|
18
|
OTHER
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
47
|
38
|
—
|
—
|
$271,691.72
|
$664,491.69
|
$388,131.03
|
2026-05-08
|
|
1
|
OTHER
|
Heart Transplant Or Implant Of Heart Assist System With Mcc
|
48
|
39
|
—
|
—
|
$3,600.00
|
$496,319.59
|
$290,072.30
|
2026-05-08
|
|
927
|
OTHER
|
Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft
|
47
|
38
|
—
|
—
|
$171,079.93
|
$417,990.80
|
$244,399.90
|
2026-05-08
|
|
583-3
|
OTHER
|
Neonate With Ecmo
|
16
|
15
|
—
|
—
|
$66,300.00
|
$265,200.00
|
$221,000.00
|
2026-05-08
|
|
588-4
|
OTHER
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
16
|
15
|
—
|
—
|
$66,300.00
|
$265,200.00
|
$221,000.00
|
2026-05-08
|
|
583-4
|
OTHER
|
Neonate With Ecmo
|
16
|
15
|
—
|
—
|
$66,300.00
|
$265,200.00
|
$221,000.00
|
2026-05-08
|
|
3
|
OTHER
|
Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…
|
47
|
38
|
—
|
—
|
$154,602.32
|
$377,620.33
|
$220,860.45
|
2026-05-08
|
|
630-4
|
OTHER
|
Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure
|
16
|
15
|
—
|
—
|
$64,117.55
|
$256,470.19
|
$213,725.16
|
2026-05-08
|
|
631-4
|
OTHER
|
Neonate Birth Weight > 2499 Grams With Other Major Procedure
|
16
|
15
|
—
|
—
|
$62,906.14
|
$251,624.57
|
$209,687.14
|
2026-05-08
|
|
7
|
OTHER
|
Lung Transplant
|
45
|
36
|
—
|
—
|
$145,486.89
|
$317,161.43
|
$207,838.42
|
2026-05-08
|
|
161-4
|
OTHER
|
Implantable Heart Assist Systems
|
16
|
15
|
—
|
—
|
$59,683.95
|
$238,735.80
|
$198,946.50
|
2026-05-08
|
|
583-2
|
OTHER
|
Neonate With Ecmo
|
16
|
15
|
—
|
—
|
$50,810.05
|
$203,240.20
|
$169,366.83
|
2026-05-08
|
|
002-4
|
OTHER
|
Heart And/or Lung Transplant
|
16
|
15
|
—
|
—
|
$50,107.75
|
$200,430.98
|
$167,025.82
|
2026-05-08
|
|
609-4
|
OTHER
|
Neonate Birth Weight 1500-2499 Grams With Major Procedure
|
16
|
15
|
—
|
—
|
$49,500.00
|
$198,000.00
|
$165,000.00
|
2026-05-08
|
|
583-1
|
OTHER
|
Neonate With Ecmo
|
16
|
15
|
—
|
—
|
$45,137.45
|
$180,549.82
|
$150,458.18
|
2026-05-08
|
|
4
|
OTHER
|
Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…
|
95
|
39
|
—
|
—
|
$102,091.45
|
$269,943.23
|
$145,844.93
|
2026-05-09
|
|
161-3
|
OTHER
|
Implantable Heart Assist Systems
|
16
|
15
|
—
|
—
|
$43,290.57
|
$173,162.27
|
$144,301.89
|
2026-05-08
|
|
841-4
|
OTHER
|
Extensive Third Degree Burns With Skin Graft
|
16
|
15
|
—
|
—
|
$41,863.19
|
$167,452.74
|
$139,543.95
|
2026-05-08
|
|
14
|
OTHER
|
Allogeneic Bone Marrow Transplant
|
46
|
37
|
—
|
—
|
$94,696.95
|
$230,850.99
|
$135,281.36
|
2026-05-08
|
|
588-3
|
OTHER
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
16
|
15
|
—
|
—
|
$39,600.00
|
$158,400.00
|
$132,000.00
|
2026-05-08
|
|
007-4
|
OTHER
|
Allogeneic Bone Marrow Transplant
|
16
|
15
|
—
|
—
|
$39,368.23
|
$157,472.90
|
$131,227.42
|
2026-05-08
|
|
588-2
|
OTHER
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
16
|
15
|
—
|
—
|
$39,000.00
|
$156,000.00
|
$130,000.00
|
2026-05-08
|
|
009-4
|
OTHER
|
Extracorporeal Membrane Oxygenation (ecmo)
|
16
|
15
|
—
|
—
|
$38,457.59
|
$153,830.35
|
$128,191.96
|
2026-05-08
|
|
161-2
|
OTHER
|
Implantable Heart Assist Systems
|
16
|
15
|
—
|
—
|
$38,228.37
|
$152,913.48
|
$127,427.90
|
2026-05-08
|
|
002-3
|
OTHER
|
Heart And/or Lung Transplant
|
16
|
15
|
—
|
—
|
$37,510.15
|
$150,040.61
|
$125,033.84
|
2026-05-08
|
|
863-4
|
OTHER
|
Neonatal Aftercare
|
16
|
15
|
—
|
—
|
$36,600.40
|
$146,401.62
|
$122,001.35
|
2026-05-08
|
|
593-4
|
OTHER
|
Neonate Birth Weight 750-999 Grams Without Major Procedure
|
16
|
15
|
—
|
—
|
$36,300.00
|
$145,200.00
|
$121,000.00
|
2026-05-08
|
|
303-4
|
OTHER
|
Dorsal And Lumbar Fusion Procedure For Curvature Of Back
|
16
|
15
|
—
|
—
|
$36,000.00
|
$144,000.00
|
$120,000.00
|
2026-05-08
|
|
001-4
|
OTHER
|
Liver Transplant And/or Intestinal Transplant
|
16
|
15
|
—
|
—
|
$36,000.00
|
$144,000.00
|
$120,000.00
|
2026-05-08
|
|
591-4
|
OTHER
|
Neonate Birth Weight 500-749 Grams Without Major Procedure
|
16
|
15
|
—
|
—
|
$36,000.00
|
$144,000.00
|
$120,000.00
|
2026-05-08
|
|
161-1
|
OTHER
|
Implantable Heart Assist Systems
|
16
|
15
|
—
|
—
|
$35,396.40
|
$141,585.61
|
$117,988.01
|
2026-05-08
|
|
2
|
OTHER
|
Heart Transplant Or Implant Of Heart Assist System Without Mcc
|
48
|
39
|
—
|
—
|
$3,600.00
|
$194,164.82
|
$113,890.19
|
2026-05-08
|
|
212
|
OTHER
|
Hip & Femur Procedures Except Major Joint Age 0-17
|
47
|
38
|
—
|
—
|
$78,818.41
|
$191,948.25
|
$112,597.73
|
2026-05-08
|
|
5
|
OTHER
|
Liver Transplant With Mcc Or Intestinal Transplant
|
45
|
36
|
—
|
—
|
$77,060.05
|
$187,640.21
|
$110,085.78
|
2026-05-08
|
|
004-4
|
OTHER
|
Tracheostomy With Mv >96 Hours With Extensive Procedure
|
16
|
15
|
—
|
—
|
$33,000.00
|
$132,000.00
|
$110,000.00
|
2026-05-08
|
|
215
|
OTHER
|
Other Heart Assist System Implant
|
50
|
40
|
—
|
—
|
$33,113.00
|
$186,678.17
|
$109,524.83
|
2026-05-08
|
|
011-3
|
OTHER
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
16
|
15
|
—
|
—
|
$32,303.95
|
$129,215.78
|
$107,679.82
|
2026-05-08
|
|
607-4
|
OTHER
|
Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…
|
16
|
15
|
—
|
—
|
$30,000.00
|
$120,000.00
|
$100,000.00
|
2026-05-08
|
|
602-4
|
OTHER
|
Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…
|
16
|
15
|
—
|
—
|
$30,000.00
|
$120,000.00
|
$100,000.00
|
2026-05-08
|
|
216
|
OTHER
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
51
|
41
|
—
|
—
|
$23,000.00
|
$170,050.37
|
$99,829.39
|
2026-05-08
|
|
593-3
|
OTHER
|
Neonate Birth Weight 750-999 Grams Without Major Procedure
|
16
|
15
|
—
|
—
|
$29,700.00
|
$118,800.00
|
$99,000.00
|
2026-05-08
|
|
160-4
|
OTHER
|
Major Cardiothoracic Repair Of Heart Anomaly
|
16
|
15
|
—
|
—
|
$29,141.81
|
$116,567.22
|
$97,139.35
|
2026-05-08
|
|
630-3
|
OTHER
|
Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure
|
16
|
15
|
—
|
—
|
$28,500.00
|
$114,000.00
|
$95,000.00
|
2026-05-08
|
|
002-2
|
OTHER
|
Heart And/or Lung Transplant
|
16
|
15
|
—
|
—
|
$28,204.06
|
$112,816.25
|
$94,013.54
|
2026-05-08
|
|
611-4
|
OTHER
|
Neonate Birth Weight 1500-1999 Grams With Major Anomaly
|
16
|
15
|
—
|
—
|
$27,900.00
|
$111,600.00
|
$93,000.00
|
2026-05-08
|
|
602-3
|
OTHER
|
Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…
|
16
|
15
|
—
|
—
|
$27,600.00
|
$110,400.00
|
$92,000.00
|
2026-05-08
|
|
453
|
OTHER
|
Combined Anterior And Posterior Spinal Fusion With Mcc
|
47
|
38
|
—
|
—
|
$64,201.30
|
$156,136.02
|
$91,716.14
|
2026-05-08
|
|
591-3
|
OTHER
|
Neonate Birth Weight 500-749 Grams Without Major Procedure
|
16
|
15
|
—
|
—
|
$27,300.00
|
$109,200.00
|
$91,000.00
|
2026-05-08
|
|
621-4
|
OTHER
|
Neonate Birth Weight 2000-2499 Grams With Major Anomaly
|
16
|
15
|
—
|
—
|
$27,000.00
|
$108,000.00
|
$90,000.00
|
2026-05-08
|
|
004-3
|
OTHER
|
Tracheostomy With Mv >96 Hours With Extensive Procedure
|
16
|
15
|
—
|
—
|
$26,761.86
|
$107,047.45
|
$89,206.21
|
2026-05-08
|
|
612-4
|
OTHER
|
Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other…
|
16
|
15
|
—
|
—
|
$26,700.00
|
$106,800.00
|
$89,000.00
|
2026-05-08
|
|
005-4
|
OTHER
|
Tracheostomy With Mv >96 Hours Without Extensive Procedure
|
32
|
15
|
—
|
—
|
$26,400.00
|
$105,600.00
|
$88,000.00
|
2026-05-09
|
|
456
|
OTHER
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
47
|
38
|
—
|
—
|
$61,380.71
|
$149,225.54
|
$87,686.73
|
2026-05-08
|
|
231
|
OTHER
|
Coronary Bypass With Ptca With Mcc
|
52
|
42
|
—
|
—
|
$18,100.00
|
$149,308.36
|
$86,874.00
|
2026-05-08
|
|
633-4
|
OTHER
|
Neonate Birth Weight > 2499 Grams With Major Anomaly
|
16
|
15
|
—
|
—
|
$25,638.26
|
$102,553.02
|
$85,460.85
|
2026-05-08
|
|
006-4
|
OTHER
|
Pancreas Transplant
|
16
|
15
|
—
|
—
|
$25,500.00
|
$102,000.00
|
$85,000.00
|
2026-05-08
|
|
842-4
|
OTHER
|
Burns With Skin Graft Except Extensive Third Degree Burns
|
16
|
15
|
—
|
—
|
$25,055.13
|
$100,220.52
|
$83,517.10
|
2026-05-08
|
|
20
|
OTHER
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc
|
47
|
38
|
—
|
—
|
$58,445.79
|
$142,034.91
|
$83,493.98
|
2026-05-08
|
|
162-4
|
OTHER
|
Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis
|
16
|
15
|
—
|
—
|
$24,921.51
|
$99,686.04
|
$83,071.70
|
2026-05-08
|
|
10
|
OTHER
|
Pancreas Transplant
|
45
|
36
|
—
|
—
|
$57,812.20
|
$140,482.60
|
$82,588.86
|
2026-05-08
|
|
19
|
OTHER
|
Simultaneous Pancreas And Kidney Transplant With Hemodialysis
|
47
|
38
|
—
|
—
|
$57,483.54
|
$139,677.38
|
$82,119.35
|
2026-05-08
|
|
006-3
|
OTHER
|
Pancreas Transplant
|
16
|
15
|
—
|
—
|
$24,512.84
|
$98,051.36
|
$81,709.47
|
2026-05-08
|
|
233
|
OTHER
|
Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc
|
52
|
42
|
—
|
—
|
$16,500.00
|
$137,723.34
|
$80,186.49
|
2026-05-08
|
|
219
|
OTHER
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
51
|
41
|
—
|
—
|
$23,000.00
|
$136,333.14
|
$80,169.36
|
2026-05-08
|
|
607-3
|
OTHER
|
Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…
|
16
|
15
|
—
|
—
|
$24,034.21
|
$96,136.85
|
$80,114.04
|
2026-05-08
|
|
602-2
|
OTHER
|
Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…
|
16
|
15
|
—
|
—
|
$24,000.00
|
$96,000.00
|
$80,000.00
|
2026-05-08
|
|
603-4
|
OTHER
|
Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition
|
16
|
15
|
—
|
—
|
$24,000.00
|
$96,000.00
|
$80,000.00
|
2026-05-08
|
|
609-3
|
OTHER
|
Neonate Birth Weight 1500-2499 Grams With Major Procedure
|
16
|
15
|
—
|
—
|
$23,878.07
|
$95,512.28
|
$79,593.57
|
2026-05-08
|
|
593-2
|
OTHER
|
Neonate Birth Weight 750-999 Grams Without Major Procedure
|
16
|
15
|
—
|
—
|
$23,700.00
|
$94,800.00
|
$79,000.00
|
2026-05-08
|
|
440-4
|
OTHER
|
Kidney Transplant
|
16
|
15
|
—
|
—
|
$23,491.02
|
$93,964.09
|
$78,303.41
|
2026-05-08
|
|
957
|
OTHER
|
Other O.r. Procedures For Multiple Significant Trauma With Mcc
|
47
|
38
|
—
|
—
|
$54,153.06
|
$131,517.65
|
$77,361.52
|
2026-05-08
|
|
007-3
|
OTHER
|
Allogeneic Bone Marrow Transplant
|
16
|
15
|
—
|
—
|
$22,977.56
|
$91,910.24
|
$76,591.87
|
2026-05-08
|
|
005-3
|
OTHER
|
Tracheostomy With Mv >96 Hours Without Extensive Procedure
|
32
|
15
|
—
|
—
|
$19,686.90
|
$89,548.34
|
$74,623.62
|
2026-05-09
|
|
001-3
|
OTHER
|
Liver Transplant And/or Intestinal Transplant
|
16
|
15
|
—
|
—
|
$22,111.28
|
$88,445.12
|
$73,704.27
|
2026-05-08
|
|
275
|
OTHER
|
Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc
|
48
|
39
|
—
|
—
|
$2,600.00
|
$124,519.07
|
$73,280.77
|
2026-05-08
|
|
591-2
|
OTHER
|
Neonate Birth Weight 500-749 Grams Without Major Procedure
|
16
|
15
|
—
|
—
|
$21,815.52
|
$87,262.07
|
$72,718.39
|
2026-05-08
|
|
870
|
OTHER
|
Septicemia Or Severe Sepsis With Mv >96 Hours
|
95
|
39
|
—
|
—
|
$50,501.85
|
$134,700.72
|
$72,627.15
|
2026-05-09
|
|
955
|
OTHER
|
Craniotomy For Multiple Significant Trauma
|
47
|
38
|
—
|
—
|
$49,579.87
|
$120,313.23
|
$70,828.38
|
2026-05-08
|
|
163-4
|
OTHER
|
Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis
|
16
|
15
|
—
|
—
|
$21,085.56
|
$84,342.24
|
$70,285.20
|
2026-05-08
|
|
608-4
|
OTHER
|
Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition
|
16
|
15
|
—
|
—
|
$21,000.00
|
$84,000.00
|
$70,000.00
|
2026-05-08
|
|
928
|
OTHER
|
Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc
|
47
|
38
|
—
|
—
|
$48,505.43
|
$117,680.83
|
$69,293.47
|
2026-05-08
|
|
268
|
OTHER
|
Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc
|
50
|
40
|
—
|
—
|
$33,113.00
|
$117,481.73
|
$69,177.39
|
2026-05-08
|
|
232-4
|
OTHER
|
Gastric Fundoplication
|
16
|
15
|
—
|
—
|
$20,644.76
|
$82,579.06
|
$68,815.88
|
2026-05-08
|
|
459
|
OTHER
|
Spinal Fusion Except Cervical With Mcc
|
47
|
38
|
—
|
—
|
$48,170.30
|
$116,859.75
|
$68,814.71
|
2026-05-08
|
|
603-3
|
OTHER
|
Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition
|
16
|
15
|
—
|
—
|
$20,624.65
|
$82,498.58
|
$68,748.82
|
2026-05-08
|
|
589-1
|
OTHER
|
Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …
|
16
|
15
|
—
|
—
|
$20,608.13
|
$82,432.52
|
$68,693.77
|
2026-05-08
|
|
207
|
OTHER
|
Respiratory System Diagnosis With Ventilator Support >96 Hours
|
95
|
39
|
—
|
—
|
$46,982.95
|
$125,402.75
|
$67,681.73
|
2026-05-09
|
|
178-4
|
OTHER
|
External Heart Assist Systems
|
16
|
15
|
—
|
—
|
$20,259.82
|
$81,039.26
|
$67,532.72
|
2026-05-08
|
|
006-2
|
OTHER
|
Pancreas Transplant
|
16
|
15
|
—
|
—
|
$20,135.51
|
$80,542.02
|
$67,118.35
|
2026-05-08
|
|
217
|
OTHER
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
51
|
41
|
—
|
—
|
$23,000.00
|
$113,786.85
|
$67,022.93
|
2026-05-08
|
|
969
|
OTHER
|
HIV With Extensive O.r. Procedures With Mcc
|
47
|
38
|
—
|
—
|
$45,955.25
|
$111,432.85
|
$65,650.35
|
2026-05-08
|
|
165-4
|
OTHER
|
Coronary Bypass With Ami Or Complex Principal Diagnosis
|
16
|
15
|
—
|
—
|
$19,530.76
|
$78,123.05
|
$65,102.54
|
2026-05-08
|
|
167-4
|
OTHER
|
Other Cardiothoracic And Thoracic Vascular Procedures
|
16
|
15
|
—
|
—
|
$19,494.43
|
$77,977.72
|
$64,981.43
|
2026-05-08
|
|
008-4
|
OTHER
|
Autologous Bone Marrow Transplant Or T-cell Immunotherapy
|
16
|
15
|
—
|
—
|
$19,457.20
|
$77,828.78
|
$64,857.32
|
2026-05-08
|
|
276
|
OTHER
|
Non-maligant Breast Disorders
|
47
|
38
|
—
|
—
|
$45,021.05
|
$109,144.04
|
$64,315.79
|
2026-05-08
|
|
573
|
OTHER
|
Skin Graft For Skin Ulcer Or Cellulitis With Mcc
|
47
|
38
|
—
|
—
|
$44,760.72
|
$108,506.20
|
$63,943.88
|
2026-05-08
|
|
461
|
OTHER
|
Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc
|
47
|
38
|
—
|
—
|
$44,606.09
|
$108,127.38
|
$63,722.99
|
2026-05-08
|
|
454
|
OTHER
|
Combined Anterior And Posterior Spinal Fusion With Cc
|
47
|
38
|
—
|
—
|
$44,459.38
|
$107,767.93
|
$63,513.40
|
2026-05-08
|
|
28
|
OTHER
|
Spinal Procedures With Mcc
|
47
|
38
|
—
|
—
|
$44,194.72
|
$107,119.53
|
$63,135.31
|
2026-05-08
|
|
232
|
OTHER
|
Coronary Bypass With Ptca Without Mcc
|
52
|
42
|
—
|
—
|
$16,600.00
|
$107,634.02
|
$62,817.29
|
2026-05-08
|
|
17
|
OTHER
|
Autologous Bone Marrow Transplant Without Cc/mcc
|
47
|
38
|
—
|
—
|
$43,881.17
|
$106,351.30
|
$62,687.39
|
2026-05-08
|
|
16
|
OTHER
|
Autologous Bone Marrow Transplant With Cc/mcc
|
47
|
38
|
—
|
—
|
$43,881.17
|
$106,351.30
|
$62,687.39
|
2026-05-08
|
|
622-4
|
OTHER
|
Neonate Birth Weight 2000-2499 Grams With Respiratory Distress Syndrome Or Other…
|
16
|
15
|
—
|
—
|
$18,777.38
|
$75,109.54
|
$62,591.28
|
2026-05-08
|
|
009-3
|
OTHER
|
Extracorporeal Membrane Oxygenation (ecmo)
|
16
|
15
|
—
|
—
|
$18,681.60
|
$74,726.39
|
$62,271.99
|
2026-05-08
|
|
266
|
OTHER
|
Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc
|
50
|
40
|
—
|
—
|
$33,113.00
|
$105,556.65
|
$62,224.04
|
2026-05-08
|
|
613-4
|
OTHER
|
Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection
|
16
|
15
|
—
|
—
|
$18,600.00
|
$74,400.00
|
$62,000.00
|
2026-05-08
|
|
218
|
OTHER
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
51
|
41
|
—
|
—
|
$23,000.00
|
$104,825.43
|
$61,797.67
|
2026-05-08
|
|
790
|
OTHER
|
Extreme Immaturity Or Respiratory Distress Syndrome, Neonate
|
47
|
38
|
—
|
—
|
$43,226.01
|
$104,746.14
|
$61,751.44
|
2026-05-08
|
|
001-2
|
OTHER
|
Liver Transplant And/or Intestinal Transplant
|
16
|
15
|
—
|
—
|
$18,447.99
|
$73,791.95
|
$61,493.29
|
2026-05-08
|
|
304-4
|
OTHER
|
Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back
|
16
|
15
|
—
|
—
|
$18,386.43
|
$73,545.73
|
$61,288.11
|
2026-05-08
|
|
631-3
|
OTHER
|
Neonate Birth Weight > 2499 Grams With Other Major Procedure
|
16
|
15
|
—
|
—
|
$18,161.23
|
$72,644.92
|
$60,537.43
|
2026-05-08
|
|
235
|
OTHER
|
Coronary Bypass Without Cardiac Catheterization With Mcc
|
52
|
42
|
—
|
—
|
$15,000.00
|
$103,678.38
|
$60,533.88
|
2026-05-08
|
|
820
|
OTHER
|
Lymphoma And Leukemia With Major O.r. Procedures With Mcc
|
47
|
38
|
—
|
—
|
$42,345.02
|
$102,587.71
|
$60,492.89
|
2026-05-08
|
|
23
|
OTHER
|
Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…
|
95
|
39
|
—
|
—
|
$41,502.15
|
$111,675.04
|
$60,380.19
|
2026-05-09
|
|
183-4
|
OTHER
|
Percutaneous Structural Cardiac Procedures
|
16
|
15
|
—
|
—
|
$18,112.59
|
$72,450.35
|
$60,375.29
|
2026-05-08
|
|
007-2
|
OTHER
|
Allogeneic Bone Marrow Transplant
|
16
|
15
|
—
|
—
|
$18,099.38
|
$72,397.50
|
$60,331.25
|
2026-05-08
|
|
625-4
|
OTHER
|
Neonate Birth Weight 2000-2499 Grams With Other Significant Condition
|
16
|
15
|
—
|
—
|
$18,049.83
|
$72,199.32
|
$60,166.10
|
2026-05-08
|
|
623-4
|
OTHER
|
Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection
|
16
|
15
|
—
|
—
|
$17,971.16
|
$71,884.64
|
$59,903.87
|
2026-05-08
|
|
457
|
OTHER
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
47
|
38
|
—
|
—
|
$41,748.83
|
$101,127.03
|
$59,641.19
|
2026-05-08
|
|
007-1
|
OTHER
|
Allogeneic Bone Marrow Transplant
|
16
|
15
|
—
|
—
|
$17,842.94
|
$71,371.78
|
$59,476.48
|
2026-05-08
|
|
607-2
|
OTHER
|
Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…
|
16
|
15
|
—
|
—
|
$17,485.32
|
$69,941.29
|
$58,284.41
|
2026-05-08
|
|
004-2
|
OTHER
|
Tracheostomy With Mv >96 Hours With Extensive Procedure
|
16
|
15
|
—
|
—
|
$17,423.47
|
$69,693.86
|
$58,078.22
|
2026-05-08
|
|
653
|
OTHER
|
Major Bladder Procedures With Mcc
|
47
|
38
|
—
|
—
|
$40,563.64
|
$98,223.29
|
$57,948.06
|
2026-05-08
|
|
179-4
|
OTHER
|
Defibrillator Implants
|
16
|
15
|
—
|
—
|
$17,356.51
|
$69,426.02
|
$57,855.02
|
2026-05-08
|
|
910-4
|
OTHER
|
Craniotomy For Multiple Significant Trauma
|
16
|
15
|
—
|
—
|
$17,330.68
|
$69,322.74
|
$57,768.95
|
2026-05-08
|
|
303-3
|
OTHER
|
Dorsal And Lumbar Fusion Procedure For Curvature Of Back
|
16
|
15
|
—
|
—
|
$17,306.96
|
$69,227.84
|
$57,689.87
|
2026-05-08
|
|
834
|
OTHER
|
Acute Leukemia Without Major O.r. Procedures With Mcc
|
47
|
38
|
—
|
—
|
$40,223.48
|
$97,389.88
|
$57,462.11
|
2026-05-08
|
|
21
|
OTHER
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc
|
47
|
38
|
—
|
—
|
$40,223.48
|
$97,389.88
|
$57,462.11
|
2026-05-08
|
|
166-4
|
OTHER
|
Coronary Bypass Without Ami Or Complex Principal Diagnosis
|
16
|
15
|
—
|
—
|
$17,192.26
|
$68,769.04
|
$57,307.53
|
2026-05-08
|
|
608-3
|
OTHER
|
Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition
|
16
|
15
|
—
|
—
|
$17,053.84
|
$68,215.34
|
$56,846.12
|
2026-05-08
|
|
8
|
OTHER
|
Simultaneous Pancreas And Kidney Transplant
|
45
|
36
|
—
|
—
|
$39,603.56
|
$95,871.05
|
$56,576.52
|
2026-05-08
|
|
680-4
|
OTHER
|
Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms
|
16
|
15
|
—
|
—
|
$16,961.95
|
$67,847.81
|
$56,539.84
|
2026-05-08
|
|
405
|
OTHER
|
Pancreas, Liver And Shunt Procedures With Mcc
|
47
|
38
|
—
|
—
|
$39,514.38
|
$95,652.56
|
$56,449.11
|
2026-05-08
|
|
162-3
|
OTHER
|
Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis
|
16
|
15
|
—
|
—
|
$16,879.38
|
$67,517.51
|
$56,264.59
|
2026-05-08
|
|
463
|
OTHER
|
Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …
|
47
|
38
|
—
|
—
|
$39,315.16
|
$95,164.50
|
$56,164.52
|
2026-05-08
|
|
11
|
OTHER
|
Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc
|
47
|
38
|
—
|
—
|
$39,278.48
|
$95,074.64
|
$56,112.12
|
2026-05-08
|
|
576
|
OTHER
|
Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc
|
47
|
38
|
—
|
—
|
$39,274.18
|
$95,064.06
|
$56,105.97
|
2026-05-08
|
|
091-4
|
OTHER
|
Other Major Head And Neck Procedures
|
16
|
15
|
—
|
—
|
$16,767.08
|
$67,068.31
|
$55,890.26
|
2026-05-08
|
|
270
|
OTHER
|
Other Major Cardiovascular Procedures With Mcc
|
101
|
42
|
—
|
—
|
$2,000.00
|
$102,827.26
|
$55,674.22
|
2026-05-09
|
|
634-4
|
OTHER
|
Neonate Birth Weight > 2499 Grams With Respiratory Distress Syndrome Or Other Ma…
|
16
|
15
|
—
|
—
|
$16,630.15
|
$66,520.62
|
$55,433.85
|
2026-05-08
|
|
220
|
OTHER
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
51
|
41
|
—
|
—
|
$23,000.00
|
$93,326.75
|
$55,092.96
|
2026-05-08
|
|
234
|
OTHER
|
Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc
|
52
|
42
|
—
|
—
|
$16,500.00
|
$93,740.82
|
$54,797.36
|
2026-05-08
|
|
850-4
|
OTHER
|
Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal…
|
16
|
15
|
—
|
—
|
$16,187.56
|
$64,750.22
|
$53,958.52
|
2026-05-08
|
|
1628971
|
OTHER
|
Imp Knee K7 Revision Complex
|
171
|
50
|
$214,098.00
|
$214,098.00
|
$500.00
|
$214,098.00
|
$53,524.50
|
2026-05-09
|
|
466
|
OTHER
|
Revision Of Hip Or Knee Replacement With Mcc
|
47
|
38
|
—
|
—
|
$37,111.63
|
$89,765.79
|
$53,016.61
|
2026-05-08
|
|
326
|
OTHER
|
Stomach, Esophageal And Duodenal Procedures With Mcc
|
95
|
39
|
—
|
—
|
$36,999.44
|
$97,197.02
|
$52,856.34
|
2026-05-09
|
|
239
|
OTHER
|
Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc
|
47
|
38
|
—
|
—
|
$36,696.67
|
$88,749.13
|
$52,423.82
|
2026-05-08
|
|
853
|
OTHER
|
Infectious And Parasitic Diseases With O.r. Procedures With Mcc
|
95
|
39
|
—
|
—
|
$36,440.65
|
$96,245.99
|
$52,173.77
|
2026-05-09
|
|
837
|
OTHER
|
Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot…
|
47
|
38
|
—
|
—
|
$36,483.08
|
$88,225.82
|
$52,118.68
|
2026-05-08
|
|
278
|
OTHER
|
Cellulitis Age >17 Without Cc
|
47
|
38
|
—
|
—
|
$36,455.04
|
$88,157.11
|
$52,078.63
|
2026-05-08
|
|
228
|
OTHER
|
Other Cardiothoracic Procedures With Mcc
|
48
|
39
|
—
|
—
|
$23,000.00
|
$87,804.71
|
$51,873.14
|
2026-05-08
|
|
630-2
|
OTHER
|
Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure
|
16
|
15
|
—
|
—
|
$15,558.79
|
$62,235.16
|
$51,862.63
|
2026-05-08
|
|
178-3
|
OTHER
|
External Heart Assist Systems
|
16
|
15
|
—
|
—
|
$15,524.26
|
$62,097.04
|
$51,747.53
|
2026-05-08
|
|
912-4
|
OTHER
|
Musculoskeletal And Other Procedures For Multiple Significant Trauma
|
16
|
15
|
—
|
—
|
$15,463.00
|
$61,852.02
|
$51,543.35
|
2026-05-08
|
|
911-4
|
OTHER
|
Extensive Abdominal Or Thoracic Procedures For Multiple Significant Trauma
|
16
|
15
|
—
|
—
|
$15,444.39
|
$61,777.55
|
$51,481.29
|
2026-05-08
|
|
169-4
|
OTHER
|
Major Abdominal Vascular Procedures
|
16
|
15
|
—
|
—
|
$15,410.16
|
$61,640.63
|
$51,367.19
|
2026-05-08
|
|
471
|
OTHER
|
Cervical Spinal Fusion With Mcc
|
50
|
40
|
—
|
—
|
$4,200.00
|
$85,584.62
|
$50,578.63
|
2026-05-08
|
|
6
|
OTHER
|
Liver Transplant Without Mcc
|
45
|
36
|
—
|
—
|
$35,346.80
|
$85,441.90
|
$50,495.43
|
2026-05-08
|
|
841-3
|
OTHER
|
Extensive Third Degree Burns With Skin Graft
|
16
|
15
|
—
|
—
|
$15,088.87
|
$60,355.48
|
$50,296.23
|
2026-05-08
|
|
021-4
|
OTHER
|
Open Craniotomy Except Trauma
|
16
|
15
|
—
|
—
|
$15,085.57
|
$60,342.26
|
$50,285.22
|
2026-05-08
|
|
1617294
|
OTHER
|
Vns 1000 Sentiva Generator
|
87
|
51
|
$200,615.00
|
$200,615.00
|
$500.00
|
$200,615.00
|
$50,153.75
|
2026-05-09
|
|
011-4
|
OTHER
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
16
|
15
|
—
|
—
|
$15,006.30
|
$60,025.20
|
$50,021.00
|
2026-05-08
|
|
023-4
|
OTHER
|
Spinal Procedures
|
15
|
14
|
—
|
—
|
$15,003.89
|
$60,015.56
|
$50,012.97
|
2026-05-08
|
|
588-1
|
OTHER
|
Female Reproductive System Reconstructive Procedures
|
16
|
15
|
—
|
—
|
$15,000.00
|
$60,000.00
|
$50,000.00
|
2026-05-08
|
|
011-2
|
OTHER
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
16
|
15
|
—
|
—
|
$15,000.00
|
$60,000.00
|
$50,000.00
|
2026-05-08
|
|
001-1
|
OTHER
|
Liver Transplant And/or Intestinal Transplant
|
16
|
15
|
—
|
—
|
$15,000.00
|
$60,000.00
|
$50,000.00
|
2026-05-08
|
|
006-1
|
OTHER
|
Pancreas Transplant
|
16
|
15
|
—
|
—
|
$15,000.00
|
$60,000.00
|
$50,000.00
|
2026-05-08
|
|
002-1
|
OTHER
|
Heart And/or Lung Transplant
|
16
|
15
|
—
|
—
|
$15,000.00
|
$60,000.00
|
$50,000.00
|
2026-05-08
|
|
245
|
OTHER
|
Aicd Generator Procedures
|
53
|
43
|
—
|
—
|
$3,600.00
|
$86,104.40
|
$49,896.72
|
2026-05-08
|
|
826
|
OTHER
|
Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. …
|
47
|
38
|
—
|
—
|
$34,816.75
|
$84,143.32
|
$49,738.22
|
2026-05-08
|
|
650
|
OTHER
|
Kidney Transplant With Hemodialysis With Mcc
|
99
|
40
|
—
|
—
|
$5,444.00
|
$91,623.31
|
$49,715.05
|
2026-05-09
|
|
981
|
OTHER
|
Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc
|
101
|
41
|
—
|
—
|
$2,600.00
|
$91,436.22
|
$49,615.54
|
2026-05-09
|
|
799
|
OTHER
|
Splenectomy With Mcc
|
47
|
38
|
—
|
—
|
$34,667.89
|
$83,778.59
|
$49,525.55
|
2026-05-08
|
|
120-4
|
OTHER
|
Major Respiratory And Chest Procedures
|
16
|
15
|
—
|
—
|
$14,797.00
|
$59,188.02
|
$49,323.35
|
2026-05-08
|
|
267
|
OTHER
|
Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc
|
51
|
41
|
—
|
—
|
$2,600.00
|
$82,895.84
|
$49,010.84
|
2026-05-08
|
|
440-3
|
OTHER
|
Kidney Transplant
|
16
|
15
|
—
|
—
|
$14,679.00
|
$58,716.00
|
$48,930.00
|
2026-05-08
|
|
612-3
|
OTHER
|
Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other…
|
16
|
15
|
—
|
—
|
$14,643.27
|
$58,573.07
|
$48,810.89
|
2026-05-08
|
|
823
|
OTHER
|
Lymphoma And Non-acute Leukemia With Other Procedures With Mcc
|
47
|
38
|
—
|
—
|
$34,126.36
|
$82,451.82
|
$48,751.95
|
2026-05-08
|
|
329
|
OTHER
|
Major Small And Large Bowel Procedures With Mcc
|
95
|
39
|
—
|
—
|
$33,496.36
|
$89,578.96
|
$48,627.69
|
2026-05-09
|
|
277
|
OTHER
|
Cellulitis Age >17 W Cc
|
47
|
38
|
—
|
—
|
$33,927.86
|
$81,965.51
|
$48,468.37
|
2026-05-08
|
|
681-4
|
OTHER
|
Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms
|
16
|
15
|
—
|
—
|
$14,535.17
|
$58,140.68
|
$48,450.57
|
2026-05-08
|
|
220-4
|
OTHER
|
Major Stomach, Esophageal And Duodenal Procedures
|
16
|
15
|
—
|
—
|
$14,530.67
|
$58,122.66
|
$48,435.55
|
2026-05-08
|
|
483-4
|
OTHER
|
Penis, Testes And Scrotal Procedures
|
16
|
15
|
—
|
—
|
$14,469.71
|
$57,878.84
|
$48,232.37
|
2026-05-08
|
|
690-4
|
OTHER
|
Acute Leukemia
|
16
|
15
|
—
|
—
|
$14,424.37
|
$57,697.48
|
$48,081.23
|
2026-05-08
|
|
260-4
|
OTHER
|
Major Pancreas, Liver And Shunt Procedures
|
16
|
15
|
—
|
—
|
$14,421.67
|
$57,686.68
|
$48,072.23
|
2026-05-08
|
|
163
|
OTHER
|
Major Chest Procedures With Mcc
|
95
|
39
|
—
|
—
|
$33,620.78
|
$87,343.63
|
$48,029.68
|
2026-05-09
|
|
455
|
OTHER
|
Combined Anterior And Posterior Spinal Fusion Without Cc/mcc
|
47
|
38
|
—
|
—
|
$33,594.89
|
$81,149.71
|
$47,992.70
|
2026-05-08
|
|
221
|
OTHER
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
51
|
41
|
—
|
—
|
$23,000.00
|
$80,920.66
|
$47,859.13
|
2026-05-08
|
|
1629604
|
OTHER
|
Imp Sentiva Vagal Nerve Stim. - Livanova
|
174
|
51
|
$190,950.00
|
$190,950.00
|
$500.00
|
$190,950.00
|
$47,737.50
|
2026-05-09
|
|
740-4
|
OTHER
|
Mental Illness Diagnosis With O.r. Procedure
|
16
|
15
|
—
|
—
|
$14,254.87
|
$51,907.08
|
$47,516.24
|
2026-05-08
|
|
089-4
|
OTHER
|
Major Cranial Or Facial Bone Procedures
|
16
|
15
|
—
|
—
|
$14,225.29
|
$56,901.17
|
$47,417.64
|
2026-05-08
|
|
312-4
|
OTHER
|
Skin Graft, Except Hand, For Musculoskeletal And Connective Tissue Diagnoses
|
16
|
15
|
—
|
—
|
$14,181.45
|
$56,725.81
|
$47,271.51
|
2026-05-08
|
|
319
|
OTHER
|
Other Endovascular Cardiac Valve Procedures With Mcc
|
97
|
40
|
—
|
—
|
$2,700.00
|
$86,975.30
|
$47,242.85
|
2026-05-09
|
|
950-4
|
OTHER
|
Extensive O.r. Procedure Unrelated To Principal Diagnosis
|
16
|
15
|
—
|
—
|
$14,172.14
|
$56,688.58
|
$47,240.48
|
2026-05-08
|
|
020-4
|
OTHER
|
Open Craniotomy For Trauma
|
16
|
15
|
—
|
—
|
$14,170.04
|
$56,680.16
|
$47,233.47
|
2026-05-08
|
|
613-3
|
OTHER
|
Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection
|
16
|
15
|
—
|
—
|
$14,159.53
|
$56,638.13
|
$47,198.44
|
2026-05-08
|
|
856
|
OTHER
|
Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc
|
47
|
38
|
—
|
—
|
$32,918.87
|
$79,493.45
|
$47,026.96
|
2026-05-08
|
|
474
|
OTHER
|
Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc
|
47
|
38
|
—
|
—
|
$32,725.41
|
$79,019.48
|
$46,750.59
|
2026-05-08
|
|
165-3
|
OTHER
|
Coronary Bypass With Ami Or Complex Principal Diagnosis
|
16
|
15
|
—
|
—
|
$14,017.50
|
$56,070.01
|
$46,725.01
|
2026-05-08
|
|
361-4
|
OTHER
|
Skin Graft For Skin And Subcutaneous Tissue Diagnoses
|
16
|
15
|
—
|
—
|
$13,995.28
|
$55,981.14
|
$46,650.95
|
2026-05-08
|
|
25
|
OTHER
|
Craniotomy And Endovascular Intracranial Procedures With Mcc
|
47
|
38
|
—
|
—
|
$32,636.24
|
$78,801.00
|
$46,623.20
|
2026-05-08
|
|
356
|
OTHER
|
Other Digestive System O.r. Procedures With Mcc
|
95
|
39
|
—
|
—
|
$31,150.44
|
$85,609.15
|
$46,516.24
|
2026-05-09
|
|
441-4
|
OTHER
|
Major Bladder Procedures
|
16
|
15
|
—
|
—
|
$13,954.45
|
$55,817.80
|
$46,514.83
|
2026-05-08
|
|
163-3
|
OTHER
|
Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis
|
16
|
15
|
—
|
—
|
$13,889.89
|
$55,559.56
|
$46,299.63
|
2026-05-08
|
|
901
|
OTHER
|
Wound Debridements For Injuries With Mcc
|
48
|
39
|
—
|
—
|
$5,500.00
|
$78,064.49
|
$46,193.75
|
2026-05-08
|
|
130-4
|
OTHER
|
Respiratory System Diagnosis With Ventilator Support > 96 Hours
|
16
|
15
|
—
|
—
|
$13,801.31
|
$55,205.24
|
$46,004.37
|
2026-05-08
|
|
178-2
|
OTHER
|
External Heart Assist Systems
|
16
|
15
|
—
|
—
|
$13,778.79
|
$55,115.16
|
$45,929.30
|
2026-05-08
|
|
005-1
|
OTHER
|
Tracheostomy With Mv >96 Hours Without Extensive Procedure
|
16
|
15
|
—
|
—
|
$13,777.89
|
$55,111.56
|
$45,926.30
|
2026-05-08
|
|
636-4
|
OTHER
|
Neonate Birth Weight > 2499 Grams With Congenital Or Perinatal Infection
|
16
|
15
|
—
|
—
|
$13,767.08
|
$55,068.31
|
$45,890.26
|
2026-05-08
|
|
160-3
|
OTHER
|
Major Cardiothoracic Repair Of Heart Anomaly
|
16
|
15
|
—
|
—
|
$13,764.68
|
$55,058.71
|
$45,882.26
|
2026-05-08
|
|
609-2
|
OTHER
|
Neonate Birth Weight 1500-2499 Grams With Major Procedure
|
16
|
15
|
—
|
—
|
$13,567.70
|
$54,270.80
|
$45,225.67
|
2026-05-08
|
|
933
|
OTHER
|
Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft
|
48
|
39
|
—
|
—
|
$5,500.00
|
$76,239.08
|
$45,129.38
|
2026-05-08
|
|
458
|
OTHER
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
47
|
38
|
—
|
—
|
$31,526.56
|
$76,082.26
|
$45,037.94
|
2026-05-08
|
|
027-4
|
OTHER
|
Other Open Craniotomy
|
16
|
15
|
—
|
—
|
$13,374.33
|
$53,497.31
|
$44,581.09
|
2026-05-08
|
|
1617292
|
OTHER
|
Vns Aspire Generator
|
87
|
51
|
$178,315.00
|
$178,315.00
|
$500.00
|
$178,315.00
|
$44,578.75
|
2026-05-09
|
|
673
|
OTHER
|
Other Kidney And Urinary Tract Procedures With Mcc
|
95
|
39
|
—
|
—
|
$30,603.15
|
$81,882.95
|
$44,534.33
|
2026-05-09
|
|
759-4
|
OTHER
|
Eating Disorders
|
16
|
15
|
—
|
—
|
$13,338.72
|
$44,462.40
|
$44,462.40
|
2026-05-08
|
|
323
|
OTHER
|
Urinary Stones W Cc, &/or Esw Lithotripsy
|
47
|
38
|
—
|
—
|
$31,105.13
|
$75,049.74
|
$44,435.90
|
2026-05-08
|
|
140
|
OTHER
|
Major Head And Neck Procedures With Mcc
|
47
|
38
|
—
|
—
|
$30,887.94
|
$74,517.62
|
$44,125.63
|
2026-05-08
|
|
423
|
OTHER
|
Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc
|
99
|
40
|
—
|
—
|
$5,444.00
|
$80,935.81
|
$44,030.56
|
2026-05-09
|
|
303-1
|
OTHER
|
Dorsal And Lumbar Fusion Procedure For Curvature Of Back
|
16
|
15
|
—
|
—
|
$13,189.66
|
$52,758.64
|
$43,965.53
|
2026-05-08
|
|
162-2
|
OTHER
|
Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis
|
16
|
15
|
—
|
—
|
$13,188.16
|
$52,752.64
|
$43,960.53
|
2026-05-08
|
|
1629473
|
OTHER
|
Imp Sphincter - Urinary Incontinance
|
171
|
50
|
$175,300.00
|
$175,300.00
|
$500.00
|
$175,300.00
|
$43,825.00
|
2026-05-09
|
|
261-4
|
OTHER
|
Major Biliary Tract Procedures
|
16
|
15
|
—
|
—
|
$13,120.90
|
$52,483.60
|
$43,736.33
|
2026-05-08
|
|
31
|
OTHER
|
Ventricular Shunt Procedures With Mcc
|
47
|
38
|
—
|
—
|
$30,610.33
|
$73,837.50
|
$43,729.04
|
2026-05-08
|
|
005-2
|
OTHER
|
Tracheostomy With Mv >96 Hours Without Extensive Procedure
|
16
|
15
|
—
|
—
|
$13,059.34
|
$52,237.37
|
$43,531.14
|
2026-05-08
|
|
793
|
OTHER
|
Full Term Neonate With Major Problems
|
47
|
38
|
—
|
—
|
$30,465.79
|
$73,483.34
|
$43,522.56
|
2026-05-08
|
|
269
|
OTHER
|
Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc
|
50
|
40
|
—
|
—
|
$30,395.31
|
$73,310.67
|
$43,421.87
|
2026-05-08
|
|
181-4
|
OTHER
|
Lower Extremity Arterial Procedures
|
16
|
15
|
—
|
—
|
$13,002.89
|
$52,011.56
|
$43,342.97
|
2026-05-08
|
|
440-2
|
OTHER
|
Kidney Transplant
|
16
|
15
|
—
|
—
|
$12,905.90
|
$51,623.62
|
$43,019.68
|
2026-05-08
|
|
236
|
OTHER
|
Coronary Bypass Without Cardiac Catheterization Without Mcc
|
52
|
42
|
—
|
—
|
$15,000.00
|
$72,454.35
|
$42,922.56
|
2026-05-08
|
|
958
|
OTHER
|
Other O.r. Procedures For Multiple Significant Trauma With Cc
|
47
|
38
|
—
|
—
|
$30,029.25
|
$72,413.82
|
$42,898.93
|
2026-05-08
|
|
176-4
|
OTHER
|
Insertion, Revision And Replacements Of Pacemaker And Other Cardiac Devices
|
16
|
15
|
—
|
—
|
$12,867.47
|
$51,469.88
|
$42,891.57
|
2026-05-08
|
|
12
|
OTHER
|
Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc
|
47
|
38
|
—
|
—
|
$29,985.38
|
$72,306.34
|
$42,836.26
|
2026-05-08
|
|
401-4
|
OTHER
|
Adrenal Procedures
|
16
|
15
|
—
|
—
|
$12,824.53
|
$51,298.13
|
$42,748.44
|
2026-05-08
|
|
614-3
|
OTHER
|
Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition
|
16
|
15
|
—
|
—
|
$12,816.42
|
$51,265.69
|
$42,721.41
|
2026-05-08
|
|
791
|
OTHER
|
Prematurity With Major Problems
|
47
|
38
|
—
|
—
|
$29,670.38
|
$71,534.59
|
$42,386.26
|
2026-05-08
|
|
510-4
|
OTHER
|
Pelvic Evisceration, Radical Hysterectomy And Other Radical Gynecological Proced…
|
16
|
15
|
—
|
—
|
$12,621.85
|
$50,487.40
|
$42,072.83
|
2026-05-08
|
|
004-1
|
OTHER
|
Tracheostomy With Mv >96 Hours With Extensive Procedure
|
16
|
15
|
—
|
—
|
$12,611.04
|
$50,444.16
|
$42,036.80
|
2026-05-08
|
|
589-3
|
OTHER
|
Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …
|
16
|
15
|
—
|
—
|
$12,603.83
|
$50,415.34
|
$42,012.78
|
2026-05-08
|
|
178-1
|
OTHER
|
External Heart Assist Systems
|
16
|
15
|
—
|
—
|
$12,596.63
|
$50,386.51
|
$41,988.76
|
2026-05-08
|
|
303-2
|
OTHER
|
Dorsal And Lumbar Fusion Procedure For Curvature Of Back
|
16
|
15
|
—
|
—
|
$12,558.79
|
$50,235.17
|
$41,862.64
|
2026-05-08
|
|
907
|
OTHER
|
Other O.r. Procedures For Injuries With Mcc
|
99
|
40
|
—
|
—
|
$5,444.00
|
$74,822.26
|
$41,575.66
|
2026-05-09
|
|
739
|
OTHER
|
Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc…
|
47
|
38
|
—
|
—
|
$29,102.24
|
$70,142.63
|
$41,574.63
|
2026-05-08
|
|
695-4
|
OTHER
|
Chemotherapy For Acute Leukemia
|
16
|
15
|
—
|
—
|
$12,406.86
|
$49,627.43
|
$41,356.19
|
2026-05-08
|
|
1629358
|
OTHER
|
Imp Vagal Nerve Stimulator - Aspire Sr
|
174
|
51
|
$164,780.00
|
$164,780.00
|
$500.00
|
$164,780.00
|
$41,195.00
|
2026-05-09
|
|
792-4
|
OTHER
|
Extensive O.r. Procedures For Other Complications Of Treatment
|
16
|
15
|
—
|
—
|
$12,343.80
|
$49,375.20
|
$41,146.00
|
2026-05-08
|
|
736
|
OTHER
|
Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc
|
47
|
38
|
—
|
—
|
$28,790.83
|
$69,379.69
|
$41,129.76
|
2026-05-08
|
|
876
|
OTHER
|
O.r. Procedures With Principal Diagnosis Of Mental Illness
|
46
|
37
|
—
|
—
|
$28,733.31
|
$69,238.73
|
$41,047.58
|
2026-05-08
|
|
609-1
|
OTHER
|
Neonate Birth Weight 1500-2499 Grams With Major Procedure
|
16
|
15
|
—
|
—
|
$12,307.17
|
$49,228.67
|
$41,023.89
|
2026-05-08
|
|
608-2
|
OTHER
|
Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition
|
16
|
15
|
—
|
—
|
$12,263.33
|
$49,053.31
|
$40,877.76
|
2026-05-08
|
|
273
|
OTHER
|
Percutaneous And Other Intracardiac Procedures With Mcc
|
47
|
38
|
—
|
—
|
$28,594.51
|
$68,898.67
|
$40,849.30
|
2026-05-08
|
|
230-4
|
OTHER
|
Major Small Bowel Procedures
|
16
|
15
|
—
|
—
|
$12,226.40
|
$48,905.58
|
$40,754.65
|
2026-05-08
|
|
234-4
|
OTHER
|
Appendectomy Without Complex Principal Diagnosis
|
16
|
15
|
—
|
—
|
$12,225.49
|
$48,901.97
|
$40,751.64
|
2026-05-08
|
|
34
|
OTHER
|
Carotid Artery Stent Procedures With Mcc
|
47
|
38
|
—
|
—
|
$28,439.17
|
$68,518.09
|
$40,627.38
|
2026-05-08
|
|
321-4
|
OTHER
|
Spinal Fusion And Other Back And Neck Procedures Except For Disc Procedures
|
16
|
15
|
—
|
—
|
$12,148.62
|
$48,594.49
|
$40,495.41
|
2026-05-08
|
|
628
|
OTHER
|
Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc
|
95
|
39
|
—
|
—
|
$28,270.01
|
$72,629.80
|
$40,421.37
|
2026-05-09
|
|
179-3
|
OTHER
|
Defibrillator Implants
|
16
|
15
|
—
|
—
|
$12,114.09
|
$48,456.37
|
$40,380.31
|
2026-05-08
|
|
904
|
OTHER
|
Skin Grafts For Injuries With Cc/mcc
|
47
|
38
|
—
|
—
|
$28,240.67
|
$68,031.78
|
$40,343.82
|
2026-05-08
|
|
511-4
|
OTHER
|
Uterine And Adnexa Procedures For Ovarian And Adnexal Malignancy
|
16
|
15
|
—
|
—
|
$12,101.78
|
$48,407.12
|
$40,339.27
|
2026-05-08
|
|
183-3
|
OTHER
|
Percutaneous Structural Cardiac Procedures
|
16
|
15
|
—
|
—
|
$12,098.18
|
$48,392.71
|
$40,327.26
|
2026-05-08
|
|
166
|
OTHER
|
Other Respiratory System O.r. Procedures With Mcc
|
95
|
39
|
—
|
—
|
$28,163.01
|
$72,842.23
|
$40,232.87
|
2026-05-09
|
|
092-4
|
OTHER
|
Facial Bone Procedures Except Major Cranial Or Facial Bone Procedures
|
16
|
15
|
—
|
—
|
$12,063.95
|
$48,255.79
|
$40,213.16
|
2026-05-08
|
|
639-4
|
OTHER
|
Neonate Birth Weight > 2499 Grams With Other Significant Condition
|
16
|
15
|
—
|
—
|
$11,997.59
|
$47,990.35
|
$39,991.96
|
2026-05-08
|
|
956
|
OTHER
|
Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma
|
47
|
38
|
—
|
—
|
$27,962.35
|
$67,349.89
|
$39,946.22
|
2026-05-08
|
|
304-3
|
OTHER
|
Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back
|
16
|
15
|
—
|
—
|
$11,962.76
|
$47,851.03
|
$39,875.86
|
2026-05-08
|
|
24
|
OTHER
|
Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…
|
47
|
38
|
—
|
—
|
$27,813.49
|
$66,985.16
|
$39,733.56
|
2026-05-08
|
|
1620167
|
OTHER
|
Imp Interstim Neurostimul For CPT 64550
|
174
|
51
|
$158,600.00
|
$158,600.00
|
$500.00
|
$158,600.00
|
$39,650.00
|
2026-05-09
|
|
616
|
OTHER
|
Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With…
|
95
|
39
|
—
|
—
|
$26,497.50
|
$68,100.50
|
$39,608.83
|
2026-05-09
|
|
121-4
|
OTHER
|
Other Respiratory And Chest Procedures
|
16
|
15
|
—
|
—
|
$11,860.07
|
$47,440.26
|
$39,533.55
|
2026-05-08
|
|
40
|
OTHER
|
Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc
|
50
|
41
|
—
|
—
|
$3,600.00
|
$66,463.62
|
$39,429.45
|
2026-05-08
|
|
651
|
OTHER
|
Kidney Transplant With Hemodialysis Without Mcc
|
95
|
39
|
—
|
—
|
$25,445.99
|
$72,220.54
|
$39,395.06
|
2026-05-09
|
|
167-3
|
OTHER
|
Other Cardiothoracic And Thoracic Vascular Procedures
|
16
|
15
|
—
|
—
|
$11,793.40
|
$47,173.62
|
$39,311.35
|
2026-05-08
|
|
166-3
|
OTHER
|
Coronary Bypass Without Ami Or Complex Principal Diagnosis
|
16
|
15
|
—
|
—
|
$11,691.01
|
$46,764.05
|
$38,970.04
|
2026-05-08
|
|
008-3
|
OTHER
|
Autologous Bone Marrow Transplant Or T-cell Immunotherapy
|
16
|
15
|
—
|
—
|
$11,660.38
|
$46,641.54
|
$38,867.95
|
2026-05-08
|
|
165-2
|
OTHER
|
Coronary Bypass With Ami Or Complex Principal Diagnosis
|
16
|
15
|
—
|
—
|
$11,659.48
|
$46,637.94
|
$38,864.95
|
2026-05-08
|
|
622
|
OTHER
|
Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor…
|
97
|
40
|
—
|
—
|
$5,500.00
|
$69,363.53
|
$38,613.01
|
2026-05-09
|
|
440-1
|
OTHER
|
Kidney Transplant
|
16
|
15
|
—
|
—
|
$11,572.11
|
$46,288.43
|
$38,573.69
|
2026-05-08
|
|
030-4
|
OTHER
|
Percutaneous Intracranial And Extracranial Vascular Procedures
|
16
|
15
|
—
|
—
|
$11,560.69
|
$46,242.78
|
$38,535.65
|
2026-05-08
|
|
170-4
|
OTHER
|
Permanent Cardiac Pacemaker Implant With Ami, Heart Failure Or Shock
|
16
|
15
|
—
|
—
|
$11,491.33
|
$45,965.33
|
$38,304.44
|
2026-05-08
|
|
460
|
OTHER
|
Spinal Fusion Except Cervical Without Mcc
|
47
|
38
|
—
|
—
|
$26,779.33
|
$64,451.44
|
$38,256.18
|
2026-05-08
|
|
612-2
|
OTHER
|
Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other…
|
16
|
15
|
—
|
—
|
$11,474.82
|
$45,899.27
|
$38,249.39
|
2026-05-08
|
|
325-4
|
OTHER
|
Non-elective Or Complex Knee Joint Replacement
|
16
|
15
|
—
|
—
|
$11,459.50
|
$45,838.02
|
$38,198.35
|
2026-05-08
|
|
162-1
|
OTHER
|
Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis
|
16
|
15
|
—
|
—
|
$11,452.00
|
$45,808.00
|
$38,173.33
|
2026-05-08
|
|
94
|
OTHER
|
Bacterial And Tuberculous Infections Of Nervous System With Mcc
|
95
|
39
|
—
|
—
|
$26,713.16
|
$68,587.88
|
$38,161.65
|
2026-05-09
|
|
335
|
OTHER
|
Peritoneal Adhesiolysis With Mcc
|
95
|
39
|
—
|
—
|
$26,531.20
|
$69,591.54
|
$37,996.74
|
2026-05-09
|
|
264-4
|
OTHER
|
Other Hepatobiliary, Pancreas And Abdominal Procedures
|
16
|
15
|
—
|
—
|
$11,384.74
|
$45,538.94
|
$37,949.12
|
2026-05-08
|
|
271
|
OTHER
|
Other Major Cardiovascular Procedures With Cc
|
100
|
41
|
—
|
—
|
$5,444.00
|
$69,307.01
|
$37,845.42
|
2026-05-09
|
|
405-4
|
OTHER
|
Other Procedures For Endocrine, Nutritional And Metabolic Disorders
|
16
|
15
|
—
|
—
|
$11,263.73
|
$45,054.91
|
$37,545.76
|
2026-05-08
|
|
802
|
OTHER
|
Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc
|
47
|
38
|
—
|
—
|
$26,253.61
|
$63,163.43
|
$37,505.16
|
2026-05-08
|
|
97
|
OTHER
|
Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc
|
47
|
38
|
—
|
—
|
$26,252.17
|
$63,159.91
|
$37,503.10
|
2026-05-08
|
|
518
|
OTHER
|
Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost…
|
47
|
38
|
—
|
—
|
$26,247.85
|
$63,149.33
|
$37,496.93
|
2026-05-08
|
|
404-4
|
OTHER
|
Thyroid, Parathyroid And Thyroglossal Procedures
|
16
|
15
|
—
|
—
|
$11,222.29
|
$44,889.17
|
$37,407.64
|
2026-05-08
|
|
710-4
|
OTHER
|
Infectious And Parasitic Diseases Including HIV With O.r. Procedure
|
16
|
15
|
—
|
—
|
$11,206.38
|
$44,825.51
|
$37,354.59
|
2026-05-08
|
|
512-4
|
OTHER
|
Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy
|
16
|
15
|
—
|
—
|
$11,201.27
|
$44,805.08
|
$37,337.57
|
2026-05-08
|
|
265
|
OTHER
|
Aicd Lead Procedures
|
47
|
38
|
—
|
—
|
$26,127.04
|
$62,853.32
|
$37,324.35
|
2026-05-08
|
|
651-4
|
OTHER
|
Other Procedures Of Blood And Blood-forming Organs
|
16
|
15
|
—
|
—
|
$11,170.34
|
$44,681.38
|
$37,234.48
|
2026-05-08
|
|
492
|
OTHER
|
Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc
|
47
|
38
|
—
|
—
|
$26,011.96
|
$62,571.41
|
$37,159.95
|
2026-05-08
|
|
252
|
OTHER
|
Other Vascular Procedures With Mcc
|
99
|
40
|
—
|
—
|
$5,444.00
|
$67,981.79
|
$37,140.54
|
2026-05-09
|
|
182-4
|
OTHER
|
Other Peripheral Vascular And Related Procedures
|
16
|
15
|
—
|
—
|
$11,122.60
|
$44,490.41
|
$37,075.34
|
2026-05-08
|