|
J3391
|
HCPCS
|
Inj, Atidarsagene Autotemcel
|
15
|
15
|
—
|
—
|
$4,505,000.00
|
$4,640,150.00
|
$4,505,000.00
|
2025-12-31
|
|
J1414
|
HCPCS
|
Inj, Beqvez, Per Tx Dose
|
6
|
4
|
—
|
—
|
$3,185,406.00
|
$3,932,600.00
|
$3,932,600.00
|
2025-12-31
|
|
J1411
|
HCPCS
|
Inj, Hemgenix, Per Tx Dose
|
21
|
17
|
—
|
—
|
$3,185,406.00
|
$3,932,600.00
|
$3,685,266.67
|
2025-12-31
|
|
J1413
|
HCPCS
|
Inj Delandistrogene Mox Rokl
|
21
|
17
|
—
|
—
|
$2,852,081.60
|
$3,521,088.40
|
$3,316,462.59
|
2025-12-31
|
|
J3394
|
HCPCS
|
Inj, Lovotibeglogene Autotem
|
21
|
17
|
—
|
—
|
$2,741,509.80
|
$3,384,580.00
|
$3,248,445.72
|
2025-12-31
|
|
J3393
|
HCPCS
|
Inj, Betibeglogene Autotemce
|
21
|
17
|
—
|
—
|
$2,548,324.80
|
$3,146,080.00
|
$2,945,740.00
|
2025-12-31
|
|
J3399
|
HCPCS
|
Inj Onase Abepar-xioi Treat
|
15
|
15
|
—
|
—
|
$2,455,110.61
|
$2,528,763.92
|
$2,455,110.61
|
2025-12-31
|
|
J3392
|
HCPCS
|
Inj, Exagamglogene Autotem
|
21
|
17
|
—
|
—
|
$2,002,255.20
|
$2,471,920.00
|
$2,332,000.00
|
2025-12-31
|
|
Q2042
|
HCPCS
|
Tisagenlecleucel-t Suspension 1 Each Flex Cont
|
85
|
34
|
$2,719,137.50
|
$1,495,525.63
45% off
|
$485,644.63
|
$3,903,690.92
|
$1,797,349.89
|
2025-12-31
|
|
Q2056
|
HCPCS
|
Ciltacabtagene Autoleucel 100000000 Cells Suspension 1 Each Bag
|
85
|
34
|
$2,394,750.00
|
$1,317,112.50
45% off
|
$473,361.93
|
$3,735,307.10
|
$1,582,929.75
|
2025-12-31
|
|
Q2041
|
HCPCS
|
Axicabtagene Ciloleucel Suspension 1 Each Package
|
85
|
34
|
$2,310,000.00
|
$1,270,500.00
45% off
|
$420,299.42
|
$3,598,266.24
|
$1,526,910.00
|
2025-12-31
|
|
Q2055
|
HCPCS
|
Idecabtagene Vicleucel 460000000 Cells Suspension 1 Each Bag
|
85
|
34
|
$2,286,275.00
|
$1,257,451.25
45% off
|
$453,609.05
|
$3,653,508.04
|
$1,511,227.77
|
2025-12-31
|
|
Q2054
|
HCPCS
|
Lisocabtagene Maraleucel Cd8 Suspension 1 Each Vial
|
85
|
34
|
$2,236,135.00
|
$1,229,874.25
45% off
|
$443,454.86
|
$3,656,040.71
|
$1,478,085.24
|
2025-12-31
|
|
Q2053
|
HCPCS
|
Brexucabtagene Autoleucel 200000000 Cells Suspension 1 Each Flex Cont
|
85
|
34
|
$2,120,000.00
|
$1,166,000.00
45% off
|
$419,041.03
|
$3,305,610.00
|
$1,401,320.00
|
2025-12-31
|
|
18
|
MS_DRG
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
31
|
24
|
—
|
—
|
$394,460.02
|
$1,606,616.07
|
$846,512.43
|
2025-12-31
|
|
Q2057
|
HCPCS
|
Afamitresgene Autoleucel
|
16
|
16
|
—
|
—
|
$770,620.00
|
$3,853,100.00
|
$770,620.00
|
2025-12-31
|
|
1
|
MS_DRG
|
Heart Transplant Or Implant Of Heart Assist System With Mcc
|
31
|
24
|
—
|
—
|
$256,726.92
|
$1,042,629.20
|
$549,352.51
|
2025-12-31
|
|
5834
|
APR_DRG
|
Neonate With Ecmo
|
14
|
14
|
—
|
—
|
$450,460.34
|
$472,983.36
|
$450,460.34
|
2025-12-31
|
|
927
|
MS_DRG
|
Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft
|
31
|
24
|
—
|
—
|
$196,092.69
|
$794,345.35
|
$418,533.85
|
2025-12-31
|
|
3
|
MS_DRG
|
Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mo…
|
31
|
24
|
—
|
—
|
$194,954.24
|
$789,683.57
|
$416,077.60
|
2025-12-31
|
|
J2326
|
HCPCS
|
Nusinersen 12 Mg/5ml Solution 5 Ml Vial
|
87
|
34
|
$599,840.74
|
$329,912.41
45% off
|
$1,280.25
|
$518,862.24
|
$391,995.92
|
2025-12-31
|
|
J0225
|
HCPCS
|
Vutrisiran 25 Mg/0.5ml Solution Prefilled Syringe 0.5 Ml Syringe
|
87
|
34
|
$486,685.00
|
$267,676.75
45% off
|
$4,222.39
|
$420,982.53
|
$318,048.65
|
2025-12-31
|
|
5884
|
APR_DRG
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
14
|
14
|
—
|
—
|
$293,873.93
|
$308,567.63
|
$293,873.93
|
2025-12-31
|
|
5833
|
APR_DRG
|
Neonate With Ecmo
|
14
|
14
|
—
|
—
|
$291,822.17
|
$306,413.28
|
$291,822.17
|
2025-12-31
|
|
Q2058
|
HCPCS
|
Obecbtge Autol Up To 400 Mil
|
15
|
15
|
—
|
—
|
$278,250.00
|
$286,597.50
|
$278,250.00
|
2025-12-31
|
|
4
|
MS_DRG
|
Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And …
|
31
|
24
|
—
|
—
|
$127,956.21
|
$515,341.34
|
$271,528.99
|
2025-12-31
|
|
24
|
APR_DRG
|
Heart And/or Lung Transplant
|
14
|
14
|
—
|
—
|
$260,252.21
|
$273,264.82
|
$260,252.21
|
2025-12-31
|
|
J3403
|
HCPCS
|
Revakinagene, Per Implant
|
15
|
15
|
—
|
—
|
$257,500.00
|
$265,225.00
|
$257,500.00
|
2025-12-31
|
|
7
|
MS_DRG
|
Lung Transplant
|
31
|
24
|
—
|
—
|
$119,767.95
|
$481,812.19
|
$253,862.77
|
2025-12-31
|
|
14
|
MS_DRG
|
Allogeneic Bone Marrow Transplant
|
31
|
24
|
—
|
—
|
$111,297.11
|
$447,125.97
|
$235,586.89
|
2025-12-31
|
|
114
|
APR_DRG
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
14
|
14
|
—
|
—
|
$228,840.29
|
$240,282.30
|
$228,840.29
|
2025-12-31
|
|
5832
|
APR_DRG
|
Neonate With Ecmo
|
14
|
14
|
—
|
—
|
$224,066.02
|
$235,269.32
|
$224,066.02
|
2025-12-31
|
|
1614
|
APR_DRG
|
Implantable Heart Assist Systems
|
14
|
14
|
—
|
—
|
$223,034.56
|
$234,186.29
|
$223,034.56
|
2025-12-31
|
|
2
|
MS_DRG
|
Heart Transplant Or Implant Of Heart Assist System Without Mcc
|
31
|
24
|
—
|
—
|
$105,063.23
|
$421,599.62
|
$222,137.28
|
2025-12-31
|
|
209
|
MS_DRG
|
Complex Aortic Arch Procedures
|
31
|
24
|
—
|
—
|
$104,945.11
|
$421,115.95
|
$221,882.44
|
2025-12-31
|
|
426
|
MS_DRG
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
31
|
24
|
—
|
—
|
$102,241.14
|
$410,043.75
|
$216,048.58
|
2025-12-31
|
|
6304
|
APR_DRG
|
Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure
|
14
|
14
|
—
|
—
|
$214,370.62
|
$225,089.15
|
$214,370.62
|
2025-12-31
|
|
212
|
MS_DRG
|
Concomitant Aortic And Mitral Valve Procedures
|
31
|
24
|
—
|
—
|
$100,904.58
|
$404,570.89
|
$213,164.98
|
2025-12-31
|
|
8414
|
APR_DRG
|
Extensive Third Degree Burns With Skin Graft
|
14
|
14
|
—
|
—
|
$211,434.26
|
$222,005.97
|
$211,434.26
|
2025-12-31
|
|
J3402
|
HCPCS
|
Inj. Remestemcel-l-rknd/ Td
|
15
|
15
|
—
|
—
|
$205,640.00
|
$211,809.20
|
$205,640.00
|
2025-12-31
|
|
5
|
MS_DRG
|
Liver Transplant With Mcc Or Intestinal Transplant
|
31
|
24
|
—
|
—
|
$95,783.75
|
$383,602.15
|
$202,116.73
|
2025-12-31
|
|
215
|
MS_DRG
|
Other Heart Assist System Implant
|
31
|
24
|
—
|
—
|
$92,571.86
|
$370,450.19
|
$195,187.07
|
2025-12-31
|
|
6094
|
APR_DRG
|
Neonate Birth Weight 1500-2499 Grams With Major Procedure
|
14
|
14
|
—
|
—
|
$193,223.50
|
$202,884.68
|
$193,223.50
|
2025-12-31
|
|
216
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
31
|
24
|
—
|
—
|
$90,989.08
|
$363,969.07
|
$191,772.23
|
2025-12-31
|
|
5883
|
APR_DRG
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
14
|
14
|
—
|
—
|
$191,127.94
|
$200,684.34
|
$191,127.94
|
2025-12-31
|
|
6314
|
APR_DRG
|
Neonate Birth Weight > 2499 Grams With Other Major Procedure
|
14
|
14
|
—
|
—
|
$189,697.12
|
$199,181.98
|
$189,697.12
|
2025-12-31
|
|
5914
|
APR_DRG
|
Neonate Birth Weight 500-749 Grams Without Major Procedure
|
14
|
14
|
—
|
—
|
$186,687.76
|
$196,022.15
|
$186,687.76
|
2025-12-31
|
|
74
|
APR_DRG
|
Allogeneic Bone Marrow Transplant
|
14
|
14
|
—
|
—
|
$177,203.63
|
$186,063.81
|
$177,203.63
|
2025-12-31
|
|
429
|
MS_DRG
|
Combined Anterior And Posterior Cervical Spinal Fusion With Mcc
|
31
|
24
|
—
|
—
|
$83,963.82
|
$335,202.17
|
$176,615.19
|
2025-12-31
|
|
94
|
APR_DRG
|
Extracorporeal Membrane Oxygenation (ecmo)
|
14
|
14
|
—
|
—
|
$176,315.60
|
$185,131.38
|
$176,315.60
|
2025-12-31
|
|
5934
|
APR_DRG
|
Neonate Birth Weight 750-999 Grams Without Major Procedure
|
14
|
14
|
—
|
—
|
$173,106.98
|
$181,762.33
|
$173,106.98
|
2025-12-31
|
|
850
|
MS_DRG
|
Acute Leukemia With Other Procedures
|
31
|
24
|
—
|
—
|
$80,782.83
|
$322,176.70
|
$169,752.18
|
2025-12-31
|
|
5882
|
APR_DRG
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
14
|
14
|
—
|
—
|
$167,710.92
|
$176,096.47
|
$167,710.92
|
2025-12-31
|
|
231
|
MS_DRG
|
Coronary Bypass With Ptca With Mcc
|
31
|
24
|
—
|
—
|
$78,696.69
|
$313,634.43
|
$165,251.33
|
2025-12-31
|
|
456
|
MS_DRG
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
31
|
24
|
—
|
—
|
$78,455.92
|
$312,648.50
|
$164,731.85
|
2025-12-31
|
|
5831
|
APR_DRG
|
Neonate With Ecmo
|
14
|
14
|
—
|
—
|
$162,866.22
|
$171,009.53
|
$162,866.22
|
2025-12-31
|
|
6034
|
APR_DRG
|
Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition
|
14
|
14
|
—
|
—
|
$160,117.95
|
$168,123.85
|
$160,117.95
|
2025-12-31
|
|
14
|
APR_DRG
|
Liver Transplant And/or Intestinal Transplant
|
14
|
14
|
—
|
—
|
$157,591.25
|
$165,470.81
|
$157,591.25
|
2025-12-31
|
|
44
|
APR_DRG
|
Tracheostomy With Mv >96 Hours With Extensive Procedure
|
14
|
14
|
—
|
—
|
$156,510.84
|
$164,336.38
|
$156,510.84
|
2025-12-31
|
|
20
|
MS_DRG
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc
|
31
|
24
|
—
|
—
|
$73,598.57
|
$292,758.70
|
$154,252.09
|
2025-12-31
|
|
1613
|
APR_DRG
|
Implantable Heart Assist Systems
|
14
|
14
|
—
|
—
|
$150,911.23
|
$158,456.79
|
$150,911.23
|
2025-12-31
|
|
219
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
31
|
24
|
—
|
—
|
$71,867.69
|
$285,671.15
|
$150,517.71
|
2025-12-31
|
|
233
|
MS_DRG
|
Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc
|
31
|
24
|
—
|
—
|
$71,566.94
|
$284,439.67
|
$149,868.86
|
2025-12-31
|
|
957
|
MS_DRG
|
Other O.r. Procedures For Multiple Significant Trauma With Mcc
|
31
|
24
|
—
|
—
|
$71,337.07
|
$283,498.38
|
$149,372.90
|
2025-12-31
|
|
23
|
APR_DRG
|
Heart And/or Lung Transplant
|
14
|
14
|
—
|
—
|
$146,130.09
|
$153,436.59
|
$146,130.09
|
2025-12-31
|
|
5881
|
APR_DRG
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
14
|
14
|
—
|
—
|
$143,751.97
|
$150,939.57
|
$143,751.97
|
2025-12-31
|
|
0812
|
RC
|
Hc Heart Acquisition, Dcd Heart Trial- Ide G180272
|
261
|
34
|
$229,000.00
|
$125,950.00
45% off
|
$39,900.00
|
$233,550.00
|
$141,980.00
|
2025-12-31
|
|
427
|
MS_DRG
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
31
|
24
|
—
|
—
|
$67,690.88
|
$268,568.01
|
$141,506.22
|
2025-12-31
|
|
10
|
MS_DRG
|
Pancreas Transplant
|
31
|
24
|
—
|
—
|
$67,301.09
|
$266,971.92
|
$140,665.25
|
2025-12-31
|
|
928
|
MS_DRG
|
Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc
|
31
|
24
|
—
|
—
|
$67,273.83
|
$266,860.30
|
$140,606.44
|
2025-12-31
|
|
19
|
MS_DRG
|
Simultaneous Pancreas And Kidney Transplant With Hemodialysis
|
31
|
24
|
—
|
—
|
$66,927.66
|
$265,442.79
|
$139,859.56
|
2025-12-31
|
|
275
|
MS_DRG
|
Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc
|
31
|
24
|
—
|
—
|
$66,889.49
|
$265,286.53
|
$139,777.23
|
2025-12-31
|
|
5913
|
APR_DRG
|
Neonate Birth Weight 500-749 Grams Without Major Procedure
|
14
|
14
|
—
|
—
|
$138,566.32
|
$145,494.64
|
$138,566.32
|
2025-12-31
|
|
870
|
MS_DRG
|
Septicemia Or Severe Sepsis With Mv >96 Hours
|
31
|
24
|
—
|
—
|
$64,903.31
|
$257,153.52
|
$135,492.02
|
2025-12-31
|
|
268
|
MS_DRG
|
Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc
|
31
|
24
|
—
|
—
|
$64,595.29
|
$255,892.27
|
$134,827.47
|
2025-12-31
|
|
113
|
APR_DRG
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
14
|
14
|
—
|
—
|
$133,459.68
|
$140,132.66
|
$133,459.68
|
2025-12-31
|
|
955
|
MS_DRG
|
Craniotomy For Multiple Significant Trauma
|
31
|
24
|
—
|
—
|
$63,261.49
|
$250,430.58
|
$131,949.75
|
2025-12-31
|
|
317
|
MS_DRG
|
Concomitant Left Atrial Appendage Closure And Cardiac Ablation
|
31
|
24
|
—
|
—
|
$62,856.23
|
$248,771.23
|
$131,075.46
|
2025-12-31
|
|
0811
|
RC
|
Hc Kidney Acquisition Live
|
72
|
34
|
$173,000.00
|
$95,150.00
45% off
|
$51,900.00
|
$149,645.00
|
$131,047.50
|
2025-12-31
|
|
447
|
MS_DRG
|
Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall…
|
31
|
24
|
—
|
—
|
$62,811.72
|
$248,588.93
|
$130,979.40
|
2025-12-31
|
|
1604
|
APR_DRG
|
Major Cardiothoracic Repair Of Heart Anomaly
|
14
|
14
|
—
|
—
|
$130,125.68
|
$136,631.96
|
$130,125.68
|
2025-12-31
|
|
217
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
31
|
24
|
—
|
—
|
$61,845.89
|
$244,634.04
|
$128,895.61
|
2025-12-31
|
|
218
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
31
|
24
|
—
|
—
|
$61,845.89
|
$244,634.04
|
$128,895.61
|
2025-12-31
|
|
6024
|
APR_DRG
|
Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…
|
14
|
14
|
—
|
—
|
$128,545.42
|
$134,972.69
|
$128,545.42
|
2025-12-31
|
|
573
|
MS_DRG
|
Skin Graft For Skin Ulcer Or Cellulitis With Mcc
|
31
|
24
|
—
|
—
|
$61,628.73
|
$243,744.84
|
$128,427.09
|
2025-12-31
|
|
J1823
|
HCPCS
|
Inebilizumab-cdon 100 Mg/10ml Solution 10 Ml Vial
|
87
|
34
|
$196,357.90
|
$107,996.85
45% off
|
$415.90
|
$169,849.58
|
$128,319.88
|
2025-12-31
|
|
207
|
MS_DRG
|
Respiratory System Diagnosis With Ventilator Support >96 Hours
|
31
|
24
|
—
|
—
|
$60,568.38
|
$239,403.01
|
$126,139.42
|
2025-12-31
|
|
1612
|
APR_DRG
|
Implantable Heart Assist Systems
|
14
|
14
|
—
|
—
|
$121,138.82
|
$127,195.76
|
$121,138.82
|
2025-12-31
|
|
266
|
MS_DRG
|
Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc
|
31
|
24
|
—
|
—
|
$57,785.37
|
$228,007.12
|
$120,135.03
|
2025-12-31
|
|
5933
|
APR_DRG
|
Neonate Birth Weight 750-999 Grams Without Major Procedure
|
14
|
14
|
—
|
—
|
$120,055.83
|
$126,058.62
|
$120,055.83
|
2025-12-31
|
|
969
|
MS_DRG
|
HIV With Extensive O.r. Procedures With Mcc
|
31
|
24
|
—
|
—
|
$57,720.86
|
$227,742.97
|
$119,995.84
|
2025-12-31
|
|
232
|
MS_DRG
|
Coronary Bypass With Ptca Without Mcc
|
31
|
24
|
—
|
—
|
$57,187.53
|
$225,559.03
|
$118,845.15
|
2025-12-31
|
|
28
|
MS_DRG
|
Spinal Procedures With Mcc
|
31
|
24
|
—
|
—
|
$56,694.16
|
$223,538.80
|
$117,780.70
|
2025-12-31
|
|
276
|
MS_DRG
|
Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator
|
31
|
24
|
—
|
—
|
$56,678.70
|
$223,475.55
|
$117,747.38
|
2025-12-31
|
|
457
|
MS_DRG
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
31
|
24
|
—
|
—
|
$56,283.47
|
$221,857.14
|
$116,894.65
|
2025-12-31
|
|
16
|
MS_DRG
|
Autologous Bone Marrow Transplant With Cc/mcc
|
31
|
24
|
—
|
—
|
$55,979.99
|
$220,614.49
|
$116,239.91
|
2025-12-31
|
|
1611
|
APR_DRG
|
Implantable Heart Assist Systems
|
14
|
14
|
—
|
—
|
$115,416.39
|
$121,187.21
|
$115,416.39
|
2025-12-31
|
|
235
|
MS_DRG
|
Coronary Bypass Without Cardiac Catheterization With Mcc
|
31
|
24
|
—
|
—
|
$55,424.84
|
$218,341.26
|
$115,042.17
|
2025-12-31
|
|
820
|
MS_DRG
|
Lymphoma And Leukemia With Major O.r. Procedures With Mcc
|
31
|
24
|
—
|
—
|
$55,390.32
|
$218,199.88
|
$114,967.67
|
2025-12-31
|
|
5891
|
APR_DRG
|
Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …
|
14
|
14
|
—
|
—
|
$114,798.89
|
$120,538.83
|
$114,798.89
|
2025-12-31
|
|
112
|
APR_DRG
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
14
|
14
|
—
|
—
|
$114,592.77
|
$120,322.41
|
$114,592.77
|
2025-12-31
|
|
64
|
APR_DRG
|
Pancreas Transplant
|
14
|
14
|
—
|
—
|
$113,366.35
|
$119,034.67
|
$113,366.35
|
2025-12-31
|
|
J2351
|
HCPCS
|
Ocrelizumab-hyaluronidase-ocsq 920-23000 Mg-unit/23 Ml Solution 23 Ml Vial
|
87
|
34
|
$173,394.06
|
$95,366.74
45% off
|
$47.23
|
$149,985.86
|
$113,313.01
|
2025-12-31
|
|
430
|
MS_DRG
|
Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc
|
31
|
24
|
—
|
—
|
$54,502.61
|
$214,564.96
|
$113,052.46
|
2025-12-31
|
|
23
|
MS_DRG
|
Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…
|
31
|
24
|
—
|
—
|
$54,168.25
|
$213,195.81
|
$112,331.07
|
2025-12-31
|
|
213
|
MS_DRG
|
Endovascular Abdominal Aorta With Iliac Branch Procedures
|
31
|
24
|
—
|
—
|
$53,955.64
|
$212,325.21
|
$111,872.36
|
2025-12-31
|
|
463
|
MS_DRG
|
Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …
|
31
|
24
|
—
|
—
|
$53,888.39
|
$212,049.90
|
$111,727.30
|
2025-12-31
|
|
5892
|
APR_DRG
|
Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …
|
14
|
14
|
—
|
—
|
$111,412.50
|
$116,983.13
|
$111,412.50
|
2025-12-31
|
|
428
|
MS_DRG
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
31
|
24
|
—
|
—
|
$53,184.25
|
$209,166.51
|
$110,208.07
|
2025-12-31
|
|
8514
|
APR_DRG
|
Gender Related Procedures
|
14
|
14
|
—
|
—
|
$109,922.42
|
$115,418.54
|
$109,922.42
|
2025-12-31
|
|
8
|
MS_DRG
|
Simultaneous Pancreas And Kidney Transplant
|
31
|
24
|
—
|
—
|
$53,026.14
|
$208,519.14
|
$109,866.97
|
2025-12-31
|
|
278
|
MS_DRG
|
Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures …
|
31
|
24
|
—
|
—
|
$52,677.25
|
$207,090.47
|
$109,114.22
|
2025-12-31
|
|
5893
|
APR_DRG
|
Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …
|
14
|
14
|
—
|
—
|
$109,038.68
|
$114,490.61
|
$109,038.68
|
2025-12-31
|
|
Q0480
|
HCPCS
|
Driver Pneumatic Vad, Rep
|
15
|
15
|
—
|
—
|
$108,727.22
|
$111,989.04
|
$108,727.22
|
2025-12-31
|
|
8424
|
APR_DRG
|
Burns With Skin Graft Except Extensive Third Degree Burns
|
14
|
14
|
—
|
—
|
$108,282.90
|
$113,697.05
|
$108,282.90
|
2025-12-31
|
|
461
|
MS_DRG
|
Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc
|
31
|
24
|
—
|
—
|
$52,284.74
|
$205,483.22
|
$108,267.37
|
2025-12-31
|
|
834
|
MS_DRG
|
Acute Leukemia With Mcc
|
31
|
24
|
—
|
—
|
$51,983.99
|
$204,251.73
|
$107,618.51
|
2025-12-31
|
|
405
|
MS_DRG
|
Pancreas, Liver And Shunt Procedures With Mcc
|
31
|
24
|
—
|
—
|
$51,807.74
|
$203,529.95
|
$107,238.21
|
2025-12-31
|
|
234
|
MS_DRG
|
Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc
|
31
|
24
|
—
|
—
|
$51,736.85
|
$203,239.75
|
$107,085.31
|
2025-12-31
|
|
11
|
MS_DRG
|
Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc
|
31
|
24
|
—
|
—
|
$51,658.72
|
$202,919.79
|
$106,916.72
|
2025-12-31
|
|
17
|
MS_DRG
|
Autologous Bone Marrow Transplant Without Cc/mcc
|
31
|
24
|
—
|
—
|
$51,460.62
|
$202,108.72
|
$106,489.38
|
2025-12-31
|
|
22
|
APR_DRG
|
Heart And/or Lung Transplant
|
14
|
14
|
—
|
—
|
$106,346.23
|
$111,663.54
|
$106,346.23
|
2025-12-31
|
|
5912
|
APR_DRG
|
Neonate Birth Weight 500-749 Grams Without Major Procedure
|
14
|
14
|
—
|
—
|
$105,077.73
|
$110,331.62
|
$105,077.73
|
2025-12-31
|
|
220
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
31
|
24
|
—
|
—
|
$50,556.58
|
$198,406.82
|
$104,538.88
|
2025-12-31
|
|
450
|
MS_DRG
|
Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically …
|
31
|
24
|
—
|
—
|
$50,527.50
|
$198,287.77
|
$104,476.15
|
2025-12-31
|
|
21
|
MS_DRG
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc
|
31
|
24
|
—
|
—
|
$50,202.23
|
$196,955.83
|
$103,774.36
|
2025-12-31
|
|
270
|
MS_DRG
|
Other Major Cardiovascular Procedures With Mcc
|
31
|
24
|
—
|
—
|
$50,043.24
|
$196,304.74
|
$103,431.31
|
2025-12-31
|
|
6303
|
APR_DRG
|
Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure
|
14
|
14
|
—
|
—
|
$102,362.09
|
$107,480.19
|
$102,362.09
|
2025-12-31
|
|
54
|
APR_DRG
|
Tracheostomy With Mv >96 Hours Without Extensive Procedure
|
14
|
14
|
—
|
—
|
$102,088.12
|
$107,192.53
|
$102,088.12
|
2025-12-31
|
|
466
|
MS_DRG
|
Revision Of Hip Or Knee Replacement With Mcc
|
31
|
24
|
—
|
—
|
$49,399.04
|
$193,666.91
|
$102,041.46
|
2025-12-31
|
|
653
|
MS_DRG
|
Major Bladder Procedures With Mcc
|
31
|
24
|
—
|
—
|
$49,317.26
|
$193,332.06
|
$101,865.03
|
2025-12-31
|
|
221
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
31
|
24
|
—
|
—
|
$47,898.03
|
$187,520.64
|
$98,803.04
|
2025-12-31
|
|
6074
|
APR_DRG
|
Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…
|
14
|
14
|
—
|
—
|
$98,514.50
|
$103,440.23
|
$98,514.50
|
2025-12-31
|
|
5932
|
APR_DRG
|
Neonate Birth Weight 750-999 Grams Without Major Procedure
|
14
|
14
|
—
|
—
|
$98,331.57
|
$103,248.15
|
$98,331.57
|
2025-12-31
|
|
43
|
APR_DRG
|
Tracheostomy With Mv >96 Hours With Extensive Procedure
|
14
|
14
|
—
|
—
|
$98,142.63
|
$103,049.76
|
$98,142.63
|
2025-12-31
|
|
21
|
APR_DRG
|
Heart And/or Lung Transplant
|
14
|
14
|
—
|
—
|
$97,800.81
|
$102,690.85
|
$97,800.81
|
2025-12-31
|
|
326
|
MS_DRG
|
Stomach, Esophageal And Duodenal Procedures With Mcc
|
31
|
24
|
—
|
—
|
$47,418.31
|
$185,556.22
|
$97,768.00
|
2025-12-31
|
|
228
|
MS_DRG
|
Other Cardiothoracic Procedures With Mcc
|
31
|
24
|
—
|
—
|
$47,054.86
|
$184,068.02
|
$96,983.88
|
2025-12-31
|
|
853
|
MS_DRG
|
Infectious And Parasitic Diseases With O.r. Procedures With Mcc
|
31
|
24
|
—
|
—
|
$46,974.90
|
$183,740.61
|
$96,811.38
|
2025-12-31
|
|
239
|
MS_DRG
|
Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc
|
31
|
24
|
—
|
—
|
$46,821.34
|
$183,111.85
|
$96,480.09
|
2025-12-31
|
|
576
|
MS_DRG
|
Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc
|
31
|
24
|
—
|
—
|
$46,635.07
|
$182,349.15
|
$96,078.22
|
2025-12-31
|
|
471
|
MS_DRG
|
Cervical Spinal Fusion With Mcc
|
31
|
24
|
—
|
—
|
$45,976.36
|
$179,651.78
|
$94,657.01
|
2025-12-31
|
|
837
|
MS_DRG
|
Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot…
|
31
|
24
|
—
|
—
|
$45,754.67
|
$178,743.98
|
$94,178.69
|
2025-12-31
|
|
3034
|
APR_DRG
|
Dorsal And Lumbar Fusion Procedure For Curvature Of Back
|
14
|
14
|
—
|
—
|
$93,459.39
|
$98,132.36
|
$93,459.39
|
2025-12-31
|
|
267
|
MS_DRG
|
Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc
|
31
|
24
|
—
|
—
|
$45,359.43
|
$177,125.56
|
$93,325.96
|
2025-12-31
|
|
K1007
|
HCPCS
|
Bil Hkaf Pc S/d Micro Sensor
|
15
|
15
|
—
|
—
|
$93,216.70
|
$96,013.20
|
$93,216.70
|
2025-12-31
|
|
650
|
MS_DRG
|
Kidney Transplant With Hemodialysis With Mcc
|
31
|
24
|
—
|
—
|
$44,819.71
|
$174,915.59
|
$92,161.54
|
2025-12-31
|
|
981
|
MS_DRG
|
Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc
|
31
|
24
|
—
|
—
|
$44,732.49
|
$174,558.42
|
$91,973.36
|
2025-12-31
|
|
826
|
MS_DRG
|
Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. …
|
31
|
24
|
—
|
—
|
$44,605.28
|
$174,037.55
|
$91,698.91
|
2025-12-31
|
|
6023
|
APR_DRG
|
Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…
|
14
|
14
|
—
|
—
|
$91,181.76
|
$95,740.85
|
$91,181.76
|
2025-12-31
|
|
6
|
MS_DRG
|
Liver Transplant Without Mcc
|
31
|
24
|
—
|
—
|
$44,234.58
|
$172,519.59
|
$90,899.11
|
2025-12-31
|
|
277
|
MS_DRG
|
Cardiac Defibrillator Implant Without Mcc
|
31
|
24
|
—
|
—
|
$44,066.49
|
$171,831.29
|
$90,536.46
|
2025-12-31
|
|
J9269
|
HCPCS
|
Tagraxofusp-erzs 1000 Mcg/ml Solution 1 Ml Vial
|
87
|
34
|
$138,417.27
|
$76,129.50
45% off
|
$290.97
|
$119,730.94
|
$90,455.68
|
2025-12-31
|
|
329
|
MS_DRG
|
Major Small And Large Bowel Procedures With Mcc
|
31
|
24
|
—
|
—
|
$43,866.61
|
$171,012.78
|
$90,105.19
|
2025-12-31
|
|
823
|
MS_DRG
|
Lymphoma And Non-acute Leukemia With Other Procedures With Mcc
|
31
|
24
|
—
|
—
|
$43,760.29
|
$170,577.48
|
$89,875.83
|
2025-12-31
|
|
245
|
MS_DRG
|
Aicd Generator Procedures
|
31
|
24
|
—
|
—
|
$43,556.77
|
$169,744.09
|
$89,436.73
|
2025-12-31
|
|
856
|
MS_DRG
|
Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc
|
31
|
24
|
—
|
—
|
$43,432.31
|
$169,234.38
|
$89,168.17
|
2025-12-31
|
|
25
|
MS_DRG
|
Craniotomy And Endovascular Intracranial Procedures With Mcc
|
31
|
24
|
—
|
—
|
$43,414.13
|
$169,159.97
|
$89,128.96
|
2025-12-31
|
|
1624
|
APR_DRG
|
Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis
|
14
|
14
|
—
|
—
|
$88,834.56
|
$93,276.29
|
$88,834.56
|
2025-12-31
|
|
799
|
MS_DRG
|
Splenic Procedures With Mcc
|
31
|
24
|
—
|
—
|
$43,252.39
|
$168,497.72
|
$88,780.03
|
2025-12-31
|
|
163
|
MS_DRG
|
Major Chest Procedures With Mcc
|
31
|
24
|
—
|
—
|
$42,824.44
|
$166,745.37
|
$87,856.73
|
2025-12-31
|
|
31
|
MS_DRG
|
Ventricular Shunt Procedures With Mcc
|
31
|
24
|
—
|
—
|
$42,812.61
|
$166,697.00
|
$87,831.24
|
2025-12-31
|
|
84
|
APR_DRG
|
Autologous Bone Marrow Transplant
|
14
|
14
|
—
|
—
|
$87,829.72
|
$92,221.21
|
$87,829.72
|
2025-12-31
|
|
319
|
MS_DRG
|
Other Endovascular Cardiac Valve Procedures With Mcc
|
31
|
24
|
—
|
—
|
$42,652.72
|
$166,042.19
|
$87,486.23
|
2025-12-31
|
|
73
|
APR_DRG
|
Allogeneic Bone Marrow Transplant
|
14
|
14
|
—
|
—
|
$86,605.88
|
$90,936.17
|
$86,605.88
|
2025-12-31
|
|
356
|
MS_DRG
|
Other Digestive System O.r. Procedures With Mcc
|
31
|
24
|
—
|
—
|
$42,015.77
|
$163,434.12
|
$86,112.06
|
2025-12-31
|
|
323
|
MS_DRG
|
Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc
|
31
|
24
|
—
|
—
|
$41,421.55
|
$161,000.92
|
$84,830.02
|
2025-12-31
|
|
474
|
MS_DRG
|
Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc
|
31
|
24
|
—
|
—
|
$41,108.10
|
$159,717.34
|
$84,153.72
|
2025-12-31
|
|
140
|
MS_DRG
|
Major Head And Neck Procedures With Mcc
|
31
|
24
|
—
|
—
|
$40,857.33
|
$158,690.49
|
$83,612.68
|
2025-12-31
|
|
448
|
MS_DRG
|
Multiple Level Spinal Fusion Except Cervical Without Mcc
|
31
|
24
|
—
|
—
|
$40,634.72
|
$157,778.96
|
$83,132.40
|
2025-12-31
|
|
4404
|
APR_DRG
|
Kidney Transplant
|
14
|
14
|
—
|
—
|
$83,017.66
|
$87,168.54
|
$83,017.66
|
2025-12-31
|
|
269
|
MS_DRG
|
Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc
|
31
|
24
|
—
|
—
|
$40,474.81
|
$157,124.16
|
$82,787.39
|
2025-12-31
|
|
12
|
MS_DRG
|
Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc
|
31
|
24
|
—
|
—
|
$40,409.38
|
$156,856.28
|
$82,646.25
|
2025-12-31
|
|
958
|
MS_DRG
|
Other O.r. Procedures For Multiple Significant Trauma With Cc
|
31
|
24
|
—
|
—
|
$40,390.32
|
$156,778.15
|
$82,605.08
|
2025-12-31
|
|
J2507
|
HCPCS
|
Pegloticase 8 Mg/ml Solution 1 Ml Vial
|
86
|
34
|
$126,104.29
|
$69,357.36
45% off
|
$3,048.08
|
$109,080.21
|
$82,409.15
|
2025-12-31
|
|
673
|
MS_DRG
|
Other Kidney And Urinary Tract Procedures With Mcc
|
31
|
24
|
—
|
—
|
$40,278.56
|
$156,320.53
|
$82,363.96
|
2025-12-31
|
|
901
|
MS_DRG
|
Wound Debridements For Injuries With Mcc
|
31
|
24
|
—
|
—
|
$40,233.13
|
$156,134.50
|
$82,265.95
|
2025-12-31
|
|
236
|
MS_DRG
|
Coronary Bypass Without Cardiac Catheterization Without Mcc
|
31
|
24
|
—
|
—
|
$40,162.25
|
$155,844.30
|
$82,113.05
|
2025-12-31
|
|
8634
|
APR_DRG
|
Neonatal Aftercare
|
14
|
14
|
—
|
—
|
$82,048.04
|
$86,150.44
|
$82,048.04
|
2025-12-31
|
|
458
|
MS_DRG
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
31
|
24
|
—
|
—
|
$40,015.05
|
$155,241.58
|
$81,795.48
|
2025-12-31
|
|
423
|
MS_DRG
|
Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc
|
31
|
24
|
—
|
—
|
$39,836.97
|
$154,512.37
|
$81,411.26
|
2025-12-31
|
|
273
|
MS_DRG
|
Percutaneous And Other Intracardiac Procedures With Mcc
|
31
|
24
|
—
|
—
|
$39,587.10
|
$153,489.23
|
$80,872.18
|
2025-12-31
|
|
J0202
|
HCPCS
|
Alemtuzumab 12 Mg/1.2ml Solution 1.2 Ml Vial
|
87
|
34
|
$123,698.91
|
$68,034.41
45% off
|
$2,072.11
|
$106,999.56
|
$80,837.24
|
2025-12-31
|
|
63
|
APR_DRG
|
Pancreas Transplant
|
14
|
14
|
—
|
—
|
$80,537.35
|
$84,564.22
|
$80,537.35
|
2025-12-31
|
|
6134
|
APR_DRG
|
Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection
|
14
|
14
|
—
|
—
|
$80,219.58
|
$84,230.56
|
$80,219.58
|
2025-12-31
|
|
6114
|
APR_DRG
|
Neonate Birth Weight 1500-1999 Grams With Major Anomaly
|
14
|
14
|
—
|
—
|
$79,844.27
|
$83,836.48
|
$79,844.27
|
2025-12-31
|
|
402
|
MS_DRG
|
Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical
|
31
|
24
|
—
|
—
|
$38,633.09
|
$149,582.70
|
$78,813.86
|
2025-12-31
|
|
802
|
MS_DRG
|
Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc
|
31
|
24
|
—
|
—
|
$38,302.37
|
$148,228.44
|
$78,100.31
|
2025-12-31
|
|
J7330
|
HCPCS
|
Cultured Chondrocytes Implnt
|
6
|
4
|
—
|
—
|
$62,504.36
|
$77,165.88
|
$77,165.88
|
2025-12-31
|
|
24
|
MS_DRG
|
Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…
|
31
|
24
|
—
|
—
|
$37,646.36
|
$145,542.24
|
$76,684.98
|
2025-12-31
|
|
J1747
|
HCPCS
|
Spesolimab-sbzo 450 Mg/7.5ml Solution 7.5 Ml Vial
|
87
|
34
|
$117,203.77
|
$64,462.08
45% off
|
$52.75
|
$101,381.26
|
$76,592.66
|
2025-12-31
|
|
933
|
MS_DRG
|
Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft
|
31
|
24
|
—
|
—
|
$37,485.53
|
$144,883.71
|
$76,338.00
|
2025-12-31
|
|
93
|
APR_DRG
|
Extracorporeal Membrane Oxygenation (ecmo)
|
14
|
14
|
—
|
—
|
$75,986.37
|
$79,785.69
|
$75,986.37
|
2025-12-31
|
|
34
|
MS_DRG
|
Carotid Artery Stent Procedures With Mcc
|
31
|
24
|
—
|
—
|
$37,272.02
|
$144,009.39
|
$75,877.33
|
2025-12-31
|
|
876
|
MS_DRG
|
O.r. Procedures With Principal Diagnosis Of Mental Illness
|
31
|
24
|
—
|
—
|
$37,219.31
|
$143,793.60
|
$75,763.63
|
2025-12-31
|
|
40
|
MS_DRG
|
Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc
|
31
|
24
|
—
|
—
|
$37,185.68
|
$143,655.95
|
$75,691.10
|
2025-12-31
|
|
907
|
MS_DRG
|
Other O.r. Procedures For Injuries With Mcc
|
31
|
24
|
—
|
—
|
$36,986.71
|
$142,841.16
|
$75,261.80
|
2025-12-31
|
|
1674
|
APR_DRG
|
Other Cardiothoracic And Thoracic Vascular Procedures
|
14
|
14
|
—
|
—
|
$74,501.45
|
$78,226.52
|
$74,501.45
|
2025-12-31
|
|
J9359
|
HCPCS
|
Loncastuximab Tesirine-lpyl 10 Mg/2 Ml Recon Soln 1 Each Vial
|
87
|
34
|
$113,857.24
|
$62,621.49
45% off
|
$182.13
|
$98,486.51
|
$74,405.71
|
2025-12-31
|
|
1634
|
APR_DRG
|
Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis
|
14
|
14
|
—
|
—
|
$73,998.17
|
$77,698.08
|
$73,998.17
|
2025-12-31
|
|
956
|
MS_DRG
|
Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma
|
31
|
24
|
—
|
—
|
$36,293.46
|
$140,002.42
|
$73,766.09
|
2025-12-31
|
|
13
|
APR_DRG
|
Liver Transplant And/or Intestinal Transplant
|
14
|
14
|
—
|
—
|
$73,721.62
|
$77,407.70
|
$73,721.62
|
2025-12-31
|
|
143
|
MS_DRG
|
Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc
|
31
|
24
|
—
|
—
|
$36,144.44
|
$139,392.25
|
$73,444.60
|
2025-12-31
|
|
166
|
MS_DRG
|
Other Respiratory System O.r. Procedures With Mcc
|
31
|
24
|
—
|
—
|
$36,063.57
|
$139,061.13
|
$73,270.13
|
2025-12-31
|
|
518
|
MS_DRG
|
Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost…
|
31
|
24
|
—
|
—
|
$36,059.94
|
$139,046.25
|
$73,262.29
|
2025-12-31
|
|
628
|
MS_DRG
|
Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc
|
31
|
24
|
—
|
—
|
$35,964.54
|
$138,655.59
|
$73,056.46
|
2025-12-31
|
|
6022
|
APR_DRG
|
Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…
|
14
|
14
|
—
|
—
|
$72,918.61
|
$76,564.54
|
$72,918.61
|
2025-12-31
|
|
651
|
MS_DRG
|
Kidney Transplant With Hemodialysis Without Mcc
|
31
|
24
|
—
|
—
|
$35,773.74
|
$137,874.29
|
$72,644.80
|
2025-12-31
|
|
6093
|
APR_DRG
|
Neonate Birth Weight 1500-2499 Grams With Major Procedure
|
14
|
14
|
—
|
—
|
$72,145.66
|
$75,752.94
|
$72,145.66
|
2025-12-31
|
|
904
|
MS_DRG
|
Skin Grafts For Injuries With Cc/mcc
|
31
|
24
|
—
|
—
|
$35,476.62
|
$136,657.69
|
$72,003.78
|
2025-12-31
|
|
492
|
MS_DRG
|
Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc
|
31
|
24
|
—
|
—
|
$35,462.99
|
$136,601.88
|
$71,974.37
|
2025-12-31
|
|
J9266
|
HCPCS
|
Pegaspargase 750 Unit/ml Solution 5 Ml Vial
|
87
|
34
|
$109,957.12
|
$60,476.42
45% off
|
$8,642.10
|
$191,862.41
|
$71,856.98
|
2025-12-31
|
|
77371
|
CPT
|
Hc Srs Multisource
|
87
|
34
|
$97,750.00
|
$53,762.50
45% off
|
$1,338.53
|
$85,455.00
|
$71,213.00
|
2025-12-31
|
|
939
|
MS_DRG
|
O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc
|
31
|
24
|
—
|
—
|
$35,071.40
|
$134,998.34
|
$71,129.49
|
2025-12-31
|
|
495
|
MS_DRG
|
Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit…
|
31
|
24
|
—
|
—
|
$35,045.96
|
$134,894.17
|
$71,074.60
|
2025-12-31
|
|
332
|
MS_DRG
|
Rectal Resection With Mcc
|
31
|
24
|
—
|
—
|
$35,000.52
|
$134,708.14
|
$70,976.58
|
2025-12-31
|
|
265
|
MS_DRG
|
Aicd Lead Procedures
|
31
|
24
|
—
|
—
|
$34,977.79
|
$134,615.13
|
$70,927.57
|
2025-12-31
|
|
1784
|
APR_DRG
|
External Heart Assist Systems
|
14
|
14
|
—
|
—
|
$70,913.23
|
$74,458.89
|
$70,913.23
|
2025-12-31
|
|
97
|
MS_DRG
|
Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc
|
31
|
24
|
—
|
—
|
$34,919.65
|
$134,377.02
|
$70,802.12
|
2025-12-31
|
|
6033
|
APR_DRG
|
Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition
|
14
|
14
|
—
|
—
|
$70,726.00
|
$74,262.30
|
$70,726.00
|
2025-12-31
|
|
279
|
MS_DRG
|
Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures …
|
31
|
24
|
—
|
—
|
$34,870.58
|
$134,176.11
|
$70,696.26
|
2025-12-31
|
|
53
|
APR_DRG
|
Tracheostomy With Mv >96 Hours Without Extensive Procedure
|
14
|
14
|
—
|
—
|
$70,519.02
|
$74,044.97
|
$70,519.02
|
2025-12-31
|
|
33289
|
CPT
|
Hc Transcath Impl Wireless Pulm Art Press Sensor For L-t Hemodynam Monitor
|
87
|
34
|
$92,989.00
|
$51,143.95
45% off
|
$19,979.00
|
$80,435.49
|
$70,439.17
|
2025-12-31
|
|
6124
|
APR_DRG
|
Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other…
|
14
|
14
|
—
|
—
|
$70,368.73
|
$73,887.17
|
$70,368.73
|
2025-12-31
|
|
739
|
MS_DRG
|
Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc…
|
31
|
24
|
—
|
—
|
$34,656.17
|
$133,298.07
|
$70,233.63
|
2025-12-31
|
|
736
|
MS_DRG
|
Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc
|
31
|
24
|
—
|
—
|
$34,580.75
|
$132,989.27
|
$70,070.92
|
2025-12-31
|
|
335
|
MS_DRG
|
Peritoneal Adhesiolysis With Mcc
|
31
|
24
|
—
|
—
|
$34,548.04
|
$132,855.33
|
$70,000.35
|
2025-12-31
|
|
408
|
MS_DRG
|
Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With…
|
31
|
24
|
—
|
—
|
$34,499.89
|
$132,658.15
|
$69,896.46
|
2025-12-31
|
|
414
|
MS_DRG
|
Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc
|
31
|
24
|
—
|
—
|
$34,472.63
|
$132,546.53
|
$69,837.65
|
2025-12-31
|
|
622
|
MS_DRG
|
Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor…
|
31
|
24
|
—
|
—
|
$34,441.72
|
$132,420.04
|
$69,771.00
|
2025-12-31
|
|
8504
|
APR_DRG
|
Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal…
|
14
|
14
|
—
|
—
|
$69,725.46
|
$73,211.73
|
$69,725.46
|
2025-12-31
|
|
271
|
MS_DRG
|
Other Major Cardiovascular Procedures With Cc
|
31
|
24
|
—
|
—
|
$34,415.39
|
$132,312.14
|
$69,714.15
|
2025-12-31
|
|
72
|
APR_DRG
|
Allogeneic Bone Marrow Transplant
|
14
|
14
|
—
|
—
|
$69,448.06
|
$72,920.46
|
$69,448.06
|
2025-12-31
|
|
467
|
MS_DRG
|
Revision Of Hip Or Knee Replacement With Cc
|
31
|
24
|
—
|
—
|
$34,145.52
|
$131,207.15
|
$69,131.94
|
2025-12-31
|
|
1654
|
APR_DRG
|
Coronary Bypass With Ami Or Complex Principal Diagnosis
|
14
|
14
|
—
|
—
|
$69,107.10
|
$72,562.46
|
$69,107.10
|
2025-12-31
|
|
94
|
MS_DRG
|
Bacterial And Tuberculous Infections Of Nervous System With Mcc
|
31
|
24
|
—
|
—
|
$34,080.11
|
$130,939.28
|
$68,990.80
|
2025-12-31
|
|
252
|
MS_DRG
|
Other Vascular Procedures With Mcc
|
31
|
24
|
—
|
—
|
$33,797.53
|
$129,782.20
|
$68,381.14
|
2025-12-31
|
|
616
|
MS_DRG
|
Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With…
|
31
|
24
|
—
|
—
|
$33,789.36
|
$129,748.72
|
$68,363.50
|
2025-12-31
|
|
6073
|
APR_DRG
|
Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…
|
14
|
14
|
—
|
—
|
$68,195.87
|
$71,605.66
|
$68,195.87
|
2025-12-31
|
|
574
|
MS_DRG
|
Skin Graft For Skin Ulcer Or Cellulitis With Cc
|
31
|
24
|
—
|
—
|
$33,643.99
|
$129,153.44
|
$68,049.85
|
2025-12-31
|
|
477
|
MS_DRG
|
Biopsies Of Musculoskeletal System And Connective Tissue With Mcc
|
31
|
24
|
—
|
—
|
$33,491.36
|
$128,528.39
|
$67,720.52
|
2025-12-31
|
|
8413
|
APR_DRG
|
Extensive Third Degree Burns With Skin Graft
|
14
|
14
|
—
|
—
|
$67,663.39
|
$71,046.56
|
$67,663.39
|
2025-12-31
|
|
6214
|
APR_DRG
|
Neonate Birth Weight 2000-2499 Grams With Major Anomaly
|
14
|
14
|
—
|
—
|
$67,590.39
|
$70,969.91
|
$67,590.39
|
2025-12-31
|
|
6804
|
APR_DRG
|
Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms
|
14
|
14
|
—
|
—
|
$67,532.85
|
$70,909.49
|
$67,532.85
|
2025-12-31
|
|
L8702
|
HCPCS
|
Ewhf S/d Uprt Micro Sensor
|
15
|
15
|
—
|
—
|
$67,452.66
|
$69,476.24
|
$67,452.66
|
2025-12-31
|
|
359
|
MS_DRG
|
Percutaneous Coronary Atherectomy With Intraluminal Device With Mcc
|
31
|
24
|
—
|
—
|
$33,345.97
|
$127,933.11
|
$67,406.88
|
2025-12-31
|
|
987
|
MS_DRG
|
Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc
|
31
|
24
|
—
|
—
|
$33,253.28
|
$127,553.62
|
$67,206.93
|
2025-12-31
|
|
6334
|
APR_DRG
|
Neonate Birth Weight > 2499 Grams With Major Anomaly
|
14
|
14
|
—
|
—
|
$66,909.34
|
$70,254.81
|
$66,909.34
|
2025-12-31
|
|
29
|
MS_DRG
|
Spinal Procedures With Cc Or Spinal Neurostimulators
|
31
|
24
|
—
|
—
|
$33,100.65
|
$126,928.58
|
$66,877.59
|
2025-12-31
|
|
420
|
MS_DRG
|
Hepatobiliary Diagnostic Procedures With Mcc
|
31
|
24
|
—
|
—
|
$33,059.76
|
$126,761.16
|
$66,789.38
|
2025-12-31
|
|
71
|
APR_DRG
|
Allogeneic Bone Marrow Transplant
|
14
|
14
|
—
|
—
|
$65,975.78
|
$69,274.57
|
$65,975.78
|
2025-12-31
|
|
J9281
|
HCPCS
|
mitoMYcin 80 (2 X 40) Mg Recon Soln 1 Each Box
|
87
|
34
|
$100,383.00
|
$55,210.65
45% off
|
$267.34
|
$86,831.30
|
$65,600.29
|
2025-12-31
|
|
3044
|
APR_DRG
|
Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back
|
14
|
14
|
—
|
—
|
$65,527.47
|
$68,803.84
|
$65,527.47
|
2025-12-31
|
|
264
|
MS_DRG
|
Other Circulatory System O.r. Procedures
|
31
|
24
|
—
|
—
|
$32,455.53
|
$124,287.02
|
$65,485.78
|
2025-12-31
|
|
33270
|
CPT
|
Hc Insert Replc Perm Subq Implant Defibrillator Sys
|
87
|
34
|
$86,072.00
|
$47,339.60
45% off
|
$19,979.00
|
$74,452.28
|
$65,199.54
|
2025-12-31
|
|
411
|
MS_DRG
|
Cholecystectomy With C.d.e. With Mcc
|
31
|
24
|
—
|
—
|
$32,116.65
|
$122,899.28
|
$64,754.59
|
2025-12-31
|
|
37
|
MS_DRG
|
Extracranial Procedures With Mcc
|
31
|
24
|
—
|
—
|
$32,014.87
|
$122,482.58
|
$64,535.04
|
2025-12-31
|
|
274
|
MS_DRG
|
Percutaneous And Other Intracardiac Procedures Without Mcc
|
31
|
24
|
—
|
—
|
$32,011.24
|
$122,467.70
|
$64,527.20
|
2025-12-31
|
|
62
|
APR_DRG
|
Pancreas Transplant
|
14
|
14
|
—
|
—
|
$64,485.70
|
$67,709.99
|
$64,485.70
|
2025-12-31
|
|
J9600
|
HCPCS
|
Porfimer Recon Soln 1 Each Vial
|
87
|
34
|
$97,966.60
|
$53,881.63
45% off
|
$20,802.53
|
$84,741.11
|
$64,021.18
|
2025-12-31
|
|
260
|
MS_DRG
|
Cardiac Pacemaker Revision Except Device Replacement With Mcc
|
31
|
24
|
—
|
—
|
$31,657.79
|
$121,020.42
|
$63,764.64
|
2025-12-31
|
|
3033
|
APR_DRG
|
Dorsal And Lumbar Fusion Procedure For Curvature Of Back
|
14
|
14
|
—
|
—
|
$63,689.56
|
$66,874.04
|
$63,689.56
|
2025-12-31
|
|
63685
|
CPT
|
Hc Insert/replc Spinal Nrstim Pls Gen/recvr, W Pkt Creation & Conn
|
87
|
34
|
$83,887.00
|
$46,137.85
45% off
|
$2,223.99
|
$72,562.26
|
$63,544.40
|
2025-12-31
|
|
579
|
MS_DRG
|
Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc
|
31
|
24
|
—
|
—
|
$31,527.89
|
$120,488.39
|
$63,484.32
|
2025-12-31
|
|
840
|
MS_DRG
|
Lymphoma And Non-acute Leukemia With Mcc
|
31
|
24
|
—
|
—
|
$31,495.14
|
$120,354.45
|
$63,413.74
|
2025-12-31
|
|
J9029
|
HCPCS
|
Instill Adstiladrin, Tx Dose
|
23
|
18
|
—
|
—
|
$54,436.99
|
$428,159.59
|
$63,342.28
|
2025-12-31
|
|
451
|
MS_DRG
|
Single Level Spinal Fusion Except Cervical Without Mcc
|
31
|
24
|
—
|
—
|
$31,454.27
|
$120,187.03
|
$63,325.53
|
2025-12-31
|
|
652
|
MS_DRG
|
Kidney Transplant
|
31
|
24
|
—
|
—
|
$31,446.10
|
$120,153.55
|
$63,307.89
|
2025-12-31
|
|
485
|
MS_DRG
|
Knee Procedures With Principal Diagnosis Of Infection With Mcc
|
31
|
24
|
—
|
—
|
$31,424.29
|
$120,064.26
|
$63,260.84
|
2025-12-31
|
|
5911
|
APR_DRG
|
Neonate Birth Weight 500-749 Grams Without Major Procedure
|
14
|
14
|
—
|
—
|
$63,164.81
|
$66,323.05
|
$63,164.81
|
2025-12-31
|
|
929
|
MS_DRG
|
Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/mcc
|
31
|
24
|
—
|
—
|
$31,367.03
|
$119,829.86
|
$63,137.34
|
2025-12-31
|
|
325
|
MS_DRG
|
Coronary Intravascular Lithotripsy Without Intraluminal Device
|
31
|
24
|
—
|
—
|
$31,272.55
|
$119,442.93
|
$62,933.47
|
2025-12-31
|
|
242
|
MS_DRG
|
Permanent Cardiac Pacemaker Implant With Mcc
|
31
|
24
|
—
|
—
|
$31,112.63
|
$118,788.12
|
$62,588.46
|
2025-12-31
|
|
9104
|
APR_DRG
|
Craniotomy For Multiple Significant Trauma
|
14
|
14
|
—
|
—
|
$62,556.76
|
$65,684.60
|
$62,556.76
|
2025-12-31
|
|
515
|
MS_DRG
|
Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc
|
31
|
24
|
—
|
—
|
$31,059.03
|
$118,568.61
|
$62,472.80
|
2025-12-31
|
|
656
|
MS_DRG
|
Kidney And Ureter Procedures For Neoplasm With Mcc
|
31
|
24
|
—
|
—
|
$31,030.87
|
$118,453.28
|
$62,412.03
|
2025-12-31
|
|
22
|
MS_DRG
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/…
|
31
|
24
|
—
|
—
|
$30,972.72
|
$118,215.17
|
$62,286.57
|
2025-12-31
|
|
6084
|
APR_DRG
|
Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition
|
14
|
14
|
—
|
—
|
$62,242.42
|
$65,354.54
|
$62,242.42
|
2025-12-31
|
|
500
|
MS_DRG
|
Soft Tissue Procedures With Mcc
|
31
|
24
|
—
|
—
|
$30,858.24
|
$117,746.38
|
$62,039.57
|
2025-12-31
|
|
829
|
MS_DRG
|
Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce…
|
31
|
24
|
—
|
—
|
$30,814.63
|
$117,567.80
|
$61,945.48
|
2025-12-31
|
|
1834
|
APR_DRG
|
Percutaneous Structural Cardiac Procedures
|
14
|
14
|
—
|
—
|
$61,799.26
|
$64,889.22
|
$61,799.26
|
2025-12-31
|
|
324
|
MS_DRG
|
Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc
|
31
|
24
|
—
|
—
|
$30,732.84
|
$117,232.96
|
$61,769.05
|
2025-12-31
|
|
229
|
MS_DRG
|
Other Cardiothoracic Procedures Without Mcc
|
31
|
24
|
—
|
—
|
$30,719.20
|
$117,177.15
|
$61,739.65
|
2025-12-31
|
|
0571T
|
CPT
|
Hc Insert/rplcmt Icds With Substernal Electrode Incld Img Guid And Eps Eval
|
87
|
34
|
$81,452.50
|
$44,798.88
45% off
|
$19,979.00
|
$70,456.41
|
$61,700.27
|
2025-12-31
|
|
258
|
MS_DRG
|
Cardiac Pacemaker Device Replacement With Mcc
|
31
|
24
|
—
|
—
|
$30,651.98
|
$116,901.83
|
$61,594.59
|
2025-12-31
|
|
6814
|
APR_DRG
|
Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms
|
14
|
14
|
—
|
—
|
$61,535.60
|
$64,612.38
|
$61,535.60
|
2025-12-31
|
|
J9229
|
HCPCS
|
Inotuzumab Ozogamicin 0.25 Mg/ml Recon Soln 1 Each Vial
|
87
|
34
|
$93,937.80
|
$51,665.79
45% off
|
$2,282.27
|
$81,256.20
|
$61,388.36
|
2025-12-31
|
|
3124
|
APR_DRG
|
Skin Graft, Except Hand, For Musculoskeletal And Connective Tissue Diagnoses
|
14
|
14
|
—
|
—
|
$61,365.55
|
$64,433.83
|
$61,365.55
|
2025-12-31
|
|
7404
|
APR_DRG
|
Mental Illness Diagnosis With O.r. Procedure
|
14
|
14
|
—
|
—
|
$61,283.96
|
$64,348.16
|
$61,283.96
|
2025-12-31
|
|
J3357
|
HCPCS
|
Ustekinumab 90 mg/mL Solution Prefilled Syringe 1 Ml Syringe
|
117
|
34
|
$122,446.13
|
$67,345.38
45% off
|
$133.84
|
$105,915.90
|
$61,223.07
|
2025-12-31
|
|
665
|
MS_DRG
|
Prostatectomy With Mcc
|
31
|
24
|
—
|
—
|
$30,462.09
|
$116,124.25
|
$61,184.88
|
2025-12-31
|
|
464
|
MS_DRG
|
Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …
|
31
|
24
|
—
|
—
|
$30,403.02
|
$115,882.41
|
$61,057.46
|
2025-12-31
|
|
6904
|
APR_DRG
|
Acute Leukemia
|
14
|
14
|
—
|
—
|
$60,957.60
|
$64,005.48
|
$60,957.60
|
2025-12-31
|
|
26
|
MS_DRG
|
Craniotomy And Endovascular Intracranial Procedures With Cc
|
31
|
24
|
—
|
—
|
$30,353.05
|
$115,677.79
|
$60,949.65
|
2025-12-31
|
|
42
|
APR_DRG
|
Tracheostomy With Mv >96 Hours With Extensive Procedure
|
14
|
14
|
—
|
—
|
$60,560.82
|
$63,588.86
|
$60,560.82
|
2025-12-31
|
|
1664
|
APR_DRG
|
Coronary Bypass Without Ami Or Complex Principal Diagnosis
|
14
|
14
|
—
|
—
|
$60,517.88
|
$63,543.77
|
$60,517.88
|
2025-12-31
|
|
662
|
MS_DRG
|
Minor Bladder Procedures With Mcc
|
31
|
24
|
—
|
—
|
$29,919.66
|
$113,903.11
|
$60,014.58
|
2025-12-31
|
|
263
|
MS_DRG
|
Vein Ligation And Stripping
|
31
|
24
|
—
|
—
|
$29,882.39
|
$113,750.57
|
$59,934.21
|
2025-12-31
|
|
469
|
MS_DRG
|
Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc…
|
31
|
24
|
—
|
—
|
$29,662.51
|
$112,850.21
|
$59,459.82
|
2025-12-31
|
|
3614
|
APR_DRG
|
Skin Graft For Skin And Subcutaneous Tissue Diagnoses
|
14
|
14
|
—
|
—
|
$59,456.36
|
$62,429.18
|
$59,456.36
|
2025-12-31
|