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 — reason	Rows
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 via	CMS hospital list
Last fetch	not_modified · 2026-10-22
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	nat. median $719,647 outlier · 2.6×
583-4 OTHER	Neonate With Ecmo	5	$613,775.20	$1,266,813.77	$1,266,813.77	nat. median $254,150 outlier · 5.0×
018 OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	15	$527,684.45	$1,823,955.11	$974,592.61	nat. median $297,123 outlier · 3.3×
63636609 OTHER	Ciltacabtagene Autoleucel 30ml	19	$61,003.36	$2,586,330.00	$804,636.00	nat. median $697,036 1.2× median
63636591 OTHER	Ciltacabtagene Autoleucel 70ml	19	$61,003.36	$2,586,330.00	$804,636.00	nat. median $697,036 1.2× median
588-4 OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	5	$433,616.69	$801,449.43	$801,449.43	nat. median $236,745 outlier · 3.4×
63633689 OTHER	Axicabtagene 68ml Inj	19	$61,003.36	$2,521,800.00	$784,560.00	nat. median $602,723 1.3× median
011-4 OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	5	$338,095.74	$783,492.62	$783,492.62	nat. median $62,526 outlier · 12.5×
63635155 OTHER	Idecabtagene Abecma 250mlinj	19	$61,003.36	$2,496,177.00	$776,588.40	nat. median $664,917 1.2× median
63635163 OTHER	Idecabtagene Abecma 500mlinj	19	$61,003.36	$2,496,177.00	$776,588.40	nat. median $664,917 1.2× median
63635148 OTHER	Idecabtagene Abecma 50ml Inj	19	$61,003.36	$2,496,177.00	$776,588.40	nat. median $664,917 1.2× median
583-3 OTHER	Neonate With Ecmo	5	$539,112.02	$765,704.66	$765,704.66	nat. median $243,100 outlier · 3.1×
63635130 OTHER	Lisocabtagene Breyanzi Inj	19	$61,003.36	$2,442,025.80	$759,741.36	nat. median $650,230 1.2× median
63634513 OTHER	Tisagenlecleucel Kymriah Inj	19	$61,003.36	$2,396,057.58	$745,440.14	nat. median $570,183 1.3× median
63634505 OTHER	Brexucabtagene Tecartus 68ml	19	$61,003.36	$2,316,600.00	$720,720.00	nat. median $602,723 1.2× median
011-3 OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	5	$192,122.80	$611,978.26	$611,978.26	nat. median $107,680 outlier · 5.7×
002-4 OTHER	Heart And/or Lung Transplant	5	$220,000.00	$593,452.08	$593,452.08	nat. median $178,618 outlier · 3.3×
609-4 OTHER	Neonate Birth Weight 1500-2499 Grams With Major Procedure	5	$362,832.52	$564,208.67	$564,208.67	nat. median $168,174 outlier · 3.4×
591-4 OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure	5	$320,634.39	$552,103.32	$552,103.32	nat. median $134,440 outlier · 4.1×
001 OTHER	Heart Transplant Or Implant Of Heart Assist System With Mcc	12	$232,080.85	$934,989.40	$525,840.46	nat. median $214,523 outlier · 2.5×
588-3 OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	5	$159,882.52	$519,550.25	$519,550.25	nat. median $148,138 outlier · 3.5×
588-2 OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	5	$153,203.74	$501,149.39	$501,149.39	nat. median $133,956 outlier · 3.7×
161-4 OTHER	Implantable Heart Assist Systems	5	$419,963.29	$493,798.58	$493,798.58	nat. median $160,594 outlier · 3.1×
593-4 OTHER	Neonate Birth Weight 750-999 Grams Without Major Procedure	5	$279,900.60	$487,593.90	$487,593.90	nat. median $128,260 outlier · 3.8×
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 · 285123.9×
631-4 OTHER	Neonate Birth Weight > 2499 Grams With Other Major Procedure	5	$303,168.08	$481,858.08	$481,858.08	nat. median $183,175 outlier · 2.6×
583-2 OTHER	Neonate With Ecmo	5	$370,944.24	$481,282.19	$481,282.19	nat. median $178,334 outlier · 2.7×
009-4 OTHER	Extracorporeal Membrane Oxygenation (ecmo)	5	$254,020.12	$475,312.78	$475,312.78	nat. median $98,526 outlier · 4.8×
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 $165,355 outlier · 2.8×
011-2 OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	5	$133,514.47	$431,577.17	$431,577.17	nat. median $50,000 outlier · 8.6×
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	nat. median $62,432 outlier · 6.8×
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	nat. median $42,825 outlier · 10.0×
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	nat. median $52,516 outlier · 8.1×
841-4 OTHER	Extensive Third Degree Burns With Skin Graft	5	$355,889.30	$422,748.48	$422,748.48	nat. median $113,251 outlier · 3.7×
591-3 OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure	5	$188,273.54	$420,003.78	$420,003.78	nat. median $95,550 outlier · 4.4×
630-4 OTHER	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure	5	$380,085.62	$409,767.20	$409,767.20	nat. median $195,063 outlier · 2.1×
583-1 OTHER	Neonate With Ecmo	5	$232,185.57	$406,411.28	$406,411.28	nat. median $161,998 outlier · 2.5×
161-3 OTHER	Implantable Heart Assist Systems	5	$203,655.72	$397,759.41	$397,759.41	nat. median $123,032 outlier · 3.2×
007-4 OTHER	Allogeneic Bone Marrow Transplant	5	$200,000.00	$366,389.04	$366,389.04	nat. median $133,615 outlier · 2.7×
004-4 OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	5	$243,777.99	$363,611.54	$363,611.54	nat. median $100,636 outlier · 3.6×
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	nat. median $107,500 outlier · 3.3×
593-3 OTHER	Neonate Birth Weight 750-999 Grams Without Major Procedure	5	$192,988.85	$348,930.54	$348,930.54	nat. median $103,950 outlier · 3.4×
007 OTHER	Lung Transplant	12	$262,742.91	$432,070.47	$347,406.69	nat. median $93,649 outlier · 3.7×
591-2 OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure	5	$155,463.05	$341,434.66	$341,434.66	nat. median $72,718 outlier · 4.7×
001-4 OTHER	Liver Transplant And/or Intestinal Transplant	5	$120,000.00	$337,371.44	$337,371.44	nat. median $120,000 outlier · 2.8×
002-3 OTHER	Heart And/or Lung Transplant	5	$140,000.00	$321,885.99	$321,885.99	nat. median $125,034 outlier · 2.6×
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 $118,265 outlier · 2.6×
014 OTHER	Allogeneic Bone Marrow Transplant	13	$107,724.87	$507,612.06	$307,668.47	nat. median $85,837 outlier · 3.6×
588-1 OTHER	Female Reproductive System Reconstructive Procedures	5	$153,203.74	$303,852.24	$303,852.24	nat. median $97,826 outlier · 3.1×
63638449 OTHER	Obecabtagene Autoleucel Inj	19	$61,003.36	$2,613,330.00	$292,162.50	nat. median $733,622 outlier · 0.4×

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.

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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