|
J1414
|
HCPCS
|
Inj, Beqvez, Per Tx Dose
|
5
|
5
|
—
|
—
|
$2,337,300.00
|
$4,653,705.00
|
$3,710,000.00
|
2025-07-01
|
|
J1411
|
HCPCS
|
Inj, Hemgenix, Per Tx Dose
|
8
|
8
|
—
|
—
|
$2,646,000.00
|
$4,653,705.00
|
$3,500,000.00
|
2025-07-01
|
|
J1413
|
HCPCS
|
Inj Delandistrogene Mox Rokl
|
11
|
11
|
—
|
—
|
$2,076,480.00
|
$4,620,864.00
|
$3,296,000.00
|
2025-07-01
|
|
J3394
|
HCPCS
|
Inj, Lovotibeglogene Autotem
|
6
|
6
|
—
|
—
|
$2,070,180.00
|
$4,476,462.00
|
$3,286,000.00
|
2025-07-01
|
|
J3393
|
HCPCS
|
Inj, Betibeglogene Autotemce
|
6
|
6
|
—
|
—
|
$1,869,840.00
|
$4,043,256.00
|
$2,968,000.00
|
2025-07-01
|
|
J3392
|
HCPCS
|
Inj, Exagamglogene Autotem
|
6
|
6
|
—
|
—
|
$1,469,160.00
|
$3,176,844.00
|
$2,332,000.00
|
2025-07-01
|
|
J3399
|
HCPCS
|
Inj Onase Abepar-xioi Treat
|
10
|
10
|
—
|
—
|
$1,400,421.08
|
$3,353,078.49
|
$2,278,598.33
|
2025-07-01
|
|
Q2057
|
HCPCS
|
Afamitresgene Autoleucel
|
2
|
2
|
—
|
—
|
$966,641.01
|
$1,049,802.54
|
$1,008,221.78
|
2025-07-01
|
|
Q2056
|
HCPCS
|
Ciltacabtagene Car-pos T
|
11
|
11
|
—
|
—
|
$310,527.00
|
$753,858.59
|
$507,195.92
|
2025-07-01
|
|
Q2042
|
HCPCS
|
Tisagenlecleucel 250000000 Cells IV Susp
|
21
|
20
|
$618,634.00
|
—
|
$94,341.69
|
$578,771.12
|
$494,907.20
|
2025-07-01
|
|
Q2055
|
HCPCS
|
Idecabtagene Vicleucel Car
|
11
|
11
|
—
|
—
|
$280,142.10
|
$719,711.05
|
$483,453.66
|
2025-07-01
|
|
Q2054
|
HCPCS
|
Lisocabtagene Mara Car Pos T
|
11
|
11
|
—
|
—
|
$273,998.34
|
$703,927.16
|
$473,853.52
|
2025-07-01
|
|
Q2053
|
HCPCS
|
Brexucabtagene Car Pos T
|
11
|
11
|
—
|
—
|
$249,089.40
|
$667,137.24
|
$449,440.00
|
2025-07-01
|
|
Q2041
|
HCPCS
|
Axicabtagene Ciloleucel Car+
|
11
|
11
|
—
|
—
|
$249,089.40
|
$727,179.59
|
$449,440.00
|
2025-07-01
|
|
18
|
MS_DRG
|
Chimeric Antigen Receptor (car) T-cell Immunotherapy
|
4
|
4
|
—
|
—
|
$211,846.75
|
$603,404.80
|
$435,982.08
|
2025-07-01
|
|
C9301
|
HCPCS
|
Obecabtagene Car Pos T
|
3
|
3
|
—
|
—
|
$278,250.00
|
$315,879.38
|
$290,856.56
|
2025-07-01
|
|
1
|
MS_DRG
|
Heart Transplant Or Implant Of Heart Assist System With Mcc
|
8
|
8
|
—
|
—
|
$158,231.76
|
$450,692.80
|
$290,598.27
|
2025-07-01
|
|
5834
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$204,766.75
|
$327,626.80
|
$266,196.78
|
2025-07-01
|
|
927
|
MS_DRG
|
Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft
|
8
|
8
|
—
|
—
|
$133,259.75
|
$379,564.80
|
$237,248.93
|
2025-07-01
|
|
3
|
MS_DRG
|
Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…
|
8
|
8
|
—
|
—
|
$120,389.23
|
$342,905.60
|
$221,099.10
|
2025-07-01
|
|
5884
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$167,964.24
|
$268,742.77
|
$218,353.51
|
2025-07-01
|
|
5833
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$162,179.28
|
$259,486.85
|
$210,833.07
|
2025-07-01
|
|
0024
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$154,978.16
|
$232,467.25
|
$193,722.71
|
2025-07-01
|
|
1614
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$160,593.78
|
$160,593.79
|
$160,593.79
|
2025-07-01
|
|
6304
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$121,914.66
|
$195,063.44
|
$158,489.05
|
2025-07-01
|
|
5832
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$119,591.80
|
$191,346.89
|
$155,469.35
|
2025-07-01
|
|
4
|
MS_DRG
|
Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…
|
8
|
8
|
—
|
—
|
$79,373.44
|
$226,080.00
|
$145,772.15
|
2025-07-01
|
|
5934
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$109,544.83
|
$175,271.74
|
$142,408.29
|
2025-07-01
|
|
5883
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$108,209.03
|
$173,134.48
|
$140,671.76
|
2025-07-01
|
|
5882
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$105,957.28
|
$169,531.65
|
$137,744.46
|
2025-07-01
|
|
5914
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$105,783.57
|
$169,253.71
|
$137,518.64
|
2025-07-01
|
|
6094
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$105,108.89
|
$168,174.25
|
$136,641.57
|
2025-07-01
|
|
14
|
MS_DRG
|
Allogeneic Bone Marrow Transplant
|
8
|
8
|
—
|
—
|
$73,597.66
|
$209,628.80
|
$135,164.72
|
2025-07-01
|
|
7
|
MS_DRG
|
Lung Transplant
|
8
|
8
|
—
|
—
|
$73,412.29
|
$209,100.80
|
$134,824.27
|
2025-07-01
|
|
5831
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$103,348.87
|
$165,358.21
|
$134,353.54
|
2025-07-01
|
|
6314
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$100,908.66
|
$161,453.84
|
$131,181.25
|
2025-07-01
|
|
0074
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$101,600.89
|
$152,401.34
|
$127,001.11
|
2025-07-01
|
|
0014
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$99,071.31
|
$148,606.97
|
$123,839.14
|
2025-07-01
|
|
1613
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$123,031.65
|
$123,031.66
|
$123,031.65
|
2025-07-01
|
|
0023
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$95,835.79
|
$143,753.72
|
$119,794.76
|
2025-07-01
|
|
6034
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$88,055.37
|
$140,888.59
|
$114,471.98
|
2025-07-01
|
|
8414
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$113,251.39
|
$113,251.39
|
$113,251.39
|
2025-07-01
|
|
212
|
MS_DRG
|
Concomitant Aortic And Mitral Valve Procedures
|
8
|
8
|
—
|
—
|
$61,195.07
|
$174,302.40
|
$112,386.92
|
2025-07-01
|
|
2
|
MS_DRG
|
Heart Transplant Or Implant Of Heart Assist System Without Mcc
|
8
|
8
|
—
|
—
|
$61,901.73
|
$176,315.20
|
$110,583.38
|
2025-07-01
|
|
5
|
MS_DRG
|
Liver Transplant With Mcc Or Intestinal Transplant
|
8
|
8
|
—
|
—
|
$59,821.62
|
$170,390.40
|
$109,864.54
|
2025-07-01
|
|
0064
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$87,491.39
|
$131,237.12
|
$109,364.26
|
2025-07-01
|
|
215
|
MS_DRG
|
Other Heart Assist System Implant
|
8
|
8
|
—
|
—
|
$59,514.91
|
$169,516.80
|
$109,301.26
|
2025-07-01
|
|
426
|
MS_DRG
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
8
|
8
|
—
|
—
|
$58,844.20
|
$167,606.40
|
$108,069.46
|
2025-07-01
|
|
0114
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$105,647.43
|
$105,647.44
|
$105,647.43
|
2025-07-01
|
|
6024
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$78,521.72
|
$125,634.78
|
$102,078.25
|
2025-07-01
|
|
0044
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$100,636.02
|
$100,636.02
|
$100,636.02
|
2025-07-01
|
|
216
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
8
|
8
|
—
|
—
|
$54,213.80
|
$154,417.60
|
$99,565.58
|
2025-07-01
|
|
1612
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$98,783.49
|
$98,783.50
|
$98,783.49
|
2025-07-01
|
|
0094
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$98,525.64
|
$98,525.65
|
$98,525.64
|
2025-07-01
|
|
850
|
MS_DRG
|
Acute Leukemia With Other Procedures
|
8
|
8
|
—
|
—
|
$51,746.65
|
$147,390.40
|
$95,034.57
|
2025-07-01
|
|
1611
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$93,844.33
|
$93,844.33
|
$93,844.33
|
2025-07-01
|
|
5933
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$70,444.62
|
$112,711.39
|
$91,578.01
|
2025-07-01
|
|
5881
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$69,745.48
|
$111,592.78
|
$90,669.13
|
2025-07-01
|
|
0022
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$71,120.53
|
$106,680.83
|
$88,900.68
|
2025-07-01
|
|
231
|
MS_DRG
|
Coronary Bypass With Ptca With Mcc
|
8
|
8
|
—
|
—
|
$47,601.03
|
$135,582.40
|
$87,420.99
|
2025-07-01
|
|
456
|
MS_DRG
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
8
|
8
|
—
|
—
|
$47,574.63
|
$135,507.20
|
$87,372.50
|
2025-07-01
|
|
429
|
MS_DRG
|
Combined Anterior And Posterior Cervical Spinal Fusion With Mcc
|
8
|
8
|
—
|
—
|
$46,852.24
|
$133,449.60
|
$86,045.80
|
2025-07-01
|
|
20
|
MS_DRG
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc
|
8
|
8
|
—
|
—
|
$45,282.18
|
$128,977.60
|
$83,162.34
|
2025-07-01
|
|
10
|
MS_DRG
|
Pancreas Transplant
|
8
|
8
|
—
|
—
|
$44,787.29
|
$127,568.00
|
$82,253.46
|
2025-07-01
|
|
19
|
MS_DRG
|
Simultaneous Pancreas And Kidney Transplant With Hemodialysis
|
8
|
8
|
—
|
—
|
$44,530.58
|
$126,836.80
|
$81,781.99
|
2025-07-01
|
|
233
|
MS_DRG
|
Coronary Bypass With Cardiac Catheterization With Mcc
|
8
|
8
|
—
|
—
|
$43,907.61
|
$125,062.40
|
$80,637.89
|
2025-07-01
|
|
5913
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$61,973.26
|
$99,157.23
|
$80,565.24
|
2025-07-01
|
|
6023
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$61,916.77
|
$99,066.83
|
$80,491.80
|
2025-07-01
|
|
219
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
8
|
8
|
—
|
—
|
$43,464.40
|
$123,800.00
|
$79,823.92
|
2025-07-01
|
|
6074
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$60,311.62
|
$96,498.59
|
$78,405.10
|
2025-07-01
|
|
957
|
MS_DRG
|
Other O.r. Procedures For Multiple Significant Trauma With Mcc
|
8
|
8
|
—
|
—
|
$41,929.17
|
$119,427.20
|
$77,004.42
|
2025-07-01
|
|
0063
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$61,519.28
|
$92,278.93
|
$76,899.10
|
2025-07-01
|
|
6303
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$58,906.49
|
$94,250.41
|
$76,578.45
|
2025-07-01
|
|
0021
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$60,969.40
|
$91,454.13
|
$76,211.76
|
2025-07-01
|
|
0073
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$59,876.01
|
$89,814.04
|
$74,845.02
|
2025-07-01
|
|
427
|
MS_DRG
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
8
|
8
|
—
|
—
|
$39,898.49
|
$113,643.20
|
$73,275.01
|
2025-07-01
|
|
275
|
MS_DRG
|
Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc
|
8
|
8
|
—
|
—
|
$39,697.95
|
$113,072.00
|
$72,906.70
|
2025-07-01
|
|
4404
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$58,209.24
|
$87,313.90
|
$72,761.57
|
2025-07-01
|
|
5932
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$55,833.73
|
$89,333.98
|
$72,583.85
|
2025-07-01
|
|
870
|
MS_DRG
|
Septicemia Or Severe Sepsis With Mv >96 Hours
|
8
|
8
|
—
|
—
|
$39,077.23
|
$111,304.00
|
$71,766.73
|
2025-07-01
|
|
0013
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$57,276.07
|
$85,914.11
|
$71,595.09
|
2025-07-01
|
|
A9543
|
HCPCS
|
Y90 Ibritumomab, Rx
|
14
|
14
|
—
|
—
|
$23,732.50
|
$93,657.53
|
$71,132.58
|
2025-07-01
|
|
955
|
MS_DRG
|
Craniotomy For Multiple Significant Trauma
|
8
|
8
|
—
|
—
|
$38,357.09
|
$109,252.80
|
$70,444.16
|
2025-07-01
|
|
447
|
MS_DRG
|
Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall…
|
8
|
8
|
—
|
—
|
$37,662.78
|
$107,275.20
|
$69,169.04
|
2025-07-01
|
|
928
|
MS_DRG
|
Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc
|
8
|
8
|
—
|
—
|
$37,517.85
|
$106,862.40
|
$68,902.88
|
2025-07-01
|
|
0043
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$68,867.98
|
$68,867.98
|
$68,867.98
|
2025-07-01
|
|
268
|
MS_DRG
|
Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc
|
8
|
8
|
—
|
—
|
$37,454.38
|
$106,681.60
|
$68,786.29
|
2025-07-01
|
|
6093
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$52,365.58
|
$83,784.94
|
$68,075.26
|
2025-07-01
|
|
1604
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$67,954.35
|
$67,954.36
|
$67,954.36
|
2025-07-01
|
|
0062
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$53,405.02
|
$80,107.54
|
$66,756.28
|
2025-07-01
|
|
207
|
MS_DRG
|
Respiratory System Diagnosis With Ventilator Support >96 Hours
|
8
|
8
|
—
|
—
|
$36,328.66
|
$103,475.20
|
$66,718.87
|
2025-07-01
|
|
217
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
8
|
8
|
—
|
—
|
$36,276.41
|
$103,326.40
|
$66,622.93
|
2025-07-01
|
|
0054
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$66,321.18
|
$66,321.18
|
$66,321.18
|
2025-07-01
|
|
969
|
MS_DRG
|
HIV With Extensive O.r. Procedures With Mcc
|
8
|
8
|
—
|
—
|
$35,525.93
|
$101,188.80
|
$65,244.64
|
2025-07-01
|
|
0084
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$51,395.68
|
$77,093.53
|
$64,244.60
|
2025-07-01
|
|
1624
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$64,045.67
|
$64,045.67
|
$64,045.67
|
2025-07-01
|
|
276
|
MS_DRG
|
Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator
|
8
|
8
|
—
|
—
|
$34,796.24
|
$99,110.40
|
$63,904.53
|
2025-07-01
|
|
317
|
MS_DRG
|
Concomitant Left Atrial Appendage Closure And Cardiac Ablation
|
8
|
8
|
—
|
—
|
$34,751.30
|
$98,982.40
|
$63,822.00
|
2025-07-01
|
|
573
|
MS_DRG
|
Skin Graft For Skin Ulcer Or Cellulitis With Mcc
|
8
|
8
|
—
|
—
|
$34,592.89
|
$98,531.20
|
$63,531.07
|
2025-07-01
|
|
461
|
MS_DRG
|
Bilateral Or Multiple Major Joint Procs Of Lower Extremity W Mcc
|
8
|
8
|
—
|
—
|
$34,472.11
|
$98,187.20
|
$63,309.27
|
2025-07-01
|
|
232
|
MS_DRG
|
Coronary Bypass With Ptca Without Mcc
|
8
|
8
|
—
|
—
|
$34,314.83
|
$97,739.20
|
$63,020.40
|
2025-07-01
|
|
28
|
MS_DRG
|
Spinal Procedures With Mcc
|
8
|
8
|
—
|
—
|
$34,150.80
|
$97,272.00
|
$62,719.17
|
2025-07-01
|
|
16
|
MS_DRG
|
Autologous Bone Marrow Transplant With Cc/mcc
|
8
|
8
|
—
|
—
|
$33,905.88
|
$96,574.40
|
$62,269.37
|
2025-07-01
|
|
17
|
MS_DRG
|
Autologous Bone Marrow Transplant Without Cc/mcc
|
8
|
8
|
—
|
—
|
$33,905.88
|
$96,574.40
|
$62,269.37
|
2025-07-01
|
|
266
|
MS_DRG
|
Endovascular Cardiac Valve Replacement W Mcc
|
8
|
8
|
—
|
—
|
$33,652.54
|
$95,852.80
|
$61,804.09
|
2025-07-01
|
|
6022
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$47,244.06
|
$75,590.50
|
$61,417.28
|
2025-07-01
|
|
218
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
8
|
8
|
—
|
—
|
$33,419.42
|
$95,188.80
|
$61,375.96
|
2025-07-01
|
|
3034
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$61,230.00
|
$61,230.01
|
$61,230.01
|
2025-07-01
|
|
6073
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$46,919.46
|
$75,071.12
|
$60,995.29
|
2025-07-01
|
|
235
|
MS_DRG
|
Coronary Bypass Without Cardiac Catheterization With Mcc
|
8
|
8
|
—
|
—
|
$33,053.73
|
$94,147.20
|
$60,704.35
|
2025-07-01
|
|
820
|
MS_DRG
|
Lymphoma And Leukemia With Major O.r. Procedures With Mcc
|
8
|
8
|
—
|
—
|
$32,706.01
|
$93,156.80
|
$60,065.76
|
2025-07-01
|
|
0012
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$48,004.27
|
$72,006.41
|
$60,005.34
|
2025-07-01
|
|
J9029
|
HCPCS
|
Instill Adstiladrin, Tx Dose
|
11
|
11
|
—
|
—
|
$38,934.00
|
$86,641.20
|
$60,000.00
|
2025-07-01
|
|
6114
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$45,832.12
|
$73,331.41
|
$59,581.76
|
2025-07-01
|
|
457
|
MS_DRG
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
8
|
8
|
—
|
—
|
$32,240.33
|
$91,830.40
|
$59,210.52
|
2025-07-01
|
|
23
|
MS_DRG
|
Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…
|
8
|
8
|
—
|
—
|
$32,047.66
|
$91,281.60
|
$58,856.67
|
2025-07-01
|
|
0072
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$46,835.71
|
$70,253.57
|
$58,544.64
|
2025-07-01
|
|
8634
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$44,932.42
|
$71,891.87
|
$58,412.14
|
2025-07-01
|
|
Q2043
|
HCPCS
|
Sipuleucel-t Auto Cd54+
|
12
|
12
|
—
|
—
|
$20,513.08
|
$93,644.70
|
$57,893.21
|
2025-07-01
|
|
790
|
MS_DRG
|
Extreme Immaturity Or Respiratory Distress Syndrome, Neonate
|
7
|
7
|
—
|
—
|
$0.70
|
$95,116.80
|
$57,563.50
|
2025-07-01
|
|
653
|
MS_DRG
|
Major Bladder Procedures With Mcc
|
8
|
8
|
—
|
—
|
$31,314.59
|
$89,193.60
|
$57,510.36
|
2025-07-01
|
|
8424
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$57,233.89
|
$57,233.90
|
$57,233.90
|
2025-07-01
|
|
21
|
MS_DRG
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc
|
8
|
8
|
—
|
—
|
$31,048.89
|
$88,436.80
|
$57,022.40
|
2025-07-01
|
|
834
|
MS_DRG
|
Acute Leukemia Without Major O.r. Procedures With Mcc
|
8
|
8
|
—
|
—
|
$31,048.89
|
$88,436.80
|
$57,022.40
|
2025-07-01
|
|
6124
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$43,827.26
|
$70,123.64
|
$56,975.45
|
2025-07-01
|
|
428
|
MS_DRG
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
8
|
8
|
—
|
—
|
$30,918.57
|
$88,065.60
|
$56,783.05
|
2025-07-01
|
|
430
|
MS_DRG
|
Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc
|
8
|
8
|
—
|
—
|
$30,729.82
|
$87,528.00
|
$56,436.42
|
2025-07-01
|
|
8
|
MS_DRG
|
Simultaneous Pancreas/kidney Transplant
|
8
|
8
|
—
|
—
|
$30,564.67
|
$87,057.60
|
$56,133.11
|
2025-07-01
|
|
405
|
MS_DRG
|
Pancreas, Liver And Shunt Procedures With Mcc
|
8
|
8
|
—
|
—
|
$30,495.02
|
$86,859.20
|
$56,005.18
|
2025-07-01
|
|
6134
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$42,999.44
|
$68,799.13
|
$55,899.29
|
2025-07-01
|
|
463
|
MS_DRG
|
Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …
|
8
|
8
|
—
|
—
|
$30,339.42
|
$86,416.00
|
$55,719.41
|
2025-07-01
|
|
6033
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$42,850.35
|
$68,560.56
|
$55,705.46
|
2025-07-01
|
|
11
|
MS_DRG
|
Tracheostomy For Face,mouth & Neck Diagnoses W Mcc
|
8
|
8
|
—
|
—
|
$30,310.77
|
$86,334.40
|
$55,666.81
|
2025-07-01
|
|
576
|
MS_DRG
|
Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc
|
8
|
8
|
—
|
—
|
$30,307.40
|
$86,324.80
|
$55,660.62
|
2025-07-01
|
|
7404
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$38,243.82
|
$72,663.26
|
$55,453.54
|
2025-07-01
|
|
234
|
MS_DRG
|
Coronary Bypass With Cardiac Catheterization Without Mcc
|
8
|
8
|
—
|
—
|
$29,885.53
|
$85,123.20
|
$54,885.85
|
2025-07-01
|
|
220
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
8
|
8
|
—
|
—
|
$29,753.52
|
$84,747.20
|
$54,643.41
|
2025-07-01
|
|
0915T
|
HCPCS
|
Insj Perm Ccm-d Sys Pg&eltrd
|
1
|
1
|
—
|
—
|
$54,504.69
|
$54,504.69
|
$54,504.69
|
2025-07-01
|
|
1634
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$54,499.12
|
$54,499.12
|
$54,499.12
|
2025-07-01
|
|
1784
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$54,135.54
|
$54,135.54
|
$54,135.54
|
2025-07-01
|
|
0011
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$42,621.17
|
$63,931.79
|
$53,276.48
|
2025-07-01
|
|
J9226
|
HCPCS
|
Histrelin Acetate (cpp) 50 Mg Sc Kit
|
23
|
22
|
$73,868.00
|
—
|
$21.00
|
$70,421.05
|
$53,184.96
|
2025-07-01
|
|
450
|
MS_DRG
|
Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically …
|
8
|
8
|
—
|
—
|
$28,930.02
|
$82,401.60
|
$53,131.01
|
2025-07-01
|
|
270
|
MS_DRG
|
Other Major Cardiovascular Procedures With Mcc
|
8
|
8
|
—
|
—
|
$28,833.96
|
$82,128.00
|
$52,954.60
|
2025-07-01
|
|
466
|
MS_DRG
|
Revision Of Hip Or Knee Replacement With Mcc
|
8
|
8
|
—
|
—
|
$28,618.25
|
$81,513.60
|
$52,558.44
|
2025-07-01
|
|
0686T
|
HCPCS
|
Hb Histotripsy Mal Hepatocellular Tiss W/img Gdn
|
19
|
18
|
$70,002.00
|
—
|
$7,875.32
|
$63,001.80
|
$52,501.50
|
2025-07-01
|
|
0061
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$41,978.79
|
$62,968.21
|
$52,473.50
|
2025-07-01
|
|
326
|
MS_DRG
|
Stomach, Esophageal And Duodenal Procedures With Mcc
|
8
|
8
|
—
|
—
|
$28,530.62
|
$81,264.00
|
$52,397.51
|
2025-07-01
|
|
0071
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$41,703.22
|
$62,554.84
|
$52,129.03
|
2025-07-01
|
|
0113
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$52,002.27
|
$52,002.27
|
$52,002.27
|
2025-07-01
|
|
239
|
MS_DRG
|
Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc
|
8
|
8
|
—
|
—
|
$28,294.13
|
$80,590.40
|
$51,963.18
|
2025-07-01
|
|
Q0480
|
HCPCS
|
Driver Pneumatic Vad, Rep
|
1
|
1
|
—
|
—
|
$51,896.90
|
$51,896.90
|
$51,896.90
|
2025-07-01
|
|
7594
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$35,786.12
|
$67,993.61
|
$51,889.87
|
2025-07-01
|
|
0268T
|
HCPCS
|
Implt/rpl Crtd Sns Dev Gen
|
1
|
1
|
—
|
—
|
$51,805.10
|
$51,805.10
|
$51,805.10
|
2025-07-01
|
|
837
|
MS_DRG
|
Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot…
|
8
|
8
|
—
|
—
|
$28,127.30
|
$80,115.20
|
$51,656.78
|
2025-07-01
|
|
278
|
MS_DRG
|
Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures …
|
8
|
8
|
—
|
—
|
$28,105.39
|
$80,052.80
|
$51,616.54
|
2025-07-01
|
|
853
|
MS_DRG
|
Infectious And Parasitic Diseases With O.r. Procedures With Mcc
|
8
|
8
|
—
|
—
|
$28,094.15
|
$80,020.80
|
$51,595.91
|
2025-07-01
|
|
228
|
MS_DRG
|
Other Cardiothoracic Procedures With Mcc
|
8
|
8
|
—
|
—
|
$27,993.04
|
$79,732.80
|
$51,410.21
|
2025-07-01
|
|
245
|
MS_DRG
|
Aicd Generator Procedures
|
8
|
8
|
—
|
—
|
$27,450.96
|
$78,188.80
|
$50,414.67
|
2025-07-01
|
|
6313
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$38,751.64
|
$62,002.64
|
$50,377.14
|
2025-07-01
|
|
471
|
MS_DRG
|
Cervical Spinal Fusion With Mcc
|
8
|
8
|
—
|
—
|
$27,285.25
|
$77,716.80
|
$50,110.34
|
2025-07-01
|
|
6
|
MS_DRG
|
Liver Transplant Without Mcc
|
8
|
8
|
—
|
—
|
$27,239.75
|
$77,587.20
|
$50,026.77
|
2025-07-01
|
|
1654
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$49,838.32
|
$49,838.33
|
$49,838.32
|
2025-07-01
|
|
6084
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$38,187.01
|
$61,099.22
|
$49,643.12
|
2025-07-01
|
|
826
|
MS_DRG
|
Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. …
|
8
|
8
|
—
|
—
|
$26,825.75
|
$76,408.00
|
$49,266.45
|
2025-07-01
|
|
799
|
MS_DRG
|
Splenic Procedures With Mcc
|
8
|
8
|
—
|
—
|
$26,709.47
|
$76,076.80
|
$49,052.90
|
2025-07-01
|
|
981
|
MS_DRG
|
Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc
|
8
|
8
|
—
|
—
|
$26,704.42
|
$76,062.40
|
$49,043.61
|
2025-07-01
|
|
1674
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$49,022.11
|
$49,022.12
|
$49,022.12
|
2025-07-01
|
|
0053
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$48,838.14
|
$48,838.14
|
$48,838.14
|
2025-07-01
|
|
90288
|
HCPCS
|
Botulism Ig IV
|
1
|
1
|
—
|
—
|
$48,705.00
|
$48,705.00
|
$48,705.00
|
2025-07-01
|
|
6302
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$37,374.04
|
$59,798.47
|
$48,586.26
|
2025-07-01
|
|
267
|
MS_DRG
|
Endovascular Cardiac Valve Replacement Without Mcc
|
8
|
8
|
—
|
—
|
$26,428.04
|
$75,275.20
|
$48,536.04
|
2025-07-01
|
|
823
|
MS_DRG
|
Lymphoma And Non-acute Leukemia With Other Procedures With Mcc
|
8
|
8
|
—
|
—
|
$26,286.48
|
$74,872.00
|
$48,276.07
|
2025-07-01
|
|
277
|
MS_DRG
|
Cardiac Defibrillator Implant Without Mcc
|
8
|
8
|
—
|
—
|
$26,131.44
|
$74,430.40
|
$47,991.33
|
2025-07-01
|
|
4403
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$38,369.43
|
$57,554.17
|
$47,961.80
|
2025-07-01
|
|
163
|
MS_DRG
|
Major Chest Procedures With Mcc
|
8
|
8
|
—
|
—
|
$25,891.58
|
$73,747.20
|
$47,550.81
|
2025-07-01
|
|
650
|
MS_DRG
|
Kidney Transplant With Hemodialysis With Mcc
|
8
|
8
|
—
|
—
|
$25,880.91
|
$73,716.80
|
$47,531.21
|
2025-07-01
|
|
221
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
8
|
8
|
—
|
—
|
$25,798.33
|
$73,481.60
|
$47,379.56
|
2025-07-01
|
|
329
|
MS_DRG
|
Major Small And Large Bowel Procedures With Mcc
|
8
|
8
|
—
|
—
|
$25,794.40
|
$73,470.40
|
$47,372.34
|
2025-07-01
|
|
0042
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$47,347.52
|
$47,347.52
|
$47,347.52
|
2025-07-01
|
|
6083
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$36,368.56
|
$58,189.70
|
$47,279.13
|
2025-07-01
|
|
6072
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$36,330.82
|
$58,129.33
|
$47,230.07
|
2025-07-01
|
|
C9293
|
HCPCS
|
Glucarpidase 1000 Units IV Solr
|
20
|
19
|
$66,274.00
|
—
|
$21.00
|
$59,646.60
|
$47,054.54
|
2025-07-01
|
|
3044
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$46,996.52
|
$46,996.52
|
$46,996.52
|
2025-07-01
|
|
6214
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$35,956.11
|
$57,529.76
|
$46,742.93
|
2025-07-01
|
|
856
|
MS_DRG
|
Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc
|
8
|
8
|
—
|
—
|
$25,343.33
|
$72,185.60
|
$46,543.92
|
2025-07-01
|
|
3033
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$46,360.72
|
$46,360.73
|
$46,360.73
|
2025-07-01
|
|
474
|
MS_DRG
|
Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc
|
8
|
8
|
—
|
—
|
$25,192.22
|
$71,755.20
|
$46,266.41
|
2025-07-01
|
|
1834
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$46,195.75
|
$46,195.76
|
$46,195.76
|
2025-07-01
|
|
25
|
MS_DRG
|
Craniotomy And Endovascular Intracranial Procedures With Mcc
|
8
|
8
|
—
|
—
|
$25,122.56
|
$71,556.80
|
$46,138.49
|
2025-07-01
|
|
901
|
MS_DRG
|
Wound Debridements For Injuries With Mcc
|
8
|
8
|
—
|
—
|
$24,887.76
|
$70,888.00
|
$45,707.26
|
2025-07-01
|
|
0093
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$45,409.62
|
$45,409.63
|
$45,409.62
|
2025-07-01
|
|
319
|
MS_DRG
|
Other Endovascular Cardiac Valve Procedures With Mcc
|
8
|
8
|
—
|
—
|
$24,675.98
|
$70,284.80
|
$45,318.32
|
2025-07-01
|
|
1664
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$44,924.65
|
$44,924.65
|
$44,924.65
|
2025-07-01
|
|
6144
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$34,555.08
|
$55,288.12
|
$44,921.60
|
2025-07-01
|
|
933
|
MS_DRG
|
Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft
|
8
|
8
|
—
|
—
|
$24,305.80
|
$69,230.40
|
$44,638.46
|
2025-07-01
|
|
458
|
MS_DRG
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
8
|
8
|
—
|
—
|
$24,255.80
|
$69,088.00
|
$44,546.65
|
2025-07-01
|
|
9104
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$44,380.87
|
$44,380.87
|
$44,380.87
|
2025-07-01
|
|
1794
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$44,105.36
|
$44,105.36
|
$44,105.36
|
2025-07-01
|
|
356
|
MS_DRG
|
Other Digestive System O.r. Procedures With Mcc
|
8
|
8
|
—
|
—
|
$23,962.02
|
$68,251.20
|
$44,007.10
|
2025-07-01
|
|
323
|
MS_DRG
|
Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc
|
8
|
8
|
—
|
—
|
$23,926.63
|
$68,150.40
|
$43,942.10
|
2025-07-01
|
|
6804
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$43,922.73
|
$43,922.74
|
$43,922.74
|
2025-07-01
|
|
1623
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$43,866.14
|
$43,866.14
|
$43,866.14
|
2025-07-01
|
|
140
|
MS_DRG
|
Major Head And Neck Procedures With Mcc
|
8
|
8
|
—
|
—
|
$23,756.98
|
$67,667.20
|
$43,630.54
|
2025-07-01
|
|
31
|
MS_DRG
|
Ventricular Shunt Procedures With Mcc
|
8
|
8
|
—
|
—
|
$23,540.15
|
$67,049.60
|
$43,232.32
|
2025-07-01
|
|
673
|
MS_DRG
|
Other Kidney And Urinary Tract Procedures With Mcc
|
8
|
8
|
—
|
—
|
$23,534.53
|
$67,033.60
|
$43,222.01
|
2025-07-01
|
|
269
|
MS_DRG
|
Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc
|
8
|
8
|
—
|
—
|
$23,372.19
|
$66,571.20
|
$42,923.86
|
2025-07-01
|
|
5912
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$32,977.20
|
$52,763.51
|
$42,870.35
|
2025-07-01
|
|
5891
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$32,816.39
|
$52,506.25
|
$42,661.32
|
2025-07-01
|
|
6334
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$32,680.47
|
$52,288.74
|
$42,484.60
|
2025-07-01
|
|
236
|
MS_DRG
|
Coronary Bypass Without Cardiac Catheterization Without Mcc
|
8
|
8
|
—
|
—
|
$23,099.19
|
$65,793.60
|
$42,422.48
|
2025-07-01
|
|
958
|
MS_DRG
|
Other O.r. Procedures For Multiple Significant Trauma With Cc
|
8
|
8
|
—
|
—
|
$23,086.27
|
$65,756.80
|
$42,398.75
|
2025-07-01
|
|
12
|
MS_DRG
|
Tracheostomy For Face,mouth & Neck Diagnoses W Cc
|
8
|
8
|
—
|
—
|
$23,052.00
|
$65,659.20
|
$42,335.82
|
2025-07-01
|
|
448
|
MS_DRG
|
Multiple Level Spinal Fusion Except Cervical Without Mcc
|
8
|
8
|
—
|
—
|
$22,938.53
|
$65,336.00
|
$42,127.43
|
2025-07-01
|
|
1694
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$42,047.58
|
$42,047.59
|
$42,047.58
|
2025-07-01
|
|
423
|
MS_DRG
|
Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc
|
8
|
8
|
—
|
—
|
$22,848.09
|
$65,078.40
|
$41,961.33
|
2025-07-01
|
|
9114
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$41,928.24
|
$41,928.25
|
$41,928.24
|
2025-07-01
|
|
3124
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$41,745.67
|
$41,745.67
|
$41,745.67
|
2025-07-01
|
|
8413
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$41,561.96
|
$41,561.96
|
$41,561.96
|
2025-07-01
|
|
0914
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$41,527.08
|
$41,527.08
|
$41,527.08
|
2025-07-01
|
|
4402
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$32,907.87
|
$49,361.83
|
$41,134.85
|
2025-07-01
|
|
907
|
MS_DRG
|
Other O.r. Procedures For Injuries With Mcc
|
8
|
8
|
—
|
—
|
$22,377.92
|
$63,739.20
|
$41,097.85
|
2025-07-01
|
|
739
|
MS_DRG
|
Uterine,adnexa Proc For Non-ovarian/adnexal Malig W Mcc
|
8
|
8
|
—
|
—
|
$22,362.19
|
$63,694.40
|
$41,068.96
|
2025-07-01
|
|
6993050
|
HCPCS
|
Implant Cochlear Device
|
1
|
1
|
—
|
—
|
$40,944.65
|
$40,944.65
|
$40,944.65
|
2025-07-01
|
|
9124
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$40,736.95
|
$40,736.95
|
$40,736.95
|
2025-07-01
|
|
628
|
MS_DRG
|
Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc
|
8
|
8
|
—
|
—
|
$22,164.46
|
$63,131.20
|
$40,705.82
|
2025-07-01
|
|
736
|
MS_DRG
|
Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc
|
8
|
8
|
—
|
—
|
$22,118.96
|
$63,001.60
|
$40,622.25
|
2025-07-01
|
|
876
|
MS_DRG
|
O.r. Procedures With Principal Diagnosis Of Mental Illness
|
8
|
8
|
—
|
—
|
$22,074.02
|
$62,873.60
|
$40,539.72
|
2025-07-01
|
|
33276
|
HCPCS
|
Insj Phrnc Nrv Stim Sys
|
5
|
5
|
—
|
—
|
$481.27
|
$76,500.85
|
$40,500.45
|
2025-07-01
|
|
0083
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$32,362.90
|
$48,544.38
|
$40,453.64
|
2025-07-01
|
|
793
|
MS_DRG
|
Full Term Neonate With Major Problems
|
7
|
7
|
—
|
—
|
$0.70
|
$66,728.00
|
$40,382.95
|
2025-07-01
|
|
402
|
MS_DRG
|
Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical
|
8
|
8
|
—
|
—
|
$21,976.27
|
$62,595.20
|
$40,360.21
|
2025-07-01
|
|
273
|
MS_DRG
|
Percutaneous Intracardiac Procedures W Mcc
|
8
|
8
|
—
|
—
|
$21,965.60
|
$62,564.80
|
$40,340.61
|
2025-07-01
|
|
34
|
MS_DRG
|
Carotid Artery Stent Procedures With Mcc
|
8
|
8
|
—
|
—
|
$21,844.27
|
$62,219.20
|
$40,117.77
|
2025-07-01
|
|
6123
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$30,822.33
|
$49,315.72
|
$40,069.03
|
2025-07-01
|
|
1783
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$40,049.04
|
$40,049.05
|
$40,049.04
|
2025-07-01
|
|
8504
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$39,885.91
|
$39,885.91
|
$39,885.91
|
2025-07-01
|
|
616
|
MS_DRG
|
Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With…
|
8
|
8
|
—
|
—
|
$21,711.14
|
$61,840.00
|
$39,873.28
|
2025-07-01
|
|
904
|
MS_DRG
|
Skin Grafts For Injuries With Cc/mcc
|
8
|
8
|
—
|
—
|
$21,689.23
|
$61,777.60
|
$39,833.04
|
2025-07-01
|
|
0234
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$39,784.23
|
$39,784.23
|
$39,784.23
|
2025-07-01
|
|
166
|
MS_DRG
|
Other Respiratory System O.r. Procedures With Mcc
|
8
|
8
|
—
|
—
|
$21,628.56
|
$61,604.80
|
$39,721.62
|
2025-07-01
|
|
956
|
MS_DRG
|
Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma
|
8
|
8
|
—
|
—
|
$21,471.84
|
$61,158.40
|
$39,433.79
|
2025-07-01
|
|
791
|
MS_DRG
|
Prematurity With Major Problems
|
7
|
7
|
—
|
—
|
$0.70
|
$64,958.40
|
$39,312.01
|
2025-07-01
|
|
0214
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$39,238.88
|
$39,238.88
|
$39,238.88
|
2025-07-01
|
|
4414
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$39,231.64
|
$39,231.65
|
$39,231.65
|
2025-07-01
|
|
24
|
MS_DRG
|
Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…
|
8
|
8
|
—
|
—
|
$21,355.56
|
$60,827.20
|
$39,220.24
|
2025-07-01
|
|
40
|
MS_DRG
|
Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc
|
8
|
8
|
—
|
—
|
$21,189.28
|
$60,353.60
|
$38,914.87
|
2025-07-01
|
|
6113
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$29,852.28
|
$47,763.65
|
$38,807.96
|
2025-07-01
|
|
2604
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$38,739.65
|
$38,739.65
|
$38,739.65
|
2025-07-01
|
|
622
|
MS_DRG
|
Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor…
|
8
|
8
|
—
|
—
|
$21,020.20
|
$59,872.00
|
$38,604.35
|
2025-07-01
|
|
0266T
|
HCPCS
|
Implt/rpl Crtd Sns Dev Total
|
2
|
2
|
—
|
—
|
$229.54
|
$76,500.85
|
$38,365.20
|
2025-07-01
|
|
0916T
|
HCPCS
|
Insj Perm Ccm-d Sys Pg Only
|
1
|
1
|
—
|
—
|
$38,158.52
|
$38,158.52
|
$38,158.52
|
2025-07-01
|
|
6456850
|
HCPCS
|
Opn Impltj Crnl Nrv Nea&pg
|
1
|
1
|
—
|
—
|
$37,913.83
|
$37,913.83
|
$37,913.83
|
2025-07-01
|
|
6458250
|
HCPCS
|
Opn Mpltj Hpglsl Nstm Ary Pg
|
1
|
1
|
—
|
—
|
$37,913.83
|
$37,913.83
|
$37,913.83
|
2025-07-01
|
|
94
|
MS_DRG
|
Bacterial And Tuberculous Infections Of Nervous System With Mcc
|
8
|
8
|
—
|
—
|
$20,496.10
|
$58,379.20
|
$37,641.82
|
2025-07-01
|
|
8633
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$28,829.84
|
$46,127.77
|
$37,478.81
|
2025-07-01
|
|
6814
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$37,453.32
|
$37,453.32
|
$37,453.32
|
2025-07-01
|
|
335
|
MS_DRG
|
Peritoneal Adhesiolysis With Mcc
|
8
|
8
|
—
|
—
|
$20,353.98
|
$57,974.40
|
$37,380.81
|
2025-07-01
|
|
1782
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$37,313.13
|
$37,313.14
|
$37,313.13
|
2025-07-01
|
|
2204
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$37,167.12
|
$37,167.12
|
$37,167.12
|
2025-07-01
|
|
802
|
MS_DRG
|
Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc
|
8
|
8
|
—
|
—
|
$20,137.15
|
$57,356.80
|
$36,982.59
|
2025-07-01
|
|
97
|
MS_DRG
|
Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc
|
8
|
8
|
—
|
—
|
$20,136.02
|
$57,353.60
|
$36,980.53
|
2025-07-01
|
|
518
|
MS_DRG
|
Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost…
|
8
|
8
|
—
|
—
|
$20,132.65
|
$57,344.00
|
$36,974.34
|
2025-07-01
|
|
0894
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$36,915.31
|
$36,915.32
|
$36,915.32
|
2025-07-01
|
|
6224
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$28,380.29
|
$45,408.49
|
$36,894.39
|
2025-07-01
|
|
1653
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$36,808.56
|
$36,808.56
|
$36,808.56
|
2025-07-01
|
|
265
|
MS_DRG
|
Aicd Lead Procedures
|
8
|
8
|
—
|
—
|
$20,038.28
|
$57,075.20
|
$36,801.02
|
2025-07-01
|
|
4401
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$29,384.58
|
$44,076.91
|
$36,730.75
|
2025-07-01
|
|
492
|
MS_DRG
|
Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc
|
8
|
8
|
—
|
—
|
$19,948.40
|
$56,819.20
|
$36,635.96
|
2025-07-01
|
|
9504
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$36,551.68
|
$36,551.68
|
$36,551.68
|
2025-07-01
|
|
1603
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$36,478.35
|
$36,478.35
|
$36,478.35
|
2025-07-01
|
|
0817T
|
HCPCS
|
Opn Insj/rplcmt Ins Ptn Subf
|
1
|
1
|
—
|
—
|
$36,455.46
|
$36,455.46
|
$36,455.46
|
2025-07-01
|
|
0816T
|
HCPCS
|
Opn Insj/rplcmt Ins Ptn Subq
|
1
|
1
|
—
|
—
|
$36,455.46
|
$36,455.46
|
$36,455.46
|
2025-07-01
|
|
6133
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$28,039.50
|
$44,863.20
|
$36,451.35
|
2025-07-01
|
|
420
|
MS_DRG
|
Hepatobiliary Diagnostic Procedures With Mcc
|
8
|
8
|
—
|
—
|
$19,826.51
|
$56,472.00
|
$36,412.09
|
2025-07-01
|
|
7524
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$25,078.78
|
$47,649.71
|
$36,364.24
|
2025-07-01
|
|
J9118
|
HCPCS
|
Calaspargase Pegol-mknl 3750 Unit/5ml IV Soln
|
23
|
22
|
$54,222.00
|
—
|
$21.00
|
$48,799.80
|
$36,328.74
|
2025-07-01
|
|
495
|
MS_DRG
|
Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit…
|
8
|
8
|
—
|
—
|
$19,776.51
|
$56,329.60
|
$36,320.27
|
2025-07-01
|
|
1633
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$36,281.35
|
$36,281.36
|
$36,281.35
|
2025-07-01
|
|
0204
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$36,200.68
|
$36,200.68
|
$36,200.68
|
2025-07-01
|
|
414
|
MS_DRG
|
Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc
|
8
|
8
|
—
|
—
|
$19,682.14
|
$56,060.80
|
$36,146.96
|
2025-07-01
|
|
987
|
MS_DRG
|
Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc
|
8
|
8
|
—
|
—
|
$19,675.96
|
$56,043.20
|
$36,135.60
|
2025-07-01
|
|
408
|
MS_DRG
|
Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With…
|
8
|
8
|
—
|
—
|
$19,668.10
|
$56,020.80
|
$36,121.16
|
2025-07-01
|
|
264
|
MS_DRG
|
Other Circulatory System O.r. Procedures
|
8
|
8
|
—
|
—
|
$19,633.27
|
$55,921.60
|
$36,057.20
|
2025-07-01
|
|
1204
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$36,033.82
|
$36,033.82
|
$36,033.82
|
2025-07-01
|
|
6904
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$35,850.54
|
$35,850.55
|
$35,850.54
|
2025-07-01
|
|
651
|
MS_DRG
|
Kidney Transplant With Hemodialysis Without Mcc
|
8
|
8
|
—
|
—
|
$19,506.32
|
$55,560.00
|
$35,824.05
|
2025-07-01
|
|
332
|
MS_DRG
|
Rectal Resection With Mcc
|
8
|
8
|
—
|
—
|
$19,484.97
|
$55,499.20
|
$35,784.85
|
2025-07-01
|
|
0052
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$35,748.37
|
$35,748.38
|
$35,748.38
|
2025-07-01
|
|
574
|
MS_DRG
|
Skin Graft For Skin Ulcer Or Cellulitis With Cc
|
8
|
8
|
—
|
—
|
$19,463.63
|
$55,438.40
|
$35,745.65
|
2025-07-01
|
|
J7330
|
HCPCS
|
Cultured Chondrocytes Implnt
|
3
|
3
|
—
|
—
|
$16,585.69
|
$67,138.44
|
$35,622.55
|
2025-07-01
|
|
271
|
MS_DRG
|
Other Major Cardiovascular Procedures With Cc
|
8
|
8
|
—
|
—
|
$19,348.47
|
$55,110.40
|
$35,534.15
|
2025-07-01
|
|
477
|
MS_DRG
|
Biopsies Of Musculoskeletal System And Connective Tissue With Mcc
|
8
|
8
|
—
|
—
|
$19,318.14
|
$55,024.00
|
$35,478.44
|
2025-07-01
|
|
665
|
MS_DRG
|
Prostatectomy With Mcc
|
8
|
8
|
—
|
—
|
$19,287.80
|
$54,937.60
|
$35,422.74
|
2025-07-01
|
|
5892
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$27,242.78
|
$43,588.48
|
$35,415.63
|
2025-07-01
|
|
252
|
MS_DRG
|
Other Vascular Procedures With Mcc
|
8
|
8
|
—
|
—
|
$19,269.83
|
$54,886.40
|
$35,389.72
|
2025-07-01
|
|
J9269
|
HCPCS
|
Tagraxofusp-erzs 1000 Mcg/ml IV Soln
|
25
|
24
|
$58,942.00
|
—
|
$21.00
|
$53,047.80
|
$35,365.20
|
2025-07-01
|
|
3614
|
APR_DRG
|
—
|
4
|
4
|
—
|
—
|
$35,352.93
|
$35,352.94
|
$35,352.93
|
2025-07-01
|
|
467
|
MS_DRG
|
Revision Of Hip Or Knee Replacement With Cc
|
8
|
8
|
—
|
—
|
$19,240.62
|
$54,803.20
|
$35,336.07
|
2025-07-01
|
|
260
|
MS_DRG
|
Cardiac Pacemaker Revision Except Device Replacement With Mcc
|
8
|
8
|
—
|
—
|
$19,133.89
|
$54,499.20
|
$35,140.06
|
2025-07-01
|