Hospital

MEDSTAR WASHINGTON HOSPITAL CENTER

Washington, DC · CCN 090011 · Rates published

89,608 distinct procedures filed

24 distinct payers

2,414,944 rate rows

2026-05-24 last MRF observed

Data quality

2,402,440 of 2,414,944 rate rows are consumer-grade (99.5%)

12,504 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	5,994
exceeds 10× this hospital's gross charge — excluded from medians	4,182
per-diem day rate — not a per-procedure price	1,158
placeholder amount (≤ $0.02) — excluded from medians	988
no usable negotiated amount (only an out-of-band fallback) — excluded from medians	182

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

Source MRF file	https://www.medstarhealth.org/-/media/project/mho/medstar/billing-and-insurance/2026/521272129_medstar_washington_hospital_center_standardcharges.csv
Found on page	https://www.medstarhealth.org/price-transparency-disclosures
Discovered via	CMS hospital list
Last fetch	not_modified · 2026-05-17
Content fingerprint	f85d58b4105960c2… · 155,342,152 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
583-4 OTHER	Neonate With Ecmo	5	$703,124.50	$1,183,389.15	$1,183,389.15	nat. median $309,400 outlier · 3.8×
018 OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	18	$554,718.66	$1,766,003.79	$1,127,393.05	nat. median $424,868 outlier · 2.7×
63637235 OTHER	Lifileucel IV Susp	11	$352,839.38	$1,034,184.38	$778,680.00	nat. median $726,362 1.1× median
588-4 OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	5	$496,739.72	$748,361.90	$748,361.90	nat. median $267,493 outlier · 2.8×
011-4 OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	5	$387,313.46	$731,575.69	$731,575.69	nat. median $105,647 outlier · 6.9×
583-3 OTHER	Neonate With Ecmo	5	$617,592.35	$714,947.33	$714,947.33	nat. median $259,487 outlier · 2.8×
63636609 OTHER	Ciltacabtagene Autoleucel 30ml	20	$72,623.05	$1,790,650.37	$616,678.06	nat. median $697,036 0.9× median
63636591 OTHER	Ciltacabtagene Autoleucel 70ml	20	$72,623.05	$1,790,650.37	$616,678.06	nat. median $697,036 0.9× median
63635155 OTHER	Idecabtagene Abecma 250mlinj	20	$72,623.05	$1,751,437.10	$585,985.81	nat. median $664,917 0.9× median
63635148 OTHER	Idecabtagene Abecma 50ml Inj	20	$72,623.05	$1,751,437.10	$585,985.81	nat. median $664,917 0.9× median
63635163 OTHER	Idecabtagene Abecma 500mlinj	20	$72,623.05	$1,751,437.10	$585,985.81	nat. median $664,917 0.9× median
63634513 OTHER	Tisagenlecleucel Kymriah Inj	20	$72,623.05	$1,871,371.06	$583,527.24	nat. median $570,183 1.0× median
63635130 OTHER	Lisocabtagene Breyanzi Inj	20	$72,623.05	$1,752,651.21	$579,067.28	nat. median $650,230 0.9× median
011-3 OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	5	$220,090.76	$571,242.36	$571,242.36	nat. median $171,094 outlier · 3.3×
63633689 OTHER	Axicabtagene 68ml Inj	20	$72,623.05	$1,724,955.03	$558,801.85	nat. median $602,723 0.9× median
002-4 OTHER	Heart And/or Lung Transplant	4	$553,923.89	$553,923.89	$553,923.89	nat. median $216,800 outlier · 2.6×
927 OTHER	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	18	$195,356.46	$873,150.05	$534,253.26	nat. median $146,562 outlier · 3.6×
609-4 OTHER	Neonate Birth Weight 1500-2499 Grams With Major Procedure	5	$415,651.25	$526,586.86	$526,586.86	nat. median $169,856 outlier · 3.1×
001 OTHER	Heart Transplant Or Implant Of Heart Assist System With Mcc	13	$154,582.08	$992,875.00	$521,540.02	nat. median $263,894 2.0× median
591-4 OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure	5	$367,310.20	$515,270.66	$515,270.66	nat. median $156,696 outlier · 3.3×
63634505 OTHER	Brexucabtagene Tecartus 68ml	20	$72,623.05	$1,584,660.00	$513,922.71	nat. median $602,723 0.9× median
003 OTHER	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…	18	$194,213.92	$868,025.78	$499,949.81	nat. median $218,232 outlier · 2.3×
588-3 OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	5	$183,157.15	$484,839.73	$484,839.73	nat. median $165,000 outlier · 2.9×
588-2 OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	5	$175,506.12	$467,638.41	$467,638.41	nat. median $153,523 outlier · 3.0×
161-4 OTHER	Implantable Heart Assist Systems	5	$460,766.80	$481,098.74	$460,766.80	nat. median $202,242 outlier · 2.3×
593-4 OTHER	Neonate Birth Weight 750-999 Grams Without Major Procedure	5	$320,646.66	$454,966.60	$454,966.60	nat. median $151,250 outlier · 3.0×
631-4 OTHER	Neonate Birth Weight > 2499 Grams With Other Major Procedure	5	$347,301.26	$449,604.70	$449,604.70	nat. median $203,379 outlier · 2.2×
583-2 OTHER	Neonate With Ecmo	5	$424,943.82	$449,066.35	$449,066.35	nat. median $191,347 outlier · 2.3×
009-4 OTHER	Extracorporeal Membrane Oxygenation (ecmo)	5	$290,998.67	$443,486.08	$443,486.08	nat. median $150,954 outlier · 2.9×
011-2 OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	5	$152,950.62	$402,601.60	$402,601.60	nat. median $52,878 outlier · 7.6×
589-2 OTHER	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational…	5	$397,994.27	$621,155.63	$397,994.27	nat. median $49,980 outlier · 8.0×
589-1 OTHER	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational…	5	$397,994.27	$643,938.33	$397,994.27	nat. median $86,371 outlier · 4.6×
589-3 OTHER	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational…	5	$288,683.10	$397,994.26	$397,994.26	nat. median $87,000 outlier · 4.6×
841-4 OTHER	Extensive Third Degree Burns With Skin Graft	5	$394,348.45	$407,697.28	$394,348.45	nat. median $151,691 outlier · 2.6×
591-3 OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure	5	$215,681.14	$391,782.68	$391,782.68	nat. median $99,157 outlier · 4.0×
630-4 OTHER	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure	5	$382,213.42	$435,415.95	$382,213.42	nat. median $210,669 1.8× median
583-1 OTHER	Neonate With Ecmo	5	$265,985.60	$379,076.28	$379,076.28	nat. median $171,226 outlier · 2.2×
161-3 OTHER	Implantable Heart Assist Systems	5	$233,302.57	$370,988.42	$370,988.42	nat. median $152,491 outlier · 2.4×
007-4 OTHER	Allogeneic Bone Marrow Transplant	4	$341,663.08	$341,663.08	$341,663.08	nat. median $172,311 2.0× median
004-4 OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	5	$279,265.57	$339,066.64	$339,066.64	nat. median $110,000 outlier · 3.1×
602-4 OTHER	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	5	$216,326.78	$332,607.21	$332,607.21	nat. median $125,000 outlier · 2.7×
004 OTHER	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…	18	$40,923.09	$566,466.86	$328,485.95	nat. median $150,232 outlier · 2.2×
593-3 OTHER	Neonate Birth Weight 750-999 Grams Without Major Procedure	5	$221,082.88	$325,342.71	$325,342.71	nat. median $112,711 outlier · 2.9×
007 OTHER	Lung Transplant	13	$231,335.31	$417,872.65	$324,603.98	nat. median $141,082 outlier · 2.3×
591-2 OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure	5	$178,094.33	$318,335.48	$318,335.48	nat. median $80,000 outlier · 4.0×
001-4 OTHER	Liver Transplant And/or Intestinal Transplant	4	$314,537.14	$314,537.14	$314,537.14	nat. median $124,561 outlier · 2.5×
014 OTHER	Allogeneic Bone Marrow Transplant	15	$110,256.99	$491,484.04	$300,870.52	nat. median $105,808 outlier · 2.8×
002-3 OTHER	Heart And/or Lung Transplant	4	$300,061.19	$300,061.19	$300,061.19	nat. median $133,471 outlier · 2.2×
63638449 OTHER	Obecabtagene Autoleucel Inj	21	$72,623.05	$1,004,062.50	$292,162.50	nat. median $733,622 outlier · 0.4×
588-1 OTHER	Female Reproductive System Reconstructive Procedures	5	$175,506.12	$283,203.06	$283,203.06	nat. median $75,325 outlier · 3.8×

Other procedures at this hospital

Browse this hospital's 89,608 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

583-4	OTHER	Neonate With Ecmo	12	5	—	—	$703,124.50	$1,183,389.15	$1,183,389.15	2026-05-24
018	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	48	18	—	—	$554,718.66	$1,766,003.79	$1,127,393.05	2026-05-24
63637235	OTHER	Lifileucel IV Susp	26	11	$1,216,687.50	$790,846.88 35% off	$352,839.38	$1,034,184.38	$778,680.00	2026-05-24
588-4	OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	12	5	—	—	$496,739.72	$748,361.90	$748,361.90	2026-05-24
011-4	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	12	5	—	—	$387,313.46	$731,575.69	$731,575.69	2026-05-24
583-3	OTHER	Neonate With Ecmo	12	5	—	—	$617,592.35	$714,947.33	$714,947.33	2026-05-24
63636609	OTHER	Ciltacabtagene Autoleucel 30ml	50	20	$1,233,356.12	$801,681.48 35% off	$72,623.05	$1,790,650.37	$616,678.06	2026-05-24
63636591	OTHER	Ciltacabtagene Autoleucel 70ml	50	20	$1,233,356.12	$801,681.48 35% off	$72,623.05	$1,790,650.37	$616,678.06	2026-05-24
63635148	OTHER	Idecabtagene Abecma 50ml Inj	50	20	$1,176,525.00	$764,741.25 35% off	$72,623.05	$1,751,437.10	$585,985.81	2026-05-24
63635163	OTHER	Idecabtagene Abecma 500mlinj	50	20	$1,176,525.00	$764,741.25 35% off	$72,623.05	$1,751,437.10	$585,985.81	2026-05-24
63635155	OTHER	Idecabtagene Abecma 250mlinj	50	20	$1,176,525.00	$764,741.25 35% off	$72,623.05	$1,751,437.10	$585,985.81	2026-05-24
63634513	OTHER	Tisagenlecleucel Kymriah Inj	50	20	$1,008,900.20	$655,785.13 35% off	$72,623.05	$1,871,371.06	$583,527.24	2026-05-24
63635130	OTHER	Lisocabtagene Breyanzi Inj	50	20	$1,150,537.50	$747,849.38 35% off	$72,623.05	$1,752,651.21	$579,067.28	2026-05-24
011-3	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	12	5	—	—	$220,090.76	$571,242.36	$571,242.36	2026-05-24
63633689	OTHER	Axicabtagene 68ml Inj	50	20	$1,189,707.75	$773,310.04 35% off	$72,623.05	$1,724,955.03	$558,801.85	2026-05-24
002-4	OTHER	Heart And/or Lung Transplant	10	4	—	—	$553,923.89	$553,923.89	$553,923.89	2026-05-24
927	OTHER	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	48	18	—	—	$195,356.46	$873,150.05	$534,253.26	2026-05-24
609-4	OTHER	Neonate Birth Weight 1500-2499 Grams With Major Procedure	12	5	—	—	$415,651.25	$526,586.86	$526,586.86	2026-05-24
001	OTHER	Heart Transplant Or Implant Of Heart Assist System With Mcc	32	13	—	—	$154,582.08	$992,875.00	$521,540.02	2026-05-24
591-4	OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure	12	5	—	—	$367,310.20	$515,270.66	$515,270.66	2026-05-24
63634505	OTHER	Brexucabtagene Tecartus 68ml	50	20	$1,091,475.00	$709,458.75 35% off	$72,623.05	$1,584,660.00	$513,922.71	2026-05-24
003	OTHER	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…	48	18	—	—	$194,213.92	$868,025.78	$499,949.81	2026-05-24
588-3	OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	12	5	—	—	$183,157.15	$484,839.73	$484,839.73	2026-05-24
588-2	OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	12	5	—	—	$175,506.12	$467,638.41	$467,638.41	2026-05-24
161-4	OTHER	Implantable Heart Assist Systems	12	5	—	—	$460,766.80	$481,098.74	$460,766.80	2026-05-24
593-4	OTHER	Neonate Birth Weight 750-999 Grams Without Major Procedure	12	5	—	—	$320,646.66	$454,966.60	$454,966.60	2026-05-24
631-4	OTHER	Neonate Birth Weight > 2499 Grams With Other Major Procedure	12	5	—	—	$347,301.26	$449,604.70	$449,604.70	2026-05-24
583-2	OTHER	Neonate With Ecmo	12	5	—	—	$424,943.82	$449,066.35	$449,066.35	2026-05-24
009-4	OTHER	Extracorporeal Membrane Oxygenation (ecmo)	12	5	—	—	$290,998.67	$443,486.08	$443,486.08	2026-05-24
011-2	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	12	5	—	—	$152,950.62	$402,601.60	$402,601.60	2026-05-24
589-2	OTHER	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …	12	5	—	—	$397,994.27	$621,155.63	$397,994.27	2026-05-24
589-1	OTHER	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …	12	5	—	—	$397,994.27	$643,938.33	$397,994.27	2026-05-24
589-3	OTHER	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …	12	5	—	—	$288,683.10	$397,994.26	$397,994.26	2026-05-24
841-4	OTHER	Extensive Third Degree Burns With Skin Graft	12	5	—	—	$394,348.45	$407,697.28	$394,348.45	2026-05-24
591-3	OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure	12	5	—	—	$215,681.14	$391,782.68	$391,782.68	2026-05-24
630-4	OTHER	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure	12	5	—	—	$382,213.42	$435,415.95	$382,213.42	2026-05-24
583-1	OTHER	Neonate With Ecmo	12	5	—	—	$265,985.60	$379,076.28	$379,076.28	2026-05-24
161-3	OTHER	Implantable Heart Assist Systems	12	5	—	—	$233,302.57	$370,988.42	$370,988.42	2026-05-24
007-4	OTHER	Allogeneic Bone Marrow Transplant	10	4	—	—	$341,663.08	$341,663.08	$341,663.08	2026-05-24
004-4	OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	12	5	—	—	$279,265.57	$339,066.64	$339,066.64	2026-05-24
602-4	OTHER	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	12	5	—	—	$216,326.78	$332,607.21	$332,607.21	2026-05-24
004	OTHER	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…	48	18	—	—	$40,923.09	$566,466.86	$328,485.95	2026-05-24
593-3	OTHER	Neonate Birth Weight 750-999 Grams Without Major Procedure	12	5	—	—	$221,082.88	$325,342.71	$325,342.71	2026-05-24
007	OTHER	Lung Transplant	32	13	—	—	$231,335.31	$417,872.65	$324,603.98	2026-05-24
591-2	OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure	12	5	—	—	$178,094.33	$318,335.48	$318,335.48	2026-05-24
001-4	OTHER	Liver Transplant And/or Intestinal Transplant	10	4	—	—	$314,537.14	$314,537.14	$314,537.14	2026-05-24
014	OTHER	Allogeneic Bone Marrow Transplant	36	15	—	—	$110,256.99	$491,484.04	$300,870.52	2026-05-24
002-3	OTHER	Heart And/or Lung Transplant	10	4	—	—	$300,061.19	$300,061.19	$300,061.19	2026-05-24
63638449	OTHER	Obecabtagene Autoleucel Inj	58	21	$1,181,250.00	$767,812.50 35% off	$72,623.05	$1,004,062.50	$292,162.50	2026-05-24
588-1	OTHER	Female Reproductive System Reconstructive Procedures	12	5	—	—	$175,506.12	$283,203.06	$283,203.06	2026-05-24
002	OTHER	Heart Transplant Or Implant Of Heart Assist System Without Mcc	32	13	—	—	$119,081.89	$992,875.00	$280,558.37	2026-05-24
215	OTHER	Other Heart Assist System Implant	48	18	—	—	$13,721.32	$992,875.00	$260,236.15	2026-05-24
212	OTHER	Hip & Femur Procedures Except Major Joint Age 0-17	48	18	—	—	$94,556.02	$444,707.19	$256,216.29	2026-05-24
593-2	OTHER	Neonate Birth Weight 750-999 Grams Without Major Procedure	12	5	—	—	$149,824.70	$253,210.03	$253,210.03	2026-05-24
009-3	OTHER	Extracorporeal Membrane Oxygenation (ecmo)	12	5	—	—	$140,920.26	$251,379.56	$251,379.56	2026-05-24
161-1	OTHER	Implantable Heart Assist Systems	12	5	—	—	$216,332.46	$251,108.32	$251,108.32	2026-05-24
161-2	OTHER	Implantable Heart Assist Systems	12	5	—	—	$227,772.09	$251,108.32	$251,108.32	2026-05-24
607-4	OTHER	Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…	12	5	—	—	$169,674.59	$247,867.59	$247,867.59	2026-05-24
160-4	OTHER	Major Cardiothoracic Repair Of Heart Anomaly	12	5	—	—	$244,140.60	$386,425.48	$244,140.60	2026-05-24
005-4	OTHER	Tracheostomy With Mv >96 Hours Without Extensive Procedure	12	5	—	—	$203,552.33	$241,520.59	$241,520.59	2026-05-24
603-4	OTHER	Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition	12	5	—	—	$240,873.34	$286,848.44	$240,873.34	2026-05-24
602-3	OTHER	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	12	5	—	—	$195,677.88	$232,190.52	$232,190.52	2026-05-24
002-2	OTHER	Heart And/or Lung Transplant	10	4	—	—	$231,864.06	$231,864.06	$231,864.06	2026-05-24
216	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	48	18	—	—	$89,369.21	$400,077.39	$230,519.85	2026-05-24
004-3	OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	12	5	—	—	$149,165.81	$225,142.03	$225,142.03	2026-05-24
005	OTHER	Liver Transplant With Mcc Or Intestinal Transplant	32	13	—	—	$94,688.03	$337,158.25	$215,923.14	2026-05-24
006-4	OTHER	Pancreas Transplant	10	4	—	—	$212,478.28	$212,478.28	$212,478.28	2026-05-24
842-4	OTHER	Burns With Skin Graft Except Extensive Third Degree Burns	12	5	—	—	$200,931.93	$211,411.01	$211,411.01	2026-05-24
231	OTHER	Coronary Bypass With Ptca With Mcc	48	18	—	—	$77,539.75	$344,749.19	$211,144.47	2026-05-24
456	OTHER	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	48	18	—	—	$77,298.10	$343,665.45	$210,481.77	2026-05-24
611-4	OTHER	Neonate Birth Weight 1500-1999 Grams With Major Anomaly	12	5	—	—	$136,196.35	$209,054.37	$209,054.37	2026-05-24
630-3	OTHER	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure	12	5	—	—	$179,605.22	$208,096.58	$208,096.58	2026-05-24
007-3	OTHER	Allogeneic Bone Marrow Transplant	10	4	—	—	$204,020.71	$204,020.71	$204,020.71	2026-05-24
303-4	OTHER	Dorsal And Lumbar Fusion Procedure For Curvature Of Back	12	5	—	—	$147,028.22	$203,070.98	$203,070.98	2026-05-24
863-4	OTHER	Neonatal Aftercare	12	5	—	—	$137,584.18	$199,508.90	$199,508.90	2026-05-24
020	OTHER	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc	48	18	—	—	$72,423.34	$321,802.44	$185,451.61	2026-05-24
162-4	OTHER	Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis	12	5	—	—	$139,051.53	$184,697.82	$184,697.82	2026-05-24
006-3	OTHER	Pancreas Transplant	10	4	—	—	$181,002.68	$181,002.68	$181,002.68	2026-05-24
28089035	OTHER	Kit Heartmate 3 Implant Commer	26	11	$299,536.89	$194,698.98 35% off	$86,865.70	$254,606.36	$179,722.13	2026-05-24
62570163	OTHER	Kit Heartmate 3 Implant Commer	26	11	$299,536.89	$194,698.98 35% off	$86,865.70	$254,606.36	$179,722.13	2026-05-24
019	OTHER	Simultaneous Pancreas And Kidney Transplant With Hemodialysis	48	18	—	—	$65,728.54	$291,776.60	$178,752.57	2026-05-24
275	OTHER	Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc	48	18	—	—	$65,690.24	$291,604.84	$178,647.54	2026-05-24
002-1	OTHER	Heart And/or Lung Transplant	10	4	—	—	$178,003.32	$178,003.32	$178,003.32	2026-05-24
453	OTHER	Combined Anterior And Posterior Spinal Fusion With Mcc	48	18	—	—	$81,474.40	$273,655.62	$177,565.01	2026-05-24
440-4	OTHER	Kidney Transplant	10	4	—	—	$175,892.36	$175,892.36	$175,892.36	2026-05-24
607-3	OTHER	Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…	12	5	—	—	$126,360.39	$174,407.42	$174,407.42	2026-05-24
001-3	OTHER	Liver Transplant And/or Intestinal Transplant	10	4	—	—	$174,207.92	$174,207.92	$174,207.92	2026-05-24
011-1	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	12	5	—	—	$86,980.57	$170,732.91	$170,732.91	2026-05-24
005-3	OTHER	Tracheostomy With Mv >96 Hours Without Extensive Procedure	12	5	—	—	$116,730.80	$170,727.01	$170,727.01	2026-05-24
602-2	OTHER	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	12	5	—	—	$147,681.42	$170,046.56	$170,046.56	2026-05-24
207	OTHER	Respiratory System Diagnosis With Ventilator Support >96 Hours	48	18	—	—	$77,090.94	$263,153.49	$166,601.63	2026-05-24
219	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	48	18	—	—	$32,945.35	$314,011.76	$165,628.60	2026-05-24
233	OTHER	Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc	48	18	—	—	$62,031.08	$312,658.10	$164,914.61	2026-05-24
218	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	48	18	—	—	$60,628.56	$268,903.47	$164,766.02	2026-05-24
957	OTHER	Other O.r. Procedures For Multiple Significant Trauma With Mcc	48	18	—	—	$51,268.15	$311,623.43	$164,368.86	2026-05-24
573	OTHER	Skin Graft For Skin Ulcer Or Cellulitis With Mcc	48	18	—	—	$60,410.61	$267,926.05	$164,168.33	2026-05-24
57502007	OTHER	Heart Acq Fee	26	11	$255,046.00	$165,779.90 35% off	$73,963.34	$216,789.10	$163,229.44	2026-05-24
268	OTHER	Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc	48	18	—	—	$45,686.61	$281,278.60	$163,109.40	2026-05-24
163-4	OTHER	Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis	12	5	—	—	$122,386.24	$162,505.30	$162,505.30	2026-05-24
609-3	OTHER	Neonate Birth Weight 1500-2499 Grams With Major Procedure	12	5	—	—	$162,492.33	$200,805.08	$162,492.33	2026-05-24
955	OTHER	Craniotomy For Multiple Significant Trauma	48	18	—	—	$62,049.21	$275,275.07	$158,662.61	2026-05-24
217	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	48	18	—	—	$60,628.56	$268,903.47	$154,994.05	2026-05-24
928	OTHER	Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc	48	18	—	—	$36,084.86	$293,334.74	$154,722.31	2026-05-24
612-4	OTHER	Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other…	12	5	—	—	$153,504.67	$158,700.73	$153,504.67	2026-05-24
006-2	OTHER	Pancreas Transplant	10	4	—	—	$153,232.06	$153,232.06	$153,232.06	2026-05-24
007-2	OTHER	Allogeneic Bone Marrow Transplant	10	4	—	—	$152,141.20	$152,141.20	$152,141.20	2026-05-24
007-1	OTHER	Allogeneic Bone Marrow Transplant	10	4	—	—	$151,971.77	$151,971.77	$151,971.77	2026-05-24
232	OTHER	Coronary Bypass With Ptca Without Mcc	48	18	—	—	$55,953.47	$247,936.09	$151,944.78	2026-05-24
178-4	OTHER	External Heart Assist Systems	12	5	—	—	$103,428.12	$151,647.85	$151,647.85	2026-05-24
028	OTHER	Spinal Procedures With Mcc	48	18	—	—	$55,458.35	$245,715.44	$150,586.89	2026-05-24
633-4	OTHER	Neonate Birth Weight > 2499 Grams With Major Anomaly	12	5	—	—	$123,493.86	$150,291.86	$150,291.86	2026-05-24
457	OTHER	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	48	18	—	—	$55,046.20	$243,866.94	$149,456.57	2026-05-24
008-4	OTHER	Autologous Bone Marrow Transplant Or T-cell Immunotherapy	10	4	—	—	$149,100.56	$149,100.56	$149,100.56	2026-05-24
870	OTHER	Septicemia Or Severe Sepsis With Mv >96 Hours	48	18	—	—	$56,418.67	$282,664.97	$149,094.43	2026-05-24
820	OTHER	Lymphoma And Leukemia With Major O.r. Procedures With Mcc	48	18	—	—	$54,149.84	$239,846.86	$146,998.35	2026-05-24
165-4	OTHER	Coronary Bypass With Ami Or Complex Principal Diagnosis	12	5	—	—	$95,536.63	$145,808.34	$145,808.34	2026-05-24
969	OTHER	HIV With Extensive O.r. Procedures With Mcc	48	18	—	—	$101,130.00	$250,336.68	$145,166.63	2026-05-24
266	OTHER	Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc	48	18	—	—	$54,626.09	$250,627.05	$144,471.05	2026-05-24
621-4	OTHER	Neonate Birth Weight 2000-2499 Grams With Major Anomaly	12	5	—	—	$117,107.58	$143,487.86	$143,487.86	2026-05-24
463	OTHER	Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …	48	18	—	—	$52,642.56	$233,086.75	$142,864.65	2026-05-24
004-2	OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	12	5	—	—	$128,573.72	$140,829.71	$140,829.71	2026-05-24
001-2	OTHER	Liver Transplant And/or Intestinal Transplant	10	4	—	—	$140,778.62	$140,778.62	$140,778.62	2026-05-24
278	OTHER	Cellulitis Age >17 Without Cc	48	18	—	—	$51,427.04	$227,635.32	$139,531.18	2026-05-24
009-2	OTHER	Extracorporeal Membrane Oxygenation (ecmo)	12	5	—	—	$87,317.59	$138,455.38	$138,455.38	2026-05-24
461	OTHER	Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc	48	18	—	—	$51,033.13	$225,868.61	$138,450.87	2026-05-24
834	OTHER	Acute Leukemia Without Major O.r. Procedures With Mcc	48	18	—	—	$50,731.31	$224,514.95	$137,623.13	2026-05-24
405	OTHER	Pancreas, Liver And Shunt Procedures With Mcc	48	18	—	—	$50,554.43	$223,721.57	$137,138.00	2026-05-24
234	OTHER	Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc	48	18	—	—	$50,483.29	$223,402.58	$136,942.93	2026-05-24
011	OTHER	Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc	48	18	—	—	$50,404.88	$223,050.87	$136,727.88	2026-05-24
017	OTHER	Autologous Bone Marrow Transplant Without Cc/mcc	36	15	—	—	$50,206.08	$222,159.34	$136,182.71	2026-05-24
023	OTHER	Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…	48	18	—	—	$52,923.40	$234,346.35	$135,097.14	2026-05-24
183-4	OTHER	Percutaneous Structural Cardiac Procedures	12	5	—	—	$110,717.52	$134,693.41	$134,693.41	2026-05-24
613-4	OTHER	Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection	12	5	—	—	$133,838.61	$160,760.69	$133,838.61	2026-05-24
162-3	OTHER	Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis	12	5	—	—	$110,299.09	$132,613.91	$132,613.91	2026-05-24
653	OTHER	Major Bladder Procedures With Mcc	48	18	—	—	$51,746.24	$212,511.97	$131,913.33	2026-05-24
910-4	OTHER	Craniotomy For Multiple Significant Trauma	12	5	—	—	$130,648.40	$135,749.52	$130,648.40	2026-05-24
466	OTHER	Revision Of Hip Or Knee Replacement With Mcc	48	18	—	—	$48,137.10	$212,880.04	$130,508.57	2026-05-24
276	OTHER	Non-maligant Breast Disorders	48	18	—	—	$55,442.85	$245,645.91	$129,568.37	2026-05-24
010	OTHER	Pancreas Transplant	32	13	—	—	$66,103.32	$196,836.63	$128,400.70	2026-05-24
016	OTHER	Autologous Bone Marrow Transplant With Cc/mcc	32	13	—	—	$54,741.63	$201,861.62	$128,301.62	2026-05-24
790	OTHER	Extreme Immaturity Or Respiratory Distress Syndrome, Neonate	48	18	—	—	$54,867.49	$243,065.38	$128,207.24	2026-05-24
650	OTHER	Kidney Transplant With Hemodialysis With Mcc	44	16	—	—	$43,541.36	$230,604.34	$127,781.70	2026-05-24
62491162	OTHER	Nupulse Ivas G150242	26	11	$199,467.50	$129,653.88 35% off	$57,845.57	$169,547.38	$127,659.20	2026-05-24
235	OTHER	Coronary Bypass Without Cardiac Catheterization With Mcc	48	18	—	—	$40,099.99	$240,002.27	$126,591.57	2026-05-24
221	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	48	18	—	—	$46,630.71	$206,124.02	$126,377.37	2026-05-24
166-4	OTHER	Coronary Bypass Without Ami Or Complex Principal Diagnosis	12	5	—	—	$70,570.89	$126,233.87	$126,233.87	2026-05-24
179-4	OTHER	Defibrillator Implants	12	5	—	—	$92,615.18	$126,112.01	$126,112.01	2026-05-24
593-1	OTHER	Neonate Birth Weight 750-999 Grams Without Major Procedure	12	5	—	—	$48,664.82	$126,091.96	$126,091.96	2026-05-24
911-4	OTHER	Extensive Abdominal Or Thoracic Procedures For Multiple Significant Trauma	12	5	—	—	$107,773.36	$125,488.95	$125,488.95	2026-05-24
631-3	OTHER	Neonate Birth Weight > 2499 Grams With Other Major Procedure	12	5	—	—	$125,157.95	$148,817.43	$125,157.95	2026-05-24
326	OTHER	Stomach, Esophageal And Duodenal Procedures With Mcc	48	18	—	—	$46,149.27	$203,964.71	$125,056.99	2026-05-24
304-4	OTHER	Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back	12	5	—	—	$124,824.61	$129,175.80	$124,824.61	2026-05-24
021	OTHER	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc	48	18	—	—	$48,943.19	$216,495.25	$124,819.04	2026-05-24
837	OTHER	Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot…	48	18	—	—	$58,313.94	$196,476.65	$124,577.74	2026-05-24
270	OTHER	Other Major Cardiovascular Procedures With Mcc	48	18	—	—	$48,783.59	$215,779.56	$124,406.97	2026-05-24
228	OTHER	Other Cardiothoracic Procedures With Mcc	48	18	—	—	$45,784.52	$202,328.87	$124,056.70	2026-05-24
167-4	OTHER	Other Cardiothoracic And Thoracic Vascular Procedures	12	5	—	—	$106,908.10	$123,922.43	$123,922.43	2026-05-24
006-1	OTHER	Pancreas Transplant	10	4	—	—	$123,869.37	$123,869.37	$123,869.37	2026-05-24
091-4	OTHER	Other Major Head And Neck Procedures	12	5	—	—	$103,002.11	$123,505.75	$123,505.75	2026-05-24
008	OTHER	Simultaneous Pancreas And Kidney Transplant	32	13	—	—	$82,944.02	$164,425.85	$123,340.24	2026-05-24
178-3	OTHER	External Heart Assist Systems	12	5	—	—	$98,107.80	$123,185.37	$123,185.37	2026-05-24
576	OTHER	Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc	48	18	—	—	$45,363.25	$200,439.48	$122,901.37	2026-05-24
62092408	OTHER	Implant Kit Heartmate Ii Lvad	26	11	$203,437.50	$132,234.38 35% off	$58,996.87	$172,921.88	$122,062.50	2026-05-24
608-4	OTHER	Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition	12	5	—	—	$121,623.22	$121,955.95	$121,955.95	2026-05-24
608-3	OTHER	Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition	12	5	—	—	$92,893.51	$121,955.95	$121,955.95	2026-05-24
680-4	OTHER	Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms	12	5	—	—	$121,565.80	$220,128.63	$121,565.80	2026-05-24
006	OTHER	Liver Transplant Without Mcc	32	13	—	—	$86,181.27	$160,189.76	$121,506.16	2026-05-24
471	OTHER	Cervical Spinal Fusion With Mcc	48	18	—	—	$44,702.15	$223,846.72	$121,088.33	2026-05-24
841-3	OTHER	Extensive Third Degree Burns With Skin Graft	12	5	—	—	$120,038.60	$136,228.54	$120,038.60	2026-05-24
912-4	OTHER	Musculoskeletal And Other Procedures For Multiple Significant Trauma	12	5	—	—	$101,500.68	$119,851.88	$119,851.88	2026-05-24
267	OTHER	Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc	48	18	—	—	$44,083.00	$194,697.68	$119,390.34	2026-05-24
607-2	OTHER	Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…	12	5	—	—	$92,925.69	$119,153.92	$119,153.92	2026-05-24
459	OTHER	Spinal Fusion Except Cervical With Mcc	48	18	—	—	$61,148.30	$176,973.88	$119,061.09	2026-05-24
440-3	OTHER	Kidney Transplant	10	4	—	—	$117,465.75	$117,465.75	$117,465.75	2026-05-24
826	OTHER	Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. …	48	18	—	—	$43,326.17	$191,303.31	$117,314.74	2026-05-24
239	OTHER	Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc	48	18	—	—	$45,550.16	$201,277.84	$116,057.33	2026-05-24
001-1	OTHER	Liver Transplant And/or Intestinal Transplant	10	4	—	—	$115,879.59	$115,879.59	$115,879.59	2026-05-24
64010739	OTHER	Kit Hf Mont Cordella Bl	26	11	$193,125.00	$125,531.25 35% off	$56,006.25	$164,156.25	$115,875.00	2026-05-24
64010887	OTHER	Kit Start Up Hf Cordella Bl	26	11	$193,125.00	$125,531.25 35% off	$56,006.25	$164,156.25	$115,875.00	2026-05-24
28514578	OTHER	Kit Hf Mont Cordella Bl	26	11	$193,125.00	$125,531.25 35% off	$56,006.25	$164,156.25	$115,875.00	2026-05-24
28514586	OTHER	Kit Start Up Hf Cordella Bl	26	11	$193,125.00	$125,531.25 35% off	$56,006.25	$164,156.25	$115,875.00	2026-05-24
220	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	48	18	—	—	$12,624.44	$218,090.19	$115,033.83	2026-05-24
823	OTHER	Lymphoma And Non-acute Leukemia With Other Procedures With Mcc	48	18	—	—	$42,478.15	$187,499.98	$114,989.07	2026-05-24
63616858	OTHER	Sodi Benzoate Phenylac.50mlsol	26	11	$179,607.35	$116,744.78 35% off	$52,086.13	$152,666.25	$114,948.70	2026-05-24
005-2	OTHER	Tracheostomy With Mv >96 Hours Without Extensive Procedure	12	5	—	—	$98,376.65	$114,702.26	$114,702.26	2026-05-24
169-4	OTHER	Major Abdominal Vascular Procedures	12	5	—	—	$108,884.75	$114,087.05	$114,087.05	2026-05-24
021-4	OTHER	Open Craniotomy Except Trauma	12	5	—	—	$100,964.87	$113,949.47	$113,949.47	2026-05-24
62535448	OTHER	Implant Heartmate Ii Pump Only	50	19	$198,112.50	$128,773.13 35% off	$57,452.62	$168,395.62	$113,655.52	2026-05-24
303-3	OTHER	Dorsal And Lumbar Fusion Procedure For Curvature Of Back	12	5	—	—	$78,585.45	$113,475.77	$113,475.77	2026-05-24
009-1	OTHER	Extracorporeal Membrane Oxygenation (ecmo)	12	5	—	—	$87,317.59	$112,237.51	$112,237.51	2026-05-24
319	OTHER	Other Endovascular Cardiac Valve Procedures With Mcc	48	18	—	—	$41,366.60	$182,514.76	$111,940.68	2026-05-24
163-3	OTHER	Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis	12	5	—	—	$82,750.82	$111,441.48	$111,441.48	2026-05-24
356	OTHER	Other Digestive System O.r. Procedures With Mcc	48	18	—	—	$40,727.40	$179,647.95	$110,187.68	2026-05-24
130-4	OTHER	Respiratory System Diagnosis With Ventilator Support > 96 Hours	12	5	—	—	$105,471.04	$110,079.38	$110,079.38	2026-05-24
023-4	OTHER	Spinal Procedures	12	5	—	—	$104,319.88	$109,985.04	$109,985.04	2026-05-24
62432323	OTHER	Pump Heartware	50	19	$173,977.50	$113,085.38 35% off	$50,453.47	$158,553.95	$109,325.78	2026-05-24
323	OTHER	Urinary Stones W Cc, &/or Esw Lithotripsy	48	18	—	—	$40,131.03	$176,973.35	$108,552.19	2026-05-24
329	OTHER	Major Small And Large Bowel Procedures With Mcc	48	18	—	—	$42,584.84	$187,978.46	$108,399.98	2026-05-24
850-4	OTHER	Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal…	12	5	—	—	$108,310.43	$149,124.16	$108,310.43	2026-05-24
160-3	OTHER	Major Cardiothoracic Repair Of Heart Anomaly	12	5	—	—	$96,169.01	$107,942.88	$107,942.88	2026-05-24
260-4	OTHER	Major Pancreas, Liver And Shunt Procedures	12	5	—	—	$83,735.37	$107,858.36	$107,858.36	2026-05-24
165-3	OTHER	Coronary Bypass With Ami Or Complex Principal Diagnosis	12	5	—	—	$63,728.32	$107,791.53	$107,791.53	2026-05-24
474	OTHER	Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc	48	18	—	—	$39,816.44	$175,562.44	$107,689.44	2026-05-24
245	OTHER	Aicd Generator Procedures	48	18	—	—	$15,920.08	$186,583.91	$107,597.04	2026-05-24
856	OTHER	Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc	48	18	—	—	$36,922.62	$186,023.64	$107,274.45	2026-05-24
799	OTHER	Splenectomy With Mcc	48	18	—	—	$41,968.42	$185,213.89	$106,808.22	2026-05-24
612-3	OTHER	Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other…	12	5	—	—	$103,873.05	$106,562.12	$106,562.12	2026-05-24
853	OTHER	Infectious And Parasitic Diseases With O.r. Procedures With Mcc	48	18	—	—	$45,704.28	$201,968.99	$106,530.54	2026-05-24
163	OTHER	Major Chest Procedures With Mcc	48	18	—	—	$43,839.40	$183,287.70	$106,285.89	2026-05-24
012	OTHER	Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc	48	18	—	—	$39,115.24	$172,417.54	$105,766.39	2026-05-24
031	OTHER	Ventricular Shunt Procedures With Mcc	48	18	—	—	$19,712.24	$183,234.53	$105,668.56	2026-05-24
673	OTHER	Other Kidney And Urinary Tract Procedures With Mcc	48	18	—	—	$38,983.93	$171,828.63	$105,406.28	2026-05-24
089-4	OTHER	Major Cranial Or Facial Bone Procedures	12	5	—	—	$96,379.17	$105,303.21	$105,303.21	2026-05-24
901	OTHER	Wound Debridements For Injuries With Mcc	48	18	—	—	$38,938.34	$171,624.15	$105,281.24	2026-05-24
220-4	OTHER	Major Stomach, Esophageal And Duodenal Procedures	12	5	—	—	$82,870.10	$104,872.76	$104,872.76	2026-05-24
458	OTHER	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	48	18	—	—	$38,719.50	$170,642.65	$104,681.07	2026-05-24
740-4	OTHER	Mental Illness Diagnosis With O.r. Procedure	12	5	—	—	$82,000.00	$104,615.28	$104,615.28	2026-05-24
609-2	OTHER	Neonate Birth Weight 1500-2499 Grams With Major Procedure	12	5	—	—	$80,592.40	$104,456.27	$104,456.27	2026-05-24
423	OTHER	Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc	48	18	—	—	$38,540.77	$169,841.09	$104,190.93	2026-05-24
401-4	OTHER	Adrenal Procedures	12	5	—	—	$103,359.96	$104,070.83	$104,070.83	2026-05-24
690-4	OTHER	Acute Leukemia	12	5	—	—	$103,579.46	$139,225.71	$103,579.46	2026-05-24
273	OTHER	Percutaneous And Other Intracardiac Procedures With Mcc	48	18	—	—	$38,290.02	$168,716.45	$103,503.24	2026-05-24
120-4	OTHER	Major Respiratory And Chest Procedures	12	5	—	—	$103,382.91	$103,784.07	$103,382.91	2026-05-24
950-4	OTHER	Extensive O.r. Procedure Unrelated To Principal Diagnosis	12	5	—	—	$102,820.77	$116,840.62	$102,820.77	2026-05-24
162-2	OTHER	Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis	12	5	—	—	$71,171.09	$101,755.47	$101,755.47	2026-05-24
614-4	OTHER	Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition	12	5	—	—	$101,585.06	$106,465.05	$101,585.06	2026-05-24
440-2	OTHER	Kidney Transplant	10	4	—	—	$101,545.16	$101,545.16	$101,545.16	2026-05-24
981	OTHER	Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc	48	18	—	—	$43,453.83	$191,875.85	$101,206.82	2026-05-24
020-4	OTHER	Open Craniotomy For Trauma	12	5	—	—	$101,091.13	$128,181.79	$101,091.13	2026-05-24
651	OTHER	Kidney Transplant With Hemodialysis Without Mcc	44	16	—	—	$34,462.98	$176,096.10	$100,721.79	2026-05-24
602-1	OTHER	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	12	5	—	—	$43,619.03	$100,179.72	$100,179.72	2026-05-24
004-1	OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	12	5	—	—	$99,484.26	$100,106.41	$100,106.41	2026-05-24
802	OTHER	Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc	48	18	—	—	$37,000.65	$162,933.75	$99,967.20	2026-05-24
312-4	OTHER	Skin Graft, Except Hand, For Musculoskeletal And Connective Tissue Diagnoses	12	5	—	—	$99,935.41	$132,010.15	$99,935.41	2026-05-24
441-4	OTHER	Major Bladder Procedures	12	5	—	—	$99,888.24	$112,148.89	$99,888.24	2026-05-24
277	OTHER	Cellulitis Age >17 W Cc	48	18	—	—	$42,785.44	$188,878.18	$99,625.67	2026-05-24
269	OTHER	Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc	48	18	—	—	$39,180.90	$172,711.99	$99,610.02	2026-05-24
178-2	OTHER	External Heart Assist Systems	12	5	—	—	$95,421.13	$99,522.66	$99,522.66	2026-05-24
63638670	OTHER	Gemcitabine 225mg Intravesical	26	11	$155,250.00	$100,912.50 35% off	$45,022.50	$131,962.50	$99,360.00	2026-05-24
603-3	OTHER	Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition	12	5	—	—	$99,250.04	$143,264.23	$99,250.04	2026-05-24
613-3	OTHER	Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection	12	5	—	—	$86,401.21	$98,990.59	$98,990.59	2026-05-24
236	OTHER	Coronary Bypass Without Cardiac Catheterization Without Mcc	48	18	—	—	$38,867.21	$171,305.16	$98,800.01	2026-05-24
681-4	OTHER	Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms	12	5	—	—	$98,482.90	$217,296.17	$98,482.90	2026-05-24
008-3	OTHER	Autologous Bone Marrow Transplant Or T-cell Immunotherapy	10	4	—	—	$98,186.11	$98,186.11	$98,186.11	2026-05-24
025	OTHER	Craniotomy And Endovascular Intracranial Procedures With Mcc	48	18	—	—	$42,130.73	$185,941.84	$98,076.87	2026-05-24
933	OTHER	Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft	48	18	—	—	$36,180.89	$159,257.20	$97,719.04	2026-05-24
034	OTHER	Carotid Artery Stent Procedures With Mcc	48	18	—	—	$35,966.62	$158,296.15	$97,131.38	2026-05-24
261-4	OTHER	Major Biliary Tract Procedures	12	5	—	—	$91,083.46	$95,668.30	$95,668.30	2026-05-24
183-3	OTHER	Percutaneous Structural Cardiac Procedures	12	5	—	—	$71,214.63	$95,239.82	$95,239.82	2026-05-24
956	OTHER	Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma	48	18	—	—	$34,984.55	$153,891.65	$94,438.10	2026-05-24
455	OTHER	Combined Anterior And Posterior Spinal Fusion Without Cc/mcc	48	18	—	—	$42,667.80	$146,158.35	$94,413.07	2026-05-24
361-4	OTHER	Skin Graft For Skin And Subcutaneous Tissue Diagnoses	12	5	—	—	$94,166.65	$118,470.79	$94,166.65	2026-05-24
143	OTHER	Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc	48	18	—	—	$34,835.01	$153,220.95	$94,027.98	2026-05-24
166	OTHER	Other Respiratory System O.r. Procedures With Mcc	48	18	—	—	$34,753.85	$152,856.98	$93,805.41	2026-05-24
518	OTHER	Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost…	48	18	—	—	$34,750.20	$152,840.62	$93,795.41	2026-05-24
628	OTHER	Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc	48	18	—	—	$34,654.46	$152,411.21	$93,532.84	2026-05-24
179-3	OTHER	Defibrillator Implants	12	5	—	—	$72,473.71	$93,396.18	$93,396.18	2026-05-24
863-3	OTHER	Neonatal Aftercare	12	5	—	—	$81,325.13	$92,962.78	$92,962.78	2026-05-24
440-1	OTHER	Kidney Transplant	10	4	—	—	$92,869.42	$92,869.42	$92,869.42	2026-05-24
024	OTHER	Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…	48	18	—	—	$36,342.29	$159,981.06	$92,279.95	2026-05-24
321-4	OTHER	Spinal Fusion And Other Back And Neck Procedures Except For Disc Procedures	12	5	—	—	$54,407.35	$92,199.19	$92,199.19	2026-05-24
904	OTHER	Skin Grafts For Injuries With Cc/mcc	48	18	—	—	$34,164.79	$257,448.66	$92,189.95	2026-05-24
140	OTHER	Major Head And Neck Procedures With Mcc	48	18	—	—	$23,851.44	$174,433.71	$92,006.79	2026-05-24
166-3	OTHER	Coronary Bypass Without Ami Or Complex Principal Diagnosis	12	5	—	—	$57,097.80	$91,949.57	$91,949.57	2026-05-24
611-3	OTHER	Neonate Birth Weight 1500-1999 Grams With Major Anomaly	12	5	—	—	$91,518.53	$93,607.30	$91,518.53	2026-05-24
178-1	OTHER	External Heart Assist Systems	12	5	—	—	$76,582.28	$91,403.15	$91,403.15	2026-05-24
040	OTHER	Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc	48	18	—	—	$35,879.99	$157,907.64	$91,086.14	2026-05-24
939	OTHER	O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc	48	18	—	—	$33,758.12	$148,391.14	$91,074.63	2026-05-24
958	OTHER	Other O.r. Procedures For Multiple Significant Trauma With Cc	48	18	—	—	$37,707.40	$172,331.65	$90,898.04	2026-05-24
332	OTHER	Rectal Resection With Mcc	48	18	—	—	$33,686.98	$148,072.15	$90,879.57	2026-05-24
265	OTHER	Aicd Lead Procedures	48	18	—	—	$33,664.20	$147,969.91	$90,817.05	2026-05-24
097	OTHER	Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc	48	18	—	—	$33,605.83	$147,708.17	$90,657.00	2026-05-24
092-4	OTHER	Facial Bone Procedures Except Major Cranial Or Facial Bone Procedures	12	5	—	—	$90,178.64	$98,624.68	$90,178.64	2026-05-24
652	OTHER	Kidney Transplant	32	13	—	—	$30,119.81	$153,197.33	$90,123.49	2026-05-24
622-4	OTHER	Neonate Birth Weight 2000-2499 Grams With Respiratory Distress Syndrome Or Other…	12	5	—	—	$60,674.34	$90,121.84	$90,121.84	2026-05-24
793	OTHER	Full Term Neonate With Major Problems	48	18	—	—	$4,074.87	$170,519.96	$89,942.45	2026-05-24
739	OTHER	Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc…	48	18	—	—	$33,341.39	$146,522.19	$89,931.79	2026-05-24
230-4	OTHER	Major Small Bowel Procedures	12	5	—	—	$89,858.26	$103,161.15	$89,858.26	2026-05-24
695-4	OTHER	Chemotherapy For Acute Leukemia	12	5	—	—	$84,017.48	$89,822.88	$89,822.88	2026-05-24
027-4	OTHER	Other Open Craniotomy	12	5	—	—	$89,758.02	$102,085.73	$89,758.02	2026-05-24
736	OTHER	Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc	48	18	—	—	$33,265.70	$146,182.75	$89,724.23	2026-05-24
181-4	OTHER	Lower Extremity Arterial Procedures	12	5	—	—	$87,126.36	$89,681.37	$89,681.37	2026-05-24
335	OTHER	Peritoneal Adhesiolysis With Mcc	48	18	—	—	$33,232.88	$146,035.53	$89,634.21	2026-05-24
62490396	OTHER	Pump Heartware Dt G090243	26	11	$140,000.00	$91,000.00 35% off	$40,600.00	$119,000.00	$89,600.00	2026-05-24
408	OTHER	Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With…	48	18	—	—	$33,184.56	$145,818.78	$89,501.67	2026-05-24
304-3	OTHER	Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back	12	5	—	—	$66,449.07	$89,484.82	$89,484.82	2026-05-24
414	OTHER	Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc	48	18	—	—	$33,157.20	$145,696.09	$89,426.65	2026-05-24
622	OTHER	Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor…	48	18	—	—	$33,126.19	$145,557.04	$89,341.62	2026-05-24
792-4	OTHER	Extensive O.r. Procedures For Other Complications Of Treatment	12	5	—	—	$89,191.96	$239,128.41	$89,191.96	2026-05-24
165-2	OTHER	Coronary Bypass With Ami Or Complex Principal Diagnosis	12	5	—	—	$53,774.97	$88,779.20	$88,779.20	2026-05-24
651-4	OTHER	Other Procedures Of Blood And Blood-forming Organs	12	5	—	—	$88,682.89	$114,239.15	$88,682.89	2026-05-24
467	OTHER	Revision Of Hip Or Knee Replacement With Cc	48	18	—	—	$32,828.93	$144,223.83	$88,526.38	2026-05-24
094	OTHER	Bacterial And Tuberculous Infections Of Nervous System With Mcc	48	18	—	—	$32,763.27	$143,929.38	$88,346.32	2026-05-24
511-4	OTHER	Uterine And Adnexa Procedures For Ovarian And Adnexal Malignancy	12	5	—	—	$82,230.15	$88,256.38	$88,256.38	2026-05-24
512-4	OTHER	Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy	12	5	—	—	$70,328.54	$87,829.87	$87,829.87	2026-05-24
162-1	OTHER	Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis	12	5	—	—	$67,335.15	$87,590.07	$87,590.07	2026-05-24
121-4	OTHER	Other Respiratory And Chest Procedures	12	5	—	—	$87,582.21	$93,635.70	$87,582.21	2026-05-24
791	OTHER	Prematurity With Major Problems	48	18	—	—	$3,499.71	$165,996.86	$87,556.68	2026-05-24
616	OTHER	Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With…	48	18	—	—	$32,471.49	$142,620.71	$87,546.10	2026-05-24
574	OTHER	Skin Graft For Skin Ulcer Or Cellulitis With Cc	48	18	—	—	$32,325.59	$141,966.37	$87,145.98	2026-05-24

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