|
Q2055
|
HCPCS
|
Idecabtagene Vicleucel 460000000 Cells IV Susp
|
37
|
24
|
$4,694,981.46
|
$2,347,490.73
50% off
|
$820.50
|
$4,225,483.00
|
$2,380,356.00
|
2024-12-15
|
|
Q2054
|
HCPCS
|
Lisocabtagene Maraleucel 70000000 Cells/ml IV Susp
|
37
|
24
|
$4,592,049.12
|
$2,296,024.56
50% off
|
$820.50
|
$4,132,844.00
|
$2,328,169.00
|
2024-12-15
|
|
Q2042
|
HCPCS
|
Tisagenlecleucel IV Infusion (wrapped)
|
37
|
24
|
$4,022,805.11
|
$2,011,402.56
50% off
|
$820.50
|
$3,620,525.00
|
$2,039,562.00
|
2024-12-15
|
|
A9520
|
HCPCS
|
Technetium-99 (tc-99) Tilmanocept (lymphoseek) Radio-isotope Injection
|
37
|
24
|
$770,386.00
|
$385,193.00
50% off
|
$10.00
|
$693,347.00
|
$390,586.00
|
2024-12-15
|
|
18
|
MS_DRG
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
9
|
7
|
$0.01
|
—
|
$261,491.00
|
$443,318.00
|
$277,699.00
|
2024-12-15
|
|
5834
|
APR_DRG
|
Neonate With Ecmo
|
11
|
10
|
$0.01
|
—
|
$267,255.00
|
$489,077.00
|
$267,255.00
|
2024-12-15
|
|
74
|
APR_DRG
|
Allogeneic Bone Marrow Transplant
|
11
|
10
|
$0.01
|
—
|
$259,986.00
|
$475,775.00
|
$259,986.00
|
2024-12-15
|
|
A9595
|
HCPCS
|
Piflufolastat F 18 9 Mci IV Sosy
|
37
|
24
|
$475,098.80
|
$237,549.40
50% off
|
$615.00
|
$427,589.00
|
$240,875.00
|
2024-12-15
|
|
A9588
|
HCPCS
|
Fluciclovine F 18 9-221 Mci/ml IV Soln
|
37
|
24
|
$460,111.00
|
$230,055.50
50% off
|
$82.00
|
$414,100.00
|
$233,276.00
|
2024-12-15
|
|
5833
|
APR_DRG
|
Neonate With Ecmo
|
11
|
10
|
$0.01
|
—
|
$226,302.00
|
$414,132.00
|
$226,302.00
|
2024-12-15
|
|
24
|
APR_DRG
|
Heart And/or Lung Transplant
|
11
|
10
|
$0.01
|
—
|
$217,696.00
|
$398,384.00
|
$217,696.00
|
2024-12-15
|
|
1
|
MS_DRG
|
Heart Transplant Or Implant Of Heart Assist System With Mcc
|
9
|
7
|
$0.01
|
—
|
$195,312.00
|
$331,544.00
|
$207,840.00
|
2024-12-15
|
|
A9572
|
HCPCS
|
Indium In-111 Pentetreotide IV Kit
|
37
|
24
|
$386,681.14
|
$193,340.57
50% off
|
$59.00
|
$348,013.00
|
$196,047.00
|
2024-12-15
|
|
927
|
MS_DRG
|
Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft
|
9
|
7
|
$0.01
|
—
|
$164,488.00
|
$279,483.00
|
$175,302.00
|
2024-12-15
|
|
5884
|
APR_DRG
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
11
|
10
|
$0.01
|
—
|
$169,168.00
|
$309,578.00
|
$169,168.00
|
2024-12-15
|
|
1614
|
APR_DRG
|
Implantable Heart Assist Systems
|
11
|
10
|
$0.01
|
—
|
$164,274.00
|
$300,621.00
|
$164,274.00
|
2024-12-15
|
|
A9569
|
HCPCS
|
Technetium-99 (tc-99) Exametazime White Blood Cells Radio-isotope Injection
|
37
|
24
|
$317,369.80
|
$158,684.90
50% off
|
$56.00
|
$285,633.00
|
$160,906.00
|
2024-12-15
|
|
3
|
MS_DRG
|
Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…
|
9
|
7
|
$0.01
|
—
|
$148,601.00
|
$252,651.00
|
$158,532.00
|
2024-12-15
|
|
94
|
APR_DRG
|
Extracorporeal Membrane Oxygenation (ecmo)
|
11
|
10
|
$0.01
|
—
|
$153,899.00
|
$281,635.00
|
$153,899.00
|
2024-12-15
|
|
C1831
|
HCPCS
|
Kit Imp Aprevo Spine Lvl 2
|
37
|
24
|
$291,808.00
|
$145,904.00
50% off
|
$820.50
|
$262,627.00
|
$147,947.00
|
2024-12-15
|
|
C1825
|
HCPCS
|
System Neo Barostim Includes 2102 Ipg 1036 Csl Kit
|
58
|
24
|
$232,120.00
|
$116,060.00
50% off
|
$820.50
|
$208,908.00
|
$134,583.50
|
2024-12-15
|
|
6304
|
APR_DRG
|
Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure
|
11
|
10
|
$0.01
|
—
|
$125,872.00
|
$230,346.00
|
$125,872.00
|
2024-12-15
|
|
6094
|
APR_DRG
|
Neonate Birth Weight 1500-2499 Grams With Major Procedure
|
11
|
10
|
$0.01
|
—
|
$124,757.00
|
$228,305.00
|
$124,757.00
|
2024-12-15
|
|
A9591
|
HCPCS
|
Fluoroestradiol F 18 4-100 Mci/ml IV Soln
|
37
|
24
|
$243,748.00
|
$121,874.00
50% off
|
$68.00
|
$219,373.00
|
$123,580.00
|
2024-12-15
|
|
C1824
|
HCPCS
|
Generator Pul Implantable Optimizer Smt F/hrt Fail
|
58
|
24
|
$190,670.00
|
$95,335.00
50% off
|
$820.50
|
$193,986.00
|
$123,397.00
|
2024-12-15
|
|
C1822
|
HCPCS
|
Construct Neuromod Nevro Pain Mgmt Omnia With Ipg Rm
|
58
|
24
|
$169,945.00
|
$84,972.50
50% off
|
$820.50
|
$193,986.00
|
$114,713.00
|
2024-12-15
|
|
5832
|
APR_DRG
|
Neonate With Ecmo
|
11
|
10
|
$0.01
|
—
|
$112,761.00
|
$206,353.00
|
$112,761.00
|
2024-12-15
|
|
114
|
APR_DRG
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
11
|
10
|
$0.01
|
—
|
$107,074.00
|
$195,945.00
|
$107,074.00
|
2024-12-15
|
|
4
|
MS_DRG
|
Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…
|
9
|
7
|
$0.01
|
—
|
$97,974.00
|
$167,142.00
|
$105,089.00
|
2024-12-15
|
|
C1882
|
HCPCS
|
Defibrillator Crdc Protecta Xt
|
1,050
|
11
|
$143,582.80
|
$71,791.40
50% off
|
$13.00
|
$243,161.00
|
$102,155.00
|
2024-12-15
|
|
C1767
|
HCPCS
|
Stimulator Proclaim Elite 7 Rechrg-free Scs
|
441
|
11
|
$141,759.00
|
$70,879.50
50% off
|
$30,605.00
|
$256,442.00
|
$101,171.00
|
2024-12-15
|
|
2004
|
APR_DRG
|
Cardiac Structural And Valvular Disorders
|
11
|
10
|
$0.01
|
—
|
$99,501.00
|
$182,087.00
|
$99,501.00
|
2024-12-15
|
|
5831
|
APR_DRG
|
Neonate With Ecmo
|
11
|
10
|
$0.01
|
—
|
$99,288.00
|
$181,698.00
|
$99,288.00
|
2024-12-15
|
|
14
|
MS_DRG
|
Allogeneic Bone Marrow Transplant
|
9
|
7
|
$0.01
|
—
|
$90,845.00
|
$155,101.00
|
$97,563.00
|
2024-12-15
|
|
7
|
MS_DRG
|
Lung Transplant
|
9
|
7
|
$0.01
|
—
|
$90,616.00
|
$154,715.00
|
$97,322.00
|
2024-12-15
|
|
C1816
|
HCPCS
|
System Stim Nerv Stimq-4 8 Elect Dl Transm Kt
|
58
|
24
|
$169,945.00
|
$84,972.50
50% off
|
$820.50
|
$152,951.00
|
$96,931.00
|
2024-12-15
|
|
C2616
|
HCPCS
|
Sphere Embol Sir Msphre 90
|
65
|
16
|
$143,417.00
|
$71,708.50
50% off
|
$17,177.00
|
$309,526.00
|
$93,221.00
|
2024-12-15
|
|
73
|
APR_DRG
|
Allogeneic Bone Marrow Transplant
|
11
|
10
|
$0.01
|
—
|
$91,739.00
|
$167,883.00
|
$91,739.00
|
2024-12-15
|
|
5883
|
APR_DRG
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
11
|
10
|
$0.01
|
—
|
$90,770.00
|
$166,109.00
|
$90,770.00
|
2024-12-15
|
|
5882
|
APR_DRG
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
11
|
10
|
$0.01
|
—
|
$90,355.00
|
$165,350.00
|
$90,355.00
|
2024-12-15
|
|
44
|
APR_DRG
|
Tracheostomy With Mv >96 Hours With Extensive Procedure
|
11
|
10
|
$0.01
|
—
|
$90,122.00
|
$164,923.00
|
$90,122.00
|
2024-12-15
|
|
8414
|
APR_DRG
|
Extensive Third Degree Burns With Skin Graft
|
11
|
10
|
$0.01
|
—
|
$89,734.00
|
$164,214.00
|
$89,734.00
|
2024-12-15
|
|
6314
|
APR_DRG
|
Neonate Birth Weight > 2499 Grams With Other Major Procedure
|
11
|
10
|
$0.01
|
—
|
$88,838.00
|
$162,573.00
|
$88,838.00
|
2024-12-15
|
|
52427-273-75
|
NDC
|
Naproxen Sodium ER 500 Mg Po Tb24
|
37
|
24
|
$174,831.53
|
$87,415.76
50% off
|
$820.50
|
$157,348.00
|
$88,640.00
|
2024-12-15
|
|
8504
|
APR_DRG
|
Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal…
|
11
|
10
|
$0.01
|
—
|
$86,498.00
|
$158,291.00
|
$86,498.00
|
2024-12-15
|
|
A9592
|
HCPCS
|
Copper Cu 64 Dotatate 1 Mci/ml IV Soln
|
37
|
24
|
$170,101.00
|
$85,050.50
50% off
|
$268.00
|
$153,091.00
|
$86,241.00
|
2024-12-15
|
|
5914
|
APR_DRG
|
Neonate Birth Weight 500-749 Grams Without Major Procedure
|
11
|
10
|
$0.01
|
—
|
$85,723.00
|
$156,873.00
|
$85,723.00
|
2024-12-15
|
|
1613
|
APR_DRG
|
Implantable Heart Assist Systems
|
11
|
10
|
$0.01
|
—
|
$85,622.00
|
$156,688.00
|
$85,622.00
|
2024-12-15
|
|
5881
|
APR_DRG
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
11
|
10
|
$0.01
|
—
|
$85,169.00
|
$155,860.00
|
$85,169.00
|
2024-12-15
|
|
C2624
|
HCPCS
|
System Cardiomems Hrt Failure Ptnt
|
37
|
24
|
$165,385.50
|
$82,692.75
50% off
|
$820.50
|
$148,847.00
|
$83,850.00
|
2024-12-15
|
|
C1721
|
HCPCS
|
Defibrillator Crdc Protecta Xt Dr 2chb
|
882
|
11
|
$117,258.57
|
$58,629.28
50% off
|
$24.00
|
$153,823.00
|
$82,900.00
|
2024-12-15
|
|
2
|
MS_DRG
|
Heart Transplant Or Implant Of Heart Assist System Without Mcc
|
9
|
7
|
$0.01
|
—
|
$76,408.00
|
$130,718.00
|
$82,324.00
|
2024-12-15
|
|
212
|
MS_DRG
|
Concomitant Aortic And Mitral Valve Procedures
|
9
|
7
|
$0.01
|
—
|
$75,536.00
|
$129,245.00
|
$81,403.00
|
2024-12-15
|
|
5
|
MS_DRG
|
Liver Transplant With Mcc Or Intestinal Transplant
|
9
|
7
|
$0.01
|
—
|
$73,840.00
|
$126,381.00
|
$79,614.00
|
2024-12-15
|
|
215
|
MS_DRG
|
Other Heart Assist System Implant
|
9
|
7
|
$0.01
|
—
|
$73,462.00
|
$125,742.00
|
$79,214.00
|
2024-12-15
|
|
426
|
MS_DRG
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
9
|
7
|
$0.01
|
—
|
$72,634.00
|
$124,344.00
|
$78,340.00
|
2024-12-15
|
|
14
|
APR_DRG
|
Liver Transplant And/or Intestinal Transplant
|
11
|
10
|
$0.01
|
—
|
$77,982.00
|
$142,708.00
|
$77,982.00
|
2024-12-15
|
|
C1722
|
HCPCS
|
Defibrillator Crdc Protecta Vr 1chb 35jl 37ml 68gm
|
903
|
11
|
$108,184.50
|
$54,092.25
50% off
|
$21,494.00
|
$189,129.00
|
$77,860.00
|
2024-12-15
|
|
L8614
|
HCPCS
|
Processor Sound Nuc 7 Cp100 Wht
|
269
|
24
|
$111,137.81
|
$55,568.91
50% off
|
$723.00
|
$156,681.00
|
$77,796.00
|
2024-12-15
|
|
84
|
APR_DRG
|
Autologous Bone Marrow Transplant Or T-cell Immunotherapy
|
11
|
10
|
$0.01
|
—
|
$77,670.00
|
$142,136.00
|
$77,670.00
|
2024-12-15
|
|
58468-0132-2
|
NDC
|
Sevelamer Carbonate 0.8 G Po Pack
|
37
|
24
|
$151,626.37
|
$75,813.18
50% off
|
$820.50
|
$136,464.00
|
$76,875.00
|
2024-12-15
|
|
58468-0132-1
|
NDC
|
Sevelamer Carbonate 0.8 G Po Pack
|
37
|
24
|
$151,626.37
|
$75,813.18
50% off
|
$820.50
|
$136,464.00
|
$76,875.00
|
2024-12-15
|
|
6814
|
APR_DRG
|
Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms
|
11
|
10
|
$0.01
|
—
|
$76,290.00
|
$139,611.00
|
$76,290.00
|
2024-12-15
|
|
1604
|
APR_DRG
|
Major Cardiothoracic Repair Of Heart Anomaly
|
11
|
10
|
$0.01
|
—
|
$76,247.00
|
$139,533.00
|
$76,247.00
|
2024-12-15
|
|
93
|
APR_DRG
|
Extracorporeal Membrane Oxygenation (ecmo)
|
11
|
10
|
$0.01
|
—
|
$75,610.00
|
$138,367.00
|
$75,610.00
|
2024-12-15
|
|
2464
|
APR_DRG
|
Gastrointestinal Vascular Insufficiency
|
11
|
10
|
$0.01
|
—
|
$73,939.00
|
$135,308.00
|
$73,939.00
|
2024-12-15
|
|
6034
|
APR_DRG
|
Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition
|
11
|
10
|
$0.01
|
—
|
$73,557.00
|
$134,610.00
|
$73,557.00
|
2024-12-15
|
|
216
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
9
|
7
|
$0.01
|
—
|
$66,918.00
|
$114,690.00
|
$72,307.00
|
2024-12-15
|
|
68382-395-01
|
NDC
|
Ribavirin 6 G In Solr
|
37
|
24
|
$141,573.77
|
$70,786.88
50% off
|
$820.50
|
$127,416.00
|
$71,778.00
|
2024-12-15
|
|
68382-395-04
|
NDC
|
Ribavirin 6 G In Solr
|
37
|
24
|
$141,573.77
|
$70,786.88
50% off
|
$820.50
|
$127,416.00
|
$71,778.00
|
2024-12-15
|
|
64
|
APR_DRG
|
Pancreas Transplant
|
11
|
10
|
$0.01
|
—
|
$71,385.00
|
$130,635.00
|
$71,385.00
|
2024-12-15
|
|
5891
|
APR_DRG
|
Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …
|
11
|
10
|
$0.01
|
—
|
$71,380.00
|
$130,624.00
|
$71,380.00
|
2024-12-15
|
|
5934
|
APR_DRG
|
Neonate Birth Weight 750-999 Grams Without Major Procedure
|
11
|
10
|
$0.01
|
—
|
$71,166.00
|
$130,234.00
|
$71,166.00
|
2024-12-15
|
|
C1820
|
HCPCS
|
Stimulator Neurostim Gastric Enterra Ii
|
336
|
11
|
$99,480.00
|
$49,740.00
50% off
|
$2,776.00
|
$190,666.00
|
$70,148.00
|
2024-12-15
|
|
5892
|
APR_DRG
|
Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …
|
11
|
10
|
$0.01
|
—
|
$69,181.00
|
$126,602.00
|
$69,181.00
|
2024-12-15
|
|
850
|
MS_DRG
|
Acute Leukemia With Other Procedures
|
9
|
7
|
$0.01
|
—
|
$63,873.00
|
$109,547.00
|
$69,092.00
|
2024-12-15
|
|
59385-027-01
|
NDC
|
Buprenorphine Hcl 900 Mcg Bu Film
|
37
|
24
|
$136,176.33
|
$68,088.17
50% off
|
$820.50
|
$122,559.00
|
$69,041.00
|
2024-12-15
|
|
59385-027-60
|
NDC
|
Buprenorphine Hcl 900 Mcg Bu Film
|
37
|
24
|
$136,176.33
|
$68,088.17
50% off
|
$820.50
|
$122,559.00
|
$69,041.00
|
2024-12-15
|
|
1624
|
APR_DRG
|
Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis
|
11
|
10
|
$0.01
|
—
|
$66,513.00
|
$121,719.00
|
$66,513.00
|
2024-12-15
|
|
6024
|
APR_DRG
|
Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…
|
11
|
10
|
$0.01
|
—
|
$65,422.00
|
$119,721.00
|
$65,422.00
|
2024-12-15
|
|
5893
|
APR_DRG
|
Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …
|
11
|
10
|
$0.01
|
—
|
$64,891.00
|
$118,750.00
|
$64,891.00
|
2024-12-15
|
|
L8619
|
HCPCS
|
Processor Sound Nuc7 Blk
|
310
|
24
|
$95,335.00
|
$47,667.50
50% off
|
$820.50
|
$156,681.00
|
$64,394.50
|
2024-12-15
|
|
231
|
MS_DRG
|
Coronary Bypass With Ptca With Mcc
|
9
|
7
|
$0.01
|
—
|
$58,756.00
|
$100,904.00
|
$63,690.00
|
2024-12-15
|
|
456
|
MS_DRG
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
9
|
7
|
$0.01
|
—
|
$58,723.00
|
$100,849.00
|
$63,656.00
|
2024-12-15
|
|
429
|
MS_DRG
|
Combined Anterior And Posterior Cervical Spinal Fusion With Mcc
|
9
|
7
|
$0.01
|
—
|
$57,832.00
|
$99,343.00
|
$62,715.00
|
2024-12-15
|
|
6214
|
APR_DRG
|
Neonate Birth Weight 2000-2499 Grams With Major Anomaly
|
11
|
10
|
$0.01
|
—
|
$62,125.00
|
$113,689.00
|
$62,125.00
|
2024-12-15
|
|
72
|
APR_DRG
|
Allogeneic Bone Marrow Transplant
|
11
|
10
|
$0.01
|
—
|
$61,638.00
|
$112,798.00
|
$61,638.00
|
2024-12-15
|
|
1612
|
APR_DRG
|
Implantable Heart Assist Systems
|
11
|
10
|
$0.01
|
—
|
$61,549.00
|
$112,634.00
|
$61,549.00
|
2024-12-15
|
|
113
|
APR_DRG
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
11
|
10
|
$0.01
|
—
|
$60,845.00
|
$111,346.00
|
$60,845.00
|
2024-12-15
|
|
20
|
MS_DRG
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc
|
9
|
7
|
$0.01
|
—
|
$55,894.00
|
$96,070.00
|
$60,669.00
|
2024-12-15
|
|
10
|
MS_DRG
|
Pancreas Transplant
|
9
|
7
|
$0.01
|
—
|
$55,283.00
|
$95,038.00
|
$60,024.00
|
2024-12-15
|
|
8634
|
APR_DRG
|
Neonatal Aftercare
|
11
|
10
|
$0.01
|
—
|
$59,901.00
|
$109,619.00
|
$59,901.00
|
2024-12-15
|
|
19
|
MS_DRG
|
Simultaneous Pancreas And Kidney Transplant With Hemodialysis
|
9
|
7
|
$0.01
|
—
|
$54,966.00
|
$94,503.00
|
$59,690.00
|
2024-12-15
|
|
6303
|
APR_DRG
|
Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure
|
11
|
10
|
$0.01
|
—
|
$59,326.00
|
$108,566.00
|
$59,326.00
|
2024-12-15
|
|
C1823
|
HCPCS
|
Generator Implantable Remede Pul Cent Sleep Apnea
|
58
|
24
|
$211,395.00
|
$105,697.50
50% off
|
$820.50
|
$190,256.00
|
$59,017.00
|
2024-12-15
|
|
77371
|
CPT
|
Hc Tr Srs 1 Session Multi Cobalt 60
|
27
|
16
|
$93,660.20
|
$46,830.10
50% off
|
$7,420.00
|
$84,294.00
|
$59,006.00
|
2024-12-15
|
|
233
|
MS_DRG
|
Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc
|
9
|
7
|
$0.01
|
—
|
$54,197.00
|
$93,204.00
|
$58,878.00
|
2024-12-15
|
|
1611
|
APR_DRG
|
Implantable Heart Assist Systems
|
11
|
10
|
$0.01
|
—
|
$58,373.00
|
$106,823.00
|
$58,373.00
|
2024-12-15
|
|
81416
|
CPT
|
Hc Exome Sequence Analysis Each Comparator Exome
|
27
|
16
|
$92,610.00
|
$46,305.00
50% off
|
$12,000.00
|
$127,797.00
|
$58,344.00
|
2024-12-15
|
|
219
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
9
|
7
|
$0.01
|
—
|
$53,650.00
|
$92,280.00
|
$58,300.00
|
2024-12-15
|
|
4404
|
APR_DRG
|
Kidney Transplant
|
11
|
10
|
$0.01
|
—
|
$58,229.00
|
$106,559.00
|
$58,229.00
|
2024-12-15
|
|
54
|
APR_DRG
|
Tracheostomy With Mv >96 Hours Without Extensive Procedure
|
11
|
10
|
$0.01
|
—
|
$57,963.00
|
$106,072.00
|
$57,963.00
|
2024-12-15
|
|
43
|
APR_DRG
|
Tracheostomy With Mv >96 Hours With Extensive Procedure
|
11
|
10
|
$0.01
|
—
|
$57,943.00
|
$106,036.00
|
$57,943.00
|
2024-12-15
|
|
5913
|
APR_DRG
|
Neonate Birth Weight 500-749 Grams Without Major Procedure
|
11
|
10
|
$0.01
|
—
|
$56,448.00
|
$103,300.00
|
$56,448.00
|
2024-12-15
|
|
6804
|
APR_DRG
|
Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms
|
11
|
10
|
$0.01
|
—
|
$56,448.00
|
$103,300.00
|
$56,448.00
|
2024-12-15
|
|
957
|
MS_DRG
|
Other O.r. Procedures For Multiple Significant Trauma With Mcc
|
9
|
7
|
$0.01
|
—
|
$51,755.00
|
$89,080.00
|
$56,300.00
|
2024-12-15
|
|
6084
|
APR_DRG
|
Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition
|
11
|
10
|
$0.01
|
—
|
$56,288.00
|
$103,007.00
|
$56,288.00
|
2024-12-15
|
|
13925-522-01
|
NDC
|
Pentamidine Isethionate 300 Mg In Solr
|
37
|
24
|
$110,911.79
|
$55,455.90
50% off
|
$820.50
|
$99,821.00
|
$56,232.00
|
2024-12-15
|
|
4414
|
APR_DRG
|
Major Bladder Procedures
|
11
|
10
|
$0.01
|
—
|
$55,106.00
|
$100,844.00
|
$55,106.00
|
2024-12-15
|
|
0187-0007-14
|
NDC
|
Ribavirin 6 G In Solr
|
37
|
24
|
$108,581.08
|
$54,290.54
50% off
|
$820.50
|
$97,723.00
|
$55,051.00
|
2024-12-15
|
|
0781-5893-31
|
NDC
|
Nevirapine ER 400 Mg Po Tb24
|
37
|
24
|
$106,455.10
|
$53,227.55
50% off
|
$820.50
|
$95,810.00
|
$53,973.00
|
2024-12-15
|
|
427
|
MS_DRG
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
9
|
7
|
$0.01
|
—
|
$49,248.00
|
$84,846.00
|
$53,654.00
|
2024-12-15
|
|
23
|
APR_DRG
|
Heart And/or Lung Transplant
|
11
|
10
|
$0.01
|
—
|
$53,618.00
|
$98,122.00
|
$53,618.00
|
2024-12-15
|
|
275
|
MS_DRG
|
Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc
|
9
|
7
|
$0.01
|
—
|
$49,001.00
|
$84,428.00
|
$53,393.00
|
2024-12-15
|
|
58914-501-56
|
NDC
|
Mesalamine 1000 Mg Re Supp
|
37
|
24
|
$104,227.09
|
$52,113.54
50% off
|
$820.50
|
$93,804.00
|
$52,843.00
|
2024-12-15
|
|
870
|
MS_DRG
|
Septicemia Or Severe Sepsis With Mv >96 Hours
|
9
|
7
|
$0.01
|
—
|
$48,235.00
|
$83,134.00
|
$52,584.00
|
2024-12-15
|
|
83
|
APR_DRG
|
Autologous Bone Marrow Transplant Or T-cell Immunotherapy
|
11
|
10
|
$0.01
|
—
|
$52,499.00
|
$96,073.00
|
$52,499.00
|
2024-12-15
|
|
33262
|
CPT
|
Hc Rmvl Impltbl Dfb Plse Gen W/repl Plse Gen 1 Lead
|
59
|
24
|
$84,270.87
|
$42,135.44
50% off
|
$16,178.00
|
$77,543.00
|
$52,298.00
|
2024-12-15
|
|
955
|
MS_DRG
|
Craniotomy For Multiple Significant Trauma
|
9
|
7
|
$0.01
|
—
|
$47,346.00
|
$81,633.00
|
$51,646.00
|
2024-12-15
|
|
1784
|
APR_DRG
|
External Heart Assist Systems
|
11
|
10
|
$0.01
|
—
|
$51,613.00
|
$94,451.00
|
$51,613.00
|
2024-12-15
|
|
33240
|
CPT
|
Hc Insj Implntbl Defib Pulse Gen W/1 Existing Ld
|
59
|
24
|
$79,329.69
|
$39,664.84
50% off
|
$16,654.00
|
$77,543.00
|
$51,088.00
|
2024-12-15
|
|
5933
|
APR_DRG
|
Neonate Birth Weight 750-999 Grams Without Major Procedure
|
11
|
10
|
$0.01
|
—
|
$50,828.00
|
$93,015.00
|
$50,828.00
|
2024-12-15
|
|
6114
|
APR_DRG
|
Neonate Birth Weight 1500-1999 Grams With Major Anomaly
|
11
|
10
|
$0.01
|
—
|
$50,770.00
|
$92,908.00
|
$50,770.00
|
2024-12-15
|
|
33264
|
CPT
|
Hc Rmvl Impltbl Dfb Pls Gen W/rplcmt Pls Gen Mlt Ld
|
59
|
24
|
$86,158.74
|
$43,079.37
50% off
|
$21,766.00
|
$77,543.00
|
$50,756.00
|
2024-12-15
|
|
447
|
MS_DRG
|
Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall…
|
9
|
7
|
$0.01
|
—
|
$46,489.00
|
$80,185.00
|
$50,741.00
|
2024-12-15
|
|
928
|
MS_DRG
|
Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc
|
9
|
7
|
$0.01
|
—
|
$46,310.00
|
$79,883.00
|
$50,552.00
|
2024-12-15
|
|
1674
|
APR_DRG
|
Other Cardiothoracic And Thoracic Vascular Procedures
|
11
|
10
|
$0.01
|
—
|
$50,545.00
|
$92,498.00
|
$50,545.00
|
2024-12-15
|
|
268
|
MS_DRG
|
Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc
|
9
|
7
|
$0.01
|
—
|
$46,231.00
|
$79,751.00
|
$50,469.00
|
2024-12-15
|
|
6904
|
APR_DRG
|
Acute Leukemia
|
11
|
10
|
$0.01
|
—
|
$50,091.00
|
$91,667.00
|
$50,091.00
|
2024-12-15
|
|
434
|
APR_DRG
|
Multiple Sclerosis, Other Demyelinating Disease And Inflammatory Neuropathies
|
11
|
10
|
$0.01
|
—
|
$49,784.00
|
$91,105.00
|
$49,784.00
|
2024-12-15
|
|
92
|
APR_DRG
|
Extracorporeal Membrane Oxygenation (ecmo)
|
11
|
10
|
$0.01
|
—
|
$49,728.00
|
$91,003.00
|
$49,728.00
|
2024-12-15
|
|
33263
|
CPT
|
Hc Rmvl Impltbl Dfb Plse Gen W/rplcmt Plse Gen 2 Ld
|
59
|
24
|
$76,768.82
|
$38,384.41
50% off
|
$16,336.00
|
$77,543.00
|
$49,439.00
|
2024-12-15
|
|
207
|
MS_DRG
|
Respiratory System Diagnosis With Ventilator Support >96 Hours
|
9
|
7
|
$0.01
|
—
|
$44,842.00
|
$77,404.00
|
$49,003.00
|
2024-12-15
|
|
217
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
9
|
7
|
$0.01
|
—
|
$44,777.00
|
$77,295.00
|
$48,935.00
|
2024-12-15
|
|
33289
|
CPT
|
Hc Rhc W/plc Pressure Sensor
|
27
|
16
|
$76,652.15
|
$38,326.07
50% off
|
$27,595.00
|
$68,987.00
|
$48,291.00
|
2024-12-15
|
|
91
|
APR_DRG
|
Extracorporeal Membrane Oxygenation (ecmo)
|
11
|
10
|
$0.01
|
—
|
$48,227.00
|
$88,255.00
|
$48,227.00
|
2024-12-15
|
|
969
|
MS_DRG
|
HIV With Extensive O.r. Procedures With Mcc
|
9
|
7
|
$0.01
|
—
|
$43,851.00
|
$75,731.00
|
$47,957.00
|
2024-12-15
|
|
6334
|
APR_DRG
|
Neonate Birth Weight > 2499 Grams With Major Anomaly
|
11
|
10
|
$0.01
|
—
|
$47,213.00
|
$86,400.00
|
$47,213.00
|
2024-12-15
|
|
33363
|
CPT
|
Hc Replace Aortic Valve Open Axillry Artry Approach
|
42
|
11
|
$68,511.79
|
$34,255.89
50% off
|
$23,869.00
|
$61,661.00
|
$47,184.50
|
2024-12-15
|
|
276
|
MS_DRG
|
Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator
|
9
|
7
|
$0.01
|
—
|
$42,950.00
|
$74,209.00
|
$47,006.00
|
2024-12-15
|
|
317
|
MS_DRG
|
Concomitant Left Atrial Appendage Closure And Cardiac Ablation
|
9
|
7
|
$0.01
|
—
|
$42,895.00
|
$74,116.00
|
$46,947.00
|
2024-12-15
|
|
3034
|
APR_DRG
|
Dorsal And Lumbar Fusion Procedure For Curvature Of Back
|
11
|
10
|
$0.01
|
—
|
$46,925.00
|
$85,873.00
|
$46,925.00
|
2024-12-15
|
|
573
|
MS_DRG
|
Skin Graft For Skin Ulcer Or Cellulitis With Mcc
|
9
|
7
|
$0.01
|
—
|
$42,699.00
|
$73,785.00
|
$46,741.00
|
2024-12-15
|
|
5912
|
APR_DRG
|
Neonate Birth Weight 500-749 Grams Without Major Procedure
|
11
|
10
|
$0.01
|
—
|
$46,607.00
|
$85,291.00
|
$46,607.00
|
2024-12-15
|
|
461
|
MS_DRG
|
Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc
|
9
|
7
|
$0.01
|
—
|
$42,550.00
|
$73,534.00
|
$46,584.00
|
2024-12-15
|
|
232
|
MS_DRG
|
Coronary Bypass With Ptca Without Mcc
|
9
|
7
|
$0.01
|
—
|
$42,356.00
|
$73,206.00
|
$46,379.00
|
2024-12-15
|
|
28
|
MS_DRG
|
Spinal Procedures With Mcc
|
9
|
7
|
$0.01
|
—
|
$42,154.00
|
$72,864.00
|
$46,165.00
|
2024-12-15
|
|
6074
|
APR_DRG
|
Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…
|
11
|
10
|
$0.01
|
—
|
$46,151.00
|
$84,456.00
|
$46,151.00
|
2024-12-15
|
|
63
|
APR_DRG
|
Pancreas Transplant
|
11
|
10
|
$0.01
|
—
|
$46,132.00
|
$84,421.00
|
$46,132.00
|
2024-12-15
|
|
C2622
|
HCPCS
|
Prosthesis Penile Tactra Malle Rear Tp Extndr 9.5m
|
121
|
24
|
$76,669.40
|
$38,334.70
50% off
|
$820.50
|
$72,494.00
|
$45,913.00
|
2024-12-15
|
|
17
|
MS_DRG
|
Autologous Bone Marrow Transplant Without Cc/mcc
|
9
|
7
|
$0.01
|
—
|
$41,851.00
|
$72,353.00
|
$45,846.00
|
2024-12-15
|
|
16
|
MS_DRG
|
Autologous Bone Marrow Transplant With Cc/mcc
|
9
|
7
|
$0.01
|
—
|
$41,851.00
|
$72,353.00
|
$45,846.00
|
2024-12-15
|
|
93582
|
CPT
|
Hc Cath Percutan Transcath Closure Pat Duct Arteriosus
|
27
|
16
|
$72,334.19
|
$36,167.10
50% off
|
$16,707.00
|
$65,101.00
|
$45,571.00
|
2024-12-15
|
|
266
|
MS_DRG
|
Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc
|
9
|
7
|
$0.01
|
—
|
$41,539.00
|
$71,825.00
|
$45,516.00
|
2024-12-15
|
|
J2326
|
HCPCS
|
Nusinersen 12 Mg/5ml It Soln
|
37
|
24
|
$89,181.49
|
$44,590.74
50% off
|
$820.50
|
$80,263.00
|
$45,215.00
|
2024-12-15
|
|
218
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
9
|
7
|
$0.01
|
—
|
$41,251.00
|
$71,339.00
|
$45,212.00
|
2024-12-15
|
|
790
|
MS_DRG
|
Extreme Immaturity Or Respiratory Distress Syndrome, Neonate
|
7
|
6
|
$0.01
|
—
|
$41,220.00
|
$71,286.00
|
$45,179.00
|
2024-12-15
|
|
47781-153-01
|
NDC
|
Naproxen Sodium ER 375 Mg Po Tb24
|
37
|
24
|
$88,294.19
|
$44,147.10
50% off
|
$820.50
|
$79,465.00
|
$44,765.00
|
2024-12-15
|
|
235
|
MS_DRG
|
Coronary Bypass Without Cardiac Catheterization With Mcc
|
9
|
7
|
$0.01
|
—
|
$40,800.00
|
$70,577.00
|
$44,736.00
|
2024-12-15
|
|
820
|
MS_DRG
|
Lymphoma And Leukemia With Major O.r. Procedures With Mcc
|
9
|
7
|
$0.01
|
—
|
$40,370.00
|
$69,852.00
|
$44,282.00
|
2024-12-15
|
|
63323-877-15
|
NDC
|
Pentamidine Isethionate 300 Mg In Solr
|
37
|
24
|
$86,990.24
|
$43,495.12
50% off
|
$820.50
|
$78,291.00
|
$44,104.00
|
2024-12-15
|
|
2204
|
APR_DRG
|
Major Stomach, Esophageal And Duodenal Procedures
|
11
|
10
|
$0.01
|
—
|
$43,978.00
|
$80,479.00
|
$43,978.00
|
2024-12-15
|
|
6134
|
APR_DRG
|
Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection
|
11
|
10
|
$0.01
|
—
|
$43,738.00
|
$80,041.00
|
$43,738.00
|
2024-12-15
|
|
457
|
MS_DRG
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
9
|
7
|
$0.01
|
—
|
$39,796.00
|
$68,881.00
|
$43,676.00
|
2024-12-15
|
|
4474
|
APR_DRG
|
Other Kidney, Urinary Tract And Related Procedures
|
11
|
10
|
$0.01
|
—
|
$43,636.00
|
$79,853.00
|
$43,636.00
|
2024-12-15
|
|
0398T
|
CPT
|
Hc MRI Guided Focused US Stereo Lesion Ablate
|
27
|
16
|
$71,584.70
|
$35,792.35
50% off
|
$12,979.00
|
$64,426.00
|
$43,452.00
|
2024-12-15
|
|
23
|
MS_DRG
|
Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…
|
9
|
7
|
$0.01
|
—
|
$39,558.00
|
$68,479.00
|
$43,425.00
|
2024-12-15
|
|
C9089
|
HCPCS
|
Bupivacaine Hcl (300 Mg Dose) 3 X 100 Mg Il Impl
|
58
|
24
|
$69,033.59
|
$34,516.80
50% off
|
$820.50
|
$63,869.00
|
$43,283.50
|
2024-12-15
|
|
22
|
APR_DRG
|
Heart And/or Lung Transplant
|
11
|
10
|
$0.01
|
—
|
$43,073.00
|
$78,824.00
|
$43,073.00
|
2024-12-15
|
|
234
|
APR_DRG
|
Spinal Procedures
|
11
|
10
|
$0.01
|
—
|
$42,989.00
|
$78,670.00
|
$42,989.00
|
2024-12-15
|
|
0234T
|
CPT
|
Hc Trluml Perip Athrc Renal Art
|
27
|
16
|
$70,590.18
|
$35,295.09
50% off
|
$10,482.00
|
$63,531.00
|
$42,848.00
|
2024-12-15
|
|
9104
|
APR_DRG
|
Craniotomy For Multiple Significant Trauma
|
11
|
10
|
$0.01
|
—
|
$42,834.00
|
$78,386.00
|
$42,834.00
|
2024-12-15
|
|
C1827
|
HCPCS
|
Generator Imp Vivistim Vns Ipg 1001
|
58
|
24
|
$244,555.00
|
$122,277.50
50% off
|
$820.50
|
$220,100.00
|
$42,623.00
|
2024-12-15
|
|
A9555
|
HCPCS
|
Rubidium-82 (rb-82) Radio-isotope Injection
|
37
|
24
|
$84,001.00
|
$42,000.50
50% off
|
$82.00
|
$75,601.00
|
$42,589.00
|
2024-12-15
|
|
653
|
MS_DRG
|
Major Bladder Procedures With Mcc
|
9
|
7
|
$0.01
|
—
|
$38,653.00
|
$66,951.00
|
$42,469.00
|
2024-12-15
|
|
112
|
APR_DRG
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
11
|
10
|
$0.01
|
—
|
$42,283.00
|
$77,379.00
|
$42,283.00
|
2024-12-15
|
|
6023
|
APR_DRG
|
Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…
|
11
|
10
|
$0.01
|
—
|
$42,282.00
|
$77,375.00
|
$42,282.00
|
2024-12-15
|
|
21
|
MS_DRG
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc
|
9
|
7
|
$0.01
|
—
|
$38,325.00
|
$66,397.00
|
$42,123.00
|
2024-12-15
|
|
834
|
MS_DRG
|
Acute Leukemia With Mcc
|
9
|
7
|
$0.01
|
—
|
$38,325.00
|
$66,397.00
|
$42,123.00
|
2024-12-15
|
|
31253
|
CPT
|
Hc Nasal/sinus Endo Total With Tiss Rem
|
57
|
24
|
$58,344.44
|
$29,172.22
50% off
|
$1,630.00
|
$105,020.00
|
$42,008.00
|
2024-12-15
|
|
428
|
MS_DRG
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
9
|
7
|
$0.01
|
—
|
$38,164.00
|
$66,125.00
|
$41,953.00
|
2024-12-15
|
|
53
|
APR_DRG
|
Tracheostomy With Mv >96 Hours Without Extensive Procedure
|
11
|
10
|
$0.01
|
—
|
$41,755.00
|
$76,411.00
|
$41,755.00
|
2024-12-15
|
|
62
|
APR_DRG
|
Pancreas Transplant
|
11
|
10
|
$0.01
|
—
|
$41,726.00
|
$76,358.00
|
$41,726.00
|
2024-12-15
|
|
430
|
MS_DRG
|
Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc
|
9
|
7
|
$0.01
|
—
|
$37,931.00
|
$65,732.00
|
$41,708.00
|
2024-12-15
|
|
C1772
|
HCPCS
|
Pump Inf Synchromed Ii Ti 3.4x1x1in 40ml
|
37
|
24
|
$82,071.00
|
$41,035.50
50% off
|
$820.50
|
$73,864.00
|
$41,610.00
|
2024-12-15
|
|
9504
|
APR_DRG
|
Extensive O.r. Procedure Unrelated To Principal Diagnosis
|
11
|
10
|
$0.01
|
—
|
$41,562.00
|
$76,059.00
|
$41,562.00
|
2024-12-15
|
|
8
|
MS_DRG
|
Simultaneous Pancreas And Kidney Transplant
|
9
|
7
|
$0.01
|
—
|
$37,727.00
|
$65,387.00
|
$41,492.00
|
2024-12-15
|
|
405
|
MS_DRG
|
Pancreas, Liver And Shunt Procedures With Mcc
|
9
|
7
|
$0.01
|
—
|
$37,641.00
|
$65,242.00
|
$41,402.00
|
2024-12-15
|
|
463
|
MS_DRG
|
Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …
|
9
|
7
|
$0.01
|
—
|
$37,449.00
|
$64,918.00
|
$41,199.00
|
2024-12-15
|
|
61
|
APR_DRG
|
Pancreas Transplant
|
11
|
10
|
$0.01
|
—
|
$41,187.00
|
$75,372.00
|
$41,187.00
|
2024-12-15
|
|
11
|
MS_DRG
|
Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc
|
9
|
7
|
$0.01
|
—
|
$37,414.00
|
$64,858.00
|
$41,161.00
|
2024-12-15
|
|
576
|
MS_DRG
|
Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc
|
9
|
7
|
$0.01
|
—
|
$37,410.00
|
$64,851.00
|
$41,157.00
|
2024-12-15
|
|
C1875
|
HCPCS
|
Stent G-armor Cov 5.2cm Lgth 10 Zig
|
247
|
24
|
$60,036.18
|
$30,018.09
50% off
|
$820.50
|
$67,039.00
|
$40,632.00
|
2024-12-15
|
|
234
|
MS_DRG
|
Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc
|
9
|
7
|
$0.01
|
—
|
$36,889.00
|
$63,972.00
|
$40,607.00
|
2024-12-15
|
|
33270
|
CPT
|
Hc Ins/rplcmnt Perm Subq Impltbl Dfb W/subq Eltrd
|
38
|
24
|
$66,011.43
|
$33,005.71
50% off
|
$21,944.00
|
$59,410.00
|
$40,542.00
|
2024-12-15
|
|
71
|
APR_DRG
|
Allogeneic Bone Marrow Transplant
|
11
|
10
|
$0.01
|
—
|
$40,474.00
|
$74,068.00
|
$40,474.00
|
2024-12-15
|
|
220
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
9
|
7
|
$0.01
|
—
|
$36,726.00
|
$63,696.00
|
$40,435.00
|
2024-12-15
|
|
13
|
APR_DRG
|
Liver Transplant And/or Intestinal Transplant
|
11
|
10
|
$0.01
|
—
|
$40,178.00
|
$73,527.00
|
$40,178.00
|
2024-12-15
|
|
6093
|
APR_DRG
|
Neonate Birth Weight 1500-2499 Grams With Major Procedure
|
11
|
10
|
$0.01
|
—
|
$40,131.00
|
$73,440.00
|
$40,131.00
|
2024-12-15
|
|
264
|
APR_DRG
|
Other Nervous System And Related Procedures
|
11
|
10
|
$0.01
|
—
|
$40,107.00
|
$73,395.00
|
$40,107.00
|
2024-12-15
|
|
37231
|
CPT
|
Hc Revascularize Tibial/peron Artery,angioplasty/stent/atherectomy Init
|
57
|
24
|
$55,657.32
|
$27,828.66
50% off
|
$8,649.00
|
$100,183.00
|
$40,073.00
|
2024-12-15
|
|
37227
|
CPT
|
Hc Revascularize Fem/pop Artery,angioplasty/stent/atherectomy
|
57
|
24
|
$55,657.32
|
$27,828.66
50% off
|
$9,227.00
|
$100,183.00
|
$40,073.00
|
2024-12-15
|
|
5932
|
APR_DRG
|
Neonate Birth Weight 750-999 Grams Without Major Procedure
|
11
|
10
|
$0.01
|
—
|
$39,934.00
|
$73,078.00
|
$39,934.00
|
2024-12-15
|
|
3033
|
APR_DRG
|
Dorsal And Lumbar Fusion Procedure For Curvature Of Back
|
11
|
10
|
$0.01
|
—
|
$39,697.00
|
$72,645.00
|
$39,697.00
|
2024-12-15
|
|
1824
|
APR_DRG
|
Other Peripheral Vascular Procedures
|
11
|
10
|
$0.01
|
—
|
$39,665.00
|
$72,586.00
|
$39,665.00
|
2024-12-15
|
|
1634
|
APR_DRG
|
Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis
|
11
|
10
|
$0.01
|
—
|
$39,641.00
|
$72,543.00
|
$39,641.00
|
2024-12-15
|
|
C2621
|
HCPCS
|
Pacemaker Dig Viva Crt-p 15ml 26gm 57x59x6mm
|
483
|
11
|
$57,959.45
|
$28,979.73
50% off
|
$8,329.00
|
$82,435.00
|
$39,583.00
|
2024-12-15
|
|
450
|
MS_DRG
|
Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically …
|
9
|
7
|
$0.01
|
—
|
$35,710.00
|
$61,980.00
|
$39,362.00
|
2024-12-15
|
|
24341
|
CPT
|
Hc Repair Tend/musc Upr Arm/elb Each
|
57
|
24
|
$54,655.25
|
$27,327.62
50% off
|
$2,399.00
|
$98,379.00
|
$39,352.00
|
2024-12-15
|
|
270
|
MS_DRG
|
Other Major Cardiovascular Procedures With Mcc
|
9
|
7
|
$0.01
|
—
|
$35,591.00
|
$61,779.00
|
$39,237.00
|
2024-12-15
|
|
7924
|
APR_DRG
|
Extensive O.r. Procedures For Other Complications Of Treatment
|
11
|
10
|
$0.01
|
—
|
$38,992.00
|
$71,356.00
|
$38,992.00
|
2024-12-15
|
|
3044
|
APR_DRG
|
Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back
|
11
|
10
|
$0.01
|
—
|
$38,983.00
|
$71,339.00
|
$38,983.00
|
2024-12-15
|
|
466
|
MS_DRG
|
Revision Of Hip Or Knee Replacement With Mcc
|
9
|
7
|
$0.01
|
—
|
$35,325.00
|
$61,330.00
|
$38,956.00
|
2024-12-15
|
|
2054
|
APR_DRG
|
Cardiomyopathy
|
11
|
10
|
$0.01
|
—
|
$38,873.00
|
$71,137.00
|
$38,873.00
|
2024-12-15
|
|
326
|
MS_DRG
|
Stomach, Esophageal And Duodenal Procedures With Mcc
|
9
|
7
|
$0.01
|
—
|
$35,217.00
|
$61,147.00
|
$38,842.00
|
2024-12-15
|
|
6954
|
APR_DRG
|
Chemotherapy For Acute Leukemia
|
11
|
10
|
$0.01
|
—
|
$38,823.00
|
$71,046.00
|
$38,823.00
|
2024-12-15
|
|
8413
|
APR_DRG
|
Extensive Third Degree Burns With Skin Graft
|
11
|
10
|
$0.01
|
—
|
$38,783.00
|
$70,973.00
|
$38,783.00
|
2024-12-15
|
|
C1817
|
HCPCS
|
Occluder Sept Amplatzer 45deg 38x4 12fr Strl Lf
|
168
|
11
|
$54,216.60
|
$27,108.30
50% off
|
$5,578.00
|
$72,372.00
|
$38,738.00
|
2024-12-15
|
|
239
|
MS_DRG
|
Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc
|
9
|
7
|
$0.01
|
—
|
$34,925.00
|
$60,654.00
|
$38,534.00
|
2024-12-15
|
|
837
|
MS_DRG
|
Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot…
|
9
|
7
|
$0.01
|
—
|
$34,719.00
|
$60,306.00
|
$38,316.00
|
2024-12-15
|
|
278
|
MS_DRG
|
Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures …
|
9
|
7
|
$0.01
|
—
|
$34,692.00
|
$60,260.00
|
$38,288.00
|
2024-12-15
|
|
853
|
MS_DRG
|
Infectious And Parasitic Diseases With O.r. Procedures With Mcc
|
9
|
7
|
$0.01
|
—
|
$34,678.00
|
$60,237.00
|
$38,273.00
|
2024-12-15
|
|
228
|
MS_DRG
|
Other Cardiothoracic Procedures With Mcc
|
9
|
7
|
$0.01
|
—
|
$34,553.00
|
$60,026.00
|
$38,142.00
|
2024-12-15
|
|
52
|
APR_DRG
|
Tracheostomy With Mv >96 Hours Without Extensive Procedure
|
11
|
10
|
$0.01
|
—
|
$38,131.00
|
$69,780.00
|
$38,131.00
|
2024-12-15
|
|
27446
|
CPT
|
Hc Knee Arthroplasty Condyle/plateau Medial Or Lateral Comptmnt
|
57
|
24
|
$52,870.37
|
$26,435.18
50% off
|
$7,074.00
|
$95,167.00
|
$38,067.00
|
2024-12-15
|
|
33365
|
CPT
|
Hc Cath Replace Aortic Valve Open Transaortic Approach
|
21
|
11
|
$54,351.85
|
$27,175.92
50% off
|
$19,567.00
|
$48,917.00
|
$38,046.00
|
2024-12-15
|
|
6514
|
APR_DRG
|
Other Procedures Of Blood And Blood-forming Organs
|
11
|
10
|
$0.01
|
—
|
$38,004.00
|
$69,546.00
|
$38,004.00
|
2024-12-15
|
|
42
|
APR_DRG
|
Tracheostomy With Mv >96 Hours With Extensive Procedure
|
11
|
10
|
$0.01
|
—
|
$37,885.00
|
$69,329.00
|
$37,885.00
|
2024-12-15
|
|
6144
|
APR_DRG
|
Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition
|
11
|
10
|
$0.01
|
—
|
$37,487.00
|
$68,601.00
|
$37,487.00
|
2024-12-15
|
|
245
|
MS_DRG
|
Aicd Generator Procedures
|
9
|
7
|
$0.01
|
—
|
$33,884.00
|
$58,896.00
|
$37,435.00
|
2024-12-15
|
|
1623
|
APR_DRG
|
Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis
|
11
|
10
|
$0.01
|
—
|
$37,423.00
|
$68,485.00
|
$37,423.00
|
2024-12-15
|
|
214
|
APR_DRG
|
Open Craniotomy Except Trauma
|
11
|
10
|
$0.01
|
—
|
$37,335.00
|
$68,322.00
|
$37,335.00
|
2024-12-15
|
|
471
|
MS_DRG
|
Cervical Spinal Fusion With Mcc
|
9
|
7
|
$0.01
|
—
|
$33,679.00
|
$58,551.00
|
$37,219.00
|
2024-12-15
|
|
2304
|
APR_DRG
|
Major Small Bowel Procedures
|
11
|
10
|
$0.01
|
—
|
$37,200.00
|
$68,076.00
|
$37,200.00
|
2024-12-15
|
|
6
|
MS_DRG
|
Liver Transplant Without Mcc
|
9
|
7
|
$0.01
|
—
|
$33,623.00
|
$58,456.00
|
$37,160.00
|
2024-12-15
|
|
224
|
APR_DRG
|
Ventricular Shunt Procedures
|
11
|
10
|
$0.01
|
—
|
$37,053.00
|
$67,807.00
|
$37,053.00
|
2024-12-15
|
|
33230
|
CPT
|
Hc Ep Insj Implntbl Defib Pulse Gen W/exist Dual Leads
|
38
|
24
|
$73,431.05
|
$36,715.52
50% off
|
$16,993.00
|
$66,088.00
|
$36,973.00
|
2024-12-15
|
|
0187-3013-30
|
NDC
|
Pyridostigmine Bromide ER 180 Mg Po Tbcr
|
37
|
24
|
$72,910.62
|
$36,455.31
50% off
|
$820.50
|
$65,620.00
|
$36,966.00
|
2024-12-15
|
|
4424
|
APR_DRG
|
Kidney And Urinary Tract Procedures For Malignancy
|
11
|
10
|
$0.01
|
—
|
$36,850.00
|
$67,436.00
|
$36,850.00
|
2024-12-15
|
|
51167-331-01
|
NDC
|
Elexacaf-tezacaf-ivacaf&ivacaf 100-50-75 (trikafta Kit Morning Dose)
|
37
|
24
|
$72,562.53
|
$36,281.26
50% off
|
$820.50
|
$65,306.00
|
$36,789.00
|
2024-12-15
|
|
93581
|
CPT
|
Hc Perc Closure,cong Vsd W/implant
|
27
|
16
|
$58,358.87
|
$29,179.44
50% off
|
$16,707.00
|
$52,523.00
|
$36,766.00
|
2024-12-15
|
|
9524
|
APR_DRG
|
Non-extensive O.r. Procedure Unrelated To Principal Diagnosis
|
11
|
10
|
$0.01
|
—
|
$36,624.00
|
$67,022.00
|
$36,624.00
|
2024-12-15
|
|
826
|
MS_DRG
|
Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. …
|
9
|
7
|
$0.01
|
—
|
$33,112.00
|
$57,593.00
|
$36,621.00
|
2024-12-15
|
|
799
|
MS_DRG
|
Splenic Procedures With Mcc
|
9
|
7
|
$0.01
|
—
|
$32,969.00
|
$57,350.00
|
$36,469.00
|
2024-12-15
|
|
981
|
MS_DRG
|
Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc
|
9
|
7
|
$0.01
|
—
|
$32,962.00
|
$57,340.00
|
$36,462.00
|
2024-12-15
|
|
93590
|
CPT
|
Hc Cath Perq Transcath Cls Paravalvr Leak 1 Mitral Valve
|
38
|
24
|
$72,334.19
|
$36,167.10
50% off
|
$801.00
|
$65,101.00
|
$36,420.00
|
2024-12-15
|
|
0408T
|
CPT
|
Hc Ins/repl Ccm System, Pulse Gen With Tv Electrodes
|
27
|
16
|
$56,505.40
|
$28,252.70
50% off
|
$20,342.00
|
$53,398.00
|
$36,389.00
|
2024-12-15
|
|
34708
|
CPT
|
Hc Evasc Rpr Dplmnt Ilio-iliac Ndgft Rpt
|
40
|
11
|
$41,561.10
|
$20,780.55
50% off
|
$14,962.00
|
$74,810.00
|
$36,366.00
|
2024-12-15
|
|
9114
|
APR_DRG
|
Extensive Abdominal Or Thoracic Procedures For Multiple Significant Trauma
|
11
|
10
|
$0.01
|
—
|
$36,289.00
|
$66,409.00
|
$36,289.00
|
2024-12-15
|
|
267
|
MS_DRG
|
Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc
|
9
|
7
|
$0.01
|
—
|
$32,621.00
|
$56,764.00
|
$36,102.00
|
2024-12-15
|
|
823
|
MS_DRG
|
Lymphoma And Non-acute Leukemia With Other Procedures With Mcc
|
9
|
7
|
$0.01
|
—
|
$32,446.00
|
$56,468.00
|
$35,918.00
|
2024-12-15
|
|
C9775
|
HCPCS
|
Hc Revasc Tibial/peroneal Art With IV Litho/ather/stent
|
38
|
24
|
$91,588.35
|
$45,794.18
50% off
|
$8,648.00
|
$82,430.00
|
$35,878.50
|
2024-12-15
|
|
C9773
|
HCPCS
|
Hc Revasc Tibial/peroneal Art With IV Litho/stent
|
38
|
24
|
$91,588.35
|
$45,794.18
50% off
|
$8,497.00
|
$82,430.00
|
$35,878.50
|
2024-12-15
|
|
C9774
|
HCPCS
|
Hc Revasc Tibial/peroneal Art With IV Litho/ather
|
38
|
24
|
$91,588.35
|
$45,794.18
50% off
|
$8,618.00
|
$82,430.00
|
$35,878.50
|
2024-12-15
|
|
277
|
MS_DRG
|
Cardiac Defibrillator Implant Without Mcc
|
9
|
7
|
$0.01
|
—
|
$32,255.00
|
$56,145.00
|
$35,716.00
|
2024-12-15
|
|
4403
|
APR_DRG
|
Kidney Transplant
|
11
|
10
|
$0.01
|
—
|
$35,639.00
|
$65,219.00
|
$35,639.00
|
2024-12-15
|
|
3154
|
APR_DRG
|
Shoulder, Upper Arm And Forearm Procedures Except Joint Replacement
|
11
|
10
|
$0.01
|
—
|
$35,636.00
|
$65,215.00
|
$35,636.00
|
2024-12-15
|
|
1694
|
APR_DRG
|
Major Abdominal Vascular Procedures
|
11
|
10
|
$0.01
|
—
|
$35,515.00
|
$64,993.00
|
$35,515.00
|
2024-12-15
|
|
163
|
MS_DRG
|
Major Chest Procedures With Mcc
|
9
|
7
|
$0.01
|
—
|
$31,959.00
|
$55,645.00
|
$35,403.00
|
2024-12-15
|
|
650
|
MS_DRG
|
Kidney Transplant With Hemodialysis With Mcc
|
9
|
7
|
$0.01
|
—
|
$31,946.00
|
$55,623.00
|
$35,389.00
|
2024-12-15
|
|
1204
|
APR_DRG
|
Major Respiratory And Chest Procedures
|
11
|
10
|
$0.01
|
—
|
$35,371.00
|
$64,729.00
|
$35,371.00
|
2024-12-15
|
|
221
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
9
|
7
|
$0.01
|
—
|
$31,844.00
|
$55,451.00
|
$35,282.00
|
2024-12-15
|
|
329
|
MS_DRG
|
Major Small And Large Bowel Procedures With Mcc
|
9
|
7
|
$0.01
|
—
|
$31,839.00
|
$55,443.00
|
$35,277.00
|
2024-12-15
|
|
4834
|
APR_DRG
|
Penis, Testes And Scrotal Procedures
|
11
|
10
|
$0.01
|
—
|
$35,237.00
|
$64,483.00
|
$35,237.00
|
2024-12-15
|
|
35355
|
CPT
|
Hc Thromboendarterectomy With Without Patch Graft Iliofemoral
|
40
|
11
|
$40,255.77
|
$20,127.88
50% off
|
$14,492.00
|
$72,460.00
|
$35,223.50
|
2024-12-15
|
|
27428
|
CPT
|
Hc Ligament Reconst Knee, Intra-artic (open)
|
57
|
24
|
$48,659.87
|
$24,329.94
50% off
|
$6,263.00
|
$87,588.00
|
$35,035.00
|
2024-12-15
|
|
894
|
APR_DRG
|
Major Cranial Or Facial Bone Procedures
|
11
|
10
|
$0.01
|
—
|
$34,859.00
|
$63,792.00
|
$34,859.00
|
2024-12-15
|
|
9124
|
APR_DRG
|
Musculoskeletal And Other Procedures For Multiple Significant Trauma
|
11
|
10
|
$0.01
|
—
|
$34,813.00
|
$63,707.00
|
$34,813.00
|
2024-12-15
|
|
1304
|
APR_DRG
|
Respiratory System Diagnosis With Ventilator Support > 96 Hours
|
11
|
10
|
$0.01
|
—
|
$34,804.00
|
$63,691.00
|
$34,804.00
|
2024-12-15
|
|
856
|
MS_DRG
|
Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc
|
9
|
7
|
$0.01
|
—
|
$31,282.00
|
$54,502.00
|
$34,689.00
|
2024-12-15
|
|
474
|
MS_DRG
|
Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc
|
9
|
7
|
$0.01
|
—
|
$31,096.00
|
$54,187.00
|
$34,492.00
|
2024-12-15
|
|
25
|
MS_DRG
|
Craniotomy And Endovascular Intracranial Procedures With Mcc
|
9
|
7
|
$0.01
|
—
|
$31,010.00
|
$54,042.00
|
$34,401.00
|
2024-12-15
|
|
1654
|
APR_DRG
|
Coronary Bypass With Ami Or Complex Principal Diagnosis
|
11
|
10
|
$0.01
|
—
|
$34,286.00
|
$62,743.00
|
$34,286.00
|
2024-12-15
|
|
901
|
MS_DRG
|
Wound Debridements For Injuries With Mcc
|
9
|
7
|
$0.01
|
—
|
$30,720.00
|
$53,552.00
|
$34,095.00
|
2024-12-15
|
|
8120000004
|
CDM
|
Hc Cadaver Donor - Lung
|
21
|
11
|
$48,659.61
|
$24,329.80
50% off
|
$17,517.00
|
$43,794.00
|
$34,062.00
|
2024-12-15
|
|
8120000001
|
CDM
|
Hc Cadaver Donor - Heart
|
21
|
11
|
$48,443.14
|
$24,221.57
50% off
|
$17,440.00
|
$43,599.00
|
$33,910.00
|
2024-12-15
|
|
319
|
MS_DRG
|
Other Endovascular Cardiac Valve Procedures With Mcc
|
9
|
7
|
$0.01
|
—
|
$30,459.00
|
$53,111.00
|
$33,819.00
|
2024-12-15
|
|
5911
|
APR_DRG
|
Neonate Birth Weight 500-749 Grams Without Major Procedure
|
11
|
10
|
$0.01
|
—
|
$33,604.00
|
$61,495.00
|
$33,604.00
|
2024-12-15
|
|
2604
|
APR_DRG
|
Major Pancreas, Liver And Shunt Procedures
|
11
|
10
|
$0.01
|
—
|
$33,421.00
|
$61,160.00
|
$33,421.00
|
2024-12-15
|
|
21
|
APR_DRG
|
Heart And/or Lung Transplant
|
11
|
10
|
$0.01
|
—
|
$33,363.00
|
$61,055.00
|
$33,363.00
|
2024-12-15
|
|
933
|
MS_DRG
|
Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft
|
9
|
7
|
$0.01
|
—
|
$30,002.00
|
$52,339.00
|
$33,337.00
|
2024-12-15
|
|
458
|
MS_DRG
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
9
|
7
|
$0.01
|
—
|
$29,940.00
|
$52,235.00
|
$33,272.00
|
2024-12-15
|
|
25609
|
CPT
|
Hc Open Rx Distal Radius Fx, Intra-articular, 3+ Frag
|
57
|
24
|
$46,177.30
|
$23,088.65
50% off
|
$3,453.00
|
$83,119.00
|
$33,248.00
|
2024-12-15
|
|
27870
|
CPT
|
Hc Asc Ankle Arthrodesis Open 27870
|
57
|
24
|
$46,090.31
|
$23,045.16
50% off
|
$7,121.00
|
$82,963.00
|
$33,185.00
|
2024-12-15
|
|
33477
|
CPT
|
Hc Cath Tcat Pulmonary Valve Implantation Prq Approach
|
21
|
11
|
$47,291.51
|
$23,645.76
50% off
|
$17,025.00
|
$42,562.00
|
$33,104.00
|
2024-12-15
|
|
1783
|
APR_DRG
|
External Heart Assist Systems
|
11
|
10
|
$0.01
|
—
|
$33,029.00
|
$60,444.00
|
$33,029.00
|
2024-12-15
|
|
1214
|
APR_DRG
|
Other Respiratory And Chest Procedures
|
11
|
10
|
$0.01
|
—
|
$33,010.00
|
$60,409.00
|
$33,010.00
|
2024-12-15
|
|
8120000003
|
CDM
|
Hc Cadaver Donor - Liver
|
21
|
11
|
$47,058.62
|
$23,529.31
50% off
|
$16,941.00
|
$42,353.00
|
$32,941.00
|
2024-12-15
|
|
6313
|
APR_DRG
|
Neonate Birth Weight > 2499 Grams With Other Major Procedure
|
11
|
10
|
$0.01
|
—
|
$32,890.00
|
$60,188.00
|
$32,890.00
|
2024-12-15
|
|
356
|
MS_DRG
|
Other Digestive System O.r. Procedures With Mcc
|
9
|
7
|
$0.01
|
—
|
$29,577.00
|
$51,622.00
|
$32,889.00
|
2024-12-15
|
|
35371
|
CPT
|
Hc Thromboendartectmy Femoral Common
|
40
|
11
|
$37,582.15
|
$18,791.08
50% off
|
$13,530.00
|
$67,648.00
|
$32,884.50
|
2024-12-15
|
|
323
|
MS_DRG
|
Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc
|
9
|
7
|
$0.01
|
—
|
$29,534.00
|
$51,549.00
|
$32,843.00
|
2024-12-15
|
|
C9767
|
HCPCS
|
Hc Revasc Endovas Any Vessel With IV Litho/ather/stent
|
27
|
16
|
$51,786.22
|
$25,893.11
50% off
|
$16,707.00
|
$46,608.00
|
$32,625.00
|
2024-12-15
|
|
6254
|
APR_DRG
|
Neonate Birth Weight 2000-2499 Grams With Other Significant Condition
|
11
|
10
|
$0.01
|
—
|
$32,624.00
|
$59,702.00
|
$32,624.00
|
2024-12-15
|
|
140
|
MS_DRG
|
Major Head And Neck Procedures With Mcc
|
9
|
7
|
$0.01
|
—
|
$29,324.00
|
$51,195.00
|
$32,622.00
|
2024-12-15
|
|
33229
|
CPT
|
Hc Remvl Perm Pm Pls Gen W/repl Plse Gen Mult Lead
|
59
|
24
|
$68,033.29
|
$34,016.64
50% off
|
$9,828.00
|
$61,230.00
|
$32,544.00
|
2024-12-15
|
|
6124
|
APR_DRG
|
Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other…
|
11
|
10
|
$0.01
|
—
|
$32,530.00
|
$59,530.00
|
$32,530.00
|
2024-12-15
|
|
0078-0697-61
|
NDC
|
Eltrombopag Olamine 25 Mg Po Pack
|
37
|
24
|
$64,108.49
|
$32,054.25
50% off
|
$820.50
|
$57,698.00
|
$32,503.00
|
2024-12-15
|
|
0078-0697-19
|
NDC
|
Eltrombopag Olamine 25 Mg Po Pack
|
37
|
24
|
$64,108.49
|
$32,054.25
50% off
|
$820.50
|
$57,698.00
|
$32,503.00
|
2024-12-15
|
|
29888
|
CPT
|
Hc Knee Scope,aid Ant Cruciate Repair
|
57
|
24
|
$44,941.54
|
$22,470.77
50% off
|
$3,300.00
|
$80,895.00
|
$32,358.00
|
2024-12-15
|