|
J1414
|
HCPCS
|
Inj, Beqvez, Per Tx Dose
|
6
|
6
|
—
|
—
|
$3,744,874.00
|
$3,999,380.00
|
$3,799,411.00
|
2025-08-26
|
|
J1411
|
HCPCS
|
Inj, Hemgenix, Per Tx Dose
|
6
|
6
|
—
|
—
|
$3,719,908.17
|
$3,972,717.47
|
$3,774,081.59
|
2025-08-26
|
|
J1413
|
HCPCS
|
Inj Delandistrogene Mox Rokl
|
6
|
6
|
—
|
—
|
$3,353,704.54
|
$3,581,626.21
|
$3,402,544.90
|
2025-08-26
|
|
J3394
|
HCPCS
|
Inj, Lovotibeglogene Autotem
|
6
|
6
|
—
|
—
|
$3,316,888.40
|
$3,542,308.00
|
$3,365,192.60
|
2025-08-26
|
|
J3393
|
HCPCS
|
Inj, Betibeglogene Autotemce
|
7
|
6
|
—
|
—
|
$2,975,926.54
|
$4,871,273.93
|
$3,033,711.52
|
2025-08-26
|
|
J3399
|
HCPCS
|
Inj Onase Abepar-xioi Treat
|
9
|
7
|
—
|
—
|
$2,445,908.66
|
$4,749,337.21
|
$2,493,402.04
|
2025-08-26
|
|
J3392
|
HCPCS
|
Inj, Exagamglogene Autotem
|
9
|
7
|
—
|
—
|
$2,353,920.80
|
$4,570,720.00
|
$2,399,628.00
|
2025-08-26
|
|
Q2042
|
HCPCS
|
Tisagenlecleucel Car-pos T
|
17
|
9
|
—
|
—
|
$584,211.57
|
$1,779,427.10
|
$978,684.91
|
2025-08-26
|
|
Q2041
|
HCPCS
|
Axicabtagene Ciloleucel Car+
|
17
|
9
|
—
|
—
|
$507,567.43
|
$1,636,873.20
|
$900,280.26
|
2025-08-26
|
|
Q2056
|
HCPCS
|
Ciltacabtagene Car-pos T
|
14
|
8
|
—
|
—
|
$558,369.09
|
$1,420,148.58
|
$851,315.28
|
2025-08-26
|
|
Q2057
|
HCPCS
|
Afamitresgene Autoleucel
|
9
|
7
|
—
|
—
|
$777,863.83
|
$1,510,415.20
|
$792,967.98
|
2025-08-26
|
|
Q2055
|
HCPCS
|
Idecabtagene Vicleucel Car
|
14
|
8
|
—
|
—
|
$532,582.11
|
$1,357,132.84
|
$791,626.02
|
2025-08-26
|
|
Q2054
|
HCPCS
|
Lisocabtagene Mara Car Pos T
|
14
|
8
|
—
|
—
|
$521,296.84
|
$1,326,789.84
|
$774,588.03
|
2025-08-26
|
|
Q2053
|
HCPCS
|
Brexucabtagene Car Pos T
|
14
|
8
|
—
|
—
|
$493,999.51
|
$1,258,432.00
|
$753,125.21
|
2025-08-26
|
|
18
|
MS_DRG
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
30
|
12
|
—
|
—
|
$337,950.15
|
$962,364.30
|
$718,845.33
|
2025-08-26
|
|
0100T
|
CPT
|
Prosth Retina Receive&gen
|
5
|
3
|
—
|
—
|
$10,931.23
|
$969,903.18
|
$533,446.75
|
2025-08-26
|
|
1
|
MS_DRG
|
Heart Transplant Or Implant Of Heart Assist System With Mcc
|
32
|
13
|
—
|
—
|
$252,661.51
|
$718,806.53
|
$525,282.46
|
2025-08-26
|
|
5834
|
APR_DRG
|
Neonate With Ecmo
|
5
|
5
|
—
|
—
|
$412,748.79
|
$412,748.79
|
$412,748.79
|
2025-08-26
|
|
3
|
MS_DRG
|
Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mo…
|
32
|
13
|
—
|
—
|
$192,463.07
|
$546,898.70
|
$397,525.59
|
2025-08-26
|
|
927
|
MS_DRG
|
Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft
|
22
|
12
|
—
|
—
|
$194,058.92
|
$605,405.86
|
$372,745.15
|
2025-08-26
|
|
5833
|
APR_DRG
|
Neonate With Ecmo
|
5
|
5
|
—
|
—
|
$331,580.96
|
$331,580.96
|
$331,580.96
|
2025-08-26
|
|
5884
|
APR_DRG
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
5
|
5
|
—
|
—
|
$326,946.69
|
$326,946.69
|
$326,946.69
|
2025-08-26
|
|
C9301
|
HCPCS
|
Apc
|
9
|
7
|
—
|
—
|
$280,865.55
|
$545,370.00
|
$286,319.25
|
2025-08-26
|
|
4
|
MS_DRG
|
Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And …
|
32
|
13
|
—
|
—
|
$126,788.26
|
$360,574.63
|
$260,804.47
|
2025-08-26
|
|
1614
|
APR_DRG
|
Implantable Heart Assist Systems
|
5
|
5
|
—
|
—
|
$253,135.11
|
$253,135.11
|
$253,135.11
|
2025-08-26
|
|
C2624
|
HCPCS
|
Hc Kit Impl Hrtmt 3 Str Lf
|
56
|
17
|
$413,792.00
|
$165,516.80
60% off
|
$31,153.50
|
$355,861.12
|
$250,344.16
|
2025-08-26
|
|
7
|
MS_DRG
|
Lung Transplant
|
32
|
13
|
—
|
—
|
$112,189.56
|
$333,492.81
|
$242,341.96
|
2025-08-26
|
|
14
|
MS_DRG
|
Allogeneic Bone Marrow Transplant
|
32
|
13
|
—
|
—
|
$118,028.86
|
$334,334.97
|
$228,461.58
|
2025-08-26
|
|
8414
|
APR_DRG
|
Extensive Third Degree Burns With Skin Graft
|
5
|
5
|
—
|
—
|
$227,879.23
|
$227,879.23
|
$227,879.23
|
2025-08-26
|
|
5832
|
APR_DRG
|
Neonate With Ecmo
|
5
|
5
|
—
|
—
|
$224,982.54
|
$224,982.54
|
$224,982.54
|
2025-08-26
|
|
2
|
MS_DRG
|
Heart Transplant Or Implant Of Heart Assist System Without Mcc
|
32
|
13
|
—
|
—
|
$99,423.43
|
$336,638.88
|
$224,784.63
|
2025-08-26
|
|
5914
|
APR_DRG
|
Neonate Birth Weight 500-749 Grams Without Major Procedure
|
5
|
5
|
—
|
—
|
$223,221.79
|
$223,221.79
|
$223,221.79
|
2025-08-26
|
|
6094
|
APR_DRG
|
Neonate Birth Weight 1500-2499 Grams With Major Procedure
|
5
|
5
|
—
|
—
|
$218,668.22
|
$218,668.22
|
$218,668.22
|
2025-08-26
|
|
212
|
MS_DRG
|
Concomitant Aortic And Mitral Valve Procedures
|
27
|
11
|
—
|
—
|
$98,299.30
|
$277,991.91
|
$214,703.13
|
2025-08-26
|
|
215
|
MS_DRG
|
Other Heart Assist System Implant
|
32
|
13
|
—
|
—
|
$95,626.57
|
$270,363.98
|
$200,596.83
|
2025-08-26
|
|
5883
|
APR_DRG
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
5
|
5
|
—
|
—
|
$199,294.19
|
$199,294.19
|
$199,294.19
|
2025-08-26
|
|
5
|
MS_DRG
|
Liver Transplant With Mcc Or Intestinal Transplant
|
32
|
13
|
—
|
—
|
$96,114.47
|
$285,015.30
|
$198,590.01
|
2025-08-26
|
|
94
|
APR_DRG
|
Extracorporeal Membrane Oxygenation (ecmo)
|
5
|
5
|
—
|
—
|
$196,822.21
|
$196,822.21
|
$196,822.21
|
2025-08-26
|
|
6314
|
APR_DRG
|
Neonate Birth Weight > 2499 Grams With Other Major Procedure
|
5
|
5
|
—
|
—
|
$194,955.35
|
$194,955.35
|
$194,955.35
|
2025-08-26
|
|
6304
|
APR_DRG
|
Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure
|
5
|
5
|
—
|
—
|
$187,764.16
|
$187,764.16
|
$187,764.16
|
2025-08-26
|
|
5934
|
APR_DRG
|
Neonate Birth Weight 750-999 Grams Without Major Procedure
|
5
|
5
|
—
|
—
|
$185,321.08
|
$185,321.08
|
$185,321.08
|
2025-08-26
|
|
426
|
MS_DRG
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
16
|
10
|
—
|
—
|
$94,559.63
|
$267,490.43
|
$180,936.04
|
2025-08-26
|
|
216
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
32
|
13
|
—
|
—
|
$87,193.77
|
$246,278.21
|
$179,973.71
|
2025-08-26
|
|
5831
|
APR_DRG
|
Neonate With Ecmo
|
5
|
5
|
—
|
—
|
$177,763.60
|
$177,763.60
|
$177,763.60
|
2025-08-26
|
|
453
|
MS_DRG
|
DRG
|
17
|
6
|
—
|
—
|
$111,605.24
|
$228,741.83
|
$176,643.15
|
2025-08-26
|
|
1613
|
APR_DRG
|
Implantable Heart Assist Systems
|
5
|
5
|
—
|
—
|
$176,480.54
|
$176,480.54
|
$176,480.54
|
2025-08-26
|
|
6034
|
APR_DRG
|
Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition
|
5
|
5
|
—
|
—
|
$173,608.19
|
$173,608.19
|
$173,608.19
|
2025-08-26
|
|
44
|
APR_DRG
|
Tracheostomy With Mv >96 Hours With Extensive Procedure
|
5
|
5
|
—
|
—
|
$172,809.33
|
$172,809.33
|
$172,809.33
|
2025-08-26
|
|
850
|
MS_DRG
|
Acute Leukemia With Other Procedures
|
16
|
10
|
—
|
—
|
$83,269.13
|
$235,072.38
|
$159,163.02
|
2025-08-26
|
|
20
|
MS_DRG
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc
|
32
|
13
|
—
|
—
|
$72,985.70
|
$232,452.25
|
$158,664.18
|
2025-08-26
|
|
231
|
MS_DRG
|
Coronary Bypass With Ptca With Mcc
|
32
|
13
|
—
|
—
|
$76,674.44
|
$216,241.17
|
$158,021.29
|
2025-08-26
|
|
456
|
MS_DRG
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
32
|
13
|
—
|
—
|
$76,632.44
|
$216,118.67
|
$157,933.64
|
2025-08-26
|
|
C9741
|
HCPCS
|
Fee Schedule
|
1
|
1
|
—
|
—
|
$148,739.04
|
$148,739.04
|
$148,739.04
|
2025-08-26
|
|
19
|
MS_DRG
|
Simultaneous Pancreas And Kidney Transplant With Hemodialysis
|
30
|
12
|
—
|
—
|
$71,790.08
|
$202,289.38
|
$147,828.29
|
2025-08-26
|
|
L6700
|
HCPCS
|
Ue Add Ext Power Myoel
|
1
|
1
|
—
|
—
|
$145,786.13
|
$145,786.13
|
$145,786.13
|
2025-08-26
|
|
233
|
MS_DRG
|
Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc
|
32
|
13
|
—
|
—
|
$70,799.08
|
$199,459.22
|
$145,760.23
|
2025-08-26
|
|
219
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
32
|
13
|
—
|
—
|
$70,094.04
|
$203,093.70
|
$144,288.90
|
2025-08-26
|
|
429
|
MS_DRG
|
Combined Anterior And Posterior Cervical Spinal Fusion With Mcc
|
16
|
10
|
—
|
—
|
$75,483.28
|
$212,836.80
|
$144,190.73
|
2025-08-26
|
|
6024
|
APR_DRG
|
Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…
|
5
|
5
|
—
|
—
|
$143,410.40
|
$143,410.40
|
$143,410.40
|
2025-08-26
|
|
275
|
MS_DRG
|
Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc
|
27
|
11
|
—
|
—
|
$64,102.53
|
$180,337.08
|
$140,251.64
|
2025-08-26
|
|
5891
|
APR_DRG
|
Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …
|
5
|
5
|
—
|
—
|
$137,867.17
|
$137,867.17
|
$137,867.17
|
2025-08-26
|
|
Q0480
|
HCPCS
|
Driver Pneumatic Vad, Rep
|
19
|
10
|
—
|
—
|
$100,939.91
|
$219,999.80
|
$133,999.88
|
2025-08-26
|
|
5892
|
APR_DRG
|
Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …
|
5
|
5
|
—
|
—
|
$132,989.76
|
$132,989.76
|
$132,989.76
|
2025-08-26
|
|
5913
|
APR_DRG
|
Neonate Birth Weight 500-749 Grams Without Major Procedure
|
5
|
5
|
—
|
—
|
$132,662.47
|
$132,662.47
|
$132,662.47
|
2025-08-26
|
|
459
|
MS_DRG
|
DRG
|
17
|
6
|
—
|
—
|
$69,179.42
|
$165,732.14
|
$132,208.27
|
2025-08-26
|
|
870
|
MS_DRG
|
Septicemia Or Severe Sepsis With Mv >96 Hours
|
32
|
13
|
—
|
—
|
$63,115.11
|
$177,529.88
|
$129,724.81
|
2025-08-26
|
|
957
|
MS_DRG
|
Other O.r. Procedures For Multiple Significant Trauma With Mcc
|
27
|
13
|
—
|
—
|
$67,651.86
|
$190,473.62
|
$129,062.74
|
2025-08-26
|
|
5933
|
APR_DRG
|
Neonate Birth Weight 750-999 Grams Without Major Procedure
|
5
|
5
|
—
|
—
|
$128,338.95
|
$128,338.95
|
$128,338.95
|
2025-08-26
|
|
268
|
MS_DRG
|
Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc
|
32
|
13
|
—
|
—
|
$60,533.53
|
$172,923.11
|
$124,337.40
|
2025-08-26
|
|
276
|
MS_DRG
|
Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator
|
27
|
11
|
—
|
—
|
$56,305.06
|
$158,070.88
|
$123,794.13
|
2025-08-26
|
|
1612
|
APR_DRG
|
Implantable Heart Assist Systems
|
5
|
5
|
—
|
—
|
$123,606.79
|
$123,606.79
|
$123,606.79
|
2025-08-26
|
|
1611
|
APR_DRG
|
Implantable Heart Assist Systems
|
5
|
5
|
—
|
—
|
$123,606.79
|
$123,606.79
|
$123,606.79
|
2025-08-26
|
|
222
|
MS_DRG
|
DRG
|
6
|
3
|
—
|
—
|
$97,216.21
|
$191,307.81
|
$123,468.40
|
2025-08-26
|
|
427
|
MS_DRG
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
16
|
10
|
—
|
—
|
$64,421.54
|
$181,158.82
|
$122,888.23
|
2025-08-26
|
|
454
|
MS_DRG
|
DRG
|
17
|
6
|
—
|
—
|
$74,434.81
|
$152,187.23
|
$121,922.32
|
2025-08-26
|
|
5893
|
APR_DRG
|
Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …
|
5
|
5
|
—
|
—
|
$120,900.02
|
$120,900.02
|
$120,900.02
|
2025-08-26
|
|
217
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
32
|
13
|
—
|
—
|
$58,659.67
|
$164,792.85
|
$120,426.92
|
2025-08-26
|
|
5912
|
APR_DRG
|
Neonate Birth Weight 500-749 Grams Without Major Procedure
|
5
|
5
|
—
|
—
|
$120,013.08
|
$120,013.08
|
$120,013.08
|
2025-08-26
|
|
207
|
MS_DRG
|
Respiratory System Diagnosis With Ventilator Support >96 Hours
|
32
|
13
|
—
|
—
|
$58,742.78
|
$165,055.70
|
$119,912.00
|
2025-08-26
|
|
1604
|
APR_DRG
|
Major Cardiothoracic Repair Of Heart Anomaly
|
5
|
5
|
—
|
—
|
$119,634.72
|
$119,634.72
|
$119,634.72
|
2025-08-26
|
|
6074
|
APR_DRG
|
Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…
|
5
|
5
|
—
|
—
|
$119,556.52
|
$119,556.52
|
$119,556.52
|
2025-08-26
|
|
43
|
APR_DRG
|
Tracheostomy With Mv >96 Hours With Extensive Procedure
|
5
|
5
|
—
|
—
|
$118,165.11
|
$118,165.11
|
$118,165.11
|
2025-08-26
|
|
266
|
MS_DRG
|
Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc
|
32
|
13
|
—
|
—
|
$54,485.72
|
$164,925.09
|
$118,113.10
|
2025-08-26
|
|
955
|
MS_DRG
|
Craniotomy For Multiple Significant Trauma
|
27
|
13
|
—
|
—
|
$61,969.53
|
$174,248.01
|
$118,108.77
|
2025-08-26
|
|
969
|
MS_DRG
|
HIV With Extensive O.r. Procedures With Mcc
|
32
|
13
|
—
|
—
|
$57,465.84
|
$181,088.53
|
$117,935.55
|
2025-08-26
|
|
447
|
MS_DRG
|
Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall…
|
16
|
10
|
—
|
—
|
$60,865.05
|
$171,091.18
|
$116,080.55
|
2025-08-26
|
|
573
|
MS_DRG
|
Skin Graft For Skin Ulcer Or Cellulitis With Mcc
|
32
|
13
|
—
|
—
|
$46,556.13
|
$157,147.06
|
$114,838.11
|
2025-08-26
|
|
461
|
MS_DRG
|
Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc
|
32
|
13
|
—
|
—
|
$55,789.46
|
$160,290.19
|
$114,437.18
|
2025-08-26
|
|
8634
|
APR_DRG
|
Neonatal Aftercare
|
5
|
5
|
—
|
—
|
$113,975.50
|
$113,975.50
|
$113,975.50
|
2025-08-26
|
|
232
|
MS_DRG
|
Coronary Bypass With Ptca Without Mcc
|
32
|
13
|
—
|
—
|
$55,539.26
|
$155,883.82
|
$113,915.04
|
2025-08-26
|
|
K1007
|
HCPCS
|
Bil Hkaf Pc S/d Micro Sensor
|
2
|
2
|
—
|
—
|
$108,131.37
|
$118,851.29
|
$113,491.33
|
2025-08-26
|
|
54
|
APR_DRG
|
Tracheostomy With Mv >96 Hours Without Extensive Procedure
|
5
|
5
|
—
|
—
|
$113,417.31
|
$113,417.31
|
$113,417.31
|
2025-08-26
|
|
28
|
MS_DRG
|
Spinal Procedures With Mcc
|
32
|
13
|
—
|
—
|
$55,278.33
|
$155,138.63
|
$113,370.52
|
2025-08-26
|
|
8424
|
APR_DRG
|
Burns With Skin Graft Except Extensive Third Degree Burns
|
5
|
5
|
—
|
—
|
$113,322.86
|
$113,322.86
|
$113,322.86
|
2025-08-26
|
|
21
|
MS_DRG
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc
|
32
|
13
|
—
|
—
|
$50,343.93
|
$169,634.95
|
$112,747.88
|
2025-08-26
|
|
16
|
MS_DRG
|
Autologous Bone Marrow Transplant With Cc/mcc
|
32
|
13
|
—
|
—
|
$54,888.73
|
$154,025.96
|
$112,557.46
|
2025-08-26
|
|
5932
|
APR_DRG
|
Neonate Birth Weight 750-999 Grams Without Major Procedure
|
5
|
5
|
—
|
—
|
$111,173.96
|
$111,173.96
|
$111,173.96
|
2025-08-26
|
|
457
|
MS_DRG
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
32
|
13
|
—
|
—
|
$52,239.23
|
$150,835.48
|
$110,352.74
|
2025-08-26
|
|
0809T
|
CPT
|
Fee Schedule
|
1
|
1
|
—
|
—
|
$110,342.16
|
$110,342.16
|
$110,342.16
|
2025-08-26
|
|
0775T
|
CPT
|
Fee Schedule
|
1
|
1
|
—
|
—
|
$110,342.16
|
$110,342.16
|
$110,342.16
|
2025-08-26
|
|
224
|
MS_DRG
|
DRG
|
6
|
3
|
—
|
—
|
$84,108.08
|
$177,130.75
|
$110,015.42
|
2025-08-26
|
|
218
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
32
|
13
|
—
|
—
|
$54,114.88
|
$151,821.03
|
$109,809.21
|
2025-08-26
|
|
235
|
MS_DRG
|
Coronary Bypass Without Cardiac Catheterization With Mcc
|
32
|
13
|
—
|
—
|
$53,533.15
|
$150,154.58
|
$109,728.56
|
2025-08-26
|
|
17
|
MS_DRG
|
Autologous Bone Marrow Transplant Without Cc/mcc
|
32
|
13
|
—
|
—
|
$51,877.98
|
$154,025.96
|
$109,724.55
|
2025-08-26
|
|
820
|
MS_DRG
|
Lymphoma And Leukemia With Major O.r. Procedures With Mcc
|
32
|
13
|
—
|
—
|
$52,980.02
|
$148,574.89
|
$108,574.25
|
2025-08-26
|
|
317
|
MS_DRG
|
Concomitant Left Atrial Appendage Closure And Cardiac Ablation
|
16
|
10
|
—
|
—
|
$56,233.58
|
$157,866.72
|
$107,175.05
|
2025-08-26
|
|
23
|
MS_DRG
|
Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…
|
32
|
13
|
—
|
—
|
$51,932.73
|
$145,583.94
|
$106,388.70
|
2025-08-26
|
|
6084
|
APR_DRG
|
Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition
|
5
|
5
|
—
|
—
|
$105,906.98
|
$105,906.98
|
$105,906.98
|
2025-08-26
|
|
3034
|
APR_DRG
|
Dorsal And Lumbar Fusion Procedure For Curvature Of Back
|
5
|
5
|
—
|
—
|
$105,033.38
|
$105,033.38
|
$105,033.38
|
2025-08-26
|
|
1624
|
APR_DRG
|
Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis
|
5
|
5
|
—
|
—
|
$104,380.27
|
$104,380.27
|
$104,380.27
|
2025-08-26
|
|
928
|
MS_DRG
|
Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc
|
22
|
12
|
—
|
—
|
$60,634.51
|
$170,435.32
|
$104,136.14
|
2025-08-26
|
|
653
|
MS_DRG
|
Major Bladder Procedures With Mcc
|
32
|
13
|
—
|
—
|
$50,766.60
|
$142,253.58
|
$103,955.14
|
2025-08-26
|
|
834
|
MS_DRG
|
Acute Leukemia With Mcc
|
32
|
13
|
—
|
—
|
$50,343.93
|
$141,046.49
|
$103,073.09
|
2025-08-26
|
|
8
|
MS_DRG
|
Simultaneous Pancreas And Kidney Transplant
|
32
|
13
|
—
|
—
|
$49,573.66
|
$139,699.22
|
$101,465.63
|
2025-08-26
|
|
405
|
MS_DRG
|
Pancreas, Liver And Shunt Procedures With Mcc
|
32
|
13
|
—
|
—
|
$49,462.85
|
$138,532.77
|
$101,234.40
|
2025-08-26
|
|
226
|
MS_DRG
|
DRG
|
6
|
3
|
—
|
—
|
$77,877.69
|
$159,932.89
|
$100,744.83
|
2025-08-26
|
|
463
|
MS_DRG
|
Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …
|
32
|
13
|
—
|
—
|
$49,215.33
|
$137,825.86
|
$100,717.85
|
2025-08-26
|
|
11
|
MS_DRG
|
Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc
|
32
|
13
|
—
|
—
|
$49,169.75
|
$137,695.71
|
$100,622.74
|
2025-08-26
|
|
576
|
MS_DRG
|
Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc
|
32
|
13
|
—
|
—
|
$49,164.39
|
$141,145.91
|
$100,611.55
|
2025-08-26
|
|
234
|
MS_DRG
|
Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc
|
32
|
13
|
—
|
—
|
$48,493.31
|
$135,763.85
|
$99,211.09
|
2025-08-26
|
|
J9029
|
HCPCS
|
Instill Adstiladrin, Tx Dose
|
15
|
9
|
—
|
—
|
$63,830.02
|
$173,040.00
|
$98,880.00
|
2025-08-26
|
|
220
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
32
|
13
|
—
|
—
|
$48,283.31
|
$135,801.41
|
$98,772.86
|
2025-08-26
|
|
6023
|
APR_DRG
|
Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…
|
5
|
5
|
—
|
—
|
$97,773.41
|
$97,773.41
|
$97,773.41
|
2025-08-26
|
|
A9543
|
HCPCS
|
Y90 Ibritumomab, Rx
|
24
|
13
|
—
|
—
|
$28,278.45
|
$279,194.92
|
$97,349.65
|
2025-08-26
|
|
10
|
MS_DRG
|
Pancreas Transplant
|
32
|
13
|
—
|
—
|
$50,092.95
|
$203,460.75
|
$97,326.18
|
2025-08-26
|
|
228
|
MS_DRG
|
Other Cardiothoracic Procedures With Mcc
|
32
|
13
|
—
|
—
|
$45,482.80
|
$129,402.55
|
$96,685.01
|
2025-08-26
|
|
6114
|
APR_DRG
|
Neonate Birth Weight 1500-1999 Grams With Major Anomaly
|
5
|
5
|
—
|
—
|
$96,358.80
|
$96,358.80
|
$96,358.80
|
2025-08-26
|
|
5881
|
APR_DRG
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
5
|
5
|
—
|
—
|
$96,212.77
|
$96,212.77
|
$96,212.77
|
2025-08-26
|
|
5882
|
APR_DRG
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
5
|
5
|
—
|
—
|
$96,212.77
|
$96,212.77
|
$96,212.77
|
2025-08-26
|
|
270
|
MS_DRG
|
Other Major Cardiovascular Procedures With Mcc
|
32
|
13
|
—
|
—
|
$46,820.51
|
$130,989.06
|
$95,720.18
|
2025-08-26
|
|
790
|
MS_DRG
|
Extreme Immaturity Or Respiratory Distress Syndrome, Neonate
|
32
|
13
|
—
|
—
|
$554.40
|
$151,716.40
|
$95,570.88
|
2025-08-26
|
|
428
|
MS_DRG
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
16
|
10
|
—
|
—
|
$50,136.62
|
$140,492.70
|
$95,464.00
|
2025-08-26
|
|
277
|
MS_DRG
|
Cardiac Defibrillator Implant Without Mcc
|
27
|
11
|
—
|
—
|
$42,521.45
|
$118,724.14
|
$95,332.36
|
2025-08-26
|
|
466
|
MS_DRG
|
Revision Of Hip Or Knee Replacement With Mcc
|
32
|
13
|
—
|
—
|
$46,477.37
|
$131,054.07
|
$95,004.10
|
2025-08-26
|
|
430
|
MS_DRG
|
Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc
|
16
|
10
|
—
|
—
|
$49,836.37
|
$139,596.95
|
$94,873.12
|
2025-08-26
|
|
326
|
MS_DRG
|
Stomach, Esophageal And Duodenal Procedures With Mcc
|
32
|
13
|
—
|
—
|
$46,337.97
|
$129,608.42
|
$94,713.19
|
2025-08-26
|
|
837
|
MS_DRG
|
Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot…
|
32
|
13
|
—
|
—
|
$45,696.37
|
$134,479.65
|
$94,318.74
|
2025-08-26
|
|
239
|
MS_DRG
|
Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc
|
32
|
13
|
—
|
—
|
$45,961.77
|
$128,531.48
|
$93,928.11
|
2025-08-26
|
|
6303
|
APR_DRG
|
Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure
|
5
|
5
|
—
|
—
|
$93,748.49
|
$93,748.49
|
$93,748.49
|
2025-08-26
|
|
853
|
MS_DRG
|
Infectious And Parasitic Diseases With O.r. Procedures With Mcc
|
32
|
13
|
—
|
—
|
$45,643.65
|
$127,638.28
|
$93,264.24
|
2025-08-26
|
|
267
|
MS_DRG
|
Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc
|
32
|
13
|
—
|
—
|
$42,993.26
|
$128,942.75
|
$92,507.58
|
2025-08-26
|
|
455
|
MS_DRG
|
DRG
|
17
|
6
|
—
|
—
|
$58,181.70
|
$119,632.97
|
$91,808.03
|
2025-08-26
|
|
223
|
MS_DRG
|
DRG
|
6
|
3
|
—
|
—
|
$71,715.38
|
$130,394.44
|
$90,700.62
|
2025-08-26
|
|
0614T
|
CPT
|
Hc Rmvl&rplcmt Substernal Impltbl Defibrillator Pg
|
55
|
17
|
$124,117.00
|
$49,646.80
60% off
|
$5,022.44
|
$120,710.56
|
$90,605.41
|
2025-08-26
|
|
471
|
MS_DRG
|
Cervical Spinal Fusion With Mcc
|
32
|
13
|
—
|
—
|
$44,356.88
|
$125,854.48
|
$90,578.93
|
2025-08-26
|
|
8413
|
APR_DRG
|
Extensive Third Degree Burns With Skin Graft
|
5
|
5
|
—
|
—
|
$90,523.06
|
$90,523.06
|
$90,523.06
|
2025-08-26
|
|
6
|
MS_DRG
|
Liver Transplant Without Mcc
|
32
|
13
|
—
|
—
|
$44,284.50
|
$123,743.93
|
$90,427.88
|
2025-08-26
|
|
245
|
MS_DRG
|
Aicd Generator Procedures
|
32
|
13
|
—
|
—
|
$44,620.49
|
$124,703.48
|
$90,328.93
|
2025-08-26
|
|
278
|
MS_DRG
|
Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures …
|
27
|
11
|
—
|
—
|
$45,661.52
|
$127,674.01
|
$90,052.20
|
2025-08-26
|
|
450
|
MS_DRG
|
Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically …
|
16
|
10
|
—
|
—
|
$46,973.31
|
$131,420.34
|
$89,367.41
|
2025-08-26
|
|
826
|
MS_DRG
|
Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. …
|
32
|
13
|
—
|
—
|
$43,625.92
|
$128,475.51
|
$89,053.52
|
2025-08-26
|
|
799
|
MS_DRG
|
Splenic Procedures With Mcc
|
32
|
13
|
—
|
—
|
$43,440.95
|
$130,119.59
|
$88,667.51
|
2025-08-26
|
|
981
|
MS_DRG
|
Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc
|
32
|
13
|
—
|
—
|
$43,432.91
|
$121,329.74
|
$88,650.73
|
2025-08-26
|
|
650
|
MS_DRG
|
Kidney Transplant With Hemodialysis With Mcc
|
30
|
12
|
—
|
—
|
$42,122.91
|
$117,570.64
|
$87,785.04
|
2025-08-26
|
|
1784
|
APR_DRG
|
External Heart Assist Systems
|
5
|
5
|
—
|
—
|
$87,701.88
|
$87,701.88
|
$87,701.88
|
2025-08-26
|
|
6022
|
APR_DRG
|
Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…
|
5
|
5
|
—
|
—
|
$87,629.26
|
$87,629.26
|
$87,629.26
|
2025-08-26
|
|
6093
|
APR_DRG
|
Neonate Birth Weight 1500-2499 Grams With Major Procedure
|
5
|
5
|
—
|
—
|
$87,447.21
|
$87,447.21
|
$87,447.21
|
2025-08-26
|
|
823
|
MS_DRG
|
Lymphoma And Non-acute Leukemia With Other Procedures With Mcc
|
32
|
13
|
—
|
—
|
$42,768.08
|
$119,413.18
|
$87,263.32
|
2025-08-26
|
|
93
|
APR_DRG
|
Extracorporeal Membrane Oxygenation (ecmo)
|
5
|
5
|
—
|
—
|
$87,111.93
|
$87,111.93
|
$87,111.93
|
2025-08-26
|
|
1634
|
APR_DRG
|
Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis
|
5
|
5
|
—
|
—
|
$86,829.61
|
$86,829.61
|
$86,829.61
|
2025-08-26
|
|
5911
|
APR_DRG
|
Neonate Birth Weight 500-749 Grams Without Major Procedure
|
5
|
5
|
—
|
—
|
$86,529.43
|
$86,529.43
|
$86,529.43
|
2025-08-26
|
|
163
|
MS_DRG
|
Major Chest Procedures With Mcc
|
32
|
13
|
—
|
—
|
$42,139.88
|
$121,024.69
|
$85,952.36
|
2025-08-26
|
|
Q2043
|
HCPCS
|
Sipuleucel-t Auto Cd54+
|
24
|
13
|
—
|
—
|
$20,266.98
|
$244,385.12
|
$85,926.50
|
2025-08-26
|
|
221
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
32
|
13
|
—
|
—
|
$41,991.55
|
$118,223.76
|
$85,642.80
|
2025-08-26
|
|
329
|
MS_DRG
|
Major Small And Large Bowel Procedures With Mcc
|
32
|
13
|
—
|
—
|
$41,985.29
|
$117,180.18
|
$85,629.75
|
2025-08-26
|
|
458
|
MS_DRG
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
32
|
13
|
—
|
—
|
$39,537.75
|
$120,260.12
|
$85,069.99
|
2025-08-26
|
|
0302T
|
CPT
|
Fee Schedule
|
1
|
1
|
—
|
—
|
$84,488.21
|
$84,488.21
|
$84,488.21
|
2025-08-26
|
|
319
|
MS_DRG
|
Other Endovascular Cardiac Valve Procedures With Mcc
|
30
|
12
|
—
|
—
|
$40,206.16
|
$112,096.60
|
$84,433.52
|
2025-08-26
|
|
33276
|
CPT
|
Insj Phrnc Nrv Stim Sys
|
14
|
9
|
—
|
—
|
$51,484.82
|
$226,757.52
|
$84,288.24
|
2025-08-26
|
|
856
|
MS_DRG
|
Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc
|
32
|
13
|
—
|
—
|
$41,267.74
|
$115,128.38
|
$84,132.32
|
2025-08-26
|
|
1674
|
APR_DRG
|
Other Cardiothoracic And Thoracic Vascular Procedures
|
5
|
5
|
—
|
—
|
$84,033.73
|
$84,033.73
|
$84,033.73
|
2025-08-26
|
|
6033
|
APR_DRG
|
Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition
|
5
|
5
|
—
|
—
|
$83,696.88
|
$83,696.88
|
$83,696.88
|
2025-08-26
|
|
474
|
MS_DRG
|
Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc
|
32
|
13
|
—
|
—
|
$41,027.37
|
$114,441.89
|
$83,630.69
|
2025-08-26
|
|
25
|
MS_DRG
|
Craniotomy And Endovascular Intracranial Procedures With Mcc
|
32
|
13
|
—
|
—
|
$40,916.56
|
$114,125.44
|
$83,399.45
|
2025-08-26
|
|
42
|
APR_DRG
|
Tracheostomy With Mv >96 Hours With Extensive Procedure
|
5
|
5
|
—
|
—
|
$82,769.19
|
$82,769.19
|
$82,769.19
|
2025-08-26
|
|
901
|
MS_DRG
|
Wound Debridements For Injuries With Mcc
|
31
|
13
|
—
|
—
|
$40,543.04
|
$113,058.70
|
$82,619.96
|
2025-08-26
|
|
323
|
MS_DRG
|
Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc
|
27
|
11
|
—
|
—
|
$39,014.11
|
$108,694.78
|
$82,526.76
|
2025-08-26
|
|
225
|
MS_DRG
|
DRG
|
6
|
3
|
—
|
—
|
$64,861.22
|
$126,371.69
|
$82,028.14
|
2025-08-26
|
|
6254
|
APR_DRG
|
Neonate Birth Weight 2000-2499 Grams With Other Significant Condition
|
5
|
5
|
—
|
—
|
$81,616.38
|
$81,616.38
|
$81,616.38
|
2025-08-26
|
|
6804
|
APR_DRG
|
Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms
|
5
|
5
|
—
|
—
|
$80,946.42
|
$80,946.42
|
$80,946.42
|
2025-08-26
|
|
3033
|
APR_DRG
|
Dorsal And Lumbar Fusion Procedure For Curvature Of Back
|
5
|
5
|
—
|
—
|
$80,658.35
|
$80,658.35
|
$80,658.35
|
2025-08-26
|
|
J7330
|
HCPCS
|
Cultured Chondrocytes Implnt
|
1
|
1
|
—
|
—
|
$80,212.19
|
$80,212.19
|
$80,212.19
|
2025-08-26
|
|
1654
|
APR_DRG
|
Coronary Bypass With Ami Or Complex Principal Diagnosis
|
5
|
5
|
—
|
—
|
$80,135.47
|
$80,135.47
|
$80,135.47
|
2025-08-26
|
|
53
|
APR_DRG
|
Tracheostomy With Mv >96 Hours Without Extensive Procedure
|
5
|
5
|
—
|
—
|
$79,722.47
|
$79,722.47
|
$79,722.47
|
2025-08-26
|
|
227
|
MS_DRG
|
DRG
|
6
|
3
|
—
|
—
|
$61,924.75
|
$125,447.21
|
$79,633.55
|
2025-08-26
|
|
356
|
MS_DRG
|
Other Digestive System O.r. Procedures With Mcc
|
32
|
13
|
—
|
—
|
$39,070.41
|
$108,853.01
|
$79,546.77
|
2025-08-26
|
|
0620T
|
CPT
|
Hc Endovascular Venous Arterialization Tibial Or Peroneal Vein Intravascular Ste…
|
51
|
17
|
$108,941.00
|
$43,576.40
60% off
|
$5,022.44
|
$168,669.88
|
$79,526.93
|
2025-08-26
|
|
6134
|
APR_DRG
|
Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection
|
5
|
5
|
—
|
—
|
$79,489.99
|
$79,489.99
|
$79,489.99
|
2025-08-26
|
|
9104
|
APR_DRG
|
Craniotomy For Multiple Significant Trauma
|
5
|
5
|
—
|
—
|
$79,208.97
|
$79,208.97
|
$79,208.97
|
2025-08-26
|
|
6124
|
APR_DRG
|
Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other…
|
5
|
5
|
—
|
—
|
$79,095.80
|
$79,095.80
|
$79,095.80
|
2025-08-26
|
|
31
|
MS_DRG
|
Ventricular Shunt Procedures With Mcc
|
32
|
13
|
—
|
—
|
$38,399.32
|
$106,936.46
|
$78,146.31
|
2025-08-26
|
|
9114
|
APR_DRG
|
Extensive Abdominal Or Thoracic Procedures For Multiple Significant Trauma
|
5
|
5
|
—
|
—
|
$77,755.93
|
$77,755.93
|
$77,755.93
|
2025-08-26
|
|
269
|
MS_DRG
|
Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc
|
32
|
13
|
—
|
—
|
$38,132.14
|
$106,847.63
|
$77,588.73
|
2025-08-26
|
|
1834
|
APR_DRG
|
Percutaneous Structural Cardiac Procedures
|
5
|
5
|
—
|
—
|
$77,299.89
|
$77,299.89
|
$77,299.89
|
2025-08-26
|
|
6073
|
APR_DRG
|
Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…
|
5
|
5
|
—
|
—
|
$76,694.65
|
$76,694.65
|
$76,694.65
|
2025-08-26
|
|
236
|
MS_DRG
|
Coronary Bypass Without Cardiac Catheterization Without Mcc
|
32
|
13
|
—
|
—
|
$37,697.85
|
$104,933.14
|
$76,682.44
|
2025-08-26
|
|
6904
|
APR_DRG
|
Acute Leukemia
|
5
|
5
|
—
|
—
|
$76,668.98
|
$76,668.98
|
$76,668.98
|
2025-08-26
|
|
12
|
MS_DRG
|
Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc
|
32
|
13
|
—
|
—
|
$37,622.79
|
$104,718.77
|
$76,525.80
|
2025-08-26
|
|
423
|
MS_DRG
|
Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc
|
32
|
13
|
—
|
—
|
$37,298.42
|
$103,792.39
|
$75,848.88
|
2025-08-26
|
|
140
|
MS_DRG
|
Major Head And Neck Procedures With Mcc
|
30
|
12
|
—
|
—
|
$38,744.25
|
$107,924.08
|
$75,717.32
|
2025-08-26
|
|
3044
|
APR_DRG
|
Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back
|
5
|
5
|
—
|
—
|
$75,220.48
|
$75,220.48
|
$75,220.48
|
2025-08-26
|
|
6214
|
APR_DRG
|
Neonate Birth Weight 2000-2499 Grams With Major Anomaly
|
5
|
5
|
—
|
—
|
$74,745.68
|
$74,745.68
|
$74,745.68
|
2025-08-26
|
|
0387T
|
CPT
|
Fee Schedule
|
1
|
1
|
—
|
—
|
$74,487.20
|
$74,487.20
|
$74,487.20
|
2025-08-26
|
|
3124
|
APR_DRG
|
Skin Graft, Except Hand, For Musculoskeletal And Connective Tissue Diagnoses
|
5
|
5
|
—
|
—
|
$74,471.17
|
$74,471.17
|
$74,471.17
|
2025-08-26
|
|
2604
|
APR_DRG
|
Major Pancreas, Liver And Shunt Procedures
|
5
|
5
|
—
|
—
|
$74,469.13
|
$74,469.13
|
$74,469.13
|
2025-08-26
|
|
C9150
|
HCPCS
|
Apc
|
1
|
1
|
—
|
—
|
$74,256.00
|
$74,256.00
|
$74,256.00
|
2025-08-26
|
|
907
|
MS_DRG
|
Other O.r. Procedures For Injuries With Mcc
|
32
|
13
|
—
|
—
|
$36,550.48
|
$101,658.92
|
$74,144.51
|
2025-08-26
|
|
673
|
MS_DRG
|
Other Kidney And Urinary Tract Procedures With Mcc
|
32
|
13
|
—
|
—
|
$38,390.38
|
$106,928.80
|
$73,715.93
|
2025-08-26
|
|
628
|
MS_DRG
|
Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc
|
32
|
13
|
—
|
—
|
$36,210.92
|
$100,709.58
|
$73,579.41
|
2025-08-26
|
|
6334
|
APR_DRG
|
Neonate Birth Weight > 2499 Grams With Major Anomaly
|
5
|
5
|
—
|
—
|
$73,537.22
|
$73,537.22
|
$73,537.22
|
2025-08-26
|
|
736
|
MS_DRG
|
Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc
|
32
|
13
|
—
|
—
|
$36,138.54
|
$106,570.29
|
$73,428.36
|
2025-08-26
|
|
6514
|
APR_DRG
|
Other Procedures Of Blood And Blood-forming Organs
|
5
|
5
|
—
|
—
|
$73,322.48
|
$73,322.48
|
$73,322.48
|
2025-08-26
|
|
2324
|
APR_DRG
|
Gastric Fundoplication
|
5
|
5
|
—
|
—
|
$73,189.63
|
$73,189.63
|
$73,189.63
|
2025-08-26
|
|
9124
|
APR_DRG
|
Musculoskeletal And Other Procedures For Multiple Significant Trauma
|
5
|
5
|
—
|
—
|
$72,927.44
|
$72,927.44
|
$72,927.44
|
2025-08-26
|
|
273
|
MS_DRG
|
Percutaneous And Other Intracardiac Procedures With Mcc
|
32
|
13
|
—
|
—
|
$35,894.59
|
$100,268.82
|
$72,919.27
|
2025-08-26
|
|
460
|
MS_DRG
|
DRG
|
17
|
6
|
—
|
—
|
$45,999.31
|
$94,097.28
|
$72,916.58
|
2025-08-26
|
|
L8702
|
HCPCS
|
Ewhf S/d Uprt Micro Sensor
|
11
|
8
|
—
|
—
|
$68,086.72
|
$132,207.21
|
$72,713.97
|
2025-08-26
|
|
34
|
MS_DRG
|
Carotid Artery Stent Procedures With Mcc
|
32
|
13
|
—
|
—
|
$35,701.57
|
$99,929.01
|
$72,516.48
|
2025-08-26
|
|
C9746
|
HCPCS
|
Fee Schedule
|
1
|
1
|
—
|
—
|
$72,378.23
|
$72,378.23
|
$72,378.23
|
2025-08-26
|
|
739
|
MS_DRG
|
Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc…
|
32
|
13
|
—
|
—
|
$36,525.46
|
$101,587.46
|
$72,087.32
|
2025-08-26
|
|
616
|
MS_DRG
|
Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With…
|
32
|
13
|
—
|
—
|
$35,489.79
|
$98,632.25
|
$72,074.52
|
2025-08-26
|
|
22
|
MS_DRG
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/…
|
32
|
13
|
—
|
—
|
$32,499.84
|
$108,901.48
|
$72,015.00
|
2025-08-26
|
|
166
|
MS_DRG
|
Other Respiratory System O.r. Procedures With Mcc
|
32
|
13
|
—
|
—
|
$35,358.43
|
$98,277.52
|
$71,800.39
|
2025-08-26
|
|
6814
|
APR_DRG
|
Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms
|
5
|
5
|
—
|
—
|
$71,562.53
|
$71,562.53
|
$71,562.53
|
2025-08-26
|
|
958
|
MS_DRG
|
Other O.r. Procedures For Multiple Significant Trauma With Cc
|
27
|
13
|
—
|
—
|
$37,677.30
|
$104,874.44
|
$71,275.87
|
2025-08-26
|
|
0571T
|
CPT
|
Hc Insert Or Replacement Implantable Icd System With Substernal Electrode(s) Inc…
|
55
|
17
|
$97,603.00
|
$39,041.20
60% off
|
$5,022.44
|
$168,478.08
|
$71,250.19
|
2025-08-26
|
|
448
|
MS_DRG
|
Multiple Level Spinal Fusion Except Cervical Without Mcc
|
16
|
10
|
—
|
—
|
$37,442.29
|
$104,203.26
|
$71,040.00
|
2025-08-26
|
|
214
|
APR_DRG
|
Open Craniotomy Except Trauma
|
5
|
5
|
—
|
—
|
$70,896.55
|
$70,896.55
|
$70,896.55
|
2025-08-26
|
|
24
|
MS_DRG
|
Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…
|
32
|
13
|
—
|
—
|
$34,924.15
|
$98,664.72
|
$70,894.10
|
2025-08-26
|
|
40
|
MS_DRG
|
Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc
|
32
|
13
|
—
|
—
|
$34,659.65
|
$96,256.34
|
$70,342.12
|
2025-08-26
|
|
6954
|
APR_DRG
|
Chemotherapy For Acute Leukemia
|
5
|
5
|
—
|
—
|
$69,965.14
|
$69,965.14
|
$69,965.14
|
2025-08-26
|
|
622
|
MS_DRG
|
Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor…
|
32
|
13
|
—
|
—
|
$34,390.68
|
$95,546.88
|
$69,780.82
|
2025-08-26
|
|
41
|
APR_DRG
|
Tracheostomy With Mv >96 Hours With Extensive Procedure
|
5
|
5
|
—
|
—
|
$69,721.74
|
$69,721.74
|
$69,721.74
|
2025-08-26
|
|
0266T
|
CPT
|
Apc
|
18
|
11
|
—
|
—
|
$5,022.44
|
$216,860.56
|
$69,629.47
|
2025-08-26
|
|
1664
|
APR_DRG
|
Coronary Bypass Without Ami Or Complex Principal Diagnosis
|
5
|
5
|
—
|
—
|
$69,058.33
|
$69,058.33
|
$69,058.33
|
2025-08-26
|
|
38240
|
CPT
|
Transplt Allo Hct/donor
|
24
|
13
|
—
|
—
|
$2,970.93
|
$275,916.62
|
$68,978.28
|
2025-08-26
|
|
1794
|
APR_DRG
|
Defibrillator Implants
|
5
|
5
|
—
|
—
|
$68,710.33
|
$68,710.33
|
$68,710.33
|
2025-08-26
|
|
402
|
MS_DRG
|
Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical
|
16
|
10
|
—
|
—
|
$35,911.57
|
$100,273.18
|
$68,252.11
|
2025-08-26
|
|
90288
|
CPT
|
Botulism Ig IV
|
1
|
1
|
—
|
—
|
$68,187.00
|
$68,187.00
|
$68,187.00
|
2025-08-26
|
|
94
|
MS_DRG
|
Bacterial And Tuberculous Infections Of Nervous System With Mcc
|
32
|
13
|
—
|
—
|
$33,556.96
|
$93,107.17
|
$68,040.96
|
2025-08-26
|
|
335
|
MS_DRG
|
Peritoneal Adhesiolysis With Mcc
|
32
|
13
|
—
|
—
|
$33,330.88
|
$92,481.93
|
$67,971.90
|
2025-08-26
|
|
0312T
|
CPT
|
Apc
|
4
|
2
|
—
|
—
|
$48,045.92
|
$136,290.39
|
$67,701.07
|
2025-08-26
|
|
0316T
|
CPT
|
Apc
|
4
|
2
|
—
|
—
|
$48,045.92
|
$89,711.23
|
$67,701.07
|
2025-08-26
|
|
1623
|
APR_DRG
|
Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis
|
5
|
5
|
—
|
—
|
$67,698.68
|
$67,698.68
|
$67,698.68
|
2025-08-26
|
|
914
|
APR_DRG
|
Other Major Head And Neck Procedures
|
5
|
5
|
—
|
—
|
$67,606.68
|
$67,606.68
|
$67,606.68
|
2025-08-26
|
|
1694
|
APR_DRG
|
Major Abdominal Vascular Procedures
|
5
|
5
|
—
|
—
|
$67,567.30
|
$67,567.30
|
$67,567.30
|
2025-08-26
|
|
6234
|
APR_DRG
|
Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection
|
5
|
5
|
—
|
—
|
$67,252.34
|
$67,252.34
|
$67,252.34
|
2025-08-26
|
|
894
|
APR_DRG
|
Major Cranial Or Facial Bone Procedures
|
5
|
5
|
—
|
—
|
$67,245.66
|
$67,245.66
|
$67,245.66
|
2025-08-26
|
|
791
|
MS_DRG
|
Prematurity With Major Problems
|
32
|
13
|
—
|
—
|
$30,705.16
|
$103,613.75
|
$67,159.46
|
2025-08-26
|
|
J9226
|
HCPCS
|
Supprelin La Implant
|
24
|
13
|
—
|
—
|
$20,266.98
|
$197,966.04
|
$66,863.91
|
2025-08-26
|
|
802
|
MS_DRG
|
Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc
|
32
|
13
|
—
|
—
|
$32,985.95
|
$95,246.63
|
$66,849.35
|
2025-08-26
|
|
651
|
MS_DRG
|
Kidney Transplant With Hemodialysis Without Mcc
|
30
|
12
|
—
|
—
|
$31,982.45
|
$88,610.54
|
$66,847.46
|
2025-08-26
|
|
97
|
MS_DRG
|
Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc
|
32
|
13
|
—
|
—
|
$32,984.17
|
$97,150.57
|
$66,845.62
|
2025-08-26
|
|
518
|
MS_DRG
|
Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost…
|
32
|
13
|
—
|
—
|
$32,978.81
|
$93,140.31
|
$66,834.43
|
2025-08-26
|
|
265
|
MS_DRG
|
Aicd Lead Procedures
|
32
|
13
|
—
|
—
|
$32,828.68
|
$91,027.29
|
$66,521.15
|
2025-08-26
|
|
93581
|
CPT
|
Hc Percutaneous Transcatheter Closure Congenital Ventricular Septal Defect W/imp…
|
61
|
17
|
$90,992.00
|
$36,396.80
60% off
|
$7,177.59
|
$89,798.29
|
$66,424.16
|
2025-08-26
|
|
C9767
|
HCPCS
|
C Revascularization,any Vessel,w/intravascular Lithotripsy Stent Placement And A…
|
56
|
17
|
$90,992.00
|
$36,396.80
60% off
|
$5,022.44
|
$89,798.29
|
$66,424.16
|
2025-08-26
|
|
956
|
MS_DRG
|
Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma
|
27
|
13
|
—
|
—
|
$35,109.12
|
$97,542.54
|
$66,325.83
|
2025-08-26
|
|
492
|
MS_DRG
|
Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc
|
32
|
13
|
—
|
—
|
$32,685.71
|
$90,621.52
|
$66,222.78
|
2025-08-26
|
|
L7181
|
HCPCS
|
Electronic Elbo Simultaneous
|
20
|
11
|
—
|
—
|
$47,655.06
|
$189,550.45
|
$66,210.12
|
2025-08-26
|
|
495
|
MS_DRG
|
Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit…
|
32
|
13
|
—
|
—
|
$32,412.27
|
$92,808.00
|
$65,652.15
|
2025-08-26
|
|
408
|
MS_DRG
|
Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With…
|
32
|
13
|
—
|
—
|
$32,239.81
|
$91,686.13
|
$65,606.68
|
2025-08-26
|
|
414
|
MS_DRG
|
Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc
|
32
|
13
|
—
|
—
|
$32,262.15
|
$89,411.87
|
$65,338.86
|
2025-08-26
|
|
987
|
MS_DRG
|
Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc
|
32
|
13
|
—
|
—
|
$32,252.32
|
$89,396.56
|
$65,318.35
|
2025-08-26
|
|
6083
|
APR_DRG
|
Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition
|
5
|
5
|
—
|
—
|
$65,222.94
|
$65,222.94
|
$65,222.94
|
2025-08-26
|
|
264
|
MS_DRG
|
Other Circulatory System O.r. Procedures
|
32
|
13
|
—
|
—
|
$32,184.41
|
$89,189.85
|
$65,104.44
|
2025-08-26
|
|
6313
|
APR_DRG
|
Neonate Birth Weight > 2499 Grams With Other Major Procedure
|
5
|
5
|
—
|
—
|
$64,970.86
|
$64,970.86
|
$64,970.86
|
2025-08-26
|
|
904
|
MS_DRG
|
Skin Grafts For Injuries With Cc/mcc
|
32
|
13
|
—
|
—
|
$35,454.94
|
$98,530.17
|
$64,925.65
|
2025-08-26
|
|
C9775
|
HCPCS
|
Hc Revascularization,endovascular,open/percutaneous,tibial/peroneal Artery(ies),…
|
53
|
17
|
$88,828.00
|
$35,531.20
60% off
|
$5,022.44
|
$89,798.29
|
$64,844.44
|
2025-08-26
|
|
C9773
|
HCPCS
|
Hc Revascularization,endovascular,open Or Percutaneous,tibial/peroneal Artery(ie…
|
53
|
17
|
$88,828.00
|
$35,531.20
60% off
|
$5,022.44
|
$89,798.29
|
$64,844.44
|
2025-08-26
|
|
C9774
|
HCPCS
|
Hc Revascularization,endovascular, Open Or Percutaneous,tibial/peroneal Artery(i…
|
53
|
17
|
$88,828.00
|
$35,531.20
60% off
|
$5,022.44
|
$89,798.29
|
$64,844.44
|
2025-08-26
|
|
36837
|
CPT
|
Hc Percutaneous Fistula Creation Upper Extremity Separate Access Artery And Vei…
|
56
|
17
|
$88,809.00
|
$35,523.60
60% off
|
$2,505.44
|
$89,798.29
|
$64,830.57
|
2025-08-26
|
|
36836
|
CPT
|
Hc Percutaneous Fistula Creation Upper Extremity Single Access Artery And Vein I…
|
56
|
17
|
$88,809.00
|
$35,523.60
60% off
|
$2,505.44
|
$89,798.29
|
$64,830.57
|
2025-08-26
|
|
274
|
APR_DRG
|
Other Open Craniotomy
|
5
|
5
|
—
|
—
|
$64,815.17
|
$64,815.17
|
$64,815.17
|
2025-08-26
|
|
332
|
MS_DRG
|
Rectal Resection With Mcc
|
32
|
13
|
—
|
—
|
$31,948.50
|
$101,450.66
|
$64,684.32
|
2025-08-26
|
|
574
|
MS_DRG
|
Skin Graft For Skin Ulcer Or Cellulitis With Cc
|
32
|
13
|
—
|
—
|
$31,914.54
|
$90,064.54
|
$64,613.46
|
2025-08-26
|
|
271
|
MS_DRG
|
Other Major Cardiovascular Procedures With Cc
|
32
|
13
|
—
|
—
|
$31,731.36
|
$87,901.09
|
$64,231.17
|
2025-08-26
|
|
234
|
APR_DRG
|
Spinal Procedures
|
5
|
5
|
—
|
—
|
$64,170.84
|
$64,170.84
|
$64,170.84
|
2025-08-26
|
|
477
|
MS_DRG
|
Biopsies Of Musculoskeletal System And Connective Tissue With Mcc
|
32
|
13
|
—
|
—
|
$31,683.10
|
$87,758.18
|
$64,130.47
|
2025-08-26
|
|
252
|
MS_DRG
|
Other Vascular Procedures With Mcc
|
32
|
13
|
—
|
—
|
$31,606.25
|
$87,538.70
|
$63,970.10
|
2025-08-26
|
|
467
|
MS_DRG
|
Revision Of Hip Or Knee Replacement With Cc
|
32
|
13
|
—
|
—
|
$31,559.79
|
$90,596.74
|
$63,873.13
|
2025-08-26
|
|
420
|
MS_DRG
|
Hepatobiliary Diagnostic Procedures With Mcc
|
32
|
13
|
—
|
—
|
$32,491.80
|
$90,065.18
|
$63,804.75
|
2025-08-26
|
|
279
|
MS_DRG
|
Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures …
|
27
|
11
|
—
|
—
|
$29,586.74
|
$81,771.18
|
$63,800.76
|
2025-08-26
|
|
260
|
MS_DRG
|
Cardiac Pacemaker Revision Except Device Replacement With Mcc
|
32
|
13
|
—
|
—
|
$31,390.00
|
$87,416.02
|
$63,518.82
|
2025-08-26
|
|
204
|
APR_DRG
|
Open Craniotomy For Trauma
|
5
|
5
|
—
|
—
|
$63,412.94
|
$63,412.94
|
$63,412.94
|
2025-08-26
|
|
224
|
APR_DRG
|
Ventricular Shunt Procedures
|
5
|
5
|
—
|
—
|
$63,351.60
|
$63,351.60
|
$63,351.60
|
2025-08-26
|
|
242
|
MS_DRG
|
Permanent Cardiac Pacemaker Implant With Mcc
|
32
|
13
|
—
|
—
|
$31,263.11
|
$86,788.87
|
$63,254.02
|
2025-08-26
|
|
2204
|
APR_DRG
|
Major Stomach, Esophageal And Duodenal Procedures
|
5
|
5
|
—
|
—
|
$63,232.79
|
$63,232.79
|
$63,232.79
|
2025-08-26
|
|
0915T
|
CPT
|
Insj Perm Ccm-d Sys Pg&eltrd
|
14
|
9
|
—
|
—
|
$36,681.47
|
$161,558.30
|
$62,963.93
|
2025-08-26
|
|
3614
|
APR_DRG
|
Skin Graft For Skin And Subcutaneous Tissue Diagnoses
|
5
|
5
|
—
|
—
|
$62,851.47
|
$62,851.47
|
$62,851.47
|
2025-08-26
|
|
9504
|
APR_DRG
|
Extensive O.r. Procedure Unrelated To Principal Diagnosis
|
5
|
5
|
—
|
—
|
$62,716.76
|
$62,716.76
|
$62,716.76
|
2025-08-26
|
|
52
|
APR_DRG
|
Tracheostomy With Mv >96 Hours Without Extensive Procedure
|
5
|
5
|
—
|
—
|
$62,706.58
|
$62,706.58
|
$62,706.58
|
2025-08-26
|
|
33903
|
CPT
|
Hc Percutaneous Pulmonary Artery Revascularization By Stent Placement Initial Ab…
|
58
|
17
|
$85,870.00
|
$34,348.00
60% off
|
$6,107.42
|
$73,848.20
|
$62,685.10
|
2025-08-26
|
|
29
|
MS_DRG
|
Spinal Procedures With Cc Or Spinal Neurostimulators
|
32
|
13
|
—
|
—
|
$30,947.68
|
$85,657.88
|
$62,595.74
|
2025-08-26
|
|
4414
|
APR_DRG
|
Major Bladder Procedures
|
5
|
5
|
—
|
—
|
$62,150.85
|
$62,150.85
|
$62,150.85
|
2025-08-26
|
|
6144
|
APR_DRG
|
Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition
|
5
|
5
|
—
|
—
|
$61,981.39
|
$61,981.39
|
$61,981.39
|
2025-08-26
|
|
37
|
MS_DRG
|
Extracranial Procedures With Mcc
|
32
|
13
|
—
|
—
|
$30,627.77
|
$84,744.26
|
$61,928.14
|
2025-08-26
|
|
L7180
|
HCPCS
|
Electronic Elbow Sequential
|
20
|
11
|
—
|
—
|
$44,387.45
|
$176,553.31
|
$61,670.22
|
2025-08-26
|
|
143
|
MS_DRG
|
Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc
|
30
|
12
|
—
|
—
|
$30,457.99
|
$84,259.38
|
$61,640.07
|
2025-08-26
|
|
665
|
MS_DRG
|
Prostatectomy With Mcc
|
32
|
13
|
—
|
—
|
$31,634.85
|
$87,620.37
|
$61,578.12
|
2025-08-26
|