Hospital

BAPTIST HEALTH - FORT SMITH

Fort Smith, AR · CCN 040055 · Rates published

2,903 distinct procedures filed

24 distinct payers

65,685 rate rows

2026-05-13 last MRF observed

Data quality

52,141 of 65,685 rate rows are consumer-grade (79.4%)

13,544 rows are marked excluded from the consumer medians — these stay visible in the raw drill-down with the same reason shown here, so nothing is silently hidden.

Excluded — reason	Rows
no usable negotiated amount (only an out-of-band fallback) — excluded from medians	12,451
template filing: same amount across many unrelated codes — excluded	820
per-diem day rate — not a per-procedure price	107
placeholder amount (≤ $0.02) — excluded from medians	107
exceeds 10× this hospital's gross charge — excluded from medians	59

Data source & audit trail ↓ Download audit trail (JSON)

Source MRF file	https://app-bhns01saas32d4fp001.cms.optimizely.com/globalassets/documents/hospital-charges/825426152_bh-fs_standardcharges.csv
Found on page	https://www.baptist-health.com/billing-insurance-financial-assistance/hospital-charges-and-negotiated-rates/
Discovered via	CMS hospital list
Last fetch	not_modified · 2026-05-17
Content fingerprint	5d3f57e6093e86e8… · 6,031,293 bytes · first seen 2026-05-13

Top 50 most expensive offerings

Outliers are flagged where this hospital's filed rate is ≥2× or ≤0.5× the national median for the same code.

Code	Description	Payers	Min $	Max $	Avg median	vs national
477 OTHER	Biopsies Of Musculoskeletal System And Connective Tissue With Mcc	1	$169,460.46	$169,460.46	$169,460.46	nat. median $32,294 outlier · 5.2×
231 OTHER	Coronary Bypass With Ptca With Mcc	2	$85,398.07	$213,995.13	$149,696.60	nat. median $74,989 2.0× median
666 OTHER	Prostatectomy With Cc	1	$134,999.87	$134,999.87	$134,999.87	nat. median $16,884 outlier · 8.0×
215 OTHER	Other Heart Assist System Implant	6	$28,541.79	$424,139.70	$121,615.10	nat. median $92,359 1.3× median
216 OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	2	$45,432.96	$151,928.07	$98,680.52	nat. median $90,130 1.1× median
266 OTHER	Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc	2	$92,346.02	$95,956.05	$94,151.04	nat. median $58,866 1.6× median
799 OTHER	Splenic Procedures With Mcc	1	$88,006.43	$88,006.43	$88,006.43	nat. median $43,209 outlier · 2.0×
235 OTHER	Coronary Bypass Without Cardiac Catheterization With Mcc	4	$59,070.90	$93,272.76	$80,484.09	nat. median $56,120 1.4× median
472 OTHER	Cervical Spinal Fusion With Cc	2	$40,882.57	$108,531.30	$74,706.93	nat. median $25,163 outlier · 3.0×
233 OTHER	Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc	6	$54,187.70	$117,957.52	$67,492.79	nat. median $68,249 1.0× median
220 OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	2	$35,936.04	$84,002.67	$59,969.35	nat. median $50,021 1.2× median
519 OTHER	Back And Neck Procedures Except Spinal Fusion With Cc	1	$57,671.37	$57,671.37	$57,671.37	nat. median $16,854 outlier · 3.4×
958 OTHER	Other O.r. Procedures For Multiple Significant Trauma With Cc	1	$57,296.40	$57,296.40	$57,296.40	nat. median $40,004 1.4× median
219 OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	2	$45,967.05	$54,343.77	$50,155.41	nat. median $72,612 0.7× median
870 OTHER	Septicemia Or Severe Sepsis With Mv >96 Hours	4	$34,489.15	$70,051.87	$49,017.99	nat. median $54,564 0.9× median
823 OTHER	Lymphoma And Non-acute Leukemia With Other Procedures With Mcc	1	$47,069.27	$47,069.27	$47,069.27	nat. median $42,232 1.1× median
234 OTHER	Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc	2	$36,803.71	$53,955.38	$45,379.54	nat. median $50,947 0.9× median
853 OTHER	Infectious And Parasitic Diseases With O.r. Procedures With Mcc	11	$19,428.38	$89,125.13	$45,176.74	nat. median $39,509 1.1× median
217 OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	1	$44,892.53	$44,892.53	$44,892.53	nat. median $60,727 0.7× median
163 OTHER	Major Chest Procedures With Mcc	4	$32,141.17	$66,083.29	$44,097.80	nat. median $47,944 0.9× median
276 OTHER	Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator	3	$35,518.23	$84,225.26	$43,615.17	nat. median $3,947 outlier · 11.1×
981 OTHER	Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc	5	$33,135.84	$66,879.83	$43,174.92	nat. median $33,955 1.3× median
302 OTHER	Atherosclerosis With Mcc	1	$43,130.06	$43,130.06	$43,130.06	nat. median $66 outlier · 655.2×
356 OTHER	Other Digestive System O.r. Procedures With Mcc	2	$29,808.48	$56,004.70	$42,906.59	nat. median $43,743 1.0× median
264 OTHER	Other Circulatory System O.r. Procedures	2	$24,964.41	$58,983.75	$41,974.08	nat. median $32,470 1.3× median
577 OTHER	Skin Graft Except For Skin Ulcer Or Cellulitis With Cc	1	$41,966.80	$41,966.80	$41,966.80	nat. median $25,312 1.7× median
321 OTHER	Percutaneous Cardiovascular Procedures With Intraluminal Device With Mcc Or 4+ A…	8	$20,026.28	$184,427.52	$41,754.21	nat. median $26,529 1.6× median
329 OTHER	Major Small And Large Bowel Procedures With Mcc	5	$27,976.77	$61,362.54	$41,478.63	nat. median $42,757 1.0× median
166 OTHER	Other Respiratory System O.r. Procedures With Mcc	5	$26,950.21	$63,879.00	$39,523.74	nat. median $38,129 1.0× median
405 OTHER	Pancreas, Liver And Shunt Procedures With Mcc	1	$37,810.82	$37,810.82	$37,810.82	nat. median $49,246 0.8× median
560 OTHER	Aftercare, Musculoskeletal System And Connective Tissue With Cc	1	$37,331.73	$37,331.73	$37,331.73	nat. median $11,735 outlier · 3.2×
228 OTHER	Other Cardiothoracic Procedures With Mcc	3	$35,868.42	$107,454.81	$36,638.36	nat. median $48,497 0.8× median
474 OTHER	Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc	2	$31,844.26	$40,730.05	$36,287.15	nat. median $31,407 1.2× median
448 OTHER	Multiple Level Spinal Fusion Except Cervical Without Mcc	6	$28,617.61	$76,883.72	$36,176.96	nat. median $35,627 1.0× median
270 OTHER	Other Major Cardiovascular Procedures With Mcc	2	$35,776.18	$36,206.66	$35,991.42	nat. median $101 outlier · 354.8×
239 OTHER	Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc	1	$35,503.37	$35,503.37	$35,503.37	nat. median $46,864 0.8× median
326 OTHER	Stomach, Esophageal And Duodenal Procedures With Mcc	3	$35,370.61	$35,796.26	$35,482.75	nat. median $45,545 0.8× median
236 OTHER	Coronary Bypass Without Cardiac Catheterization Without Mcc	4	$28,787.31	$202,335.31	$35,305.65	nat. median $40,949 0.9× median
783 OTHER	Cesarean Section With Sterilization With Mcc	1	$34,375.82	$34,375.82	$34,375.82	nat. median $18,401 1.9× median
269 OTHER	Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc	4	$29,072.07	$117,844.55	$34,137.45	nat. median $39,944 0.9× median
267 OTHER	Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc	2	$32,813.38	$33,192.24	$33,002.81	nat. median $45,097 0.7× median
867 OTHER	Other Infectious And Parasitic Diseases Diagnoses With Mcc	2	$15,394.05	$49,771.43	$32,582.74	nat. median $20,892 1.6× median
33264 OTHER	33264 - Rmvl Impltbl Dfb Pls Gen W-rplcmt Pls Gen Mlt Ld	15	$6,256.00	$63,444.30	$32,369.50	nat. median $29,348 1.1× median
492 OTHER	Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc	1	$32,077.99	$32,077.99	$32,077.99	nat. median $33,378 1.0× median
63685 OTHER	63685 - Insj-rplcmt Spinal Npg-rcvr Pocket Crtjandconnj	16	$2,184.00	$62,370.70	$31,527.30	nat. median $25,009 1.3× median
33249 OTHER	33249 - Insj-rplcmt Perm Dfb W-trnsvns Lds 1-dual Chmbr	19	$377.34	$63,444.30	$31,445.20	nat. median $30,055 1.0× median
277 OTHER	Cardiac Defibrillator Implant Without Mcc	1	$31,382.42	$31,382.42	$31,382.42	nat. median $44,716 0.7× median
451 OTHER	Single Level Spinal Fusion Except Cervical Without Mcc	3	$15,598.40	$40,519.18	$31,144.08	nat. median $2,024 outlier · 15.4×
668 OTHER	Transurethral Procedures With Mcc	2	$20,770.06	$41,400.37	$31,085.22	nat. median $27,684 1.1× median
673 OTHER	Other Kidney And Urinary Tract Procedures With Mcc	3	$29,321.24	$31,240.50	$29,608.70	nat. median $38,593 0.8× median

Other procedures at this hospital

Browse this hospital's 2,903 published procedures. Use the slice to choose what to show, then sort or filter any column.

Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
Code	Type	Description	Rate rows	Payers	Gross	Cash	Min $	Max $	Avg median	Last observed

0421T	OTHER	0421t - Transurethral Waterjet Ablation Prostate Compl	3	3	$298.03	$74.51 75% off	$11,169.00	$11,169.00	$11,169.00	2026-05-13
0913T	OTHER	0913t - Perq Tcat Ther Rx Dlvr Ntrac Rx Balo 1 Maj C Art	19	19	$13,769.60	$3,442.40 75% off	$406.56	$23,333.50	$11,181.40	2026-05-13
100	OTHER	Seizures With Mcc	6	6	$75,756.36	$18,939.09 75% off	$6,799.19	$26,530.56	$16,240.62	2026-05-13
102	OTHER	Headaches With Mcc	3	3	$68,398.56	$17,099.64 75% off	$8,928.26	$18,313.14	$15,765.72	2026-05-13
103	OTHER	Headaches Without Mcc	5	5	$40,449.97	$10,112.49 75% off	$8,574.04	$16,037.20	$12,625.47	2026-05-13
143	OTHER	Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc	1	1	$291,537.65	$72,884.41 75% off	$27,897.53	$27,897.53	$27,897.53	2026-05-13
157	OTHER	Dental And Oral Diseases With Mcc	1	1	$60,520.39	$15,130.10 75% off	$15,507.85	$15,507.85	$15,507.85	2026-05-13
163	OTHER	Major Chest Procedures With Mcc	4	4	$146,951.10	$36,737.78 75% off	$32,141.17	$66,083.29	$44,097.80	2026-05-13
164	OTHER	Major Chest Procedures With Cc	3	3	$81,107.77	$20,276.94 75% off	$15,529.51	$17,989.45	$17,797.95	2026-05-13
165	OTHER	Major Chest Procedures Without Cc/mcc	1	1	$59,253.64	$14,813.41 75% off	$14,684.97	$14,684.97	$14,684.97	2026-05-13
166	OTHER	Other Respiratory System O.r. Procedures With Mcc	5	5	$103,119.71	$25,779.93 75% off	$26,950.21	$63,879.00	$39,523.74	2026-05-13
167	OTHER	Other Respiratory System O.r. Procedures With Cc	3	3	$71,356.02	$17,839.01 75% off	$13,017.48	$18,448.23	$13,858.96	2026-05-13
168	OTHER	Other Respiratory System O.r. Procedures Without Cc/mcc	1	1	$73,424.45	$18,356.11 75% off	$17,775.39	$17,775.39	$17,775.39	2026-05-13
175	OTHER	Pulmonary Embolism With Mcc Or Acute Cor Pulmonale	5	5	$58,575.21	$14,643.80 75% off	$10,143.44	$14,453.30	$10,514.09	2026-05-13
177	OTHER	Respiratory Infections And Inflammations With Mcc	8	8	$62,625.00	$15,656.25 75% off	$11,574.53	$21,613.79	$12,722.51	2026-05-13
178	OTHER	Respiratory Infections And Inflammations With Cc	4	4	$46,625.70	$11,656.43 75% off	$4,055.00	$85,714.79	$20,396.75	2026-05-13
180	OTHER	Respiratory Neoplasms With Mcc	3	3	$77,440.37	$19,360.09 75% off	$12,483.39	$17,622.70	$12,627.01	2026-05-13
186	OTHER	Pleural Effusion With Mcc	2	2	$61,049.78	$15,262.45 75% off	$11,942.44	$21,081.59	$16,512.01	2026-05-13
193	OTHER	Simple Pneumonia And Pleurisy With Mcc	10	10	$48,389.01	$12,097.25 75% off	$9,515.13	$21,640.52	$11,420.31	2026-05-13
196	OTHER	Interstitial Lung Disease With Mcc	3	3	$56,420.15	$14,105.04 75% off	$6,912.62	$25,618.11	$19,130.77	2026-05-13
199	OTHER	Pneumothorax With Mcc	3	3	$66,773.10	$16,693.28 75% off	$12,603.80	$21,976.71	$13,575.03	2026-05-13
200	OTHER	Pneumothorax With Cc	4	4	$45,316.46	$11,329.12 75% off	$8,070.22	$18,359.18	$10,540.19	2026-05-13
20692	OTHER	20692 - Application Multiplane External Fixation System	20	20	$10,289.07	$2,572.27 75% off	$377.34	$25,950.00	$12,772.80	2026-05-13
207	OTHER	Respiratory System Diagnosis With Ventilator Support >96 Hours	3	3	$190,222.03	$47,555.51 75% off	$15,997.75	$35,190.66	$20,395.24	2026-05-13
208	OTHER	Respiratory System Diagnosis With Ventilator Support <=96 Hours	8	8	$115,089.80	$28,772.45 75% off	$14,245.24	$35,866.93	$19,972.65	2026-05-13
215	OTHER	Other Heart Assist System Implant	6	6	$439,407.42	$109,851.86 75% off	$28,541.79	$424,139.70	$121,615.10	2026-05-13
216	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	2	2	$423,663.53	$105,915.88 75% off	$45,432.96	$151,928.07	$98,680.52	2026-05-13
217	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	1	1	$164,803.13	$41,200.78 75% off	$44,892.53	$44,892.53	$44,892.53	2026-05-13
219	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	2	2	$343,735.80	$85,933.95 75% off	$45,967.05	$54,343.77	$50,155.41	2026-05-13
220	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	2	2	$276,058.09	$69,014.52 75% off	$35,936.04	$84,002.67	$59,969.35	2026-05-13
22514	OTHER	22514 - Perq Vert Agmntj Cavity Crtj Uni-bi Cannulj Lmbr	16	16	$13,814.03	$3,453.51 75% off	$6,256.00	$16,082.00	$10,592.10	2026-05-13
22551	OTHER	22551 - Arthrd Ant Interbody Decompress Cervical Belw C2	16	16	$7,964.12	$1,991.03 75% off	$5,571.00	$25,950.00	$13,117.30	2026-05-13
22612	OTHER	22612 - Arthrodesis Posterior-pstlat Tq 1ntrspc Lumbar	19	19	$10,102.56	$2,525.64 75% off	$6,256.00	$35,521.60	$20,888.80	2026-05-13
22630	OTHER	22630 - Arthrodesis Posterior Interbody 1 Ntrspc Lumbar	16	16	$8,434.69	$2,108.67 75% off	$5,571.00	$54,844.20	$27,722.85	2026-05-13
228	OTHER	Other Cardiothoracic Procedures With Mcc	3	3	$166,910.20	$41,727.55 75% off	$35,868.42	$107,454.81	$36,638.36	2026-05-13
22856	OTHER	22856 - Total Disc Arthrp Ant Single Interspace Cervical	15	15	$20,549.47	$5,137.37 75% off	$6,256.00	$35,521.60	$18,081.60	2026-05-13
229	OTHER	Other Cardiothoracic Procedures Without Mcc	3	3	$95,929.17	$23,982.29 75% off	$21,830.92	$40,785.72	$23,226.53	2026-05-13
231	OTHER	Coronary Bypass With Ptca With Mcc	2	2	$370,606.67	$92,651.67 75% off	$85,398.07	$213,995.13	$149,696.60	2026-05-13
233	OTHER	Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc	6	6	$343,351.72	$85,837.93 75% off	$54,187.70	$117,957.52	$67,492.79	2026-05-13
234	OTHER	Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc	2	2	$321,248.63	$80,312.16 75% off	$36,803.71	$53,955.38	$45,379.54	2026-05-13
23470	OTHER	23470 - Arthroplasty Glenohumrl Jt Hemiarthroplasty	20	20	$27,078.48	$6,769.62 75% off	$377.34	$25,950.00	$12,928.25	2026-05-13
23472	OTHER	23472 - Arthroplasty Glenohumeral Joint Total Shoulder	16	16	$22,787.44	$5,696.86 75% off	$6,256.00	$35,440.00	$17,914.30	2026-05-13
235	OTHER	Coronary Bypass Without Cardiac Catheterization With Mcc	4	4	$281,431.77	$70,357.94 75% off	$59,070.90	$93,272.76	$80,484.09	2026-05-13
236	OTHER	Coronary Bypass Without Cardiac Catheterization Without Mcc	4	4	$226,251.11	$56,562.78 75% off	$28,787.31	$202,335.31	$35,305.65	2026-05-13
23615	OTHER	23615 - Optx Prox Humeral Fx W-int Fixj Rpr Tuberosity	20	20	$31,341.86	$7,835.47 75% off	$377.34	$25,950.00	$12,772.80	2026-05-13
23630	OTHER	23630 - Optx Greater Humeral Tuberosity Fx W-int Fixj	16	16	$15,985.84	$3,996.46 75% off	$6,256.00	$14,666.50	$10,592.10	2026-05-13
239	OTHER	Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc	1	1	$121,466.49	$30,366.62 75% off	$35,503.37	$35,503.37	$35,503.37	2026-05-13
240	OTHER	Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc	2	2	$108,770.86	$27,192.72 75% off	$20,485.61	$20,741.52	$20,613.57	2026-05-13
243	OTHER	Permanent Cardiac Pacemaker Implant With Cc	3	3	$79,543.31	$19,885.83 75% off	$15,958.19	$16,149.62	$15,992.82	2026-05-13
244	OTHER	Permanent Cardiac Pacemaker Implant Without Cc/mcc	1	1	$53,032.46	$13,258.12 75% off	$13,029.17	$13,029.17	$13,029.17	2026-05-13
24430	OTHER	24430 - Repair Non-malunion Humerus W-o Graft	20	20	$46,887.36	$11,721.84 75% off	$406.56	$25,950.00	$12,772.80	2026-05-13
24516	OTHER	24516 - Tx Humrl Shft Fx W-insj Imed Implt W-wo Cerclage	16	16	$17,105.40	$4,276.35 75% off	$6,256.00	$25,950.00	$13,117.30	2026-05-13
250	OTHER	Percutaneous Cardiovascular Procedures Without Intraluminal Device With Mcc	2	2	$91,039.54	$22,759.89 75% off	$16,354.17	$23,324.37	$19,839.27	2026-05-13
251	OTHER	Percutaneous Cardiovascular Procedures Without Intraluminal Device Without Mcc	2	2	$72,052.47	$18,013.12 75% off	$11,198.60	$20,516.94	$15,857.77	2026-05-13
252	OTHER	Other Vascular Procedures With Mcc	4	4	$122,342.22	$30,585.56 75% off	$22,236.44	$46,643.15	$24,412.41	2026-05-13
253	OTHER	Other Vascular Procedures With Cc	4	4	$96,828.39	$24,207.10 75% off	$18,015.23	$25,868.30	$20,681.97	2026-05-13
254	OTHER	Other Vascular Procedures Without Cc/mcc	3	3	$68,371.94	$17,092.99 75% off	$12,494.40	$12,846.85	$12,632.23	2026-05-13
261	OTHER	Cardiac Pacemaker Revision Except Device Replacement With Cc	1	1	$58,828.43	$14,707.11 75% off	$13,663.25	$13,663.25	$13,663.25	2026-05-13
264	OTHER	Other Circulatory System O.r. Procedures	2	2	$141,535.17	$35,383.79 75% off	$24,964.41	$58,983.75	$41,974.08	2026-05-13
266	OTHER	Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc	2	2	$126,489.71	$31,622.43 75% off	$92,346.02	$95,956.05	$94,151.04	2026-05-13
267	OTHER	Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc	2	2	$104,952.43	$26,238.11 75% off	$32,813.38	$33,192.24	$33,002.81	2026-05-13
269	OTHER	Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc	4	4	$116,863.08	$29,215.77 75% off	$29,072.07	$117,844.55	$34,137.45	2026-05-13
270	OTHER	Other Major Cardiovascular Procedures With Mcc	2	2	$156,729.85	$39,182.46 75% off	$35,776.18	$36,206.66	$35,991.42	2026-05-13
271	OTHER	Other Major Cardiovascular Procedures With Cc	2	2	$116,114.15	$29,028.54 75% off	$24,134.25	$24,447.65	$24,290.95	2026-05-13
27130	OTHER	27130 - Arthrp Acetblr-prox Fem Prostc Agrft-algrft	19	19	$38,425.28	$9,606.32 75% off	$406.56	$25,950.00	$12,861.70	2026-05-13
27447	OTHER	27447 - Arthrp Kne Condyleandplatu Medialandlat Compartments	20	20	$21,551.29	$5,387.82 75% off	$406.56	$25,950.00	$12,928.25	2026-05-13
276	OTHER	Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator	3	3	$165,440.69	$41,360.17 75% off	$35,518.23	$84,225.26	$43,615.17	2026-05-13
277	OTHER	Cardiac Defibrillator Implant Without Mcc	1	1	$174,117.53	$43,529.38 75% off	$31,382.42	$31,382.42	$31,382.42	2026-05-13
27759	OTHER	27759 - Tx Tibl Shft Fx Imed Implt W-wo Screwsand-cercla	16	16	$17,303.70	$4,325.93 75% off	$6,256.00	$25,950.00	$13,117.30	2026-05-13
27827	OTHER	27827 - Open Treatment Fracture Distal Tibia Only	20	20	$8,925.28	$2,231.32 75% off	$406.56	$25,950.00	$12,772.80	2026-05-13
27871	OTHER	27871 - Arthrodesis Tibiofibular Joint Proximal-distal	19	19	$27,379.04	$6,844.76 75% off	$6,256.00	$25,950.00	$16,103.00	2026-05-13
279	OTHER	Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures …	2	2	$138,666.84	$34,666.71 75% off	$22,776.35	$28,945.35	$25,860.85	2026-05-13
280	OTHER	Acute Myocardial Infarction, Discharged Alive With Mcc	9	9	$56,189.01	$14,047.25 75% off	$11,543.94	$26,431.36	$12,094.03	2026-05-13
28297	OTHER	28297 - Corrj Hlx Vlgs Bncty Sesmdc Joint Arthrodesis	20	20	$27,491.54	$6,872.89 75% off	$317.63	$25,950.00	$11,582.60	2026-05-13
28485	OTHER	28485 - Open Treatment Metatarsal Fracture Each	16	16	$12,126.02	$3,031.51 75% off	$6,256.00	$14,666.50	$10,592.10	2026-05-13
286	OTHER	Circulatory Disorders Except Ami, With Cardiac Catheterization With Mcc	5	5	$78,716.56	$19,679.14 75% off	$11,400.00	$23,400.14	$15,874.55	2026-05-13
28725	OTHER	28725 - Arthrodesis Subtalar	16	16	$10,282.86	$2,570.72 75% off	$6,256.00	$25,950.00	$13,117.30	2026-05-13
28730	OTHER	28730 - Arthrd Midtarsl-tarsometatarsal Mult-transvrs	20	20	$10,824.32	$2,706.08 75% off	$377.34	$25,950.00	$12,772.80	2026-05-13
288	OTHER	Acute And Subacute Endocarditis With Mcc	1	1	$41,106.78	$10,276.70 75% off	$15,365.25	$15,365.25	$15,365.25	2026-05-13
29827	OTHER	29827 - Surgical Arthroscopy Shoulder W-rotator Cuff Rpr	16	16	$8,059.92	$2,014.98 75% off	$6,256.00	$14,666.50	$10,592.10	2026-05-13
29828	OTHER	29828 - Surgical Arthroscopy Shoulder Biceps Tenodesis	16	16	$7,471.06	$1,867.77 75% off	$7,028.18	$14,666.50	$10,592.10	2026-05-13
29889	OTHER	29889 - Arthrs Aided Pst Cruciate Ligm Rpr-agmntj-rcnstj	20	20	$12,786.45	$3,196.61 75% off	$377.34	$25,950.00	$12,772.80	2026-05-13
299	OTHER	Peripheral Vascular Disorders With Mcc	4	4	$64,516.41	$16,129.10 75% off	$10,905.15	$80,852.93	$13,462.08	2026-05-13
300	OTHER	Peripheral Vascular Disorders With Cc	6	6	$58,128.68	$14,532.17 75% off	$7,820.15	$90,305.05	$11,863.85	2026-05-13
301	OTHER	Peripheral Vascular Disorders Without Cc/mcc	1	1	$45,014.37	$11,253.59 75% off	$17,659.53	$17,659.53	$17,659.53	2026-05-13
302	OTHER	Atherosclerosis With Mcc	1	1	$75,310.11	$18,827.53 75% off	$43,130.06	$43,130.06	$43,130.06	2026-05-13
308	OTHER	Cardiac Arrhythmia And Conduction Disorders With Mcc	7	7	$50,121.69	$12,530.42 75% off	$8,746.62	$41,516.40	$10,892.89	2026-05-13
314	OTHER	Other Circulatory System Diagnoses With Mcc	4	4	$85,531.53	$21,382.88 75% off	$12,690.85	$31,925.01	$17,723.49	2026-05-13
321	OTHER	Percutaneous Cardiovascular Procedures With Intraluminal Device With Mcc Or 4+ A…	8	8	$123,771.62	$30,942.91 75% off	$20,026.28	$184,427.52	$41,754.21	2026-05-13
322	OTHER	Percutaneous Cardiovascular Procedures With Intraluminal Device Without Mcc	12	12	$94,676.62	$23,669.16 75% off	$6,045.24	$44,914.76	$17,298.17	2026-05-13
326	OTHER	Stomach, Esophageal And Duodenal Procedures With Mcc	3	3	$147,646.37	$36,911.59 75% off	$35,370.61	$35,796.26	$35,482.75	2026-05-13
327	OTHER	Stomach, Esophageal And Duodenal Procedures With Cc	3	3	$104,097.59	$26,024.40 75% off	$8,810.76	$19,061.02	$17,370.37	2026-05-13
328	OTHER	Stomach, Esophageal And Duodenal Procedures Without Cc/mcc	2	2	$81,018.35	$20,254.59 75% off	$12,406.11	$15,986.19	$14,196.15	2026-05-13
329	OTHER	Major Small And Large Bowel Procedures With Mcc	5	5	$283,531.06	$70,882.77 75% off	$27,976.77	$61,362.54	$41,478.63	2026-05-13
330	OTHER	Major Small And Large Bowel Procedures With Cc	8	8	$116,068.84	$29,017.21 75% off	$16,705.44	$33,287.15	$20,600.81	2026-05-13
33207	OTHER	33207 - Ins New-rplc Prm Pacemaker W-transv Eltrd Ventr	19	19	$20,384.00	$5,096.00 75% off	$406.56	$21,125.90	$10,579.10	2026-05-13
33208	OTHER	33208 - Ins New-rplcmt Prm Pm W-transv Eltrd Atrialandvent	19	19	$20,849.48	$5,212.37 75% off	$377.34	$21,125.90	$10,579.10	2026-05-13
33227	OTHER	33227 - Remvl Perm Pm Plse Gen W-repl Plse Gen Sngl Lead	15	15	$15,994.16	$3,998.54 75% off	$6,256.00	$16,726.50	$11,541.00	2026-05-13
33228	OTHER	33228 - Remvl Perm Pm Pls Gen W-repl Plse Gen 2 Lead Sys	15	15	$20,384.00	$5,096.00 75% off	$6,256.00	$21,125.90	$11,541.00	2026-05-13
33229	OTHER	33229 - Remvl Perm Pm Pls Gen W-repl Plse Gen Mult Lead	15	15	$35,433.84	$8,858.46 75% off	$6,256.00	$38,932.40	$19,863.40	2026-05-13
33249	OTHER	33249 - Insj-rplcmt Perm Dfb W-trnsvns Lds 1-dual Chmbr	19	19	$71,817.77	$17,954.44 75% off	$377.34	$63,444.30	$31,445.20	2026-05-13
33262	OTHER	33262 - Rmvl Impltbl Dfb Plse Gen W-repl Plse Gen 1 Lead	15	15	$45,207.76	$11,301.94 75% off	$6,256.00	$44,959.50	$22,938.50	2026-05-13
33263	OTHER	33263 - Rmvl Impltbl Dfb Plse Gen W-rplcmt Plse Gen 2 Ld	15	15	$45,207.76	$11,301.94 75% off	$6,256.00	$44,959.50	$22,938.50	2026-05-13
33264	OTHER	33264 - Rmvl Impltbl Dfb Pls Gen W-rplcmt Pls Gen Mlt Ld	15	15	$64,396.80	$16,099.20 75% off	$6,256.00	$63,444.30	$32,369.50	2026-05-13
33274	OTHER	33274 - Tcat Insj-rpl Perm Leadless Pacemaker Rv W-img	19	19	$30,497.31	$7,624.33 75% off	$6,256.00	$38,932.40	$22,594.20	2026-05-13
336	OTHER	Peritoneal Adhesiolysis With Cc	3	3	$103,754.07	$25,938.52 75% off	$14,977.28	$80,075.44	$15,171.21	2026-05-13
337	OTHER	Peritoneal Adhesiolysis Without Cc/mcc	2	2	$74,717.65	$18,679.41 75% off	$11,019.85	$12,082.66	$11,551.26	2026-05-13
345	OTHER	Minor Small And Large Bowel Procedures With Cc	1	1	$58,631.71	$14,657.93 75% off	$13,524.91	$13,524.91	$13,524.91	2026-05-13
346	OTHER	Minor Small And Large Bowel Procedures Without Cc/mcc	1	1	$36,160.94	$9,040.24 75% off	$12,586.41	$12,586.41	$12,586.41	2026-05-13
353	OTHER	Hernia Procedures Except Inguinal And Femoral With Mcc	1	1	$66,016.70	$16,504.18 75% off	$20,618.83	$20,618.83	$20,618.83	2026-05-13
354	OTHER	Hernia Procedures Except Inguinal And Femoral With Cc	5	5	$75,939.37	$18,984.84 75% off	$12,505.11	$22,335.44	$15,449.39	2026-05-13
355	OTHER	Hernia Procedures Except Inguinal And Femoral Without Cc/mcc	2	2	$65,485.94	$16,371.49 75% off	$8,351.17	$17,504.92	$12,928.04	2026-05-13
356	OTHER	Other Digestive System O.r. Procedures With Mcc	2	2	$136,438.42	$34,109.61 75% off	$29,808.48	$56,004.70	$42,906.59	2026-05-13
357	OTHER	Other Digestive System O.r. Procedures With Cc	1	1	$114,325.59	$28,581.40 75% off	$17,661.85	$17,661.85	$17,661.85	2026-05-13
358	OTHER	Other Digestive System O.r. Procedures Without Cc/mcc	2	2	$43,731.50	$10,932.88 75% off	$10,796.54	$19,409.82	$15,103.18	2026-05-13
368	OTHER	Major Esophageal Disorders With Mcc	1	1	$67,895.42	$16,973.86 75% off	$11,674.59	$11,674.59	$11,674.59	2026-05-13
36837	OTHER	36837 - Perq Av Fistula Creation Uxtr Sep Access Sites	19	19	$42,623.36	$10,655.84 75% off	$406.56	$37,052.60	$18,364.60	2026-05-13
36903	OTHER	36903 - Intro Cath Dialysis Circuit W-tcat Plmt IV Stent	19	19	$19,911.84	$4,977.96 75% off	$377.34	$23,333.50	$11,564.90	2026-05-13
36905	OTHER	36905 - Perq Thrmbc-nfs Dial Circuit Trluml Balo Angiop	20	20	$19,911.84	$4,977.96 75% off	$317.63	$23,333.50	$11,624.75	2026-05-13
371	OTHER	Major Gastrointestinal Disorders And Peritoneal Infections With Mcc	3	3	$57,586.86	$14,396.72 75% off	$9,648.35	$32,440.85	$17,563.69	2026-05-13
37182	OTHER	37182 - Insj Transvns Intrahepatc Portosysic Shunt	12	12	$12,919.92	$3,229.98 75% off	$6,256.00	$37,052.60	$18,459.60	2026-05-13
372	OTHER	Major Gastrointestinal Disorders And Peritoneal Infections With Cc	6	6	$48,906.78	$12,226.70 75% off	$7,622.49	$30,948.14	$11,431.40	2026-05-13
37236	OTHER	37236 - Open-perq Placement Intravascular Stent Initial	15	15	$17,288.99	$4,322.25 75% off	$6,256.00	$23,333.50	$11,904.80	2026-05-13
37241	OTHER	37241 - Vascular Embolization Or Occlusion Venous Rsandi	20	20	$19,692.40	$4,923.10 75% off	$377.34	$23,333.50	$11,624.75	2026-05-13
37242	OTHER	37242 - Vascular Embolization Or Occlusion Arterial Rsandi	20	20	$17,915.68	$4,478.92 75% off	$377.34	$37,052.60	$17,487.70	2026-05-13
37243	OTHER	37243 - Vascular Embolize-occlude Organ Tumor Infarct	19	19	$19,692.40	$4,923.10 75% off	$377.34	$23,333.50	$11,564.90	2026-05-13
377	OTHER	Gastrointestinal Hemorrhage With Mcc	1	1	$26,770.12	$6,692.53 75% off	$16,332.22	$16,332.22	$16,332.22	2026-05-13
38571	OTHER	38571 - Laps Surg Bilateral Total Pelvic Lmphadectomy	16	16	$15,816.43	$3,954.11 75% off	$8,528.00	$21,485.40	$12,662.05	2026-05-13
386	OTHER	Inflammatory Bowel Disease With Cc	2	2	$22,481.10	$5,620.28 75% off	$8,017.52	$13,031.53	$10,524.53	2026-05-13
388	OTHER	Gastrointestinal Obstruction With Mcc	2	2	$51,198.87	$12,799.72 75% off	$21,024.10	$23,511.90	$22,268.00	2026-05-13
389	OTHER	Gastrointestinal Obstruction With Cc	4	4	$33,985.13	$8,496.28 75% off	$6,457.63	$15,166.27	$12,511.46	2026-05-13
393	OTHER	Other Digestive System Diagnoses With Mcc	2	2	$53,125.54	$13,281.39 75% off	$11,840.64	$16,741.36	$14,291.00	2026-05-13
397	OTHER	Appendix Procedures With Mcc	2	2	$100,536.09	$25,134.02 75% off	$10,869.16	$41,093.35	$25,981.25	2026-05-13
398	OTHER	Appendix Procedures With Cc	4	4	$76,410.09	$19,102.52 75% off	$11,622.08	$28,629.74	$20,698.91	2026-05-13
399	OTHER	Appendix Procedures Without Cc/mcc	4	4	$62,743.50	$15,685.88 75% off	$8,189.79	$47,918.12	$12,857.89	2026-05-13
405	OTHER	Pancreas, Liver And Shunt Procedures With Mcc	1	1	$203,678.33	$50,919.58 75% off	$37,810.82	$37,810.82	$37,810.82	2026-05-13
417	OTHER	Laparoscopic Cholecystectomy Without C.d.e. With Mcc	8	8	$109,429.92	$27,357.48 75% off	$16,829.98	$63,270.32	$23,575.57	2026-05-13
418	OTHER	Laparoscopic Cholecystectomy Without C.d.e. With Cc	5	5	$75,503.78	$18,875.95 75% off	$11,868.25	$22,387.74	$14,980.33	2026-05-13
419	OTHER	Laparoscopic Cholecystectomy Without C.d.e. Without Cc/mcc	4	4	$61,806.08	$15,451.52 75% off	$9,791.79	$18,128.86	$13,190.05	2026-05-13
432	OTHER	Cirrhosis And Alcoholic Hepatitis With Mcc	3	3	$56,071.85	$14,017.96 75% off	$13,930.74	$36,154.57	$21,006.63	2026-05-13
43280	OTHER	43280 - Laps Surg Esopg-gstr Fundoplasty	16	16	$25,287.20	$6,321.80 75% off	$6,256.00	$21,485.40	$11,138.95	2026-05-13
43281	OTHER	43281 - Laps Rpr Paraesphgl Hrna Incl Fundplsty W-o Mesh	16	16	$28,660.59	$7,165.15 75% off	$6,256.00	$21,485.40	$11,138.95	2026-05-13
43282	OTHER	43282 - Laps Rpr Paraesphgl Hrna Incl Fundplsty W-mesh	15	15	$27,929.54	$6,982.39 75% off	$6,256.00	$21,485.40	$10,961.90	2026-05-13
435	OTHER	Malignancy Of Hepatobiliary System Or Pancreas With Mcc	2	2	$44,344.08	$11,086.02 75% off	$15,595.44	$18,330.69	$16,963.06	2026-05-13
436	OTHER	Malignancy Of Hepatobiliary System Or Pancreas With Cc	2	2	$54,944.41	$13,736.10 75% off	$15,070.02	$15,333.34	$15,201.68	2026-05-13
437	OTHER	Malignancy Of Hepatobiliary System Or Pancreas Without Cc/mcc	2	2	$54,048.85	$13,512.21 75% off	$5,924.30	$42,298.20	$24,111.25	2026-05-13
438	OTHER	Disorders Of Pancreas Except Malignancy With Mcc	3	3	$48,519.14	$12,129.79 75% off	$12,629.48	$22,890.85	$12,780.00	2026-05-13
442	OTHER	Disorders Of Liver Except Malignancy, Cirrhosis Or Alcoholic Hepatitis With Cc	1	1	$35,959.44	$8,989.86 75% off	$24,548.80	$24,548.80	$24,548.80	2026-05-13
445	OTHER	Disorders Of The Biliary Tract With Cc	1	1	$41,231.53	$10,307.88 75% off	$14,880.56	$14,880.56	$14,880.56	2026-05-13
448	OTHER	Multiple Level Spinal Fusion Except Cervical Without Mcc	6	6	$139,930.08	$34,982.52 75% off	$28,617.61	$76,883.72	$36,176.96	2026-05-13
451	OTHER	Single Level Spinal Fusion Except Cervical Without Mcc	3	3	$96,678.38	$24,169.60 75% off	$15,598.40	$40,519.18	$31,144.08	2026-05-13
463	OTHER	Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …	1	1	$104,573.65	$26,143.41 75% off	$21,952.76	$21,952.76	$21,952.76	2026-05-13
464	OTHER	Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …	3	3	$101,251.49	$25,312.87 75% off	$20,726.07	$26,779.19	$23,332.39	2026-05-13
465	OTHER	Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …	1	1	$66,263.02	$16,565.76 75% off	$15,682.19	$15,682.19	$15,682.19	2026-05-13
467	OTHER	Revision Of Hip Or Knee Replacement With Cc	1	1	$120,288.34	$30,072.09 75% off	$18,507.50	$18,507.50	$18,507.50	2026-05-13
472	OTHER	Cervical Spinal Fusion With Cc	2	2	$102,199.96	$25,549.99 75% off	$40,882.57	$108,531.30	$74,706.93	2026-05-13
473	OTHER	Cervical Spinal Fusion Without Cc/mcc	2	2	$97,450.25	$24,362.56 75% off	$16,746.71	$32,573.06	$24,659.89	2026-05-13
474	OTHER	Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc	2	2	$148,365.35	$37,091.34 75% off	$31,844.26	$40,730.05	$36,287.15	2026-05-13
475	OTHER	Amputation For Musculoskeletal System And Connective Tissue Disorders With Cc	3	3	$88,444.74	$22,111.19 75% off	$15,286.62	$28,322.72	$15,484.59	2026-05-13
477	OTHER	Biopsies Of Musculoskeletal System And Connective Tissue With Mcc	1	1	$129,165.74	$32,291.44 75% off	$169,460.46	$169,460.46	$169,460.46	2026-05-13
481	OTHER	Hip And Femur Procedures Except Major Joint With Cc	7	7	$10,948.82	$2,737.21 75% off	$8,528.00	$14,910.76	$11,454.50	2026-05-13
492	OTHER	Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc	1	1	$139,613.99	$34,903.50 75% off	$32,077.99	$32,077.99	$32,077.99	2026-05-13
493	OTHER	Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Cc	5	5	$88,696.47	$22,174.12 75% off	$757.91	$32,646.40	$21,805.88	2026-05-13
496	OTHER	Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit…	1	1	$93,073.19	$23,268.30 75% off	$14,201.16	$14,201.16	$14,201.16	2026-05-13
501	OTHER	Soft Tissue Procedures With Cc	2	2	$57,678.12	$14,419.53 75% off	$12,889.88	$15,790.59	$14,340.24	2026-05-13
504	OTHER	Foot Procedures With Cc	1	1	$68,781.61	$17,195.40 75% off	$12,683.06	$12,683.06	$12,683.06	2026-05-13
50543	OTHER	50543 - Laparoscopy Surg Partial Nephrectomy	15	15	$29,748.52	$7,437.13 75% off	$6,256.00	$21,485.40	$10,961.90	2026-05-13
50544	OTHER	50544 - Laparoscopy Surg Pyeloplasty	15	15	$41,127.84	$10,281.96 75% off	$6,256.00	$21,485.40	$10,961.90	2026-05-13
50562	OTHER	50562 - Renal Ndsc Nephros-pyelostomy Rescj Tumor	16	16	$8,234.66	$2,058.67 75% off	$1,511.00	$19,133.90	$11,643.55	2026-05-13
506	OTHER	Major Thumb Or Joint Procedures	1	1	$60,363.26	$15,090.82 75% off	$15,191.62	$15,191.62	$15,191.62	2026-05-13
50947	OTHER	50947 - Laps Urtroneocstost W-cstscandurtrl Stent Plmt	16	16	$41,127.84	$10,281.96 75% off	$8,237.65	$21,485.40	$10,704.00	2026-05-13
513	OTHER	Hand Or Wrist Procedures, Except Major Thumb Or Joint Procedures With Cc/mcc	2	2	$66,874.89	$16,718.72 75% off	$10,816.87	$15,350.08	$13,083.48	2026-05-13
517	OTHER	Other Musculoskeletal System And Connective Tissue O.r. Procedures Without Cc/mc…	2	2	$53,918.95	$13,479.74 75% off	$10,728.12	$10,856.48	$10,792.30	2026-05-13
519	OTHER	Back And Neck Procedures Except Spinal Fusion With Cc	1	1	$120,445.98	$30,111.50 75% off	$57,671.37	$57,671.37	$57,671.37	2026-05-13
521	OTHER	Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc	2	2	$108,781.23	$27,195.31 75% off	$21,152.63	$22,608.57	$21,880.60	2026-05-13
522	OTHER	Hip Replacement With Principal Diagnosis Of Hip Fracture Without Mcc	3	3	$85,651.29	$21,412.82 75% off	$14,962.54	$44,575.69	$15,127.72	2026-05-13
53440	OTHER	53440 - Sling Opration Corrj Male Urinary Incontinence	16	16	$25,319.84	$6,329.96 75% off	$2,184.00	$26,667.10	$13,479.75	2026-05-13
53445	OTHER	53445 - Insj Inflatable Urethral-bladder Neck Sphincter	18	18	$27,258.40	$6,814.60 75% off	$2,184.00	$41,892.40	$22,038.20	2026-05-13
536	OTHER	Fractures Of Hip And Pelvis Without Mcc	3	3	$29,375.95	$7,343.99 75% off	$6,103.09	$30,072.05	$12,432.17	2026-05-13
53865	OTHER	53865 - Cysto Insj Temp Dev Ischmc Rmdlg Bldr Neckandprst8	19	19	$8,147.36	$2,036.84 75% off	$3,360.00	$19,133.90	$11,246.95	2026-05-13
542	OTHER	Pathological Fractures And Musculoskeletal And Connective Tissue Malignancy With…	1	1	$58,326.92	$14,581.73 75% off	$14,012.51	$14,012.51	$14,012.51	2026-05-13
54400	OTHER	54400 - Insj Penile Prosthesis Non-inflatable Semi-rigid	20	20	$8,519.16	$2,129.79 75% off	$377.34	$26,667.10	$13,125.80	2026-05-13
54405	OTHER	54405 - Insj Multi-component Inflatable Penile Prosth	19	19	$14,902.47	$3,725.62 75% off	$3,384.00	$41,892.40	$22,638.20	2026-05-13
54410	OTHER	54410 - Rmvl And Rplcmt Inflatable Penile Prosth Same Sess	19	19	$24,339.35	$6,084.84 75% off	$3,384.00	$41,892.40	$22,638.20	2026-05-13
54411	OTHER	54411 - Rmvl And Rplcmt Nfltbl Penile Prosth Infected Fiel	15	15	$27,724.32	$6,931.08 75% off	$698.00	$41,892.40	$21,373.60	2026-05-13
551	OTHER	Medical Back Problems With Mcc	1	1	$42,155.07	$10,538.77 75% off	$10,785.04	$10,785.04	$10,785.04	2026-05-13
554	OTHER	Bone Diseases And Arthropathies Without Mcc	1	1	$35,955.69	$8,988.92 75% off	$14,318.53	$14,318.53	$14,318.53	2026-05-13
557	OTHER	Tendonitis, Myositis And Bursitis With Mcc	3	3	$64,350.89	$16,087.72 75% off	$11,572.39	$81,326.12	$26,631.17	2026-05-13
55866	OTHER	55866 - Laps Surg Prst8ect Rpbic Rad W-nerve Sparing	15	15	$8,483.75	$2,120.94 75% off	$6,256.00	$21,485.40	$11,541.00	2026-05-13
55867	OTHER	55867 - Laps Surg Prst8ect Smpl Stot Robotic Assistance	15	15	$28,467.33	$7,116.83 75% off	$6,256.00	$21,485.40	$10,961.90	2026-05-13
559	OTHER	Aftercare, Musculoskeletal System And Connective Tissue With Mcc	1	1	$64,668.19	$16,167.05 75% off	$13,217.54	$13,217.54	$13,217.54	2026-05-13
560	OTHER	Aftercare, Musculoskeletal System And Connective Tissue With Cc	1	1	$48,378.68	$12,094.67 75% off	$37,331.73	$37,331.73	$37,331.73	2026-05-13
562	OTHER	Fracture, Sprain, Strain And Dislocation Except Femur, Hip, Pelvis And Thigh Wit…	1	1	$50,430.82	$12,607.71 75% off	$10,988.47	$10,988.47	$10,988.47	2026-05-13
564	OTHER	Other Musculoskeletal System And Connective Tissue Diagnoses With Mcc	2	2	$46,644.92	$11,661.23 75% off	$11,278.62	$12,002.69	$11,640.66	2026-05-13
570	OTHER	Skin Debridement With Mcc	2	2	$93,233.69	$23,308.42 75% off	$21,195.81	$21,423.96	$21,309.89	2026-05-13
571	OTHER	Skin Debridement With Cc	4	4	$68,551.82	$17,137.96 75% off	$8,848.75	$44,181.58	$27,199.09	2026-05-13
572	OTHER	Skin Debridement Without Cc/mcc	2	2	$56,323.40	$14,080.85 75% off	$9,111.74	$14,999.71	$12,055.72	2026-05-13
57425	OTHER	57425 - Laparoscopy Colpopexy Suspension Vaginal Apex	20	20	$30,433.43	$7,608.36 75% off	$317.63	$21,485.40	$10,704.00	2026-05-13
577	OTHER	Skin Graft Except For Skin Ulcer Or Cellulitis With Cc	1	1	$60,960.13	$15,240.03 75% off	$41,966.80	$41,966.80	$41,966.80	2026-05-13
579	OTHER	Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc	2	2	$82,862.32	$20,715.58 75% off	$22,862.52	$23,446.51	$23,154.51	2026-05-13
580	OTHER	Other Skin, Subcutaneous Tissue And Breast Procedures With Cc	2	2	$93,314.04	$23,328.51 75% off	$13,314.22	$18,293.47	$15,803.85	2026-05-13
58542	OTHER	58542 - Laps Supracrv Hysterect 250 Gm-less Than Rmvl Tube-ovar	16	16	$22,353.24	$5,588.31 75% off	$8,528.00	$21,485.40	$12,662.05	2026-05-13
58571	OTHER	58571 - Laps Total Hysterect 250 Gm-less Than W-rmvl Tube-ovary	16	16	$37,314.23	$9,328.56 75% off	$8,528.00	$21,485.40	$12,662.05	2026-05-13
58573	OTHER	58573 - Laparoscopy Tot Hysterectomy Greater Than 250 G W-tube-ovar	16	16	$47,511.36	$11,877.84 75% off	$8,528.00	$21,485.40	$12,662.05	2026-05-13
592	OTHER	Skin Ulcers With Mcc	2	2	$24,323.18	$6,080.80 75% off	$8,089.80	$22,131.11	$15,110.46	2026-05-13
602	OTHER	Cellulitis With Mcc	3	3	$41,651.88	$10,412.97 75% off	$10,971.31	$21,911.76	$19,325.42	2026-05-13
616	OTHER	Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With…	3	3	$133,035.65	$33,258.91 75% off	$20,534.34	$39,114.08	$27,110.79	2026-05-13
617	OTHER	Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With…	4	4	$86,795.21	$21,698.80 75% off	$13,748.08	$19,493.59	$15,673.97	2026-05-13
623	OTHER	Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor…	3	3	$60,311.30	$15,077.83 75% off	$13,769.01	$15,331.65	$14,278.01	2026-05-13
628	OTHER	Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc	1	1	$245,854.72	$61,463.68 75% off	$27,911.89	$27,911.89	$27,911.89	2026-05-13
63685	OTHER	63685 - Insj-rplcmt Spinal Npg-rcvr Pocket Crtjandconnj	16	16	$15,684.24	$3,921.06 75% off	$2,184.00	$62,370.70	$31,527.30	2026-05-13
637	OTHER	Diabetes With Mcc	7	7	$58,204.68	$14,551.17 75% off	$7,070.24	$21,422.80	$11,073.36	2026-05-13
642	OTHER	Inborn And Other Disorders Of Metabolism	1	1	$38,673.46	$9,668.37 75% off	$11,104.25	$11,104.25	$11,104.25	2026-05-13
643	OTHER	Endocrine Disorders With Mcc	3	3	$49,219.52	$12,304.88 75% off	$9,215.19	$21,760.35	$10,720.33	2026-05-13
64590	OTHER	64590 - Ins-rplc Perph Sac-gstrc Npg-rcvr Pckt Crtjandconn	16	16	$8,776.11	$2,194.03 75% off	$2,184.00	$39,212.20	$19,821.10	2026-05-13
653	OTHER	Major Bladder Procedures With Mcc	2	2	$214,871.42	$53,717.86 75% off	$23,502.33	$28,140.76	$25,821.54	2026-05-13
654	OTHER	Major Bladder Procedures With Cc	1	1	$126,825.66	$31,706.42 75% off	$25,630.31	$25,630.31	$25,630.31	2026-05-13
657	OTHER	Kidney And Ureter Procedures For Neoplasm With Cc	3	3	$76,139.09	$19,034.77 75% off	$16,601.90	$25,152.83	$24,001.64	2026-05-13
658	OTHER	Kidney And Ureter Procedures For Neoplasm Without Cc/mcc	5	5	$74,615.37	$18,653.84 75% off	$10,805.86	$87,330.87	$13,659.33	2026-05-13
659	OTHER	Kidney And Ureter Procedures For Non-neoplasm With Mcc	4	4	$71,878.69	$17,969.67 75% off	$12,050.43	$19,187.00	$18,525.32	2026-05-13
660	OTHER	Kidney And Ureter Procedures For Non-neoplasm With Cc	8	8	$55,608.54	$13,902.14 75% off	$10,378.94	$29,321.03	$17,907.09	2026-05-13
661	OTHER	Kidney And Ureter Procedures For Non-neoplasm Without Cc/mcc	4	4	$40,180.28	$10,045.07 75% off	$8,324.51	$17,095.68	$13,973.70	2026-05-13
666	OTHER	Prostatectomy With Cc	1	1	$104,833.91	$26,208.48 75% off	$134,999.87	$134,999.87	$134,999.87	2026-05-13
668	OTHER	Transurethral Procedures With Mcc	2	2	$53,250.57	$13,312.64 75% off	$20,770.06	$41,400.37	$31,085.22	2026-05-13
673	OTHER	Other Kidney And Urinary Tract Procedures With Mcc	3	3	$152,573.76	$38,143.44 75% off	$29,321.24	$31,240.50	$29,608.70	2026-05-13
674	OTHER	Other Kidney And Urinary Tract Procedures With Cc	3	3	$59,047.24	$14,761.81 75% off	$16,340.75	$34,227.07	$16,360.79	2026-05-13
682	OTHER	Renal Failure With Mcc	7	7	$55,911.43	$13,977.86 75% off	$10,786.39	$20,857.22	$13,603.46	2026-05-13
683	OTHER	Renal Failure With Cc	10	10	$34,881.37	$8,720.34 75% off	$6,651.76	$33,985.05	$12,068.25	2026-05-13
684	OTHER	Renal Failure Without Cc/mcc	3	3	$34,961.15	$8,740.29 75% off	$6,248.35	$40,509.64	$11,492.01	2026-05-13
686	OTHER	Kidney And Urinary Tract Neoplasms With Mcc	2	2	$36,705.76	$9,176.44 75% off	$13,593.23	$17,934.80	$15,764.01	2026-05-13
690	OTHER	Kidney And Urinary Tract Infections Without Mcc	9	9	$33,992.11	$8,498.03 75% off	$4,525.68	$13,684.57	$10,538.14	2026-05-13
693	OTHER	Urinary Stones With Mcc	1	1	$41,136.86	$10,284.22 75% off	$21,835.44	$21,835.44	$21,835.44	2026-05-13
698	OTHER	Other Kidney And Urinary Tract Diagnoses With Mcc	7	7	$62,817.26	$15,704.32 75% off	$12,023.07	$39,558.45	$15,265.93	2026-05-13
707	OTHER	Major Male Pelvic Procedures With Cc/mcc	1	1	$73,115.15	$18,278.79 75% off	$13,962.41	$13,962.41	$13,962.41	2026-05-13
708	OTHER	Major Male Pelvic Procedures Without Cc/mcc	1	1	$75,871.18	$18,967.80 75% off	$10,968.68	$10,968.68	$10,968.68	2026-05-13
709	OTHER	Penis Procedures With Cc/mcc	1	1	$122,156.60	$30,539.15 75% off	$22,879.01	$22,879.01	$22,879.01	2026-05-13
711	OTHER	Testes Procedures With Cc/mcc	2	2	$101,892.35	$25,473.09 75% off	$13,753.69	$36,148.55	$24,951.12	2026-05-13
713	OTHER	Transurethral Prostatectomy With Cc/mcc	1	1	$35,862.78	$8,965.70 75% off	$11,691.60	$11,691.60	$11,691.60	2026-05-13
741	OTHER	Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy Without…	1	1	$88,797.02	$22,199.26 75% off	$18,676.84	$18,676.84	$18,676.84	2026-05-13
742	OTHER	Uterine And Adnexa Procedures For Non-malignancy With Cc/mcc	2	2	$69,520.07	$17,380.02 75% off	$18,351.71	$23,984.57	$21,168.14	2026-05-13
743	OTHER	Uterine And Adnexa Procedures For Non-malignancy Without Cc/mcc	2	2	$64,032.61	$16,008.15 75% off	$10,827.86	$18,424.40	$14,626.13	2026-05-13
744	OTHER	D&c, Conization, Laparoscopy And Tubal Interruption With Cc/mcc	1	1	$101,464.25	$25,366.06 75% off	$14,068.85	$14,068.85	$14,068.85	2026-05-13
768	OTHER	Vaginal Delivery With O.r. Procedures Except Sterilization And/or D&c	2	2	$42,460.59	$10,615.15 75% off	$11,068.74	$14,580.42	$12,824.58	2026-05-13
769	OTHER	Postpartum And Post Abortion Diagnoses With O.r. Procedures	1	1	$40,119.59	$10,029.90 75% off	$29,408.13	$29,408.13	$29,408.13	2026-05-13
779	OTHER	Abortion Without D&c	1	1	$27,697.59	$6,924.40 75% off	$12,273.92	$12,273.92	$12,273.92	2026-05-13
783	OTHER	Cesarean Section With Sterilization With Mcc	1	1	$45,951.03	$11,487.76 75% off	$34,375.82	$34,375.82	$34,375.82	2026-05-13
786	OTHER	Cesarean Section Without Sterilization With Mcc	2	2	$33,794.24	$8,448.56 75% off	$16,368.09	$22,552.25	$19,460.17	2026-05-13
787	OTHER	Cesarean Section Without Sterilization With Cc	6	6	$41,255.25	$10,313.81 75% off	$8,170.00	$17,735.02	$12,791.40	2026-05-13
788	OTHER	Cesarean Section Without Sterilization Without Cc/mcc	7	7	$37,817.79	$9,454.45 75% off	$8,172.16	$23,072.14	$12,301.21	2026-05-13
799	OTHER	Splenic Procedures With Mcc	1	1	$218,415.59	$54,603.90 75% off	$88,006.43	$88,006.43	$88,006.43	2026-05-13
801	OTHER	Splenic Procedures Without Cc/mcc	1	1	$59,203.84	$14,800.96 75% off	$16,499.30	$16,499.30	$16,499.30	2026-05-13
805	OTHER	Vaginal Delivery Without Sterilization Or D&c With Mcc	4	4	$40,540.15	$10,135.04 75% off	$9,062.93	$16,738.04	$13,961.36	2026-05-13
808	OTHER	Major Hematological And Immunological Diagnoses Except Sickle Cell Crisis And Co…	4	4	$58,733.34	$14,683.34 75% off	$16,216.22	$55,575.99	$26,715.17	2026-05-13
809	OTHER	Major Hematological And Immunological Diagnoses Except Sickle Cell Crisis And Co…	2	2	$53,663.68	$13,415.92 75% off	$9,086.26	$31,907.45	$20,496.86	2026-05-13
810	OTHER	Major Hematological And Immunological Diagnoses Except Sickle Cell Crisis And Co…	2	2	$39,925.21	$9,981.30 75% off	$15,971.45	$24,691.11	$20,331.28	2026-05-13
813	OTHER	Coagulation Disorders	3	3	$76,198.81	$19,049.70 75% off	$11,705.56	$21,048.16	$11,849.83	2026-05-13
823	OTHER	Lymphoma And Non-acute Leukemia With Other Procedures With Mcc	1	1	$116,657.64	$29,164.41 75% off	$47,069.27	$47,069.27	$47,069.27	2026-05-13
831	OTHER	Other Antepartum Diagnoses Without O.r. Procedures With Mcc	2	2	$38,816.10	$9,704.03 75% off	$12,233.03	$14,164.85	$13,198.94	2026-05-13
840	OTHER	Lymphoma And Non-acute Leukemia With Mcc	1	1	$67,966.28	$16,991.57 75% off	$22,378.61	$22,378.61	$22,378.61	2026-05-13
841	OTHER	Lymphoma And Non-acute Leukemia With Cc	2	2	$48,174.42	$12,043.61 75% off	$11,235.72	$11,370.22	$11,302.97	2026-05-13
843	OTHER	Other Myeloproliferative Disorders Or Poorly Differentiated Neoplastic Diagnoses…	1	1	$72,761.85	$18,190.46 75% off	$19,354.13	$19,354.13	$19,354.13	2026-05-13
847	OTHER	Chemotherapy Without Acute Leukemia As Secondary Diagnosis With Cc	3	3	$54,585.73	$13,646.43 75% off	$17,277.71	$21,077.81	$17,277.71	2026-05-13
853	OTHER	Infectious And Parasitic Diseases With O.r. Procedures With Mcc	11	11	$175,530.18	$43,882.55 75% off	$19,428.38	$89,125.13	$45,176.74	2026-05-13
854	OTHER	Infectious And Parasitic Diseases With O.r. Procedures With Cc	5	5	$83,968.09	$20,992.02 75% off	$12,466.56	$27,168.17	$18,048.84	2026-05-13
856	OTHER	Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc	2	2	$174,012.58	$43,503.15 75% off	$17,590.35	$38,872.02	$28,231.18	2026-05-13
857	OTHER	Postoperative Or Post-traumatic Infections With O.r. Procedures With Cc	3	3	$80,728.65	$20,182.16 75% off	$7,415.91	$29,626.50	$22,008.28	2026-05-13
862	OTHER	Postoperative And Post-traumatic Infections With Mcc	5	5	$105,483.48	$26,370.87 75% off	$13,265.93	$58,274.67	$24,142.13	2026-05-13
864	OTHER	Fever And Inflammatory Conditions	2	2	$41,035.51	$10,258.88 75% off	$6,636.11	$15,086.07	$10,861.09	2026-05-13
867	OTHER	Other Infectious And Parasitic Diseases Diagnoses With Mcc	2	2	$84,719.61	$21,179.90 75% off	$15,394.05	$49,771.43	$32,582.74	2026-05-13
870	OTHER	Septicemia Or Severe Sepsis With Mv >96 Hours	4	4	$225,099.91	$56,274.98 75% off	$34,489.15	$70,051.87	$49,017.99	2026-05-13
871	OTHER	Septicemia Or Severe Sepsis Without Mv >96 Hours With Mcc	12	12	$78,278.13	$19,569.53 75% off	$6,213.00	$32,161.03	$18,670.87	2026-05-13
907	OTHER	Other O.r. Procedures For Injuries With Mcc	4	4	$130,146.49	$32,536.62 75% off	$24,326.71	$40,248.44	$28,547.42	2026-05-13
908	OTHER	Other O.r. Procedures For Injuries With Cc	2	2	$86,182.19	$21,545.55 75% off	$11,111.72	$26,047.38	$18,579.55	2026-05-13
915	OTHER	Allergic Reactions With Mcc	4	4	$44,639.64	$11,159.91 75% off	$9,120.24	$22,817.31	$16,087.68	2026-05-13
916	OTHER	Allergic Reactions Without Mcc	2	2	$19,245.49	$4,811.37 75% off	$8,719.63	$23,171.40	$15,945.51	2026-05-13
917	OTHER	Poisoning And Toxic Effects Of Drugs With Mcc	9	9	$63,324.91	$15,831.23 75% off	$8,095.24	$23,070.63	$12,273.50	2026-05-13
919	OTHER	Complications Of Treatment With Mcc	4	4	$73,671.30	$18,417.83 75% off	$5,189.08	$19,493.55	$15,949.51	2026-05-13
92924	OTHER	92924 - Perq Trluml C Athrc Angiop 1 Maj C Artand-branches	19	19	$31,560.88	$7,890.22 75% off	$406.56	$23,333.50	$11,684.60	2026-05-13
92928	OTHER	92928 - Perq Tcat Plmt Ntrac St 1 Les 1+c Segments	19	19	$34,548.80	$8,637.20 75% off	$406.56	$23,333.50	$11,684.60	2026-05-13
92937	OTHER	92937 - Perq Trluml Revsc Of--cab Grf 1 Maj C Artand-brnch	19	19	$36,276.24	$9,069.06 75% off	$406.56	$23,333.50	$11,684.60	2026-05-13
92943	OTHER	92943 - Perq Trluml Revsc Chrnc Tot Occls 1 C Art Antgrd	19	19	$35,837.62	$8,959.41 75% off	$406.56	$23,333.50	$11,684.60	2026-05-13
93580	OTHER	93580 - Prq Tcat Clsr Cgen Intratrl Comunicaj W-implt	19	19	$48,667.84	$12,166.96 75% off	$1,261.71	$37,052.60	$18,364.60	2026-05-13
956	OTHER	Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma	2	2	$144,974.73	$36,243.68 75% off	$14,475.33	$24,062.24	$19,268.78	2026-05-13
958	OTHER	Other O.r. Procedures For Multiple Significant Trauma With Cc	1	1	$155,324.24	$38,831.06 75% off	$57,296.40	$57,296.40	$57,296.40	2026-05-13
981	OTHER	Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc	5	5	$163,474.25	$40,868.56 75% off	$33,135.84	$66,879.83	$43,174.92	2026-05-13
982	OTHER	Extensive O.r. Procedures Unrelated To Principal Diagnosis With Cc	3	3	$100,959.23	$25,239.81 75% off	$15,807.26	$22,176.39	$17,286.97	2026-05-13
987	OTHER	Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc	3	3	$130,938.41	$32,734.60 75% off	$19,899.66	$36,479.23	$24,558.45	2026-05-13
988	OTHER	Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Cc	3	3	$79,753.96	$19,938.49 75% off	$12,264.57	$17,493.39	$12,411.47	2026-05-13
999	OTHER	Ungroupable	1	1	$99,550.09	$24,887.52 75% off	$19,029.88	$19,029.88	$19,029.88	2026-05-13
C9600	OTHER	C9600 - Perc Drug-el Cor Stent Sing	16	16	$34,548.80	$8,637.20 75% off	$11,181.40	$23,333.50	$16,607.22	2026-05-13
C9602	OTHER	C9602 - Perc D-e Cor Stent Ather S	16	16	$48,667.84	$12,166.96 75% off	$11,541.00	$37,052.60	$21,600.55	2026-05-13
C9604	OTHER	C9604 - Perc D-e Cor Revasc T Cabg S	16	16	$36,276.24	$9,069.06 75% off	$11,181.40	$23,333.50	$16,607.22	2026-05-13
C9607	OTHER	C9607 - Perc D-e Cor Revasc Chro Sin	16	16	$48,667.84	$12,166.96 75% off	$11,541.00	$37,052.60	$21,600.55	2026-05-13
C9764	OTHER	C9764 - Revasc Intravasc Lithotripsy	15	15	$16,803.28	$4,200.82 75% off	$10,818.00	$23,333.50	$17,075.75	2026-05-13
C9765	OTHER	C9765 - Revasc Intra Lithotrip-stent	15	15	$33,986.99	$8,496.75 75% off	$11,541.00	$37,052.60	$24,296.80	2026-05-13
C9766	OTHER	C9766 - Revasc Intra Lithotrip-ather	15	15	$30,897.36	$7,724.34 75% off	$11,541.00	$37,052.60	$24,296.80	2026-05-13
C9767	OTHER	C9767 - Revasc Lithotrip-stent-ather	15	15	$39,608.40	$9,902.10 75% off	$11,541.00	$37,052.60	$24,296.80	2026-05-13
C9772	OTHER	C9772 - Revasc Lithotrip Tibi-perone	15	15	$24,103.04	$6,025.76 75% off	$11,181.40	$23,333.50	$17,257.45	2026-05-13
C9775	OTHER	C9775 - Revasc Lith-sten-ath Tib-per	15	15	$43,718.48	$10,929.62 75% off	$11,541.00	$37,052.60	$24,296.80	2026-05-13
C9781	OTHER	C9781 - Arthro-shoul Surg; W-spacer	15	15	$9,851.57	$2,462.89 75% off	$10,818.00	$25,950.00	$18,384.00	2026-05-13

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