Hospital

AHMC ANAHEIM REGIONAL MEDICAL CENTER

Anaheim, CA · CCN 050226 · Rates published

14,013 distinct procedures filed

92 distinct payers

2,020,219 rate rows

2026-05-09 last MRF observed

Data quality

1,894,418 of 2,020,219 rate rows are consumer-grade (93.8%)

125,801 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	79,284
no usable negotiated amount (only an out-of-band fallback) — excluded from medians	31,723
placeholder amount (≤ $0.02) — excluded from medians	8,860
exceeds 10× this hospital's gross charge — excluded from medians	4,793
template filing: same amount across many unrelated codes — excluded	1,141

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

Source MRF file	https://www.ahmchealth.com/docs/PricingTransparency-Anaheim_Regional_Medical_Center-3289-2026.csv
Found on page	https://www.ahmchealth.com/armc/getpage.php?name=Price_Transparency
Discovered via	CMS hospital list
Last fetch	not_modified · 2026-05-17
Content fingerprint	7eb48c005ee3e6a7… · 635,684,773 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
018 OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	49	$4,000.00	$1,146,545.69	$496,769.81	nat. median $424,868 1.2× median
18 OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	46	$4,000.00	$1,092,824.04	$478,571.30	nat. median $386,529 1.2× median
007 OTHER	Lung Transplant	48	$4,000.00	$753,119.89	$326,320.09	nat. median $141,082 outlier · 2.3×
7 OTHER	Lung Transplant	45	$4,000.00	$730,119.52	$319,746.27	nat. median $169,933 1.9× median
001 OTHER	Heart Transplant Or Implant Of Heart Assist System With Mcc	51	$2,500.00	$655,244.01	$283,915.86	nat. median $263,894 1.1× median
631-4 OTHER	Neonate Birth Weight > 2499 Grams With Other Major Procedure	18	$66,444.90	$321,201.66	$256,961.33	nat. median $203,379 1.3× median
927 OTHER	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	49	$4,000.00	$545,771.24	$239,021.82	nat. median $146,562 1.6× median
630-4 OTHER	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure	18	$67,235.26	$285,512.74	$228,410.19	nat. median $210,669 1.1× median
583-4 OTHER	Neonate With Ecmo	18	$66,300.00	$276,250.00	$221,000.00	nat. median $309,400 0.7× median
583-3 OTHER	Neonate With Ecmo	18	$66,300.00	$276,250.00	$221,000.00	nat. median $259,487 0.9× median
588-4 OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	18	$66,300.00	$276,250.00	$221,000.00	nat. median $267,493 0.8× median
3 OTHER	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…	46	$4,000.00	$493,202.18	$216,002.30	nat. median $181,005 1.2× median
003 OTHER	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…	50	$4,000.00	$496,752.10	$215,250.04	nat. median $218,232 1.0× median
161-4 OTHER	Implantable Heart Assist Systems	18	$60,672.49	$266,296.95	$213,037.56	nat. median $202,242 1.1× median
002-4 OTHER	Heart And/or Lung Transplant	18	$52,032.00	$255,786.23	$204,628.98	nat. median $216,800 0.9× median
583-2 OTHER	Neonate With Ecmo	18	$52,725.55	$244,254.80	$195,403.84	nat. median $191,347 1.0× median
583-1 OTHER	Neonate With Ecmo	18	$47,052.96	$223,695.26	$178,956.21	nat. median $171,226 1.0× median
841-4 OTHER	Extensive Third Degree Burns With Skin Graft	18	$43,525.04	$208,085.71	$166,468.57	nat. median $151,691 1.1× median
609-4 OTHER	Neonate Birth Weight 1500-2499 Grams With Major Procedure	18	$49,500.00	$206,250.00	$165,000.00	nat. median $169,856 1.0× median
161-3 OTHER	Implantable Heart Assist Systems	18	$45,039.89	$203,423.91	$162,739.13	nat. median $152,491 1.1× median
007-4 OTHER	Allogeneic Bone Marrow Transplant	18	$40,084.54	$187,294.49	$149,835.59	nat. median $172,311 0.9× median
4 OTHER	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…	46	$4,000.00	$325,675.17	$142,643.74	nat. median $134,983 1.1× median
004 OTHER	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…	49	$4,000.00	$324,853.51	$140,775.85	nat. median $150,232 0.9× median
009-4 OTHER	Extracorporeal Membrane Oxygenation (ecmo)	18	$39,673.36	$173,750.00	$139,000.00	nat. median $150,954 0.9× median
011-3 OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	18	$32,303.95	$266,830.00	$134,599.78	nat. median $171,094 0.8× median
14 OTHER	Allogeneic Bone Marrow Transplant	46	$4,000.00	$302,084.28	$132,313.50	nat. median $100,915 1.3× median
588-3 OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	18	$39,600.00	$165,000.00	$132,000.00	nat. median $165,000 0.8× median
002-3 OTHER	Heart And/or Lung Transplant	18	$38,734.67	$164,413.56	$131,530.85	nat. median $133,471 1.0× median
588-2 OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	18	$39,000.00	$162,500.00	$130,000.00	nat. median $153,523 0.8× median
161-2 OTHER	Implantable Heart Assist Systems	18	$32,997.52	$161,825.51	$129,460.41	nat. median $109,992 1.2× median
863-4 OTHER	Neonatal Aftercare	18	$36,635.04	$158,704.92	$126,963.94	nat. median $108,047 1.2× median
014 OTHER	Allogeneic Bone Marrow Transplant	49	$4,000.00	$282,110.80	$122,257.79	nat. median $105,808 1.2× median
593-4 OTHER	Neonate Birth Weight 750-999 Grams Without Major Procedure	18	$36,300.00	$151,250.00	$121,000.00	nat. median $151,250 0.8× median
591-4 OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure	18	$36,000.00	$150,000.00	$120,000.00	nat. median $156,696 0.8× median
001-4 OTHER	Liver Transplant And/or Intestinal Transplant	18	$36,000.00	$150,000.00	$120,000.00	nat. median $124,561 1.0× median
303-4 OTHER	Dorsal And Lumbar Fusion Procedure For Curvature Of Back	18	$36,000.00	$150,000.00	$120,000.00	nat. median $108,000 1.1× median
161-1 OTHER	Implantable Heart Assist Systems	18	$32,997.52	$147,485.01	$117,988.01	nat. median $101,352 1.2× median
002 OTHER	Heart Transplant Or Implant Of Heart Assist System Without Mcc	51	$2,500.00	$266,116.34	$115,328.27	nat. median $117,167 1.0× median
2 OTHER	Heart Transplant Or Implant Of Heart Assist System Without Mcc	47	$2,500.00	$254,312.82	$111,394.81	nat. median $111,558 1.0× median
212 OTHER	Hip & Femur Procedures Except Major Joint Age 0-17	49	$4,000.00	$255,446.39	$110,705.57	nat. median $90,581 1.2× median
004-4 OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	18	$33,000.00	$137,500.00	$110,000.00	nat. median $110,000 1.0× median
5 OTHER	Liver Transplant With Mcc Or Intestinal Transplant	45	$4,000.00	$245,816.71	$107,674.44	nat. median $94,894 1.1× median
160-4 OTHER	Major Cardiothoracic Repair Of Heart Anomaly	18	$29,141.81	$133,657.41	$106,925.93	nat. median $106,926 1.0× median
005 OTHER	Liver Transplant With Mcc Or Intestinal Transplant	48	$4,000.00	$242,307.75	$105,013.32	nat. median $104,489 1.0× median
215 OTHER	Other Heart Assist System Implant	55	$2,500.00	$244,563.98	$103,477.86	nat. median $92,359 1.1× median
002-2 OTHER	Heart And/or Lung Transplant	18	$28,204.06	$126,904.58	$101,523.66	nat. median $106,681 1.0× median
607-4 OTHER	Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…	18	$30,000.00	$125,000.00	$100,000.00	nat. median $100,015 1.0× median
602-4 OTHER	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	18	$30,000.00	$125,000.00	$100,000.00	nat. median $125,000 0.8× median
593-3 OTHER	Neonate Birth Weight 750-999 Grams Without Major Procedure	18	$29,700.00	$123,750.00	$99,000.00	nat. median $112,711 0.9× median
216 OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	57	$2,500.00	$230,005.97	$98,646.55	nat. median $90,130 1.1× median

Other procedures at this hospital

Browse this hospital's 14,013 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

001	OTHER	Heart Transplant Or Implant Of Heart Assist System With Mcc	71	51	—	—	$2,500.00	$655,244.01	$283,915.86	2026-05-09
001-1	OTHER	Liver Transplant And/or Intestinal Transplant	23	18	—	—	$15,000.00	$62,500.00	$50,000.00	2026-05-09
001-2	OTHER	Liver Transplant And/or Intestinal Transplant	46	18	—	—	$18,433.97	$76,866.61	$61,493.29	2026-05-09
001-3	OTHER	Liver Transplant And/or Intestinal Transplant	46	18	—	—	$22,111.28	$95,194.33	$76,155.46	2026-05-09
001-4	OTHER	Liver Transplant And/or Intestinal Transplant	46	18	—	—	$36,000.00	$150,000.00	$120,000.00	2026-05-09
002	OTHER	Heart Transplant Or Implant Of Heart Assist System Without Mcc	71	51	—	—	$2,500.00	$266,116.34	$115,328.27	2026-05-09
002-1	OTHER	Heart And/or Lung Transplant	46	18	—	—	$15,000.00	$62,500.00	$50,000.00	2026-05-09
002-2	OTHER	Heart And/or Lung Transplant	46	18	—	—	$28,204.06	$126,904.58	$101,523.66	2026-05-09
002-3	OTHER	Heart And/or Lung Transplant	46	18	—	—	$38,734.67	$164,413.56	$131,530.85	2026-05-09
002-4	OTHER	Heart And/or Lung Transplant	46	18	—	—	$52,032.00	$255,786.23	$204,628.98	2026-05-09
003	OTHER	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…	63	50	—	—	$4,000.00	$496,752.10	$215,250.04	2026-05-09
004	OTHER	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…	62	49	—	—	$4,000.00	$324,853.51	$140,775.85	2026-05-09
004-1	OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	46	18	—	—	$12,611.04	$54,437.46	$43,549.97	2026-05-09
004-2	OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	46	18	—	—	$17,423.47	$76,836.05	$61,468.84	2026-05-09
004-3	OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	46	18	—	—	$26,761.86	$113,750.00	$91,000.00	2026-05-09
004-4	OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	46	18	—	—	$33,000.00	$137,500.00	$110,000.00	2026-05-09
005	OTHER	Liver Transplant With Mcc Or Intestinal Transplant	61	48	—	—	$4,000.00	$242,307.75	$105,013.32	2026-05-09
005-1	OTHER	Tracheostomy With Mv >96 Hours Without Extensive Procedure	46	18	—	—	$10,196.36	$57,407.88	$42,484.84	2026-05-09
005-2	OTHER	Tracheostomy With Mv >96 Hours Without Extensive Procedure	46	18	—	—	$13,059.34	$62,465.06	$49,972.05	2026-05-09
005-3	OTHER	Tracheostomy With Mv >96 Hours Without Extensive Procedure	46	18	—	—	$19,686.90	$93,279.52	$74,623.62	2026-05-09
005-4	OTHER	Tracheostomy With Mv >96 Hours Without Extensive Procedure	46	18	—	—	$26,400.00	$110,000.00	$88,000.00	2026-05-09
006	OTHER	Liver Transplant Without Mcc	61	48	—	—	$4,000.00	$150,947.65	$65,432.02	2026-05-09
006-1	OTHER	Pancreas Transplant	46	18	—	—	$15,000.00	$62,500.00	$50,000.00	2026-05-09
006-2	OTHER	Pancreas Transplant	46	18	—	—	$20,077.55	$83,897.94	$67,118.35	2026-05-09
006-3	OTHER	Pancreas Transplant	46	18	—	—	$23,743.48	$102,136.84	$81,709.47	2026-05-09
006-4	OTHER	Pancreas Transplant	46	18	—	—	$25,500.00	$106,250.00	$85,000.00	2026-05-09
007	OTHER	Lung Transplant	62	48	—	—	$4,000.00	$753,119.89	$326,320.09	2026-05-09
007-1	OTHER	Allogeneic Bone Marrow Transplant	46	18	—	—	$17,842.94	$93,333.85	$74,345.60	2026-05-09
007-2	OTHER	Allogeneic Bone Marrow Transplant	46	18	—	—	$18,099.38	$83,057.51	$66,446.01	2026-05-09
007-3	OTHER	Allogeneic Bone Marrow Transplant	46	18	—	—	$22,977.56	$111,591.43	$89,273.14	2026-05-09
007-4	OTHER	Allogeneic Bone Marrow Transplant	46	18	—	—	$40,084.54	$187,294.49	$149,835.59	2026-05-09
008	OTHER	Simultaneous Pancreas And Kidney Transplant	61	48	—	—	$4,000.00	$147,760.51	$64,051.21	2026-05-09
008-3	OTHER	Autologous Bone Marrow Transplant Or T-cell Immunotherapy	46	18	—	—	$11,660.38	$53,381.34	$42,705.07	2026-05-09
008-4	OTHER	Autologous Bone Marrow Transplant Or T-cell Immunotherapy	46	18	—	—	$19,457.20	$81,385.20	$65,108.16	2026-05-09
009-1	OTHER	Extracorporeal Membrane Oxygenation (ecmo)	46	18	—	—	$10,361.72	$61,109.46	$43,173.82	2026-05-09
009-2	OTHER	Extracorporeal Membrane Oxygenation (ecmo)	46	18	—	—	$10,907.31	$74,554.67	$45,447.11	2026-05-09
009-3	OTHER	Extracorporeal Membrane Oxygenation (ecmo)	46	18	—	—	$18,681.60	$137,638.09	$77,839.99	2026-05-09
009-4	OTHER	Extracorporeal Membrane Oxygenation (ecmo)	46	18	—	—	$39,673.36	$173,750.00	$139,000.00	2026-05-09
010	OTHER	Pancreas Transplant	61	48	—	—	$4,000.00	$169,229.04	$73,352.34	2026-05-09
011	OTHER	Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc	62	49	—	—	$4,000.00	$129,094.94	$55,964.45	2026-05-09
011-2	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	46	18	—	—	$15,000.00	$62,500.00	$50,000.00	2026-05-09
011-3	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	46	18	—	—	$32,303.95	$266,830.00	$134,599.78	2026-05-09
011-4	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	46	18	—	—	$15,006.30	$62,526.25	$50,021.00	2026-05-09
012	OTHER	Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc	62	49	—	—	$4,000.00	$100,232.25	$43,459.83	2026-05-09
014	OTHER	Allogeneic Bone Marrow Transplant	62	49	—	—	$4,000.00	$282,110.80	$122,257.79	2026-05-09
016	OTHER	Autologous Bone Marrow Transplant With Cc/mcc	62	49	—	—	$4,000.00	$140,182.18	$60,767.94	2026-05-09
017	OTHER	Autologous Bone Marrow Transplant Without Cc/mcc	62	49	—	—	$4,000.00	$128,586.74	$55,744.27	2026-05-09
018	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	62	49	—	—	$4,000.00	$1,146,545.69	$496,769.81	2026-05-09
019	OTHER	Simultaneous Pancreas And Kidney Transplant With Hemodialysis	62	49	—	—	$4,000.00	$168,270.88	$72,937.22	2026-05-09
020	OTHER	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc	62	49	—	—	$4,000.00	$185,386.64	$80,352.54	2026-05-09
020-4	OTHER	Open Craniotomy For Trauma	46	18	—	—	$13,195.07	$59,041.84	$47,233.47	2026-05-09
021	OTHER	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc	62	49	—	—	$4,000.00	$125,358.03	$54,345.45	2026-05-09
021-4	OTHER	Open Craniotomy Except Trauma	46	18	—	—	$14,892.39	$62,856.53	$50,285.22	2026-05-09
023	OTHER	Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…	64	51	—	—	$3,000.00	$135,533.75	$58,754.03	2026-05-09
023-4	OTHER	Spinal Procedures	46	18	—	—	$14,368.91	$62,516.21	$50,012.97	2026-05-09
024	OTHER	Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…	64	51	—	—	$3,000.00	$93,143.05	$40,388.47	2026-05-09
025	OTHER	Craniotomy And Endovascular Intracranial Procedures With Mcc	62	49	—	—	$4,000.00	$107,941.55	$46,799.85	2026-05-09
027-4	OTHER	Other Open Craniotomy	46	18	—	—	$11,699.05	$55,726.36	$44,581.09	2026-05-09
028	OTHER	Spinal Procedures With Mcc	62	49	—	—	$4,000.00	$142,014.51	$61,561.79	2026-05-09
031	OTHER	Ventricular Shunt Procedures With Mcc	62	49	—	—	$4,000.00	$106,398.30	$46,131.24	2026-05-09
034	OTHER	Carotid Artery Stent Procedures With Mcc	62	49	—	—	$4,000.00	$92,182.61	$39,972.37	2026-05-09
040	OTHER	Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc	64	50	—	—	$4,000.00	$91,961.11	$39,876.40	2026-05-09
089-4	OTHER	Major Cranial Or Facial Bone Procedures	46	18	—	—	$13,750.98	$59,272.05	$47,417.64	2026-05-09
091-4	OTHER	Other Major Head And Neck Procedures	46	18	—	—	$16,153.70	$69,862.82	$55,890.26	2026-05-09
092-4	OTHER	Facial Bone Procedures Except Major Cranial Or Facial Bone Procedures	46	18	—	—	$11,754.71	$50,266.45	$40,213.16	2026-05-09
0:00	OTHER	Liver Transplant And/or Intestinal Transplant	23	18	—	—	$15,000.00	$62,500.00	$50,000.00	2026-05-06
10	OTHER	Pancreas Transplant	58	45	—	—	$4,000.00	$184,409.68	$80,784.85	2026-05-06
11	OTHER	Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc	59	46	—	—	$4,000.00	$125,281.00	$54,892.94	2026-05-06
12	OTHER	Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc	59	46	—	—	$4,000.00	$95,632.92	$41,910.31	2026-05-06
120-4	OTHER	Major Respiratory And Chest Procedures	46	18	—	—	$13,497.51	$61,654.19	$49,323.35	2026-05-09
121-4	OTHER	Other Respiratory And Chest Procedures	46	18	—	—	$11,411.87	$49,416.94	$39,533.55	2026-05-09
130-4	OTHER	Respiratory System Diagnosis With Ventilator Support > 96 Hours	46	18	—	—	$13,801.31	$59,923.47	$47,938.78	2026-05-09
13602534	OTHER	Y-90 Zevelin Yttreium <=40mci	263	87	$41,862.00	$41,862.00	$52.50	$192,180.62	$41,862.00	2026-05-09
14	OTHER	Allogeneic Bone Marrow Transplant	59	46	—	—	$4,000.00	$302,084.28	$132,313.50	2026-05-06
140	OTHER	Major Head And Neck Procedures With Mcc	121	49	—	—	$4,000.00	$101,381.55	$43,957.76	2026-05-09
16	OTHER	Autologous Bone Marrow Transplant With Cc/mcc	59	46	—	—	$4,000.00	$139,965.12	$61,322.98	2026-05-06
160-3	OTHER	Major Cardiothoracic Repair Of Heart Anomaly	46	18	—	—	$13,764.68	$58,748.09	$46,998.47	2026-05-09
160-4	OTHER	Major Cardiothoracic Repair Of Heart Anomaly	46	18	—	—	$29,141.81	$133,657.41	$106,925.93	2026-05-09
161-1	OTHER	Implantable Heart Assist Systems	46	18	—	—	$32,997.52	$147,485.01	$117,988.01	2026-05-09
161-2	OTHER	Implantable Heart Assist Systems	46	18	—	—	$32,997.52	$161,825.51	$129,460.41	2026-05-09
161-3	OTHER	Implantable Heart Assist Systems	46	18	—	—	$45,039.89	$203,423.91	$162,739.13	2026-05-09
161-4	OTHER	Implantable Heart Assist Systems	46	18	—	—	$60,672.49	$266,296.95	$213,037.56	2026-05-09
162-2	OTHER	Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis	46	18	—	—	$13,188.16	$55,345.18	$44,276.14	2026-05-09
162-3	OTHER	Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis	46	18	—	—	$16,879.38	$72,317.38	$57,853.90	2026-05-09
162-4	OTHER	Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis	46	18	—	—	$24,231.34	$103,839.63	$83,071.70	2026-05-09
163	OTHER	Major Chest Procedures With Mcc	121	49	—	—	$4,000.00	$107,231.06	$46,989.03	2026-05-09
163-3	OTHER	Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis	46	18	—	—	$13,889.89	$60,672.17	$48,537.74	2026-05-09
163-4	OTHER	Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis	46	18	—	—	$21,085.56	$88,756.88	$71,005.50	2026-05-09
1630988	OTHER	Cath Elite Bi-caval Dual Lumen	105	41	$83,845.00	$83,845.00	$52.50	$83,845.00	$41,922.50	2026-05-09
165-2	OTHER	Coronary Bypass With Ami Or Complex Principal Diagnosis	46	18	—	—	$11,569.93	$48,581.19	$38,864.95	2026-05-09
165-3	OTHER	Coronary Bypass With Ami Or Complex Principal Diagnosis	46	18	—	—	$14,017.50	$58,664.61	$46,931.69	2026-05-09
165-4	OTHER	Coronary Bypass With Ami Or Complex Principal Diagnosis	46	18	—	—	$19,097.70	$81,378.18	$65,102.54	2026-05-09
1656047	OTHER	Cl Impella Heart Pump	105	41	$100,000.00	$100,000.00	$52.50	$100,000.00	$50,000.00	2026-05-09
1656048	OTHER	Cl Impella Cp Heart Pump	109	43	$125,000.00	$125,000.00	$52.50	$125,000.00	$62,500.00	2026-05-09
166	OTHER	Other Respiratory System O.r. Procedures With Mcc	121	49	—	—	$4,000.00	$89,818.97	$39,364.44	2026-05-09
166-3	OTHER	Coronary Bypass Without Ami Or Complex Principal Diagnosis	46	18	—	—	$11,691.01	$49,951.91	$39,961.53	2026-05-09
166-4	OTHER	Coronary Bypass Without Ami Or Complex Principal Diagnosis	46	18	—	—	$16,514.02	$71,634.41	$57,307.53	2026-05-09
167-3	OTHER	Other Cardiothoracic And Thoracic Vascular Procedures	46	18	—	—	$10,060.24	$49,139.19	$39,311.35	2026-05-09
167-4	OTHER	Other Cardiothoracic And Thoracic Vascular Procedures	46	18	—	—	$16,208.72	$81,226.79	$64,981.43	2026-05-09
169-4	OTHER	Major Abdominal Vascular Procedures	46	18	—	—	$14,910.52	$64,208.99	$51,367.19	2026-05-09
17	OTHER	Autologous Bone Marrow Transplant Without Cc/mcc	59	46	—	—	$4,000.00	$139,965.12	$61,322.98	2026-05-06
176-4	OTHER	Insertion, Revision And Replacements Of Pacemaker And Other Cardiac Devices	46	18	—	—	$10,179.50	$53,614.46	$42,414.60	2026-05-09
178-1	OTHER	External Heart Assist Systems	46	18	—	—	$11,916.27	$52,485.95	$41,988.76	2026-05-09
178-2	OTHER	External Heart Assist Systems	46	18	—	—	$12,988.03	$57,411.63	$45,929.30	2026-05-09
178-3	OTHER	External Heart Assist Systems	46	18	—	—	$15,524.26	$67,130.84	$53,704.67	2026-05-09
178-4	OTHER	External Heart Assist Systems	46	18	—	—	$19,868.61	$84,415.90	$67,532.72	2026-05-09
179-3	OTHER	Defibrillator Implants	46	18	—	—	$12,114.09	$50,746.99	$40,597.59	2026-05-09
179-4	OTHER	Defibrillator Implants	46	18	—	—	$16,497.81	$72,318.77	$57,855.02	2026-05-09
18	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	59	46	—	—	$4,000.00	$1,092,824.04	$478,571.30	2026-05-06
181-4	OTHER	Lower Extremity Arterial Procedures	46	18	—	—	$11,688.88	$54,178.71	$43,342.97	2026-05-09
183-3	OTHER	Percutaneous Structural Cardiac Procedures	46	18	—	—	$12,098.18	$51,760.71	$41,408.57	2026-05-09
183-4	OTHER	Percutaneous Structural Cardiac Procedures	46	18	—	—	$17,630.63	$75,469.11	$60,375.29	2026-05-09
19	OTHER	Simultaneous Pancreas And Kidney Transplant With Hemodialysis	59	46	—	—	$4,000.00	$183,361.13	$80,325.70	2026-05-06
2	OTHER	Heart Transplant Or Implant Of Heart Assist System Without Mcc	67	47	—	—	$2,500.00	$254,312.82	$111,394.81	2026-05-06
20	OTHER	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc	59	46	—	—	$4,000.00	$186,431.04	$81,669.99	2026-05-06
207	OTHER	Respiratory System Diagnosis With Ventilator Support >96 Hours	121	49	—	—	$4,000.00	$151,954.80	$65,868.37	2026-05-09
21	OTHER	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc	59	46	—	—	$4,000.00	$128,295.83	$56,213.11	2026-05-06
212	OTHER	Hip & Femur Procedures Except Major Joint Age 0-17	121	49	—	—	$4,000.00	$255,446.39	$110,705.57	2026-05-09
215	OTHER	Other Heart Assist System Implant	154	55	—	—	$2,500.00	$244,563.98	$103,477.86	2026-05-09
216	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	160	57	—	—	$2,500.00	$230,005.97	$98,646.55	2026-05-09
217	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	158	56	—	—	$4,000.00	$155,232.44	$67,288.39	2026-05-09
218	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	152	56	—	—	$4,000.00	$155,232.44	$67,288.39	2026-05-09
219	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	158	56	—	—	$4,000.00	$180,945.68	$78,428.52	2026-05-09
220	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	158	56	—	—	$4,000.00	$126,267.19	$54,739.34	2026-05-09
220-4	OTHER	Major Stomach, Esophageal And Duodenal Procedures	46	18	—	—	$13,694.37	$60,544.44	$48,435.55	2026-05-09
221	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	158	56	—	—	$4,000.00	$119,446.11	$51,784.14	2026-05-09
228	OTHER	Other Cardiothoracic Procedures With Mcc	146	55	—	—	$4,000.00	$117,282.71	$50,846.86	2026-05-09
23	OTHER	Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…	60	47	—	—	$4,000.00	$132,375.26	$57,999.45	2026-05-06
230-4	OTHER	Major Small Bowel Procedures	46	18	—	—	$11,712.41	$50,943.31	$40,754.65	2026-05-09
231	OTHER	Coronary Bypass With Ptca With Mcc	160	57	—	—	$2,500.00	$198,467.04	$86,019.56	2026-05-09
232	OTHER	Coronary Bypass With Ptca Without Mcc	158	56	—	—	$4,000.00	$143,280.35	$62,110.20	2026-05-09
232-4	OTHER	Gastric Fundoplication	46	18	—	—	$14,591.53	$86,019.85	$60,798.06	2026-05-09
233	OTHER	Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc	160	57	—	—	$2,500.00	$180,816.66	$79,211.50	2026-05-09
234	OTHER	Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc	160	57	—	—	$2,500.00	$129,295.42	$56,051.30	2026-05-09
234-4	OTHER	Appendectomy Without Complex Principal Diagnosis	46	18	—	—	$11,344.77	$50,939.55	$40,751.64	2026-05-09
235	OTHER	Coronary Bypass Without Cardiac Catheterization With Mcc	154	55	—	—	$4,000.00	$138,757.80	$60,150.83	2026-05-09
236	OTHER	Coronary Bypass Without Cardiac Catheterization Without Mcc	154	55	—	—	$4,000.00	$99,598.14	$43,185.11	2026-05-09
239	OTHER	Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc	121	49	—	—	$4,000.00	$117,044.15	$51,286.10	2026-05-09
24	OTHER	Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…	60	47	—	—	$4,000.00	$88,703.87	$38,876.14	2026-05-06
245	OTHER	Aicd Generator Procedures	137	53	—	—	$4,000.00	$113,600.30	$49,778.07	2026-05-09
25	OTHER	Craniotomy And Endovascular Intracranial Procedures With Mcc	59	46	—	—	$4,000.00	$104,090.05	$45,613.61	2026-05-06
260-4	OTHER	Major Pancreas, Liver And Shunt Procedures	46	18	—	—	$14,088.41	$60,090.29	$48,072.23	2026-05-09
261-4	OTHER	Major Biliary Tract Procedures	46	18	—	—	$12,479.18	$54,670.41	$43,736.33	2026-05-09
266	OTHER	Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc	139	52	—	—	$4,000.00	$144,814.28	$62,774.77	2026-05-09
267	OTHER	Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc	150	54	—	—	$2,500.00	$112,932.68	$48,962.23	2026-05-09
268	OTHER	Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc	140	53	—	—	$3,000.00	$162,286.69	$70,344.60	2026-05-09
269	OTHER	Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc	140	53	—	—	$3,000.00	$100,400.11	$43,532.56	2026-05-09
270	OTHER	Other Major Cardiovascular Procedures With Mcc	152	55	—	—	$2,495.00	$124,950.05	$53,283.78	2026-05-09
273	OTHER	Percutaneous And Other Intracardiac Procedures With Mcc	141	51	—	—	$4,000.00	$98,122.51	$42,545.80	2026-05-09
275	OTHER	Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc	140	52	—	—	$2,500.00	$168,172.96	$72,894.80	2026-05-09
276	OTHER	Non-maligant Breast Disorders	121	49	—	—	$4,000.00	$143,601.70	$62,915.41	2026-05-09
277	OTHER	Cellulitis Age >17 W Cc	121	49	—	—	$4,000.00	$109,615.39	$47,525.03	2026-05-09
278	OTHER	Cellulitis Age >17 Without Cc	121	49	—	—	$4,000.00	$131,708.25	$57,096.65	2026-05-09
28	OTHER	Spinal Procedures With Mcc	59	46	—	—	$4,000.00	$140,965.42	$61,761.01	2026-05-06
3	OTHER	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…	59	46	—	—	$4,000.00	$493,202.18	$216,002.30	2026-05-06
303-1	OTHER	Dorsal And Lumbar Fusion Procedure For Curvature Of Back	46	18	—	—	$9,780.06	$54,956.91	$40,750.25	2026-05-09
303-2	OTHER	Dorsal And Lumbar Fusion Procedure For Curvature Of Back	46	18	—	—	$11,084.30	$52,328.30	$41,862.64	2026-05-09
303-3	OTHER	Dorsal And Lumbar Fusion Procedure For Curvature Of Back	46	18	—	—	$14,829.74	$72,112.34	$57,689.87	2026-05-09
303-4	OTHER	Dorsal And Lumbar Fusion Procedure For Curvature Of Back	46	18	—	—	$36,000.00	$150,000.00	$120,000.00	2026-05-09
304-3	OTHER	Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back	46	18	—	—	$11,663.11	$49,844.82	$39,875.86	2026-05-09
304-4	OTHER	Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back	46	18	—	—	$16,327.98	$76,610.14	$61,288.11	2026-05-09
31	OTHER	Ventricular Shunt Procedures With Mcc	59	46	—	—	$4,000.00	$97,626.73	$42,783.38	2026-05-06
312-4	OTHER	Skin Graft, Except Hand, For Musculoskeletal And Connective Tissue Diagnoses	46	18	—	—	$13,042.41	$59,089.39	$47,271.51	2026-05-09
319	OTHER	Other Endovascular Cardiac Valve Procedures With Mcc	130	51	—	—	$3,000.00	$105,987.98	$45,953.47	2026-05-09
321-4	OTHER	Spinal Fusion And Other Back And Neck Procedures Except For Disc Procedures	46	18	—	—	$12,021.22	$50,619.26	$40,495.41	2026-05-09
323	OTHER	Urinary Stones W Cc, &/or Esw Lithotripsy	121	49	—	—	$4,000.00	$102,829.23	$44,584.96	2026-05-09
326	OTHER	Stomach, Esophageal And Duodenal Procedures With Mcc	124	49	—	—	$4,000.00	$118,215.22	$51,709.09	2026-05-09
329	OTHER	Major Small And Large Bowel Procedures With Mcc	121	49	—	—	$4,000.00	$109,102.48	$47,302.82	2026-05-09
34	OTHER	Carotid Artery Stent Procedures With Mcc	59	46	—	—	$4,000.00	$90,700.01	$39,750.23	2026-05-06
356	OTHER	Other Digestive System O.r. Procedures With Mcc	122	50	—	—	$3,000.00	$104,353.84	$45,245.49	2026-05-09
361-4	OTHER	Skin Graft For Skin And Subcutaneous Tissue Diagnoses	46	18	—	—	$12,281.05	$58,313.69	$46,650.95	2026-05-09
4	OTHER	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…	59	46	—	—	$4,000.00	$325,675.17	$142,643.74	2026-05-06
401-4	OTHER	Adrenal Procedures	46	18	—	—	$12,824.53	$56,618.61	$45,294.89	2026-05-09
405	OTHER	Pancreas, Liver And Shunt Procedures With Mcc	123	49	—	—	$4,000.00	$129,477.24	$56,130.08	2026-05-09
423	OTHER	Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc	126	51	—	—	$3,000.00	$98,763.60	$42,823.55	2026-05-09
440-1	OTHER	Kidney Transplant	46	18	—	—	$11,572.11	$50,456.79	$40,365.43	2026-05-09
440-2	OTHER	Kidney Transplant	46	18	—	—	$12,905.90	$55,228.56	$44,182.85	2026-05-09
440-3	OTHER	Kidney Transplant	46	18	—	—	$14,679.00	$63,984.99	$51,187.99	2026-05-09
440-4	OTHER	Kidney Transplant	46	18	—	—	$23,068.94	$97,879.26	$78,303.41	2026-05-09
441-4	OTHER	Major Bladder Procedures	46	18	—	—	$13,036.37	$58,143.54	$46,514.83	2026-05-09
453	OTHER	Combined Anterior And Posterior Spinal Fusion With Mcc	125	49	—	—	$4,000.00	$208,526.20	$90,377.64	2026-05-09
454	OTHER	Combined Anterior And Posterior Spinal Fusion With Cc	125	49	—	—	$4,000.00	$144,532.21	$62,652.56	2026-05-09
455	OTHER	Combined Anterior And Posterior Spinal Fusion Without Cc/mcc	125	49	—	—	$4,000.00	$109,314.63	$47,394.73	2026-05-09
456	OTHER	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	125	49	—	—	$4,000.00	$197,849.27	$85,770.13	2026-05-09
457	OTHER	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	125	49	—	—	$4,000.00	$140,960.81	$61,105.27	2026-05-09
458	OTHER	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	125	49	—	—	$4,000.00	$100,549.80	$44,063.37	2026-05-09
459	OTHER	Spinal Fusion Except Cervical With Mcc	125	49	—	—	$4,000.00	$156,561.25	$67,864.09	2026-05-09
461	OTHER	Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc	125	49	—	—	$4,000.00	$142,277.83	$62,335.70	2026-05-09
463	OTHER	Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …	121	49	—	—	$4,000.00	$134,815.72	$58,442.95	2026-05-09
466	OTHER	Revision Of Hip Or Knee Replacement With Mcc	125	49	—	—	$4,000.00	$123,297.23	$53,452.62	2026-05-09
471	OTHER	Cervical Spinal Fusion With Mcc	148	53	—	—	$2,500.00	$114,515.58	$49,648.01	2026-05-09
474	OTHER	Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc	121	49	—	—	$4,000.00	$104,374.55	$45,738.19	2026-05-09
483-4	OTHER	Penis, Testes And Scrotal Procedures	46	18	—	—	$14,397.22	$60,290.46	$48,232.37	2026-05-09
5	OTHER	Liver Transplant With Mcc Or Intestinal Transplant	58	45	—	—	$4,000.00	$245,816.71	$107,674.44	2026-05-06
510-4	OTHER	Pelvic Evisceration, Radical Hysterectomy And Other Radical Gynecological Proced…	23	18	—	—	$12,621.85	$52,591.04	$42,072.83	2026-05-06
511-4	OTHER	Uterine And Adnexa Procedures For Ovarian And Adnexal Malignancy	46	18	—	—	$11,500.92	$50,424.09	$40,339.27	2026-05-09
518	OTHER	Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost…	131	49	—	—	$4,000.00	$89,072.74	$38,625.03	2026-05-09
570	OTHER	Skin Debridement With Mcc	121	49	—	—	$4,000.00	$124,467.34	$53,959.56	2026-05-09
573	OTHER	Skin Graft For Skin Ulcer Or Cellulitis With Mcc	121	49	—	—	$4,000.00	$154,675.29	$67,047.00	2026-05-09
576	OTHER	Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc	121	49	—	—	$4,000.00	$125,267.24	$54,886.91	2026-05-09
583-1	OTHER	Neonate With Ecmo	46	18	—	—	$47,052.96	$223,695.26	$178,956.21	2026-05-09
583-2	OTHER	Neonate With Ecmo	46	18	—	—	$52,725.55	$244,254.80	$195,403.84	2026-05-09
583-3	OTHER	Neonate With Ecmo	46	18	—	—	$66,300.00	$276,250.00	$221,000.00	2026-05-09
583-4	OTHER	Neonate With Ecmo	46	18	—	—	$66,300.00	$276,250.00	$221,000.00	2026-05-09
588-1	OTHER	Female Reproductive System Reconstructive Procedures	46	18	—	—	$15,000.00	$62,500.00	$50,000.00	2026-05-09
588-2	OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	46	18	—	—	$39,000.00	$162,500.00	$130,000.00	2026-05-09
588-3	OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	46	18	—	—	$39,600.00	$165,000.00	$132,000.00	2026-05-09
588-4	OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	46	18	—	—	$66,300.00	$276,250.00	$221,000.00	2026-05-09
589-1	OTHER	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …	46	18	—	—	$20,608.13	$226,788.26	$85,867.21	2026-05-09
589-3	OTHER	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …	46	18	—	—	$12,603.83	$108,750.00	$52,515.97	2026-05-09
591-2	OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure	46	18	—	—	$21,815.52	$100,000.00	$80,000.00	2026-05-09
591-3	OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure	46	18	—	—	$27,300.00	$113,750.00	$91,000.00	2026-05-09
591-4	OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure	46	18	—	—	$36,000.00	$150,000.00	$120,000.00	2026-05-09
593-2	OTHER	Neonate Birth Weight 750-999 Grams Without Major Procedure	46	18	—	—	$23,700.00	$98,750.00	$79,000.00	2026-05-09
593-3	OTHER	Neonate Birth Weight 750-999 Grams Without Major Procedure	46	18	—	—	$29,700.00	$123,750.00	$99,000.00	2026-05-09
593-4	OTHER	Neonate Birth Weight 750-999 Grams Without Major Procedure	46	18	—	—	$36,300.00	$151,250.00	$121,000.00	2026-05-09
6	OTHER	Liver Transplant Without Mcc	58	45	—	—	$4,000.00	$135,089.40	$59,187.95	2026-05-06
602-2	OTHER	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	46	18	—	—	$24,000.00	$100,000.00	$80,000.00	2026-05-09
602-3	OTHER	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	46	18	—	—	$27,600.00	$115,000.00	$92,000.00	2026-05-09
602-4	OTHER	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	46	18	—	—	$30,000.00	$125,000.00	$100,000.00	2026-05-09
603-2	OTHER	Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition	46	18	—	—	$10,343.70	$52,761.18	$42,208.94	2026-05-09
603-3	OTHER	Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition	46	18	—	—	$14,717.79	$85,936.03	$61,324.14	2026-05-09
603-4	OTHER	Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition	46	18	—	—	$24,000.00	$100,000.00	$80,000.00	2026-05-09
607-2	OTHER	Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…	46	18	—	—	$17,485.32	$73,765.74	$59,012.59	2026-05-09
607-3	OTHER	Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…	46	18	—	—	$24,034.21	$107,500.00	$86,000.00	2026-05-09
607-4	OTHER	Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…	46	18	—	—	$30,000.00	$125,000.00	$100,000.00	2026-05-09
608-2	OTHER	Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition	46	18	—	—	$10,932.60	$51,097.20	$40,877.76	2026-05-09
608-3	OTHER	Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition	46	18	—	—	$17,053.84	$75,516.23	$60,412.98	2026-05-09
608-4	OTHER	Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition	46	18	—	—	$21,000.00	$87,500.00	$70,000.00	2026-05-09
609-1	OTHER	Neonate Birth Weight 1500-2499 Grams With Major Procedure	46	18	—	—	$12,307.17	$51,980.68	$41,584.54	2026-05-09
609-2	OTHER	Neonate Birth Weight 1500-2499 Grams With Major Procedure	46	18	—	—	$13,567.70	$64,579.96	$51,663.97	2026-05-09
609-3	OTHER	Neonate Birth Weight 1500-2499 Grams With Major Procedure	46	18	—	—	$23,878.07	$100,851.29	$80,681.03	2026-05-09
609-4	OTHER	Neonate Birth Weight 1500-2499 Grams With Major Procedure	46	18	—	—	$49,500.00	$206,250.00	$165,000.00	2026-05-09
611-4	OTHER	Neonate Birth Weight 1500-1999 Grams With Major Anomaly	46	18	—	—	$27,900.00	$116,250.00	$93,000.00	2026-05-09
612-3	OTHER	Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other…	46	18	—	—	$14,643.27	$65,894.49	$52,715.59	2026-05-09
612-4	OTHER	Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other…	46	18	—	—	$26,700.00	$111,250.00	$89,000.00	2026-05-09
613-3	OTHER	Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection	46	18	—	—	$14,159.53	$61,163.80	$48,931.04	2026-05-09
613-4	OTHER	Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection	46	18	—	—	$18,600.00	$77,500.00	$62,000.00	2026-05-09
614-3	OTHER	Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition	46	18	—	—	$12,489.67	$53,401.76	$42,721.41	2026-05-09
616	OTHER	Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With…	121	49	—	—	$4,000.00	$90,156.24	$39,512.12	2026-05-09
621-4	OTHER	Neonate Birth Weight 2000-2499 Grams With Major Anomaly	46	18	—	—	$27,000.00	$112,500.00	$90,000.00	2026-05-09
622-4	OTHER	Neonate Birth Weight 2000-2499 Grams With Respiratory Distress Syndrome Or Other…	46	18	—	—	$17,086.48	$78,239.10	$62,591.28	2026-05-09
623-4	OTHER	Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection	46	18	—	—	$16,424.02	$74,879.84	$59,903.87	2026-05-09
625-4	OTHER	Neonate Birth Weight 2000-2499 Grams With Other Significant Condition	46	18	—	—	$15,601.28	$75,207.63	$60,166.10	2026-05-09
628	OTHER	Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc	121	49	—	—	$4,000.00	$92,007.81	$40,322.91	2026-05-09
630-2	OTHER	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure	46	18	—	—	$12,228.57	$64,828.29	$50,952.39	2026-05-09
630-3	OTHER	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure	46	18	—	—	$28,500.00	$118,750.00	$95,000.00	2026-05-09
630-4	OTHER	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure	46	18	—	—	$67,235.26	$285,512.74	$228,410.19	2026-05-09
631-3	OTHER	Neonate Birth Weight > 2499 Grams With Other Major Procedure	46	18	—	—	$18,161.23	$77,517.16	$62,013.73	2026-05-09
631-4	OTHER	Neonate Birth Weight > 2499 Grams With Other Major Procedure	46	18	—	—	$66,444.90	$321,201.66	$256,961.33	2026-05-09
633-4	OTHER	Neonate Birth Weight > 2499 Grams With Major Anomaly	46	18	—	—	$25,638.26	$119,330.16	$95,464.13	2026-05-09
634-4	OTHER	Neonate Birth Weight > 2499 Grams With Respiratory Distress Syndrome Or Other Ma…	46	18	—	—	$16,222.39	$69,292.31	$55,433.85	2026-05-09
636-4	OTHER	Neonate Birth Weight > 2499 Grams With Congenital Or Perinatal Infection	46	18	—	—	$10,525.84	$57,362.83	$43,857.66	2026-05-09
650	OTHER	Kidney Transplant With Hemodialysis With Mcc	126	51	—	—	$3,000.00	$111,547.91	$48,362.28	2026-05-09
653	OTHER	Major Bladder Procedures With Mcc	121	49	—	—	$4,000.00	$129,381.09	$56,688.33	2026-05-09
673	OTHER	Other Kidney And Urinary Tract Procedures With Mcc	122	50	—	—	$4,000.00	$99,896.59	$43,314.41	2026-05-09
680-4	OTHER	Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms	46	18	—	—	$15,897.68	$70,674.80	$56,539.84	2026-05-09
681-4	OTHER	Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms	46	18	—	—	$12,850.64	$60,563.21	$48,450.57	2026-05-09
690-4	OTHER	Acute Leukemia	46	18	—	—	$13,523.59	$60,101.54	$48,081.23	2026-05-09
695-4	OTHER	Chemotherapy For Acute Leukemia	46	18	—	—	$11,707.64	$51,695.24	$41,356.19	2026-05-09
7	OTHER	Lung Transplant	59	45	—	—	$4,000.00	$730,119.52	$319,746.27	2026-05-06
736	OTHER	Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc	121	49	—	—	$4,000.00	$91,821.96	$40,241.53	2026-05-09
739	OTHER	Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc…	121	49	—	—	$4,000.00	$92,815.41	$40,676.55	2026-05-09
740-4	OTHER	Mental Illness Diagnosis With O.r. Procedure	46	18	—	—	$12,976.77	$56,918.10	$46,982.69	2026-05-09
790	OTHER	Extreme Immaturity Or Respiratory Distress Syndrome, Neonate	121	49	—	—	$4,000.00	$140,503.88	$60,907.31	2026-05-09
791	OTHER	Prematurity With Major Problems	122	50	—	—	$4,000.00	$182,494.00	$41,874.15	2026-05-09
792-4	OTHER	Extensive O.r. Procedures For Other Complications Of Treatment	46	18	—	—	$11,624.32	$51,432.50	$41,146.00	2026-05-09
793	OTHER	Full Term Neonate With Major Problems	121	49	—	—	$4,000.00	$99,150.59	$42,991.21	2026-05-09
799	OTHER	Splenectomy With Mcc	121	49	—	—	$4,000.00	$110,571.68	$48,451.86	2026-05-09
8	OTHER	Simultaneous Pancreas And Kidney Transplant	58	45	—	—	$4,000.00	$133,807.47	$58,626.60	2026-05-06
802	OTHER	Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc	121	49	—	—	$4,000.00	$94,826.18	$41,117.68	2026-05-09
820	OTHER	Lymphoma And Leukemia With Major O.r. Procedures With Mcc	121	49	—	—	$4,000.00	$138,669.22	$60,112.45	2026-05-09
823	OTHER	Lymphoma And Non-acute Leukemia With Other Procedures With Mcc	121	49	—	—	$4,000.00	$108,844.03	$47,695.34	2026-05-09
826	OTHER	Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. …	121	49	—	—	$4,000.00	$111,046.63	$48,659.84	2026-05-09
834	OTHER	Acute Leukemia Without Major O.r. Procedures With Mcc	121	49	—	—	$4,000.00	$129,929.51	$56,326.02	2026-05-09
837	OTHER	Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot…	121	49	—	—	$4,000.00	$116,362.75	$50,987.72	2026-05-09
841-3	OTHER	Extensive Third Degree Burns With Skin Graft	46	18	—	—	$15,088.87	$88,797.47	$62,870.29	2026-05-09
841-4	OTHER	Extensive Third Degree Burns With Skin Graft	46	18	—	—	$43,525.04	$208,085.71	$166,468.57	2026-05-09
842-4	OTHER	Burns With Skin Graft Except Extensive Third Degree Burns	46	18	—	—	$25,055.13	$115,655.59	$92,524.47	2026-05-09
850-4	OTHER	Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal…	46	18	—	—	$14,147.88	$67,448.15	$53,958.52	2026-05-09
853	OTHER	Infectious And Parasitic Diseases With O.r. Procedures With Mcc	125	52	—	—	$4,000.00	$168,623.98	$50,928.43	2026-05-09
856	OTHER	Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc	121	49	—	—	$4,000.00	$107,988.20	$46,820.06	2026-05-09
863-4	OTHER	Neonatal Aftercare	46	18	—	—	$36,635.04	$158,704.92	$126,963.94	2026-05-09
870	OTHER	Septicemia Or Severe Sepsis With Mv >96 Hours	121	49	—	—	$4,000.00	$163,076.99	$70,687.00	2026-05-09
876	OTHER	O.r. Procedures With Principal Diagnosis Of Mental Illness	119	48	—	—	$4,000.00	$92,047.36	$40,161.16	2026-05-09
901	OTHER	Wound Debridements For Injuries With Mcc	121	49	—	—	$4,000.00	$103,130.96	$45,193.64	2026-05-09
907	OTHER	Other O.r. Procedures For Injuries With Mcc	126	51	—	—	$3,000.00	$92,879.66	$40,704.69	2026-05-09
910-4	OTHER	Craniotomy For Multiple Significant Trauma	46	18	—	—	$17,096.66	$72,211.19	$57,768.95	2026-05-09
911-4	OTHER	Extensive Abdominal Or Thoracic Procedures For Multiple Significant Trauma	46	18	—	—	$15,444.39	$68,397.65	$54,718.12	2026-05-09
912-4	OTHER	Musculoskeletal And Other Procedures For Multiple Significant Trauma	46	18	—	—	$15,463.00	$65,298.19	$52,238.55	2026-05-09
927	OTHER	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	123	49	—	—	$4,000.00	$545,771.24	$239,021.82	2026-05-09
928	OTHER	Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc	121	49	—	—	$4,000.00	$169,159.08	$73,322.03	2026-05-09
933	OTHER	Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft	121	49	—	—	$4,000.00	$100,754.02	$44,152.80	2026-05-09
950-4	OTHER	Extensive O.r. Procedure Unrelated To Principal Diagnosis	46	18	—	—	$13,423.41	$59,050.60	$47,240.48	2026-05-09
955	OTHER	Craniotomy For Multiple Significant Trauma	121	49	—	—	$4,000.00	$158,864.44	$69,284.14	2026-05-09
956	OTHER	Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma	121	49	—	—	$4,000.00	$89,671.86	$39,084.13	2026-05-09
957	OTHER	Other O.r. Procedures For Multiple Significant Trauma With Mcc	121	49	—	—	$4,000.00	$179,584.25	$77,838.68	2026-05-09
958	OTHER	Other O.r. Procedures For Multiple Significant Trauma With Cc	121	49	—	—	$4,000.00	$100,183.30	$43,438.63	2026-05-09
969	OTHER	HIV With Extensive O.r. Procedures With Mcc	121	49	—	—	$4,000.00	$204,326.10	$88,557.96	2026-05-09
981	OTHER	Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc	144	53	—	—	$2,500.00	$111,324.15	$48,442.82	2026-05-09

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