|
J3391
|
OTHER
|
Inj- Atidarsagene Autotemcel
|
12
|
6
|
—
|
—
|
$4,505,000.00
|
$4,550,050.00
|
$4,505,000.00
|
2026-05-24
|
|
J1414
|
OTHER
|
Inj- Beqvez- Per Tx Dose
|
2
|
1
|
—
|
—
|
$3,927,000.00
|
$3,927,000.00
|
$3,927,000.00
|
2026-05-24
|
|
J1411
|
OTHER
|
Inj- Hemgenix- Per Tx Dose
|
14
|
6
|
—
|
—
|
$3,685,266.67
|
$3,927,000.00
|
$3,685,266.67
|
2026-05-24
|
|
J1413
|
OTHER
|
Inj Delandistrogene Mox Rokl
|
14
|
6
|
—
|
—
|
$3,316,462.59
|
$3,590,400.00
|
$3,316,462.59
|
2026-05-24
|
|
J3394
|
OTHER
|
Inj- Lovotibeglogene Autotem
|
14
|
6
|
—
|
—
|
$3,248,445.72
|
$3,478,200.00
|
$3,248,445.72
|
2026-05-24
|
|
J3393
|
OTHER
|
Inj- Betibeglogene Autotemce
|
14
|
6
|
—
|
—
|
$2,945,740.00
|
$3,141,600.00
|
$2,945,740.00
|
2026-05-24
|
|
J3399
|
OTHER
|
Inj Onase Abepar-xioi Treat
|
14
|
6
|
—
|
—
|
$2,455,110.61
|
$2,630,876.26
|
$2,455,110.61
|
2026-05-24
|
|
J3392
|
OTHER
|
Inj- Exagamglogene Autotem
|
14
|
6
|
—
|
—
|
$2,332,000.00
|
$2,468,400.00
|
$2,332,000.00
|
2026-05-24
|
|
Q2057
|
OTHER
|
Afamitresgene Autoleucel
|
20
|
8
|
—
|
—
|
$770,620.00
|
$815,694.00
|
$770,620.00
|
2026-05-24
|
|
Q2042
|
OTHER
|
Tisagenlecleucel Car-pos T
|
24
|
9
|
—
|
—
|
$529,192.86
|
$636,157.04
|
$591,726.20
|
2026-05-24
|
|
C9301
|
OTHER
|
Obecabtagene Car Pos T
|
2
|
1
|
—
|
—
|
$589,050.00
|
$589,050.00
|
$589,050.00
|
2026-05-24
|
|
Q2056
|
OTHER
|
Ciltacabtagene Car-pos T
|
22
|
8
|
—
|
—
|
$527,123.43
|
$688,852.34
|
$565,868.95
|
2026-05-24
|
|
Q2054
|
OTHER
|
Lisocabtagene Mara Car Pos T
|
22
|
8
|
—
|
—
|
$516,726.08
|
$643,116.82
|
$562,538.19
|
2026-05-24
|
|
Q2055
|
OTHER
|
Idecabtagene Vicleucel Car
|
22
|
8
|
—
|
—
|
$526,587.59
|
$657,039.31
|
$557,317.93
|
2026-05-24
|
|
Q2041
|
OTHER
|
Axicabtagene Ciloleucel Car+
|
24
|
9
|
—
|
—
|
$489,455.96
|
$586,384.13
|
$533,230.17
|
2026-05-24
|
|
Q2053
|
OTHER
|
Brexucabtagene Car Pos T
|
22
|
8
|
—
|
—
|
$460,530.40
|
$538,692.00
|
$489,304.61
|
2026-05-24
|
|
Q2058
|
OTHER
|
Obecbtge Autol Up To 400 Mil
|
12
|
6
|
—
|
—
|
$278,250.00
|
$281,032.50
|
$278,250.00
|
2026-05-24
|
|
MS-018
|
OTHER
|
Chimeric Antigen Receptor (car) T-cell Immunotherapy
|
18
|
8
|
—
|
—
|
$273,192.19
|
$1,302,780.20
|
$275,924.11
|
2026-05-24
|
|
J3403
|
OTHER
|
Revakinagene- Per Implant
|
12
|
6
|
—
|
—
|
$257,500.00
|
$260,075.00
|
$257,500.00
|
2026-05-24
|
|
J3402
|
OTHER
|
Inj. Remestemcel-l-rknd/ Td
|
18
|
8
|
—
|
—
|
$205,640.00
|
$207,696.40
|
$205,640.00
|
2026-05-24
|
|
MS-001
|
OTHER
|
Heart Transplant Or Implant Of Heart Assist System With Mcc
|
18
|
8
|
—
|
—
|
$154,197.03
|
$709,380.98
|
$177,290.74
|
2026-05-24
|
|
5697876
|
OTHER
|
Generator Nrstm Vagus Nrv Eplp--1000
|
22
|
10
|
$145,160.92
|
$145,160.92
|
$108,870.69
|
$137,902.87
|
$137,322.23
|
2026-05-24
|
|
MS-927
|
OTHER
|
Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft
|
18
|
8
|
—
|
—
|
$135,072.06
|
$770,229.70
|
$136,422.78
|
2026-05-24
|
|
MS-003
|
OTHER
|
Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face- Mouth…
|
18
|
8
|
—
|
—
|
$109,966.47
|
$529,994.43
|
$134,279.36
|
2026-05-24
|
|
6704760
|
OTHER
|
Tremelimumab-actl 20 mg/mL Inj Soln 15mL (Imjudo)
|
22
|
10
|
$132,052.90
|
$132,052.90
|
$99,039.67
|
$125,450.25
|
$124,922.04
|
2026-05-24
|
|
2094060
|
OTHER
|
Implant Cochlear (z43006) Nucleus 24k C124r (st)-ch
|
22
|
10
|
$122,329.91
|
$122,329.91
|
$91,747.43
|
$116,213.41
|
$115,724.09
|
2026-05-24
|
|
2094061
|
OTHER
|
Implant Cochlear (z43007) Nulceus 24 Contour C124r(cs)-ch
|
22
|
10
|
$122,329.91
|
$122,329.91
|
$91,747.43
|
$116,213.41
|
$115,724.09
|
2026-05-24
|
|
5413394
|
OTHER
|
Generator Nrstm Vns Aspiresr Pls Modl 106 Strl Lf--106
|
22
|
10
|
$119,523.93
|
$119,523.93
|
$89,642.95
|
$113,547.73
|
$113,069.64
|
2026-05-24
|
|
5116037
|
OTHER
|
Ipilimumab 200 Mg Vial (jw-)
|
22
|
10
|
$116,615.85
|
$116,615.85
|
$87,461.89
|
$110,785.06
|
$110,318.59
|
2026-05-24
|
|
5314215
|
OTHER
|
Vns Generator (model 103) Cyberonics-ch
|
22
|
10
|
$112,779.18
|
$112,779.18
|
$84,584.38
|
$107,140.22
|
$106,689.10
|
2026-05-24
|
|
5344261
|
OTHER
|
Generator Nrstm 1.8x1.6x.27in Vns .2in Tecothane Ss Ti Sil 2--104
|
22
|
10
|
$112,779.18
|
$112,779.18
|
$84,584.38
|
$107,140.22
|
$106,689.10
|
2026-05-24
|
|
Q0480
|
OTHER
|
Driver Pneumatic Vad- Rep
|
18
|
7
|
—
|
—
|
$49,634.94
|
$107,182.14
|
$106,120.93
|
2026-05-24
|
|
5626810
|
OTHER
|
Generator Activa (37612) Medtronic Inc (consignment)
|
22
|
10
|
$109,205.67
|
$109,205.67
|
$81,904.25
|
$103,745.39
|
$103,308.56
|
2026-05-24
|
|
6685655
|
OTHER
|
Calaspargase Pegol-mknl 750 unit(s)/mL Inj 5mL (Asparlas)
|
22
|
10
|
$101,138.10
|
$101,138.10
|
$75,853.58
|
$96,081.20
|
$95,676.64
|
2026-05-24
|
|
80507539
|
OTHER
|
Bi-v A/v Lead+lv Lead
|
22
|
10
|
$97,934.45
|
$97,934.45
|
$73,450.84
|
$93,037.73
|
$92,645.99
|
2026-05-24
|
|
80507537
|
OTHER
|
Bi-v Atrial Lead + Lv Lead
|
22
|
10
|
$97,934.45
|
$97,934.45
|
$73,450.84
|
$93,037.73
|
$92,645.99
|
2026-05-24
|
|
80507538
|
OTHER
|
Bi-v Ventricular Lead+ Lv Lead
|
22
|
10
|
$97,934.45
|
$97,934.45
|
$73,450.84
|
$93,037.73
|
$92,645.99
|
2026-05-24
|
|
MS-004
|
OTHER
|
Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face- Mouth And Nec…
|
18
|
8
|
—
|
—
|
$71,056.12
|
$352,595.93
|
$87,629.66
|
2026-05-24
|
|
6123412
|
OTHER
|
Generator (b35200) Medtronic Inc.-ch
|
22
|
10
|
$89,387.52
|
$89,387.52
|
$67,040.64
|
$84,918.14
|
$84,560.59
|
2026-05-24
|
|
MS-007
|
OTHER
|
Lung Transplant
|
18
|
8
|
—
|
—
|
$71,256.40
|
$435,774.78
|
$81,928.30
|
2026-05-24
|
|
6149318
|
OTHER
|
Ipg Generator (nipg2500) Nevro-ch
|
22
|
10
|
$86,543.33
|
$86,543.33
|
$64,907.50
|
$82,216.16
|
$81,869.99
|
2026-05-24
|
|
5546254
|
OTHER
|
Kit Nrstm Senza Ipg Strl Lf Disp--nipg1500
|
22
|
10
|
$86,522.19
|
$86,522.19
|
$64,891.64
|
$82,196.08
|
$81,849.99
|
2026-05-24
|
|
6003758
|
OTHER
|
Ravulizumab-cwvz 100 mg/mL Inj 11 Ml (ultomiris)(jw-)
|
22
|
10
|
$86,110.80
|
$86,110.80
|
$64,583.10
|
$81,805.26
|
$81,460.82
|
2026-05-24
|
|
5516144
|
OTHER
|
Dbs Neuro Stimulator (37601) Medtronic
|
22
|
10
|
$85,384.40
|
$85,384.40
|
$64,038.30
|
$81,115.18
|
$80,773.64
|
2026-05-24
|
|
6329288
|
OTHER
|
Kit Generator Wavewriter Alpha--sc-1232
|
22
|
10
|
$80,448.76
|
$80,448.76
|
$60,336.57
|
$76,426.32
|
$76,104.53
|
2026-05-24
|
|
MS-014
|
OTHER
|
Allogeneic Bone Marrow Transplant
|
18
|
8
|
—
|
—
|
$66,126.57
|
$345,140.72
|
$76,030.19
|
2026-05-24
|
|
6185309
|
OTHER
|
Generator Infinity 7 (6662) Abbott Spine-ch
|
22
|
10
|
$76,791.92
|
$76,791.92
|
$57,593.94
|
$72,952.32
|
$72,645.16
|
2026-05-24
|
|
5629070
|
OTHER
|
Fem Hd S-rom 36mm +6 (hip) (1365-33-000) Depuy-ch
|
22
|
10
|
$76,753.42
|
$76,753.42
|
$57,565.06
|
$72,915.75
|
$72,608.74
|
2026-05-24
|
|
5529966
|
OTHER
|
Ocrelizumab 300 Mg/10 Ml Vial
|
22
|
10
|
$76,329.35
|
$76,329.35
|
$57,247.01
|
$72,512.88
|
$72,207.57
|
2026-05-24
|
|
MS-209
|
OTHER
|
Kidney And Urinary Tract Signs And Symptoms Age 0-17
|
16
|
8
|
—
|
—
|
$71,607.39
|
$174,875.54
|
$71,965.43
|
2026-05-24
|
|
79964568
|
OTHER
|
Inc For Vagus N Elect Impl
|
22
|
10
|
$75,965.01
|
$75,965.01
|
$56,973.76
|
$72,166.76
|
$71,862.90
|
2026-05-24
|
|
K1007
|
OTHER
|
Bil Hkaf Pc S/d Micro Sensor
|
2
|
1
|
—
|
—
|
$71,776.86
|
$71,776.86
|
$71,776.86
|
2026-05-24
|
|
MS-002
|
OTHER
|
Heart Transplant Or Implant Of Heart Assist System Without Mcc
|
18
|
8
|
—
|
—
|
$62,351.42
|
$450,720.70
|
$71,689.64
|
2026-05-24
|
|
5704551
|
OTHER
|
Coil Penumbra Ruby Pod14 Rbypod14 ^rbypod14-ch
|
22
|
10
|
$75,696.15
|
$75,696.15
|
$56,772.11
|
$71,911.34
|
$71,608.56
|
2026-05-24
|
|
MS-426
|
OTHER
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
18
|
8
|
—
|
—
|
$69,724.65
|
$183,078.66
|
$70,421.90
|
2026-05-24
|
|
5628820
|
OTHER
|
Stem Corail Amt Sz 10 135 High Col (hip) (l971110) Depuy-ch
|
22
|
10
|
$74,262.46
|
$74,262.46
|
$55,696.84
|
$70,549.34
|
$70,252.29
|
2026-05-24
|
|
5628789
|
OTHER
|
Stem Corail Sz 8 (hip) (3l92498) Depuy-ch
|
22
|
10
|
$74,262.46
|
$74,262.46
|
$55,696.84
|
$70,549.34
|
$70,252.29
|
2026-05-24
|
|
5628786
|
OTHER
|
Stem Tibial 15x90 (knee) (86-6469) Depuy-ch
|
22
|
10
|
$74,262.46
|
$74,262.46
|
$55,696.84
|
$70,549.34
|
$70,252.29
|
2026-05-24
|
|
5628798
|
OTHER
|
Stem Corail Sz 18 (hip) (3l92508) Depuy-ch
|
22
|
10
|
$74,258.92
|
$74,258.92
|
$55,694.19
|
$70,545.97
|
$70,248.94
|
2026-05-24
|
|
5628801
|
OTHER
|
Stem Corail2 Sz 11 (hip) (3l92511) Depuy-ch
|
22
|
10
|
$74,258.92
|
$74,258.92
|
$55,694.19
|
$70,545.97
|
$70,248.94
|
2026-05-24
|
|
5628800
|
OTHER
|
Stem Corail2 Sz 10 (hip) (3l92510) Depuy-ch
|
22
|
10
|
$74,258.92
|
$74,258.92
|
$55,694.19
|
$70,545.97
|
$70,248.94
|
2026-05-24
|
|
5628802
|
OTHER
|
Stem Corail2 Sz 12 (hip) (3l92512) Depuy-ch
|
22
|
10
|
$74,258.92
|
$74,258.92
|
$55,694.19
|
$70,545.97
|
$70,248.94
|
2026-05-24
|
|
5628795
|
OTHER
|
Stem Corail Sz 15 (hip) (3l92505) Depuy-ch
|
22
|
10
|
$74,258.92
|
$74,258.92
|
$55,694.19
|
$70,545.97
|
$70,248.94
|
2026-05-24
|
|
5628796
|
OTHER
|
Stem Corail Sz 16 (hip) (3l92506) Depuy-ch
|
22
|
10
|
$74,258.92
|
$74,258.92
|
$55,694.19
|
$70,545.97
|
$70,248.94
|
2026-05-24
|
|
5628797
|
OTHER
|
Stem Corail2 Sz 8 (hip) (3l92507) Depuy-ch
|
22
|
10
|
$74,258.92
|
$74,258.92
|
$55,694.19
|
$70,545.97
|
$70,248.94
|
2026-05-24
|
|
5628799
|
OTHER
|
Stem Corail2 Sz 9 (hip) (3l92509) Depuy-ch
|
22
|
10
|
$74,258.92
|
$74,258.92
|
$55,694.19
|
$70,545.97
|
$70,248.94
|
2026-05-24
|
|
5787589
|
OTHER
|
Graft Nrv 70mm 1-2mm Avance Algrf Strl--111270
|
22
|
10
|
$74,258.92
|
$74,258.92
|
$55,694.19
|
$70,545.97
|
$70,248.94
|
2026-05-24
|
|
5628804
|
OTHER
|
Stem Corail2 Sz 14 (hip) (3l92514) Depuy-ch
|
22
|
10
|
$74,097.90
|
$74,097.90
|
$55,573.42
|
$70,393.00
|
$70,096.61
|
2026-05-24
|
|
MS-212
|
OTHER
|
Testes Procedures Age 0-17
|
18
|
8
|
—
|
—
|
$68,794.04
|
$383,481.80
|
$69,481.98
|
2026-05-24
|
|
5740412
|
OTHER
|
Generator Intellis Neurostimulator (97715) Medtronic
|
22
|
10
|
$72,322.74
|
$72,322.74
|
$54,242.06
|
$68,706.60
|
$68,417.31
|
2026-05-24
|
|
79964575
|
OTHER
|
64575 Csc Incision For Implant Of Neurostimulator Electrode Array; Peripheral Ne…
|
22
|
10
|
$71,630.73
|
$71,630.73
|
$53,723.05
|
$68,049.19
|
$67,762.67
|
2026-05-24
|
|
L8702
|
OTHER
|
Ewhf S/d Uprt Micro Sensor
|
14
|
6
|
—
|
—
|
$51,938.55
|
$68,127.19
|
$67,452.66
|
2026-05-24
|
|
6686260
|
OTHER
|
Tebentafusp-tebn 100 Mcg/0.5 Ml Inj (Kimmtrak)
|
22
|
10
|
$71,128.35
|
$71,128.35
|
$53,346.26
|
$67,571.93
|
$67,287.42
|
2026-05-24
|
|
80533289
|
OTHER
|
Cv CardioMEMS Procedure Ccw Cath
|
22
|
10
|
$70,956.93
|
$70,956.93
|
$53,217.70
|
$67,409.08
|
$67,125.26
|
2026-05-24
|
|
6329281
|
OTHER
|
Generator Wavewriter (m365sc12320) Boston Scientific Neuro-ch
|
22
|
10
|
$70,291.07
|
$70,291.07
|
$52,718.30
|
$66,776.52
|
$66,495.35
|
2026-05-24
|
|
5272303
|
OTHER
|
Generator Pulse (sc-1132) Boston Scientific-ch
|
22
|
10
|
$69,775.94
|
$69,775.94
|
$52,331.96
|
$66,287.14
|
$66,008.04
|
2026-05-24
|
|
MS-005
|
OTHER
|
Liver Transplant With Mcc Or Intestinal Transplant
|
18
|
8
|
—
|
—
|
$56,731.88
|
$376,914.12
|
$65,228.47
|
2026-05-24
|
|
MS-215
|
OTHER
|
Other Heart Assist System Implant
|
18
|
8
|
—
|
—
|
$62,992.09
|
$189,930.35
|
$63,622.01
|
2026-05-24
|
|
6329286
|
OTHER
|
Generator Wavewriter Pulse (sc-1216) Boston Scientific Neuro
|
22
|
10
|
$67,103.67
|
$67,103.67
|
$50,327.75
|
$63,748.49
|
$63,480.07
|
2026-05-24
|
|
J9029
|
OTHER
|
Instill Adstiladrin- Tx Dose
|
22
|
8
|
—
|
—
|
$63,342.28
|
$78,746.23
|
$63,342.28
|
2026-05-24
|
|
79963685
|
OTHER
|
63685 Csc Insrt/redo Spine Generator
|
44
|
10
|
$76,966.31
|
$76,966.31
|
$39,318.06
|
$96,433.11
|
$62,967.14
|
2026-05-24
|
|
MS-216
|
OTHER
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
18
|
8
|
—
|
—
|
$61,890.02
|
$243,465.86
|
$62,508.92
|
2026-05-24
|
|
5630850
|
OTHER
|
Polatuzumab Vedotin-piiq 140 Mg Vial (Polivy)
|
22
|
10
|
$64,023.70
|
$64,023.70
|
$48,017.77
|
$60,822.51
|
$60,566.42
|
2026-05-24
|
|
79954416
|
OTHER
|
54416 Csc Rmvl/rplcmnt Of Non-inflatable/inflatable Penile Prosthesis, Same Oper…
|
22
|
10
|
$63,639.47
|
$63,639.47
|
$47,729.60
|
$60,457.50
|
$60,202.94
|
2026-05-24
|
|
5591170
|
OTHER
|
Generator Proclaim 7 Elite (3662) St. Jude Medical
|
22
|
10
|
$63,432.60
|
$63,432.60
|
$47,574.45
|
$60,260.97
|
$60,007.24
|
2026-05-24
|
|
6815518
|
OTHER
|
Generator Pulse Inspire--3028
|
22
|
10
|
$62,999.27
|
$62,999.27
|
$47,249.45
|
$59,849.31
|
$59,597.31
|
2026-05-24
|
|
6682603
|
OTHER
|
Nivolumab/relatlimab-rmbw 240 Mg-80 Mg/20 Ml Inj (Opdualag)
|
22
|
10
|
$60,906.60
|
$60,906.60
|
$45,679.95
|
$57,861.27
|
$57,617.64
|
2026-05-24
|
|
MS-429
|
OTHER
|
Combined Anterior And Posterior Cervical Spinal Fusion With Mcc
|
18
|
8
|
—
|
—
|
$56,998.44
|
$296,078.34
|
$57,568.43
|
2026-05-24
|
|
A9543
|
OTHER
|
Y90 Ibritumomab- Rx
|
16
|
7
|
—
|
—
|
$54,555.55
|
$57,392.80
|
$56,824.55
|
2026-05-24
|
|
6764354
|
OTHER
|
Generator Wavewriter--sc-1432
|
22
|
10
|
$59,801.78
|
$59,801.78
|
$44,851.34
|
$56,811.69
|
$56,572.48
|
2026-05-24
|
|
6793988
|
OTHER
|
Tarlatamab-dlle 10 Mg Vial (Imdelltra) [jw]
|
22
|
10
|
$59,659.60
|
$59,659.60
|
$44,744.70
|
$56,676.62
|
$56,437.98
|
2026-05-24
|
|
80099986
|
OTHER
|
**Cysto Bilateral / Litho Bilateral
|
22
|
10
|
$59,634.87
|
$59,634.87
|
$44,726.15
|
$56,653.13
|
$56,414.59
|
2026-05-24
|
|
81910369
|
OTHER
|
S Yttrium-90per Source
|
22
|
10
|
$58,699.84
|
$58,699.84
|
$44,024.88
|
$55,764.85
|
$55,530.05
|
2026-05-24
|
|
MS-850
|
OTHER
|
Acute Leukemia With Other Procedures
|
18
|
8
|
—
|
—
|
$54,783.57
|
$326,999.71
|
$55,331.40
|
2026-05-24
|
|
Q2043
|
OTHER
|
Sipuleucel-t Auto Cd54+
|
26
|
9
|
—
|
—
|
$48,591.58
|
$71,002.44
|
$55,272.32
|
2026-05-24
|
|
MS-231
|
OTHER
|
Coronary Bypass With Ptca With Mcc
|
18
|
8
|
—
|
—
|
$53,331.02
|
$251,418.08
|
$53,864.33
|
2026-05-24
|
|
80504080
|
OTHER
|
Cv Optimizer Procedure Ccw Cath
|
22
|
10
|
$56,735.75
|
$56,735.75
|
$42,551.81
|
$53,898.96
|
$53,672.02
|
2026-05-24
|
|
80502004
|
OTHER
|
Cv Optimizer Implant Ccw Cath
|
22
|
10
|
$56,636.71
|
$56,636.71
|
$42,477.53
|
$53,804.87
|
$53,578.33
|
2026-05-24
|
|
6792277
|
OTHER
|
Efgartigimod Alfa-hyaluronidase-qvfc 180 Mg-2,000 units/mL 5.6 Ml Vial (Vyvgart …
|
22
|
10
|
$56,487.85
|
$56,487.85
|
$42,365.89
|
$53,663.46
|
$53,437.51
|
2026-05-24
|
|
MS-456
|
OTHER
|
Spinal Fusion Except Cervical With Spinal Curvature- Malignancy- Infection Or Ex…
|
18
|
8
|
—
|
—
|
$45,742.05
|
$241,974.82
|
$53,163.37
|
2026-05-24
|
|
80533232
|
OTHER
|
Remv&replc Icd Gen Bi-v
|
22
|
10
|
$55,137.21
|
$55,137.21
|
$41,352.91
|
$52,380.35
|
$52,159.80
|
2026-05-24
|
|
80533229
|
OTHER
|
Remove & Replace Pm Gen; Bi-v
|
22
|
10
|
$55,137.21
|
$55,137.21
|
$41,352.91
|
$52,380.35
|
$52,159.80
|
2026-05-24
|
|
5344324
|
OTHER
|
Neurostimulator Impl 2inx1.7in Intstm Ii Thk.3in 10-14hz 0-4--3058
|
22
|
10
|
$55,030.23
|
$55,030.23
|
$41,272.67
|
$52,278.72
|
$52,058.60
|
2026-05-24
|
|
MS-020
|
OTHER
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc
|
18
|
8
|
—
|
—
|
$49,781.27
|
$272,718.68
|
$50,279.08
|
2026-05-24
|
|
8285554
|
OTHER
|
Retifanlimab-dlwr 25 mg/mL 20 Ml Vial (Zynyz)
|
22
|
10
|
$52,469.05
|
$52,469.05
|
$39,351.79
|
$49,845.60
|
$49,635.72
|
2026-05-24
|
|
79964590
|
OTHER
|
Insrt/redo Pn/gastr Stimul
|
22
|
10
|
$52,422.61
|
$52,422.61
|
$39,316.96
|
$49,801.48
|
$49,591.79
|
2026-05-24
|
|
MS-219
|
OTHER
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
18
|
8
|
—
|
—
|
$48,576.09
|
$168,239.24
|
$49,061.85
|
2026-05-24
|
|
5742400
|
OTHER
|
Luspatercept-aamt 75 Mg Inj (Reblozyl) (jw-)
|
22
|
10
|
$51,797.15
|
$51,797.15
|
$38,847.86
|
$49,207.29
|
$49,000.10
|
2026-05-24
|
|
80099983
|
OTHER
|
**Litho Bilateral
|
22
|
10
|
$51,777.02
|
$51,777.02
|
$38,832.76
|
$49,188.17
|
$48,981.06
|
2026-05-24
|
|
80502024
|
OTHER
|
Cv CardioMEMS Implant Ccw Cath
|
22
|
10
|
$51,711.79
|
$51,711.79
|
$38,783.84
|
$49,126.20
|
$48,919.35
|
2026-05-24
|
|
5286525
|
OTHER
|
Mesh Srg Phasix 12x10in Mfl Scfld Full Rsrb Poly-4-hb Rect--1190500
|
22
|
10
|
$51,675.35
|
$51,675.35
|
$38,756.51
|
$49,091.58
|
$48,884.88
|
2026-05-24
|
|
MS-233
|
OTHER
|
Coronary Bypass With Cardiac Catheterization With Mcc
|
18
|
8
|
—
|
—
|
$48,366.69
|
$173,599.89
|
$48,832.17
|
2026-05-24
|
|
MS-957
|
OTHER
|
Other O.r. Procedures For Multiple Significant Trauma With Mcc
|
18
|
8
|
—
|
—
|
$41,265.35
|
$203,669.24
|
$48,206.63
|
2026-05-24
|
|
5340981
|
OTHER
|
Tissue Biologic Xcm 25 X 35 (xm106.2535tcs) Synthes Cmf-ch
|
22
|
10
|
$50,832.29
|
$50,832.29
|
$38,124.22
|
$48,290.68
|
$48,087.35
|
2026-05-24
|
|
80512037
|
OTHER
|
Inser/repos Single Icd + Leads
|
22
|
10
|
$50,358.31
|
$50,358.31
|
$37,768.73
|
$47,840.39
|
$47,638.96
|
2026-05-24
|
|
80503260
|
OTHER
|
Ephys Eval Subq Implt Defib
|
22
|
10
|
$50,358.31
|
$50,358.31
|
$37,768.73
|
$47,840.39
|
$47,638.96
|
2026-05-24
|
|
80503190
|
OTHER
|
Insert Subq Defib W/eltrd
|
22
|
10
|
$50,358.31
|
$50,358.31
|
$37,768.73
|
$47,840.39
|
$47,638.96
|
2026-05-24
|
|
80512066
|
OTHER
|
Ins/repos Leads-ins Dual Icd
|
22
|
10
|
$50,358.31
|
$50,358.31
|
$37,768.73
|
$47,840.39
|
$47,638.96
|
2026-05-24
|
|
80503250
|
OTHER
|
Repos Subq Defib Eltrd &/gen
|
22
|
10
|
$50,358.31
|
$50,358.31
|
$37,768.73
|
$47,840.39
|
$47,638.96
|
2026-05-24
|
|
L7181
|
OTHER
|
Electronic Elbo Simultaneous
|
18
|
7
|
—
|
—
|
$22,081.68
|
$47,683.38
|
$47,211.27
|
2026-05-24
|
|
79962361
|
OTHER
|
Implant Spine Infusion Pump Nonprogrammable
|
22
|
10
|
$49,610.17
|
$49,610.17
|
$37,207.63
|
$47,129.66
|
$46,931.22
|
2026-05-24
|
|
79900092
|
OTHER
|
Breast Reconstruction- Bilateral
|
22
|
10
|
$48,578.17
|
$48,578.17
|
$36,433.63
|
$46,149.26
|
$45,954.95
|
2026-05-24
|
|
1525036
|
OTHER
|
Coagulation Factor VIIa 5000 Mcg (recombinant)
|
22
|
10
|
$48,454.80
|
$48,454.80
|
$36,341.10
|
$46,032.06
|
$45,838.24
|
2026-05-24
|
|
6603601
|
OTHER
|
Hemin 350 Mg Vial (recons C Swfi 48mL Per Pkg Insert)
|
22
|
10
|
$48,406.90
|
$48,406.90
|
$36,305.18
|
$45,986.56
|
$45,792.93
|
2026-05-24
|
|
MS-427
|
OTHER
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
18
|
8
|
—
|
—
|
$40,049.33
|
$142,927.03
|
$45,667.84
|
2026-05-24
|
|
6735877
|
OTHER
|
Ublituximab-xiiy 150 Mg/6 Ml Vial (Briumvi) (jw-)
|
22
|
10
|
$48,164.20
|
$48,164.20
|
$36,123.15
|
$45,755.99
|
$45,563.33
|
2026-05-24
|
|
MS-010
|
OTHER
|
Pancreas Transplant
|
18
|
8
|
—
|
—
|
$39,483.14
|
$187,374.28
|
$45,396.44
|
2026-05-24
|
|
MS-928
|
OTHER
|
Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc
|
18
|
8
|
—
|
—
|
$42,333.35
|
$83,604.86
|
$45,377.46
|
2026-05-24
|
|
5549885
|
OTHER
|
Alloderm 16 X 20 Tissue (1518320) Life Cell-ch
|
22
|
10
|
$47,771.85
|
$47,771.85
|
$35,828.89
|
$45,383.26
|
$45,192.17
|
2026-05-24
|
|
MS-019
|
OTHER
|
Simultaneous Pancreas And Kidney Transplant With Hemodialysis
|
18
|
8
|
—
|
—
|
$39,257.00
|
$268,707.07
|
$45,136.42
|
2026-05-24
|
|
MS-275
|
OTHER
|
Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc
|
18
|
8
|
—
|
—
|
$44,084.20
|
$219,822.19
|
$45,109.85
|
2026-05-24
|
|
J9226
|
OTHER
|
Supprelin La Implant
|
26
|
9
|
—
|
—
|
$30,489.35
|
$56,301.78
|
$45,020.65
|
2026-05-24
|
|
6080017
|
OTHER
|
Neurostimulator Impl Intstm Mic Surescan Rchrg--97810
|
22
|
10
|
$47,456.54
|
$47,456.54
|
$35,592.40
|
$45,083.71
|
$44,893.89
|
2026-05-24
|
|
6681674
|
OTHER
|
Risankizumab-rzaa 600 Mg/10 Ml Vial (Skyrizi)
|
22
|
10
|
$46,751.70
|
$46,751.70
|
$35,063.77
|
$44,414.12
|
$44,227.11
|
2026-05-24
|
|
79919361
|
OTHER
|
19361 Csc Breast Reconstruction With Latissimus Dorsi Flap, Without Prosthetic I…
|
22
|
10
|
$46,742.19
|
$46,742.19
|
$35,056.64
|
$44,405.08
|
$44,218.11
|
2026-05-24
|
|
J7330
|
OTHER
|
Cultured Chondrocytes Implnt
|
6
|
3
|
—
|
—
|
$95.00
|
$73,852.28
|
$44,053.20
|
2026-05-24
|
|
5650267
|
OTHER
|
Hd Flex 16 X 20--pf1620
|
22
|
10
|
$46,538.55
|
$46,538.55
|
$34,903.91
|
$44,211.62
|
$44,025.47
|
2026-05-24
|
|
2972033
|
OTHER
|
Brentuximab Vedotin 50 Mg Vial
|
22
|
10
|
$46,294.50
|
$46,294.50
|
$34,720.88
|
$43,979.78
|
$43,794.60
|
2026-05-24
|
|
MS-870
|
OTHER
|
Septicemia Or Severe Sepsis With Mv >96 Hours
|
18
|
8
|
—
|
—
|
$39,150.25
|
$184,605.20
|
$43,726.90
|
2026-05-24
|
|
MS-268
|
OTHER
|
Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc
|
18
|
8
|
—
|
—
|
$36,888.24
|
$195,504.01
|
$43,512.43
|
2026-05-24
|
|
MS-955
|
OTHER
|
Craniotomy For Multiple Significant Trauma
|
18
|
8
|
—
|
—
|
$42,583.71
|
$212,366.98
|
$43,009.55
|
2026-05-24
|
|
6321279
|
OTHER
|
Pump Synchromed (8637-20) Medtronic Inc-ch
|
22
|
10
|
$45,392.53
|
$45,392.53
|
$34,044.40
|
$43,122.90
|
$42,941.33
|
2026-05-24
|
|
MS-317
|
OTHER
|
Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc
|
18
|
8
|
—
|
—
|
$42,301.55
|
$219,609.19
|
$42,724.57
|
2026-05-24
|
|
MS-447
|
OTHER
|
Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall…
|
18
|
8
|
—
|
—
|
$42,270.55
|
$149,814.22
|
$42,693.26
|
2026-05-24
|
|
79962362
|
OTHER
|
Implant Spine Infusion Pump Programmable
|
22
|
10
|
$45,121.90
|
$45,121.90
|
$33,841.43
|
$42,865.80
|
$42,685.32
|
2026-05-24
|
|
79919369
|
OTHER
|
19361 Csc Breast Reconstr W/lat Flap Bce
|
22
|
10
|
$44,836.58
|
$44,836.58
|
$33,627.44
|
$42,594.75
|
$42,415.40
|
2026-05-24
|
|
5923294
|
OTHER
|
Graft Flex Hd Pliable Pre Med. Thin 19 X 22 (pp1500) Muscular Skeletal Transplan…
|
22
|
10
|
$44,662.32
|
$44,662.32
|
$33,496.74
|
$42,429.20
|
$42,250.55
|
2026-05-24
|
|
MS-217
|
OTHER
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
18
|
8
|
—
|
—
|
$41,598.06
|
$159,719.00
|
$42,014.04
|
2026-05-24
|
|
6724215
|
OTHER
|
Dostarlimab-gxly 500 Mg/10 Ml Inj (Jemperli)
|
22
|
10
|
$44,366.35
|
$44,366.35
|
$33,274.76
|
$42,148.03
|
$41,970.57
|
2026-05-24
|
|
L7180
|
OTHER
|
Electronic Elbow Sequential
|
22
|
9
|
—
|
—
|
$19,600.87
|
$42,326.28
|
$41,907.21
|
2026-05-24
|
|
MS-573
|
OTHER
|
Skin Graft For Skin Ulcer Or Cellulitis With Mcc
|
18
|
8
|
—
|
—
|
$41,446.86
|
$207,893.86
|
$41,861.32
|
2026-05-24
|
|
79900107
|
OTHER
|
Suture Of Quadriceps Or Hamstring Muscle Rupture; Primary
|
22
|
10
|
$44,144.84
|
$44,144.84
|
$33,108.63
|
$41,937.60
|
$41,761.02
|
2026-05-24
|
|
MS-218
|
OTHER
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
18
|
8
|
—
|
—
|
$32,308.09
|
$145,057.09
|
$41,598.06
|
2026-05-24
|
|
5913090
|
OTHER
|
Mesh Preform (5690654) Stryker Cmf-ch
|
22
|
10
|
$43,958.84
|
$43,958.84
|
$32,969.13
|
$41,760.90
|
$41,585.06
|
2026-05-24
|
|
80099987
|
OTHER
|
**Cysto Bilateral / Litho Left
|
22
|
10
|
$43,697.32
|
$43,697.32
|
$32,772.99
|
$41,512.45
|
$41,337.66
|
2026-05-24
|
|
80099988
|
OTHER
|
**Cysto Bilateral / Litho Right
|
22
|
10
|
$43,697.32
|
$43,697.32
|
$32,772.99
|
$41,512.45
|
$41,337.66
|
2026-05-24
|
|
5283755
|
OTHER
|
Stem Long Omnifit (6088-0730-200r) Stryker Orthopedics-ch
|
22
|
10
|
$43,570.08
|
$43,570.08
|
$32,677.56
|
$41,391.58
|
$41,217.30
|
2026-05-24
|
|
5283754
|
OTHER
|
Stem Lomg Ominfit (6088-0730-200l)stryker Orthopedics-ch
|
22
|
10
|
$43,570.08
|
$43,570.08
|
$32,677.56
|
$41,391.58
|
$41,217.30
|
2026-05-24
|
|
0266T
|
OTHER
|
Implt/rpl Crtd Sns Dev Total
|
18
|
7
|
—
|
—
|
$176.13
|
$49,950.56
|
$41,193.46
|
2026-05-24
|
|
79900025
|
OTHER
|
Implant Neuroelectrodes, Sacral Nerve, Incision; Bilater
|
22
|
10
|
$43,436.97
|
$43,436.97
|
$32,577.73
|
$41,265.12
|
$41,091.37
|
2026-05-24
|
|
6321278
|
OTHER
|
Pump It 40ml Snchr Ii Prgm Radopq Id Bctr Rtn Fltr Sil Thk26--8637-40
|
22
|
10
|
$43,334.24
|
$43,334.24
|
$32,500.68
|
$41,167.53
|
$40,994.19
|
2026-05-24
|
|
88036906
|
OTHER
|
Thrmbc/nfs Dialysis Circuit
|
22
|
10
|
$43,318.25
|
$43,318.25
|
$32,488.69
|
$41,152.34
|
$40,979.06
|
2026-05-24
|
|
5467848
|
OTHER
|
Atezolizumab 60 mg/mL Injection 20 Ml Vial(jw-)
|
22
|
10
|
$43,049.40
|
$43,049.40
|
$32,287.05
|
$40,896.93
|
$40,724.73
|
2026-05-24
|
|
MS-207
|
OTHER
|
Respiratory System Diagnosis With Ventilator Support >96 Hours
|
18
|
8
|
—
|
—
|
$36,205.40
|
$200,793.66
|
$40,708.56
|
2026-05-24
|
|
5322113
|
OTHER
|
Vedolizumab 300 Mg Vial
|
22
|
10
|
$42,992.50
|
$42,992.50
|
$32,244.38
|
$40,842.88
|
$40,670.90
|
2026-05-24
|
|
80512063
|
OTHER
|
Implant Lv Lead- Ccw Cath
|
22
|
10
|
$42,797.25
|
$42,797.25
|
$32,097.94
|
$40,657.39
|
$40,486.20
|
2026-05-24
|
|
80512064
|
OTHER
|
Implant Single Icd-gen Only
|
22
|
10
|
$42,756.70
|
$42,756.70
|
$32,067.52
|
$40,618.86
|
$40,447.84
|
2026-05-24
|
|
80503210
|
OTHER
|
Insert Subq Defib Pls Gen
|
22
|
10
|
$42,756.70
|
$42,756.70
|
$32,067.52
|
$40,618.86
|
$40,447.84
|
2026-05-24
|
|
80512065
|
OTHER
|
Implant Dual Icd-gen Only
|
22
|
10
|
$42,756.70
|
$42,756.70
|
$32,067.52
|
$40,618.86
|
$40,447.84
|
2026-05-24
|
|
5288468
|
OTHER
|
Neurostimulator Impl 60mmx55mm Activa Sc 1 Chnl Prm Cell--37603
|
22
|
10
|
$42,586.27
|
$42,586.27
|
$31,939.70
|
$40,456.96
|
$40,286.61
|
2026-05-24
|
|
80533230
|
OTHER
|
Remv&replc Icd Gen Sing Lead
|
22
|
10
|
$42,459.33
|
$42,459.33
|
$31,844.50
|
$40,336.36
|
$40,166.53
|
2026-05-24
|
|
80533231
|
OTHER
|
Remv&replc Icd Gen Dual Lead
|
22
|
10
|
$42,459.33
|
$42,459.33
|
$31,844.50
|
$40,336.36
|
$40,166.53
|
2026-05-24
|
|
79923615
|
OTHER
|
23615 Treat Humerus Fracture
|
22
|
10
|
$42,454.62
|
$42,454.62
|
$31,840.97
|
$40,331.89
|
$40,162.07
|
2026-05-24
|
|
79924515
|
OTHER
|
Csc 24515 Open Treat Humerus Shaft Fracture W/plates Screws W Or W/out Cerclage
|
22
|
10
|
$42,454.62
|
$42,454.62
|
$31,840.97
|
$40,331.89
|
$40,162.07
|
2026-05-24
|
|
79922869
|
OTHER
|
22869 Csc Insj Stablj Dev Without Dcmprn, Single Level
|
22
|
10
|
$42,454.03
|
$42,454.03
|
$31,840.52
|
$40,331.33
|
$40,161.51
|
2026-05-24
|
|
5283628
|
OTHER
|
CT Discogram Cerv Or Thoracic CT Guided
|
22
|
10
|
$42,205.72
|
$42,205.72
|
$31,654.29
|
$40,095.43
|
$39,926.61
|
2026-05-24
|
|
80099985
|
OTHER
|
**Cysto Right / Litho Right
|
22
|
10
|
$42,142.85
|
$42,142.85
|
$31,607.14
|
$40,035.71
|
$39,867.14
|
2026-05-24
|
|
80099984
|
OTHER
|
**Cysto Left / Litho Left
|
22
|
10
|
$42,142.85
|
$42,142.85
|
$31,607.14
|
$40,035.71
|
$39,867.14
|
2026-05-24
|
|
79924579
|
OTHER
|
24579 Csc Treat Humerus Fracture
|
22
|
10
|
$41,591.13
|
$41,591.13
|
$31,193.35
|
$39,511.57
|
$39,345.21
|
2026-05-24
|
|
3832034
|
OTHER
|
Natalizumab 300 Mg/15 Ml Vial
|
22
|
10
|
$41,571.95
|
$41,571.95
|
$31,178.96
|
$39,493.35
|
$39,327.06
|
2026-05-24
|
|
MS-266
|
OTHER
|
Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc
|
18
|
8
|
—
|
—
|
$38,770.78
|
$157,943.95
|
$39,158.49
|
2026-05-24
|
|
6765859
|
OTHER
|
Pump Synchromed It 20ml--8667-20
|
22
|
10
|
$41,365.68
|
$41,365.68
|
$31,024.26
|
$39,297.40
|
$39,131.93
|
2026-05-24
|
|
MS-969
|
OTHER
|
HIV With Extensive O.r. Procedures With Mcc
|
18
|
8
|
—
|
—
|
$38,725.87
|
$234,555.11
|
$39,113.12
|
2026-05-24
|
|
761042
|
OTHER
|
Alteplase (tpa) 1 Mg/1 Ml (100 Mg Vial)
|
22
|
10
|
$41,338.95
|
$41,338.95
|
$31,004.21
|
$39,272.00
|
$39,106.65
|
2026-05-24
|
|
5700550
|
OTHER
|
Cemiplimab-rwlc 350 Mg/7 Ml Vial (Libtayo)
|
22
|
10
|
$41,064.90
|
$41,064.90
|
$30,798.68
|
$39,011.66
|
$38,847.40
|
2026-05-24
|
|
6785926
|
OTHER
|
Glofitamab-gxbm 1 mg/mL 10 Ml Vial (Columvi)
|
22
|
10
|
$40,815.05
|
$40,815.05
|
$30,611.29
|
$38,774.30
|
$38,611.04
|
2026-05-24
|
|
MS-232
|
OTHER
|
Coronary Bypass With Ptca Without Mcc
|
18
|
8
|
—
|
—
|
$32,978.27
|
$169,339.77
|
$38,354.51
|
2026-05-24
|
|
5516145
|
OTHER
|
Dbs Neuro Stimulator Multi Program (37602) Medtronic-ch
|
22
|
10
|
$40,427.94
|
$40,427.94
|
$30,320.96
|
$38,406.54
|
$38,244.83
|
2026-05-24
|
|
5628712
|
OTHER
|
Stem Actis Std Sz 9 (hip) (1010-13-090) Depuy-ch
|
22
|
10
|
$40,309.22
|
$40,309.22
|
$30,231.92
|
$38,293.76
|
$38,132.52
|
2026-05-24
|
|
MS-457
|
OTHER
|
Spinal Fusion Except Cervical With Spinal Curvature- Malignancy- Infection Or Ex…
|
18
|
8
|
—
|
—
|
$37,725.03
|
$175,978.46
|
$38,102.28
|
2026-05-24
|
|
MS-028
|
OTHER
|
Spinal Procedures With Mcc
|
18
|
8
|
—
|
—
|
$30,893.99
|
$145,021.59
|
$38,010.98
|
2026-05-24
|
|
MS-276
|
OTHER
|
Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator
|
18
|
8
|
—
|
—
|
$28,914.25
|
$189,433.34
|
$38,000.23
|
2026-05-24
|
|
6093370
|
OTHER
|
Daratumumab-hyaluronidase-fihj 1800 Mg-30,000 Units/15 Ml Inj (Darzalex Faspro)
|
22
|
10
|
$40,010.20
|
$40,010.20
|
$30,007.65
|
$38,009.69
|
$37,849.65
|
2026-05-24
|
|
L2006
|
OTHER
|
Kaf Sng/dbl Swg/stn Mcpr Cus
|
14
|
6
|
—
|
—
|
$29,127.73
|
$38,206.49
|
$37,828.21
|
2026-05-24
|
|
6692352
|
OTHER
|
Tenecteplase 50 Mg Vial
|
22
|
10
|
$39,852.20
|
$39,852.20
|
$29,889.15
|
$37,859.59
|
$37,700.18
|
2026-05-24
|
|
MS-790
|
OTHER
|
Extreme Immaturity Or Respiratory Distress Syndrome- Neonate
|
16
|
8
|
—
|
—
|
$27,793.97
|
$50,658.58
|
$37,601.03
|
2026-05-24
|
|
MS-016
|
OTHER
|
Autolous Bone Marrow Transplant With Cc/mcc
|
18
|
8
|
—
|
—
|
$32,627.23
|
$107,497.03
|
$37,513.73
|
2026-05-24
|
|
MS-235
|
OTHER
|
Coronary Bypass Without Cardiac Catheterization With Mcc
|
18
|
8
|
—
|
—
|
$37,127.18
|
$132,667.24
|
$37,498.45
|
2026-05-24
|
|
MS-820
|
OTHER
|
Lymphoma And Leukemia With Major O.r. Procedures With Mcc
|
18
|
8
|
—
|
—
|
$37,103.14
|
$168,984.76
|
$37,474.17
|
2026-05-24
|
|
6705538
|
OTHER
|
Neurostimulator Interstim X--97800
|
22
|
10
|
$39,490.76
|
$39,490.76
|
$29,618.07
|
$37,516.22
|
$37,358.26
|
2026-05-24
|
|
MS-430
|
OTHER
|
Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc
|
18
|
8
|
—
|
—
|
$36,485.05
|
$133,377.26
|
$36,849.90
|
2026-05-24
|
|
761188
|
OTHER
|
Gemtuzumab Ozogamicin 4.5 Mg Vial
|
22
|
10
|
$38,886.60
|
$38,886.60
|
$29,164.95
|
$36,942.27
|
$36,786.72
|
2026-05-24
|
|
MS-023
|
OTHER
|
Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…
|
18
|
8
|
—
|
—
|
$36,252.24
|
$151,944.28
|
$36,614.76
|
2026-05-24
|
|
79954400
|
OTHER
|
54400 Csc Insert Semi-rigid Prosthesis
|
22
|
10
|
$38,604.75
|
$38,604.75
|
$28,953.56
|
$36,674.51
|
$36,520.09
|
2026-05-24
|
|
79920692
|
OTHER
|
20692 Csc Apply Bone Fixation Device Bce
|
22
|
10
|
$38,442.39
|
$38,442.39
|
$28,831.79
|
$36,520.27
|
$36,366.50
|
2026-05-24
|
|
79924430
|
OTHER
|
24430 Csc Repair Of Humerus Bce
|
22
|
10
|
$38,442.39
|
$38,442.39
|
$28,831.79
|
$36,520.27
|
$36,366.50
|
2026-05-24
|
|
MS-213
|
OTHER
|
Splenic Procedures Age 0-17
|
16
|
8
|
—
|
—
|
$36,104.20
|
$88,171.38
|
$36,284.72
|
2026-05-24
|
|
6018284
|
OTHER
|
Cage Cascadia Interbody 22mm (6101-2225014l28-g2) Stryker Spine-ch
|
22
|
10
|
$38,192.86
|
$38,192.86
|
$28,644.64
|
$36,283.22
|
$36,130.45
|
2026-05-24
|
|
MS-463
|
OTHER
|
Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …
|
18
|
8
|
—
|
—
|
$30,280.48
|
$129,543.15
|
$36,057.39
|
2026-05-24
|
|
5650265
|
OTHER
|
Graft Flex Hd Pliable 20 X 20 Cm (pf2202) Muscular Skeletal Transplant (perpetua…
|
22
|
10
|
$38,030.13
|
$38,030.13
|
$28,522.60
|
$36,128.62
|
$35,976.50
|
2026-05-24
|
|
80503870
|
OTHER
|
Leadless C Pm Ins/rpl Ventr
|
22
|
10
|
$37,763.31
|
$37,763.31
|
$28,322.48
|
$35,875.14
|
$35,724.09
|
2026-05-24
|
|
MS-428
|
OTHER
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
18
|
8
|
—
|
—
|
$31,086.02
|
$125,709.04
|
$35,567.09
|
2026-05-24
|
|
MS-278
|
OTHER
|
Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures …
|
18
|
8
|
—
|
—
|
$35,214.07
|
$163,162.60
|
$35,566.22
|
2026-05-24
|
|
MS-008
|
OTHER
|
Simultaneous Pancreas/kidney Transplant
|
18
|
8
|
—
|
—
|
$30,838.41
|
$191,776.40
|
$35,457.01
|
2026-05-24
|
|
2344035
|
OTHER
|
Cabazitaxel 60 Mg Vial
|
22
|
10
|
$37,454.05
|
$37,454.05
|
$28,090.54
|
$35,581.35
|
$35,431.53
|
2026-05-24
|
|
MS-461
|
OTHER
|
Bilateral Or Multiple Major Joint Procs Of Lower Extremity W Mcc
|
18
|
8
|
—
|
—
|
$34,940.77
|
$226,780.39
|
$35,290.18
|
2026-05-24
|
|
79954405
|
OTHER
|
Insert Multi-comp Penis Pros
|
22
|
10
|
$37,228.79
|
$37,228.79
|
$27,921.59
|
$35,367.35
|
$35,218.44
|
2026-05-24
|
|
79954401
|
OTHER
|
Affinity Clipboard Data Has Be
|
22
|
10
|
$37,228.79
|
$37,228.79
|
$27,921.59
|
$35,367.35
|
$35,218.44
|
2026-05-24
|
|
79953445
|
OTHER
|
53445 Csc Inst Of Inflatable Urethral/bladder Neck Sphincter, Incl Plcmt Of Pump…
|
22
|
10
|
$37,228.78
|
$37,228.78
|
$27,921.58
|
$35,367.34
|
$35,218.43
|
2026-05-24
|
|
5715036
|
OTHER
|
Immune Globulin-hyaluronidase 10%-160 units/mL 300 Ml (jw-)
|
22
|
10
|
$37,064.80
|
$37,064.80
|
$27,798.60
|
$35,211.56
|
$35,063.30
|
2026-05-24
|
|
5570158
|
OTHER
|
Lanreotide 120 Mg/0.5 Ml Syringe
|
22
|
10
|
$36,993.85
|
$36,993.85
|
$27,745.39
|
$35,144.16
|
$34,996.18
|
2026-05-24
|
|
MS-234
|
OTHER
|
Coronary Bypass With Cardiac Catheterization Without Mcc
|
18
|
8
|
—
|
—
|
$34,559.29
|
$135,436.32
|
$34,904.88
|
2026-05-24
|
|
2100832
|
OTHER
|
Bone Graft Infuse Lg Kit (7510800) Medtronic Sofamor
|
22
|
10
|
$36,872.36
|
$36,872.36
|
$27,654.27
|
$35,028.74
|
$34,881.25
|
2026-05-24
|
|
MS-011
|
OTHER
|
Tracheostomy For Face- Mouth And Neck Diagnoses Or Laryngectomy With Mcc
|
18
|
8
|
—
|
—
|
$34,504.88
|
$148,323.18
|
$34,849.93
|
2026-05-24
|
|
MS-834
|
OTHER
|
Acute Leukemia Without Major O.r. Procedures With Mcc
|
18
|
8
|
—
|
—
|
$33,159.85
|
$241,726.31
|
$34,731.37
|
2026-05-24
|
|
90288
|
OTHER
|
Botulism Ig IV
|
4
|
2
|
—
|
—
|
$95.00
|
$69,333.00
|
$34,714.00
|
2026-05-24
|
|
MS-405
|
OTHER
|
Pancreas- Liver And Shunt Procedures With Mcc
|
18
|
8
|
—
|
—
|
$32,176.58
|
$153,825.83
|
$34,608.64
|
2026-05-24
|
|
MS-017
|
OTHER
|
Autolous Bone Marrow Transplant Without Cc/mcc
|
18
|
8
|
—
|
—
|
$29,890.36
|
$89,498.02
|
$34,366.97
|
2026-05-24
|
|
L8701
|
OTHER
|
Ewh S/d Uprt Micro Sensor
|
14
|
6
|
—
|
—
|
$26,399.02
|
$34,627.28
|
$34,284.44
|
2026-05-24
|
|
79927871
|
OTHER
|
27871 Csc Fusion Of Tibiofibular Joint
|
22
|
10
|
$36,035.47
|
$36,035.47
|
$27,026.60
|
$34,233.70
|
$34,089.55
|
2026-05-24
|
|
MS-220
|
OTHER
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
18
|
8
|
—
|
—
|
$33,737.49
|
$132,170.22
|
$34,074.87
|
2026-05-24
|
|
MS-450
|
OTHER
|
Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically …
|
18
|
8
|
—
|
—
|
$33,717.25
|
$126,028.55
|
$34,054.42
|
2026-05-24
|
|
6351310
|
OTHER
|
Cabotegravir-rilpivirine 600-900 Mg Kit
|
22
|
10
|
$35,897.50
|
$35,897.50
|
$26,923.12
|
$34,102.62
|
$33,959.03
|
2026-05-24
|
|
79900020
|
OTHER
|
Implant Neuroelectrodes; Sacrel Bilateral
|
22
|
10
|
$35,857.09
|
$35,857.09
|
$26,892.82
|
$34,064.24
|
$33,920.81
|
2026-05-24
|
|
80099982
|
OTHER
|
**Litho Right
|
22
|
10
|
$35,839.75
|
$35,839.75
|
$26,879.81
|
$34,047.76
|
$33,904.40
|
2026-05-24
|
|
80099981
|
OTHER
|
**Litho Left
|
22
|
10
|
$35,839.75
|
$35,839.75
|
$26,879.81
|
$34,047.76
|
$33,904.40
|
2026-05-24
|
|
79950590
|
OTHER
|
Fragmenting Of Kidney Stone; Unilateral
|
22
|
10
|
$35,781.28
|
$35,781.28
|
$26,835.96
|
$33,992.22
|
$33,849.09
|
2026-05-24
|
|
1643026
|
OTHER
|
Octreotide 30 Mg Depot
|
22
|
10
|
$35,760.25
|
$35,760.25
|
$26,820.19
|
$33,972.24
|
$33,829.20
|
2026-05-24
|
|
MS-021
|
OTHER
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc
|
18
|
8
|
—
|
—
|
$33,490.76
|
$206,225.31
|
$33,825.67
|
2026-05-24
|
|
MS-270
|
OTHER
|
Other Major Cardiovascular Procedures With Mcc
|
18
|
8
|
—
|
—
|
$33,380.05
|
$126,348.06
|
$33,713.85
|
2026-05-24
|
|
5344259
|
OTHER
|
Vns Lead 2mm (304-2.0) Cyberonics--304-2.0
|
22
|
10
|
$35,525.33
|
$35,525.33
|
$26,644.00
|
$33,749.06
|
$33,606.96
|
2026-05-24
|
|
711027
|
OTHER
|
Xa Angiogram Spine Selective
|
22
|
10
|
$35,483.32
|
$35,483.32
|
$26,612.49
|
$33,709.15
|
$33,567.22
|
2026-05-24
|
|
81910100
|
OTHER
|
Arterio Spinal E/ves
|
22
|
10
|
$35,483.32
|
$35,483.32
|
$26,612.49
|
$33,709.15
|
$33,567.22
|
2026-05-24
|
|
81910087
|
OTHER
|
Arterio Visceral
|
22
|
10
|
$35,483.32
|
$35,483.32
|
$26,612.49
|
$33,709.15
|
$33,567.22
|
2026-05-24
|
|
798493
|
OTHER
|
Xa Angiogram Visceral
|
22
|
10
|
$35,483.32
|
$35,483.32
|
$26,612.49
|
$33,709.15
|
$33,567.22
|
2026-05-24
|
|
2718147
|
OTHER
|
Ipilimumab 50 Mg Vial
|
22
|
10
|
$35,478.70
|
$35,478.70
|
$26,609.02
|
$33,704.76
|
$33,562.85
|
2026-05-24
|
|
5298905
|
OTHER
|
Obinutuzumab 25 mg/mL 40 Ml Inj Soln
|
22
|
10
|
$35,316.05
|
$35,316.05
|
$26,487.04
|
$33,550.25
|
$33,408.98
|
2026-05-24
|
|
MS-653
|
OTHER
|
Major Bladder Procedures With Mcc
|
18
|
8
|
—
|
—
|
$32,874.57
|
$194,474.48
|
$33,203.31
|
2026-05-24
|
|
2094062
|
OTHER
|
Implant Cochlear (z43063)sprint Speech Processor-ch
|
22
|
10
|
$34,872.11
|
$34,872.11
|
$26,154.08
|
$33,128.50
|
$32,989.02
|
2026-05-24
|
|
MS-466
|
OTHER
|
Revision Of Hip Or Knee Replacement With Mcc
|
18
|
8
|
—
|
—
|
$31,079.42
|
$114,419.72
|
$32,931.51
|
2026-05-24
|
|
79954410
|
OTHER
|
Remove/replace Penis Prosth
|
22
|
10
|
$34,558.87
|
$34,558.87
|
$25,919.15
|
$32,830.93
|
$32,692.69
|
2026-05-24
|
|
56840843
|
OTHER
|
Graft Cartiform 20mm (abs-1101-20) Arthrex-ch
|
22
|
10
|
$34,536.10
|
$34,536.10
|
$25,902.07
|
$32,809.30
|
$32,671.15
|
2026-05-24
|
|
5286524
|
OTHER
|
Mesh Srg Phasix 10x8in Mfl Scfld Full Rsrb Poly-4-hb Rect--1190400
|
22
|
10
|
$34,492.74
|
$34,492.74
|
$25,869.56
|
$32,768.10
|
$32,630.13
|
2026-05-24
|
|
6055292
|
OTHER
|
Femoral Distal 65mm (6495-2-020) Stryker 3 Rivers Ortho-ch
|
22
|
10
|
$34,263.59
|
$34,263.59
|
$25,697.69
|
$32,550.41
|
$32,413.36
|
2026-05-24
|
|
2101158
|
OTHER
|
Stem Calcar (1571-63-000) Depuy-ch
|
22
|
10
|
$34,020.82
|
$34,020.82
|
$25,515.62
|
$32,319.78
|
$32,183.70
|
2026-05-24
|
|
80593654
|
OTHER
|
Comp Ep Study W/vt Abl- Ccw Cath
|
22
|
10
|
$33,989.37
|
$33,989.37
|
$25,492.03
|
$32,289.90
|
$32,153.94
|
2026-05-24
|
|
80593653
|
OTHER
|
Comp Ep Study W/svt Abl- Ccw Cath
|
22
|
10
|
$33,989.37
|
$33,989.37
|
$25,492.03
|
$32,289.90
|
$32,153.94
|
2026-05-24
|
|
0620T
|
OTHER
|
Evasc Ven Artlz Tibl/prnl Vn
|
14
|
6
|
—
|
—
|
$17,417.14
|
$38,850.56
|
$32,039.46
|
2026-05-24
|
|
5702786
|
OTHER
|
Trevo Pro Vue 4 X 20 80052-ch
|
22
|
10
|
$33,809.55
|
$33,809.55
|
$25,357.16
|
$32,119.07
|
$31,983.83
|
2026-05-24
|
|
MS-221
|
OTHER
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
18
|
8
|
—
|
—
|
$31,677.52
|
$105,047.46
|
$31,886.38
|
2026-05-24
|
|
5650269
|
OTHER
|
Graft Flex Hd Shaped 13 X 22 Cm (1.7 - 2.0mm Diam) Sf3002 Muscular Skeletal Tran…
|
22
|
10
|
$33,686.71
|
$33,686.71
|
$25,265.03
|
$32,002.37
|
$31,867.63
|
2026-05-24
|
|
MS-228
|
OTHER
|
Other Cardiothoracic Procedures With Mcc
|
18
|
8
|
—
|
—
|
$31,299.29
|
$181,871.62
|
$31,612.28
|
2026-05-24
|
|
MS-853
|
OTHER
|
Infectious And Parasitic Diseases With O.r. Procedures With Mcc
|
18
|
8
|
—
|
—
|
$31,243.62
|
$120,419.39
|
$31,556.05
|
2026-05-24
|
|
MS-326
|
OTHER
|
Stomach- Esophageal And Duodenal Procedures With Mcc
|
18
|
8
|
—
|
—
|
$27,473.18
|
$129,756.16
|
$31,552.35
|
2026-05-24
|
|
2100796
|
OTHER
|
Kit Bngf Med Infs--7510400
|
22
|
10
|
$33,177.47
|
$33,177.47
|
$24,883.10
|
$31,518.60
|
$31,385.89
|
2026-05-24
|
|
MS-576
|
OTHER
|
Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc
|
18
|
8
|
—
|
—
|
$31,007.01
|
$194,296.97
|
$31,317.08
|
2026-05-24
|
|
5816371
|
OTHER
|
Lurbinectedin 4 Mg Vial
|
22
|
10
|
$33,075.00
|
$33,075.00
|
$24,806.25
|
$31,421.25
|
$31,288.95
|
2026-05-24
|
|
5787606
|
OTHER
|
Graft Flex Hd Structural (non Perf) 16 X 20cm (472620) Muscular Skeleton Transpl…
|
22
|
10
|
$32,960.90
|
$32,960.90
|
$24,720.68
|
$31,312.86
|
$31,181.01
|
2026-05-24
|
|
5702556
|
OTHER
|
Gdc Coil Matrix 2 360 Ultrasoft 3x8-ch
|
22
|
10
|
$32,960.90
|
$32,960.90
|
$24,720.68
|
$31,312.86
|
$31,181.01
|
2026-05-24
|
|
MS-239
|
OTHER
|
Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc
|
18
|
8
|
—
|
—
|
$27,892.46
|
$113,212.69
|
$31,136.70
|
2026-05-24
|
|
6079520
|
OTHER
|
Pm Generator, Neurostimulator (implantable), With Rechargeable Battery And Charg…
|
22
|
10
|
$32,750.80
|
$32,750.80
|
$24,563.10
|
$31,113.26
|
$30,982.26
|
2026-05-24
|
|
6003757
|
OTHER
|
Ravulizumab-cwvz 100 mg/mL Inj 3 Ml (Ultomiris)
|
22
|
10
|
$32,719.35
|
$32,719.35
|
$24,539.51
|
$31,083.38
|
$30,952.51
|
2026-05-24
|
|
5626441
|
OTHER
|
Atezolizumab 60 mg/mL Injection 14 Ml Vial
|
22
|
10
|
$32,664.45
|
$32,664.45
|
$24,498.34
|
$31,031.23
|
$30,900.57
|
2026-05-24
|
|
5376305
|
OTHER
|
Pegfilgrastim 6 Mg/0.6 Ml On Body Injector
|
22
|
10
|
$32,382.20
|
$32,382.20
|
$24,286.65
|
$30,763.09
|
$30,633.56
|
2026-05-24
|
|
761254
|
OTHER
|
Pegfilgrastim 6 Mg/0.6 Ml Syr
|
22
|
10
|
$32,382.20
|
$32,382.20
|
$24,286.65
|
$30,763.09
|
$30,633.56
|
2026-05-24
|
|
MS-471
|
OTHER
|
Cervical Spinal Fusion With Mcc
|
18
|
8
|
—
|
—
|
$26,975.22
|
$106,218.99
|
$30,548.35
|
2026-05-24
|
|
5578350
|
OTHER
|
Nivolumab 10 mg/mL 24 Ml (240 Mg) Vial (jw-)
|
22
|
10
|
$32,158.25
|
$32,158.25
|
$24,118.69
|
$30,550.34
|
$30,421.70
|
2026-05-24
|
|
7069296
|
OTHER
|
Nivolumab-nvhy 600 Mg And Hyaluronidase 10,000 Units Per 5 Ml / (5 Ml Vial)
|
22
|
10
|
$32,158.25
|
$32,158.25
|
$24,118.69
|
$30,550.34
|
$30,421.70
|
2026-05-24
|
|
5757402
|
OTHER
|
Lead Nrstm 43cm 3mm Vns Perenniaflex Vagus Nrv Sil Bp Modl--304-30
|
22
|
10
|
$32,130.77
|
$32,130.77
|
$24,098.08
|
$30,524.23
|
$30,395.71
|
2026-05-24
|
|
MS-837
|
OTHER
|
Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot…
|
18
|
8
|
—
|
—
|
$10,945.25
|
$111,970.15
|
$30,393.98
|
2026-05-24
|
|
5703031
|
OTHER
|
Trevo Provue Stent Retriever 6mm X 25mm 90186-ch
|
22
|
10
|
$32,119.31
|
$32,119.31
|
$24,089.48
|
$30,513.34
|
$30,384.87
|
2026-05-24
|
|
5702246
|
OTHER
|
Stent Vasc 4mm 30mm Entrp 2--enf403012
|
22
|
10
|
$31,915.09
|
$31,915.09
|
$23,936.32
|
$30,319.34
|
$30,191.68
|
2026-05-24
|
|
5702209
|
OTHER
|
Stent Vasc 4mm 16mm Entrp 2--enf401612
|
22
|
10
|
$31,915.09
|
$31,915.09
|
$23,936.32
|
$30,319.34
|
$30,191.68
|
2026-05-24
|
|
5702244
|
OTHER
|
Stent Enterprise 2 4.0 X 39mm Enf403912--enf403912
|
22
|
10
|
$31,915.09
|
$31,915.09
|
$23,936.32
|
$30,319.34
|
$30,191.68
|
2026-05-24
|
|
MS-267
|
OTHER
|
Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc
|
18
|
8
|
—
|
—
|
$25,194.66
|
$142,252.51
|
$30,118.78
|
2026-05-24
|
|
MS-981
|
OTHER
|
Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc
|
18
|
8
|
—
|
—
|
$29,682.26
|
$139,163.92
|
$29,979.08
|
2026-05-24
|
|
5641558
|
OTHER
|
Flex Hd 16 X 20--pf2620
|
22
|
10
|
$31,669.14
|
$31,669.14
|
$23,751.86
|
$30,085.68
|
$29,959.01
|
2026-05-24
|
|
MS-826
|
OTHER
|
Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. …
|
18
|
8
|
—
|
—
|
$29,593.69
|
$171,505.33
|
$29,889.63
|
2026-05-24
|
|
MS-650
|
OTHER
|
Neonate Birthwt 15001999g Without Signif O.r. Proc W Other Prob
|
18
|
8
|
—
|
—
|
$25,868.70
|
$161,778.06
|
$29,742.99
|
2026-05-24
|
|
80512036
|
OTHER
|
Insert Pm Dual Chamber
|
22
|
10
|
$31,233.06
|
$31,233.06
|
$23,424.80
|
$29,671.41
|
$29,546.47
|
2026-05-24
|
|
80512048
|
OTHER
|
Upgrade Pm-sing To Dual W Test
|
22
|
10
|
$31,228.94
|
$31,228.94
|
$23,421.70
|
$29,667.49
|
$29,542.58
|
2026-05-24
|
|
0408T
|
OTHER
|
Insj/rplc Cardiac Modulj Sys
|
14
|
7
|
—
|
—
|
$29,349.17
|
$35,588.36
|
$29,349.17
|
2026-05-24
|
|
0571T
|
OTHER
|
Insj/rplcmt Icds Ss Eltrd
|
12
|
6
|
—
|
—
|
$29,349.17
|
$35,588.36
|
$29,349.17
|
2026-05-24
|
|
0915T
|
OTHER
|
Insj Perm Ccm-d Sys Pg&eltrd
|
12
|
6
|
—
|
—
|
$29,349.17
|
$35,588.36
|
$29,349.17
|
2026-05-24
|
|
MS-006
|
OTHER
|
Liver Transplant Without Mcc
|
18
|
8
|
—
|
—
|
$25,514.35
|
$170,937.32
|
$29,335.57
|
2026-05-24
|
|
MS-823
|
OTHER
|
Lymphoma And Non-acute Leukemia With Other Procedures With Mcc
|
18
|
8
|
—
|
—
|
$29,005.33
|
$127,235.58
|
$29,295.39
|
2026-05-24
|
|
79900066
|
OTHER
|
Laparoscopy, Remove Adnexa; Bilateral
|
22
|
10
|
$30,920.69
|
$30,920.69
|
$23,190.52
|
$29,374.66
|
$29,250.97
|
2026-05-24
|
|
MS-277
|
OTHER
|
Other Major Cardiovascular Procedures With Mcc
|
18
|
8
|
—
|
—
|
$27,584.88
|
$146,193.12
|
$29,218.53
|
2026-05-24
|
|
5530493
|
OTHER
|
Ramucirumab 10 mg/mL 50 Ml Soln (500 Mg) (jw-)
|
22
|
10
|
$30,846.55
|
$30,846.55
|
$23,134.91
|
$29,304.22
|
$29,180.84
|
2026-05-24
|
|
MS-245
|
OTHER
|
Aicd Generator Procedures
|
18
|
8
|
—
|
—
|
$28,863.62
|
$170,937.32
|
$29,152.26
|
2026-05-24
|