Price Transparencybeta Hospital negotiated rates

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

MEDSTAR GEORGETOWN UNIVERSITY HOSPITAL

Washington, DC · CCN 090004 · Rates published

85,693 distinct procedures filed
42 distinct payers
1,194,895 rate rows
2026-07-30 last MRF observed
Data quality

1,189,554 of 1,194,895 rate rows are consumer-grade (99.6%)

5,341 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 2,874
exceeds 10× this hospital's gross charge — excluded from medians 1,901
placeholder amount (≤ $0.02) — excluded from medians 298
per-diem day rate — not a per-procedure price 187
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 81
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://www.medstarhealth.org/-/media/project/mho/medstar/billing-and-insurance/2026/522218584_medstar_georgetown_university_hospital_standardcharges.csv
Found on page https://www.medstarhealth.org/price-transparency-disclosures
Discovered viaCMS hospital list
Last fetch not_modified · 2026-09-21
Content fingerprint 216bf4e59243abae… · 130,616,328 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
63637235
OTHER 		Lifileucel IV Susp 9 $826,000.00 $2,655,000.00 $1,896,850.00 —
583-4
OTHER 		Neonate With Ecmo 5 $613,775.20 $1,266,813.77 $1,266,813.77 —
018
OTHER 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 15 $527,684.45 $1,823,955.11 $974,592.61 nat. median
$149,977
outlier · 6.5×
63636609
OTHER 		Ciltacabtagene Autoleucel 30ml 19 $61,003.36 $2,586,330.00 $804,636.00 —
63636591
OTHER 		Ciltacabtagene Autoleucel 70ml 19 $61,003.36 $2,586,330.00 $804,636.00 —
588-4
OTHER 		Neonate Birth Weight < 1500 Grams With Major Procedure 5 $433,616.69 $801,449.43 $801,449.43 —
63633689
OTHER 		Axicabtagene 68ml Inj 19 $61,003.36 $2,521,800.00 $784,560.00 —
011-4
OTHER 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 5 $338,095.74 $783,492.62 $783,492.62 —
63635155
OTHER 		Idecabtagene Abecma 250mlinj 19 $61,003.36 $2,496,177.00 $776,588.40 —
63635163
OTHER 		Idecabtagene Abecma 500mlinj 19 $61,003.36 $2,496,177.00 $776,588.40 —
63635148
OTHER 		Idecabtagene Abecma 50ml Inj 19 $61,003.36 $2,496,177.00 $776,588.40 —
583-3
OTHER 		Neonate With Ecmo 5 $539,112.02 $765,704.66 $765,704.66 —
63635130
OTHER 		Lisocabtagene Breyanzi Inj 19 $61,003.36 $2,442,025.80 $759,741.36 —
63634513
OTHER 		Tisagenlecleucel Kymriah Inj 19 $61,003.36 $2,396,057.58 $745,440.14 —
63634505
OTHER 		Brexucabtagene Tecartus 68ml 19 $61,003.36 $2,316,600.00 $720,720.00 —
011-3
OTHER 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 5 $192,122.80 $611,978.26 $611,978.26 —
002-4
OTHER 		Heart And/or Lung Transplant 5 $220,000.00 $593,452.08 $593,452.08 —
609-4
OTHER 		Neonate Birth Weight 1500-2499 Grams With Major Procedure 5 $362,832.52 $564,208.67 $564,208.67 —
591-4
OTHER 		Neonate Birth Weight 500-749 Grams Without Major Procedure 5 $320,634.39 $552,103.32 $552,103.32 —
001
OTHER 		Heart Transplant Or Implant Of Heart Assist System With Mcc 12 $232,080.85 $934,989.40 $525,840.46 nat. median
$177,883
outlier · 3.0×
588-3
OTHER 		Neonate Birth Weight < 1500 Grams With Major Procedure 5 $159,882.52 $519,550.25 $519,550.25 —
588-2
OTHER 		Neonate Birth Weight < 1500 Grams With Major Procedure 5 $153,203.74 $501,149.39 $501,149.39 —
161-4
OTHER 		Implantable Heart Assist Systems 5 $419,963.29 $493,798.58 $493,798.58 —
593-4
OTHER 		Neonate Birth Weight 750-999 Grams Without Major Procedure 5 $279,900.60 $487,593.90 $487,593.90 —
927
OTHER 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 15 $191,026.77 $901,802.42 $481,859.44 nat. median
$2
outlier · 299291.6×
631-4
OTHER 		Neonate Birth Weight > 2499 Grams With Other Major Procedure 5 $303,168.08 $481,858.08 $481,858.08 —
583-2
OTHER 		Neonate With Ecmo 5 $370,944.24 $481,282.19 $481,282.19 —
009-4
OTHER 		Extracorporeal Membrane Oxygenation (ecmo) 5 $254,020.12 $475,312.78 $475,312.78 —
003
OTHER 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 15 $189,908.36 $896,510.00 $456,713.24 nat. median
$119,739
outlier · 3.8×
011-2
OTHER 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 5 $133,514.47 $431,577.17 $431,577.17 —
589-1
OTHER 		Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational… 5 $426,648.54 $562,110.10 $426,648.54 —
589-2
OTHER 		Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational… 5 $426,648.54 $542,222.50 $426,648.54 —
589-3
OTHER 		Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational… 5 $251,998.80 $426,648.53 $426,648.53 —
841-4
OTHER 		Extensive Third Degree Burns With Skin Graft 5 $355,889.30 $422,748.48 $422,748.48 —
591-3
OTHER 		Neonate Birth Weight 500-749 Grams Without Major Procedure 5 $188,273.54 $420,003.78 $420,003.78 —
630-4
OTHER 		Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 5 $380,085.62 $409,767.20 $409,767.20 —
583-1
OTHER 		Neonate With Ecmo 5 $232,185.57 $406,411.28 $406,411.28 —
161-3
OTHER 		Implantable Heart Assist Systems 5 $203,655.72 $397,759.41 $397,759.41 —
007-4
OTHER 		Allogeneic Bone Marrow Transplant 5 $200,000.00 $366,389.04 $366,389.04 —
004-4
OTHER 		Tracheostomy With Mv >96 Hours With Extensive Procedure 5 $243,777.99 $363,611.54 $363,611.54 —
602-4
OTHER 		Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 5 $188,837.13 $356,701.65 $356,701.65 —
593-3
OTHER 		Neonate Birth Weight 750-999 Grams Without Major Procedure 5 $192,988.85 $348,930.54 $348,930.54 —
007
OTHER 		Lung Transplant 12 $262,742.91 $432,070.47 $347,406.69 nat. median
$67,163
outlier · 5.2×
591-2
OTHER 		Neonate Birth Weight 500-749 Grams Without Major Procedure 5 $155,463.05 $341,434.66 $341,434.66 —
001-4
OTHER 		Liver Transplant And/or Intestinal Transplant 5 $120,000.00 $337,371.44 $337,371.44 —
002-3
OTHER 		Heart And/or Lung Transplant 5 $140,000.00 $321,885.99 $321,885.99 —
004
OTHER 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 15 $149,883.73 $585,055.44 $312,612.24 nat. median
$106,489
outlier · 2.9×
014
OTHER 		Allogeneic Bone Marrow Transplant 13 $107,724.87 $507,612.06 $307,668.47 nat. median
$77,841
outlier · 4.0×
588-1
OTHER 		Female Reproductive System Reconstructive Procedures 5 $153,203.74 $303,852.24 $303,852.24 —
63638449
OTHER 		Obecabtagene Autoleucel Inj 19 $61,003.36 $2,613,330.00 $292,162.50 —

Other procedures at this hospital

Browse this hospital's 85,693 published procedures. Use the slice to choose what to show, then sort or filter any column.

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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
             
63637235 OTHER Lifileucel IV Susp 12 9 $2,950,000.00 $1,917,500.00 35% off $826,000.00 $2,655,000.00 $1,896,850.00 2026-05-09
583-4 OTHER Neonate With Ecmo 6 5 — — $613,775.20 $1,266,813.77 $1,266,813.77 2026-05-09
018 OTHER Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 20 15 — — $527,684.45 $1,823,955.11 $974,592.61 2026-05-09
63636591 OTHER Ciltacabtagene Autoleucel 70ml 23 19 $2,873,700.00 $1,867,905.00 35% off $61,003.36 $2,586,330.00 $804,636.00 2026-05-09
63636609 OTHER Ciltacabtagene Autoleucel 30ml 23 19 $2,873,700.00 $1,867,905.00 35% off $61,003.36 $2,586,330.00 $804,636.00 2026-05-09
588-4 OTHER Neonate Birth Weight < 1500 Grams With Major Procedure 6 5 — — $433,616.69 $801,449.43 $801,449.43 2026-05-09
63633689 OTHER Axicabtagene 68ml Inj 23 19 $2,802,000.00 $1,821,300.00 35% off $61,003.36 $2,521,800.00 $784,560.00 2026-05-09
011-4 OTHER Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 6 5 — — $338,095.74 $783,492.62 $783,492.62 2026-05-09
63635148 OTHER Idecabtagene Abecma 50ml Inj 23 19 $2,773,530.00 $1,802,794.50 35% off $61,003.36 $2,496,177.00 $776,588.40 2026-05-09
63635155 OTHER Idecabtagene Abecma 250mlinj 23 19 $2,773,530.00 $1,802,794.50 35% off $61,003.36 $2,496,177.00 $776,588.40 2026-05-09
63635163 OTHER Idecabtagene Abecma 500mlinj 23 19 $2,773,530.00 $1,802,794.50 35% off $61,003.36 $2,496,177.00 $776,588.40 2026-05-09
583-3 OTHER Neonate With Ecmo 6 5 — — $539,112.02 $765,704.66 $765,704.66 2026-05-09
63635130 OTHER Lisocabtagene Breyanzi Inj 23 19 $2,713,362.00 $1,763,685.30 35% off $61,003.36 $2,442,025.80 $759,741.36 2026-05-09
63634513 OTHER Tisagenlecleucel Kymriah Inj 23 19 $2,662,286.20 $1,730,486.03 35% off $61,003.36 $2,396,057.58 $745,440.14 2026-05-09
63634505 OTHER Brexucabtagene Tecartus 68ml 23 19 $2,574,000.00 $1,673,100.00 35% off $61,003.36 $2,316,600.00 $720,720.00 2026-05-09
011-3 OTHER Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 6 5 — — $192,122.80 $611,978.26 $611,978.26 2026-05-09
002-4 OTHER Heart And/or Lung Transplant 6 5 — — $220,000.00 $593,452.08 $593,452.08 2026-05-09
609-4 OTHER Neonate Birth Weight 1500-2499 Grams With Major Procedure 6 5 — — $362,832.52 $564,208.67 $564,208.67 2026-05-09
591-4 OTHER Neonate Birth Weight 500-749 Grams Without Major Procedure 6 5 — — $320,634.39 $552,103.32 $552,103.32 2026-05-09
001 OTHER Heart Transplant Or Implant Of Heart Assist System With Mcc 13 12 — — $232,080.85 $934,989.40 $525,840.46 2026-05-09
588-3 OTHER Neonate Birth Weight < 1500 Grams With Major Procedure 6 5 — — $159,882.52 $519,550.25 $519,550.25 2026-05-09
588-2 OTHER Neonate Birth Weight < 1500 Grams With Major Procedure 6 5 — — $153,203.74 $501,149.39 $501,149.39 2026-05-09
161-4 OTHER Implantable Heart Assist Systems 6 5 — — $419,963.29 $493,798.58 $493,798.58 2026-05-09
593-4 OTHER Neonate Birth Weight 750-999 Grams Without Major Procedure 6 5 — — $279,900.60 $487,593.90 $487,593.90 2026-05-09
927 OTHER Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 20 15 — — $191,026.77 $901,802.42 $481,859.44 2026-05-09
631-4 OTHER Neonate Birth Weight > 2499 Grams With Other Major Procedure 6 5 — — $303,168.08 $481,858.08 $481,858.08 2026-05-09
583-2 OTHER Neonate With Ecmo 6 5 — — $370,944.24 $481,282.19 $481,282.19 2026-05-09
009-4 OTHER Extracorporeal Membrane Oxygenation (ecmo) 6 5 — — $254,020.12 $475,312.78 $475,312.78 2026-05-09
003 OTHER Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 20 15 — — $189,908.36 $896,510.00 $456,713.24 2026-05-09
011-2 OTHER Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 6 5 — — $133,514.47 $431,577.17 $431,577.17 2026-05-09
589-2 OTHER Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 6 5 — — $426,648.54 $542,222.50 $426,648.54 2026-05-09
589-1 OTHER Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 6 5 — — $426,648.54 $562,110.10 $426,648.54 2026-05-09
589-3 OTHER Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 6 5 — — $251,998.80 $426,648.53 $426,648.53 2026-05-09
841-4 OTHER Extensive Third Degree Burns With Skin Graft 6 5 — — $355,889.30 $422,748.48 $422,748.48 2026-05-09
591-3 OTHER Neonate Birth Weight 500-749 Grams Without Major Procedure 6 5 — — $188,273.54 $420,003.78 $420,003.78 2026-05-09
630-4 OTHER Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 6 5 — — $380,085.62 $409,767.20 $409,767.20 2026-05-09
583-1 OTHER Neonate With Ecmo 6 5 — — $232,185.57 $406,411.28 $406,411.28 2026-05-09
161-3 OTHER Implantable Heart Assist Systems 6 5 — — $203,655.72 $397,759.41 $397,759.41 2026-05-09
007-4 OTHER Allogeneic Bone Marrow Transplant 6 5 — — $200,000.00 $366,389.04 $366,389.04 2026-05-09
004-4 OTHER Tracheostomy With Mv >96 Hours With Extensive Procedure 6 5 — — $243,777.99 $363,611.54 $363,611.54 2026-05-09
602-4 OTHER Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 6 5 — — $188,837.13 $356,701.65 $356,701.65 2026-05-09
593-3 OTHER Neonate Birth Weight 750-999 Grams Without Major Procedure 6 5 — — $192,988.85 $348,930.54 $348,930.54 2026-05-09
007 OTHER Lung Transplant 13 12 — — $262,742.91 $432,070.47 $347,406.69 2026-05-09
591-2 OTHER Neonate Birth Weight 500-749 Grams Without Major Procedure 6 5 — — $155,463.05 $341,434.66 $341,434.66 2026-05-09
001-4 OTHER Liver Transplant And/or Intestinal Transplant 6 5 — — $120,000.00 $337,371.44 $337,371.44 2026-05-09
002-3 OTHER Heart And/or Lung Transplant 6 5 — — $140,000.00 $321,885.99 $321,885.99 2026-05-09
004 OTHER Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 20 15 — — $149,883.73 $585,055.44 $312,612.24 2026-05-09
014 OTHER Allogeneic Bone Marrow Transplant 15 13 — — $107,724.87 $507,612.06 $307,668.47 2026-05-09
588-1 OTHER Female Reproductive System Reconstructive Procedures 6 5 — — $153,203.74 $303,852.24 $303,852.24 2026-05-09
63638449 OTHER Obecabtagene Autoleucel Inj 26 19 $2,903,700.00 $1,887,405.00 35% off $61,003.36 $2,613,330.00 $292,162.50 2026-05-09
593-2 OTHER Neonate Birth Weight 750-999 Grams Without Major Procedure 6 5 — — $130,785.78 $271,767.62 $271,767.62 2026-05-09
009-3 OTHER Extracorporeal Membrane Oxygenation (ecmo) 6 5 — — $123,012.87 $269,809.50 $269,809.50 2026-05-09
161-2 OTHER Implantable Heart Assist Systems 6 5 — — $198,828.03 $269,519.35 $269,519.35 2026-05-09
161-1 OTHER Implantable Heart Assist Systems 6 5 — — $188,842.09 $269,519.34 $269,519.34 2026-05-09
607-4 OTHER Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 6 5 — — $148,113.25 $266,052.62 $266,052.62 2026-05-09
160-4 OTHER Major Cardiothoracic Repair Of Heart Anomaly 6 5 — — $262,065.73 $337,320.60 $262,065.73 2026-05-09
005-4 OTHER Tracheostomy With Mv >96 Hours Without Extensive Procedure 6 5 — — $177,685.99 $259,263.00 $259,263.00 2026-05-09
603-4 OTHER Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 6 5 — — $250,397.28 $258,570.62 $258,570.62 2026-05-09
602-3 OTHER Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 6 5 — — $170,812.19 $249,282.30 $249,282.30 2026-05-09
002-2 OTHER Heart And/or Lung Transplant 6 5 — — $138,000.00 $248,933.06 $248,933.06 2026-05-09
212 OTHER Hip & Femur Procedures Except Major Joint Age 0-17 20 15 — — $97,515.41 $459,300.24 $245,417.57 2026-05-09
002 OTHER Heart Transplant Or Implant Of Heart Assist System Without Mcc 13 12 — — $111,071.40 $378,074.17 $244,572.79 2026-05-09
004-3 OTHER Tracheostomy With Mv >96 Hours With Extensive Procedure 6 5 — — $130,210.62 $241,742.26 $241,742.26 2026-05-09
006-4 OTHER Pancreas Transplant 6 5 — — $85,000.00 $228,195.39 $228,195.39 2026-05-09
842-4 OTHER Burns With Skin Graft Except Extensive Third Degree Burns 6 5 — — $175,398.58 $227,053.69 $227,053.69 2026-05-09
215 OTHER Other Heart Assist System Implant 20 15 — — $89,329.48 $420,563.77 $224,719.53 2026-05-09
611-4 OTHER Neonate Birth Weight 1500-1999 Grams With Major Anomaly 6 5 — — $118,889.25 $224,532.71 $224,532.71 2026-05-09
630-3 OTHER Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 6 5 — — $156,781.95 $223,508.13 $223,508.13 2026-05-09
005 OTHER Liver Transplant With Mcc Or Intestinal Transplant 13 12 — — $92,484.77 $485,468.21 $222,721.51 2026-05-09
216 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 20 15 — — $87,774.59 $413,205.91 $220,788.02 2026-05-09
007-3 OTHER Allogeneic Bone Marrow Transplant 6 5 — — $132,000.00 $219,148.03 $219,148.03 2026-05-09
303-4 OTHER Dorsal And Lumbar Fusion Procedure For Curvature Of Back 6 5 — — $128,344.66 $218,132.06 $218,132.06 2026-05-09
863-4 OTHER Neonatal Aftercare 6 5 — — $120,100.72 $214,321.58 $214,321.58 2026-05-09
162-4 OTHER Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 6 5 — — $121,381.60 $198,477.64 $198,477.64 2026-05-09
006-3 OTHER Pancreas Transplant 6 5 — — $85,000.00 $194,524.81 $194,524.81 2026-05-09
002-1 OTHER Heart And/or Lung Transplant 6 5 — — $50,000.00 $191,316.28 $191,316.28 2026-05-09
231 OTHER Coronary Bypass With Ptca With Mcc 20 15 — — $75,698.73 $356,062.12 $190,254.41 2026-05-09
456 OTHER Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 20 15 — — $75,462.17 $354,942.81 $189,656.34 2026-05-09
440-4 OTHER Kidney Transplant 6 5 — — $134,355.73 $189,058.12 $189,058.12 2026-05-09
607-3 OTHER Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 6 5 — — $110,303.19 $187,469.63 $187,469.63 2026-05-09
001-3 OTHER Liver Transplant And/or Intestinal Transplant 6 5 — — $92,000.00 $187,256.22 $187,256.22 2026-05-09
011-1 OTHER Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 6 5 — — $75,927.55 $183,538.87 $183,538.87 2026-05-09
005-3 OTHER Tracheostomy With Mv >96 Hours Without Extensive Procedure 6 5 — — $101,897.28 $183,532.56 $183,532.56 2026-05-09
602-2 OTHER Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 6 5 — — $128,914.86 $182,804.65 $182,804.65 2026-05-09
453 OTHER Combined Anterior And Posterior Spinal Fusion With Mcc 20 15 — — $79,550.24 $273,655.62 $176,602.93 2026-05-09
163-4 OTHER Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis 6 5 — — $106,834.06 $174,737.50 $174,737.50 2026-05-09
609-3 OTHER Neonate Birth Weight 1500-2499 Grams With Major Procedure 6 5 — — $174,723.62 $175,287.85 $174,723.62 2026-05-09
219 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 20 15 — — $68,990.00 $324,316.04 $173,291.55 2026-05-09
233 OTHER Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 20 15 — — $68,694.55 $322,917.96 $172,544.52 2026-05-09
957 OTHER Other O.r. Procedures For Multiple Significant Trauma With Mcc 20 15 — — $68,468.73 $321,849.34 $171,973.52 2026-05-09
020 OTHER Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 20 15 — — $70,690.40 $332,362.37 $169,316.90 2026-05-09
612-4 OTHER Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other… 6 5 — — $138,533.89 $165,109.20 $165,109.20 2026-05-09
006-2 OTHER Pancreas Transplant 6 5 — — $85,000.00 $164,817.57 $164,817.57 2026-05-09
007-2 OTHER Allogeneic Bone Marrow Transplant 6 5 — — $120,000.00 $163,650.64 $163,650.64 2026-05-09
007-1 OTHER Allogeneic Bone Marrow Transplant 6 5 — — $150,550.70 $163,469.40 $163,469.40 2026-05-09
178-4 OTHER External Heart Assist Systems 6 5 — — $90,285.02 $163,122.90 $163,122.90 2026-05-09
928 OTHER Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 20 15 — — $64,477.07 $302,960.50 $161,880.67 2026-05-09
28089035 OTHER Kit Heartmate 3 Implant Commer 12 9 $262,918.61 $170,897.10 35% off $73,617.21 $236,626.75 $161,694.95 2026-05-09
62570163 OTHER Kit Heartmate 3 Implant Commer 12 9 $262,918.61 $170,897.10 35% off $73,617.21 $236,626.75 $161,694.95 2026-05-09
633-4 OTHER Neonate Birth Weight > 2499 Grams With Major Anomaly 6 5 — — $107,800.92 $161,672.33 $161,672.33 2026-05-09
019 OTHER Simultaneous Pancreas And Kidney Transplant With Hemodialysis 20 15 — — $64,136.99 $415,282.85 $161,020.79 2026-05-09
008-4 OTHER Autologous Bone Marrow Transplant Or T-cell Immunotherapy 6 5 — — $120,000.00 $160,397.96 $160,397.96 2026-05-09
62092408 OTHER Implant Kit Heartmate Ii Lvad 12 9 $255,492.65 $166,070.22 35% off $71,537.94 $229,943.38 $157,127.98 2026-05-09
165-4 OTHER Coronary Bypass With Ami Or Complex Principal Diagnosis 6 5 — — $83,396.34 $156,876.16 $156,876.16 2026-05-09
268 OTHER Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 20 15 — — $69,121.06 $290,508.75 $155,227.32 2026-05-09
621-4 OTHER Neonate Birth Weight 2000-2499 Grams With Major Anomaly 6 5 — — $102,226.18 $154,393.86 $154,393.86 2026-05-09
57300006 OTHER Small Bowel Acq Cadaver 12 9 $238,467.00 $155,003.55 35% off $66,770.76 $214,620.30 $153,334.28 2026-05-09
955 OTHER Craniotomy For Multiple Significant Trauma 20 15 — — $60,535.40 $284,308.20 $151,914.20 2026-05-09
004-2 OTHER Tracheostomy With Mv >96 Hours With Extensive Procedure 6 5 — — $112,235.26 $151,550.34 $151,550.34 2026-05-09
001-2 OTHER Liver Transplant And/or Intestinal Transplant 6 5 — — $87,000.00 $151,495.68 $151,495.68 2026-05-09
57000010 OTHER Liver Acq Living Donor 12 9 $232,310.00 $151,001.50 35% off $65,046.80 $209,079.00 $149,375.33 2026-05-09
57000002 OTHER Liver Acq Cadaver Donor 12 9 $232,310.00 $151,001.50 35% off $65,046.80 $209,079.00 $149,375.33 2026-05-09
009-2 OTHER Extracorporeal Membrane Oxygenation (ecmo) 6 5 — — $76,221.74 $149,010.43 $149,010.43 2026-05-09
870 OTHER Septicemia Or Severe Sepsis With Mv >96 Hours 20 15 — — $62,148.32 $291,940.61 $148,724.65 2026-05-09
218 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 20 15 — — $59,144.74 $277,727.52 $148,397.95 2026-05-09
217 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 20 15 — — $59,144.74 $277,727.52 $148,397.95 2026-05-09
573 OTHER Skin Graft For Skin Ulcer Or Cellulitis With Mcc 20 15 — — $58,931.40 $276,718.03 $147,858.55 2026-05-09
183-4 OTHER Percutaneous Structural Cardiac Procedures 6 5 — — $96,648.13 $144,986.11 $144,986.11 2026-05-09
613-4 OTHER Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection 6 5 — — $140,332.09 $144,071.70 $144,071.70 2026-05-09
162-3 OTHER Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 6 5 — — $96,282.87 $142,761.59 $142,761.59 2026-05-09
910-4 OTHER Craniotomy For Multiple Significant Trauma 6 5 — — $118,499.20 $140,659.02 $140,659.02 2026-05-09
017 OTHER Autologous Bone Marrow Transplant Without Cc/mcc 15 13 — — $48,942.42 $229,449.49 $139,195.95 2026-05-09
207 OTHER Respiratory System Diagnosis With Ventilator Support >96 Hours 20 15 — — $20,138.44 $271,788.86 $138,458.65 2026-05-09
266 OTHER Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 20 15 — — $55,155.76 $258,851.36 $138,311.86 2026-05-09
969 OTHER HIV With Extensive O.r. Procedures With Mcc 20 15 — — $108,661.45 $258,551.47 $138,151.62 2026-05-09
232 OTHER Coronary Bypass With Ptca Without Mcc 20 15 — — $54,568.41 $256,072.10 $136,826.82 2026-05-09
166-4 OTHER Coronary Bypass Without Ami Or Complex Principal Diagnosis 6 5 — — $61,603.12 $135,936.64 $135,936.64 2026-05-09
179-4 OTHER Defibrillator Implants 6 5 — — $80,846.14 $135,806.28 $135,806.28 2026-05-09
593-1 OTHER Neonate Birth Weight 750-999 Grams Without Major Procedure 6 5 — — $42,480.75 $135,784.84 $135,784.84 2026-05-09
028 OTHER Spinal Procedures With Mcc 20 15 — — $54,083.75 $253,778.58 $135,601.32 2026-05-09
276 OTHER Non-maligant Breast Disorders 20 15 — — $54,068.57 $253,706.77 $135,562.96 2026-05-09
911-4 OTHER Extensive Abdominal Or Thoracic Procedures For Multiple Significant Trauma 6 5 — — $94,078.10 $135,139.77 $135,139.77 2026-05-09
631-3 OTHER Neonate Birth Weight > 2499 Grams With Other Major Procedure 6 5 — — $129,906.51 $134,785.70 $134,785.70 2026-05-09
304-4 OTHER Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back 6 5 — — $112,760.83 $134,429.10 $134,429.10 2026-05-09
790 OTHER Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 20 15 — — $53,505.36 $251,041.55 $134,138.85 2026-05-09
167-4 OTHER Other Cardiothoracic And Thoracic Vascular Procedures 6 5 — — $93,322.79 $133,464.02 $133,464.02 2026-05-09
006-1 OTHER Pancreas Transplant 6 5 — — $50,000.00 $133,407.25 $133,407.25 2026-05-09
008 OTHER Simultaneous Pancreas And Kidney Transplant 13 12 — — $79,226.05 $284,940.68 $133,108.96 2026-05-09
091-4 OTHER Other Major Head And Neck Procedures 6 5 — — $89,913.15 $133,018.27 $133,018.27 2026-05-09
178-3 OTHER External Heart Assist Systems 6 5 — — $85,640.78 $132,675.56 $132,675.56 2026-05-09
235 OTHER Coronary Bypass Without Cardiac Catheterization With Mcc 20 15 — — $52,836.81 $247,877.93 $132,448.43 2026-05-09
820 OTHER Lymphoma And Leukemia With Major O.r. Procedures With Mcc 20 15 — — $52,802.89 $247,717.42 $132,362.67 2026-05-09
016 OTHER Autologous Bone Marrow Transplant With Cc/mcc 13 12 — — $53,382.18 $211,321.32 $132,351.75 2026-05-09
608-4 OTHER Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 6 5 — — $106,168.00 $131,360.40 $131,360.40 2026-05-09
608-3 OTHER Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 6 5 — — $81,089.10 $131,360.39 $131,360.39 2026-05-09
010 OTHER Pancreas Transplant 13 12 — — $64,503.85 $239,410.05 $131,204.74 2026-05-09
680-4 OTHER Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 6 5 — — $130,943.03 $192,155.86 $130,943.03 2026-05-09
841-3 OTHER Extensive Third Degree Burns With Skin Graft 6 5 — — $118,917.34 $129,309.33 $129,309.33 2026-05-09
912-4 OTHER Musculoskeletal And Other Procedures For Multiple Significant Trauma 6 5 — — $88,602.52 $129,109.59 $129,109.59 2026-05-09
607-2 OTHER Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 6 5 — — $81,117.19 $128,362.97 $128,362.97 2026-05-09
457 OTHER Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 20 15 — — $53,680.30 $251,869.42 $128,311.01 2026-05-09
440-3 OTHER Kidney Transplant 6 5 — — $126,557.07 $131,253.50 $126,557.07 2026-05-09
006 OTHER Liver Transplant Without Mcc 13 12 — — $83,381.53 $167,696.61 $125,539.07 2026-05-09
001-1 OTHER Liver Transplant And/or Intestinal Transplant 4 3 — — $124,860.30 $124,860.30 $124,860.30 2026-05-09
461 OTHER Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 20 15 — — $49,752.01 $233,280.47 $124,648.58 2026-05-09
834 OTHER Acute Leukemia Without Major O.r. Procedures With Mcc 20 15 — — $49,456.55 $231,882.40 $123,901.55 2026-05-09
62535448 OTHER Implant Heartmate Ii Pump Only 22 16 $231,014.31 $150,159.30 35% off $64,684.01 $207,912.88 $123,821.91 2026-05-09
005-2 OTHER Tracheostomy With Mv >96 Hours Without Extensive Procedure 6 5 — — $85,875.48 $123,600.85 $123,600.85 2026-05-09
023 OTHER Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 20 15 — — $51,602.35 $242,036.41 $123,301.74 2026-05-09
234 OTHER Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 20 15 — — $49,213.77 $230,733.52 $123,287.68 2026-05-09
011 OTHER Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 20 15 — — $49,137.01 $230,370.28 $123,093.58 2026-05-09
169-4 OTHER Major Abdominal Vascular Procedures 6 5 — — $95,048.26 $122,942.74 $122,942.74 2026-05-09
021-4 OTHER Open Craniotomy Except Trauma 6 5 — — $88,134.79 $122,795.57 $122,795.57 2026-05-09
463 OTHER Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 20 15 — — $48,234.84 $240,735.48 $122,638.99 2026-05-09
303-3 OTHER Dorsal And Lumbar Fusion Procedure For Curvature Of Back 6 5 — — $68,599.23 $122,288.84 $122,288.84 2026-05-09
009-1 OTHER Extracorporeal Membrane Oxygenation (ecmo) 6 5 — — $76,221.74 $120,964.23 $120,964.23 2026-05-09
220 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 20 15 — — $48,054.30 $225,246.81 $120,355.96 2026-05-09
163-3 OTHER Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis 6 5 — — $72,235.29 $120,112.68 $120,112.68 2026-05-09
28514586 OTHER Kit Start Up Hf Cordella Bl 12 9 $193,125.00 $125,531.25 35% off $54,075.00 $173,812.50 $118,771.88 2026-05-09
64010739 OTHER Kit Hf Mont Cordella Bl 12 9 $193,125.00 $125,531.25 35% off $54,075.00 $173,812.50 $118,771.88 2026-05-09
64010887 OTHER Kit Start Up Hf Cordella Bl 12 9 $193,125.00 $125,531.25 35% off $54,075.00 $173,812.50 $118,771.88 2026-05-09
28514578 OTHER Kit Hf Mont Cordella Bl 12 9 $193,125.00 $125,531.25 35% off $54,075.00 $173,812.50 $118,771.88 2026-05-09
130-4 OTHER Respiratory System Diagnosis With Ventilator Support > 96 Hours 6 5 — — $92,068.35 $118,655.60 $118,655.60 2026-05-09
62432323 OTHER Pump Heartware 22 16 $212,933.99 $138,407.09 35% off $59,621.52 $191,640.59 $118,578.62 2026-05-09
023-4 OTHER Spinal Procedures 6 5 — — $91,063.47 $118,554.68 $118,554.68 2026-05-09
459 OTHER Spinal Fusion Except Cervical With Mcc 20 15 — — $59,653.50 $176,973.88 $118,313.69 2026-05-09
405 OTHER Pancreas, Liver And Shunt Procedures With Mcc 20 15 — — $49,283.40 $231,062.98 $117,711.49 2026-05-09
653 OTHER Major Bladder Procedures With Mcc 20 15 — — $47,742.85 $219,485.54 $117,277.55 2026-05-09
850-4 OTHER Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal… 6 5 — — $116,763.29 $130,174.26 $116,763.29 2026-05-09
160-3 OTHER Major Cardiothoracic Repair Of Heart Anomaly 6 5 — — $83,948.36 $116,370.11 $116,370.11 2026-05-09
260-4 OTHER Major Pancreas, Liver And Shunt Procedures 6 5 — — $73,094.72 $116,279.70 $116,279.70 2026-05-09
165-3 OTHER Coronary Bypass With Ami Or Complex Principal Diagnosis 6 5 — — $55,630.07 $116,208.21 $116,208.21 2026-05-09
612-3 OTHER Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other… 6 5 — — $90,673.42 $114,893.05 $114,893.05 2026-05-09
021 OTHER Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 20 15 — — $47,706.20 $223,599.53 $113,909.34 2026-05-09
221 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 20 15 — — $45,442.57 $212,887.97 $113,752.27 2026-05-09
089-4 OTHER Major Cranial Or Facial Bone Procedures 6 5 — — $84,131.82 $113,546.36 $113,546.36 2026-05-09
220-4 OTHER Major Stomach, Esophageal And Duodenal Procedures 6 5 — — $72,339.42 $113,085.89 $113,085.89 2026-05-09
740-4 OTHER Mental Illness Diagnosis With O.r. Procedure 6 5 — — $82,000.00 $112,810.45 $112,810.45 2026-05-09
609-2 OTHER Neonate Birth Weight 1500-2499 Grams With Major Procedure 6 5 — — $70,351.15 $112,640.36 $112,640.36 2026-05-09
326 OTHER Stomach, Esophageal And Duodenal Procedures With Mcc 20 15 — — $44,971.31 $210,657.80 $112,560.63 2026-05-09
401-4 OTHER Adrenal Procedures 6 5 — — $90,225.53 $112,228.04 $112,228.04 2026-05-09
466 OTHER Revision Of Hip Or Knee Replacement With Mcc 20 15 — — $46,917.14 $219,865.69 $112,007.20 2026-05-09
690-4 OTHER Acute Leukemia 6 5 — — $111,702.40 $121,533.66 $111,702.40 2026-05-09
228 OTHER Other Cardiothoracic Procedures With Mcc 20 15 — — $44,614.26 $208,968.28 $111,657.88 2026-05-09
120-4 OTHER Major Respiratory And Chest Procedures 6 5 — — $90,595.74 $111,492.14 $111,492.14 2026-05-09
239 OTHER Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 20 15 — — $44,384.85 $207,882.76 $111,077.85 2026-05-09
950-4 OTHER Extensive O.r. Procedure Unrelated To Principal Diagnosis 6 5 — — $101,993.14 $110,890.80 $110,890.80 2026-05-09
576 OTHER Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 20 15 — — $44,201.89 $207,016.89 $110,615.18 2026-05-09
853 OTHER Infectious And Parasitic Diseases With O.r. Procedures With Mcc 20 15 — — $44,535.71 $208,596.59 $109,915.86 2026-05-09
162-2 OTHER Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 6 5 — — $62,127.04 $109,751.21 $109,751.21 2026-05-09
614-4 OTHER Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition 6 5 — — $92,936.04 $109,568.92 $109,568.92 2026-05-09
440-2 OTHER Kidney Transplant 6 5 — — $106,250.63 $109,526.23 $109,526.23 2026-05-09
020-4 OTHER Open Craniotomy For Trauma 6 5 — — $109,040.54 $111,893.14 $109,040.54 2026-05-09
651 OTHER Kidney Transplant With Hemodialysis Without Mcc 15 14 — — $33,531.86 $184,348.36 $108,940.11 2026-05-09
837 OTHER Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 20 15 — — $54,791.23 $202,924.02 $108,428.25 2026-05-09
602-1 OTHER Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 6 5 — — $38,076.16 $108,065.58 $108,065.58 2026-05-09
004-1 OTHER Tracheostomy With Mv >96 Hours With Extensive Procedure 6 5 — — $86,842.34 $107,987.15 $107,987.15 2026-05-09
312-4 OTHER Skin Graft, Except Hand, For Musculoskeletal And Connective Tissue Diagnoses 6 5 — — $107,804.22 $115,235.01 $107,804.22 2026-05-09
441-4 OTHER Major Bladder Procedures 6 5 — — $97,897.61 $107,753.77 $107,753.77 2026-05-09
267 OTHER Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 20 15 — — $42,948.70 $201,086.67 $107,446.49 2026-05-09
178-2 OTHER External Heart Assist Systems 6 5 — — $83,295.53 $107,362.69 $107,362.69 2026-05-09
603-3 OTHER Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 6 5 — — $107,071.06 $125,058.98 $107,071.06 2026-05-09
613-3 OTHER Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection 6 5 — — $75,421.80 $106,793.53 $106,793.53 2026-05-09
681-4 OTHER Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 6 5 — — $106,250.43 $189,683.34 $106,250.43 2026-05-09
008-3 OTHER Autologous Bone Marrow Transplant Or T-cell Immunotherapy 6 5 — — $105,932.94 $231,805.00 $105,932.94 2026-05-09
981 OTHER Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 20 15 — — $42,332.79 $294,480.80 $105,889.24 2026-05-09
277 OTHER Cellulitis Age >17 W Cc 20 15 — — $41,678.53 $195,076.20 $104,234.92 2026-05-09
823 OTHER Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 20 15 — — $41,377.73 $193,652.78 $103,474.35 2026-05-09
261-4 OTHER Major Biliary Tract Procedures 6 5 — — $79,509.06 $103,239.55 $103,239.55 2026-05-09
245 OTHER Aicd Generator Procedures 20 15 — — $41,177.78 $192,706.65 $102,968.80 2026-05-09
183-3 OTHER Percutaneous Structural Cardiac Procedures 6 5 — — $62,165.06 $102,781.18 $102,781.18 2026-05-09
799 OTHER Splenectomy With Mcc 20 15 — — $40,878.78 $191,291.68 $102,212.74 2026-05-09
361-4 OTHER Skin Graft For Skin And Subcutaneous Tissue Diagnoses 6 5 — — $101,633.18 $103,416.16 $101,633.18 2026-05-09
163 OTHER Major Chest Procedures With Mcc 20 15 — — $53,147.17 $189,302.27 $101,149.74 2026-05-09
179-3 OTHER Defibrillator Implants 6 5 — — $63,264.14 $100,808.98 $100,808.98 2026-05-09
319 OTHER Other Endovascular Cardiac Valve Procedures With Mcc 20 15 — — $40,289.66 $188,503.97 $100,723.19 2026-05-09
826 OTHER Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 20 15 — — $42,207.84 $197,580.92 $100,654.56 2026-05-09
863-3 OTHER Neonatal Aftercare 6 5 — — $70,990.77 $100,345.36 $100,345.36 2026-05-09
440-1 OTHER Kidney Transplant 6 5 — — $64,364.87 $100,245.48 $100,245.48 2026-05-09
321-4 OTHER Spinal Fusion And Other Back And Neck Procedures Except For Disc Procedures 6 5 — — $47,493.56 $99,528.51 $99,528.51 2026-05-09
166-3 OTHER Coronary Bypass Without Ami Or Complex Principal Diagnosis 6 5 — — $49,842.12 $99,261.48 $99,261.48 2026-05-09
329 OTHER Major Small And Large Bowel Procedures With Mcc 20 15 — — $41,482.18 $194,146.97 $98,905.19 2026-05-09
611-3 OTHER Neonate Birth Weight 1500-1999 Grams With Major Anomaly 6 5 — — $81,712.19 $98,800.38 $98,800.38 2026-05-09
178-1 OTHER External Heart Assist Systems 6 5 — — $66,850.62 $98,676.96 $98,676.96 2026-05-09
856 OTHER Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 20 15 — — $41,055.51 $192,127.99 $97,876.65 2026-05-09
025 OTHER Craniotomy And Endovascular Intracranial Procedures With Mcc 20 15 — — $41,037.66 $192,043.51 $97,833.61 2026-05-09
092-4 OTHER Facial Bone Procedures Except Major Cranial Or Facial Bone Procedures 6 5 — — $86,091.99 $97,367.06 $97,367.06 2026-05-09
622-4 OTHER Neonate Birth Weight 2000-2499 Grams With Respiratory Distress Syndrome Or Other… 6 5 — — $52,964.17 $97,306.30 $97,306.30 2026-05-09
230-4 OTHER Major Small Bowel Procedures 6 5 — — $90,051.99 $97,024.34 $97,024.34 2026-05-09
695-4 OTHER Chemotherapy For Acute Leukemia 6 5 — — $73,340.98 $96,986.50 $96,986.50 2026-05-09
027-4 OTHER Other Open Craniotomy 6 5 — — $89,113.22 $96,917.11 $96,917.11 2026-05-09
474 OTHER Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 20 15 — — $38,772.25 $181,323.51 $96,886.46 2026-05-09
181-4 OTHER Lower Extremity Arterial Procedures 6 5 — — $76,054.81 $96,835.12 $96,835.12 2026-05-09
304-3 OTHER Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back 6 5 — — $58,005.07 $96,624.86 $96,624.86 2026-05-09
031 OTHER Ventricular Shunt Procedures With Mcc 20 15 — — $34,467.80 $189,247.36 $96,409.16 2026-05-09
792-4 OTHER Extensive O.r. Procedures For Other Complications Of Treatment 6 5 — — $96,311.57 $208,741.25 $96,311.57 2026-05-09
140 OTHER Major Head And Neck Procedures With Mcc 20 15 — — $38,525.90 $180,157.74 $96,263.55 2026-05-09
165-2 OTHER Coronary Bypass With Ami Or Complex Principal Diagnosis 6 5 — — $46,941.54 $95,870.03 $95,870.03 2026-05-09
651-4 OTHER Other Procedures Of Blood And Blood-forming Organs 6 5 — — $95,767.01 $99,722.25 $95,767.01 2026-05-09
269 OTHER Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 20 15 — — $38,150.13 $178,379.52 $95,313.40 2026-05-09
511-4 OTHER Uterine And Adnexa Procedures For Ovarian And Adnexal Malignancy 6 5 — — $71,780.78 $95,310.75 $95,310.75 2026-05-09
958 OTHER Other O.r. Procedures For Multiple Significant Trauma With Cc 20 15 — — $38,067.11 $177,986.71 $95,103.51 2026-05-09
512-4 OTHER Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy 6 5 — — $61,391.57 $94,854.49 $94,854.49 2026-05-09
652 OTHER Kidney Transplant 13 12 — — $29,280.45 $160,376.50 $94,828.48 2026-05-09
673 OTHER Other Kidney And Urinary Tract Procedures With Mcc 20 15 — — $37,957.32 $177,467.18 $94,825.91 2026-05-09
162-1 OTHER Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 6 5 — — $58,778.56 $94,597.97 $94,597.97 2026-05-09
121-4 OTHER Other Respiratory And Chest Procedures 6 5 — — $81,736.98 $94,589.57 $94,589.57 2026-05-09
236 OTHER Coronary Bypass Without Cardiac Catheterization Without Mcc 20 15 — — $37,843.07 $176,926.53 $94,537.02 2026-05-09
356 OTHER Other Digestive System O.r. Procedures With Mcc 20 15 — — $15,950.34 $185,543.09 $94,522.07 2026-05-09
458 OTHER Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 20 15 — — $37,698.48 $231,107.04 $94,171.40 2026-05-09
455 OTHER Combined Anterior And Posterior Spinal Fusion Without Cc/mcc 20 15 — — $41,563.38 $146,158.35 $93,860.87 2026-05-09
623-4 OTHER Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection 6 5 — — $78,249.67 $93,615.02 $93,615.02 2026-05-09
030-4 OTHER Percutaneous Intracranial And Extracranial Vascular Procedures 6 5 — — $65,346.61 $93,197.66 $93,197.66 2026-05-09
273 OTHER Percutaneous And Other Intracardiac Procedures With Mcc 20 15 — — $37,278.07 $174,252.87 $93,108.41 2026-05-09
634-4 OTHER Neonate Birth Weight > 2499 Grams With Respiratory Distress Syndrome Or Other Ma… 6 5 — — $65,166.46 $92,493.30 $92,493.30 2026-05-09
603-2 OTHER Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 6 5 — — $72,742.69 $92,412.35 $92,412.35 2026-05-09
223-4 OTHER Other Small And Large Bowel Procedures 6 5 — — $63,153.41 $92,025.69 $92,025.69 2026-05-09
757-4 OTHER Organic Mental Health Disturbances 6 5 — — $38,466.00 $91,984.90 $91,984.90 2026-05-09
303-2 OTHER Dorsal And Lumbar Fusion Procedure For Curvature Of Back 6 5 — — $65,773.02 $91,936.12 $91,936.12 2026-05-09
710-4 OTHER Infectious And Parasitic Diseases Including HIV With O.r. Procedure 6 5 — — $73,896.31 $91,822.58 $91,822.58 2026-05-09
163-2 OTHER Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis 6 5 — — $46,586.19 $91,797.35 $91,797.35 2026-05-09
405-4 OTHER Other Procedures For Endocrine, Nutritional And Metabolic Disorders 6 5 — — $82,421.22 $91,408.38 $91,408.38 2026-05-09
160-2 OTHER Major Cardiothoracic Repair Of Heart Anomaly 6 5 — — $39,211.60 $91,309.56 $91,309.56 2026-05-09
614-3 OTHER Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition 6 5 — — $59,829.72 $91,179.62 $91,179.62 2026-05-09
609-1 OTHER Neonate Birth Weight 1500-2499 Grams With Major Procedure 6 5 — — $70,351.15 $91,077.85 $91,077.85 2026-05-09
170-4 OTHER Permanent Cardiac Pacemaker Implant With Ami, Heart Failure Or Shock 6 5 — — $66,252.32 $90,783.91 $90,783.91 2026-05-09
403-4 OTHER Procedures For Obesity 6 5 — — $62,882.35 $90,720.83 $90,720.83 2026-05-09
012 OTHER Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 20 15 — — $38,085.85 $178,075.41 $90,717.78 2026-05-09
901 OTHER Wound Debridements For Injuries With Mcc 20 15 — — $13,347.51 $177,255.99 $90,300.34 2026-05-09
802 OTHER Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 20 15 — — $36,015.94 $168,280.42 $89,917.15 2026-05-09
175-4 OTHER Percutaneous Cardiac Intervention Without Ami 6 5 — — $50,842.04 $89,770.47 $89,770.47 2026-05-09
793 OTHER Full Term Neonate With Major Problems 20 15 — — $18,288.40 $176,115.56 $89,719.36 2026-05-09
264-4 OTHER Other Hepatobiliary, Pancreas And Abdominal Procedures 6 5 — — $51,951.03 $89,467.70 $89,467.70 2026-05-09
630-2 OTHER Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 6 5 — — $89,317.79 $116,940.65 $89,317.79 2026-05-09
130-3 OTHER Respiratory System Diagnosis With Ventilator Support > 96 Hours 6 5 — — $64,273.97 $89,265.85 $89,265.85 2026-05-09
029-4 OTHER Other Percutaneous Intracranial Procedures 6 5 — — $70,984.16 $89,198.57 $89,198.57 2026-05-09
022-4 OTHER Ventricular Shunt Procedures 6 5 — — $82,713.76 $89,133.39 $89,133.39 2026-05-09
625-4 OTHER Neonate Birth Weight 2000-2499 Grams With Other Significant Condition 6 5 — — $89,030.99 $112,205.51 $89,030.99 2026-05-09
711-4 OTHER Post-operative, Post-trauma, Other Device Infections With O.r. Procedure 6 5 — — $63,826.08 $88,841.14 $88,841.14 2026-05-09
63638670 OTHER Gemcitabine 225mg Intravesical 12 9 $138,000.00 $89,700.00 35% off $38,640.00 $124,200.00 $88,734.00 2026-05-09
933 OTHER Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 20 15 — — $35,213.49 $164,483.22 $87,888.20 2026-05-09
165-1 OTHER Coronary Bypass With Ami Or Complex Principal Diagnosis 6 5 — — $40,399.93 $87,707.85 $87,707.85 2026-05-09
404-4 OTHER Thyroid, Parathyroid And Thyroglossal Procedures 6 5 — — $82,632.77 $87,640.56 $87,640.56 2026-05-09
034 OTHER Carotid Artery Stent Procedures With Mcc 20 15 — — $35,003.75 $163,490.63 $87,357.82 2026-05-09
791 OTHER Prematurity With Major Problems 20 15 — — $6,725.45 $171,444.04 $87,339.53 2026-05-09
650-4 OTHER Splenectomy 6 5 — — $43,619.50 $87,318.87 $87,318.87 2026-05-09
040 OTHER Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 20 15 — — $34,918.95 $163,089.37 $87,143.42 2026-05-09
447-4 OTHER Other Kidney, Urinary Tract And Related Procedures 6 5 — — $78,664.51 $86,774.30 $86,774.30 2026-05-09
907 OTHER Other O.r. Procedures For Injuries With Mcc 20 15 — — $34,723.46 $162,164.35 $86,649.17 2026-05-09
442-4 OTHER Kidney And Urinary Tract Procedures For Malignancy 6 5 — — $69,610.72 $86,555.63 $86,555.63 2026-05-09
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