|
1
|
MS_DRG
|
Heart Transplant Or Implant Of Heart Assist System With Mcc
|
7
|
7
|
$1,013,217.92
|
$1,013,217.92
|
$150,761.82
|
$171,540.38
|
$171,540.38
|
2026-10-22
|
|
3
|
MS_DRG
|
Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…
|
7
|
7
|
$654,925.45
|
$654,925.45
|
$107,516.64
|
$130,058.39
|
$130,058.39
|
2026-10-22
|
|
10526684
|
LOCAL
|
Evoque Tricuspid Valve Replacement System 44 Mm Valve
|
29
|
19
|
$253,700.00
|
$253,700.00
|
$59,936.63
|
$248,626.00
|
$126,850.00
|
2026-10-22
|
|
10488372
|
LOCAL
|
Triclip G4 System
|
29
|
19
|
$230,100.00
|
$230,100.00
|
$54,361.13
|
$225,498.00
|
$115,050.00
|
2026-10-22
|
|
C1825
|
HCPCS
|
Barostim Neo2 Generator
|
58
|
19
|
$196,175.00
|
$196,175.00
|
$43,907.06
|
$202,370.00
|
$101,959.38
|
2026-10-22
|
|
7462585
|
LOCAL
|
System Valve Heart Sapien Thv 26mm W/retro Flex 3 Transfermoral
|
29
|
19
|
$191,750.00
|
$191,750.00
|
$45,300.94
|
$187,915.00
|
$95,875.00
|
2026-10-22
|
|
8140238
|
LOCAL
|
System Valve Heart 20mm Tavr Trans 9600tfx
|
29
|
19
|
$191,750.00
|
$191,750.00
|
$45,300.94
|
$187,915.00
|
$95,875.00
|
2026-10-22
|
|
7466049
|
LOCAL
|
System Valve Heart 29mm W/commander Delivery Sapien Thv 3 Transfermoral 9600cm…
|
29
|
19
|
$191,750.00
|
$191,750.00
|
$45,300.94
|
$187,915.00
|
$95,875.00
|
2026-10-22
|
|
8255998
|
LOCAL
|
System Valve Heart 26mm W/certitute Delivery Sapien 3 Ultra S3usta126a
|
29
|
19
|
$191,750.00
|
$191,750.00
|
$45,300.94
|
$187,915.00
|
$95,875.00
|
2026-10-22
|
|
8255996
|
LOCAL
|
System Valve Heart 23mm W/certitute Delivery Sapien 3 Ultra S3usta123a
|
29
|
19
|
$191,750.00
|
$191,750.00
|
$45,300.94
|
$187,915.00
|
$95,875.00
|
2026-10-22
|
|
8914167
|
LOCAL
|
System Valve Heart 26mm Tavr Trans 9600tfx26a
|
29
|
19
|
$191,750.00
|
$191,750.00
|
$45,300.94
|
$187,915.00
|
$95,875.00
|
2026-10-22
|
|
7462584
|
LOCAL
|
System Valve Heart Sapien Thv 23mm W/retro Flex 3 Transfermoral
|
29
|
19
|
$191,750.00
|
$191,750.00
|
$45,300.94
|
$187,915.00
|
$95,875.00
|
2026-10-22
|
|
7673956
|
LOCAL
|
System Valve Heart 23mm W/commander Delivery Sapien 3 Ultra Thv Transfermoral S3…
|
29
|
19
|
$191,750.00
|
$191,750.00
|
$45,300.94
|
$187,915.00
|
$95,875.00
|
2026-10-22
|
|
9798321
|
LOCAL
|
Thoracic Branch Endoprosthesis Aortic Component 37mmx12mmx20cm 24fr Tac123720a
|
29
|
19
|
$188,800.00
|
$188,800.00
|
$44,604.00
|
$185,024.00
|
$94,400.00
|
2026-10-22
|
|
9797631
|
LOCAL
|
Thoracic Branch Endoprosthesis Aortic Component 28mmx8mmx15cm 22fr Tac082815a
|
29
|
19
|
$188,800.00
|
$188,800.00
|
$44,604.00
|
$185,024.00
|
$94,400.00
|
2026-10-22
|
|
9798307
|
LOCAL
|
Thoracic Branch Endoprosthesis Aortic Component 40mmx8mmx20cm 26fr Tac084020a
|
29
|
19
|
$188,800.00
|
$188,800.00
|
$44,604.00
|
$185,024.00
|
$94,400.00
|
2026-10-22
|
|
9797629
|
LOCAL
|
Thoracic Branch Endoprosthesis Aortic Component 28mmx8mmx10cm 22fr Tac082810a
|
29
|
19
|
$188,800.00
|
$188,800.00
|
$44,604.00
|
$185,024.00
|
$94,400.00
|
2026-10-22
|
|
9798315
|
LOCAL
|
Thoracic Branch Endoprosthesis Aortic Component 34mmx12mmx15cm 24fr Tac123415a
|
29
|
19
|
$188,800.00
|
$188,800.00
|
$44,604.00
|
$185,024.00
|
$94,400.00
|
2026-10-22
|
|
9798309
|
LOCAL
|
Thoracic Branch Endoprosthesis Aortic Component 45mmx8mmx15cm 26fr Tac084515a
|
29
|
19
|
$188,800.00
|
$188,800.00
|
$44,604.00
|
$185,024.00
|
$94,400.00
|
2026-10-22
|
|
9798313
|
LOCAL
|
Thoracic Branch Endoprosthesis Aortic Component 31mmx12mmx20cm 22fr Tac123120a
|
29
|
19
|
$188,800.00
|
$188,800.00
|
$44,604.00
|
$185,024.00
|
$94,400.00
|
2026-10-22
|
|
9798331
|
LOCAL
|
Thoracic Branch Endoprosthesis Side Branch Component 8mmx8mmx6cm Tsb080806a
|
29
|
19
|
$188,800.00
|
$188,800.00
|
$44,604.00
|
$185,024.00
|
$94,400.00
|
2026-10-22
|
|
9798317
|
LOCAL
|
Thoracic Branch Endoprosthesis Aortic Component 34mmx12mmx20cm 24fr Tac123420a
|
29
|
19
|
$188,800.00
|
$188,800.00
|
$44,604.00
|
$185,024.00
|
$94,400.00
|
2026-10-22
|
|
9798319
|
LOCAL
|
Thoracic Branch Endoprosthesis Aortic Component 37mmx12mmx15cm 24fr Tac123715a
|
29
|
19
|
$188,800.00
|
$188,800.00
|
$44,604.00
|
$185,024.00
|
$94,400.00
|
2026-10-22
|
|
9798323
|
LOCAL
|
Thoracic Branch Endoprosthesis Aortic Component 40mmx12mmx15cm 26fr Tac124015a
|
29
|
19
|
$188,800.00
|
$188,800.00
|
$44,604.00
|
$185,024.00
|
$94,400.00
|
2026-10-22
|
|
9798305
|
LOCAL
|
Thoracic Branch Endoprosthesis Aortic Component 40mmx8mmx15cm 26fr Tac084015a
|
29
|
19
|
$188,800.00
|
$188,800.00
|
$44,604.00
|
$185,024.00
|
$94,400.00
|
2026-10-22
|
|
9797291
|
LOCAL
|
Thoracic Branch Endoprosthesis Aortic Component 21mmx8mmx10cm 20fr Tac082110a
|
29
|
19
|
$188,800.00
|
$188,800.00
|
$44,604.00
|
$185,024.00
|
$94,400.00
|
2026-10-22
|
|
9798297
|
LOCAL
|
Thoracic Branch Endoprosthesis Aortic Component 34mmx8mmx15cm 24fr Tac083415a
|
29
|
19
|
$188,800.00
|
$188,800.00
|
$44,604.00
|
$185,024.00
|
$94,400.00
|
2026-10-22
|
|
9798293
|
LOCAL
|
Thoracic Branch Endoprosthesis Aortic Component 31mmx8mmx15cm 22fr Tac083115a
|
29
|
19
|
$188,800.00
|
$188,800.00
|
$44,604.00
|
$185,024.00
|
$94,400.00
|
2026-10-22
|
|
9798301
|
LOCAL
|
Thoracic Branch Endoprosthesis Aortic Component 37mmx8mmx15cm 24fr Tac083715a
|
29
|
19
|
$188,800.00
|
$188,800.00
|
$44,604.00
|
$185,024.00
|
$94,400.00
|
2026-10-22
|
|
9797293
|
LOCAL
|
Thoracic Branch Endoprosthesis Aortic Component 26mmx8mmx10cm 20fr Tac082610a
|
29
|
19
|
$188,800.00
|
$188,800.00
|
$44,604.00
|
$185,024.00
|
$94,400.00
|
2026-10-22
|
|
9798329
|
LOCAL
|
Thoracic Branch Endoprosthesis Aortic Component 45mmx12mmx20cm 26fr Tac124520a
|
29
|
19
|
$188,800.00
|
$188,800.00
|
$44,604.00
|
$185,024.00
|
$94,400.00
|
2026-10-22
|
|
9798327
|
LOCAL
|
Thoracic Branch Endoprosthesis Aortic Component 45mmx12mmx15cm 26fr Tac124515a
|
29
|
19
|
$188,800.00
|
$188,800.00
|
$44,604.00
|
$185,024.00
|
$94,400.00
|
2026-10-22
|
|
9798311
|
LOCAL
|
Thoracic Branch Endoprosthesis Aortic Component 31mmx12mmx15cm 22fr Tac123115a
|
29
|
19
|
$188,800.00
|
$188,800.00
|
$44,604.00
|
$185,024.00
|
$94,400.00
|
2026-10-22
|
|
9798295
|
LOCAL
|
Thoracic Branch Endoprosthesis Aortic Component 31mmx8mmx20cm 22fr Tac083120a
|
29
|
19
|
$188,800.00
|
$188,800.00
|
$44,604.00
|
$185,024.00
|
$94,400.00
|
2026-10-22
|
|
9798303
|
LOCAL
|
Thoracic Branch Endoprosthesis Aortic Component 37mmx8mmx20cm 24fr Tac083720a
|
29
|
19
|
$188,800.00
|
$188,800.00
|
$44,604.00
|
$185,024.00
|
$94,400.00
|
2026-10-22
|
|
9798325
|
LOCAL
|
Thoracic Branch Endoprosthesis Aortic Component 40mmx12mmx20cm 26fr Tac124020a
|
29
|
19
|
$188,800.00
|
$188,800.00
|
$44,604.00
|
$185,024.00
|
$94,400.00
|
2026-10-22
|
|
9798291
|
LOCAL
|
Thoracic Branch Endoprosthesis Aortic Component 28mmx8mmx20cm 22fr Tac082820a
|
29
|
19
|
$188,800.00
|
$188,800.00
|
$44,604.00
|
$185,024.00
|
$94,400.00
|
2026-10-22
|
|
9797625
|
LOCAL
|
Thoracic Branch Endoprosthesis Aortic Component 26mmx8mmx15cm 20fr Tac082615a
|
29
|
19
|
$188,800.00
|
$188,800.00
|
$44,604.00
|
$185,024.00
|
$94,400.00
|
2026-10-22
|
|
9798299
|
LOCAL
|
Thoracic Branch Endoprosthesis Aortic Component 34mmx8mmx20cm 24fr Tac083420a
|
29
|
19
|
$188,800.00
|
$188,800.00
|
$44,604.00
|
$185,024.00
|
$94,400.00
|
2026-10-22
|
|
9842210
|
LOCAL
|
Tavr Evolutfx 26mm
|
29
|
19
|
$177,000.00
|
$177,000.00
|
$41,816.25
|
$173,460.00
|
$88,500.00
|
2026-10-22
|
|
9842212
|
LOCAL
|
Valve Transcatheter Aortic Evolut Fx 23 Mm Evolutfx-23
|
29
|
19
|
$177,000.00
|
$177,000.00
|
$41,816.25
|
$173,460.00
|
$88,500.00
|
2026-10-22
|
|
9842206
|
LOCAL
|
Valve Transcatheter Aortic Evolut Fx 34 Mm Evolutfx-34
|
29
|
19
|
$177,000.00
|
$177,000.00
|
$41,816.25
|
$173,460.00
|
$88,500.00
|
2026-10-22
|
|
9842208
|
LOCAL
|
Tavr Evolutfx 29mm
|
29
|
19
|
$177,000.00
|
$177,000.00
|
$41,816.25
|
$173,460.00
|
$88,500.00
|
2026-10-22
|
|
A9543
|
HCPCS
|
Y 90 Zevalin
|
29
|
19
|
$176,372.00
|
$176,372.00
|
$41,667.89
|
$172,844.56
|
$88,186.00
|
2026-10-22
|
|
10424847
|
LOCAL
|
37mm Tambe Aoric Compnnt
|
29
|
19
|
$171,100.00
|
$171,100.00
|
$40,422.38
|
$167,678.00
|
$85,550.00
|
2026-10-22
|
|
10424845
|
LOCAL
|
Tambe Aortc Compnt 31mm
|
29
|
19
|
$171,100.00
|
$171,100.00
|
$40,422.38
|
$167,678.00
|
$85,550.00
|
2026-10-22
|
|
4
|
MS_DRG
|
Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…
|
7
|
7
|
$398,880.51
|
$398,880.51
|
$69,473.13
|
$85,067.44
|
$85,067.44
|
2026-10-22
|
|
7371214
|
LOCAL
|
Transcath Heart Valve System (ir)
|
29
|
19
|
$164,823.00
|
$164,823.00
|
$38,939.43
|
$161,526.54
|
$82,411.50
|
2026-10-22
|
|
C2624
|
HCPCS
|
System Pa Sensor And Delivery Cardiomems Cm Patient System
|
32
|
19
|
$120,950.00
|
$120,950.00
|
$28,574.44
|
$118,531.00
|
$81,641.25
|
2026-10-22
|
|
J9029
|
HCPCS
|
Nadofaragene Firadenovec Vncg (adstiladrin) Bladder Instillation
|
29
|
19
|
$155,304.00
|
$155,304.00
|
$36,690.57
|
$152,197.92
|
$77,652.00
|
2026-10-22
|
|
C1604
|
HCPCS
|
Detour System Cap
|
29
|
19
|
$147,500.00
|
$147,500.00
|
$34,846.88
|
$144,550.00
|
$73,750.00
|
2026-10-22
|
|
7456468
|
LOCAL
|
Catheter Cardiac Assist Impella 5.0
|
29
|
19
|
$147,500.00
|
$147,500.00
|
$34,846.88
|
$144,550.00
|
$73,750.00
|
2026-10-22
|
|
10389195
|
LOCAL
|
Impella Rp Flex W Smart Assist Set
|
29
|
19
|
$147,500.00
|
$147,500.00
|
$34,846.88
|
$144,550.00
|
$73,750.00
|
2026-10-22
|
|
7468501
|
LOCAL
|
Catheter Cardiac Assist Impella Rp US Hde 004334
|
29
|
19
|
$147,500.00
|
$147,500.00
|
$34,846.88
|
$144,550.00
|
$73,750.00
|
2026-10-22
|
|
7457205
|
LOCAL
|
Catheter Cardiac Assist Impella Ld 005082
|
29
|
19
|
$147,500.00
|
$147,500.00
|
$34,846.88
|
$144,550.00
|
$73,750.00
|
2026-10-22
|
|
7462910
|
LOCAL
|
Catheter Cardiac Assist Impella Cp 4.0 0048-0003
|
29
|
19
|
$147,500.00
|
$147,500.00
|
$34,846.88
|
$144,550.00
|
$73,750.00
|
2026-10-22
|
|
7450035
|
LOCAL
|
Aortoiliac Graft R010
|
29
|
19
|
$146,291.00
|
$146,291.00
|
$34,561.25
|
$143,365.18
|
$73,145.50
|
2026-10-22
|
|
69488-0003-01
|
NDC
|
Lutetium Lu 177 Dotatate 370 Mbq/ml Sol
|
29
|
19
|
$144,681.21
|
$144,681.21
|
$34,180.94
|
$141,787.59
|
$72,340.61
|
2026-10-22
|
|
Q2043
|
HCPCS
|
Sipuleucel-t IV Susp 250 Ml
|
29
|
19
|
$144,487.83
|
$144,487.83
|
$34,135.25
|
$141,598.07
|
$72,243.92
|
2026-10-22
|
|
C1824
|
HCPCS
|
Generator Pulse Ccm Optimizer Smart Ipg 10-b411-3-US
|
29
|
19
|
$135,700.00
|
$135,700.00
|
$32,059.13
|
$132,986.00
|
$67,850.00
|
2026-10-22
|
|
212
|
MS_DRG
|
Concomitant Aortic And Mitral Valve Procedures
|
7
|
7
|
$578,674.53
|
$578,674.53
|
$66,901.57
|
$90,123.34
|
$66,901.57
|
2026-10-22
|
|
C1822
|
HCPCS
|
Kit Neurostimulator Nipg2000
|
83
|
19
|
$120,950.00
|
$120,950.00
|
$102.06
|
$123,156.60
|
$64,782.00
|
2026-10-22
|
|
9174066
|
LOCAL
|
Tandemlung Kit - Dl31rd 5730-3631
|
29
|
19
|
$126,850.00
|
$126,850.00
|
$29,968.31
|
$124,313.00
|
$63,425.00
|
2026-10-22
|
|
9174032
|
LOCAL
|
Tandemlung Kit - Dl29 5730-2916
|
29
|
19
|
$126,850.00
|
$126,850.00
|
$29,968.31
|
$124,313.00
|
$63,425.00
|
2026-10-22
|
|
9174034
|
LOCAL
|
Tandemlung Kit - Dl31 5730-3118
|
29
|
19
|
$126,850.00
|
$126,850.00
|
$29,968.31
|
$124,313.00
|
$63,425.00
|
2026-10-22
|
|
J9226
|
HCPCS
|
Histrelin 50 Mg Implant (supprelin La)
|
29
|
19
|
$126,229.45
|
$126,229.45
|
$29,821.71
|
$123,704.86
|
$63,114.73
|
2026-10-22
|
|
10298756
|
LOCAL
|
Zenith Flx Mainbody Ext Esbe-prox
|
29
|
19
|
$125,694.00
|
$125,694.00
|
$29,695.21
|
$123,180.12
|
$62,847.00
|
2026-10-22
|
|
215
|
MS_DRG
|
Other Heart Assist System Implant
|
7
|
7
|
$704,076.77
|
$704,076.77
|
$61,305.92
|
$73,518.71
|
$61,305.92
|
2026-10-22
|
|
216
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
7
|
7
|
$602,702.69
|
$602,702.69
|
$60,243.04
|
$63,580.15
|
$60,243.04
|
2026-10-22
|
|
9747341
|
LOCAL
|
Stent Graft Valiant Captivia Proximal Main 32x32x200 Vamf3232c200tu
|
29
|
19
|
$119,623.00
|
$119,623.00
|
$28,260.93
|
$117,230.54
|
$59,811.50
|
2026-10-22
|
|
7449746
|
LOCAL
|
Catheter Cardiac Assist Impella 2.5
|
29
|
19
|
$118,000.00
|
$118,000.00
|
$27,877.50
|
$115,640.00
|
$59,000.00
|
2026-10-22
|
|
69488-0010-61
|
NDC
|
Lutetium Lu 177 Vipivotide Tetraxetan 1000 Mbq/ml Sol
|
29
|
19
|
$117,817.50
|
$117,817.50
|
$27,834.38
|
$115,461.15
|
$58,908.75
|
2026-10-22
|
|
9174030
|
LOCAL
|
Protekduo Kit - Dl31 5720-3118
|
29
|
19
|
$115,050.00
|
$115,050.00
|
$27,180.56
|
$112,749.00
|
$57,525.00
|
2026-10-22
|
|
9174064
|
LOCAL
|
Protekduo Kit - Dl31rd 5720-3631
|
29
|
19
|
$115,050.00
|
$115,050.00
|
$27,180.56
|
$112,749.00
|
$57,525.00
|
2026-10-22
|
|
9174026
|
LOCAL
|
Tandemheart Kit - Ts72/a17 5710-7217
|
29
|
19
|
$115,050.00
|
$115,050.00
|
$27,180.56
|
$112,749.00
|
$57,525.00
|
2026-10-22
|
|
9174024
|
LOCAL
|
Tandemheart Kit - Ts72/a15 5710-7215
|
29
|
19
|
$115,050.00
|
$115,050.00
|
$27,180.56
|
$112,749.00
|
$57,525.00
|
2026-10-22
|
|
9174022
|
LOCAL
|
Tandemheart Kit - Ts62/a17 5710-6217
|
29
|
19
|
$115,050.00
|
$115,050.00
|
$27,180.56
|
$112,749.00
|
$57,525.00
|
2026-10-22
|
|
9174020
|
LOCAL
|
Tandemheart Kit - Ts62/a15 5710-6215
|
29
|
19
|
$115,050.00
|
$115,050.00
|
$27,180.56
|
$112,749.00
|
$57,525.00
|
2026-10-22
|
|
9174028
|
LOCAL
|
Protekduo Kit - Dl29 5720-2916
|
29
|
19
|
$115,050.00
|
$115,050.00
|
$27,180.56
|
$112,749.00
|
$57,525.00
|
2026-10-22
|
|
9747343
|
LOCAL
|
Stent Graft Valiant Captivia Distal Closed Web Straight 32x32x200mm Vamc3232c20…
|
29
|
19
|
$115,021.00
|
$115,021.00
|
$27,173.71
|
$112,720.58
|
$57,510.50
|
2026-10-22
|
|
7434479
|
LOCAL
|
Ambicor 14mmx20cm 72401455
|
29
|
19
|
$114,932.00
|
$114,932.00
|
$27,152.69
|
$112,633.36
|
$57,466.00
|
2026-10-22
|
|
429
|
MS_DRG
|
Combined Anterior And Posterior Cervical Spinal Fusion With Mcc
|
4
|
4
|
$572,982.62
|
$572,982.62
|
$55,525.39
|
$55,525.39
|
$55,525.39
|
2026-10-22
|
|
9942635
|
LOCAL
|
Pulse Generator IV 3028
|
29
|
19
|
$107,528.00
|
$107,528.00
|
$25,403.49
|
$105,377.44
|
$53,764.00
|
2026-10-22
|
|
C9293
|
HCPCS
|
Glucarpidase 1000 Units IV Inj
|
29
|
19
|
$106,574.78
|
$106,574.78
|
$25,178.29
|
$104,443.28
|
$53,287.39
|
2026-10-22
|
|
231
|
MS_DRG
|
Coronary Bypass With Ptca With Mcc
|
7
|
7
|
$537,482.13
|
$537,482.13
|
$51,988.38
|
$54,381.30
|
$51,988.38
|
2026-10-22
|
|
456
|
MS_DRG
|
Spinal Fusion Except Cervical With Spinal Curvature Malignancy Infection Or Exte…
|
7
|
7
|
$335,195.44
|
$335,195.44
|
$44,723.02
|
$51,826.69
|
$51,826.69
|
2026-10-22
|
|
9710309
|
LOCAL
|
Plate Cmf Ns 23mm 600002309
|
29
|
19
|
$101,376.00
|
$101,376.00
|
$23,950.08
|
$99,348.48
|
$50,688.00
|
2026-10-22
|
|
9174036
|
LOCAL
|
Tandemlife Kit V24/a15 5740-2415
|
29
|
19
|
$97,350.00
|
$97,350.00
|
$22,998.94
|
$95,403.00
|
$48,675.00
|
2026-10-22
|
|
9174038
|
LOCAL
|
Tandemlife Kit - V24/a17 5740-2417
|
29
|
19
|
$97,350.00
|
$97,350.00
|
$22,998.94
|
$95,403.00
|
$48,675.00
|
2026-10-22
|
|
20
|
MS_DRG
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc
|
7
|
7
|
$369,517.31
|
$369,517.31
|
$48,564.85
|
$60,161.85
|
$48,564.85
|
2026-10-22
|
|
9785406
|
LOCAL
|
Graft Endovascular Dissection W/proform 8tapered Component Zenith Tx2 20f 28-29x…
|
29
|
19
|
$96,996.00
|
$96,996.00
|
$22,915.31
|
$95,056.08
|
$48,498.00
|
2026-10-22
|
|
0266T
|
CPT
|
Implant/replace Carotid Sinus Baroreflex Device Total System - Ccl
|
29
|
19
|
$79,755.00
|
$79,755.00
|
$19,340.59
|
$78,159.90
|
$47,853.00
|
2026-10-22
|
|
9581349
|
LOCAL
|
Full Implant Package Non-rechargeable F15 4b01
|
29
|
19
|
$95,521.00
|
$95,521.00
|
$22,566.84
|
$93,610.58
|
$47,760.50
|
2026-10-22
|
|
219
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
7
|
7
|
$441,644.80
|
$441,644.80
|
$47,402.52
|
$52,706.04
|
$47,402.52
|
2026-10-22
|
|
233
|
MS_DRG
|
Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc
|
7
|
7
|
$433,827.49
|
$433,827.49
|
$47,200.56
|
$47,744.29
|
$47,200.56
|
2026-10-22
|
|
9295935
|
LOCAL
|
Stent Graft Thoracic Main Coveredseal Valiant Navion Str 22f Vnmc4040c95tu
|
29
|
19
|
$94,400.00
|
$94,400.00
|
$22,302.00
|
$92,512.00
|
$47,200.00
|
2026-10-22
|
|
9295934
|
LOCAL
|
Stent Graft Thoracic Main Coveredseal Valiant Navion Str 22f Vnmc4040c55tu
|
29
|
19
|
$94,400.00
|
$94,400.00
|
$22,302.00
|
$92,512.00
|
$47,200.00
|
2026-10-22
|
|
9785404
|
LOCAL
|
Graft Thoracic Endovascular Proximal Component Zenith Alpha 18f 36x32x209mm G381…
|
29
|
19
|
$94,194.00
|
$94,194.00
|
$22,253.33
|
$92,310.12
|
$47,097.00
|
2026-10-22
|
|
957
|
MS_DRG
|
Other O.r. Procedures For Multiple Significant Trauma With Mcc
|
7
|
7
|
$384,357.25
|
$384,357.25
|
$40,346.04
|
$47,046.20
|
$47,046.20
|
2026-10-22
|
|
10493089
|
LOCAL
|
Web Sl 6.0mm By 2.0 Mm
|
29
|
19
|
$92,455.00
|
$92,455.00
|
$21,842.49
|
$90,605.90
|
$46,227.50
|
2026-10-22
|
|
427
|
MS_DRG
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
4
|
4
|
$393,467.89
|
$393,467.89
|
$44,597.68
|
$44,597.68
|
$44,597.68
|
2026-10-22
|
|
7460581
|
LOCAL
|
Stent Graft Thoracic C-tag Endoprosthesis 45x15
|
29
|
19
|
$89,037.00
|
$89,037.00
|
$21,034.99
|
$87,256.26
|
$44,518.50
|
2026-10-22
|
|
7460576
|
LOCAL
|
Stent Graft Thoracic C-tag Endoprosthesis 31x26x10
|
29
|
19
|
$89,037.00
|
$89,037.00
|
$21,034.99
|
$87,256.26
|
$44,518.50
|
2026-10-22
|
|
8909771
|
LOCAL
|
Stent Graft Thoracic C-tag Endoprosthesis 22f 34x34x20 Tgu34320
|
29
|
19
|
$89,037.00
|
$89,037.00
|
$21,034.99
|
$87,256.26
|
$44,518.50
|
2026-10-22
|
|
7460385
|
LOCAL
|
Graft Tag Conformable Endoprosthesis Thoracic Gore Tag 34mmx34mm 10cm
|
29
|
19
|
$89,037.00
|
$89,037.00
|
$21,034.99
|
$87,256.26
|
$44,518.50
|
2026-10-22
|
|
7460577
|
LOCAL
|
Stent Graft Thoracic C-tag Endoprosthesis 31x10
|
29
|
19
|
$89,037.00
|
$89,037.00
|
$21,034.99
|
$87,256.26
|
$44,518.50
|
2026-10-22
|
|
7457394
|
LOCAL
|
Stent Graft Endoprosthesis Thoracic Tag 22fr 13x31x15
|
29
|
19
|
$89,037.00
|
$89,037.00
|
$21,034.99
|
$87,256.26
|
$44,518.50
|
2026-10-22
|
|
8706165
|
LOCAL
|
Extender Aortic Endoprosthesis Cxa320005c ? ? ? ? ? ? ?
|
29
|
19
|
$89,037.00
|
$89,037.00
|
$21,034.99
|
$87,256.26
|
$44,518.50
|
2026-10-22
|
|
7460580
|
LOCAL
|
Stent Graft Thoracic C-tag Endoprosthesis 40x15
|
29
|
19
|
$89,037.00
|
$89,037.00
|
$21,034.99
|
$87,256.26
|
$44,518.50
|
2026-10-22
|
|
7460386
|
LOCAL
|
Graft Tag Conformable Endoprosthesis Thoracic Gore Tag 20f 26mmx26mm 10cm
|
29
|
19
|
$89,037.00
|
$89,037.00
|
$21,034.99
|
$87,256.26
|
$44,518.50
|
2026-10-22
|
|
7460578
|
LOCAL
|
Stent Graft Thoracic C-tag Endoprosthesis 37x15
|
29
|
19
|
$89,037.00
|
$89,037.00
|
$21,034.99
|
$87,256.26
|
$44,518.50
|
2026-10-22
|
|
7460579
|
LOCAL
|
Stent Graft Thoracic C-tag Endoprosthesis 40x10
|
29
|
19
|
$89,037.00
|
$89,037.00
|
$21,034.99
|
$87,256.26
|
$44,518.50
|
2026-10-22
|
|
7462738
|
LOCAL
|
Stent Graft Endoprosthesis Thoracic Tag 20fr 34mmx15cm
|
29
|
19
|
$89,037.00
|
$89,037.00
|
$21,034.99
|
$87,256.26
|
$44,518.50
|
2026-10-22
|
|
7460319
|
LOCAL
|
Stent Graft Thoracic C-tag Endoprosthesis 21x21x10
|
29
|
19
|
$89,037.00
|
$89,037.00
|
$21,034.99
|
$87,256.26
|
$44,518.50
|
2026-10-22
|
|
8909773
|
LOCAL
|
Stent Graft Thoracic C-tag Endoprosthesis 22f 34x34x10 Tgu34310
|
29
|
19
|
$89,037.00
|
$89,037.00
|
$21,034.99
|
$87,256.26
|
$44,518.50
|
2026-10-22
|
|
7459835
|
LOCAL
|
Stent Graft Thoracic C-tag Endoprosthesis 26x21x10
|
29
|
19
|
$89,037.00
|
$89,037.00
|
$21,034.99
|
$87,256.26
|
$44,518.50
|
2026-10-22
|
|
7457395
|
LOCAL
|
Stent Graft Endoprosthesis Thoracic Tag 20fr 28x28x10
|
29
|
19
|
$89,037.00
|
$89,037.00
|
$21,034.99
|
$87,256.26
|
$44,518.50
|
2026-10-22
|
|
9842702
|
LOCAL
|
Defib Amplia Crtd Quad Dtmb1q1
|
29
|
19
|
$88,931.00
|
$88,931.00
|
$21,009.95
|
$87,152.38
|
$44,465.50
|
2026-10-22
|
|
9174040
|
LOCAL
|
Tandem Life Kit 5740-0000
|
29
|
19
|
$88,500.00
|
$88,500.00
|
$20,908.13
|
$86,730.00
|
$44,250.00
|
2026-10-22
|
|
8821699
|
LOCAL
|
Graft Endovascular Afx2 Aaa System Bifurcated 22mmx80mmx16mmx40mm Bea22-80/i16-4…
|
29
|
19
|
$88,495.00
|
$88,495.00
|
$20,906.94
|
$86,725.10
|
$44,247.50
|
2026-10-22
|
|
9763499
|
LOCAL
|
Graft Endovascular Afx2 Aaa System Bifurcated 25x80x13x40mm Bea25-80/113-40
|
29
|
19
|
$88,495.00
|
$88,495.00
|
$20,906.94
|
$86,725.10
|
$44,247.50
|
2026-10-22
|
|
9936316
|
LOCAL
|
Graft Endovascular Afx2 Aaa System Bifurcated 25mmx70mmx16mm30mm Bea25-70/116-3…
|
29
|
19
|
$88,495.00
|
$88,495.00
|
$20,906.94
|
$86,725.10
|
$44,247.50
|
2026-10-22
|
|
8576343
|
LOCAL
|
Graft Endovascular Afx2 Aaa Sys Bifurcated 22x60x16x40mm Bea22-60/i16-40
|
29
|
19
|
$88,495.00
|
$88,495.00
|
$20,906.94
|
$86,725.10
|
$44,247.50
|
2026-10-22
|
|
275
|
MS_DRG
|
Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc
|
7
|
7
|
$384,316.22
|
$384,316.22
|
$43,102.09
|
$44,059.53
|
$44,059.53
|
2026-10-22
|
|
C1882
|
HCPCS
|
Defib Crome Crtd Hf Quad MRI Is4 Df1
|
716
|
19
|
$88,929.00
|
$88,929.00
|
$7,736.01
|
$115,640.00
|
$43,811.87
|
2026-10-22
|
|
8892536
|
LOCAL
|
Graft Endovascular Fenestrated Aaa Proximal Body Zenith 20f 38x124mm G32542
|
29
|
19
|
$86,424.00
|
$86,424.00
|
$20,417.67
|
$84,695.52
|
$43,212.00
|
2026-10-22
|
|
9052226
|
LOCAL
|
Stent Graft Abdominal Zenith Proximal Body Fenestrated Extension 28mm 94mm 20 Fr…
|
29
|
19
|
$86,424.00
|
$86,424.00
|
$20,417.67
|
$84,695.52
|
$43,212.00
|
2026-10-22
|
|
9276937
|
LOCAL
|
Kit Oxygenator Tube Hls Set Advanced 7.0 Beq-hls 701052794
|
29
|
19
|
$85,599.00
|
$85,599.00
|
$20,222.76
|
$83,887.02
|
$42,799.50
|
2026-10-22
|
|
10194766
|
LOCAL
|
Cannula W/180deg Str Dilator Circuit W/2 Bubble Traps Angiov
|
29
|
19
|
$85,550.00
|
$85,550.00
|
$20,211.19
|
$83,839.00
|
$42,775.00
|
2026-10-22
|
|
870
|
MS_DRG
|
Septicemia Or Severe Sepsis With Mv >96 Hours
|
7
|
7
|
$265,775.19
|
$265,775.19
|
$38,278.07
|
$42,725.75
|
$42,725.75
|
2026-10-22
|
|
9721871
|
LOCAL
|
Plate Cmf Ns 34mm 600003409
|
29
|
19
|
$85,438.00
|
$85,438.00
|
$20,184.73
|
$83,729.24
|
$42,719.00
|
2026-10-22
|
|
268
|
MS_DRG
|
Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc
|
7
|
7
|
$352,896.96
|
$352,896.96
|
$36,066.44
|
$42,518.91
|
$42,518.91
|
2026-10-22
|
|
C1767
|
HCPCS
|
Activa Sc Neurostimulator - New
|
423
|
19
|
$88,500.00
|
$88,500.00
|
$959.18
|
$226,336.88
|
$41,982.38
|
2026-10-22
|
|
955
|
MS_DRG
|
Craniotomy For Multiple Significant Trauma
|
7
|
7
|
$421,870.47
|
$421,870.47
|
$41,623.22
|
$50,240.49
|
$41,623.22
|
2026-10-22
|
|
J9269
|
HCPCS
|
Tagraxofusp (elzonris) 1000 Mcg Injection
|
29
|
19
|
$83,214.97
|
$83,214.97
|
$19,659.54
|
$81,550.67
|
$41,607.49
|
2026-10-22
|
|
317
|
MS_DRG
|
Concomitant Left Atrial Appendage Closure And Cardiac Ablation
|
7
|
7
|
$466,629.72
|
$466,629.72
|
$41,351.09
|
$50,931.26
|
$41,351.09
|
2026-10-22
|
|
447
|
MS_DRG
|
Multiple Level Spinal Fusion Except Cervical With Mcc Or Custommade Anatomically…
|
4
|
4
|
$544,473.13
|
$544,473.13
|
$41,321.20
|
$41,321.20
|
$41,321.20
|
2026-10-22
|
|
9506883
|
LOCAL
|
Maquet Hls Set
|
29
|
19
|
$82,375.00
|
$82,375.00
|
$19,461.09
|
$80,727.50
|
$41,187.50
|
2026-10-22
|
|
C1722
|
HCPCS
|
Aurora Ev-icd Device
|
328
|
19
|
$71,390.00
|
$71,390.00
|
$3,769.42
|
$127,204.00
|
$40,982.50
|
2026-10-22
|
|
218
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
7
|
7
|
$465,162.07
|
$465,162.07
|
$31,588.33
|
$40,672.61
|
$40,672.61
|
2026-10-22
|
|
217
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
7
|
7
|
$469,130.75
|
$469,130.75
|
$40,672.61
|
$44,040.32
|
$40,672.61
|
2026-10-22
|
|
C1820
|
HCPCS
|
Activa Rc Neurostimulator
|
838
|
19
|
$103,250.00
|
$103,250.00
|
$150.73
|
$176,051.12
|
$40,090.50
|
2026-10-22
|
|
207
|
MS_DRG
|
Respiratory System Diagnosis With Ventilator Support >96 Hours
|
7
|
7
|
$246,348.41
|
$246,348.41
|
$35,398.82
|
$39,814.74
|
$39,814.74
|
2026-10-22
|
|
9218350
|
LOCAL
|
Device Embolization Y-shape Pulserider Aneurysm Neck Reconstruction Device 2.7 -…
|
29
|
19
|
$79,077.00
|
$79,077.00
|
$18,681.94
|
$77,495.46
|
$39,538.50
|
2026-10-22
|
|
9218348
|
LOCAL
|
Device Embolization T-shape Pulserider Aneurysm Neck Reconstruction Device 3.5 -…
|
29
|
19
|
$79,077.00
|
$79,077.00
|
$18,681.94
|
$77,495.46
|
$39,538.50
|
2026-10-22
|
|
9218344
|
LOCAL
|
Device Embolization T-shape Pulserider Aneurysm Neck Reconstruction Device 3.5 -…
|
29
|
19
|
$79,077.00
|
$79,077.00
|
$18,681.94
|
$77,495.46
|
$39,538.50
|
2026-10-22
|
|
9218342
|
LOCAL
|
Device Embolization T-shape Pulserider Aneurysm Neck Reconstruction Device 2.7 -…
|
29
|
19
|
$79,077.00
|
$79,077.00
|
$18,681.94
|
$77,495.46
|
$39,538.50
|
2026-10-22
|
|
9218346
|
LOCAL
|
Device Embolization T-shape Pulserider Aneurysm Neck Reconstruction Device 2.7 -…
|
29
|
19
|
$79,077.00
|
$79,077.00
|
$18,681.94
|
$77,495.46
|
$39,538.50
|
2026-10-22
|
|
9218356
|
LOCAL
|
Device Embolization Y-shape Pulserider Aneurysm Neck Reconstruction Device 3.5 -…
|
29
|
19
|
$79,077.00
|
$79,077.00
|
$18,681.94
|
$77,495.46
|
$39,538.50
|
2026-10-22
|
|
9218352
|
LOCAL
|
Device Embolization Y-shape Pulserider Aneurysm Neck Reconstruction Device 3.5 -…
|
29
|
19
|
$79,077.00
|
$79,077.00
|
$18,681.94
|
$77,495.46
|
$39,538.50
|
2026-10-22
|
|
9218354
|
LOCAL
|
Device Embolization Y-shape Pulserider Aneurysm Neck Reconstruction Device 2.7 -…
|
29
|
19
|
$79,077.00
|
$79,077.00
|
$18,681.94
|
$77,495.46
|
$39,538.50
|
2026-10-22
|
|
9902239
|
LOCAL
|
Device Embolization Pipeline 2.5 X 18
|
29
|
19
|
$77,880.00
|
$77,880.00
|
$18,399.15
|
$76,322.40
|
$38,940.00
|
2026-10-22
|
|
9174042
|
LOCAL
|
Tandemheart Pump Kit 5120-0000
|
29
|
19
|
$76,700.00
|
$76,700.00
|
$18,120.38
|
$75,166.00
|
$38,350.00
|
2026-10-22
|
|
266
|
MS_DRG
|
Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc
|
7
|
7
|
$335,305.95
|
$335,305.95
|
$37,945.87
|
$56,057.63
|
$37,945.87
|
2026-10-22
|
|
232
|
MS_DRG
|
Coronary Bypass With Ptca Without Mcc
|
7
|
7
|
$332,563.02
|
$332,563.02
|
$32,243.59
|
$37,544.39
|
$37,544.39
|
2026-10-22
|
|
28
|
MS_DRG
|
Spinal Procedures With Mcc
|
7
|
7
|
$307,429.39
|
$307,429.39
|
$30,205.73
|
$37,213.08
|
$37,213.08
|
2026-10-22
|
|
276
|
MS_DRG
|
Cardiac Defibrillator Implant With Mcc
|
7
|
7
|
$286,522.15
|
$286,522.15
|
$28,270.10
|
$37,202.71
|
$37,202.71
|
2026-10-22
|
|
00003-2328-22A
|
NDC
|
Ipilimumab 200 Mg/40 Ml (investigational)
|
29
|
19
|
$74,273.71
|
$74,273.71
|
$17,547.16
|
$72,788.24
|
$37,136.86
|
2026-10-22
|
|
457
|
MS_DRG
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
7
|
7
|
$309,175.54
|
$309,175.54
|
$36,937.30
|
$41,298.80
|
$36,937.30
|
2026-10-22
|
|
8912344
|
LOCAL
|
Stent Graft Abdominal Aortic Body Ovation 15f 34x820mm Tv-ab3480-j
|
29
|
19
|
$73,745.00
|
$73,745.00
|
$17,422.26
|
$72,270.10
|
$36,872.50
|
2026-10-22
|
|
8238109
|
LOCAL
|
Stent Graft Aortic Body Ovation Ix 14f 23mm X 80mm Tv-ab2380-j
|
29
|
19
|
$73,745.00
|
$73,745.00
|
$17,422.26
|
$72,270.10
|
$36,872.50
|
2026-10-22
|
|
8409155
|
LOCAL
|
Stent Graft Aortic Body Ovation Ix 14f 26mm X 80mm Tv-ab2680-j
|
29
|
19
|
$73,745.00
|
$73,745.00
|
$17,422.26
|
$72,270.10
|
$36,872.50
|
2026-10-22
|
|
790
|
MS_DRG
|
Extreme Immaturity Or Respiratory Distress Syndrome, Neonate
|
7
|
7
|
$178,334.98
|
$178,334.98
|
$5,728.91
|
$36,817.71
|
$36,817.71
|
2026-10-22
|
|
235
|
MS_DRG
|
Coronary Bypass Without Cardiac Catheterization With Mcc
|
7
|
7
|
$363,420.60
|
$363,420.60
|
$36,360.71
|
$38,067.17
|
$36,360.71
|
2026-10-22
|
|
820
|
MS_DRG
|
Lymphoma And Leukemia With Major O.r. Procedures With Mcc
|
7
|
7
|
$972,361.64
|
$972,361.64
|
$36,337.52
|
$48,606.66
|
$36,337.52
|
2026-10-22
|
|
7874255
|
LOCAL
|
Mitra Clip
|
29
|
19
|
$72,155.00
|
$72,155.00
|
$17,046.62
|
$70,711.90
|
$36,077.50
|
2026-10-22
|
|
430
|
MS_DRG
|
Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc
|
4
|
4
|
$272,309.25
|
$272,309.25
|
$35,741.41
|
$35,741.41
|
$35,741.41
|
2026-10-22
|
|
23
|
MS_DRG
|
Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…
|
7
|
7
|
$254,580.81
|
$254,580.81
|
$35,516.88
|
$36,110.01
|
$35,516.88
|
2026-10-22
|
|
213
|
MS_DRG
|
Endovascular Abdominal Aorta With Iliac Branch Procedures
|
7
|
7
|
$338,872.19
|
$338,872.19
|
$35,374.10
|
$47,297.76
|
$35,374.10
|
2026-10-22
|
|
10424833
|
LOCAL
|
Bashir Endovascular Catheter .035 8f
|
29
|
19
|
$70,682.00
|
$70,682.00
|
$16,698.62
|
$69,268.36
|
$35,341.00
|
2026-10-22
|
|
10424835
|
LOCAL
|
Bashir S B Endovsclr Cath .035 8f
|
29
|
19
|
$70,682.00
|
$70,682.00
|
$16,698.62
|
$69,268.36
|
$35,341.00
|
2026-10-22
|
|
463
|
MS_DRG
|
Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …
|
7
|
7
|
$267,010.18
|
$267,010.18
|
$29,605.89
|
$35,328.95
|
$35,328.95
|
2026-10-22
|
|
Q4130
|
HCPCS
|
Ex Strattice Thick 20x30
|
116
|
19
|
$74,921.50
|
$74,921.50
|
$7,762.70
|
$143,660.16
|
$35,090.46
|
2026-10-22
|
|
J9118
|
HCPCS
|
Calaspargase Pegol Mknl (asparlas) 3750 Units/5 Ml
|
29
|
19
|
$70,076.58
|
$70,076.58
|
$16,555.59
|
$68,675.05
|
$35,038.29
|
2026-10-22
|
|
J9359
|
HCPCS
|
Loncastuximab Tesirine Lpyl 10 Mg (zynlonta)
|
29
|
19
|
$69,947.00
|
$69,947.00
|
$16,524.98
|
$68,548.06
|
$34,973.50
|
2026-10-22
|
|
428
|
MS_DRG
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
4
|
4
|
$338,736.64
|
$338,736.64
|
$34,856.09
|
$34,856.09
|
$34,856.09
|
2026-10-22
|
|
7445206
|
LOCAL
|
Stent Zenith Flex Aaa Mbds 26x111
|
29
|
19
|
$69,656.00
|
$69,656.00
|
$16,456.23
|
$68,262.88
|
$34,828.00
|
2026-10-22
|
|
7457171
|
LOCAL
|
Stent Graft Bifurcated Main Body 32mm X 111mm G48429
|
29
|
19
|
$69,656.00
|
$69,656.00
|
$16,456.23
|
$68,262.88
|
$34,828.00
|
2026-10-22
|
|
7455320
|
LOCAL
|
Stent Graft Iliac Leg 28-82 G48417
|
29
|
19
|
$69,656.00
|
$69,656.00
|
$16,456.23
|
$68,262.88
|
$34,828.00
|
2026-10-22
|
|
7457959
|
LOCAL
|
Stent Zenith Flex Aaa W/ztrak 18fr 26mm 96mm
|
29
|
19
|
$69,656.00
|
$69,656.00
|
$16,456.23
|
$68,262.88
|
$34,828.00
|
2026-10-22
|
|
8353329
|
LOCAL
|
Saphenous Vein Graft >80 Cm V010
|
29
|
19
|
$69,615.00
|
$69,615.00
|
$16,446.54
|
$68,222.70
|
$34,807.50
|
2026-10-22
|
|
278
|
MS_DRG
|
Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures …
|
7
|
7
|
$264,014.39
|
$264,014.39
|
$34,515.63
|
$46,131.97
|
$34,515.63
|
2026-10-22
|
|
9581351
|
LOCAL
|
Neurostimulator Non-rechargeable F15 4101
|
29
|
19
|
$68,741.00
|
$68,741.00
|
$16,240.06
|
$67,366.18
|
$34,370.50
|
2026-10-22
|
|
7458071
|
LOCAL
|
Stent Graft Afx Mainbody 28x80x16x40 Bifurcated Ba28-80/i16-40
|
29
|
19
|
$68,322.00
|
$68,322.00
|
$16,141.07
|
$66,955.56
|
$34,161.00
|
2026-10-22
|
|
7915863
|
LOCAL
|
Graft Endovascular Afx Aaa System Bifuracated Mainbody 25x16x90x30mm Ba25-90/116…
|
29
|
19
|
$68,322.00
|
$68,322.00
|
$16,141.07
|
$66,955.56
|
$34,161.00
|
2026-10-22
|
|
834
|
MS_DRG
|
Acute Leukemia Without Major O.r. Procedures With Mcc
|
7
|
7
|
$305,282.90
|
$305,282.90
|
$32,421.11
|
$34,050.09
|
$34,050.09
|
2026-10-22
|
|
405
|
MS_DRG
|
Pancreas, Liver And Shunt Procedures With Mcc
|
7
|
7
|
$206,193.63
|
$206,193.63
|
$31,459.75
|
$33,931.72
|
$33,931.72
|
2026-10-22
|
|
234
|
MS_DRG
|
Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc
|
7
|
7
|
$355,130.70
|
$355,130.70
|
$33,884.13
|
$43,873.55
|
$33,884.13
|
2026-10-22
|
|
11
|
MS_DRG
|
Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc
|
7
|
7
|
$456,020.98
|
$456,020.98
|
$33,831.65
|
$48,386.09
|
$33,831.65
|
2026-10-22
|
|
9609163
|
LOCAL
|
Graft Femoral Condyle 32147001
|
29
|
19
|
$67,408.00
|
$67,408.00
|
$15,925.14
|
$66,059.84
|
$33,704.00
|
2026-10-22
|
|
C1772
|
HCPCS
|
Pump Syncromed 8637-20 8637-20
|
29
|
19
|
$66,924.00
|
$66,924.00
|
$4,932.24
|
$65,585.52
|
$33,462.00
|
2026-10-22
|
|
7468536
|
LOCAL
|
Graft Endovascular Fenestrated Aaa Proximal Body Zenith 22f 36x122mm G32548
|
29
|
19
|
$66,847.00
|
$66,847.00
|
$15,792.60
|
$65,510.06
|
$33,423.50
|
2026-10-22
|
|
220
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
7
|
7
|
$374,382.93
|
$374,382.93
|
$33,091.55
|
$43,181.18
|
$33,091.55
|
2026-10-22
|
|
450
|
MS_DRG
|
Single Level Spinal Fusion Except Cervical With Mcc Or Custommade Anatomically D…
|
4
|
4
|
$230,026.96
|
$230,026.96
|
$33,072.02
|
$33,072.02
|
$33,072.02
|
2026-10-22
|
|
21
|
MS_DRG
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc
|
7
|
7
|
$254,180.47
|
$254,180.47
|
$32,853.59
|
$43,874.63
|
$32,853.59
|
2026-10-22
|
|
270
|
MS_DRG
|
Other Major Cardiovascular Procedures With Mcc
|
7
|
7
|
$292,108.11
|
$292,108.11
|
$32,746.81
|
$37,449.58
|
$32,746.81
|
2026-10-22
|
|
9736849
|
LOCAL
|
Mesh Strattice Perforated 20x20 2020002p
|
29
|
19
|
$65,154.00
|
$65,154.00
|
$15,392.63
|
$63,850.92
|
$32,577.00
|
2026-10-22
|
|
C2622
|
HCPCS
|
Pump Cylinder Es2818 Es2818
|
83
|
19
|
$63,508.00
|
$63,508.00
|
$3,561.66
|
$62,602.40
|
$32,554.20
|
2026-10-22
|
|
9798285
|
LOCAL
|
Thoracic Branch Endoprosthesis Aortic Extender 37mmx4.2mmx5cm 24fr Te3742a
|
29
|
19
|
$64,900.00
|
$64,900.00
|
$15,332.63
|
$63,602.00
|
$32,450.00
|
2026-10-22
|
|
9798279
|
LOCAL
|
Thoracic Branch Endoprosthesis Aortic Extender 28mmx4mmx4cm 22fr Te2840a
|
29
|
19
|
$64,900.00
|
$64,900.00
|
$15,332.63
|
$63,602.00
|
$32,450.00
|
2026-10-22
|
|
9841733
|
LOCAL
|
Graft Endovascular Aaa Thoracic Proximal Component Zenith Alpha 18f 40x117mm G3…
|
29
|
19
|
$64,900.00
|
$64,900.00
|
$15,332.63
|
$63,602.00
|
$32,450.00
|
2026-10-22
|
|
9798287
|
LOCAL
|
Thoracic Branch Endoprosthesis Aortic Extender 40mmx4.3mmx6cm 26fr Te4043a
|
29
|
19
|
$64,900.00
|
$64,900.00
|
$15,332.63
|
$63,602.00
|
$32,450.00
|
2026-10-22
|
|
9798283
|
LOCAL
|
Thoracic Branch Endoprosthesis Aortic Extender 34mmx4.2mmx5cm 24fr Te3442a
|
29
|
19
|
$64,900.00
|
$64,900.00
|
$15,332.63
|
$63,602.00
|
$32,450.00
|
2026-10-22
|
|
9798277
|
LOCAL
|
Thoracic Branch Endoprosthesis Aortic Extender 26mmx3.8mmx4cm 20fr Te2638a
|
29
|
19
|
$64,900.00
|
$64,900.00
|
$15,332.63
|
$63,602.00
|
$32,450.00
|
2026-10-22
|
|
9798281
|
LOCAL
|
Thoracic Branch Endoprosthesis Aortic Extender 31mmx4mmx4cm 22fr Te3140a
|
29
|
19
|
$64,900.00
|
$64,900.00
|
$15,332.63
|
$63,602.00
|
$32,450.00
|
2026-10-22
|
|
9798289
|
LOCAL
|
Thoracic Branch Endoprosthesis Aortic Extender 45mmx4.6mmx6.5cm 26fr Te4546a
|
29
|
19
|
$64,900.00
|
$64,900.00
|
$15,332.63
|
$63,602.00
|
$32,450.00
|
2026-10-22
|
|
466
|
MS_DRG
|
Revision Of Hip Or Knee Replacement With Mcc
|
7
|
7
|
$218,710.94
|
$218,710.94
|
$30,387.03
|
$32,314.22
|
$32,314.22
|
2026-10-22
|
|
653
|
MS_DRG
|
Major Bladder Procedures With Mcc
|
7
|
7
|
$256,819.43
|
$256,819.43
|
$32,259.31
|
$43,066.58
|
$32,259.31
|
2026-10-22
|
|
C1721
|
HCPCS
|
Gallant Dr Defib
|
415
|
19
|
$58,941.00
|
$58,941.00
|
$826.88
|
$95,692.10
|
$32,081.25
|
2026-10-22
|
|
9944791
|
LOCAL
|
Cylinder Pump 22cm Es2922
|
29
|
19
|
$63,880.00
|
$63,880.00
|
$15,091.65
|
$62,602.40
|
$31,940.00
|
2026-10-22
|
|
C1715
|
HCPCS
|
Pump Urology 72404238 72404238
|
29
|
19
|
$63,225.00
|
$63,225.00
|
$2.10
|
$61,960.50
|
$31,612.50
|
2026-10-22
|
|
7455600
|
LOCAL
|
Implant Penile 15cmx12mm 72404231
|
29
|
19
|
$63,225.00
|
$63,225.00
|
$14,936.91
|
$61,960.50
|
$31,612.50
|
2026-10-22
|
|
7457898
|
LOCAL
|
Stent Graft Excluder Aaa System Del C3 Endoprothesis Trunk I Psi Lateral Leg 23m…
|
29
|
19
|
$62,936.00
|
$62,936.00
|
$14,868.63
|
$61,677.28
|
$31,468.00
|
2026-10-22
|
|
7452486
|
LOCAL
|
Stent Endoprosthesis Trunk-ispilateral Leg 18f 31mm X 14.5cm 17cm
|
29
|
19
|
$62,936.00
|
$62,936.00
|
$14,868.63
|
$61,677.28
|
$31,468.00
|
2026-10-22
|
|
7463866
|
LOCAL
|
Stent Graft Excluder Endo Leg 23x12x18
|
29
|
19
|
$62,936.00
|
$62,936.00
|
$14,868.63
|
$61,677.28
|
$31,468.00
|
2026-10-22
|
|
221
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
7
|
7
|
$308,147.05
|
$308,147.05
|
$30,971.81
|
$31,306.26
|
$31,306.26
|
2026-10-22
|
|
7446031
|
LOCAL
|
Centrimag Centrigugal Pump Head 102953
|
29
|
19
|
$62,540.00
|
$62,540.00
|
$14,775.08
|
$61,289.20
|
$31,270.00
|
2026-10-22
|
|
326
|
MS_DRG
|
Stomach, Esophageal And Duodenal Procedures With Mcc
|
7
|
7
|
$255,428.22
|
$255,428.22
|
$26,861.13
|
$30,984.10
|
$30,984.10
|
2026-10-22
|
|
8499334
|
LOCAL
|
Saphenous Vein Graft 70-79 Cm V010
|
29
|
19
|
$61,945.00
|
$61,945.00
|
$14,634.51
|
$60,706.10
|
$30,972.50
|
2026-10-22
|
|
9506881
|
LOCAL
|
Centrimag Blood Pump
|
29
|
19
|
$61,782.00
|
$61,782.00
|
$14,596.00
|
$60,546.36
|
$30,891.00
|
2026-10-22
|
|
33289
|
CPT
|
33289 - Pf Transcatheter Implant Wireless Pulmonary Artery Sensor Long Term Hemo…
|
75
|
19
|
$54,741.00
|
$54,741.00
|
$255.81
|
$61,251.00
|
$30,769.85
|
2026-10-22
|
|
228
|
MS_DRG
|
Other Cardiothoracic Procedures With Mcc
|
7
|
7
|
$238,010.48
|
$238,010.48
|
$30,740.04
|
$31,511.40
|
$30,740.04
|
2026-10-22
|
|
853
|
MS_DRG
|
Infectious And Parasitic Diseases With O.r. Procedures With Mcc
|
7
|
7
|
$278,371.92
|
$278,371.92
|
$30,686.35
|
$31,042.82
|
$30,686.35
|
2026-10-22
|
|
239
|
MS_DRG
|
Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc
|
7
|
7
|
$393,645.62
|
$393,645.62
|
$27,271.07
|
$30,583.24
|
$30,583.24
|
2026-10-22
|
|
576
|
MS_DRG
|
Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc
|
7
|
7
|
$330,208.56
|
$330,208.56
|
$30,458.16
|
$40,620.41
|
$30,458.16
|
2026-10-22
|
|
C2616
|
HCPCS
|
Brachytherapy Source Non-stranded Y90
|
44
|
19
|
$36,191.00
|
$36,191.00
|
$13,349.74
|
$37,916.20
|
$30,178.20
|
2026-10-22
|
|
471
|
MS_DRG
|
Cervical Spinal Fusion With Mcc
|
7
|
7
|
$270,238.80
|
$270,238.80
|
$26,374.27
|
$30,015.80
|
$30,015.80
|
2026-10-22
|
|
837
|
MS_DRG
|
Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot…
|
7
|
7
|
$77,613.17
|
$77,613.17
|
$10,701.42
|
$29,866.92
|
$29,866.92
|
2026-10-22
|
|
7466497
|
LOCAL
|
Kit Graft Hd Flex 8x20cm Rk1208
|
29
|
19
|
$59,227.00
|
$59,227.00
|
$13,992.38
|
$58,042.46
|
$29,613.50
|
2026-10-22
|
|
267
|
MS_DRG
|
Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc
|
7
|
7
|
$277,614.61
|
$277,614.61
|
$24,633.38
|
$29,601.51
|
$29,601.51
|
2026-10-22
|
|
9947830
|
LOCAL
|
Allograft Silo Si Joint Fusion 113-12220
|
29
|
19
|
$59,000.00
|
$59,000.00
|
$13,938.75
|
$57,820.00
|
$29,500.00
|
2026-10-22
|
|
J2507
|
HCPCS
|
Pegloticase 8 Mg/ml Sol
|
29
|
19
|
$58,503.02
|
$58,503.02
|
$13,821.34
|
$57,332.96
|
$29,251.51
|
2026-10-22
|
|
650
|
MS_DRG
|
Kidney Transplant With Hemodialysis With Mcc
|
7
|
7
|
$609,082.28
|
$609,082.28
|
$25,292.40
|
$29,239.08
|
$29,239.08
|
2026-10-22
|
|
981
|
MS_DRG
|
Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc
|
7
|
7
|
$258,427.28
|
$258,427.28
|
$29,180.51
|
$29,475.69
|
$29,180.51
|
2026-10-22
|
|
826
|
MS_DRG
|
Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. …
|
7
|
7
|
$117,462.67
|
$117,462.67
|
$29,095.09
|
$38,769.23
|
$29,095.09
|
2026-10-22
|
|
10744338
|
LOCAL
|
12.5cm X 17.5cm Restrata Meshed
|
29
|
19
|
$57,761.00
|
$57,761.00
|
$13,646.04
|
$56,605.78
|
$28,880.50
|
2026-10-22
|
|
277
|
MS_DRG
|
Cardiac Defibrillator Implant Without Mcc
|
7
|
7
|
$224,860.99
|
$224,860.99
|
$26,970.34
|
$28,733.27
|
$28,733.27
|
2026-10-22
|
|
329
|
MS_DRG
|
Major Small And Large Bowel Procedures With Mcc
|
7
|
7
|
$229,740.99
|
$229,740.99
|
$23,654.80
|
$28,599.04
|
$28,599.04
|
2026-10-22
|
|
823
|
MS_DRG
|
Lymphoma And Non-acute Leukemia With Other Procedures With Mcc
|
7
|
7
|
$198,038.71
|
$198,038.71
|
$28,527.65
|
$37,997.78
|
$28,527.65
|
2026-10-22
|
|
245
|
MS_DRG
|
Aicd Generator Procedures
|
7
|
7
|
$143,634.96
|
$143,634.96
|
$28,390.98
|
$37,812.17
|
$28,390.98
|
2026-10-22
|
|
11059065
|
LOCAL
|
Treo Stent Graft 33x80 Mm
|
29
|
19
|
$56,640.00
|
$56,640.00
|
$13,381.20
|
$55,507.20
|
$28,320.00
|
2026-10-22
|
|
856
|
MS_DRG
|
Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc
|
7
|
7
|
$225,833.44
|
$225,833.44
|
$20,619.01
|
$28,307.39
|
$28,307.39
|
2026-10-22
|
|
25
|
MS_DRG
|
Craniotomy And Endovascular Intracranial Procedures With Mcc
|
7
|
7
|
$245,256.24
|
$245,256.24
|
$28,295.19
|
$29,584.91
|
$28,295.19
|
2026-10-22
|
|
799
|
MS_DRG
|
Splenic Procedures With Mcc
|
7
|
7
|
$120,278.72
|
$120,278.72
|
$22,750.47
|
$28,186.58
|
$28,186.58
|
2026-10-22
|
|
8705693
|
LOCAL
|
Excluder Aaa Endoprosthesis Cxt201412c
|
29
|
19
|
$56,050.00
|
$56,050.00
|
$13,241.81
|
$54,929.00
|
$28,025.00
|
2026-10-22
|
|
8705685
|
LOCAL
|
Excluder Aaa Endoprosthesis Cxt281416c ? ? ? ?
|
29
|
19
|
$56,050.00
|
$56,050.00
|
$13,241.81
|
$54,929.00
|
$28,025.00
|
2026-10-22
|
|
8705687
|
LOCAL
|
Excluder Aaa Endoprosthesis Cxt321418c ? ? ? ?
|
29
|
19
|
$56,050.00
|
$56,050.00
|
$13,241.81
|
$54,929.00
|
$28,025.00
|
2026-10-22
|
|
8705737
|
LOCAL
|
Excluder Aaa Endoprosthesis Cxt361416c ? ? ? ?
|
29
|
19
|
$56,050.00
|
$56,050.00
|
$13,241.81
|
$54,929.00
|
$28,025.00
|
2026-10-22
|
|
8705721
|
LOCAL
|
Excluder Aaa Endoprosthesis Cxt281214c
|
29
|
19
|
$56,050.00
|
$56,050.00
|
$13,241.81
|
$54,929.00
|
$28,025.00
|
2026-10-22
|
|
8705697
|
LOCAL
|
Excluder Aaa Endoprosthesis Cxt231214c
|
29
|
19
|
$56,050.00
|
$56,050.00
|
$13,241.81
|
$54,929.00
|
$28,025.00
|
2026-10-22
|
|
8705703
|
LOCAL
|
Excluder Aaa Endoprosthesis Cxt231414c
|
29
|
19
|
$56,050.00
|
$56,050.00
|
$13,241.81
|
$54,929.00
|
$28,025.00
|
2026-10-22
|
|
8705713
|
LOCAL
|
Excluder Aaa Endoprosthesis Cxt261412c ? ? ? ?
|
29
|
19
|
$56,050.00
|
$56,050.00
|
$13,241.81
|
$54,929.00
|
$28,025.00
|
2026-10-22
|
|
8705683
|
LOCAL
|
Excluder Aaa Endoprosthesis Cxt281216c ? ? ?
|
29
|
19
|
$56,050.00
|
$56,050.00
|
$13,241.81
|
$54,929.00
|
$28,025.00
|
2026-10-22
|
|
8705731
|
LOCAL
|
Excluder Aaa Endoprosthesis Cxt321414c ? ? ?
|
29
|
19
|
$56,050.00
|
$56,050.00
|
$13,241.81
|
$54,929.00
|
$28,025.00
|
2026-10-22
|
|
8705695
|
LOCAL
|
Excluder Aaa Endoprosthesis Cxt231212c
|
29
|
19
|
$56,050.00
|
$56,050.00
|
$13,241.81
|
$54,929.00
|
$28,025.00
|
2026-10-22
|
|
8705681
|
LOCAL
|
Excluder Aaa Endoprosthesis Cxt261416c ? ? ? ?
|
29
|
19
|
$56,050.00
|
$56,050.00
|
$13,241.81
|
$54,929.00
|
$28,025.00
|
2026-10-22
|
|
8705673
|
LOCAL
|
Excluder Aaa Endoprosthesis Cxt201414c ? ? ?
|
29
|
19
|
$56,050.00
|
$56,050.00
|
$13,241.81
|
$54,929.00
|
$28,025.00
|
2026-10-22
|
|
8705689
|
LOCAL
|
Excluder Aaa Endoprosthesis Cxt201214c ? ? ?
|
29
|
19
|
$56,050.00
|
$56,050.00
|
$13,241.81
|
$54,929.00
|
$28,025.00
|
2026-10-22
|
|
8705711
|
LOCAL
|
Excluder Aaa Endoprosthesis Cxt261218c ? ? ? ?
|
29
|
19
|
$56,050.00
|
$56,050.00
|
$13,241.81
|
$54,929.00
|
$28,025.00
|
2026-10-22
|
|
8705717
|
LOCAL
|
Excluder Aaa Endoprosthesis Cxt261418c ? ? ? ?
|
29
|
19
|
$56,050.00
|
$56,050.00
|
$13,241.81
|
$54,929.00
|
$28,025.00
|
2026-10-22
|
|
8705671
|
LOCAL
|
Excluder Aaa Endoprosthesis Cxt201212c ? ? ?
|
29
|
19
|
$56,050.00
|
$56,050.00
|
$13,241.81
|
$54,929.00
|
$28,025.00
|
2026-10-22
|
|
8705739
|
LOCAL
|
Excluder Aaa Endoprosthesis Cxt361418c
|
29
|
19
|
$56,050.00
|
$56,050.00
|
$13,241.81
|
$54,929.00
|
$28,025.00
|
2026-10-22
|
|
8705701
|
LOCAL
|
Excluder Aaa Endoprosthesis Cxt231412c ? ? ? ?
|
29
|
19
|
$56,050.00
|
$56,050.00
|
$13,241.81
|
$54,929.00
|
$28,025.00
|
2026-10-22
|
|
8705691
|
LOCAL
|
Excluder Aaa Endoprosthesis Cxt201216c ? ? ? ?
|
29
|
19
|
$56,050.00
|
$56,050.00
|
$13,241.81
|
$54,929.00
|
$28,025.00
|
2026-10-22
|
|
8705735
|
LOCAL
|
Excluder Aaa Endoprosthesis Cxt361414c ? ? ? ?
|
29
|
19
|
$56,050.00
|
$56,050.00
|
$13,241.81
|
$54,929.00
|
$28,025.00
|
2026-10-22
|
|
8705705
|
LOCAL
|
Excluder Aaa Endoprosthesis Cxt231418c ? ? ? ?
|
29
|
19
|
$56,050.00
|
$56,050.00
|
$13,241.81
|
$54,929.00
|
$28,025.00
|
2026-10-22
|
|
8705723
|
LOCAL
|
Excluder Aaa Endoprosthesis Cxt281218c ? ? ? ?
|
29
|
19
|
$56,050.00
|
$56,050.00
|
$13,241.81
|
$54,929.00
|
$28,025.00
|
2026-10-22
|
|
8705727
|
LOCAL
|
Excluder Aaa Endoprosthesis?cxt281414c
|
29
|
19
|
$56,050.00
|
$56,050.00
|
$13,241.81
|
$54,929.00
|
$28,025.00
|
2026-10-22
|
|
8705677
|
LOCAL
|
Excluder Aaa Endoprosthesis Cxt231416c ? ? ? ?
|
29
|
19
|
$56,050.00
|
$56,050.00
|
$13,241.81
|
$54,929.00
|
$28,025.00
|
2026-10-22
|
|
8705715
|
LOCAL
|
Excluder Aaa Endoprosthesis Cxt261414c
|
29
|
19
|
$56,050.00
|
$56,050.00
|
$13,241.81
|
$54,929.00
|
$28,025.00
|
2026-10-22
|
|
8705719
|
LOCAL
|
Excluder Aaa Endoprosthesis Cxt281212c ? ? ? ?
|
29
|
19
|
$56,050.00
|
$56,050.00
|
$13,241.81
|
$54,929.00
|
$28,025.00
|
2026-10-22
|
|
8706163
|
LOCAL
|
Excluder Aaa Endoprosthesis Cxt201416c ? ? ? ? ? ? ? ?
|
29
|
19
|
$56,050.00
|
$56,050.00
|
$13,241.81
|
$54,929.00
|
$28,025.00
|
2026-10-22
|
|
8705733
|
LOCAL
|
Excluder Aaa Endoprosthesis?cxt321416c
|
29
|
19
|
$56,050.00
|
$56,050.00
|
$13,241.81
|
$54,929.00
|
$28,025.00
|
2026-10-22
|
|
8705699
|
LOCAL
|
Excluder Aaa Endoprosthesis Cxt231218c ? ? ? ?
|
29
|
19
|
$56,050.00
|
$56,050.00
|
$13,241.81
|
$54,929.00
|
$28,025.00
|
2026-10-22
|
|
8705679
|
LOCAL
|
Excluder Aaa Endoprosthesis Cxt261216c ? ? ? ?
|
29
|
19
|
$56,050.00
|
$56,050.00
|
$13,241.81
|
$54,929.00
|
$28,025.00
|
2026-10-22
|
|
8705729
|
LOCAL
|
Excluder Aaa Endoprosthesis Cxt281418c ? ? ? ?
|
29
|
19
|
$56,050.00
|
$56,050.00
|
$13,241.81
|
$54,929.00
|
$28,025.00
|
2026-10-22
|
|
8705725
|
LOCAL
|
Excluder Aaa Endoprosthesis Cxt281412c ? ? ?
|
29
|
19
|
$56,050.00
|
$56,050.00
|
$13,241.81
|
$54,929.00
|
$28,025.00
|
2026-10-22
|
|
8705709
|
LOCAL
|
Excluder Aaa Endoprosthesis Cxt261214c
|
29
|
19
|
$56,050.00
|
$56,050.00
|
$13,241.81
|
$54,929.00
|
$28,025.00
|
2026-10-22
|
|
7456251
|
LOCAL
|
Implant Tmj Unilateral Chg010
|
29
|
19
|
$56,050.00
|
$56,050.00
|
$13,241.81
|
$54,929.00
|
$28,025.00
|
2026-10-22
|
|
8705675
|
LOCAL
|
Excluder Aaa Endoprosthesis Cxt231216c ? ? ? ?
|
29
|
19
|
$56,050.00
|
$56,050.00
|
$13,241.81
|
$54,929.00
|
$28,025.00
|
2026-10-22
|
|
8705707
|
LOCAL
|
Excluder Aaa Endoprosthesis Cxt261212c ? ? ? ?
|
29
|
19
|
$56,050.00
|
$56,050.00
|
$13,241.81
|
$54,929.00
|
$28,025.00
|
2026-10-22
|
|
163
|
MS_DRG
|
Major Chest Procedures With Mcc
|
7
|
7
|
$272,191.51
|
$272,191.51
|
$23,581.10
|
$27,899.20
|
$27,899.20
|
2026-10-22
|
|
31
|
MS_DRG
|
Ventricular Shunt Procedures With Mcc
|
7
|
7
|
$328,196.03
|
$328,196.03
|
$17,993.68
|
$27,891.27
|
$27,891.27
|
2026-10-22
|
|
319
|
MS_DRG
|
Other Endovascular Cardiac Valve Procedures With Mcc
|
7
|
7
|
$265,460.23
|
$265,460.23
|
$27,783.89
|
$31,459.75
|
$27,783.89
|
2026-10-22
|
|
J9281
|
HCPCS
|
Mitomycin (for Pyelocalyceal Soln) Kit
|
29
|
19
|
$55,329.64
|
$55,329.64
|
$13,071.63
|
$54,223.05
|
$27,664.82
|
2026-10-22
|
|
93656
|
CPT
|
93656 - Pf Ep Eval With Cath Insertion Transseptal Tx Atrial Fib By Pulmonary Vein…
|
75
|
19
|
$41,256.00
|
$41,256.00
|
$721.62
|
$47,767.00
|
$27,505.11
|
2026-10-22
|
|
93654
|
CPT
|
93654 - Pf Ep Eval With Cath Insertion Ablation Tx Ventricular Tachycardia/ventric…
|
75
|
19
|
$41,256.00
|
$41,256.00
|
$767.69
|
$47,767.00
|
$27,505.11
|
2026-10-22
|
|
93653
|
CPT
|
93653 - Pf Ep Eval W/cath Insertion Ablation Tx Of Supraventricular Arrhythmia
|
75
|
19
|
$41,256.00
|
$41,256.00
|
$636.95
|
$47,767.00
|
$27,505.11
|
2026-10-22
|
|
356
|
MS_DRG
|
Other Digestive System O.r. Procedures With Mcc
|
7
|
7
|
$228,239.59
|
$228,239.59
|
$23,913.57
|
$27,356.17
|
$27,356.17
|
2026-10-22
|
|
L8614
|
HCPCS
|
Baha 6 Max Brown
|
255
|
19
|
$67,909.00
|
$67,909.00
|
$5,262.47
|
$126,178.92
|
$27,163.60
|
2026-10-22
|
|
J3357
|
HCPCS
|
Ustekinumab 45 Mg/0.5 Ml Inj
|
58
|
19
|
$54,051.33
|
$54,051.33
|
$8,513.09
|
$70,627.06
|
$27,025.67
|
2026-10-22
|
|
323
|
MS_DRG
|
Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc
|
7
|
7
|
$288,197.00
|
$288,197.00
|
$26,957.14
|
$37,974.10
|
$26,957.14
|
2026-10-22
|
|
8726885
|
LOCAL
|
Implant Midface Peak Patient Specific Trial 60-000-26-09
|
29
|
19
|
$53,558.00
|
$53,558.00
|
$12,653.08
|
$52,486.84
|
$26,779.00
|
2026-10-22
|
|
474
|
MS_DRG
|
Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc
|
7
|
7
|
$205,612.89
|
$205,612.89
|
$23,611.22
|
$26,746.64
|
$26,746.64
|
2026-10-22
|
|
140
|
MS_DRG
|
Major Head And Neck Procedures With Mcc
|
7
|
7
|
$215,883.44
|
$215,883.44
|
$26,578.24
|
$29,945.90
|
$26,578.24
|
2026-10-22
|
|
C1737
|
HCPCS
|
Liberty Si Lateral Implant System Size B Rescue
|
29
|
19
|
$53,100.00
|
$53,100.00
|
$12,544.88
|
$52,038.00
|
$26,550.00
|
2026-10-22
|
|
9956328
|
LOCAL
|
Cannula F18 Alphavac System 85 Degree H787253020
|
29
|
19
|
$53,100.00
|
$53,100.00
|
$12,544.88
|
$52,038.00
|
$26,550.00
|
2026-10-22
|
|
68875-0102-01
|
NDC
|
Teduglutide 5 Mg Subcut Kit
|
29
|
19
|
$53,025.53
|
$53,025.53
|
$12,527.28
|
$51,965.02
|
$26,512.77
|
2026-10-22
|
|
J3316
|
HCPCS
|
Triptorelin 22.5 Mg Injection (triptodur)
|
29
|
19
|
$52,949.82
|
$52,949.82
|
$12,509.39
|
$51,890.82
|
$26,474.91
|
2026-10-22
|
|
9950139
|
LOCAL
|
Graft Endovascular Aaa Bifurcated Main Body Zenith Flex 18f 26mmx82mm G48412
|
29
|
19
|
$52,941.00
|
$52,941.00
|
$12,507.31
|
$51,882.18
|
$26,470.50
|
2026-10-22
|