Hospital

LOMPOC VALLEY MEDICAL CENTER

Lompoc, CA · CCN 050110 · Rates published

1,751 distinct procedures filed

16 distinct payers

18,788 rate rows

2026-05-09 last MRF observed

Data quality

18,746 of 18,788 rate rows are consumer-grade (99.8%)

42 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
per-diem day rate — not a per-procedure price	34
percent-of-charges filed in the dollar field — excluded from medians	8

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

Source MRF file	https://lompocvalleymedicalcenter.pg.revenuemasters.com/cdm-files/956001880_lompoc-valley-medical-center_standardcharges.csv
Found on page	https://lompocvalleymedicalcenter.pg.revenuemasters.com/disclaimer?
Discovered via	Discovered by HANK
Last fetch	not_modified · 2026-05-18
Content fingerprint	0cafb0fdd083f637… · 5,832,931 bytes · first seen 2026-05-09

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
18 OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	1	$354,839.72	$354,839.72	$354,839.72	nat. median $386,529 0.9× median
1 OTHER	Heart Transplant Or Implant Of Heart Assist System With Mcc	1	$265,170.85	$265,170.85	$265,170.85	nat. median $239,422 1.1× median
927 OTHER	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	1	$223,406.15	$223,406.15	$223,406.15	nat. median $146,562 1.5× median
3 OTHER	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…	1	$201,880.74	$201,880.74	$201,880.74	nat. median $181,005 1.1× median
4 OTHER	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…	1	$133,283.49	$133,283.49	$133,283.49	nat. median $134,983 1.0× median
14 OTHER	Allogeneic Bone Marrow Transplant	1	$123,623.74	$123,623.74	$123,623.74	nat. median $100,915 1.2× median
7 OTHER	Lung Transplant	1	$123,313.71	$123,313.71	$123,313.71	nat. median $169,933 0.7× median
2 OTHER	Heart Transplant Or Implant Of Heart Assist System Without Mcc	1	$104,062.78	$104,062.78	$104,062.78	nat. median $111,558 0.9× median
212 OTHER	Concomitant Aortic And Mitral Valve Procedures	1	$102,880.90	$102,880.90	$102,880.90	nat. median $90,581 1.1× median
5 OTHER	Liver Transplant With Mcc Or Intestinal Transplant	1	$100,583.87	$100,583.87	$100,583.87	nat. median $94,894 1.1× median
215 OTHER	Other Heart Assist System Implant	1	$100,070.91	$100,070.91	$100,070.91	nat. median $92,359 1.1× median
426 OTHER	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	1	$98,949.17	$98,949.17	$98,949.17	nat. median $80,273 1.2× median
216 OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	1	$91,205.02	$91,205.02	$91,205.02	nat. median $90,130 1.0× median
850 OTHER	Acute Leukemia With Other Procedures	1	$87,078.81	$87,078.81	$87,078.81	nat. median $407 outlier · 213.8×
231 OTHER	Coronary Bypass With Ptca With Mcc	1	$80,145.43	$80,145.43	$80,145.43	nat. median $74,989 1.1× median
456 OTHER	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	1	$80,101.28	$80,101.28	$80,101.28	nat. median $76,493 1.0× median
429 OTHER	Combined Anterior And Posterior Cervical Spinal Fusion With Mcc	1	$78,893.10	$78,893.10	$78,893.10	nat. median $62,997 1.3× median
20 OTHER	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc	1	$76,267.26	$76,267.26	$76,267.26	nat. median $74,209 1.0× median
10 OTHER	Pancreas Transplant	1	$75,439.57	$75,439.57	$75,439.57	nat. median $62,879 1.2× median
19 OTHER	Simultaneous Pancreas And Kidney Transplant With Hemodialysis	1	$75,010.23	$75,010.23	$75,010.23	nat. median $61,133 1.2× median
233 OTHER	Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc	1	$73,968.33	$73,968.33	$73,968.33	nat. median $68,249 1.1× median
219 OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	1	$73,227.08	$73,227.08	$73,227.08	nat. median $72,612 1.0× median
957 OTHER	Other O.r. Procedures For Multiple Significant Trauma With Mcc	1	$70,659.48	$70,659.48	$70,659.48	nat. median $68,309 1.0× median
427 OTHER	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	1	$67,263.25	$67,263.25	$67,263.25	nat. median $51,811 1.3× median
275 OTHER	Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc	1	$66,927.86	$66,927.86	$66,927.86	nat. median $29,655 outlier · 2.3×
870 OTHER	Septicemia Or Severe Sepsis With Mv >96 Hours	1	$65,889.73	$65,889.73	$65,889.73	nat. median $54,603 1.2× median
955 OTHER	Craniotomy For Multiple Significant Trauma	1	$64,685.32	$64,685.32	$64,685.32	nat. median $62,467 1.0× median
447 OTHER	Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall…	1	$63,524.12	$63,524.12	$63,524.12	nat. median $54,322 1.2× median
928 OTHER	Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc	1	$63,281.73	$63,281.73	$63,281.73	nat. median $46,003 1.4× median
268 OTHER	Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc	1	$63,175.57	$63,175.57	$63,175.57	nat. median $67,670 0.9× median
207 OTHER	Respiratory System Diagnosis With Ventilator Support >96 Hours	1	$61,292.84	$61,292.84	$61,292.84	nat. median $66,849 0.9× median
217 OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	1	$61,205.47	$61,205.47	$61,205.47	nat. median $60,727 1.0× median
969 OTHER	HIV With Extensive O.r. Procedures With Mcc	1	$59,950.32	$59,950.32	$59,950.32	nat. median $64,729 0.9× median
276 OTHER	Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator	1	$58,729.93	$58,729.93	$58,729.93	nat. median $3,947 outlier · 14.9×
317 OTHER	Concomitant Left Atrial Appendage Closure And Cardiac Ablation	1	$58,654.77	$58,654.77	$58,654.77	nat. median $48,503 1.2× median
573 OTHER	Skin Graft For Skin Ulcer Or Cellulitis With Mcc	1	$58,389.84	$58,389.84	$58,389.84	nat. median $54,881 1.1× median
461 OTHER	Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc	1	$58,187.85	$58,187.85	$58,187.85	nat. median $53,999 1.1× median
232 OTHER	Coronary Bypass With Ptca Without Mcc	1	$57,924.80	$57,924.80	$57,924.80	nat. median $56,351 1.0× median
28 OTHER	Spinal Procedures With Mcc	1	$57,650.46	$57,650.46	$57,650.46	nat. median $52,701 1.1× median
16 OTHER	Autologous Bone Marrow Transplant With Cc/mcc	1	$57,240.86	$57,240.86	$57,240.86	nat. median $50,271 1.1× median
17 OTHER	Autologous Bone Marrow Transplant Without Cc/mcc	1	$57,240.86	$57,240.86	$57,240.86	nat. median $46,040 1.2× median
266 OTHER	Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc	1	$56,817.14	$56,817.14	$56,817.14	nat. median $58,866 1.0× median
218 OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	1	$56,427.26	$56,427.26	$56,427.26	nat. median $56,507 1.0× median
790 OTHER	Extreme Immaturity Or Respiratory Distress Syndrome, Neonate	1	$56,384.99	$56,384.99	$56,384.99	nat. median $42,495 1.3× median
235 OTHER	Coronary Bypass Without Cardiac Catheterization With Mcc	1	$55,815.66	$55,815.66	$55,815.66	nat. median $56,120 1.0× median
820 OTHER	Lymphoma And Leukemia With Major O.r. Procedures With Mcc	1	$55,234.12	$55,234.12	$55,234.12	nat. median $45,972 1.2× median
457 OTHER	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	1	$54,455.28	$54,455.28	$54,455.28	nat. median $52,731 1.0× median
23 OTHER	Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…	1	$54,133.05	$54,133.05	$54,133.05	nat. median $56,822 1.0× median
653 OTHER	Major Bladder Procedures With Mcc	1	$52,907.03	$52,907.03	$52,907.03	nat. median $54,646 1.0× median
21 OTHER	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc	1	$52,462.65	$52,462.65	$52,462.65	nat. median $55,888 0.9× median

Other procedures at this hospital

Browse this hospital's 1,751 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

1	OTHER	Heart Transplant Or Implant Of Heart Assist System With Mcc	1	1	—	—	$265,170.85	$265,170.85	$265,170.85	2026-05-09
10	OTHER	Pancreas Transplant	1	1	—	—	$75,439.57	$75,439.57	$75,439.57	2026-05-09
100	OTHER	Seizures With Mcc	1	1	—	—	$19,186.19	$19,186.19	$19,186.19	2026-05-09
11	OTHER	Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc	1	1	—	—	$51,228.16	$51,228.16	$51,228.16	2026-05-09
113	OTHER	Orbital Procedures With Cc/mcc	1	1	—	—	$21,735.00	$21,735.00	$21,735.00	2026-05-09
12	OTHER	Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc	1	1	—	—	$39,088.17	$39,088.17	$39,088.17	2026-05-09
13	OTHER	Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy Without Cc/mcc	1	1	—	—	$25,430.92	$25,430.92	$25,430.92	2026-05-09
135	OTHER	Sinus And Mastoid Procedures With Cc/mcc	1	1	—	—	$23,186.50	$23,186.50	$23,186.50	2026-05-09
14	OTHER	Allogeneic Bone Marrow Transplant	1	1	—	—	$123,623.74	$123,623.74	$123,623.74	2026-05-09
140	OTHER	Major Head And Neck Procedures With Mcc	1	1	—	—	$40,267.23	$40,267.23	$40,267.23	2026-05-09
141	OTHER	Major Head And Neck Procedures With Cc	1	1	—	—	$20,719.42	$20,719.42	$20,719.42	2026-05-09
143	OTHER	Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc	1	1	—	—	$31,555.41	$31,555.41	$31,555.41	2026-05-09
146	OTHER	Ear, Nose, Mouth And Throat Malignancy With Mcc	1	1	—	—	$22,087.30	$22,087.30	$22,087.30	2026-05-09
16	OTHER	Autologous Bone Marrow Transplant With Cc/mcc	1	1	—	—	$57,240.86	$57,240.86	$57,240.86	2026-05-09
163	OTHER	Major Chest Procedures With Mcc	1	1	—	—	$43,837.25	$43,837.25	$43,837.25	2026-05-09
164	OTHER	Major Chest Procedures With Cc	1	1	—	—	$24,181.41	$24,181.41	$24,181.41	2026-05-09
166	OTHER	Other Respiratory System O.r. Procedures With Mcc	1	1	—	—	$36,707.52	$36,707.52	$36,707.52	2026-05-09
17	OTHER	Autologous Bone Marrow Transplant Without Cc/mcc	1	1	—	—	$57,240.86	$57,240.86	$57,240.86	2026-05-09
173	OTHER	Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary…	1	1	—	—	$29,363.59	$29,363.59	$29,363.59	2026-05-09
18	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	1	1	—	—	$354,839.72	$354,839.72	$354,839.72	2026-05-09
19	OTHER	Simultaneous Pancreas And Kidney Transplant With Hemodialysis	1	1	—	—	$75,010.23	$75,010.23	$75,010.23	2026-05-09
2	OTHER	Heart Transplant Or Implant Of Heart Assist System Without Mcc	1	1	—	—	$104,062.78	$104,062.78	$104,062.78	2026-05-09
20	OTHER	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc	1	1	—	—	$76,267.26	$76,267.26	$76,267.26	2026-05-09
207	OTHER	Respiratory System Diagnosis With Ventilator Support >96 Hours	1	1	—	—	$61,292.84	$61,292.84	$61,292.84	2026-05-09
208	OTHER	Respiratory System Diagnosis With Ventilator Support <=96 Hours	1	1	—	—	$25,748.47	$25,748.47	$25,748.47	2026-05-09
21	OTHER	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc	1	1	—	—	$52,462.65	$52,462.65	$52,462.65	2026-05-09
212	OTHER	Concomitant Aortic And Mitral Valve Procedures	1	1	—	—	$102,880.90	$102,880.90	$102,880.90	2026-05-09
213	OTHER	Endovascular Abdominal Aorta With Iliac Branch Procedures	1	1	—	—	$19,186.19	$19,186.19	$19,186.19	2026-05-09
215	OTHER	Other Heart Assist System Implant	1	1	—	—	$100,070.91	$100,070.91	$100,070.91	2026-05-09
216	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	1	1	—	—	$91,205.02	$91,205.02	$91,205.02	2026-05-09
217	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	1	1	—	—	$61,205.47	$61,205.47	$61,205.47	2026-05-09
218	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	1	1	—	—	$56,427.26	$56,427.26	$56,427.26	2026-05-09
219	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	1	1	—	—	$73,227.08	$73,227.08	$73,227.08	2026-05-09
22	OTHER	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/…	1	1	—	—	$33,702.13	$33,702.13	$33,702.13	2026-05-09
220	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	1	1	—	—	$50,296.20	$50,296.20	$50,296.20	2026-05-09
221	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	1	1	—	—	$43,681.30	$43,681.30	$43,681.30	2026-05-09
228	OTHER	Other Cardiothoracic Procedures With Mcc	1	1	—	—	$47,351.86	$47,351.86	$47,351.86	2026-05-09
229	OTHER	Other Cardiothoracic Procedures Without Mcc	1	1	—	—	$29,717.78	$29,717.78	$29,717.78	2026-05-09
23	OTHER	Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…	1	1	—	—	$54,133.05	$54,133.05	$54,133.05	2026-05-09
231	OTHER	Coronary Bypass With Ptca With Mcc	1	1	—	—	$80,145.43	$80,145.43	$80,145.43	2026-05-09
232	OTHER	Coronary Bypass With Ptca Without Mcc	1	1	—	—	$57,924.80	$57,924.80	$57,924.80	2026-05-09
233	OTHER	Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc	1	1	—	—	$73,968.33	$73,968.33	$73,968.33	2026-05-09
234	OTHER	Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc	1	1	—	—	$50,516.99	$50,516.99	$50,516.99	2026-05-09
235	OTHER	Coronary Bypass Without Cardiac Catheterization With Mcc	1	1	—	—	$55,815.66	$55,815.66	$55,815.66	2026-05-09
236	OTHER	Coronary Bypass Without Cardiac Catheterization Without Mcc	1	1	—	—	$39,167.09	$39,167.09	$39,167.09	2026-05-09
239	OTHER	Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc	1	1	—	—	$47,855.42	$47,855.42	$47,855.42	2026-05-09
24	OTHER	Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…	1	1	—	—	$36,250.94	$36,250.94	$36,250.94	2026-05-09
240	OTHER	Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc	1	1	—	—	$27,894.25	$27,894.25	$27,894.25	2026-05-09
242	OTHER	Permanent Cardiac Pacemaker Implant With Mcc	1	1	—	—	$32,401.88	$32,401.88	$32,401.88	2026-05-09
243	OTHER	Permanent Cardiac Pacemaker Implant With Cc	1	1	—	—	$21,699.29	$21,699.29	$21,699.29	2026-05-09
245	OTHER	Aicd Generator Procedures	1	1	—	—	$46,445.27	$46,445.27	$46,445.27	2026-05-09
25	OTHER	Craniotomy And Endovascular Intracranial Procedures With Mcc	1	1	—	—	$42,551.10	$42,551.10	$42,551.10	2026-05-09
250	OTHER	Percutaneous Cardiovascular Procedures Without Intraluminal Device With Mcc	1	1	—	—	$22,261.11	$22,261.11	$22,261.11	2026-05-09
252	OTHER	Other Vascular Procedures With Mcc	1	1	—	—	$32,762.64	$32,762.64	$32,762.64	2026-05-09
253	OTHER	Other Vascular Procedures With Cc	1	1	—	—	$24,519.62	$24,519.62	$24,519.62	2026-05-09
255	OTHER	Upper Limb And Toe Amputation For Circulatory System Disorders With Mcc	1	1	—	—	$25,116.20	$25,116.20	$25,116.20	2026-05-09
258	OTHER	Cardiac Pacemaker Device Replacement With Mcc	1	1	—	—	$26,891.81	$26,891.81	$26,891.81	2026-05-09
26	OTHER	Craniotomy And Endovascular Intracranial Procedures With Cc	1	1	—	—	$29,269.64	$29,269.64	$29,269.64	2026-05-09
260	OTHER	Cardiac Pacemaker Revision Except Device Replacement With Mcc	1	1	—	—	$32,535.28	$32,535.28	$32,535.28	2026-05-09
263	OTHER	Vein Ligation And Stripping	1	1	—	—	$25,732.50	$25,732.50	$25,732.50	2026-05-09
264	OTHER	Other Circulatory System O.r. Procedures	1	1	—	—	$33,370.48	$33,370.48	$33,370.48	2026-05-09
265	OTHER	Aicd Lead Procedures	1	1	—	—	$34,047.86	$34,047.86	$34,047.86	2026-05-09
266	OTHER	Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc	1	1	—	—	$56,817.14	$56,817.14	$56,817.14	2026-05-09
267	OTHER	Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc	1	1	—	—	$44,734.46	$44,734.46	$44,734.46	2026-05-09
268	OTHER	Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc	1	1	—	—	$63,175.57	$63,175.57	$63,175.57	2026-05-09
269	OTHER	Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc	1	1	—	—	$39,623.68	$39,623.68	$39,623.68	2026-05-09
27	OTHER	Craniotomy And Endovascular Intracranial Procedures Without Cc/mcc	1	1	—	—	$23,719.18	$23,719.18	$23,719.18	2026-05-09
270	OTHER	Other Major Cardiovascular Procedures With Mcc	1	1	—	—	$48,758.28	$48,758.28	$48,758.28	2026-05-09
271	OTHER	Other Major Cardiovascular Procedures With Cc	1	1	—	—	$32,894.17	$32,894.17	$32,894.17	2026-05-09
272	OTHER	Other Major Cardiovascular Procedures Without Cc/mcc	1	1	—	—	$24,042.36	$24,042.36	$24,042.36	2026-05-09
273	OTHER	Percutaneous And Other Intracardiac Procedures With Mcc	1	1	—	—	$37,271.22	$37,271.22	$37,271.22	2026-05-09
274	OTHER	Percutaneous And Other Intracardiac Procedures Without Mcc	1	1	—	—	$29,855.88	$29,855.88	$29,855.88	2026-05-09
275	OTHER	Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc	1	1	—	—	$66,927.86	$66,927.86	$66,927.86	2026-05-09
276	OTHER	Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator	1	1	—	—	$58,729.93	$58,729.93	$58,729.93	2026-05-09
277	OTHER	Cardiac Defibrillator Implant Without Mcc	1	1	—	—	$44,238.42	$44,238.42	$44,238.42	2026-05-09
278	OTHER	Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures …	1	1	—	—	$47,539.76	$47,539.76	$47,539.76	2026-05-09
279	OTHER	Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures …	1	1	—	—	$30,639.41	$30,639.41	$30,639.41	2026-05-09
28	OTHER	Spinal Procedures With Mcc	1	1	—	—	$57,650.46	$57,650.46	$57,650.46	2026-05-09
283	OTHER	Acute Myocardial Infarction, Expired With Mcc	1	1	—	—	$18,905.29	$18,905.29	$18,905.29	2026-05-09
286	OTHER	Circulatory Disorders Except Ami, With Cardiac Catheterization With Mcc	1	1	—	—	$21,328.20	$21,328.20	$21,328.20	2026-05-09
288	OTHER	Acute And Subacute Endocarditis With Mcc	1	1	—	—	$26,196.59	$26,196.59	$26,196.59	2026-05-09
29	OTHER	Spinal Procedures With Cc Or Spinal Neurostimulators	1	1	—	—	$32,070.24	$32,070.24	$32,070.24	2026-05-09
3	OTHER	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…	1	1	—	—	$201,880.74	$201,880.74	$201,880.74	2026-05-09
30	OTHER	Spinal Procedures Without Cc/mcc	1	1	—	—	$21,441.87	$21,441.87	$21,441.87	2026-05-09
31	OTHER	Ventricular Shunt Procedures With Mcc	1	1	—	—	$39,904.58	$39,904.58	$39,904.58	2026-05-09
314	OTHER	Other Circulatory System Diagnoses With Mcc	1	1	—	—	$20,766.39	$20,766.39	$20,766.39	2026-05-09
317	OTHER	Concomitant Left Atrial Appendage Closure And Cardiac Ablation	1	1	—	—	$58,654.77	$58,654.77	$58,654.77	2026-05-09
319	OTHER	Other Endovascular Cardiac Valve Procedures With Mcc	1	1	—	—	$41,804.22	$41,804.22	$41,804.22	2026-05-09
32	OTHER	Ventricular Shunt Procedures With Cc	1	1	—	—	$20,598.23	$20,598.23	$20,598.23	2026-05-09
320	OTHER	Other Endovascular Cardiac Valve Procedures Without Mcc	1	1	—	—	$22,281.77	$22,281.77	$22,281.77	2026-05-09
321	OTHER	Percutaneous Cardiovascular Procedures With Intraluminal Device With Mcc Or 4+ A…	1	1	—	—	$27,279.83	$27,279.83	$27,279.83	2026-05-09
323	OTHER	Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc	1	1	—	—	$40,550.95	$40,550.95	$40,550.95	2026-05-09
324	OTHER	Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc	1	1	—	—	$30,552.05	$30,552.05	$30,552.05	2026-05-09
325	OTHER	Coronary Intravascular Lithotripsy Without Intraluminal Device	1	1	—	—	$27,423.56	$27,423.56	$27,423.56	2026-05-09
326	OTHER	Stomach, Esophageal And Duodenal Procedures With Mcc	1	1	—	—	$48,250.95	$48,250.95	$48,250.95	2026-05-09
327	OTHER	Stomach, Esophageal And Duodenal Procedures With Cc	1	1	—	—	$23,346.21	$23,346.21	$23,346.21	2026-05-09
329	OTHER	Major Small And Large Bowel Procedures With Mcc	1	1	—	—	$43,674.73	$43,674.73	$43,674.73	2026-05-09
330	OTHER	Major Small And Large Bowel Procedures With Cc	1	1	—	—	$22,741.19	$22,741.19	$22,741.19	2026-05-09
332	OTHER	Rectal Resection With Mcc	1	1	—	—	$33,122.46	$33,122.46	$33,122.46	2026-05-09
333	OTHER	Rectal Resection With Cc	1	1	—	—	$20,501.46	$20,501.46	$20,501.46	2026-05-09
335	OTHER	Peritoneal Adhesiolysis With Mcc	1	1	—	—	$34,575.84	$34,575.84	$34,575.84	2026-05-09
336	OTHER	Peritoneal Adhesiolysis With Cc	1	1	—	—	$20,379.32	$20,379.32	$20,379.32	2026-05-09
34	OTHER	Carotid Artery Stent Procedures With Mcc	1	1	—	—	$37,068.30	$37,068.30	$37,068.30	2026-05-09
344	OTHER	Minor Small And Large Bowel Procedures With Mcc	1	1	—	—	$25,848.99	$25,848.99	$25,848.99	2026-05-09
347	OTHER	Anal And Stomal Procedures With Mcc	1	1	—	—	$22,770.31	$22,770.31	$22,770.31	2026-05-09
35	OTHER	Carotid Artery Stent Procedures With Cc	1	1	—	—	$21,905.98	$21,905.98	$21,905.98	2026-05-09
350	OTHER	Inguinal And Femoral Hernia Procedures With Mcc	1	1	—	—	$23,257.89	$23,257.89	$23,257.89	2026-05-09
353	OTHER	Hernia Procedures Except Inguinal And Femoral With Mcc	1	1	—	—	$28,089.66	$28,089.66	$28,089.66	2026-05-09
356	OTHER	Other Digestive System O.r. Procedures With Mcc	1	1	—	—	$40,610.14	$40,610.14	$40,610.14	2026-05-09
357	OTHER	Other Digestive System O.r. Procedures With Cc	1	1	—	—	$21,691.78	$21,691.78	$21,691.78	2026-05-09
37	OTHER	Extracranial Procedures With Mcc	1	1	—	—	$31,733.90	$31,733.90	$31,733.90	2026-05-09
374	OTHER	Digestive Malignancy With Mcc	1	1	—	—	$20,370.88	$20,370.88	$20,370.88	2026-05-09
380	OTHER	Complicated Peptic Ulcer With Mcc	1	1	—	—	$18,613.10	$18,613.10	$18,613.10	2026-05-09
397	OTHER	Appendix Procedures With Mcc	1	1	—	—	$23,813.13	$23,813.13	$23,813.13	2026-05-09
4	OTHER	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…	1	1	—	—	$133,283.49	$133,283.49	$133,283.49	2026-05-09
40	OTHER	Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc	1	1	—	—	$35,972.85	$35,972.85	$35,972.85	2026-05-09
402	OTHER	Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical	1	1	—	—	$37,289.06	$37,289.06	$37,289.06	2026-05-09
405	OTHER	Pancreas, Liver And Shunt Procedures With Mcc	1	1	—	—	$51,536.32	$51,536.32	$51,536.32	2026-05-09
406	OTHER	Pancreas, Liver And Shunt Procedures With Cc	1	1	—	—	$26,919.07	$26,919.07	$26,919.07	2026-05-09
407	OTHER	Pancreas, Liver And Shunt Procedures Without Cc/mcc	1	1	—	—	$20,600.10	$20,600.10	$20,600.10	2026-05-09
408	OTHER	Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With…	1	1	—	—	$33,428.74	$33,428.74	$33,428.74	2026-05-09
409	OTHER	Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With…	1	1	—	—	$20,230.88	$20,230.88	$20,230.88	2026-05-09
41	OTHER	Peripheral, Cranial Nerve And Other Nervous System Procedures With Cc Or Periphe…	1	1	—	—	$21,750.02	$21,750.02	$21,750.02	2026-05-09
411	OTHER	Cholecystectomy With C.d.e. With Mcc	1	1	—	—	$26,242.64	$26,242.64	$26,242.64	2026-05-09
412	OTHER	Cholecystectomy With C.d.e. With Cc	1	1	—	—	$20,560.64	$20,560.64	$20,560.64	2026-05-09
414	OTHER	Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc	1	1	—	—	$33,452.21	$33,452.21	$33,452.21	2026-05-09
415	OTHER	Cholecystectomy Except By Laparoscope Without C.d.e. With Cc	1	1	—	—	$19,118.54	$19,118.54	$19,118.54	2026-05-09
417	OTHER	Laparoscopic Cholecystectomy Without C.d.e. With Mcc	1	1	—	—	$22,861.44	$22,861.44	$22,861.44	2026-05-09
420	OTHER	Hepatobiliary Diagnostic Procedures With Mcc	1	1	—	—	$33,693.67	$33,693.67	$33,693.67	2026-05-09
423	OTHER	Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc	1	1	—	—	$38,747.14	$38,747.14	$38,747.14	2026-05-09
424	OTHER	Other Hepatobiliary Or Pancreas O.r. Procedures With Cc	1	1	—	—	$21,985.84	$21,985.84	$21,985.84	2026-05-09
426	OTHER	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	1	1	—	—	$98,949.17	$98,949.17	$98,949.17	2026-05-09
427	OTHER	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	1	1	—	—	$67,263.25	$67,263.25	$67,263.25	2026-05-09
428	OTHER	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	1	1	—	—	$52,244.68	$52,244.68	$52,244.68	2026-05-09
429	OTHER	Combined Anterior And Posterior Cervical Spinal Fusion With Mcc	1	1	—	—	$78,893.10	$78,893.10	$78,893.10	2026-05-09
430	OTHER	Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc	1	1	—	—	$51,929.02	$51,929.02	$51,929.02	2026-05-09
432	OTHER	Cirrhosis And Alcoholic Hepatitis With Mcc	1	1	—	—	$18,940.04	$18,940.04	$18,940.04	2026-05-09
447	OTHER	Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall…	1	1	—	—	$63,524.12	$63,524.12	$63,524.12	2026-05-09
448	OTHER	Multiple Level Spinal Fusion Except Cervical Without Mcc	1	1	—	—	$38,898.40	$38,898.40	$38,898.40	2026-05-09
450	OTHER	Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically …	1	1	—	—	$48,918.92	$48,918.92	$48,918.92	2026-05-09
451	OTHER	Single Level Spinal Fusion Except Cervical Without Mcc	1	1	—	—	$29,527.07	$29,527.07	$29,527.07	2026-05-09
456	OTHER	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	1	1	—	—	$80,101.28	$80,101.28	$80,101.28	2026-05-09
457	OTHER	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	1	1	—	—	$54,455.28	$54,455.28	$54,455.28	2026-05-09
458	OTHER	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	1	1	—	—	$41,101.48	$41,101.48	$41,101.48	2026-05-09
461	OTHER	Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc	1	1	—	—	$58,187.85	$58,187.85	$58,187.85	2026-05-09
462	OTHER	Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without Mcc	1	1	—	—	$27,439.53	$27,439.53	$27,439.53	2026-05-09
463	OTHER	Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …	1	1	—	—	$51,276.07	$51,276.07	$51,276.07	2026-05-09
464	OTHER	Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …	1	1	—	—	$28,236.22	$28,236.22	$28,236.22	2026-05-09
466	OTHER	Revision Of Hip Or Knee Replacement With Mcc	1	1	—	—	$48,397.50	$48,397.50	$48,397.50	2026-05-09
467	OTHER	Revision Of Hip Or Knee Replacement With Cc	1	1	—	—	$32,713.79	$32,713.79	$32,713.79	2026-05-09
468	OTHER	Revision Of Hip Or Knee Replacement Without Cc/mcc	1	1	—	—	$25,180.08	$25,180.08	$25,180.08	2026-05-09
469	OTHER	Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc…	1	1	—	—	$31,243.51	$31,243.51	$31,243.51	2026-05-09
471	OTHER	Cervical Spinal Fusion With Mcc	1	1	—	—	$46,168.12	$46,168.12	$46,168.12	2026-05-09
472	OTHER	Cervical Spinal Fusion With Cc	1	1	—	—	$27,753.32	$27,753.32	$27,753.32	2026-05-09
473	OTHER	Cervical Spinal Fusion Without Cc/mcc	1	1	—	—	$22,775.94	$22,775.94	$22,775.94	2026-05-09
474	OTHER	Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc	1	1	—	—	$42,667.60	$42,667.60	$42,667.60	2026-05-09
475	OTHER	Amputation For Musculoskeletal System And Connective Tissue Disorders With Cc	1	1	—	—	$20,802.10	$20,802.10	$20,802.10	2026-05-09
477	OTHER	Biopsies Of Musculoskeletal System And Connective Tissue With Mcc	1	1	—	—	$32,843.44	$32,843.44	$32,843.44	2026-05-09
478	OTHER	Biopsies Of Musculoskeletal System And Connective Tissue With Cc	1	1	—	—	$22,505.36	$22,505.36	$22,505.36	2026-05-09
480	OTHER	Hip And Femur Procedures Except Major Joint With Mcc	1	1	—	—	$28,164.81	$28,164.81	$28,164.81	2026-05-09
481	OTHER	Hip And Femur Procedures Except Major Joint With Cc	1	1	—	—	$20,027.96	$20,027.96	$20,027.96	2026-05-09
483	OTHER	Major Joint Or Limb Reattachment Procedures Of Upper Extremities	1	1	—	—	$24,474.53	$24,474.53	$24,474.53	2026-05-09
485	OTHER	Knee Procedures With Principal Diagnosis Of Infection With Mcc	1	1	—	—	$30,779.39	$30,779.39	$30,779.39	2026-05-09
486	OTHER	Knee Procedures With Principal Diagnosis Of Infection With Cc	1	1	—	—	$20,460.12	$20,460.12	$20,460.12	2026-05-09
488	OTHER	Knee Procedures Without Principal Diagnosis Of Infection With Cc/mcc	1	1	—	—	$18,999.23	$18,999.23	$18,999.23	2026-05-09
492	OTHER	Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc	1	1	—	—	$33,897.53	$33,897.53	$33,897.53	2026-05-09
493	OTHER	Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Cc	1	1	—	—	$23,091.62	$23,091.62	$23,091.62	2026-05-09
495	OTHER	Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit…	1	1	—	—	$33,610.05	$33,610.05	$33,610.05	2026-05-09
496	OTHER	Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit…	1	1	—	—	$19,070.63	$19,070.63	$19,070.63	2026-05-09
498	OTHER	Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur With Cc…	1	1	—	—	$24,255.63	$24,255.63	$24,255.63	2026-05-09
5	OTHER	Liver Transplant With Mcc Or Intestinal Transplant	1	1	—	—	$100,583.87	$100,583.87	$100,583.87	2026-05-09
500	OTHER	Soft Tissue Procedures With Mcc	1	1	—	—	$30,304.01	$30,304.01	$30,304.01	2026-05-09
503	OTHER	Foot Procedures With Mcc	1	1	—	—	$25,398.98	$25,398.98	$25,398.98	2026-05-09
507	OTHER	Major Shoulder Or Elbow Joint Procedures With Cc/mcc	1	1	—	—	$18,743.68	$18,743.68	$18,743.68	2026-05-09
510	OTHER	Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Mcc	1	1	—	—	$27,385.98	$27,385.98	$27,385.98	2026-05-09
511	OTHER	Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Cc	1	1	—	—	$18,959.77	$18,959.77	$18,959.77	2026-05-09
515	OTHER	Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc	1	1	—	—	$29,587.19	$29,587.19	$29,587.19	2026-05-09
516	OTHER	Other Musculoskeletal System And Connective Tissue O.r. Procedures With Cc	1	1	—	—	$19,434.21	$19,434.21	$19,434.21	2026-05-09
518	OTHER	Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost…	1	1	—	—	$34,205.69	$34,205.69	$34,205.69	2026-05-09
519	OTHER	Back And Neck Procedures Except Spinal Fusion With Cc	1	1	—	—	$19,060.29	$19,060.29	$19,060.29	2026-05-09
52	OTHER	Spinal Disorders And Injuries With Cc/mcc	1	1	—	—	$19,441.72	$19,441.72	$19,441.72	2026-05-09
521	OTHER	Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc	1	1	—	—	$27,917.73	$27,917.73	$27,917.73	2026-05-09
522	OTHER	Hip Replacement With Principal Diagnosis Of Hip Fracture Without Mcc	1	1	—	—	$20,339.88	$20,339.88	$20,339.88	2026-05-09
539	OTHER	Osteomyelitis With Mcc	1	1	—	—	$19,534.74	$19,534.74	$19,534.74	2026-05-09
545	OTHER	Connective Tissue Disorders With Mcc	1	1	—	—	$24,274.43	$24,274.43	$24,274.43	2026-05-09
548	OTHER	Septic Arthritis With Mcc	1	1	—	—	$19,461.46	$19,461.46	$19,461.46	2026-05-09
56	OTHER	Degenerative Nervous System Disorders With Mcc	1	1	—	—	$24,060.22	$24,060.22	$24,060.22	2026-05-09
570	OTHER	Skin Debridement With Mcc	1	1	—	—	$28,814.93	$28,814.93	$28,814.93	2026-05-09
573	OTHER	Skin Graft For Skin Ulcer Or Cellulitis With Mcc	1	1	—	—	$58,389.84	$58,389.84	$58,389.84	2026-05-09
574	OTHER	Skin Graft For Skin Ulcer Or Cellulitis With Cc	1	1	—	—	$33,086.76	$33,086.76	$33,086.76	2026-05-09
575	OTHER	Skin Graft For Skin Ulcer Or Cellulitis Without Cc/mcc	1	1	—	—	$19,293.27	$19,293.27	$19,293.27	2026-05-09
576	OTHER	Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc	1	1	—	—	$51,222.53	$51,222.53	$51,222.53	2026-05-09
577	OTHER	Skin Graft Except For Skin Ulcer Or Cellulitis With Cc	1	1	—	—	$25,551.18	$25,551.18	$25,551.18	2026-05-09
579	OTHER	Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc	1	1	—	—	$31,156.13	$31,156.13	$31,156.13	2026-05-09
584	OTHER	Breast Biopsy, Local Excision And Other Breast Procedures With Cc/mcc	1	1	—	—	$19,769.60	$19,769.60	$19,769.60	2026-05-09
585	OTHER	Breast Biopsy, Local Excision And Other Breast Procedures Without Cc/mcc	1	1	—	—	$19,184.30	$19,184.30	$19,184.30	2026-05-09
592	OTHER	Skin Ulcers With Mcc	1	1	—	—	$19,853.21	$19,853.21	$19,853.21	2026-05-09
595	OTHER	Major Skin Disorders With Mcc	1	1	—	—	$20,405.63	$20,405.63	$20,405.63	2026-05-09
6	OTHER	Liver Transplant Without Mcc	1	1	—	—	$46,092.01	$46,092.01	$46,092.01	2026-05-09
61	OTHER	Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A…	1	1	—	—	$25,932.60	$25,932.60	$25,932.60	2026-05-09
614	OTHER	Adrenal And Pituitary Procedures With Cc/mcc	1	1	—	—	$21,945.44	$21,945.44	$21,945.44	2026-05-09
616	OTHER	Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With…	1	1	—	—	$36,845.63	$36,845.63	$36,845.63	2026-05-09
617	OTHER	Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With…	1	1	—	—	$18,681.68	$18,681.68	$18,681.68	2026-05-09
619	OTHER	O.r. Procedures For Obesity With Mcc	1	1	—	—	$26,149.62	$26,149.62	$26,149.62	2026-05-09
628	OTHER	Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc	1	1	—	—	$37,603.79	$37,603.79	$37,603.79	2026-05-09
629	OTHER	Other Endocrine, Nutritional And Metabolic O.r. Procedures With Cc	1	1	—	—	$21,664.54	$21,664.54	$21,664.54	2026-05-09
64	OTHER	Intracranial Hemorrhage Or Cerebral Infarction With Mcc	1	1	—	—	$19,222.82	$19,222.82	$19,222.82	2026-05-09
650	OTHER	Kidney Transplant With Hemodialysis With Mcc	1	1	—	—	$43,819.41	$43,819.41	$43,819.41	2026-05-09
651	OTHER	Kidney Transplant With Hemodialysis Without Mcc	1	1	—	—	$33,158.16	$33,158.16	$33,158.16	2026-05-09
652	OTHER	Kidney Transplant	1	1	—	—	$29,389.89	$29,389.89	$29,389.89	2026-05-09
653	OTHER	Major Bladder Procedures With Mcc	1	1	—	—	$52,907.03	$52,907.03	$52,907.03	2026-05-09
654	OTHER	Major Bladder Procedures With Cc	1	1	—	—	$27,047.77	$27,047.77	$27,047.77	2026-05-09
655	OTHER	Major Bladder Procedures Without Cc/mcc	1	1	—	—	$20,050.51	$20,050.51	$20,050.51	2026-05-09
656	OTHER	Kidney And Ureter Procedures For Neoplasm With Mcc	1	1	—	—	$31,142.98	$31,142.98	$31,142.98	2026-05-09
659	OTHER	Kidney And Ureter Procedures For Non-neoplasm With Mcc	1	1	—	—	$24,813.69	$24,813.69	$24,813.69	2026-05-09
662	OTHER	Minor Bladder Procedures With Mcc	1	1	—	—	$29,842.73	$29,842.73	$29,842.73	2026-05-09
665	OTHER	Prostatectomy With Mcc	1	1	—	—	$32,792.71	$32,792.71	$32,792.71	2026-05-09
668	OTHER	Transurethral Procedures With Mcc	1	1	—	—	$27,932.77	$27,932.77	$27,932.77	2026-05-09
673	OTHER	Other Kidney And Urinary Tract Procedures With Mcc	1	1	—	—	$39,895.19	$39,895.19	$39,895.19	2026-05-09
674	OTHER	Other Kidney And Urinary Tract Procedures With Cc	1	1	—	—	$22,221.65	$22,221.65	$22,221.65	2026-05-09
7	OTHER	Lung Transplant	1	1	—	—	$123,313.71	$123,313.71	$123,313.71	2026-05-09
707	OTHER	Major Male Pelvic Procedures With Cc/mcc	1	1	—	—	$18,766.23	$18,766.23	$18,766.23	2026-05-09
709	OTHER	Penis Procedures With Cc/mcc	1	1	—	—	$21,645.74	$21,645.74	$21,645.74	2026-05-09
711	OTHER	Testes Procedures With Cc/mcc	1	1	—	—	$18,484.39	$18,484.39	$18,484.39	2026-05-09
715	OTHER	Other Male Reproductive System O.r. Procedures For Malignancy With Cc/mcc	1	1	—	—	$21,750.97	$21,750.97	$21,750.97	2026-05-09
734	OTHER	Pelvic Evisceration, Radical Hysterectomy And Radical Vulvectomy With Cc/mcc	1	1	—	—	$20,290.08	$20,290.08	$20,290.08	2026-05-09
736	OTHER	Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc	1	1	—	—	$37,527.70	$37,527.70	$37,527.70	2026-05-09
737	OTHER	Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Cc	1	1	—	—	$19,309.25	$19,309.25	$19,309.25	2026-05-09
739	OTHER	Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc…	1	1	—	—	$37,934.49	$37,934.49	$37,934.49	2026-05-09
744	OTHER	D&c, Conization, Laparoscopy And Tubal Interruption With Cc/mcc	1	1	—	—	$18,892.13	$18,892.13	$18,892.13	2026-05-09
749	OTHER	Other Female Reproductive System O.r. Procedures With Cc/mcc	1	1	—	—	$24,854.07	$24,854.07	$24,854.07	2026-05-09
790	OTHER	Extreme Immaturity Or Respiratory Distress Syndrome, Neonate	1	1	—	—	$56,384.99	$56,384.99	$56,384.99	2026-05-09
791	OTHER	Prematurity With Major Problems	1	1	—	—	$38,676.67	$38,676.67	$38,676.67	2026-05-09
792	OTHER	Prematurity Without Major Problems	1	1	—	—	$23,549.13	$23,549.13	$23,549.13	2026-05-09
793	OTHER	Full Term Neonate With Major Problems	1	1	—	—	$39,715.75	$39,715.75	$39,715.75	2026-05-09
799	OTHER	Splenic Procedures With Mcc	1	1	—	—	$45,205.15	$45,205.15	$45,205.15	2026-05-09
8	OTHER	Simultaneous Pancreas And Kidney Transplant	1	1	—	—	$51,652.81	$51,652.81	$51,652.81	2026-05-09
80	OTHER	Nontraumatic Stupor And Coma With Mcc	1	1	—	—	$19,209.67	$19,209.67	$19,209.67	2026-05-09
800	OTHER	Splenic Procedures With Cc	1	1	—	—	$27,909.28	$27,909.28	$27,909.28	2026-05-09
802	OTHER	Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc	1	1	—	—	$34,213.20	$34,213.20	$34,213.20	2026-05-09
808	OTHER	Major Hematological And Immunological Diagnoses Except Sickle Cell Crisis And Co…	1	1	—	—	$22,051.60	$22,051.60	$22,051.60	2026-05-09
814	OTHER	Reticuloendothelial And Immunity Disorders With Mcc	1	1	—	—	$20,174.51	$20,174.51	$20,174.51	2026-05-09
817	OTHER	Other Antepartum Diagnoses With O.r. Procedures With Mcc	1	1	—	—	$24,351.46	$24,351.46	$24,351.46	2026-05-09
82	OTHER	Traumatic Stupor And Coma >1 Hour With Mcc	1	1	—	—	$22,332.50	$22,332.50	$22,332.50	2026-05-09
820	OTHER	Lymphoma And Leukemia With Major O.r. Procedures With Mcc	1	1	—	—	$55,234.12	$55,234.12	$55,234.12	2026-05-09
821	OTHER	Lymphoma And Leukemia With Major O.r. Procedures With Cc	1	1	—	—	$21,507.64	$21,507.64	$21,507.64	2026-05-09
823	OTHER	Lymphoma And Non-acute Leukemia With Other Procedures With Mcc	1	1	—	—	$44,497.71	$44,497.71	$44,497.71	2026-05-09
824	OTHER	Lymphoma And Non-acute Leukemia With Other Procedures With Cc	1	1	—	—	$21,197.61	$21,197.61	$21,197.61	2026-05-09
826	OTHER	Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. …	1	1	—	—	$45,399.62	$45,399.62	$45,399.62	2026-05-09
827	OTHER	Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. …	1	1	—	—	$22,705.49	$22,705.49	$22,705.49	2026-05-09
829	OTHER	Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce…	1	1	—	—	$29,506.40	$29,506.40	$29,506.40	2026-05-09
834	OTHER	Acute Leukemia With Mcc	1	1	—	—	$52,462.65	$52,462.65	$52,462.65	2026-05-09
835	OTHER	Acute Leukemia With Cc	1	1	—	—	$20,601.05	$20,601.05	$20,601.05	2026-05-09
837	OTHER	Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot…	1	1	—	—	$47,576.40	$47,576.40	$47,576.40	2026-05-09
838	OTHER	Chemotherapy With Acute Leukemia As Secondary Diagnosis With Cc Or High Dose Che…	1	1	—	—	$19,589.21	$19,589.21	$19,589.21	2026-05-09
840	OTHER	Lymphoma And Non-acute Leukemia With Mcc	1	1	—	—	$30,494.74	$30,494.74	$30,494.74	2026-05-09
846	OTHER	Chemotherapy Without Acute Leukemia As Secondary Diagnosis With Mcc	1	1	—	—	$24,527.13	$24,527.13	$24,527.13	2026-05-09
849	OTHER	Radiotherapy	1	1	—	—	$25,629.15	$25,629.15	$25,629.15	2026-05-09
85	OTHER	Traumatic Stupor And Coma <1 Hour With Mcc	1	1	—	—	$21,823.30	$21,823.30	$21,823.30	2026-05-09
850	OTHER	Acute Leukemia With Other Procedures	1	1	—	—	$87,078.81	$87,078.81	$87,078.81	2026-05-09
853	OTHER	Infectious And Parasitic Diseases With O.r. Procedures With Mcc	1	1	—	—	$47,520.97	$47,520.97	$47,520.97	2026-05-09
854	OTHER	Infectious And Parasitic Diseases With O.r. Procedures With Cc	1	1	—	—	$19,306.43	$19,306.43	$19,306.43	2026-05-09
856	OTHER	Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc	1	1	—	—	$42,920.33	$42,920.33	$42,920.33	2026-05-09
857	OTHER	Postoperative Or Post-traumatic Infections With O.r. Procedures With Cc	1	1	—	—	$21,005.02	$21,005.02	$21,005.02	2026-05-09
867	OTHER	Other Infectious And Parasitic Diseases Diagnoses With Mcc	1	1	—	—	$20,679.96	$20,679.96	$20,679.96	2026-05-09
870	OTHER	Septicemia Or Severe Sepsis With Mv >96 Hours	1	1	—	—	$65,889.73	$65,889.73	$65,889.73	2026-05-09
871	OTHER	Septicemia Or Severe Sepsis Without Mv >96 Hours With Mcc	1	1	—	—	$18,968.23	$18,968.23	$18,968.23	2026-05-09
876	OTHER	O.r. Procedures With Principal Diagnosis Of Mental Illness	1	1	—	—	$37,452.54	$37,452.54	$37,452.54	2026-05-09
901	OTHER	Wound Debridements For Injuries With Mcc	1	1	—	—	$42,158.41	$42,158.41	$42,158.41	2026-05-09
902	OTHER	Wound Debridements For Injuries With Cc	1	1	—	—	$18,362.25	$18,362.25	$18,362.25	2026-05-09
904	OTHER	Skin Grafts For Injuries With Cc/mcc	1	1	—	—	$36,809.00	$36,809.00	$36,809.00	2026-05-09
906	OTHER	Hand Procedures For Injuries	1	1	—	—	$21,038.83	$21,038.83	$21,038.83	2026-05-09
907	OTHER	Other O.r. Procedures For Injuries With Mcc	1	1	—	—	$37,960.80	$37,960.80	$37,960.80	2026-05-09
908	OTHER	Other O.r. Procedures For Injuries With Cc	1	1	—	—	$19,484.94	$19,484.94	$19,484.94	2026-05-09
927	OTHER	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	1	1	—	—	$223,406.15	$223,406.15	$223,406.15	2026-05-09
928	OTHER	Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc	1	1	—	—	$63,281.73	$63,281.73	$63,281.73	2026-05-09
929	OTHER	Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/mcc	1	1	—	—	$30,413.94	$30,413.94	$30,413.94	2026-05-09
933	OTHER	Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft	1	1	—	—	$41,185.10	$41,185.10	$41,185.10	2026-05-09
934	OTHER	Full Thickness Burn Without Skin Graft Or Inhalation Injury	1	1	—	—	$20,694.05	$20,694.05	$20,694.05	2026-05-09
935	OTHER	Non-extensive Burns	1	1	—	—	$21,169.42	$21,169.42	$21,169.42	2026-05-09
939	OTHER	O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc	1	1	—	—	$30,353.81	$30,353.81	$30,353.81	2026-05-09
94	OTHER	Bacterial And Tuberculous Infections Of Nervous System With Mcc	1	1	—	—	$34,813.54	$34,813.54	$34,813.54	2026-05-09
940	OTHER	O.r. Procedures With Diagnoses Of Other Contact With Health Services With Cc	1	1	—	—	$20,370.88	$20,370.88	$20,370.88	2026-05-09
941	OTHER	O.r. Procedures With Diagnoses Of Other Contact With Health Services Without Cc/…	1	1	—	—	$18,894.94	$18,894.94	$18,894.94	2026-05-09
95	OTHER	Bacterial And Tuberculous Infections Of Nervous System With Cc	1	1	—	—	$23,055.91	$23,055.91	$23,055.91	2026-05-09
955	OTHER	Craniotomy For Multiple Significant Trauma	1	1	—	—	$64,685.32	$64,685.32	$64,685.32	2026-05-09
956	OTHER	Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma	1	1	—	—	$36,445.42	$36,445.42	$36,445.42	2026-05-09
957	OTHER	Other O.r. Procedures For Multiple Significant Trauma With Mcc	1	1	—	—	$70,659.48	$70,659.48	$70,659.48	2026-05-09
958	OTHER	Other O.r. Procedures For Multiple Significant Trauma With Cc	1	1	—	—	$39,145.49	$39,145.49	$39,145.49	2026-05-09
959	OTHER	Other O.r. Procedures For Multiple Significant Trauma Without Cc/mcc	1	1	—	—	$25,373.61	$25,373.61	$25,373.61	2026-05-09
96	OTHER	Bacterial And Tuberculous Infections Of Nervous System Without Cc/mcc	1	1	—	—	$23,055.91	$23,055.91	$23,055.91	2026-05-09
963	OTHER	Other Multiple Significant Trauma With Mcc	1	1	—	—	$26,057.56	$26,057.56	$26,057.56	2026-05-09
969	OTHER	HIV With Extensive O.r. Procedures With Mcc	1	1	—	—	$59,950.32	$59,950.32	$59,950.32	2026-05-09
97	OTHER	Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc	1	1	—	—	$34,211.33	$34,211.33	$34,211.33	2026-05-09
970	OTHER	HIV With Extensive O.r. Procedures Without Mcc	1	1	—	—	$25,461.93	$25,461.93	$25,461.93	2026-05-09
974	OTHER	HIV With Major Related Condition With Mcc	1	1	—	—	$28,589.46	$28,589.46	$28,589.46	2026-05-09
98	OTHER	Non-bacterial Infection Of Nervous System Except Viral Meningitis With Cc	1	1	—	—	$20,914.83	$20,914.83	$20,914.83	2026-05-09
981	OTHER	Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc	1	1	—	—	$45,196.69	$45,196.69	$45,196.69	2026-05-09
982	OTHER	Extensive O.r. Procedures Unrelated To Principal Diagnosis With Cc	1	1	—	—	$23,535.98	$23,535.98	$23,535.98	2026-05-09
987	OTHER	Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc	1	1	—	—	$33,441.89	$33,441.89	$33,441.89	2026-05-09

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