|
640
|
MS_DRG
|
Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes With M…
|
7
|
7
|
$198,476.00
|
$168,704.60
|
$158,780.80
|
$188,552.20
|
$185,575.06
|
2026-02-04
|
|
808
|
MS_DRG
|
Major Hematological And Immunological Diagnoses Except Sickle Cell Crisis And Co…
|
7
|
7
|
$133,610.55
|
$113,568.97
|
$106,888.44
|
$126,930.02
|
$124,925.86
|
2026-02-04
|
|
94
|
MS_DRG
|
Bacterial And Tuberculous Infections Of Nervous System With Mcc
|
7
|
7
|
$131,113.00
|
$111,446.05
|
$104,890.40
|
$124,557.35
|
$122,590.66
|
2026-02-04
|
|
241
|
MS_DRG
|
Amputation For Circulatory System Disorders Except Upper Limb And Toe Without Cc…
|
7
|
7
|
$118,259.00
|
$100,520.15
|
$94,607.20
|
$112,346.05
|
$110,572.17
|
2026-02-04
|
|
624
|
MS_DRG
|
Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor…
|
7
|
7
|
$103,992.11
|
$88,393.29
|
$83,193.69
|
$98,792.50
|
$97,232.62
|
2026-02-04
|
|
913
|
MS_DRG
|
Traumatic Injury With Mcc
|
7
|
7
|
$95,269.00
|
$80,978.65
|
$76,215.20
|
$90,505.55
|
$89,076.51
|
2026-02-04
|
|
918
|
MS_DRG
|
Poisoning And Toxic Effects Of Drugs Without Mcc
|
7
|
7
|
$77,180.71
|
$65,603.60
|
$61,744.57
|
$73,321.67
|
$72,163.96
|
2026-02-04
|
|
296
|
MS_DRG
|
Cardiac Arrest, Unexplained With Mcc
|
7
|
7
|
$74,805.38
|
$63,584.57
|
$59,844.30
|
$71,065.11
|
$69,943.03
|
2026-02-04
|
|
329
|
MS_DRG
|
Major Small And Large Bowel Procedures With Mcc
|
7
|
7
|
$70,755.48
|
$60,142.16
|
$56,604.38
|
$67,217.71
|
$66,156.37
|
2026-02-04
|
|
661
|
MS_DRG
|
Kidney And Ureter Procedures For Non-neoplasm Without Cc/mcc
|
7
|
7
|
$64,927.97
|
$55,188.77
|
$51,942.38
|
$61,681.57
|
$60,707.65
|
2026-02-04
|
|
336
|
MS_DRG
|
Peritoneal Adhesiolysis With Cc
|
7
|
7
|
$64,423.91
|
$54,760.32
|
$51,539.13
|
$61,202.71
|
$60,236.36
|
2026-02-04
|
|
208
|
MS_DRG
|
Respiratory System Diagnosis With Ventilator Support <=96 Hours
|
7
|
7
|
$63,993.06
|
$54,394.10
|
$51,194.44
|
$60,793.40
|
$59,833.51
|
2026-02-04
|
|
896
|
MS_DRG
|
Alcohol, Drug Abuse Or Dependence Without Rehabilitation Therapy With Mcc
|
7
|
7
|
$61,086.98
|
$51,923.93
|
$48,869.58
|
$58,032.63
|
$57,116.32
|
2026-02-04
|
|
330
|
MS_DRG
|
Major Small And Large Bowel Procedures With Cc
|
7
|
7
|
$60,241.34
|
$51,205.14
|
$48,193.08
|
$57,229.28
|
$56,325.66
|
2026-02-04
|
|
470
|
MS_DRG
|
Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity Without …
|
7
|
7
|
$59,621.68
|
$50,678.43
|
$47,697.34
|
$56,640.59
|
$55,746.27
|
2026-02-04
|
|
521
|
MS_DRG
|
Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc
|
7
|
7
|
$58,787.50
|
$49,969.38
|
$47,030.00
|
$55,848.13
|
$54,966.31
|
2026-02-04
|
|
480
|
MS_DRG
|
Hip And Femur Procedures Except Major Joint With Mcc
|
7
|
7
|
$54,989.98
|
$46,741.48
|
$43,991.98
|
$52,240.48
|
$51,415.63
|
2026-02-04
|
|
522
|
MS_DRG
|
Hip Replacement With Principal Diagnosis Of Hip Fracture Without Mcc
|
7
|
7
|
$54,102.92
|
$45,987.48
|
$43,282.34
|
$51,397.78
|
$50,586.23
|
2026-02-04
|
|
142
|
MS_DRG
|
Major Head And Neck Procedures Without Cc/mcc
|
7
|
7
|
$53,620.10
|
$45,577.09
|
$42,896.08
|
$50,939.10
|
$50,134.79
|
2026-02-04
|
|
177
|
MS_DRG
|
Respiratory Infections And Inflammations With Mcc
|
7
|
7
|
$52,766.20
|
$44,851.27
|
$42,212.96
|
$50,127.89
|
$49,336.40
|
2026-02-04
|
|
493
|
MS_DRG
|
Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Cc
|
7
|
7
|
$52,226.28
|
$44,392.34
|
$41,781.02
|
$49,614.97
|
$48,831.57
|
2026-02-04
|
|
72
|
MS_DRG
|
Other Cerebrovascular Disorders Without Cc/mcc
|
7
|
7
|
$49,082.07
|
$41,719.76
|
$39,265.66
|
$46,627.97
|
$45,891.74
|
2026-02-04
|
|
840
|
MS_DRG
|
Lymphoma And Non-acute Leukemia With Mcc
|
7
|
7
|
$45,874.63
|
$38,993.44
|
$36,699.70
|
$43,580.90
|
$42,892.78
|
2026-02-04
|
|
331
|
MS_DRG
|
Major Small And Large Bowel Procedures Without Cc/mcc
|
7
|
7
|
$45,811.39
|
$38,939.68
|
$36,649.11
|
$43,520.82
|
$42,833.65
|
2026-02-04
|
|
C9765
|
HCPCS
|
Revascularization, Endovascular, Open Or Percutaneous, Lower Extremity Artery(ie…
|
8
|
8
|
$50,000.00
|
$42,500.00
|
$18,000.00
|
$47,500.00
|
$42,500.00
|
2026-02-04
|
|
340
|
MS_DRG
|
Appendectomy With Complicated Principal Diagnosis Without Cc/mcc
|
7
|
7
|
$45,145.46
|
$38,373.64
|
$36,116.37
|
$42,888.19
|
$42,211.01
|
2026-02-04
|
|
337
|
MS_DRG
|
Peritoneal Adhesiolysis Without Cc/mcc
|
7
|
7
|
$44,907.12
|
$38,171.05
|
$35,925.70
|
$42,661.76
|
$41,988.16
|
2026-02-04
|
|
206
|
MS_DRG
|
Other Respiratory System Diagnoses Without Mcc
|
7
|
7
|
$44,725.00
|
$38,016.25
|
$35,780.00
|
$42,488.75
|
$41,817.88
|
2026-02-04
|
|
433
|
MS_DRG
|
Cirrhosis And Alcoholic Hepatitis With Cc
|
7
|
7
|
$43,291.37
|
$36,797.67
|
$34,633.10
|
$41,126.80
|
$40,477.43
|
2026-02-04
|
|
434
|
MS_DRG
|
Cirrhosis And Alcoholic Hepatitis Without Cc/mcc
|
7
|
7
|
$43,051.50
|
$36,593.78
|
$34,441.20
|
$40,898.93
|
$40,253.15
|
2026-02-04
|
|
482
|
MS_DRG
|
Hip And Femur Procedures Except Major Joint Without Cc/mcc
|
7
|
7
|
$41,880.33
|
$35,598.28
|
$33,504.26
|
$39,786.31
|
$39,158.11
|
2026-02-04
|
|
481
|
MS_DRG
|
Hip And Femur Procedures Except Major Joint With Cc
|
7
|
7
|
$40,475.02
|
$34,403.76
|
$32,380.01
|
$38,451.26
|
$37,844.14
|
2026-02-04
|
|
280
|
MS_DRG
|
Acute Myocardial Infarction, Discharged Alive With Mcc
|
7
|
7
|
$40,318.84
|
$34,271.01
|
$32,255.07
|
$38,302.90
|
$37,698.12
|
2026-02-04
|
|
254
|
MS_DRG
|
Other Vascular Procedures Without Cc/mcc
|
7
|
7
|
$39,773.04
|
$33,807.08
|
$31,818.43
|
$37,784.38
|
$37,187.79
|
2026-02-04
|
|
297
|
MS_DRG
|
Cardiac Arrest, Unexplained With Cc
|
7
|
7
|
$39,700.14
|
$33,745.12
|
$31,760.11
|
$37,715.13
|
$37,119.63
|
2026-02-04
|
|
342
|
MS_DRG
|
Appendectomy Without Complicated Principal Diagnosis With Cc
|
7
|
7
|
$39,028.03
|
$33,173.83
|
$31,222.42
|
$37,076.63
|
$36,491.21
|
2026-02-04
|
|
39
|
MS_DRG
|
Extracranial Procedures Without Cc/mcc
|
7
|
7
|
$38,511.25
|
$32,734.56
|
$30,809.00
|
$36,585.69
|
$36,008.02
|
2026-02-04
|
|
494
|
MS_DRG
|
Lower Extremity And Humerus Procedures Except Hip, Foot And Femur Without Cc/mcc
|
7
|
7
|
$37,738.25
|
$32,077.51
|
$30,190.60
|
$35,851.34
|
$35,285.26
|
2026-02-04
|
|
419
|
MS_DRG
|
Laparoscopic Cholecystectomy Without C.d.e. Without Cc/mcc
|
7
|
7
|
$37,237.22
|
$31,651.64
|
$29,789.78
|
$35,375.36
|
$34,816.80
|
2026-02-04
|
|
375
|
MS_DRG
|
Digestive Malignancy With Cc
|
7
|
7
|
$36,080.99
|
$30,668.84
|
$28,864.79
|
$34,276.94
|
$33,735.73
|
2026-02-04
|
|
989
|
MS_DRG
|
Non-extensive O.r. Procedures Unrelated To Principal Diagnosis Without Cc/mcc
|
7
|
7
|
$35,935.92
|
$30,545.53
|
$28,748.74
|
$34,139.12
|
$33,600.09
|
2026-02-04
|
|
593
|
MS_DRG
|
Skin Ulcers With Cc
|
7
|
7
|
$35,825.66
|
$30,451.81
|
$28,660.53
|
$34,034.38
|
$33,496.99
|
2026-02-04
|
|
469
|
MS_DRG
|
Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc…
|
7
|
7
|
$35,335.29
|
$30,034.99
|
$28,268.23
|
$33,568.52
|
$33,038.49
|
2026-02-04
|
|
349
|
MS_DRG
|
Anal And Stomal Procedures Without Cc/mcc
|
7
|
7
|
$34,057.40
|
$28,948.79
|
$27,245.92
|
$32,354.53
|
$31,843.67
|
2026-02-04
|
|
983
|
MS_DRG
|
Extensive O.r. Procedures Unrelated To Principal Diagnosis Without Cc/mcc
|
7
|
7
|
$33,703.55
|
$28,648.02
|
$26,962.84
|
$32,018.37
|
$31,512.82
|
2026-02-04
|
|
439
|
MS_DRG
|
Disorders Of Pancreas Except Malignancy With Cc
|
7
|
7
|
$32,845.50
|
$27,918.67
|
$26,276.40
|
$31,203.22
|
$30,710.54
|
2026-02-04
|
|
747
|
MS_DRG
|
Vagina, Cervix And Vulva Procedures Without Cc/mcc
|
7
|
7
|
$32,243.92
|
$27,407.33
|
$25,795.14
|
$30,631.72
|
$30,148.07
|
2026-02-04
|
|
355
|
MS_DRG
|
Hernia Procedures Except Inguinal And Femoral Without Cc/mcc
|
7
|
7
|
$31,728.67
|
$26,969.37
|
$25,382.94
|
$30,142.24
|
$29,666.31
|
2026-02-04
|
|
389
|
MS_DRG
|
Gastrointestinal Obstruction With Cc
|
7
|
7
|
$31,566.52
|
$26,831.54
|
$25,253.22
|
$29,988.20
|
$29,514.70
|
2026-02-04
|
|
637
|
MS_DRG
|
Diabetes With Mcc
|
7
|
7
|
$31,433.34
|
$26,718.33
|
$25,146.67
|
$29,861.67
|
$29,390.17
|
2026-02-04
|
|
418
|
MS_DRG
|
Laparoscopic Cholecystectomy Without C.d.e. With Cc
|
7
|
7
|
$30,978.71
|
$26,331.91
|
$24,782.97
|
$29,429.78
|
$28,965.10
|
2026-02-04
|
|
56
|
MS_DRG
|
Degenerative Nervous System Disorders With Mcc
|
7
|
7
|
$29,712.38
|
$25,255.52
|
$23,769.90
|
$28,226.76
|
$27,781.07
|
2026-02-04
|
|
64
|
MS_DRG
|
Intracranial Hemorrhage Or Cerebral Infarction With Mcc
|
7
|
7
|
$29,698.29
|
$25,243.55
|
$23,758.63
|
$28,213.38
|
$27,767.90
|
2026-02-04
|
|
354
|
MS_DRG
|
Hernia Procedures Except Inguinal And Femoral With Cc
|
7
|
7
|
$29,362.73
|
$24,958.32
|
$23,490.18
|
$27,894.59
|
$27,454.15
|
2026-02-04
|
|
558
|
MS_DRG
|
Tendonitis, Myositis And Bursitis Without Mcc
|
7
|
7
|
$29,052.27
|
$24,694.43
|
$23,241.82
|
$27,599.66
|
$27,163.87
|
2026-02-04
|
|
J2327
|
HCPCS
|
Injection, Risankizumab-rzaa, Intravenous, 1 Mg
|
8
|
8
|
$31,771.25
|
$27,005.56
|
$11,437.65
|
$30,182.69
|
$27,005.56
|
2026-02-04
|
|
308
|
MS_DRG
|
Cardiac Arrhythmia And Conduction Disorders With Mcc
|
7
|
7
|
$27,096.84
|
$23,032.31
|
$21,677.47
|
$25,742.00
|
$25,335.55
|
2026-02-04
|
|
442
|
MS_DRG
|
Disorders Of Liver Except Malignancy, Cirrhosis Or Alcoholic Hepatitis With Cc
|
7
|
7
|
$26,945.34
|
$22,903.54
|
$21,556.27
|
$25,598.07
|
$25,193.89
|
2026-02-04
|
|
917
|
MS_DRG
|
Poisoning And Toxic Effects Of Drugs With Mcc
|
7
|
7
|
$26,782.86
|
$22,765.43
|
$21,426.29
|
$25,443.72
|
$25,041.97
|
2026-02-04
|
|
603
|
MS_DRG
|
Cellulitis Without Mcc
|
7
|
7
|
$25,786.47
|
$21,918.50
|
$20,629.17
|
$24,497.14
|
$24,110.35
|
2026-02-04
|
|
909
|
MS_DRG
|
Other O.r. Procedures For Injuries Without Cc/mcc
|
7
|
7
|
$25,509.70
|
$21,683.25
|
$20,407.76
|
$24,234.22
|
$23,851.57
|
2026-02-04
|
|
307
|
MS_DRG
|
Cardiac Congenital And Valvular Disorders Without Mcc
|
7
|
7
|
$25,425.17
|
$21,611.39
|
$20,340.14
|
$24,153.91
|
$23,772.53
|
2026-02-04
|
|
314
|
MS_DRG
|
Other Circulatory System Diagnoses With Mcc
|
7
|
7
|
$25,203.42
|
$21,422.91
|
$20,162.74
|
$23,943.25
|
$23,565.20
|
2026-02-04
|
|
948
|
MS_DRG
|
Signs And Symptoms Without Mcc
|
7
|
7
|
$25,007.51
|
$21,256.38
|
$20,006.01
|
$23,757.13
|
$23,382.02
|
2026-02-04
|
|
810
|
MS_DRG
|
Major Hematological And Immunological Diagnoses Except Sickle Cell Crisis And Co…
|
7
|
7
|
$24,870.06
|
$21,139.55
|
$19,896.05
|
$23,626.56
|
$23,253.51
|
2026-02-04
|
|
571
|
MS_DRG
|
Skin Debridement With Cc
|
7
|
7
|
$24,409.25
|
$20,747.86
|
$19,527.40
|
$23,188.79
|
$22,822.65
|
2026-02-04
|
|
602
|
MS_DRG
|
Cellulitis With Mcc
|
7
|
7
|
$24,192.98
|
$20,564.03
|
$19,354.38
|
$22,983.33
|
$22,620.43
|
2026-02-04
|
|
J3380
|
HCPCS
|
Injection, Vedolizumab, Intravenous, 1 Mg
|
8
|
8
|
$26,490.50
|
$22,516.93
|
$9,536.58
|
$25,165.98
|
$22,516.93
|
2026-02-04
|
|
683
|
MS_DRG
|
Renal Failure With Cc
|
7
|
7
|
$23,716.43
|
$20,158.96
|
$18,973.14
|
$22,530.60
|
$22,174.86
|
2026-02-04
|
|
388
|
MS_DRG
|
Gastrointestinal Obstruction With Mcc
|
7
|
7
|
$23,343.17
|
$19,841.69
|
$18,674.54
|
$22,176.01
|
$21,825.86
|
2026-02-04
|
|
563
|
MS_DRG
|
Fracture, Sprain, Strain And Dislocation Except Femur, Hip, Pelvis And Thigh Wit…
|
7
|
7
|
$23,183.27
|
$19,705.78
|
$18,546.62
|
$22,024.11
|
$21,676.36
|
2026-02-04
|
|
872
|
MS_DRG
|
Septicemia Or Severe Sepsis Without Mv >96 Hours Without Mcc
|
7
|
7
|
$22,864.27
|
$19,434.63
|
$18,291.41
|
$21,721.05
|
$21,378.09
|
2026-02-04
|
|
392
|
MS_DRG
|
Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders Without Mcc
|
7
|
7
|
$22,825.96
|
$19,402.06
|
$18,260.77
|
$21,684.66
|
$21,342.27
|
2026-02-04
|
|
638
|
MS_DRG
|
Diabetes With Cc
|
7
|
7
|
$22,678.50
|
$19,276.73
|
$18,142.80
|
$21,544.58
|
$21,204.40
|
2026-02-04
|
|
440
|
MS_DRG
|
Disorders Of Pancreas Except Malignancy Without Cc/mcc
|
7
|
7
|
$22,615.42
|
$19,223.10
|
$18,092.33
|
$21,484.65
|
$21,145.41
|
2026-02-04
|
|
186
|
MS_DRG
|
Pleural Effusion With Mcc
|
7
|
7
|
$21,734.24
|
$18,474.10
|
$17,387.39
|
$20,647.52
|
$20,321.51
|
2026-02-04
|
|
592
|
MS_DRG
|
Skin Ulcers With Mcc
|
7
|
7
|
$21,000.20
|
$17,850.17
|
$16,800.16
|
$19,950.19
|
$19,635.19
|
2026-02-04
|
|
391
|
MS_DRG
|
Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders With Mcc
|
7
|
7
|
$20,473.58
|
$17,402.54
|
$16,378.86
|
$19,449.90
|
$19,142.80
|
2026-02-04
|
|
682
|
MS_DRG
|
Renal Failure With Mcc
|
7
|
7
|
$20,267.00
|
$17,226.95
|
$16,213.60
|
$19,253.65
|
$18,949.65
|
2026-02-04
|
|
J3101
|
HCPCS
|
Injection, Tenecteplase, 1 Mg
|
8
|
8
|
$22,198.20
|
$18,868.47
|
$7,991.35
|
$21,088.29
|
$18,868.47
|
2026-02-04
|
|
871
|
MS_DRG
|
Septicemia Or Severe Sepsis Without Mv >96 Hours With Mcc
|
7
|
7
|
$20,050.95
|
$17,043.31
|
$16,040.76
|
$19,048.40
|
$18,747.64
|
2026-02-04
|
|
700
|
MS_DRG
|
Other Kidney And Urinary Tract Diagnoses Without Cc/mcc
|
7
|
7
|
$20,028.05
|
$17,023.84
|
$16,022.44
|
$19,026.65
|
$18,726.23
|
2026-02-04
|
|
372
|
MS_DRG
|
Major Gastrointestinal Disorders And Peritoneal Infections With Cc
|
7
|
7
|
$19,927.19
|
$16,938.11
|
$15,941.75
|
$18,930.83
|
$18,631.92
|
2026-02-04
|
|
605
|
MS_DRG
|
Trauma To The Skin, Subcutaneous Tissue And Breast Without Mcc
|
7
|
7
|
$19,650.22
|
$16,702.69
|
$15,720.18
|
$18,667.71
|
$18,372.96
|
2026-02-04
|
|
373
|
MS_DRG
|
Major Gastrointestinal Disorders And Peritoneal Infections Without Cc/mcc
|
7
|
7
|
$19,131.55
|
$16,261.81
|
$15,305.24
|
$18,174.97
|
$17,887.99
|
2026-02-04
|
|
776
|
MS_DRG
|
Postpartum And Post Abortion Diagnoses Without O.r. Procedures
|
7
|
7
|
$19,086.71
|
$16,223.70
|
$15,269.37
|
$18,132.37
|
$17,846.07
|
2026-02-04
|
|
897
|
MS_DRG
|
Alcohol, Drug Abuse Or Dependence Without Rehabilitation Therapy Without Mcc
|
7
|
7
|
$18,688.70
|
$15,885.39
|
$14,950.96
|
$17,754.26
|
$17,473.93
|
2026-02-04
|
|
74
|
MS_DRG
|
Cranial And Peripheral Nerve Disorders Without Mcc
|
7
|
7
|
$18,618.75
|
$15,825.94
|
$14,895.00
|
$17,687.81
|
$17,408.53
|
2026-02-04
|
|
291
|
MS_DRG
|
Heart Failure And Shock With Mcc
|
7
|
7
|
$18,451.01
|
$15,683.36
|
$14,760.81
|
$17,528.46
|
$17,251.70
|
2026-02-04
|
|
178
|
MS_DRG
|
Respiratory Infections And Inflammations With Cc
|
7
|
7
|
$18,257.06
|
$15,518.50
|
$14,605.65
|
$17,344.20
|
$17,070.35
|
2026-02-04
|
|
438
|
MS_DRG
|
Disorders Of Pancreas Except Malignancy With Mcc
|
7
|
7
|
$18,117.92
|
$15,400.23
|
$14,494.33
|
$17,212.02
|
$16,940.25
|
2026-02-04
|
|
894
|
MS_DRG
|
Alcohol, Drug Abuse Or Dependence, Left Ama
|
7
|
7
|
$18,045.55
|
$15,338.71
|
$14,436.44
|
$17,143.27
|
$16,872.58
|
2026-02-04
|
|
101
|
MS_DRG
|
Seizures Without Mcc
|
7
|
7
|
$17,865.24
|
$15,185.45
|
$14,292.19
|
$16,971.97
|
$16,703.99
|
2026-02-04
|
|
309
|
MS_DRG
|
Cardiac Arrhythmia And Conduction Disorders With Cc
|
7
|
7
|
$17,778.50
|
$15,111.72
|
$14,222.80
|
$16,889.57
|
$16,622.90
|
2026-02-04
|
|
100
|
MS_DRG
|
Seizures With Mcc
|
7
|
7
|
$17,607.41
|
$14,966.30
|
$14,085.93
|
$16,727.04
|
$16,462.93
|
2026-02-04
|
|
305
|
MS_DRG
|
Hypertension Without Mcc
|
7
|
7
|
$17,419.95
|
$14,806.96
|
$13,935.96
|
$16,548.95
|
$16,287.65
|
2026-02-04
|
|
394
|
MS_DRG
|
Other Digestive System Diagnoses With Cc
|
7
|
7
|
$17,154.82
|
$14,581.60
|
$13,723.86
|
$16,297.08
|
$16,039.76
|
2026-02-04
|
|
71
|
MS_DRG
|
Other Cerebrovascular Disorders With Cc
|
7
|
7
|
$17,141.50
|
$14,570.28
|
$13,713.20
|
$16,284.43
|
$16,027.30
|
2026-02-04
|
|
184
|
MS_DRG
|
Major Chest Trauma With Cc
|
7
|
7
|
$17,124.27
|
$14,555.63
|
$13,699.41
|
$16,268.05
|
$16,011.19
|
2026-02-04
|
|
690
|
MS_DRG
|
Kidney And Urinary Tract Infections Without Mcc
|
7
|
7
|
$16,786.77
|
$14,268.75
|
$13,429.41
|
$15,947.43
|
$15,695.63
|
2026-02-04
|
|
189
|
MS_DRG
|
Pulmonary Edema And Respiratory Failure
|
7
|
7
|
$16,585.82
|
$14,097.95
|
$13,268.66
|
$15,756.53
|
$15,507.74
|
2026-02-04
|
|
594
|
MS_DRG
|
Skin Ulcers Without Cc/mcc
|
7
|
7
|
$16,367.75
|
$13,912.59
|
$13,094.20
|
$15,549.36
|
$15,303.85
|
2026-02-04
|
|
304
|
MS_DRG
|
Hypertension With Mcc
|
7
|
7
|
$15,979.59
|
$13,582.65
|
$12,783.67
|
$15,180.61
|
$14,940.92
|
2026-02-04
|
|
758
|
MS_DRG
|
Infections, Female Reproductive System With Cc
|
7
|
7
|
$15,689.34
|
$13,335.94
|
$12,551.47
|
$14,904.87
|
$14,669.53
|
2026-02-04
|
|
201
|
MS_DRG
|
Pneumothorax Without Cc/mcc
|
7
|
7
|
$15,268.97
|
$12,978.62
|
$12,215.18
|
$14,505.52
|
$14,276.49
|
2026-02-04
|
|
289
|
MS_DRG
|
Acute And Subacute Endocarditis With Cc
|
7
|
7
|
$15,150.13
|
$12,877.61
|
$12,120.10
|
$14,392.62
|
$14,165.37
|
2026-02-04
|
|
281
|
MS_DRG
|
Acute Myocardial Infarction, Discharged Alive With Cc
|
7
|
7
|
$15,099.86
|
$12,834.88
|
$12,079.89
|
$14,344.87
|
$14,118.37
|
2026-02-04
|
|
639
|
MS_DRG
|
Diabetes Without Cc/mcc
|
7
|
7
|
$15,075.44
|
$12,814.13
|
$12,060.35
|
$14,321.67
|
$14,095.54
|
2026-02-04
|
|
193
|
MS_DRG
|
Simple Pneumonia And Pleurisy With Mcc
|
7
|
7
|
$14,686.45
|
$12,483.48
|
$11,749.16
|
$13,952.12
|
$13,731.83
|
2026-02-04
|
|
66
|
MS_DRG
|
Intracranial Hemorrhage Or Cerebral Infarction Without Cc/mcc
|
7
|
7
|
$14,427.00
|
$12,262.95
|
$11,541.60
|
$13,705.65
|
$13,489.24
|
2026-02-04
|
|
J1569
|
HCPCS
|
Injection, Immune Globulin, (gammagard Liquid), Non-lyophilized, (e.g., Liquid),…
|
8
|
8
|
$15,693.00
|
$13,339.05
|
$5,649.48
|
$14,908.35
|
$13,339.05
|
2026-02-04
|
|
194
|
MS_DRG
|
Simple Pneumonia And Pleurisy With Cc
|
7
|
7
|
$14,014.59
|
$11,912.40
|
$11,211.67
|
$13,313.86
|
$13,103.64
|
2026-02-04
|
|
835
|
MS_DRG
|
Acute Leukemia With Cc
|
7
|
7
|
$13,903.25
|
$11,817.76
|
$11,122.60
|
$13,208.09
|
$12,999.54
|
2026-02-04
|
|
293
|
MS_DRG
|
Heart Failure And Shock Without Cc/mcc
|
7
|
7
|
$13,523.79
|
$11,495.22
|
$10,819.03
|
$12,847.60
|
$12,644.74
|
2026-02-04
|
|
179
|
MS_DRG
|
Respiratory Infections And Inflammations Without Cc/mcc
|
7
|
7
|
$13,372.75
|
$11,366.84
|
$10,698.20
|
$12,704.11
|
$12,503.52
|
2026-02-04
|
|
809
|
MS_DRG
|
Major Hematological And Immunological Diagnoses Except Sickle Cell Crisis And Co…
|
7
|
7
|
$13,341.20
|
$11,340.02
|
$10,672.96
|
$12,674.14
|
$12,474.02
|
2026-02-04
|
|
65
|
MS_DRG
|
Intracranial Hemorrhage Or Cerebral Infarction With Cc Or Tpa In 24 Hours
|
7
|
7
|
$13,213.67
|
$11,231.62
|
$10,570.94
|
$12,552.99
|
$12,354.78
|
2026-02-04
|
|
176
|
MS_DRG
|
Pulmonary Embolism Without Mcc
|
7
|
7
|
$12,977.39
|
$11,030.78
|
$10,381.91
|
$12,328.52
|
$12,133.86
|
2026-02-04
|
|
378
|
MS_DRG
|
Gastrointestinal Hemorrhage With Cc
|
7
|
7
|
$12,850.61
|
$10,923.02
|
$10,280.49
|
$12,208.08
|
$12,015.32
|
2026-02-04
|
|
641
|
MS_DRG
|
Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes Withou…
|
7
|
7
|
$12,634.01
|
$10,738.91
|
$10,107.21
|
$12,002.31
|
$11,812.80
|
2026-02-04
|
|
Q5115
|
HCPCS
|
Injection, Rituximab-abbs, Biosimilar, (truxima), 10 Mg
|
8
|
8
|
$13,698.00
|
$11,643.30
|
$4,931.28
|
$13,013.10
|
$11,643.30
|
2026-02-04
|
|
Q5111
|
HCPCS
|
Injection, Pegfilgrastim-cbqv (udenyca), Biosimilar, 0.5 Mg
|
8
|
8
|
$13,527.00
|
$11,497.95
|
$4,869.72
|
$12,850.65
|
$11,497.95
|
2026-02-04
|
|
292
|
MS_DRG
|
Heart Failure And Shock With Cc
|
7
|
7
|
$12,065.36
|
$10,255.55
|
$9,652.29
|
$11,462.09
|
$11,281.11
|
2026-02-04
|
|
190
|
MS_DRG
|
Chronic Obstructive Pulmonary Disease With Mcc
|
7
|
7
|
$11,997.87
|
$10,198.19
|
$9,598.29
|
$11,397.97
|
$11,218.00
|
2026-02-04
|
|
384
|
MS_DRG
|
Uncomplicated Peptic Ulcer Without Mcc
|
7
|
7
|
$11,815.00
|
$10,042.75
|
$9,452.00
|
$11,224.25
|
$11,047.03
|
2026-02-04
|
|
559
|
MS_DRG
|
Aftercare, Musculoskeletal System And Connective Tissue With Mcc
|
7
|
7
|
$11,753.75
|
$9,990.69
|
$9,403.00
|
$11,166.06
|
$10,989.76
|
2026-02-04
|
|
379
|
MS_DRG
|
Gastrointestinal Hemorrhage Without Cc/mcc
|
7
|
7
|
$11,708.41
|
$9,952.15
|
$9,366.73
|
$11,122.99
|
$10,947.36
|
2026-02-04
|
|
395
|
MS_DRG
|
Other Digestive System Diagnoses Without Cc/mcc
|
7
|
7
|
$11,579.63
|
$9,842.69
|
$9,263.70
|
$11,000.65
|
$10,826.95
|
2026-02-04
|
|
Q5122
|
HCPCS
|
Injection, Pegfilgrastim-apgf (nyvepria), Biosimilar, 0.5 Mg
|
8
|
8
|
$12,717.00
|
$10,809.45
|
$4,578.12
|
$12,081.15
|
$10,809.45
|
2026-02-04
|
|
557
|
MS_DRG
|
Tendonitis, Myositis And Bursitis With Mcc
|
7
|
7
|
$11,236.25
|
$9,550.81
|
$8,989.00
|
$10,674.44
|
$10,505.89
|
2026-02-04
|
|
312
|
MS_DRG
|
Syncope And Collapse
|
7
|
7
|
$10,330.22
|
$8,780.69
|
$8,264.18
|
$9,813.71
|
$9,658.76
|
2026-02-04
|
|
812
|
MS_DRG
|
Red Blood Cell Disorders Without Mcc
|
7
|
7
|
$10,202.51
|
$8,672.13
|
$8,162.01
|
$9,692.38
|
$9,539.35
|
2026-02-04
|
|
192
|
MS_DRG
|
Chronic Obstructive Pulmonary Disease Without Cc/mcc
|
7
|
7
|
$9,794.15
|
$8,325.03
|
$7,835.32
|
$9,304.44
|
$9,157.53
|
2026-02-04
|
|
390
|
MS_DRG
|
Gastrointestinal Obstruction Without Cc/mcc
|
7
|
7
|
$9,564.48
|
$8,129.81
|
$7,651.59
|
$9,086.26
|
$8,942.79
|
2026-02-04
|
|
536
|
MS_DRG
|
Fractures Of Hip And Pelvis Without Mcc
|
7
|
7
|
$9,554.58
|
$8,121.39
|
$7,643.66
|
$9,076.85
|
$8,933.53
|
2026-02-04
|
|
300
|
MS_DRG
|
Peripheral Vascular Disorders With Cc
|
7
|
7
|
$9,458.50
|
$8,039.73
|
$7,566.80
|
$8,985.58
|
$8,843.70
|
2026-02-04
|
|
684
|
MS_DRG
|
Renal Failure Without Cc/mcc
|
7
|
7
|
$9,451.61
|
$8,033.87
|
$7,561.29
|
$8,979.03
|
$8,837.26
|
2026-02-04
|
|
C1734
|
HCPCS
|
Orthopedic/device/drug Matrix For Opposing Bone-to-bone Or Soft Tissue-to Bone (…
|
24
|
8
|
$9,787.80
|
$8,319.63
|
$3,320.64
|
$10,538.20
|
$8,762.80
|
2026-02-04
|
|
27696611_1
|
CDM
|
Viabahn 8mm X 15cm Endoprosthesis W Heparin
|
8
|
8
|
$9,940.00
|
$8,449.00
|
$3,578.40
|
$9,443.00
|
$8,449.00
|
2026-02-04
|
|
689
|
MS_DRG
|
Kidney And Urinary Tract Infections With Mcc
|
7
|
7
|
$8,740.45
|
$7,429.38
|
$6,992.36
|
$8,303.43
|
$8,172.32
|
2026-02-04
|
|
698
|
MS_DRG
|
Other Kidney And Urinary Tract Diagnoses With Mcc
|
7
|
7
|
$8,594.25
|
$7,305.11
|
$6,875.40
|
$8,164.54
|
$8,035.62
|
2026-02-04
|
|
310
|
MS_DRG
|
Cardiac Arrhythmia And Conduction Disorders Without Cc/mcc
|
7
|
7
|
$8,511.53
|
$7,234.80
|
$6,809.22
|
$8,085.95
|
$7,958.28
|
2026-02-04
|
|
C1762
|
HCPCS
|
Connective Tissue, Human (includes Fascia Lata)
|
72
|
8
|
$9,424.00
|
$8,010.40
|
$2,298.24
|
$19,744.80
|
$7,819.69
|
2026-02-04
|
|
204
|
MS_DRG
|
Respiratory Signs And Symptoms
|
7
|
7
|
$8,312.91
|
$7,065.97
|
$6,650.33
|
$7,897.26
|
$7,772.57
|
2026-02-04
|
|
311
|
MS_DRG
|
Angina Pectoris
|
7
|
7
|
$8,280.25
|
$7,038.21
|
$6,624.20
|
$7,866.24
|
$7,742.03
|
2026-02-04
|
|
C1764
|
HCPCS
|
Event Recorder, Cardiac (implantable)
|
16
|
8
|
$8,995.00
|
$7,645.75
|
$2,880.00
|
$9,490.50
|
$7,600.00
|
2026-02-04
|
|
27725336_1
|
CDM
|
Viabahn Stent 7fr X10 X120
|
8
|
8
|
$8,920.00
|
$7,582.00
|
$3,211.20
|
$8,474.00
|
$7,582.00
|
2026-02-04
|
|
37799
|
HCPCS
|
Other Procedure On Blood Vessel
|
10
|
8
|
$8,960.00
|
$7,616.00
|
$174.64
|
$8,512.00
|
$7,580.16
|
2026-02-04
|
|
J0565
|
HCPCS
|
Injection, Bezlotoxumab, 10 Mg
|
8
|
8
|
$8,741.52
|
$7,430.29
|
$3,146.95
|
$8,304.44
|
$7,430.29
|
2026-02-04
|
|
27983135_1
|
CDM
|
Nail Long Distal 11mm 380mm X 125' Rt
|
8
|
8
|
$8,616.90
|
$7,324.37
|
$3,102.08
|
$8,186.06
|
$7,324.37
|
2026-02-04
|
|
27992288_1
|
CDM
|
Tfna Nail 11mm X 420mm 130' Left
|
8
|
8
|
$8,598.52
|
$7,308.74
|
$3,095.47
|
$8,168.59
|
$7,308.74
|
2026-02-04
|
|
27994880_1
|
CDM
|
Tfna Nail 12mm X 380mm 130' Left
|
8
|
8
|
$8,598.52
|
$7,308.74
|
$3,095.47
|
$8,168.59
|
$7,308.74
|
2026-02-04
|
|
27992287_1
|
CDM
|
Tfna Nail 11mm X 400mm 130' Left
|
8
|
8
|
$8,598.52
|
$7,308.74
|
$3,095.47
|
$8,168.59
|
$7,308.74
|
2026-02-04
|
|
27696670_1
|
CDM
|
Operating Room Services - General Classification
|
8
|
8
|
$8,584.00
|
$7,296.40
|
$3,090.24
|
$8,154.80
|
$7,296.40
|
2026-02-04
|
|
28062047_1
|
CDM
|
Viabahn 018 6mm X10
|
8
|
8
|
$8,466.00
|
$7,196.10
|
$3,047.76
|
$8,042.70
|
$7,196.10
|
2026-02-04
|
|
282
|
MS_DRG
|
Acute Myocardial Infarction, Discharged Alive Without Cc/mcc
|
7
|
7
|
$7,595.75
|
$6,456.39
|
$6,076.60
|
$7,215.96
|
$7,102.03
|
2026-02-04
|
|
92
|
MS_DRG
|
Other Disorders Of Nervous System With Cc
|
7
|
7
|
$7,530.25
|
$6,400.71
|
$6,024.20
|
$7,153.74
|
$7,040.78
|
2026-02-04
|
|
376
|
MS_DRG
|
Digestive Malignancy Without Cc/mcc
|
7
|
7
|
$7,489.75
|
$6,366.29
|
$5,991.80
|
$7,115.26
|
$7,002.92
|
2026-02-04
|
|
191
|
MS_DRG
|
Chronic Obstructive Pulmonary Disease With Cc
|
7
|
7
|
$7,438.25
|
$6,322.51
|
$5,950.60
|
$7,066.34
|
$6,954.76
|
2026-02-04
|
|
28705269_1
|
CDM
|
Trochanteric Grip, 4-hole Plate, 190 Mm
|
8
|
8
|
$8,174.00
|
$6,947.90
|
$2,942.64
|
$7,765.30
|
$6,947.90
|
2026-02-04
|
|
28705275_1
|
CDM
|
Cable Plate, 10-hole Curved, 290 Mm
|
8
|
8
|
$8,114.00
|
$6,896.90
|
$2,921.04
|
$7,708.30
|
$6,896.90
|
2026-02-04
|
|
947
|
MS_DRG
|
Signs And Symptoms With Mcc
|
7
|
7
|
$7,360.30
|
$6,256.26
|
$5,888.24
|
$6,992.29
|
$6,881.88
|
2026-02-04
|
|
315
|
MS_DRG
|
Other Circulatory System Diagnoses With Cc
|
7
|
7
|
$7,332.50
|
$6,232.63
|
$5,866.00
|
$6,965.88
|
$6,855.89
|
2026-02-04
|
|
27994872_1
|
CDM
|
Tfna Nail 12mm X 340mm 130' Left
|
8
|
8
|
$8,036.00
|
$6,830.60
|
$2,892.96
|
$7,634.20
|
$6,830.60
|
2026-02-04
|
|
28062046_1
|
CDM
|
Viabahn 018 6mm X 5
|
8
|
8
|
$7,996.00
|
$6,796.60
|
$2,878.56
|
$7,596.20
|
$6,796.60
|
2026-02-04
|
|
769
|
MS_DRG
|
Postpartum And Post Abortion Diagnoses With O.r. Procedures
|
7
|
7
|
$7,230.25
|
$6,145.71
|
$5,784.20
|
$6,868.74
|
$6,760.28
|
2026-02-04
|
|
27696671_1
|
CDM
|
Viabahn Vbx 8mm X 59mm 135cm Balloon Expandable W Heparin
|
8
|
8
|
$7,948.00
|
$6,755.80
|
$2,861.28
|
$7,550.60
|
$6,755.80
|
2026-02-04
|
|
C1874
|
HCPCS
|
Stent, Coated/covered, With Delivery System
|
80
|
8
|
$7,879.00
|
$6,697.15
|
$86.40
|
$9,443.00
|
$6,627.65
|
2026-02-04
|
|
25683930_1
|
CDM
|
Labor Room/delivery - General Classification
|
8
|
8
|
$7,630.00
|
$6,485.50
|
$2,746.80
|
$7,248.50
|
$6,485.50
|
2026-02-04
|
|
26792516_1
|
CDM
|
Graft Aflex301
|
8
|
8
|
$7,610.78
|
$6,469.16
|
$2,739.88
|
$7,230.24
|
$6,469.16
|
2026-02-04
|
|
27992285_1
|
CDM
|
Tfna Nail 11mm X 360mm 130' Left
|
8
|
8
|
$7,594.02
|
$6,454.92
|
$2,733.85
|
$7,214.32
|
$6,454.92
|
2026-02-04
|
|
27701325_1
|
CDM
|
Graft Bovine Collagen 5mm X 46cm
|
8
|
8
|
$7,478.00
|
$6,356.30
|
$2,692.08
|
$7,104.10
|
$6,356.30
|
2026-02-04
|
|
28470019_1
|
CDM
|
Diamondback 360 Microcrown 4fr, 1.25mm X 145cm
|
8
|
8
|
$7,390.00
|
$6,281.50
|
$2,660.40
|
$7,020.50
|
$6,281.50
|
2026-02-04
|
|
790
|
MS_DRG
|
Extreme Immaturity Or Respiratory Distress Syndrome, Neonate
|
7
|
7
|
$6,712.25
|
$5,705.41
|
$5,369.80
|
$6,376.64
|
$6,275.95
|
2026-02-04
|
|
27696669_1
|
CDM
|
Viabahn Balloon Expandable With Heparin 8mm X 29mm X 135cm
|
8
|
8
|
$7,008.00
|
$5,956.80
|
$2,522.88
|
$6,657.60
|
$5,956.80
|
2026-02-04
|
|
28893008_1
|
CDM
|
Valvulotome Eze-sit 91cm W/cutting Heads & Tributary Sleeves
|
8
|
8
|
$6,798.00
|
$5,778.30
|
$2,447.28
|
$6,458.10
|
$5,778.30
|
2026-02-04
|
|
C1783
|
HCPCS
|
Ocular Implant, Aqueous Drainage Assist Device
|
8
|
8
|
$6,750.00
|
$5,737.50
|
$2,430.00
|
$6,412.50
|
$5,737.50
|
2026-02-04
|
|
27753571_1
|
CDM
|
Valvulotome 1.5 Hydro 98cm
|
8
|
8
|
$6,598.00
|
$5,608.30
|
$2,375.28
|
$6,268.10
|
$5,608.30
|
2026-02-04
|
|
93
|
MS_DRG
|
Other Disorders Of Nervous System Without Cc/mcc
|
7
|
7
|
$5,912.00
|
$5,025.20
|
$4,729.60
|
$5,616.40
|
$5,527.72
|
2026-02-04
|
|
793
|
MS_DRG
|
Full Term Neonate With Major Problems
|
7
|
7
|
$5,907.63
|
$5,021.48
|
$4,726.10
|
$5,612.24
|
$5,523.63
|
2026-02-04
|
|
20955
|
HCPCS
|
Bone Graft At Lower Leg With Microvascular Connection
|
7
|
6
|
$6,495.00
|
$5,520.75
|
$345.00
|
$6,170.25
|
$5,520.75
|
2026-02-04
|
|
Q4187
|
HCPCS
|
Epicord, Per Square Centimeter
|
8
|
8
|
$6,420.00
|
$5,457.00
|
$2,311.20
|
$6,099.00
|
$5,457.00
|
2026-02-04
|
|
28705288_1
|
CDM
|
Cable Plate, 10-hole Straight, 290 Mm
|
8
|
8
|
$6,418.00
|
$5,455.30
|
$2,310.48
|
$6,097.10
|
$5,455.30
|
2026-02-04
|
|
74177
|
HCPCS
|
CT Scan Of Abdomen And Pelvis With Contrast
|
8
|
8
|
$6,410.00
|
$5,448.50
|
$2,307.60
|
$6,089.50
|
$5,448.50
|
2026-02-04
|
|
74178
|
HCPCS
|
CT Scan Of Abdomen And Pelvis Before And After Contrast
|
16
|
8
|
$6,315.00
|
$5,367.75
|
$2,228.40
|
$6,118.00
|
$5,448.24
|
2026-02-04
|
|
74174
|
HCPCS
|
CT Scan Of Blood Vessels Of Abdomen And Pelvis With Contrast
|
16
|
8
|
$6,315.00
|
$5,367.75
|
$2,228.40
|
$6,118.00
|
$5,448.24
|
2026-02-04
|
|
73720
|
HCPCS
|
MRI Scan Of Leg Before And After Contrast
|
16
|
8
|
$7,112.50
|
$6,045.62
|
$2,048.40
|
$8,108.25
|
$5,405.50
|
2026-02-04
|
|
75635
|
HCPCS
|
CT Scan Of Abdominal Aorta And Both Leg Arteries With Contrast
|
8
|
8
|
$6,220.00
|
$5,287.00
|
$2,239.20
|
$5,909.00
|
$5,287.00
|
2026-02-04
|
|
3015855_1
|
CDM
|
Nursery - Newborn - Level Iii
|
7
|
7
|
$5,640.00
|
$4,794.00
|
$4,512.00
|
$5,358.00
|
$5,273.40
|
2026-02-04
|
|
33440
|
HCPCS
|
Replacement Of Aortic And Pulmonary Valves And Enlargement Of Outflow Tract From…
|
13
|
8
|
$6,988.00
|
$5,939.80
|
$345.00
|
$7,101.25
|
$5,167.99
|
2026-02-04
|
|
27719602_1
|
CDM
|
Quick Clear Aspiration Cath & Pump
|
8
|
8
|
$6,000.00
|
$5,100.00
|
$2,160.00
|
$5,700.00
|
$5,100.00
|
2026-02-04
|
|
33019
|
HCPCS
|
Drainage Of Heart Sac Using Tube And CT Imaging Guidance
|
23
|
8
|
$6,000.00
|
$5,100.00
|
$178.31
|
$7,410.00
|
$5,100.00
|
2026-02-04
|
|
26035347_1
|
CDM
|
Graft Injectable Miig 15cc
|
8
|
8
|
$5,960.00
|
$5,066.00
|
$2,145.60
|
$5,662.00
|
$5,066.00
|
2026-02-04
|
|
45346
|
HCPCS
|
Destruction Of Polyp Or Growth Of Lower Large Bowel Using A Flexible Endoscope
|
8
|
8
|
$5,943.00
|
$5,051.55
|
$2,139.48
|
$5,645.85
|
$5,051.55
|
2026-02-04
|
|
72156
|
HCPCS
|
MRI Scan Of Upper Spinal Canal Before And After Contrast
|
8
|
8
|
$5,920.00
|
$5,032.00
|
$2,131.20
|
$5,624.00
|
$5,032.00
|
2026-02-04
|
|
72157
|
HCPCS
|
MRI Scan Of Middle Spinal Canal Before And After Contrast
|
8
|
8
|
$5,920.00
|
$5,032.00
|
$2,131.20
|
$5,624.00
|
$5,032.00
|
2026-02-04
|
|
72158
|
HCPCS
|
MRI Scan Of Lower Spinal Canal Before And After Contrast
|
8
|
8
|
$5,920.00
|
$5,032.00
|
$2,131.20
|
$5,624.00
|
$5,032.00
|
2026-02-04
|
|
565
|
MS_DRG
|
Other Musculoskeletal System And Connective Tissue Diagnoses With Cc
|
7
|
7
|
$5,363.25
|
$4,558.76
|
$4,290.60
|
$5,095.09
|
$5,014.64
|
2026-02-04
|
|
72197
|
HCPCS
|
MRI Scan Of Pelvis Before And After Contrast
|
16
|
8
|
$5,805.00
|
$4,934.25
|
$2,048.40
|
$5,624.00
|
$5,008.32
|
2026-02-04
|
|
70543
|
HCPCS
|
MRI Scan Of Bone Of Eye Socket, Face, And/or Neck Before And After Contrast
|
16
|
8
|
$5,721.00
|
$4,862.85
|
$1,987.92
|
$5,624.00
|
$5,008.32
|
2026-02-04
|
|
Q4186
|
HCPCS
|
Epifix, Per Square Centimeter
|
40
|
8
|
$5,979.00
|
$5,082.15
|
$1,072.08
|
$13,315.91
|
$4,958.36
|
2026-02-04
|
|
9259111_1
|
CDM
|
Intensive Care Unit - General Classification
|
7
|
7
|
$5,285.00
|
$4,492.25
|
$4,228.00
|
$5,020.75
|
$4,941.48
|
2026-02-04
|
|
25774824_1
|
CDM
|
Wristjack
|
8
|
8
|
$5,800.00
|
$4,930.00
|
$2,088.00
|
$5,510.00
|
$4,930.00
|
2026-02-04
|
|
28078553_1
|
CDM
|
Hanarostent Col Uncovered 25dm X 9cm
|
8
|
8
|
$5,775.00
|
$4,908.75
|
$2,079.00
|
$5,486.25
|
$4,908.75
|
2026-02-04
|
|
70553
|
HCPCS
|
MRI Scan Of Brain Before And After Contrast
|
8
|
8
|
$5,740.00
|
$4,879.00
|
$2,066.40
|
$5,453.00
|
$4,879.00
|
2026-02-04
|
|
73223
|
HCPCS
|
MRI Scan Of Arm Joint Before And After Contrast
|
16
|
8
|
$6,412.50
|
$5,450.62
|
$1,846.80
|
$7,310.25
|
$4,873.50
|
2026-02-04
|
|
25683929_1
|
CDM
|
Labor Room/delivery - General Classification
|
8
|
8
|
$5,600.00
|
$4,760.00
|
$2,016.00
|
$5,320.00
|
$4,760.00
|
2026-02-04
|
|
28575
|
HCPCS
|
Closed Treatment Of Dislocated Ankle Joint Under Anesthesia
|
8
|
8
|
$5,590.00
|
$4,751.50
|
$2,012.40
|
$5,310.50
|
$4,751.50
|
2026-02-04
|
|
J0897
|
HCPCS
|
Injection, Denosumab, 1 Mg
|
23
|
8
|
$5,631.75
|
$4,786.99
|
$345.00
|
$5,497.89
|
$4,741.93
|
2026-02-04
|
|
73220
|
HCPCS
|
MRI Scan Of Arm Before And After Contrast
|
16
|
8
|
$6,225.00
|
$5,291.25
|
$1,792.80
|
$7,096.50
|
$4,731.00
|
2026-02-04
|
|
27384765_1
|
CDM
|
Myosure Fms-xl Tissue Removal (50-601xl)
|
8
|
8
|
$5,557.32
|
$4,723.72
|
$2,000.64
|
$5,279.45
|
$4,723.72
|
2026-02-04
|
|
71552
|
HCPCS
|
MRI Scan Of Chest Before And After Contrast
|
8
|
8
|
$5,520.00
|
$4,692.00
|
$1,987.20
|
$5,244.00
|
$4,692.00
|
2026-02-04
|
|
74183
|
HCPCS
|
MRI Scan Of Abdomen Before And After Contrast
|
16
|
8
|
$5,415.00
|
$4,602.75
|
$1,911.60
|
$5,244.00
|
$4,669.92
|
2026-02-04
|
|
73723
|
HCPCS
|
MRI Scan Of Leg Joint Before And After Contrast
|
16
|
8
|
$6,125.00
|
$5,206.25
|
$1,764.00
|
$6,982.50
|
$4,655.00
|
2026-02-04
|
|
26035971_1
|
CDM
|
Therma Choice Ballon Uterine
|
8
|
8
|
$5,475.48
|
$4,654.16
|
$1,971.17
|
$5,201.71
|
$4,654.16
|
2026-02-04
|
|
J0875
|
HCPCS
|
Injection, Dalbavancin, 5 Mg
|
8
|
8
|
$5,433.50
|
$4,618.48
|
$1,956.06
|
$5,161.83
|
$4,618.48
|
2026-02-04
|
|
28475347_1
|
CDM
|
Jada System - Vacumm Induced Hemorrhage System (jada-2002)
|
8
|
8
|
$5,400.00
|
$4,590.00
|
$1,944.00
|
$5,130.00
|
$4,590.00
|
2026-02-04
|
|
V2623
|
HCPCS
|
Prosthetic Eye, Plastic, Custom
|
8
|
8
|
$5,400.00
|
$4,590.00
|
$1,944.00
|
$5,130.00
|
$4,590.00
|
2026-02-04
|
|
0441T
|
HCPCS
|
Freezing Destruction Of Nerve In Leg, Accessed Through The Skin, Using Imaging G…
|
8
|
8
|
$5,400.00
|
$4,590.00
|
$1,944.00
|
$5,130.00
|
$4,590.00
|
2026-02-04
|
|
27701321_1
|
CDM
|
Graft Bovine Collagen 5mm X 40cm
|
8
|
8
|
$5,378.00
|
$4,571.30
|
$1,936.08
|
$5,109.10
|
$4,571.30
|
2026-02-04
|
|
Q4196
|
HCPCS
|
Puraply Am, Per Square Centimeter
|
32
|
8
|
$5,390.00
|
$4,581.50
|
$1,512.00
|
$11,286.00
|
$4,559.50
|
2026-02-04
|
|
70546
|
HCPCS
|
MRI Scan Of Blood Vessels Of Head Before And After Contrast
|
8
|
8
|
$5,310.00
|
$4,513.50
|
$1,911.60
|
$5,044.50
|
$4,513.50
|
2026-02-04
|
|
951
|
MS_DRG
|
Other Factors Influencing Health Status
|
7
|
7
|
$4,797.66
|
$4,078.01
|
$3,838.13
|
$4,557.77
|
$4,485.81
|
2026-02-04
|
|
27945087_1
|
CDM
|
Fibulink Syndesmosis Repair Kit/ss
|
8
|
8
|
$5,273.60
|
$4,482.56
|
$1,898.50
|
$5,009.92
|
$4,482.56
|
2026-02-04
|
|
C9358
|
HCPCS
|
Dermal Substitute, Native, Non-denatured Collagen, Fetal Bovine Origin (surgimen…
|
16
|
8
|
$5,268.00
|
$4,477.80
|
$1,698.48
|
$5,527.10
|
$4,482.10
|
2026-02-04
|
|
27384750_1
|
CDM
|
Myosure Reach Tissue Removal
|
8
|
8
|
$5,246.68
|
$4,459.68
|
$1,888.80
|
$4,984.35
|
$4,459.68
|
2026-02-04
|
|
74176
|
HCPCS
|
CT Scan Of Abdomen And Pelvis Without Contrast
|
24
|
8
|
$5,300.00
|
$4,505.00
|
$1,068.48
|
$5,234.50
|
$4,435.30
|
2026-02-04
|
|
C2623
|
HCPCS
|
Catheter, Transluminal Angioplasty, Drug-coated, Non-laser
|
32
|
8
|
$5,200.00
|
$4,420.00
|
$1,476.00
|
$5,510.00
|
$4,433.40
|
2026-02-04
|
|
789
|
MS_DRG
|
Neonates, Died Or Transferred To Another Acute Care Facility
|
7
|
7
|
$4,736.87
|
$4,026.34
|
$3,789.50
|
$4,500.03
|
$4,428.97
|
2026-02-04
|
|
26638187_1
|
CDM
|
Allosource, Allowrap, Double Sided Membrane 4x4 Cm
|
8
|
8
|
$5,196.00
|
$4,416.60
|
$1,870.56
|
$4,936.20
|
$4,416.60
|
2026-02-04
|
|
28387666_1
|
CDM
|
Trice - Tenex Txb Procedure Pack (internal Component - 557-1002-001)
|
8
|
8
|
$5,180.00
|
$4,403.00
|
$1,864.80
|
$4,921.00
|
$4,403.00
|
2026-02-04
|
|
Q4101
|
HCPCS
|
Apligraf, Per Square Centimeter
|
8
|
8
|
$5,180.00
|
$4,403.00
|
$1,864.80
|
$4,921.00
|
$4,403.00
|
2026-02-04
|
|
70549
|
HCPCS
|
MRI Scan Of Blood Vessels Of Neck Before And After Contrast
|
8
|
8
|
$5,130.00
|
$4,360.50
|
$1,846.80
|
$4,873.50
|
$4,360.50
|
2026-02-04
|
|
27500715_1
|
CDM
|
Pleurx Peritoneal Catheter Starter Kit W/bottles
|
8
|
8
|
$5,128.00
|
$4,358.80
|
$1,846.08
|
$4,871.60
|
$4,358.80
|
2026-02-04
|
|
A4353
|
HCPCS
|
Intermittent Urinary Catheter, With Insertion Supplies
|
8
|
8
|
$5,128.00
|
$4,358.80
|
$1,846.08
|
$4,871.60
|
$4,358.80
|
2026-02-04
|
|
27873874_1
|
CDM
|
Graft Fusion Bioline 8mm-40cm Peripheral
|
8
|
8
|
$5,100.00
|
$4,335.00
|
$1,836.00
|
$4,845.00
|
$4,335.00
|
2026-02-04
|
|
27994885_1
|
CDM
|
Tfna Short Nail 11mm 130'
|
8
|
8
|
$5,073.70
|
$4,312.65
|
$1,826.53
|
$4,820.02
|
$4,312.65
|
2026-02-04
|
|
27365
|
HCPCS
|
Extensive Removal Of Growth Of Thigh Or Knee Bone
|
7
|
6
|
$5,070.00
|
$4,309.50
|
$345.00
|
$4,816.50
|
$4,309.50
|
2026-02-04
|
|
28422662_1
|
CDM
|
Spider Rx Filter 6mm (zammit)
|
8
|
8
|
$5,049.00
|
$4,291.65
|
$1,817.64
|
$4,796.55
|
$4,291.65
|
2026-02-04
|
|
Q4100
|
HCPCS
|
Skin Substitute, Not Otherwise Specified
|
72
|
8
|
$5,020.00
|
$4,267.00
|
$1,130.76
|
$13,524.68
|
$4,279.18
|
2026-02-04
|
|
792
|
MS_DRG
|
Prematurity Without Major Problems
|
7
|
7
|
$4,556.50
|
$3,873.03
|
$3,645.20
|
$4,328.68
|
$4,260.33
|
2026-02-04
|
|
26035864_1
|
CDM
|
Dermograft Aflex200
|
8
|
8
|
$4,974.00
|
$4,227.90
|
$1,790.64
|
$4,725.30
|
$4,227.90
|
2026-02-04
|
|
74185
|
HCPCS
|
MRI Scan Of Blood Vessels Of Abdomen
|
8
|
8
|
$4,970.00
|
$4,224.50
|
$1,789.20
|
$4,721.50
|
$4,224.50
|
2026-02-04
|
|
64561
|
HCPCS
|
Insertion Of Sacral Nerve Neurostimulator Electrode Array
|
16
|
8
|
$10,744.00
|
$9,132.40
|
$271.19
|
$19,211.85
|
$4,177.76
|
2026-02-04
|
|
J0129
|
HCPCS
|
Injection, Abatacept, 10 Mg (code May Be Used For Medicare When Drug Administere…
|
8
|
8
|
$4,851.25
|
$4,123.56
|
$1,746.45
|
$4,608.69
|
$4,123.56
|
2026-02-04
|
|
24620
|
HCPCS
|
Closed Treatment Of Broken And Dislocated Forearm Bones At Elbow With Manipulati…
|
8
|
8
|
$4,827.00
|
$4,102.95
|
$1,737.72
|
$4,585.65
|
$4,102.95
|
2026-02-04
|
|
29043317_1
|
CDM
|
Endoclot Phs 3g (replacing Hemospray 911225)
|
8
|
8
|
$4,800.00
|
$4,080.00
|
$1,728.00
|
$4,560.00
|
$4,080.00
|
2026-02-04
|
|
26035847_1
|
CDM
|
Novasure Sterile Kit
|
8
|
8
|
$4,784.00
|
$4,066.40
|
$1,722.24
|
$4,544.80
|
$4,066.40
|
2026-02-04
|
|
27873875_1
|
CDM
|
Graft Bioline 8mm-80cm Peripheral
|
8
|
8
|
$4,760.00
|
$4,046.00
|
$1,713.60
|
$4,522.00
|
$4,046.00
|
2026-02-04
|
|
70542
|
HCPCS
|
MRI Scan Of Bone Of Eye Socket, Face, And/or Neck With Contrast
|
8
|
8
|
$4,720.00
|
$4,012.00
|
$1,699.20
|
$4,484.00
|
$4,012.00
|
2026-02-04
|
|
552
|
MS_DRG
|
Medical Back Problems Without Mcc
|
7
|
7
|
$4,258.00
|
$3,619.30
|
$3,406.40
|
$4,045.10
|
$3,981.23
|
2026-02-04
|
|
28348783_1
|
CDM
|
Tightrope Ii Rt Implant System W/flipcutter & Fiberstick
|
8
|
8
|
$4,652.56
|
$3,954.68
|
$1,674.92
|
$4,419.93
|
$3,954.68
|
2026-02-04
|
|
25683928_1
|
CDM
|
Labor Room/delivery - General Classification
|
8
|
8
|
$4,650.00
|
$3,952.50
|
$1,674.00
|
$4,417.50
|
$3,952.50
|
2026-02-04
|
|
27813717_1
|
CDM
|
Venaseal
|
8
|
8
|
$4,618.00
|
$3,925.30
|
$1,662.48
|
$4,387.10
|
$3,925.30
|
2026-02-04
|
|
J2357
|
HCPCS
|
Injection, Omalizumab, 5 Mg
|
8
|
8
|
$4,616.00
|
$3,923.60
|
$1,661.76
|
$4,385.20
|
$3,923.60
|
2026-02-04
|
|
59618
|
HCPCS
|
Cesarean Delivery And Care Before And After Delivery Following Attempted Vaginal…
|
13
|
8
|
$4,730.00
|
$4,020.50
|
$345.00
|
$4,807.00
|
$3,915.31
|
2026-02-04
|
|
73219
|
HCPCS
|
MRI Scan Of Arm With Contrast
|
16
|
8
|
$5,150.00
|
$4,377.50
|
$1,483.20
|
$5,871.00
|
$3,914.00
|
2026-02-04
|
|
25683725_1
|
CDM
|
Nursery - Newborn - Level Iii
|
7
|
7
|
$4,185.00
|
$3,557.25
|
$3,348.00
|
$3,975.75
|
$3,912.98
|
2026-02-04
|
|
73719
|
HCPCS
|
MRI Scan Of Leg With Contrast
|
16
|
8
|
$5,137.50
|
$4,366.88
|
$1,479.60
|
$5,856.75
|
$3,904.50
|
2026-02-04
|
|
26035313_1
|
CDM
|
Kit Wrist Fixator Radiolucent
|
8
|
8
|
$4,580.22
|
$3,893.19
|
$1,648.88
|
$4,351.21
|
$3,893.19
|
2026-02-04
|
|
844
|
MS_DRG
|
Other Myeloproliferative Disorders Or Poorly Differentiated Neoplastic Diagnoses…
|
7
|
7
|
$4,137.75
|
$3,517.09
|
$3,310.20
|
$3,930.86
|
$3,868.80
|
2026-02-04
|
|
J3262
|
HCPCS
|
Injection, Tocilizumab, 1 Mg
|
24
|
8
|
$4,553.00
|
$3,870.05
|
$655.65
|
$7,785.49
|
$3,851.84
|
2026-02-04
|
|
72147
|
HCPCS
|
MRI Scan Of Middle Spinal Canal With Contrast
|
8
|
8
|
$4,520.00
|
$3,842.00
|
$1,627.20
|
$4,294.00
|
$3,842.00
|
2026-02-04
|
|
59510
|
HCPCS
|
Cesarean Delivery With Care Before And After Delivery
|
13
|
8
|
$4,220.00
|
$3,587.00
|
$345.00
|
$5,142.35
|
$3,841.91
|
2026-02-04
|
|
J3111
|
HCPCS
|
Injection, Romosozumab-aqqg, 1 Mg
|
8
|
8
|
$4,506.75
|
$3,830.74
|
$1,622.43
|
$4,281.41
|
$3,830.74
|
2026-02-04
|
|
26035998_1
|
CDM
|
Screwdriver Blade 1.5/ 2.0mm
|
8
|
8
|
$4,460.00
|
$3,791.00
|
$1,605.60
|
$4,237.00
|
$3,791.00
|
2026-02-04
|
|
70552
|
HCPCS
|
MRI Scan Of Brain With Contrast
|
8
|
8
|
$4,440.00
|
$3,774.00
|
$1,598.40
|
$4,218.00
|
$3,774.00
|
2026-02-04
|
|
45110
|
HCPCS
|
Removal Of Rectum With Creation Of Opening From Large Bowel To Skin Through Abdo…
|
5
|
5
|
$4,430.00
|
$3,765.50
|
$345.00
|
$4,208.50
|
$3,765.50
|
2026-02-04
|
|
74175
|
HCPCS
|
CT Scan Of Blood Vessels Of Abdomen With Contrast
|
24
|
8
|
$4,380.00
|
$3,723.00
|
$1,400.40
|
$6,118.00
|
$3,709.25
|
2026-02-04
|
|
C8908
|
HCPCS
|
Magnetic Resonance Imaging Without Contrast Followed By With Contrast, Breast; B…
|
8
|
8
|
$4,350.00
|
$3,697.50
|
$1,566.00
|
$4,132.50
|
$3,697.50
|
2026-02-04
|
|
72149
|
HCPCS
|
MRI Scan Of Lower Spinal Canal With Contrast
|
8
|
8
|
$4,350.00
|
$3,697.50
|
$1,566.00
|
$4,132.50
|
$3,697.50
|
2026-02-04
|
|
72142
|
HCPCS
|
MRI Scan Of Upper Spinal Canal With Contrast
|
8
|
8
|
$4,350.00
|
$3,697.50
|
$1,566.00
|
$4,132.50
|
$3,697.50
|
2026-02-04
|
|
44141
|
HCPCS
|
Partial Removal Of Large Bowel With Creation Of Opening To Skin
|
5
|
5
|
$4,345.00
|
$3,693.25
|
$345.00
|
$4,127.75
|
$3,693.25
|
2026-02-04
|
|
73718
|
HCPCS
|
MRI Scan Of Leg Without Contrast
|
16
|
8
|
$4,837.50
|
$4,111.88
|
$1,393.20
|
$5,514.75
|
$3,676.50
|
2026-02-04
|
|
74181
|
HCPCS
|
MRI Scan Of Abdomen Without Contrast
|
16
|
8
|
$4,590.00
|
$3,901.50
|
$1,393.20
|
$5,044.50
|
$3,676.50
|
2026-02-04
|
|
59610
|
HCPCS
|
Vaginal Delivery And Care Before And After Delivery After Previous Cesarean Deli…
|
13
|
8
|
$4,220.00
|
$3,587.00
|
$345.00
|
$4,289.25
|
$3,644.86
|
2026-02-04
|
|
27134
|
HCPCS
|
Revision Of Thigh Bone And Hip Joint Prosthesis
|
20
|
8
|
$4,895.00
|
$4,160.75
|
$345.00
|
$4,650.25
|
$3,620.03
|
2026-02-04
|
|
44144
|
HCPCS
|
Partial Removal Of Large Bowel With Creation Of 2 Openings From Small Or Large B…
|
5
|
5
|
$4,230.00
|
$3,595.50
|
$345.00
|
$4,018.50
|
$3,595.50
|
2026-02-04
|
|
70548
|
HCPCS
|
MRI Scan Of Blood Vessels Of Neck With Contrast
|
8
|
8
|
$4,230.00
|
$3,595.50
|
$1,522.80
|
$4,018.50
|
$3,595.50
|
2026-02-04
|
|
15273
|
HCPCS
|
Skin Substitute Graft To Wound 100.0 Sq Cm Or More Of Trunk, Arms, Or Legs, 100.…
|
24
|
8
|
$4,240.00
|
$3,604.00
|
$170.18
|
$4,511.55
|
$3,587.04
|
2026-02-04
|
|
15271
|
HCPCS
|
Application Of Skin Substitute Graft To Wound Of Trunk, Arms, Or Legs, 25.0 Sq C…
|
24
|
8
|
$4,240.00
|
$3,604.00
|
$75.14
|
$4,511.55
|
$3,587.04
|
2026-02-04
|
|
70496
|
HCPCS
|
CT Scan Of Blood Vessels Of Head With Contrast
|
8
|
8
|
$4,210.00
|
$3,578.50
|
$1,515.60
|
$3,999.50
|
$3,578.50
|
2026-02-04
|
|
26945088_1
|
CDM
|
Anterior Tibial Tendon Graft
|
8
|
8
|
$4,208.16
|
$3,576.94
|
$1,514.94
|
$3,997.75
|
$3,576.94
|
2026-02-04
|
|
27850949_1
|
CDM
|
Closurefast 7cm Catheter
|
8
|
8
|
$4,200.00
|
$3,570.00
|
$1,512.00
|
$3,990.00
|
$3,570.00
|
2026-02-04
|
|
70498
|
HCPCS
|
CT Scan Of Blood Vessels Of Neck With Contrast
|
16
|
8
|
$4,125.00
|
$3,506.25
|
$1,458.00
|
$3,990.00
|
$3,553.20
|
2026-02-04
|
|
72196
|
HCPCS
|
MRI Scan Of Pelvis With Contrast
|
8
|
8
|
$4,180.00
|
$3,553.00
|
$1,504.80
|
$3,971.00
|
$3,553.00
|
2026-02-04
|
|
25778433_1
|
CDM
|
Aris Sling
|
8
|
8
|
$4,180.00
|
$3,553.00
|
$1,504.80
|
$3,971.00
|
$3,553.00
|
2026-02-04
|
|
G0257
|
HCPCS
|
Unscheduled Or Emergency Dialysis Treatment For An Esrd Patient In A Hospital Ou…
|
8
|
8
|
$4,170.00
|
$3,544.50
|
$1,501.20
|
$3,961.50
|
$3,544.50
|
2026-02-04
|
|
25919984_16
|
CDM
|
37228 Tib/per Revasc W/tla
|
2
|
2
|
$5,660.00
|
$4,811.00
|
$2,264.00
|
$4,811.00
|
$3,537.50
|
2026-02-04
|
|
25776803_1
|
CDM
|
Enseal Impact Tissue Fusion
|
8
|
8
|
$4,159.92
|
$3,535.93
|
$1,497.57
|
$3,951.92
|
$3,535.93
|
2026-02-04
|
|
73222
|
HCPCS
|
MRI Scan Of Arm Joint With Contrast
|
32
|
8
|
$3,916.00
|
$3,328.60
|
$1,409.76
|
$5,580.30
|
$3,524.40
|
2026-02-04
|
|
71551
|
HCPCS
|
MRI Scan Of Chest With Contrast
|
8
|
8
|
$4,110.00
|
$3,493.50
|
$1,479.60
|
$3,904.50
|
$3,493.50
|
2026-02-04
|
|
70540
|
HCPCS
|
MRI Scan Of Bone Of Eye Socket, Face, And/or Neck Without Contrast
|
8
|
8
|
$4,110.00
|
$3,493.50
|
$1,479.60
|
$3,904.50
|
$3,493.50
|
2026-02-04
|
|
70545
|
HCPCS
|
MRI Scan Of Blood Vessels Of Head With Contrast
|
8
|
8
|
$4,110.00
|
$3,493.50
|
$1,479.60
|
$3,904.50
|
$3,493.50
|
2026-02-04
|
|
59400
|
HCPCS
|
Vaginal Delivery With Care Before And After Delivery
|
13
|
8
|
$4,918.00
|
$4,180.30
|
$345.00
|
$4,672.10
|
$3,487.39
|
2026-02-04
|
|
C1771
|
HCPCS
|
Repair Device, Urinary, Incontinence, With Sling Graft
|
8
|
8
|
$4,100.00
|
$3,485.00
|
$1,476.00
|
$3,895.00
|
$3,485.00
|
2026-02-04
|
|
28699092_1
|
CDM
|
Allograft Axis Dermis 4cm X 7cm (dr. Johns)
|
8
|
8
|
$4,034.00
|
$3,428.90
|
$1,452.24
|
$3,832.30
|
$3,428.90
|
2026-02-04
|
|
33018
|
HCPCS
|
Drainage Of Heart Sac Using Tube And Imaging Guidance (5 Years Or Younger Or Any…
|
23
|
8
|
$4,000.00
|
$3,400.00
|
$245.41
|
$4,940.00
|
$3,400.00
|
2026-02-04
|
|
28641200_1
|
CDM
|
Tyrx Absorbable Antibacterial Envelope, Large (dr. Hoppe) **do Not Reorder**
|
8
|
8
|
$3,990.00
|
$3,391.50
|
$1,436.40
|
$3,790.50
|
$3,391.50
|
2026-02-04
|
|
27095231_1
|
CDM
|
Quickset Kit 8cc
|
8
|
8
|
$3,990.00
|
$3,391.50
|
$1,436.40
|
$3,790.50
|
$3,391.50
|
2026-02-04
|