|
681
|
OTHER
|
Neonate, Birth Weight >2499 Grams, With Significant O.r. Procedures, With Multip…
|
1
|
1
|
—
|
—
|
$219,846.35
|
$219,846.35
|
$219,846.35
|
2026-05-06
|
|
318
|
OTHER
|
Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc
|
1
|
1
|
—
|
—
|
$55,262.31
|
$55,262.31
|
$55,262.31
|
2026-05-06
|
|
860-2
|
OTHER
|
Rehabilitation
|
1
|
1
|
—
|
—
|
$51,783.10
|
$51,783.10
|
$51,783.10
|
2026-05-06
|
|
860-4
|
OTHER
|
Rehabilitation
|
1
|
1
|
—
|
—
|
$48,151.57
|
$48,151.57
|
$48,151.57
|
2026-05-06
|
|
630-4
|
OTHER
|
Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure
|
9
|
9
|
—
|
—
|
$259,594.55
|
$259,594.55
|
$259,594.55
|
2026-05-06
|
|
631-4
|
OTHER
|
Neonate Birth Weight > 2499 Grams With Other Major Procedure
|
9
|
9
|
—
|
—
|
$256,025.31
|
$256,025.31
|
$256,025.31
|
2026-05-06
|
|
161-4
|
OTHER
|
Implantable Heart Assist Systems
|
9
|
9
|
—
|
—
|
$247,898.96
|
$247,898.96
|
$247,898.96
|
2026-05-06
|
|
588-4
|
OTHER
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
9
|
9
|
—
|
—
|
$221,000.00
|
$221,000.00
|
$221,000.00
|
2026-05-06
|
|
583-3
|
OTHER
|
Neonate With Ecmo
|
9
|
9
|
—
|
—
|
$221,000.00
|
$221,000.00
|
$221,000.00
|
2026-05-06
|
|
583-4
|
OTHER
|
Neonate With Ecmo
|
9
|
9
|
—
|
—
|
$221,000.00
|
$221,000.00
|
$221,000.00
|
2026-05-06
|
|
583-2
|
OTHER
|
Neonate With Ecmo
|
9
|
9
|
—
|
—
|
$201,501.78
|
$201,501.78
|
$201,501.78
|
2026-05-06
|
|
002-4
|
OTHER
|
Heart And/or Lung Transplant
|
9
|
9
|
—
|
—
|
$198,669.88
|
$198,669.88
|
$198,669.88
|
2026-05-06
|
|
583-1
|
OTHER
|
Neonate With Ecmo
|
9
|
9
|
—
|
—
|
$178,399.18
|
$178,399.18
|
$178,399.18
|
2026-05-06
|
|
161-3
|
OTHER
|
Implantable Heart Assist Systems
|
9
|
9
|
—
|
—
|
$170,338.90
|
$170,338.90
|
$170,338.90
|
2026-05-06
|
|
609-4
|
OTHER
|
Neonate Birth Weight 1500-2499 Grams With Major Procedure
|
9
|
9
|
—
|
—
|
$165,000.00
|
$165,000.00
|
$165,000.00
|
2026-05-06
|
|
841-4
|
OTHER
|
Extensive Third Degree Burns With Skin Graft
|
9
|
9
|
—
|
—
|
$164,242.21
|
$164,242.21
|
$164,242.21
|
2026-05-06
|
|
007-4
|
OTHER
|
Allogeneic Bone Marrow Transplant
|
9
|
9
|
—
|
—
|
$154,364.51
|
$154,364.51
|
$154,364.51
|
2026-05-06
|
|
161-2
|
OTHER
|
Implantable Heart Assist Systems
|
9
|
9
|
—
|
—
|
$149,066.24
|
$149,066.24
|
$149,066.24
|
2026-05-06
|
|
863-4
|
OTHER
|
Neonatal Aftercare
|
9
|
9
|
—
|
—
|
$141,734.50
|
$141,734.50
|
$141,734.50
|
2026-05-06
|
|
002-3
|
OTHER
|
Heart And/or Lung Transplant
|
9
|
9
|
—
|
—
|
$140,000.00
|
$140,000.00
|
$140,000.00
|
2026-05-06
|
|
009-4
|
OTHER
|
Extracorporeal Membrane Oxygenation (ecmo)
|
9
|
9
|
—
|
—
|
$139,000.00
|
$139,000.00
|
$139,000.00
|
2026-05-06
|
|
588-3
|
OTHER
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
9
|
9
|
—
|
—
|
$132,000.00
|
$132,000.00
|
$132,000.00
|
2026-05-06
|
|
011-3
|
OTHER
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
9
|
9
|
—
|
—
|
$131,563.25
|
$131,563.25
|
$131,563.25
|
2026-05-06
|
|
588-2
|
OTHER
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
9
|
9
|
—
|
—
|
$130,000.00
|
$130,000.00
|
$130,000.00
|
2026-05-06
|
|
593-4
|
OTHER
|
Neonate Birth Weight 750-999 Grams Without Major Procedure
|
9
|
9
|
—
|
—
|
$121,000.00
|
$121,000.00
|
$121,000.00
|
2026-05-06
|
|
591-4
|
OTHER
|
Neonate Birth Weight 500-749 Grams Without Major Procedure
|
9
|
9
|
—
|
—
|
$120,000.00
|
$120,000.00
|
$120,000.00
|
2026-05-06
|
|
303-4
|
OTHER
|
Dorsal And Lumbar Fusion Procedure For Curvature Of Back
|
9
|
9
|
—
|
—
|
$120,000.00
|
$120,000.00
|
$120,000.00
|
2026-05-06
|
|
001-4
|
OTHER
|
Liver Transplant And/or Intestinal Transplant
|
9
|
9
|
—
|
—
|
$120,000.00
|
$120,000.00
|
$120,000.00
|
2026-05-06
|
|
160-4
|
OTHER
|
Major Cardiothoracic Repair Of Heart Anomaly
|
9
|
9
|
—
|
—
|
$118,684.89
|
$118,684.89
|
$118,684.89
|
2026-05-06
|
|
161-1
|
OTHER
|
Implantable Heart Assist Systems
|
9
|
9
|
—
|
—
|
$117,988.01
|
$117,988.01
|
$117,988.01
|
2026-05-06
|
|
002-2
|
OTHER
|
Heart And/or Lung Transplant
|
9
|
9
|
—
|
—
|
$114,865.77
|
$114,865.77
|
$114,865.77
|
2026-05-06
|
|
004-4
|
OTHER
|
Tracheostomy With Mv >96 Hours With Extensive Procedure
|
9
|
9
|
—
|
—
|
$110,000.00
|
$110,000.00
|
$110,000.00
|
2026-05-06
|
|
633-4
|
OTHER
|
Neonate Birth Weight > 2499 Grams With Major Anomaly
|
9
|
9
|
—
|
—
|
$104,416.09
|
$104,416.09
|
$104,416.09
|
2026-05-06
|
|
842-4
|
OTHER
|
Burns With Skin Graft Except Extensive Third Degree Burns
|
9
|
9
|
—
|
—
|
$102,041.22
|
$102,041.22
|
$102,041.22
|
2026-05-06
|
|
162-4
|
OTHER
|
Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis
|
9
|
9
|
—
|
—
|
$101,497.03
|
$101,497.03
|
$101,497.03
|
2026-05-06
|
|
607-4
|
OTHER
|
Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…
|
9
|
9
|
—
|
—
|
$100,000.00
|
$100,000.00
|
$100,000.00
|
2026-05-06
|
|
602-4
|
OTHER
|
Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…
|
9
|
9
|
—
|
—
|
$100,000.00
|
$100,000.00
|
$100,000.00
|
2026-05-06
|
|
593-3
|
OTHER
|
Neonate Birth Weight 750-999 Grams Without Major Procedure
|
9
|
9
|
—
|
—
|
$99,000.00
|
$99,000.00
|
$99,000.00
|
2026-05-06
|
|
609-3
|
OTHER
|
Neonate Birth Weight 1500-2499 Grams With Major Procedure
|
9
|
9
|
—
|
—
|
$97,247.45
|
$97,247.45
|
$97,247.45
|
2026-05-06
|
|
630-3
|
OTHER
|
Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure
|
9
|
9
|
—
|
—
|
$95,000.00
|
$95,000.00
|
$95,000.00
|
2026-05-06
|
|
007-3
|
OTHER
|
Allogeneic Bone Marrow Transplant
|
9
|
9
|
—
|
—
|
$93,579.98
|
$93,579.98
|
$93,579.98
|
2026-05-06
|
|
611-4
|
OTHER
|
Neonate Birth Weight 1500-1999 Grams With Major Anomaly
|
9
|
9
|
—
|
—
|
$93,000.00
|
$93,000.00
|
$93,000.00
|
2026-05-06
|
|
602-3
|
OTHER
|
Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…
|
9
|
9
|
—
|
—
|
$92,000.00
|
$92,000.00
|
$92,000.00
|
2026-05-06
|
|
591-3
|
OTHER
|
Neonate Birth Weight 500-749 Grams Without Major Procedure
|
9
|
9
|
—
|
—
|
$91,000.00
|
$91,000.00
|
$91,000.00
|
2026-05-06
|
|
004-3
|
OTHER
|
Tracheostomy With Mv >96 Hours With Extensive Procedure
|
9
|
9
|
—
|
—
|
$91,000.00
|
$91,000.00
|
$91,000.00
|
2026-05-06
|
|
001-3
|
OTHER
|
Liver Transplant And/or Intestinal Transplant
|
9
|
9
|
—
|
—
|
$90,051.91
|
$90,051.91
|
$90,051.91
|
2026-05-06
|
|
621-4
|
OTHER
|
Neonate Birth Weight 2000-2499 Grams With Major Anomaly
|
9
|
9
|
—
|
—
|
$90,000.00
|
$90,000.00
|
$90,000.00
|
2026-05-06
|
|
440-4
|
OTHER
|
Kidney Transplant
|
9
|
9
|
—
|
—
|
$90,000.00
|
$90,000.00
|
$90,000.00
|
2026-05-06
|
|
612-4
|
OTHER
|
Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other…
|
9
|
9
|
—
|
—
|
$89,000.00
|
$89,000.00
|
$89,000.00
|
2026-05-06
|
|
005-4
|
OTHER
|
Tracheostomy With Mv >96 Hours Without Extensive Procedure
|
9
|
9
|
—
|
—
|
$88,000.00
|
$88,000.00
|
$88,000.00
|
2026-05-06
|
|
607-3
|
OTHER
|
Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…
|
9
|
9
|
—
|
—
|
$86,000.00
|
$86,000.00
|
$86,000.00
|
2026-05-06
|
|
163-4
|
OTHER
|
Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis
|
9
|
9
|
—
|
—
|
$85,874.48
|
$85,874.48
|
$85,874.48
|
2026-05-06
|
|
006-4
|
OTHER
|
Pancreas Transplant
|
9
|
9
|
—
|
—
|
$85,000.00
|
$85,000.00
|
$85,000.00
|
2026-05-06
|
|
006-3
|
OTHER
|
Pancreas Transplant
|
9
|
9
|
—
|
—
|
$85,000.00
|
$85,000.00
|
$85,000.00
|
2026-05-06
|
|
232-4
|
OTHER
|
Gastric Fundoplication
|
9
|
9
|
—
|
—
|
$84,079.27
|
$84,079.27
|
$84,079.27
|
2026-05-06
|
|
589-1
|
OTHER
|
Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …
|
9
|
9
|
—
|
—
|
$83,930.07
|
$83,930.07
|
$83,930.07
|
2026-05-06
|
|
178-4
|
OTHER
|
External Heart Assist Systems
|
9
|
9
|
—
|
—
|
$82,511.51
|
$82,511.51
|
$82,511.51
|
2026-05-06
|
|
006-2
|
OTHER
|
Pancreas Transplant
|
9
|
9
|
—
|
—
|
$82,005.23
|
$82,005.23
|
$82,005.23
|
2026-05-06
|
|
603-4
|
OTHER
|
Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition
|
9
|
9
|
—
|
—
|
$80,000.00
|
$80,000.00
|
$80,000.00
|
2026-05-06
|
|
602-2
|
OTHER
|
Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…
|
9
|
9
|
—
|
—
|
$80,000.00
|
$80,000.00
|
$80,000.00
|
2026-05-06
|
|
603-3
|
OTHER
|
Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition
|
9
|
9
|
—
|
—
|
$80,000.00
|
$80,000.00
|
$80,000.00
|
2026-05-06
|
|
591-2
|
OTHER
|
Neonate Birth Weight 500-749 Grams Without Major Procedure
|
9
|
9
|
—
|
—
|
$80,000.00
|
$80,000.00
|
$80,000.00
|
2026-05-06
|
|
165-4
|
OTHER
|
Coronary Bypass With Ami Or Complex Principal Diagnosis
|
9
|
9
|
—
|
—
|
$79,542.31
|
$79,542.31
|
$79,542.31
|
2026-05-06
|
|
167-4
|
OTHER
|
Other Cardiothoracic And Thoracic Vascular Procedures
|
9
|
9
|
—
|
—
|
$79,394.34
|
$79,394.34
|
$79,394.34
|
2026-05-06
|
|
008-4
|
OTHER
|
Autologous Bone Marrow Transplant Or T-cell Immunotherapy
|
9
|
9
|
—
|
—
|
$79,242.70
|
$79,242.70
|
$79,242.70
|
2026-05-06
|
|
593-2
|
OTHER
|
Neonate Birth Weight 750-999 Grams Without Major Procedure
|
9
|
9
|
—
|
—
|
$79,000.00
|
$79,000.00
|
$79,000.00
|
2026-05-06
|
|
005-3
|
OTHER
|
Tracheostomy With Mv >96 Hours Without Extensive Procedure
|
9
|
9
|
—
|
—
|
$77,000.00
|
$77,000.00
|
$77,000.00
|
2026-05-06
|
|
009-3
|
OTHER
|
Extracorporeal Membrane Oxygenation (ecmo)
|
9
|
9
|
—
|
—
|
$76,083.95
|
$76,083.95
|
$76,083.95
|
2026-05-06
|
|
001-2
|
OTHER
|
Liver Transplant And/or Intestinal Transplant
|
9
|
9
|
—
|
—
|
$75,132.53
|
$75,132.53
|
$75,132.53
|
2026-05-06
|
|
304-4
|
OTHER
|
Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back
|
9
|
9
|
—
|
—
|
$74,881.84
|
$74,881.84
|
$74,881.84
|
2026-05-06
|
|
631-3
|
OTHER
|
Neonate Birth Weight > 2499 Grams With Other Major Procedure
|
9
|
9
|
—
|
—
|
$73,964.66
|
$73,964.66
|
$73,964.66
|
2026-05-06
|
|
183-4
|
OTHER
|
Percutaneous Structural Cardiac Procedures
|
9
|
9
|
—
|
—
|
$73,766.55
|
$73,766.55
|
$73,766.55
|
2026-05-06
|
|
007-2
|
OTHER
|
Allogeneic Bone Marrow Transplant
|
9
|
9
|
—
|
—
|
$73,712.74
|
$73,712.74
|
$73,712.74
|
2026-05-06
|
|
625-4
|
OTHER
|
Neonate Birth Weight 2000-2499 Grams With Other Significant Condition
|
9
|
9
|
—
|
—
|
$73,510.96
|
$73,510.96
|
$73,510.96
|
2026-05-06
|
|
623-4
|
OTHER
|
Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection
|
9
|
9
|
—
|
—
|
$73,190.57
|
$73,190.57
|
$73,190.57
|
2026-05-06
|
|
622-4
|
OTHER
|
Neonate Birth Weight 2000-2499 Grams With Respiratory Distress Syndrome Or Other…
|
9
|
9
|
—
|
—
|
$73,000.00
|
$73,000.00
|
$73,000.00
|
2026-05-06
|
|
007-1
|
OTHER
|
Allogeneic Bone Marrow Transplant
|
9
|
9
|
—
|
—
|
$72,668.39
|
$72,668.39
|
$72,668.39
|
2026-05-06
|
|
607-2
|
OTHER
|
Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…
|
9
|
9
|
—
|
—
|
$71,211.91
|
$71,211.91
|
$71,211.91
|
2026-05-06
|
|
179-4
|
OTHER
|
Defibrillator Implants
|
9
|
9
|
—
|
—
|
$70,687.29
|
$70,687.29
|
$70,687.29
|
2026-05-06
|
|
910-4
|
OTHER
|
Craniotomy For Multiple Significant Trauma
|
9
|
9
|
—
|
—
|
$70,582.12
|
$70,582.12
|
$70,582.12
|
2026-05-06
|
|
303-3
|
OTHER
|
Dorsal And Lumbar Fusion Procedure For Curvature Of Back
|
9
|
9
|
—
|
—
|
$70,485.51
|
$70,485.51
|
$70,485.51
|
2026-05-06
|
|
166-4
|
OTHER
|
Coronary Bypass Without Ami Or Complex Principal Diagnosis
|
9
|
9
|
—
|
—
|
$70,018.36
|
$70,018.36
|
$70,018.36
|
2026-05-06
|
|
608-4
|
OTHER
|
Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition
|
9
|
9
|
—
|
—
|
$70,000.00
|
$70,000.00
|
$70,000.00
|
2026-05-06
|
|
004-2
|
OTHER
|
Tracheostomy With Mv >96 Hours With Extensive Procedure
|
9
|
9
|
—
|
—
|
$70,000.00
|
$70,000.00
|
$70,000.00
|
2026-05-06
|
|
608-3
|
OTHER
|
Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition
|
9
|
9
|
—
|
—
|
$69,454.61
|
$69,454.61
|
$69,454.61
|
2026-05-06
|
|
680-4
|
OTHER
|
Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms
|
9
|
9
|
—
|
—
|
$69,080.40
|
$69,080.40
|
$69,080.40
|
2026-05-06
|
|
162-3
|
OTHER
|
Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis
|
9
|
9
|
—
|
—
|
$68,744.10
|
$68,744.10
|
$68,744.10
|
2026-05-06
|
|
091-4
|
OTHER
|
Other Major Head And Neck Procedures
|
9
|
9
|
—
|
—
|
$68,286.74
|
$68,286.74
|
$68,286.74
|
2026-05-06
|
|
634-4
|
OTHER
|
Neonate Birth Weight > 2499 Grams With Respiratory Distress Syndrome Or Other Ma…
|
9
|
9
|
—
|
—
|
$67,729.09
|
$67,729.09
|
$67,729.09
|
2026-05-06
|
|
850-4
|
OTHER
|
Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal…
|
9
|
9
|
—
|
—
|
$65,926.54
|
$65,926.54
|
$65,926.54
|
2026-05-06
|
|
630-2
|
OTHER
|
Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure
|
9
|
9
|
—
|
—
|
$63,365.79
|
$63,365.79
|
$63,365.79
|
2026-05-06
|
|
178-3
|
OTHER
|
External Heart Assist Systems
|
9
|
9
|
—
|
—
|
$63,225.15
|
$63,225.15
|
$63,225.15
|
2026-05-06
|
|
912-4
|
OTHER
|
Musculoskeletal And Other Procedures For Multiple Significant Trauma
|
9
|
9
|
—
|
—
|
$62,975.68
|
$62,975.68
|
$62,975.68
|
2026-05-06
|
|
911-4
|
OTHER
|
Extensive Abdominal Or Thoracic Procedures For Multiple Significant Trauma
|
9
|
9
|
—
|
—
|
$62,899.86
|
$62,899.86
|
$62,899.86
|
2026-05-06
|
|
169-4
|
OTHER
|
Major Abdominal Vascular Procedures
|
9
|
9
|
—
|
—
|
$62,760.45
|
$62,760.45
|
$62,760.45
|
2026-05-06
|
|
613-4
|
OTHER
|
Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection
|
9
|
9
|
—
|
—
|
$62,000.00
|
$62,000.00
|
$62,000.00
|
2026-05-06
|
|
841-3
|
OTHER
|
Extensive Third Degree Burns With Skin Graft
|
9
|
9
|
—
|
—
|
$61,451.95
|
$61,451.95
|
$61,451.95
|
2026-05-06
|
|
021-4
|
OTHER
|
Open Craniotomy Except Trauma
|
9
|
9
|
—
|
—
|
$61,438.50
|
$61,438.50
|
$61,438.50
|
2026-05-06
|
|
023-4
|
OTHER
|
Spinal Procedures
|
9
|
9
|
—
|
—
|
$61,105.87
|
$61,105.87
|
$61,105.87
|
2026-05-06
|
|
120-4
|
OTHER
|
Major Respiratory And Chest Procedures
|
9
|
9
|
—
|
—
|
$60,263.29
|
$60,263.29
|
$60,263.29
|
2026-05-06
|
|
440-3
|
OTHER
|
Kidney Transplant
|
9
|
9
|
—
|
—
|
$59,782.69
|
$59,782.69
|
$59,782.69
|
2026-05-06
|
|
612-3
|
OTHER
|
Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other…
|
9
|
9
|
—
|
—
|
$59,637.16
|
$59,637.16
|
$59,637.16
|
2026-05-06
|
|
681-4
|
OTHER
|
Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms
|
9
|
9
|
—
|
—
|
$59,196.92
|
$59,196.92
|
$59,196.92
|
2026-05-06
|
|
220-4
|
OTHER
|
Major Stomach, Esophageal And Duodenal Procedures
|
9
|
9
|
—
|
—
|
$59,178.58
|
$59,178.58
|
$59,178.58
|
2026-05-06
|
|
483-4
|
OTHER
|
Penis, Testes And Scrotal Procedures
|
9
|
9
|
—
|
—
|
$58,930.33
|
$58,930.33
|
$58,930.33
|
2026-05-06
|
|
690-4
|
OTHER
|
Acute Leukemia
|
9
|
9
|
—
|
—
|
$58,745.67
|
$58,745.67
|
$58,745.67
|
2026-05-06
|
|
260-4
|
OTHER
|
Major Pancreas, Liver And Shunt Procedures
|
9
|
9
|
—
|
—
|
$58,734.66
|
$58,734.66
|
$58,734.66
|
2026-05-06
|
|
089-4
|
OTHER
|
Major Cranial Or Facial Bone Procedures
|
9
|
9
|
—
|
—
|
$57,934.89
|
$57,934.89
|
$57,934.89
|
2026-05-06
|
|
312-4
|
OTHER
|
Skin Graft, Except Hand, For Musculoskeletal And Connective Tissue Diagnoses
|
9
|
9
|
—
|
—
|
$57,756.34
|
$57,756.34
|
$57,756.34
|
2026-05-06
|
|
950-4
|
OTHER
|
Extensive O.r. Procedure Unrelated To Principal Diagnosis
|
9
|
9
|
—
|
—
|
$57,718.43
|
$57,718.43
|
$57,718.43
|
2026-05-06
|
|
020-4
|
OTHER
|
Open Craniotomy For Trauma
|
9
|
9
|
—
|
—
|
$57,709.87
|
$57,709.87
|
$57,709.87
|
2026-05-06
|
|
613-3
|
OTHER
|
Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection
|
9
|
9
|
—
|
—
|
$57,667.07
|
$57,667.07
|
$57,667.07
|
2026-05-06
|
|
165-3
|
OTHER
|
Coronary Bypass With Ami Or Complex Principal Diagnosis
|
9
|
9
|
—
|
—
|
$57,088.64
|
$57,088.64
|
$57,088.64
|
2026-05-06
|
|
361-4
|
OTHER
|
Skin Graft For Skin And Subcutaneous Tissue Diagnoses
|
9
|
9
|
—
|
—
|
$56,998.15
|
$56,998.15
|
$56,998.15
|
2026-05-06
|
|
441-4
|
OTHER
|
Major Bladder Procedures
|
9
|
9
|
—
|
—
|
$56,831.83
|
$56,831.83
|
$56,831.83
|
2026-05-06
|
|
163-3
|
OTHER
|
Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis
|
9
|
9
|
—
|
—
|
$56,568.91
|
$56,568.91
|
$56,568.91
|
2026-05-06
|
|
130-4
|
OTHER
|
Respiratory System Diagnosis With Ventilator Support > 96 Hours
|
9
|
9
|
—
|
—
|
$56,208.15
|
$56,208.15
|
$56,208.15
|
2026-05-06
|
|
178-2
|
OTHER
|
External Heart Assist Systems
|
9
|
9
|
—
|
—
|
$56,116.44
|
$56,116.44
|
$56,116.44
|
2026-05-06
|
|
005-1
|
OTHER
|
Tracheostomy With Mv >96 Hours Without Extensive Procedure
|
9
|
9
|
—
|
—
|
$56,112.77
|
$56,112.77
|
$56,112.77
|
2026-05-06
|
|
636-4
|
OTHER
|
Neonate Birth Weight > 2499 Grams With Congenital Or Perinatal Infection
|
9
|
9
|
—
|
—
|
$56,068.74
|
$56,068.74
|
$56,068.74
|
2026-05-06
|
|
160-3
|
OTHER
|
Major Cardiothoracic Repair Of Heart Anomaly
|
9
|
9
|
—
|
—
|
$56,058.96
|
$56,058.96
|
$56,058.96
|
2026-05-06
|
|
609-2
|
OTHER
|
Neonate Birth Weight 1500-2499 Grams With Major Procedure
|
9
|
9
|
—
|
—
|
$55,256.74
|
$55,256.74
|
$55,256.74
|
2026-05-06
|
|
027-4
|
OTHER
|
Other Open Craniotomy
|
9
|
9
|
—
|
—
|
$54,469.19
|
$54,469.19
|
$54,469.19
|
2026-05-06
|
|
303-1
|
OTHER
|
Dorsal And Lumbar Fusion Procedure For Curvature Of Back
|
9
|
9
|
—
|
—
|
$53,717.11
|
$53,717.11
|
$53,717.11
|
2026-05-06
|
|
162-2
|
OTHER
|
Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis
|
9
|
9
|
—
|
—
|
$53,710.99
|
$53,710.99
|
$53,710.99
|
2026-05-06
|
|
261-4
|
OTHER
|
Major Biliary Tract Procedures
|
9
|
9
|
—
|
—
|
$53,437.06
|
$53,437.06
|
$53,437.06
|
2026-05-06
|
|
005-2
|
OTHER
|
Tracheostomy With Mv >96 Hours Without Extensive Procedure
|
9
|
9
|
—
|
—
|
$53,186.37
|
$53,186.37
|
$53,186.37
|
2026-05-06
|
|
181-4
|
OTHER
|
Lower Extremity Arterial Procedures
|
9
|
9
|
—
|
—
|
$52,956.46
|
$52,956.46
|
$52,956.46
|
2026-05-06
|
|
740-4
|
OTHER
|
Mental Illness Diagnosis With O.r. Procedure
|
9
|
9
|
—
|
—
|
$52,850.07
|
$62,344.93
|
$52,850.07
|
2026-05-06
|
|
440-2
|
OTHER
|
Kidney Transplant
|
9
|
9
|
—
|
—
|
$52,561.46
|
$52,561.46
|
$52,561.46
|
2026-05-06
|
|
176-4
|
OTHER
|
Insertion, Revision And Replacements Of Pacemaker And Other Cardiac Devices
|
9
|
9
|
—
|
—
|
$52,404.93
|
$52,404.93
|
$52,404.93
|
2026-05-06
|
|
401-4
|
OTHER
|
Adrenal Procedures
|
9
|
9
|
—
|
—
|
$52,230.06
|
$52,230.06
|
$52,230.06
|
2026-05-06
|
|
614-3
|
OTHER
|
Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition
|
9
|
9
|
—
|
—
|
$52,197.04
|
$52,197.04
|
$52,197.04
|
2026-05-06
|
|
510-4
|
OTHER
|
Pelvic Evisceration, Radical Hysterectomy And Other Radical Gynecological Proced…
|
9
|
9
|
—
|
—
|
$51,404.60
|
$51,404.60
|
$51,404.60
|
2026-05-06
|
|
004-1
|
OTHER
|
Tracheostomy With Mv >96 Hours With Extensive Procedure
|
9
|
9
|
—
|
—
|
$51,360.58
|
$51,360.58
|
$51,360.58
|
2026-05-06
|
|
589-3
|
OTHER
|
Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …
|
9
|
9
|
—
|
—
|
$51,331.23
|
$51,331.23
|
$51,331.23
|
2026-05-06
|
|
178-1
|
OTHER
|
External Heart Assist Systems
|
9
|
9
|
—
|
—
|
$51,301.88
|
$51,301.88
|
$51,301.88
|
2026-05-06
|
|
303-2
|
OTHER
|
Dorsal And Lumbar Fusion Procedure For Curvature Of Back
|
9
|
9
|
—
|
—
|
$51,147.79
|
$51,147.79
|
$51,147.79
|
2026-05-06
|
|
695-4
|
OTHER
|
Chemotherapy For Acute Leukemia
|
9
|
9
|
—
|
—
|
$50,529.01
|
$50,529.01
|
$50,529.01
|
2026-05-06
|
|
792-4
|
OTHER
|
Extensive O.r. Procedures For Other Complications Of Treatment
|
9
|
9
|
—
|
—
|
$50,272.20
|
$50,272.20
|
$50,272.20
|
2026-05-06
|
|
609-1
|
OTHER
|
Neonate Birth Weight 1500-2499 Grams With Major Procedure
|
9
|
9
|
—
|
—
|
$50,123.00
|
$50,123.00
|
$50,123.00
|
2026-05-06
|
|
011-4
|
OTHER
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
9
|
9
|
—
|
—
|
$50,021.00
|
$50,021.00
|
$50,021.00
|
2026-05-06
|
|
002-1
|
OTHER
|
Heart And/or Lung Transplant
|
9
|
9
|
—
|
—
|
$50,000.00
|
$50,000.00
|
$50,000.00
|
2026-05-06
|
|
011-2
|
OTHER
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
9
|
9
|
—
|
—
|
$50,000.00
|
$50,000.00
|
$50,000.00
|
2026-05-06
|
|
588-1
|
OTHER
|
Female Reproductive System Reconstructive Procedures
|
9
|
9
|
—
|
—
|
$50,000.00
|
$50,000.00
|
$50,000.00
|
2026-05-06
|
|
006-1
|
OTHER
|
Pancreas Transplant
|
9
|
9
|
—
|
—
|
$50,000.00
|
$50,000.00
|
$50,000.00
|
2026-05-06
|
|
001-1
|
OTHER
|
Liver Transplant And/or Intestinal Transplant
|
9
|
9
|
—
|
—
|
$50,000.00
|
$50,000.00
|
$50,000.00
|
2026-05-06
|
|
608-2
|
OTHER
|
Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition
|
9
|
9
|
—
|
—
|
$49,944.46
|
$49,944.46
|
$49,944.46
|
2026-05-06
|
|
230-4
|
OTHER
|
Major Small Bowel Procedures
|
9
|
9
|
—
|
—
|
$49,794.04
|
$49,794.04
|
$49,794.04
|
2026-05-06
|
|
234-4
|
OTHER
|
Appendectomy Without Complex Principal Diagnosis
|
9
|
9
|
—
|
—
|
$49,790.37
|
$49,790.37
|
$49,790.37
|
2026-05-06
|
|
321-4
|
OTHER
|
Spinal Fusion And Other Back And Neck Procedures Except For Disc Procedures
|
9
|
9
|
—
|
—
|
$49,477.31
|
$49,477.31
|
$49,477.31
|
2026-05-06
|
|
179-3
|
OTHER
|
Defibrillator Implants
|
9
|
9
|
—
|
—
|
$49,336.68
|
$49,336.68
|
$49,336.68
|
2026-05-06
|
|
511-4
|
OTHER
|
Uterine And Adnexa Procedures For Ovarian And Adnexal Malignancy
|
9
|
9
|
—
|
—
|
$49,286.54
|
$49,286.54
|
$49,286.54
|
2026-05-06
|
|
183-3
|
OTHER
|
Percutaneous Structural Cardiac Procedures
|
9
|
9
|
—
|
—
|
$49,271.86
|
$49,271.86
|
$49,271.86
|
2026-05-06
|
|
092-4
|
OTHER
|
Facial Bone Procedures Except Major Cranial Or Facial Bone Procedures
|
9
|
9
|
—
|
—
|
$49,132.45
|
$49,132.45
|
$49,132.45
|
2026-05-06
|
|
639-4
|
OTHER
|
Neonate Birth Weight > 2499 Grams With Other Significant Condition
|
9
|
9
|
—
|
—
|
$48,862.19
|
$48,862.19
|
$48,862.19
|
2026-05-06
|
|
304-3
|
OTHER
|
Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back
|
9
|
9
|
—
|
—
|
$48,720.34
|
$48,720.34
|
$48,720.34
|
2026-05-06
|
|
121-4
|
OTHER
|
Other Respiratory And Chest Procedures
|
9
|
9
|
—
|
—
|
$48,302.10
|
$48,302.10
|
$48,302.10
|
2026-05-06
|
|
167-3
|
OTHER
|
Other Cardiothoracic And Thoracic Vascular Procedures
|
9
|
9
|
—
|
—
|
$48,030.62
|
$48,030.62
|
$48,030.62
|
2026-05-06
|
|
166-3
|
OTHER
|
Coronary Bypass Without Ami Or Complex Principal Diagnosis
|
9
|
9
|
—
|
—
|
$47,613.61
|
$47,613.61
|
$47,613.61
|
2026-05-06
|
|
008-3
|
OTHER
|
Autologous Bone Marrow Transplant Or T-cell Immunotherapy
|
9
|
9
|
—
|
—
|
$47,488.88
|
$47,488.88
|
$47,488.88
|
2026-05-06
|
|
165-2
|
OTHER
|
Coronary Bypass With Ami Or Complex Principal Diagnosis
|
9
|
9
|
—
|
—
|
$47,485.21
|
$47,485.21
|
$47,485.21
|
2026-05-06
|
|
440-1
|
OTHER
|
Kidney Transplant
|
9
|
9
|
—
|
—
|
$47,129.34
|
$47,129.34
|
$47,129.34
|
2026-05-06
|
|
030-4
|
OTHER
|
Percutaneous Intracranial And Extracranial Vascular Procedures
|
9
|
9
|
—
|
—
|
$47,082.87
|
$47,082.87
|
$47,082.87
|
2026-05-06
|
|
170-4
|
OTHER
|
Permanent Cardiac Pacemaker Implant With Ami, Heart Failure Or Shock
|
9
|
9
|
—
|
—
|
$46,800.38
|
$46,800.38
|
$46,800.38
|
2026-05-06
|
|
612-2
|
OTHER
|
Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other…
|
9
|
9
|
—
|
—
|
$46,733.12
|
$46,733.12
|
$46,733.12
|
2026-05-06
|
|
325-4
|
OTHER
|
Non-elective Or Complex Knee Joint Replacement
|
9
|
9
|
—
|
—
|
$46,670.76
|
$46,670.76
|
$46,670.76
|
2026-05-06
|
|
162-1
|
OTHER
|
Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis
|
9
|
9
|
—
|
—
|
$46,640.18
|
$46,640.18
|
$46,640.18
|
2026-05-06
|
|
264-4
|
OTHER
|
Other Hepatobiliary, Pancreas And Abdominal Procedures
|
9
|
9
|
—
|
—
|
$46,366.25
|
$46,366.25
|
$46,366.25
|
2026-05-06
|
|
405-4
|
OTHER
|
Other Procedures For Endocrine, Nutritional And Metabolic Disorders
|
9
|
9
|
—
|
—
|
$45,873.42
|
$45,873.42
|
$45,873.42
|
2026-05-06
|
|
404-4
|
OTHER
|
Thyroid, Parathyroid And Thyroglossal Procedures
|
9
|
9
|
—
|
—
|
$45,704.66
|
$45,704.66
|
$45,704.66
|
2026-05-06
|
|
710-4
|
OTHER
|
Infectious And Parasitic Diseases Including HIV With O.r. Procedure
|
9
|
9
|
—
|
—
|
$45,639.85
|
$45,639.85
|
$45,639.85
|
2026-05-06
|
|
512-4
|
OTHER
|
Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy
|
9
|
9
|
—
|
—
|
$45,619.06
|
$45,619.06
|
$45,619.06
|
2026-05-06
|
|
651-4
|
OTHER
|
Other Procedures Of Blood And Blood-forming Organs
|
9
|
9
|
—
|
—
|
$45,493.10
|
$45,493.10
|
$45,493.10
|
2026-05-06
|
|
182-4
|
OTHER
|
Other Peripheral Vascular And Related Procedures
|
9
|
9
|
—
|
—
|
$45,298.66
|
$45,298.66
|
$45,298.66
|
2026-05-06
|
|
175-4
|
OTHER
|
Percutaneous Cardiac Intervention Without Ami
|
9
|
9
|
—
|
—
|
$45,111.56
|
$45,111.56
|
$45,111.56
|
2026-05-06
|
|
163-2
|
OTHER
|
Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis
|
9
|
9
|
—
|
—
|
$45,110.34
|
$45,110.34
|
$45,110.34
|
2026-05-06
|
|
403-4
|
OTHER
|
Procedures For Obesity
|
9
|
9
|
—
|
—
|
$44,687.21
|
$44,687.21
|
$44,687.21
|
2026-05-06
|
|
026-4
|
OTHER
|
Other Nervous System And Related Procedures
|
9
|
9
|
—
|
—
|
$44,569.81
|
$44,569.81
|
$44,569.81
|
2026-05-06
|
|
097-4
|
OTHER
|
Tonsil And Adenoid Procedures
|
9
|
9
|
—
|
—
|
$44,542.91
|
$44,542.91
|
$44,542.91
|
2026-05-06
|
|
009-2
|
OTHER
|
Extracorporeal Membrane Oxygenation (ecmo)
|
9
|
9
|
—
|
—
|
$44,421.84
|
$44,421.84
|
$44,421.84
|
2026-05-06
|
|
231-4
|
OTHER
|
Major Large Bowel Procedures
|
9
|
9
|
—
|
—
|
$44,306.89
|
$44,306.89
|
$44,306.89
|
2026-05-06
|
|
910-3
|
OTHER
|
Craniotomy For Multiple Significant Trauma
|
9
|
9
|
—
|
—
|
$44,008.50
|
$44,008.50
|
$44,008.50
|
2026-05-06
|
|
650-4
|
OTHER
|
Splenectomy
|
9
|
9
|
—
|
—
|
$43,878.87
|
$43,878.87
|
$43,878.87
|
2026-05-06
|
|
447-4
|
OTHER
|
Other Kidney, Urinary Tract And Related Procedures
|
9
|
9
|
—
|
—
|
$43,723.57
|
$43,723.57
|
$43,723.57
|
2026-05-06
|
|
514-4
|
OTHER
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
9
|
9
|
—
|
—
|
$43,701.55
|
$43,701.55
|
$43,701.55
|
2026-05-06
|
|
442-4
|
OTHER
|
Kidney And Urinary Tract Procedures For Malignancy
|
9
|
9
|
—
|
—
|
$43,543.80
|
$43,543.80
|
$43,543.80
|
2026-05-06
|
|
001
|
OTHER
|
Heart Transplant Or Implant Of Heart Assist System With Mcc
|
32
|
27
|
—
|
—
|
$223,204.97
|
$717,444.56
|
$312,520.48
|
2026-05-06
|
|
007
|
OTHER
|
Lung Transplant
|
32
|
27
|
—
|
—
|
$193,182.64
|
$672,163.58
|
$292,798.10
|
2026-05-06
|
|
002
|
OTHER
|
Heart Transplant Or Implant Of Heart Assist System Without Mcc
|
32
|
27
|
—
|
—
|
$87,610.68
|
$281,605.77
|
$122,688.48
|
2026-05-06
|
|
005
|
OTHER
|
Liver Transplant With Mcc Or Intestinal Transplant
|
32
|
27
|
—
|
—
|
$84,682.70
|
$272,194.40
|
$118,589.30
|
2026-05-06
|
|
010
|
OTHER
|
Pancreas Transplant
|
32
|
27
|
—
|
—
|
$63,520.37
|
$204,172.63
|
$88,962.04
|
2026-05-06
|
|
016
|
OTHER
|
Autologous Bone Marrow Transplant With Cc/mcc
|
32
|
27
|
—
|
—
|
$48,203.68
|
$154,940.40
|
$67,518.67
|
2026-05-06
|
|
008
|
OTHER
|
Simultaneous Pancreas And Kidney Transplant
|
32
|
27
|
—
|
—
|
$43,500.58
|
$139,823.30
|
$60,934.34
|
2026-05-06
|
|
006
|
OTHER
|
Liver Transplant Without Mcc
|
32
|
27
|
—
|
—
|
$38,820.43
|
$124,779.96
|
$54,382.12
|
2026-05-06
|
|
014
|
OTHER
|
Allogeneic Bone Marrow Transplant
|
33
|
28
|
—
|
—
|
$104,073.88
|
$334,523.18
|
$145,736.95
|
2026-05-06
|
|
017
|
OTHER
|
Autologous Bone Marrow Transplant Without Cc/mcc
|
33
|
28
|
—
|
—
|
$48,203.68
|
$154,940.40
|
$67,518.67
|
2026-05-06
|
|
790
|
OTHER
|
Extreme Immaturity Or Respiratory Distress Syndrome, Neonate
|
33
|
29
|
—
|
—
|
$4,999.11
|
$152,625.06
|
$66,510.21
|
2026-05-06
|
|
793
|
OTHER
|
Full Term Neonate With Major Problems
|
33
|
29
|
—
|
—
|
$27,480.98
|
$107,530.49
|
$46,869.02
|
2026-05-06
|
|
791
|
OTHER
|
Prematurity With Major Problems
|
33
|
29
|
—
|
—
|
$3,238.38
|
$104,719.55
|
$45,644.70
|
2026-05-06
|
|
018
|
OTHER
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
34
|
29
|
—
|
—
|
$202,673.24
|
$2,860,061.00
|
$462,198.02
|
2026-05-06
|
|
927
|
OTHER
|
Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft
|
34
|
29
|
—
|
—
|
$23,008.91
|
$604,460.32
|
$263,309.57
|
2026-05-06
|
|
003
|
OTHER
|
Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…
|
34
|
29
|
—
|
—
|
$17,684.81
|
$546,228.49
|
$237,946.38
|
2026-05-06
|
|
004
|
OTHER
|
Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…
|
34
|
29
|
—
|
—
|
$11,433.09
|
$360,655.31
|
$157,118.95
|
2026-05-06
|
|
212
|
OTHER
|
Hip & Femur Procedures Except Major Joint Age 0-17
|
34
|
29
|
—
|
—
|
$21,703.61
|
$278,408.52
|
$121,295.90
|
2026-05-06
|
|
019
|
OTHER
|
Simultaneous Pancreas And Kidney Transplant With Hemodialysis
|
34
|
29
|
—
|
—
|
$16,368.90
|
$203,011.13
|
$88,456.15
|
2026-05-06
|
|
957
|
OTHER
|
Other O.r. Procedures For Multiple Significant Trauma With Mcc
|
34
|
29
|
—
|
—
|
$13,751.52
|
$191,241.23
|
$83,329.70
|
2026-05-06
|
|
870
|
OTHER
|
Septicemia Or Severe Sepsis With Mv >96 Hours
|
34
|
29
|
—
|
—
|
$12,760.95
|
$178,337.86
|
$77,709.56
|
2026-05-06
|
|
928
|
OTHER
|
Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc
|
34
|
29
|
—
|
—
|
$9,781.48
|
$171,282.51
|
$74,636.57
|
2026-05-06
|
|
207
|
OTHER
|
Respiratory System Diagnosis With Ventilator Support >96 Hours
|
34
|
29
|
—
|
—
|
$11,335.75
|
$165,902.11
|
$72,293.10
|
2026-05-06
|
|
969
|
OTHER
|
HIV With Extensive O.r. Procedures With Mcc
|
34
|
29
|
—
|
—
|
$10,903.42
|
$162,270.23
|
$70,711.22
|
2026-05-06
|
|
573
|
OTHER
|
Skin Graft For Skin Ulcer Or Cellulitis With Mcc
|
34
|
29
|
—
|
—
|
$11,051.17
|
$158,048.73
|
$68,872.52
|
2026-05-06
|
|
820
|
OTHER
|
Lymphoma And Leukemia With Major O.r. Procedures With Mcc
|
34
|
29
|
—
|
—
|
$12,726.97
|
$149,511.69
|
$65,154.17
|
2026-05-06
|
|
834
|
OTHER
|
Acute Leukemia Without Major O.r. Procedures With Mcc
|
34
|
29
|
—
|
—
|
$10,666.20
|
$142,014.13
|
$61,888.56
|
2026-05-06
|
|
405
|
OTHER
|
Pancreas, Liver And Shunt Procedures With Mcc
|
34
|
29
|
—
|
—
|
$13,510.47
|
$139,508.19
|
$60,797.09
|
2026-05-06
|
|
463
|
OTHER
|
Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …
|
34
|
29
|
—
|
—
|
$9,726.06
|
$138,804.14
|
$60,490.44
|
2026-05-06
|
|
011
|
OTHER
|
Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc
|
34
|
29
|
—
|
—
|
$13,587.19
|
$138,674.54
|
$60,433.99
|
2026-05-06
|
|
576
|
OTHER
|
Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc
|
34
|
29
|
—
|
—
|
$11,820.67
|
$138,659.29
|
$60,427.34
|
2026-05-06
|
|
326
|
OTHER
|
Stomach, Esophageal And Duodenal Procedures With Mcc
|
34
|
29
|
—
|
—
|
$12,819.71
|
$130,620.40
|
$56,925.96
|
2026-05-06
|
|
239
|
OTHER
|
Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc
|
34
|
29
|
—
|
—
|
$8,814.70
|
$129,550.43
|
$56,459.93
|
2026-05-06
|
|
837
|
OTHER
|
Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot…
|
34
|
29
|
—
|
—
|
$9,832.47
|
$128,795.56
|
$56,131.14
|
2026-05-06
|
|
853
|
OTHER
|
Infectious And Parasitic Diseases With O.r. Procedures With Mcc
|
34
|
29
|
—
|
—
|
$12,007.46
|
$128,645.62
|
$56,065.83
|
2026-05-06
|
|
826
|
OTHER
|
Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. …
|
34
|
29
|
—
|
—
|
$14,285.16
|
$122,906.83
|
$53,566.27
|
2026-05-06
|
|
799
|
OTHER
|
Splenectomy With Mcc
|
34
|
29
|
—
|
—
|
$14,853.47
|
$122,380.72
|
$53,337.12
|
2026-05-06
|
|
823
|
OTHER
|
Lymphoma And Non-acute Leukemia With Other Procedures With Mcc
|
34
|
29
|
—
|
—
|
$10,882.37
|
$120,466.94
|
$52,503.56
|
2026-05-06
|
|
163
|
OTHER
|
Major Chest Procedures With Mcc
|
34
|
29
|
—
|
—
|
$13,736.33
|
$118,680.23
|
$51,725.35
|
2026-05-06
|
|
329
|
OTHER
|
Major Small And Large Bowel Procedures With Mcc
|
34
|
29
|
—
|
—
|
$10,874.75
|
$118,240.56
|
$51,533.85
|
2026-05-06
|
|
856
|
OTHER
|
Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc
|
34
|
29
|
—
|
—
|
$11,154.11
|
$116,199.68
|
$50,644.93
|
2026-05-06
|
|
474
|
OTHER
|
Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc
|
34
|
29
|
—
|
—
|
$10,772.02
|
$115,516.01
|
$50,347.16
|
2026-05-06
|
|
901
|
OTHER
|
Wound Debridements For Injuries With Mcc
|
34
|
29
|
—
|
—
|
$5,016.94
|
$114,138.52
|
$49,747.19
|
2026-05-06
|
|
933
|
OTHER
|
Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft
|
34
|
29
|
—
|
—
|
$15,937.09
|
$111,505.48
|
$48,600.35
|
2026-05-06
|
|
323
|
OTHER
|
Urinary Stones W Cc, &/or Esw Lithotripsy
|
34
|
29
|
—
|
—
|
$26,344.85
|
$109,789.92
|
$47,853.13
|
2026-05-06
|
|
140
|
OTHER
|
Major Head And Neck Procedures With Mcc
|
34
|
29
|
—
|
—
|
$5,389.78
|
$184,620.42
|
$47,518.81
|
2026-05-06
|
|
673
|
OTHER
|
Other Kidney And Urinary Tract Procedures With Mcc
|
34
|
29
|
—
|
—
|
$8,711.14
|
$108,015.91
|
$47,080.45
|
2026-05-06
|
|
958
|
OTHER
|
Other O.r. Procedures For Multiple Significant Trauma With Cc
|
34
|
29
|
—
|
—
|
$17,792.70
|
$105,987.78
|
$46,197.09
|
2026-05-06
|
|
012
|
OTHER
|
Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc
|
34
|
29
|
—
|
—
|
$11,404.52
|
$105,832.78
|
$46,129.57
|
2026-05-06
|
|
739
|
OTHER
|
Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc…
|
34
|
29
|
—
|
—
|
$12,825.62
|
$102,711.74
|
$44,770.19
|
2026-05-06
|
|
628
|
OTHER
|
Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc
|
34
|
29
|
—
|
—
|
$14,372.56
|
$101,817.11
|
$44,380.53
|
2026-05-06
|
|
736
|
OTHER
|
Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc
|
34
|
29
|
—
|
—
|
$13,808.49
|
$101,611.26
|
$44,290.87
|
2026-05-06
|
|
166
|
OTHER
|
Other Respiratory System O.r. Procedures With Mcc
|
34
|
29
|
—
|
—
|
$30,922.11
|
$261,403.24
|
$43,749.46
|
2026-05-06
|
|
616
|
OTHER
|
Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With…
|
34
|
29
|
—
|
—
|
$8,346.39
|
$99,766.10
|
$43,487.20
|
2026-05-06
|
|
904
|
OTHER
|
Skin Grafts For Injuries With Cc/mcc
|
34
|
29
|
—
|
—
|
$14,761.41
|
$99,666.97
|
$43,444.02
|
2026-05-06
|
|
650
|
OTHER
|
Kidney Transplant With Hemodialysis With Mcc
|
35
|
29
|
—
|
—
|
$4,749.34
|
$236,647.50
|
$51,704.33
|
2026-05-06
|
|
275
|
OTHER
|
Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc
|
36
|
31
|
—
|
—
|
$11,392.76
|
$181,146.24
|
$78,932.77
|
2026-05-06
|
|
276
|
OTHER
|
Non-maligant Breast Disorders
|
36
|
31
|
—
|
—
|
$36,264.29
|
$158,968.78
|
$69,273.25
|
2026-05-06
|
|
466
|
OTHER
|
Revision Of Hip Or Knee Replacement With Mcc
|
36
|
31
|
—
|
—
|
$18,784.33
|
$131,016.89
|
$57,098.66
|
2026-05-06
|
|
278
|
OTHER
|
Cellulitis Age >17 Without Cc
|
36
|
31
|
—
|
—
|
$14,430.94
|
$128,696.44
|
$56,087.97
|
2026-05-06
|
|
981
|
OTHER
|
Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc
|
36
|
30
|
—
|
—
|
$10,453.44
|
$122,357.86
|
$53,327.16
|
2026-05-06
|
|
277
|
OTHER
|
Cellulitis Age >17 W Cc
|
36
|
31
|
—
|
—
|
$16,407.11
|
$232,912.00
|
$52,198.04
|
2026-05-06
|
|
356
|
OTHER
|
Other Digestive System O.r. Procedures With Mcc
|
36
|
30
|
—
|
—
|
$10,422.09
|
$109,950.05
|
$47,922.88
|
2026-05-06
|
|
423
|
OTHER
|
Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc
|
36
|
30
|
—
|
—
|
$14,613.00
|
$104,910.17
|
$45,727.73
|
2026-05-06
|
|
907
|
OTHER
|
Other O.r. Procedures For Injuries With Mcc
|
36
|
30
|
—
|
—
|
$11,453.01
|
$102,782.93
|
$44,801.19
|
2026-05-06
|
|
023
|
OTHER
|
Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…
|
37
|
30
|
—
|
—
|
$14,098.31
|
$146,533.01
|
$63,856.78
|
2026-05-06
|
|
653
|
OTHER
|
Major Bladder Procedures With Mcc
|
37
|
31
|
—
|
—
|
$11,200.00
|
$324,470.83
|
$62,412.17
|
2026-05-06
|
|
319
|
OTHER
|
Other Endovascular Cardiac Valve Procedures With Mcc
|
38
|
32
|
—
|
—
|
$13,188.34
|
$113,180.33
|
$49,329.84
|
2026-05-06
|
|
020
|
OTHER
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc
|
39
|
32
|
—
|
—
|
$19,893.13
|
$206,411.74
|
$89,937.30
|
2026-05-06
|
|
955
|
OTHER
|
Craniotomy For Multiple Significant Trauma
|
39
|
32
|
—
|
—
|
$15,122.80
|
$175,079.59
|
$76,290.41
|
2026-05-06
|
|
461
|
OTHER
|
Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc
|
39
|
32
|
—
|
—
|
$18,423.92
|
$157,502.29
|
$68,634.52
|
2026-05-06
|
|
021
|
OTHER
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc
|
39
|
32
|
—
|
—
|
$11,225.75
|
$148,181.97
|
$61,888.56
|
2026-05-06
|
|
025
|
OTHER
|
Craniotomy And Endovascular Intracranial Procedures With Mcc
|
39
|
32
|
—
|
—
|
$16,317.80
|
$115,200.86
|
$50,209.89
|
2026-05-06
|
|
031
|
OTHER
|
Ventricular Shunt Procedures With Mcc
|
39
|
32
|
—
|
—
|
$14,375.44
|
$108,041.36
|
$47,091.53
|
2026-05-06
|
|
245
|
OTHER
|
Aicd Generator Procedures
|
41
|
34
|
—
|
—
|
$14,676.00
|
$125,735.54
|
$54,798.33
|
2026-05-06
|
|
034
|
OTHER
|
Carotid Artery Stent Procedures With Mcc
|
41
|
34
|
—
|
—
|
$14,271.00
|
$100,368.47
|
$43,749.57
|
2026-05-06
|
|
215
|
OTHER
|
Other Heart Assist System Implant
|
43
|
35
|
—
|
—
|
$14,676.00
|
$270,806.71
|
$117,984.89
|
2026-05-06
|
|
268
|
OTHER
|
Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc
|
43
|
35
|
—
|
—
|
$7,942.00
|
$170,995.32
|
$74,511.48
|
2026-05-06
|
|
232
|
OTHER
|
Coronary Bypass With Ptca Without Mcc
|
43
|
35
|
—
|
—
|
$14,676.00
|
$156,790.67
|
$68,324.57
|
2026-05-06
|
|
266
|
OTHER
|
Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc
|
43
|
35
|
—
|
—
|
$14,676.00
|
$153,794.16
|
$67,019.42
|
2026-05-06
|
|
218
|
OTHER
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
43
|
35
|
—
|
—
|
$14,676.00
|
$152,739.43
|
$66,560.03
|
2026-05-06
|
|
270
|
OTHER
|
Other Major Cardiovascular Procedures With Mcc
|
43
|
35
|
—
|
—
|
$5,098.34
|
$131,992.85
|
$57,523.74
|
2026-05-06
|
|
267
|
OTHER
|
Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc
|
43
|
35
|
—
|
—
|
$5,649.78
|
$121,107.42
|
$52,782.53
|
2026-05-06
|
|
269
|
OTHER
|
Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc
|
43
|
35
|
—
|
—
|
$8,325.81
|
$107,281.44
|
$46,760.55
|
2026-05-06
|
|
273
|
OTHER
|
Percutaneous And Other Intracardiac Procedures With Mcc
|
43
|
35
|
—
|
—
|
$14,271.00
|
$100,917.40
|
$43,988.66
|
2026-05-06
|
|
216
|
OTHER
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
44
|
36
|
—
|
—
|
$14,676.00
|
$246,822.23
|
$107,538.31
|
2026-05-06
|
|
231
|
OTHER
|
Coronary Bypass With Ptca With Mcc
|
44
|
36
|
—
|
—
|
$14,223.01
|
$216,903.17
|
$94,506.90
|
2026-05-06
|
|
233
|
OTHER
|
Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc
|
44
|
36
|
—
|
—
|
$14,676.00
|
$200,192.58
|
$87,228.51
|
2026-05-06
|
|
219
|
OTHER
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
44
|
36
|
—
|
—
|
$14,676.00
|
$198,187.29
|
$86,355.10
|
2026-05-06
|
|
217
|
OTHER
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
44
|
36
|
—
|
—
|
$14,676.00
|
$165,665.72
|
$72,190.15
|
2026-05-06
|
|
235
|
OTHER
|
Coronary Bypass Without Cardiac Catheterization With Mcc
|
44
|
36
|
—
|
—
|
$14,676.00
|
$151,084.89
|
$65,839.38
|
2026-05-06
|
|
234
|
OTHER
|
Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc
|
44
|
36
|
—
|
—
|
$14,676.00
|
$136,750.61
|
$59,596.01
|
2026-05-06
|
|
220
|
OTHER
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
44
|
36
|
—
|
—
|
$14,676.00
|
$136,153.35
|
$59,335.87
|
2026-05-06
|
|
228
|
OTHER
|
Other Cardiothoracic Procedures With Mcc
|
44
|
36
|
—
|
—
|
$14,676.00
|
$128,188.15
|
$55,866.58
|
2026-05-06
|
|
221
|
OTHER
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
44
|
36
|
—
|
—
|
$14,676.00
|
$118,258.33
|
$51,541.59
|
2026-05-06
|
|
236
|
OTHER
|
Coronary Bypass Without Cardiac Catheterization Without Mcc
|
44
|
36
|
—
|
—
|
$14,676.00
|
$106,046.24
|
$46,222.55
|
2026-05-06
|
|
453
|
OTHER
|
Combined Anterior And Posterior Spinal Fusion With Mcc
|
45
|
36
|
—
|
—
|
$17,250.00
|
$226,751.69
|
$98,796.48
|
2026-05-06
|
|
456
|
OTHER
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
45
|
36
|
—
|
—
|
$17,250.00
|
$216,783.74
|
$94,454.88
|
2026-05-06
|
|
459
|
OTHER
|
Spinal Fusion Except Cervical With Mcc
|
45
|
36
|
—
|
—
|
$17,250.00
|
$170,098.15
|
$74,120.72
|
2026-05-06
|
|
454
|
OTHER
|
Combined Anterior And Posterior Spinal Fusion With Cc
|
45
|
36
|
—
|
—
|
$17,250.00
|
$156,983.78
|
$68,408.68
|
2026-05-06
|
|
028
|
OTHER
|
Spinal Procedures With Mcc
|
45
|
36
|
—
|
—
|
$14,241.03
|
$156,048.50
|
$68,001.31
|
2026-05-06
|
|
457
|
OTHER
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
45
|
36
|
—
|
—
|
$17,250.00
|
$147,404.72
|
$64,236.47
|
2026-05-06
|
|
471
|
OTHER
|
Cervical Spinal Fusion With Mcc
|
45
|
36
|
—
|
—
|
$17,250.00
|
$124,985.81
|
$54,471.79
|
2026-05-06
|
|
455
|
OTHER
|
Combined Anterior And Posterior Spinal Fusion Without Cc/mcc
|
45
|
36
|
—
|
—
|
$17,250.00
|
$118,588.73
|
$51,685.50
|
2026-05-06
|
|
458
|
OTHER
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
45
|
36
|
—
|
—
|
$17,250.00
|
$111,279.26
|
$48,501.82
|
2026-05-06
|
|
5623297
|
OTHER
|
Aicd Single Chamber (26001-28000)
|
47
|
30
|
$134,750.00
|
$80,850.00
40% off
|
$13,663.65
|
$134,750.00
|
$51,622.72
|
2026-05-06
|
|
27023222
|
OTHER
|
Aicd Dual Chamber (26001-28000)
|
47
|
30
|
$134,750.00
|
$80,850.00
40% off
|
$13,663.65
|
$134,750.00
|
$51,622.72
|
2026-05-06
|
|
5623296
|
OTHER
|
Aicd Single Chamber (24001-26000)
|
47
|
30
|
$125,100.00
|
$75,060.00
40% off
|
$12,685.14
|
$125,100.00
|
$47,925.81
|
2026-05-06
|
|
5623295
|
OTHER
|
Aicd Single Chamber (22001-24000)
|
47
|
30
|
$113,500.00
|
$68,100.00
40% off
|
$11,508.90
|
$113,500.00
|
$43,481.85
|
2026-05-06
|
|
2700181
|
OTHER
|
Generator Neurostimulator C1767 22-24k
|
48
|
30
|
$113,495.00
|
$68,097.00
40% off
|
$11,508.39
|
$113,495.00
|
$43,479.93
|
2026-05-06
|
|
2856831
|
OTHER
|
Sipuleucel-t 50m/250 Ml Inj
|
77
|
56
|
$105,172.23
|
$63,103.34
40% off
|
$3,124.00
|
$105,172.23
|
$55,536.50
|
2026-05-06
|
|
5622502
|
OTHER
|
Insj/rplcmt Perm Dfb W/trnsvns Lds 1/dua
|
89
|
58
|
$59,555.00
|
$35,733.00
40% off
|
$895.01
|
$113,103.77
|
$46,171.79
|
2026-05-06
|
|
5600108
|
OTHER
|
Rmvl Rplcmt Dfb Gen Mlt Ld 33264
|
89
|
58
|
$56,135.00
|
$33,681.00
40% off
|
$325.13
|
$92,291.35
|
$46,171.79
|
2026-05-06
|