|
8285410
|
OTHER
|
Imp Maci Wprotective Spacer 10mm X 10mm
|
72
|
47
|
$157,026.00
|
$157,026.00
|
$950.00
|
$157,026.00
|
$94,215.60
|
2026-05-27
|
|
48003323101
|
OTHER
|
Insrtn Imp Defib Pls Gnrtr W-existng Mltpl Leads
|
57
|
39
|
$121,563.00
|
$121,563.00
|
$950.00
|
$121,563.00
|
$91,172.25
|
2026-05-27
|
|
48003324901
|
OTHER
|
Insrtn Rplcmnt Perm Defib Sngle Or Dual
|
57
|
39
|
$121,563.00
|
$121,563.00
|
$950.00
|
$121,563.00
|
$91,172.25
|
2026-05-27
|
|
48003326401
|
OTHER
|
Rmvl Implntbl Difib Pls Gnrtr Mltpl Lead Sys
|
57
|
39
|
$121,563.00
|
$121,563.00
|
$950.00
|
$121,563.00
|
$91,172.25
|
2026-05-27
|
|
48003327001
|
OTHER
|
Insrtn Perm Impl Defib Sys W-elctrd
|
57
|
39
|
$121,563.00
|
$121,563.00
|
$950.00
|
$121,563.00
|
$91,172.25
|
2026-05-27
|
|
44700278009
|
OTHER
|
IM Stryker Surpass Evolve Fds-long 40mm
|
79
|
55
|
$98,117.00
|
$98,117.00
|
$950.00
|
$98,117.00
|
$53,768.12
|
2026-05-27
|
|
44700278011
|
OTHER
|
IM Stryker Surpass Streamline M00-long 40-50mm
|
79
|
55
|
$98,117.00
|
$98,117.00
|
$950.00
|
$98,117.00
|
$53,768.12
|
2026-05-27
|
|
8281511
|
OTHER
|
Imp Icd System Dx Df4 ProMRI
|
80
|
55
|
$94,045.00
|
$94,045.00
|
$950.00
|
$94,045.00
|
$49,279.58
|
2026-05-27
|
|
8240012
|
OTHER
|
Cardioverterdfib Other
|
80
|
55
|
$94,044.00
|
$94,044.00
|
$950.00
|
$94,044.00
|
$49,279.06
|
2026-05-27
|
|
8286756
|
OTHER
|
Imp Nail Precice Femur Str 10.7mmx275
|
79
|
55
|
$91,833.00
|
$91,833.00
|
$950.00
|
$91,833.00
|
$50,324.48
|
2026-05-27
|
|
8254090
|
OTHER
|
Imp Sub Q Aicd System
|
80
|
55
|
$90,295.00
|
$90,295.00
|
$950.00
|
$90,295.00
|
$47,314.58
|
2026-05-27
|
|
44700278005
|
OTHER
|
IM Stryker Surpass Evolve Fd
|
79
|
55
|
$90,218.00
|
$90,218.00
|
$950.00
|
$90,218.00
|
$49,439.46
|
2026-05-27
|
|
44700278010
|
OTHER
|
IM Stryker Surpass Streamline M00-short 15-30mm
|
79
|
55
|
$90,218.00
|
$90,218.00
|
$950.00
|
$90,218.00
|
$49,439.46
|
2026-05-27
|
|
44700278008
|
OTHER
|
IM Stryker Surpass Evolve Fds-short 12-30mm
|
79
|
55
|
$90,218.00
|
$90,218.00
|
$950.00
|
$90,218.00
|
$49,439.46
|
2026-05-27
|
|
8133748
|
OTHER
|
Implant Ipg Kit
|
81
|
56
|
$90,121.00
|
$90,121.00
|
$950.00
|
$90,121.00
|
$45,060.50
|
2026-05-27
|
|
8280252
|
OTHER
|
Impella Blood Pump 2.5
|
79
|
55
|
$86,822.00
|
$86,822.00
|
$950.00
|
$86,822.00
|
$47,578.46
|
2026-05-27
|
|
8280254
|
OTHER
|
Impella Blood Pump Cp
|
79
|
55
|
$86,822.00
|
$86,822.00
|
$950.00
|
$86,822.00
|
$47,578.46
|
2026-05-27
|
|
48003323001
|
OTHER
|
Insrtn Implntbl Defibpls Gnrtr W-exstng Dual Lds
|
57
|
39
|
$85,340.00
|
$85,340.00
|
$950.00
|
$85,340.00
|
$64,005.00
|
2026-05-27
|
|
48003326301
|
OTHER
|
Rmvl Implntbl Difib Pls Gnrtr Dual Lead Sys
|
57
|
39
|
$85,340.00
|
$85,340.00
|
$950.00
|
$85,340.00
|
$64,005.00
|
2026-05-27
|
|
48003326201
|
OTHER
|
Rmvl Implntbl Difib Pls Gnrtr Sngl Lead Sys
|
57
|
39
|
$85,340.00
|
$85,340.00
|
$950.00
|
$85,340.00
|
$64,005.00
|
2026-05-27
|
|
48003324001
|
OTHER
|
Insrt Imp Defib Pls Gnrtr W-exstng Sngl Lead
|
57
|
39
|
$85,340.00
|
$85,340.00
|
$950.00
|
$85,340.00
|
$64,005.00
|
2026-05-27
|
|
36000408T01
|
OTHER
|
Insertionreplacement Ccm System
|
61
|
40
|
$85,340.00
|
$85,340.00
|
$950.00
|
$85,340.00
|
$64,005.00
|
2026-05-27
|
|
44700278007
|
OTHER
|
IM Stryker Surpass Evolve Fdcd
|
79
|
55
|
$77,175.00
|
$77,175.00
|
$950.00
|
$77,175.00
|
$42,291.90
|
2026-05-27
|
|
44700278006
|
OTHER
|
IM Stryker Surpass Evolve Fdc
|
79
|
55
|
$77,175.00
|
$77,175.00
|
$950.00
|
$77,175.00
|
$42,291.90
|
2026-05-27
|
|
48003322901
|
OTHER
|
Remvrplc Perm Pcmkrpls Gnrtr W-mltpl Lead Sys
|
57
|
39
|
$68,925.00
|
$68,925.00
|
$950.00
|
$68,925.00
|
$51,693.75
|
2026-05-27
|
|
36000238T01
|
OTHER
|
Transluminal Peripheral Atherectomy Iliac Ea Vessl
|
61
|
40
|
$59,436.00
|
$59,436.00
|
$950.00
|
$59,436.00
|
$44,577.00
|
2026-05-27
|
|
48003327401
|
OTHER
|
Trnscth Insrtn Rplcmnt Perm Ldls Pcmkr
|
57
|
39
|
$59,436.00
|
$59,436.00
|
$950.00
|
$59,436.00
|
$44,577.00
|
2026-05-27
|
|
48103327401
|
OTHER
|
Trnscth Insrtn Rplcmnt Perm Ldls Pcmkr
|
59
|
40
|
$59,436.00
|
$59,436.00
|
$950.00
|
$59,436.00
|
$44,577.00
|
2026-05-27
|
|
45006121000
|
OTHER
|
Pierce Skull Implant Device
|
112
|
79
|
$52,500.00
|
$52,500.00
|
$336.41
|
$200,025.00
|
$52,500.00
|
2026-05-27
|
|
018
|
OTHER
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
67
|
59
|
—
|
—
|
$423,643.69
|
$2,860,061.00
|
$529,554.61
|
2026-05-27
|
|
007
|
OTHER
|
Lung Transplant
|
65
|
57
|
—
|
—
|
$157,292.59
|
$2,162,847.20
|
$352,432.11
|
2026-05-27
|
|
631-4
|
OTHER
|
Neonate Birth Weight > 2499 Grams With Other Major Procedure
|
14
|
14
|
—
|
—
|
$246,029.61
|
$344,441.45
|
$285,394.34
|
2026-05-27
|
|
001
|
OTHER
|
Heart Transplant Or Implant Of Heart Assist System With Mcc
|
68
|
59
|
—
|
—
|
$3,600.00
|
$846,592.03
|
$284,703.58
|
2026-05-27
|
|
583-3
|
OTHER
|
Neonate With Ecmo
|
14
|
14
|
—
|
—
|
$221,000.00
|
$309,400.00
|
$256,360.00
|
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
|
|
583-4
|
OTHER
|
Neonate With Ecmo
|
14
|
14
|
—
|
—
|
$221,000.00
|
$309,400.00
|
$256,360.00
|
2026-05-27
|
|
630-4
|
OTHER
|
Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure
|
14
|
14
|
—
|
—
|
$218,779.15
|
$306,290.81
|
$253,783.82
|
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
|
|
161-4
|
OTHER
|
Implantable Heart Assist Systems
|
14
|
14
|
—
|
—
|
$202,241.64
|
$283,138.30
|
$234,600.30
|
2026-05-27
|
|
002-4
|
OTHER
|
Heart And/or Lung Transplant
|
14
|
14
|
—
|
—
|
$198,684.72
|
$278,158.61
|
$230,474.28
|
2026-05-27
|
|
583-2
|
OTHER
|
Neonate With Ecmo
|
14
|
14
|
—
|
—
|
$189,486.59
|
$265,281.23
|
$219,804.45
|
2026-05-27
|
|
927
|
OTHER
|
Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft
|
69
|
59
|
—
|
—
|
$173,730.49
|
$494,046.08
|
$217,163.11
|
2026-05-27
|
|
003
|
OTHER
|
Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…
|
71
|
60
|
—
|
—
|
$172,715.97
|
$2,117,774.85
|
$215,894.96
|
2026-05-27
|
|
589-1
|
OTHER
|
Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …
|
14
|
14
|
—
|
—
|
$175,822.97
|
$246,152.16
|
$203,954.65
|
2026-05-27
|
|
583-1
|
OTHER
|
Neonate With Ecmo
|
14
|
14
|
—
|
—
|
$173,038.96
|
$242,254.54
|
$200,725.20
|
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
|
|
841-4
|
OTHER
|
Extensive Third Degree Burns With Skin Graft
|
14
|
14
|
—
|
—
|
$161,334.88
|
$225,868.83
|
$187,148.46
|
2026-05-27
|
|
161-3
|
OTHER
|
Implantable Heart Assist Systems
|
14
|
14
|
—
|
—
|
$157,953.69
|
$221,135.17
|
$183,226.28
|
2026-05-27
|
|
007-4
|
OTHER
|
Allogeneic Bone Marrow Transplant
|
14
|
14
|
—
|
—
|
$149,835.59
|
$209,769.83
|
$173,809.28
|
2026-05-27
|
|
009-4
|
OTHER
|
Extracorporeal Membrane Oxygenation (ecmo)
|
14
|
14
|
—
|
—
|
$139,000.00
|
$194,600.00
|
$161,240.00
|
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
|
|
002-3
|
OTHER
|
Heart And/or Lung Transplant
|
14
|
14
|
—
|
—
|
$131,530.85
|
$184,143.19
|
$152,575.78
|
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
|
|
004
|
OTHER
|
Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…
|
69
|
59
|
—
|
—
|
$118,012.05
|
$1,033,168.20
|
$147,515.06
|
2026-05-27
|
|
863-4
|
OTHER
|
Neonatal Aftercare
|
14
|
14
|
—
|
—
|
$126,963.94
|
$177,749.52
|
$147,278.17
|
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
|
|
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
|
|
001-4
|
OTHER
|
Liver Transplant And/or Intestinal Transplant
|
14
|
14
|
—
|
—
|
$120,000.00
|
$168,000.00
|
$139,200.00
|
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
|
|
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
|
|
009-3
|
OTHER
|
Extracorporeal Membrane Oxygenation (ecmo)
|
14
|
14
|
—
|
—
|
$110,110.47
|
$154,154.66
|
$127,728.14
|
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
|
|
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
|
|
160-4
|
OTHER
|
Major Cardiothoracic Repair Of Heart Anomaly
|
14
|
14
|
—
|
—
|
$106,925.93
|
$149,696.30
|
$124,034.08
|
2026-05-27
|
|
014
|
OTHER
|
Allogeneic Bone Marrow Transplant
|
67
|
59
|
—
|
—
|
$33,049.73
|
$325,179.62
|
$122,709.29
|
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
|
|
002-2
|
OTHER
|
Heart And/or Lung Transplant
|
14
|
14
|
—
|
—
|
$101,523.66
|
$142,133.12
|
$117,767.45
|
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
|
|
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
|
|
002
|
OTHER
|
Heart Transplant Or Implant Of Heart Assist System Without Mcc
|
68
|
59
|
—
|
—
|
$3,600.00
|
$752,886.92
|
$115,765.37
|
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
|
|
212
|
OTHER
|
Hip & Femur Procedures Except Major Joint Age 0-17
|
67
|
59
|
—
|
—
|
$88,906.45
|
$294,502.61
|
$111,133.06
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
005
|
OTHER
|
Liver Transplant With Mcc Or Intestinal Transplant
|
65
|
57
|
—
|
—
|
$84,343.17
|
$473,562.45
|
$105,428.96
|
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
|
|
860-2
|
OTHER
|
Rehabilitation
|
14
|
14
|
—
|
—
|
$103,566.20
|
$103,566.20
|
$103,566.20
|
2026-05-27
|
|
007-3
|
OTHER
|
Allogeneic Bone Marrow Transplant
|
14
|
14
|
—
|
—
|
$89,273.14
|
$124,982.40
|
$103,556.85
|
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
|
|
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
|
|
215
|
OTHER
|
Other Heart Assist System Implant
|
74
|
62
|
—
|
—
|
$9,838.00
|
$335,128.60
|
$101,851.23
|
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
|
|
216
|
OTHER
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
74
|
62
|
—
|
—
|
$6,253.00
|
$303,808.65
|
$100,088.20
|
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
|
|
006-4
|
OTHER
|
Pancreas Transplant
|
14
|
14
|
—
|
—
|
$85,000.00
|
$119,000.00
|
$98,600.00
|
2026-05-27
|
|
969
|
OTHER
|
HIV With Extensive O.r. Procedures With Mcc
|
67
|
59
|
—
|
—
|
$74,349.06
|
$740,885.64
|
$97,108.97
|
2026-05-27
|
|
860-4
|
OTHER
|
Rehabilitation
|
14
|
14
|
—
|
—
|
$96,303.14
|
$96,303.14
|
$96,303.14
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
006-3
|
OTHER
|
Pancreas Transplant
|
14
|
14
|
—
|
—
|
$79,144.95
|
$110,802.93
|
$91,808.14
|
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
|
|
453
|
OTHER
|
Combined Anterior And Posterior Spinal Fusion With Mcc
|
67
|
59
|
—
|
—
|
$72,610.26
|
$273,655.62
|
$90,762.83
|
2026-05-27
|
|
440-4
|
OTHER
|
Kidney Transplant
|
14
|
14
|
—
|
—
|
$76,896.47
|
$107,655.06
|
$89,199.90
|
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
|
|
007-1
|
OTHER
|
Allogeneic Bone Marrow Transplant
|
14
|
14
|
—
|
—
|
$74,667.08
|
$104,533.91
|
$86,613.82
|
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
|
|
231
|
OTHER
|
Coronary Bypass With Ptca With Mcc
|
76
|
63
|
—
|
—
|
$6,211.00
|
$312,560.30
|
$86,395.70
|
2026-05-27
|
|
456
|
OTHER
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
67
|
59
|
—
|
—
|
$68,901.99
|
$325,502.69
|
$86,127.49
|
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
|
|
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
|
|
020
|
OTHER
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc
|
68
|
60
|
—
|
—
|
$64,573.53
|
$387,183.73
|
$80,716.91
|
2026-05-27
|
|
219
|
OTHER
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
77
|
64
|
—
|
—
|
$9,500.00
|
$302,432.06
|
$78,788.87
|
2026-05-27
|
|
233
|
OTHER
|
Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc
|
77
|
64
|
—
|
—
|
$6,253.00
|
$296,128.08
|
$78,453.88
|
2026-05-27
|
|
957
|
OTHER
|
Other O.r. Procedures For Multiple Significant Trauma With Mcc
|
72
|
61
|
—
|
—
|
$62,558.24
|
$318,429.23
|
$78,197.80
|
2026-05-27
|
|
006-2
|
OTHER
|
Pancreas Transplant
|
14
|
14
|
—
|
—
|
$66,925.17
|
$93,695.24
|
$77,633.20
|
2026-05-27
|
|
007-2
|
OTHER
|
Allogeneic Bone Marrow Transplant
|
14
|
14
|
—
|
—
|
$66,446.01
|
$93,024.41
|
$77,077.37
|
2026-05-27
|
|
178-4
|
OTHER
|
External Heart Assist Systems
|
14
|
14
|
—
|
—
|
$66,228.69
|
$92,720.17
|
$76,825.28
|
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
|
|
860-1
|
OTHER
|
Rehabilitation
|
14
|
14
|
—
|
—
|
$74,940.00
|
$74,940.00
|
$74,940.00
|
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
|
|
010
|
OTHER
|
Pancreas Transplant
|
65
|
57
|
—
|
—
|
$58,961.70
|
$363,908.35
|
$73,702.12
|
2026-05-27
|
|
928
|
OTHER
|
Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc
|
69
|
60
|
—
|
—
|
$48,627.25
|
$238,146.91
|
$73,671.76
|
2026-05-27
|
|
019
|
OTHER
|
Simultaneous Pancreas And Kidney Transplant With Hemodialysis
|
67
|
59
|
—
|
—
|
$13,913.56
|
$194,208.34
|
$73,286.17
|
2026-05-27
|
|
275
|
OTHER
|
Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc
|
73
|
63
|
—
|
—
|
$6,800.00
|
$194,095.69
|
$73,243.66
|
2026-05-27
|
|
006
|
OTHER
|
Liver Transplant Without Mcc
|
65
|
57
|
—
|
—
|
$56,320.81
|
$613,006.45
|
$72,466.45
|
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
|
|
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
|
|
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
|
|
001-2
|
OTHER
|
Liver Transplant And/or Intestinal Transplant
|
14
|
14
|
—
|
—
|
$61,446.58
|
$86,025.21
|
$71,278.04
|
2026-05-27
|
|
870
|
OTHER
|
Septicemia Or Severe Sepsis With Mv >96 Hours
|
70
|
59
|
—
|
—
|
$27,420.00
|
$205,349.01
|
$71,031.24
|
2026-05-27
|
|
008
|
OTHER
|
Simultaneous Pancreas And Kidney Transplant
|
65
|
57
|
—
|
—
|
$56,598.76
|
$591,940.40
|
$70,748.45
|
2026-05-27
|
|
268
|
OTHER
|
Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc
|
70
|
59
|
—
|
—
|
$33,247.00
|
$540,754.16
|
$70,688.14
|
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
|
|
955
|
OTHER
|
Craniotomy For Multiple Significant Trauma
|
68
|
59
|
—
|
—
|
$55,361.93
|
$346,221.85
|
$69,202.41
|
2026-05-27
|
|
009-2
|
OTHER
|
Extracorporeal Membrane Oxygenation (ecmo)
|
14
|
14
|
—
|
—
|
$59,643.74
|
$83,501.24
|
$69,186.74
|
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
|
|
459
|
OTHER
|
Spinal Fusion Except Cervical With Mcc
|
67
|
59
|
—
|
—
|
$54,561.97
|
$191,307.89
|
$68,202.46
|
2026-05-27
|
|
183-4
|
OTHER
|
Percutaneous Structural Cardiac Procedures
|
14
|
14
|
—
|
—
|
$58,768.76
|
$82,276.26
|
$68,171.76
|
2026-05-27
|
|
217
|
OTHER
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
74
|
62
|
—
|
—
|
$9,500.00
|
$179,207.76
|
$67,625.57
|
2026-05-27
|
|
218
|
OTHER
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
76
|
63
|
—
|
—
|
$9,500.00
|
$179,207.76
|
$67,625.57
|
2026-05-27
|
|
573
|
OTHER
|
Skin Graft For Skin Ulcer Or Cellulitis With Mcc
|
67
|
59
|
—
|
—
|
$50,719.95
|
$178,566.75
|
$67,383.68
|
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
|
|
207
|
OTHER
|
Respiratory System Diagnosis With Ventilator Support >96 Hours
|
69
|
59
|
—
|
—
|
$53,479.08
|
$557,980.25
|
$66,848.85
|
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
|
|
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
|
|
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
|
|
841-3
|
OTHER
|
Extensive Third Degree Burns With Skin Graft
|
14
|
14
|
—
|
—
|
$55,499.16
|
$77,698.82
|
$64,379.03
|
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
|
|
179-4
|
OTHER
|
Defibrillator Implants
|
14
|
14
|
—
|
—
|
$54,992.69
|
$76,989.77
|
$63,791.52
|
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
|
|
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
|
|
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
|
|
266
|
OTHER
|
Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc
|
70
|
59
|
—
|
—
|
$33,247.00
|
$187,383.61
|
$63,102.57
|
2026-05-27
|
|
454
|
OTHER
|
Combined Anterior And Posterior Spinal Fusion With Cc
|
67
|
59
|
—
|
—
|
$50,384.09
|
$176,659.20
|
$62,980.11
|
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
|
|
167-4
|
OTHER
|
Other Cardiothoracic And Thoracic Vascular Procedures
|
14
|
14
|
—
|
—
|
$54,029.06
|
$75,640.68
|
$62,673.71
|
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
|
|
232
|
OTHER
|
Coronary Bypass With Ptca Without Mcc
|
76
|
63
|
—
|
—
|
$6,253.00
|
$194,247.61
|
$62,436.61
|
2026-05-27
|
|
178-3
|
OTHER
|
External Heart Assist Systems
|
14
|
14
|
—
|
—
|
$53,704.67
|
$75,186.54
|
$62,297.42
|
2026-05-27
|
|
028
|
OTHER
|
Spinal Procedures With Mcc
|
68
|
60
|
—
|
—
|
$49,509.65
|
$173,593.20
|
$61,887.06
|
2026-05-27
|
|
276
|
OTHER
|
Non-maligant Breast Disorders
|
70
|
61
|
—
|
—
|
$38,719.00
|
$163,955.10
|
$61,869.85
|
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
|
|
457
|
OTHER
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
67
|
59
|
—
|
—
|
$49,143.68
|
$172,310.03
|
$61,429.60
|
2026-05-27
|
|
790
|
OTHER
|
Extreme Immaturity Or Respiratory Distress Syndrome, Neonate
|
65
|
58
|
—
|
—
|
$4,356.29
|
$139,301.01
|
$61,231.21
|
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
|
|
016
|
OTHER
|
Autologous Bone Marrow Transplant With Cc/mcc
|
67
|
59
|
—
|
—
|
$48,873.23
|
$176,947.00
|
$61,091.54
|
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
|
|
235
|
OTHER
|
Coronary Bypass Without Cardiac Catheterization With Mcc
|
77
|
64
|
—
|
—
|
$9,500.00
|
$160,253.93
|
$60,473.18
|
2026-05-27
|
|
570
|
OTHER
|
Skin Debridement With Mcc
|
67
|
59
|
—
|
—
|
$35,722.48
|
$561,768.89
|
$60,465.72
|
2026-05-27
|
|
820
|
OTHER
|
Lymphoma And Leukemia With Major O.r. Procedures With Mcc
|
67
|
59
|
—
|
—
|
$48,347.78
|
$160,152.00
|
$60,434.72
|
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
|
|
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
|
|
440-3
|
OTHER
|
Kidney Transplant
|
14
|
14
|
—
|
—
|
$51,187.99
|
$71,663.19
|
$59,378.07
|
2026-05-27
|
|
023
|
OTHER
|
Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…
|
71
|
62
|
—
|
—
|
$24,585.33
|
$286,913.55
|
$59,073.46
|
2026-05-27
|
|
463
|
OTHER
|
Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …
|
69
|
60
|
—
|
—
|
$47,009.39
|
$192,872.37
|
$58,761.74
|
2026-05-27
|
|
754-2
|
OTHER
|
Depression Except Major Depressive Disorder
|
15
|
15
|
—
|
—
|
$30,711.72
|
$58,323.45
|
$58,323.45
|
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
|
|
002-1
|
OTHER
|
Heart And/or Lung Transplant
|
14
|
14
|
—
|
—
|
$50,000.00
|
$70,000.00
|
$58,000.00
|
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
|
|
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
|
|
011-1
|
OTHER
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
14
|
14
|
—
|
—
|
$50,000.00
|
$70,000.00
|
$58,000.00
|
2026-05-27
|
|
588-1
|
OTHER
|
Female Reproductive System Reconstructive Procedures
|
14
|
14
|
—
|
—
|
$50,000.00
|
$70,000.00
|
$58,000.00
|
2026-05-27
|
|
006-1
|
OTHER
|
Pancreas Transplant
|
14
|
14
|
—
|
—
|
$50,000.00
|
$70,000.00
|
$58,000.00
|
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
|
|
169-4
|
OTHER
|
Major Abdominal Vascular Procedures
|
14
|
14
|
—
|
—
|
$49,701.73
|
$69,582.42
|
$57,654.01
|
2026-05-27
|
|
021-4
|
OTHER
|
Open Craniotomy Except Trauma
|
14
|
14
|
—
|
—
|
$49,641.30
|
$69,497.82
|
$57,583.91
|
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
|
|
278
|
OTHER
|
Cellulitis Age >17 Without Cc
|
67
|
59
|
—
|
—
|
$12,266.30
|
$152,143.45
|
$57,412.62
|
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
|
|
461
|
OTHER
|
Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc
|
67
|
59
|
—
|
—
|
$45,580.33
|
$373,981.41
|
$56,975.41
|
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
|
|
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
|
|
009-1
|
OTHER
|
Extracorporeal Membrane Oxygenation (ecmo)
|
14
|
14
|
—
|
—
|
$48,887.57
|
$68,442.60
|
$56,709.58
|
2026-05-27
|
|
834
|
OTHER
|
Acute Leukemia Without Major O.r. Procedures With Mcc
|
67
|
59
|
—
|
—
|
$33,843.26
|
$150,097.09
|
$56,640.41
|
2026-05-27
|
|
405
|
OTHER
|
Pancreas, Liver And Shunt Procedures With Mcc
|
69
|
60
|
—
|
—
|
$10,032.00
|
$164,551.45
|
$56,444.06
|
2026-05-27
|
|
232-4
|
OTHER
|
Gastric Fundoplication
|
14
|
14
|
—
|
—
|
$48,638.45
|
$68,093.83
|
$56,420.60
|
2026-05-27
|
|
234
|
OTHER
|
Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc
|
78
|
64
|
—
|
—
|
$6,253.00
|
$161,737.52
|
$56,365.13
|
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
|
|
011
|
OTHER
|
Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc
|
67
|
59
|
—
|
—
|
$45,022.46
|
$225,144.85
|
$56,278.07
|
2026-05-27
|
|
017
|
OTHER
|
Autologous Bone Marrow Transplant Without Cc/mcc
|
67
|
59
|
—
|
—
|
$16,063.41
|
$148,552.22
|
$56,057.44
|
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
|
|
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
|
|
023-4
|
OTHER
|
Spinal Procedures
|
14
|
14
|
—
|
—
|
$47,896.38
|
$67,054.93
|
$55,559.81
|
2026-05-27
|
|
220
|
OTHER
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
77
|
64
|
—
|
—
|
$9,500.00
|
$145,883.63
|
$55,050.43
|
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
|
|
021
|
OTHER
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc
|
68
|
60
|
—
|
—
|
$43,724.57
|
$369,444.80
|
$54,655.71
|
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
|
|
270
|
OTHER
|
Other Major Cardiovascular Procedures With Mcc
|
73
|
60
|
—
|
—
|
$3,300.00
|
$144,368.30
|
$54,478.60
|
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
|
|
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
|
|
466
|
OTHER
|
Revision Of Hip Or Knee Replacement With Mcc
|
67
|
59
|
—
|
—
|
$43,008.82
|
$142,466.70
|
$53,761.02
|
2026-05-27
|
|
653
|
OTHER
|
Major Bladder Procedures With Mcc
|
68
|
60
|
—
|
—
|
$42,935.96
|
$432,627.77
|
$53,669.95
|
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
|
|
480-2
|
OTHER
|
Major Male Pelvic Procedures
|
15
|
15
|
—
|
—
|
$28,133.19
|
$53,166.39
|
$53,166.39
|
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
|
|
740-4
|
OTHER
|
Mental Illness Diagnosis With O.r. Procedure
|
14
|
14
|
—
|
—
|
$45,534.48
|
$63,748.27
|
$52,820.00
|
2026-05-27
|
|
401-4
|
OTHER
|
Adrenal Procedures
|
14
|
14
|
—
|
—
|
$45,294.89
|
$63,412.85
|
$52,542.07
|
2026-05-27
|
|
690-4
|
OTHER
|
Acute Leukemia
|
14
|
14
|
—
|
—
|
$45,078.63
|
$63,110.08
|
$52,291.21
|
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
|
|
221
|
OTHER
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
77
|
64
|
—
|
—
|
$9,500.00
|
$138,036.03
|
$52,089.07
|
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
|
|
326
|
OTHER
|
Stomach, Esophageal And Duodenal Procedures With Mcc
|
67
|
59
|
—
|
—
|
$41,243.76
|
$381,082.36
|
$51,554.70
|
2026-05-27
|
|
228
|
OTHER
|
Other Cardiothoracic Procedures With Mcc
|
76
|
63
|
—
|
—
|
$9,500.00
|
$135,547.09
|
$51,149.84
|
2026-05-27
|
|
480-1
|
OTHER
|
Major Male Pelvic Procedures
|
15
|
15
|
—
|
—
|
$27,102.83
|
$51,105.65
|
$51,105.65
|
2026-05-27
|
|
853
|
OTHER
|
Infectious And Parasitic Diseases With O.r. Procedures With Mcc
|
69
|
60
|
—
|
—
|
$40,848.62
|
$691,104.58
|
$51,060.78
|
2026-05-27
|
|
239
|
OTHER
|
Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc
|
67
|
59
|
—
|
—
|
$40,711.80
|
$195,923.00
|
$50,889.75
|
2026-05-27
|
|
576
|
OTHER
|
Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc
|
67
|
59
|
—
|
—
|
$10,820.87
|
$134,308.01
|
$50,682.27
|
2026-05-27
|
|
471
|
OTHER
|
Cervical Spinal Fusion With Mcc
|
69
|
60
|
—
|
—
|
$3,400.00
|
$389,336.94
|
$49,948.51
|
2026-05-27
|
|
837
|
OTHER
|
Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot…
|
67
|
59
|
—
|
—
|
$39,761.24
|
$468,312.38
|
$49,701.55
|
2026-05-27
|
|
162-2
|
OTHER
|
Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis
|
15
|
15
|
—
|
—
|
$32,543.30
|
$61,986.60
|
$49,589.28
|
2026-05-27
|
|
440-2
|
OTHER
|
Kidney Transplant
|
15
|
15
|
—
|
—
|
$32,477.99
|
$61,855.99
|
$49,484.79
|
2026-05-27
|
|
020-4
|
OTHER
|
Open Craniotomy For Trauma
|
15
|
15
|
—
|
—
|
$32,338.49
|
$61,576.97
|
$49,261.58
|
2026-05-27
|
|
267
|
OTHER
|
Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc
|
71
|
60
|
—
|
—
|
$3,300.00
|
$166,713.80
|
$49,261.29
|
2026-05-27
|
|
004-1
|
OTHER
|
Tracheostomy With Mv >96 Hours With Extensive Procedure
|
15
|
15
|
—
|
—
|
$32,034.98
|
$60,969.96
|
$48,775.97
|
2026-05-27
|
|
312-4
|
OTHER
|
Skin Graft, Except Hand, For Musculoskeletal And Connective Tissue Diagnoses
|
15
|
15
|
—
|
—
|
$31,982.29
|
$60,864.58
|
$48,691.66
|
2026-05-27
|
|
441-4
|
OTHER
|
Major Bladder Procedures
|
15
|
15
|
—
|
—
|
$31,968.19
|
$60,836.38
|
$48,669.11
|
2026-05-27
|
|
650
|
OTHER
|
Kidney Transplant With Hemodialysis With Mcc
|
67
|
59
|
—
|
—
|
$38,928.10
|
$236,647.50
|
$48,660.12
|
2026-05-27
|
|
981
|
OTHER
|
Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc
|
70
|
60
|
—
|
—
|
$2,200.00
|
$147,810.05
|
$48,562.96
|
2026-05-27
|
|
178-2
|
OTHER
|
External Heart Assist Systems
|
15
|
15
|
—
|
—
|
$31,855.40
|
$60,610.79
|
$48,488.63
|
2026-05-27
|
|
826
|
OTHER
|
Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. …
|
67
|
59
|
—
|
—
|
$38,737.02
|
$149,954.58
|
$48,421.27
|
2026-05-27
|
|
681-4
|
OTHER
|
Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms
|
15
|
15
|
—
|
—
|
$31,534.82
|
$59,969.64
|
$47,975.72
|
2026-05-27
|
|
008-3
|
OTHER
|
Autologous Bone Marrow Transplant Or T-cell Immunotherapy
|
15
|
15
|
—
|
—
|
$31,443.55
|
$59,787.10
|
$47,829.68
|
2026-05-27
|
|
277
|
OTHER
|
Cellulitis Age >17 W Cc
|
70
|
61
|
—
|
—
|
$38,256.89
|
$232,912.00
|
$47,821.11
|
2026-05-27
|
|
455
|
OTHER
|
Combined Anterior And Posterior Spinal Fusion Without Cc/mcc
|
67
|
59
|
—
|
—
|
$38,152.42
|
$146,158.35
|
$47,690.53
|
2026-05-27
|
|
329
|
OTHER
|
Major Small And Large Bowel Procedures With Mcc
|
68
|
59
|
—
|
—
|
$38,078.74
|
$162,067.99
|
$47,598.43
|
2026-05-27
|
|
823
|
OTHER
|
Lymphoma And Non-acute Leukemia With Other Procedures With Mcc
|
67
|
59
|
—
|
—
|
$37,984.02
|
$170,430.30
|
$47,480.03
|
2026-05-27
|
|
603-2
|
OTHER
|
Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition
|
15
|
15
|
—
|
—
|
$31,096.26
|
$59,092.52
|
$47,274.01
|
2026-05-27
|
|
245
|
OTHER
|
Aicd Generator Procedures
|
76
|
63
|
—
|
—
|
$3,600.00
|
$125,221.28
|
$47,253.31
|
2026-05-27
|
|
856
|
OTHER
|
Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc
|
67
|
59
|
—
|
—
|
$37,691.73
|
$124,853.85
|
$47,114.66
|
2026-05-27
|
|
025
|
OTHER
|
Craniotomy And Endovascular Intracranial Procedures With Mcc
|
70
|
60
|
—
|
—
|
$37,675.54
|
$204,327.67
|
$47,094.43
|
2026-05-27
|
|
799
|
OTHER
|
Splenectomy With Mcc
|
67
|
59
|
—
|
—
|
$37,531.42
|
$124,322.81
|
$46,914.27
|
2026-05-27
|
|
614-3
|
OTHER
|
Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition
|
15
|
15
|
—
|
—
|
$30,692.58
|
$58,285.15
|
$46,628.12
|
2026-05-27
|
|
261-4
|
OTHER
|
Major Biliary Tract Procedures
|
15
|
15
|
—
|
—
|
$30,668.08
|
$58,236.16
|
$46,588.93
|
2026-05-27
|
|
609-1
|
OTHER
|
Neonate Birth Weight 1500-2499 Grams With Major Procedure
|
15
|
15
|
—
|
—
|
$30,659.18
|
$58,218.36
|
$46,574.68
|
2026-05-27
|
|
163
|
OTHER
|
Major Chest Procedures With Mcc
|
68
|
59
|
—
|
—
|
$37,150.06
|
$460,004.33
|
$46,437.58
|
2026-05-27
|
|
031
|
OTHER
|
Ventricular Shunt Procedures With Mcc
|
67
|
59
|
—
|
—
|
$37,139.54
|
$130,220.52
|
$46,424.43
|
2026-05-27
|
|
183-3
|
OTHER
|
Percutaneous Structural Cardiac Procedures
|
15
|
15
|
—
|
—
|
$30,536.00
|
$57,972.00
|
$46,377.60
|
2026-05-27
|
|
319
|
OTHER
|
Other Endovascular Cardiac Valve Procedures With Mcc
|
70
|
60
|
—
|
—
|
$3,400.00
|
$124,093.30
|
$46,246.29
|
2026-05-27
|
|
361-4
|
OTHER
|
Skin Graft For Skin And Subcutaneous Tissue Diagnoses
|
15
|
15
|
—
|
—
|
$30,205.78
|
$57,311.55
|
$45,849.24
|
2026-05-27
|
|
630-2
|
OTHER
|
Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure
|
15
|
15
|
—
|
—
|
$30,083.33
|
$57,066.67
|
$45,653.34
|
2026-05-27
|
|
356
|
OTHER
|
Other Digestive System O.r. Procedures With Mcc
|
67
|
59
|
—
|
—
|
$36,429.46
|
$330,339.55
|
$45,536.82
|
2026-05-27
|
|
179-3
|
OTHER
|
Defibrillator Implants
|
15
|
15
|
—
|
—
|
$29,968.31
|
$56,836.63
|
$45,469.30
|
2026-05-27
|
|
440-1
|
OTHER
|
Kidney Transplant
|
15
|
15
|
—
|
—
|
$29,805.80
|
$56,511.60
|
$45,209.28
|
2026-05-27
|
|
321-4
|
OTHER
|
Spinal Fusion And Other Back And Neck Procedures Except For Disc Procedures
|
15
|
15
|
—
|
—
|
$29,599.51
|
$56,099.01
|
$44,879.21
|
2026-05-27
|
|
323
|
OTHER
|
Urinary Stones W Cc, &/or Esw Lithotripsy
|
67
|
59
|
—
|
—
|
$35,899.94
|
$118,918.56
|
$44,874.93
|
2026-05-27
|
|
166-3
|
OTHER
|
Coronary Bypass Without Ami Or Complex Principal Diagnosis
|
15
|
15
|
—
|
—
|
$29,523.07
|
$55,946.14
|
$44,756.91
|
2026-05-27
|
|
474
|
OTHER
|
Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc
|
67
|
59
|
—
|
—
|
$35,620.60
|
$117,993.23
|
$44,525.75
|
2026-05-27
|
|
178-1
|
OTHER
|
External Heart Assist Systems
|
15
|
15
|
—
|
—
|
$29,354.62
|
$55,609.25
|
$44,487.40
|
2026-05-27
|
|
140
|
OTHER
|
Major Head And Neck Procedures With Mcc
|
67
|
59
|
—
|
—
|
$35,397.14
|
$184,620.42
|
$44,246.43
|
2026-05-27
|
|
092-4
|
OTHER
|
Facial Bone Procedures Except Major Cranial Or Facial Bone Procedures
|
15
|
15
|
—
|
—
|
$28,977.65
|
$54,855.30
|
$43,884.24
|
2026-05-27
|
|
269
|
OTHER
|
Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc
|
70
|
59
|
—
|
—
|
$33,247.00
|
$209,018.27
|
$43,820.34
|
2026-05-27
|
|
012
|
OTHER
|
Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc
|
67
|
59
|
—
|
—
|
$34,997.97
|
$170,114.57
|
$43,747.46
|
2026-05-27
|
|
230-4
|
OTHER
|
Major Small Bowel Procedures
|
15
|
15
|
—
|
—
|
$28,878.95
|
$54,657.90
|
$43,726.32
|
2026-05-27
|
|
958
|
OTHER
|
Other O.r. Procedures For Multiple Significant Trauma With Cc
|
69
|
60
|
—
|
—
|
$34,980.97
|
$246,330.20
|
$43,726.21
|
2026-05-27
|
|
695-4
|
OTHER
|
Chemotherapy For Acute Leukemia
|
15
|
15
|
—
|
—
|
$28,867.82
|
$54,635.64
|
$43,708.52
|
2026-05-27
|
|
027-4
|
OTHER
|
Other Open Craniotomy
|
15
|
15
|
—
|
—
|
$28,847.79
|
$54,595.58
|
$43,676.46
|
2026-05-27
|
|
181-4
|
OTHER
|
Lower Extremity Arterial Procedures
|
15
|
15
|
—
|
—
|
$28,824.04
|
$54,548.09
|
$43,638.47
|
2026-05-27
|
|
510-2
|
OTHER
|
Pelvic Evisceration, Radical Hysterectomy And Other Radical Gynecological Proced…
|
15
|
15
|
—
|
—
|
$23,367.12
|
$43,634.24
|
$43,634.24
|
2026-05-27
|
|
673
|
OTHER
|
Other Kidney And Urinary Tract Procedures With Mcc
|
67
|
59
|
—
|
—
|
$34,881.38
|
$174,696.12
|
$43,601.72
|
2026-05-27
|
|
901
|
OTHER
|
Wound Debridements For Injuries With Mcc
|
68
|
59
|
—
|
—
|
$34,840.90
|
$115,410.47
|
$43,551.12
|
2026-05-27
|
|
304-3
|
OTHER
|
Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back
|
15
|
15
|
—
|
—
|
$28,763.94
|
$54,427.87
|
$43,542.30
|
2026-05-27
|
|
236
|
OTHER
|
Coronary Bypass Without Cardiac Catheterization Without Mcc
|
77
|
64
|
—
|
—
|
$9,500.00
|
$115,201.27
|
$43,472.18
|
2026-05-27
|
|
792-4
|
OTHER
|
Extensive O.r. Procedures For Other Complications Of Treatment
|
15
|
15
|
—
|
—
|
$28,673.40
|
$54,246.81
|
$43,397.45
|
2026-05-27
|
|
458
|
OTHER
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
67
|
59
|
—
|
—
|
$34,646.57
|
$121,479.54
|
$43,308.21
|
2026-05-27
|
|
793
|
OTHER
|
Full Term Neonate With Major Problems
|
67
|
59
|
—
|
—
|
$7,257.47
|
$98,457.13
|
$43,277.86
|
2026-05-27
|
|
165-2
|
OTHER
|
Coronary Bypass With Ami Or Complex Principal Diagnosis
|
15
|
15
|
—
|
—
|
$28,546.51
|
$53,993.02
|
$43,194.41
|
2026-05-27
|
|
651-4
|
OTHER
|
Other Procedures Of Blood And Blood-forming Organs
|
15
|
15
|
—
|
—
|
$28,516.82
|
$53,933.64
|
$43,146.91
|
2026-05-27
|
|
423
|
OTHER
|
Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc
|
67
|
59
|
—
|
—
|
$34,487.87
|
$129,419.50
|
$43,109.84
|
2026-05-27
|
|
511-4
|
OTHER
|
Uterine And Adnexa Procedures For Ovarian And Adnexal Malignancy
|
15
|
15
|
—
|
—
|
$28,385.48
|
$53,670.96
|
$42,936.77
|
2026-05-27
|
|
273
|
OTHER
|
Percutaneous And Other Intracardiac Procedures With Mcc
|
69
|
59
|
—
|
—
|
$34,265.22
|
$117,267.40
|
$42,831.52
|
2026-05-27
|
|
512-4
|
OTHER
|
Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy
|
15
|
15
|
—
|
—
|
$28,254.13
|
$53,408.26
|
$42,726.61
|
2026-05-27
|
|
162-1
|
OTHER
|
Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis
|
15
|
15
|
—
|
—
|
$28,179.92
|
$53,259.85
|
$42,607.88
|
2026-05-27
|
|
121-4
|
OTHER
|
Other Respiratory And Chest Procedures
|
15
|
15
|
—
|
—
|
$28,177.70
|
$53,255.40
|
$42,604.32
|
2026-05-27
|
|
234-4
|
OTHER
|
Appendectomy Without Complex Principal Diagnosis
|
15
|
15
|
—
|
—
|
$28,021.12
|
$52,942.25
|
$42,353.80
|
2026-05-27
|
|
791
|
OTHER
|
Prematurity With Major Problems
|
65
|
58
|
—
|
—
|
$7,138.94
|
$95,910.56
|
$42,158.49
|
2026-05-27
|
|
030-4
|
OTHER
|
Percutaneous Intracranial And Extracranial Vascular Procedures
|
15
|
15
|
—
|
—
|
$27,776.97
|
$52,453.95
|
$41,963.16
|
2026-05-27
|
|
802
|
OTHER
|
Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc
|
67
|
59
|
—
|
—
|
$33,120.35
|
$230,149.08
|
$41,400.44
|
2026-05-27
|
|
303-2
|
OTHER
|
Dorsal And Lumbar Fusion Procedure For Curvature Of Back
|
15
|
15
|
—
|
—
|
$27,413.37
|
$51,726.74
|
$41,381.39
|
2026-05-27
|
|
710-4
|
OTHER
|
Infectious And Parasitic Diseases Including HIV With O.r. Procedure
|
15
|
15
|
—
|
—
|
$27,380.72
|
$51,661.43
|
$41,329.14
|
2026-05-27
|
|
163-2
|
OTHER
|
Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis
|
15
|
15
|
—
|
—
|
$27,374.03
|
$51,648.07
|
$41,318.46
|
2026-05-27
|
|
607-1
|
OTHER
|
Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…
|
15
|
15
|
—
|
—
|
$27,370.33
|
$51,640.65
|
$41,312.52
|
2026-05-27
|