Hospital

LUTHERAN MEDICAL CENTER

Wheat Ridge, CO · CCN 060009 · Rates published

26,863 distinct procedures filed

21 distinct payers

1,477,932 rate rows

2026-05-14 last MRF observed

Data quality

1,459,937 of 1,477,932 rate rows are consumer-grade (98.8%)

17,995 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
placeholder amount (≤ $0.02) — excluded from medians	7,352
template filing: same amount across many unrelated codes — excluded	5,658
per-diem day rate — not a per-procedure price	2,940
no usable negotiated amount (only an out-of-band fallback) — excluded from medians	2,045

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

Source MRF file	https://intermountainhealthcare.org/sc10media/files/intermountain-health/locations/hospital-prices/841103606_lutheran-medical-center_standardcharges.ashx
Discovered via	Discovered by HANK (automated)
Last fetch	not_modified · 2026-05-19
Content fingerprint	3b73f6c2dc1c6b19… · 6,090,258 bytes · first seen 2026-05-15

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
J3399 OTHER	Inj Onase Abepar-xioi Treat	6	$2,430,559.50	$3,884,946.48	$3,884,946.48	nat. median $2,472,216 1.6× median
J3393 OTHER	Inj Betibeglogene Autotemce	6	$50.00	$4,897,200.00	$2,916,282.60	nat. median $2,968,000 1.0× median
MS-018 OTHER	Chimeric Antigen Receptor (car) T-cell Immunotherapy	17	$302,027.59	$991,606.64	$908,566.11	nat. median $309,559 outlier · 2.9×
Q2042 OTHER	Tisagenlecleucel Car-pos T	9	$50.00	$1,538,488.12	$863,696.72	nat. median $591,726 1.5× median
Q2056 OTHER	Ciltacabtagene Car-pos T	9	$50.00	$1,471,259.27	$837,683.55	nat. median $583,076 1.4× median
Q2055 OTHER	Idecabtagene Vicleucel Car	9	$50.00	$1,449,026.62	$830,699.97	nat. median $558,082 1.5× median
Q2054 OTHER	Lisocabtagene Mara Car Pos T	9	$50.00	$1,462,599.29	$819,043.85	nat. median $562,538 1.5× median
Q2041 OTHER	Axicabtagene Ciloleucel Car+	9	$50.00	$1,386,398.44	$807,075.90	nat. median $533,230 1.5× median
Q2053 OTHER	Brexucabtagene Car Pos T	9	$50.00	$1,272,191.99	$741,576.00	nat. median $489,720 1.5× median
MS-001 OTHER	Heart Transplant Or Implant Of Heart Assist System With Mcc	17	$196,003.76	$643,512.82	$544,067.58	nat. median $224,278 outlier · 2.4×
MS-927 OTHER	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	17	$149,328.90	$490,271.53	$449,214.52	nat. median $175,322 outlier · 2.6×
MS-003 OTHER	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face- Mouth…	17	$148,452.53	$487,394.27	$446,578.21	nat. median $169,886 outlier · 2.6×
143901 OTHER	Sipuleucel-t In Lactated Ringers 50 Million Cell/250 Ml IV Suspension	16	$102,021.10	$551,465.43	$315,713.96	nat. median $255,642 1.2× median
MS-004 OTHER	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face- Mouth And Nec…	17	$96,878.97	$318,069.70	$291,433.46	nat. median $107,587 outlier · 2.7×
MS-007 OTHER	Lung Transplant	16	$90,575.83	$297,375.44	$267,343.93	nat. median $95,292 outlier · 2.8×
J3403 OTHER	Revakinagene Per Implant	5	$254,925.00	$669,500.00	$256,212.50	nat. median $265,000 1.0× median
MS-014 OTHER	Allogeneic Bone Marrow Transplant	16	$84,055.17	$275,967.04	$248,097.53	nat. median $91,600 outlier · 2.7×
202663 OTHER	Lutetium Lu 177 Dotatate 10 Mci/ml (370 Mbq/ml) Intravenous Solution	16	$79,365.33	$429,001.80	$245,603.53	nat. median $133,815 1.8× median
MS-209 OTHER	Complex Aortic Arch Procedures	17	$79,165.55	$259,913.60	$238,147.55	nat. median $81,783 outlier · 2.9×
MS-426 OTHER	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	17	$77,084.08	$253,079.82	$231,886.05	nat. median $84,247 outlier · 2.8×
MS-212 OTHER	Concomitant Aortic And Mitral Valve?procedures	17	$76,055.24	$249,701.96	$228,791.06	nat. median $87,208 outlier · 2.6×
MS-002 OTHER	Heart Transplant Or Implant Of Heart Assist System Without Mcc	17	$79,256.47	$260,212.12	$220,000.25	nat. median $91,287 outlier · 2.4×
MS-005 OTHER	Liver Transplant With Mcc Or Intestinal Transplant	17	$72,113.33	$236,760.01	$216,932.92	nat. median $85,046 outlier · 2.6×
210658 OTHER	Inebilizumab-cdon 10 Mg/ml Intravenous Solution	16	$67,995.34	$384,643.69	$210,418.01	nat. median $198,864 1.1× median
MS-215 OTHER	Other Heart Assist System Implant	17	$69,640.89	$228,642.59	$209,495.28	nat. median $80,736 outlier · 2.6×
MS-216 OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	17	$68,422.51	$224,642.44	$205,830.11	nat. median $76,284 outlier · 2.7×
J3402 OTHER	Inj. Remestemcel-l-rknd/ Td	5	$203,583.60	$534,664.00	$204,611.80	nat. median $205,640 1.0× median
MS-453 OTHER	Combined Anterior/posterior Spinal Fusion W Mcc	4	$134,303.38	$203,484.33	$203,484.33	nat. median $121,295 1.7× median
216356 OTHER	Lutetium Lu-177 Vipivotide Tetraxetan 27 Mci/ml (1,000 Mbq/ml) IV Soln	16	$64,629.16	$349,346.82	$200,001.05	nat. median $121,941 1.6× median
2722109771 OTHER	Hc Percutaneous Ventricular Assist Device Lvl 71	16	$64,392.55	$348,067.85	$199,268.84	nat. median $113,676 1.8× median
2782649771 OTHER	Hc Valve Implant Lvl 71	16	$64,392.55	$348,067.85	$199,268.84	nat. median $113,676 1.8× median
2721649601 OTHER	Hc Kit Pump Device Cardiac Ventricular Smartassist 5.5 S2	16	$61,807.02	$334,092.00	$191,267.67	nat. median $109,112 1.8× median
2782649770 OTHER	Hc Valve Implant Lvl 70	16	$61,326.21	$331,493.05	$189,779.77	nat. median $108,263 1.8× median
278TRIG470 OTHER	Hc Ntap Triclip G4 Vlv Rpr Systm	16	$61,326.21	$331,493.05	$189,779.77	nat. median $108,263 1.8× median
2721649701 OTHER	Hc Pump Blood Vad With Valves	16	$61,309.76	$331,404.10	$189,728.85	nat. median $108,234 1.8× median
MS-429 OTHER	Combined Anterior And Posterior Cervical Spinal Fusion With Mcc	17	$63,014.62	$206,887.44	$189,561.98	nat. median $69,654 outlier · 2.7×
MS-850 OTHER	Acute Leukemia With Other Procedures	17	$60,565.97	$198,848.10	$182,195.88	nat. median $70,217 outlier · 2.6×
MS-231 OTHER	Coronary Bypass With Ptca With Mcc	17	$58,960.10	$193,575.79	$177,365.10	nat. median $64,520 outlier · 2.7×
MS-456 OTHER	Spinal Fusion Except Cervical With Spinal Curvature- Malignancy- Infection Or Ex…	17	$58,774.76	$192,967.27	$176,807.54	nat. median $65,528 outlier · 2.7×
192637 OTHER	Flutemetamol F-18 5 Mci (185 Mbq) Intravenous Solution	16	$37,484.70	$607,860.00	$170,200.80	nat. median $117,976 1.4× median
MS-020 OTHER	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc	17	$55,035.68	$180,691.25	$165,559.55	nat. median $64,597 outlier · 2.6×
275C188267 OTHER	Hc Icd Biv/crt-d Lvl 67	16	$52,975.85	$286,355.95	$163,938.78	nat. median $93,521 1.8× median
MS-219 OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	17	$53,703.29	$176,316.80	$161,551.43	nat. median $59,911 outlier · 2.7×
MS-233 OTHER	Coronary Bypass With Cardiac Catheterization With Mcc	17	$53,471.78	$175,556.73	$160,855.01	nat. median $60,330 outlier · 2.7×
MS-957 OTHER	Other O.r. Procedures For Multiple Significant Trauma With Mcc	17	$53,294.83	$174,975.76	$160,322.70	nat. median $59,203 outlier · 2.7×
278C188966 OTHER	Hc Implantable-insertable Device Noc Lvl 66	16	$50,453.18	$272,719.90	$156,132.14	nat. median $89,068 1.8× median
278C182366 OTHER	Hc Neurostim Generator/lead Lvl 66	16	$50,453.18	$272,719.90	$156,132.14	nat. median $89,068 1.8× median
2782649766 OTHER	Hc Valve Implant Lvl 66	16	$50,453.18	$272,719.90	$156,132.14	nat. median $89,068 1.8× median
MS-459 OTHER	Spinal Fusion Except Cervical With Mcc	4	$100,519.14	$152,297.50	$152,297.50	nat. median $72,631 outlier · 2.1×
MS-427 OTHER	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	17	$50,488.07	$165,760.71	$151,879.34	nat. median $54,639 outlier · 2.8×

Other procedures at this hospital

Browse this hospital's 26,863 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

J3399	OTHER	Inj Onase Abepar-xioi Treat	20	6	—	—	$2,430,559.50	$3,884,946.48	$3,884,946.48	2026-05-14
J3393	OTHER	Inj Betibeglogene Autotemce	33	6	—	—	$50.00	$4,897,200.00	$2,916,282.60	2026-05-14
MS-018	OTHER	Chimeric Antigen Receptor (car) T-cell Immunotherapy	57	17	—	—	$302,027.59	$991,606.64	$908,566.11	2026-05-14
Q2042	OTHER	Tisagenlecleucel Car-pos T	45	9	—	—	$50.00	$1,538,488.12	$863,696.72	2026-05-14
Q2056	OTHER	Ciltacabtagene Car-pos T	45	9	—	—	$50.00	$1,471,259.27	$837,683.55	2026-05-14
Q2055	OTHER	Idecabtagene Vicleucel Car	45	9	—	—	$50.00	$1,449,026.62	$830,699.97	2026-05-14
Q2054	OTHER	Lisocabtagene Mara Car Pos T	45	9	—	—	$50.00	$1,462,599.29	$819,043.85	2026-05-14
Q2041	OTHER	Axicabtagene Ciloleucel Car+	45	9	—	—	$50.00	$1,386,398.44	$807,075.90	2026-05-14
Q2053	OTHER	Brexucabtagene Car Pos T	45	9	—	—	$50.00	$1,272,191.99	$741,576.00	2026-05-14
MS-001	OTHER	Heart Transplant Or Implant Of Heart Assist System With Mcc	46	17	—	—	$196,003.76	$643,512.82	$544,067.58	2026-05-14
MS-927	OTHER	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	58	17	—	—	$149,328.90	$490,271.53	$449,214.52	2026-05-14
MS-003	OTHER	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face- Mouth…	58	17	—	—	$148,452.53	$487,394.27	$446,578.21	2026-05-14
143901	OTHER	Sipuleucel-t In Lactated Ringers 50 Million Cell/250 Ml IV Suspension	71	16	$551,465.43	—	$102,021.10	$551,465.43	$315,713.96	2026-05-14
MS-004	OTHER	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face- Mouth And Nec…	58	17	—	—	$96,878.97	$318,069.70	$291,433.46	2026-05-14
MS-007	OTHER	Lung Transplant	45	16	—	—	$90,575.83	$297,375.44	$267,343.93	2026-05-14
J3403	OTHER	Revakinagene Per Implant	10	5	—	—	$254,925.00	$669,500.00	$256,212.50	2026-05-14
MS-014	OTHER	Allogeneic Bone Marrow Transplant	45	16	—	—	$84,055.17	$275,967.04	$248,097.53	2026-05-14
202663	OTHER	Lutetium Lu 177 Dotatate 10 Mci/ml (370 Mbq/ml) Intravenous Solution	71	16	$429,001.80	—	$79,365.33	$429,001.80	$245,603.53	2026-05-14
MS-209	OTHER	Complex Aortic Arch Procedures	58	17	—	—	$79,165.55	$259,913.60	$238,147.55	2026-05-14
MS-426	OTHER	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	58	17	—	—	$77,084.08	$253,079.82	$231,886.05	2026-05-14
MS-212	OTHER	Concomitant Aortic And Mitral Valve?procedures	58	17	—	—	$76,055.24	$249,701.96	$228,791.06	2026-05-14
MS-002	OTHER	Heart Transplant Or Implant Of Heart Assist System Without Mcc	46	17	—	—	$79,256.47	$260,212.12	$220,000.25	2026-05-14
MS-005	OTHER	Liver Transplant With Mcc Or Intestinal Transplant	57	17	—	—	$72,113.33	$236,760.01	$216,932.92	2026-05-14
210658	OTHER	Inebilizumab-cdon 10 Mg/ml Intravenous Solution	142	16	$376,093.03	—	$67,995.34	$384,643.69	$210,418.01	2026-05-14
MS-215	OTHER	Other Heart Assist System Implant	58	17	—	—	$69,640.89	$228,642.59	$209,495.28	2026-05-14
MS-216	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	58	17	—	—	$68,422.51	$224,642.44	$205,830.11	2026-05-14
J3402	OTHER	Inj. Remestemcel-l-rknd/ Td	10	5	—	—	$203,583.60	$534,664.00	$204,611.80	2026-05-14
MS-453	OTHER	Combined Anterior/posterior Spinal Fusion W Mcc	11	4	—	—	$134,303.38	$203,484.33	$203,484.33	2026-05-14
216356	OTHER	Lutetium Lu-177 Vipivotide Tetraxetan 27 Mci/ml (1,000 Mbq/ml) IV Soln	71	16	$349,346.82	—	$64,629.16	$349,346.82	$200,001.05	2026-05-14
2782649771	OTHER	Hc Valve Implant Lvl 71	71	16	$348,067.85	—	$64,392.55	$348,067.85	$199,268.84	2026-05-14
2722109771	OTHER	Hc Percutaneous Ventricular Assist Device Lvl 71	71	16	$348,067.85	—	$64,392.55	$348,067.85	$199,268.84	2026-05-14
2721649601	OTHER	Hc Kit Pump Device Cardiac Ventricular Smartassist 5.5 S2	71	16	$334,092.00	—	$61,807.02	$334,092.00	$191,267.67	2026-05-14
2782649770	OTHER	Hc Valve Implant Lvl 70	71	16	$331,493.05	—	$61,326.21	$331,493.05	$189,779.77	2026-05-14
278TRIG470	OTHER	Hc Ntap Triclip G4 Vlv Rpr Systm	71	16	$331,493.05	—	$61,326.21	$331,493.05	$189,779.77	2026-05-14
2721649701	OTHER	Hc Pump Blood Vad With Valves	71	16	$331,404.10	—	$61,309.76	$331,404.10	$189,728.85	2026-05-14
MS-429	OTHER	Combined Anterior And Posterior Cervical Spinal Fusion With Mcc	58	17	—	—	$63,014.62	$206,887.44	$189,561.98	2026-05-14
MS-850	OTHER	Acute Leukemia With Other Procedures	58	17	—	—	$60,565.97	$198,848.10	$182,195.88	2026-05-14
MS-231	OTHER	Coronary Bypass With Ptca With Mcc	58	17	—	—	$58,960.10	$193,575.79	$177,365.10	2026-05-14
MS-456	OTHER	Spinal Fusion Except Cervical With Spinal Curvature- Malignancy- Infection Or Ex…	58	17	—	—	$58,774.76	$192,967.27	$176,807.54	2026-05-14
192637	OTHER	Flutemetamol F-18 5 Mci (185 Mbq) Intravenous Solution	142	16	$405,240.00	—	$37,484.70	$607,860.00	$170,200.80	2026-05-14
MS-020	OTHER	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc	58	17	—	—	$55,035.68	$180,691.25	$165,559.55	2026-05-14
275C188267	OTHER	Hc Icd Biv/crt-d Lvl 67	71	16	$286,355.95	—	$52,975.85	$286,355.95	$163,938.78	2026-05-14
MS-219	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	58	17	—	—	$53,703.29	$176,316.80	$161,551.43	2026-05-14
MS-233	OTHER	Coronary Bypass With Cardiac Catheterization With Mcc	58	17	—	—	$53,471.78	$175,556.73	$160,855.01	2026-05-14
MS-957	OTHER	Other O.r. Procedures For Multiple Significant Trauma With Mcc	58	17	—	—	$53,294.83	$174,975.76	$160,322.70	2026-05-14
278C182366	OTHER	Hc Neurostim Generator/lead Lvl 66	71	16	$272,719.90	—	$50,453.18	$272,719.90	$156,132.14	2026-05-14
2782649766	OTHER	Hc Valve Implant Lvl 66	71	16	$272,719.90	—	$50,453.18	$272,719.90	$156,132.14	2026-05-14
278C188966	OTHER	Hc Implantable-insertable Device Noc Lvl 66	71	16	$272,719.90	—	$50,453.18	$272,719.90	$156,132.14	2026-05-14
MS-459	OTHER	Spinal Fusion Except Cervical With Mcc	11	4	—	—	$100,519.14	$152,297.50	$152,297.50	2026-05-14
MS-427	OTHER	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	58	17	—	—	$50,488.07	$165,760.71	$151,879.34	2026-05-14
MS-928	OTHER	Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc	58	17	—	—	$50,167.04	$164,706.71	$150,913.61	2026-05-14
MS-019	OTHER	Simultaneous Pancreas And Kidney Transplant With Hemodialysis	57	17	—	—	$49,900.56	$163,831.82	$150,111.98	2026-05-14
MS-275	OTHER	Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc	58	17	—	—	$49,871.19	$163,735.38	$150,023.62	2026-05-14
2782649765	OTHER	Hc Valve Implant Lvl 65	71	16	$259,733.15	—	$48,050.63	$259,733.15	$148,697.23	2026-05-14
MS-010	OTHER	Pancreas Transplant	45	16	—	—	$50,188.02	$164,775.60	$148,135.15	2026-05-14
MS-870	OTHER	Septicemia Or Severe Sepsis With Mv >96 Hours	58	17	—	—	$48,342.26	$158,715.66	$145,424.27	2026-05-14
MS-268	OTHER	Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc	58	17	—	—	$48,105.16	$157,937.22	$144,711.02	2026-05-14
K1007	OTHER	Bil Hkaf Pc S/d Micro Sensor	4	1	—	—	$142,064.43	$142,064.43	$142,064.43	2026-05-14
MS-955	OTHER	Craniotomy For Multiple Significant Trauma	58	17	—	—	$47,078.42	$154,566.25	$141,622.34	2026-05-14
2782669764	OTHER	Hc Vascular Stent Graft Implant Lvl 64	71	16	$247,364.85	—	$45,762.50	$247,364.85	$141,616.38	2026-05-14
2782649764	OTHER	Hc Valve Implant Lvl 64	71	16	$247,364.85	—	$45,762.50	$247,364.85	$141,616.38	2026-05-14
MS-317	OTHER	Concomitant Left Atrial Appendage Closure And Cardiac Ablation	58	17	—	—	$46,766.48	$153,542.10	$140,683.96	2026-05-14
MS-447	OTHER	Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall…	58	17	—	—	$46,732.21	$153,429.58	$140,580.86	2026-05-14
MS-454	OTHER	Combined Anterior/posterior Spinal Fusion W Cc	11	4	—	—	$92,698.64	$140,448.60	$140,448.60	2026-05-14
MS-218	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	58	17	—	—	$45,988.73	$150,988.61	$138,344.31	2026-05-14
MS-217	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	58	17	—	—	$45,988.73	$150,988.61	$138,344.31	2026-05-14
MS-573	OTHER	Skin Graft For Skin Ulcer Or Cellulitis With Mcc	58	17	—	—	$45,821.57	$150,439.80	$137,841.46	2026-05-14
MS-207	OTHER	Respiratory System Diagnosis With Ventilator Support >96 Hours	58	17	—	—	$45,005.35	$147,760.02	$135,386.09	2026-05-14
278C188963	OTHER	Hc Implantable-insertable Device Noc Lvl 63	71	16	$235,585.45	—	$43,583.31	$235,585.45	$134,872.67	2026-05-14
2782649763	OTHER	Hc Valve Implant Lvl 63	71	16	$235,585.45	—	$43,583.31	$235,585.45	$134,872.67	2026-05-14
Q0480	OTHER	Driver Pneumatic Vad Rep	14	6	—	—	$109,037.80	$286,361.89	$133,099.54	2026-05-14
183256	OTHER	Radium Ra 223 Dichlor 1,100 Kbq/ml (30 Microcurie/ml) Intravenous Soln	71	16	$230,906.68	—	$42,717.74	$230,906.68	$132,194.07	2026-05-14
MS-266	OTHER	Endovascular Cardiac Valve Replacement W Mcc	58	17	—	—	$42,863.04	$140,726.45	$128,941.54	2026-05-14
MS-969	OTHER	HIV With Extensive O.r. Procedures With Mcc	58	17	—	—	$42,813.38	$140,563.41	$128,792.15	2026-05-14
2782669762	OTHER	Hc Vascular Stent Graft Implant Lvl 62	71	16	$224,367.00	—	$41,507.89	$224,367.00	$128,450.11	2026-05-14
278C187462	OTHER	Hc Stent Coated/covered Implant Lvl 62	71	16	$224,367.00	—	$41,507.89	$224,367.00	$128,450.11	2026-05-14
278C188962	OTHER	Hc Implantable-insertable Device Noc Lvl 62	71	16	$224,367.00	—	$41,507.89	$224,367.00	$128,450.11	2026-05-14
MS-232	OTHER	Coronary Bypass With Ptca Without Mcc	58	17	—	—	$42,402.82	$139,215.48	$127,557.10	2026-05-14
MS-028	OTHER	Spinal Procedures With Mcc	58	17	—	—	$42,023.04	$137,968.59	$126,414.63	2026-05-14
MS-276	OTHER	Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator	58	17	—	—	$42,011.15	$137,929.56	$126,378.86	2026-05-14
MS-457	OTHER	Spinal Fusion Except Cervical With Spinal Curvature- Malignancy- Infection Or Ex…	58	17	—	—	$41,706.90	$136,930.67	$125,463.62	2026-05-14
MS-790	OTHER	Extreme Immaturity Or Respiratory Distress Syndrome- Neonate	48	15	—	—	$41,569.82	$136,106.15	$125,051.24	2026-05-14
MS-235	OTHER	Coronary Bypass Without Cardiac Catheterization With Mcc	58	17	—	—	$41,045.95	$134,760.66	$123,475.34	2026-05-14
MS-820	OTHER	Lymphoma And Leukemia With Major O.r. Procedures With Mcc	58	17	—	—	$41,019.37	$134,673.40	$123,395.39	2026-05-14
MS-016	OTHER	Autolous Bone Marrow Transplant With Cc/mcc	45	16	—	—	$41,473.30	$136,163.70	$122,412.73	2026-05-14
2782649761	OTHER	Hc Valve Implant Lvl 61	71	16	$213,682.80	—	$39,531.32	$213,682.80	$122,333.40	2026-05-14
278C182361	OTHER	Hc Neurostim Generator/lead Lvl 61	71	16	$213,682.80	—	$39,531.32	$213,682.80	$122,333.40	2026-05-14
2722109761	OTHER	Hc Percutaneous Ventricular Assist Device Lvl 61	71	16	$213,682.80	—	$39,531.32	$213,682.80	$122,333.40	2026-05-14
MS-430	OTHER	Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc	58	17	—	—	$40,336.04	$132,429.92	$121,339.78	2026-05-14
MS-023	OTHER	Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…	58	17	—	—	$40,078.66	$131,584.88	$120,565.51	2026-05-14
MS-213	OTHER	Endovascular Abdominal Aorta With Iliac Branch Procedures	58	17	—	—	$39,915.00	$131,047.54	$120,073.18	2026-05-14
MS-463	OTHER	Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …	58	17	—	—	$39,863.24	$130,877.62	$119,917.48	2026-05-14
MS-428	OTHER	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	58	17	—	—	$39,321.19	$129,097.99	$118,286.88	2026-05-14
2721649501	OTHER	Hc Set Pump Impella Cp W/smart Assist	71	16	$205,011.00	—	$37,927.03	$205,011.00	$117,368.80	2026-05-14
MS-278	OTHER	Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures …	58	17	—	—	$38,930.92	$127,816.65	$117,112.85	2026-05-14
2722109760	OTHER	Hc Percutaneous Ventricular Assist Device Lvl 60	71	16	$203,507.35	—	$37,648.86	$203,507.35	$116,507.96	2026-05-14
MS-461	OTHER	Bilateral Or Multiple Major Joint Procs Of Lower Extremity W Mcc	58	17	—	—	$38,628.77	$126,824.65	$116,203.92	2026-05-14
MS-008	OTHER	Simultaneous Pancreas/kidney Transplant	45	16	—	—	$39,199.49	$128,698.43	$115,701.36	2026-05-14
MS-834	OTHER	Acute Leukemia Without Major O.r. Procedures With Mcc	58	17	—	—	$38,397.26	$126,064.57	$115,507.50	2026-05-14
MS-405	OTHER	Pancreas- Liver And Shunt Procedures With Mcc	58	17	—	—	$38,261.58	$125,619.09	$115,099.32	2026-05-14
MS-234	OTHER	Coronary Bypass With Cardiac Catheterization Without Mcc	58	17	—	—	$38,207.02	$125,439.98	$114,935.21	2026-05-14
MS-011	OTHER	Tracheostomy For Facemouth & Neck Diagnoses W Mcc	58	17	—	—	$38,146.87	$125,242.50	$114,754.26	2026-05-14
MS-220	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	58	17	—	—	$37,298.48	$122,457.09	$112,202.11	2026-05-14
MS-017	OTHER	Autolous Bone Marrow Transplant Without Cc/mcc	45	16	—	—	$37,994.40	$124,741.90	$112,144.40	2026-05-14
MS-450	OTHER	Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically …	58	17	—	—	$37,276.10	$122,383.60	$112,134.78	2026-05-14
MS-021	OTHER	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc	58	17	—	—	$37,025.71	$121,561.53	$111,381.55	2026-05-14
MS-270	OTHER	Other Major Cardiovascular Procedures With Mcc	58	17	—	—	$36,903.31	$121,159.68	$111,013.35	2026-05-14
275C188259	OTHER	Hc Icd Biv/crt-d Lvl 59	71	16	$193,816.50	—	$35,856.05	$193,816.50	$110,959.95	2026-05-14
272C176959	OTHER	Hc Guidewire Lvl 59	71	16	$193,816.50	—	$35,856.05	$193,816.50	$110,959.95	2026-05-14
278C188959	OTHER	Hc Implantable-insertable Device Noc Lvl 59	71	16	$193,816.50	—	$35,856.05	$193,816.50	$110,959.95	2026-05-14
275C172159	OTHER	Hc Icd Dual Chamber Lvl 59	71	16	$193,816.50	—	$35,856.05	$193,816.50	$110,959.95	2026-05-14
2782649759	OTHER	Hc Valve Implant Lvl 59	71	16	$193,816.50	—	$35,856.05	$193,816.50	$110,959.95	2026-05-14
278LIMFW59	OTHER	Hc Ntap Limflow System	71	16	$193,816.50	—	$35,856.05	$193,816.50	$110,959.95	2026-05-14
278C262459	OTHER	Hc Wireless Pressure Sensor Lvl 59	71	16	$193,816.50	—	$35,856.05	$193,816.50	$110,959.95	2026-05-14
278C182359	OTHER	Hc Neurostim Generator/lead Lvl 59	71	16	$193,816.50	—	$35,856.05	$193,816.50	$110,959.95	2026-05-14
2722109759	OTHER	Hc Percutaneous Ventricular Assist Device Lvl 59	71	16	$193,816.50	—	$35,856.05	$193,816.50	$110,959.95	2026-05-14
MS-466	OTHER	Revision Of Hip Or Knee Replacement With Mcc	58	17	—	—	$36,407.42	$119,531.60	$109,521.62	2026-05-14
MS-653	OTHER	Major Bladder Procedures With Mcc	58	17	—	—	$36,344.47	$119,324.93	$109,332.26	2026-05-14
189298	OTHER	Alemtuzumab 12 Mg/1.2 Ml Intravenous Solution	71	16	$186,740.81	—	$34,547.05	$186,740.81	$106,909.11	2026-05-14
MS-221	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	58	17	—	—	$35,251.99	$115,738.11	$106,045.81	2026-05-14
MS-455	OTHER	Combined Anterior/posterior Spinal Fusion Without Cc/mcc	11	4	—	—	$69,802.47	$105,758.39	$105,758.39	2026-05-14
2722109758	OTHER	Hc Percutaneous Ventricular Assist Device Lvl 58	71	16	$184,587.05	—	$34,148.60	$184,587.05	$105,676.09	2026-05-14
2782649758	OTHER	Hc Valve Implant Lvl 58	71	16	$184,587.05	—	$34,148.60	$184,587.05	$105,676.09	2026-05-14
MS-326	OTHER	Stomach- Esophageal And Duodenal Procedures With Mcc	58	17	—	—	$34,882.69	$114,525.67	$104,934.90	2026-05-14
MS-228	OTHER	Other Cardiothoracic Procedures With Mcc	58	17	—	—	$34,602.93	$113,607.15	$104,093.30	2026-05-14
MS-853	OTHER	Infectious And Parasitic Diseases With O.r. Procedures With Mcc	58	17	—	—	$34,541.38	$113,405.07	$103,908.14	2026-05-14
MS-239	OTHER	Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc	58	17	—	—	$34,423.18	$113,017.00	$103,552.57	2026-05-14
MS-576	OTHER	Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc	58	17	—	—	$34,279.80	$112,546.26	$103,121.25	2026-05-14
MS-471	OTHER	Cervical Spinal Fusion With Mcc	58	17	—	—	$33,772.72	$110,881.44	$101,595.85	2026-05-14
MS-837	OTHER	Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot…	58	17	—	—	$33,602.06	$110,321.14	$101,082.47	2026-05-14
2722109757	OTHER	Hc Percutaneous Ventricular Assist Device Lvl 57	71	16	$175,797.10	—	$32,522.46	$175,797.10	$100,643.84	2026-05-14
MS-267	OTHER	Endovascular Cardiac Valve Replacement Without Mcc	58	17	—	—	$33,297.82	$109,322.25	$100,167.23	2026-05-14
199175	OTHER	Ocrelizumab 30 Mg/ml Intravenous Solution	71	16	$173,734.97	—	$32,140.97	$173,734.97	$99,463.27	2026-05-14
MS-650	OTHER	Kidney Transplant With Hemodialysis With Mcc	57	17	—	—	$32,882.36	$107,958.25	$98,917.46	2026-05-14
MS-981	OTHER	Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc	58	17	—	—	$32,815.22	$107,737.80	$98,715.47	2026-05-14
MS-826	OTHER	Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. …	58	17	—	—	$32,717.30	$107,416.32	$98,420.91	2026-05-14
MS-006	OTHER	Liver Transplant Without Mcc	57	17	—	—	$32,431.94	$106,479.43	$97,562.48	2026-05-14
MS-277	OTHER	Cardiac Defibrillator Implant Without Mcc	58	17	—	—	$32,302.55	$106,054.62	$97,173.24	2026-05-14
MS-329	OTHER	Major Small And Large Bowel Procedures With Mcc	58	17	—	—	$32,148.68	$105,549.43	$96,710.36	2026-05-14
MS-823	OTHER	Lymphoma And Non-acute Leukemia With Other Procedures With Mcc	58	17	—	—	$32,066.84	$105,280.76	$96,464.19	2026-05-14
MS-245	OTHER	Aicd Generator Procedures	58	17	—	—	$31,910.17	$104,766.39	$95,992.90	2026-05-14
278C182656	OTHER	Hc Gen Neuro Rchg W Bat & Lds & Cmpnts Implant Lvl 56	71	16	$167,425.75	—	$30,973.76	$167,425.75	$95,851.24	2026-05-14
275C188256	OTHER	Hc Icd Biv/crt-d Lvl 56	71	16	$167,425.75	—	$30,973.76	$167,425.75	$95,851.24	2026-05-14
275C172256	OTHER	Hc Icd Single Chamber Lvl 56	71	16	$167,425.75	—	$30,973.76	$167,425.75	$95,851.24	2026-05-14
2721489756	OTHER	Hc Cardiovascular Non Implant Supply Lvl 56	71	16	$167,425.75	—	$30,973.76	$167,425.75	$95,851.24	2026-05-14
MS-856	OTHER	Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc	58	17	—	—	$31,814.35	$104,451.80	$95,704.65	2026-05-14
MS-025	OTHER	Craniotomy And Endovascular Intracranial Procedures With Mcc	58	17	—	—	$31,800.37	$104,405.87	$95,662.57	2026-05-14
MS-799	OTHER	Splenic Procedures With Mcc	58	17	—	—	$31,675.87	$103,997.13	$95,288.06	2026-05-14
MS-163	OTHER	Major Chest Procedures With Mcc	58	17	—	—	$31,346.45	$102,915.57	$94,297.07	2026-05-14
MS-031	OTHER	Ventricular Shunt Procedures With Mcc	58	17	—	—	$31,337.35	$102,885.72	$94,269.72	2026-05-14
MS-319	OTHER	Other Endovascular Cardiac Valve Procedures With Mcc	58	17	—	—	$31,214.26	$102,481.57	$93,899.42	2026-05-14
MS-356	OTHER	Other Digestive System O.r. Procedures With Mcc	58	17	—	—	$30,723.96	$100,871.87	$92,424.51	2026-05-14
275C188255	OTHER	Hc Icd Biv/crt-d Lvl 55	71	16	$159,453.00	—	$29,498.80	$159,453.00	$91,286.84	2026-05-14
2782669755	OTHER	Hc Vascular Stent Graft Implant Lvl 55	71	16	$159,453.00	—	$29,498.80	$159,453.00	$91,286.84	2026-05-14
2782649755	OTHER	Hc Valve Implant Lvl 55	71	16	$159,453.00	—	$29,498.80	$159,453.00	$91,286.84	2026-05-14
MS-323	OTHER	Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc	58	17	—	—	$30,266.55	$99,370.09	$91,048.50	2026-05-14
MS-474	OTHER	Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc	58	17	—	—	$30,025.25	$98,577.86	$90,322.62	2026-05-14
MS-140	OTHER	Major Head And Neck Procedures With Mcc	58	17	—	—	$29,832.21	$97,944.08	$89,741.91	2026-05-14
MS-448	OTHER	Multiple Level Spinal Fusion Except Cervical Without Mcc	58	17	—	—	$29,660.85	$97,381.49	$89,226.43	2026-05-14
MS-269	OTHER	Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc	58	17	—	—	$29,537.75	$96,977.34	$88,856.13	2026-05-14
MS-012	OTHER	Tracheostomy For Facemouth & Neck Diagnoses W Cc	58	17	—	—	$29,487.40	$96,812.01	$88,704.64	2026-05-14
MS-958	OTHER	Other O.r. Procedures For Multiple Significant Trauma With Cc	58	17	—	—	$29,472.71	$96,763.79	$88,660.46	2026-05-14
MS-673	OTHER	Other Kidney And Urinary Tract Procedures With Mcc	58	17	—	—	$29,386.68	$96,481.34	$88,401.66	2026-05-14
MS-901	OTHER	Wound Debridements For Injuries With Mcc	58	17	—	—	$29,351.71	$96,366.53	$88,296.46	2026-05-14
MS-236	OTHER	Coronary Bypass Without Cardiac Catheterization Without Mcc	58	17	—	—	$29,297.16	$96,187.41	$88,132.35	2026-05-14
MS-458	OTHER	Spinal Fusion Except Cervical With Spinal Curvature- Malignancy- Infection Or Ex…	58	17	—	—	$29,183.85	$95,815.41	$87,791.50	2026-05-14
MS-423	OTHER	Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc	58	17	—	—	$29,046.76	$95,365.34	$87,379.12	2026-05-14
275C188254	OTHER	Hc Icd Biv/crt-d Lvl 54	71	16	$151,859.90	—	$28,094.08	$151,859.90	$86,939.79	2026-05-14
2782669754	OTHER	Hc Vascular Stent Graft Implant Lvl 54	71	16	$151,859.90	—	$28,094.08	$151,859.90	$86,939.79	2026-05-14
MS-273	OTHER	Percutaneous Intracardiac Procedures W Mcc	58	17	—	—	$28,854.42	$94,733.86	$86,800.52	2026-05-14
MS-791	OTHER	Prematurity With Major Problems	48	15	—	—	$28,389.31	$96,758.00	$85,401.36	2026-05-14
J7330	OTHER	Cultured Chondrocytes Implnt	28	4	—	—	$50.00	$203,694.25	$85,400.52	2026-05-14
L8702	OTHER	Ewhf S/d Uprt Micro Sensor	14	6	—	—	$66,778.13	$175,376.92	$85,126.05	2026-05-14
MS-402	OTHER	Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical	58	17	—	—	$28,120.04	$92,322.74	$84,591.32	2026-05-14
MS-460	OTHER	Spinal Fusion Except Cervical Without Mcc	11	4	—	—	$55,439.13	$83,996.36	$83,996.36	2026-05-14
MS-802	OTHER	Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc	58	17	—	—	$27,865.45	$91,486.89	$83,825.46	2026-05-14
C1826	OTHER	Gen Neuro Clo Loop Rechg	10	5	—	—	$25.85	$166,250.00	$83,137.93	2026-05-14
A9543	OTHER	Y90 Ibritumomab Rx	52	9	—	—	$50.00	$147,743.83	$82,995.41	2026-05-14
2721489753	OTHER	Hc Cardiovascular Non Implant Supply Lvl 53	71	16	$144,174.05	—	$26,672.20	$144,174.05	$82,539.64	2026-05-14
2781909753	OTHER	Hc Embolization Device Implant Lvl 53	71	16	$144,174.05	—	$26,672.20	$144,174.05	$82,539.64	2026-05-14
278C188953	OTHER	Hc Implantable-insertable Device Noc Lvl 53	71	16	$144,174.05	—	$26,672.20	$144,174.05	$82,539.64	2026-05-14
275C172153	OTHER	Hc Icd Dual Chamber Lvl 53	71	16	$144,174.05	—	$26,672.20	$144,174.05	$82,539.64	2026-05-14
278C171701	OTHER	Hc Brachytherapy Source Hdr Ir192	71	16	$144,174.05	—	$26,672.20	$144,174.05	$82,539.64	2026-05-14
275C188253	OTHER	Hc Icd Biv/crt-d Lvl 53	71	16	$144,174.05	—	$26,672.20	$144,174.05	$82,539.64	2026-05-14
278C182053	OTHER	Hc Generator Neuro Rechg Battery System Implant Lvl 53	71	16	$144,174.05	—	$26,672.20	$144,174.05	$82,539.64	2026-05-14
278C261601	OTHER	Hc Brachytx Non-str Yttrium-90	71	16	$144,174.05	—	$26,672.20	$144,174.05	$82,539.64	2026-05-14
2782669753	OTHER	Hc Vascular Stent Graft Implant Lvl 53	71	16	$144,174.05	—	$26,672.20	$144,174.05	$82,539.64	2026-05-14
278C187453	OTHER	Hc Stent Coated/covered Implant Lvl 53	71	16	$144,174.05	—	$26,672.20	$144,174.05	$82,539.64	2026-05-14
2782019753	OTHER	Hc General Supply Implant Lvl 53	71	16	$144,174.05	—	$26,672.20	$144,174.05	$82,539.64	2026-05-14
MS-024	OTHER	Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…	58	17	—	—	$27,360.47	$89,828.96	$82,306.38	2026-05-14
MS-933	OTHER	Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft	58	17	—	—	$27,236.67	$89,422.51	$81,933.97	2026-05-14
MS-793	OTHER	Full Term Neonate With Major Problems	48	15	—	—	$25,181.10	$95,483.84	$81,775.92	2026-05-14
MS-034	OTHER	Carotid Artery Stent Procedures With Mcc	58	17	—	—	$27,072.31	$88,882.88	$81,439.53	2026-05-14
MS-876	OTHER	O.r. Procedures With Principal Diagnosis Of Mental Illness	58	17	—	—	$27,031.75	$88,749.70	$81,317.50	2026-05-14
MS-040	OTHER	Peripheral- Cranial Nerve And Other Nervous System Procedures With Mcc	58	17	—	—	$27,005.87	$88,664.74	$81,239.65	2026-05-14
MS-907	OTHER	Other O.r. Procedures For Injuries With Mcc	58	17	—	—	$26,852.69	$88,161.85	$80,778.87	2026-05-14
7613724101	OTHER	Hc Vasc Embolize/occlude Venous	71	16	$139,007.60	—	$25,716.41	$139,007.60	$79,581.85	2026-05-14
MS-956	OTHER	Limb Reattachment- Hip And Femur Procedures For Multiple Significant Trauma	58	17	—	—	$26,319.04	$86,409.77	$79,173.52	2026-05-14
MS-143	OTHER	Other Ear- Nose- Mouth And Throat O.r. Procedures With Mcc	58	17	—	—	$26,204.34	$86,033.18	$78,828.46	2026-05-14
MS-166	OTHER	Other Respiratory System O.r. Procedures With Mcc	58	17	—	—	$26,142.09	$85,828.81	$78,641.21	2026-05-14
MS-518	OTHER	Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost…	58	17	—	—	$26,139.29	$85,819.62	$78,632.79	2026-05-14
MS-628	OTHER	Other Endocrine- Nutritional And Metabolic O.r. Procedures With Mcc	58	17	—	—	$26,065.85	$85,578.51	$78,411.87	2026-05-14
MS-651	OTHER	Kidney Transplant With Hemodialysis Without Mcc	57	17	—	—	$25,918.97	$85,096.29	$77,970.03	2026-05-14
MS-904	OTHER	Skin Grafts For Injuries With Cc/mcc	58	17	—	—	$25,690.26	$84,345.40	$77,282.02	2026-05-14
MS-492	OTHER	Lower Extremity And Humerus Procedures Except Hip- Foot And Femur With Mcc	58	17	—	—	$25,679.77	$84,310.95	$77,250.46	2026-05-14
MS-939	OTHER	O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc	58	17	—	—	$25,378.32	$83,321.25	$76,343.64	2026-05-14
MS-495	OTHER	Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit…	58	17	—	—	$25,358.74	$83,256.95	$76,284.73	2026-05-14
MS-332	OTHER	Rectal Resection With Mcc	58	17	—	—	$25,323.77	$83,142.13	$76,179.53	2026-05-14
MS-265	OTHER	Aicd Lead Procedures	58	17	—	—	$25,306.28	$83,084.73	$76,126.93	2026-05-14
MS-097	OTHER	Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc	58	17	—	—	$25,261.52	$82,937.76	$75,992.27	2026-05-14
MS-279	OTHER	Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures …	58	17	—	—	$25,223.75	$82,813.76	$75,878.66	2026-05-14
MS-739	OTHER	Uterineadnexa Proc For Non-ovarian/adnexal Malig W Mcc	58	17	—	—	$25,058.69	$82,271.84	$75,382.11	2026-05-14
MS-736	OTHER	Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc	58	17	—	—	$25,000.64	$82,081.24	$75,207.48	2026-05-14
MS-335	OTHER	Peritoneal Adhesiolysis With Mcc	58	17	—	—	$24,975.46	$81,998.58	$75,131.74	2026-05-14
2781909752	OTHER	Hc Embolization Device Implant Lvl 52	71	16	$131,067.25	—	$24,247.44	$131,067.25	$75,036.00	2026-05-14
275C188252	OTHER	Hc Icd Biv/crt-d Lvl 52	71	16	$131,067.25	—	$24,247.44	$131,067.25	$75,036.00	2026-05-14
2782679752	OTHER	Hc Left Atrial Appendage Implant Lvl 52	71	16	$131,067.25	—	$24,247.44	$131,067.25	$75,036.00	2026-05-14
2782649752	OTHER	Hc Valve Implant Lvl 52	71	16	$131,067.25	—	$24,247.44	$131,067.25	$75,036.00	2026-05-14
275C172252	OTHER	Hc Icd Single Chamber Lvl 52	71	16	$131,067.25	—	$24,247.44	$131,067.25	$75,036.00	2026-05-14
278C182052	OTHER	Hc Generator Neuro Rechg Battery System Implant Lvl 52	71	16	$131,067.25	—	$24,247.44	$131,067.25	$75,036.00	2026-05-14
278C188952	OTHER	Hc Implantable-insertable Device Noc Lvl 52	71	16	$131,067.25	—	$24,247.44	$131,067.25	$75,036.00	2026-05-14
278C187452	OTHER	Hc Stent Coated/covered Implant Lvl 52	71	16	$131,067.25	—	$24,247.44	$131,067.25	$75,036.00	2026-05-14
2782019752	OTHER	Hc General Supply Implant Lvl 52	71	16	$131,067.25	—	$24,247.44	$131,067.25	$75,036.00	2026-05-14
MS-408	OTHER	Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With…	58	17	—	—	$24,938.39	$81,876.87	$75,020.22	2026-05-14
MS-414	OTHER	Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc	58	17	—	—	$24,917.41	$81,807.98	$74,957.10	2026-05-14
MS-622	OTHER	Skin Grafts And Wound Debridement For Endocrine- Nutritional And Metabolic Disor…	58	17	—	—	$24,893.63	$81,729.91	$74,885.57	2026-05-14
MS-271	OTHER	Other Major Cardiovascular Procedures With Cc	58	17	—	—	$24,873.35	$81,663.32	$74,824.55	2026-05-14
MS-467	OTHER	Revision Of Hip Or Knee Replacement With Cc	58	17	—	—	$24,665.62	$80,981.32	$74,199.66	2026-05-14
MS-094	OTHER	Bacterial And Tuberculous Infections Of Nervous System With Mcc	58	17	—	—	$24,615.26	$80,815.98	$74,048.18	2026-05-14
MS-252	OTHER	Other Vascular Procedures With Mcc	58	17	—	—	$24,397.74	$80,101.83	$73,393.83	2026-05-14
MS-616	OTHER	Amputation Of Lower Limb For Endocrine- Nutritional And Metabolic Disorders With…	58	17	—	—	$24,391.45	$80,081.17	$73,374.90	2026-05-14
J9029	OTHER	Instill Adstiladrin Tx Dose	55	11	—	—	$50.00	$164,689.93	$73,080.00	2026-05-14
MS-574	OTHER	Skin Graft For Skin Ulcer Or Cellulitis With Cc	58	17	—	—	$24,279.54	$79,713.76	$73,038.26	2026-05-14
J9226	OTHER	Supprelin La Implant	64	13	—	—	$50.00	$117,053.69	$72,861.11	2026-05-14
MS-477	OTHER	Biopsies Of Musculoskeletal System And Connective Tissue With Mcc	58	17	—	—	$24,162.04	$79,327.98	$72,684.78	2026-05-14
MS-359	OTHER	Percutaneous Coronary Atherectomy With Intraluminal Device With Mcc	58	17	—	—	$24,050.13	$78,960.57	$72,348.14	2026-05-14
MS-987	OTHER	Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc	58	17	—	—	$23,978.79	$78,726.35	$72,133.54	2026-05-14
MS-029	OTHER	Spinal Procedures With Cc Or Spinal Neurostimulators	58	17	—	—	$23,861.29	$78,340.57	$71,780.06	2026-05-14
MS-420	OTHER	Hepatobiliary Diagnostic Procedures With Mcc	58	17	—	—	$23,829.82	$78,237.24	$71,685.38	2026-05-14
MS-264	OTHER	Other Circulatory System O.r. Procedures	58	17	—	—	$23,364.71	$76,710.20	$70,286.22	2026-05-14
MS-411	OTHER	Cholecystectomy With C.d.e. With Mcc	58	17	—	—	$23,103.82	$75,853.68	$69,501.43	2026-05-14
MS-037	OTHER	Extracranial Procedures With Mcc	58	17	—	—	$23,025.49	$75,596.49	$69,265.78	2026-05-14
MS-274	OTHER	Percutaneous Intracardiac Procedures Without Mcc	58	17	—	—	$23,022.69	$75,587.31	$69,257.37	2026-05-14
MS-260	OTHER	Cardiac Pacemaker Revision Except Device Replacement With Mcc	58	17	—	—	$22,750.62	$74,694.05	$68,438.91	2026-05-14
275C262151	OTHER	Hc Pacemaker Biv Crt-p Lvl 51	71	16	$119,152.00	—	$22,043.12	$119,152.00	$68,214.52	2026-05-14
275C172151	OTHER	Hc Icd Dual Chamber Lvl 51	71	16	$119,152.00	—	$22,043.12	$119,152.00	$68,214.52	2026-05-14
278C187651	OTHER	Hc Stent Non Coated/non Covered Implant Lvl 51	71	16	$119,152.00	—	$22,043.12	$119,152.00	$68,214.52	2026-05-14
272C188951	OTHER	Hc Implantable-insertable Device Noc Non Implant Lvl 51	71	16	$119,152.00	—	$22,043.12	$119,152.00	$68,214.52	2026-05-14
2782649751	OTHER	Hc Valve Implant Lvl 51	71	16	$119,152.00	—	$22,043.12	$119,152.00	$68,214.52	2026-05-14
278C188951	OTHER	Hc Implantable-insertable Device Noc Lvl 51	71	16	$119,152.00	—	$22,043.12	$119,152.00	$68,214.52	2026-05-14
2782669751	OTHER	Hc Vascular Stent Graft Implant Lvl 51	71	16	$119,152.00	—	$22,043.12	$119,152.00	$68,214.52	2026-05-14
278C187451	OTHER	Hc Stent Coated/covered Implant Lvl 51	71	16	$119,152.00	—	$22,043.12	$119,152.00	$68,214.52	2026-05-14
275C188251	OTHER	Hc Icd Biv/crt-d Lvl 51	71	16	$119,152.00	—	$22,043.12	$119,152.00	$68,214.52	2026-05-14
275C172251	OTHER	Hc Icd Single Chamber Lvl 51	71	16	$119,152.00	—	$22,043.12	$119,152.00	$68,214.52	2026-05-14
2781909751	OTHER	Hc Embolization Device Implant Lvl 51	71	16	$119,152.00	—	$22,043.12	$119,152.00	$68,214.52	2026-05-14
2781949751	OTHER	Hc Endoprosthesis Implant Lvl 51	71	16	$119,152.00	—	$22,043.12	$119,152.00	$68,214.52	2026-05-14
MS-579	OTHER	Other Skin- Subcutaneous Tissue And Breast Procedures With Mcc	58	17	—	—	$22,650.60	$74,365.68	$68,138.04	2026-05-14
MS-840	OTHER	Lymphoma And Non-acute Leukemia With Mcc	58	17	—	—	$22,625.42	$74,283.01	$68,062.30	2026-05-14
MS-451	OTHER	Single Level Spinal Fusion Except Cervical Without Mcc	58	17	—	—	$22,593.95	$74,179.68	$67,967.62	2026-05-14
MS-485	OTHER	Knee Procedures With Principal Diagnosis Of Infection With Mcc	58	17	—	—	$22,570.87	$74,103.90	$67,898.18	2026-05-14
MS-929	OTHER	Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/mcc	58	17	—	—	$22,526.80	$73,959.23	$67,765.63	2026-05-14
0424T	OTHER	Insj/rplc Nstim Apnea Compl	16	4	—	—	$4,129.00	$67,659.00	$67,659.00	2026-05-14
0427T	OTHER	Insj/rplc Nstim Apnea Pls Gn	16	4	—	—	$4,129.00	$67,659.00	$67,659.00	2026-05-14
0431T	OTHER	Rmvl/rplc Nstim Apnea Pls Gn	16	4	—	—	$4,129.00	$67,659.00	$67,659.00	2026-05-14
206941	OTHER	Polatuzumab Vedotin-piiq 140 Mg Intravenous Solution	71	16	$118,014.96	—	$21,832.77	$118,014.96	$67,563.56	2026-05-14
MS-325	OTHER	Coronary Intravascular Lithotripsy Without Intraluminal Device	58	17	—	—	$22,454.06	$73,720.42	$67,546.82	2026-05-14
MS-242	OTHER	Permanent Cardiac Pacemaker Implant With Mcc	58	17	—	—	$22,330.97	$73,316.27	$67,176.51	2026-05-14
MS-515	OTHER	Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc	58	17	—	—	$22,289.70	$73,180.78	$67,052.38	2026-05-14
MS-656	OTHER	Kidney And Ureter Procedures For Neoplasm With Mcc	58	17	—	—	$22,268.02	$73,109.60	$66,987.15	2026-05-14
MS-022	OTHER	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/…	58	17	—	—	$22,223.26	$72,962.64	$66,852.50	2026-05-14
MS-652	OTHER	Kidney Transplant	45	16	—	—	$22,587.65	$74,159.01	$66,669.80	2026-05-14
MS-500	OTHER	Soft Tissue Procedures With Mcc	58	17	—	—	$22,135.13	$72,673.30	$66,587.39	2026-05-14
MS-829	OTHER	Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce…	58	17	—	—	$22,101.56	$72,563.08	$66,486.40	2026-05-14
Q2043	OTHER	Sipuleucel-t Auto Cd54+	61	11	—	—	$50.00	$143,708.03	$66,326.78	2026-05-14
MS-324	OTHER	Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc	58	17	—	—	$22,038.61	$72,356.41	$66,297.04	2026-05-14
MS-229	OTHER	Other Cardiothoracic Procedures Without Mcc	58	17	—	—	$22,028.12	$72,321.97	$66,265.48	2026-05-14
MS-258	OTHER	Cardiac Pacemaker Device Replacement With Mcc	58	17	—	—	$21,976.36	$72,152.04	$66,109.78	2026-05-14
7613724201	OTHER	Hc Vasc Embolize/occlude Artery	71	16	$114,964.55	—	$21,268.44	$114,964.55	$65,817.20	2026-05-14
MS-665	OTHER	Prostatectomy With Mcc	58	17	—	—	$21,830.19	$71,672.12	$65,670.05	2026-05-14
MS-464	OTHER	Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …	58	17	—	—	$21,784.72	$71,522.86	$65,533.29	2026-05-14
MS-026	OTHER	Craniotomy And Endovascular Intracranial Procedures With Cc	58	17	—	—	$21,746.26	$71,396.56	$65,417.57	2026-05-14
2721649401	OTHER	Hc Oxygenator Perfusion Set Cardiohelp Hls Adv 7	71	16	$113,659.60	—	$21,027.03	$113,659.60	$65,070.12	2026-05-14
MS-662	OTHER	Minor Bladder Procedures With Mcc	58	17	—	—	$21,412.63	$70,301.22	$64,413.96	2026-05-14
MS-263	OTHER	Vein Ligation And Stripping	58	17	—	—	$21,383.96	$70,207.08	$64,327.70	2026-05-14
MS-469	OTHER	Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc…	58	17	—	—	$21,214.70	$69,651.37	$63,818.53	2026-05-14
MS-510	OTHER	Shoulderelbow Or Forearm Procexc Major Joint Proc W Mcc	58	17	—	—	$21,125.87	$69,359.74	$63,551.32	2026-05-14
MS-625	OTHER	Thyroid- Parathyroid And Thyroglossal Procedures With Mcc	58	17	—	—	$21,123.08	$69,350.56	$63,542.90	2026-05-14
MS-498	OTHER	Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur With Cc…	58	17	—	—	$21,099.99	$69,274.78	$63,473.47	2026-05-14
144240	OTHER	Cabazitaxel 10 Mg/ml (first Dilution) Intravenous Solution	71	16	$110,203.26	—	$20,387.60	$110,203.26	$63,091.37	2026-05-14
MS-173	OTHER	Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary…	58	17	—	—	$20,817.43	$68,347.07	$62,623.46	2026-05-14
275C172150	OTHER	Hc Icd Dual Chamber Lvl 50	71	16	$108,319.90	—	$20,039.18	$108,319.90	$62,013.14	2026-05-14
278C187650	OTHER	Hc Stent Non Coated/non Covered Implant Lvl 50	71	16	$108,319.90	—	$20,039.18	$108,319.90	$62,013.14	2026-05-14
2781909750	OTHER	Hc Embolization Device Implant Lvl 50	71	16	$108,319.90	—	$20,039.18	$108,319.90	$62,013.14	2026-05-14
272C175750	OTHER	Hc Catheter Thromb/embolectomy Lvl 50	71	16	$108,319.90	—	$20,039.18	$108,319.90	$62,013.14	2026-05-14
272C188750	OTHER	Hc Catheter Guiding Lvl 50	71	16	$108,319.90	—	$20,039.18	$108,319.90	$62,013.14	2026-05-14
275C188250	OTHER	Hc Icd Biv/crt-d Lvl 50	71	16	$108,319.90	—	$20,039.18	$108,319.90	$62,013.14	2026-05-14
278C188950	OTHER	Hc Implantable-insertable Device Noc Lvl 50	71	16	$108,319.90	—	$20,039.18	$108,319.90	$62,013.14	2026-05-14
2782669750	OTHER	Hc Vascular Stent Graft Implant Lvl 50	71	16	$108,319.90	—	$20,039.18	$108,319.90	$62,013.14	2026-05-14
2721489750	OTHER	Hc Cardiovascular Non Implant Supply Lvl 50	71	16	$108,319.90	—	$20,039.18	$108,319.90	$62,013.14	2026-05-14
MS-472	OTHER	Cervical Spinal Fusion With Cc	58	17	—	—	$20,605.51	$67,651.29	$61,985.94	2026-05-14

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