|
J3391
|
HCPCS
|
Inj, Atidarsagene Autotemcel
|
11
|
10
|
—
|
—
|
$4,505,000.00
|
$4,865,400.00
|
$4,505,000.00
|
2025-12-31
|
|
J1414
|
HCPCS
|
Inj, Beqvez, Per Tx Dose
|
5
|
4
|
—
|
—
|
$3,932,600.00
|
$3,932,600.00
|
$3,932,600.00
|
2025-12-31
|
|
J1411
|
HCPCS
|
Inj, Hemgenix, Per Tx Dose
|
16
|
12
|
—
|
—
|
$3,685,266.67
|
$3,980,088.00
|
$3,685,266.67
|
2025-12-31
|
|
J1413
|
HCPCS
|
Inj Delandistrogene Mox Rokl
|
16
|
12
|
—
|
—
|
$3,316,462.59
|
$3,581,779.60
|
$3,316,462.59
|
2025-12-31
|
|
J3394
|
HCPCS
|
Inj, Lovotibeglogene Autotem
|
16
|
12
|
—
|
—
|
$3,248,445.72
|
$3,508,321.37
|
$3,248,445.72
|
2025-12-31
|
|
J3393
|
HCPCS
|
Inj, Betibeglogene Autotemce
|
16
|
12
|
—
|
—
|
$2,945,740.00
|
$3,181,399.20
|
$2,945,740.00
|
2025-12-31
|
|
J3399
|
HCPCS
|
Inj Onase Abepar-xioi Treat
|
11
|
10
|
—
|
—
|
$2,455,110.61
|
$2,651,519.45
|
$2,455,110.61
|
2025-12-31
|
|
J3392
|
HCPCS
|
Inj, Exagamglogene Autotem
|
16
|
12
|
—
|
—
|
$2,332,000.00
|
$2,518,560.00
|
$2,332,000.00
|
2025-12-31
|
|
Q2057
|
HCPCS
|
Afamitresgene Autoleucel
|
12
|
11
|
—
|
—
|
$770,620.00
|
$1,040,337.00
|
$770,620.00
|
2025-12-31
|
|
18
|
MS_DRG
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
26
|
19
|
—
|
—
|
$302,254.65
|
$1,272,338.02
|
$601,202.82
|
2025-12-31
|
|
Q2042
|
HCPCS
|
Tisagenlecleucel Car-pos T
|
14
|
12
|
—
|
—
|
$591,726.20
|
$780,738.18
|
$591,726.20
|
2025-12-31
|
|
Q2056
|
HCPCS
|
Ciltacabtagene Car-pos T
|
14
|
12
|
—
|
—
|
$565,868.95
|
$747,061.42
|
$565,868.95
|
2025-12-31
|
|
Q2054
|
HCPCS
|
Lisocabtagene Mara Car Pos T
|
14
|
12
|
—
|
—
|
$547,475.13
|
$731,208.14
|
$562,538.19
|
2025-12-31
|
|
Q2055
|
HCPCS
|
Idecabtagene Vicleucel Car
|
14
|
12
|
—
|
—
|
$557,317.93
|
$730,701.61
|
$557,317.93
|
2025-12-31
|
|
Q2041
|
HCPCS
|
Axicabtagene Ciloleucel Car+
|
14
|
12
|
—
|
—
|
$518,888.18
|
$719,653.25
|
$533,230.17
|
2025-12-31
|
|
Q2053
|
HCPCS
|
Brexucabtagene Car Pos T
|
14
|
12
|
—
|
—
|
$489,304.61
|
$661,122.00
|
$489,304.61
|
2025-12-31
|
|
5834
|
APR_DRG
|
Neonate With Ecmo
|
8
|
8
|
—
|
—
|
$399,559.09
|
$411,545.86
|
$399,559.09
|
2025-12-31
|
|
1
|
MS_DRG
|
Heart Transplant Or Implant Of Heart Assist System With Mcc
|
26
|
19
|
—
|
—
|
$196,151.11
|
$825,696.19
|
$390,156.45
|
2025-12-31
|
|
927
|
MS_DRG
|
Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft
|
26
|
19
|
—
|
—
|
$149,441.17
|
$629,071.13
|
$297,247.54
|
2025-12-31
|
|
3
|
MS_DRG
|
Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mo…
|
26
|
19
|
—
|
—
|
$148,564.13
|
$625,379.29
|
$295,503.07
|
2025-12-31
|
|
Q2058
|
HCPCS
|
Obecbtge Autol Up To 400 Mil
|
11
|
10
|
—
|
—
|
$278,250.00
|
$300,510.00
|
$278,250.00
|
2025-12-31
|
|
5884
|
APR_DRG
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
8
|
8
|
—
|
—
|
$260,666.67
|
$268,486.67
|
$260,666.67
|
2025-12-31
|
|
5833
|
APR_DRG
|
Neonate With Ecmo
|
8
|
8
|
—
|
—
|
$258,846.76
|
$266,612.16
|
$258,846.76
|
2025-12-31
|
|
J3403
|
HCPCS
|
Revakinagene, Per Implant
|
11
|
10
|
—
|
—
|
$257,500.00
|
$278,100.00
|
$257,500.00
|
2025-12-31
|
|
24
|
APR_DRG
|
Heart And/or Lung Transplant
|
8
|
8
|
—
|
—
|
$230,844.16
|
$237,769.48
|
$230,844.16
|
2025-12-31
|
|
J3402
|
HCPCS
|
Inj. Remestemcel-l-rknd/ Td
|
11
|
10
|
—
|
—
|
$205,640.00
|
$222,091.20
|
$205,640.00
|
2025-12-31
|
|
114
|
APR_DRG
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
8
|
8
|
—
|
—
|
$202,981.73
|
$209,071.18
|
$202,981.73
|
2025-12-31
|
|
5832
|
APR_DRG
|
Neonate With Ecmo
|
8
|
8
|
—
|
—
|
$198,746.94
|
$204,709.35
|
$198,746.94
|
2025-12-31
|
|
1614
|
APR_DRG
|
Implantable Heart Assist Systems
|
8
|
8
|
—
|
—
|
$197,832.03
|
$203,766.99
|
$197,832.03
|
2025-12-31
|
|
4
|
MS_DRG
|
Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And …
|
26
|
19
|
—
|
—
|
$96,951.79
|
$408,117.65
|
$192,843.00
|
2025-12-31
|
|
6304
|
APR_DRG
|
Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure
|
8
|
8
|
—
|
—
|
$190,147.11
|
$195,851.52
|
$190,147.11
|
2025-12-31
|
|
8414
|
APR_DRG
|
Extensive Third Degree Burns With Skin Graft
|
8
|
8
|
—
|
—
|
$187,542.55
|
$193,168.83
|
$187,542.55
|
2025-12-31
|
|
7
|
MS_DRG
|
Lung Transplant
|
26
|
19
|
—
|
—
|
$90,643.92
|
$381,564.69
|
$180,296.24
|
2025-12-31
|
|
6094
|
APR_DRG
|
Neonate Birth Weight 1500-2499 Grams With Major Procedure
|
8
|
8
|
—
|
—
|
$171,389.57
|
$176,531.26
|
$171,389.57
|
2025-12-31
|
|
5883
|
APR_DRG
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
8
|
8
|
—
|
—
|
$169,530.81
|
$174,616.73
|
$169,530.81
|
2025-12-31
|
|
6314
|
APR_DRG
|
Neonate Birth Weight > 2499 Grams With Other Major Procedure
|
8
|
8
|
—
|
—
|
$168,261.67
|
$173,309.52
|
$168,261.67
|
2025-12-31
|
|
14
|
MS_DRG
|
Allogeneic Bone Marrow Transplant
|
26
|
19
|
—
|
—
|
$84,118.35
|
$354,095.41
|
$167,316.51
|
2025-12-31
|
|
5914
|
APR_DRG
|
Neonate Birth Weight 500-749 Grams Without Major Procedure
|
8
|
8
|
—
|
—
|
$165,592.36
|
$170,560.13
|
$165,592.36
|
2025-12-31
|
|
2
|
MS_DRG
|
Heart Transplant Or Implant Of Heart Assist System Without Mcc
|
26
|
19
|
—
|
—
|
$79,316.05
|
$333,880.16
|
$157,764.44
|
2025-12-31
|
|
209
|
MS_DRG
|
Complex Aortic Arch Procedures
|
26
|
19
|
—
|
—
|
$79,225.06
|
$333,497.12
|
$157,583.45
|
2025-12-31
|
|
74
|
APR_DRG
|
Allogeneic Bone Marrow Transplant
|
8
|
8
|
—
|
—
|
$157,179.92
|
$161,895.32
|
$157,179.92
|
2025-12-31
|
|
94
|
APR_DRG
|
Extracorporeal Membrane Oxygenation (ecmo)
|
8
|
8
|
—
|
—
|
$156,392.23
|
$161,084.00
|
$156,392.23
|
2025-12-31
|
|
5934
|
APR_DRG
|
Neonate Birth Weight 750-999 Grams Without Major Procedure
|
8
|
8
|
—
|
—
|
$153,546.19
|
$158,152.58
|
$153,546.19
|
2025-12-31
|
|
426
|
MS_DRG
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
26
|
19
|
—
|
—
|
$77,142.03
|
$324,728.64
|
$153,440.17
|
2025-12-31
|
|
212
|
MS_DRG
|
Concomitant Aortic And Mitral Valve Procedures
|
26
|
19
|
—
|
—
|
$76,112.42
|
$320,394.48
|
$151,392.21
|
2025-12-31
|
|
5882
|
APR_DRG
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
8
|
8
|
—
|
—
|
$148,759.87
|
$153,222.67
|
$148,759.87
|
2025-12-31
|
|
5831
|
APR_DRG
|
Neonate With Ecmo
|
8
|
8
|
—
|
—
|
$144,462.62
|
$148,796.50
|
$144,462.62
|
2025-12-31
|
|
5
|
MS_DRG
|
Liver Transplant With Mcc Or Intestinal Transplant
|
26
|
19
|
—
|
—
|
$72,167.54
|
$303,788.57
|
$143,545.62
|
2025-12-31
|
|
6034
|
APR_DRG
|
Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition
|
8
|
8
|
—
|
—
|
$142,024.89
|
$146,285.64
|
$142,024.89
|
2025-12-31
|
|
14
|
APR_DRG
|
Liver Transplant And/or Intestinal Transplant
|
8
|
8
|
—
|
—
|
$139,783.71
|
$143,977.22
|
$139,783.71
|
2025-12-31
|
|
44
|
APR_DRG
|
Tracheostomy With Mv >96 Hours With Extensive Procedure
|
8
|
8
|
—
|
—
|
$138,825.38
|
$142,990.14
|
$138,825.38
|
2025-12-31
|
|
215
|
MS_DRG
|
Other Heart Assist System Implant
|
26
|
19
|
—
|
—
|
$69,693.25
|
$293,373.05
|
$138,624.09
|
2025-12-31
|
|
216
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
26
|
19
|
—
|
—
|
$68,473.95
|
$288,240.42
|
$136,198.84
|
2025-12-31
|
|
1613
|
APR_DRG
|
Implantable Heart Assist Systems
|
8
|
8
|
—
|
—
|
$133,858.52
|
$137,874.28
|
$133,858.52
|
2025-12-31
|
|
23
|
APR_DRG
|
Heart And/or Lung Transplant
|
8
|
8
|
—
|
—
|
$129,617.64
|
$133,506.17
|
$129,617.64
|
2025-12-31
|
|
Q0480
|
HCPCS
|
Driver Pneumatic Vad, Rep
|
11
|
10
|
—
|
—
|
$129,537.54
|
$139,900.54
|
$129,537.54
|
2025-12-31
|
|
5881
|
APR_DRG
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
8
|
8
|
—
|
—
|
$127,508.24
|
$131,333.49
|
$127,508.24
|
2025-12-31
|
|
429
|
MS_DRG
|
Combined Anterior And Posterior Cervical Spinal Fusion With Mcc
|
26
|
19
|
—
|
—
|
$63,062.00
|
$265,458.85
|
$125,434.13
|
2025-12-31
|
|
5913
|
APR_DRG
|
Neonate Birth Weight 500-749 Grams Without Major Procedure
|
8
|
8
|
—
|
—
|
$122,908.56
|
$126,595.82
|
$122,908.56
|
2025-12-31
|
|
J2351
|
HCPCS
|
Ocrelizumab-hyaluronidase-ocsq 920-23000 Mg-unit/23 Ml Solution 23 Ml Vial
|
70
|
30
|
$175,458.15
|
$96,501.99
45% off
|
$47.23
|
$154,403.17
|
$121,066.12
|
2025-12-31
|
|
850
|
MS_DRG
|
Acute Leukemia With Other Procedures
|
26
|
19
|
—
|
—
|
$60,611.50
|
$255,143.51
|
$120,559.94
|
2025-12-31
|
|
113
|
APR_DRG
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
8
|
8
|
—
|
—
|
$118,378.96
|
$121,930.33
|
$118,378.96
|
2025-12-31
|
|
231
|
MS_DRG
|
Coronary Bypass With Ptca With Mcc
|
26
|
19
|
—
|
—
|
$59,004.44
|
$248,378.57
|
$117,363.39
|
2025-12-31
|
|
456
|
MS_DRG
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
26
|
19
|
—
|
—
|
$58,818.95
|
$247,597.78
|
$116,994.45
|
2025-12-31
|
|
1604
|
APR_DRG
|
Major Cardiothoracic Repair Of Heart Anomaly
|
8
|
8
|
—
|
—
|
$115,421.70
|
$118,884.35
|
$115,421.70
|
2025-12-31
|
|
6024
|
APR_DRG
|
Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…
|
8
|
8
|
—
|
—
|
$114,020.01
|
$117,440.61
|
$114,020.01
|
2025-12-31
|
|
K1007
|
HCPCS
|
Bil Hkaf Pc S/d Micro Sensor
|
11
|
10
|
—
|
—
|
$111,860.04
|
$120,808.84
|
$111,860.04
|
2025-12-31
|
|
20
|
MS_DRG
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc
|
26
|
19
|
—
|
—
|
$55,077.05
|
$231,846.32
|
$109,551.60
|
2025-12-31
|
|
1612
|
APR_DRG
|
Implantable Heart Assist Systems
|
8
|
8
|
—
|
—
|
$107,450.34
|
$110,673.85
|
$107,450.34
|
2025-12-31
|
|
219
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
26
|
19
|
—
|
—
|
$53,743.66
|
$226,233.43
|
$106,899.40
|
2025-12-31
|
|
5933
|
APR_DRG
|
Neonate Birth Weight 750-999 Grams Without Major Procedure
|
8
|
8
|
—
|
—
|
$106,489.72
|
$109,684.41
|
$106,489.72
|
2025-12-31
|
|
233
|
MS_DRG
|
Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc
|
26
|
19
|
—
|
—
|
$53,511.99
|
$225,258.17
|
$106,438.58
|
2025-12-31
|
|
957
|
MS_DRG
|
Other O.r. Procedures For Multiple Significant Trauma With Mcc
|
26
|
19
|
—
|
—
|
$53,334.90
|
$224,512.73
|
$106,086.34
|
2025-12-31
|
|
1611
|
APR_DRG
|
Implantable Heart Assist Systems
|
8
|
8
|
—
|
—
|
$102,374.54
|
$105,445.78
|
$102,374.54
|
2025-12-31
|
|
5891
|
APR_DRG
|
Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …
|
8
|
8
|
—
|
—
|
$101,826.81
|
$104,881.61
|
$101,826.81
|
2025-12-31
|
|
112
|
APR_DRG
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
8
|
8
|
—
|
—
|
$101,643.98
|
$104,693.30
|
$101,643.98
|
2025-12-31
|
|
64
|
APR_DRG
|
Pancreas Transplant
|
8
|
8
|
—
|
—
|
$100,556.15
|
$103,572.83
|
$100,556.15
|
2025-12-31
|
|
427
|
MS_DRG
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
26
|
19
|
—
|
—
|
$50,526.04
|
$212,688.83
|
$100,499.33
|
2025-12-31
|
|
10
|
MS_DRG
|
Pancreas Transplant
|
26
|
19
|
—
|
—
|
$50,225.75
|
$211,424.82
|
$99,902.07
|
2025-12-31
|
|
928
|
MS_DRG
|
Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc
|
26
|
19
|
—
|
—
|
$50,204.75
|
$211,336.43
|
$99,860.30
|
2025-12-31
|
|
19
|
MS_DRG
|
Simultaneous Pancreas And Kidney Transplant With Hemodialysis
|
26
|
19
|
—
|
—
|
$49,938.07
|
$210,213.85
|
$99,329.86
|
2025-12-31
|
|
275
|
MS_DRG
|
Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc
|
26
|
19
|
—
|
—
|
$49,908.68
|
$210,090.11
|
$99,271.39
|
2025-12-31
|
|
5892
|
APR_DRG
|
Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …
|
8
|
8
|
—
|
—
|
$98,823.08
|
$101,787.77
|
$98,823.08
|
2025-12-31
|
|
8514
|
APR_DRG
|
Gender Related Procedures
|
8
|
8
|
—
|
—
|
$97,501.37
|
$100,426.41
|
$97,501.37
|
2025-12-31
|
|
5893
|
APR_DRG
|
Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …
|
8
|
8
|
—
|
—
|
$96,717.49
|
$99,619.01
|
$96,717.49
|
2025-12-31
|
|
870
|
MS_DRG
|
Septicemia Or Severe Sepsis With Mv >96 Hours
|
26
|
19
|
—
|
—
|
$48,378.61
|
$203,649.28
|
$96,227.99
|
2025-12-31
|
|
8424
|
APR_DRG
|
Burns With Skin Graft Except Extensive Third Degree Burns
|
8
|
8
|
—
|
—
|
$96,047.12
|
$98,928.53
|
$96,047.12
|
2025-12-31
|
|
268
|
MS_DRG
|
Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc
|
26
|
19
|
—
|
—
|
$48,141.32
|
$202,650.45
|
$95,756.01
|
2025-12-31
|
|
J9269
|
HCPCS
|
Tagraxofusp-erzs 1000 Mcg/ml Solution 1 Ml Vial
|
71
|
30
|
$138,417.27
|
$76,129.50
45% off
|
$356.93
|
$121,807.20
|
$95,507.92
|
2025-12-31
|
|
22
|
APR_DRG
|
Heart And/or Lung Transplant
|
8
|
8
|
—
|
—
|
$94,329.28
|
$97,159.16
|
$94,329.28
|
2025-12-31
|
|
955
|
MS_DRG
|
Craniotomy For Multiple Significant Trauma
|
26
|
19
|
—
|
—
|
$47,113.82
|
$198,325.13
|
$93,712.23
|
2025-12-31
|
|
5912
|
APR_DRG
|
Neonate Birth Weight 500-749 Grams Without Major Procedure
|
8
|
8
|
—
|
—
|
$93,204.12
|
$96,000.24
|
$93,204.12
|
2025-12-31
|
|
317
|
MS_DRG
|
Concomitant Left Atrial Appendage Closure And Cardiac Ablation
|
26
|
19
|
—
|
—
|
$46,801.64
|
$197,011.04
|
$93,091.29
|
2025-12-31
|
|
447
|
MS_DRG
|
Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall…
|
26
|
19
|
—
|
—
|
$46,767.35
|
$196,866.66
|
$93,023.07
|
2025-12-31
|
|
217
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
26
|
19
|
—
|
—
|
$46,023.31
|
$193,734.64
|
$91,543.14
|
2025-12-31
|
|
218
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
26
|
19
|
—
|
—
|
$46,023.31
|
$193,734.64
|
$91,543.14
|
2025-12-31
|
|
573
|
MS_DRG
|
Skin Graft For Skin Ulcer Or Cellulitis With Mcc
|
26
|
19
|
—
|
—
|
$45,856.01
|
$193,030.45
|
$91,210.39
|
2025-12-31
|
|
6303
|
APR_DRG
|
Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure
|
8
|
8
|
—
|
—
|
$90,795.35
|
$93,519.21
|
$90,795.35
|
2025-12-31
|
|
54
|
APR_DRG
|
Tracheostomy With Mv >96 Hours Without Extensive Procedure
|
8
|
8
|
—
|
—
|
$90,552.33
|
$93,268.90
|
$90,552.33
|
2025-12-31
|
|
207
|
MS_DRG
|
Respiratory System Diagnosis With Ventilator Support >96 Hours
|
26
|
19
|
—
|
—
|
$45,039.17
|
$189,592.00
|
$89,585.66
|
2025-12-31
|
|
J2507
|
HCPCS
|
Pegloticase 8 Mg/ml Solution 1 Ml Vial
|
71
|
30
|
$127,605.41
|
$70,182.98
45% off
|
$3,660.83
|
$112,292.76
|
$88,047.74
|
2025-12-31
|
|
6074
|
APR_DRG
|
Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…
|
8
|
8
|
—
|
—
|
$87,382.53
|
$90,004.01
|
$87,382.53
|
2025-12-31
|
|
J9228
|
HCPCS
|
Ipilimumab 200 Mg/40ml Solution 40 Ml Vial
|
91
|
30
|
$145,600.75
|
$80,080.42
45% off
|
$183.48
|
$128,128.66
|
$87,360.45
|
2025-12-31
|
|
5932
|
APR_DRG
|
Neonate Birth Weight 750-999 Grams Without Major Procedure
|
8
|
8
|
—
|
—
|
$87,220.27
|
$89,836.88
|
$87,220.27
|
2025-12-31
|
|
43
|
APR_DRG
|
Tracheostomy With Mv >96 Hours With Extensive Procedure
|
8
|
8
|
—
|
—
|
$87,052.68
|
$89,664.26
|
$87,052.68
|
2025-12-31
|
|
21
|
APR_DRG
|
Heart And/or Lung Transplant
|
8
|
8
|
—
|
—
|
$86,749.48
|
$89,351.96
|
$86,749.48
|
2025-12-31
|
|
J0202
|
HCPCS
|
Alemtuzumab 12 Mg/1.2ml Solution 1.2 Ml Vial
|
71
|
30
|
$125,171.40
|
$68,844.27
45% off
|
$2,429.89
|
$110,150.83
|
$86,368.26
|
2025-12-31
|
|
266
|
MS_DRG
|
Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc
|
26
|
19
|
—
|
—
|
$42,895.26
|
$180,567.18
|
$85,321.27
|
2025-12-31
|
|
969
|
MS_DRG
|
HIV With Extensive O.r. Procedures With Mcc
|
26
|
19
|
—
|
—
|
$42,845.57
|
$180,357.98
|
$85,222.43
|
2025-12-31
|
|
232
|
MS_DRG
|
Coronary Bypass With Ptca Without Mcc
|
26
|
19
|
—
|
—
|
$42,434.69
|
$178,628.45
|
$84,405.18
|
2025-12-31
|
|
28
|
MS_DRG
|
Spinal Procedures With Mcc
|
26
|
19
|
—
|
—
|
$42,054.63
|
$177,028.55
|
$83,649.20
|
2025-12-31
|
|
276
|
MS_DRG
|
Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator
|
26
|
19
|
—
|
—
|
$42,042.73
|
$176,978.46
|
$83,625.54
|
2025-12-31
|
|
457
|
MS_DRG
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
26
|
19
|
—
|
—
|
$41,738.24
|
$175,696.78
|
$83,019.92
|
2025-12-31
|
|
3034
|
APR_DRG
|
Dorsal And Lumbar Fusion Procedure For Curvature Of Back
|
8
|
8
|
—
|
—
|
$82,898.64
|
$85,385.60
|
$82,898.64
|
2025-12-31
|
|
16
|
MS_DRG
|
Autologous Bone Marrow Transplant With Cc/mcc
|
26
|
19
|
—
|
—
|
$41,504.48
|
$174,712.68
|
$82,554.91
|
2025-12-31
|
|
235
|
MS_DRG
|
Coronary Bypass Without Cardiac Catheterization With Mcc
|
26
|
19
|
—
|
—
|
$41,076.81
|
$172,912.43
|
$81,704.26
|
2025-12-31
|
|
820
|
MS_DRG
|
Lymphoma And Leukemia With Major O.r. Procedures With Mcc
|
26
|
19
|
—
|
—
|
$41,050.22
|
$172,800.47
|
$81,651.35
|
2025-12-31
|
|
L8702
|
HCPCS
|
Ewhf S/d Uprt Micro Sensor
|
11
|
10
|
—
|
—
|
$80,943.19
|
$87,418.65
|
$80,943.19
|
2025-12-31
|
|
6023
|
APR_DRG
|
Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…
|
8
|
8
|
—
|
—
|
$80,878.38
|
$83,304.73
|
$80,878.38
|
2025-12-31
|
|
430
|
MS_DRG
|
Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc
|
26
|
19
|
—
|
—
|
$40,366.37
|
$169,921.83
|
$80,291.15
|
2025-12-31
|
|
23
|
MS_DRG
|
Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…
|
26
|
19
|
—
|
—
|
$40,108.79
|
$168,837.56
|
$79,778.82
|
2025-12-31
|
|
213
|
MS_DRG
|
Endovascular Abdominal Aorta With Iliac Branch Procedures
|
26
|
19
|
—
|
—
|
$39,945.00
|
$168,148.10
|
$79,453.04
|
2025-12-31
|
|
463
|
MS_DRG
|
Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …
|
26
|
19
|
—
|
—
|
$39,893.20
|
$167,930.07
|
$79,350.01
|
2025-12-31
|
|
1624
|
APR_DRG
|
Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis
|
8
|
8
|
—
|
—
|
$78,796.41
|
$81,160.30
|
$78,796.41
|
2025-12-31
|
|
428
|
MS_DRG
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
26
|
19
|
—
|
—
|
$39,350.75
|
$165,646.61
|
$78,271.03
|
2025-12-31
|
|
8
|
MS_DRG
|
Simultaneous Pancreas And Kidney Transplant
|
26
|
19
|
—
|
—
|
$39,228.96
|
$165,133.93
|
$78,028.78
|
2025-12-31
|
|
84
|
APR_DRG
|
Autologous Bone Marrow Transplant
|
8
|
8
|
—
|
—
|
$77,905.11
|
$80,242.26
|
$77,905.11
|
2025-12-31
|
|
278
|
MS_DRG
|
Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures …
|
26
|
19
|
—
|
—
|
$38,960.19
|
$164,002.52
|
$77,494.17
|
2025-12-31
|
|
J7330
|
HCPCS
|
Cultured Chondrocytes Implnt
|
5
|
4
|
—
|
—
|
$77,165.88
|
$77,165.88
|
$77,165.88
|
2025-12-31
|
|
461
|
MS_DRG
|
Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc
|
26
|
19
|
—
|
—
|
$38,657.80
|
$162,729.67
|
$76,892.73
|
2025-12-31
|
|
73
|
APR_DRG
|
Allogeneic Bone Marrow Transplant
|
8
|
8
|
—
|
—
|
$76,819.56
|
$79,124.15
|
$76,819.56
|
2025-12-31
|
|
834
|
MS_DRG
|
Acute Leukemia With Mcc
|
26
|
19
|
—
|
—
|
$38,426.13
|
$161,754.41
|
$76,431.89
|
2025-12-31
|
|
405
|
MS_DRG
|
Pancreas, Liver And Shunt Procedures With Mcc
|
26
|
19
|
—
|
—
|
$38,290.34
|
$161,182.81
|
$76,161.80
|
2025-12-31
|
|
234
|
MS_DRG
|
Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc
|
26
|
19
|
—
|
—
|
$38,235.75
|
$160,952.99
|
$76,053.21
|
2025-12-31
|
|
11
|
MS_DRG
|
Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc
|
26
|
19
|
—
|
—
|
$38,175.54
|
$160,699.60
|
$75,933.48
|
2025-12-31
|
|
17
|
MS_DRG
|
Autologous Bone Marrow Transplant Without Cc/mcc
|
26
|
19
|
—
|
—
|
$38,022.96
|
$160,057.29
|
$75,629.98
|
2025-12-31
|
|
220
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
26
|
19
|
—
|
—
|
$37,326.51
|
$157,125.62
|
$74,244.71
|
2025-12-31
|
|
450
|
MS_DRG
|
Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically …
|
26
|
19
|
—
|
—
|
$37,304.12
|
$157,031.33
|
$74,200.15
|
2025-12-31
|
|
21
|
MS_DRG
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc
|
26
|
19
|
—
|
—
|
$37,053.53
|
$155,976.52
|
$73,701.74
|
2025-12-31
|
|
4404
|
APR_DRG
|
Kidney Transplant
|
8
|
8
|
—
|
—
|
$73,636.81
|
$75,845.91
|
$73,636.81
|
2025-12-31
|
|
33249
|
CPT
|
Hc Insert Replc Perm Impl Defib W Transven Lead(s) Dual Chambr
|
74
|
30
|
$99,497.00
|
$54,723.35
45% off
|
$14,782.00
|
$87,557.36
|
$73,627.78
|
2025-12-31
|
|
270
|
MS_DRG
|
Other Major Cardiovascular Procedures With Mcc
|
26
|
19
|
—
|
—
|
$36,931.06
|
$155,460.90
|
$73,458.10
|
2025-12-31
|
|
8634
|
APR_DRG
|
Neonatal Aftercare
|
8
|
8
|
—
|
—
|
$72,776.75
|
$74,960.05
|
$72,776.75
|
2025-12-31
|
|
466
|
MS_DRG
|
Revision Of Hip Or Knee Replacement With Mcc
|
26
|
19
|
—
|
—
|
$36,434.79
|
$153,371.91
|
$72,471.01
|
2025-12-31
|
|
653
|
MS_DRG
|
Major Bladder Procedures With Mcc
|
26
|
19
|
—
|
—
|
$36,371.80
|
$153,106.73
|
$72,345.71
|
2025-12-31
|
|
63
|
APR_DRG
|
Pancreas Transplant
|
8
|
8
|
—
|
—
|
$71,436.76
|
$73,579.86
|
$71,436.76
|
2025-12-31
|
|
6134
|
APR_DRG
|
Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection
|
8
|
8
|
—
|
—
|
$71,154.90
|
$73,289.55
|
$71,154.90
|
2025-12-31
|
|
6114
|
APR_DRG
|
Neonate Birth Weight 1500-1999 Grams With Major Anomaly
|
8
|
8
|
—
|
—
|
$70,822.00
|
$72,946.66
|
$70,822.00
|
2025-12-31
|
|
221
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
26
|
19
|
—
|
—
|
$35,278.49
|
$148,504.45
|
$70,171.05
|
2025-12-31
|
|
326
|
MS_DRG
|
Stomach, Esophageal And Duodenal Procedures With Mcc
|
26
|
19
|
—
|
—
|
$34,908.92
|
$146,948.75
|
$69,435.96
|
2025-12-31
|
|
J9281
|
HCPCS
|
mitoMYcin 80 (2 X 40) Mg Recon Soln 1 Each Box
|
71
|
30
|
$100,383.00
|
$55,210.65
45% off
|
$318.53
|
$88,337.04
|
$69,264.27
|
2025-12-31
|
|
228
|
MS_DRG
|
Other Cardiothoracic Procedures With Mcc
|
26
|
19
|
—
|
—
|
$34,628.94
|
$145,770.19
|
$68,879.06
|
2025-12-31
|
|
853
|
MS_DRG
|
Infectious And Parasitic Diseases With O.r. Procedures With Mcc
|
26
|
19
|
—
|
—
|
$34,567.34
|
$145,510.91
|
$68,756.55
|
2025-12-31
|
|
239
|
MS_DRG
|
Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc
|
26
|
19
|
—
|
—
|
$34,449.06
|
$145,012.97
|
$68,521.26
|
2025-12-31
|
|
576
|
MS_DRG
|
Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc
|
26
|
19
|
—
|
—
|
$34,305.57
|
$144,408.96
|
$68,235.85
|
2025-12-31
|
|
93
|
APR_DRG
|
Extracorporeal Membrane Oxygenation (ecmo)
|
8
|
8
|
—
|
—
|
$67,400.04
|
$69,422.04
|
$67,400.04
|
2025-12-31
|
|
471
|
MS_DRG
|
Cervical Spinal Fusion With Mcc
|
26
|
19
|
—
|
—
|
$33,798.11
|
$142,272.82
|
$67,226.49
|
2025-12-31
|
|
837
|
MS_DRG
|
Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot…
|
26
|
19
|
—
|
—
|
$33,627.32
|
$141,553.90
|
$66,886.79
|
2025-12-31
|
|
267
|
MS_DRG
|
Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc
|
26
|
19
|
—
|
—
|
$33,322.85
|
$140,272.21
|
$66,281.17
|
2025-12-31
|
|
1674
|
APR_DRG
|
Other Cardiothoracic And Thoracic Vascular Procedures
|
8
|
8
|
—
|
—
|
$66,082.91
|
$68,065.40
|
$66,082.91
|
2025-12-31
|
|
1634
|
APR_DRG
|
Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis
|
8
|
8
|
—
|
—
|
$65,636.50
|
$67,605.60
|
$65,636.50
|
2025-12-31
|
|
650
|
MS_DRG
|
Kidney Transplant With Hemodialysis With Mcc
|
26
|
19
|
—
|
—
|
$32,907.07
|
$138,522.05
|
$65,454.18
|
2025-12-31
|
|
13
|
APR_DRG
|
Liver Transplant And/or Intestinal Transplant
|
8
|
8
|
—
|
—
|
$65,391.21
|
$67,352.95
|
$65,391.21
|
2025-12-31
|
|
981
|
MS_DRG
|
Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc
|
26
|
19
|
—
|
—
|
$32,839.90
|
$138,239.20
|
$65,320.53
|
2025-12-31
|
|
826
|
MS_DRG
|
Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. …
|
26
|
19
|
—
|
—
|
$32,741.90
|
$137,826.70
|
$65,125.61
|
2025-12-31
|
|
6022
|
APR_DRG
|
Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…
|
8
|
8
|
—
|
—
|
$64,678.93
|
$66,619.30
|
$64,678.93
|
2025-12-31
|
|
6
|
MS_DRG
|
Liver Transplant Without Mcc
|
26
|
19
|
—
|
—
|
$32,456.32
|
$136,624.57
|
$64,557.59
|
2025-12-31
|
|
277
|
MS_DRG
|
Cardiac Defibrillator Implant Without Mcc
|
26
|
19
|
—
|
—
|
$32,326.83
|
$136,079.48
|
$64,300.03
|
2025-12-31
|
|
329
|
MS_DRG
|
Major Small And Large Bowel Procedures With Mcc
|
26
|
19
|
—
|
—
|
$32,172.84
|
$135,431.28
|
$63,993.74
|
2025-12-31
|
|
6093
|
APR_DRG
|
Neonate Birth Weight 1500-2499 Grams With Major Procedure
|
8
|
8
|
—
|
—
|
$63,993.32
|
$65,913.12
|
$63,993.32
|
2025-12-31
|
|
J9029
|
HCPCS
|
Instill Adstiladrin, Tx Dose
|
18
|
14
|
—
|
—
|
$63,342.28
|
$85,631.92
|
$63,975.71
|
2025-12-31
|
|
823
|
MS_DRG
|
Lymphoma And Non-acute Leukemia With Other Procedures With Mcc
|
26
|
19
|
—
|
—
|
$32,090.95
|
$135,086.55
|
$63,830.85
|
2025-12-31
|
|
245
|
MS_DRG
|
Aicd Generator Procedures
|
26
|
19
|
—
|
—
|
$31,934.16
|
$134,426.55
|
$63,518.99
|
2025-12-31
|
|
856
|
MS_DRG
|
Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc
|
26
|
19
|
—
|
—
|
$31,838.27
|
$134,022.90
|
$63,328.25
|
2025-12-31
|
|
25
|
MS_DRG
|
Craniotomy And Endovascular Intracranial Procedures With Mcc
|
26
|
19
|
—
|
—
|
$31,824.27
|
$133,963.97
|
$63,300.41
|
2025-12-31
|
|
799
|
MS_DRG
|
Splenic Procedures With Mcc
|
26
|
19
|
—
|
—
|
$31,699.68
|
$133,439.51
|
$63,052.59
|
2025-12-31
|
|
1784
|
APR_DRG
|
External Heart Assist Systems
|
8
|
8
|
—
|
—
|
$62,900.16
|
$64,787.16
|
$62,900.16
|
2025-12-31
|
|
6033
|
APR_DRG
|
Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition
|
8
|
8
|
—
|
—
|
$62,734.09
|
$64,616.11
|
$62,734.09
|
2025-12-31
|
|
53
|
APR_DRG
|
Tracheostomy With Mv >96 Hours Without Extensive Procedure
|
8
|
8
|
—
|
—
|
$62,550.49
|
$64,427.00
|
$62,550.49
|
2025-12-31
|
|
6124
|
APR_DRG
|
Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other…
|
8
|
8
|
—
|
—
|
$62,417.18
|
$64,289.70
|
$62,417.18
|
2025-12-31
|
|
163
|
MS_DRG
|
Major Chest Procedures With Mcc
|
26
|
19
|
—
|
—
|
$31,370.01
|
$132,051.76
|
$62,396.85
|
2025-12-31
|
|
31
|
MS_DRG
|
Ventricular Shunt Procedures With Mcc
|
26
|
19
|
—
|
—
|
$31,360.92
|
$132,013.45
|
$62,378.76
|
2025-12-31
|
|
A9606
|
HCPCS
|
Radium Ra 223 Dichloride 30 Mcci/ml Solution 1 Each Vial
|
70
|
30
|
$90,266.68
|
$49,646.68
45% off
|
$172.22
|
$79,434.68
|
$62,284.01
|
2025-12-31
|
|
319
|
MS_DRG
|
Other Endovascular Cardiac Valve Procedures With Mcc
|
26
|
19
|
—
|
—
|
$31,237.72
|
$131,494.89
|
$62,133.72
|
2025-12-31
|
|
8504
|
APR_DRG
|
Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal…
|
8
|
8
|
—
|
—
|
$61,846.60
|
$63,702.00
|
$61,846.60
|
2025-12-31
|
|
72
|
APR_DRG
|
Allogeneic Bone Marrow Transplant
|
8
|
8
|
—
|
—
|
$61,600.54
|
$63,448.56
|
$61,600.54
|
2025-12-31
|
|
1654
|
APR_DRG
|
Coronary Bypass With Ami Or Complex Principal Diagnosis
|
8
|
8
|
—
|
—
|
$61,298.11
|
$63,137.05
|
$61,298.11
|
2025-12-31
|
|
356
|
MS_DRG
|
Other Digestive System O.r. Procedures With Mcc
|
26
|
19
|
—
|
—
|
$30,747.05
|
$129,429.46
|
$61,157.77
|
2025-12-31
|
|
J2350
|
HCPCS
|
Ocrelizumab 300 Mg/10ml Solution 10 Ml Vial
|
71
|
30
|
$87,734.08
|
$48,253.75
45% off
|
$59.41
|
$77,205.99
|
$60,536.51
|
2025-12-31
|
|
6073
|
APR_DRG
|
Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…
|
8
|
8
|
—
|
—
|
$60,489.86
|
$62,304.56
|
$60,489.86
|
2025-12-31
|
|
323
|
MS_DRG
|
Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc
|
26
|
19
|
—
|
—
|
$30,289.30
|
$127,502.51
|
$60,247.25
|
2025-12-31
|
|
8413
|
APR_DRG
|
Extensive Third Degree Burns With Skin Graft
|
8
|
8
|
—
|
—
|
$60,017.55
|
$61,818.08
|
$60,017.55
|
2025-12-31
|
|
6214
|
APR_DRG
|
Neonate Birth Weight 2000-2499 Grams With Major Anomaly
|
8
|
8
|
—
|
—
|
$59,952.79
|
$61,751.37
|
$59,952.79
|
2025-12-31
|
|
6804
|
APR_DRG
|
Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms
|
8
|
8
|
—
|
—
|
$59,901.75
|
$61,698.80
|
$59,901.75
|
2025-12-31
|
|
474
|
MS_DRG
|
Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc
|
26
|
19
|
—
|
—
|
$30,047.82
|
$126,486.01
|
$59,766.93
|
2025-12-31
|
|
140
|
MS_DRG
|
Major Head And Neck Procedures With Mcc
|
26
|
19
|
—
|
—
|
$29,854.64
|
$125,672.80
|
$59,382.68
|
2025-12-31
|
|
6334
|
APR_DRG
|
Neonate Birth Weight > 2499 Grams With Major Anomaly
|
8
|
8
|
—
|
—
|
$59,348.70
|
$61,129.16
|
$59,348.70
|
2025-12-31
|
|
448
|
MS_DRG
|
Multiple Level Spinal Fusion Except Cervical Without Mcc
|
26
|
19
|
—
|
—
|
$29,683.16
|
$124,950.93
|
$59,041.58
|
2025-12-31
|
|
269
|
MS_DRG
|
Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc
|
26
|
19
|
—
|
—
|
$29,559.96
|
$124,432.36
|
$58,796.55
|
2025-12-31
|
|
12
|
MS_DRG
|
Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc
|
26
|
19
|
—
|
—
|
$29,509.57
|
$124,220.22
|
$58,696.31
|
2025-12-31
|
|
958
|
MS_DRG
|
Other O.r. Procedures For Multiple Significant Trauma With Cc
|
26
|
19
|
—
|
—
|
$29,494.86
|
$124,158.35
|
$58,667.07
|
2025-12-31
|
|
71
|
APR_DRG
|
Allogeneic Bone Marrow Transplant
|
8
|
8
|
—
|
—
|
$58,520.63
|
$60,276.25
|
$58,520.63
|
2025-12-31
|
|
673
|
MS_DRG
|
Other Kidney And Urinary Tract Procedures With Mcc
|
26
|
19
|
—
|
—
|
$29,408.77
|
$123,795.94
|
$58,495.83
|
2025-12-31
|
|
901
|
MS_DRG
|
Wound Debridements For Injuries With Mcc
|
26
|
19
|
—
|
—
|
$29,373.78
|
$123,648.62
|
$58,426.22
|
2025-12-31
|
|
236
|
MS_DRG
|
Coronary Bypass Without Cardiac Catheterization Without Mcc
|
26
|
19
|
—
|
—
|
$29,319.17
|
$123,418.80
|
$58,317.62
|
2025-12-31
|
|
3044
|
APR_DRG
|
Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back
|
8
|
8
|
—
|
—
|
$58,122.98
|
$59,866.67
|
$58,122.98
|
2025-12-31
|
|
458
|
MS_DRG
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
26
|
19
|
—
|
—
|
$29,205.79
|
$122,941.49
|
$58,092.08
|
2025-12-31
|
|
423
|
MS_DRG
|
Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc
|
26
|
19
|
—
|
—
|
$29,068.60
|
$122,363.99
|
$57,819.21
|
2025-12-31
|
|
L7181
|
HCPCS
|
Electronic Elbo Simultaneous
|
11
|
10
|
—
|
—
|
$57,614.51
|
$62,223.67
|
$57,614.51
|
2025-12-31
|
|
273
|
MS_DRG
|
Percutaneous And Other Intracardiac Procedures With Mcc
|
26
|
19
|
—
|
—
|
$28,876.11
|
$121,553.73
|
$57,436.35
|
2025-12-31
|
|
62
|
APR_DRG
|
Pancreas Transplant
|
8
|
8
|
—
|
—
|
$57,198.93
|
$58,914.90
|
$57,198.93
|
2025-12-31
|
|
A9543
|
HCPCS
|
Y90 Ibritumomab, Rx
|
11
|
10
|
—
|
—
|
$56,824.55
|
$61,370.51
|
$56,824.55
|
2025-12-31
|
|
3033
|
APR_DRG
|
Dorsal And Lumbar Fusion Procedure For Curvature Of Back
|
8
|
8
|
—
|
—
|
$56,492.75
|
$58,187.53
|
$56,492.75
|
2025-12-31
|
|
38240
|
CPT
|
Transplt Allo Hct/donor
|
18
|
13
|
—
|
—
|
$8,391.64
|
$60,750.29
|
$56,250.27
|
2025-12-31
|
|
5911
|
APR_DRG
|
Neonate Birth Weight 500-749 Grams Without Major Procedure
|
8
|
8
|
—
|
—
|
$56,027.30
|
$57,708.12
|
$56,027.30
|
2025-12-31
|
|
402
|
MS_DRG
|
Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical
|
26
|
19
|
—
|
—
|
$28,141.18
|
$118,460.01
|
$55,974.51
|
2025-12-31
|
|
Q2043
|
HCPCS
|
Sipuleucel-t Auto Cd54+
|
18
|
14
|
—
|
—
|
$55,272.32
|
$75,527.06
|
$55,825.04
|
2025-12-31
|
|
9104
|
APR_DRG
|
Craniotomy For Multiple Significant Trauma
|
8
|
8
|
—
|
—
|
$55,487.95
|
$57,152.59
|
$55,487.95
|
2025-12-31
|
|
802
|
MS_DRG
|
Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc
|
26
|
19
|
—
|
—
|
$27,886.40
|
$117,387.52
|
$55,467.74
|
2025-12-31
|
|
6084
|
APR_DRG
|
Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition
|
8
|
8
|
—
|
—
|
$55,209.13
|
$56,865.40
|
$55,209.13
|
2025-12-31
|
|
1834
|
APR_DRG
|
Percutaneous Structural Cardiac Procedures
|
8
|
8
|
—
|
—
|
$54,816.05
|
$56,460.53
|
$54,816.05
|
2025-12-31
|
|
6814
|
APR_DRG
|
Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms
|
8
|
8
|
—
|
—
|
$54,582.18
|
$56,219.65
|
$54,582.18
|
2025-12-31
|
|
24
|
MS_DRG
|
Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…
|
26
|
19
|
—
|
—
|
$27,381.04
|
$115,260.22
|
$54,462.54
|
2025-12-31
|
|
876
|
MS_DRG
|
O.r. Procedures With Principal Diagnosis Of Mental Illness
|
25
|
18
|
—
|
—
|
$27,052.07
|
$113,875.41
|
$54,462.43
|
2025-12-31
|
|
3124
|
APR_DRG
|
Skin Graft, Except Hand, For Musculoskeletal And Connective Tissue Diagnoses
|
8
|
8
|
—
|
—
|
$54,431.35
|
$56,064.29
|
$54,431.35
|
2025-12-31
|
|
7404
|
APR_DRG
|
Mental Illness Diagnosis With O.r. Procedure
|
8
|
8
|
—
|
—
|
$54,358.98
|
$55,989.75
|
$54,358.98
|
2025-12-31
|
|
933
|
MS_DRG
|
Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft
|
26
|
19
|
—
|
—
|
$27,257.14
|
$114,738.71
|
$54,216.12
|
2025-12-31
|
|
6904
|
APR_DRG
|
Acute Leukemia
|
8
|
8
|
—
|
—
|
$54,069.50
|
$55,691.59
|
$54,069.50
|
2025-12-31
|
|
34
|
MS_DRG
|
Carotid Artery Stent Procedures With Mcc
|
26
|
19
|
—
|
—
|
$27,092.66
|
$114,046.30
|
$53,888.95
|
2025-12-31
|
|
40
|
MS_DRG
|
Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc
|
26
|
19
|
—
|
—
|
$27,026.16
|
$113,766.40
|
$53,756.68
|
2025-12-31
|
|
42
|
APR_DRG
|
Tracheostomy With Mv >96 Hours With Extensive Procedure
|
8
|
8
|
—
|
—
|
$53,717.55
|
$55,329.08
|
$53,717.55
|
2025-12-31
|
|
1664
|
APR_DRG
|
Coronary Bypass Without Ami Or Complex Principal Diagnosis
|
8
|
8
|
—
|
—
|
$53,679.46
|
$55,289.84
|
$53,679.46
|
2025-12-31
|
|
907
|
MS_DRG
|
Other O.r. Procedures For Injuries With Mcc
|
26
|
19
|
—
|
—
|
$26,872.89
|
$113,121.14
|
$53,451.79
|
2025-12-31
|
|
3614
|
APR_DRG
|
Skin Graft For Skin And Subcutaneous Tissue Diagnoses
|
8
|
8
|
—
|
—
|
$52,737.89
|
$54,320.03
|
$52,737.89
|
2025-12-31
|
|
914
|
APR_DRG
|
Other Major Head And Neck Procedures
|
8
|
8
|
—
|
—
|
$52,580.20
|
$54,157.61
|
$52,580.20
|
2025-12-31
|
|
12
|
APR_DRG
|
Liver Transplant And/or Intestinal Transplant
|
8
|
8
|
—
|
—
|
$52,530.68
|
$54,106.60
|
$52,530.68
|
2025-12-31
|
|
956
|
MS_DRG
|
Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma
|
26
|
19
|
—
|
—
|
$26,338.83
|
$110,873.03
|
$52,389.52
|
2025-12-31
|
|
L7180
|
HCPCS
|
Electronic Elbow Sequential
|
11
|
10
|
—
|
—
|
$52,277.90
|
$56,460.13
|
$52,277.90
|
2025-12-31
|
|
143
|
MS_DRG
|
Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc
|
26
|
19
|
—
|
—
|
$26,224.04
|
$110,389.82
|
$52,161.19
|
2025-12-31
|
|
9114
|
APR_DRG
|
Extensive Abdominal Or Thoracic Procedures For Multiple Significant Trauma
|
8
|
8
|
—
|
—
|
$52,038.57
|
$53,599.73
|
$52,038.57
|
2025-12-31
|
|
166
|
MS_DRG
|
Other Respiratory System O.r. Procedures With Mcc
|
26
|
19
|
—
|
—
|
$26,161.74
|
$110,127.59
|
$52,037.29
|
2025-12-31
|
|
518
|
MS_DRG
|
Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost…
|
26
|
19
|
—
|
—
|
$26,158.93
|
$110,115.81
|
$52,031.72
|
2025-12-31
|
|
6302
|
APR_DRG
|
Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure
|
8
|
8
|
—
|
—
|
$51,957.82
|
$53,516.55
|
$51,957.82
|
2025-12-31
|
|
628
|
MS_DRG
|
Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc
|
26
|
19
|
—
|
—
|
$26,085.44
|
$109,806.44
|
$51,885.54
|
2025-12-31
|
|
214
|
APR_DRG
|
Open Craniotomy Except Trauma
|
8
|
8
|
—
|
—
|
$51,721.66
|
$53,273.31
|
$51,721.66
|
2025-12-31
|
|
651
|
MS_DRG
|
Kidney Transplant With Hemodialysis Without Mcc
|
26
|
19
|
—
|
—
|
$25,938.45
|
$109,187.69
|
$51,593.17
|
2025-12-31
|
|
J3241
|
HCPCS
|
Teprotumumab-trbw 500 Mg Recon Soln 1 Each Vial
|
71
|
30
|
$74,432.30
|
$40,937.77
45% off
|
$359.19
|
$65,500.42
|
$51,358.29
|
2025-12-31
|
|
904
|
MS_DRG
|
Skin Grafts For Injuries With Cc/mcc
|
26
|
19
|
—
|
—
|
$25,709.58
|
$108,224.22
|
$51,137.90
|
2025-12-31
|
|
492
|
MS_DRG
|
Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc
|
26
|
19
|
—
|
—
|
$25,699.07
|
$108,180.02
|
$51,117.02
|
2025-12-31
|
|
7594
|
APR_DRG
|
Eating Disorders
|
8
|
8
|
—
|
—
|
$51,044.43
|
$52,575.76
|
$51,044.43
|
2025-12-31
|
|
1794
|
APR_DRG
|
Defibrillator Implants
|
8
|
8
|
—
|
—
|
$50,975.87
|
$52,505.15
|
$50,975.87
|
2025-12-31
|
|
6144
|
APR_DRG
|
Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition
|
8
|
8
|
—
|
—
|
$50,959.11
|
$52,487.88
|
$50,959.11
|
2025-12-31
|
|
6313
|
APR_DRG
|
Neonate Birth Weight > 2499 Grams With Other Major Procedure
|
8
|
8
|
—
|
—
|
$50,524.89
|
$52,040.64
|
$50,524.89
|
2025-12-31
|
|
939
|
MS_DRG
|
O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc
|
26
|
19
|
—
|
—
|
$25,397.41
|
$106,910.12
|
$50,516.98
|
2025-12-31
|
|
495
|
MS_DRG
|
Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit…
|
26
|
19
|
—
|
—
|
$25,377.80
|
$106,827.62
|
$50,477.99
|
2025-12-31
|
|
332
|
MS_DRG
|
Rectal Resection With Mcc
|
26
|
19
|
—
|
—
|
$25,342.82
|
$106,680.30
|
$50,408.38
|
2025-12-31
|
|
265
|
MS_DRG
|
Aicd Lead Procedures
|
26
|
19
|
—
|
—
|
$25,325.31
|
$106,606.64
|
$50,373.57
|
2025-12-31
|
|
1623
|
APR_DRG
|
Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis
|
8
|
8
|
—
|
—
|
$50,338.26
|
$51,848.41
|
$50,338.26
|
2025-12-31
|
|
97
|
MS_DRG
|
Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc
|
26
|
19
|
—
|
—
|
$25,280.51
|
$106,418.08
|
$50,284.47
|
2025-12-31
|
|
279
|
MS_DRG
|
Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures …
|
26
|
19
|
—
|
—
|
$25,242.72
|
$106,258.97
|
$50,209.29
|
2025-12-31
|
|
739
|
MS_DRG
|
Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc…
|
26
|
19
|
—
|
—
|
$25,077.53
|
$105,563.62
|
$49,880.73
|
2025-12-31
|
|
6254
|
APR_DRG
|
Neonate Birth Weight 2000-2499 Grams With Other Significant Condition
|
8
|
8
|
—
|
—
|
$49,854.52
|
$51,350.16
|
$49,854.52
|
2025-12-31
|
|
736
|
MS_DRG
|
Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc
|
26
|
19
|
—
|
—
|
$25,019.43
|
$105,319.07
|
$49,765.18
|
2025-12-31
|
|
335
|
MS_DRG
|
Peritoneal Adhesiolysis With Mcc
|
26
|
19
|
—
|
—
|
$24,994.24
|
$105,213.00
|
$49,715.05
|
2025-12-31
|
|
408
|
MS_DRG
|
Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With…
|
26
|
19
|
—
|
—
|
$24,957.14
|
$105,056.84
|
$49,641.26
|
2025-12-31
|
|
1204
|
APR_DRG
|
Major Respiratory And Chest Procedures
|
8
|
8
|
—
|
—
|
$49,617.60
|
$51,106.13
|
$49,617.60
|
2025-12-31
|
|
414
|
MS_DRG
|
Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc
|
26
|
19
|
—
|
—
|
$24,936.15
|
$104,968.45
|
$49,599.50
|
2025-12-31
|
|
622
|
MS_DRG
|
Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor…
|
26
|
19
|
—
|
—
|
$24,912.34
|
$104,868.27
|
$49,552.16
|
2025-12-31
|
|
271
|
MS_DRG
|
Other Major Cardiovascular Procedures With Cc
|
26
|
19
|
—
|
—
|
$24,892.05
|
$104,782.82
|
$49,511.79
|
2025-12-31
|
|
2604
|
APR_DRG
|
Major Pancreas, Liver And Shunt Procedures
|
8
|
8
|
—
|
—
|
$49,219.19
|
$50,695.77
|
$49,219.19
|
2025-12-31
|
|
467
|
MS_DRG
|
Revision Of Hip Or Knee Replacement With Cc
|
26
|
19
|
—
|
—
|
$24,684.16
|
$103,907.74
|
$49,098.29
|
2025-12-31
|
|
94
|
MS_DRG
|
Bacterial And Tuberculous Infections Of Nervous System With Mcc
|
26
|
19
|
—
|
—
|
$24,633.76
|
$103,695.60
|
$48,998.06
|
2025-12-31
|
|
9124
|
APR_DRG
|
Musculoskeletal And Other Procedures For Multiple Significant Trauma
|
8
|
8
|
—
|
—
|
$48,664.60
|
$50,124.54
|
$48,664.60
|
2025-12-31
|
|
252
|
MS_DRG
|
Other Vascular Procedures With Mcc
|
26
|
19
|
—
|
—
|
$24,416.09
|
$102,779.27
|
$48,565.07
|
2025-12-31
|
|
616
|
MS_DRG
|
Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With…
|
26
|
19
|
—
|
—
|
$24,409.78
|
$102,752.75
|
$48,552.54
|
2025-12-31
|
|
274
|
APR_DRG
|
Other Open Craniotomy
|
8
|
8
|
—
|
—
|
$48,481.78
|
$49,936.23
|
$48,481.78
|
2025-12-31
|
|
574
|
MS_DRG
|
Skin Graft For Skin Ulcer Or Cellulitis With Cc
|
26
|
19
|
—
|
—
|
$24,297.80
|
$102,281.33
|
$48,329.79
|
2025-12-31
|
|
2324
|
APR_DRG
|
Gastric Fundoplication
|
8
|
8
|
—
|
—
|
$48,152.68
|
$49,597.26
|
$48,152.68
|
2025-12-31
|
|
477
|
MS_DRG
|
Biopsies Of Musculoskeletal System And Connective Tissue With Mcc
|
26
|
19
|
—
|
—
|
$24,180.20
|
$101,786.33
|
$48,095.89
|
2025-12-31
|
|
6954
|
APR_DRG
|
Chemotherapy For Acute Leukemia
|
8
|
8
|
—
|
—
|
$47,915.77
|
$49,353.24
|
$47,915.77
|
2025-12-31
|
|
359
|
MS_DRG
|
Percutaneous Coronary Atherectomy With Intraluminal Device With Mcc
|
26
|
19
|
—
|
—
|
$24,068.21
|
$101,314.91
|
$47,873.13
|
2025-12-31
|
|
987
|
MS_DRG
|
Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc
|
26
|
19
|
—
|
—
|
$23,996.81
|
$101,014.38
|
$47,731.13
|
2025-12-31
|
|
41
|
APR_DRG
|
Tracheostomy With Mv >96 Hours With Extensive Procedure
|
8
|
8
|
—
|
—
|
$47,669.71
|
$49,099.80
|
$47,669.71
|
2025-12-31
|
|
37227
|
CPT
|
Hc Revasc, Endvasc, Fem, Poplit Art, W Stent & Athrect
|
74
|
30
|
$64,414.00
|
$35,427.70
45% off
|
$14,782.00
|
$56,684.32
|
$47,666.36
|
2025-12-31
|
|
2204
|
APR_DRG
|
Major Stomach, Esophageal And Duodenal Procedures
|
8
|
8
|
—
|
—
|
$47,617.15
|
$49,045.66
|
$47,617.15
|
2025-12-31
|
|
29
|
MS_DRG
|
Spinal Procedures With Cc Or Spinal Neurostimulators
|
26
|
19
|
—
|
—
|
$23,879.24
|
$100,519.38
|
$47,497.23
|
2025-12-31
|
|
234
|
APR_DRG
|
Spinal Procedures
|
8
|
8
|
—
|
—
|
$47,486.12
|
$48,910.70
|
$47,486.12
|
2025-12-31
|
|
420
|
MS_DRG
|
Hepatobiliary Diagnostic Procedures With Mcc
|
26
|
19
|
—
|
—
|
$23,847.73
|
$100,386.79
|
$47,434.58
|
2025-12-31
|
|
1694
|
APR_DRG
|
Major Abdominal Vascular Procedures
|
8
|
8
|
—
|
—
|
$47,306.34
|
$48,725.53
|
$47,306.34
|
2025-12-31
|
|
J9334
|
HCPCS
|
Efgartigimod Alfa-hyaluronidase-qvfc 1008-11200 Mg-ut/5.6 Ml Solution 5.6 Ml Via…
|
71
|
30
|
$68,385.95
|
$37,612.28
45% off
|
$33.89
|
$60,179.64
|
$47,186.31
|
2025-12-31
|
|
1603
|
APR_DRG
|
Major Cardiothoracic Repair Of Heart Anomaly
|
8
|
8
|
—
|
—
|
$46,747.18
|
$48,149.60
|
$46,747.18
|
2025-12-31
|
|
264
|
MS_DRG
|
Other Circulatory System O.r. Procedures
|
26
|
19
|
—
|
—
|
$23,382.26
|
$98,427.44
|
$46,508.75
|
2025-12-31
|
|
111
|
APR_DRG
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
8
|
8
|
—
|
—
|
$46,349.53
|
$47,740.02
|
$46,349.53
|
2025-12-31
|
|
204
|
APR_DRG
|
Open Craniotomy For Trauma
|
8
|
8
|
—
|
—
|
$46,338.10
|
$47,728.24
|
$46,338.10
|
2025-12-31
|
|
1783
|
APR_DRG
|
External Heart Assist Systems
|
8
|
8
|
—
|
—
|
$46,332.01
|
$47,721.97
|
$46,332.01
|
2025-12-31
|
|
411
|
MS_DRG
|
Cholecystectomy With C.d.e. With Mcc
|
26
|
19
|
—
|
—
|
$23,121.19
|
$97,328.43
|
$45,989.45
|
2025-12-31
|
|
37
|
MS_DRG
|
Extracranial Procedures With Mcc
|
26
|
19
|
—
|
—
|
$23,042.80
|
$96,998.43
|
$45,833.52
|
2025-12-31
|
|
274
|
MS_DRG
|
Percutaneous And Other Intracardiac Procedures Without Mcc
|
26
|
19
|
—
|
—
|
$23,040.00
|
$96,986.65
|
$45,827.96
|
2025-12-31
|
|
9504
|
APR_DRG
|
Extensive O.r. Procedure Unrelated To Principal Diagnosis
|
8
|
8
|
—
|
—
|
$45,737.05
|
$47,109.16
|
$45,737.05
|
2025-12-31
|
|
11
|
APR_DRG
|
Liver Transplant And/or Intestinal Transplant
|
8
|
8
|
—
|
—
|
$45,674.58
|
$47,044.82
|
$45,674.58
|
2025-12-31
|