Price Transparencybeta Hospital negotiated rates

Hospital facility prices. What the hospital charges for the facility side of care — the surgeon’s and anesthesiologist’s fees are billed separately and are not included. How we scope prices →

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Hospital

ADVENTHEALTH ROLLINS BROOK

Lampasas, TX · CCN 451323 · Rates published

Your selected procedure

You selected 807 (MS_DRG)

Vaginal Delivery Without Sterilization Or D&C Without Cc/Mcc

This hospital’s price: $6,095 across 9 payers · range $1,600-$10,476

Source: https://urldefense.com/v3/__https://hospitalpricedisclosure.com/download.aspx?pi=xqaC6yKVnYmTn8rcdghdug*-*__;Kio!!OwHQNGuS!NNxzc3gzcCDbWC_3aBKJU3Bm28st5mdzWI_DoAkJmDmhsUhsHjB8niD15jvlGIrs7b_d4aR0fJBjowy6rVbgBT4DGb9Rog$ · 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.

27,854 distinct procedures filed
34 distinct payers
968,615 rate rows
2026-04-01 last MRF observed
Data quality

919,814 of 968,615 rate rows are consumer-grade (95.0%)

48,801 rows are marked excluded from the consumer medians — these stay visible in the raw drill-down with the same reason shown here, so nothing is silently hidden.

Excluded — reasonRows
per-diem day rate — not a per-procedure price 20,009
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 19,905
exceeds 10× this hospital's gross charge — excluded from medians 7,985
template filing: same amount across many unrelated codes — excluded 727
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 174
below 25% of the Medicare reference for this DRG — likely a mislabeled per-diem; excluded from rankings 1
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://HospitalPriceDisclosure.com/download.aspx?pi=xqaC6yKVnYmTn8rcdghdug*-*
Found on page https://HospitalPriceDisclosure.com/Default.aspx?ci=RsbcVwMa5jfnDZuYpIqAxQ*-*
Discovered viaCMS hospital list
Last fetch not_modified · 2026-08-10
Content fingerprint 9f8bb07cc34b8099… · 10,305,247 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
Q2055
HCPCS 		Idecabtagene Vicleucel 460000000 Cells IV Susp 25 $820.50 $4,225,483.00 $2,380,356.00 nat. median
$610,161
outlier · 3.9×
Q2054
HCPCS 		Lisocabtagene Maraleucel 70000000 Cells/ml IV Susp 25 $820.50 $4,132,844.00 $2,328,169.00 nat. median
$624,417
outlier · 3.7×
Q2042
HCPCS 		Tisagenlecleucel IV Infusion (wrapped) 25 $820.50 $3,620,525.00 $2,039,562.00 nat. median
$691,418
outlier · 2.9×
C9098
HCPCS 		Ciltacabtagene Car Pos T 1 $1,843,957.50 $2,121,748.50 $1,982,853.00 nat. median
$30,221
outlier · 65.6×
Q2056
HCPCS 		Ciltacabtagene Car-pos T 1 $1,783,089.00 $2,051,710.20 $1,917,399.60 nat. median
$631,793
outlier · 3.0×
C9081
HCPCS 		Idecabtagene Car Pos T 1 $1,663,527.25 $1,914,136.55 $1,788,831.90 nat. median
$27,427
outlier · 65.2×
C9076
HCPCS 		Lisocabtagene Car Pos T 1 $1,627,044.65 $1,872,157.87 $1,749,601.26 nat. median
$27,935
outlier · 62.6×
C9073
HCPCS 		Brexucabtagene Autoleucel Ca 1 $1,479,131.50 $1,701,961.70 $1,590,546.60 nat. median
$27,071
outlier · 58.8×
Q2053
HCPCS 		Brexucabtagene Car Pos T 1 $1,430,305.80 $1,645,780.44 $1,538,043.12 nat. median
$577,541
outlier · 2.7×
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 1 $1,364,247.50 $1,569,770.50 $1,467,009.00 nat. median
$588,565
outlier · 2.5×
J9029
HCPCS 		Inj, Adstiladrin, Per Tx Dos 1 $616,000.00 $708,800.00 $662,400.00 nat. median
$69,291
outlier · 9.6×
A9520
HCPCS 		Technetium-99 (tc-99) Tilmanocept (lymphoseek) Radio-isotope Injection 25 $10.00 $693,347.00 $390,586.00 nat. median
$1,032
outlier · 378.4×
18
MS_DRG 		Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 7 $261,491.00 $670,974.35 $352,464.00 nat. median
$370,165
1.0× median
5834
APR_DRG 		Neonate With Ecmo 3 $267,255.00 $267,255.00 $267,255.00 nat. median
$311,018
0.9× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 8 $195,312.00 $435,435.36 $263,261.00 nat. median
$261,939
1.0× median
74
APR_DRG 		Allogeneic Bone Marrow Transplant 3 $259,986.00 $259,986.00 $259,986.00 nat. median
$175,480
1.5× median
Q2043
HCPCS 		Sipuleucel-t Auto Cd54+ 1 $234,419.53 $269,734.68 $252,077.10 nat. median
$65,655
outlier · 3.8×
A9595
HCPCS 		Piflufolastat F 18 9 Mci IV Sosy 25 $615.00 $427,589.00 $240,875.00 nat. median
$896
outlier · 268.7×
A9588
HCPCS 		Fluciclovine F 18 9-221 Mci/ml IV Soln 25 $82.00 $414,100.00 $233,276.00 nat. median
$741
outlier · 314.7×
C9074
HCPCS 		Injection, Lumasiran 1 $211,750.00 $243,650.00 $227,700.00 nat. median
$501
outlier · 454.3×
5833
APR_DRG 		Neonate With Ecmo 3 $226,302.00 $226,302.00 $226,302.00 nat. median
$250,089
0.9× median
A9543
HCPCS 		Y90 Ibritumomab, Rx 1 $209,960.94 $241,591.42 $225,776.18 nat. median
$63,643
outlier · 3.5×
24
APR_DRG 		Heart And/or Lung Transplant 3 $217,696.00 $217,696.00 $217,696.00 nat. median
$243,231
0.9× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 8 $163,051.42 $331,744.07 $214,253.02 nat. median
$205,166
1.0× median
0100T
OTHER 		Prosth Retina Receive&Gen 1 $190,625.63 $219,600.72 $205,113.17 nat. median
$5,118
outlier · 40.1×
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 8 $148,601.00 $329,797.16 $200,300.00 nat. median
$199,832
1.0× median
A9572
HCPCS 		Indium In-111 Pentetreotide IV Kit 25 $59.00 $348,013.00 $196,047.00 nat. median
$4,658
outlier · 42.1×
5884
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 3 $169,168.00 $169,168.00 $169,168.00 nat. median
$254,667
0.7× median
1614
APR_DRG 		Implantable Heart Assist Systems 3 $164,274.00 $164,274.00 $164,274.00 nat. median
$209,486
0.8× median
A9569
HCPCS 		Technetium-99 (tc-99) Exametazime White Blood Cells Radio-isotope Injection 25 $56.00 $285,633.00 $160,906.00 nat. median
$1,956
outlier · 82.2×
C1831
HCPCS 		Kit Imp Aprevo Spine Lvl 2 24 $820.50 $262,627.00 $158,452.00 nat. median
$7,752
outlier · 20.4×
J7330
HCPCS 		Cultured Chondrocytes Implnt 1 $146,989.15 $169,132.97 $158,061.06 nat. median
$75,807
outlier · 2.1×
94
APR_DRG 		Extracorporeal Membrane Oxygenation (ecmo) 3 $153,899.00 $153,899.00 $153,899.00 nat. median
$165,599
0.9× median
J9226
HCPCS 		Supprelin La Implant 1 $141,483.73 $162,798.16 $152,140.95 nat. median
$55,200
outlier · 2.8×
C1825
HCPCS 		System Neo Barostim Includes 2102 Ipg 1036 Csl Kit 24 $820.50 $208,908.00 $134,583.50 nat. median
$53,130
outlier · 2.5×
209
MS_DRG 		Complex Aortic Arch Procedures 2 $86,440.43 $175,871.51 $131,155.97 nat. median
$96,134
1.4× median
6304
APR_DRG 		Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 3 $125,872.00 $125,872.00 $125,872.00 nat. median
$160,171
0.8× median
6094
APR_DRG 		Neonate Birth Weight 1500-2499 Grams With Major Procedure 3 $124,757.00 $124,757.00 $124,757.00 nat. median
$168,174
0.7× median
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 8 $97,974.00 $215,223.05 $124,015.04 nat. median
$132,706
0.9× median
A9591
HCPCS 		Fluoroestradiol F 18 4-100 Mci/ml IV Soln 25 $2.89 $219,373.00 $123,580.00 nat. median
$1,106
outlier · 111.7×
C1824
HCPCS 		Generator Pul Implantable Optimizer Smt F/hrt Fail 24 $820.50 $193,986.00 $123,397.00 nat. median
$35,282
outlier · 3.5×
14
MS_DRG 		Allogeneic Bone Marrow Transplant 8 $90,845.00 $186,734.13 $122,449.00 nat. median
$114,305
1.1× median
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 8 $76,408.00 $176,073.51 $118,385.00 nat. median
$108,240
1.1× median
C1822
HCPCS 		Construct Neuromod Nevro Pain Mgmt Omnia With Ipg Rm 24 $820.50 $193,986.00 $118,000.00 nat. median
$32,176
outlier · 3.7×
7
MS_DRG 		Lung Transplant 8 $90,616.00 $201,220.21 $115,877.22 nat. median
$122,690
0.9× median
215
MS_DRG 		Other Heart Assist System Implant 8 $73,462.00 $154,711.87 $113,820.00 nat. median
$98,002
1.2× median
5832
APR_DRG 		Neonate With Ecmo 3 $112,761.00 $112,761.00 $112,761.00 nat. median
$169,230
0.7× median
114
APR_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 3 $107,074.00 $107,074.00 $107,074.00 nat. median
$119,243
0.9× median
C1882
HCPCS 		Defibrillator Crdc Protecta Xt 11 $13.00 $243,161.00 $101,966.00 nat. median
$27,675
outlier · 3.7×
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 7 $75,536.00 $168,961.77 $101,814.00 nat. median
$100,978
1.0× median

Other procedures at this hospital

Browse this hospital's 27,854 published procedures. Use the slice to choose what to show, then sort or filter any column.

Slice
Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
Code Type Description Rate rows Payers Gross Cash Min $ Max $ Avg median Last observed
             
Q2055 HCPCS Idecabtagene Vicleucel 460000000 Cells IV Susp 41 25 $4,694,981.46 $2,347,490.73 50% off $820.50 $4,225,483.00 $2,380,356.00 2026-04-01
Q2054 HCPCS Lisocabtagene Maraleucel 70000000 Cells/ml IV Susp 41 25 $4,592,049.12 $2,296,024.56 50% off $820.50 $4,132,844.00 $2,328,169.00 2026-04-01
Q2042 HCPCS Tisagenlecleucel IV Infusion (wrapped) 41 25 $4,022,805.11 $2,011,402.56 50% off $820.50 $3,620,525.00 $2,039,562.00 2026-04-01
C9098 HCPCS Ciltacabtagene Car Pos T 2 1 — — $1,843,957.50 $2,121,748.50 $1,982,853.00 2026-04-01
Q2056 HCPCS Ciltacabtagene Car-pos T 2 1 — — $1,783,089.00 $2,051,710.20 $1,917,399.60 2026-04-01
C9081 HCPCS Idecabtagene Car Pos T 2 1 — — $1,663,527.25 $1,914,136.55 $1,788,831.90 2026-04-01
C9076 HCPCS Lisocabtagene Car Pos T 2 1 — — $1,627,044.65 $1,872,157.87 $1,749,601.26 2026-04-01
C9073 HCPCS Brexucabtagene Autoleucel Ca 2 1 — — $1,479,131.50 $1,701,961.70 $1,590,546.60 2026-04-01
Q2053 HCPCS Brexucabtagene Car Pos T 2 1 — — $1,430,305.80 $1,645,780.44 $1,538,043.12 2026-04-01
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 2 1 — — $1,364,247.50 $1,569,770.50 $1,467,009.00 2026-04-01
J9029 HCPCS Inj, Adstiladrin, Per Tx Dos 2 1 — — $616,000.00 $708,800.00 $662,400.00 2026-04-01
A9520 HCPCS Technetium-99 (tc-99) Tilmanocept (lymphoseek) Radio-isotope Injection 41 25 $770,386.00 $385,193.00 50% off $10.00 $693,347.00 $390,586.00 2026-04-01
18 MS_DRG Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 9 7 $0.01 — $261,491.00 $670,974.35 $352,464.00 2026-04-01
5834 APR_DRG Neonate With Ecmo 3 3 $0.01 — $267,255.00 $267,255.00 $267,255.00 2024-12-15
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 11 8 $0.01 — $195,312.00 $435,435.36 $263,261.00 2026-04-01
74 APR_DRG Allogeneic Bone Marrow Transplant 3 3 $0.01 — $259,986.00 $259,986.00 $259,986.00 2024-12-15
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 2 1 — — $234,419.53 $269,734.68 $252,077.10 2026-04-01
A9595 HCPCS Piflufolastat F 18 9 Mci IV Sosy 41 25 $475,098.80 $237,549.40 50% off $615.00 $427,589.00 $240,875.00 2026-04-01
A9588 HCPCS Fluciclovine F 18 9-221 Mci/ml IV Soln 41 25 $460,111.00 $230,055.50 50% off $82.00 $414,100.00 $233,276.00 2026-04-01
C9074 HCPCS Injection, Lumasiran 2 1 — — $211,750.00 $243,650.00 $227,700.00 2026-04-01
5833 APR_DRG Neonate With Ecmo 3 3 $0.01 — $226,302.00 $226,302.00 $226,302.00 2024-12-15
A9543 HCPCS Y90 Ibritumomab, Rx 2 1 — — $209,960.94 $241,591.42 $225,776.18 2026-04-01
24 APR_DRG Heart And/or Lung Transplant 3 3 $0.01 — $217,696.00 $217,696.00 $217,696.00 2024-12-15
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 11 8 $0.01 — $163,051.42 $331,744.07 $214,253.02 2026-04-01
0100T OTHER Prosth Retina Receive&Gen 2 1 — — $190,625.63 $219,600.72 $205,113.17 2026-04-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 11 8 $0.01 — $148,601.00 $329,797.16 $200,300.00 2026-04-01
A9572 HCPCS Indium In-111 Pentetreotide IV Kit 41 25 $386,681.14 $193,340.57 50% off $59.00 $348,013.00 $196,047.00 2026-04-01
5884 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 3 3 $0.01 — $169,168.00 $169,168.00 $169,168.00 2024-12-15
1614 APR_DRG Implantable Heart Assist Systems 3 3 $0.01 — $164,274.00 $164,274.00 $164,274.00 2024-12-15
A9569 HCPCS Technetium-99 (tc-99) Exametazime White Blood Cells Radio-isotope Injection 41 25 $317,369.80 $158,684.90 50% off $56.00 $285,633.00 $160,906.00 2026-04-01
C1831 HCPCS Kit Imp Aprevo Spine Lvl 2 39 24 $291,808.00 $145,904.00 50% off $820.50 $262,627.00 $158,452.00 2024-12-15
J7330 HCPCS Cultured Chondrocytes Implnt 2 1 — — $146,989.15 $169,132.97 $158,061.06 2026-04-01
94 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 3 3 $0.01 — $153,899.00 $153,899.00 $153,899.00 2024-12-15
J9226 HCPCS Supprelin La Implant 2 1 — — $141,483.73 $162,798.16 $152,140.95 2026-04-01
C1825 HCPCS System Neo Barostim Includes 2102 Ipg 1036 Csl Kit 62 24 $232,120.00 $116,060.00 50% off $820.50 $208,908.00 $134,583.50 2024-12-15
209 MS_DRG Complex Aortic Arch Procedures 2 2 — — $86,440.43 $175,871.51 $131,155.97 2026-04-01
6304 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 3 3 $0.01 — $125,872.00 $125,872.00 $125,872.00 2024-12-15
6094 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 3 3 $0.01 — $124,757.00 $124,757.00 $124,757.00 2024-12-15
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 11 8 $0.01 — $97,974.00 $215,223.05 $124,015.04 2026-04-01
A9591 HCPCS Fluoroestradiol F 18 4-100 Mci/ml IV Soln 41 25 $243,748.00 $121,874.00 50% off $2.89 $219,373.00 $123,580.00 2026-04-01
C1824 HCPCS Generator Pul Implantable Optimizer Smt F/hrt Fail 62 24 $190,670.00 $95,335.00 50% off $820.50 $193,986.00 $123,397.00 2024-12-15
14 MS_DRG Allogeneic Bone Marrow Transplant 11 8 $0.01 — $90,845.00 $186,734.13 $122,449.00 2026-04-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 11 8 $0.01 — $76,408.00 $176,073.51 $118,385.00 2026-04-01
C1822 HCPCS Construct Neuromod Nevro Pain Mgmt Omnia With Ipg Rm 62 24 $169,945.00 $84,972.50 50% off $820.50 $193,986.00 $118,000.00 2024-12-15
7 MS_DRG Lung Transplant 11 8 $0.01 — $90,616.00 $201,220.21 $115,877.22 2026-04-01
215 MS_DRG Other Heart Assist System Implant 11 8 $0.01 — $73,462.00 $154,711.87 $113,820.00 2026-04-01
5832 APR_DRG Neonate With Ecmo 3 3 $0.01 — $112,761.00 $112,761.00 $112,761.00 2024-12-15
114 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 3 3 $0.01 — $107,074.00 $107,074.00 $107,074.00 2024-12-15
C1882 HCPCS Defibrillator Crdc Protecta Xt 1,150 11 $143,582.80 $71,791.40 50% off $13.00 $243,161.00 $101,966.00 2024-12-15
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 9 7 $0.01 — $75,536.00 $168,961.77 $101,814.00 2026-04-01
C1767 HCPCS Stimulator Proclaim Elite 7 Rechrg-free Scs 483 11 $141,759.00 $70,879.50 50% off $30,605.00 $256,442.00 $101,171.00 2024-12-15
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 11 8 $0.01 — $73,840.00 $160,204.55 $99,529.00 2026-04-01
2004 APR_DRG Cardiac Structural And Valvular Disorders 3 3 $0.01 — $99,501.00 $99,501.00 $99,501.00 2024-12-15
5831 APR_DRG Neonate With Ecmo 3 3 $0.01 — $99,288.00 $99,288.00 $99,288.00 2024-12-15
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 9 7 $0.01 — $72,634.00 $171,247.41 $97,903.00 2026-04-01
C1816 HCPCS System Stim Nerv Stimq-4 8 Elect Dl Transm Kt 62 24 $169,945.00 $84,972.50 50% off $820.50 $152,951.00 $96,931.00 2024-12-15
52427-273-75 NDC Naproxen Sodium ER 500 Mg Po Tb24 39 24 $174,831.53 $87,415.76 50% off $820.50 $157,348.00 $94,934.00 2024-12-15
453 MS_DRG Combined Anterior And Posterior Spinal Fusion With Mcc 2 1 — — $87,917.82 $101,059.40 $94,488.61 2026-04-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 11 8 $0.01 — $66,918.00 $152,005.15 $93,856.27 2026-04-01
C2616 HCPCS Sphere Embol Sir Msphre 90 73 17 $143,417.00 $71,708.50 50% off $17,177.00 $309,526.00 $92,491.00 2026-04-01
73 APR_DRG Allogeneic Bone Marrow Transplant 3 3 $0.01 — $91,739.00 $91,739.00 $91,739.00 2024-12-15
5883 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 3 3 $0.01 — $90,770.00 $90,770.00 $90,770.00 2024-12-15
5882 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 3 3 $0.01 — $90,355.00 $90,355.00 $90,355.00 2024-12-15
44 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 3 3 $0.01 — $90,122.00 $90,122.00 $90,122.00 2024-12-15
C2624 HCPCS System Cardiomems Hrt Failure Ptnt 39 24 $165,385.50 $82,692.75 50% off $820.50 $148,847.00 $89,804.00 2024-12-15
8414 APR_DRG Extensive Third Degree Burns With Skin Graft 3 3 $0.01 — $89,734.00 $89,734.00 $89,734.00 2024-12-15
J9600 HCPCS Porfimer Sodium Injection 2 1 — — $83,434.12 $96,003.42 $89,718.77 2026-04-01
6314 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 3 3 $0.01 — $88,838.00 $88,838.00 $88,838.00 2024-12-15
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 11 8 $0.01 — $55,894.00 $122,265.41 $86,600.00 2026-04-01
8504 APR_DRG Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal… 3 3 $0.01 — $86,498.00 $86,498.00 $86,498.00 2024-12-15
A9592 HCPCS Copper Cu 64 Dotatate 1 Mci/ml IV Soln 41 25 $170,101.00 $85,050.50 50% off $268.00 $153,091.00 $86,241.00 2026-04-01
850 MS_DRG Acute Leukemia With Other Procedures 9 7 $0.01 — $63,873.00 $134,551.31 $86,094.00 2026-04-01
5914 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 3 3 $0.01 — $85,723.00 $85,723.00 $85,723.00 2024-12-15
1613 APR_DRG Implantable Heart Assist Systems 3 3 $0.01 — $85,622.00 $85,622.00 $85,622.00 2024-12-15
5881 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 3 3 $0.01 — $85,169.00 $85,169.00 $85,169.00 2024-12-15
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 11 8 $0.01 — $58,723.00 $130,572.03 $84,872.90 2026-04-01
222 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 2 1 — — $77,988.63 $89,646.04 $83,817.33 2026-04-01
C1721 HCPCS Defibrillator Crdc Protecta Xt Dr 2chb 966 11 $117,258.57 $58,629.28 50% off $24.00 $153,823.00 $82,634.00 2024-12-15
58468-0132-1 NDC Sevelamer Carbonate 0.8 G Po Pack 39 24 $151,626.37 $75,813.18 50% off $820.50 $136,464.00 $82,333.00 2024-12-15
58468-0132-2 NDC Sevelamer Carbonate 0.8 G Po Pack 39 24 $151,626.37 $75,813.18 50% off $820.50 $136,464.00 $82,333.00 2024-12-15
231 MS_DRG Coronary Bypass With Ptca With Mcc 11 8 $0.01 — $58,756.00 $130,983.79 $79,197.00 2026-04-01
L8614 HCPCS Processor Sound Nuc 7 Cp100 Wht 294 25 $111,137.81 $55,568.91 50% off $723.00 $156,681.00 $78,538.50 2026-04-01
14 APR_DRG Liver Transplant And/or Intestinal Transplant 3 3 $0.01 — $77,982.00 $77,982.00 $77,982.00 2024-12-15
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 9 7 $0.01 — $57,832.00 $139,991.16 $77,951.00 2026-04-01
C1722 HCPCS Defibrillator Crdc Protecta Vr 1chb 35jl 37ml 68gm 989 11 $108,184.50 $54,092.25 50% off $21,494.00 $189,129.00 $77,688.00 2024-12-15
84 APR_DRG Autologous Bone Marrow Transplant Or T-cell Immunotherapy 3 3 $0.01 — $77,670.00 $77,670.00 $77,670.00 2024-12-15
68382-395-04 NDC Ribavirin 6 G In Solr 39 24 $141,573.77 $70,786.88 50% off $820.50 $127,416.00 $76,875.00 2024-12-15
68382-395-01 NDC Ribavirin 6 G In Solr 39 24 $141,573.77 $70,786.88 50% off $820.50 $127,416.00 $76,875.00 2024-12-15
6814 APR_DRG Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 3 3 $0.01 — $76,290.00 $76,290.00 $76,290.00 2024-12-15
1604 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 3 3 $0.01 — $76,247.00 $76,247.00 $76,247.00 2024-12-15
93 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 3 3 $0.01 — $75,610.00 $75,610.00 $75,610.00 2024-12-15
224 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 2 1 — — $69,124.89 $79,457.38 $74,291.14 2026-04-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 9 7 $0.01 — $54,486.16 $110,857.41 $74,089.00 2026-04-01
59385-027-01 NDC Buprenorphine Hcl 900 Mcg Bu Film 39 24 $136,176.33 $68,088.17 50% off $820.50 $122,559.00 $73,944.00 2024-12-15
59385-027-60 NDC Buprenorphine Hcl 900 Mcg Bu Film 39 24 $136,176.33 $68,088.17 50% off $820.50 $122,559.00 $73,944.00 2024-12-15
2464 APR_DRG Gastrointestinal Vascular Insufficiency 3 3 $0.01 — $73,939.00 $73,939.00 $73,939.00 2024-12-15
6034 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 3 3 $0.01 — $73,557.00 $73,557.00 $73,557.00 2024-12-15
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 11 8 $0.01 — $53,650.00 $119,305.43 $73,273.57 2026-04-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 11 8 $0.01 — $54,197.00 $118,791.12 $73,052.00 2026-04-01
64 APR_DRG Pancreas Transplant 3 3 $0.01 — $71,385.00 $71,385.00 $71,385.00 2024-12-15
5891 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 3 3 $0.01 — $71,380.00 $71,380.00 $71,380.00 2024-12-15
5934 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 3 3 $0.01 — $71,166.00 $71,166.00 $71,166.00 2024-12-15
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 11 8 $0.01 — $51,755.00 $118,398.01 $70,409.96 2026-04-01
C1820 HCPCS Stimulator Neurostim Gastric Enterra Ii 368 11 $99,480.00 $49,740.00 50% off $2,776.00 $190,666.00 $69,733.50 2024-12-15
5892 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 3 3 $0.01 — $69,181.00 $69,181.00 $69,181.00 2024-12-15
459 MS_DRG Spinal Fusion Except Cervical With Mcc 2 1 — — $64,038.79 $73,611.04 $68,824.91 2026-04-01
226 MS_DRG Cardiac Defibrillator Implant Without Cardiac Catheterization With Mcc 2 1 — — $62,503.24 $71,845.96 $67,174.60 2026-04-01
1624 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 3 3 $0.01 — $66,513.00 $66,513.00 $66,513.00 2024-12-15
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 9 7 $0.01 — $49,248.00 $112,162.61 $66,382.00 2026-04-01
213 MS_DRG Endovascular Abdominal Aorta With Iliac Branch Procedures 2 2 — — $43,582.97 $88,673.81 $66,128.39 2026-04-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 9 7 $0.01 — $49,001.00 $110,792.16 $66,048.00 2026-04-01
J7310 HCPCS Ganciclovir Long Act Implant 2 1 — — $61,353.60 $70,596.48 $65,975.04 2026-04-01
6024 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 3 3 $0.01 — $65,422.00 $65,422.00 $65,422.00 2024-12-15
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 11 8 $0.01 — $48,235.00 $107,395.55 $65,015.00 2026-04-01
5893 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 3 3 $0.01 — $64,891.00 $64,891.00 $64,891.00 2024-12-15
L8619 HCPCS Processor Sound Nuc7 Blk 338 24 $95,335.00 $47,667.50 50% off $820.50 $156,681.00 $64,394.50 2024-12-15
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 11 8 $0.01 — $41,539.00 $95,223.08 $64,359.00 2026-04-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc/Mcc 11 8 $0.01 — $41,851.00 $92,135.68 $64,349.08 2026-04-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 11 8 $0.01 — $47,346.00 $104,587.83 $63,817.00 2026-04-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 11 8 $0.01 — $46,231.00 $106,868.81 $63,390.18 2026-04-01
A9604 HCPCS Sm 153 Lexidronam 2 1 — — $58,353.56 $67,144.49 $62,749.03 2026-04-01
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 9 7 $0.01 — $46,489.00 $103,818.70 $62,662.00 2026-04-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/Mcc 11 8 $0.01 — $46,310.00 $111,449.41 $62,421.00 2026-04-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 11 8 $0.01 — $44,777.00 $102,167.01 $62,165.85 2026-04-01
6214 APR_DRG Neonate Birth Weight 2000-2499 Grams With Major Anomaly 3 3 $0.01 — $62,125.00 $62,125.00 $62,125.00 2024-12-15
72 APR_DRG Allogeneic Bone Marrow Transplant 3 3 $0.01 — $61,638.00 $61,638.00 $61,638.00 2024-12-15
1612 APR_DRG Implantable Heart Assist Systems 3 3 $0.01 — $61,549.00 $61,549.00 $61,549.00 2024-12-15
454 MS_DRG Combined Anterior And Posterior Spinal Fusion With Cc 2 1 — — $57,244.25 $65,800.88 $61,522.57 2026-04-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 11 8 $0.01 — $39,796.00 $92,654.65 $60,873.30 2026-04-01
113 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 3 3 $0.01 — $60,845.00 $60,845.00 $60,845.00 2024-12-15
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 11 8 $0.01 — $44,842.00 $99,982.37 $60,442.00 2026-04-01
223 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 2 1 — — $56,103.10 $64,489.15 $60,296.12 2026-04-01
13925-522-01 NDC Pentamidine Isethionate 300 Mg In Solr 39 24 $110,911.79 $55,455.90 50% off $820.50 $99,821.00 $60,225.00 2024-12-15
10 MS_DRG Pancreas Transplant 11 8 $0.01 — $37,160.63 $111,496.03 $60,024.00 2026-04-01
8634 APR_DRG Neonatal Aftercare 3 3 $0.01 — $59,901.00 $59,901.00 $59,901.00 2024-12-15
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 11 8 $0.01 — $38,325.00 $88,884.36 $59,380.00 2026-04-01
C1823 HCPCS Generator Implantable Remede Pul Cent Sleep Apnea 62 24 $211,395.00 $105,697.50 50% off $820.50 $190,256.00 $59,352.50 2024-12-15
6303 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 3 3 $0.01 — $59,326.00 $59,326.00 $59,326.00 2024-12-15
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 11 8 $0.01 — $43,851.00 $95,112.76 $59,107.00 2026-04-01
77371 CPT Hc Tr Srs 1 Session Multi Cobalt 60 29 16 $93,660.20 $46,830.10 50% off $7,420.00 $84,294.00 $59,006.00 2024-12-15
0187-0007-14 NDC Ribavirin 6 G In Solr 39 24 $108,581.08 $54,290.54 50% off $820.50 $97,723.00 $58,960.00 2024-12-15
1611 APR_DRG Implantable Heart Assist Systems 3 3 $0.01 — $58,373.00 $58,373.00 $58,373.00 2024-12-15
81416 CPT Hc Exome Sequence Analysis Each Comparator Exome 29 16 $92,610.00 $46,305.00 50% off $12,000.00 $127,797.00 $58,344.00 2024-12-15
4404 APR_DRG Kidney Transplant 3 3 $0.01 — $58,229.00 $58,229.00 $58,229.00 2024-12-15
54 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 3 3 $0.01 — $57,963.00 $57,963.00 $57,963.00 2024-12-15
43 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 3 3 $0.01 — $57,943.00 $57,943.00 $57,943.00 2024-12-15
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 9 7 $0.01 — $42,950.00 $93,330.55 $57,893.00 2026-04-01
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 9 7 $0.01 — $42,895.00 $103,894.84 $57,818.00 2026-04-01
0781-5893-31 NDC Nevirapine ER 400 Mg Po Tb24 39 24 $106,455.10 $53,227.55 50% off $820.50 $95,810.00 $57,805.00 2024-12-15
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 11 8 $0.01 — $42,178.54 $85,816.37 $57,354.00 2026-04-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 11 8 $0.01 — $42,699.00 $101,795.65 $57,102.27 2026-04-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 11 8 $0.01 — $42,356.00 $94,200.68 $57,092.00 2026-04-01
28 MS_DRG Spinal Procedures With Mcc 11 8 $0.01 — $42,154.00 $93,356.97 $56,819.00 2026-04-01
225 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 2 1 — — $52,793.68 $60,685.06 $56,739.37 2026-04-01
58914-501-56 NDC Mesalamine 1000 Mg Re Supp 39 24 $104,227.09 $52,113.54 50% off $820.50 $93,804.00 $56,595.00 2024-12-15
5913 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 3 3 $0.01 — $56,448.00 $56,448.00 $56,448.00 2024-12-15
6804 APR_DRG Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 3 3 $0.01 — $56,448.00 $56,448.00 $56,448.00 2024-12-15
6084 APR_DRG Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 3 3 $0.01 — $56,288.00 $56,288.00 $56,288.00 2024-12-15
33276 HCPCS Insj Phrnc Nrv Stim Sys 3 2 — — $4,826.69 $64,800.72 $56,250.63 2026-04-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 11 8 $0.01 — $41,251.00 $102,167.01 $55,602.00 2026-04-01
4414 APR_DRG Major Bladder Procedures 3 3 $0.01 — $55,106.00 $55,106.00 $55,106.00 2024-12-15
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 11 8 $0.01 — $40,800.00 $91,186.31 $54,997.47 2026-04-01
834 MS_DRG Acute Leukemia With Mcc 11 8 $0.01 — $38,325.00 $85,302.07 $54,604.01 2026-04-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 11 8 $0.01 — $40,370.00 $91,127.26 $54,415.00 2026-04-01
93656 HCPCS Tx Atrial Fib Pulm Vein Isol 4 1 — — $25,544.09 $90,528.25 $54,051.29 2026-04-01
93653 HCPCS Ep & Ablate Supravent Arrhyt 4 1 — — $25,544.09 $90,528.25 $54,051.29 2026-04-01
93654 HCPCS Ep & Ablate Ventric Tachy 4 1 — — $25,544.09 $90,528.25 $54,051.29 2026-04-01
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 11 8 $0.01 — $34,719.00 $74,649.21 $53,792.00 2026-04-01
23 APR_DRG Heart And/or Lung Transplant 3 3 $0.01 — $53,618.00 $53,618.00 $53,618.00 2024-12-15
228 MS_DRG Other Cardiothoracic Procedures With Mcc 11 8 $0.01 — $34,553.00 $76,872.70 $53,536.00 2026-04-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 11 8 $0.01 — $39,558.00 $89,037.40 $53,320.00 2026-04-01
227 MS_DRG Cardiac Defibrillator Implant Without Cardiac Catheterization Without Mcc 2 1 — — $48,872.10 $56,177.30 $52,524.70 2026-04-01
83 APR_DRG Autologous Bone Marrow Transplant Or T-cell Immunotherapy 3 3 $0.01 — $52,499.00 $52,499.00 $52,499.00 2024-12-15
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 11 8 $0.01 — $37,727.00 $87,084.27 $52,488.07 2026-04-01
33262 CPT Hc Rmvl Impltbl Dfb Plse Gen W/repl Plse Gen 1 Lead 63 24 $84,270.87 $42,135.44 50% off $16,178.00 $77,543.00 $52,298.00 2024-12-15
653 MS_DRG Major Bladder Procedures With Mcc 11 8 $0.01 — $38,653.00 $80,741.66 $52,100.00 2026-04-01
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 9 7 $0.01 — $41,220.00 $92,350.10 $52,085.26 2026-04-01
1784 APR_DRG External Heart Assist Systems 3 3 $0.01 — $51,613.00 $51,613.00 $51,613.00 2024-12-15
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 9 7 $0.01 — $38,164.00 $87,354.64 $51,441.00 2026-04-01
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 9 7 $0.01 — $37,931.00 $89,609.20 $51,127.00 2026-04-01
33240 CPT Hc Insj Implntbl Defib Pulse Gen W/1 Existing Ld 63 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 3 3 $0.01 — $50,828.00 $50,828.00 $50,828.00 2024-12-15
6114 APR_DRG Neonate Birth Weight 1500-1999 Grams With Major Anomaly 3 3 $0.01 — $50,770.00 $50,770.00 $50,770.00 2024-12-15
33264 CPT Hc Rmvl Impltbl Dfb Pls Gen W/rplcmt Pls Gen Mlt Ld 63 24 $86,158.74 $43,079.37 50% off $21,766.00 $77,543.00 $50,756.00 2024-12-15
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 11 8 $0.01 — $37,641.00 $85,000.63 $50,737.00 2026-04-01
1674 APR_DRG Other Cardiothoracic And Thoracic Vascular Procedures 3 3 $0.01 — $50,545.00 $50,545.00 $50,545.00 2024-12-15
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 11 8 $0.01 — $32,621.00 $73,973.31 $50,543.00 2026-04-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 11 8 $0.01 — $37,449.00 $88,558.83 $50,478.00 2026-04-01
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 11 8 $0.01 — $37,414.00 $84,745.81 $50,430.00 2026-04-01
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 11 8 $0.01 — $37,410.00 $76,154.85 $50,424.00 2026-04-01
6904 APR_DRG Acute Leukemia 3 3 $0.01 — $50,091.00 $50,091.00 $50,091.00 2024-12-15
434 APR_DRG Multiple Sclerosis, Other Demyelinating Disease And Inflammatory Neuropathies 3 3 $0.01 — $49,784.00 $49,784.00 $49,784.00 2024-12-15
92 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 3 3 $0.01 — $49,728.00 $49,728.00 $49,728.00 2024-12-15
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 11 8 $0.01 — $36,889.00 $84,879.43 $49,723.00 2026-04-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 11 8 $0.01 — $36,726.00 $82,861.05 $49,588.94 2026-04-01
33263 CPT Hc Rmvl Impltbl Dfb Plse Gen W/rplcmt Plse Gen 2 Ld 63 24 $76,768.82 $38,384.41 50% off $16,336.00 $77,543.00 $49,439.00 2024-12-15
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 11 8 $0.01 — $35,217.00 $77,494.22 $49,258.09 2026-04-01
245 MS_DRG Aicd Generator Procedures 11 8 $0.01 — $33,884.00 $70,890.57 $48,672.10 2026-04-01
455 MS_DRG Combined Anterior And Posterior Spinal Fusion Without Cc/Mcc 2 1 — — $44,985.10 $51,709.28 $48,347.19 2026-04-01
33289 CPT Hc Rhc W/plc Pressure Sensor 29 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) 3 3 $0.01 — $48,227.00 $48,227.00 $48,227.00 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 $82,811.32 $48,133.00 2026-04-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 11 8 $0.01 — $35,591.00 $81,983.15 $47,973.00 2026-04-01
47781-153-01 NDC Naproxen Sodium ER 375 Mg Po Tb24 39 24 $88,294.19 $44,147.10 50% off $820.50 $79,465.00 $47,944.00 2024-12-15
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/Mcc 11 8 $0.01 — $41,485.88 $84,407.08 $47,778.42 2026-04-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 11 8 $0.01 — $35,325.00 $80,881.51 $47,656.19 2026-04-01
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 11 8 $0.01 — $34,678.00 $76,735.97 $47,651.52 2026-04-01
63323-877-15 NDC Pentamidine Isethionate 300 Mg In Solr 39 24 $86,990.24 $43,495.12 50% off $820.50 $78,291.00 $47,236.00 2024-12-15
6334 APR_DRG Neonate Birth Weight > 2499 Grams With Major Anomaly 3 3 $0.01 — $47,213.00 $47,213.00 $47,213.00 2024-12-15
33363 CPT Hc Replace Aortic Valve Open Axillry Artry Approach 46 11 $68,511.79 $34,255.89 50% off $23,869.00 $61,661.00 $47,184.50 2024-12-15
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 11 8 $0.01 — $34,925.00 $76,473.37 $47,075.00 2026-04-01
3034 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 3 3 $0.01 — $46,925.00 $46,925.00 $46,925.00 2024-12-15
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 11 8 $0.01 — $33,112.00 $72,683.66 $46,870.19 2026-04-01
38240 HCPCS Transplt Allo Hct/donor 3 2 — — $4,826.69 $53,907.67 $46,794.85 2026-04-01
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 9 7 $0.01 — $34,692.00 $86,487.62 $46,761.00 2026-04-01
J1412 HCPCS Inj Roctavian Ml 2x10^13vc G 2 1 — — $43,438.82 $49,982.85 $46,710.83 2026-04-01
471 MS_DRG Cervical Spinal Fusion With Mcc 11 8 $0.01 — $33,679.00 $75,028.34 $46,677.66 2026-04-01
5912 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 3 3 $0.01 — $46,607.00 $46,607.00 $46,607.00 2024-12-15
799 MS_DRG Splenic Procedures With Mcc 11 8 $0.01 — $32,969.00 $70,370.05 $46,209.43 2026-04-01
81416 HCPCS Exome Sequence Analysis 3 2 — — $10,800.00 $53,160.00 $46,200.00 2026-04-01
6074 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 3 3 $0.01 — $46,151.00 $46,151.00 $46,151.00 2024-12-15
63 APR_DRG Pancreas Transplant 3 3 $0.01 — $46,132.00 $46,132.00 $46,132.00 2024-12-15
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 11 8 $0.01 — $31,839.00 $71,420.42 $45,862.69 2026-04-01
93582 CPT Hc Cath Percutan Transcath Closure Pat Duct Arteriosus 29 16 $72,334.19 $36,167.10 50% off $16,707.00 $65,101.00 $45,571.00 2024-12-15
163 MS_DRG Major Chest Procedures With Mcc 11 8 $0.01 — $31,959.00 $69,638.21 $45,549.60 2026-04-01
6 MS_DRG Liver Transplant Without Mcc 11 8 $0.01 — $33,623.00 $72,049.71 $45,532.78 2026-04-01
C2622 HCPCS Prosthesis Penile Tactra Malle Rear Tp Extndr 9.5m 131 24 $76,669.40 $38,334.70 50% off $820.50 $72,494.00 $45,358.00 2024-12-15
J2326 HCPCS Nusinersen 12 Mg/5ml It Soln 41 25 $89,181.49 $44,590.74 50% off $820.50 $80,263.00 $45,215.00 2026-04-01
C1772 HCPCS Pump Inf Synchromed Ii Ti 3.4x1x1in 40ml 39 24 $82,071.00 $41,035.50 50% off $820.50 $73,864.00 $44,565.00 2024-12-15
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 11 8 $0.01 — $32,962.00 $72,901.19 $44,430.00 2026-04-01
2204 APR_DRG Major Stomach, Esophageal And Duodenal Procedures 3 3 $0.01 — $43,978.00 $43,978.00 $43,978.00 2024-12-15
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 11 8 $0.01 — $29,940.00 $64,833.86 $43,869.19 2026-04-01
6134 APR_DRG Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection 3 3 $0.01 — $43,738.00 $43,738.00 $43,738.00 2024-12-15
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 11 8 $0.01 — $32,446.00 $71,238.62 $43,735.00 2026-04-01
4474 APR_DRG Other Kidney, Urinary Tract And Related Procedures 3 3 $0.01 — $43,636.00 $43,636.00 $43,636.00 2024-12-15
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 9 7 $0.01 — $32,255.00 $71,762.25 $43,477.00 2026-04-01
0398T CPT Hc MRI Guided Focused US Stereo Lesion Ablate 29 16 $71,584.70 $35,792.35 50% off $12,979.00 $64,426.00 $43,452.00 2024-12-15
0571T OTHER Insj/rplcmt Icds Ss Eltrd 2 1 — — $40,353.30 $46,487.00 $43,420.15 2026-04-01
22 APR_DRG Heart And/or Lung Transplant 3 3 $0.01 — $43,073.00 $43,073.00 $43,073.00 2024-12-15
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 9 7 $0.01 — $31,946.00 $73,050.35 $43,060.00 2026-04-01
234 APR_DRG Spinal Procedures 3 3 $0.01 — $42,989.00 $42,989.00 $42,989.00 2024-12-15
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 11 8 $0.01 — $31,844.00 $78,314.63 $42,956.09 2026-04-01
C9089 HCPCS Bupivacaine Hcl (300 Mg Dose) 3 X 100 Mg Il Impl 64 25 $69,033.59 $34,516.80 50% off $3.77 $63,869.00 $42,938.50 2026-04-01
C1827 HCPCS Generator Imp Vivistim Vns Ipg 1001 62 24 $244,555.00 $122,277.50 50% off $820.50 $220,100.00 $42,865.50 2024-12-15
0234T CPT Hc Trluml Perip Athrc Renal Art 29 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 3 3 $0.01 — $42,834.00 $42,834.00 $42,834.00 2024-12-15
A9555 HCPCS Rubidium-82 (rb-82) Radio-isotope Injection 41 25 $84,001.00 $42,000.50 50% off $82.00 $75,601.00 $42,589.00 2026-04-01
112 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 3 3 $0.01 — $42,283.00 $42,283.00 $42,283.00 2024-12-15
6023 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 3 3 $0.01 — $42,282.00 $42,282.00 $42,282.00 2024-12-15
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 11 8 $0.01 — $31,282.00 $70,677.70 $42,165.00 2026-04-01
G2170 HCPCS Avf By Tissue W Thermal E 4 1 — — $19,924.96 $70,614.07 $42,161.22 2026-04-01
G2171 HCPCS Avf Use Magnetic/art/ven 4 1 — — $19,924.96 $70,614.07 $42,161.22 2026-04-01
31253 CPT Hc Nasal/sinus Endo Total With Tiss Rem 59 24 $58,344.44 $29,172.22 50% off $1,630.00 $105,020.00 $42,008.00 2024-12-15
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 11 8 $0.01 — $31,010.00 $70,646.62 $41,798.00 2026-04-01
53 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 3 3 $0.01 — $41,755.00 $41,755.00 $41,755.00 2024-12-15
62 APR_DRG Pancreas Transplant 3 3 $0.01 — $41,726.00 $41,726.00 $41,726.00 2024-12-15
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 11 8 $0.01 — $31,096.00 $66,703.08 $41,628.05 2026-04-01
9504 APR_DRG Extensive O.r. Procedure Unrelated To Principal Diagnosis 3 3 $0.01 — $41,562.00 $41,562.00 $41,562.00 2024-12-15
901 MS_DRG Wound Debridements For Injuries With Mcc 11 8 $0.01 — $30,720.00 $65,206.77 $41,407.00 2026-04-01
69930 HCPCS Implant Cochlear Device 3 2 — — $8,715.36 $47,675.98 $41,385.40 2026-04-01
61 APR_DRG Pancreas Transplant 3 3 $0.01 — $41,187.00 $41,187.00 $41,187.00 2024-12-15
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 11 8 $0.01 — $30,459.00 $69,344.54 $41,055.00 2026-04-01
31 MS_DRG Ventricular Shunt Procedures With Mcc 11 8 $0.01 — $29,057.00 $69,618.01 $40,884.08 2026-04-01
C1875 HCPCS Stent G-armor Cov 5.2cm Lgth 10 Zig 269 24 $60,036.18 $30,018.09 50% off $820.50 $67,039.00 $40,632.00 2024-12-15
33270 CPT Hc Ins/rplcmnt Perm Subq Impltbl Dfb W/subq Eltrd 40 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 3 3 $0.01 — $40,474.00 $40,474.00 $40,474.00 2024-12-15
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 11 8 $0.01 — $27,298.06 $55,540.58 $40,383.13 2026-04-01
33264 HCPCS Rmvl & Rplcmt Dfb Gen Mlt Ld 3 2 — — $8,715.36 $46,487.00 $40,353.30 2026-04-01
33270 HCPCS Ins/rep Subq Defibrillator 3 2 — — $8,715.36 $46,487.00 $40,353.30 2026-04-01
33231 HCPCS Insrt Pulse Gen W/mult Leads 3 2 — — $8,715.36 $46,487.00 $40,353.30 2026-04-01
33249 HCPCS Insj/rplcmt Defib W/lead(s) 3 2 — — $8,715.36 $46,487.00 $40,353.30 2026-04-01
13 APR_DRG Liver Transplant And/or Intestinal Transplant 3 3 $0.01 — $40,178.00 $40,178.00 $40,178.00 2024-12-15
6093 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 3 3 $0.01 — $40,131.00 $40,131.00 $40,131.00 2024-12-15
264 APR_DRG Other Nervous System And Related Procedures 3 3 $0.01 — $40,107.00 $40,107.00 $40,107.00 2024-12-15
37231 CPT Hc Revascularize Tibial/peron Artery,angioplasty/stent/atherectomy Init 59 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 59 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 3 3 $0.01 — $39,934.00 $39,934.00 $39,934.00 2024-12-15
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 11 8 $0.01 — $28,849.00 $65,620.08 $39,873.77 2026-04-01
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 11 8 $0.01 — $29,577.00 $68,255.33 $39,867.00 2026-04-01
359 MS_DRG Percutaneous Coronary Atherectomy With Intraluminal Device With Mcc 2 2 — — $26,260.21 $53,428.97 $39,844.59 2026-04-01
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 9 7 $0.01 — $29,534.00 $67,239.14 $39,808.00 2026-04-01
460 MS_DRG Spinal Fusion Except Cervical Without Mcc 2 1 — — $37,013.90 $42,546.58 $39,780.24 2026-04-01
3033 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 3 3 $0.01 — $39,697.00 $39,697.00 $39,697.00 2024-12-15
1824 APR_DRG Other Peripheral Vascular Procedures 3 3 $0.01 — $39,665.00 $39,665.00 $39,665.00 2024-12-15
1634 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis 3 3 $0.01 — $39,641.00 $39,641.00 $39,641.00 2024-12-15
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 11 8 $0.01 — $28,202.00 $64,529.31 $39,610.22 2026-04-01
0187-3013-30 NDC Pyridostigmine Bromide ER 180 Mg Po Tbcr 39 24 $72,910.62 $36,455.31 50% off $820.50 $65,620.00 $39,590.00 2024-12-15
140 MS_DRG Major Head And Neck Procedures With Mcc 9 7 $0.01 — $29,324.00 $66,274.23 $39,526.00 2026-04-01
51167-331-01 NDC Elexacaf-tezacaf-ivacaf&ivacaf 100-50-75 (trikafta Kit Morning Dose) 39 24 $72,562.53 $36,281.26 50% off $820.50 $65,306.00 $39,401.00 2024-12-15
24341 CPT Hc Repair Tend/musc Upr Arm/elb Each 59 24 $54,655.25 $27,327.62 50% off $2,399.00 $98,379.00 $39,352.00 2024-12-15
C2621 HCPCS Pacemaker Dig Viva Crt-p 15ml 26gm 57x59x6mm 529 11 $57,959.45 $28,979.73 50% off $8,329.00 $82,435.00 $39,310.00 2024-12-15
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 11 8 $0.01 — $28,496.00 $65,475.58 $39,168.15 2026-04-01
0427T OTHER Insj/rplc Nstim Apnea Pls Gn 2 1 — — $36,398.43 $41,930.99 $39,164.71 2026-04-01
0266T OTHER Implt/rpl Crtd Sns Dev Total 2 1 — — $36,398.43 $41,930.99 $39,164.71 2026-04-01
0268T OTHER Implt/rpl Crtd Sns Dev Gen 2 1 — — $36,398.43 $41,930.99 $39,164.71 2026-04-01
0424T OTHER Insj/rplc Nstim Apnea Compl 2 1 — — $36,398.43 $41,930.99 $39,164.71 2026-04-01
0312T OTHER Laps Impltj Nstim Vagus 2 1 — — $36,398.43 $41,930.99 $39,164.71 2026-04-01
0316T OTHER Replc Vagus Nerve Pls Gen 2 1 — — $36,398.43 $41,930.99 $39,164.71 2026-04-01
0431T OTHER Rmvl/rplc Nstim Apnea Pls Gn 2 1 — — $36,398.43 $41,930.99 $39,164.71 2026-04-01
7924 APR_DRG Extensive O.r. Procedures For Other Complications Of Treatment 3 3 $0.01 — $38,992.00 $38,992.00 $38,992.00 2024-12-15
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