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Hospital facility prices. What the hospital charges for the facility side of care — the surgeon’s and anesthesiologist’s fees are billed separately and are not included. How we scope prices →

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Hospital

Pam Rehabilitation Hospital Of Dover

Dover, DE · CCN 083027 · Rates published

10,372 distinct procedures filed
16 distinct payers
27,751 rate rows
2025-09-11 last MRF observed
Data quality

27,643 of 27,751 rate rows are consumer-grade (99.6%)

108 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 — reasonRows
template filing: same amount across many unrelated codes — excluded 51
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 38
per-diem day rate — not a per-procedure price 19
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://sthpiprd.blob.core.windows.net/machine-readable-files/10965/320518669_pam-squared-at-dover-llc_standardcharges.csv
Found on page https://search.hospitalpriceindex.com/hpi2/machineReadable/RehabHospitalDover/10965
Discovered viaCMS hospital list
Last fetch not_modified · 2026-05-17
Content fingerprint b7f29b1f5e20071d… · 10,041,014 bytes · first seen 2026-05-09

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
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 1 $387,472.40 $387,472.40 $387,472.40 nat. median
$634,303
0.6× median
B0407
LOCAL 		Traumatic Spinal Cord Injury M <24.50 And A >=61.50 6 $89,514.82 $134,272.23 $89,514.82 nat. median
$79,920
1.1× median
C0407
LOCAL 		Traumatic Spinal Cord Injury M <24.50 And A >=61.50 6 $79,603.78 $119,405.67 $79,603.78 nat. median
$70,083
1.1× median
B1904
LOCAL 		Guillain-barré M <38.50 6 $77,456.85 $116,185.28 $77,456.85 nat. median
$68,345
1.1× median
D0407
LOCAL 		Traumatic Spinal Cord Injury M <24.50 And A >=61.50 6 $77,274.76 $115,912.14 $77,274.76 nat. median
$67,662
1.1× median
B1806
LOCAL 		Major Multiple Trauma With Brain Or Spinal Cord Injury M <30.50 6 $72,860.21 $109,290.32 $72,860.21 nat. median
$64,290
1.1× median
A0407
LOCAL 		Traumatic Spinal Cord Injury M <24.50 And A >=61.50 6 $70,215.72 $105,323.58 $70,215.72 nat. median
$61,956
1.1× median
B0406
LOCAL 		Traumatic Spinal Cord Injury M >=24.50 And M <31.50 And A >=61.50 6 $65,477.22 $98,215.83 $65,477.22 nat. median
$59,111
1.1× median
B0404
LOCAL 		Traumatic Spinal Cord Injury M <31.50 And A <61.50 6 $64,526.56 $96,789.84 $64,526.56 nat. median
$57,695
1.1× median
B0505
LOCAL 		Non-traumatic Spinal Cord Injury M <39.50 6 $63,863.84 $95,795.76 $63,863.84 nat. median
$56,226
1.1× median
B0106
LOCAL 		Stroke M <41.50 And A <84.50 6 $61,536.94 $92,305.41 $61,536.94 nat. median
$53,762
1.1× median
C1904
LOCAL 		Guillain-barré M <38.50 6 $59,548.80 $89,323.20 $59,548.80 nat. median
$52,544
1.1× median
C0406
LOCAL 		Traumatic Spinal Cord Injury M >=24.50 And M <31.50 And A >=61.50 6 $58,227.62 $87,341.43 $58,227.62 nat. median
$52,063
1.1× median
C1806
LOCAL 		Major Multiple Trauma With Brain Or Spinal Cord Injury M <30.50 6 $58,123.87 $87,185.81 $58,123.87 nat. median
$51,172
1.1× median
C0404
LOCAL 		Traumatic Spinal Cord Injury M <31.50 And A <61.50 6 $57,382.82 $86,074.23 $57,382.82 nat. median
$50,633
1.1× median
D0406
LOCAL 		Traumatic Spinal Cord Injury M >=24.50 And M <31.50 And A >=61.50 6 $56,523.20 $84,784.80 $56,523.20 nat. median
$49,763
1.1× median
B0205
LOCAL 		Traumatic Brain Injury M <35.50 6 $55,864.72 $83,797.08 $55,864.72 nat. median
$49,196
1.1× median
D0404
LOCAL 		Traumatic Spinal Cord Injury M <31.50 And A <61.50 6 $55,703.80 $83,555.70 $55,703.80 nat. median
$49,042
1.1× median
D1904
LOCAL 		Guillain-barré M <38.50 6 $55,566.18 $83,349.27 $55,566.18 nat. median
$49,620
1.1× median
B1705
LOCAL 		Major Multiple Trauma Without Brain Or Spinal Cord Injury M <36.50 6 $55,515.37 $83,273.06 $55,515.37 nat. median
$48,876
1.1× median
D1806
LOCAL 		Major Multiple Trauma With Brain Or Spinal Cord Injury M <30.50 6 $55,180.83 $82,771.25 $55,180.83 nat. median
$48,581
1.1× median
A1904
LOCAL 		Guillain-barré M <38.50 6 $54,604.93 $81,907.40 $54,604.93 nat. median
$48,824
1.1× median
B0105
LOCAL 		Stroke M <41.50 And A >=84.50 6 $54,103.13 $81,154.70 $54,103.13 nat. median
$48,375
1.1× median
C0106
LOCAL 		Stroke M <41.50 And A <84.50 6 $53,368.43 $80,052.65 $53,368.43 nat. median
$46,986
1.1× median
B1903
LOCAL 		Guillain-barré M >=38.50 And M <51.50 6 $53,173.64 $79,760.46 $53,173.64 nat. median
$46,919
1.1× median
B0604
LOCAL 		Neurological M <43.50 6 $52,729.01 $79,093.52 $52,729.01 nat. median
$46,423
1.1× median
A0406
LOCAL 		Traumatic Spinal Cord Injury M >=24.50 And M <31.50 And A >=61.50 6 $51,361.24 $77,041.86 $51,361.24 nat. median
$45,230
1.1× median
B0405
LOCAL 		Traumatic Spinal Cord Injury M >=31.50 And M <41.50 6 $51,314.66 $76,971.99 $51,314.66 nat. median
$46,326
1.1× median
B1805
LOCAL 		Major Multiple Trauma With Brain Or Spinal Cord Injury M >=30.50 And M <40.50 6 $51,304.07 $76,956.11 $51,304.07 nat. median
$45,253
1.1× median
A1806
LOCAL 		Major Multiple Trauma With Brain Or Spinal Cord Injury M <30.50 6 $51,162.22 $76,743.33 $51,162.22 nat. median
$45,144
1.1× median
A0404
LOCAL 		Traumatic Spinal Cord Injury M <31.50 And A <61.50 6 $50,615.95 $75,923.93 $50,615.95 nat. median
$44,562
1.1× median
B0305
LOCAL 		Non-traumatic Brain Injury M <42.50 And A <78.50 6 $50,486.80 $75,730.20 $50,486.80 nat. median
$44,232
1.1× median
A5104
LOCAL 		Expired, Not Orthopedic, Length Of Stay Is 16 Days Or More 6 $50,463.51 $75,695.27 $50,463.51 nat. median
$44,527
1.1× median
B1604
LOCAL 		Pain Syndrome M <43.50 6 $49,703.40 $74,555.10 $49,703.40 nat. median
$43,857
1.1× median
C0505
LOCAL 		Non-traumatic Spinal Cord Injury M <39.50 6 $49,684.35 $74,526.53 $49,684.35 nat. median
$43,704
1.1× median
B0704
LOCAL 		Fracture Of Lower Extremity M <41.50 6 $49,275.71 $73,913.57 $49,275.71 nat. median
$43,383
1.1× median
B2102
LOCAL 		Burns M <52.50 6 $49,070.33 $73,605.50 $49,070.33 nat. median
$43,298
1.1× median
D0106
LOCAL 		Stroke M <41.50 And A <84.50 6 $48,769.68 $73,154.52 $48,769.68 nat. median
$42,703
1.1× median
B1004
LOCAL 		Amputation Lower Extremity M <47.50 6 $48,720.98 $73,081.47 $48,720.98 nat. median
$42,470
1.1× median
B1504
LOCAL 		Pulmonary M <45.50 6 $48,155.66 $72,233.49 $48,155.66 nat. median
$43,057
1.1× median
B1704
LOCAL 		Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=36.50 And M <41.50 6 $47,306.63 $70,959.95 $47,306.63 nat. median
$41,742
1.1× median
B2005
LOCAL 		Miscellaneous M <46.50 And A <77.50 6 $47,029.26 $70,543.89 $47,029.26 nat. median
$40,995
1.1× median
D0505
LOCAL 		Non-traumatic Spinal Cord Injury M <39.50 6 $46,938.22 $70,407.33 $46,938.22 nat. median
$41,099
1.1× median
C0105
LOCAL 		Stroke M <41.50 And A >=84.50 6 $46,921.28 $70,381.92 $46,921.28 nat. median
$41,402
1.1× median
A0106
LOCAL 		Stroke M <41.50 And A <84.50 6 $46,476.65 $69,714.98 $46,476.65 nat. median
$39,573
1.2× median
B1204
LOCAL 		Osteoarthritis M <49.50 And A <74.50 6 $46,235.28 $69,352.92 $46,235.28 nat. median
$40,797
1.1× median
C0205
LOCAL 		Traumatic Brain Injury M <35.50 6 $46,010.85 $69,016.28 $46,010.85 nat. median
$40,508
1.1× median
B0504
LOCAL 		Non-traumatic Spinal Cord Injury M >=39.50 And M <48.50 6 $45,960.03 $68,940.05 $45,960.03 nat. median
$41,330
1.1× median
B0304
LOCAL 		Non-traumatic Brain Injury M <42.50 And A >=78.50 6 $45,777.95 $68,666.93 $45,777.95 nat. median
$41,166
1.1× median
C0405
LOCAL 		Traumatic Spinal Cord Injury M >=31.50 And M <41.50 6 $45,633.97 $68,450.96 $45,633.97 nat. median
$40,176
1.1× median

Other procedures at this hospital

Browse this hospital's 10,372 published procedures. Use the slice to choose what to show, then sort or filter any column.

Slice
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
             
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 1 1 — — $387,472.40 $387,472.40 $387,472.40 2025-09-11
B0407 LOCAL Traumatic Spinal Cord Injury M <24.50 And A >=61.50 7 6 — — $89,514.82 $134,272.23 $89,514.82 2025-09-11
C0407 LOCAL Traumatic Spinal Cord Injury M <24.50 And A >=61.50 7 6 — — $79,603.78 $119,405.67 $79,603.78 2025-09-11
B1904 LOCAL Guillain-barré M <38.50 7 6 — — $77,456.85 $116,185.28 $77,456.85 2025-09-11
D0407 LOCAL Traumatic Spinal Cord Injury M <24.50 And A >=61.50 7 6 — — $77,274.76 $115,912.14 $77,274.76 2025-09-11
B1806 LOCAL Major Multiple Trauma With Brain Or Spinal Cord Injury M <30.50 7 6 — — $72,860.21 $109,290.32 $72,860.21 2025-09-11
A0407 LOCAL Traumatic Spinal Cord Injury M <24.50 And A >=61.50 7 6 — — $70,215.72 $105,323.58 $70,215.72 2025-09-11
B0406 LOCAL Traumatic Spinal Cord Injury M >=24.50 And M <31.50 And A >=61.50 7 6 — — $65,477.22 $98,215.83 $65,477.22 2025-09-11
B0404 LOCAL Traumatic Spinal Cord Injury M <31.50 And A <61.50 7 6 — — $64,526.56 $96,789.84 $64,526.56 2025-09-11
B0505 LOCAL Non-traumatic Spinal Cord Injury M <39.50 7 6 — — $63,863.84 $95,795.76 $63,863.84 2025-09-11
B0106 LOCAL Stroke M <41.50 And A <84.50 7 6 — — $61,536.94 $92,305.41 $61,536.94 2025-09-11
C1904 LOCAL Guillain-barré M <38.50 7 6 — — $59,548.80 $89,323.20 $59,548.80 2025-09-11
C0406 LOCAL Traumatic Spinal Cord Injury M >=24.50 And M <31.50 And A >=61.50 7 6 — — $58,227.62 $87,341.43 $58,227.62 2025-09-11
C1806 LOCAL Major Multiple Trauma With Brain Or Spinal Cord Injury M <30.50 7 6 — — $58,123.87 $87,185.81 $58,123.87 2025-09-11
C0404 LOCAL Traumatic Spinal Cord Injury M <31.50 And A <61.50 7 6 — — $57,382.82 $86,074.23 $57,382.82 2025-09-11
D0406 LOCAL Traumatic Spinal Cord Injury M >=24.50 And M <31.50 And A >=61.50 7 6 — — $56,523.20 $84,784.80 $56,523.20 2025-09-11
B0205 LOCAL Traumatic Brain Injury M <35.50 7 6 — — $55,864.72 $83,797.08 $55,864.72 2025-09-11
D0404 LOCAL Traumatic Spinal Cord Injury M <31.50 And A <61.50 7 6 — — $55,703.80 $83,555.70 $55,703.80 2025-09-11
D1904 LOCAL Guillain-barré M <38.50 7 6 — — $55,566.18 $83,349.27 $55,566.18 2025-09-11
B1705 LOCAL Major Multiple Trauma Without Brain Or Spinal Cord Injury M <36.50 7 6 — — $55,515.37 $83,273.06 $55,515.37 2025-09-11
D1806 LOCAL Major Multiple Trauma With Brain Or Spinal Cord Injury M <30.50 7 6 — — $55,180.83 $82,771.25 $55,180.83 2025-09-11
A1904 LOCAL Guillain-barré M <38.50 7 6 — — $54,604.93 $81,907.40 $54,604.93 2025-09-11
B0105 LOCAL Stroke M <41.50 And A >=84.50 7 6 — — $54,103.13 $81,154.70 $54,103.13 2025-09-11
C0106 LOCAL Stroke M <41.50 And A <84.50 7 6 — — $53,368.43 $80,052.65 $53,368.43 2025-09-11
B1903 LOCAL Guillain-barré M >=38.50 And M <51.50 7 6 — — $53,173.64 $79,760.46 $53,173.64 2025-09-11
B0604 LOCAL Neurological M <43.50 7 6 — — $52,729.01 $79,093.52 $52,729.01 2025-09-11
A0406 LOCAL Traumatic Spinal Cord Injury M >=24.50 And M <31.50 And A >=61.50 7 6 — — $51,361.24 $77,041.86 $51,361.24 2025-09-11
B0405 LOCAL Traumatic Spinal Cord Injury M >=31.50 And M <41.50 7 6 — — $51,314.66 $76,971.99 $51,314.66 2025-09-11
B1805 LOCAL Major Multiple Trauma With Brain Or Spinal Cord Injury M >=30.50 And M <40.50 7 6 — — $51,304.07 $76,956.11 $51,304.07 2025-09-11
A1806 LOCAL Major Multiple Trauma With Brain Or Spinal Cord Injury M <30.50 7 6 — — $51,162.22 $76,743.33 $51,162.22 2025-09-11
A0404 LOCAL Traumatic Spinal Cord Injury M <31.50 And A <61.50 7 6 — — $50,615.95 $75,923.93 $50,615.95 2025-09-11
B0305 LOCAL Non-traumatic Brain Injury M <42.50 And A <78.50 7 6 — — $50,486.80 $75,730.20 $50,486.80 2025-09-11
A5104 LOCAL Expired, Not Orthopedic, Length Of Stay Is 16 Days Or More 7 6 — — $50,463.51 $75,695.27 $50,463.51 2025-09-11
B1604 LOCAL Pain Syndrome M <43.50 7 6 — — $49,703.40 $74,555.10 $49,703.40 2025-09-11
C0505 LOCAL Non-traumatic Spinal Cord Injury M <39.50 7 6 — — $49,684.35 $74,526.53 $49,684.35 2025-09-11
B0704 LOCAL Fracture Of Lower Extremity M <41.50 7 6 — — $49,275.71 $73,913.57 $49,275.71 2025-09-11
B2102 LOCAL Burns M <52.50 7 6 — — $49,070.33 $73,605.50 $49,070.33 2025-09-11
D0106 LOCAL Stroke M <41.50 And A <84.50 7 6 — — $48,769.68 $73,154.52 $48,769.68 2025-09-11
B1004 LOCAL Amputation Lower Extremity M <47.50 7 6 — — $48,720.98 $73,081.47 $48,720.98 2025-09-11
B1504 LOCAL Pulmonary M <45.50 7 6 — — $48,155.66 $72,233.49 $48,155.66 2025-09-11
B1704 LOCAL Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=36.50 And M <41.50 7 6 — — $47,306.63 $70,959.95 $47,306.63 2025-09-11
B2005 LOCAL Miscellaneous M <46.50 And A <77.50 7 6 — — $47,029.26 $70,543.89 $47,029.26 2025-09-11
D0505 LOCAL Non-traumatic Spinal Cord Injury M <39.50 7 6 — — $46,938.22 $70,407.33 $46,938.22 2025-09-11
C0105 LOCAL Stroke M <41.50 And A >=84.50 7 6 — — $46,921.28 $70,381.92 $46,921.28 2025-09-11
A0106 LOCAL Stroke M <41.50 And A <84.50 7 6 — — $46,476.65 $69,714.98 $46,476.65 2025-09-11
B1204 LOCAL Osteoarthritis M <49.50 And A <74.50 7 6 — — $46,235.28 $69,352.92 $46,235.28 2025-09-11
C0205 LOCAL Traumatic Brain Injury M <35.50 7 6 — — $46,010.85 $69,016.28 $46,010.85 2025-09-11
B0504 LOCAL Non-traumatic Spinal Cord Injury M >=39.50 And M <48.50 7 6 — — $45,960.03 $68,940.05 $45,960.03 2025-09-11
B0304 LOCAL Non-traumatic Brain Injury M <42.50 And A >=78.50 7 6 — — $45,777.95 $68,666.93 $45,777.95 2025-09-11
C0405 LOCAL Traumatic Spinal Cord Injury M >=31.50 And M <41.50 7 6 — — $45,633.97 $68,450.96 $45,633.97 2025-09-11
B1404 LOCAL Cardiac M <45.50 7 6 — — $45,432.83 $68,149.25 $45,432.83 2025-09-11
B0904 LOCAL Other Orthopedic M <44.5 7 6 — — $45,343.90 $68,015.85 $45,343.90 2025-09-11
B1304 LOCAL Rheumatoid Other Arthritis M <44.50 And A >=64.50 7 6 — — $45,343.90 $68,015.85 $45,343.90 2025-09-11
B2004 LOCAL Miscellaneous M <46.50 And A >=77.50 7 6 — — $44,617.67 $66,926.51 $44,617.67 2025-09-11
D0405 LOCAL Traumatic Spinal Cord Injury M >=31.50 And M <41.50 7 6 — — $44,297.96 $66,446.94 $44,297.96 2025-09-11
B1203 LOCAL Osteoarthritis M <49.50 And A >=74.50 7 6 — — $44,090.46 $66,135.69 $44,090.46 2025-09-11
B0805 LOCAL Replacement Of Lower-extremity Joint M <42.50 7 6 — — $43,643.72 $65,465.58 $43,643.72 2025-09-11
B0204 LOCAL Traumatic Brain Injury M >=35.50 And M <49.50 7 6 — — $43,611.96 $65,417.94 $43,611.96 2025-09-11
B1305 LOCAL Rheumatoid Other Arthritis M <51.50 And A <64.50 7 6 — — $43,423.52 $65,135.28 $43,423.52 2025-09-11
B0104 LOCAL Stroke M >=41.50 And M <50.50 7 6 — — $43,266.84 $64,900.26 $43,266.84 2025-09-11
A0505 LOCAL Non-traumatic Spinal Cord Injury M <39.50 7 6 — — $43,254.13 $64,881.20 $43,254.13 2025-09-11
C1705 LOCAL Major Multiple Trauma Without Brain Or Spinal Cord Injury M <36.50 7 6 — — $43,152.50 $64,728.75 $43,152.50 2025-09-11
D0105 LOCAL Stroke M <41.50 And A >=84.50 7 6 — — $42,877.26 $64,315.89 $42,877.26 2025-09-11
B1103 LOCAL Amputation Non-lower Extremity M <52.50 7 6 — — $42,464.38 $63,696.57 $42,464.38 2025-09-11
B1804 LOCAL Major Multiple Trauma With Brain Or Spinal Cord Injury M >=40.50 And M <45.50 7 6 — — $42,316.17 $63,474.26 $42,316.17 2025-09-11
B0603 LOCAL Neurological M >=43.50 And M <52.50 7 6 — — $42,045.16 $63,067.74 $42,045.16 2025-09-11
B1703 LOCAL Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=41.50 And M <50.50 7 6 — — $41,795.32 $62,692.98 $41,795.32 2025-09-11
D0205 LOCAL Traumatic Brain Injury M <35.50 7 6 — — $41,791.09 $62,686.64 $41,791.09 2025-09-11
B0403 LOCAL Traumatic Spinal Cord Injury M >=41.50 And M <47.50 7 6 — — $41,327.40 $61,991.10 $41,327.40 2025-09-11
C1805 LOCAL Major Multiple Trauma With Brain Or Spinal Cord Injury M >=30.50 And M <40.50 7 6 — — $40,927.23 $61,390.85 $40,927.23 2025-09-11
L7180 HCPCS Electronic Elbow Sequential 1 1 — — $40,925.01 $40,925.01 $40,925.01 2025-09-11
C1903 LOCAL Guillain-barré M >=38.50 And M <51.50 7 6 — — $40,878.53 $61,317.80 $40,878.53 2025-09-11
A0105 LOCAL Stroke M <41.50 And A >=84.50 7 6 — — $40,863.71 $61,295.57 $40,863.71 2025-09-11
C0305 LOCAL Non-traumatic Brain Injury M <42.50 And A <78.50 7 6 — — $40,391.56 $60,587.34 $40,391.56 2025-09-11
B0703 LOCAL Fracture Of Lower Extremity M >=41.50 And M <52.50 7 6 — — $40,336.51 $60,504.77 $40,336.51 2025-09-11
C1004 LOCAL Amputation Lower Extremity M <47.50 7 6 — — $40,294.16 $60,441.24 $40,294.16 2025-09-11
A0405 LOCAL Traumatic Spinal Cord Injury M >=31.50 And M <41.50 7 6 — — $40,251.82 $60,377.73 $40,251.82 2025-09-11
B1603 LOCAL Pain Syndrome M >=43.50 And M <58.50 7 6 — — $40,116.31 $60,174.47 $40,116.31 2025-09-11
D1705 LOCAL Major Multiple Trauma Without Brain Or Spinal Cord Injury M <36.50 7 6 — — $39,963.86 $59,945.79 $39,963.86 2025-09-11
B0303 LOCAL Non-traumatic Brain Injury M >=42.50 And M <52.50 7 6 — — $39,483.24 $59,224.86 $39,483.24 2025-09-11
C0604 LOCAL Neurological M <43.50 7 6 — — $39,476.89 $59,215.34 $39,476.89 2025-09-11
A0205 LOCAL Traumatic Brain Injury M <35.50 7 6 — — $39,345.62 $59,018.43 $39,345.62 2025-09-11
C1504 LOCAL Pulmonary M <45.50 7 6 — — $39,085.19 $58,627.79 $39,085.19 2025-09-11
B1503 LOCAL Pulmonary M >=45.50 And M <56.50 7 6 — — $38,886.16 $58,329.24 $38,886.16 2025-09-11
D1805 LOCAL Major Multiple Trauma With Brain Or Spinal Cord Injury M >=30.50 And M <40.50 7 6 — — $38,854.40 $58,281.60 $38,854.40 2025-09-11
B1803 LOCAL Major Multiple Trauma With Brain Or Spinal Cord Injury M >=45.50 And M <55.50 7 6 — — $38,695.61 $58,043.42 $38,695.61 2025-09-11
B0503 LOCAL Non-traumatic Spinal Cord Injury M >=48.50 And M <53.50 7 6 — — $38,663.85 $57,995.78 $38,663.85 2025-09-11
D1903 LOCAL Guillain-barré M >=38.50 And M <51.50 7 6 — — $38,145.11 $57,217.67 $38,145.11 2025-09-11
C0704 LOCAL Fracture Of Lower Extremity M <41.50 7 6 — — $38,117.59 $57,176.39 $38,117.59 2025-09-11
B1003 LOCAL Amputation Lower Extremity M >=47.50 And M <55.50 7 6 — — $38,056.19 $57,084.29 $38,056.19 2025-09-11
A5102 LOCAL Expired, Orthopedic, Length Of Stay Is 14 Days Or More 7 6 — — $37,954.56 $56,931.84 $37,954.56 2025-09-11
B0903 LOCAL Other Orthopedic M >=44.50 And M <51.50 7 6 — — $37,842.34 $56,763.51 $37,842.34 2025-09-11
C2005 LOCAL Miscellaneous M <46.50 And A <77.50 7 6 — — $37,564.97 $56,347.46 $37,564.97 2025-09-11
C0104 LOCAL Stroke M >=41.50 And M <50.50 7 6 — — $37,522.63 $56,283.95 $37,522.63 2025-09-11
C1304 LOCAL Rheumatoid Other Arthritis M <44.50 And A >=64.50 7 6 — — $37,490.87 $56,236.31 $37,490.87 2025-09-11
A1903 LOCAL Guillain-barré M >=38.50 And M <51.50 7 6 — — $37,484.52 $56,226.78 $37,484.52 2025-09-11
B2003 LOCAL Miscellaneous M >=46.50 And M <55.50 7 6 — — $37,317.25 $55,975.88 $37,317.25 2025-09-11
D2102 LOCAL Burns M <52.50 7 6 — — $37,287.61 $55,931.42 $37,287.61 2025-09-11
C2102 LOCAL Burns M <52.50 7 6 — — $37,287.61 $55,931.42 $37,287.61 2025-09-11
D0305 LOCAL Non-traumatic Brain Injury M <42.50 And A <78.50 7 6 — — $37,103.40 $55,655.10 $37,103.40 2025-09-11
B1403 LOCAL Cardiac M >=45.50 And M <55.50 7 6 — — $37,078.00 $55,617.00 $37,078.00 2025-09-11
C1604 LOCAL Pain Syndrome M <43.50 7 6 — — $36,917.08 $55,375.62 $36,917.08 2025-09-11
D0604 LOCAL Neurological M <43.50 7 6 — — $36,853.56 $55,280.34 $36,853.56 2025-09-11
D1004 LOCAL Amputation Lower Extremity M <47.50 7 6 — — $36,806.98 $55,210.47 $36,806.98 2025-09-11
C1704 LOCAL Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=36.50 And M <41.50 7 6 — — $36,770.99 $55,156.49 $36,770.99 2025-09-11
D1504 LOCAL Pulmonary M <45.50 7 6 — — $36,758.29 $55,137.44 $36,758.29 2025-09-11
C0403 LOCAL Traumatic Spinal Cord Injury M >=41.50 And M <47.50 7 6 — — $36,751.93 $55,127.90 $36,751.93 2025-09-11
C0304 LOCAL Non-traumatic Brain Injury M <42.50 And A >=78.50 7 6 — — $36,624.90 $54,937.35 $36,624.90 2025-09-11
B0804 LOCAL Replacement Of Lower-extremity Joint M >=42.50 And M <51.50 7 6 — — $36,389.88 $54,584.82 $36,389.88 2025-09-11
C0904 LOCAL Other Orthopedic M <44.5 7 6 — — $36,317.89 $54,476.84 $36,317.89 2025-09-11
A1705 LOCAL Major Multiple Trauma Without Brain Or Spinal Cord Injury M <36.50 7 6 — — $36,256.49 $54,384.74 $36,256.49 2025-09-11
D0704 LOCAL Fracture Of Lower Extremity M <41.50 7 6 — — $36,108.28 $54,162.42 $36,108.28 2025-09-11
A1805 LOCAL Major Multiple Trauma With Brain Or Spinal Cord Injury M >=30.50 And M <40.50 7 6 — — $36,025.70 $54,038.55 $36,025.70 2025-09-11
C0204 LOCAL Traumatic Brain Injury M >=35.50 And M <49.50 7 6 — — $35,921.96 $53,882.94 $35,921.96 2025-09-11
B1303 LOCAL Rheumatoid Other Arthritis M >=44.50 And M <51.50 And A >=64.50 7 6 — — $35,905.02 $53,857.53 $35,905.02 2025-09-11
C1305 LOCAL Rheumatoid Other Arthritis M <51.50 And A <64.50 7 6 — — $35,902.90 $53,854.35 $35,902.90 2025-09-11
C1404 LOCAL Cardiac M <45.50 7 6 — — $35,790.68 $53,686.02 $35,790.68 2025-09-11
D1304 LOCAL Rheumatoid Other Arthritis M <44.50 And A >=64.50 7 6 — — $35,786.45 $53,679.68 $35,786.45 2025-09-11
C0504 LOCAL Non-traumatic Spinal Cord Injury M >=39.50 And M <48.50 7 6 — — $35,754.69 $53,632.04 $35,754.69 2025-09-11
B0602 LOCAL Neurological M >=52.50 And M <64.50 7 6 — — $35,682.70 $53,524.05 $35,682.70 2025-09-11
D0403 LOCAL Traumatic Spinal Cord Injury M >=41.50 And M <47.50 7 6 — — $35,676.35 $53,514.53 $35,676.35 2025-09-11
C2004 LOCAL Miscellaneous M <46.50 And A >=77.50 7 6 — — $35,638.24 $53,457.36 $35,638.24 2025-09-11
B1902 LOCAL Guillain-barré M >=51.50 And M <66.50 7 6 — — $35,242.31 $52,863.47 $35,242.31 2025-09-11
B1702 LOCAL Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=50.50 And M <57.50 7 6 — — $35,172.44 $52,758.66 $35,172.44 2025-09-11
B0203 LOCAL Traumatic Brain Injury M >=49.50 And M <61.50 7 6 — — $35,163.97 $52,745.96 $35,163.97 2025-09-11
C1204 LOCAL Osteoarthritis M <49.50 And A <74.50 7 6 — — $35,151.26 $52,726.89 $35,151.26 2025-09-11
D2005 LOCAL Miscellaneous M <46.50 And A <77.50 7 6 — — $35,091.98 $52,637.97 $35,091.98 2025-09-11
C0805 LOCAL Replacement Of Lower-extremity Joint M <42.50 7 6 — — $35,019.99 $52,529.99 $35,019.99 2025-09-11
A0305 LOCAL Non-traumatic Brain Injury M <42.50 And A <78.50 7 6 — — $34,971.29 $52,456.94 $34,971.29 2025-09-11
A1504 LOCAL Pulmonary M <45.50 7 6 — — $34,384.80 $51,577.20 $34,384.80 2025-09-11
D0104 LOCAL Stroke M >=41.50 And M <50.50 7 6 — — $34,289.53 $51,434.30 $34,289.53 2025-09-11
D1305 LOCAL Rheumatoid Other Arthritis M <51.50 And A <64.50 7 6 — — $34,270.47 $51,405.71 $34,270.47 2025-09-11
B1502 LOCAL Pulmonary M >=56.50 And M <68.50 7 6 — — $34,215.42 $51,323.13 $34,215.42 2025-09-11
C1103 LOCAL Amputation Non-lower Extremity M <52.50 7 6 — — $34,134.96 $51,202.44 $34,134.96 2025-09-11
D1103 LOCAL Amputation Non-lower Extremity M <52.50 7 6 — — $34,134.96 $51,202.44 $34,134.96 2025-09-11
D1704 LOCAL Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=36.50 And M <41.50 7 6 — — $34,054.51 $51,081.77 $34,054.51 2025-09-11
B1102 LOCAL Amputation Non-lower Extremity M >=52.50 And M <58.50 7 6 — — $34,052.39 $51,078.59 $34,052.39 2025-09-11
B1202 LOCAL Osteoarthritis M >=49.50 And M <61.50 7 6 — — $34,033.33 $51,050.00 $34,033.33 2025-09-11
B0103 LOCAL Stroke M >=50.50 And M <63.50 7 6 — — $33,902.06 $50,853.09 $33,902.06 2025-09-11
D0904 LOCAL Other Orthopedic M <44.5 7 6 — — $33,851.25 $50,776.88 $33,851.25 2025-09-11
D0504 LOCAL Non-traumatic Spinal Cord Injury M >=39.50 And M <48.50 7 6 — — $33,779.26 $50,668.89 $33,779.26 2025-09-11
C1804 LOCAL Major Multiple Trauma With Brain Or Spinal Cord Injury M >=40.50 And M <45.50 7 6 — — $33,758.09 $50,637.14 $33,758.09 2025-09-11
B0502 LOCAL Non-traumatic Spinal Cord Injury M >=53.50 And M <60.50 7 6 — — $33,730.56 $50,595.84 $33,730.56 2025-09-11
D0304 LOCAL Non-traumatic Brain Injury M <42.50 And A >=78.50 7 6 — — $33,643.75 $50,465.63 $33,643.75 2025-09-11
C1203 LOCAL Osteoarthritis M <49.50 And A >=74.50 7 6 — — $33,518.83 $50,278.25 $33,518.83 2025-09-11
A1103 LOCAL Amputation Non-lower Extremity M <52.50 7 6 — — $33,444.73 $50,167.10 $33,444.73 2025-09-11
D1604 LOCAL Pain Syndrome M <43.50 7 6 — — $33,368.50 $50,052.75 $33,368.50 2025-09-11
A0704 LOCAL Fracture Of Lower Extremity M <41.50 7 6 — — $33,360.03 $50,040.05 $33,360.03 2025-09-11
D2004 LOCAL Miscellaneous M <46.50 And A >=77.50 7 6 — — $33,292.28 $49,938.42 $33,292.28 2025-09-11
A1304 LOCAL Rheumatoid Other Arthritis M <44.50 And A >=64.50 7 6 — — $33,292.28 $49,938.42 $33,292.28 2025-09-11
D1404 LOCAL Cardiac M <45.50 7 6 — — $33,277.46 $49,916.19 $33,277.46 2025-09-11
A0604 LOCAL Neurological M <43.50 7 6 — — $33,237.23 $49,855.85 $33,237.23 2025-09-11
A1004 LOCAL Amputation Lower Extremity M <47.50 7 6 — — $32,976.80 $49,465.20 $32,976.80 2025-09-11
D1204 LOCAL Osteoarthritis M <49.50 And A <74.50 7 6 — — $32,957.75 $49,436.63 $32,957.75 2025-09-11
B0402 LOCAL Traumatic Spinal Cord Injury M >=47.50 And M <56.50 7 6 — — $32,932.34 $49,398.51 $32,932.34 2025-09-11
B0302 LOCAL Non-traumatic Brain Injury M >=52.50 And M <65.50 7 6 — — $32,813.77 $49,220.66 $32,813.77 2025-09-11
B0702 LOCAL Fracture Of Lower Extremity M >=52.50 And M <61.50 7 6 — — $32,801.07 $49,201.61 $32,801.07 2025-09-11
A0104 LOCAL Stroke M >=41.50 And M <50.50 7 6 — — $32,678.27 $49,017.41 $32,678.27 2025-09-11
D0204 LOCAL Traumatic Brain Injury M >=35.50 And M <49.50 7 6 — — $32,625.33 $48,938.00 $32,625.33 2025-09-11
C1703 LOCAL Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=41.50 And M <50.50 7 6 — — $32,487.71 $48,731.57 $32,487.71 2025-09-11
B1002 LOCAL Amputation Lower Extremity M >=55.50 And M <64.50 7 6 — — $32,481.36 $48,722.04 $32,481.36 2025-09-11
B0803 LOCAL Replacement Of Lower-extremity Joint M >=51.50 And M <57.50 7 6 — — $32,481.36 $48,722.04 $32,481.36 2025-09-11
A0403 LOCAL Traumatic Spinal Cord Injury M >=41.50 And M <47.50 7 6 — — $32,417.84 $48,626.76 $32,417.84 2025-09-11
D1804 LOCAL Major Multiple Trauma With Brain Or Spinal Cord Injury M >=40.50 And M <45.50 7 6 — — $32,047.31 $48,070.97 $32,047.31 2025-09-11
A2005 LOCAL Miscellaneous M <46.50 And A <77.50 7 6 — — $31,941.45 $47,912.18 $31,941.45 2025-09-11
D0805 LOCAL Replacement Of Lower-extremity Joint M <42.50 7 6 — — $31,928.75 $47,893.13 $31,928.75 2025-09-11
A1305 LOCAL Rheumatoid Other Arthritis M <51.50 And A <64.50 7 6 — — $31,882.17 $47,823.26 $31,882.17 2025-09-11
B2101 LOCAL Burns M >=52.50 7 6 — — $31,863.11 $47,794.67 $31,863.11 2025-09-11
A2102 LOCAL Burns M <52.50 7 6 — — $31,844.05 $47,766.08 $31,844.05 2025-09-11
B1602 LOCAL Pain Syndrome M >=58.50 And M <65.50 7 6 — — $31,765.71 $47,648.57 $31,765.71 2025-09-11
A0304 LOCAL Non-traumatic Brain Injury M <42.50 And A >=78.50 7 6 — — $31,710.66 $47,565.99 $31,710.66 2025-09-11
B0902 LOCAL Other Orthopedic M >=51.50 And M <63.50 7 6 — — $31,689.49 $47,534.24 $31,689.49 2025-09-11
C0303 LOCAL Non-traumatic Brain Injury M >=42.50 And M <52.50 7 6 — — $31,587.86 $47,381.79 $31,587.86 2025-09-11
B1302 LOCAL Rheumatoid Other Arthritis M >=51.50 And M <62.50 7 6 — — $31,560.34 $47,340.51 $31,560.34 2025-09-11
C1503 LOCAL Pulmonary M >=45.50 And M <56.50 7 6 — — $31,560.34 $47,340.51 $31,560.34 2025-09-11
C0603 LOCAL Neurological M >=43.50 And M <52.50 7 6 — — $31,477.76 $47,216.64 $31,477.76 2025-09-11
C1003 LOCAL Amputation Lower Extremity M >=47.50 And M <55.50 7 6 — — $31,473.53 $47,210.30 $31,473.53 2025-09-11
D1203 LOCAL Osteoarthritis M <49.50 And A >=74.50 7 6 — — $31,429.07 $47,143.61 $31,429.07 2025-09-11
C0703 LOCAL Fracture Of Lower Extremity M >=41.50 And M <52.50 7 6 — — $31,202.52 $46,803.78 $31,202.52 2025-09-11
B2002 LOCAL Miscellaneous M >=55.50 And M <66.50 7 6 — — $31,162.29 $46,743.44 $31,162.29 2025-09-11
A0504 LOCAL Non-traumatic Spinal Cord Injury M >=39.50 And M <48.50 7 6 — — $31,128.41 $46,692.62 $31,128.41 2025-09-11
A0904 LOCAL Other Orthopedic M <44.5 7 6 — — $30,971.73 $46,457.60 $30,971.73 2025-09-11
A1704 LOCAL Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=36.50 And M <41.50 7 6 — — $30,895.51 $46,343.27 $30,895.51 2025-09-11
A1604 LOCAL Pain Syndrome M <43.50 7 6 — — $30,889.16 $46,333.74 $30,889.16 2025-09-11
C1803 LOCAL Major Multiple Trauma With Brain Or Spinal Cord Injury M >=45.50 And M <55.50 7 6 — — $30,870.10 $46,305.15 $30,870.10 2025-09-11
A0204 LOCAL Traumatic Brain Injury M >=35.50 And M <49.50 7 6 — — $30,717.66 $46,076.49 $30,717.66 2025-09-11
A1404 LOCAL Cardiac M <45.50 7 6 — — $30,620.26 $45,930.39 $30,620.26 2025-09-11
C0903 LOCAL Other Orthopedic M >=44.50 And M <51.50 7 6 — — $30,309.02 $45,463.53 $30,309.02 2025-09-11
B1402 LOCAL Cardiac M >=55.50 And M <68.50 7 6 — — $30,302.67 $45,454.01 $30,302.67 2025-09-11
A2004 LOCAL Miscellaneous M <46.50 And A >=77.50 7 6 — — $30,302.67 $45,454.01 $30,302.67 2025-09-11
A1204 LOCAL Osteoarthritis M <49.50 And A <74.50 7 6 — — $30,131.17 $45,196.76 $30,131.17 2025-09-11
B1802 LOCAL Major Multiple Trauma With Brain Or Spinal Cord Injury M >=55.50 And M <67.50 7 6 — — $30,118.46 $45,177.69 $30,118.46 2025-09-11
D1703 LOCAL Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=41.50 And M <50.50 7 6 — — $30,088.82 $45,133.23 $30,088.82 2025-09-11
C0503 LOCAL Non-traumatic Spinal Cord Injury M >=48.50 And M <53.50 7 6 — — $30,078.23 $45,117.35 $30,078.23 2025-09-11
C2003 LOCAL Miscellaneous M >=46.50 And M <55.50 7 6 — — $29,807.22 $44,710.83 $29,807.22 2025-09-11
C1603 LOCAL Pain Syndrome M >=43.50 And M <58.50 7 6 — — $29,796.63 $44,694.95 $29,796.63 2025-09-11
A0805 LOCAL Replacement Of Lower-extremity Joint M <42.50 7 6 — — $29,779.70 $44,669.55 $29,779.70 2025-09-11
A1804 LOCAL Major Multiple Trauma With Brain Or Spinal Cord Injury M >=40.50 And M <45.50 7 6 — — $29,714.06 $44,571.09 $29,714.06 2025-09-11
C1303 LOCAL Rheumatoid Other Arthritis M >=44.50 And M <51.50 And A >=64.50 7 6 — — $29,688.65 $44,532.98 $29,688.65 2025-09-11
D1503 LOCAL Pulmonary M >=45.50 And M <56.50 7 6 — — $29,682.30 $44,523.45 $29,682.30 2025-09-11
D0703 LOCAL Fracture Of Lower Extremity M >=41.50 And M <52.50 7 6 — — $29,557.38 $44,336.07 $29,557.38 2025-09-11
C0103 LOCAL Stroke M >=50.50 And M <63.50 7 6 — — $29,402.82 $44,104.23 $29,402.82 2025-09-11
D0603 LOCAL Neurological M >=43.50 And M <52.50 7 6 — — $29,385.88 $44,078.82 $29,385.88 2025-09-11
D1803 LOCAL Major Multiple Trauma With Brain Or Spinal Cord Injury M >=45.50 And M <55.50 7 6 — — $29,307.54 $43,961.31 $29,307.54 2025-09-11
C0402 LOCAL Traumatic Spinal Cord Injury M >=47.50 And M <56.50 7 6 — — $29,286.37 $43,929.56 $29,286.37 2025-09-11
C1403 LOCAL Cardiac M >=45.50 And M <55.50 7 6 — — $29,210.14 $43,815.21 $29,210.14 2025-09-11
C0804 LOCAL Replacement Of Lower-extremity Joint M >=42.50 And M <51.50 7 6 — — $29,199.56 $43,799.34 $29,199.56 2025-09-11
B0802 LOCAL Replacement Of Lower-extremity Joint M >=57.50 And M <63.50 7 6 — — $29,182.62 $43,773.93 $29,182.62 2025-09-11
D0303 LOCAL Non-traumatic Brain Injury M >=42.50 And M <52.50 7 6 — — $29,017.47 $43,526.21 $29,017.47 2025-09-11
C0203 LOCAL Traumatic Brain Injury M >=49.50 And M <61.50 7 6 — — $28,962.42 $43,443.63 $28,962.42 2025-09-11
D1003 LOCAL Amputation Lower Extremity M >=47.50 And M <55.50 7 6 — — $28,750.69 $43,126.04 $28,750.69 2025-09-11
A1203 LOCAL Osteoarthritis M <49.50 And A >=74.50 7 6 — — $28,731.64 $43,097.46 $28,731.64 2025-09-11
D0402 LOCAL Traumatic Spinal Cord Injury M >=47.50 And M <56.50 7 6 — — $28,428.86 $42,643.29 $28,428.86 2025-09-11
D0503 LOCAL Non-traumatic Spinal Cord Injury M >=48.50 And M <53.50 7 6 — — $28,416.16 $42,624.24 $28,416.16 2025-09-11
D1303 LOCAL Rheumatoid Other Arthritis M >=44.50 And M <51.50 And A >=64.50 7 6 — — $28,337.82 $42,506.73 $28,337.82 2025-09-11
B1701 LOCAL Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=57.50 7 6 — — $28,310.30 $42,465.45 $28,310.30 2025-09-11
D0903 LOCAL Other Orthopedic M >=44.50 And M <51.50 7 6 — — $28,251.01 $42,376.52 $28,251.01 2025-09-11
B0202 LOCAL Traumatic Brain Injury M >=61.50 And M <73.50 7 6 — — $28,236.19 $42,354.29 $28,236.19 2025-09-11
B0601 LOCAL Neurological M >=64.50 7 6 — — $28,132.44 $42,198.66 $28,132.44 2025-09-11
B1201 LOCAL Osteoarthritis M >=61.50 7 6 — — $28,111.27 $42,166.91 $28,111.27 2025-09-11
D2003 LOCAL Miscellaneous M >=46.50 And M <55.50 7 6 — — $27,844.49 $41,766.74 $27,844.49 2025-09-11
C1502 LOCAL Pulmonary M >=56.50 And M <68.50 7 6 — — $27,770.39 $41,655.59 $27,770.39 2025-09-11
A1503 LOCAL Pulmonary M >=45.50 And M <56.50 7 6 — — $27,766.15 $41,649.23 $27,766.15 2025-09-11
B1601 LOCAL Pain Syndrome M >=65.50 7 6 — — $27,719.57 $41,579.36 $27,719.57 2025-09-11
D1102 LOCAL Amputation Non-lower Extremity M >=52.50 And M <58.50 7 6 — — $27,372.34 $41,058.51 $27,372.34 2025-09-11
C1102 LOCAL Amputation Non-lower Extremity M >=52.50 And M <58.50 7 6 — — $27,372.34 $41,058.51 $27,372.34 2025-09-11
A0303 LOCAL Non-traumatic Brain Injury M >=42.50 And M <52.50 7 6 — — $27,349.05 $41,023.58 $27,349.05 2025-09-11
C1702 LOCAL Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=50.50 And M <57.50 7 6 — — $27,340.58 $41,010.87 $27,340.58 2025-09-11
A0703 LOCAL Fracture Of Lower Extremity M >=41.50 And M <52.50 7 6 — — $27,308.82 $40,963.23 $27,308.82 2025-09-11
A1703 LOCAL Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=41.50 And M <50.50 7 6 — — $27,298.23 $40,947.35 $27,298.23 2025-09-11
A1803 LOCAL Major Multiple Trauma With Brain Or Spinal Cord Injury M >=45.50 And M <55.50 7 6 — — $27,173.31 $40,759.97 $27,173.31 2025-09-11
D1403 LOCAL Cardiac M >=45.50 And M <55.50 7 6 — — $27,158.49 $40,737.74 $27,158.49 2025-09-11
C1902 LOCAL Guillain-barré M >=51.50 And M <66.50 7 6 — — $27,094.97 $40,642.46 $27,094.97 2025-09-11
B1501 LOCAL Pulmonary M >=68.50 7 6 — — $26,972.17 $40,458.26 $26,972.17 2025-09-11
D1603 LOCAL Pain Syndrome M >=43.50 And M <58.50 7 6 — — $26,931.94 $40,397.91 $26,931.94 2025-09-11
B0501 LOCAL Non-traumatic Spinal Cord Injury M >=60.50 7 6 — — $26,887.48 $40,331.22 $26,887.48 2025-09-11
D0103 LOCAL Stroke M >=50.50 And M <63.50 7 6 — — $26,868.42 $40,302.63 $26,868.42 2025-09-11
C1002 LOCAL Amputation Lower Extremity M >=55.50 And M <64.50 7 6 — — $26,862.07 $40,293.11 $26,862.07 2025-09-11
A1102 LOCAL Amputation Non-lower Extremity M >=52.50 And M <58.50 7 6 — — $26,819.72 $40,229.58 $26,819.72 2025-09-11
B1101 LOCAL Amputation Non-lower Extremity M >=58.50 7 6 — — $26,783.73 $40,175.60 $26,783.73 2025-09-11
C0602 LOCAL Neurological M >=52.50 And M <64.50 7 6 — — $26,715.98 $40,073.97 $26,715.98 2025-09-11
D0804 LOCAL Replacement Of Lower-extremity Joint M >=42.50 And M <51.50 7 6 — — $26,622.81 $39,934.22 $26,622.81 2025-09-11
B0701 LOCAL Fracture Of Lower Extremity M >=61.50 7 6 — — $26,555.06 $39,832.59 $26,555.06 2025-09-11
A0603 LOCAL Neurological M >=43.50 And M <52.50 7 6 — — $26,502.13 $39,753.20 $26,502.13 2025-09-11
A1303 LOCAL Rheumatoid Other Arthritis M >=44.50 And M <51.50 And A >=64.50 7 6 — — $26,362.39 $39,543.59 $26,362.39 2025-09-11
D0203 LOCAL Traumatic Brain Injury M >=49.50 And M <61.50 7 6 — — $26,305.22 $39,457.83 $26,305.22 2025-09-11
B0102 LOCAL Stroke M >=63.50 And M <72.50 7 6 — — $26,303.10 $39,454.65 $26,303.10 2025-09-11
C0302 LOCAL Non-traumatic Brain Injury M >=52.50 And M <65.50 7 6 — — $26,254.41 $39,381.62 $26,254.41 2025-09-11
C0502 LOCAL Non-traumatic Spinal Cord Injury M >=53.50 And M <60.50 7 6 — — $26,239.59 $39,359.39 $26,239.59 2025-09-11
A0503 LOCAL Non-traumatic Spinal Cord Injury M >=48.50 And M <53.50 7 6 — — $26,186.65 $39,279.98 $26,186.65 2025-09-11
D1502 LOCAL Pulmonary M >=56.50 And M <68.50 7 6 — — $26,116.78 $39,175.17 $26,116.78 2025-09-11
C1302 LOCAL Rheumatoid Other Arthritis M >=51.50 And M <62.50 7 6 — — $26,095.61 $39,143.42 $26,095.61 2025-09-11
C0803 LOCAL Replacement Of Lower-extremity Joint M >=51.50 And M <57.50 7 6 — — $26,063.85 $39,095.78 $26,063.85 2025-09-11
C1202 LOCAL Osteoarthritis M >=49.50 And M <61.50 7 6 — — $25,873.29 $38,809.94 $25,873.29 2025-09-11
A0903 LOCAL Other Orthopedic M >=44.50 And M <51.50 7 6 — — $25,847.89 $38,771.84 $25,847.89 2025-09-11
A0402 LOCAL Traumatic Spinal Cord Injury M >=47.50 And M <56.50 7 6 — — $25,833.07 $38,749.61 $25,833.07 2025-09-11
A1003 LOCAL Amputation Lower Extremity M >=47.50 And M <55.50 7 6 — — $25,758.96 $38,638.44 $25,758.96 2025-09-11
B0801 LOCAL Replacement Of Lower-extremity Joint M >=63.50 7 6 — — $25,739.90 $38,609.85 $25,739.90 2025-09-11
B1001 LOCAL Amputation Lower Extremity M >=64.50 7 6 — — $25,640.39 $38,460.59 $25,640.39 2025-09-11
A0103 LOCAL Stroke M >=50.50 And M <63.50 7 6 — — $25,604.40 $38,406.60 $25,604.40 2025-09-11
B0401 LOCAL Traumatic Spinal Cord Injury M >=56.50 7 6 — — $25,534.53 $38,301.80 $25,534.53 2025-09-11
B0901 LOCAL Other Orthopedic M >=63.50 7 6 — — $25,443.48 $38,165.22 $25,443.48 2025-09-11
C0902 LOCAL Other Orthopedic M >=51.50 And M <63.50 7 6 — — $25,382.08 $38,073.12 $25,382.08 2025-09-11
B0301 LOCAL Non-traumatic Brain Injury M >=65.50 7 6 — — $25,379.97 $38,069.96 $25,379.97 2025-09-11
C0702 LOCAL Fracture Of Lower Extremity M >=52.50 And M <61.50 7 6 — — $25,373.61 $38,060.42 $25,373.61 2025-09-11
A2003 LOCAL Miscellaneous M >=46.50 And M <55.50 7 6 — — $25,343.97 $38,015.96 $25,343.97 2025-09-11
D1702 LOCAL Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=50.50 And M <57.50 7 6 — — $25,320.68 $37,981.02 $25,320.68 2025-09-11
D1902 LOCAL Guillain-barré M >=51.50 And M <66.50 7 6 — — $25,282.57 $37,923.86 $25,282.57 2025-09-11
B2001 LOCAL Miscellaneous M >=66.50 7 6 — — $24,992.50 $37,488.75 $24,992.50 2025-09-11
A1403 LOCAL Cardiac M >=45.50 And M <55.50 7 6 — — $24,990.38 $37,485.57 $24,990.38 2025-09-11
D0602 LOCAL Neurological M >=52.50 And M <64.50 7 6 — — $24,939.57 $37,409.36 $24,939.57 2025-09-11
A1603 LOCAL Pain Syndrome M >=43.50 And M <58.50 7 6 — — $24,931.10 $37,396.65 $24,931.10 2025-09-11
D1302 LOCAL Rheumatoid Other Arthritis M >=51.50 And M <62.50 7 6 — — $24,909.93 $37,364.90 $24,909.93 2025-09-11
C2002 LOCAL Miscellaneous M >=55.50 And M <66.50 7 6 — — $24,890.87 $37,336.31 $24,890.87 2025-09-11
A1902 LOCAL Guillain-barré M >=51.50 And M <66.50 7 6 — — $24,844.29 $37,266.44 $24,844.29 2025-09-11
A0804 LOCAL Replacement Of Lower-extremity Joint M >=42.50 And M <51.50 7 6 — — $24,829.47 $37,244.21 $24,829.47 2025-09-11
D0502 LOCAL Non-traumatic Spinal Cord Injury M >=53.50 And M <60.50 7 6 — — $24,791.36 $37,187.04 $24,791.36 2025-09-11
A0203 LOCAL Traumatic Brain Injury M >=49.50 And M <61.50 7 6 — — $24,765.95 $37,148.93 $24,765.95 2025-09-11
D1002 LOCAL Amputation Lower Extremity M >=55.50 And M <64.50 7 6 — — $24,539.40 $36,809.10 $24,539.40 2025-09-11
A1502 LOCAL Pulmonary M >=56.50 And M <68.50 7 6 — — $24,431.42 $36,647.13 $24,431.42 2025-09-11
D1202 LOCAL Osteoarthritis M >=49.50 And M <61.50 7 6 — — $24,259.92 $36,389.88 $24,259.92 2025-09-11
D2101 LOCAL Burns M >=52.50 7 6 — — $24,211.22 $36,316.83 $24,211.22 2025-09-11
C2101 LOCAL Burns M >=52.50 7 6 — — $24,211.22 $36,316.83 $24,211.22 2025-09-11
D0302 LOCAL Non-traumatic Brain Injury M >=52.50 And M <65.50 7 6 — — $24,115.94 $36,173.91 $24,115.94 2025-09-11
D0702 LOCAL Fracture Of Lower Extremity M >=52.50 And M <61.50 7 6 — — $24,035.49 $36,053.24 $24,035.49 2025-09-11
C1802 LOCAL Major Multiple Trauma With Brain Or Spinal Cord Injury M >=55.50 And M <67.50 7 6 — — $24,027.02 $36,040.53 $24,027.02 2025-09-11
B1401 LOCAL Cardiac M >=68.50 7 6 — — $23,893.63 $35,840.45 $23,893.63 2025-09-11
C1402 LOCAL Cardiac M >=55.50 And M <68.50 7 6 — — $23,872.45 $35,808.68 $23,872.45 2025-09-11
D0803 LOCAL Replacement Of Lower-extremity Joint M >=51.50 And M <57.50 7 6 — — $23,762.36 $35,643.54 $23,762.36 2025-09-11
D0902 LOCAL Other Orthopedic M >=51.50 And M <63.50 7 6 — — $23,656.49 $35,484.74 $23,656.49 2025-09-11
C1602 LOCAL Pain Syndrome M >=58.50 And M <65.50 7 6 — — $23,595.09 $35,392.64 $23,595.09 2025-09-11
C0802 LOCAL Replacement Of Lower-extremity Joint M >=57.50 And M <63.50 7 6 — — $23,417.24 $35,125.86 $23,417.24 2025-09-11
C0202 LOCAL Traumatic Brain Injury M >=61.50 And M <73.50 7 6 — — $23,256.32 $34,884.48 $23,256.32 2025-09-11
D2002 LOCAL Miscellaneous M >=55.50 And M <66.50 7 6 — — $23,252.09 $34,878.14 $23,252.09 2025-09-11
A1302 LOCAL Rheumatoid Other Arthritis M >=51.50 And M <62.50 7 6 — — $23,171.63 $34,757.45 $23,171.63 2025-09-11
B1301 LOCAL Rheumatoid Other Arthritis M >=62.50 7 6 — — $23,089.06 $34,633.59 $23,089.06 2025-09-11
A1702 LOCAL Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=50.50 And M <57.50 7 6 — — $22,972.61 $34,458.92 $22,972.61 2025-09-11
A0502 LOCAL Non-traumatic Spinal Cord Injury M >=53.50 And M <60.50 7 6 — — $22,843.45 $34,265.18 $22,843.45 2025-09-11
78804 CPT Nm Tumor Imaging Wb; 2+days 21 16 $29,462.40 $29,462.40 $559.97 $25,043.04 $22,833.36 2025-09-11
C0102 LOCAL Stroke M >=63.50 And M <72.50 7 6 — — $22,811.69 $34,217.54 $22,811.69 2025-09-11
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