Hospital

CHAPMAN GLOBAL MEDICAL CENTER

Orange, CA · CCN 050745 · Rates published

14,752 distinct procedures filed

90 distinct payers

1,300,534 rate rows

2026-05-27 last MRF observed

Data quality

1,259,938 of 1,300,534 rate rows are consumer-grade (96.9%)

40,596 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
no usable negotiated amount (only an out-of-band fallback) — excluded from medians	25,311
per-diem day rate — not a per-procedure price	12,876
template filing: same amount across many unrelated codes — excluded	1,743
exceeds 10× this hospital's gross charge — excluded from medians	607
placeholder amount (≤ $0.02) — excluded from medians	59

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

Source MRF file	http://www.chapmanglobalmedicalcenter.com/csv/550883864_chapman-global-medical-center_standardcharges.csv
Found on page	https://www.chapmanglobalmedicalcenter.com/pricing-transparency/
Discovered via	Discovered by HANK (automated)
Last fetch	not_modified · 2026-05-18
Content fingerprint	5500170e1a240bd8… · 441,089,376 bytes · first seen 2026-05-13

Top 50 most expensive offerings

Outliers are flagged where this hospital's filed rate is ≥2× or ≤0.5× the national median for the same code.

Code	Description	Payers	Min $	Max $	Avg median	vs national
018 OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	51	$629,342.12	$2,860,061.00	$786,677.65	nat. median $424,868 1.9× median
007 OTHER	Lung Transplant	50	$252,533.69	$2,162,847.20	$549,353.30	nat. median $141,082 outlier · 3.9×
631-4 OTHER	Neonate Birth Weight > 2499 Grams With Other Major Procedure	14	$248,574.92	$348,004.89	$288,346.91	nat. median $203,379 1.4× median
001 OTHER	Heart Transplant Or Implant Of Heart Assist System With Mcc	51	$211,289.14	$846,592.03	$264,111.43	nat. median $263,894 1.0× median
630-4 OTHER	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure	14	$221,021.61	$309,430.25	$256,385.07	nat. median $210,669 1.2× median
583-4 OTHER	Neonate With Ecmo	14	$221,000.00	$309,400.00	$256,360.00	nat. median $309,400 0.8× median
588-4 OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	14	$221,000.00	$309,400.00	$256,360.00	nat. median $267,493 1.0× median
583-3 OTHER	Neonate With Ecmo	14	$221,000.00	$309,400.00	$256,360.00	nat. median $259,487 1.0× median
011-3 OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	14	$213,464.00	$298,849.60	$247,618.24	nat. median $171,094 1.4× median
161-4 OTHER	Implantable Heart Assist Systems	14	$202,241.64	$283,138.30	$234,600.30	nat. median $202,242 1.2× median
004 OTHER	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…	50	$186,257.79	$949,211.27	$232,822.24	nat. median $150,232 1.5× median
002-4 OTHER	Heart And/or Lung Transplant	14	$200,068.76	$280,096.26	$232,079.76	nat. median $216,800 1.1× median
583-2 OTHER	Neonate With Ecmo	14	$190,864.34	$267,210.08	$221,402.64	nat. median $191,347 1.2× median
589-1 OTHER	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational…	14	$177,128.63	$247,980.08	$205,469.21	nat. median $86,371 outlier · 2.4×
583-1 OTHER	Neonate With Ecmo	14	$174,416.71	$244,183.39	$202,323.39	nat. median $171,226 1.2× median
927 OTHER	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	50	$161,039.48	$533,443.28	$201,299.35	nat. median $146,562 1.4× median
003 OTHER	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…	50	$160,095.98	$645,099.41	$200,119.98	nat. median $218,232 0.9× median
609-4 OTHER	Neonate Birth Weight 1500-2499 Grams With Major Procedure	14	$165,000.00	$231,000.00	$191,400.00	nat. median $169,856 1.1× median
841-4 OTHER	Extensive Third Degree Burns With Skin Graft	14	$162,530.19	$227,542.27	$188,535.02	nat. median $151,691 1.2× median
161-3 OTHER	Implantable Heart Assist Systems	14	$159,211.91	$222,896.67	$184,685.82	nat. median $152,491 1.2× median
002 OTHER	Heart Transplant Or Implant Of Heart Assist System Without Mcc	51	$141,447.46	$752,886.92	$176,809.32	nat. median $117,167 1.5× median
007-4 OTHER	Allogeneic Bone Marrow Transplant	14	$149,835.59	$209,769.83	$173,809.28	nat. median $172,311 1.0× median
969 OTHER	HIV With Extensive O.r. Procedures With Mcc	50	$119,740.09	$740,885.64	$164,261.91	nat. median $64,729 outlier · 2.5×
009-4 OTHER	Extracorporeal Membrane Oxygenation (ecmo)	14	$139,000.00	$194,600.00	$161,240.00	nat. median $150,954 1.1× median
588-3 OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	14	$132,000.00	$184,800.00	$153,120.00	nat. median $165,000 0.9× median
002-3 OTHER	Heart And/or Lung Transplant	14	$131,530.85	$184,143.19	$152,575.78	nat. median $133,471 1.1× median
588-2 OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	14	$130,000.00	$182,000.00	$150,800.00	nat. median $153,523 1.0× median
863-4 OTHER	Neonatal Aftercare	14	$126,963.94	$177,749.52	$147,278.17	nat. median $108,047 1.4× median
593-4 OTHER	Neonate Birth Weight 750-999 Grams Without Major Procedure	14	$121,000.00	$169,400.00	$140,360.00	nat. median $151,250 0.9× median
303-4 OTHER	Dorsal And Lumbar Fusion Procedure For Curvature Of Back	14	$120,000.00	$168,000.00	$139,200.00	nat. median $108,000 1.3× median
591-4 OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure	14	$120,000.00	$168,000.00	$139,200.00	nat. median $156,696 0.9× median
001-4 OTHER	Liver Transplant And/or Intestinal Transplant	14	$120,000.00	$168,000.00	$139,200.00	nat. median $124,561 1.1× median
510-4 OTHER	Pelvic Evisceration, Radical Hysterectomy And Other Radical Gynecological Proced…	14	$137,644.70	$137,644.70	$137,644.70	nat. median $35,828 outlier · 3.8×
006 OTHER	Liver Transplant Without Mcc	50	$90,876.65	$613,006.45	$128,060.00	nat. median $50,611 outlier · 2.5×
009-3 OTHER	Extracorporeal Membrane Oxygenation (ecmo)	14	$110,110.47	$154,154.66	$127,728.14	nat. median $87,912 1.5× median
004-4 OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	14	$110,000.00	$154,000.00	$127,600.00	nat. median $110,000 1.2× median
161-1 OTHER	Implantable Heart Assist Systems	14	$109,991.74	$153,988.44	$127,590.42	nat. median $101,352 1.3× median
161-2 OTHER	Implantable Heart Assist Systems	14	$109,991.74	$153,988.44	$127,590.42	nat. median $109,992 1.2× median
008 OTHER	Simultaneous Pancreas And Kidney Transplant	50	$99,426.68	$591,940.40	$124,283.35	nat. median $59,265 outlier · 2.1×
160-4 OTHER	Major Cardiothoracic Repair Of Heart Anomaly	14	$106,925.93	$149,696.30	$124,034.08	nat. median $106,926 1.2× median
754-3 OTHER	Depression Except Major Depressive Disorder	14	$118,394.95	$118,394.95	$118,394.95	nat. median $7,054 outlier · 16.8×
002-2 OTHER	Heart And/or Lung Transplant	14	$101,523.66	$142,133.12	$117,767.45	nat. median $106,681 1.1× median
207 OTHER	Respiratory System Diagnosis With Ventilator Support >96 Hours	50	$93,502.70	$557,980.25	$116,878.37	nat. median $66,849 1.7× median
607-4 OTHER	Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…	14	$100,000.00	$140,000.00	$116,000.00	nat. median $100,015 1.2× median
602-4 OTHER	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	14	$100,000.00	$140,000.00	$116,000.00	nat. median $125,000 0.9× median
593-3 OTHER	Neonate Birth Weight 750-999 Grams Without Major Procedure	14	$99,000.00	$138,600.00	$114,840.00	nat. median $112,711 1.0× median
014 OTHER	Allogeneic Bone Marrow Transplant	51	$33,049.73	$300,663.83	$113,458.05	nat. median $105,808 1.1× median
268 OTHER	Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc	51	$63,228.00	$540,754.16	$113,162.17	nat. median $67,670 1.7× median
570 OTHER	Skin Debridement With Mcc	50	$57,898.50	$561,768.89	$111,568.10	nat. median $33,751 outlier · 3.3×
633-4 OTHER	Neonate Birth Weight > 2499 Grams With Major Anomaly	14	$95,464.13	$133,649.78	$110,738.40	nat. median $74,597 1.5× median

Other procedures at this hospital

Browse this hospital's 14,752 published procedures. Use the slice to choose what to show, then sort or filter any column.

Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
Code	Type	Description	Rate rows	Payers	Gross	Cash	Min $	Max $	Avg median	Last observed

001	OTHER	Heart Transplant Or Implant Of Heart Assist System With Mcc	63	51	—	—	$211,289.14	$846,592.03	$264,111.43	2026-05-27
001-1	OTHER	Liver Transplant And/or Intestinal Transplant	14	14	—	—	$50,000.00	$70,000.00	$58,000.00	2026-05-27
001-2	OTHER	Liver Transplant And/or Intestinal Transplant	14	14	—	—	$61,446.58	$86,025.21	$71,278.04	2026-05-27
001-3	OTHER	Liver Transplant And/or Intestinal Transplant	14	14	—	—	$76,155.46	$106,617.64	$88,340.33	2026-05-27
001-4	OTHER	Liver Transplant And/or Intestinal Transplant	14	14	—	—	$120,000.00	$168,000.00	$139,200.00	2026-05-27
002	OTHER	Heart Transplant Or Implant Of Heart Assist System Without Mcc	63	51	—	—	$141,447.46	$752,886.92	$176,809.32	2026-05-27
002-1	OTHER	Heart And/or Lung Transplant	14	14	—	—	$50,000.00	$70,000.00	$58,000.00	2026-05-27
002-2	OTHER	Heart And/or Lung Transplant	14	14	—	—	$101,523.66	$142,133.12	$117,767.45	2026-05-27
002-3	OTHER	Heart And/or Lung Transplant	14	14	—	—	$131,530.85	$184,143.19	$152,575.78	2026-05-27
002-4	OTHER	Heart And/or Lung Transplant	14	14	—	—	$200,068.76	$280,096.26	$232,079.76	2026-05-27
003	OTHER	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…	61	50	—	—	$160,095.98	$645,099.41	$200,119.98	2026-05-27
004	OTHER	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…	61	50	—	—	$186,257.79	$949,211.27	$232,822.24	2026-05-27
004-1	OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	16	16	—	—	$32,034.98	$60,969.96	$48,775.97	2026-05-27
004-2	OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	14	14	—	—	$61,468.84	$86,056.38	$71,303.86	2026-05-27
004-3	OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	14	14	—	—	$91,000.00	$127,400.00	$105,560.00	2026-05-27
004-4	OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	14	14	—	—	$110,000.00	$154,000.00	$127,600.00	2026-05-27
005	OTHER	Liver Transplant With Mcc Or Intestinal Transplant	62	50	—	—	$83,591.51	$473,562.45	$104,489.39	2026-05-27
005-2	OTHER	Tracheostomy With Mv >96 Hours Without Extensive Procedure	14	14	—	—	$49,972.05	$69,960.87	$57,967.58	2026-05-27
005-3	OTHER	Tracheostomy With Mv >96 Hours Without Extensive Procedure	14	14	—	—	$74,623.62	$104,473.07	$86,563.39	2026-05-27
005-4	OTHER	Tracheostomy With Mv >96 Hours Without Extensive Procedure	14	14	—	—	$88,000.00	$123,200.00	$102,080.00	2026-05-27
006	OTHER	Liver Transplant Without Mcc	62	50	—	—	$90,876.65	$613,006.45	$128,060.00	2026-05-27
006-1	OTHER	Pancreas Transplant	14	14	—	—	$50,000.00	$70,000.00	$58,000.00	2026-05-27
006-2	OTHER	Pancreas Transplant	14	14	—	—	$66,925.17	$93,695.24	$77,633.20	2026-05-27
006-3	OTHER	Pancreas Transplant	14	14	—	—	$79,144.95	$110,802.93	$91,808.14	2026-05-27
006-4	OTHER	Pancreas Transplant	14	14	—	—	$85,000.00	$119,000.00	$98,600.00	2026-05-27
007	OTHER	Lung Transplant	62	50	—	—	$252,533.69	$2,162,847.20	$549,353.30	2026-05-27
007-1	OTHER	Allogeneic Bone Marrow Transplant	14	14	—	—	$74,667.08	$104,533.91	$86,613.82	2026-05-27
007-2	OTHER	Allogeneic Bone Marrow Transplant	14	14	—	—	$66,446.01	$93,024.41	$77,077.37	2026-05-27
007-3	OTHER	Allogeneic Bone Marrow Transplant	14	14	—	—	$89,273.14	$124,982.40	$103,556.85	2026-05-27
007-4	OTHER	Allogeneic Bone Marrow Transplant	14	14	—	—	$149,835.59	$209,769.83	$173,809.28	2026-05-27
008	OTHER	Simultaneous Pancreas And Kidney Transplant	62	50	—	—	$99,426.68	$591,940.40	$124,283.35	2026-05-27
008-3	OTHER	Autologous Bone Marrow Transplant Or T-cell Immunotherapy	16	16	—	—	$31,443.55	$59,787.10	$47,829.68	2026-05-27
008-4	OTHER	Autologous Bone Marrow Transplant Or T-cell Immunotherapy	14	14	—	—	$65,108.16	$91,151.42	$75,525.46	2026-05-27
009-1	OTHER	Extracorporeal Membrane Oxygenation (ecmo)	14	14	—	—	$48,887.57	$68,442.60	$56,709.58	2026-05-27
009-2	OTHER	Extracorporeal Membrane Oxygenation (ecmo)	14	14	—	—	$59,643.74	$83,501.24	$69,186.74	2026-05-27
009-3	OTHER	Extracorporeal Membrane Oxygenation (ecmo)	14	14	—	—	$110,110.47	$154,154.66	$127,728.14	2026-05-27
009-4	OTHER	Extracorporeal Membrane Oxygenation (ecmo)	14	14	—	—	$139,000.00	$194,600.00	$161,240.00	2026-05-27
010	OTHER	Pancreas Transplant	62	50	—	—	$54,305.43	$363,908.35	$67,881.79	2026-05-27
011	OTHER	Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc	61	50	—	—	$41,342.04	$225,144.85	$51,677.55	2026-05-27
011-1	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	14	14	—	—	$50,000.00	$70,000.00	$58,000.00	2026-05-27
011-2	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	14	14	—	—	$50,000.00	$70,000.00	$58,000.00	2026-05-27
011-3	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	14	14	—	—	$213,464.00	$298,849.60	$247,618.24	2026-05-27
011-4	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	14	14	—	—	$50,021.00	$70,029.40	$58,024.36	2026-05-27
014	OTHER	Allogeneic Bone Marrow Transplant	64	51	—	—	$33,049.73	$300,663.83	$113,458.05	2026-05-27
016	OTHER	Autologous Bone Marrow Transplant With Cc/mcc	64	51	—	—	$44,923.25	$176,947.00	$56,154.06	2026-05-27
017	OTHER	Autologous Bone Marrow Transplant Without Cc/mcc	63	51	—	—	$16,063.41	$136,401.77	$51,472.37	2026-05-27
018	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	63	51	—	—	$629,342.12	$2,860,061.00	$786,677.65	2026-05-27
019	OTHER	Simultaneous Pancreas And Kidney Transplant With Hemodialysis	64	51	—	—	$13,913.56	$178,861.62	$67,494.95	2026-05-27
020	OTHER	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc	61	50	—	—	$63,506.14	$387,183.73	$79,382.67	2026-05-27
020-4	OTHER	Open Craniotomy For Trauma	16	16	—	—	$32,338.49	$61,576.97	$49,261.58	2026-05-27
021	OTHER	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc	61	50	—	—	$52,315.94	$369,444.80	$65,394.92	2026-05-27
021-4	OTHER	Open Craniotomy Except Trauma	14	14	—	—	$49,641.30	$69,497.82	$57,583.91	2026-05-27
022	OTHER	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/…	61	50	—	—	$45,408.27	$357,603.65	$58,472.12	2026-05-27
023	OTHER	Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…	61	50	—	—	$31,931.32	$286,913.55	$54,277.25	2026-05-27
023-4	OTHER	Spinal Procedures	14	14	—	—	$47,896.38	$67,054.93	$55,559.81	2026-05-27
025	OTHER	Craniotomy And Endovascular Intracranial Procedures With Mcc	61	50	—	—	$34,509.47	$114,312.63	$43,136.84	2026-05-27
027-4	OTHER	Other Open Craniotomy	16	16	—	—	$28,847.79	$54,595.58	$43,676.46	2026-05-27
028	OTHER	Spinal Procedures With Mcc	61	50	—	—	$45,515.09	$150,768.73	$56,893.86	2026-05-27
029-4	OTHER	Other Percutaneous Intracranial Procedures	16	16	—	—	$26,625.29	$50,150.58	$40,120.46	2026-05-27
030-4	OTHER	Percutaneous Intracranial And Extracranial Vascular Procedures	16	16	—	—	$27,776.97	$52,453.95	$41,963.16	2026-05-27
031	OTHER	Ventricular Shunt Procedures With Mcc	61	50	—	—	$34,011.00	$123,249.83	$42,513.75	2026-05-27
089-4	OTHER	Major Cranial Or Facial Bone Procedures	14	14	—	—	$45,836.60	$64,171.24	$53,170.46	2026-05-27
091-4	OTHER	Other Major Head And Neck Procedures	14	14	—	—	$53,845.66	$75,383.92	$62,460.96	2026-05-27
092-4	OTHER	Facial Bone Procedures Except Major Cranial Or Facial Bone Procedures	16	16	—	—	$28,977.65	$54,855.30	$43,884.24	2026-05-27
120-4	OTHER	Major Respiratory And Chest Procedures	14	14	—	—	$44,991.70	$62,988.38	$52,190.37	2026-05-27
121-4	OTHER	Other Respiratory And Chest Procedures	16	16	—	—	$28,177.70	$53,255.40	$42,604.32	2026-05-27
130-3	OTHER	Respiratory System Diagnosis With Ventilator Support > 96 Hours	16	16	—	—	$26,644.58	$50,189.16	$40,151.33	2026-05-27
130-4	OTHER	Respiratory System Diagnosis With Ventilator Support > 96 Hours	14	14	—	—	$47,938.78	$67,114.29	$55,608.99	2026-05-27
140	OTHER	Major Head And Neck Procedures With Mcc	61	50	—	—	$32,390.58	$184,620.42	$40,488.22	2026-05-27
160-2	OTHER	Major Cardiothoracic Repair Of Heart Anomaly	16	16	—	—	$27,233.04	$51,366.08	$41,092.87	2026-05-27
160-3	OTHER	Major Cardiothoracic Repair Of Heart Anomaly	14	14	—	—	$46,998.47	$65,797.86	$54,518.23	2026-05-27
160-4	OTHER	Major Cardiothoracic Repair Of Heart Anomaly	14	14	—	—	$106,925.93	$149,696.30	$124,034.08	2026-05-27
161-1	OTHER	Implantable Heart Assist Systems	14	14	—	—	$109,991.74	$153,988.44	$127,590.42	2026-05-27
161-2	OTHER	Implantable Heart Assist Systems	14	14	—	—	$109,991.74	$153,988.44	$127,590.42	2026-05-27
161-3	OTHER	Implantable Heart Assist Systems	14	14	—	—	$159,211.91	$222,896.67	$184,685.82	2026-05-27
161-4	OTHER	Implantable Heart Assist Systems	14	14	—	—	$202,241.64	$283,138.30	$234,600.30	2026-05-27
162-1	OTHER	Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis	16	16	—	—	$28,179.92	$53,259.85	$42,607.88	2026-05-27
162-2	OTHER	Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis	16	16	—	—	$32,543.30	$61,986.60	$49,589.28	2026-05-27
162-3	OTHER	Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis	14	14	—	—	$57,853.90	$80,995.46	$67,110.52	2026-05-27
162-4	OTHER	Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis	14	14	—	—	$80,771.14	$113,079.60	$93,694.52	2026-05-27
163	OTHER	Major Chest Procedures With Mcc	61	50	—	—	$70,136.14	$460,004.33	$87,670.18	2026-05-27
163-2	OTHER	Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis	16	16	—	—	$27,374.03	$51,648.07	$41,318.46	2026-05-27
163-3	OTHER	Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis	14	14	—	—	$48,537.74	$67,952.84	$56,303.78	2026-05-27
163-4	OTHER	Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis	14	14	—	—	$71,005.50	$99,407.70	$82,366.38	2026-05-27
165-2	OTHER	Coronary Bypass With Ami Or Complex Principal Diagnosis	16	16	—	—	$28,546.51	$53,993.02	$43,194.41	2026-05-27
165-3	OTHER	Coronary Bypass With Ami Or Complex Principal Diagnosis	14	14	—	—	$46,931.69	$65,704.37	$54,440.76	2026-05-27
165-4	OTHER	Coronary Bypass With Ami Or Complex Principal Diagnosis	14	14	—	—	$63,659.01	$89,122.61	$73,844.45	2026-05-27
166-3	OTHER	Coronary Bypass Without Ami Or Complex Principal Diagnosis	16	16	—	—	$29,523.07	$55,946.14	$44,756.91	2026-05-27
166-4	OTHER	Coronary Bypass Without Ami Or Complex Principal Diagnosis	14	14	—	—	$55,046.75	$77,065.45	$63,854.23	2026-05-27
167-4	OTHER	Other Cardiothoracic And Thoracic Vascular Procedures	14	14	—	—	$54,029.06	$75,640.68	$62,673.71	2026-05-27
169-4	OTHER	Major Abdominal Vascular Procedures	14	14	—	—	$49,701.73	$69,582.42	$57,654.01	2026-05-27
170-4	OTHER	Permanent Cardiac Pacemaker Implant With Ami, Heart Failure Or Shock	16	16	—	—	$27,081.66	$51,063.32	$40,850.66	2026-05-27
175-4	OTHER	Percutaneous Cardiac Intervention Without Ami	16	16	—	—	$26,790.03	$50,480.05	$40,384.04	2026-05-27
178-1	OTHER	External Heart Assist Systems	16	16	—	—	$29,354.62	$55,609.25	$44,487.40	2026-05-27
178-2	OTHER	External Heart Assist Systems	16	16	—	—	$31,855.40	$60,610.79	$48,488.63	2026-05-27
178-3	OTHER	External Heart Assist Systems	14	14	—	—	$53,704.67	$75,186.54	$62,297.42	2026-05-27
178-4	OTHER	External Heart Assist Systems	14	14	—	—	$66,228.69	$92,720.17	$76,825.28	2026-05-27
179-3	OTHER	Defibrillator Implants	16	16	—	—	$29,968.31	$56,836.63	$45,469.30	2026-05-27
179-4	OTHER	Defibrillator Implants	14	14	—	—	$54,992.69	$76,989.77	$63,791.52	2026-05-27
181-4	OTHER	Lower Extremity Arterial Procedures	16	16	—	—	$28,824.04	$54,548.09	$43,638.47	2026-05-27
183-3	OTHER	Percutaneous Structural Cardiac Procedures	16	16	—	—	$30,536.00	$57,972.00	$46,377.60	2026-05-27
183-4	OTHER	Percutaneous Structural Cardiac Procedures	14	14	—	—	$58,768.76	$82,276.26	$68,171.76	2026-05-27
207	OTHER	Respiratory System Diagnosis With Ventilator Support >96 Hours	61	50	—	—	$93,502.70	$557,980.25	$116,878.37	2026-05-27
212	OTHER	Hip & Femur Procedures Except Major Joint Age 0-17	61	50	—	—	$82,153.81	$272,134.49	$102,692.26	2026-05-27
215	OTHER	Other Heart Assist System Implant	63	51	—	—	$75,248.18	$335,128.60	$94,060.23	2026-05-27
216	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	64	52	—	—	$1,900.00	$303,808.65	$92,420.62	2026-05-27
217	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	63	51	—	—	$49,784.52	$164,911.22	$62,230.65	2026-05-27
218	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	63	51	—	—	$44,604.51	$164,911.22	$62,230.65	2026-05-27
219	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	63	51	—	—	$58,089.94	$302,432.06	$72,612.43	2026-05-27
220	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	63	51	—	—	$40,428.69	$133,920.03	$50,535.86	2026-05-27
220-4	OTHER	Major Stomach, Esophageal And Duodenal Procedures	14	14	—	—	$45,647.91	$63,907.07	$52,951.57	2026-05-27
221	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	63	51	—	—	$38,225.46	$129,859.38	$47,781.83	2026-05-27
228	OTHER	Other Cardiothoracic Procedures With Mcc	63	51	—	—	$37,526.67	$124,307.10	$46,908.34	2026-05-27
230-4	OTHER	Major Small Bowel Procedures	16	16	—	—	$28,878.95	$54,657.90	$43,726.32	2026-05-27
231	OTHER	Coronary Bypass With Ptca With Mcc	64	52	—	—	$4,500.00	$312,560.30	$79,686.69	2026-05-27
232	OTHER	Coronary Bypass With Ptca Without Mcc	64	52	—	—	$3,400.00	$194,247.61	$57,404.95	2026-05-27
232-4	OTHER	Gastric Fundoplication	14	14	—	—	$48,638.45	$68,093.83	$56,420.60	2026-05-27
233	OTHER	Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc	64	52	—	—	$1,900.00	$215,419.13	$72,300.87	2026-05-27
234	OTHER	Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc	64	52	—	—	$1,900.00	$151,346.44	$51,758.51	2026-05-27
234-4	OTHER	Appendectomy Without Complex Principal Diagnosis	16	16	—	—	$28,021.12	$52,942.25	$42,353.80	2026-05-27
235	OTHER	Coronary Bypass Without Cardiac Catheterization With Mcc	63	51	—	—	$44,463.17	$147,284.24	$55,578.96	2026-05-27
239	OTHER	Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc	61	50	—	—	$37,333.16	$195,923.00	$46,666.45	2026-05-27
245	OTHER	Aicd Generator Procedures	64	51	—	—	$6,333.00	$114,704.22	$43,284.61	2026-05-27
260-4	OTHER	Major Pancreas, Liver And Shunt Procedures	14	14	—	—	$46,961.37	$65,745.92	$54,475.18	2026-05-27
261-4	OTHER	Major Biliary Tract Procedures	16	16	—	—	$30,668.08	$58,236.16	$46,588.93	2026-05-27
264-4	OTHER	Other Hepatobiliary, Pancreas And Abdominal Procedures	16	16	—	—	$26,703.21	$50,306.41	$40,245.13	2026-05-27
266	OTHER	Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc	63	51	—	—	$46,419.43	$187,383.61	$58,024.29	2026-05-27
267	OTHER	Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc	64	52	—	—	$1,900.00	$166,713.80	$45,152.01	2026-05-27
268	OTHER	Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc	63	51	—	—	$63,228.00	$540,754.16	$113,162.17	2026-05-27
269	OTHER	Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc	63	51	—	—	$32,073.57	$209,018.27	$40,091.96	2026-05-27
270	OTHER	Other Major Cardiovascular Procedures With Mcc	64	52	—	—	$1,900.00	$132,510.79	$50,004.07	2026-05-27
275	OTHER	Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc	62	50	—	—	$6,333.00	$178,756.81	$67,455.40	2026-05-27
276	OTHER	Non-maligant Breast Disorders	61	50	—	—	$45,502.30	$150,726.35	$56,877.87	2026-05-27
277	OTHER	Cellulitis Age >17 W Cc	61	50	—	—	$35,050.12	$232,912.00	$43,812.65	2026-05-27
278	OTHER	Cellulitis Age >17 Without Cc	61	50	—	—	$12,266.30	$139,741.62	$52,732.69	2026-05-27
303-2	OTHER	Dorsal And Lumbar Fusion Procedure For Curvature Of Back	16	16	—	—	$27,413.37	$51,726.74	$41,381.39	2026-05-27
303-3	OTHER	Dorsal And Lumbar Fusion Procedure For Curvature Of Back	14	14	—	—	$49,432.46	$69,205.44	$57,341.65	2026-05-27
303-4	OTHER	Dorsal And Lumbar Fusion Procedure For Curvature Of Back	14	14	—	—	$120,000.00	$168,000.00	$139,200.00	2026-05-27
304-3	OTHER	Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back	16	16	—	—	$28,763.94	$54,427.87	$43,542.30	2026-05-27
304-4	OTHER	Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back	14	14	—	—	$54,426.59	$76,197.23	$63,134.85	2026-05-27
312-4	OTHER	Skin Graft, Except Hand, For Musculoskeletal And Connective Tissue Diagnoses	16	16	—	—	$31,982.29	$60,864.58	$48,691.66	2026-05-27
319	OTHER	Other Endovascular Cardiac Valve Procedures With Mcc	64	52	—	—	$3,400.00	$124,093.30	$42,348.07	2026-05-27
321-4	OTHER	Spinal Fusion And Other Back And Neck Procedures Except For Disc Procedures	16	16	—	—	$29,599.51	$56,099.01	$44,879.21	2026-05-27
323	OTHER	Urinary Stones W Cc, &/or Esw Lithotripsy	61	50	—	—	$32,858.17	$108,842.69	$41,072.71	2026-05-27
326	OTHER	Stomach, Esophageal And Duodenal Procedures With Mcc	61	50	—	—	$54,314.31	$381,082.36	$67,892.89	2026-05-27
329	OTHER	Major Small And Large Bowel Procedures With Mcc	61	50	—	—	$34,884.45	$162,067.99	$43,605.56	2026-05-27
347	OTHER	Anal And Stomal Procedures With Mcc	61	50	—	—	$31,100.58	$294,993.23	$40,467.66	2026-05-27
356	OTHER	Other Digestive System O.r. Procedures With Mcc	61	50	—	—	$42,814.18	$330,339.55	$53,517.73	2026-05-27
36000238T01	OTHER	Transluminal Peripheral Atherectomy Iliac Ea Vessl	56	39	$59,436.00	$59,436.00	$950.00	$59,436.00	$41,605.20	2026-05-27
36000408T01	OTHER	Insertionreplacement Ccm System	56	39	$85,340.00	$85,340.00	$950.00	$85,340.00	$59,738.00	2026-05-27
36003722703	OTHER	Revasc Fempop Uniltrl Angio W-stent Athrctmy Bi	81	57	$89,155.00	$89,155.00	$632.91	$89,155.00	$40,119.75	2026-05-27
36003722903	OTHER	Revsclr Opnperc Tib Prnl Artry W-athrctmy Intl Bi	81	57	$89,155.00	$89,155.00	$613.18	$89,155.00	$40,119.75	2026-05-27
36003723003	OTHER	Revsclr Opnperc Tib Prnl Artry W-stent Intl Bil	81	57	$89,155.00	$89,155.00	$594.56	$89,155.00	$40,119.75	2026-05-27
36003723103	OTHER	Rvsclr Opnperc Tib Prnl Artry W-stntarthrctmy Bi	81	57	$89,155.00	$89,155.00	$646.31	$89,155.00	$40,119.75	2026-05-27
361-4	OTHER	Skin Graft For Skin And Subcutaneous Tissue Diagnoses	16	16	—	—	$30,205.78	$57,311.55	$45,849.24	2026-05-27
401-4	OTHER	Adrenal Procedures	14	14	—	—	$45,294.89	$63,412.85	$52,542.07	2026-05-27
403-4	OTHER	Procedures For Obesity	16	16	—	—	$27,063.85	$51,027.70	$40,822.16	2026-05-27
405	OTHER	Pancreas, Liver And Shunt Procedures With Mcc	62	51	—	—	$19,803.00	$157,405.59	$51,831.92	2026-05-27
405-4	OTHER	Other Procedures For Endocrine, Nutritional And Metabolic Disorders	16	16	—	—	$27,261.98	$51,423.96	$41,139.17	2026-05-27
440-1	OTHER	Kidney Transplant	16	16	—	—	$29,805.80	$56,511.60	$45,209.28	2026-05-27
440-2	OTHER	Kidney Transplant	16	16	—	—	$32,477.99	$61,855.99	$49,484.79	2026-05-27
440-3	OTHER	Kidney Transplant	14	14	—	—	$51,187.99	$71,663.19	$59,378.07	2026-05-27
440-4	OTHER	Kidney Transplant	14	14	—	—	$76,896.47	$107,655.06	$89,199.90	2026-05-27
441-4	OTHER	Major Bladder Procedures	16	16	—	—	$31,968.19	$60,836.38	$48,669.11	2026-05-27
44700278005	OTHER	IM Stryker Surpass Evolve Fd	76	53	$90,218.00	$90,218.00	$950.00	$90,218.00	$51,780.62	2026-05-27
44700278006	OTHER	IM Stryker Surpass Evolve Fdc	76	53	$77,175.00	$77,175.00	$950.00	$77,175.00	$44,294.59	2026-05-27
44700278007	OTHER	IM Stryker Surpass Evolve Fdcd	76	53	$77,175.00	$77,175.00	$950.00	$77,175.00	$44,294.59	2026-05-27
44700278008	OTHER	IM Stryker Surpass Evolve Fds-short 12-30mm	76	53	$90,218.00	$90,218.00	$950.00	$90,218.00	$51,780.62	2026-05-27
44700278009	OTHER	IM Stryker Surpass Evolve Fds-long 40mm	76	53	$98,117.00	$98,117.00	$950.00	$98,117.00	$56,314.25	2026-05-27
44700278010	OTHER	IM Stryker Surpass Streamline M00-short 15-30mm	76	53	$90,218.00	$90,218.00	$950.00	$90,218.00	$51,780.62	2026-05-27
44700278011	OTHER	IM Stryker Surpass Streamline M00-long 40-50mm	76	53	$98,117.00	$98,117.00	$950.00	$98,117.00	$56,314.25	2026-05-27
45006121000	OTHER	Pierce Skull Implant Device	105	74	$52,500.00	$52,500.00	$336.41	$200,025.00	$52,500.00	2026-05-27
453	OTHER	Combined Anterior And Posterior Spinal Fusion With Mcc	61	50	—	—	$66,998.49	$273,655.62	$83,748.11	2026-05-27
454	OTHER	Combined Anterior And Posterior Spinal Fusion With Cc	62	51	—	—	$46,328.31	$228,039.10	$57,910.39	2026-05-27
455	OTHER	Combined Anterior And Posterior Spinal Fusion Without Cc/mcc	61	50	—	—	$34,952.97	$146,158.35	$43,691.21	2026-05-27
456	OTHER	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	61	50	—	—	$63,549.82	$325,502.69	$79,437.27	2026-05-27
457	OTHER	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	62	51	—	—	$45,174.74	$235,902.53	$56,468.43	2026-05-27
459	OTHER	Spinal Fusion Except Cervical With Mcc	61	50	—	—	$50,213.72	$176,973.88	$62,767.15	2026-05-27
461	OTHER	Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc	61	50	—	—	$53,598.18	$373,981.41	$66,997.73	2026-05-27
463	OTHER	Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …	61	50	—	—	$43,189.86	$143,066.43	$53,987.33	2026-05-27
466	OTHER	Revision Of Hip Or Knee Replacement With Mcc	61	50	—	—	$39,469.38	$130,742.30	$49,336.72	2026-05-27
471	OTHER	Cervical Spinal Fusion With Mcc	63	52	—	—	$3,400.00	$389,336.94	$69,770.50	2026-05-27
474	OTHER	Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc	61	50	—	—	$32,598.39	$107,982.18	$40,747.99	2026-05-27
480-1	OTHER	Major Male Pelvic Procedures	16	16	—	—	$27,102.83	$51,105.65	$51,105.65	2026-05-27
480-2	OTHER	Major Male Pelvic Procedures	16	16	—	—	$28,133.19	$53,166.39	$53,166.39	2026-05-27
48003322901	OTHER	Remvrplc Perm Pcmkrpls Gnrtr W-mltpl Lead Sys	53	38	$68,925.00	$68,925.00	$950.00	$68,925.00	$44,801.25	2026-05-27
48003323001	OTHER	Insrtn Implntbl Defibpls Gnrtr W-exstng Dual Lds	53	38	$85,340.00	$85,340.00	$950.00	$85,340.00	$55,471.00	2026-05-27
48003323101	OTHER	Insrtn Imp Defib Pls Gnrtr W-existng Mltpl Leads	53	38	$121,563.00	$121,563.00	$950.00	$121,563.00	$79,015.95	2026-05-27
48003324001	OTHER	Insrt Imp Defib Pls Gnrtr W-exstng Sngl Lead	53	38	$85,340.00	$85,340.00	$950.00	$85,340.00	$55,471.00	2026-05-27
48003324901	OTHER	Insrtn Rplcmnt Perm Defib Sngle Or Dual	53	38	$121,563.00	$121,563.00	$950.00	$121,563.00	$79,015.95	2026-05-27
48003326201	OTHER	Rmvl Implntbl Difib Pls Gnrtr Sngl Lead Sys	53	38	$85,340.00	$85,340.00	$950.00	$85,340.00	$55,471.00	2026-05-27
48003326301	OTHER	Rmvl Implntbl Difib Pls Gnrtr Dual Lead Sys	53	38	$85,340.00	$85,340.00	$950.00	$85,340.00	$55,471.00	2026-05-27
48003326401	OTHER	Rmvl Implntbl Difib Pls Gnrtr Mltpl Lead Sys	53	38	$121,563.00	$121,563.00	$950.00	$121,563.00	$79,015.95	2026-05-27
48003327001	OTHER	Insrtn Perm Impl Defib Sys W-elctrd	53	38	$121,563.00	$121,563.00	$950.00	$121,563.00	$79,015.95	2026-05-27
483-4	OTHER	Penis, Testes And Scrotal Procedures	14	14	—	—	$47,990.73	$67,187.02	$55,669.25	2026-05-27
510-1	OTHER	Pelvic Evisceration, Radical Hysterectomy And Other Radical Gynecological Proced…	14	14	—	—	$64,646.12	$64,646.12	$64,646.12	2026-05-27
510-2	OTHER	Pelvic Evisceration, Radical Hysterectomy And Other Radical Gynecological Proced…	16	16	—	—	$23,367.12	$43,634.24	$43,634.24	2026-05-27
510-3	OTHER	Pelvic Evisceration, Radical Hysterectomy And Other Radical Gynecological Proced…	16	16	—	—	$22,031.19	$40,962.37	$40,962.37	2026-05-27
510-4	OTHER	Pelvic Evisceration, Radical Hysterectomy And Other Radical Gynecological Proced…	14	14	—	—	$137,644.70	$137,644.70	$137,644.70	2026-05-27
511-4	OTHER	Uterine And Adnexa Procedures For Ovarian And Adnexal Malignancy	16	16	—	—	$28,385.48	$53,670.96	$42,936.77	2026-05-27
512-4	OTHER	Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy	16	16	—	—	$28,254.13	$53,408.26	$42,726.61	2026-05-27
570	OTHER	Skin Debridement With Mcc	61	50	—	—	$57,898.50	$561,768.89	$111,568.10	2026-05-27
573	OTHER	Skin Graft For Skin Ulcer Or Cellulitis With Mcc	61	50	—	—	$49,604.55	$164,315.08	$62,005.69	2026-05-27
576	OTHER	Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc	61	50	—	—	$10,820.87	$123,154.78	$46,473.50	2026-05-27
583-1	OTHER	Neonate With Ecmo	14	14	—	—	$174,416.71	$244,183.39	$202,323.39	2026-05-27
583-2	OTHER	Neonate With Ecmo	14	14	—	—	$190,864.34	$267,210.08	$221,402.64	2026-05-27
583-3	OTHER	Neonate With Ecmo	14	14	—	—	$221,000.00	$309,400.00	$256,360.00	2026-05-27
583-4	OTHER	Neonate With Ecmo	14	14	—	—	$221,000.00	$309,400.00	$256,360.00	2026-05-27
588-1	OTHER	Female Reproductive System Reconstructive Procedures	14	14	—	—	$50,000.00	$70,000.00	$58,000.00	2026-05-27
588-2	OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	14	14	—	—	$130,000.00	$182,000.00	$150,800.00	2026-05-27
588-3	OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	14	14	—	—	$132,000.00	$184,800.00	$153,120.00	2026-05-27
588-4	OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	14	14	—	—	$221,000.00	$309,400.00	$256,360.00	2026-05-27
589-1	OTHER	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …	14	14	—	—	$177,128.63	$247,980.08	$205,469.21	2026-05-27
589-3	OTHER	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …	14	14	—	—	$87,000.00	$121,800.00	$100,920.00	2026-05-27
591-2	OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure	14	14	—	—	$80,000.00	$112,000.00	$92,800.00	2026-05-27
591-3	OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure	14	14	—	—	$91,000.00	$127,400.00	$105,560.00	2026-05-27
591-4	OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure	14	14	—	—	$120,000.00	$168,000.00	$139,200.00	2026-05-27
593-2	OTHER	Neonate Birth Weight 750-999 Grams Without Major Procedure	14	14	—	—	$79,000.00	$110,600.00	$91,640.00	2026-05-27
593-3	OTHER	Neonate Birth Weight 750-999 Grams Without Major Procedure	14	14	—	—	$99,000.00	$138,600.00	$114,840.00	2026-05-27
593-4	OTHER	Neonate Birth Weight 750-999 Grams Without Major Procedure	14	14	—	—	$121,000.00	$169,400.00	$140,360.00	2026-05-27
602-1	OTHER	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	14	14	—	—	$49,524.69	$69,334.57	$57,448.64	2026-05-27
602-2	OTHER	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	14	14	—	—	$80,000.00	$112,000.00	$92,800.00	2026-05-27
602-3	OTHER	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	14	14	—	—	$92,000.00	$128,800.00	$106,720.00	2026-05-27
602-4	OTHER	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	14	14	—	—	$100,000.00	$140,000.00	$116,000.00	2026-05-27
603-2	OTHER	Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition	16	16	—	—	$31,096.26	$59,092.52	$47,274.01	2026-05-27
603-3	OTHER	Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition	14	14	—	—	$49,059.31	$68,683.03	$56,908.80	2026-05-27
603-4	OTHER	Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition	14	14	—	—	$80,000.00	$112,000.00	$92,800.00	2026-05-27
607-1	OTHER	Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…	16	16	—	—	$27,370.33	$51,640.65	$41,312.52	2026-05-27
607-2	OTHER	Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…	14	14	—	—	$59,012.59	$82,617.63	$68,454.61	2026-05-27
607-3	OTHER	Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…	14	14	—	—	$86,000.00	$120,400.00	$99,760.00	2026-05-27
607-4	OTHER	Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…	14	14	—	—	$100,000.00	$140,000.00	$116,000.00	2026-05-27
608-2	OTHER	Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition	16	16	—	—	$27,059.40	$51,018.80	$40,815.04	2026-05-27
608-3	OTHER	Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition	14	14	—	—	$60,412.98	$84,578.17	$70,079.06	2026-05-27
608-4	OTHER	Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition	14	14	—	—	$70,000.00	$98,000.00	$81,200.00	2026-05-27
609-1	OTHER	Neonate Birth Weight 1500-2499 Grams With Major Procedure	16	16	—	—	$30,659.18	$58,218.36	$46,574.68	2026-05-27
609-2	OTHER	Neonate Birth Weight 1500-2499 Grams With Major Procedure	14	14	—	—	$51,663.97	$72,329.56	$59,930.21	2026-05-27
609-3	OTHER	Neonate Birth Weight 1500-2499 Grams With Major Procedure	14	14	—	—	$80,681.03	$112,953.44	$93,589.99	2026-05-27
609-4	OTHER	Neonate Birth Weight 1500-2499 Grams With Major Procedure	14	14	—	—	$165,000.00	$231,000.00	$191,400.00	2026-05-27
611-4	OTHER	Neonate Birth Weight 1500-1999 Grams With Major Anomaly	14	14	—	—	$93,000.00	$130,200.00	$107,880.00	2026-05-27
612-3	OTHER	Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other…	14	14	—	—	$52,715.59	$73,801.83	$61,150.08	2026-05-27
612-4	OTHER	Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other…	14	14	—	—	$89,000.00	$124,600.00	$103,240.00	2026-05-27
613-3	OTHER	Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection	14	14	—	—	$48,931.04	$68,503.46	$56,760.01	2026-05-27
613-4	OTHER	Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection	14	14	—	—	$62,000.00	$86,800.00	$71,920.00	2026-05-27
614-3	OTHER	Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition	16	16	—	—	$30,692.58	$58,285.15	$46,628.12	2026-05-27
621-4	OTHER	Neonate Birth Weight 2000-2499 Grams With Major Anomaly	14	14	—	—	$90,000.00	$126,000.00	$104,400.00	2026-05-27
622-4	OTHER	Neonate Birth Weight 2000-2499 Grams With Respiratory Distress Syndrome Or Other…	14	14	—	—	$56,954.93	$79,736.90	$66,067.72	2026-05-27
623-4	OTHER	Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection	14	14	—	—	$54,746.74	$76,645.44	$63,506.22	2026-05-27
625-4	OTHER	Neonate Birth Weight 2000-2499 Grams With Other Significant Condition	14	14	—	—	$52,004.27	$72,805.98	$60,324.95	2026-05-27
630-2	OTHER	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure	16	16	—	—	$30,083.33	$57,066.67	$45,653.34	2026-05-27
630-3	OTHER	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure	14	14	—	—	$95,000.00	$133,000.00	$110,200.00	2026-05-27
630-4	OTHER	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure	14	14	—	—	$221,021.61	$309,430.25	$256,385.07	2026-05-27
631-3	OTHER	Neonate Birth Weight > 2499 Grams With Other Major Procedure	14	14	—	—	$62,013.73	$86,819.22	$71,935.93	2026-05-27
631-4	OTHER	Neonate Birth Weight > 2499 Grams With Other Major Procedure	14	14	—	—	$248,574.92	$348,004.89	$288,346.91	2026-05-27
633-4	OTHER	Neonate Birth Weight > 2499 Grams With Major Anomaly	14	14	—	—	$95,464.13	$133,649.78	$110,738.40	2026-05-27
634-4	OTHER	Neonate Birth Weight > 2499 Grams With Respiratory Distress Syndrome Or Other Ma…	14	14	—	—	$54,074.64	$75,704.50	$62,726.58	2026-05-27
650	OTHER	Kidney Transplant With Hemodialysis With Mcc	64	51	—	—	$35,674.34	$236,647.50	$44,592.93	2026-05-27
651-4	OTHER	Other Procedures Of Blood And Blood-forming Organs	16	16	—	—	$28,516.82	$53,933.64	$43,146.91	2026-05-27
653	OTHER	Major Bladder Procedures With Mcc	61	50	—	—	$65,426.16	$432,627.77	$81,782.70	2026-05-27
680-4	OTHER	Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms	14	14	—	—	$52,992.28	$74,189.19	$61,471.04	2026-05-27
681-4	OTHER	Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms	16	16	—	—	$31,534.82	$59,969.64	$47,975.72	2026-05-27
690-4	OTHER	Acute Leukemia	14	14	—	—	$45,078.63	$63,110.08	$52,291.21	2026-05-27
695-4	OTHER	Chemotherapy For Acute Leukemia	16	16	—	—	$28,867.82	$54,635.64	$43,708.52	2026-05-27
710-4	OTHER	Infectious And Parasitic Diseases Including HIV With O.r. Procedure	16	16	—	—	$27,380.72	$51,661.43	$41,329.14	2026-05-27
740-4	OTHER	Mental Illness Diagnosis With O.r. Procedure	14	14	—	—	$45,534.48	$63,748.27	$52,820.00	2026-05-27
754-2	OTHER	Depression Except Major Depressive Disorder	16	16	—	—	$30,711.72	$58,323.45	$58,323.45	2026-05-27
754-3	OTHER	Depression Except Major Depressive Disorder	14	14	—	—	$118,394.95	$118,394.95	$118,394.95	2026-05-27
754-4	OTHER	Depression Except Major Depressive Disorder	16	16	—	—	$28,080.17	$53,060.35	$42,448.28	2026-05-27
790	OTHER	Extreme Immaturity Or Respiratory Distress Syndrome, Neonate	61	50	—	—	$4,356.29	$149,152.46	$56,283.95	2026-05-27
792-4	OTHER	Extensive O.r. Procedures For Other Complications Of Treatment	16	16	—	—	$28,673.40	$54,246.81	$43,397.45	2026-05-27
799	OTHER	Splenectomy With Mcc	61	50	—	—	$34,375.44	$113,868.64	$42,969.30	2026-05-27
820	OTHER	Lymphoma And Leukemia With Major O.r. Procedures With Mcc	61	50	—	—	$44,434.56	$159,643.33	$55,543.20	2026-05-27
823	OTHER	Lymphoma And Non-acute Leukemia With Other Procedures With Mcc	61	50	—	—	$34,796.35	$170,430.30	$43,495.44	2026-05-27
8240012	OTHER	Cardioverterdfib Other	77	54	$94,044.00	$94,044.00	$950.00	$94,044.00	$51,526.71	2026-05-27
8240013	OTHER	Cardio Verterdfib Sc	77	54	$79,457.00	$79,457.00	$950.00	$79,457.00	$43,534.49	2026-05-27
826	OTHER	Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. …	61	50	—	—	$35,496.62	$149,954.58	$44,370.78	2026-05-27
8285410	OTHER	Imp Maci Wprotective Spacer 10mm X 10mm	66	44	$157,026.00	$157,026.00	$950.00	$157,026.00	$95,456.11	2026-05-27
8286756	OTHER	Imp Nail Precice Femur Str 10.7mmx275	76	53	$91,833.00	$91,833.00	$950.00	$91,833.00	$52,707.55	2026-05-27
834	OTHER	Acute Leukemia Without Major O.r. Procedures With Mcc	61	50	—	—	$33,843.26	$137,838.48	$52,014.52	2026-05-27
837	OTHER	Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot…	61	50	—	—	$72,344.04	$468,312.38	$90,430.05	2026-05-27
841-3	OTHER	Extensive Third Degree Burns With Skin Graft	14	14	—	—	$59,117.17	$82,764.04	$68,575.92	2026-05-27
841-4	OTHER	Extensive Third Degree Burns With Skin Graft	14	14	—	—	$162,530.19	$227,542.27	$188,535.02	2026-05-27
842-4	OTHER	Burns With Skin Graft Except Extensive Third Degree Burns	14	14	—	—	$92,524.47	$129,534.26	$107,328.39	2026-05-27
850-4	OTHER	Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal…	14	14	—	—	$47,159.61	$66,023.45	$54,705.15	2026-05-27
853	OTHER	Infectious And Parasitic Diseases With O.r. Procedures With Mcc	62	51	—	—	$37,460.42	$292,282.75	$46,825.52	2026-05-27
856	OTHER	Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc	61	50	—	—	$34,524.52	$114,362.48	$43,155.65	2026-05-27
860-1	OTHER	Rehabilitation	14	14	—	—	$74,940.00	$74,940.00	$74,940.00	2026-05-27
860-2	OTHER	Rehabilitation	14	14	—	—	$103,566.20	$103,566.20	$103,566.20	2026-05-27
860-4	OTHER	Rehabilitation	14	14	—	—	$96,303.14	$96,303.14	$96,303.14	2026-05-27
863-4	OTHER	Neonatal Aftercare	14	14	—	—	$126,963.94	$177,749.52	$147,278.17	2026-05-27
870	OTHER	Septicemia Or Severe Sepsis With Mv >96 Hours	61	50	—	—	$52,318.32	$205,349.01	$65,397.90	2026-05-27
910-4	OTHER	Craniotomy For Multiple Significant Trauma	14	14	—	—	$56,988.86	$79,784.40	$66,107.07	2026-05-27
911-4	OTHER	Extensive Abdominal Or Thoracic Procedures For Multiple Significant Trauma	14	14	—	—	$54,718.12	$76,605.37	$63,473.01	2026-05-27
912-4	OTHER	Musculoskeletal And Other Procedures For Multiple Significant Trauma	14	14	—	—	$52,238.55	$73,133.97	$60,596.72	2026-05-27
927	OTHER	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	61	50	—	—	$161,039.48	$533,443.28	$201,299.35	2026-05-27
928	OTHER	Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc	61	50	—	—	$49,560.14	$179,811.88	$67,853.54	2026-05-27
950-4	OTHER	Extensive O.r. Procedure Unrelated To Principal Diagnosis	14	14	—	—	$44,744.70	$62,642.58	$51,903.85	2026-05-27
955	OTHER	Craniotomy For Multiple Significant Trauma	61	50	—	—	$50,957.66	$203,377.17	$63,697.08	2026-05-27
957	OTHER	Other O.r. Procedures For Multiple Significant Trauma With Mcc	61	50	—	—	$57,650.19	$190,966.27	$72,062.74	2026-05-27
969	OTHER	HIV With Extensive O.r. Procedures With Mcc	61	50	—	—	$119,740.09	$740,885.64	$164,261.91	2026-05-27
981	OTHER	Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc	61	50	—	—	$35,602.06	$117,931.84	$44,502.58	2026-05-27

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