Hospital

LAC/RANCHO LOS AMIGOS NATIONAL REHABILITATION CTR

Downey, CA · CCN 050717 · Rates published

15,955 distinct procedures filed

4 distinct payers

214,876 rate rows

2026-05-09 last MRF observed

Data quality

210,618 of 214,876 rate rows are consumer-grade (98.0%)

4,258 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
template filing: same amount across many unrelated codes — excluded	3,904
placeholder amount (≤ $0.02) — excluded from medians	309
per-diem day rate — not a per-procedure price	45

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

Source MRF file	https://file.lacounty.gov/SDSInter/dhs/1157356_956000927_RanchoLosAmigosNationalRehab.CenterCenter_standardcharges.csv
Found on page	https://dhs.lacounty.gov/patient-information/get-coverage/hospital-price-transparency/
Discovered via	Discovered by HANK
Last fetch	not_modified · 2026-05-18
Content fingerprint	2a04fb3c79a3e330… · 51,057,031 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
J1411 OTHER	"inj, Hemgenix, Per Tx Dose"	3	$4,325,397.49	$4,974,207.11	$4,325,397.49	nat. median $3,685,267 1.2× median
J1413 OTHER	"inj Delandistrogene Mox Rokl"	3	$3,892,532.14	$4,476,411.96	$3,892,532.14	nat. median $3,327,860 1.2× median
J3394 OTHER	"inj, Lovotibeglogene Autotem"	3	$3,812,700.74	$4,384,605.85	$3,812,700.74	nat. median $3,286,000 1.2× median
J3393 OTHER	"inj, Betibeglogene Autotemce"	3	$3,457,415.04	$3,976,027.30	$3,457,415.04	nat. median $2,968,000 1.2× median
J3399 OTHER	"inj Onase Abepar-xioi Treat"	3	$2,881,563.32	$3,313,797.82	$2,881,563.32	nat. median $2,472,216 1.2× median
J3392 OTHER	"inj, Exagamglogene Autotem"	3	$2,737,068.40	$4,926,723.12	$2,737,068.40	nat. median $2,332,000 1.2× median
602-4 OTHER	"neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Othe…	1	$935,686.66	$1,173,861.45	$1,105,811.51	nat. median $125,000 outlier · 8.8×
607-4 OTHER	"neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Othe…	1	$769,282.77	$965,100.20	$909,152.36	nat. median $100,015 outlier · 9.1×
602-3 OTHER	"neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Othe…	1	$765,551.22	$960,418.80	$904,742.35	nat. median $99,067 outlier · 9.1×
607-3 OTHER	"neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Othe…	1	$618,154.91	$775,503.43	$730,546.71	nat. median $77,124 outlier · 9.5×
602-2 OTHER	"neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Othe…	1	$617,455.25	$774,625.67	$729,719.84	nat. median $80,000 outlier · 9.1×
004-4 OTHER	"tracheostomy With Mv >96 Hours With Extensive Procedure"	1	$544,456.76	$683,045.75	$643,448.90	nat. median $110,000 outlier · 5.8×
612-4 OTHER	"neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Othe…	1	$524,749.50	$658,322.10	$620,158.50	nat. median $76,321 outlier · 8.1×
740-4 OTHER	"mental Illness Diagnosis With O.r. Procedure"	1	$488,017.04	$612,239.55	$576,747.41	nat. median $47,516 outlier · 12.1×
161-4 OTHER	"implantable Heart Assist Systems"	1	$476,822.38	$598,195.35	$563,517.36	nat. median $202,242 outlier · 2.8×
602-1 OTHER	"neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Othe…	1	$475,423.05	$596,439.82	$561,863.60	nat. median $27,022 outlier · 20.8×
607-2 OTHER	"neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Othe…	1	$471,225.05	$591,173.25	$556,902.33	nat. median $58,129 outlier · 9.6×
018 OTHER	"chimeric Antigen Receptor (car) T-cell And Other Immunotherapies"	3	$550,703.91	$991,267.04	$550,703.91	nat. median $424,868 1.3× median
005-4 OTHER	"tracheostomy With Mv >96 Hours Without Extensive Procedure"	1	$462,129.39	$579,762.33	$546,152.92	nat. median $88,000 outlier · 6.2×
612-3 OTHER	"neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Othe…	1	$427,262.70	$536,020.48	$504,946.83	nat. median $50,119 outlier · 10.1×
009-4 OTHER	"extracorporeal Membrane Oxygenation (ecmo)"	1	$405,573.06	$508,809.84	$479,313.61	nat. median $150,954 outlier · 3.2×
B0406 OTHER	"traumatic Spinal Cord Injury M >=24.50 And M <31.50 And A >=61.50.,comorbidi"	3	$400,779.48	$721,403.07	$460,896.41	nat. median $62,870 outlier · 7.3×
004-3 OTHER	"tracheostomy With Mv >96 Hours With Extensive Procedure"	1	$384,699.69	$482,623.25	$454,645.09	nat. median $91,000 outlier · 5.0×
759-4 OTHER	"eating Disorders"	1	$354,614.05	$444,879.45	$419,089.33	nat. median $30,804 outlier · 13.6×
011-4 OTHER	"chimeric Antigen Receptor (car) T-cell And Other Immunotherapies"	1	$353,681.16	$443,709.10	$417,986.83	nat. median $105,647 outlier · 4.0×
160-4 OTHER	"major Cardiothoracic Repair Of Heart Anomaly"	1	$351,698.78	$441,222.10	$415,644.01	nat. median $106,926 outlier · 3.9×
005-3 OTHER	"tracheostomy With Mv >96 Hours Without Extensive Procedure"	1	$349,949.61	$439,027.69	$413,576.81	nat. median $65,623 outlier · 6.3×
161-3 OTHER	"implantable Heart Assist Systems"	1	$347,500.78	$435,955.52	$410,682.74	nat. median $152,491 outlier · 2.7×
607-1 OTHER	"neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Othe…	1	$345,051.95	$432,883.35	$407,788.67	nat. median $29,559 outlier · 13.8×
C1904 OTHER	"guillain-barr� M <38.50.,comorbidity In Tier 2"	3	$337,741.58	$607,934.85	$388,402.82	nat. median $57,113 outlier · 6.8×
761-4 OTHER	"schizoaffective Disorders"	1	$316,715.48	$397,333.96	$374,300.11	nat. median $36,899 outlier · 10.1×
428-4 OTHER	"genetic Disorders"	1	$308,319.48	$386,800.81	$364,377.57	nat. median $71,517 outlier · 5.1×
612-2 OTHER	"neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Othe…	1	$305,754.04	$383,582.34	$361,345.69	nat. median $38,190 outlier · 9.5×
758-4 OTHER	"disorders Of Impulse Control & Development"	1	$297,941.11	$373,780.66	$352,112.22	nat. median $13,558 outlier · 26.0×
757-4 OTHER	"organic Mental Health Conditions And Disturbances"	1	$282,898.29	$354,908.76	$334,334.34	nat. median $23,300 outlier · 14.3×
622-4 OTHER	"neonate Birth Weight 2000-2499 Grams With Respiratory Distress Syndrome Or Othe…	1	$281,382.34	$353,006.94	$332,542.77	nat. median $47,571 outlier · 7.0×
003 OTHER	"ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mout…	3	$331,190.91	$596,143.64	$331,190.91	nat. median $218,232 1.5× median
695-4 OTHER	"chemotherapy For Acute Leukemia"	1	$266,805.97	$334,720.21	$315,316.14	nat. median $46,809 outlier · 6.7×
622-3 OTHER	"neonate Birth Weight 2000-2499 Grams With Respiratory Distress Syndrome Or Othe…	1	$265,639.86	$333,257.28	$313,938.01	nat. median $22,876 outlier · 13.7×
361-4 OTHER	"skin Graft For Skin And Subcutaneous Tissue Diagnoses"	1	$262,957.81	$329,892.52	$310,768.32	nat. median $46,651 outlier · 6.7×
J3403 OTHER	"revakinagene, Per Implant"	3	$302,227.75	$604,455.50	$302,227.75	nat. median $265,000 1.1× median
005-2 OTHER	"tracheostomy With Mv >96 Hours Without Extensive Procedure"	1	$253,862.15	$318,481.60	$300,018.90	nat. median $46,727 outlier · 6.4×
690-4 OTHER	"acute Leukemia"	1	$253,512.31	$318,042.72	$299,605.46	nat. median $53,939 outlier · 5.6×
751-4 OTHER	"depressive Disorders"	1	$248,148.21	$311,313.21	$293,266.06	nat. median $16,720 outlier · 17.5×
091-4 OTHER	"other Major Head And Neck Procedures"	1	$247,331.93	$310,289.15	$292,301.37	nat. median $53,846 outlier · 5.4×
680-4 OTHER	"major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms"	1	$245,582.77	$308,094.74	$290,234.18	nat. median $61,090 outlier · 4.8×
B0404 OTHER	"traumatic Spinal Cord Injury M <31.50 And A <61.50.,comorbidity In Tier 1"	3	$250,141.67	$450,255.01	$287,662.93	nat. median $60,491 outlier · 4.8×
681-4 OTHER	"other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms"	1	$242,667.49	$304,437.40	$286,788.85	nat. median $52,952 outlier · 5.4×
312-4 OTHER	"skin Graft For Musculoskeletal And Connective Tissue Diagnoses"	1	$242,434.27	$304,144.81	$286,513.23	nat. median $47,272 outlier · 6.1×
A1904 OTHER	"guillain-barr� M <38.50.,without Comorbidities"	3	$247,996.40	$446,393.52	$285,195.86	nat. median $50,010 outlier · 5.7×

Other procedures at this hospital

Browse this hospital's 15,955 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

J1411	OTHER	"inj, Hemgenix, Per Tx Dose"	5	3	—	—	$4,325,397.49	$4,974,207.11	$4,325,397.49	2026-05-09
J1413	OTHER	"inj Delandistrogene Mox Rokl"	5	3	—	—	$3,892,532.14	$4,476,411.96	$3,892,532.14	2026-05-09
J3394	OTHER	"inj, Lovotibeglogene Autotem"	5	3	—	—	$3,812,700.74	$4,384,605.85	$3,812,700.74	2026-05-09
J3393	OTHER	"inj, Betibeglogene Autotemce"	5	3	—	—	$3,457,415.04	$3,976,027.30	$3,457,415.04	2026-05-09
J3399	OTHER	"inj Onase Abepar-xioi Treat"	5	3	—	—	$2,881,563.32	$3,313,797.82	$2,881,563.32	2026-05-09
J3392	OTHER	"inj, Exagamglogene Autotem"	6	3	—	—	$2,737,068.40	$4,926,723.12	$2,737,068.40	2026-05-09
602-4	OTHER	"neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Othe…	5	1	—	—	$935,686.66	$1,173,861.45	$1,105,811.51	2026-05-09
607-4	OTHER	"neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Othe…	5	1	—	—	$769,282.77	$965,100.20	$909,152.36	2026-05-09
602-3	OTHER	"neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Othe…	5	1	—	—	$765,551.22	$960,418.80	$904,742.35	2026-05-09
607-3	OTHER	"neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Othe…	5	1	—	—	$618,154.91	$775,503.43	$730,546.71	2026-05-09
602-2	OTHER	"neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Othe…	5	1	—	—	$617,455.25	$774,625.67	$729,719.84	2026-05-09
004-4	OTHER	"tracheostomy With Mv >96 Hours With Extensive Procedure"	5	1	—	—	$544,456.76	$683,045.75	$643,448.90	2026-05-09
612-4	OTHER	"neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Othe…	5	1	—	—	$524,749.50	$658,322.10	$620,158.50	2026-05-09
740-4	OTHER	"mental Illness Diagnosis With O.r. Procedure"	5	1	—	—	$488,017.04	$612,239.55	$576,747.41	2026-05-09
161-4	OTHER	"implantable Heart Assist Systems"	5	1	—	—	$476,822.38	$598,195.35	$563,517.36	2026-05-09
602-1	OTHER	"neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Othe…	5	1	—	—	$475,423.05	$596,439.82	$561,863.60	2026-05-09
607-2	OTHER	"neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Othe…	5	1	—	—	$471,225.05	$591,173.25	$556,902.33	2026-05-09
018	OTHER	"chimeric Antigen Receptor (car) T-cell And Other Immunotherapies"	8	3	—	—	$550,703.91	$991,267.04	$550,703.91	2026-05-09
005-4	OTHER	"tracheostomy With Mv >96 Hours Without Extensive Procedure"	5	1	—	—	$462,129.39	$579,762.33	$546,152.92	2026-05-09
612-3	OTHER	"neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Othe…	5	1	—	—	$427,262.70	$536,020.48	$504,946.83	2026-05-09
009-4	OTHER	"extracorporeal Membrane Oxygenation (ecmo)"	5	1	—	—	$405,573.06	$508,809.84	$479,313.61	2026-05-09
B0406	OTHER	"traumatic Spinal Cord Injury M >=24.50 And M <31.50 And A >=61.50.,comorbidi"	5	3	—	—	$400,779.48	$721,403.07	$460,896.41	2026-05-09
004-3	OTHER	"tracheostomy With Mv >96 Hours With Extensive Procedure"	5	1	—	—	$384,699.69	$482,623.25	$454,645.09	2026-05-09
759-4	OTHER	"eating Disorders"	5	1	—	—	$354,614.05	$444,879.45	$419,089.33	2026-05-09
011-4	OTHER	"chimeric Antigen Receptor (car) T-cell And Other Immunotherapies"	5	1	—	—	$353,681.16	$443,709.10	$417,986.83	2026-05-09
160-4	OTHER	"major Cardiothoracic Repair Of Heart Anomaly"	5	1	—	—	$351,698.78	$441,222.10	$415,644.01	2026-05-09
005-3	OTHER	"tracheostomy With Mv >96 Hours Without Extensive Procedure"	5	1	—	—	$349,949.61	$439,027.69	$413,576.81	2026-05-09
161-3	OTHER	"implantable Heart Assist Systems"	5	1	—	—	$347,500.78	$435,955.52	$410,682.74	2026-05-09
607-1	OTHER	"neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Othe…	5	1	—	—	$345,051.95	$432,883.35	$407,788.67	2026-05-09
C1904	OTHER	"guillain-barr� M <38.50.,comorbidity In Tier 2"	5	3	—	—	$337,741.58	$607,934.85	$388,402.82	2026-05-09
761-4	OTHER	"schizoaffective Disorders"	5	1	—	—	$316,715.48	$397,333.96	$374,300.11	2026-05-09
428-4	OTHER	"genetic Disorders"	5	1	—	—	$308,319.48	$386,800.81	$364,377.57	2026-05-09
612-2	OTHER	"neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Othe…	5	1	—	—	$305,754.04	$383,582.34	$361,345.69	2026-05-09
758-4	OTHER	"disorders Of Impulse Control & Development"	5	1	—	—	$297,941.11	$373,780.66	$352,112.22	2026-05-09
757-4	OTHER	"organic Mental Health Conditions And Disturbances"	5	1	—	—	$282,898.29	$354,908.76	$334,334.34	2026-05-09
622-4	OTHER	"neonate Birth Weight 2000-2499 Grams With Respiratory Distress Syndrome Or Othe…	5	1	—	—	$281,382.34	$353,006.94	$332,542.77	2026-05-09
003	OTHER	"ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mout…	8	3	—	—	$331,190.91	$596,143.64	$331,190.91	2026-05-09
695-4	OTHER	"chemotherapy For Acute Leukemia"	5	1	—	—	$266,805.97	$334,720.21	$315,316.14	2026-05-09
622-3	OTHER	"neonate Birth Weight 2000-2499 Grams With Respiratory Distress Syndrome Or Othe…	5	1	—	—	$265,639.86	$333,257.28	$313,938.01	2026-05-09
361-4	OTHER	"skin Graft For Skin And Subcutaneous Tissue Diagnoses"	5	1	—	—	$262,957.81	$329,892.52	$310,768.32	2026-05-09
J3403	OTHER	"revakinagene, Per Implant"	7	3	—	—	$302,227.75	$604,455.50	$302,227.75	2026-05-09
005-2	OTHER	"tracheostomy With Mv >96 Hours Without Extensive Procedure"	5	1	—	—	$253,862.15	$318,481.60	$300,018.90	2026-05-09
690-4	OTHER	"acute Leukemia"	5	1	—	—	$253,512.31	$318,042.72	$299,605.46	2026-05-09
751-4	OTHER	"depressive Disorders"	5	1	—	—	$248,148.21	$311,313.21	$293,266.06	2026-05-09
091-4	OTHER	"other Major Head And Neck Procedures"	5	1	—	—	$247,331.93	$310,289.15	$292,301.37	2026-05-09
680-4	OTHER	"major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms"	5	1	—	—	$245,582.77	$308,094.74	$290,234.18	2026-05-09
B0404	OTHER	"traumatic Spinal Cord Injury M <31.50 And A <61.50.,comorbidity In Tier 1"	5	3	—	—	$250,141.67	$450,255.01	$287,662.93	2026-05-09
681-4	OTHER	"other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms"	5	1	—	—	$242,667.49	$304,437.40	$286,788.85	2026-05-09
312-4	OTHER	"skin Graft For Musculoskeletal And Connective Tissue Diagnoses"	5	1	—	—	$242,434.27	$304,144.81	$286,513.23	2026-05-09
A1904	OTHER	"guillain-barr� M <38.50.,without Comorbidities"	5	3	—	—	$247,996.40	$446,393.52	$285,195.86	2026-05-09
009-3	OTHER	"extracorporeal Membrane Oxygenation (ecmo)"	5	1	—	—	$239,169.16	$300,048.58	$282,654.46	2026-05-09
004-2	OTHER	"tracheostomy With Mv >96 Hours With Extensive Procedure"	5	1	—	—	$235,437.61	$295,367.18	$278,244.45	2026-05-09
753-4	OTHER	"bipolar Disorders"	5	1	—	—	$233,805.06	$293,319.07	$276,315.07	2026-05-09
162-4	OTHER	"cardiac Valve Procedures With Ami Or Complex Principal Diagnosis"	5	1	—	—	$231,939.28	$290,978.37	$274,110.06	2026-05-09
261-4	OTHER	"major Biliary Tract Procedures"	5	1	—	—	$231,706.06	$290,685.78	$273,834.43	2026-05-09
405-4	OTHER	"other Procedures For Endocrine, Nutritional And Metabolic Disorders"	5	1	—	—	$227,624.67	$285,565.50	$269,010.98	2026-05-09
740-3	OTHER	"mental Illness Diagnosis With O.r. Procedure"	5	1	—	—	$227,041.62	$284,834.03	$268,321.91	2026-05-09
634-4	OTHER	"neonate Birth Weight > 2499 Grams With Respiratory Distress Syndrome Or Other M…	5	1	—	—	$225,059.23	$282,347.03	$265,979.09	2026-05-09
130-4	OTHER	"respiratory System Diagnosis With Ventilator Support > 96 Hours"	5	1	—	—	$222,610.40	$279,274.86	$263,085.02	2026-05-09
447-4	OTHER	"other Kidney, Urinary Tract And Related Non-percutaneous Procedures"	5	1	—	—	$219,345.29	$275,178.64	$259,226.25	2026-05-09
761-3	OTHER	"schizoaffective Disorders"	5	1	—	—	$218,062.57	$273,569.41	$257,710.31	2026-05-09
950-4	OTHER	"extensive O.r. Procedure Unrelated To Principal Diagnosis"	5	1	—	—	$216,779.85	$271,960.17	$256,194.37	2026-05-09
220-4	OTHER	"major Stomach, Esophageal And Duodenal Procedures"	5	1	—	—	$213,864.57	$268,302.83	$252,749.04	2026-05-09
023-4	OTHER	"spinal Procedures"	5	1	—	—	$212,115.41	$266,108.42	$250,681.85	2026-05-09
612-1	OTHER	"neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Othe…	5	1	—	—	$209,549.97	$262,889.96	$247,649.96	2026-05-09
401-4	OTHER	"adrenal Procedures"	5	1	—	—	$209,433.36	$262,743.66	$247,512.15	2026-05-09
303-4	OTHER	"dorsal And Lumbar Fusion Procedure For Curvature Of Back"	5	1	—	—	$207,917.41	$260,841.85	$245,720.58	2026-05-09
484-4	OTHER	"other Male Reproductive System And Related Procedures"	5	1	—	—	$207,334.36	$260,110.38	$245,031.51	2026-05-09
004	OTHER	"tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Ne…	8	3	—	—	$242,541.22	$436,574.20	$242,541.22	2026-05-09
D0407	OTHER	"traumatic Spinal Cord Injury M <24.50 And A >=61.50.,comorbidity In Tier 3"	5	3	—	—	$210,084.95	$378,152.91	$241,597.69	2026-05-09
230-4	OTHER	"major Small Bowel Procedures"	5	1	—	—	$204,419.08	$256,453.03	$241,586.19	2026-05-09
026-4	OTHER	"other Nervous System And Related Procedures"	5	1	—	—	$204,302.47	$256,306.74	$241,448.38	2026-05-09
J3402	OTHER	"inj. Remestemcel-l-rknd/ Td"	7	3	—	—	$241,359.67	$482,719.34	$241,359.67	2026-05-09
C0406	OTHER	"traumatic Spinal Cord Injury M >=24.50 And M <31.50 And A >=61.50.,comorbidi"	5	3	—	—	$209,204.18	$376,567.52	$240,584.80	2026-05-09
441-4	OTHER	"major Bladder Procedures"	5	1	—	—	$202,669.92	$254,258.62	$239,518.99	2026-05-09
043-4	OTHER	"multiple Sclerosis, Other Demyelinating Disease And Inflammatory Neuropathies"	5	1	—	—	$201,387.20	$252,649.39	$238,003.05	2026-05-09
520-4	OTHER	"other GYN Procedures For Malignancy"	5	1	—	—	$199,521.42	$250,308.69	$235,798.04	2026-05-09
428-3	OTHER	"genetic Disorders"	5	1	—	—	$199,288.20	$250,016.10	$235,522.42	2026-05-09
022-4	OTHER	"ventricular Shunt Procedures"	5	1	—	—	$197,305.81	$247,529.11	$233,179.60	2026-05-09
049-4	OTHER	"bacterial And Tuberculous Infections Of Nervous System"	5	1	—	—	$196,839.37	$246,943.93	$232,628.34	2026-05-09
121-4	OTHER	"other Respiratory And Chest Procedures"	5	1	—	—	$196,722.76	$246,797.64	$232,490.53	2026-05-09
161-2	OTHER	"implantable Heart Assist Systems"	5	1	—	—	$196,023.09	$245,919.88	$231,663.65	2026-05-09
092-4	OTHER	"facial Bone Procedures Except Major Cranial Or Facial Bone Procedures"	5	1	—	—	$195,789.87	$245,627.29	$231,388.03	2026-05-09
651-4	OTHER	"other Procedures Of Blood And Blood-forming Organs"	5	1	—	—	$195,323.43	$245,042.12	$230,836.78	2026-05-09
951-4	OTHER	"moderately Extensive O.r. Procedure Unrelated To Principal Diagnosis"	5	1	—	—	$195,206.81	$244,895.82	$230,698.96	2026-05-09
305-4	OTHER	"amputation Of Lower Limb Except Toes"	5	1	—	—	$194,740.37	$244,310.65	$230,147.71	2026-05-09
004-1	OTHER	"tracheostomy With Mv >96 Hours With Extensive Procedure"	5	1	—	—	$194,390.54	$243,871.76	$229,734.27	2026-05-09
260-4	OTHER	"major Pancreas, Liver And Shunt Procedures"	5	1	—	—	$193,690.87	$242,994.00	$228,907.39	2026-05-09
089-4	OTHER	"major Cranial Or Facial Bone Procedures"	5	1	—	—	$193,107.82	$242,262.53	$228,218.33	2026-05-09
759-3	OTHER	"eating Disorders"	5	1	—	—	$192,991.21	$242,116.24	$228,080.52	2026-05-09
163-4	OTHER	"cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis"	5	1	—	—	$191,825.10	$240,653.30	$226,702.39	2026-05-09
B0205	OTHER	"traumatic Brain Injury M <35.50.,comorbidity In Tier 1"	5	3	—	—	$196,196.55	$353,153.78	$225,626.03	2026-05-09
165-4	OTHER	"coronary Bypass With Ami Or Complex Principal Diagnosis"	5	1	—	—	$190,775.60	$239,336.66	$225,462.07	2026-05-09
304-4	OTHER	"dorsal And Lumbar Fusion Procedure Except For Curvature Of Back"	5	1	—	—	$190,425.76	$238,897.78	$225,048.63	2026-05-09
C0404	OTHER	"traumatic Spinal Cord Injury M <31.50 And A <61.50.,comorbidity In Tier 2"	5	3	—	—	$195,448.61	$351,807.51	$224,765.91	2026-05-09
952-4	OTHER	"non-extensive O.r. Procedure Unrelated To Principal Diagnosis"	5	1	—	—	$189,609.49	$237,873.72	$224,083.94	2026-05-09
485-4	OTHER	"prostatectomy Procedures"	5	1	—	—	$187,277.27	$234,947.84	$221,327.68	2026-05-09
622-2	OTHER	"neonate Birth Weight 2000-2499 Grams With Respiratory Distress Syndrome Or Othe…	5	1	—	—	$186,927.43	$234,508.96	$220,914.24	2026-05-09
232-4	OTHER	"gastric Fundoplication"	5	1	—	—	$186,577.60	$234,070.08	$220,500.80	2026-05-09
073-4	OTHER	"orbit And Eye Procedures"	5	1	—	—	$185,994.55	$233,338.61	$219,811.74	2026-05-09
120-4	OTHER	"major Respiratory And Chest Procedures"	5	1	—	—	$185,877.93	$233,192.32	$219,673.92	2026-05-09
690-3	OTHER	"acute Leukemia"	5	1	—	—	$185,877.93	$233,192.32	$219,673.92	2026-05-09
098-4	OTHER	"other Ear, Nose, Mouth, Throat, Craniofacial, And Neck Procedures"	5	1	—	—	$185,644.71	$232,899.73	$219,398.30	2026-05-09
792-4	OTHER	"extensive O.r. Procedures For Other Complications Of Treatment"	5	1	—	—	$184,711.82	$231,729.38	$218,295.79	2026-05-09
710-4	OTHER	"infectious And Parasitic Diseases Including HIV With O.r. Procedure"	5	1	—	—	$184,595.21	$231,583.09	$218,157.98	2026-05-09
512-4	OTHER	"uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy"	5	1	—	—	$183,545.71	$230,266.44	$216,917.66	2026-05-09
050-4	OTHER	"non-bacterial Infections Of Nervous System Except Viral Meningitis"	5	1	—	—	$182,729.44	$229,242.38	$215,952.97	2026-05-09
040-4	OTHER	"spinal Disorders And Injuries"	5	1	—	—	$182,612.83	$229,096.09	$215,815.16	2026-05-09
444-4	OTHER	"renal Dialysis Access Device Procedures"	5	1	—	—	$182,379.60	$228,803.50	$215,539.53	2026-05-09
299-4	OTHER	"multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical"	5	1	—	—	$182,146.38	$228,510.92	$215,263.91	2026-05-09
130-3	OTHER	"respiratory System Diagnosis With Ventilator Support > 96 Hours"	5	1	—	—	$182,146.38	$228,510.92	$215,263.91	2026-05-09
321-4	OTHER	"spinal Fusion And Other Back And Neck Procedures Except For Disc Procedures"	5	1	—	—	$181,913.16	$228,218.33	$214,988.28	2026-05-09
Q2053	OTHER	"brexucabtagene Car Pos T"	15	4	—	—	$151,630.74	$1,148,593.64	$214,810.21	2026-05-09
231-4	OTHER	"major Large Bowel Procedures"	5	1	—	—	$180,980.27	$227,047.98	$213,885.78	2026-05-09
511-4	OTHER	"uterine And Adnexa Procedures For Ovarian And Adnexal Malignancy"	5	1	—	—	$180,397.22	$226,316.51	$213,196.71	2026-05-09
011-3	OTHER	"chimeric Antigen Receptor (car) T-cell And Other Immunotherapies"	5	1	—	—	$179,930.77	$225,731.33	$212,645.46	2026-05-09
Q2042	OTHER	"tisagenlecleucel Car-pos T"	15	4	—	—	$149,434.07	$1,389,018.08	$211,698.27	2026-05-09
167-4	OTHER	"other Cardiothoracic And Thoracic Circulatory Procedures"	5	1	—	—	$179,114.50	$224,707.28	$211,680.77	2026-05-09
264-4	OTHER	"other Hepatobiliary, Pancreas And Abdominal Procedures"	5	1	—	—	$178,997.89	$224,560.98	$211,542.96	2026-05-09
C0407	OTHER	"traumatic Spinal Cord Injury M <24.50 And A >=61.50.,comorbidity In Tier 2"	5	3	—	—	$183,538.10	$330,368.58	$211,068.82	2026-05-09
027-4	OTHER	"other Open Craniotomy"	5	1	—	—	$177,948.39	$223,244.34	$210,302.64	2026-05-09
A1806	OTHER	"major Multiple Trauma With Brain Or Spinal Cord Injury M <30.50.,without Com"	5	3	—	—	$181,983.72	$327,570.70	$209,281.28	2026-05-09
310-4	OTHER	"vertebral And Intervertebral Spinal Procedures Including Disc Procedures"	5	1	—	—	$177,015.50	$222,073.99	$209,200.13	2026-05-09
C0205	OTHER	"traumatic Brain Injury M <35.50.,comorbidity In Tier 2"	5	3	—	—	$181,625.20	$326,925.35	$208,868.98	2026-05-09
224-4	OTHER	"peritoneal Adhesiolysis"	5	1	—	—	$176,315.83	$221,196.23	$208,373.26	2026-05-09
363-4	OTHER	"breast Procedures Except Mastectomy"	5	1	—	—	$175,499.56	$220,172.17	$207,408.57	2026-05-09
483-4	OTHER	"penis, Testes And Scrotal Procedures"	5	1	—	—	$173,750.39	$217,977.76	$205,341.37	2026-05-09
D0405	OTHER	"traumatic Spinal Cord Injury M >=31.50 And M <41.50.,comorbidity In Tier 3"	5	3	—	—	$178,532.13	$321,357.83	$205,311.95	2026-05-09
227-4	OTHER	"hernia Procedures Except Inguinal, Femoral And Umbilical"	5	1	—	—	$172,351.06	$216,222.24	$203,687.61	2026-05-09
317-4	OTHER	"tendon, Muscle And Other Soft Tissue Procedures"	5	1	—	—	$172,117.84	$215,929.65	$203,411.99	2026-05-09
180-4	OTHER	"other Circulatory System Procedures"	5	1	—	—	$171,884.61	$215,637.06	$203,136.36	2026-05-09
Q2056	OTHER	"ciltacabtagene Car-pos T"	15	4	—	—	$142,823.89	$1,328,320.76	$202,333.84	2026-05-09
518-4	OTHER	"other Female Reproductive System And Related Procedures"	5	1	—	—	$170,835.12	$214,320.42	$201,896.05	2026-05-09
058-4	OTHER	"other Disorders Of Nervous System"	5	1	—	—	$170,485.28	$213,881.54	$201,482.61	2026-05-09
166-4	OTHER	"coronary Bypass Without Ami Or Complex Principal Diagnosis"	5	1	—	—	$170,368.67	$213,735.24	$201,344.79	2026-05-09
404-4	OTHER	"thyroid, Parathyroid And Thyroglossal Procedures"	5	1	—	—	$170,018.84	$213,296.36	$200,931.35	2026-05-09
691-4	OTHER	"lymphoma, Myeloma And Non-acute Leukemia"	5	1	—	—	$169,552.39	$212,711.19	$200,380.10	2026-05-09
181-4	OTHER	"lower Extremity Vascular Procedures"	5	1	—	—	$169,435.78	$212,564.89	$200,242.29	2026-05-09
890-4	OTHER	"hiv With Multiple Major HIV Related Conditions"	5	1	—	—	$169,085.95	$212,126.01	$199,828.85	2026-05-09
Q2057	OTHER	"afamitresgene Autoleucel"	15	4	—	—	$140,779.19	$1,808,953.38	$199,437.18	2026-05-09
193-4	OTHER	"acute And Subacute Endocarditis"	5	1	—	—	$168,736.12	$211,687.13	$199,415.41	2026-05-09
223-4	OTHER	"other Small And Large Bowel Procedures"	5	1	—	—	$168,036.45	$210,809.37	$198,588.53	2026-05-09
222-4	OTHER	"other Stomach, Esophageal And Duodenal Procedures"	5	1	—	—	$167,570.01	$210,224.19	$198,037.28	2026-05-09
364-4	OTHER	"other Skin, Subcutaneous Tissue And Related Procedures"	5	1	—	—	$166,403.90	$208,761.25	$196,659.15	2026-05-09
320-4	OTHER	"other Musculoskeletal System And Connective Tissue Procedures"	5	1	—	—	$166,287.29	$208,614.96	$196,521.34	2026-05-09
D1806	OTHER	"major Multiple Trauma With Brain Or Spinal Cord Injury M <30.50.,comorbidity"	5	3	—	—	$169,830.62	$305,695.11	$195,305.21	2026-05-09
793-4	OTHER	"moderately Extensive O.r. Procedures For Other Complications Of Treatment"	5	1	—	—	$165,237.79	$207,298.31	$195,281.02	2026-05-09
212	OTHER	"concomitant Aortic And Mitral Valve Procedures"	8	3	—	—	$193,252.53	$347,854.55	$193,252.53	2026-05-09
029-4	OTHER	"other Percutaneous Intracranial Procedures"	5	1	—	—	$163,488.62	$205,103.91	$193,213.83	2026-05-09
Q2055	OTHER	"idecabtagene Vicleucel Car"	15	4	—	—	$136,227.91	$1,308,248.12	$192,989.53	2026-05-09
448-4	OTHER	"other Kidney, Urinary Tract And Related Percutaneous Procedures"	5	1	—	—	$163,138.79	$204,665.03	$192,800.39	2026-05-09
423-4	OTHER	"inborn Errors Of Metabolism"	5	1	—	—	$163,022.18	$204,518.73	$192,662.57	2026-05-09
C0405	OTHER	"traumatic Spinal Cord Injury M >=31.50 And M <41.50.,comorbidity In Tier 2"	5	3	—	—	$167,521.98	$301,539.55	$192,650.27	2026-05-09
443-4	OTHER	"kidney And Urinary Tract Procedures For Non-malignancy"	5	1	—	—	$162,905.57	$204,372.44	$192,524.76	2026-05-09
300-4	OTHER	"single Level Combined Anterior And Posterior Spinal Fusion Except Cervical"	5	1	—	—	$162,788.96	$204,226.14	$192,386.95	2026-05-09
513-4	OTHER	"uterine And Adnexa Procedures For Non-malignancy Except Leiomyoma"	5	1	—	—	$162,788.96	$204,226.14	$192,386.95	2026-05-09
Q2058	OTHER	"obecbtge Autol Up To 400 Mil"	15	4	—	—	$135,550.80	$653,164.06	$192,030.30	2026-05-09
313-4	OTHER	"knee And Lower Leg Procedures Except Foot"	5	1	—	—	$162,439.12	$203,787.26	$191,973.51	2026-05-09
209	OTHER	"complex Aortic Arch Procedures"	8	3	—	—	$191,430.99	$344,575.78	$191,430.99	2026-05-09
445-4	OTHER	"other Bladder Procedures"	5	1	—	—	$161,739.46	$202,909.50	$191,146.63	2026-05-09
309-4	OTHER	"other Significant Hip And Femur Surgery"	5	1	—	—	$160,923.18	$201,885.44	$190,181.94	2026-05-09
Q2054	OTHER	"lisocabtagene Mara Car Pos T"	15	4	—	—	$133,341.26	$1,320,502.14	$188,900.12	2026-05-09
692-4	OTHER	"radiotherapy"	5	1	—	—	$159,757.07	$200,422.51	$188,803.81	2026-05-09
634-3	OTHER	"neonate Birth Weight > 2499 Grams With Respiratory Distress Syndrome Or Other M…	5	1	—	—	$159,523.85	$200,129.92	$188,528.18	2026-05-09
040-3	OTHER	"spinal Disorders And Injuries"	5	1	—	—	$159,290.63	$199,837.33	$188,252.56	2026-05-09
A0405	OTHER	"traumatic Spinal Cord Injury M >=31.50 And M <41.50.,without Comorbidities"	5	3	—	—	$163,028.75	$293,451.74	$187,483.06	2026-05-09
179-4	OTHER	"defibrillator Implants"	5	1	—	—	$158,241.13	$198,520.69	$187,012.24	2026-05-09
344-4	OTHER	"osteomyelitis, Septic Arthritis And Other Musculoskeletal Infections"	5	1	—	—	$158,241.13	$198,520.69	$187,012.24	2026-05-09
162-3	OTHER	"cardiac Valve Procedures With Ami Or Complex Principal Diagnosis"	5	1	—	—	$157,891.29	$198,081.81	$186,598.80	2026-05-09
314-4	OTHER	"foot And Toe Procedures"	5	1	—	—	$157,658.07	$197,789.22	$186,323.18	2026-05-09
B1806	OTHER	"major Multiple Trauma With Brain Or Spinal Cord Injury M <30.50.,comorbidity"	5	3	—	—	$161,887.21	$291,396.98	$186,170.29	2026-05-09
462-4	OTHER	"nephritis And Nephrosis"	5	1	—	—	$157,075.02	$197,057.75	$185,634.11	2026-05-09
426	OTHER	"multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wi…	8	3	—	—	$185,421.95	$333,759.51	$185,421.95	2026-05-09
Q2041	OTHER	"axicabtagene Ciloleucel Car+"	15	4	—	—	$129,829.46	$1,251,704.50	$183,925.06	2026-05-09
312-3	OTHER	"skin Graft For Musculoskeletal And Connective Tissue Diagnoses"	5	1	—	—	$155,442.46	$195,009.64	$183,704.73	2026-05-09
170-4	OTHER	"permanent Cardiac Pacemaker Implant With Ami, Heart Failure Or Shock"	5	1	—	—	$155,209.24	$194,717.05	$183,429.10	2026-05-09
130-2	OTHER	"respiratory System Diagnosis With Ventilator Support > 96 Hours"	5	1	—	—	$155,209.24	$194,717.05	$183,429.10	2026-05-09
A0404	OTHER	"traumatic Spinal Cord Injury M <31.50 And A <61.50.,without Comorbidities"	5	3	—	—	$158,893.81	$286,008.86	$182,727.88	2026-05-09
D1904	OTHER	"guillain-barr� M <38.50.,comorbidity In Tier 3"	5	3	—	—	$158,338.04	$285,008.48	$182,088.75	2026-05-09
183-4	OTHER	"percutaneous Structural Cardiac Procedures"	5	1	—	—	$154,043.13	$193,254.11	$182,050.97	2026-05-09
114-4	OTHER	"dental Diseases And Disorders"	5	1	—	—	$154,043.13	$193,254.11	$182,050.97	2026-05-09
794-4	OTHER	"non-extensive O.r. Procedures For Other Complications Of Treatment"	5	1	—	—	$153,226.85	$192,230.05	$181,086.28	2026-05-09
403-4	OTHER	"procedures For Obesity"	5	1	—	—	$153,110.24	$192,083.76	$180,948.47	2026-05-09
316-4	OTHER	"hand And Wrist Procedures"	5	1	—	—	$152,877.02	$191,791.17	$180,672.84	2026-05-09
042-4	OTHER	"degenerative Nervous System Disorders Except Multiple Sclerosis"	5	1	—	—	$152,760.41	$191,644.88	$180,535.03	2026-05-09
216	OTHER	"cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriz…	8	3	—	—	$178,429.07	$321,172.33	$178,429.07	2026-05-09
850	OTHER	"acute Leukemia With Other Procedures"	8	3	—	—	$178,122.57	$320,620.63	$178,122.57	2026-05-09
058-3	OTHER	"other Disorders Of Nervous System"	5	1	—	—	$150,661.41	$189,011.59	$178,054.40	2026-05-09
361-3	OTHER	"skin Graft For Skin And Subcutaneous Tissue Diagnoses"	5	1	—	—	$150,661.41	$189,011.59	$178,054.40	2026-05-09
169-4	OTHER	"major Abdominal Vascular Procedures"	5	1	—	—	$150,194.97	$188,426.41	$177,503.14	2026-05-09
442-4	OTHER	"kidney And Urinary Tract Procedures For Malignancy"	5	1	—	—	$149,028.86	$186,963.48	$176,125.01	2026-05-09
740-2	OTHER	"mental Illness Diagnosis With O.r. Procedure"	5	1	—	—	$147,629.53	$185,207.95	$174,471.26	2026-05-09
446-4	OTHER	"urethral And Transurethral Procedures"	5	1	—	—	$147,396.30	$184,915.36	$174,195.63	2026-05-09
752-4	OTHER	"personality Disorders"	5	1	—	—	$147,163.08	$184,622.78	$173,920.01	2026-05-09
752-3	OTHER	"personality Disorders"	5	1	—	—	$147,163.08	$184,622.78	$173,920.01	2026-05-09
049-3	OTHER	"bacterial And Tuberculous Infections Of Nervous System"	5	1	—	—	$146,696.64	$184,037.60	$173,368.75	2026-05-09
048-4	OTHER	"peripheral, Cranial And Autonomic Nerve Disorders"	5	1	—	—	$146,580.03	$183,891.31	$173,230.94	2026-05-09
282-4	OTHER	"disorders Of Pancreas Except Malignancy"	5	1	—	—	$146,346.81	$183,598.72	$172,955.32	2026-05-09
229-4	OTHER	"other Digestive System And Abdominal Procedures"	5	1	—	—	$146,230.19	$183,452.43	$172,817.50	2026-05-09
315-4	OTHER	"shoulder, Upper Arm And Forearm Procedures Except Joint Replacement"	5	1	—	—	$146,230.19	$183,452.43	$172,817.50	2026-05-09
226-4	OTHER	"anal And Perineal Procedures"	5	1	—	—	$145,763.75	$182,867.25	$172,266.25	2026-05-09
215	OTHER	"other Heart Assist System Implant"	8	3	—	—	$172,251.46	$310,052.63	$172,251.46	2026-05-09
421-4	OTHER	"malnutrition, Failure To Thrive And Other Nutritional Disorders"	5	1	—	—	$145,530.53	$182,574.66	$171,990.62	2026-05-09
775-4	OTHER	"alcohol Abuse And Dependence"	5	1	—	—	$145,413.92	$182,428.37	$171,852.81	2026-05-09
381-4	OTHER	"major Skin Disorders"	5	1	—	—	$144,131.20	$180,819.14	$170,336.87	2026-05-09
346-4	OTHER	"connective Tissue Disorders"	5	1	—	—	$143,897.97	$180,526.55	$170,061.24	2026-05-09
024-4	OTHER	"open Extracranial Vascular Procedures"	5	1	—	—	$143,548.14	$180,087.67	$169,647.80	2026-05-09
695-3	OTHER	"chemotherapy For Acute Leukemia"	5	1	—	—	$142,498.64	$178,771.02	$168,407.49	2026-05-09
263-4	OTHER	"cholecystectomy"	5	1	—	—	$142,382.03	$178,624.73	$168,269.67	2026-05-09
343-4	OTHER	"musculoskeletal Malignancy And Pathological Fracture Due To Musculoskeletal Mal…	5	1	—	—	$141,915.59	$178,039.55	$167,718.42	2026-05-09
182-4	OTHER	"other Peripheral Vascular And Related Procedures"	5	1	—	—	$141,565.75	$177,600.67	$167,304.98	2026-05-09
429	OTHER	"combined Anterior And Posterior Cervical Spinal Fusion With Mcc"	8	3	—	—	$167,138.27	$300,848.89	$167,138.27	2026-05-09
323-4	OTHER	"non-elective Or Complex Hip Joint Replacement"	5	1	—	—	$140,866.09	$176,722.91	$166,478.10	2026-05-09
192-4	OTHER	"cardiac Catheterization For Other Non-coronary Conditions"	5	1	—	—	$140,516.26	$176,284.03	$166,064.67	2026-05-09
228-4	OTHER	"inguinal, Femoral And Umbilical Hernia Procedures"	5	1	—	—	$140,516.26	$176,284.03	$166,064.67	2026-05-09
753-3	OTHER	"bipolar Disorders"	5	1	—	—	$140,516.26	$176,284.03	$166,064.67	2026-05-09
005-1	OTHER	"tracheostomy With Mv >96 Hours Without Extensive Procedure"	5	1	—	—	$139,933.20	$175,552.56	$165,375.60	2026-05-09
514-4	OTHER	"female Reproductive System Reconstructive Procedures"	5	1	—	—	$139,933.20	$175,552.56	$165,375.60	2026-05-09
091-3	OTHER	"other Major Head And Neck Procedures"	5	1	—	—	$139,816.59	$175,406.27	$165,237.79	2026-05-09
519-4	OTHER	"uterine And Adnexa Procedures For Leiomyoma"	5	1	—	—	$139,116.92	$174,528.50	$164,410.91	2026-05-09
724-4	OTHER	"other Infectious And Parasitic Diseases"	5	1	—	—	$138,300.65	$173,504.45	$163,446.22	2026-05-09
710-3	OTHER	"infectious And Parasitic Diseases Including HIV With O.r. Procedure"	5	1	—	—	$137,600.98	$172,626.68	$162,619.34	2026-05-09
110-4	OTHER	"ear, Nose, Mouth, Throat And Cranial Or Facial Malignancies"	5	1	—	—	$136,901.31	$171,748.92	$161,792.46	2026-05-09
171-4	OTHER	"permanent Cardiac Pacemaker Implant Without Ami, Heart Failure Or Shock"	5	1	—	—	$136,085.04	$170,724.86	$160,827.77	2026-05-09
230-3	OTHER	"major Small Bowel Procedures"	5	1	—	—	$136,085.04	$170,724.86	$160,827.77	2026-05-09
231	OTHER	"coronary Bypass With Ptca With Mcc"	8	3	—	—	$160,700.42	$289,260.76	$160,700.42	2026-05-09
C1705	OTHER	"major Multiple Trauma Without Brain Or Spinal Cord Injury M <36.50.,comorbid"	5	3	—	—	$139,638.26	$251,348.87	$160,584.00	2026-05-09
C0502	OTHER	"non-traumatic Spinal Cord Injury M >=53.50 And M <60.50.,comorbidity In Tier"	5	3	—	—	$139,492.60	$251,086.67	$160,416.49	2026-05-09
456	OTHER	"spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or E…	8	3	—	—	$160,406.12	$288,731.02	$160,406.12	2026-05-09
233-4	OTHER	"appendectomy With Complex Principal Diagnosis"	5	1	—	—	$135,385.37	$169,847.10	$160,000.89	2026-05-09
758-3	OTHER	"disorders Of Impulse Control & Development"	5	1	—	—	$135,385.37	$169,847.10	$160,000.89	2026-05-09
165-3	OTHER	"coronary Bypass With Ami Or Complex Principal Diagnosis"	5	1	—	—	$135,035.54	$169,408.22	$159,587.45	2026-05-09
861-4	OTHER	"signs, Symptoms And Other Factors Influencing Health Status"	5	1	—	—	$134,569.09	$168,823.05	$159,036.20	2026-05-09
759-2	OTHER	"eating Disorders"	5	1	—	—	$134,452.48	$168,676.75	$158,898.39	2026-05-09
325-4	OTHER	"non-elective Or Complex Knee Joint Replacement"	5	1	—	—	$134,219.26	$168,384.16	$158,622.76	2026-05-09
D2005	OTHER	"miscellaneous M <46.50 And A <77.50.,comorbidity In Tier 3"	5	3	—	—	$137,210.35	$246,978.63	$157,791.90	2026-05-09
650-4	OTHER	"splenic Procedures"	5	1	—	—	$133,169.76	$167,067.52	$157,382.45	2026-05-09
380-4	OTHER	"skin Ulcers"	5	1	—	—	$132,819.93	$166,628.64	$156,969.01	2026-05-09
245-4	OTHER	"inflammatory Bowel Disease"	5	1	—	—	$132,819.93	$166,628.64	$156,969.01	2026-05-09
020	OTHER	"intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc"	8	3	—	—	$155,821.16	$280,478.09	$155,821.16	2026-05-09
193-3	OTHER	"acute And Subacute Endocarditis"	5	1	—	—	$131,770.43	$165,311.99	$155,728.69	2026-05-09
B0505	OTHER	"non-traumatic Spinal Cord Injury M <39.50.,comorbidity In Tier 1"	5	3	—	—	$135,109.44	$243,197.00	$155,375.86	2026-05-09
482-4	OTHER	"transurethral Prostatectomy"	5	1	—	—	$131,420.60	$164,873.11	$155,315.25	2026-05-09
469-4	OTHER	"acute Kidney Injury"	5	1	—	—	$131,070.76	$164,434.23	$154,901.81	2026-05-09
051-4	OTHER	"viral Meningitis"	5	1	—	—	$130,604.32	$163,849.06	$154,350.56	2026-05-09
751-3	OTHER	"depressive Disorders"	5	1	—	—	$130,021.27	$163,117.59	$153,661.50	2026-05-09
011-2	OTHER	"chimeric Antigen Receptor (car) T-cell And Other Immunotherapies"	5	1	—	—	$129,904.65	$162,971.29	$153,523.68	2026-05-09
696-4	OTHER	"other Chemotherapy"	5	1	—	—	$129,788.04	$162,825.00	$153,385.87	2026-05-09
030-4	OTHER	"percutaneous Intracranial And Extracranial Vascular Procedures"	5	1	—	—	$129,438.21	$162,386.12	$152,972.43	2026-05-09
662-4	OTHER	"sickle Cell Anemia Crisis"	5	1	—	—	$129,321.60	$162,239.82	$152,834.62	2026-05-09
D2102	OTHER	"burns M <52.50.,comorbidity In Tier 3"	5	3	—	—	$132,870.26	$239,166.47	$152,800.80	2026-05-09
757-3	OTHER	"organic Mental Health Conditions And Disturbances"	5	1	—	—	$129,204.99	$162,093.53	$152,696.80	2026-05-09
194-4	OTHER	"heart Failure"	5	1	—	—	$129,088.38	$161,947.24	$152,558.99	2026-05-09
160-3	OTHER	"major Cardiothoracic Repair Of Heart Anomaly"	5	1	—	—	$128,738.54	$161,508.36	$152,145.55	2026-05-09
252-4	OTHER	"malfunction, Reaction And Complication Of Gastrointestinal Device Or Procedure"	5	1	—	—	$128,738.54	$161,508.36	$152,145.55	2026-05-09
280-4	OTHER	"alcoholic Liver Disease"	5	1	—	—	$128,738.54	$161,508.36	$152,145.55	2026-05-09
043-3	OTHER	"multiple Sclerosis, Other Demyelinating Disease And Inflammatory Neuropathies"	5	1	—	—	$128,621.93	$161,362.06	$152,007.74	2026-05-09
233	OTHER	"coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc"	8	3	—	—	$151,985.95	$273,574.71	$151,985.95	2026-05-09
131-4	OTHER	"cystic Fibrosis - Pulmonary Disease"	5	1	—	—	$128,388.71	$161,069.47	$151,732.11	2026-05-09
427-4	OTHER	"thyroid Disorders"	5	1	—	—	$128,272.10	$160,923.18	$151,594.30	2026-05-09
C1805	OTHER	"major Multiple Trauma With Brain Or Spinal Cord Injury M >=30.50 And M <40.5"	5	3	—	—	$131,786.62	$237,215.91	$151,554.61	2026-05-09
176-4	OTHER	"insertion, Revision And Replacements Of Pacemaker And Other Cardiac Devices"	5	1	—	—	$128,155.49	$160,776.89	$151,456.49	2026-05-09
680-3	OTHER	"major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms"	5	1	—	—	$127,922.27	$160,484.30	$151,180.86	2026-05-09
248-4	OTHER	"major Gastrointestinal And Peritoneal Infections"	5	1	—	—	$127,922.27	$160,484.30	$151,180.86	2026-05-09
175-4	OTHER	"percutaneous Cardiac Intervention Without Ami"	5	1	—	—	$127,805.66	$160,338.00	$151,043.05	2026-05-09
D0404	OTHER	"traumatic Spinal Cord Injury M <31.50 And A <61.50.,comorbidity In Tier 3"	5	3	—	—	$131,324.80	$236,384.63	$151,023.52	2026-05-09
220-3	OTHER	"major Stomach, Esophageal And Duodenal Procedures"	5	1	—	—	$127,105.99	$159,460.24	$150,216.17	2026-05-09
305-3	OTHER	"amputation Of Lower Limb Except Toes"	5	1	—	—	$126,639.55	$158,875.07	$149,664.92	2026-05-09
219	OTHER	"cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Cathete…	8	3	—	—	$149,649.48	$269,369.06	$149,649.48	2026-05-09
622-1	OTHER	"neonate Birth Weight 2000-2499 Grams With Respiratory Distress Syndrome Or Othe…	5	1	—	—	$126,522.94	$158,728.77	$149,527.11	2026-05-09
950-3	OTHER	"extensive O.r. Procedure Unrelated To Principal Diagnosis"	5	1	—	—	$125,823.27	$157,851.01	$148,700.23	2026-05-09
761-2	OTHER	"schizoaffective Disorders"	5	1	—	—	$125,706.66	$157,704.72	$148,562.41	2026-05-09
D0505	OTHER	"non-traumatic Spinal Cord Injury M <39.50.,comorbidity In Tier 3"	5	3	—	—	$128,957.90	$232,124.21	$148,301.58	2026-05-09
C0504	OTHER	"non-traumatic Spinal Cord Injury M >=39.50 And M <48.50.,comorbidity In Tier"	5	3	—	—	$128,940.78	$232,093.40	$148,281.89	2026-05-09
232-3	OTHER	"gastric Fundoplication"	5	1	—	—	$125,356.83	$157,265.84	$148,148.98	2026-05-09
892-4	OTHER	"hiv With Major HIV Related Condition"	5	1	—	—	$125,240.21	$157,119.54	$148,011.16	2026-05-09
870	OTHER	"septicemia Or Severe Sepsis With Mv >96 Hours"	8	3	—	—	$147,897.29	$266,215.12	$147,897.29	2026-05-09
349-4	OTHER	"malfunction, Reaction, Complication Of Orthopedic Device Or Procedure"	5	1	—	—	$125,123.60	$156,973.25	$147,873.35	2026-05-09
383-4	OTHER	"cellulitis And Other Skin Infections"	5	1	—	—	$125,123.60	$156,973.25	$147,873.35	2026-05-09
A0205	OTHER	"traumatic Brain Injury M <35.50.,without Comorbidities"	5	3	—	—	$128,472.08	$231,249.74	$147,742.89	2026-05-09
322-4	OTHER	"shoulder And Elbow Joint Replacement"	5	1	—	—	$124,890.38	$156,680.66	$147,597.72	2026-05-09
B0704	OTHER	"fracture Of Lower Extremity M <41.50.,comorbidity In Tier 1"	5	3	—	—	$128,086.88	$230,556.38	$147,299.91	2026-05-09
573	OTHER	"skin Graft For Skin Ulcer Or Cellulitis With Mcc"	8	3	—	—	$146,598.94	$263,878.09	$146,598.94	2026-05-09
308-4	OTHER	"hip And Femur Fracture Repair"	5	1	—	—	$123,957.49	$155,510.31	$146,495.22	2026-05-09
131-3	OTHER	"cystic Fibrosis - Pulmonary Disease"	5	1	—	—	$123,141.22	$154,486.25	$145,530.53	2026-05-09
424-4	OTHER	"other Endocrine Disorders"	5	1	—	—	$123,024.61	$154,339.96	$145,392.72	2026-05-09
759-1	OTHER	"eating Disorders"	5	1	—	—	$123,024.61	$154,339.96	$145,392.72	2026-05-09
660-4	OTHER	"major Hematologic Or Immunologic Diagnoses Except Sickle Cell Crisis And Coagul…	5	1	—	—	$122,907.99	$154,193.67	$145,254.90	2026-05-09
500-4	OTHER	"malignancy, Male Reproductive System"	5	1	—	—	$122,907.99	$154,193.67	$145,254.90	2026-05-09
224-3	OTHER	"peritoneal Adhesiolysis"	5	1	—	—	$122,907.99	$154,193.67	$145,254.90	2026-05-09
023-3	OTHER	"spinal Procedures"	5	1	—	—	$122,907.99	$154,193.67	$145,254.90	2026-05-09
862-3	OTHER	"other Aftercare And Convalescence"	5	1	—	—	$122,791.38	$154,047.37	$145,117.09	2026-05-09
461-4	OTHER	"kidney And Urinary Tract Malignancy"	5	1	—	—	$122,791.38	$154,047.37	$145,117.09	2026-05-09
862-4	OTHER	"other Aftercare And Convalescence"	5	1	—	—	$122,791.38	$154,047.37	$145,117.09	2026-05-09
694-4	OTHER	"lymphatic And Other Malignancies And Neoplasms Of Uncertain Behavior"	5	1	—	—	$122,674.77	$153,901.08	$144,979.28	2026-05-09
163-3	OTHER	"cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis"	5	1	—	—	$122,558.16	$153,754.78	$144,841.46	2026-05-09
042-3	OTHER	"degenerative Nervous System Disorders Except Multiple Sclerosis"	5	1	—	—	$122,441.55	$153,608.49	$144,703.65	2026-05-09
240-4	OTHER	"digestive Malignancy"	5	1	—	—	$122,441.55	$153,608.49	$144,703.65	2026-05-09
050-3	OTHER	"non-bacterial Infections Of Nervous System Except Viral Meningitis"	5	1	—	—	$122,324.94	$153,462.20	$144,565.84	2026-05-09
178-4	OTHER	"external Heart Assist Devices"	5	1	—	—	$122,324.94	$153,462.20	$144,565.84	2026-05-09

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