 Million Car Pos (Tecartus) All
|
145
|
95
|
$2,668,974.00
|
$1,734,833.10
35% off
|
$377,084.40
|
$2,482,145.82
|
$513,922.71
|
2026-03-01
|
|
Q2054
|
HCPCS
|
Hc Lisocabtagene Mara Car Pos T (Breyanzi)
|
112
|
95
|
$2,956,964.98
|
$1,922,027.24
35% off
|
$455,372.61
|
$2,749,977.43
|
$584,689.29
|
2026-03-01
|
|
Q2055
|
HCPCS
|
Hc Idecabtagene Vicleucel Car 50ml (Abecma)
|
112
|
95
|
$2,884,057.54
|
$1,874,637.40
35% off
|
$444,144.86
|
$2,682,173.51
|
$580,405.00
|
2026-03-01
|
|
Q2056
|
CPT
|
Hc Ciltacabtagene Car-pos T (Carvykti) 30 Ml
|
111
|
94
|
$2,776,552.00
|
$1,804,758.80
35% off
|
$4,903.67
|
$2,582,193.36
|
$611,155.56
|
2026-03-01
|
|
Rx24338005008_C9399_100094_000
|
OTHER
|
Carmustine In Polifeprosan 77 Mg Wafer For Implant
|
64
|
47
|
$1,025,807.40
|
$666,774.98
35% off
|
$10.04
|
$1,902,341.00
|
$132,107.31
|
2026-05-28
|
|
Rx50633021011_C9293_100094_000
|
OTHER
|
Glucarpidase 1000 Unit Intravenous Solution 1 Eac
|
46
|
35
|
$148,225.00
|
$96,346.25
35% off
|
$29,860.20
|
$148,225.00
|
$74,112.50
|
2026-05-06
|
|
Rx64406005801_J2326_100094_000
|
OTHER
|
Nusinersen Pf 12 Mg 5 Ml Intrathecal Solution 5 Ml
|
82
|
61
|
$418,481.00
|
$272,012.65
35% off
|
$787.50
|
$418,481.00
|
$175,275.75
|
2026-05-28
|
|
Rx68382039601_J3490_100094_000
|
OTHER
|
Sodium Benzoate 10 -sodium Phenylacetate 10 Intra
|
56
|
44
|
$284,700.00
|
$185,055.00
35% off
|
$2,230.27
|
$284,700.00
|
$112,478.40
|
2026-05-28
|
|
Rx71336100301_J0225_100094_000
|
OTHER
|
Vutrisiran 25 Mg 0.5 Ml Subcutaneous Syringe 0.5 M
|
56
|
38
|
$459,740.10
|
$298,831.07
35% off
|
$87,601.50
|
$459,740.10
|
$152,065.27
|
2026-05-06
|