|
J1414
|
HCPCS
|
Inj, Beqvez, Per Tx Dose
|
7
|
7
|
—
|
—
|
$3,635,800.00
|
$3,817,590.00
|
$3,744,874.00
|
2025-07-28
|
|
J1411
|
HCPCS
|
Inj, Hemgenix, Per Tx Dose
|
7
|
7
|
—
|
—
|
$3,611,561.33
|
$3,792,139.40
|
$3,719,908.17
|
2025-07-28
|
|
J1413
|
HCPCS
|
Inj Delandistrogene Mox Rokl
|
7
|
7
|
—
|
—
|
$3,256,023.83
|
$3,418,825.02
|
$3,353,704.54
|
2025-07-28
|
|
J3394
|
HCPCS
|
Inj, Lovotibeglogene Autotem
|
7
|
7
|
—
|
—
|
$3,220,280.00
|
$3,381,294.00
|
$3,316,888.40
|
2025-07-28
|
|
J3393
|
HCPCS
|
Inj, Betibeglogene Autotemce
|
8
|
7
|
—
|
—
|
$2,889,249.07
|
$4,871,273.93
|
$2,975,926.54
|
2025-07-28
|
|
J3399
|
HCPCS
|
Inj Onase Abepar-xioi Treat
|
10
|
8
|
—
|
—
|
$2,374,668.61
|
$4,393,136.92
|
$2,457,782.00
|
2025-07-28
|
|
J3392
|
HCPCS
|
Inj, Exagamglogene Autotem
|
10
|
8
|
—
|
—
|
$2,285,360.00
|
$4,227,916.00
|
$2,365,347.60
|
2025-07-28
|
|
Q2056
|
HCPCS
|
Ciltacabtagene Car-pos T
|
15
|
9
|
—
|
—
|
$542,105.91
|
$1,902,048.26
|
$788,640.00
|
2025-07-28
|
|
Q2057
|
HCPCS
|
Afamitresgene Autoleucel
|
10
|
8
|
—
|
—
|
$755,207.60
|
$1,397,134.06
|
$781,639.86
|
2025-07-28
|
|
Q2042
|
HCPCS
|
Tisagenlecleucel Car-pos T
|
15
|
9
|
—
|
—
|
$567,195.70
|
$2,239,870.39
|
$761,878.92
|
2025-07-28
|
|
Q2055
|
HCPCS
|
Idecabtagene Vicleucel Car
|
15
|
9
|
—
|
—
|
$517,070.01
|
$2,092,117.21
|
$711,472.00
|
2025-07-28
|
|
Q2053
|
HCPCS
|
Brexucabtagene Car Pos T
|
15
|
9
|
—
|
—
|
$479,611.17
|
$1,932,630.48
|
$697,625.99
|
2025-07-28
|
|
Q2041
|
HCPCS
|
Axicabtagene Ciloleucel Car+
|
15
|
9
|
—
|
—
|
$492,783.91
|
$1,938,487.92
|
$695,932.84
|
2025-07-28
|
|
Q2054
|
HCPCS
|
Lisocabtagene Mara Car Pos T
|
15
|
9
|
—
|
—
|
$506,113.44
|
$2,045,284.43
|
$695,868.80
|
2025-07-28
|
|
18
|
MS_DRG
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
22
|
13
|
—
|
—
|
$304,236.63
|
$788,461.51
|
$527,494.52
|
2025-07-28
|
|
5834
|
APR_DRG
|
Neonate With Ecmo
|
5
|
5
|
—
|
—
|
$362,861.68
|
$381,004.77
|
$373,747.53
|
2025-07-28
|
|
1
|
MS_DRG
|
Heart Transplant Or Implant Of Heart Assist System With Mcc
|
24
|
14
|
—
|
—
|
$227,429.94
|
$603,053.38
|
$370,669.04
|
2025-07-28
|
|
927
|
MS_DRG
|
Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft
|
23
|
13
|
—
|
—
|
$161,564.59
|
$495,972.58
|
$323,132.05
|
2025-07-28
|
|
5833
|
APR_DRG
|
Neonate With Ecmo
|
5
|
5
|
—
|
—
|
$291,504.25
|
$306,079.46
|
$300,249.38
|
2025-07-28
|
|
5884
|
APR_DRG
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
5
|
5
|
—
|
—
|
$287,430.11
|
$301,801.61
|
$296,053.01
|
2025-07-28
|
|
3
|
MS_DRG
|
Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mo…
|
24
|
14
|
—
|
—
|
$168,114.82
|
$448,070.46
|
$286,811.57
|
2025-07-28
|
|
C9301
|
HCPCS
|
Apc
|
10
|
8
|
—
|
—
|
$272,685.00
|
$504,467.25
|
$282,228.97
|
2025-07-28
|
|
1614
|
APR_DRG
|
Implantable Heart Assist Systems
|
5
|
5
|
—
|
—
|
$222,539.80
|
$233,666.79
|
$229,215.99
|
2025-07-28
|
|
8414
|
APR_DRG
|
Extensive Third Degree Burns With Skin Graft
|
5
|
5
|
—
|
—
|
$200,336.49
|
$210,353.31
|
$206,346.58
|
2025-07-28
|
|
5832
|
APR_DRG
|
Neonate With Ecmo
|
5
|
5
|
—
|
—
|
$197,789.90
|
$207,679.40
|
$203,723.60
|
2025-07-28
|
|
5914
|
APR_DRG
|
Neonate Birth Weight 500-749 Grams Without Major Procedure
|
5
|
5
|
—
|
—
|
$196,241.97
|
$206,054.07
|
$202,129.23
|
2025-07-28
|
|
6094
|
APR_DRG
|
Neonate Birth Weight 1500-2499 Grams With Major Procedure
|
5
|
5
|
—
|
—
|
$192,238.77
|
$201,850.71
|
$198,005.93
|
2025-07-28
|
|
4
|
MS_DRG
|
Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And …
|
24
|
14
|
—
|
—
|
$105,558.12
|
$295,415.91
|
$193,561.77
|
2025-07-28
|
|
5883
|
APR_DRG
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
5
|
5
|
—
|
—
|
$175,206.39
|
$183,966.71
|
$180,462.58
|
2025-07-28
|
|
94
|
APR_DRG
|
Extracorporeal Membrane Oxygenation (ecmo)
|
5
|
5
|
—
|
—
|
$173,033.19
|
$181,684.85
|
$178,224.19
|
2025-07-28
|
|
6314
|
APR_DRG
|
Neonate Birth Weight > 2499 Grams With Other Major Procedure
|
5
|
5
|
—
|
—
|
$171,391.97
|
$179,961.57
|
$176,533.73
|
2025-07-28
|
|
7
|
MS_DRG
|
Lung Transplant
|
24
|
14
|
—
|
—
|
$93,403.90
|
$273,229.40
|
$170,292.52
|
2025-07-28
|
|
6304
|
APR_DRG
|
Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure
|
5
|
5
|
—
|
—
|
$165,069.95
|
$173,323.45
|
$170,022.05
|
2025-07-28
|
|
5934
|
APR_DRG
|
Neonate Birth Weight 750-999 Grams Without Major Procedure
|
5
|
5
|
—
|
—
|
$162,922.15
|
$171,068.26
|
$167,809.81
|
2025-07-28
|
|
14
|
MS_DRG
|
Allogeneic Bone Marrow Transplant
|
24
|
14
|
—
|
—
|
$106,186.50
|
$273,919.33
|
$165,197.27
|
2025-07-28
|
|
5831
|
APR_DRG
|
Neonate With Ecmo
|
5
|
5
|
—
|
—
|
$156,278.11
|
$164,092.01
|
$160,966.45
|
2025-07-28
|
|
2
|
MS_DRG
|
Heart Transplant Or Implant Of Heart Assist System Without Mcc
|
24
|
14
|
—
|
—
|
$89,431.38
|
$331,683.42
|
$160,046.99
|
2025-07-28
|
|
1613
|
APR_DRG
|
Implantable Heart Assist Systems
|
5
|
5
|
—
|
—
|
$155,150.12
|
$162,907.63
|
$159,804.63
|
2025-07-28
|
|
6034
|
APR_DRG
|
Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition
|
5
|
5
|
—
|
—
|
$152,624.94
|
$160,256.19
|
$157,203.69
|
2025-07-28
|
|
212
|
MS_DRG
|
Concomitant Aortic And Mitral Valve Procedures
|
19
|
12
|
—
|
—
|
$88,419.04
|
$227,758.77
|
$156,578.02
|
2025-07-28
|
|
44
|
APR_DRG
|
Tracheostomy With Mv >96 Hours With Extensive Procedure
|
5
|
5
|
—
|
—
|
$151,922.64
|
$159,518.77
|
$156,480.32
|
2025-07-28
|
|
426
|
MS_DRG
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
17
|
11
|
—
|
—
|
$85,051.28
|
$219,009.19
|
$150,562.92
|
2025-07-28
|
|
C2624
|
HCPCS
|
Hc Kit Intro Cardio Mem
|
50
|
18
|
$208,750.00
|
$83,500.00
60% off
|
$19,838.00
|
$237,929.04
|
$150,300.00
|
2025-07-28
|
|
C9741
|
HCPCS
|
Fee Schedule
|
1
|
1
|
—
|
—
|
$148,739.04
|
$148,739.04
|
$148,739.04
|
2025-07-28
|
|
215
|
MS_DRG
|
Other Heart Assist System Implant
|
24
|
14
|
—
|
—
|
$86,012.12
|
$232,307.48
|
$148,647.74
|
2025-07-28
|
|
L6700
|
HCPCS
|
Ue Add Ext Power Myoel
|
1
|
1
|
—
|
—
|
$145,786.13
|
$145,786.13
|
$145,786.13
|
2025-07-28
|
|
5
|
MS_DRG
|
Liver Transplant With Mcc Or Intestinal Transplant
|
24
|
14
|
—
|
—
|
$86,451.49
|
$222,647.01
|
$141,224.84
|
2025-07-28
|
|
850
|
MS_DRG
|
Acute Leukemia With Other Procedures
|
17
|
11
|
—
|
—
|
$74,883.62
|
$192,593.19
|
$132,402.64
|
2025-07-28
|
|
216
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
24
|
14
|
—
|
—
|
$78,417.95
|
$217,154.68
|
$130,195.29
|
2025-07-28
|
|
6024
|
APR_DRG
|
Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…
|
5
|
5
|
—
|
—
|
$126,077.03
|
$132,380.88
|
$129,859.34
|
2025-07-28
|
|
Q0480
|
HCPCS
|
Driver Pneumatic Vad, Rep
|
17
|
10
|
—
|
—
|
$97,999.91
|
$337,999.70
|
$124,999.89
|
2025-07-28
|
|
5891
|
APR_DRG
|
Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …
|
5
|
5
|
—
|
—
|
$121,203.78
|
$127,263.97
|
$124,839.89
|
2025-07-28
|
|
5892
|
APR_DRG
|
Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …
|
5
|
5
|
—
|
—
|
$116,915.88
|
$122,761.68
|
$120,423.36
|
2025-07-28
|
|
5913
|
APR_DRG
|
Neonate Birth Weight 500-749 Grams Without Major Procedure
|
5
|
5
|
—
|
—
|
$116,628.15
|
$122,459.56
|
$120,126.99
|
2025-07-28
|
|
429
|
MS_DRG
|
Combined Anterior And Posterior Cervical Spinal Fusion With Mcc
|
17
|
11
|
—
|
—
|
$67,872.07
|
$174,376.92
|
$119,879.44
|
2025-07-28
|
|
453
|
MS_DRG
|
DRG
|
8
|
5
|
—
|
—
|
$89,306.63
|
$191,410.75
|
$119,247.14
|
2025-07-28
|
|
5933
|
APR_DRG
|
Neonate Birth Weight 750-999 Grams Without Major Procedure
|
5
|
5
|
—
|
—
|
$112,827.19
|
$118,468.55
|
$116,212.01
|
2025-07-28
|
|
456
|
MS_DRG
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
24
|
14
|
—
|
—
|
$68,906.95
|
$179,012.44
|
$115,473.39
|
2025-07-28
|
|
20
|
MS_DRG
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc
|
24
|
14
|
—
|
—
|
$65,622.88
|
$214,864.48
|
$113,746.52
|
2025-07-28
|
|
1612
|
APR_DRG
|
Implantable Heart Assist Systems
|
5
|
5
|
—
|
—
|
$108,666.99
|
$114,100.34
|
$111,927.00
|
2025-07-28
|
|
1611
|
APR_DRG
|
Implantable Heart Assist Systems
|
5
|
5
|
—
|
—
|
$108,666.99
|
$114,100.34
|
$111,927.00
|
2025-07-28
|
|
231
|
MS_DRG
|
Coronary Bypass With Ptca With Mcc
|
24
|
14
|
—
|
—
|
$68,944.77
|
$177,163.83
|
$111,709.17
|
2025-07-28
|
|
19
|
MS_DRG
|
Simultaneous Pancreas And Kidney Transplant With Hemodialysis
|
22
|
13
|
—
|
—
|
$64,546.16
|
$165,736.06
|
$111,381.95
|
2025-07-28
|
|
0809T
|
CPT
|
Fee Schedule
|
1
|
1
|
—
|
—
|
$110,342.16
|
$110,342.16
|
$110,342.16
|
2025-07-28
|
|
0775T
|
CPT
|
Fee Schedule
|
1
|
1
|
—
|
—
|
$110,342.16
|
$110,342.16
|
$110,342.16
|
2025-07-28
|
|
K1007
|
HCPCS
|
Bil Hkaf Pc S/d Micro Sensor
|
2
|
2
|
—
|
—
|
$104,868.79
|
$115,588.71
|
$110,228.75
|
2025-07-28
|
|
5893
|
APR_DRG
|
Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …
|
5
|
5
|
—
|
—
|
$106,287.37
|
$111,601.74
|
$109,476.00
|
2025-07-28
|
|
5912
|
APR_DRG
|
Neonate Birth Weight 500-749 Grams Without Major Procedure
|
5
|
5
|
—
|
—
|
$105,507.63
|
$110,783.02
|
$108,672.86
|
2025-07-28
|
|
1604
|
APR_DRG
|
Major Cardiothoracic Repair Of Heart Anomaly
|
5
|
5
|
—
|
—
|
$105,175.01
|
$110,433.76
|
$108,330.26
|
2025-07-28
|
|
6074
|
APR_DRG
|
Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…
|
5
|
5
|
—
|
—
|
$105,106.25
|
$110,361.57
|
$108,259.44
|
2025-07-28
|
|
43
|
APR_DRG
|
Tracheostomy With Mv >96 Hours With Extensive Procedure
|
5
|
5
|
—
|
—
|
$103,883.02
|
$109,077.17
|
$106,999.51
|
2025-07-28
|
|
233
|
MS_DRG
|
Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc
|
24
|
14
|
—
|
—
|
$63,653.72
|
$163,417.47
|
$105,164.74
|
2025-07-28
|
|
219
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
24
|
14
|
—
|
—
|
$63,018.79
|
$167,707.18
|
$104,045.76
|
2025-07-28
|
|
8634
|
APR_DRG
|
Neonatal Aftercare
|
5
|
5
|
—
|
—
|
$100,199.79
|
$105,209.78
|
$103,205.78
|
2025-07-28
|
|
54
|
APR_DRG
|
Tracheostomy With Mv >96 Hours Without Extensive Procedure
|
5
|
5
|
—
|
—
|
$99,709.06
|
$104,694.52
|
$102,700.34
|
2025-07-28
|
|
8424
|
APR_DRG
|
Burns With Skin Graft Except Extensive Third Degree Burns
|
5
|
5
|
—
|
—
|
$99,626.03
|
$104,607.33
|
$102,614.81
|
2025-07-28
|
|
427
|
MS_DRG
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
17
|
11
|
—
|
—
|
$57,910.42
|
$148,496.15
|
$102,087.11
|
2025-07-28
|
|
275
|
MS_DRG
|
Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc
|
19
|
12
|
—
|
—
|
$57,623.13
|
$147,749.77
|
$101,573.99
|
2025-07-28
|
|
5932
|
APR_DRG
|
Neonate Birth Weight 750-999 Grams Without Major Procedure
|
5
|
5
|
—
|
—
|
$97,736.86
|
$102,623.70
|
$100,668.96
|
2025-07-28
|
|
J9029
|
HCPCS
|
Instill Adstiladrin, Tx Dose
|
15
|
9
|
—
|
—
|
$61,970.89
|
$218,737.05
|
$98,880.00
|
2025-07-28
|
|
447
|
MS_DRG
|
Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall…
|
17
|
11
|
—
|
—
|
$54,707.63
|
$140,175.16
|
$96,366.65
|
2025-07-28
|
|
6084
|
APR_DRG
|
Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition
|
5
|
5
|
—
|
—
|
$93,106.48
|
$97,761.80
|
$95,899.67
|
2025-07-28
|
|
957
|
MS_DRG
|
Other O.r. Procedures For Multiple Significant Trauma With Mcc
|
23
|
13
|
—
|
—
|
$60,819.49
|
$156,054.03
|
$95,519.63
|
2025-07-28
|
|
3034
|
APR_DRG
|
Dorsal And Lumbar Fusion Procedure For Curvature Of Back
|
5
|
5
|
—
|
—
|
$92,338.46
|
$96,955.39
|
$95,108.62
|
2025-07-28
|
|
1624
|
APR_DRG
|
Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis
|
5
|
5
|
—
|
—
|
$91,764.30
|
$96,352.51
|
$94,517.23
|
2025-07-28
|
|
870
|
MS_DRG
|
Septicemia Or Severe Sepsis With Mv >96 Hours
|
24
|
14
|
—
|
—
|
$56,733.92
|
$145,439.55
|
$93,819.40
|
2025-07-28
|
|
222
|
MS_DRG
|
DRG
|
6
|
3
|
—
|
—
|
$80,937.78
|
$175,327.30
|
$93,802.27
|
2025-07-28
|
|
928
|
MS_DRG
|
Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc
|
23
|
13
|
—
|
—
|
$54,403.02
|
$139,635.76
|
$91,388.48
|
2025-07-28
|
|
268
|
MS_DRG
|
Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc
|
24
|
14
|
—
|
—
|
$54,409.07
|
$144,794.77
|
$91,131.86
|
2025-07-28
|
|
207
|
MS_DRG
|
Respiratory System Diagnosis With Ventilator Support >96 Hours
|
24
|
14
|
—
|
—
|
$52,315.00
|
$135,209.75
|
$90,124.36
|
2025-07-28
|
|
0614T
|
CPT
|
Hc Rmvl&rplcmt Substernal Impltbl Defibrillator Pg
|
55
|
18
|
$124,117.00
|
$49,646.80
60% off
|
$5,481.40
|
$114,450.25
|
$89,364.24
|
2025-07-28
|
|
276
|
MS_DRG
|
Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator
|
19
|
12
|
—
|
—
|
$50,601.13
|
$129,506.32
|
$89,032.11
|
2025-07-28
|
|
969
|
MS_DRG
|
HIV With Extensive O.r. Procedures With Mcc
|
24
|
14
|
—
|
—
|
$51,646.46
|
$132,222.14
|
$88,921.18
|
2025-07-28
|
|
317
|
MS_DRG
|
Concomitant Left Atrial Appendage Closure And Cardiac Ablation
|
17
|
11
|
—
|
—
|
$50,536.75
|
$129,339.06
|
$88,917.13
|
2025-07-28
|
|
6023
|
APR_DRG
|
Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…
|
5
|
5
|
—
|
—
|
$85,955.98
|
$90,253.78
|
$88,534.66
|
2025-07-28
|
|
6114
|
APR_DRG
|
Neonate Birth Weight 1500-1999 Grams With Major Anomaly
|
5
|
5
|
—
|
—
|
$84,712.34
|
$88,947.96
|
$87,253.71
|
2025-07-28
|
|
5882
|
APR_DRG
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
5
|
5
|
—
|
—
|
$84,583.96
|
$88,813.16
|
$87,121.48
|
2025-07-28
|
|
5881
|
APR_DRG
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
5
|
5
|
—
|
—
|
$84,583.96
|
$88,813.16
|
$87,121.48
|
2025-07-28
|
|
A9604
|
HCPCS
|
C Samarium 153 Up To 150mci - A9604
|
60
|
18
|
$120,256.00
|
$48,102.40
60% off
|
$4,228.61
|
$86,584.32
|
$86,584.32
|
2025-07-28
|
|
217
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
24
|
14
|
—
|
—
|
$52,721.57
|
$135,180.10
|
$86,477.55
|
2025-07-28
|
|
461
|
MS_DRG
|
Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc
|
24
|
14
|
—
|
—
|
$46,668.09
|
$128,299.99
|
$86,366.72
|
2025-07-28
|
|
6303
|
APR_DRG
|
Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure
|
5
|
5
|
—
|
—
|
$82,417.53
|
$86,538.40
|
$84,890.05
|
2025-07-28
|
|
0302T
|
CPT
|
Fee Schedule
|
1
|
1
|
—
|
—
|
$84,488.21
|
$84,488.21
|
$84,488.21
|
2025-07-28
|
|
266
|
MS_DRG
|
Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc
|
24
|
14
|
—
|
—
|
$48,962.72
|
$147,763.70
|
$84,328.46
|
2025-07-28
|
|
573
|
MS_DRG
|
Skin Graft For Skin Ulcer Or Cellulitis With Mcc
|
24
|
14
|
—
|
—
|
$38,760.51
|
$128,749.49
|
$83,472.40
|
2025-07-28
|
|
33249
|
CPT
|
C Insert Or Replacement Permanent Implantable Defibrillator System,w/transvenous…
|
60
|
18
|
$115,208.00
|
$46,083.20
60% off
|
$5,481.40
|
$153,826.61
|
$82,949.76
|
2025-07-28
|
|
17
|
MS_DRG
|
Autologous Bone Marrow Transplant Without Cc/mcc
|
24
|
14
|
—
|
—
|
$43,191.23
|
$126,192.56
|
$82,371.34
|
2025-07-28
|
|
16
|
MS_DRG
|
Autologous Bone Marrow Transplant With Cc/mcc
|
24
|
14
|
—
|
—
|
$49,325.65
|
$140,039.48
|
$82,371.34
|
2025-07-28
|
|
0548T
|
CPT
|
Fee Schedule
|
1
|
1
|
—
|
—
|
$82,234.21
|
$82,234.21
|
$82,234.21
|
2025-07-28
|
|
8413
|
APR_DRG
|
Extensive Third Degree Burns With Skin Graft
|
5
|
5
|
—
|
—
|
$79,581.94
|
$83,561.04
|
$81,969.40
|
2025-07-28
|
|
28
|
MS_DRG
|
Spinal Procedures With Mcc
|
24
|
14
|
—
|
—
|
$49,676.50
|
$127,104.11
|
$81,670.64
|
2025-07-28
|
|
224
|
MS_DRG
|
DRG
|
6
|
3
|
—
|
—
|
$70,024.55
|
$153,281.00
|
$81,526.29
|
2025-07-28
|
|
459
|
MS_DRG
|
DRG
|
8
|
5
|
—
|
—
|
$57,595.62
|
$140,156.08
|
$81,440.93
|
2025-07-28
|
|
457
|
MS_DRG
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
24
|
14
|
—
|
—
|
$46,939.64
|
$135,371.64
|
$81,364.45
|
2025-07-28
|
|
232
|
MS_DRG
|
Coronary Bypass With Ptca Without Mcc
|
24
|
14
|
—
|
—
|
$49,911.48
|
$127,714.59
|
$81,356.96
|
2025-07-28
|
|
454
|
MS_DRG
|
DRG
|
8
|
5
|
—
|
—
|
$59,236.94
|
$126,962.44
|
$80,893.29
|
2025-07-28
|
|
955
|
MS_DRG
|
Craniotomy For Multiple Significant Trauma
|
23
|
13
|
—
|
—
|
$55,702.26
|
$142,759.27
|
$80,433.27
|
2025-07-28
|
|
21
|
MS_DRG
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc
|
24
|
14
|
—
|
—
|
$45,232.83
|
$156,807.91
|
$80,276.68
|
2025-07-28
|
|
820
|
MS_DRG
|
Lymphoma And Leukemia With Major O.r. Procedures With Mcc
|
24
|
14
|
—
|
—
|
$47,606.76
|
$121,726.83
|
$80,061.89
|
2025-07-28
|
|
1784
|
APR_DRG
|
External Heart Assist Systems
|
5
|
5
|
—
|
—
|
$77,101.74
|
$80,956.83
|
$79,414.80
|
2025-07-28
|
|
235
|
MS_DRG
|
Coronary Bypass Without Cardiac Catheterization With Mcc
|
24
|
14
|
—
|
—
|
$48,104.88
|
$125,548.76
|
$79,384.96
|
2025-07-28
|
|
6022
|
APR_DRG
|
Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…
|
5
|
5
|
—
|
—
|
$77,037.90
|
$80,889.80
|
$79,349.04
|
2025-07-28
|
|
33276
|
CPT
|
Insj Phrnc Nrv Stim Sys
|
15
|
10
|
—
|
—
|
$47,048.17
|
$226,757.52
|
$79,323.21
|
2025-07-28
|
|
6093
|
APR_DRG
|
Neonate Birth Weight 1500-2499 Grams With Major Procedure
|
5
|
5
|
—
|
—
|
$76,877.86
|
$80,721.75
|
$79,184.19
|
2025-07-28
|
|
428
|
MS_DRG
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
17
|
11
|
—
|
—
|
$45,046.13
|
$115,074.22
|
$79,110.43
|
2025-07-28
|
|
93
|
APR_DRG
|
Extracorporeal Membrane Oxygenation (ecmo)
|
5
|
5
|
—
|
—
|
$76,583.10
|
$80,412.26
|
$78,880.60
|
2025-07-28
|
|
430
|
MS_DRG
|
Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc
|
17
|
11
|
—
|
—
|
$44,775.75
|
$114,371.74
|
$78,627.50
|
2025-07-28
|
|
1634
|
APR_DRG
|
Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis
|
5
|
5
|
—
|
—
|
$76,334.90
|
$80,151.65
|
$78,624.95
|
2025-07-28
|
|
218
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
24
|
14
|
—
|
—
|
$48,628.76
|
$124,382.02
|
$78,612.20
|
2025-07-28
|
|
5911
|
APR_DRG
|
Neonate Birth Weight 500-749 Grams Without Major Procedure
|
5
|
5
|
—
|
—
|
$76,071.00
|
$79,874.55
|
$78,353.13
|
2025-07-28
|
|
23
|
MS_DRG
|
Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…
|
24
|
14
|
—
|
—
|
$46,663.62
|
$119,276.53
|
$76,771.35
|
2025-07-28
|
|
1674
|
APR_DRG
|
Other Cardiothoracic And Thoracic Vascular Procedures
|
5
|
5
|
—
|
—
|
$73,876.95
|
$77,570.80
|
$76,093.26
|
2025-07-28
|
|
6033
|
APR_DRG
|
Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition
|
5
|
5
|
—
|
—
|
$73,580.81
|
$77,259.85
|
$75,788.23
|
2025-07-28
|
|
834
|
MS_DRG
|
Acute Leukemia With Mcc
|
24
|
14
|
—
|
—
|
$45,232.83
|
$125,963.08
|
$75,104.27
|
2025-07-28
|
|
42
|
APR_DRG
|
Tracheostomy With Mv >96 Hours With Extensive Procedure
|
5
|
5
|
—
|
—
|
$72,765.25
|
$76,403.51
|
$74,948.21
|
2025-07-28
|
|
226
|
MS_DRG
|
DRG
|
6
|
3
|
—
|
—
|
$64,227.03
|
$137,657.68
|
$74,796.47
|
2025-07-28
|
|
576
|
MS_DRG
|
Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc
|
24
|
14
|
—
|
—
|
$43,237.97
|
$112,799.54
|
$74,764.16
|
2025-07-28
|
|
463
|
MS_DRG
|
Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …
|
24
|
14
|
—
|
—
|
$44,216.47
|
$112,918.71
|
$74,674.73
|
2025-07-28
|
|
0387T
|
CPT
|
Fee Schedule
|
1
|
1
|
—
|
—
|
$74,487.20
|
$74,487.20
|
$74,487.20
|
2025-07-28
|
|
653
|
MS_DRG
|
Major Bladder Procedures With Mcc
|
24
|
14
|
—
|
—
|
$45,613.46
|
$116,548.16
|
$74,200.86
|
2025-07-28
|
|
69715
|
CPT
|
Fee Schedule
|
1
|
1
|
—
|
—
|
$74,094.11
|
$74,094.11
|
$74,094.11
|
2025-07-28
|
|
450
|
MS_DRG
|
Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically …
|
17
|
11
|
—
|
—
|
$42,197.42
|
$107,673.14
|
$74,022.39
|
2025-07-28
|
|
6254
|
APR_DRG
|
Neonate Birth Weight 2000-2499 Grams With Other Significant Condition
|
5
|
5
|
—
|
—
|
$71,751.77
|
$75,339.36
|
$73,904.32
|
2025-07-28
|
|
405
|
MS_DRG
|
Pancreas, Liver And Shunt Procedures With Mcc
|
24
|
14
|
—
|
—
|
$44,439.37
|
$119,309.01
|
$73,815.98
|
2025-07-28
|
|
6804
|
APR_DRG
|
Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms
|
5
|
5
|
—
|
—
|
$71,162.79
|
$74,720.93
|
$73,297.68
|
2025-07-28
|
|
3033
|
APR_DRG
|
Dorsal And Lumbar Fusion Procedure For Curvature Of Back
|
5
|
5
|
—
|
—
|
$70,909.53
|
$74,455.01
|
$73,036.82
|
2025-07-28
|
|
1654
|
APR_DRG
|
Coronary Bypass With Ami Or Complex Principal Diagnosis
|
5
|
5
|
—
|
—
|
$70,449.85
|
$73,972.34
|
$72,563.35
|
2025-07-28
|
|
C9746
|
HCPCS
|
Fee Schedule
|
1
|
1
|
—
|
—
|
$72,378.23
|
$72,378.23
|
$72,378.23
|
2025-07-28
|
|
8
|
MS_DRG
|
Simultaneous Pancreas And Kidney Transplant
|
24
|
14
|
—
|
—
|
$44,539.16
|
$113,757.08
|
$72,292.15
|
2025-07-28
|
|
53
|
APR_DRG
|
Tracheostomy With Mv >96 Hours Without Extensive Procedure
|
5
|
5
|
—
|
—
|
$70,086.77
|
$73,591.11
|
$72,189.38
|
2025-07-28
|
|
6134
|
APR_DRG
|
Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection
|
5
|
5
|
—
|
—
|
$69,882.39
|
$73,376.51
|
$71,978.86
|
2025-07-28
|
|
278
|
MS_DRG
|
Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures …
|
19
|
12
|
—
|
—
|
$41,016.09
|
$104,603.99
|
$71,912.43
|
2025-07-28
|
|
9104
|
APR_DRG
|
Craniotomy For Multiple Significant Trauma
|
5
|
5
|
—
|
—
|
$69,635.34
|
$73,117.10
|
$71,724.40
|
2025-07-28
|
|
6124
|
APR_DRG
|
Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other…
|
5
|
5
|
—
|
—
|
$69,535.84
|
$73,012.63
|
$71,621.92
|
2025-07-28
|
|
11
|
MS_DRG
|
Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc
|
24
|
14
|
—
|
—
|
$44,175.42
|
$112,812.08
|
$71,289.51
|
2025-07-28
|
|
220
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
24
|
14
|
—
|
—
|
$43,377.14
|
$112,425.92
|
$71,199.64
|
2025-07-28
|
|
234
|
MS_DRG
|
Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc
|
24
|
14
|
—
|
—
|
$43,566.25
|
$111,229.42
|
$71,050.68
|
2025-07-28
|
|
223
|
MS_DRG
|
DRG
|
6
|
3
|
—
|
—
|
$60,344.34
|
$129,335.92
|
$70,886.80
|
2025-07-28
|
|
0312T
|
CPT
|
Apc
|
2
|
2
|
—
|
—
|
$5,481.40
|
$136,290.39
|
$70,885.90
|
2025-07-28
|
|
0424T
|
CPT
|
Apc
|
2
|
2
|
—
|
—
|
$5,481.40
|
$136,290.39
|
$70,885.90
|
2025-07-28
|
|
9114
|
APR_DRG
|
Extensive Abdominal Or Thoracic Procedures For Multiple Significant Trauma
|
5
|
5
|
—
|
—
|
$68,357.92
|
$71,775.82
|
$70,408.66
|
2025-07-28
|
|
0571T
|
CPT
|
Hc Insert Or Replacement Implantable Icd System With Substernal Electrode(s) Inc…
|
55
|
18
|
$97,603.00
|
$39,041.20
60% off
|
$5,481.40
|
$162,672.22
|
$70,274.16
|
2025-07-28
|
|
228
|
MS_DRG
|
Other Cardiothoracic Procedures With Mcc
|
24
|
14
|
—
|
—
|
$40,855.14
|
$129,402.55
|
$70,253.37
|
2025-07-28
|
|
837
|
MS_DRG
|
Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot…
|
24
|
14
|
—
|
—
|
$41,047.47
|
$118,655.26
|
$70,162.74
|
2025-07-28
|
|
1834
|
APR_DRG
|
Percutaneous Structural Cardiac Procedures
|
5
|
5
|
—
|
—
|
$67,956.99
|
$71,354.84
|
$69,995.70
|
2025-07-28
|
|
6073
|
APR_DRG
|
Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…
|
5
|
5
|
—
|
—
|
$67,424.91
|
$70,796.16
|
$69,447.66
|
2025-07-28
|
|
466
|
MS_DRG
|
Revision Of Hip Or Knee Replacement With Mcc
|
24
|
14
|
—
|
—
|
$41,750.80
|
$111,282.90
|
$69,445.63
|
2025-07-28
|
|
6904
|
APR_DRG
|
Acute Leukemia
|
5
|
5
|
—
|
—
|
$67,402.35
|
$70,772.46
|
$69,424.42
|
2025-07-28
|
|
C9767
|
HCPCS
|
C Revascularization,any Vessel,w/intravascular Lithotripsy Stent Placement And A…
|
55
|
18
|
$96,386.00
|
$38,554.40
60% off
|
$5,481.40
|
$80,321.51
|
$69,397.92
|
2025-07-28
|
|
L8702
|
HCPCS
|
Ewhf S/d Uprt Micro Sensor
|
12
|
9
|
—
|
—
|
$66,103.61
|
$227,989.99
|
$69,078.27
|
2025-07-28
|
|
270
|
MS_DRG
|
Other Major Cardiovascular Procedures With Mcc
|
24
|
14
|
—
|
—
|
$42,059.81
|
$107,880.91
|
$68,849.66
|
2025-07-28
|
|
790
|
MS_DRG
|
Extreme Immaturity Or Respiratory Distress Syndrome, Neonate
|
20
|
13
|
—
|
—
|
$37,391.70
|
$124,287.93
|
$68,662.77
|
2025-07-28
|
|
326
|
MS_DRG
|
Stomach, Esophageal And Duodenal Procedures With Mcc
|
24
|
14
|
—
|
—
|
$41,625.26
|
$111,963.71
|
$68,629.27
|
2025-07-28
|
|
3044
|
APR_DRG
|
Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back
|
5
|
5
|
—
|
—
|
$66,128.91
|
$69,435.36
|
$68,112.78
|
2025-07-28
|
|
10
|
MS_DRG
|
Pancreas Transplant
|
24
|
14
|
—
|
—
|
$35,142.34
|
$166,691.51
|
$67,835.04
|
2025-07-28
|
|
245
|
MS_DRG
|
Aicd Generator Procedures
|
24
|
14
|
—
|
—
|
$40,078.58
|
$112,719.48
|
$67,779.24
|
2025-07-28
|
|
6214
|
APR_DRG
|
Neonate Birth Weight 2000-2499 Grams With Major Anomaly
|
5
|
5
|
—
|
—
|
$65,711.51
|
$68,997.08
|
$67,682.85
|
2025-07-28
|
|
853
|
MS_DRG
|
Infectious And Parasitic Diseases With O.r. Procedures With Mcc
|
24
|
14
|
—
|
—
|
$40,999.99
|
$104,562.18
|
$67,575.88
|
2025-07-28
|
|
33231
|
CPT
|
C Insert Implantable Defibrillator Pulse Generator Only,with Existing Multiple L…
|
60
|
18
|
$93,804.00
|
$37,521.60
60% off
|
$5,481.40
|
$153,826.61
|
$67,538.88
|
2025-07-28
|
|
33264
|
CPT
|
C Removal Implantable Defibrillator Pulse Generator W/replacement Implantable De…
|
60
|
18
|
$93,804.00
|
$37,521.60
60% off
|
$5,481.40
|
$153,826.61
|
$67,538.88
|
2025-07-28
|
|
3124
|
APR_DRG
|
Skin Graft, Except Hand, For Musculoskeletal And Connective Tissue Diagnoses
|
5
|
5
|
—
|
—
|
$65,470.17
|
$68,743.68
|
$67,434.28
|
2025-07-28
|
|
2604
|
APR_DRG
|
Major Pancreas, Liver And Shunt Procedures
|
5
|
5
|
—
|
—
|
$65,468.37
|
$68,741.79
|
$67,432.43
|
2025-07-28
|
|
0620T
|
CPT
|
Hc Endovascular Venous Arterialization Tibial Or Peroneal Vein Intravascular Ste…
|
55
|
18
|
$93,378.00
|
$37,351.20
60% off
|
$5,481.40
|
$97,200.47
|
$67,232.16
|
2025-07-28
|
|
77371
|
CPT
|
C Gamma Knife Delivery-intermed
|
74
|
18
|
$103,060.00
|
$41,224.00
60% off
|
$4,041.24
|
$91,270.08
|
$67,036.32
|
2025-07-28
|
|
277
|
MS_DRG
|
Cardiac Defibrillator Implant Without Mcc
|
19
|
12
|
—
|
—
|
$38,188.29
|
$99,569.57
|
$66,861.76
|
2025-07-28
|
|
6334
|
APR_DRG
|
Neonate Birth Weight > 2499 Grams With Major Anomaly
|
5
|
5
|
—
|
—
|
$64,649.11
|
$67,881.56
|
$66,588.58
|
2025-07-28
|
|
239
|
MS_DRG
|
Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc
|
24
|
14
|
—
|
—
|
$41,286.47
|
$105,306.47
|
$66,546.20
|
2025-07-28
|
|
6514
|
APR_DRG
|
Other Procedures Of Blood And Blood-forming Organs
|
5
|
5
|
—
|
—
|
$64,460.32
|
$67,683.34
|
$66,394.13
|
2025-07-28
|
|
267
|
MS_DRG
|
Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc
|
24
|
14
|
—
|
—
|
$38,613.19
|
$116,610.74
|
$66,361.24
|
2025-07-28
|
|
2324
|
APR_DRG
|
Gastric Fundoplication
|
5
|
5
|
—
|
—
|
$64,343.52
|
$67,560.70
|
$66,273.83
|
2025-07-28
|
|
471
|
MS_DRG
|
Cervical Spinal Fusion With Mcc
|
24
|
14
|
—
|
—
|
$39,841.19
|
$104,449.78
|
$66,068.74
|
2025-07-28
|
|
9124
|
APR_DRG
|
Musculoskeletal And Other Procedures For Multiple Significant Trauma
|
5
|
5
|
—
|
—
|
$64,113.03
|
$67,318.68
|
$66,036.42
|
2025-07-28
|
|
799
|
MS_DRG
|
Splenic Procedures With Mcc
|
24
|
14
|
—
|
—
|
$39,016.35
|
$107,096.00
|
$65,608.49
|
2025-07-28
|
|
826
|
MS_DRG
|
Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. …
|
24
|
14
|
—
|
—
|
$39,182.93
|
$104,866.18
|
$65,543.51
|
2025-07-28
|
|
6
|
MS_DRG
|
Liver Transplant Without Mcc
|
24
|
14
|
—
|
—
|
$39,776.01
|
$101,382.22
|
$65,471.65
|
2025-07-28
|
|
650
|
MS_DRG
|
Kidney Transplant With Hemodialysis With Mcc
|
22
|
13
|
—
|
—
|
$37,829.39
|
$96,324.82
|
$65,000.54
|
2025-07-28
|
|
6814
|
APR_DRG
|
Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms
|
5
|
5
|
—
|
—
|
$62,913.08
|
$66,058.74
|
$64,800.47
|
2025-07-28
|
|
0266T
|
CPT
|
Apc
|
16
|
11
|
—
|
—
|
$5,481.40
|
$124,971.63
|
$64,361.90
|
2025-07-28
|
|
214
|
APR_DRG
|
Open Craniotomy Except Trauma
|
5
|
5
|
—
|
—
|
$62,327.60
|
$65,443.98
|
$64,197.43
|
2025-07-28
|
|
981
|
MS_DRG
|
Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc
|
24
|
14
|
—
|
—
|
$39,009.11
|
$99,389.79
|
$64,187.91
|
2025-07-28
|
|
38240
|
CPT
|
Transplt Allo Hct/donor
|
22
|
13
|
—
|
—
|
$2,837.77
|
$221,064.92
|
$63,997.67
|
2025-07-28
|
|
36836
|
CPT
|
Hc Percutaneous Fistula Creation Upper Extremity Single Access Artery And Vein I…
|
60
|
18
|
$88,422.00
|
$35,368.80
60% off
|
$2,393.14
|
$86,557.93
|
$63,663.84
|
2025-07-28
|
|
36837
|
CPT
|
Hc Percutaneous Fistula Creation Upper Extremity Separate Access Artery And Vei…
|
60
|
18
|
$88,422.00
|
$35,368.80
60% off
|
$2,393.14
|
$86,557.93
|
$63,663.84
|
2025-07-28
|
|
6954
|
APR_DRG
|
Chemotherapy For Acute Leukemia
|
5
|
5
|
—
|
—
|
$61,508.77
|
$64,584.21
|
$63,354.03
|
2025-07-28
|
|
41
|
APR_DRG
|
Tracheostomy With Mv >96 Hours With Extensive Procedure
|
5
|
5
|
—
|
—
|
$61,294.79
|
$64,359.53
|
$63,133.63
|
2025-07-28
|
|
163
|
MS_DRG
|
Major Chest Procedures With Mcc
|
24
|
14
|
—
|
—
|
$37,844.68
|
$103,290.10
|
$63,029.32
|
2025-07-28
|
|
225
|
MS_DRG
|
DRG
|
6
|
3
|
—
|
—
|
$54,000.49
|
$117,149.98
|
$62,624.12
|
2025-07-28
|
|
36906
|
CPT
|
Hc Percut Translmnl Mech Thromb/inf Thromb,circuit,any Method,inc Image W/transc…
|
60
|
18
|
$86,861.00
|
$34,744.40
60% off
|
$5,481.40
|
$74,487.20
|
$62,539.92
|
2025-07-28
|
|
1664
|
APR_DRG
|
Coronary Bypass Without Ami Or Complex Principal Diagnosis
|
5
|
5
|
—
|
—
|
$60,711.55
|
$63,747.13
|
$62,532.90
|
2025-07-28
|
|
221
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
24
|
14
|
—
|
—
|
$37,711.09
|
$96,017.49
|
$62,487.48
|
2025-07-28
|
|
329
|
MS_DRG
|
Major Small And Large Bowel Procedures With Mcc
|
24
|
14
|
—
|
—
|
$37,705.46
|
$100,983.25
|
$62,417.67
|
2025-07-28
|
|
1794
|
APR_DRG
|
Defibrillator Implants
|
5
|
5
|
—
|
—
|
$60,405.62
|
$63,425.90
|
$62,217.79
|
2025-07-28
|
|
823
|
MS_DRG
|
Lymphoma And Non-acute Leukemia With Other Procedures With Mcc
|
24
|
14
|
—
|
—
|
$38,410.40
|
$97,834.31
|
$62,108.26
|
2025-07-28
|
|
455
|
MS_DRG
|
DRG
|
8
|
5
|
—
|
—
|
$46,539.77
|
$99,748.62
|
$62,073.12
|
2025-07-28
|
|
319
|
MS_DRG
|
Other Endovascular Cardiac Valve Procedures With Mcc
|
22
|
13
|
—
|
—
|
$36,103.26
|
$91,840.27
|
$62,003.90
|
2025-07-28
|
|
1623
|
APR_DRG
|
Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis
|
5
|
5
|
—
|
—
|
$59,516.24
|
$62,492.05
|
$61,301.73
|
2025-07-28
|
|
323
|
MS_DRG
|
Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc
|
19
|
12
|
—
|
—
|
$35,029.76
|
$89,051.28
|
$61,220.36
|
2025-07-28
|
|
914
|
APR_DRG
|
Other Major Head And Neck Procedures
|
5
|
5
|
—
|
—
|
$59,435.36
|
$62,407.13
|
$61,218.42
|
2025-07-28
|
|
1694
|
APR_DRG
|
Major Abdominal Vascular Procedures
|
5
|
5
|
—
|
—
|
$59,400.74
|
$62,370.78
|
$61,182.77
|
2025-07-28
|
|
458
|
MS_DRG
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
24
|
14
|
—
|
—
|
$35,501.33
|
$104,462.27
|
$60,958.93
|
2025-07-28
|
|
6234
|
APR_DRG
|
Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection
|
5
|
5
|
—
|
—
|
$59,123.85
|
$62,080.04
|
$60,897.56
|
2025-07-28
|
|
894
|
APR_DRG
|
Major Cranial Or Facial Bone Procedures
|
5
|
5
|
—
|
—
|
$59,117.97
|
$62,073.87
|
$60,891.51
|
2025-07-28
|
|
856
|
MS_DRG
|
Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc
|
24
|
14
|
—
|
—
|
$37,059.27
|
$94,641.47
|
$60,483.90
|
2025-07-28
|
|
25
|
MS_DRG
|
Craniotomy And Endovascular Intracranial Procedures With Mcc
|
24
|
14
|
—
|
—
|
$36,743.01
|
$93,517.19
|
$60,135.42
|
2025-07-28
|
|
93580
|
CPT
|
Hc Percutaneous Transcatheter Closure Congenital Interartrial Communication W/im…
|
60
|
18
|
$83,320.00
|
$33,328.00
60% off
|
$6,855.87
|
$74,487.20
|
$59,990.40
|
2025-07-28
|
|
140
|
MS_DRG
|
Major Head And Neck Procedures With Mcc
|
22
|
13
|
—
|
—
|
$34,786.73
|
$88,419.88
|
$59,718.36
|
2025-07-28
|
|
227
|
MS_DRG
|
DRG
|
6
|
3
|
—
|
—
|
$51,016.96
|
$109,344.56
|
$59,474.71
|
2025-07-28
|
|
474
|
MS_DRG
|
Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc
|
24
|
14
|
—
|
—
|
$36,842.80
|
$93,761.62
|
$59,472.02
|
2025-07-28
|
|
901
|
MS_DRG
|
Wound Debridements For Injuries With Mcc
|
24
|
14
|
—
|
—
|
$36,406.64
|
$92,628.46
|
$59,269.42
|
2025-07-28
|
|
6083
|
APR_DRG
|
Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition
|
5
|
5
|
—
|
—
|
$57,339.73
|
$60,206.72
|
$59,059.93
|
2025-07-28
|
|
93591
|
CPT
|
C Percutaneous Transcatheter Closure Paravalvular Leal:initial Occlusion Device,…
|
55
|
18
|
$81,777.00
|
$32,710.80
60% off
|
$18,773.81
|
$74,487.20
|
$58,879.44
|
2025-07-28
|
|
6313
|
APR_DRG
|
Neonate Birth Weight > 2499 Grams With Other Major Procedure
|
5
|
5
|
—
|
—
|
$57,118.13
|
$59,974.03
|
$58,831.67
|
2025-07-28
|
|
448
|
MS_DRG
|
Multiple Level Spinal Fusion Except Cervical Without Mcc
|
17
|
11
|
—
|
—
|
$33,614.25
|
$85,373.73
|
$58,692.15
|
2025-07-28
|
|
274
|
APR_DRG
|
Other Open Craniotomy
|
5
|
5
|
—
|
—
|
$56,981.25
|
$59,830.32
|
$58,690.69
|
2025-07-28
|
|
Q2043
|
HCPCS
|
Sipuleucel-t Auto Cd54+
|
22
|
13
|
—
|
—
|
$19,358.56
|
$219,924.53
|
$58,391.21
|
2025-07-28
|
|
A9543
|
HCPCS
|
Y90 Ibritumomab, Rx
|
22
|
13
|
—
|
—
|
$27,010.94
|
$292,798.95
|
$58,194.02
|
2025-07-28
|
|
234
|
APR_DRG
|
Spinal Procedures
|
5
|
5
|
—
|
—
|
$56,414.80
|
$59,235.54
|
$58,107.24
|
2025-07-28
|
|
356
|
MS_DRG
|
Other Digestive System O.r. Procedures With Mcc
|
24
|
14
|
—
|
—
|
$35,080.46
|
$89,346.95
|
$57,827.22
|
2025-07-28
|
|
L7181
|
HCPCS
|
Electronic Elbo Simultaneous
|
18
|
11
|
—
|
—
|
$46,267.04
|
$189,550.45
|
$57,630.95
|
2025-07-28
|
|
33903
|
CPT
|
Hc Percutaneous Pulmonary Artery Revascularization By Stent Placement Initial Ab…
|
60
|
18
|
$79,906.00
|
$31,962.40
60% off
|
$5,833.67
|
$57,532.32
|
$57,532.32
|
2025-07-28
|
|
204
|
APR_DRG
|
Open Craniotomy For Trauma
|
5
|
5
|
—
|
—
|
$55,748.50
|
$58,535.93
|
$57,420.96
|
2025-07-28
|
|
224
|
APR_DRG
|
Ventricular Shunt Procedures
|
5
|
5
|
—
|
—
|
$55,694.58
|
$58,479.30
|
$57,365.41
|
2025-07-28
|
|
2204
|
APR_DRG
|
Major Stomach, Esophageal And Duodenal Procedures
|
5
|
5
|
—
|
—
|
$55,590.12
|
$58,369.63
|
$57,257.83
|
2025-07-28
|
|
3614
|
APR_DRG
|
Skin Graft For Skin And Subcutaneous Tissue Diagnoses
|
5
|
5
|
—
|
—
|
$55,254.89
|
$58,017.64
|
$56,912.54
|
2025-07-28
|
|
9504
|
APR_DRG
|
Extensive O.r. Procedure Unrelated To Principal Diagnosis
|
5
|
5
|
—
|
—
|
$55,136.47
|
$57,893.29
|
$56,790.56
|
2025-07-28
|
|
52
|
APR_DRG
|
Tracheostomy With Mv >96 Hours Without Extensive Procedure
|
5
|
5
|
—
|
—
|
$55,127.51
|
$57,883.89
|
$56,781.34
|
2025-07-28
|
|
0915T
|
CPT
|
Insj Perm Ccm-d Sys Pg&eltrd
|
15
|
10
|
—
|
—
|
$33,520.48
|
$161,558.30
|
$56,515.54
|
2025-07-28
|
|
269
|
MS_DRG
|
Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc
|
24
|
14
|
—
|
—
|
$34,235.50
|
$89,829.97
|
$56,321.84
|
2025-07-28
|
|
4414
|
APR_DRG
|
Major Bladder Procedures
|
5
|
5
|
—
|
—
|
$54,638.96
|
$57,370.91
|
$56,278.13
|
2025-07-28
|
|
31
|
MS_DRG
|
Ventricular Shunt Procedures With Mcc
|
24
|
14
|
—
|
—
|
$34,476.11
|
$90,902.20
|
$56,247.33
|
2025-07-28
|
|
402
|
MS_DRG
|
Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical
|
17
|
11
|
—
|
—
|
$32,235.76
|
$81,805.94
|
$56,230.05
|
2025-07-28
|
|
6144
|
APR_DRG
|
Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition
|
5
|
5
|
—
|
—
|
$54,489.98
|
$57,214.48
|
$56,124.68
|
2025-07-28
|
|
6072
|
APR_DRG
|
Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…
|
5
|
5
|
—
|
—
|
$54,104.90
|
$56,810.14
|
$55,728.05
|
2025-07-28
|
|
1783
|
APR_DRG
|
External Heart Assist Systems
|
5
|
5
|
—
|
—
|
$54,075.57
|
$56,779.35
|
$55,697.84
|
2025-07-28
|
|
93653
|
CPT
|
C Ep Eval W/induct Arryth, Pacing, Svt Ablation
|
60
|
18
|
$76,796.00
|
$30,718.40
60% off
|
$11,086.02
|
$91,697.96
|
$55,293.12
|
2025-07-28
|
|
93654
|
CPT
|
C Ep Eval W/induct Arryth, Pacing, Vt Ablation, And 3d Mapping When Perf
|
60
|
18
|
$76,796.00
|
$30,718.40
60% off
|
$11,086.02
|
$91,697.96
|
$55,293.12
|
2025-07-28
|
|
93656
|
CPT
|
Hc Compre Ep Eval W/transsept Cath, Mult Elect Caths, Induc Of Arrhythmia, Ablat…
|
60
|
18
|
$76,796.00
|
$30,718.40
60% off
|
$11,086.02
|
$91,697.96
|
$55,293.12
|
2025-07-28
|
|
236
|
MS_DRG
|
Coronary Bypass Without Cardiac Catheterization Without Mcc
|
24
|
14
|
—
|
—
|
$33,844.40
|
$85,971.67
|
$55,216.90
|
2025-07-28
|
|
33263
|
CPT
|
C Removal Implantable Defibrillator Pulse Generator W/replacement Implantable De…
|
60
|
18
|
$76,516.00
|
$30,606.40
60% off
|
$5,481.40
|
$110,857.90
|
$55,091.52
|
2025-07-28
|
|
12
|
MS_DRG
|
Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc
|
24
|
14
|
—
|
—
|
$33,610.56
|
$85,796.06
|
$54,920.21
|
2025-07-28
|
|
36903
|
CPT
|
C Intro Ndl/cath W/diagnostic Angio Dialysis Circuit,placmnt Vascular Stent,inc …
|
60
|
18
|
$75,983.00
|
$30,393.20
60% off
|
$5,481.40
|
$54,707.76
|
$54,707.76
|
2025-07-28
|
|
1204
|
APR_DRG
|
Major Respiratory And Chest Procedures
|
5
|
5
|
—
|
—
|
$52,792.26
|
$55,431.88
|
$54,376.03
|
2025-07-28
|
|
423
|
MS_DRG
|
Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc
|
24
|
14
|
—
|
—
|
$33,484.69
|
$87,006.78
|
$54,053.23
|
2025-07-28
|
|
C9752
|
HCPCS
|
Fee Schedule
|
1
|
1
|
—
|
—
|
$53,987.24
|
$53,987.24
|
$53,987.24
|
2025-07-28
|
|
628
|
MS_DRG
|
Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc
|
24
|
14
|
—
|
—
|
$32,505.35
|
$82,492.75
|
$53,911.76
|
2025-07-28
|
|
6092
|
APR_DRG
|
Neonate Birth Weight 1500-2499 Grams With Major Procedure
|
5
|
5
|
—
|
—
|
$52,115.96
|
$54,721.75
|
$53,679.44
|
2025-07-28
|
|
6091
|
APR_DRG
|
Neonate Birth Weight 1500-2499 Grams With Major Procedure
|
5
|
5
|
—
|
—
|
$52,115.96
|
$54,721.75
|
$53,679.44
|
2025-07-28
|
|
L7180
|
HCPCS
|
Electronic Elbow Sequential
|
18
|
11
|
—
|
—
|
$43,094.61
|
$176,553.31
|
$53,679.31
|
2025-07-28
|
|
907
|
MS_DRG
|
Other O.r. Procedures For Injuries With Mcc
|
24
|
14
|
—
|
—
|
$32,811.14
|
$83,287.22
|
$53,670.75
|
2025-07-28
|
|
166
|
MS_DRG
|
Other Respiratory System O.r. Procedures With Mcc
|
24
|
14
|
—
|
—
|
$31,737.64
|
$80,498.22
|
$53,550.51
|
2025-07-28
|
|
673
|
MS_DRG
|
Other Kidney And Urinary Tract Procedures With Mcc
|
24
|
14
|
—
|
—
|
$33,616.29
|
$87,591.97
|
$53,476.32
|
2025-07-28
|
|
958
|
MS_DRG
|
Other O.r. Procedures For Multiple Significant Trauma With Cc
|
23
|
13
|
—
|
—
|
$33,825.89
|
$87,556.43
|
$53,419.67
|
2025-07-28
|
|
1814
|
APR_DRG
|
Lower Extremity Arterial Procedures
|
5
|
5
|
—
|
—
|
$51,747.90
|
$54,335.30
|
$53,300.34
|
2025-07-28
|
|
8412
|
APR_DRG
|
Extensive Third Degree Burns With Skin Graft
|
5
|
5
|
—
|
—
|
$51,715.52
|
$54,301.29
|
$53,266.98
|
2025-07-28
|
|
8411
|
APR_DRG
|
Extensive Third Degree Burns With Skin Graft
|
5
|
5
|
—
|
—
|
$51,715.52
|
$54,301.29
|
$53,266.98
|
2025-07-28
|
|
0408T
|
CPT
|
Insj/rplc Cardiac Modulj Sys
|
17
|
11
|
—
|
—
|
$5,481.40
|
$119,841.25
|
$53,154.47
|
2025-07-28
|
|
736
|
MS_DRG
|
Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc
|
24
|
14
|
—
|
—
|
$32,440.16
|
$88,655.72
|
$53,016.18
|
2025-07-28
|
|
2614
|
APR_DRG
|
Major Biliary Tract Procedures
|
5
|
5
|
—
|
—
|
$51,449.24
|
$54,021.70
|
$52,992.72
|
2025-07-28
|
|
616
|
MS_DRG
|
Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With…
|
24
|
14
|
—
|
—
|
$31,855.94
|
$83,046.82
|
$52,989.22
|
2025-07-28
|
|
0803T
|
CPT
|
Hc Transcatheter Removal And Replacement Permanent Dual Chamber Leadless Pacemak…
|
54
|
18
|
$73,586.00
|
$29,434.40
60% off
|
$19,713.69
|
$86,557.93
|
$52,981.92
|
2025-07-28
|
|
0801T
|
CPT
|
Hc Transcatheter Removal And Replacement Permanent Dual Chamber Leadless Pacemak…
|
54
|
18
|
$73,586.00
|
$29,434.40
60% off
|
$19,713.69
|
$93,648.15
|
$52,981.92
|
2025-07-28
|
|
0802T
|
CPT
|
Hc Transcatheter Removal And Replacement Dual Chamber Leadless Pacemaker Inc Ima…
|
54
|
18
|
$73,586.00
|
$29,434.40
60% off
|
$19,713.69
|
$93,648.15
|
$52,981.92
|
2025-07-28
|
|
33270
|
CPT
|
C Insert/repl Subq Icd W/electrode, Induction Of Arrythmia, & Progamming
|
60
|
18
|
$73,515.00
|
$29,406.00
60% off
|
$5,481.40
|
$153,826.61
|
$52,930.80
|
2025-07-28
|
|
273
|
MS_DRG
|
Percutaneous And Other Intracardiac Procedures With Mcc
|
24
|
14
|
—
|
—
|
$32,220.47
|
$81,752.64
|
$52,895.70
|
2025-07-28
|
|
22
|
MS_DRG
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/…
|
24
|
14
|
—
|
—
|
$29,163.34
|
$101,176.87
|
$52,879.63
|
2025-07-28
|
|
304
|
APR_DRG
|
Percutaneous Intracranial And Extracranial Vascular Procedures
|
5
|
5
|
—
|
—
|
$51,281.49
|
$53,845.57
|
$52,819.94
|
2025-07-28
|
|
33287
|
CPT
|
Rmv&rplcmt Phrnc Nrv Stim Pg
|
16
|
10
|
—
|
—
|
$31,860.24
|
$149,240.42
|
$52,805.19
|
2025-07-28
|
|
34
|
MS_DRG
|
Carotid Artery Stent Procedures With Mcc
|
24
|
14
|
—
|
—
|
$32,046.65
|
$82,751.17
|
$52,778.23
|
2025-07-28
|
|
1764
|
APR_DRG
|
Insertion, Revision And Replacements Of Pacemaker And Other Cardiac Devices
|
5
|
5
|
—
|
—
|
$50,933.58
|
$53,480.26
|
$52,461.58
|
2025-07-28
|
|
C1826
|
HCPCS
|
Hc Neurostim Implant Inceptiv MRI Strl Lf Disp
|
54
|
18
|
$72,634.00
|
$29,053.60
60% off
|
$19,458.65
|
$52,296.48
|
$52,296.48
|
2025-07-28
|
|
6224
|
APR_DRG
|
Neonate Birth Weight 2000-2499 Grams With Respiratory Distress Syndrome Or Other…
|
5
|
5
|
—
|
—
|
$50,738.88
|
$53,275.82
|
$52,261.04
|
2025-07-28
|
|
0268T
|
CPT
|
Apc
|
17
|
11
|
—
|
—
|
$5,481.40
|
$113,905.57
|
$51,894.03
|
2025-07-28
|
|
64582
|
CPT
|
Opn Mpltj Hpglsl Nstm Ary Pg
|
17
|
11
|
—
|
—
|
$5,481.40
|
$151,489.88
|
$51,894.03
|
2025-07-28
|
|
40
|
MS_DRG
|
Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc
|
24
|
14
|
—
|
—
|
$31,108.35
|
$82,401.40
|
$51,651.12
|
2025-07-28
|
|
739
|
MS_DRG
|
Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc…
|
24
|
14
|
—
|
—
|
$32,788.61
|
$83,228.68
|
$51,521.03
|
2025-07-28
|
|
24
|
MS_DRG
|
Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…
|
24
|
14
|
—
|
—
|
$31,346.55
|
$81,874.65
|
$51,444.48
|
2025-07-28
|
|
1603
|
APR_DRG
|
Major Cardiothoracic Repair Of Heart Anomaly
|
5
|
5
|
—
|
—
|
$49,891.92
|
$52,386.52
|
$51,388.68
|
2025-07-28
|
|
622
|
MS_DRG
|
Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor…
|
24
|
14
|
—
|
—
|
$30,866.13
|
$78,233.99
|
$51,282.49
|
2025-07-28
|
|
3214
|
APR_DRG
|
Cervical Spinal Fusion And Other Back Or Neck Procedures Except Disc Excision Or…
|
5
|
5
|
—
|
—
|
$49,772.05
|
$52,260.65
|
$51,265.21
|
2025-07-28
|
|
956
|
MS_DRG
|
Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma
|
23
|
13
|
—
|
—
|
$31,513.12
|
$80,132.02
|
$51,219.39
|
2025-07-28
|