|
J3391
|
HCPCS
|
Inj, Atidarsagene Autotemcel
|
22
|
7
|
—
|
—
|
$56,052.70
|
$4,388,710.78
|
$4,179,724.55
|
2026-01-02
|
|
C9172
|
HCPCS
|
Inj, Beqvez, Per Tx Dose
|
22
|
7
|
—
|
—
|
$35,077.10
|
$3,719,501.31
|
$3,542,382.20
|
2026-01-02
|
|
J1411
|
HCPCS
|
Inj, Hemgenix, Per Tx Dose
|
22
|
7
|
—
|
—
|
$35,077.10
|
$3,694,704.64
|
$3,518,766.32
|
2026-01-02
|
|
J1413
|
HCPCS
|
Inj Delandistrogene Mox Rokl
|
22
|
7
|
—
|
—
|
$35,077.10
|
$3,333,086.13
|
$3,174,367.74
|
2026-01-02
|
|
J3394
|
HCPCS
|
Inj, Lovotibeglogene Autotem
|
22
|
7
|
—
|
—
|
$56,052.70
|
$3,269,707.33
|
$3,114,006.98
|
2026-01-02
|
|
J3393
|
HCPCS
|
Inj, Betibeglogene Autotemce
|
11
|
7
|
—
|
—
|
$57,139.93
|
$2,958,243.38
|
$2,817,374.65
|
2026-01-02
|
|
J3399
|
HCPCS
|
Inj Onase Abepar-xioi Treat
|
11
|
7
|
—
|
—
|
$24,873.46
|
$2,458,395.47
|
$2,341,329.02
|
2026-01-02
|
|
J3392
|
HCPCS
|
Inj, Exagamglogene Autotem
|
22
|
7
|
—
|
—
|
$56,052.70
|
$2,337,972.25
|
$2,226,640.24
|
2026-01-02
|
|
89100000S1-3348-3413
|
CDM
|
Hc Rx 891 Cell Therapy W/hcpcs
|
4
|
4
|
$1,924,681.00
|
$866,106.45
55% off
|
$882,658.71
|
$1,635,978.85
|
$1,477,192.67
|
2026-01-02
|
|
7355431111
|
NDC
|
Betibeglogene Autotemcel IV Susp [190339]
|
13
|
9
|
$2,800,000.00
|
$1,260,000.00
55% off
|
$56,052.70
|
$2,845,548.39
|
$1,284,080.00
|
2026-01-02
|
|
7189414009
|
NDC
|
Onasemnogene Abeparvovec-xioi 1x5.5ml & 8x8.3ml IV Kit [168092]
|
25
|
11
|
$2,188,750.00
|
$984,937.50
55% off
|
$24,400.17
|
$2,458,395.47
|
$1,003,760.75
|
2026-01-02
|
|
7189412002
|
NDC
|
Onasemnogene Abeparvovec-xioi 2x8.3 Ml IV Kit [168071]
|
25
|
11
|
$2,188,750.00
|
$984,937.50
55% off
|
$24,400.17
|
$2,458,395.47
|
$1,003,760.75
|
2026-01-02
|
|
7189412404
|
NDC
|
Onasemnogene Abeparvovec-xioi 2x5.5ml & 2x8.3ml IV Kit [168075]
|
25
|
11
|
$2,188,750.00
|
$984,937.50
55% off
|
$24,400.17
|
$2,458,395.47
|
$1,003,760.75
|
2026-01-02
|
|
7189412905
|
NDC
|
Onasemnogene Abeparvovec-xioi 5x8.3 Ml IV Kit [168080]
|
25
|
11
|
$2,188,750.00
|
$984,937.50
55% off
|
$24,400.17
|
$2,458,395.47
|
$1,003,760.75
|
2026-01-02
|
|
7189414109
|
NDC
|
Onasemnogene Abeparvovec-xioi 9x8.3 Ml IV Kit [168093]
|
25
|
11
|
$2,188,750.00
|
$984,937.50
55% off
|
$24,400.17
|
$2,458,395.47
|
$1,003,760.75
|
2026-01-02
|
|
7189413909
|
NDC
|
Onasemnogene Abeparvovec-xioi 2x5.5ml & 7x8.3ml IV Kit [168091]
|
25
|
11
|
$2,188,750.00
|
$984,937.50
55% off
|
$24,400.17
|
$2,458,395.47
|
$1,003,760.75
|
2026-01-02
|
|
7189413006
|
NDC
|
Onasemnogene Abeparvovec-xioi 2x5.5ml & 4x8.3ml IV Kit [168082]
|
25
|
11
|
$2,188,750.00
|
$984,937.50
55% off
|
$24,400.17
|
$2,458,395.47
|
$1,003,760.75
|
2026-01-02
|
|
7189412604
|
NDC
|
Onasemnogene Abeparvovec-xioi 4x8.3 Ml IV Kit [168077]
|
25
|
11
|
$2,188,750.00
|
$984,937.50
55% off
|
$24,400.17
|
$2,458,395.47
|
$1,003,760.75
|
2026-01-02
|
|
7189413106
|
NDC
|
Onasemnogene Abeparvovec-xioi 1x5.5ml & 5x8.3ml IV Kit [168083]
|
25
|
11
|
$2,188,750.00
|
$984,937.50
55% off
|
$24,400.17
|
$2,458,395.47
|
$1,003,760.75
|
2026-01-02
|
|
7189413307
|
NDC
|
Onasemnogene Abeparvovec-xioi 2x5.5ml & 5x8.3ml IV Kit [168085]
|
25
|
11
|
$2,188,750.00
|
$984,937.50
55% off
|
$24,400.17
|
$2,458,395.47
|
$1,003,760.75
|
2026-01-02
|
|
7189413708
|
NDC
|
Onasemnogene Abeparvovec-xioi 1x5.5ml & 7x8.3ml IV Kit [168089]
|
25
|
11
|
$2,188,750.00
|
$984,937.50
55% off
|
$24,400.17
|
$2,458,395.47
|
$1,003,760.75
|
2026-01-02
|
|
7189412203
|
NDC
|
Onasemnogene Abeparvovec-xioi 1x5.5ml & 2x8.3ml IV Kit [168073]
|
25
|
11
|
$2,188,750.00
|
$984,937.50
55% off
|
$24,400.17
|
$2,458,395.47
|
$1,003,760.75
|
2026-01-02
|
|
7189412504
|
NDC
|
Onasemnogene Abeparvovec-xioi 1x5.5ml & 3x8.3ml IV Kit [168076]
|
25
|
11
|
$2,188,750.00
|
$984,937.50
55% off
|
$24,400.17
|
$2,458,395.47
|
$1,003,760.75
|
2026-01-02
|
|
7189413206
|
NDC
|
Onasemnogene Abeparvovec-xioi 6x8.3 Ml IV Kit [168084]
|
25
|
11
|
$2,188,750.00
|
$984,937.50
55% off
|
$24,400.17
|
$2,458,395.47
|
$1,003,760.75
|
2026-01-02
|
|
7189413808
|
NDC
|
Onasemnogene Abeparvovec-xioi 8x8.3 Ml IV Kit [168090]
|
25
|
11
|
$2,188,750.00
|
$984,937.50
55% off
|
$24,400.17
|
$2,458,395.47
|
$1,003,760.75
|
2026-01-02
|
|
7189412103
|
NDC
|
Onasemnogene Abeparvovec-xioi 2x5.5ml & 1x8.3ml IV Kit [168072]
|
25
|
11
|
$2,188,750.00
|
$984,937.50
55% off
|
$24,400.17
|
$2,458,395.47
|
$1,003,760.75
|
2026-01-02
|
|
7189412705
|
NDC
|
Onasemnogene Abeparvovec-xioi 2x5.5ml & 3x8.3ml IV Kit [168078]
|
25
|
11
|
$2,188,750.00
|
$984,937.50
55% off
|
$24,400.17
|
$2,458,395.47
|
$1,003,760.75
|
2026-01-02
|
|
7189412805
|
NDC
|
Onasemnogene Abeparvovec-xioi 1x5.5ml & 4x8.3ml IV Kit [168079]
|
25
|
11
|
$2,188,750.00
|
$984,937.50
55% off
|
$24,400.17
|
$2,458,395.47
|
$1,003,760.75
|
2026-01-02
|
|
7189412303
|
NDC
|
Onasemnogene Abeparvovec-xioi 3x8.3 Ml IV Kit [168074]
|
25
|
11
|
$2,188,750.00
|
$984,937.50
55% off
|
$24,400.17
|
$2,458,395.47
|
$1,003,760.75
|
2026-01-02
|
|
7189413608
|
NDC
|
Onasemnogene Abeparvovec-xioi 2x5.5ml & 6x8.3ml IV Kit [168088]
|
25
|
11
|
$2,188,750.00
|
$984,937.50
55% off
|
$24,400.17
|
$2,458,395.47
|
$1,003,760.75
|
2026-01-02
|
|
7189413507
|
NDC
|
Onasemnogene Abeparvovec-xioi 7x8.3 Ml IV Kit [168087]
|
25
|
11
|
$2,188,750.00
|
$984,937.50
55% off
|
$24,400.17
|
$2,458,395.47
|
$1,003,760.75
|
2026-01-02
|
|
7189413407
|
NDC
|
Onasemnogene Abeparvovec-xioi 1x5.5ml & 6x8.3ml IV Kit [168086]
|
25
|
11
|
$2,188,750.00
|
$984,937.50
55% off
|
$24,400.17
|
$2,458,395.47
|
$1,003,760.75
|
2026-01-02
|
|
7128711901
|
NDC
|
Axicabtagene Ciloleucel 200000000 Cells IV Susp [182862]
|
13
|
9
|
$2,225,823.60
|
$1,001,620.62
55% off
|
$56,052.70
|
$1,891,950.06
|
$986,039.85
|
2026-01-02
|
|
5957251501
|
NDC
|
Idecabtagene Vicleucel 460000000 Cells IV Susp [178522]
|
13
|
9
|
$2,202,963.40
|
$991,333.53
55% off
|
$56,052.70
|
$1,872,518.89
|
$975,912.79
|
2026-01-02
|
|
0078095819
|
NDC
|
Tisagenlecleucel 600000000 Cells IV Susp [182865]
|
13
|
9
|
$2,161,056.95
|
$972,475.63
55% off
|
$56,052.70
|
$1,836,898.41
|
$957,348.23
|
2026-01-02
|
|
7315390001
|
NDC
|
Lisocabtagene Maraleucel 70000000 Cells/ml IV Susp [178176]
|
13
|
9
|
$2,154,648.35
|
$969,591.76
55% off
|
$56,052.70
|
$1,831,451.10
|
$954,509.22
|
2026-01-02
|
|
7128721901
|
NDC
|
Brexucabtagene Autoleucel 200000000 Cells IV Susp [176998]
|
13
|
9
|
$2,042,040.00
|
$918,918.00
55% off
|
$56,052.70
|
$1,735,734.00
|
$904,623.72
|
2026-01-02
|
|
18
|
MS_DRG
|
Chimeric Antigen Receptor (car) T-cell Immunotherapy
|
9
|
3
|
—
|
—
|
$487,890.49
|
$1,511,981.58
|
$824,195.90
|
2026-01-02
|
|
Q2057
|
HCPCS
|
Afamitresgene Autoleucel
|
22
|
7
|
—
|
—
|
$56,052.70
|
$772,593.56
|
$735,803.39
|
2026-01-02
|
|
Q2042
|
HCPCS
|
Tisagenlecleucel Car-pos T
|
11
|
7
|
—
|
—
|
$57,139.93
|
$579,805.67
|
$552,195.88
|
2026-01-02
|
|
Q2056
|
HCPCS
|
Ciltacabtagene Car-pos T
|
22
|
7
|
—
|
—
|
$56,052.70
|
$554,796.03
|
$528,377.17
|
2026-01-02
|
|
Q2054
|
HCPCS
|
Lisocabtagene Mara Car Pos T
|
11
|
7
|
—
|
—
|
$57,139.93
|
$543,022.79
|
$517,164.56
|
2026-01-02
|
|
Q2055
|
HCPCS
|
Idecabtagene Vicleucel Car
|
11
|
7
|
—
|
—
|
$57,139.93
|
$542,646.62
|
$516,806.30
|
2026-01-02
|
|
Q2041
|
HCPCS
|
Axicabtagene Ciloleucel Car+
|
11
|
7
|
—
|
—
|
$57,139.93
|
$534,441.69
|
$508,992.08
|
2026-01-02
|
|
Q2053
|
HCPCS
|
Brexucabtagene Car Pos T
|
11
|
7
|
—
|
—
|
$57,139.93
|
$490,974.17
|
$467,594.45
|
2026-01-02
|
|
5831
|
APR_DRG
|
Neonate With Ecmo
|
40
|
5
|
—
|
—
|
$184,859.66
|
$523,053.34
|
$372,670.52
|
2026-01-02
|
|
5891
|
APR_DRG
|
Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …
|
40
|
5
|
—
|
—
|
$55,899.77
|
$479,024.83
|
$323,226.67
|
2026-01-02
|
|
Q2058
|
HCPCS
|
Obecbtge Autol Up To 400 Mil
|
22
|
7
|
—
|
—
|
$56,052.70
|
$271,067.43
|
$258,159.46
|
2026-01-02
|
|
1
|
MS_DRG
|
Heart Transplant Or Implant Of Heart Assist System With Mcc
|
27
|
9
|
—
|
—
|
$205,689.10
|
$1,129,323.48
|
$254,698.92
|
2026-01-02
|
|
426
|
MS_DRG
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
15
|
7
|
—
|
—
|
$94,178.01
|
$419,979.74
|
$228,935.05
|
2026-01-02
|
|
927
|
MS_DRG
|
Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft
|
30
|
9
|
—
|
—
|
$178,923.82
|
$951,094.50
|
$228,437.17
|
2026-01-02
|
|
850
|
MS_DRG
|
Acute Leukemia With Other Procedures
|
15
|
7
|
—
|
—
|
$82,930.43
|
$369,323.49
|
$201,321.84
|
2026-01-02
|
|
3
|
MS_DRG
|
Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…
|
30
|
9
|
—
|
—
|
$161,642.97
|
$859,235.71
|
$200,336.14
|
2026-01-02
|
|
429
|
MS_DRG
|
Combined Anterior And Posterior Cervical Spinal Fusion With Mcc
|
15
|
7
|
—
|
—
|
$75,174.19
|
$334,391.34
|
$182,279.98
|
2026-01-02
|
|
8120000011-3348-3426
|
CDM
|
Hc Cadaver Donor - Kidney/pancreas
|
6
|
5
|
$281,585.00
|
$126,713.25
55% off
|
$103,398.01
|
$239,347.25
|
$170,288.53
|
2026-01-02
|
|
27500000S2-30304
|
CDM
|
Kit Left Right Ventric Taht
|
30
|
12
|
$307,489.75
|
$138,370.39
55% off
|
$78,717.38
|
$261,366.29
|
$170,041.83
|
2026-01-02
|
|
212
|
MS_DRG
|
Concomitant Aortic And Mitral Valve Procedures
|
21
|
9
|
—
|
—
|
$96,579.80
|
$436,758.24
|
$164,846.49
|
2026-01-02
|
|
1611
|
APR_DRG
|
Implantable Heart Assist Systems
|
40
|
5
|
—
|
—
|
$150,350.79
|
$357,888.68
|
$164,182.33
|
2026-01-02
|
|
111
|
APR_DRG
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
57
|
8
|
—
|
—
|
$60,451.38
|
$955,702.00
|
$160,610.94
|
2026-01-02
|
|
427
|
MS_DRG
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
15
|
7
|
—
|
—
|
$64,154.51
|
$284,761.45
|
$155,226.24
|
2026-01-02
|
|
447
|
MS_DRG
|
Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall…
|
15
|
7
|
—
|
—
|
$60,611.54
|
$268,804.83
|
$154,415.00
|
2026-01-02
|
|
317
|
MS_DRG
|
Concomitant Left Atrial Appendage Closure And Cardiac Ablation
|
15
|
7
|
—
|
—
|
$55,997.68
|
$248,025.15
|
$142,479.00
|
2026-01-02
|
|
6091
|
APR_DRG
|
Neonate Birth Weight 1500-2499 Grams With Major Procedure
|
30
|
5
|
—
|
—
|
$56,011.62
|
$309,202.38
|
$142,307.91
|
2026-01-02
|
|
5911
|
APR_DRG
|
Neonate Birth Weight 500-749 Grams Without Major Procedure
|
40
|
5
|
—
|
—
|
$89,241.46
|
$273,241.54
|
$141,191.12
|
2026-01-02
|
|
8120000012-3348-3425
|
CDM
|
Hc Cadaver Donor - Double Lung
|
6
|
5
|
$225,080.00
|
$101,286.00
55% off
|
$82,649.38
|
$191,318.00
|
$136,117.13
|
2026-01-02
|
|
5931
|
APR_DRG
|
Neonate Birth Weight 750-999 Grams Without Major Procedure
|
40
|
5
|
—
|
—
|
$33,821.98
|
$238,528.61
|
$132,553.35
|
2026-01-02
|
|
4
|
MS_DRG
|
Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…
|
30
|
9
|
—
|
—
|
$106,572.31
|
$566,499.96
|
$132,350.15
|
2026-01-02
|
|
8110000003-3348-3432
|
CDM
|
Hc Living Donor -kidney/pancreas
|
6
|
5
|
$217,966.00
|
$98,084.70
55% off
|
$80,037.12
|
$185,271.10
|
$131,814.94
|
2026-01-02
|
|
27800000S2-4119
|
CDM
|
Heartmate 3 Lvad Implant Kit
|
58
|
12
|
$242,817.75
|
$109,267.99
55% off
|
$56,405.95
|
$206,395.09
|
$130,393.13
|
2026-01-02
|
|
5881
|
APR_DRG
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
30
|
5
|
—
|
—
|
$121,976.53
|
$369,523.98
|
$130,199.31
|
2026-01-02
|
|
8120000003-3348-3429
|
CDM
|
Hc Cadaver Donor - Liver
|
6
|
5
|
$213,768.00
|
$96,195.60
55% off
|
$78,495.61
|
$181,702.80
|
$129,276.20
|
2026-01-02
|
|
428
|
MS_DRG
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
15
|
7
|
—
|
—
|
$49,923.90
|
$220,670.38
|
$126,799.00
|
2026-01-02
|
|
0187001050
|
NDC
|
Sod Benz-sod Phenylacet 10-10 % IV Soln [40917]
|
30
|
12
|
$228,303.50
|
$102,736.58
55% off
|
$58,445.70
|
$194,057.98
|
$126,251.84
|
2026-01-02
|
|
430
|
MS_DRG
|
Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc
|
15
|
7
|
—
|
—
|
$49,624.79
|
$219,323.29
|
$125,990.00
|
2026-01-02
|
|
6021
|
APR_DRG
|
Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…
|
40
|
5
|
—
|
—
|
$30,315.17
|
$160,925.18
|
$122,927.94
|
2026-01-02
|
|
14
|
MS_DRG
|
Allogeneic Bone Marrow Transplant
|
26
|
9
|
—
|
—
|
$86,992.76
|
$525,277.37
|
$118,851.15
|
2026-01-02
|
|
450
|
MS_DRG
|
Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically …
|
15
|
7
|
—
|
—
|
$46,772.62
|
$206,477.81
|
$118,610.00
|
2026-01-02
|
|
7
|
MS_DRG
|
Lung Transplant
|
26
|
9
|
—
|
—
|
$93,106.83
|
$523,954.33
|
$118,554.15
|
2026-01-02
|
|
27800000S2-4169
|
CDM
|
Heartmate Iii Implant Kit
|
44
|
12
|
$221,233.95
|
$99,555.28
55% off
|
$45,920.00
|
$188,048.86
|
$116,984.43
|
2026-01-02
|
|
8120000004-3348-3428
|
CDM
|
Hc Cadaver Donor - Lung
|
6
|
5
|
$186,232.00
|
$83,804.40
55% off
|
$68,384.39
|
$158,297.20
|
$112,623.80
|
2026-01-02
|
|
233
|
MS_DRG
|
Coronary Bypass With Cardiac Catheterization With Mcc
|
22
|
9
|
—
|
—
|
$70,441.79
|
$313,375.11
|
$112,349.02
|
2026-01-02
|
|
6301
|
APR_DRG
|
Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure
|
40
|
5
|
—
|
—
|
$39,453.94
|
$323,905.31
|
$112,240.55
|
2026-01-02
|
|
8120000001-3348-3431
|
CDM
|
Hc Cadaver Donor - Heart
|
6
|
5
|
$184,746.00
|
$83,135.70
55% off
|
$67,838.73
|
$157,034.10
|
$111,725.14
|
2026-01-02
|
|
2
|
MS_DRG
|
Heart Transplant Or Implant Of Heart Assist System Without Mcc
|
29
|
9
|
—
|
—
|
$83,113.58
|
$702,939.00
|
$109,541.92
|
2026-01-02
|
|
8110000002-3348-3433
|
CDM
|
Hc Living Donor - Liver
|
6
|
5
|
$176,800.00
|
$79,560.00
55% off
|
$64,920.96
|
$150,280.00
|
$106,919.80
|
2026-01-02
|
|
6300487101
|
NDC
|
Corticotropin 80 Unit/ml Inj Gel (acthar) [9685]
|
14
|
8
|
$226,520.00
|
$101,934.00
55% off
|
$57,989.12
|
$192,542.00
|
$102,115.21
|
2026-01-02
|
|
6813510001
|
NDC
|
Elosulfase Alfa 5 Mg/5ml IV Soln [125260]
|
109
|
12
|
$266,739.00
|
$120,032.55
55% off
|
$275.43
|
$329,460.34
|
$102,009.43
|
2026-01-02
|
|
91
|
APR_DRG
|
Extracorporeal Membrane Oxygenation (ecmo)
|
30
|
5
|
—
|
—
|
$60,685.61
|
$216,473.50
|
$99,868.33
|
2026-01-02
|
|
41
|
APR_DRG
|
Tracheostomy With Mv >96 Hours With Extensive Procedure
|
40
|
5
|
—
|
—
|
$69,141.44
|
$207,745.26
|
$99,657.93
|
2026-01-02
|
|
215
|
MS_DRG
|
Other Heart Assist System Implant
|
30
|
9
|
—
|
—
|
$77,534.37
|
$424,766.72
|
$99,357.91
|
2026-01-02
|
|
8120000002-3348-3430
|
CDM
|
Hc Cadaver Donor - Kidney
|
6
|
5
|
$160,580.00
|
$72,261.00
55% off
|
$58,964.98
|
$136,493.00
|
$97,110.76
|
2026-01-02
|
|
5
|
MS_DRG
|
Liver Transplant With Mcc Or Intestinal Transplant
|
26
|
9
|
—
|
—
|
$78,560.59
|
$426,955.74
|
$96,779.93
|
2026-01-02
|
|
8411
|
APR_DRG
|
Extensive Third Degree Burns With Skin Graft
|
30
|
5
|
—
|
—
|
$61,525.14
|
$303,285.44
|
$96,543.36
|
2026-01-02
|
|
276
|
MS_DRG
|
Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator
|
21
|
9
|
—
|
—
|
$56,068.89
|
$248,345.88
|
$93,733.66
|
2026-01-02
|
|
448
|
MS_DRG
|
Multiple Level Spinal Fusion Except Cervical Without Mcc
|
15
|
7
|
—
|
—
|
$37,277.83
|
$163,715.68
|
$92,887.37
|
2026-01-02
|
|
216
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
30
|
9
|
—
|
—
|
$72,791.22
|
$386,931.90
|
$90,550.83
|
2026-01-02
|
|
7133610031
|
NDC
|
Vutrisiran Sodium 25 Mg/0.5ml Sc Sosy [189592]
|
28
|
11
|
$596,755.00
|
$268,539.75
55% off
|
$4,758.69
|
$507,241.75
|
$89,194.73
|
2026-01-02
|
|
402
|
MS_DRG
|
Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical
|
15
|
7
|
—
|
—
|
$35,752.93
|
$156,847.92
|
$88,990.81
|
2026-01-02
|
|
461
|
MS_DRG
|
Bilateral Or Multiple Major Joint Procs Of Lower Extremity W Mcc
|
22
|
9
|
—
|
—
|
$55,555.25
|
$246,032.58
|
$88,205.85
|
2026-01-02
|
|
266
|
MS_DRG
|
Endovascular Cardiac Valve Replacement W Mcc
|
22
|
9
|
—
|
—
|
$54,256.46
|
$240,183.15
|
$86,108.76
|
2026-01-02
|
|
4401
|
APR_DRG
|
Kidney Transplant
|
66
|
9
|
—
|
—
|
$22,964.74
|
$123,138.57
|
$84,593.78
|
2026-01-02
|
|
7267755103
|
NDC
|
Inebilizumab-cdon 100 Mg/10ml IV Soln [173306]
|
72
|
12
|
$218,333.35
|
$98,250.01
55% off
|
$472.09
|
$556,750.04
|
$81,389.18
|
2026-01-02
|
|
6031
|
APR_DRG
|
Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition
|
40
|
5
|
—
|
—
|
$28,895.34
|
$213,386.16
|
$80,779.54
|
2026-01-02
|
|
8100000008-3348-3435
|
CDM
|
Hc Acq Liver - Ldlr
|
6
|
5
|
$132,385.00
|
$59,573.25
55% off
|
$48,611.77
|
$112,527.25
|
$80,059.83
|
2026-01-02
|
|
231
|
MS_DRG
|
Coronary Bypass With Ptca With Mcc
|
30
|
9
|
—
|
—
|
$61,597.58
|
$339,735.60
|
$79,564.61
|
2026-01-02
|
|
456
|
MS_DRG
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
30
|
9
|
—
|
—
|
$63,877.01
|
$339,547.17
|
$79,520.75
|
2026-01-02
|
|
6311
|
APR_DRG
|
Neonate Birth Weight > 2499 Grams With Other Major Procedure
|
40
|
5
|
—
|
—
|
$12,240.28
|
$258,356.92
|
$78,962.76
|
2026-01-02
|
|
6071
|
APR_DRG
|
Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…
|
40
|
5
|
—
|
—
|
$45,772.78
|
$126,220.69
|
$78,473.80
|
2026-01-02
|
|
11
|
MS_DRG
|
Tracheostomy For Face,mouth & Neck Diagnoses W Mcc
|
22
|
9
|
—
|
—
|
$47,187.58
|
$216,332.42
|
$77,557.97
|
2026-01-02
|
|
51
|
APR_DRG
|
Tracheostomy With Mv >96 Hours Without Extensive Procedure
|
40
|
5
|
—
|
—
|
$46,483.35
|
$151,422.30
|
$77,155.01
|
2026-01-02
|
|
234
|
MS_DRG
|
Coronary Bypass With Cardiac Catheterization Without Mcc
|
22
|
9
|
—
|
—
|
$47,553.54
|
$213,297.46
|
$76,469.90
|
2026-01-02
|
|
20
|
MS_DRG
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc
|
30
|
9
|
—
|
—
|
$60,799.01
|
$323,185.62
|
$76,184.75
|
2026-01-02
|
|
8120000005-3348-3427
|
CDM
|
Hc Cadaver Donor - Pancreas
|
6
|
5
|
$121,005.00
|
$54,452.25
55% off
|
$44,433.04
|
$102,854.25
|
$73,177.77
|
2026-01-02
|
|
10
|
MS_DRG
|
Pancreas Transplant
|
26
|
9
|
—
|
—
|
$36,537.12
|
$319,653.52
|
$72,692.77
|
2026-01-02
|
|
219
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
30
|
9
|
—
|
—
|
$58,358.33
|
$310,211.85
|
$72,692.16
|
2026-01-02
|
|
19
|
MS_DRG
|
Simultaneous Pancreas And Kidney Transplant With Hemodialysis
|
26
|
9
|
—
|
—
|
$59,789.85
|
$317,821.31
|
$72,281.48
|
2026-01-02
|
|
8
|
MS_DRG
|
Simultaneous Pancreas/kidney Transplant
|
18
|
9
|
—
|
—
|
$48,114.82
|
$218,144.58
|
$72,236.04
|
2026-01-02
|
|
957
|
MS_DRG
|
Other O.r. Procedures For Multiple Significant Trauma With Mcc
|
30
|
9
|
—
|
—
|
$54,897.54
|
$299,254.71
|
$70,141.59
|
2026-01-02
|
|
451
|
MS_DRG
|
Single Level Spinal Fusion Except Cervical Without Mcc
|
15
|
7
|
—
|
—
|
$28,398.17
|
$123,723.91
|
$69,752.86
|
2026-01-02
|
|
1781
|
APR_DRG
|
External Heart Assist Systems
|
40
|
5
|
—
|
—
|
$53,224.59
|
$76,940.03
|
$68,911.09
|
2026-01-02
|
|
27800000S2-28262
|
CDM
|
Maci Autologous Cultured Chondrocytes On Porcine Collagen Membra
|
32
|
12
|
$124,363.25
|
$55,963.46
55% off
|
$31,836.99
|
$105,708.76
|
$68,772.88
|
2026-01-02
|
|
8100000003-3348-3436
|
CDM
|
Hc Acq Kidney - Ldkd
|
6
|
5
|
$112,082.00
|
$50,436.90
55% off
|
$41,156.51
|
$95,269.70
|
$67,781.59
|
2026-01-02
|
|
8110000001-3348-3434
|
CDM
|
Hc Living Donor - Kidney
|
6
|
5
|
$112,082.00
|
$50,436.90
55% off
|
$41,156.51
|
$95,269.70
|
$67,781.59
|
2026-01-02
|
|
267
|
MS_DRG
|
Endovascular Cardiac Valve Replacement Without Mcc
|
22
|
9
|
—
|
—
|
$42,807.70
|
$188,620.83
|
$67,623.01
|
2026-01-02
|
|
275
|
MS_DRG
|
Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc
|
29
|
9
|
—
|
—
|
$53,301.24
|
$283,330.16
|
$66,390.18
|
2026-01-02
|
|
870
|
MS_DRG
|
Septicemia Or Severe Sepsis With Mv >96 Hours
|
30
|
9
|
—
|
—
|
$52,467.82
|
$278,900.00
|
$65,403.49
|
2026-01-02
|
|
27800000S2-2992
|
CDM
|
Membrane Maci Collagen Bone Graft Substitue For Knees Lab Grown
|
32
|
12
|
$117,567.00
|
$52,905.15
55% off
|
$30,097.15
|
$99,931.95
|
$65,014.55
|
2026-01-02
|
|
1621
|
APR_DRG
|
Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis
|
40
|
5
|
—
|
—
|
$46,797.84
|
$103,440.24
|
$64,800.90
|
2026-01-02
|
|
928
|
MS_DRG
|
Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc
|
30
|
9
|
—
|
—
|
$50,390.07
|
$267,770.46
|
$62,812.78
|
2026-01-02
|
|
268
|
MS_DRG
|
Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc
|
30
|
9
|
—
|
—
|
$50,305.98
|
$267,317.42
|
$62,707.32
|
2026-01-02
|
|
207
|
MS_DRG
|
Respiratory System Diagnosis With Ventilator Support >96 Hours
|
30
|
9
|
—
|
—
|
$48,814.65
|
$259,282.98
|
$62,010.11
|
2026-01-02
|
|
9999702330
|
NDC
|
Pembrolizumab 400 Mg In Nacl 0.9% 100 Ml Ivpb (premix/batched) [5200197]
|
30
|
12
|
$111,164.00
|
$50,023.80
55% off
|
$28,457.98
|
$94,489.40
|
$61,473.69
|
2026-01-02
|
|
969
|
MS_DRG
|
HIV With Extensive O.r. Procedures With Mcc
|
30
|
9
|
—
|
—
|
$47,751.21
|
$253,553.84
|
$61,186.55
|
2026-01-02
|
|
217
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
30
|
9
|
—
|
—
|
$48,315.14
|
$258,910.13
|
$60,750.30
|
2026-01-02
|
|
J9029
|
HCPCS
|
Instill Adstiladrin, Tx Dose
|
11
|
7
|
—
|
—
|
$35,757.47
|
$63,593.50
|
$60,565.24
|
2026-01-02
|
|
6121
|
APR_DRG
|
Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other…
|
40
|
5
|
—
|
—
|
$33,290.37
|
$118,057.24
|
$59,569.94
|
2026-01-02
|
|
27800000S2-28732
|
CDM
|
Maci: Autologus Cultured Chondrocytes On Porcine Collagen Membra
|
30
|
12
|
$107,116.60
|
$48,202.47
55% off
|
$27,421.85
|
$91,049.11
|
$59,235.48
|
2026-01-02
|
|
9101
|
APR_DRG
|
Craniotomy For Multiple Significant Trauma
|
60
|
9
|
—
|
—
|
$33,973.31
|
$273,760.20
|
$58,557.65
|
2026-01-02
|
|
573
|
MS_DRG
|
Skin Graft For Skin Ulcer Or Cellulitis With Mcc
|
30
|
9
|
—
|
—
|
$46,515.13
|
$246,894.55
|
$57,953.35
|
2026-01-02
|
|
232
|
MS_DRG
|
Coronary Bypass With Ptca Without Mcc
|
30
|
9
|
—
|
—
|
$45,152.23
|
$244,910.00
|
$57,491.39
|
2026-01-02
|
|
C9098
|
HCPCS
|
Ciltacabtagene Car Pos T
|
12
|
6
|
—
|
—
|
$56,052.70
|
$502,897.50
|
$57,442.54
|
2026-01-02
|
|
739
|
MS_DRG
|
Uterine,adnexa Proc For Non-ovarian/adnexal Malig W Mcc
|
22
|
9
|
—
|
—
|
$33,639.54
|
$159,602.24
|
$57,219.46
|
2026-01-02
|
|
28
|
MS_DRG
|
Spinal Procedures With Mcc
|
30
|
9
|
—
|
—
|
$45,740.48
|
$243,739.31
|
$57,218.88
|
2026-01-02
|
|
J3402
|
HCPCS
|
Inj. Remestemcel-l-rknd/ Td
|
10
|
5
|
—
|
—
|
$56,052.70
|
$59,996.93
|
$57,156.84
|
2026-01-02
|
|
J3403
|
HCPCS
|
Revakinagene, Per Implant
|
10
|
5
|
—
|
—
|
$56,052.70
|
$59,996.93
|
$57,156.84
|
2026-01-02
|
|
C9301
|
HCPCS
|
Obecabtagene Car Pos T
|
10
|
5
|
—
|
—
|
$56,052.70
|
$59,996.93
|
$57,156.84
|
2026-01-02
|
|
C9081
|
HCPCS
|
Idecabtagene Car Pos T
|
10
|
5
|
—
|
—
|
$56,052.70
|
$59,996.93
|
$57,156.84
|
2026-01-02
|
|
C9073
|
HCPCS
|
Brexucabtagene Autoleucel Ca
|
10
|
5
|
—
|
—
|
$56,052.70
|
$59,996.93
|
$57,156.84
|
2026-01-02
|
|
C9076
|
HCPCS
|
Lisocabtagene Car Pos T
|
10
|
5
|
—
|
—
|
$56,052.70
|
$59,996.93
|
$57,156.84
|
2026-01-02
|
|
6081
|
APR_DRG
|
Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition
|
40
|
5
|
—
|
—
|
$24,155.55
|
$90,475.34
|
$56,613.72
|
2026-01-02
|
|
38240
|
HCPCS
|
Transplt Allo Hct/donor
|
11
|
7
|
—
|
—
|
$6,227.32
|
$59,293.79
|
$56,470.28
|
2026-01-02
|
|
7613824001-3348-4019
|
CDM
|
Hc Trnsplj Allogeneic Hematopoietic Cells Per Donor
|
29
|
12
|
$141,772.00
|
$63,797.40
55% off
|
$6,108.83
|
$174,351.45
|
$56,470.28
|
2026-01-02
|
|
273
|
MS_DRG
|
Percutaneous Intracardiac Procedures W Mcc
|
22
|
9
|
—
|
—
|
$35,736.02
|
$156,771.75
|
$56,204.70
|
2026-01-02
|
|
17
|
MS_DRG
|
Autologous Bone Marrow Transplant Without Cc/mcc
|
26
|
9
|
—
|
—
|
$45,605.00
|
$241,991.30
|
$56,167.09
|
2026-01-02
|
|
16
|
MS_DRG
|
Autologous Bone Marrow Transplant With Cc/mcc
|
26
|
9
|
—
|
—
|
$45,605.00
|
$241,991.30
|
$56,167.09
|
2026-01-02
|
|
218
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
30
|
9
|
—
|
—
|
$43,240.21
|
$238,519.34
|
$56,003.79
|
2026-01-02
|
|
235
|
MS_DRG
|
Coronary Bypass Without Cardiac Catheterization With Mcc
|
30
|
9
|
—
|
—
|
$44,476.08
|
$235,909.35
|
$55,396.24
|
2026-01-02
|
|
820
|
MS_DRG
|
Lymphoma And Leukemia With Major O.r. Procedures With Mcc
|
30
|
9
|
—
|
—
|
$44,015.43
|
$233,427.65
|
$55,020.80
|
2026-01-02
|
|
457
|
MS_DRG
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
30
|
9
|
—
|
—
|
$43,398.51
|
$230,104.02
|
$54,945.93
|
2026-01-02
|
|
3031
|
APR_DRG
|
Dorsal And Lumbar Fusion Procedure For Curvature Of Back
|
40
|
5
|
—
|
—
|
$49,324.33
|
$109,374.08
|
$54,800.88
|
2026-01-02
|
|
790
|
MS_DRG
|
Extreme Immaturity Or Respiratory Distress Syndrome, Neonate
|
28
|
9
|
—
|
—
|
$38,617.42
|
$155,643.00
|
$54,551.99
|
2026-01-02
|
|
A9543
|
HCPCS
|
Y90 Ibritumomab, Rx
|
11
|
7
|
—
|
—
|
$53,834.75
|
$56,970.08
|
$54,373.10
|
2026-01-02
|
|
21
|
MS_DRG
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc
|
30
|
9
|
—
|
—
|
$41,820.10
|
$221,600.51
|
$54,245.43
|
2026-01-02
|
|
23
|
MS_DRG
|
Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…
|
30
|
9
|
—
|
—
|
$43,028.43
|
$228,728.87
|
$53,724.79
|
2026-01-02
|
|
7289300704
|
NDC
|
Ibritumomab Tiuxetan For Y-90 3.2 Mg/2ml IV Kit [41815]
|
30
|
12
|
$66,804.65
|
$30,062.09
55% off
|
$17,101.99
|
$70,462.44
|
$53,602.57
|
2026-01-02
|
|
Q2043
|
HCPCS
|
Sipuleucel-t Auto Cd54+
|
24
|
8
|
—
|
—
|
$35,077.10
|
$57,870.49
|
$53,418.33
|
2026-01-02
|
|
12
|
MS_DRG
|
Tracheostomy For Face,mouth & Neck Diagnoses W Cc
|
19
|
9
|
—
|
—
|
$37,058.23
|
$164,525.54
|
$53,089.57
|
2026-01-02
|
|
6111
|
APR_DRG
|
Neonate Birth Weight 1500-1999 Grams With Major Anomaly
|
40
|
5
|
—
|
—
|
$18,614.39
|
$101,316.27
|
$52,892.71
|
2026-01-02
|
|
653
|
MS_DRG
|
Major Bladder Procedures With Mcc
|
30
|
9
|
—
|
—
|
$41,091.36
|
$223,496.86
|
$52,506.90
|
2026-01-02
|
|
834
|
MS_DRG
|
Acute Leukemia Without Major O.r. Procedures With Mcc
|
30
|
9
|
—
|
—
|
$41,820.10
|
$221,600.51
|
$52,065.47
|
2026-01-02
|
|
576
|
MS_DRG
|
Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc
|
30
|
9
|
—
|
—
|
$40,837.79
|
$216,308.37
|
$51,612.60
|
2026-01-02
|
|
463
|
MS_DRG
|
Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …
|
30
|
9
|
—
|
—
|
$40,880.21
|
$216,536.89
|
$51,553.90
|
2026-01-02
|
|
405
|
MS_DRG
|
Pancreas, Liver And Shunt Procedures With Mcc
|
30
|
9
|
—
|
—
|
$41,086.34
|
$217,647.44
|
$51,145.29
|
2026-01-02
|
|
27800000S2-21030
|
CDM
|
Zenith Spiral Aaa Iliac Leg 14 Fr 144 Mm X 13 Mm
|
30
|
12
|
$91,897.40
|
$41,353.83
55% off
|
$23,525.73
|
$78,112.79
|
$50,819.26
|
2026-01-02
|
|
1601
|
APR_DRG
|
Major Cardiothoracic Repair Of Heart Anomaly
|
40
|
5
|
—
|
—
|
$26,424.12
|
$287,461.38
|
$50,126.54
|
2026-01-02
|
|
220
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
30
|
9
|
—
|
—
|
$39,808.59
|
$212,355.30
|
$49,913.40
|
2026-01-02
|
|
1771
|
APR_DRG
|
Cardiac Pacemaker And Defibrillator Revision Except Device Replacement
|
40
|
5
|
—
|
—
|
$14,769.40
|
$85,551.36
|
$49,788.15
|
2026-01-02
|
|
1791
|
APR_DRG
|
Defibrillator Implants
|
40
|
5
|
—
|
—
|
$35,795.80
|
$68,896.31
|
$49,427.71
|
2026-01-02
|
|
4810483T01-3348-5341
|
CDM
|
Hc Cath Tmvi W/prosthetic Valve Percutaneous Approach
|
27
|
12
|
$95,678.00
|
$43,055.10
55% off
|
$21,321.50
|
$81,326.30
|
$49,178.49
|
2026-01-02
|
|
6131
|
APR_DRG
|
Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection
|
40
|
5
|
—
|
—
|
$20,996.13
|
$119,589.66
|
$49,043.53
|
2026-01-02
|
|
1631
|
APR_DRG
|
Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis
|
40
|
5
|
—
|
—
|
$33,882.51
|
$91,042.95
|
$48,606.01
|
2026-01-02
|
|
270
|
MS_DRG
|
Other Major Cardiovascular Procedures With Mcc
|
30
|
9
|
—
|
—
|
$38,383.87
|
$205,792.24
|
$48,385.68
|
2026-01-02
|
|
466
|
MS_DRG
|
Revision Of Hip Or Knee Replacement With Mcc
|
30
|
9
|
—
|
—
|
$38,600.04
|
$204,252.70
|
$48,027.30
|
2026-01-02
|
|
7269451501
|
NDC
|
Calaspargase Pegol-mknl 3750 Unit/5ml IV Soln [170117]
|
95
|
12
|
$95,819.25
|
$43,118.66
55% off
|
$16,368.51
|
$179,346.52
|
$47,954.63
|
2026-01-02
|
|
326
|
MS_DRG
|
Stomach, Esophageal And Duodenal Procedures With Mcc
|
30
|
9
|
—
|
—
|
$38,483.95
|
$203,627.27
|
$47,881.71
|
2026-01-02
|
|
7218704011
|
NDC
|
Tagraxofusp-erzs 1000 Mcg/ml IV Soln [166309]
|
100
|
12
|
$91,612.85
|
$41,225.78
55% off
|
$324.88
|
$168,715.78
|
$47,523.12
|
2026-01-02
|
|
239
|
MS_DRG
|
Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc
|
30
|
9
|
—
|
—
|
$36,485.52
|
$201,939.39
|
$47,488.82
|
2026-01-02
|
|
33990
|
HCPCS
|
Insj Perq Vad L Hrt Arterial
|
5
|
5
|
—
|
—
|
$47,007.05
|
$49,357.40
|
$47,477.12
|
2026-01-02
|
|
33995
|
HCPCS
|
Insj Perq Vad R Hrt Venous
|
5
|
5
|
—
|
—
|
$47,007.05
|
$49,357.40
|
$47,477.12
|
2026-01-02
|
|
278
|
MS_DRG
|
Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures …
|
29
|
9
|
—
|
—
|
$33,856.20
|
$200,592.30
|
$47,284.45
|
2026-01-02
|
|
837
|
MS_DRG
|
Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot…
|
30
|
9
|
—
|
—
|
$36,767.87
|
$200,748.66
|
$47,211.64
|
2026-01-02
|
|
853
|
MS_DRG
|
Infectious And Parasitic Diseases With O.r. Procedures With Mcc
|
30
|
9
|
—
|
—
|
$37,905.72
|
$200,512.12
|
$47,156.58
|
2026-01-02
|
|
0452T
|
OTHER
|
Insj/rplcmt Dev Vasc Seal
|
10
|
5
|
—
|
—
|
$46,112.63
|
$49,357.40
|
$47,020.96
|
2026-01-02
|
|
33982
|
HCPCS
|
Replace Vad Intra Without Bp
|
10
|
5
|
—
|
—
|
$46,112.63
|
$49,357.40
|
$47,020.96
|
2026-01-02
|
|
33983
|
HCPCS
|
Replace Vad Intra W/bp
|
10
|
5
|
—
|
—
|
$46,112.63
|
$49,357.40
|
$47,020.96
|
2026-01-02
|
|
33991
|
HCPCS
|
Insj Perq Vad L Hrt Artl&ven
|
10
|
5
|
—
|
—
|
$46,112.63
|
$49,357.40
|
$47,020.96
|
2026-01-02
|
|
0459T
|
OTHER
|
Relocaj Rplcmt Aortic Ventr
|
10
|
5
|
—
|
—
|
$46,112.63
|
$49,357.40
|
$47,020.96
|
2026-01-02
|
|
33975
|
HCPCS
|
Implant Ventricular Device
|
10
|
5
|
—
|
—
|
$46,112.63
|
$49,357.40
|
$47,020.96
|
2026-01-02
|
|
0451T
|
OTHER
|
Insj/rplcmt Aortic Ventr Sys
|
10
|
5
|
—
|
—
|
$46,112.63
|
$49,357.40
|
$47,020.96
|
2026-01-02
|
|
0454T
|
OTHER
|
Insj/rplcmt Subq Electrode
|
10
|
5
|
—
|
—
|
$46,112.63
|
$49,357.40
|
$47,020.96
|
2026-01-02
|
|
0453T
|
OTHER
|
Insj/rplcmt Mech-elec Ntrfce
|
10
|
5
|
—
|
—
|
$46,112.63
|
$49,357.40
|
$47,020.96
|
2026-01-02
|
|
33981
|
HCPCS
|
Replace Vad Pump Ext
|
10
|
5
|
—
|
—
|
$46,112.63
|
$49,357.40
|
$47,020.96
|
2026-01-02
|
|
33979
|
HCPCS
|
Insert Intracorporeal Device
|
10
|
5
|
—
|
—
|
$46,112.63
|
$49,357.40
|
$47,020.96
|
2026-01-02
|
|
228
|
MS_DRG
|
Other Cardiothoracic Procedures With Mcc
|
30
|
9
|
—
|
—
|
$37,771.77
|
$199,790.46
|
$46,988.60
|
2026-01-02
|
|
1831
|
APR_DRG
|
Percutaneous Structural Cardiac Procedures
|
40
|
5
|
—
|
—
|
$39,056.54
|
$82,362.60
|
$46,635.94
|
2026-01-02
|
|
27800000S2-21364
|
CDM
|
Boston Scientific Wavewriter Alpha Implantable Pulse Generator K
|
30
|
12
|
$84,193.50
|
$37,887.08
55% off
|
$21,553.54
|
$71,564.48
|
$46,559.01
|
2026-01-02
|
|
27800000S2-21362
|
CDM
|
Wave Writer Alpha Implantable Pulse Generator Kit
|
30
|
12
|
$84,193.50
|
$37,887.08
55% off
|
$21,553.54
|
$71,564.48
|
$46,559.01
|
2026-01-02
|
|
27800000S2-21363
|
CDM
|
Implantable Pulse Generator Kit
|
30
|
12
|
$84,193.50
|
$37,887.08
55% off
|
$21,553.54
|
$71,564.48
|
$46,559.01
|
2026-01-02
|
|
27800000S2-21360
|
CDM
|
Wavewriter Alpha Prime Implantable Pulse Generator Kit
|
30
|
12
|
$84,193.50
|
$37,887.08
55% off
|
$21,553.54
|
$71,564.48
|
$46,559.01
|
2026-01-02
|
|
3110000001-3348-7028
|
CDM
|
Hc Auto Islet Isolation
|
11
|
8
|
$100,687.00
|
$45,309.15
55% off
|
$25,775.87
|
$85,583.95
|
$46,175.06
|
2026-01-02
|
|
1301
|
APR_DRG
|
Respiratory System Diagnosis With Ventilator Support > 96 Hours
|
40
|
5
|
—
|
—
|
$36,634.01
|
$78,459.76
|
$46,131.80
|
2026-01-02
|
|
245
|
MS_DRG
|
Aicd Generator Procedures
|
30
|
9
|
—
|
—
|
$34,395.11
|
$195,921.59
|
$46,088.01
|
2026-01-02
|
|
471
|
MS_DRG
|
Cervical Spinal Fusion With Mcc
|
30
|
9
|
—
|
—
|
$36,834.10
|
$194,738.87
|
$45,812.71
|
2026-01-02
|
|
799
|
MS_DRG
|
Splenic Procedures With Mcc
|
30
|
9
|
—
|
—
|
$36,071.32
|
$190,629.44
|
$45,413.13
|
2026-01-02
|
|
27200000S2-31551
|
CDM
|
Device Left Ventricular Assist
|
31
|
8
|
$92,250.00
|
$41,512.50
55% off
|
$21,516.80
|
$78,412.50
|
$45,134.85
|
2026-01-02
|
|
826
|
MS_DRG
|
Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. …
|
30
|
9
|
—
|
—
|
$35,126.07
|
$191,459.35
|
$45,049.31
|
2026-01-02
|
|
274
|
MS_DRG
|
Percutaneous Intracardiac Procedures Without Mcc
|
22
|
9
|
—
|
—
|
$28,709.73
|
$125,127.13
|
$44,859.69
|
2026-01-02
|
|
981
|
MS_DRG
|
Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc
|
30
|
9
|
—
|
—
|
$35,981.51
|
$190,593.36
|
$44,847.73
|
2026-01-02
|
|
6
|
MS_DRG
|
Liver Transplant Without Mcc
|
26
|
9
|
—
|
—
|
$36,713.99
|
$194,414.13
|
$44,579.07
|
2026-01-02
|
|
5024255401
|
NDC
|
Ocrelizumab-hyaluronidase-ocsq 920-23000 Mg-ut/23ml Sc Soln [200072]
|
39
|
11
|
$90,880.25
|
$40,896.11
55% off
|
$45.11
|
$175,448.16
|
$44,258.68
|
2026-01-02
|
|
823
|
MS_DRG
|
Lymphoma And Non-acute Leukemia With Other Procedures With Mcc
|
30
|
9
|
—
|
—
|
$34,171.20
|
$187,610.51
|
$44,153.39
|
2026-01-02
|
|
469
|
MS_DRG
|
Major Joint Replacement Or Reattachment Of Lower Extremity W Mcc
|
22
|
9
|
—
|
—
|
$30,024.55
|
$131,048.72
|
$44,147.06
|
2026-01-02
|
|
277
|
MS_DRG
|
Cardiac Defibrillator Implant Without Mcc
|
29
|
9
|
—
|
—
|
$35,305.56
|
$186,503.97
|
$44,031.19
|
2026-01-02
|
|
27800000S2-21361
|
CDM
|
Wavewriter Alpha 16 Implantable Pulse Generator Kit
|
58
|
12
|
$84,193.50
|
$37,887.08
55% off
|
$16,328.63
|
$71,564.48
|
$43,946.56
|
2026-01-02
|
|
27800000S2-3443
|
CDM
|
Cath Impella 5.5
|
30
|
12
|
$78,750.00
|
$35,437.50
55% off
|
$20,160.00
|
$66,937.50
|
$43,548.75
|
2026-01-02
|
|
27800000S2-3442
|
CDM
|
Use Item # 409163 - Cath Impella 5.5
|
30
|
12
|
$78,750.00
|
$35,437.50
55% off
|
$20,160.00
|
$66,937.50
|
$43,548.75
|
2026-01-02
|
|
J9226
|
HCPCS
|
Supprelin La Implant
|
11
|
7
|
—
|
—
|
$35,757.47
|
$45,677.07
|
$43,501.97
|
2026-01-02
|
|
6797900201
|
NDC
|
Histrelin Acetate (cpp) 50 Mg Sc Kit [93924]
|
21
|
11
|
$0.05
|
—
|
$0.03
|
$56,494.88
|
$43,501.97
|
2026-01-02
|
|
4803327601-3348-5468
|
CDM
|
Hc Insertion Phrenic Nerve Stimulator System
|
28
|
11
|
$139,727.00
|
$62,877.15
55% off
|
$1,018.29
|
$118,767.95
|
$43,356.21
|
2026-01-02
|
|
221
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
30
|
9
|
—
|
—
|
$34,864.26
|
$184,126.52
|
$43,342.39
|
2026-01-02
|
|
329
|
MS_DRG
|
Major Small And Large Bowel Procedures With Mcc
|
30
|
9
|
—
|
—
|
$34,284.30
|
$184,098.45
|
$43,335.85
|
2026-01-02
|
|
163
|
MS_DRG
|
Major Chest Procedures With Mcc
|
27
|
9
|
—
|
—
|
$34,987.79
|
$184,792.05
|
$43,292.96
|
2026-01-02
|
|
321
|
MS_DRG
|
Percutaneous Cardiovascular Procedures With Intraluminal Device With Mmc Or 4+ A…
|
21
|
9
|
—
|
—
|
$26,268.83
|
$104,332.37
|
$43,077.78
|
2026-01-02
|
|
33276
|
HCPCS
|
Insj Phrnc Nrv Stim Sys
|
11
|
7
|
—
|
—
|
$28,874.18
|
$45,115.75
|
$42,967.38
|
2026-01-02
|
|
6901
|
APR_DRG
|
Acute Leukemia
|
40
|
5
|
—
|
—
|
$14,932.57
|
$103,569.81
|
$42,954.71
|
2026-01-02
|
|
3041
|
APR_DRG
|
Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back
|
40
|
5
|
—
|
—
|
$27,874.22
|
$96,093.70
|
$42,643.26
|
2026-01-02
|
|
856
|
MS_DRG
|
Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc
|
30
|
9
|
—
|
—
|
$33,613.30
|
$180,879.07
|
$42,586.46
|
2026-01-02
|
|
1671
|
APR_DRG
|
Other Cardiothoracic And Thoracic Vascular Procedures
|
40
|
5
|
—
|
—
|
$24,517.42
|
$79,528.77
|
$42,469.07
|
2026-01-02
|
|
650
|
MS_DRG
|
Kidney Transplant With Hemodialysis With Mcc
|
26
|
9
|
—
|
—
|
$34,137.80
|
$184,715.87
|
$42,402.01
|
2026-01-02
|
|
474
|
MS_DRG
|
Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc
|
30
|
9
|
—
|
—
|
$32,659.96
|
$179,800.59
|
$42,335.41
|
2026-01-02
|
|
27800000S2-5692
|
CDM
|
Sc-1232 Implantable Pulse Generator Kit
|
30
|
12
|
$76,538.80
|
$34,442.46
55% off
|
$19,593.93
|
$65,057.98
|
$42,325.96
|
2026-01-02
|
|
27200000S2-34209
|
CDM
|
Impella 5.5 With Smartassist
|
13
|
8
|
$92,250.00
|
$41,512.50
55% off
|
$23,616.00
|
$78,412.50
|
$42,305.85
|
2026-01-02
|
|
1651
|
APR_DRG
|
Coronary Bypass With Ami Or Complex Principal Diagnosis
|
40
|
5
|
—
|
—
|
$32,165.29
|
$71,069.55
|
$42,147.11
|
2026-01-02
|
|
8631
|
APR_DRG
|
Neonatal Aftercare
|
40
|
5
|
—
|
—
|
$13,860.13
|
$102,348.68
|
$41,903.49
|
2026-01-02
|
|
901
|
MS_DRG
|
Wound Debridements For Injuries With Mcc
|
30
|
9
|
—
|
—
|
$32,849.71
|
$177,627.61
|
$41,829.59
|
2026-01-02
|
|
458
|
MS_DRG
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
30
|
9
|
—
|
—
|
$32,820.74
|
$173,117.26
|
$41,510.07
|
2026-01-02
|
|
319
|
MS_DRG
|
Other Endovascular Cardiac Valve Procedures With Mcc
|
30
|
9
|
—
|
—
|
$33,108.55
|
$176,116.14
|
$41,477.76
|
2026-01-02
|
|
7133610001
|
NDC
|
Patisiran Sodium 10 Mg/5ml IV Soln [162886]
|
86
|
12
|
$112,136.10
|
$50,461.25
55% off
|
$95.31
|
$128,252.00
|
$41,408.26
|
2026-01-02
|
|
25
|
MS_DRG
|
Craniotomy And Endovascular Intracranial Procedures With Mcc
|
27
|
9
|
—
|
—
|
$33,519.18
|
$179,303.45
|
$41,227.77
|
2026-01-02
|
|
462
|
MS_DRG
|
Bilateral Or Multiple Major Joint Procs Of Lower Extremity Without Mcc
|
22
|
9
|
—
|
—
|
$26,420.16
|
$104,955.41
|
$41,162.83
|
2026-01-02
|
|
510
|
MS_DRG
|
Shoulder,elbow Or Forearm Proc,exc Major Joint Proc W Mcc
|
22
|
9
|
—
|
—
|
$25,759.70
|
$104,746.51
|
$41,080.90
|
2026-01-02
|
|
27800000S2-21755
|
CDM
|
25mm Harmony Transcatheter Pulmonary Valve
|
30
|
12
|
$74,250.00
|
$33,412.50
55% off
|
$19,008.00
|
$63,112.50
|
$41,060.25
|
2026-01-02
|
|
5789406103
|
NDC
|
Ustekinumab 90 Mg/ml Sc Sosy [126168]
|
25
|
12
|
$145,757.30
|
$65,590.79
55% off
|
$150.56
|
$123,893.71
|
$41,001.53
|
2026-01-02
|
|
933
|
MS_DRG
|
Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft
|
30
|
9
|
—
|
—
|
$23,167.06
|
$173,474.07
|
$40,862.74
|
2026-01-02
|
|
323
|
MS_DRG
|
Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc
|
29
|
9
|
—
|
—
|
$31,424.23
|
$170,767.86
|
$40,397.43
|
2026-01-02
|
|
356
|
MS_DRG
|
Other Digestive System O.r. Procedures With Mcc
|
30
|
9
|
—
|
—
|
$32,431.54
|
$171,020.44
|
$40,291.60
|
2026-01-02
|
|
8501
|
APR_DRG
|
Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal…
|
40
|
5
|
—
|
—
|
$18,923.62
|
$110,933.25
|
$40,070.87
|
2026-01-02
|
|
27800000S2-3309
|
CDM
|
Kit Nrstm Rns Vns
|
58
|
12
|
$74,435.50
|
$33,495.98
55% off
|
$17,790.72
|
$63,270.18
|
$39,971.86
|
2026-01-02
|
|
27800000S2-21834
|
CDM
|
Thoraflex Hybrid Ante-flo Hybrid Stent Device 30/32 X10mm
|
30
|
12
|
$71,750.00
|
$32,287.50
55% off
|
$18,368.00
|
$60,987.50
|
$39,677.75
|
2026-01-02
|
|
27800000S2-9311
|
CDM
|
Graft Thoraflex Hybrid Plexus 100 30mmx32mm
|
30
|
12
|
$71,750.00
|
$32,287.50
55% off
|
$18,368.00
|
$60,987.50
|
$39,677.75
|
2026-01-02
|
|
27800000S2-21835
|
CDM
|
Thoraflex Hybrid Ante-flo Hybrid Stent Device
|
30
|
12
|
$71,750.00
|
$32,287.50
55% off
|
$18,368.00
|
$60,987.50
|
$39,677.75
|
2026-01-02
|
|
27800000S2-9310
|
CDM
|
Graft Thoraflex Hybrid Plexus 150 30mmx32mm
|
30
|
12
|
$71,750.00
|
$32,287.50
55% off
|
$18,368.00
|
$60,987.50
|
$39,677.75
|
2026-01-02
|
|
27800000S2-21833
|
CDM
|
Thoraflex Hybrid Ante-flo Stent Device
|
30
|
12
|
$71,750.00
|
$32,287.50
55% off
|
$18,368.00
|
$60,987.50
|
$39,677.75
|
2026-01-02
|
|
673
|
MS_DRG
|
Other Kidney And Urinary Tract Procedures With Mcc
|
30
|
9
|
—
|
—
|
$28,069.28
|
$167,969.44
|
$39,581.40
|
2026-01-02
|
|
3110000002-3348-7027
|
CDM
|
Hc Auto Islet Isolation Aborted Case
|
11
|
8
|
$86,118.00
|
$38,753.10
55% off
|
$22,046.21
|
$73,200.30
|
$39,493.71
|
2026-01-02
|
|
269
|
MS_DRG
|
Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc
|
30
|
9
|
—
|
—
|
$31,565.42
|
$166,810.78
|
$39,311.68
|
2026-01-02
|
|
4810569T01-3348-5340
|
CDM
|
Hc Ttvr Percutaneous Approach Initial Prosthesis
|
30
|
12
|
$84,749.00
|
$38,137.05
55% off
|
$21,321.50
|
$72,036.65
|
$39,264.21
|
2026-01-02
|
|
140
|
MS_DRG
|
Major Head And Neck Procedures With Mcc
|
27
|
9
|
—
|
—
|
$28,677.27
|
$169,557.09
|
$39,037.74
|
2026-01-02
|
|
236
|
MS_DRG
|
Coronary Bypass Without Cardiac Catheterization Without Mcc
|
30
|
9
|
—
|
—
|
$30,674.30
|
$164,862.31
|
$38,858.12
|
2026-01-02
|
|
958
|
MS_DRG
|
Other O.r. Procedures For Multiple Significant Trauma With Cc
|
30
|
9
|
—
|
—
|
$30,701.63
|
$164,770.10
|
$38,836.66
|
2026-01-02
|
|
27800000S2-21904
|
CDM
|
Wavewriter Alpha
|
30
|
12
|
$70,161.25
|
$31,572.56
55% off
|
$17,961.28
|
$59,637.06
|
$38,799.17
|
2026-01-02
|
|
27800000S2-21902
|
CDM
|
Wavewriter Alpha Prime Pulse Generator
|
30
|
12
|
$70,161.25
|
$31,572.56
55% off
|
$17,961.28
|
$59,637.06
|
$38,799.17
|
2026-01-02
|
|
31
|
MS_DRG
|
Ventricular Shunt Procedures With Mcc
|
27
|
9
|
—
|
—
|
$31,246.62
|
$168,009.54
|
$38,690.00
|
2026-01-02
|
|
793
|
MS_DRG
|
Full Term Neonate With Major Problems
|
28
|
9
|
—
|
—
|
$27,091.57
|
$109,190.00
|
$38,682.68
|
2026-01-02
|
|
423
|
MS_DRG
|
Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc
|
30
|
9
|
—
|
—
|
$29,685.27
|
$163,070.20
|
$38,440.96
|
2026-01-02
|
|
27800000S2-21918
|
CDM
|
Rns Neurostimulator Kit
|
30
|
12
|
$69,495.00
|
$31,272.75
55% off
|
$17,790.72
|
$59,070.75
|
$38,430.74
|
2026-01-02
|
|
27800000S2-9628
|
CDM
|
Mesh Xenmatrix 30cm X 40cm
|
44
|
12
|
$69,331.00
|
$31,198.95
55% off
|
$17,594.71
|
$58,931.35
|
$38,263.03
|
2026-01-02
|
|
13
|
MS_DRG
|
Tracheostomy For Face,mouth & Neck Diagnoses Without Cc/mcc
|
22
|
9
|
—
|
—
|
$24,516.93
|
$97,119.85
|
$38,089.78
|
2026-01-02
|
|
5024215001
|
NDC
|
Ocrelizumab 300 Mg/10ml IV Soln [137896]
|
128
|
12
|
$90,820.25
|
$40,869.11
55% off
|
$57.00
|
$175,448.16
|
$38,072.54
|
2026-01-02
|
|
791
|
MS_DRG
|
Prematurity With Major Problems
|
28
|
9
|
—
|
—
|
$26,373.11
|
$106,294.00
|
$37,693.59
|
2026-01-02
|
|
907
|
MS_DRG
|
Other O.r. Procedures For Injuries With Mcc
|
30
|
9
|
—
|
—
|
$28,232.47
|
$159,714.50
|
$37,659.83
|
2026-01-02
|
|
211
|
APR_DRG
|
Open Craniotomy Except Trauma
|
40
|
5
|
—
|
—
|
$22,780.46
|
$75,107.61
|
$37,535.57
|
2026-01-02
|
|
6231
|
APR_DRG
|
Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection
|
40
|
5
|
—
|
—
|
$12,687.68
|
$66,683.61
|
$37,453.66
|
2026-01-02
|
|
27800000S2-3511
|
CDM
|
Harmony Transcatheter Pulmonary Valve Tpv 25
|
30
|
12
|
$67,650.00
|
$30,442.50
55% off
|
$17,318.40
|
$57,502.50
|
$37,410.45
|
2026-01-02
|
|
628
|
MS_DRG
|
Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc
|
30
|
9
|
—
|
—
|
$30,050.17
|
$158,191.00
|
$37,317.94
|
2026-01-02
|
|
1661
|
APR_DRG
|
Coronary Bypass Without Ami Or Complex Principal Diagnosis
|
40
|
5
|
—
|
—
|
$25,233.25
|
$52,497.59
|
$37,283.13
|
2026-01-02
|
|
8901
|
APR_DRG
|
HIV With Multiple Major HIV Related Conditions
|
40
|
5
|
—
|
—
|
$10,903.35
|
$95,262.70
|
$37,265.32
|
2026-01-02
|
|
166
|
MS_DRG
|
Other Respiratory System O.r. Procedures With Mcc
|
30
|
9
|
—
|
—
|
$29,340.22
|
$154,366.23
|
$37,242.81
|
2026-01-02
|
|
736
|
MS_DRG
|
Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc
|
30
|
9
|
—
|
—
|
$29,505.38
|
$157,866.26
|
$37,229.60
|
2026-01-02
|
|
876
|
MS_DRG
|
O.r. Procedures With Principal Diagnosis Of Mental Illness
|
30
|
9
|
—
|
—
|
$28,323.56
|
$157,545.52
|
$37,154.94
|
2026-01-02
|
|
8421
|
APR_DRG
|
Burns With Skin Graft Except Extensive Third Degree Burns
|
40
|
5
|
—
|
—
|
$17,232.72
|
$149,472.98
|
$37,040.03
|
2026-01-02
|
|
27800000S1-29308
|
CDM
|
Valve Heart Sapien 3 Thv 20mm
|
30
|
12
|
$66,625.00
|
$29,981.25
55% off
|
$17,056.00
|
$56,631.25
|
$36,843.62
|
2026-01-02
|
|
27800000S1-29088
|
CDM
|
Vlv Aor 26mm Edwrd Sapien 3
|
30
|
12
|
$66,625.00
|
$29,981.25
55% off
|
$17,056.00
|
$56,631.25
|
$36,843.62
|
2026-01-02
|
|
27800000S1-29087
|
CDM
|
Vlv Aor 26mm Sapien 3 Cmndr
|
30
|
12
|
$66,625.00
|
$29,981.25
55% off
|
$17,056.00
|
$56,631.25
|
$36,843.62
|
2026-01-02
|
|
27800000S1-29093
|
CDM
|
Valve Thv Sapien3 Xt 26mm
|
30
|
12
|
$66,625.00
|
$29,981.25
55% off
|
$17,056.00
|
$56,631.25
|
$36,843.62
|
2026-01-02
|
|
27800000S1-29090
|
CDM
|
Vlv Aor 23mm Edwrd Sapien 3
|
30
|
12
|
$66,625.00
|
$29,981.25
55% off
|
$17,056.00
|
$56,631.25
|
$36,843.62
|
2026-01-02
|
|
27800000S1-29095
|
CDM
|
Valve Aortic Od23 Mm Sapien 3 Ultra Valve Commander
|
30
|
12
|
$66,625.00
|
$29,981.25
55% off
|
$17,056.00
|
$56,631.25
|
$36,843.62
|
2026-01-02
|
|
27800000S1-29089
|
CDM
|
Vlv Aor 23mm Sapien 3 Cmndr
|
30
|
12
|
$66,625.00
|
$29,981.25
55% off
|
$17,056.00
|
$56,631.25
|
$36,843.62
|
2026-01-02
|
|
27800000S1-29092
|
CDM
|
Valve Thv Sapien3 Xt 29mm
|
30
|
12
|
$66,625.00
|
$29,981.25
55% off
|
$17,056.00
|
$56,631.25
|
$36,843.62
|
2026-01-02
|
|
27800000S1-29094
|
CDM
|
Valve Thv Sapien3 Xt 23mm
|
30
|
12
|
$66,625.00
|
$29,981.25
55% off
|
$17,056.00
|
$56,631.25
|
$36,843.62
|
2026-01-02
|