Hospital

CHILDREN'S HOSPITAL AT MISSION

Mission Viejo, CA · CCN 053306 · Rates published

3,794 distinct procedures filed

33 distinct payers

112,007 rate rows

2026-05-08 last MRF observed

Data quality

109,028 of 112,007 rate rows are consumer-grade (97.3%)

2,979 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
per-diem day rate — not a per-procedure price	2,103
exceeds 10× this hospital's gross charge — excluded from medians	523
placeholder amount (≤ $0.02) — excluded from medians	226
no usable negotiated amount (only an out-of-band fallback) — excluded from medians	127

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

Source MRF file	https://choc.org/files/charges/330528802_Childrens-Hospital-at-Mission_standardcharges.csv
Found on page	https://choc.org/patients/billing/price-transparency/
Discovered via	Discovered by HANK
Last fetch	not_modified · 2026-05-15
Content fingerprint	435b1eee622039e1… · 46,326,070 bytes · first seen 2026-05-08

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
631-4 OTHER	Neonate Birth Weight > 2499 Grams With Other Major Procedure	10	$234,754.80	$352,132.20	$281,705.76	nat. median $203,379 1.4× median
583-4 OTHER	Neonate With Ecmo	10	$221,000.00	$331,500.00	$265,200.00	nat. median $309,400 0.9× median
588-4 OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	10	$221,000.00	$331,500.00	$265,200.00	nat. median $267,493 1.0× median
583-3 OTHER	Neonate With Ecmo	10	$221,000.00	$331,500.00	$265,200.00	nat. median $259,487 1.0× median
011-3 OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	10	$210,107.48	$315,161.22	$252,128.97	nat. median $171,094 1.5× median
630-4 OTHER	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure	10	$208,845.86	$313,268.79	$250,615.03	nat. median $210,669 1.2× median
161-4 OTHER	Implantable Heart Assist Systems	10	$202,241.64	$303,362.46	$242,689.97	nat. median $202,242 1.2× median
002-4 OTHER	Heart And/or Lung Transplant	10	$192,553.89	$288,830.84	$231,064.66	nat. median $216,800 1.1× median
583-2 OTHER	Neonate With Ecmo	10	$183,383.63	$275,075.45	$220,060.36	nat. median $191,347 1.2× median
589-1 OTHER	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational…	10	$170,039.34	$255,059.01	$204,047.21	nat. median $86,371 outlier · 2.4×
583-1 OTHER	Neonate With Ecmo	10	$166,936.00	$250,404.00	$200,323.20	nat. median $171,226 1.2× median
609-4 OTHER	Neonate Birth Weight 1500-2499 Grams With Major Procedure	10	$165,000.00	$247,500.00	$198,000.00	nat. median $169,856 1.2× median
841-4 OTHER	Extensive Third Degree Burns With Skin Graft	10	$156,040.07	$234,060.11	$187,248.08	nat. median $151,691 1.2× median
161-3 OTHER	Implantable Heart Assist Systems	10	$152,380.21	$228,570.32	$182,856.25	nat. median $152,491 1.2× median
007-4 OTHER	Allogeneic Bone Marrow Transplant	10	$146,315.55	$219,473.32	$175,578.66	nat. median $172,311 1.0× median
009-4 OTHER	Extracorporeal Membrane Oxygenation (ecmo)	10	$139,000.00	$208,500.00	$166,800.00	nat. median $150,954 1.1× median
480-4 OTHER	Major Male Pelvic Procedures	2	$142,154.32	$182,769.84	$162,462.08	nat. median $27,837 outlier · 5.8×
588-3 OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	10	$132,000.00	$198,000.00	$158,400.00	nat. median $165,000 1.0× median
002-3 OTHER	Heart And/or Lung Transplant	10	$130,685.47	$196,028.21	$156,822.57	nat. median $133,471 1.2× median
588-2 OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	10	$130,000.00	$195,000.00	$156,000.00	nat. median $153,523 1.0× median
863-4 OTHER	Neonatal Aftercare	10	$126,963.94	$190,445.91	$152,356.73	nat. median $108,047 1.4× median
593-4 OTHER	Neonate Birth Weight 750-999 Grams Without Major Procedure	10	$121,000.00	$181,500.00	$145,200.00	nat. median $151,250 1.0× median
591-4 OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure	10	$120,000.00	$180,000.00	$144,000.00	nat. median $156,696 0.9× median
303-4 OTHER	Dorsal And Lumbar Fusion Procedure For Curvature Of Back	10	$120,000.00	$180,000.00	$144,000.00	nat. median $108,000 1.3× median
001-4 OTHER	Liver Transplant And/or Intestinal Transplant	10	$120,000.00	$180,000.00	$144,000.00	nat. median $124,561 1.2× median
271 OTHER	Other Major Cardiovascular Procedures With Cc	3	$120,952.00	$137,481.00	$137,481.00	nat. median $4,454 outlier · 30.9×
009-3 OTHER	Extracorporeal Membrane Oxygenation (ecmo)	10	$110,110.47	$165,165.71	$132,132.57	nat. median $87,912 1.5× median
004-4 OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	10	$110,000.00	$165,000.00	$132,000.00	nat. median $110,000 1.2× median
161-2 OTHER	Implantable Heart Assist Systems	10	$109,991.74	$164,987.61	$131,990.09	nat. median $109,992 1.2× median
161-1 OTHER	Implantable Heart Assist Systems	10	$109,991.74	$164,987.61	$131,990.09	nat. median $101,352 1.3× median
233 OTHER	Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc	4	$34,453.00	$137,481.00	$129,216.50	nat. median $68,249 1.9× median
270 OTHER	Other Major Cardiovascular Procedures With Mcc	4	$34,453.00	$137,481.00	$129,216.50	nat. median $101 outlier · 1273.8×
234 OTHER	Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc	4	$34,453.00	$137,481.00	$129,216.50	nat. median $50,947 outlier · 2.5×
268 OTHER	Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc	4	$34,453.00	$137,481.00	$129,216.50	nat. median $67,670 1.9× median
160-4 OTHER	Major Cardiothoracic Repair Of Heart Anomaly	10	$106,925.93	$160,388.89	$128,311.12	nat. median $106,926 1.2× median
002-2 OTHER	Heart And/or Lung Transplant	10	$101,523.66	$152,285.49	$121,828.40	nat. median $106,681 1.1× median
602-4 OTHER	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	10	$100,000.00	$150,000.00	$120,000.00	nat. median $125,000 1.0× median
607-4 OTHER	Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…	10	$100,000.00	$150,000.00	$120,000.00	nat. median $100,015 1.2× median
593-3 OTHER	Neonate Birth Weight 750-999 Grams Without Major Procedure	10	$99,000.00	$148,500.00	$118,800.00	nat. median $112,711 1.1× median
633-4 OTHER	Neonate Birth Weight > 2499 Grams With Major Anomaly	10	$95,464.13	$143,196.20	$114,556.96	nat. median $74,597 1.5× median
630-3 OTHER	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure	10	$95,000.00	$142,500.00	$114,000.00	nat. median $95,000 1.2× median
611-4 OTHER	Neonate Birth Weight 1500-1999 Grams With Major Anomaly	10	$93,000.00	$139,500.00	$111,600.00	nat. median $93,000 1.2× median
842-4 OTHER	Burns With Skin Graft Except Extensive Third Degree Burns	10	$92,524.47	$138,786.71	$111,029.36	nat. median $83,517 1.3× median
602-3 OTHER	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	10	$92,000.00	$138,000.00	$110,400.00	nat. median $99,067 1.1× median
004-3 OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	10	$91,000.00	$136,500.00	$109,200.00	nat. median $91,000 1.2× median
591-3 OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure	10	$91,000.00	$136,500.00	$109,200.00	nat. median $99,157 1.1× median
621-4 OTHER	Neonate Birth Weight 2000-2499 Grams With Major Anomaly	10	$90,000.00	$135,000.00	$108,000.00	nat. median $80,035 1.3× median
007-3 OTHER	Allogeneic Bone Marrow Transplant	10	$89,273.14	$133,909.71	$107,127.77	nat. median $104,111 1.0× median
612-4 OTHER	Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other…	10	$89,000.00	$133,500.00	$106,800.00	nat. median $76,321 1.4× median
005-4 OTHER	Tracheostomy With Mv >96 Hours Without Extensive Procedure	10	$88,000.00	$132,000.00	$105,600.00	nat. median $88,000 1.2× median

Other procedures at this hospital

Browse this hospital's 3,794 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

631-4	OTHER	Neonate Birth Weight > 2499 Grams With Other Major Procedure	10	10	—	—	$234,754.80	$352,132.20	$281,705.76	2026-05-08
583-4	OTHER	Neonate With Ecmo	10	10	—	—	$221,000.00	$331,500.00	$265,200.00	2026-05-08
583-3	OTHER	Neonate With Ecmo	10	10	—	—	$221,000.00	$331,500.00	$265,200.00	2026-05-08
588-4	OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	10	10	—	—	$221,000.00	$331,500.00	$265,200.00	2026-05-08
011-3	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	10	10	—	—	$210,107.48	$315,161.22	$252,128.97	2026-05-08
630-4	OTHER	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure	10	10	—	—	$208,845.86	$313,268.79	$250,615.03	2026-05-08
161-4	OTHER	Implantable Heart Assist Systems	10	10	—	—	$202,241.64	$303,362.46	$242,689.97	2026-05-08
002-4	OTHER	Heart And/or Lung Transplant	10	10	—	—	$192,553.89	$288,830.84	$231,064.66	2026-05-08
583-2	OTHER	Neonate With Ecmo	10	10	—	—	$183,383.63	$275,075.45	$220,060.36	2026-05-08
589-1	OTHER	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …	10	10	—	—	$170,039.34	$255,059.01	$204,047.21	2026-05-08
583-1	OTHER	Neonate With Ecmo	10	10	—	—	$166,936.00	$250,404.00	$200,323.20	2026-05-08
609-4	OTHER	Neonate Birth Weight 1500-2499 Grams With Major Procedure	10	10	—	—	$165,000.00	$247,500.00	$198,000.00	2026-05-08
841-4	OTHER	Extensive Third Degree Burns With Skin Graft	10	10	—	—	$156,040.07	$234,060.11	$187,248.08	2026-05-08
161-3	OTHER	Implantable Heart Assist Systems	10	10	—	—	$152,380.21	$228,570.32	$182,856.25	2026-05-08
007-4	OTHER	Allogeneic Bone Marrow Transplant	10	10	—	—	$146,315.55	$219,473.32	$175,578.66	2026-05-08
009-4	OTHER	Extracorporeal Membrane Oxygenation (ecmo)	10	10	—	—	$139,000.00	$208,500.00	$166,800.00	2026-05-08
480-4	OTHER	Major Male Pelvic Procedures	2	2	—	—	$142,154.32	$182,769.84	$162,462.08	2026-05-08
588-3	OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	10	10	—	—	$132,000.00	$198,000.00	$158,400.00	2026-05-08
002-3	OTHER	Heart And/or Lung Transplant	10	10	—	—	$130,685.47	$196,028.21	$156,822.57	2026-05-08
588-2	OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	10	10	—	—	$130,000.00	$195,000.00	$156,000.00	2026-05-08
863-4	OTHER	Neonatal Aftercare	10	10	—	—	$126,963.94	$190,445.91	$152,356.73	2026-05-08
593-4	OTHER	Neonate Birth Weight 750-999 Grams Without Major Procedure	10	10	—	—	$121,000.00	$181,500.00	$145,200.00	2026-05-08
591-4	OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure	10	10	—	—	$120,000.00	$180,000.00	$144,000.00	2026-05-08
001-4	OTHER	Liver Transplant And/or Intestinal Transplant	10	10	—	—	$120,000.00	$180,000.00	$144,000.00	2026-05-08
303-4	OTHER	Dorsal And Lumbar Fusion Procedure For Curvature Of Back	10	10	—	—	$120,000.00	$180,000.00	$144,000.00	2026-05-08
271	OTHER	Other Major Cardiovascular Procedures With Cc	3	3	—	—	$120,952.00	$137,481.00	$137,481.00	2026-05-08
009-3	OTHER	Extracorporeal Membrane Oxygenation (ecmo)	10	10	—	—	$110,110.47	$165,165.71	$132,132.57	2026-05-08
004-4	OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	10	10	—	—	$110,000.00	$165,000.00	$132,000.00	2026-05-08
161-1	OTHER	Implantable Heart Assist Systems	10	10	—	—	$109,991.74	$164,987.61	$131,990.09	2026-05-08
161-2	OTHER	Implantable Heart Assist Systems	10	10	—	—	$109,991.74	$164,987.61	$131,990.09	2026-05-08
268	OTHER	Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc	4	4	—	—	$34,453.00	$137,481.00	$129,216.50	2026-05-08
270	OTHER	Other Major Cardiovascular Procedures With Mcc	4	4	—	—	$34,453.00	$137,481.00	$129,216.50	2026-05-08
234	OTHER	Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc	4	4	—	—	$34,453.00	$137,481.00	$129,216.50	2026-05-08
233	OTHER	Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc	4	4	—	—	$34,453.00	$137,481.00	$129,216.50	2026-05-08
160-4	OTHER	Major Cardiothoracic Repair Of Heart Anomaly	10	10	—	—	$106,925.93	$160,388.89	$128,311.12	2026-05-08
002-2	OTHER	Heart And/or Lung Transplant	10	10	—	—	$101,523.66	$152,285.49	$121,828.40	2026-05-08
607-4	OTHER	Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…	10	10	—	—	$100,000.00	$150,000.00	$120,000.00	2026-05-08
602-4	OTHER	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	10	10	—	—	$100,000.00	$150,000.00	$120,000.00	2026-05-08
593-3	OTHER	Neonate Birth Weight 750-999 Grams Without Major Procedure	10	10	—	—	$99,000.00	$148,500.00	$118,800.00	2026-05-08
633-4	OTHER	Neonate Birth Weight > 2499 Grams With Major Anomaly	10	10	—	—	$95,464.13	$143,196.20	$114,556.96	2026-05-08
630-3	OTHER	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure	10	10	—	—	$95,000.00	$142,500.00	$114,000.00	2026-05-08
611-4	OTHER	Neonate Birth Weight 1500-1999 Grams With Major Anomaly	10	10	—	—	$93,000.00	$139,500.00	$111,600.00	2026-05-08
842-4	OTHER	Burns With Skin Graft Except Extensive Third Degree Burns	10	10	—	—	$92,524.47	$138,786.71	$111,029.36	2026-05-08
602-3	OTHER	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	10	10	—	—	$92,000.00	$138,000.00	$110,400.00	2026-05-08
004-3	OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	10	10	—	—	$91,000.00	$136,500.00	$109,200.00	2026-05-08
591-3	OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure	10	10	—	—	$91,000.00	$136,500.00	$109,200.00	2026-05-08
621-4	OTHER	Neonate Birth Weight 2000-2499 Grams With Major Anomaly	10	10	—	—	$90,000.00	$135,000.00	$108,000.00	2026-05-08
007-3	OTHER	Allogeneic Bone Marrow Transplant	10	10	—	—	$89,273.14	$133,909.71	$107,127.77	2026-05-08
612-4	OTHER	Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other…	10	10	—	—	$89,000.00	$133,500.00	$106,800.00	2026-05-08
005-4	OTHER	Tracheostomy With Mv >96 Hours Without Extensive Procedure	10	10	—	—	$88,000.00	$132,000.00	$105,600.00	2026-05-08
589-3	OTHER	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …	10	10	—	—	$87,000.00	$130,500.00	$104,400.00	2026-05-08
607-3	OTHER	Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…	10	10	—	—	$86,000.00	$129,000.00	$103,200.00	2026-05-08
006-4	OTHER	Pancreas Transplant	10	10	—	—	$85,000.00	$127,500.00	$102,000.00	2026-05-08
162-4	OTHER	Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis	10	10	—	—	$80,771.14	$121,156.71	$96,925.37	2026-05-08
609-3	OTHER	Neonate Birth Weight 1500-2499 Grams With Major Procedure	10	10	—	—	$80,681.03	$121,021.54	$96,817.23	2026-05-08
603-4	OTHER	Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition	10	10	—	—	$80,000.00	$120,000.00	$96,000.00	2026-05-08
602-2	OTHER	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	10	10	—	—	$80,000.00	$120,000.00	$96,000.00	2026-05-08
591-2	OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure	10	10	—	—	$80,000.00	$120,000.00	$96,000.00	2026-05-08
006-3	OTHER	Pancreas Transplant	10	10	—	—	$79,144.95	$118,717.42	$94,973.94	2026-05-08
593-2	OTHER	Neonate Birth Weight 750-999 Grams Without Major Procedure	10	10	—	—	$79,000.00	$118,500.00	$94,800.00	2026-05-08
440-4	OTHER	Kidney Transplant	10	10	—	—	$76,896.47	$115,344.71	$92,275.76	2026-05-08
001-3	OTHER	Liver Transplant And/or Intestinal Transplant	10	10	—	—	$76,155.46	$114,233.19	$91,386.55	2026-05-08
007-1	OTHER	Allogeneic Bone Marrow Transplant	10	10	—	—	$74,667.08	$112,000.62	$89,600.49	2026-05-08
005-3	OTHER	Tracheostomy With Mv >96 Hours Without Extensive Procedure	10	10	—	—	$74,623.62	$111,935.43	$89,548.34	2026-05-08
163-4	OTHER	Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis	10	10	—	—	$71,005.50	$106,508.25	$85,206.60	2026-05-08
608-4	OTHER	Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition	10	10	—	—	$70,000.00	$105,000.00	$84,000.00	2026-05-08
006-2	OTHER	Pancreas Transplant	10	10	—	—	$66,925.17	$100,387.76	$80,310.21	2026-05-08
007-2	OTHER	Allogeneic Bone Marrow Transplant	10	10	—	—	$66,446.01	$99,669.01	$79,735.21	2026-05-08
178-4	OTHER	External Heart Assist Systems	10	10	—	—	$66,228.69	$99,343.04	$79,474.43	2026-05-08
008-4	OTHER	Autologous Bone Marrow Transplant Or T-cell Immunotherapy	10	10	—	—	$65,108.16	$97,662.24	$78,129.79	2026-05-08
165-4	OTHER	Coronary Bypass With Ami Or Complex Principal Diagnosis	10	10	—	—	$63,659.01	$95,488.51	$76,390.81	2026-05-08
631-3	OTHER	Neonate Birth Weight > 2499 Grams With Other Major Procedure	10	10	—	—	$62,013.73	$93,020.60	$74,416.48	2026-05-08
613-4	OTHER	Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection	10	10	—	—	$62,000.00	$93,000.00	$74,400.00	2026-05-08
004-2	OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	10	10	—	—	$61,468.84	$92,203.26	$73,762.61	2026-05-08
001-2	OTHER	Liver Transplant And/or Intestinal Transplant	10	10	—	—	$61,446.58	$92,169.87	$73,735.90	2026-05-08
608-3	OTHER	Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition	10	10	—	—	$60,412.98	$90,619.47	$72,495.58	2026-05-08
009-2	OTHER	Extracorporeal Membrane Oxygenation (ecmo)	10	10	—	—	$59,643.74	$89,465.61	$71,572.49	2026-05-08
607-2	OTHER	Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…	10	10	—	—	$59,012.59	$88,518.88	$70,815.11	2026-05-08
183-4	OTHER	Percutaneous Structural Cardiac Procedures	10	10	—	—	$58,768.76	$88,153.14	$70,522.51	2026-05-08
162-3	OTHER	Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis	10	10	—	—	$57,853.90	$86,780.85	$69,424.68	2026-05-08
910-4	OTHER	Craniotomy For Multiple Significant Trauma	10	10	—	—	$56,988.86	$85,483.29	$68,386.63	2026-05-08
622-4	OTHER	Neonate Birth Weight 2000-2499 Grams With Respiratory Distress Syndrome Or Other…	10	10	—	—	$56,954.93	$85,432.40	$68,345.92	2026-05-08
166-4	OTHER	Coronary Bypass Without Ami Or Complex Principal Diagnosis	10	10	—	—	$55,046.75	$82,570.13	$66,056.10	2026-05-08
179-4	OTHER	Defibrillator Implants	10	10	—	—	$54,992.69	$82,489.04	$65,991.23	2026-05-08
623-4	OTHER	Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection	10	10	—	—	$54,746.74	$82,120.11	$65,696.09	2026-05-08
911-4	OTHER	Extensive Abdominal Or Thoracic Procedures For Multiple Significant Trauma	10	10	—	—	$54,718.12	$82,077.18	$65,661.74	2026-05-08
304-4	OTHER	Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back	10	10	—	—	$54,426.59	$81,639.88	$65,311.91	2026-05-08
634-4	OTHER	Neonate Birth Weight > 2499 Grams With Respiratory Distress Syndrome Or Other Ma…	10	10	—	—	$54,074.64	$81,111.96	$64,889.57	2026-05-08
167-4	OTHER	Other Cardiothoracic And Thoracic Vascular Procedures	10	10	—	—	$54,029.06	$81,043.59	$64,834.87	2026-05-08
091-4	OTHER	Other Major Head And Neck Procedures	10	10	—	—	$53,845.66	$80,768.49	$64,614.79	2026-05-08
178-3	OTHER	External Heart Assist Systems	10	10	—	—	$53,704.67	$80,557.01	$64,445.60	2026-05-08
680-4	OTHER	Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms	10	10	—	—	$52,992.28	$79,488.42	$63,590.74	2026-05-08
612-3	OTHER	Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other…	10	10	—	—	$52,715.59	$79,073.38	$63,258.71	2026-05-08
841-3	OTHER	Extensive Third Degree Burns With Skin Graft	10	10	—	—	$52,320.18	$78,480.27	$62,784.21	2026-05-08
912-4	OTHER	Musculoskeletal And Other Procedures For Multiple Significant Trauma	10	10	—	—	$52,238.55	$78,357.83	$62,686.26	2026-05-08
625-4	OTHER	Neonate Birth Weight 2000-2499 Grams With Other Significant Condition	10	10	—	—	$52,004.27	$78,006.40	$62,405.12	2026-05-08
609-2	OTHER	Neonate Birth Weight 1500-2499 Grams With Major Procedure	10	10	—	—	$51,663.97	$77,495.96	$61,996.76	2026-05-08
440-3	OTHER	Kidney Transplant	10	10	—	—	$51,187.99	$76,781.99	$61,425.59	2026-05-08
011-4	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	10	10	—	—	$50,021.00	$75,031.50	$60,025.20	2026-05-08
006-1	OTHER	Pancreas Transplant	10	10	—	—	$50,000.00	$75,000.00	$60,000.00	2026-05-08
002-1	OTHER	Heart And/or Lung Transplant	10	10	—	—	$50,000.00	$75,000.00	$60,000.00	2026-05-08
001-1	OTHER	Liver Transplant And/or Intestinal Transplant	10	10	—	—	$50,000.00	$75,000.00	$60,000.00	2026-05-08
588-1	OTHER	Female Reproductive System Reconstructive Procedures	10	10	—	—	$50,000.00	$75,000.00	$60,000.00	2026-05-08
011-2	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	10	10	—	—	$50,000.00	$75,000.00	$60,000.00	2026-05-08
011-1	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	10	10	—	—	$50,000.00	$75,000.00	$60,000.00	2026-05-08
005-2	OTHER	Tracheostomy With Mv >96 Hours Without Extensive Procedure	10	10	—	—	$49,972.05	$74,958.08	$59,966.46	2026-05-08
169-4	OTHER	Major Abdominal Vascular Procedures	10	10	—	—	$49,701.73	$74,552.60	$59,642.07	2026-05-08
021-4	OTHER	Open Craniotomy Except Trauma	10	10	—	—	$49,641.30	$74,461.95	$59,569.56	2026-05-08
602-1	OTHER	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	10	10	—	—	$49,524.69	$74,287.04	$59,429.62	2026-05-08
303-3	OTHER	Dorsal And Lumbar Fusion Procedure For Curvature Of Back	10	10	—	—	$49,432.46	$74,148.69	$59,318.95	2026-05-08
603-3	OTHER	Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition	10	10	—	—	$49,059.31	$73,588.96	$58,871.18	2026-05-08
613-3	OTHER	Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection	10	10	—	—	$48,931.04	$73,396.56	$58,717.25	2026-05-08
009-1	OTHER	Extracorporeal Membrane Oxygenation (ecmo)	10	10	—	—	$48,887.57	$73,331.35	$58,665.08	2026-05-08
232-4	OTHER	Gastric Fundoplication	10	10	—	—	$48,638.45	$72,957.67	$58,366.14	2026-05-08
163-3	OTHER	Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis	10	10	—	—	$48,537.74	$72,806.61	$58,245.29	2026-05-08
483-4	OTHER	Penis, Testes And Scrotal Procedures	10	10	—	—	$47,990.73	$71,986.10	$57,588.88	2026-05-08
130-4	OTHER	Respiratory System Diagnosis With Ventilator Support > 96 Hours	10	10	—	—	$47,938.78	$71,908.17	$57,526.54	2026-05-08
023-4	OTHER	Spinal Procedures	10	10	—	—	$47,896.38	$71,844.57	$57,475.65	2026-05-08
850-4	OTHER	Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal…	10	10	—	—	$47,159.61	$70,739.42	$56,591.53	2026-05-08
160-3	OTHER	Major Cardiothoracic Repair Of Heart Anomaly	10	10	—	—	$46,998.47	$70,497.71	$56,398.16	2026-05-08
260-4	OTHER	Major Pancreas, Liver And Shunt Procedures	10	10	—	—	$46,961.37	$70,442.06	$56,353.65	2026-05-08
165-3	OTHER	Coronary Bypass With Ami Or Complex Principal Diagnosis	10	10	—	—	$46,931.69	$70,397.54	$56,318.03	2026-05-08
510-4	OTHER	Pelvic Evisceration, Radical Hysterectomy And Other Radical Gynecological Proced…	2	2	—	—	$48,175.65	$61,940.12	$55,057.89	2026-05-08
089-4	OTHER	Major Cranial Or Facial Bone Procedures	10	10	—	—	$45,836.60	$68,754.90	$55,003.92	2026-05-08
220-4	OTHER	Major Stomach, Esophageal And Duodenal Procedures	10	10	—	—	$45,647.91	$68,471.87	$54,777.49	2026-05-08
740-4	OTHER	Mental Illness Diagnosis With O.r. Procedure	10	10	—	—	$45,534.48	$68,301.72	$54,641.38	2026-05-08
401-4	OTHER	Adrenal Procedures	10	10	—	—	$45,294.89	$67,942.33	$54,353.87	2026-05-08
690-4	OTHER	Acute Leukemia	10	10	—	—	$45,078.63	$67,617.94	$54,094.35	2026-05-08
120-4	OTHER	Major Respiratory And Chest Procedures	10	10	—	—	$44,991.70	$67,487.55	$53,990.04	2026-05-08
950-4	OTHER	Extensive O.r. Procedure Unrelated To Principal Diagnosis	10	10	—	—	$44,744.70	$67,117.05	$53,693.64	2026-05-08
162-2	OTHER	Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis	10	10	—	—	$44,276.14	$66,414.21	$53,131.37	2026-05-08
440-2	OTHER	Kidney Transplant	10	10	—	—	$44,182.85	$66,274.27	$53,019.42	2026-05-08
303-1	OTHER	Dorsal And Lumbar Fusion Procedure For Curvature Of Back	10	10	—	—	$44,010.05	$66,015.08	$52,812.06	2026-05-08
020-4	OTHER	Open Craniotomy For Trauma	10	10	—	—	$43,983.55	$65,975.33	$52,780.26	2026-05-08
004-1	OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	10	10	—	—	$43,549.97	$65,324.96	$52,259.96	2026-05-08
312-4	OTHER	Skin Graft, Except Hand, For Musculoskeletal And Connective Tissue Diagnoses	10	10	—	—	$43,474.70	$65,212.05	$52,169.64	2026-05-08
441-4	OTHER	Major Bladder Procedures	10	10	—	—	$43,454.56	$65,181.84	$52,145.47	2026-05-08
178-2	OTHER	External Heart Assist Systems	10	10	—	—	$43,293.42	$64,940.13	$51,952.10	2026-05-08
681-4	OTHER	Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms	10	10	—	—	$42,835.46	$64,253.19	$51,402.55	2026-05-08
008-3	OTHER	Autologous Bone Marrow Transplant Or T-cell Immunotherapy	10	10	—	—	$42,705.07	$64,057.60	$51,246.08	2026-05-08
603-2	OTHER	Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition	10	10	—	—	$42,208.94	$63,313.41	$50,650.73	2026-05-08
614-3	OTHER	Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition	10	10	—	—	$41,632.25	$62,448.38	$49,958.70	2026-05-08
261-4	OTHER	Major Biliary Tract Procedures	10	10	—	—	$41,597.26	$62,395.89	$49,916.71	2026-05-08
609-1	OTHER	Neonate Birth Weight 1500-2499 Grams With Major Procedure	10	10	—	—	$41,584.54	$62,376.81	$49,901.45	2026-05-08
183-3	OTHER	Percutaneous Structural Cardiac Procedures	10	10	—	—	$41,408.57	$62,112.85	$49,690.29	2026-05-08
361-4	OTHER	Skin Graft For Skin And Subcutaneous Tissue Diagnoses	10	10	—	—	$40,936.82	$61,405.23	$49,124.18	2026-05-08
630-2	OTHER	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure	10	10	—	—	$40,761.91	$61,142.87	$48,914.29	2026-05-08
179-3	OTHER	Defibrillator Implants	10	10	—	—	$40,597.59	$60,896.38	$48,717.11	2026-05-08
440-1	OTHER	Kidney Transplant	10	10	—	—	$40,365.43	$60,548.15	$48,438.51	2026-05-08
321-4	OTHER	Spinal Fusion And Other Back And Neck Procedures Except For Disc Procedures	10	10	—	—	$40,070.72	$60,106.08	$48,084.87	2026-05-08
166-3	OTHER	Coronary Bypass Without Ami Or Complex Principal Diagnosis	10	10	—	—	$39,961.53	$59,942.29	$47,953.84	2026-05-08
178-1	OTHER	External Heart Assist Systems	10	10	—	—	$39,720.89	$59,581.33	$47,665.07	2026-05-08
092-4	OTHER	Facial Bone Procedures Except Major Cranial Or Facial Bone Procedures	10	10	—	—	$39,182.36	$58,773.54	$47,018.83	2026-05-08
230-4	OTHER	Major Small Bowel Procedures	10	10	—	—	$39,041.36	$58,562.04	$46,849.63	2026-05-08
695-4	OTHER	Chemotherapy For Acute Leukemia	10	10	—	—	$39,025.46	$58,538.19	$46,830.55	2026-05-08
027-4	OTHER	Other Open Craniotomy	10	10	—	—	$38,996.84	$58,495.26	$46,796.21	2026-05-08
181-4	OTHER	Lower Extremity Arterial Procedures	10	10	—	—	$38,962.92	$58,444.38	$46,755.51	2026-05-08
304-3	OTHER	Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back	10	10	—	—	$38,877.05	$58,315.58	$46,652.46	2026-05-08
792-4	OTHER	Extensive O.r. Procedures For Other Complications Of Treatment	10	10	—	—	$38,747.72	$58,121.58	$46,497.26	2026-05-08
165-2	OTHER	Coronary Bypass With Ami Or Complex Principal Diagnosis	10	10	—	—	$38,566.44	$57,849.66	$46,279.73	2026-05-08
651-4	OTHER	Other Procedures Of Blood And Blood-forming Organs	10	10	—	—	$38,524.03	$57,786.04	$46,228.83	2026-05-08
511-4	OTHER	Uterine And Adnexa Procedures For Ovarian And Adnexal Malignancy	10	10	—	—	$38,336.40	$57,504.60	$46,003.68	2026-05-08
512-4	OTHER	Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy	10	10	—	—	$38,148.76	$57,223.14	$45,778.51	2026-05-08
162-1	OTHER	Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis	10	10	—	—	$38,042.75	$57,064.13	$45,651.30	2026-05-08
121-4	OTHER	Other Respiratory And Chest Procedures	10	10	—	—	$38,039.57	$57,059.35	$45,647.49	2026-05-08
234-4	OTHER	Appendectomy Without Complex Principal Diagnosis	10	10	—	—	$37,815.89	$56,723.83	$45,379.07	2026-05-08
030-4	OTHER	Percutaneous Intracranial And Extracranial Vascular Procedures	10	10	—	—	$37,467.11	$56,200.67	$44,960.54	2026-05-08
303-2	OTHER	Dorsal And Lumbar Fusion Procedure For Curvature Of Back	10	10	—	—	$36,947.67	$55,421.50	$44,337.21	2026-05-08
710-4	OTHER	Infectious And Parasitic Diseases Including HIV With O.r. Procedure	10	10	—	—	$36,901.02	$55,351.53	$44,281.22	2026-05-08
163-2	OTHER	Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis	10	10	—	—	$36,891.48	$55,337.22	$44,269.77	2026-05-08
607-1	OTHER	Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…	10	10	—	—	$36,886.18	$55,329.27	$44,263.42	2026-05-08
405-4	OTHER	Other Procedures For Endocrine, Nutritional And Metabolic Disorders	10	10	—	—	$36,731.40	$55,097.10	$44,077.68	2026-05-08
160-2	OTHER	Major Cardiothoracic Repair Of Heart Anomaly	10	10	—	—	$36,690.06	$55,035.09	$44,028.07	2026-05-08
170-4	OTHER	Permanent Cardiac Pacemaker Implant With Ami, Heart Failure Or Shock	10	10	—	—	$36,473.80	$54,710.70	$43,768.56	2026-05-08
403-4	OTHER	Procedures For Obesity	10	10	—	—	$36,448.36	$54,672.54	$43,738.03	2026-05-08
608-2	OTHER	Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition	10	10	—	—	$36,442.00	$54,663.00	$43,730.40	2026-05-08
175-4	OTHER	Percutaneous Cardiac Intervention Without Ami	10	10	—	—	$36,057.18	$54,085.77	$43,268.62	2026-05-08
264-4	OTHER	Other Hepatobiliary, Pancreas And Abdominal Procedures	10	10	—	—	$35,933.15	$53,899.73	$43,119.78	2026-05-08
130-3	OTHER	Respiratory System Diagnosis With Ventilator Support > 96 Hours	10	10	—	—	$35,849.40	$53,774.10	$43,019.28	2026-05-08
029-4	OTHER	Other Percutaneous Intracranial Procedures	10	10	—	—	$35,821.84	$53,732.76	$42,986.21	2026-05-08
022-4	OTHER	Ventricular Shunt Procedures	10	10	—	—	$35,795.34	$53,693.01	$42,954.40	2026-05-08
160-1	OTHER	Major Cardiothoracic Repair Of Heart Anomaly	10	10	—	—	$35,744.45	$53,616.67	$42,893.34	2026-05-08
711-4	OTHER	Post-operative, Post-trauma, Other Device Infections With O.r. Procedure	10	10	—	—	$35,675.55	$53,513.33	$42,810.66	2026-05-08
165-1	OTHER	Coronary Bypass With Ami Or Complex Principal Diagnosis	10	10	—	—	$35,209.10	$52,813.65	$42,250.92	2026-05-08
404-4	OTHER	Thyroid, Parathyroid And Thyroglossal Procedures	10	10	—	—	$35,181.54	$52,772.31	$42,217.85	2026-05-08
636-4	OTHER	Neonate Birth Weight > 2499 Grams With Congenital Or Perinatal Infection	10	10	—	—	$35,086.13	$52,629.19	$42,103.36	2026-05-08
650-4	OTHER	Splenectomy	10	10	—	—	$35,049.03	$52,573.54	$42,058.83	2026-05-08
447-4	OTHER	Other Kidney, Urinary Tract And Related Procedures	10	10	—	—	$34,825.35	$52,238.02	$41,790.42	2026-05-08
442-4	OTHER	Kidney And Urinary Tract Procedures For Malignancy	10	10	—	—	$34,735.24	$52,102.86	$41,682.29	2026-05-08
612-2	OTHER	Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other…	10	10	—	—	$34,705.55	$52,058.33	$41,646.66	2026-05-08
008-2	OTHER	Autologous Bone Marrow Transplant Or T-cell Immunotherapy	10	10	—	—	$34,562.44	$51,843.66	$41,474.93	2026-05-08
860-2	OTHER	Rehabilitation	2	2	—	—	$36,248.17	$46,604.79	$41,426.48	2026-05-08
091-3	OTHER	Other Major Head And Neck Procedures	10	10	—	—	$34,200.95	$51,301.42	$41,041.14	2026-05-08
231-4	OTHER	Major Large Bowel Procedures	10	10	—	—	$34,163.84	$51,245.76	$40,996.61	2026-05-08
951-4	OTHER	Moderately Extensive O.r. Procedure Unrelated To Principal Diagnosis	10	10	—	—	$34,017.55	$51,026.33	$40,821.06	2026-05-08
005-1	OTHER	Tracheostomy With Mv >96 Hours Without Extensive Procedure	10	10	—	—	$33,987.87	$50,981.81	$40,785.44	2026-05-08
176-4	OTHER	Insertion, Revision And Replacements Of Pacemaker And Other Cardiac Devices	10	10	—	—	$33,931.68	$50,897.52	$40,718.01	2026-05-08
183-2	OTHER	Percutaneous Structural Cardiac Procedures	10	10	—	—	$33,870.20	$50,805.30	$40,644.24	2026-05-08
021-3	OTHER	Open Craniotomy Except Trauma	10	10	—	—	$33,823.55	$50,735.33	$40,588.26	2026-05-08
169-3	OTHER	Major Abdominal Vascular Procedures	10	10	—	—	$33,780.09	$50,670.13	$40,536.10	2026-05-08
910-3	OTHER	Craniotomy For Multiple Significant Trauma	10	10	—	—	$33,747.22	$50,620.83	$40,496.67	2026-05-08
095-4	OTHER	Cleft Lip And Palate Repair	10	10	—	—	$33,567.01	$50,350.51	$40,280.41	2026-05-08
167-3	OTHER	Other Cardiothoracic And Thoracic Vascular Procedures	10	10	—	—	$33,534.14	$50,301.21	$40,240.97	2026-05-08
325-4	OTHER	Non-elective Or Complex Knee Joint Replacement	10	10	—	—	$33,455.70	$50,183.55	$40,146.84	2026-05-08
179-2	OTHER	Defibrillator Implants	10	10	—	—	$33,373.01	$50,059.51	$40,047.61	2026-05-08
589-2	OTHER	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …	10	10	—	—	$33,354.00	$50,031.00	$40,024.80	2026-05-08
166-2	OTHER	Coronary Bypass Without Ami Or Complex Principal Diagnosis	10	10	—	—	$33,063.46	$49,595.19	$39,676.15	2026-05-08
631-2	OTHER	Neonate Birth Weight > 2499 Grams With Other Major Procedure	10	10	—	—	$32,860.98	$49,291.47	$39,433.18	2026-05-08
026-4	OTHER	Other Nervous System And Related Procedures	10	10	—	—	$32,788.89	$49,183.33	$39,346.67	2026-05-08
313-4	OTHER	Knee And Lower Leg Procedures Except Foot	10	10	—	—	$32,735.89	$49,103.83	$39,283.07	2026-05-08
043-4	OTHER	Multiple Sclerosis, Other Demyelinating Disease And Inflammatory Neuropathies	10	10	—	—	$32,685.00	$49,027.50	$39,222.00	2026-05-08
097-4	OTHER	Tonsil And Adenoid Procedures	10	10	—	—	$32,600.20	$48,900.30	$39,120.24	2026-05-08
174-4	OTHER	Percutaneous Cardiac Intervention With Ami	10	10	—	—	$32,537.65	$48,806.48	$39,045.18	2026-05-08
623-3	OTHER	Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection	10	10	—	—	$32,381.81	$48,572.72	$38,858.17	2026-05-08
229-4	OTHER	Other Digestive System And Abdominal Procedures	10	10	—	—	$32,356.37	$48,534.56	$38,827.65	2026-05-08
842-3	OTHER	Burns With Skin Graft Except Extensive Third Degree Burns	10	10	—	—	$32,270.50	$48,405.75	$38,724.60	2026-05-08
860-4	OTHER	Rehabilitation	2	2	—	—	$33,706.10	$43,336.41	$38,521.26	2026-05-08
224-4	OTHER	Peritoneal Adhesiolysis	10	10	—	—	$32,045.76	$48,068.64	$38,454.91	2026-05-08
089-3	OTHER	Major Cranial Or Facial Bone Procedures	10	10	—	—	$31,968.38	$47,952.57	$38,362.06	2026-05-08
183-1	OTHER	Percutaneous Structural Cardiac Procedures	10	10	—	—	$31,960.95	$47,941.43	$38,353.14	2026-05-08
163-1	OTHER	Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis	10	10	—	—	$31,937.63	$47,906.44	$38,325.15	2026-05-08
222-4	OTHER	Other Stomach, Esophageal And Duodenal Procedures	10	10	—	—	$31,914.31	$47,871.47	$38,297.18	2026-05-08
752-4	OTHER	Disorders Of Personality And Impulse Control	10	10	—	—	$30,406.97	$49,970.46	$38,159.70	2026-05-08
227-4	OTHER	Hernia Procedures Except Inguinal, Femoral And Umbilical	10	10	—	—	$31,715.01	$47,572.51	$38,058.01	2026-05-08
171-4	OTHER	Permanent Cardiac Pacemaker Implant Without Ami, Heart Failure Or Shock	10	10	—	—	$31,699.11	$47,548.67	$38,038.93	2026-05-08
309-4	OTHER	Other Significant Hip And Femur Surgery	10	10	—	—	$31,657.77	$47,486.65	$37,989.32	2026-05-08
130-1	OTHER	Respiratory System Diagnosis With Ventilator Support > 96 Hours	10	10	—	—	$31,638.68	$47,458.02	$37,966.42	2026-05-08
182-4	OTHER	Other Peripheral Vascular And Related Procedures	10	10	—	—	$31,433.03	$47,149.54	$37,719.64	2026-05-08
180-4	OTHER	Other Circulatory System Procedures	10	10	—	—	$31,390.62	$47,085.93	$37,668.74	2026-05-08
519-4	OTHER	Uterine And Adnexa Procedures For Leiomyoma	10	10	—	—	$31,329.14	$46,993.71	$37,594.97	2026-05-08
305-4	OTHER	Amputation Of Lower Limb Except Toes	10	10	—	—	$31,219.95	$46,829.93	$37,463.94	2026-05-08
023-3	OTHER	Spinal Procedures	10	10	—	—	$31,165.88	$46,748.82	$37,399.06	2026-05-08
444-4	OTHER	Renal Dialysis Access Device Procedures	10	10	—	—	$31,001.56	$46,502.34	$37,201.87	2026-05-08
815-4	OTHER	Other Injury, Poisoning And Toxic Effect Diagnoses	10	10	—	—	$30,893.43	$46,340.15	$37,072.12	2026-05-08
518-4	OTHER	Other Female Reproductive System And Related Procedures	10	10	—	—	$30,851.03	$46,276.54	$37,021.24	2026-05-08
315-4	OTHER	Shoulder, Upper Arm And Forearm Procedures Except Joint Replacement	10	10	—	—	$30,730.18	$46,095.27	$36,876.21	2026-05-08
484-4	OTHER	Other Male Reproductive System And Related Procedures	10	10	—	—	$30,651.73	$45,977.60	$36,782.07	2026-05-08
513-4	OTHER	Uterine And Adnexa Procedures For Non-malignancy Except Leiomyoma	10	10	—	—	$30,615.69	$45,923.53	$36,738.82	2026-05-08
098-4	OTHER	Other Ear, Nose, Mouth And Throat Procedures	10	10	—	—	$30,608.27	$45,912.40	$36,729.93	2026-05-08
910-2	OTHER	Craniotomy For Multiple Significant Trauma	10	10	—	—	$30,577.52	$45,866.28	$36,693.03	2026-05-08
323-4	OTHER	Non-elective Or Complex Hip Joint Replacement	10	10	—	—	$30,530.88	$45,796.32	$36,637.06	2026-05-08
639-4	OTHER	Neonate Birth Weight > 2499 Grams With Other Significant Condition	10	10	—	—	$30,420.63	$45,630.94	$36,504.76	2026-05-08
952-4	OTHER	Non-extensive O.r. Procedure Unrelated To Principal Diagnosis	10	10	—	—	$30,279.64	$45,419.46	$36,335.57	2026-05-08
024-4	OTHER	Open Extracranial Vascular Procedures	10	10	—	—	$30,002.95	$45,004.43	$36,003.54	2026-05-08
322-4	OTHER	Shoulder And Elbow Joint Replacement	10	10	—	—	$29,956.31	$44,934.47	$35,947.57	2026-05-08
166-1	OTHER	Coronary Bypass Without Ami Or Complex Principal Diagnosis	10	10	—	—	$29,768.67	$44,653.00	$35,722.40	2026-05-08
42330134	OTHER	Trauma 2 Actvtn Full W Cc	31	25	$48,333.00	$48,333.00	$2,086.00	$48,333.00	$35,476.42	2026-05-08
793-4	OTHER	Moderately Extensive O.r. Procedures For Other Complications Of Treatment	10	10	—	—	$29,505.76	$44,258.64	$35,406.91	2026-05-08
320-4	OTHER	Other Musculoskeletal System And Connective Tissue Procedures	10	10	—	—	$29,353.11	$44,029.67	$35,223.74	2026-05-08
324-4	OTHER	Elective Hip Joint Replacement	10	10	—	—	$29,312.83	$43,969.25	$35,175.40	2026-05-08
130-2	OTHER	Respiratory System Diagnosis With Ventilator Support > 96 Hours	10	10	—	—	$29,252.40	$43,878.60	$35,102.88	2026-05-08
911-3	OTHER	Extensive Abdominal Or Thoracic Procedures For Multiple Significant Trauma	10	10	—	—	$29,241.80	$43,862.70	$35,090.16	2026-05-08
008-1	OTHER	Autologous Bone Marrow Transplant Or T-cell Immunotherapy	10	10	—	—	$29,173.95	$43,760.93	$35,008.74	2026-05-08
020-3	OTHER	Open Craniotomy For Trauma	10	10	—	—	$29,111.41	$43,667.11	$34,933.69	2026-05-08
321-3	OTHER	Spinal Fusion And Other Back And Neck Procedures Except For Disc Procedures	10	10	—	—	$28,755.21	$43,132.82	$34,506.25	2026-05-08
245	OTHER	Aicd Generator Procedures	1	1	—	—	$34,453.00	$34,453.00	$34,453.00	2026-05-08
252	OTHER	Other Vascular Procedures With Mcc	1	1	—	—	$34,453.00	$34,453.00	$34,453.00	2026-05-08
579	OTHER	Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc	1	1	—	—	$34,453.00	$34,453.00	$34,453.00	2026-05-08
177-4	OTHER	Cardiac Pacemaker And Defibrillator Revision Except Device Replacement	10	10	—	—	$28,401.14	$42,601.71	$34,081.37	2026-05-08
050-4	OTHER	Non-bacterial Infections Of Nervous System Except Viral Meningitis	10	10	—	—	$28,382.06	$42,573.09	$34,058.47	2026-05-08
310-4	OTHER	Vertebral And Intervertebral Spinal Procedures Including Disc Procedures	10	10	—	—	$28,318.45	$42,477.68	$33,982.14	2026-05-08
443-4	OTHER	Kidney And Urinary Tract Procedures For Non-malignancy	10	10	—	—	$28,305.73	$42,458.60	$33,966.88	2026-05-08
548-4	OTHER	Postpartum And Post Abortion Diagnosis With O.r. Procedure	10	10	—	—	$28,243.18	$42,364.77	$33,891.82	2026-05-08
514-4	OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	10	10	—	—	$28,211.38	$42,317.07	$33,853.65	2026-05-08
626-4	OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	10	10	—	—	$28,181.70	$42,272.55	$33,818.04	2026-05-08
304-2	OTHER	Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back	10	10	—	—	$28,158.38	$42,237.57	$33,790.06	2026-05-08
680-3	OTHER	Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms	10	10	—	—	$28,131.87	$42,197.81	$33,758.24	2026-05-08
179-1	OTHER	Defibrillator Implants	10	10	—	—	$28,107.49	$42,161.24	$33,728.99	2026-05-08
625-3	OTHER	Neonate Birth Weight 2000-2499 Grams With Other Significant Condition	10	10	—	—	$27,972.86	$41,959.29	$33,567.43	2026-05-08
073-4	OTHER	Orbit And Eye Procedures	10	10	—	—	$27,839.29	$41,758.93	$33,407.15	2026-05-08
441-3	OTHER	Major Bladder Procedures	10	10	—	—	$27,832.93	$41,749.40	$33,399.51	2026-05-08
120-3	OTHER	Major Respiratory And Chest Procedures	10	10	—	—	$27,685.57	$41,528.35	$33,222.68	2026-05-08
027-3	OTHER	Other Open Craniotomy	10	10	—	—	$27,547.76	$41,321.64	$33,057.31	2026-05-08
169-2	OTHER	Major Abdominal Vascular Procedures	10	10	—	—	$27,495.81	$41,243.72	$32,994.97	2026-05-08
759-4	OTHER	Eating Disorders	10	10	—	—	$23,951.90	$58,574.50	$32,933.86	2026-05-08
030-3	OTHER	Percutaneous Intracranial And Extracranial Vascular Procedures	10	10	—	—	$27,424.79	$41,137.18	$32,909.75	2026-05-08
794-4	OTHER	Non-extensive O.r. Procedures For Other Complications Of Treatment	10	10	—	—	$27,396.16	$41,094.24	$32,875.39	2026-05-08
841-2	OTHER	Extensive Third Degree Burns With Skin Graft	10	10	—	—	$27,312.42	$40,968.63	$32,774.90	2026-05-08
850-3	OTHER	Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal…	10	10	—	—	$27,270.01	$40,905.01	$32,724.01	2026-05-08
363-4	OTHER	Breast Procedures Except Mastectomy	10	10	—	—	$27,154.46	$40,731.69	$32,585.35	2026-05-08
317-4	OTHER	Tendon, Muscle And Other Soft Tissue Procedures	10	10	—	—	$27,123.72	$40,685.58	$32,548.47	2026-05-08
263-4	OTHER	Cholecystectomy	10	10	—	—	$27,036.79	$40,555.18	$32,444.15	2026-05-08
260-3	OTHER	Major Pancreas, Liver And Shunt Procedures	10	10	—	—	$26,973.18	$40,459.77	$32,367.82	2026-05-08
613-2	OTHER	Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection	10	10	—	—	$26,880.96	$40,321.44	$32,257.15	2026-05-08
691-4	OTHER	Lymphoma, Myeloma And Non-acute Leukemia	10	10	—	—	$26,595.79	$39,893.69	$31,914.95	2026-05-08
362-4	OTHER	Mastectomy Procedures	10	10	—	—	$26,583.07	$39,874.60	$31,899.68	2026-05-08
170-3	OTHER	Permanent Cardiac Pacemaker Implant With Ami, Heart Failure Or Shock	10	10	—	—	$26,369.99	$39,554.99	$31,643.99	2026-05-08
308-4	OTHER	Hip And Femur Fracture Repair	10	10	—	—	$26,257.62	$39,386.43	$31,509.14	2026-05-08
640-4	OTHER	Neonate Birth Weight > 2499 Grams, Normal Newborn Or Neonate With Other Problem	10	10	—	—	$26,249.14	$39,373.71	$31,498.97	2026-05-08
181-3	OTHER	Lower Extremity Arterial Procedures	10	10	—	—	$26,147.37	$39,221.06	$31,376.85	2026-05-08
912-3	OTHER	Musculoskeletal And Other Procedures For Multiple Significant Trauma	10	10	—	—	$26,081.74	$39,122.61	$31,298.09	2026-05-08
950-3	OTHER	Extensive O.r. Procedure Unrelated To Principal Diagnosis	10	10	—	—	$26,055.14	$39,082.71	$31,266.17	2026-05-08
325-3	OTHER	Non-elective Or Complex Knee Joint Replacement	10	10	—	—	$25,927.93	$38,891.90	$31,113.51	2026-05-08
326-4	OTHER	Elective Knee Joint Replacement	10	10	—	—	$25,927.93	$38,891.90	$31,113.51	2026-05-08
220-3	OTHER	Major Stomach, Esophageal And Duodenal Procedures	10	10	—	—	$25,818.74	$38,728.11	$30,982.49	2026-05-08
314-4	OTHER	Foot And Toe Procedures	10	10	—	—	$25,759.37	$38,639.06	$30,911.24	2026-05-08
690-3	OTHER	Acute Leukemia	10	10	—	—	$25,746.65	$38,619.98	$30,895.98	2026-05-08
223-4	OTHER	Other Small And Large Bowel Procedures	10	10	—	—	$25,727.95	$38,591.93	$30,873.54	2026-05-08
049-4	OTHER	Bacterial And Tuberculous Infections Of Nervous System	10	10	—	—	$25,716.97	$38,575.46	$30,860.36	2026-05-08
029-3	OTHER	Other Percutaneous Intracranial Procedures	10	10	—	—	$25,653.36	$38,480.04	$30,784.03	2026-05-08

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