Hospital

COVENANT HOSPITAL PLAINVIEW

Plainview, TX · CCN 450539 · Rates published

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You selected 93306 (HCPCS)

Tte w/doppler complete

This hospital’s price: $445 across 5 payers · range $286-$579

Source: https://pricetransparency.providence.org/txnm/live/752426010_covenant-hospital-plainview_standardcharges.json · observed 2026-04-01

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

15,168 distinct procedures filed

18 distinct payers

371,402 rate rows

2026-04-01 last MRF observed

Data quality

263,620 of 371,402 rate rows are consumer-grade (71.0%)

107,782 rows are marked excluded from the consumer medians — these stay visible in the raw drill-down with the same reason shown here, so nothing is silently hidden.

Excluded — reason	Rows
no usable negotiated amount (only an out-of-band fallback) — excluded from medians	102,008
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only	5,334
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians	388
placeholder amount (≤ $0.02) — excluded from medians	28
below 25% of the Medicare reference for this DRG — likely a mislabeled per-diem; excluded from rankings	24

Data source & audit trail ↓ Download audit trail (JSON)

Source MRF file	https://pricetransparency.providence.org/txnm/live/752426010_covenant-hospital-plainview_standardcharges.json
Found on page	https://www.providence.org/billing-support/pricing-transparency
Discovered via	Discovered by HANK
Last fetch	not_modified · 2026-10-12
Content fingerprint	922056f36aac2149… · 179,394,156 bytes · first seen 2026-05-09

Top 50 most expensive offerings

Outliers are flagged where this hospital's filed rate is ≥2× or ≤0.5× the national median for the same code.

Code	Description	Payers	Min $	Max $	Avg median	vs national
C9098 HCPCS	Ciltacabtagene Car Pos T	1	$1,776,904.50	$1,791,273.00	$1,776,904.50	nat. median $31,873 outlier · 55.7×
Q2040 HCPCS	Tisagenlecleucel Car-pos T	1	$1,674,137.50	$1,687,675.00	$1,674,137.50	nat. median $10,345 outlier · 161.8×
J1413 HCPCS	Inj Delandistrogene Mox Rokl	4	$0.04	$3,504,052.08	$1,610,867.56	nat. median $3,324,572 outlier · 0.5×
C9081 HCPCS	Idecabtagene Car Pos T	1	$1,603,035.35	$1,615,997.90	$1,603,035.35	nat. median $27,427 outlier · 58.4×
C9076 HCPCS	Lisocabtagene Car Pos T	1	$1,567,879.39	$1,580,557.66	$1,567,879.39	nat. median $27,935 outlier · 56.1×
C9073 HCPCS	Brexucabtagene Autoleucel Ca	1	$1,425,344.90	$1,436,870.60	$1,425,344.90	nat. median $27,071 outlier · 52.7×
Q2056 HCPCS	Ciltacabtagene Car-pos T	4	$570,839.96	$1,732,143.60	$1,169,555.71	nat. median $646,415 1.8× median
Q2055 HCPCS	Idecabtagene Vicleucel Car	4	$542,987.65	$1,562,654.28	$1,070,344.33	nat. median $622,245 1.7× median
Q2054 HCPCS	Lisocabtagene Mara Car Pos T	4	$545,393.01	$1,528,383.91	$1,054,654.67	nat. median $640,950 1.6× median
Q2042 HCPCS	Tisagenlecleucel Car-pos T	4	$595,755.38	$1,436,870.60	$1,036,652.82	nat. median $738,272 1.4× median
Q2053 HCPCS	Brexucabtagene Car Pos T	4	$474,611.88	$1,389,439.92	$947,248.13	nat. median $591,650 1.6× median
Q2041 HCPCS	Axicabtagene Ciloleucel Car+	4	$515,893.64	$1,325,269.00	$937,869.66	nat. median $608,101 1.5× median
18 MS_DRG	Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies	8	$251,979.56	$706,131.79	$341,898.64	nat. median $359,358 1.0× median
J9029 HCPCS	Inj, Adstiladrin, Per Tx Dos	4	$62,353.83	$598,400.00	$330,708.92	nat. median $68,423 outlier · 4.8×
1 MS_DRG	Heart Transplant Or Implant Of Heart Assist System With Mcc	8	$188,207.88	$527,422.04	$213,032.14	nat. median $249,124 0.9× median
C9074 HCPCS	Injection, Lumasiran	1	$204,050.00	$205,700.00	$204,050.00	nat. median $501 outlier · 407.1×
C9031 HCPCS	Lutetium Lu 177 Dotatate, Tx	1	$186,798.50	$188,309.00	$186,798.50	nat. median $524 outlier · 356.7×
3 MS_DRG	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…	8	$143,196.60	$401,926.03	$171,436.33	nat. median $190,557 0.9× median
927 MS_DRG	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	8	$158,515.75	$444,214.65	$163,809.08	nat. median $198,433 0.8× median
0100T OTHER	Prosth Retina Receive&Gen	3	$8,191.47	$443,776.46	$158,632.11	nat. median $5,128 outlier · 30.9×
453 MS_DRG	Combined Anterior And Posterior Spinal Fusion With Mcc	1	$129,892.31	$163,543.74	$154,834.55	nat. median $71,201 outlier · 2.2×
Q2043 HCPCS	Sipuleucel-t Auto Cd54+	4	$54,581.12	$227,721.83	$142,629.59	nat. median $65,720 outlier · 2.2×
J7330 HCPCS	Cultured Chondrocytes Implnt	1	$141,644.09	$142,789.46	$141,644.09	nat. median $75,037 1.9× median
A9543 HCPCS	Y90 Ibritumomab, Rx	4	$55,119.81	$203,962.06	$131,137.95	nat. median $63,643 outlier · 2.1×
222 MS_DRG	Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock…	2	$11,759.00	$144,340.69	$126,402.12	nat. median $47,579 outlier · 2.7×
224 MS_DRG	Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh…	2	$11,759.00	$133,644.18	$117,034.96	nat. median $39,629 outlier · 3.0×
459 MS_DRG	Spinal Fusion Except Cervical With Mcc	1	$97,217.68	$122,404.04	$115,885.67	nat. median $52,841 outlier · 2.2×
4 MS_DRG	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…	8	$94,410.65	$277,121.46	$114,191.67	nat. median $126,722 0.9× median
454 MS_DRG	Combined Anterior And Posterior Spinal Fusion With Cc	1	$89,654.04	$112,880.87	$106,869.64	nat. median $49,639 outlier · 2.2×
226 MS_DRG	Cardiac Defibrillator Implant Without Cardiac Catheterization With Mcc	2	$11,759.00	$120,668.49	$105,671.88	nat. median $38,225 outlier · 2.8×
7 MS_DRG	Lung Transplant	8	$87,319.71	$244,699.30	$101,848.40	nat. median $117,894 0.9× median
14 MS_DRG	Allogeneic Bone Marrow Transplant	8	$87,540.21	$245,317.23	$94,971.74	nat. median $110,192 0.9× median
212 MS_DRG	Concomitant Aortic And Mitral Valve Procedures	8	$72,787.69	$203,975.69	$91,078.15	nat. median $97,414 0.9× median
2 MS_DRG	Heart Transplant Or Implant Of Heart Assist System Without Mcc	8	$73,633.64	$206,346.31	$89,911.06	nat. median $103,967 0.9× median
J9226 HCPCS	Supprelin La Implant	4	$39,938.22	$137,441.33	$89,888.41	nat. median $55,159 1.6× median
209 MS_DRG	Complex Aortic Arch Procedures	7	$88,018.88	$94,755.01	$89,815.18	nat. median $92,655 1.0× median
426 MS_DRG	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	8	$9,178.05	$196,270.27	$87,620.08	nat. median $93,270 0.9× median
223 MS_DRG	Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock…	2	$11,759.00	$98,381.89	$86,155.05	nat. median $32,619 outlier · 2.6×
K1007 HCPCS	Bil Hkaf Pc S/d Micro Sensor	1	$84,700.00	$87,780.00	$84,700.00	nat. median $97,020 0.9× median
0424T OTHER	Insj/rplc Nstim Apnea Compl	2	$58,528.67	$91,916.54	$83,861.97	nat. median $22,425 outlier · 3.7×
215 MS_DRG	Other Heart Assist System Implant	8	$11,759.00	$198,378.73	$83,759.06	nat. median $93,917 0.9× median
225 MS_DRG	Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh…	2	$11,759.00	$95,346.75	$83,497.11	nat. median $34,024 outlier · 2.5×
227 MS_DRG	Cardiac Defibrillator Implant Without Cardiac Catheterization Without Mcc	2	$11,759.00	$94,649.23	$82,886.28	nat. median $31,634 outlier · 2.6×
216 MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	8	$64,483.97	$199,113.33	$82,606.12	nat. median $90,581 0.9× median
5 MS_DRG	Liver Transplant With Mcc Or Intestinal Transplant	8	$71,153.95	$199,397.38	$82,377.95	nat. median $94,964 0.9× median
455 MS_DRG	Combined Anterior And Posterior Spinal Fusion Without Cc/Mcc	1	$67,509.88	$84,999.78	$80,473.29	nat. median $38,944 outlier · 2.1×
J9600 HCPCS	Porfimer Sodium Injection	1	$80,400.15	$81,050.29	$80,400.15	nat. median $30,131 outlier · 2.7×
0283T OTHER	Periph Field Stimul Perm	2	$52,586.40	$89,970.12	$75,347.68	nat. median $14,059 outlier · 5.4×
33270 HCPCS	Ins/rep Subq Defibrillator	5	$5,619.00	$105,981.85	$72,867.30	nat. median $32,113 outlier · 2.3×
33264 HCPCS	Rmvl & Rplcmt Dfb Gen Mlt Ld	5	$5,619.00	$105,981.85	$72,867.30	nat. median $31,564 outlier · 2.3×

Other procedures at this hospital

Browse this hospital's 15,168 published procedures. Use the slice to choose what to show, then sort or filter any column.

Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
Code	Type	Description	Rate rows	Payers	Gross	Cash	Min $	Max $	Avg median	Last observed

C9098	HCPCS	Ciltacabtagene Car Pos T	8	1	—	—	$1,776,904.50	$1,791,273.00	$1,776,904.50	2026-04-01
Q2040	HCPCS	Tisagenlecleucel Car-pos T	8	1	—	—	$1,674,137.50	$1,687,675.00	$1,674,137.50	2026-04-01
J1413	HCPCS	Inj Delandistrogene Mox Rokl	16	4	—	—	$0.04	$3,504,052.08	$1,610,867.56	2026-04-01
C9081	HCPCS	Idecabtagene Car Pos T	8	1	—	—	$1,603,035.35	$1,615,997.90	$1,603,035.35	2026-04-01
C9076	HCPCS	Lisocabtagene Car Pos T	8	1	—	—	$1,567,879.39	$1,580,557.66	$1,567,879.39	2026-04-01
C9073	HCPCS	Brexucabtagene Autoleucel Ca	8	1	—	—	$1,425,344.90	$1,436,870.60	$1,425,344.90	2026-04-01
Q2056	HCPCS	Ciltacabtagene Car-pos T	16	4	—	—	$570,839.96	$1,732,143.60	$1,169,555.71	2026-04-01
Q2055	HCPCS	Idecabtagene Vicleucel Car	16	4	—	—	$542,987.65	$1,562,654.28	$1,070,344.33	2026-04-01
Q2054	HCPCS	Lisocabtagene Mara Car Pos T	16	4	—	—	$545,393.01	$1,528,383.91	$1,054,654.67	2026-04-01
Q2042	HCPCS	Tisagenlecleucel Car-pos T	16	4	—	—	$595,755.38	$1,436,870.60	$1,036,652.82	2026-04-01
Q2053	HCPCS	Brexucabtagene Car Pos T	16	4	—	—	$474,611.88	$1,389,439.92	$947,248.13	2026-04-01
Q2041	HCPCS	Axicabtagene Ciloleucel Car+	16	4	—	—	$515,893.64	$1,325,269.00	$937,869.66	2026-04-01
18	MS_DRG	Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies	36	8	—	—	$251,979.56	$706,131.79	$341,898.64	2026-04-01
J9029	HCPCS	Inj, Adstiladrin, Per Tx Dos	16	4	—	—	$62,353.83	$598,400.00	$330,708.92	2026-04-01
1	MS_DRG	Heart Transplant Or Implant Of Heart Assist System With Mcc	28	8	—	—	$188,207.88	$527,422.04	$213,032.14	2026-04-01
C9074	HCPCS	Injection, Lumasiran	8	1	—	—	$204,050.00	$205,700.00	$204,050.00	2026-04-01
C9031	HCPCS	Lutetium Lu 177 Dotatate, Tx	8	1	—	—	$186,798.50	$188,309.00	$186,798.50	2026-04-01
3	MS_DRG	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…	36	8	—	—	$143,196.60	$401,926.03	$171,436.33	2026-04-01
927	MS_DRG	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	28	8	—	—	$158,515.75	$444,214.65	$163,809.08	2026-04-01
0100T	OTHER	Prosth Retina Receive&Gen	16	3	—	—	$8,191.47	$443,776.46	$158,632.11	2026-04-01
453	MS_DRG	Combined Anterior And Posterior Spinal Fusion With Mcc	8	1	—	—	$129,892.31	$163,543.74	$154,834.55	2026-04-01
Q2043	HCPCS	Sipuleucel-t Auto Cd54+	16	4	—	—	$54,581.12	$227,721.83	$142,629.59	2026-04-01
J7330	HCPCS	Cultured Chondrocytes Implnt	8	1	—	—	$141,644.09	$142,789.46	$141,644.09	2026-04-01
A9543	HCPCS	Y90 Ibritumomab, Rx	16	4	—	—	$55,119.81	$203,962.06	$131,137.95	2026-04-01
222	MS_DRG	Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock…	10	2	—	—	$11,759.00	$144,340.69	$126,402.12	2026-04-01
224	MS_DRG	Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh…	10	2	—	—	$11,759.00	$133,644.18	$117,034.96	2026-04-01
459	MS_DRG	Spinal Fusion Except Cervical With Mcc	8	1	—	—	$97,217.68	$122,404.04	$115,885.67	2026-04-01
4	MS_DRG	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…	36	8	—	—	$94,410.65	$277,121.46	$114,191.67	2026-04-01
454	MS_DRG	Combined Anterior And Posterior Spinal Fusion With Cc	8	1	—	—	$89,654.04	$112,880.87	$106,869.64	2026-04-01
226	MS_DRG	Cardiac Defibrillator Implant Without Cardiac Catheterization With Mcc	10	2	—	—	$11,759.00	$120,668.49	$105,671.88	2026-04-01
7	MS_DRG	Lung Transplant	28	8	—	—	$87,319.71	$244,699.30	$101,848.40	2026-04-01
14	MS_DRG	Allogeneic Bone Marrow Transplant	28	8	—	—	$87,540.21	$245,317.23	$94,971.74	2026-04-01
212	MS_DRG	Concomitant Aortic And Mitral Valve Procedures	36	8	—	—	$72,787.69	$203,975.69	$91,078.15	2026-04-01
2	MS_DRG	Heart Transplant Or Implant Of Heart Assist System Without Mcc	28	8	—	—	$73,633.64	$206,346.31	$89,911.06	2026-04-01
J9226	HCPCS	Supprelin La Implant	16	4	—	—	$39,938.22	$137,441.33	$89,888.41	2026-04-01
209	MS_DRG	Complex Aortic Arch Procedures	18	7	—	—	$88,018.88	$94,755.01	$89,815.18	2026-04-01
426	MS_DRG	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	30	8	—	—	$9,178.05	$196,270.27	$87,620.08	2026-04-01
223	MS_DRG	Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock…	10	2	—	—	$11,759.00	$98,381.89	$86,155.05	2026-04-01
K1007	HCPCS	Bil Hkaf Pc S/d Micro Sensor	8	1	—	—	$84,700.00	$87,780.00	$84,700.00	2026-04-01
0424T	OTHER	Insj/rplc Nstim Apnea Compl	14	2	—	—	$58,528.67	$91,916.54	$83,861.97	2026-04-01
215	MS_DRG	Other Heart Assist System Implant	38	8	—	—	$11,759.00	$198,378.73	$83,759.06	2026-04-01
225	MS_DRG	Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh…	10	2	—	—	$11,759.00	$95,346.75	$83,497.11	2026-04-01
227	MS_DRG	Cardiac Defibrillator Implant Without Cardiac Catheterization Without Mcc	10	2	—	—	$11,759.00	$94,649.23	$82,886.28	2026-04-01
216	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	36	8	—	—	$64,483.97	$199,113.33	$82,606.12	2026-04-01
5	MS_DRG	Liver Transplant With Mcc Or Intestinal Transplant	28	8	—	—	$71,153.95	$199,397.38	$82,377.95	2026-04-01
455	MS_DRG	Combined Anterior And Posterior Spinal Fusion Without Cc/Mcc	8	1	—	—	$67,509.88	$84,999.78	$80,473.29	2026-04-01
J9600	HCPCS	Porfimer Sodium Injection	8	1	—	—	$80,400.15	$81,050.29	$80,400.15	2026-04-01
0283T	OTHER	Periph Field Stimul Perm	14	2	—	—	$52,586.40	$89,970.12	$75,347.68	2026-04-01
33249	HCPCS	Insj/rplcmt Defib W/lead(s)	24	5	—	—	$8,624.00	$105,981.85	$72,867.30	2026-04-01
33264	HCPCS	Rmvl & Rplcmt Dfb Gen Mlt Ld	24	5	—	—	$5,619.00	$105,981.85	$72,867.30	2026-04-01
33270	HCPCS	Ins/rep Subq Defibrillator	24	5	—	—	$5,619.00	$105,981.85	$72,867.30	2026-04-01
33231	HCPCS	Insrt Pulse Gen W/mult Leads	24	5	—	—	$5,619.00	$105,981.85	$72,867.30	2026-04-01
429	MS_DRG	Combined Anterior And Posterior Cervical Spinal Fusion With Mcc	28	8	—	—	$55,727.88	$156,168.33	$72,782.50	2026-04-01
231	MS_DRG	Coronary Bypass With Ptca With Mcc	36	8	—	—	$56,619.26	$158,666.28	$72,103.21	2026-04-01
456	MS_DRG	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	36	8	—	—	$56,587.19	$174,729.66	$71,897.49	2026-04-01
850	MS_DRG	Acute Leukemia With Other Procedures	28	8	—	—	$61,549.91	$172,483.62	$70,200.16	2026-04-01
20	MS_DRG	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc	36	8	—	—	$53,860.26	$159,342.95	$67,747.27	2026-04-01
69930	HCPCS	Implant Cochlear Device	26	6	—	—	$3,300.00	$102,199.16	$66,547.72	2026-04-01
219	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	36	8	—	—	$51,698.63	$159,634.81	$66,268.37	2026-04-01
233	MS_DRG	Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc	36	8	—	—	$52,225.18	$147,036.50	$66,011.40	2026-04-01
957	MS_DRG	Other O.r. Procedures For Multiple Significant Trauma With Mcc	36	8	—	—	$49,872.44	$139,759.42	$65,814.99	2026-04-01
C9741	HCPCS	Impl Pressure Sensor W/angio	14	2	—	—	$6,758.55	$94,949.14	$65,583.43	2026-04-01
38240	HCPCS	Transplt Allo Hct/donor	24	5	—	—	$7,187.00	$108,938.41	$64,767.44	2026-04-01
460	MS_DRG	Spinal Fusion Except Cervical Without Mcc	8	1	—	—	$53,618.28	$67,509.27	$63,914.21	2026-04-01
64568	HCPCS	Inc For Vagus N Elect Impl	24	5	—	—	$4,837.00	$89,970.12	$63,580.44	2026-04-01
275	MS_DRG	Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc	36	8	—	—	$47,218.35	$132,637.49	$62,014.88	2026-04-01
870	MS_DRG	Septicemia Or Severe Sepsis With Mv >96 Hours	36	8	—	—	$46,483.33	$131,300.90	$60,317.84	2026-04-01
0809T	OTHER	Arthrd Si Jt Prq Tfx&implt	8	1	—	—	$44,014.24	$63,722.10	$60,218.48	2026-04-01
0775T	OTHER	Arthrd Si Jt Prq Iartic Impl	8	1	—	—	$44,014.24	$63,722.10	$60,218.48	2026-04-01
268	MS_DRG	Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc	36	8	—	—	$44,550.23	$129,223.43	$60,054.66	2026-04-01
0431T	OTHER	Rmvl/rplc Nstim Apnea Pls Gn	14	2	—	—	$45,539.12	$84,735.53	$59,697.33	2026-04-01
0427T	OTHER	Insj/rplc Nstim Apnea Pls Gn	14	2	—	—	$45,539.12	$84,735.53	$59,697.33	2026-04-01
427	MS_DRG	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	28	8	—	—	$47,433.51	$132,924.72	$59,572.07	2026-04-01
10	MS_DRG	Pancreas Transplant	28	8	—	—	$53,272.91	$149,288.69	$59,255.63	2026-04-01
928	MS_DRG	Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/Mcc	28	8	—	—	$44,625.74	$125,056.38	$59,233.51	2026-04-01
J7310	HCPCS	Ganciclovir Long Act Implant	8	1	—	—	$59,122.56	$59,600.64	$59,122.56	2026-04-01
19	MS_DRG	Simultaneous Pancreas And Kidney Transplant With Hemodialysis	28	8	—	—	$52,966.21	$148,429.20	$58,952.48	2026-04-01
955	MS_DRG	Craniotomy For Multiple Significant Trauma	36	8	—	—	$45,624.03	$127,853.93	$58,915.01	2026-04-01
0316T	OTHER	Replc Vagus Nerve Pls Gen	14	2	—	—	$44,874.55	$84,735.53	$58,826.14	2026-04-01
0268T	OTHER	Implt/rpl Crtd Sns Dev Gen	14	2	—	—	$44,874.55	$84,735.53	$58,826.14	2026-04-01
63685	HCPCS	Insrt/redo Spine N Generator	26	6	—	—	$2,150.00	$89,970.12	$58,528.67	2026-04-01
0266T	OTHER	Implt/rpl Crtd Sns Dev Total	14	2	—	—	$8,157.94	$84,735.53	$58,528.67	2026-04-01
61886	HCPCS	Implant Neurostim Arrays	26	6	—	—	$2,300.00	$89,970.12	$58,528.67	2026-04-01
0312T	OTHER	Laps Impltj Nstim Vagus	14	2	—	—	$8,157.94	$84,735.53	$58,528.67	2026-04-01
217	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	36	8	—	—	$43,148.35	$133,233.27	$57,705.50	2026-04-01
218	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	36	8	—	—	$39,751.89	$122,745.70	$57,705.50	2026-04-01
573	MS_DRG	Skin Graft For Skin Ulcer Or Cellulitis With Mcc	36	8	—	—	$41,146.42	$117,222.38	$57,519.96	2026-04-01
207	MS_DRG	Respiratory System Diagnosis With Ventilator Support >96 Hours	36	8	—	—	$43,217.17	$130,228.23	$56,613.99	2026-04-01
317	MS_DRG	Concomitant Left Atrial Appendage Closure And Cardiac Ablation	28	8	—	—	$41,334.85	$115,834.21	$55,647.29	2026-04-01
447	MS_DRG	Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall…	28	8	—	—	$44,797.46	$125,537.62	$55,611.15	2026-04-01
0426T	OTHER	Insj/rplc Nstim Apnea Stm Ld	14	2	—	—	$38,751.63	$59,697.33	$55,087.07	2026-04-01
266	MS_DRG	Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc	36	8	—	—	$40,027.85	$117,750.23	$54,236.10	2026-04-01
969	MS_DRG	HIV With Extensive O.r. Procedures With Mcc	36	8	—	—	$42,256.30	$129,560.88	$54,180.99	2026-04-01
232	MS_DRG	Coronary Bypass With Ptca Without Mcc	36	8	—	—	$40,815.66	$114,379.26	$53,725.29	2026-04-01
28	MS_DRG	Spinal Procedures With Mcc	36	8	—	—	$40,620.55	$125,427.94	$53,303.74	2026-04-01
276	MS_DRG	Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator	36	8	—	—	$41,388.31	$117,073.45	$53,290.54	2026-04-01
457	MS_DRG	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	36	8	—	—	$38,348.00	$118,410.78	$52,952.84	2026-04-01
33240	HCPCS	Insrt Pulse Gen W/singl Lead	24	5	—	—	$8,624.00	$78,808.13	$52,580.34	2026-04-01
33263	HCPCS	Rmvl & Rplcmt Dfb Gen 2 Lead	24	5	—	—	$5,619.00	$78,808.13	$52,580.34	2026-04-01
33262	HCPCS	Rmvl& Replc Pulse Gen 1 Lead	24	5	—	—	$5,619.00	$78,808.13	$52,580.34	2026-04-01
33230	HCPCS	Insrt Pulse Gen W/dual Leads	24	5	—	—	$5,619.00	$78,808.13	$52,580.34	2026-04-01
235	MS_DRG	Coronary Bypass Without Cardiac Catheterization With Mcc	36	8	—	—	$39,315.55	$110,859.90	$52,219.21	2026-04-01
820	MS_DRG	Lymphoma And Leukemia With Major O.r. Procedures With Mcc	36	8	—	—	$38,901.94	$113,991.18	$52,189.71	2026-04-01
0414T	OTHER	Rmvl & Rpl Car Modulj Pls Gn	24	5	—	—	$8,624.00	$75,415.41	$51,591.15	2026-04-01
0408T	OTHER	Insj/rplc Cardiac Modulj Sys	24	5	—	—	$8,624.00	$75,415.41	$51,591.15	2026-04-01
0409T	OTHER	Insj/rplc Car Modulj Pls Gn	24	5	—	—	$8,624.00	$75,415.41	$51,591.15	2026-04-01
23	MS_DRG	Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…	36	8	—	—	$38,118.81	$106,867.08	$51,145.56	2026-04-01
463	MS_DRG	Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …	38	8	—	—	$9,837.12	$106,770.94	$50,785.53	2026-04-01
790	MS_DRG	Extreme Immaturity Or Respiratory Distress Syndrome, Neonate	28	8	—	—	$39,724.49	$111,321.43	$50,166.92	2026-04-01
16	MS_DRG	Autologous Bone Marrow Transplant With Cc/Mcc	28	8	—	—	$40,329.21	$113,016.07	$50,065.13	2026-04-01
278	MS_DRG	Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures …	36	8	—	—	$33,429.38	$93,680.40	$49,871.61	2026-04-01
248	MS_DRG	Percutaneous Cardiovascular Procedures With Non-drug-eluting Stent With Mcc Or 4…	10	2	—	—	$13,952.00	$56,740.15	$49,688.52	2026-04-01
461	MS_DRG	Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc	36	8	—	—	$41,005.43	$128,541.00	$49,536.24	2026-04-01
246	MS_DRG	Percutaneous Cardiovascular Procedures With Drug-eluting Stent With Mcc Or 4+ Ar…	10	2	—	—	$13,508.00	$56,468.68	$49,450.79	2026-04-01
834	MS_DRG	Acute Leukemia With Mcc	36	8	—	—	$36,930.75	$105,551.23	$49,279.27	2026-04-01
405	MS_DRG	Pancreas, Liver And Shunt Procedures With Mcc	36	8	—	—	$36,272.57	$103,782.93	$49,128.65	2026-04-01
234	MS_DRG	Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc	36	8	—	—	$35,547.57	$99,616.30	$49,068.11	2026-04-01
11	MS_DRG	Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc	36	8	—	—	$36,053.40	$101,033.80	$49,001.35	2026-04-01
430	MS_DRG	Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc	28	8	—	—	$36,551.21	$102,428.83	$48,865.79	2026-04-01
213	MS_DRG	Endovascular Abdominal Aorta With Iliac Branch Procedures	18	7	—	—	$47,453.32	$51,084.95	$48,421.75	2026-04-01
220	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	36	8	—	—	$35,389.88	$109,276.70	$48,059.67	2026-04-01
0308T	OTHER	Insj Ocular Telescope Prosth	24	5	—	—	$4,837.00	$79,384.95	$47,864.06	2026-04-01
428	MS_DRG	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	28	8	—	—	$36,785.75	$103,086.08	$47,795.53	2026-04-01
21	MS_DRG	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc	36	8	—	—	$36,933.42	$115,776.44	$47,756.90	2026-04-01
8	MS_DRG	Simultaneous Pancreas And Kidney Transplant	28	8	—	—	$36,355.43	$101,880.18	$47,667.19	2026-04-01
270	MS_DRG	Other Major Cardiovascular Procedures With Mcc	36	8	—	—	$34,297.37	$96,112.81	$47,621.04	2026-04-01
J9266	HCPCS	Pegaspargase Injection	16	4	—	—	$27,571.34	$65,529.25	$47,495.49	2026-04-01
653	MS_DRG	Major Bladder Procedures With Mcc	36	8	—	—	$37,246.80	$104,378.12	$47,000.76	2026-04-01
466	MS_DRG	Revision Of Hip Or Knee Replacement With Mcc	38	8	—	—	$17,984.60	$97,776.75	$46,958.81	2026-04-01
33276	HCPCS	Insj Phrnc Nrv Stim Sys	18	4	—	—	$5,619.00	$130,951.46	$46,680.79	2026-04-01
17	MS_DRG	Autologous Bone Marrow Transplant Without Cc/Mcc	28	8	—	—	$40,329.21	$113,016.07	$46,396.30	2026-04-01
0387T	OTHER	Leadless C Pm Ins/rpl Ventr	14	2	—	—	$32,200.98	$51,055.62	$46,138.72	2026-04-01
221	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	38	8	—	—	$8,628.00	$94,751.32	$45,679.38	2026-04-01
450	MS_DRG	Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically …	28	8	—	—	$34,410.30	$96,429.27	$45,638.79	2026-04-01
326	MS_DRG	Stomach, Esophageal And Duodenal Procedures With Mcc	40	8	—	—	$8,160.31	$95,748.29	$45,378.24	2026-04-01
C9746	HCPCS	Trans Imp Balloon Cont	14	2	—	—	$31,552.62	$49,395.17	$45,209.72	2026-04-01
228	MS_DRG	Other Cardiothoracic Procedures With Mcc	38	8	—	—	$8,050.00	$94,988.56	$44,960.65	2026-04-01
853	MS_DRG	Infectious And Parasitic Diseases With O.r. Procedures With Mcc	38	8	—	—	$33,420.02	$94,245.80	$44,892.51	2026-04-01
239	MS_DRG	Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc	36	8	—	—	$33,653.89	$94,309.57	$44,868.19	2026-04-01
576	MS_DRG	Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc	36	8	—	—	$36,048.72	$107,136.66	$44,709.04	2026-04-01
0620T	OTHER	Evasc Ven Artlz Tibl/prnl Vn	18	4	—	—	$6,794.00	$46,746.24	$44,247.19	2026-04-01
338	MS_DRG	Appendectomy With Complicated Principal Diagnosis With Mcc	8	1	—	—	$41,401.90	$50,079.81	$44,200.15	2026-04-01
471	MS_DRG	Cervical Spinal Fusion With Mcc	36	8	—	—	$32,454.47	$92,732.00	$44,146.21	2026-04-01
837	MS_DRG	Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot…	36	8	—	—	$33,455.44	$93,753.43	$43,956.79	2026-04-01
37230	HCPCS	Tib/per Revasc W/stent	16	3	—	—	$6,794.00	$51,055.62	$43,834.92	2026-04-01
G2171	HCPCS	Avf Use Magnetic/art/ven	16	1	—	—	$32,039.34	$52,761.30	$43,834.92	2026-04-01
37231	HCPCS	Tib/per Revasc Stent & Ather	16	3	—	—	$6,794.00	$51,055.62	$43,834.92	2026-04-01
37227	HCPCS	Fem/popl Revasc Stnt & Ather	16	3	—	—	$6,794.00	$51,055.62	$43,834.92	2026-04-01
G2170	HCPCS	Avf By Tissue W Thermal E	16	1	—	—	$32,039.34	$52,761.30	$43,834.92	2026-04-01
37229	HCPCS	Tib/per Revasc W/ather	16	3	—	—	$6,794.00	$51,055.62	$43,834.92	2026-04-01
267	MS_DRG	Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc	36	8	—	—	$31,434.80	$92,000.55	$43,619.09	2026-04-01
981	MS_DRG	Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc	36	8	—	—	$31,768.23	$89,365.07	$43,083.43	2026-04-01
826	MS_DRG	Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. …	36	8	—	—	$31,907.89	$89,416.67	$42,974.74	2026-04-01
277	MS_DRG	Cardiac Defibrillator Implant Without Mcc	36	8	—	—	$31,086.00	$90,156.85	$42,514.38	2026-04-01
823	MS_DRG	Lymphoma And Non-acute Leukemia With Other Procedures With Mcc	36	8	—	—	$31,266.41	$87,619.05	$42,252.75	2026-04-01
245	MS_DRG	Aicd Generator Procedures	36	8	—	—	$32,651.59	$91,500.79	$42,078.86	2026-04-01
856	MS_DRG	Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc	40	8	—	—	$11,228.14	$84,475.08	$41,972.50	2026-04-01
25	MS_DRG	Craniotomy And Endovascular Intracranial Procedures With Mcc	36	8	—	—	$29,881.90	$83,739.18	$41,956.98	2026-04-01
799	MS_DRG	Splenic Procedures With Mcc	36	8	—	—	$31,769.57	$93,403.13	$41,818.79	2026-04-01
63655	HCPCS	Implant Neuroelectrodes	24	5	—	—	$7,837.00	$58,826.14	$41,813.09	2026-04-01
163	MS_DRG	Major Chest Procedures With Mcc	36	8	—	—	$30,796.67	$88,859.84	$41,453.15	2026-04-01
31	MS_DRG	Ventricular Shunt Procedures With Mcc	36	8	—	—	$27,999.58	$78,464.29	$41,443.05	2026-04-01
319	MS_DRG	Other Endovascular Cardiac Valve Procedures With Mcc	36	8	—	—	$29,350.69	$82,250.53	$41,306.42	2026-04-01
93656	HCPCS	Tx Atrial Fib Pulm Vein Isol	38	5	—	—	$2,550.51	$67,640.74	$41,074.89	2026-04-01
650	MS_DRG	Kidney Transplant With Hemodialysis With Mcc	28	8	—	—	$30,783.97	$86,267.09	$41,005.18	2026-04-01
356	MS_DRG	Other Digestive System O.r. Procedures With Mcc	38	8	—	—	$23,339.47	$80,661.20	$40,665.39	2026-04-01
329	MS_DRG	Major Small And Large Bowel Procedures With Mcc	44	8	—	—	$14,704.82	$85,980.59	$40,571.74	2026-04-01
6	MS_DRG	Liver Transplant Without Mcc	28	8	—	—	$32,400.35	$90,796.72	$40,530.16	2026-04-01
323	MS_DRG	Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc	36	8	—	—	$28,459.97	$79,754.46	$40,254.49	2026-04-01
474	MS_DRG	Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc	36	8	—	—	$29,964.76	$83,971.38	$39,986.66	2026-04-01
33229	HCPCS	Remv&replc Pm Gen Mult Leads	24	5	—	—	$5,619.00	$56,423.54	$39,925.67	2026-04-01
33221	HCPCS	Insert Pulse Gen Mult Leads	24	5	—	—	$5,619.00	$56,423.54	$39,925.67	2026-04-01
140	MS_DRG	Major Head And Neck Procedures With Mcc	36	8	—	—	$28,258.18	$79,188.96	$39,772.40	2026-04-01
12	MS_DRG	Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc	36	8	—	—	$27,418.92	$76,837.07	$39,389.67	2026-04-01
958	MS_DRG	Other O.r. Procedures For Multiple Significant Trauma With Cc	36	8	—	—	$27,459.68	$76,951.29	$39,373.36	2026-04-01
269	MS_DRG	Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc	38	8	—	—	$8,050.00	$78,397.10	$39,351.87	2026-04-01
81280	HCPCS	Long Qt Synd Gene Full Seq	8	1	—	—	$38,415.32	$44,125.71	$39,297.84	2026-04-01
673	MS_DRG	Other Kidney And Urinary Tract Procedures With Mcc	36	8	—	—	$27,997.58	$78,458.67	$39,277.88	2026-04-01
901	MS_DRG	Wound Debridements For Injuries With Mcc	36	8	—	—	$29,602.60	$82,956.47	$39,239.07	2026-04-01
236	MS_DRG	Coronary Bypass Without Cardiac Catheterization Without Mcc	38	8	—	—	$8,628.00	$76,994.36	$39,085.44	2026-04-01
458	MS_DRG	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	36	8	—	—	$28,850.87	$89,085.59	$39,052.74	2026-04-01
423	MS_DRG	Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc	36	8	—	—	$27,176.36	$76,157.34	$38,900.58	2026-04-01
64590	HCPCS	Insrt/redo Pn/gastr Stimul	26	6	—	—	$2,150.00	$58,826.14	$38,751.63	2026-04-01
61885	HCPCS	Insrt/redo Neurostim 1 Array	26	6	—	—	$2,150.00	$58,826.14	$38,751.63	2026-04-01
64580	HCPCS	Implant Neuroelectrodes	26	6	—	—	$1,000.00	$58,826.14	$38,751.63	2026-04-01
273	MS_DRG	Percutaneous And Other Intracardiac Procedures With Mcc	38	8	—	—	$8,909.00	$73,465.46	$38,595.20	2026-04-01
448	MS_DRG	Multiple Level Spinal Fusion Except Cervical Without Mcc	28	8	—	—	$27,283.94	$76,458.82	$37,607.79	2026-04-01
802	MS_DRG	Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc	36	8	—	—	$23,952.30	$67,122.42	$37,589.38	2026-04-01
341	MS_DRG	Appendectomy Without Complicated Principal Diagnosis With Mcc	8	1	—	—	$35,206.81	$42,586.22	$37,586.35	2026-04-01
793	MS_DRG	Full Term Neonate With Major Problems	38	9	—	—	$59.58	$78,095.40	$37,082.62	2026-04-01
24	MS_DRG	Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…	36	8	—	—	$25,400.95	$71,425.70	$37,028.87	2026-04-01
34	MS_DRG	Carotid Artery Stent Procedures With Mcc	36	8	—	—	$25,982.96	$73,548.41	$36,709.03	2026-04-01
40	MS_DRG	Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc	36	8	—	—	$25,203.17	$72,588.86	$36,635.26	2026-04-01
907	MS_DRG	Other O.r. Procedures For Injuries With Mcc	38	8	—	—	$21,284.41	$74,591.91	$36,378.64	2026-04-01
791	MS_DRG	Prematurity With Major Problems	32	8	—	—	$1,837.89	$76,026.27	$36,266.83	2026-04-01
402	MS_DRG	Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical	28	8	—	—	$26,254.91	$73,575.13	$35,982.85	2026-04-01
956	MS_DRG	Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma	36	8	—	—	$25,539.94	$73,111.05	$35,872.92	2026-04-01
143	MS_DRG	Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc	36	8	—	—	$22,061.96	$62,693.55	$35,745.60	2026-04-01
166	MS_DRG	Other Respiratory System O.r. Procedures With Mcc	36	8	—	—	$25,732.38	$76,496.83	$35,676.51	2026-04-01
518	MS_DRG	Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost…	36	8	—	—	$23,946.95	$73,943.29	$35,673.40	2026-04-01
628	MS_DRG	Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc	36	8	—	—	$26,369.18	$75,680.55	$35,591.89	2026-04-01
C9607	HCPCS	Perc D-e Cor Revasc Chro Sin	24	5	—	—	$7,837.00	$51,055.62	$35,493.14	2026-04-01
0238T	OTHER	Trluml Perip Athrc Iliac Art	24	5	—	—	$8,624.00	$51,055.62	$35,493.14	2026-04-01
93582	HCPCS	Perq Transcath Closure Pda	24	5	—	—	$7,837.00	$51,055.62	$35,493.14	2026-04-01
93580	HCPCS	Transcath Closure Of Asd	24	5	—	—	$7,837.00	$51,055.62	$35,493.14	2026-04-01
93581	HCPCS	Transcath Closure Of Vsd	24	5	—	—	$7,837.00	$51,055.62	$35,493.14	2026-04-01
92933	HCPCS	Prq Card Stent/ath/angio	24	5	—	—	$7,837.00	$51,055.62	$35,493.14	2026-04-01
C9602	HCPCS	Perc D-e Cor Stent Ather S	24	5	—	—	$7,837.00	$51,055.62	$35,493.14	2026-04-01
93591	HCPCS	Perq Transcath Cls Aortic	24	5	—	—	$7,837.00	$50,813.00	$35,400.60	2026-04-01
93590	HCPCS	Perq Transcath Cls Mitral	24	5	—	—	$7,837.00	$50,813.00	$35,400.60	2026-04-01
36906	HCPCS	Thrmbc/nfs Dialysis Circuit	24	5	—	—	$8,624.00	$50,813.00	$35,400.60	2026-04-01
54401	HCPCS	Insert Self-contd Prosthesis	26	6	—	—	$2,300.00	$51,140.22	$35,323.66	2026-04-01
53445	HCPCS	Insert Uro/ves Nck Sphincter	26	6	—	—	$1,000.00	$51,140.22	$35,323.66	2026-04-01
54416	HCPCS	Remv/repl Penis Contain Pros	26	6	—	—	$2,300.00	$51,140.22	$35,323.66	2026-04-01
54410	HCPCS	Remove/replace Penis Prosth	26	6	—	—	$2,300.00	$51,140.22	$35,323.66	2026-04-01
53447	HCPCS	Remove/replace Ur Sphincter	26	6	—	—	$1,000.00	$51,140.22	$35,323.66	2026-04-01
54405	HCPCS	Insert Multi-comp Penis Pros	26	6	—	—	$2,300.00	$51,140.22	$35,323.66	2026-04-01
22867	HCPCS	Insj Stablj Dev W/dcmprn	24	5	—	—	$7,187.00	$50,544.84	$35,304.46	2026-04-01
904	MS_DRG	Skin Grafts For Injuries With Cc/Mcc	36	8	—	—	$25,798.53	$72,296.20	$35,175.00	2026-04-01
492	MS_DRG	Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc	36	8	—	—	$23,727.78	$66,493.26	$35,163.35	2026-04-01
933	MS_DRG	Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft	28	8	—	—	$28,911.01	$81,018.41	$35,051.26	2026-04-01
0398T	OTHER	Mrgfus Strtctc Les Abltj	22	2	—	—	$8,157.94	$44,626.79	$34,876.40	2026-04-01
876	MS_DRG	O.r. Procedures With Principal Diagnosis Of Mental Illness	28	8	—	—	$26,256.25	$73,578.88	$34,835.15	2026-04-01
939	MS_DRG	O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc	36	8	—	—	$21,207.33	$60,614.19	$34,828.76	2026-04-01
495	MS_DRG	Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit…	36	8	—	—	$23,522.64	$67,512.07	$34,807.01	2026-04-01
332	MS_DRG	Rectal Resection With Mcc	36	8	—	—	$23,176.52	$68,386.79	$34,768.21	2026-04-01
265	MS_DRG	Aicd Lead Procedures	36	8	—	—	$23,834.03	$66,790.99	$34,748.79	2026-04-01
97	MS_DRG	Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc	36	8	—	—	$23,953.63	$68,562.11	$34,699.12	2026-04-01
279	MS_DRG	Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures …	36	8	—	—	$21,410.46	$60,337.07	$34,657.19	2026-04-01
739	MS_DRG	Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc…	36	8	—	—	$26,599.04	$74,539.48	$34,473.97	2026-04-01
335	MS_DRG	Peritoneal Adhesiolysis With Mcc	38	8	—	—	$24,214.90	$67,858.32	$34,463.26	2026-04-01
0870T	OTHER	Imp Subq Prtl Ascts Pmp Sys	10	4	—	—	$4,837.00	$36,307.39	$34,414.59	2026-04-01
736	MS_DRG	Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc	36	8	—	—	$26,309.04	$73,726.81	$34,409.54	2026-04-01
93654	HCPCS	Ep & Ablate Ventric Tachy	32	5	—	—	$2,539.65	$67,640.74	$34,387.99	2026-04-01
93653	HCPCS	Ep & Ablate Supravent Arrhyt	32	5	—	—	$1,908.99	$67,640.74	$34,387.99	2026-04-01
C9760	HCPCS	Non-blind Interatrial Shunt	24	4	—	—	$25,126.01	$47,626.91	$34,376.38	2026-04-01
408	MS_DRG	Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With…	36	8	—	—	$23,394.35	$70,170.17	$34,340.46	2026-04-01
414	MS_DRG	Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc	36	8	—	—	$23,411.06	$66,456.37	$34,317.17	2026-04-01
622	MS_DRG	Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor…	38	8	—	—	$22,839.35	$72,119.45	$34,209.32	2026-04-01
271	MS_DRG	Other Major Cardiovascular Procedures With Cc	38	8	—	—	$8,050.00	$65,155.59	$34,186.86	2026-04-01
467	MS_DRG	Revision Of Hip Or Knee Replacement With Cc	36	8	—	—	$22,885.18	$65,723.03	$34,037.68	2026-04-01
94	MS_DRG	Bacterial And Tuberculous Infections Of Nervous System With Mcc	36	8	—	—	$24,378.61	$68,317.09	$33,981.79	2026-04-01
616	MS_DRG	Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With…	38	8	—	—	$25,825.26	$74,609.77	$33,813.49	2026-04-01
69715	HCPCS	Temple Bne Implnt W/Stimulat	16	3	—	—	$6,200.00	$46,403.09	$33,801.79	2026-04-01
252	MS_DRG	Other Vascular Procedures With Mcc	36	8	—	—	$22,920.60	$64,231.25	$33,740.35	2026-04-01
651	MS_DRG	Kidney Transplant With Hemodialysis Without Mcc	28	8	—	—	$23,201.24	$65,017.71	$33,661.62	2026-04-01
574	MS_DRG	Skin Graft For Skin Ulcer Or Cellulitis With Cc	36	8	—	—	$23,151.13	$64,877.27	$33,609.15	2026-04-01
477	MS_DRG	Biopsies Of Musculoskeletal System And Connective Tissue With Mcc	36	8	—	—	$22,978.06	$64,392.29	$33,478.73	2026-04-01
987	MS_DRG	Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc	36	8	—	—	$23,407.05	$65,594.45	$33,275.34	2026-04-01
0571T	OTHER	Insj/rplcmt Icds Ss Eltrd	18	4	—	—	$8,624.00	$93,942.48	$33,266.15	2026-04-01
C2616	HCPCS	Brachytx, Non-str,yttrium-90	16	4	—	—	$17,237.88	$61,016.90	$33,216.95	2026-04-01
62361	HCPCS	Implant Spine Infusion Pump	26	6	—	—	$2,150.00	$53,552.19	$33,198.04	2026-04-01
62362	HCPCS	Implant Spine Infusion Pump	26	6	—	—	$2,150.00	$53,552.19	$33,198.04	2026-04-01
29	MS_DRG	Spinal Procedures With Cc Or Spinal Neurostimulators	36	8	—	—	$22,428.13	$69,253.49	$33,144.91	2026-04-01
C9752	HCPCS	Intraosseous Des Lumb/sacrum	8	1	—	—	$23,920.43	$34,631.07	$32,726.95	2026-04-01
61891	HCPCS	Rev/rplcmt Sk-mnt Crnl Nstm	18	4	—	—	$5,619.00	$60,652.66	$32,703.22	2026-04-01
33287	HCPCS	Rmv&rplcmt Phrnc Nrv Stim Pg	18	4	—	—	$5,619.00	$86,096.10	$32,703.22	2026-04-01
64582	HCPCS	Opn Mpltj Hpglsl Nstm Ary Pg	18	4	—	—	$4,837.00	$87,484.73	$32,703.22	2026-04-01
264	MS_DRG	Other Circulatory System O.r. Procedures	36	8	—	—	$23,352.92	$65,442.77	$32,593.72	2026-04-01
411	MS_DRG	Cholecystectomy With C.d.e. With Mcc	36	8	—	—	$18,284.62	$54,302.61	$32,304.15	2026-04-01
420	MS_DRG	Hepatobiliary Diagnostic Procedures With Mcc	40	8	—	—	$3,866.35	$66,085.05	$32,244.87	2026-04-01
37	MS_DRG	Extracranial Procedures With Mcc	36	8	—	—	$22,188.92	$63,636.14	$32,217.21	2026-04-01
274	MS_DRG	Percutaneous And Other Intracardiac Procedures Without Mcc	38	8	—	—	$8,909.00	$61,094.91	$32,137.58	2026-04-01
260	MS_DRG	Cardiac Pacemaker Revision Except Device Replacement With Mcc	38	8	—	—	$12,212.00	$63,793.08	$31,836.30	2026-04-01
69718	HCPCS	Revise Temple Bone Implant	16	3	—	—	$6,200.00	$35,159.42	$31,812.01	2026-04-01
579	MS_DRG	Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc	36	8	—	—	$21,777.31	$63,006.49	$31,801.08	2026-04-01
840	MS_DRG	Lymphoma And Non-acute Leukemia With Mcc	36	8	—	—	$21,311.57	$59,722.22	$31,773.14	2026-04-01
485	MS_DRG	Knee Procedures With Principal Diagnosis Of Infection With Mcc	36	8	—	—	$21,540.10	$62,097.83	$31,712.60	2026-04-01
359	MS_DRG	Percutaneous Coronary Atherectomy With Intraluminal Device With Mcc	18	7	—	—	$31,056.94	$33,433.74	$31,690.75	2026-04-01
325	MS_DRG	Coronary Intravascular Lithotripsy Without Intraluminal Device	36	8	—	—	$19,123.88	$53,591.58	$31,582.95	2026-04-01
0915T	OTHER	Insj Perm Ccm-d Sys Pg&eltrd	10	4	—	—	$8,624.00	$33,266.15	$31,531.90	2026-04-01
247	MS_DRG	Percutaneous Cardiovascular Procedures With Drug-eluting Stent Without Mcc	10	2	—	—	$9,884.00	$35,997.51	$31,523.76	2026-04-01
515	MS_DRG	Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc	36	8	—	—	$20,662.08	$59,599.97	$31,400.50	2026-04-01
656	MS_DRG	Kidney And Ureter Procedures For Neoplasm With Mcc	36	8	—	—	$21,767.95	$61,001.15	$31,376.44	2026-04-01
242	MS_DRG	Permanent Cardiac Pacemaker Implant With Mcc	38	8	—	—	$8,554.00	$65,134.85	$31,371.62	2026-04-01
22	MS_DRG	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/…	36	8	—	—	$23,590.13	$66,107.52	$31,326.76	2026-04-01
500	MS_DRG	Soft Tissue Procedures With Mcc	36	8	—	—	$21,171.92	$61,132.62	$31,228.94	2026-04-01
829	MS_DRG	Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce…	36	8	—	—	$20,604.62	$59,454.81	$31,191.68	2026-04-01
324	MS_DRG	Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc	36	8	—	—	$21,348.99	$59,827.08	$31,121.81	2026-04-01
229	MS_DRG	Other Cardiothoracic Procedures Without Mcc	38	8	—	—	$8,050.00	$59,941.18	$31,036.27	2026-04-01
0908T	OTHER	Opn Imp Int Nstm Sys Vgs Nrv	10	4	—	—	$4,837.00	$32,703.22	$30,998.31	2026-04-01
0909T	OTHER	Rplcmt Int Nstim Sys Vgs Nrv	10	4	—	—	$4,837.00	$32,703.22	$30,998.31	2026-04-01
258	MS_DRG	Cardiac Pacemaker Device Replacement With Mcc	38	8	—	—	$12,212.00	$52,531.73	$30,978.96	2026-04-01
665	MS_DRG	Prostatectomy With Mcc	36	8	—	—	$22,941.98	$64,291.17	$30,890.47	2026-04-01
464	MS_DRG	Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …	36	8	—	—	$19,702.55	$56,581.79	$30,840.00	2026-04-01
26	MS_DRG	Craniotomy And Endovascular Intracranial Procedures With Cc	36	8	—	—	$20,436.23	$57,269.21	$30,797.31	2026-04-01
662	MS_DRG	Minor Bladder Procedures With Mcc	36	8	—	—	$20,843.83	$58,411.45	$30,427.00	2026-04-01
33289	HCPCS	Tcat Impl Wrls P-art Prs Snr	18	4	—	—	$8,624.00	$82,997.65	$30,398.83	2026-04-01
263	MS_DRG	Vein Ligation And Stripping	38	8	—	—	$17,920.46	$53,260.11	$30,322.97	2026-04-01
451	MS_DRG	Single Level Spinal Fusion Except Cervical Without Mcc	28	8	—	—	$20,619.32	$57,782.28	$30,155.07	2026-04-01
652	MS_DRG	Kidney Transplant	28	8	—	—	$20,521.76	$57,508.90	$30,148.43	2026-04-01
469	MS_DRG	Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc…	38	8	—	—	$11,994.10	$62,772.72	$30,135.55	2026-04-01
510	MS_DRG	Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Mcc	36	8	—	—	$19,097.16	$53,516.68	$30,108.70	2026-04-01
625	MS_DRG	Thyroid, Parathyroid And Thyroglossal Procedures With Mcc	36	8	—	—	$19,156.63	$55,069.88	$30,105.59	2026-04-01
929	MS_DRG	Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/Mcc	28	8	—	—	$21,250.10	$59,549.94	$30,084.26	2026-04-01
498	MS_DRG	Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur With Cc…	36	8	—	—	$16,870.05	$49,222.05	$30,079.98	2026-04-01
249	MS_DRG	Percutaneous Cardiovascular Procedures With Non-drug-eluting Stent Without Mcc	10	2	—	—	$10,044.00	$34,248.07	$29,991.74	2026-04-01
A9604	HCPCS	Sm 153 Lexidronam	16	4	—	—	$3,065.01	$56,686.32	$29,782.60	2026-04-01
173	MS_DRG	Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary…	36	8	—	—	$20,503.05	$57,969.29	$29,766.35	2026-04-01
472	MS_DRG	Cervical Spinal Fusion With Cc	36	8	—	—	$19,357.75	$55,714.61	$29,531.11	2026-04-01

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