|
4309002
|
OTHER
|
Alteplase Per 1 Mg
|
35
|
15
|
$99,562.68
|
$24,890.67
75% off
|
$65.26
|
$111,510.20
|
$49,980.47
|
2026-05-18
|
|
9002
|
OTHER
|
Alteplase Per 1 Mg
|
35
|
15
|
$99,562.68
|
$24,890.67
75% off
|
$65.26
|
$111,510.20
|
$49,980.47
|
2026-05-18
|
|
28530
|
OTHER
|
Tenecteplase Per 1 Mg
|
35
|
15
|
$93,472.60
|
$23,368.15
75% off
|
$111.49
|
$104,689.31
|
$46,923.25
|
2026-05-18
|
|
4810414T01
|
OTHER
|
Hc Rmvl Rpl Cardiac Modulj Sys Pls Generator Onl
|
35
|
15
|
$79,044.00
|
$19,761.00
75% off
|
$111.49
|
$88,529.28
|
$44,027.51
|
2026-05-18
|
|
4810408T01
|
OTHER
|
Hc Insj/rplc Car Modulj Sys Pls Gen Transvns Eltrd
|
35
|
15
|
$79,044.00
|
$19,761.00
75% off
|
$111.49
|
$88,529.28
|
$44,027.51
|
2026-05-18
|
|
4810409T01
|
OTHER
|
Hc Insj/rplc Cardiac Modulj Sys Pls Generator Only
|
35
|
15
|
$79,044.00
|
$19,761.00
75% off
|
$111.49
|
$88,529.28
|
$44,027.51
|
2026-05-18
|
|
4810415T01
|
OTHER
|
Hc Repos Cardiac Modulj Transvenous Electrode
|
35
|
15
|
$79,044.00
|
$19,761.00
75% off
|
$111.49
|
$88,529.28
|
$39,680.09
|
2026-05-18
|
|
4810410T01
|
OTHER
|
Hc Insj/rplc Car Modulj Sys Atrial Electrode Only
|
35
|
15
|
$79,044.00
|
$19,761.00
75% off
|
$111.49
|
$88,529.28
|
$39,680.09
|
2026-05-18
|
|
4810411T01
|
OTHER
|
Hc Insj/rplc Car Modulj Sys Ventr Electrode Only
|
35
|
15
|
$79,044.00
|
$19,761.00
75% off
|
$111.49
|
$88,529.28
|
$39,680.09
|
2026-05-18
|
|
4810412T01
|
OTHER
|
Hc Removal Cardiac Modulj Sys Pls Generator Only
|
35
|
15
|
$79,044.00
|
$19,761.00
75% off
|
$111.49
|
$88,529.28
|
$39,680.09
|
2026-05-18
|
|
4810416T01
|
OTHER
|
Hc Reloc Skin Pocket Cardiac Modulj Pulse Generato
|
35
|
15
|
$79,044.00
|
$19,761.00
75% off
|
$111.49
|
$88,529.28
|
$39,680.09
|
2026-05-18
|
|
4810413T01
|
OTHER
|
Hc Removal Cardiac Modulj Sys Transvenous Electrod
|
35
|
15
|
$79,044.00
|
$19,761.00
75% off
|
$111.49
|
$88,529.28
|
$39,680.09
|
2026-05-18
|
|
4813341801
|
OTHER
|
Hc Cath Tcat Mitral Valve Repair Initial Prosthesi
|
31
|
15
|
$131,981.00
|
$32,995.25
75% off
|
$111.49
|
$147,818.72
|
$79,188.60
|
2026-05-18
|
|
326
|
OTHER
|
ALPRAZolam 1 Mg Tablet 100 Each Bottle
|
26
|
10
|
$13.87
|
$3.47
75% off
|
$2.77
|
$141,996.26
|
$41,477.79
|
2026-05-18
|
|
018
|
OTHER
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
14
|
10
|
—
|
—
|
$508,596.31
|
$1,229,457.49
|
$869,026.90
|
2026-05-18
|
|
927
|
OTHER
|
Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft
|
14
|
10
|
—
|
—
|
$148,284.63
|
$607,870.08
|
$378,077.35
|
2026-05-18
|
|
003
|
OTHER
|
Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…
|
14
|
10
|
—
|
—
|
$147,414.58
|
$604,302.67
|
$375,858.62
|
2026-05-18
|
|
004
|
OTHER
|
Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…
|
14
|
10
|
—
|
—
|
$147,555.79
|
$394,363.21
|
$270,959.50
|
2026-05-18
|
|
212
|
OTHER
|
Hip & Femur Procedures Except Major Joint Age 0-17
|
14
|
10
|
—
|
—
|
$75,539.56
|
$309,596.50
|
$192,568.03
|
2026-05-18
|
|
215
|
OTHER
|
Other Heart Assist System Implant
|
14
|
10
|
—
|
—
|
$69,171.49
|
$283,485.75
|
$176,328.62
|
2026-05-18
|
|
216
|
OTHER
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
14
|
10
|
—
|
—
|
$67,961.89
|
$278,526.10
|
$173,243.99
|
2026-05-18
|
|
231
|
OTHER
|
Coronary Bypass With Ptca With Mcc
|
14
|
10
|
—
|
—
|
$58,567.76
|
$240,007.68
|
$149,287.72
|
2026-05-18
|
|
456
|
OTHER
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
14
|
10
|
—
|
—
|
$58,383.74
|
$239,253.20
|
$148,818.47
|
2026-05-18
|
|
020
|
OTHER
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc
|
14
|
10
|
—
|
—
|
$54,671.63
|
$224,032.60
|
$139,352.11
|
2026-05-18
|
|
969
|
OTHER
|
HIV With Extensive O.r. Procedures With Mcc
|
14
|
10
|
—
|
—
|
$101,886.65
|
$174,279.53
|
$138,083.09
|
2026-05-18
|
|
219
|
OTHER
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
14
|
10
|
—
|
—
|
$53,348.86
|
$218,608.88
|
$135,978.87
|
2026-05-18
|
|
233
|
OTHER
|
Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc
|
14
|
10
|
—
|
—
|
$53,119.02
|
$217,666.49
|
$135,392.76
|
2026-05-18
|
|
957
|
OTHER
|
Other O.r. Procedures For Multiple Significant Trauma With Mcc
|
14
|
10
|
—
|
—
|
$52,943.35
|
$216,946.17
|
$134,944.76
|
2026-05-18
|
|
268
|
OTHER
|
Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc
|
14
|
10
|
—
|
—
|
$69,401.56
|
$195,820.69
|
$132,611.12
|
2026-05-18
|
|
207
|
OTHER
|
Respiratory System Diagnosis With Ventilator Support >96 Hours
|
14
|
10
|
—
|
—
|
$71,671.52
|
$183,202.34
|
$127,436.93
|
2026-05-18
|
|
928
|
OTHER
|
Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc
|
14
|
10
|
—
|
—
|
$49,838.12
|
$204,213.94
|
$127,026.03
|
2026-05-18
|
|
019
|
OTHER
|
Simultaneous Pancreas And Kidney Transplant With Hemodialysis
|
14
|
10
|
—
|
—
|
$49,573.56
|
$203,129.20
|
$126,351.38
|
2026-05-18
|
|
275
|
OTHER
|
Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc
|
14
|
10
|
—
|
—
|
$49,544.41
|
$203,009.62
|
$126,277.01
|
2026-05-18
|
|
870
|
OTHER
|
Septicemia Or Severe Sepsis With Mv >96 Hours
|
14
|
10
|
—
|
—
|
$48,026.51
|
$196,785.86
|
$122,406.18
|
2026-05-18
|
|
955
|
OTHER
|
Craniotomy For Multiple Significant Trauma
|
14
|
10
|
—
|
—
|
$46,771.77
|
$191,641.15
|
$119,206.46
|
2026-05-18
|
|
218
|
OTHER
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
14
|
10
|
—
|
—
|
$45,689.95
|
$187,205.37
|
$116,447.66
|
2026-05-18
|
|
217
|
OTHER
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
14
|
10
|
—
|
—
|
$45,689.95
|
$187,205.37
|
$116,447.66
|
2026-05-18
|
|
573
|
OTHER
|
Skin Graft For Skin Ulcer Or Cellulitis With Mcc
|
14
|
10
|
—
|
—
|
$45,524.00
|
$186,524.91
|
$116,024.46
|
2026-05-18
|
|
266
|
OTHER
|
Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc
|
14
|
10
|
—
|
—
|
$42,586.81
|
$174,481.68
|
$108,534.24
|
2026-05-18
|
|
232
|
OTHER
|
Coronary Bypass With Ptca Without Mcc
|
14
|
10
|
—
|
—
|
$42,129.91
|
$172,608.28
|
$107,369.10
|
2026-05-18
|
|
028
|
OTHER
|
Spinal Procedures With Mcc
|
14
|
10
|
—
|
—
|
$41,752.87
|
$171,062.31
|
$106,407.59
|
2026-05-18
|
|
276
|
OTHER
|
Non-maligant Breast Disorders
|
14
|
10
|
—
|
—
|
$41,741.06
|
$171,013.91
|
$106,377.49
|
2026-05-18
|
|
457
|
OTHER
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
14
|
10
|
—
|
—
|
$41,439.01
|
$169,775.42
|
$105,607.21
|
2026-05-18
|
|
790
|
OTHER
|
Extreme Immaturity Or Respiratory Distress Syndrome, Neonate
|
14
|
10
|
—
|
—
|
$41,302.91
|
$169,217.39
|
$105,260.15
|
2026-05-18
|
|
235
|
OTHER
|
Coronary Bypass Without Cardiac Catheterization With Mcc
|
14
|
10
|
—
|
—
|
$40,782.83
|
$167,084.91
|
$103,933.87
|
2026-05-18
|
|
820
|
OTHER
|
Lymphoma And Leukemia With Major O.r. Procedures With Mcc
|
14
|
10
|
—
|
—
|
$40,756.44
|
$166,976.72
|
$103,866.58
|
2026-05-18
|
|
023
|
OTHER
|
Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…
|
14
|
10
|
—
|
—
|
$39,822.53
|
$163,147.37
|
$101,484.95
|
2026-05-18
|
|
463
|
OTHER
|
Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …
|
14
|
10
|
—
|
—
|
$39,608.65
|
$162,270.46
|
$100,939.55
|
2026-05-18
|
|
278
|
OTHER
|
Cellulitis Age >17 Without Cc
|
14
|
10
|
—
|
—
|
$38,683.06
|
$158,475.28
|
$98,579.17
|
2026-05-18
|
|
461
|
OTHER
|
Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc
|
14
|
10
|
—
|
—
|
$39,709.40
|
$157,245.33
|
$98,477.37
|
2026-05-18
|
|
653
|
OTHER
|
Major Bladder Procedures With Mcc
|
14
|
10
|
—
|
—
|
$48,941.61
|
$147,946.70
|
$98,444.15
|
2026-05-18
|
|
405
|
OTHER
|
Pancreas, Liver And Shunt Procedures With Mcc
|
14
|
10
|
—
|
—
|
$38,018.54
|
$155,750.61
|
$96,884.57
|
2026-05-18
|
|
234
|
OTHER
|
Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc
|
14
|
10
|
—
|
—
|
$37,964.37
|
$155,528.53
|
$96,746.45
|
2026-05-18
|
|
011
|
OTHER
|
Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc
|
14
|
10
|
—
|
—
|
$37,904.66
|
$155,283.68
|
$96,594.17
|
2026-05-18
|
|
837
|
OTHER
|
Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot…
|
14
|
10
|
—
|
—
|
$54,375.95
|
$136,783.22
|
$95,579.59
|
2026-05-18
|
|
021
|
OTHER
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc
|
14
|
10
|
—
|
—
|
$38,488.96
|
$150,719.78
|
$94,604.37
|
2026-05-18
|
|
220
|
OTHER
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
14
|
10
|
—
|
—
|
$37,062.39
|
$151,830.15
|
$94,446.27
|
2026-05-18
|
|
270
|
OTHER
|
Other Major Cardiovascular Procedures With Mcc
|
14
|
10
|
—
|
—
|
$36,670.08
|
$150,221.54
|
$93,445.81
|
2026-05-18
|
|
466
|
OTHER
|
Revision Of Hip Or Knee Replacement With Mcc
|
14
|
10
|
—
|
—
|
$36,177.76
|
$148,202.94
|
$92,190.35
|
2026-05-18
|
|
163
|
OTHER
|
Major Chest Procedures With Mcc
|
14
|
10
|
—
|
—
|
$52,534.87
|
$127,601.33
|
$90,068.10
|
2026-05-18
|
|
471
|
OTHER
|
Cervical Spinal Fusion With Mcc
|
14
|
10
|
—
|
—
|
$41,175.21
|
$137,477.92
|
$89,326.57
|
2026-05-18
|
|
221
|
OTHER
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
14
|
10
|
—
|
—
|
$35,030.66
|
$143,499.53
|
$89,265.10
|
2026-05-18
|
|
228
|
OTHER
|
Other Cardiothoracic Procedures With Mcc
|
14
|
10
|
—
|
—
|
$34,386.29
|
$140,857.43
|
$87,621.86
|
2026-05-18
|
|
853
|
OTHER
|
Infectious And Parasitic Diseases With O.r. Procedures With Mcc
|
14
|
10
|
—
|
—
|
$34,325.19
|
$140,606.88
|
$87,466.04
|
2026-05-18
|
|
239
|
OTHER
|
Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc
|
14
|
10
|
—
|
—
|
$34,207.83
|
$140,125.72
|
$87,166.77
|
2026-05-18
|
|
576
|
OTHER
|
Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc
|
14
|
10
|
—
|
—
|
$34,065.48
|
$139,542.07
|
$86,803.77
|
2026-05-18
|
|
267
|
OTHER
|
Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc
|
14
|
10
|
—
|
—
|
$33,090.59
|
$135,544.74
|
$84,317.66
|
2026-05-18
|
|
650
|
OTHER
|
Kidney Transplant With Hemodialysis With Mcc
|
14
|
10
|
—
|
—
|
$32,678.14
|
$133,853.56
|
$83,265.85
|
2026-05-18
|
|
981
|
OTHER
|
Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc
|
14
|
10
|
—
|
—
|
$32,611.48
|
$133,580.24
|
$83,095.86
|
2026-05-18
|
|
826
|
OTHER
|
Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. …
|
14
|
10
|
—
|
—
|
$32,514.26
|
$133,181.64
|
$82,847.95
|
2026-05-18
|
|
277
|
OTHER
|
Cellulitis Age >17 W Cc
|
14
|
10
|
—
|
—
|
$32,102.51
|
$131,493.31
|
$81,797.91
|
2026-05-18
|
|
329
|
OTHER
|
Major Small And Large Bowel Procedures With Mcc
|
14
|
10
|
—
|
—
|
$31,949.74
|
$130,866.95
|
$81,408.35
|
2026-05-18
|
|
823
|
OTHER
|
Lymphoma And Non-acute Leukemia With Other Procedures With Mcc
|
14
|
10
|
—
|
—
|
$31,868.49
|
$130,533.84
|
$81,201.16
|
2026-05-18
|
|
245
|
OTHER
|
Aicd Generator Procedures
|
14
|
10
|
—
|
—
|
$31,712.97
|
$129,896.09
|
$80,804.53
|
2026-05-18
|
|
025
|
OTHER
|
Craniotomy And Endovascular Intracranial Procedures With Mcc
|
14
|
10
|
—
|
—
|
$31,603.94
|
$129,449.10
|
$80,526.52
|
2026-05-18
|
|
799
|
OTHER
|
Splenectomy With Mcc
|
14
|
10
|
—
|
—
|
$31,480.35
|
$128,942.31
|
$80,211.33
|
2026-05-18
|
|
031
|
OTHER
|
Ventricular Shunt Procedures With Mcc
|
14
|
10
|
—
|
—
|
$31,144.27
|
$127,564.32
|
$79,354.29
|
2026-05-18
|
|
319
|
OTHER
|
Other Endovascular Cardiac Valve Procedures With Mcc
|
14
|
10
|
—
|
—
|
$31,022.05
|
$127,063.23
|
$79,042.64
|
2026-05-18
|
|
356
|
OTHER
|
Other Digestive System O.r. Procedures With Mcc
|
14
|
10
|
—
|
—
|
$31,501.30
|
$125,067.41
|
$78,284.35
|
2026-05-18
|
|
323
|
OTHER
|
Urinary Stones W Cc, &/or Esw Lithotripsy
|
14
|
10
|
—
|
—
|
$30,081.19
|
$123,205.41
|
$76,643.30
|
2026-05-18
|
|
140
|
OTHER
|
Major Head And Neck Procedures With Mcc
|
14
|
10
|
—
|
—
|
$29,649.98
|
$121,437.36
|
$75,543.67
|
2026-05-18
|
|
269
|
OTHER
|
Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc
|
14
|
10
|
—
|
—
|
$29,357.65
|
$120,238.73
|
$74,798.19
|
2026-05-18
|
|
012
|
OTHER
|
Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc
|
14
|
10
|
—
|
—
|
$29,307.66
|
$120,033.74
|
$74,670.70
|
2026-05-18
|
|
958
|
OTHER
|
Other O.r. Procedures For Multiple Significant Trauma With Cc
|
14
|
10
|
—
|
—
|
$29,293.07
|
$119,973.95
|
$74,633.51
|
2026-05-18
|
|
673
|
OTHER
|
Other Kidney And Urinary Tract Procedures With Mcc
|
14
|
10
|
—
|
—
|
$29,207.68
|
$119,623.75
|
$74,415.71
|
2026-05-18
|
|
901
|
OTHER
|
Wound Debridements For Injuries With Mcc
|
14
|
10
|
—
|
—
|
$29,172.96
|
$119,481.40
|
$74,327.18
|
2026-05-18
|
|
236
|
OTHER
|
Coronary Bypass Without Cardiac Catheterization Without Mcc
|
14
|
10
|
—
|
—
|
$29,118.78
|
$119,259.32
|
$74,189.05
|
2026-05-18
|
|
458
|
OTHER
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
14
|
10
|
—
|
—
|
$29,006.30
|
$118,798.09
|
$73,902.20
|
2026-05-18
|
|
793
|
OTHER
|
Full Term Neonate With Major Problems
|
14
|
10
|
—
|
—
|
$28,985.47
|
$118,712.68
|
$73,849.07
|
2026-05-18
|
|
423
|
OTHER
|
Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc
|
14
|
10
|
—
|
—
|
$28,870.20
|
$118,240.06
|
$73,555.13
|
2026-05-18
|
|
273
|
OTHER
|
Percutaneous And Other Intracardiac Procedures With Mcc
|
14
|
10
|
—
|
—
|
$28,679.25
|
$117,457.11
|
$73,068.18
|
2026-05-18
|
|
791
|
OTHER
|
Prematurity With Major Problems
|
14
|
10
|
—
|
—
|
$28,217.50
|
$115,563.79
|
$71,890.65
|
2026-05-18
|
|
802
|
OTHER
|
Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc
|
14
|
10
|
—
|
—
|
$27,697.41
|
$113,431.31
|
$70,564.36
|
2026-05-18
|
|
024
|
OTHER
|
Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…
|
14
|
10
|
—
|
—
|
$27,196.08
|
$111,375.70
|
$69,285.89
|
2026-05-18
|
|
933
|
OTHER
|
Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft
|
14
|
10
|
—
|
—
|
$27,073.18
|
$110,871.77
|
$68,972.48
|
2026-05-18
|
|
034
|
OTHER
|
Carotid Artery Stent Procedures With Mcc
|
14
|
10
|
—
|
—
|
$26,910.00
|
$110,202.70
|
$68,556.35
|
2026-05-18
|
|
876
|
OTHER
|
O.r. Procedures With Principal Diagnosis Of Mental Illness
|
14
|
10
|
—
|
—
|
$26,869.72
|
$110,037.57
|
$68,453.65
|
2026-05-18
|
|
040
|
OTHER
|
Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc
|
14
|
10
|
—
|
—
|
$26,844.03
|
$109,932.23
|
$68,388.13
|
2026-05-18
|
|
907
|
OTHER
|
Other O.r. Procedures For Injuries With Mcc
|
14
|
10
|
—
|
—
|
$26,691.96
|
$109,308.71
|
$68,000.34
|
2026-05-18
|
|
570
|
OTHER
|
Skin Debridement With Mcc
|
14
|
10
|
—
|
—
|
$49,266.36
|
$83,736.06
|
$66,972.80
|
2026-05-18
|
|
956
|
OTHER
|
Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma
|
14
|
10
|
—
|
—
|
$26,162.16
|
$107,136.37
|
$66,649.26
|
2026-05-18
|
|
143
|
OTHER
|
Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc
|
14
|
10
|
—
|
—
|
$26,048.28
|
$106,669.45
|
$66,358.87
|
2026-05-18
|
|
166
|
OTHER
|
Other Respiratory System O.r. Procedures With Mcc
|
14
|
10
|
—
|
—
|
$25,986.49
|
$106,416.06
|
$66,201.27
|
2026-05-18
|
|
518
|
OTHER
|
Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost…
|
14
|
10
|
—
|
—
|
$25,983.71
|
$106,404.67
|
$66,194.19
|
2026-05-18
|
|
628
|
OTHER
|
Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc
|
14
|
10
|
—
|
—
|
$25,910.79
|
$106,105.72
|
$66,008.26
|
2026-05-18
|
|
651
|
OTHER
|
Kidney Transplant With Hemodialysis Without Mcc
|
14
|
10
|
—
|
—
|
$25,764.98
|
$105,507.83
|
$65,636.40
|
2026-05-18
|
|
904
|
OTHER
|
Skin Grafts For Injuries With Cc/mcc
|
14
|
10
|
—
|
—
|
$25,537.92
|
$104,576.83
|
$65,057.38
|
2026-05-18
|
|
492
|
OTHER
|
Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc
|
14
|
10
|
—
|
—
|
$25,527.50
|
$104,534.12
|
$65,030.81
|
2026-05-18
|
|
939
|
OTHER
|
O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc
|
14
|
10
|
—
|
—
|
$25,228.23
|
$103,307.02
|
$64,267.62
|
2026-05-18
|
|
495
|
OTHER
|
Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit…
|
14
|
10
|
—
|
—
|
$25,208.79
|
$103,227.30
|
$64,218.04
|
2026-05-18
|
|
332
|
OTHER
|
Rectal Resection With Mcc
|
14
|
10
|
—
|
—
|
$25,174.06
|
$103,084.95
|
$64,129.50
|
2026-05-18
|
|
265
|
OTHER
|
Aicd Lead Procedures
|
14
|
10
|
—
|
—
|
$25,156.71
|
$103,013.77
|
$64,085.24
|
2026-05-18
|
|
097
|
OTHER
|
Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc
|
14
|
10
|
—
|
—
|
$25,112.27
|
$102,831.56
|
$63,971.92
|
2026-05-18
|
|
279
|
OTHER
|
Cellulitis Age 0-17
|
14
|
10
|
—
|
—
|
$25,074.78
|
$102,677.81
|
$63,876.29
|
2026-05-18
|
|
739
|
OTHER
|
Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc…
|
14
|
10
|
—
|
—
|
$24,910.90
|
$102,005.90
|
$63,458.40
|
2026-05-18
|
|
335
|
OTHER
|
Peritoneal Adhesiolysis With Mcc
|
14
|
10
|
—
|
—
|
$24,828.28
|
$101,667.09
|
$63,247.68
|
2026-05-18
|
|
408
|
OTHER
|
Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With…
|
14
|
10
|
—
|
—
|
$24,791.47
|
$101,516.20
|
$63,153.83
|
2026-05-18
|
|
414
|
OTHER
|
Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc
|
14
|
10
|
—
|
—
|
$24,770.64
|
$101,430.78
|
$63,100.71
|
2026-05-18
|
|
622
|
OTHER
|
Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor…
|
14
|
10
|
—
|
—
|
$24,747.03
|
$101,333.98
|
$63,040.50
|
2026-05-18
|
|
271
|
OTHER
|
Other Major Cardiovascular Procedures With Cc
|
14
|
10
|
—
|
—
|
$24,726.89
|
$101,251.42
|
$62,989.15
|
2026-05-18
|
|
467
|
OTHER
|
Revision Of Hip Or Knee Replacement With Cc
|
14
|
10
|
—
|
—
|
$24,520.66
|
$100,405.83
|
$62,463.25
|
2026-05-18
|
|
094
|
OTHER
|
Bacterial And Tuberculous Infections Of Nervous System With Mcc
|
14
|
10
|
—
|
—
|
$24,470.67
|
$100,200.84
|
$62,335.75
|
2026-05-18
|
|
022
|
OTHER
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/…
|
14
|
10
|
—
|
—
|
$33,559.24
|
$90,463.76
|
$62,011.50
|
2026-05-18
|
|
616
|
OTHER
|
Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With…
|
14
|
10
|
—
|
—
|
$24,248.47
|
$99,289.77
|
$61,769.12
|
2026-05-18
|
|
574
|
OTHER
|
Skin Graft For Skin Ulcer Or Cellulitis With Cc
|
14
|
10
|
—
|
—
|
$24,137.37
|
$98,834.23
|
$61,485.80
|
2026-05-18
|
|
477
|
OTHER
|
Biopsies Of Musculoskeletal System And Connective Tissue With Mcc
|
14
|
10
|
—
|
—
|
$24,020.72
|
$98,355.92
|
$61,188.32
|
2026-05-18
|
|
987
|
OTHER
|
Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc
|
14
|
10
|
—
|
—
|
$23,838.79
|
$97,609.98
|
$60,724.39
|
2026-05-18
|
|
029
|
OTHER
|
Spinal Procedures With Cc Or Spinal Neurostimulators
|
14
|
10
|
—
|
—
|
$23,722.13
|
$97,131.66
|
$60,426.89
|
2026-05-18
|
|
420
|
OTHER
|
Hepatobiliary Diagnostic Procedures With Mcc
|
14
|
10
|
—
|
—
|
$23,690.90
|
$97,003.54
|
$60,347.22
|
2026-05-18
|
|
264
|
OTHER
|
Other Circulatory System O.r. Procedures
|
14
|
10
|
—
|
—
|
$23,229.13
|
$95,110.22
|
$59,169.68
|
2026-05-18
|
|
411
|
OTHER
|
Cholecystectomy With C.d.e. With Mcc
|
14
|
10
|
—
|
—
|
$22,970.12
|
$94,048.25
|
$58,509.18
|
2026-05-18
|
|
037
|
OTHER
|
Extracranial Procedures With Mcc
|
14
|
10
|
—
|
—
|
$22,892.37
|
$93,729.38
|
$58,310.88
|
2026-05-18
|
|
274
|
OTHER
|
Percutaneous And Other Intracardiac Procedures Without Mcc
|
14
|
10
|
—
|
—
|
$22,889.59
|
$93,717.99
|
$58,303.79
|
2026-05-18
|
|
260
|
OTHER
|
Cardiac Pacemaker Revision Except Device Replacement With Mcc
|
14
|
10
|
—
|
—
|
$22,619.47
|
$92,610.47
|
$57,614.97
|
2026-05-18
|
|
579
|
OTHER
|
Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc
|
14
|
10
|
—
|
—
|
$22,520.19
|
$92,203.33
|
$57,361.76
|
2026-05-18
|
|
840
|
OTHER
|
Lymphoma And Non-acute Leukemia With Mcc
|
14
|
10
|
—
|
—
|
$22,495.18
|
$92,100.84
|
$57,298.01
|
2026-05-18
|
|
485
|
OTHER
|
Knee Procedures With Principal Diagnosis Of Infection With Mcc
|
14
|
10
|
—
|
—
|
$22,441.02
|
$91,878.76
|
$57,159.89
|
2026-05-18
|
|
929
|
OTHER
|
Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/mcc
|
14
|
10
|
—
|
—
|
$22,397.29
|
$91,699.40
|
$57,048.35
|
2026-05-18
|
|
242
|
OTHER
|
Permanent Cardiac Pacemaker Implant With Mcc
|
14
|
10
|
—
|
—
|
$22,202.86
|
$90,902.21
|
$56,552.54
|
2026-05-18
|
|
515
|
OTHER
|
Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc
|
14
|
10
|
—
|
—
|
$22,161.89
|
$90,734.23
|
$56,448.06
|
2026-05-18
|
|
656
|
OTHER
|
Kidney And Ureter Procedures For Neoplasm With Mcc
|
14
|
10
|
—
|
—
|
$22,140.37
|
$90,645.97
|
$56,393.17
|
2026-05-18
|
|
500
|
OTHER
|
Soft Tissue Procedures With Mcc
|
14
|
10
|
—
|
—
|
$22,008.44
|
$90,105.02
|
$56,056.73
|
2026-05-18
|
|
829
|
OTHER
|
Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce…
|
14
|
10
|
—
|
—
|
$21,975.11
|
$89,968.36
|
$55,971.74
|
2026-05-18
|
|
229
|
OTHER
|
Other Cardiothoracic Procedures Without Mcc
|
14
|
10
|
—
|
—
|
$21,902.20
|
$89,669.41
|
$55,785.81
|
2026-05-18
|
|
258
|
OTHER
|
Cardiac Pacemaker Device Replacement With Mcc
|
14
|
10
|
—
|
—
|
$21,850.81
|
$89,458.73
|
$55,654.77
|
2026-05-18
|
|
665
|
OTHER
|
Prostatectomy With Mcc
|
14
|
10
|
—
|
—
|
$21,705.69
|
$88,863.69
|
$55,284.69
|
2026-05-18
|
|
464
|
OTHER
|
Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …
|
14
|
10
|
—
|
—
|
$21,660.56
|
$88,678.62
|
$55,169.59
|
2026-05-18
|
|
026
|
OTHER
|
Craniotomy And Endovascular Intracranial Procedures With Cc
|
14
|
10
|
—
|
—
|
$21,622.36
|
$88,522.03
|
$55,072.19
|
2026-05-18
|
|
662
|
OTHER
|
Minor Bladder Procedures With Mcc
|
14
|
10
|
—
|
—
|
$21,291.15
|
$87,163.97
|
$54,227.56
|
2026-05-18
|
|
263
|
OTHER
|
Vein Ligation And Stripping
|
14
|
10
|
—
|
—
|
$21,262.68
|
$87,047.24
|
$54,154.96
|
2026-05-18
|
|
510
|
OTHER
|
Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Mcc
|
14
|
10
|
—
|
—
|
$21,006.45
|
$85,996.66
|
$53,501.56
|
2026-05-18
|
|
625
|
OTHER
|
Thyroid, Parathyroid And Thyroglossal Procedures With Mcc
|
14
|
10
|
—
|
—
|
$21,003.68
|
$85,985.27
|
$53,494.47
|
2026-05-18
|
|
498
|
OTHER
|
Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur With Cc…
|
14
|
10
|
—
|
—
|
$20,980.77
|
$85,891.31
|
$53,436.04
|
2026-05-18
|
|
173
|
OTHER
|
Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary…
|
14
|
10
|
—
|
—
|
$20,700.24
|
$84,741.08
|
$52,720.66
|
2026-05-18
|
|
959
|
OTHER
|
Other O.r. Procedures For Multiple Significant Trauma Without Cc/mcc
|
14
|
10
|
—
|
—
|
$20,475.96
|
$83,821.47
|
$52,148.71
|
2026-05-18
|
|
668
|
OTHER
|
Transurethral Procedures With Mcc
|
14
|
10
|
—
|
—
|
$20,308.61
|
$83,135.32
|
$51,721.96
|
2026-05-18
|
|
480
|
OTHER
|
Hip And Femur Procedures Except Major Joint With Mcc
|
14
|
10
|
—
|
—
|
$20,255.14
|
$82,916.09
|
$51,585.61
|
2026-05-18
|
|
353
|
OTHER
|
Hernia Procedures Except Inguinal And Femoral With Mcc
|
14
|
10
|
—
|
—
|
$20,183.62
|
$82,622.84
|
$51,403.23
|
2026-05-18
|
|
406
|
OTHER
|
Pancreas, Liver And Shunt Procedures With Cc
|
14
|
10
|
—
|
—
|
$20,171.14
|
$82,571.59
|
$51,371.36
|
2026-05-18
|
|
974
|
OTHER
|
HIV With Major Related Condition With Mcc
|
14
|
10
|
—
|
—
|
$20,072.53
|
$82,167.31
|
$51,119.92
|
2026-05-18
|
|
013
|
OTHER
|
Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy Without Cc/mcc
|
14
|
10
|
—
|
—
|
$20,043.36
|
$82,047.73
|
$51,045.54
|
2026-05-18
|
|
521
|
OTHER
|
Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc
|
14
|
10
|
—
|
—
|
$19,962.82
|
$81,717.46
|
$50,840.14
|
2026-05-18
|
|
240
|
OTHER
|
Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc
|
14
|
10
|
—
|
—
|
$19,826.03
|
$81,156.59
|
$50,491.31
|
2026-05-18
|
|
800
|
OTHER
|
Splenectomy With Cc
|
14
|
10
|
—
|
—
|
$19,540.65
|
$79,986.43
|
$49,763.54
|
2026-05-18
|
|
654
|
OTHER
|
Major Bladder Procedures With Cc
|
14
|
10
|
—
|
—
|
$19,470.50
|
$79,698.87
|
$49,584.68
|
2026-05-18
|
|
503
|
OTHER
|
Foot Procedures With Mcc
|
14
|
10
|
—
|
—
|
$19,413.56
|
$79,465.41
|
$49,439.49
|
2026-05-18
|
|
619
|
OTHER
|
O.r. Procedures For Obesity With Mcc
|
14
|
10
|
—
|
—
|
$20,082.26
|
$78,416.01
|
$49,249.14
|
2026-05-18
|
|
483
|
OTHER
|
Major Joint Or Limb Reattachment Procedures Of Upper Extremities
|
14
|
10
|
—
|
—
|
$19,280.25
|
$78,918.76
|
$49,099.50
|
2026-05-18
|
|
061
|
OTHER
|
Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A…
|
14
|
10
|
—
|
—
|
$19,177.48
|
$78,497.39
|
$48,837.43
|
2026-05-18
|
|
208
|
OTHER
|
Respiratory System Diagnosis With Ventilator Support <=96 Hours
|
14
|
10
|
—
|
—
|
$19,119.15
|
$78,258.24
|
$48,688.69
|
2026-05-18
|
|
468
|
OTHER
|
Revision Of Hip Or Knee Replacement Without Cc/mcc
|
14
|
10
|
—
|
—
|
$19,114.29
|
$78,238.31
|
$48,676.30
|
2026-05-18
|
|
963
|
OTHER
|
Other Multiple Significant Trauma With Mcc
|
14
|
10
|
—
|
—
|
$19,015.70
|
$77,834.02
|
$48,424.86
|
2026-05-18
|
|
970
|
OTHER
|
HIV With Extensive O.r. Procedures Without Mcc
|
14
|
10
|
—
|
—
|
$21,532.51
|
$75,089.42
|
$48,310.96
|
2026-05-18
|
|
321
|
OTHER
|
Kidney & Urinary Tract Infections Age >17 Without Cc
|
14
|
10
|
—
|
—
|
$18,925.42
|
$77,463.90
|
$48,194.66
|
2026-05-18
|
|
849
|
OTHER
|
Radiotherapy
|
14
|
10
|
—
|
—
|
$18,846.96
|
$77,142.17
|
$47,994.57
|
2026-05-18
|
|
288
|
OTHER
|
Acute And Subacute Endocarditis With Mcc
|
14
|
10
|
—
|
—
|
$18,824.06
|
$77,048.22
|
$47,936.14
|
2026-05-18
|
|
255
|
OTHER
|
Upper Limb And Toe Amputation For Circulatory System Disorders With Mcc
|
14
|
10
|
—
|
—
|
$18,762.94
|
$76,797.68
|
$47,780.31
|
2026-05-18
|
|
462
|
OTHER
|
Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without Mcc
|
14
|
10
|
—
|
—
|
$18,503.24
|
$75,732.86
|
$47,118.05
|
2026-05-18
|
|
577
|
OTHER
|
Skin Graft Except For Skin Ulcer Or Cellulitis With Cc
|
14
|
10
|
—
|
—
|
$18,438.68
|
$75,468.08
|
$46,953.38
|
2026-05-18
|
|
846
|
OTHER
|
Chemotherapy Without Acute Leukemia As Secondary Diagnosis With Mcc
|
14
|
10
|
—
|
—
|
$18,034.56
|
$73,811.07
|
$45,922.82
|
2026-05-18
|
|
344
|
OTHER
|
Minor Small And Large Bowel Procedures With Mcc
|
14
|
10
|
—
|
—
|
$17,967.19
|
$73,534.90
|
$45,751.04
|
2026-05-18
|
|
096
|
OTHER
|
Bacterial And Tuberculous Infections Of Nervous System Without Cc/mcc
|
14
|
10
|
—
|
—
|
$17,942.19
|
$73,432.40
|
$45,687.29
|
2026-05-18
|
|
095
|
OTHER
|
Bacterial And Tuberculous Infections Of Nervous System With Cc
|
14
|
10
|
—
|
—
|
$17,942.19
|
$73,432.40
|
$45,687.29
|
2026-05-18
|
|
749
|
OTHER
|
Other Female Reproductive System O.r. Procedures With Cc/mcc
|
14
|
10
|
—
|
—
|
$17,861.65
|
$73,102.14
|
$45,481.89
|
2026-05-18
|
|
272
|
OTHER
|
Other Major Cardiovascular Procedures Without Cc/mcc
|
14
|
10
|
—
|
—
|
$17,760.27
|
$72,686.46
|
$45,223.36
|
2026-05-18
|
|
659
|
OTHER
|
Kidney And Ureter Procedures For Non-neoplasm With Mcc
|
14
|
10
|
—
|
—
|
$17,676.25
|
$72,341.96
|
$45,009.11
|
2026-05-18
|
|
493
|
OTHER
|
Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Cc
|
14
|
10
|
—
|
—
|
$17,642.91
|
$72,205.30
|
$44,924.11
|
2026-05-18
|
|
164
|
OTHER
|
Major Chest Procedures With Cc
|
14
|
10
|
—
|
—
|
$17,558.91
|
$71,860.80
|
$44,709.86
|
2026-05-18
|
|
027
|
OTHER
|
Craniotomy And Endovascular Intracranial Procedures Without Cc/mcc
|
14
|
10
|
—
|
—
|
$17,551.27
|
$71,829.49
|
$44,690.38
|
2026-05-18
|
|
350
|
OTHER
|
Inguinal And Femoral Hernia Procedures With Mcc
|
14
|
10
|
—
|
—
|
$17,336.01
|
$70,946.88
|
$44,141.44
|
2026-05-18
|
|
545
|
OTHER
|
Connective Tissue Disorders With Mcc
|
14
|
10
|
—
|
—
|
$17,265.19
|
$70,656.48
|
$43,960.83
|
2026-05-18
|
|
347
|
OTHER
|
Anal And Stomal Procedures With Mcc
|
14
|
10
|
—
|
—
|
$21,839.79
|
$65,358.03
|
$43,598.91
|
2026-05-18
|
|
478
|
OTHER
|
Biopsies Of Musculoskeletal System And Connective Tissue With Cc
|
14
|
10
|
—
|
—
|
$17,108.95
|
$70,015.88
|
$43,562.42
|
2026-05-18
|
|
982
|
OTHER
|
Extensive O.r. Procedures Unrelated To Principal Diagnosis With Cc
|
14
|
10
|
—
|
—
|
$17,104.10
|
$69,995.95
|
$43,550.03
|
2026-05-18
|
|
792
|
OTHER
|
Prematurity Without Major Problems
|
14
|
10
|
—
|
—
|
$17,039.51
|
$69,731.17
|
$43,385.34
|
2026-05-18
|
|
327
|
OTHER
|
Stomach, Esophageal And Duodenal Procedures With Cc
|
14
|
10
|
—
|
—
|
$17,004.80
|
$69,588.82
|
$43,296.81
|
2026-05-18
|
|
320
|
OTHER
|
Other Endovascular Cardiac Valve Procedures Without Mcc
|
14
|
10
|
—
|
—
|
$16,734.68
|
$68,481.30
|
$42,607.99
|
2026-05-18
|
|
330
|
OTHER
|
Major Small And Large Bowel Procedures With Cc
|
14
|
10
|
—
|
—
|
$16,678.44
|
$68,250.68
|
$42,464.56
|
2026-05-18
|
|
397
|
OTHER
|
Coagulation Disorders
|
14
|
10
|
—
|
—
|
$16,662.46
|
$68,185.20
|
$42,423.83
|
2026-05-18
|
|
035
|
OTHER
|
Carotid Artery Stent Procedures With Cc
|
14
|
10
|
—
|
—
|
$16,631.92
|
$68,059.93
|
$42,345.93
|
2026-05-18
|
|
417
|
OTHER
|
Laparoscopic Cholecystectomy Without C.d.e. With Mcc
|
14
|
10
|
—
|
—
|
$16,603.45
|
$67,943.19
|
$42,273.32
|
2026-05-18
|
|
333
|
OTHER
|
Rectal Resection With Cc
|
14
|
10
|
—
|
—
|
$16,296.53
|
$66,684.78
|
$41,490.65
|
2026-05-18
|
|
674
|
OTHER
|
Other Kidney And Urinary Tract Procedures With Cc
|
14
|
10
|
—
|
—
|
$16,271.53
|
$66,582.28
|
$41,426.90
|
2026-05-18
|
|
940
|
OTHER
|
O.r. Procedures With Diagnoses Of Other Contact With Health Services With Cc
|
14
|
10
|
—
|
—
|
$16,259.73
|
$66,533.88
|
$41,396.81
|
2026-05-18
|
|
709
|
OTHER
|
Penis Procedures With Cc/mcc
|
14
|
10
|
—
|
—
|
$16,191.69
|
$66,254.86
|
$41,223.28
|
2026-05-18
|
|
357
|
OTHER
|
Other Digestive System O.r. Procedures With Cc
|
14
|
10
|
—
|
—
|
$16,180.58
|
$66,209.31
|
$41,194.94
|
2026-05-18
|
|
056
|
OTHER
|
Degenerative Nervous System Disorders With Mcc
|
14
|
10
|
—
|
—
|
$16,163.92
|
$66,140.98
|
$41,152.45
|
2026-05-18
|
|
827
|
OTHER
|
Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. …
|
14
|
10
|
—
|
—
|
$16,081.28
|
$65,802.18
|
$40,941.73
|
2026-05-18
|
|
098
|
OTHER
|
Non-bacterial Infection Of Nervous System Except Viral Meningitis With Cc
|
14
|
10
|
—
|
—
|
$15,968.10
|
$65,338.10
|
$40,653.10
|
2026-05-18
|
|
082
|
OTHER
|
Traumatic Stupor And Coma >1 Hour With Mcc
|
14
|
10
|
—
|
—
|
$15,903.53
|
$65,073.32
|
$40,488.43
|
2026-05-18
|
|
783
|
OTHER
|
Cesarean Section With Sterilization With Mcc
|
14
|
10
|
—
|
—
|
$14,209.00
|
$66,675.61
|
$40,442.31
|
2026-05-18
|
|
817
|
OTHER
|
Other Antepartum Diagnoses With O.r. Procedures With Mcc
|
14
|
10
|
—
|
—
|
$15,875.75
|
$64,959.43
|
$40,417.59
|
2026-05-18
|
|
475
|
OTHER
|
Amputation For Musculoskeletal System And Connective Tissue Disorders With Cc
|
14
|
10
|
—
|
—
|
$15,834.78
|
$64,791.45
|
$40,313.11
|
2026-05-18
|
|
085
|
OTHER
|
Traumatic Stupor And Coma <1 Hour With Mcc
|
14
|
10
|
—
|
—
|
$15,808.41
|
$64,683.26
|
$40,245.83
|
2026-05-18
|
|
824
|
OTHER
|
Lymphoma And Non-acute Leukemia With Other Procedures With Cc
|
14
|
10
|
—
|
—
|
$15,764.65
|
$64,503.90
|
$40,134.28
|
2026-05-18
|
|
001
|
OTHER
|
Heart Transplant Or Implant Of Heart Assist System With Mcc
|
12
|
9
|
—
|
—
|
$194,622.76
|
$761,073.08
|
$477,847.92
|
2026-05-18
|
|
007
|
OTHER
|
Lung Transplant
|
12
|
9
|
—
|
—
|
$217,136.01
|
$375,563.60
|
$296,349.80
|
2026-05-18
|
|
002
|
OTHER
|
Heart Transplant Or Implant Of Heart Assist System Without Mcc
|
12
|
9
|
—
|
—
|
$111,149.24
|
$307,749.02
|
$209,449.13
|
2026-05-18
|
|
014
|
OTHER
|
Allogeneic Bone Marrow Transplant
|
12
|
9
|
—
|
—
|
$83,481.77
|
$326,382.13
|
$204,931.95
|
2026-05-18
|
|
005
|
OTHER
|
Liver Transplant With Mcc Or Intestinal Transplant
|
12
|
9
|
—
|
—
|
$71,626.09
|
$280,012.56
|
$175,819.33
|
2026-05-18
|
|
010
|
OTHER
|
Pancreas Transplant
|
12
|
9
|
—
|
—
|
$49,858.96
|
$194,877.66
|
$122,368.31
|
2026-05-18
|
|
008
|
OTHER
|
Simultaneous Pancreas And Kidney Transplant
|
12
|
9
|
—
|
—
|
$76,207.31
|
$152,209.72
|
$114,208.51
|
2026-05-18
|
|
006
|
OTHER
|
Liver Transplant Without Mcc
|
12
|
9
|
—
|
—
|
$77,748.58
|
$125,931.65
|
$101,840.12
|
2026-05-18
|
|
016
|
OTHER
|
Autologous Bone Marrow Transplant With Cc/mcc
|
12
|
9
|
—
|
—
|
$41,207.09
|
$161,038.79
|
$101,122.94
|
2026-05-18
|
|
017
|
OTHER
|
Autologous Bone Marrow Transplant Without Cc/mcc
|
12
|
9
|
—
|
—
|
$37,753.29
|
$147,530.40
|
$92,641.85
|
2026-05-18
|
|
652
|
OTHER
|
Kidney Transplant
|
12
|
9
|
—
|
—
|
$22,457.68
|
$87,706.76
|
$55,082.22
|
2026-05-18
|
|
583-3
|
OTHER
|
Neonate With Ecmo
|
10
|
6
|
—
|
—
|
$221,000.00
|
$247,520.00
|
$232,050.00
|
2026-05-18
|
|
588-4
|
OTHER
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
10
|
6
|
—
|
—
|
$221,000.00
|
$247,520.00
|
$232,050.00
|
2026-05-18
|
|
583-4
|
OTHER
|
Neonate With Ecmo
|
10
|
6
|
—
|
—
|
$221,000.00
|
$247,520.00
|
$232,050.00
|
2026-05-18
|
|
011-3
|
OTHER
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
10
|
6
|
—
|
—
|
$204,995.11
|
$229,594.52
|
$215,244.87
|
2026-05-18
|
|
631-4
|
OTHER
|
Neonate Birth Weight > 2499 Grams With Other Major Procedure
|
10
|
6
|
—
|
—
|
$197,455.24
|
$221,149.87
|
$207,328.00
|
2026-05-18
|
|
630-4
|
OTHER
|
Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure
|
10
|
6
|
—
|
—
|
$179,071.67
|
$200,560.27
|
$188,025.25
|
2026-05-18
|
|
609-4
|
OTHER
|
Neonate Birth Weight 1500-2499 Grams With Major Procedure
|
10
|
6
|
—
|
—
|
$165,000.00
|
$184,800.00
|
$173,250.00
|
2026-05-18
|
|
453
|
OTHER
|
Combined Anterior And Posterior Spinal Fusion With Mcc
|
10
|
7
|
—
|
—
|
$61,563.96
|
$273,655.62
|
$167,609.79
|
2026-05-18
|
|
583-2
|
OTHER
|
Neonate With Ecmo
|
10
|
6
|
—
|
—
|
$138,429.14
|
$155,040.64
|
$145,350.60
|
2026-05-18
|
|
588-3
|
OTHER
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
10
|
6
|
—
|
—
|
$132,000.00
|
$147,840.00
|
$138,600.00
|
2026-05-18
|
|
593-4
|
OTHER
|
Neonate Birth Weight 750-999 Grams Without Major Procedure
|
10
|
6
|
—
|
—
|
$121,000.00
|
$135,520.00
|
$127,050.00
|
2026-05-18
|
|
591-4
|
OTHER
|
Neonate Birth Weight 500-749 Grams Without Major Procedure
|
10
|
6
|
—
|
—
|
$120,000.00
|
$134,400.00
|
$126,000.00
|
2026-05-18
|
|
002-4
|
OTHER
|
Heart And/or Lung Transplant
|
10
|
6
|
—
|
—
|
$119,164.66
|
$133,464.42
|
$125,122.89
|
2026-05-18
|
|
588-2
|
OTHER
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
10
|
6
|
—
|
—
|
$110,647.94
|
$123,925.69
|
$116,180.34
|
2026-05-18
|
|
459
|
OTHER
|
Spinal Fusion Except Cervical With Mcc
|
10
|
7
|
—
|
—
|
$46,085.75
|
$176,973.88
|
$111,529.82
|
2026-05-18
|
|
602-4
|
OTHER
|
Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…
|
10
|
6
|
—
|
—
|
$100,000.00
|
$112,000.00
|
$105,000.00
|
2026-05-18
|
|
593-3
|
OTHER
|
Neonate Birth Weight 750-999 Grams Without Major Procedure
|
10
|
6
|
—
|
—
|
$99,000.00
|
$110,880.00
|
$103,950.00
|
2026-05-18
|
|
607-4
|
OTHER
|
Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…
|
10
|
6
|
—
|
—
|
$98,924.77
|
$110,795.74
|
$103,871.01
|
2026-05-18
|
|
630-3
|
OTHER
|
Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure
|
10
|
6
|
—
|
—
|
$95,000.00
|
$106,400.00
|
$99,750.00
|
2026-05-18
|
|
591-3
|
OTHER
|
Neonate Birth Weight 500-749 Grams Without Major Procedure
|
10
|
6
|
—
|
—
|
$91,000.00
|
$101,920.00
|
$95,550.00
|
2026-05-18
|
|
161-4
|
OTHER
|
Implantable Heart Assist Systems
|
10
|
6
|
—
|
—
|
$88,926.10
|
$99,597.23
|
$93,372.41
|
2026-05-18
|
|
602-3
|
OTHER
|
Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…
|
10
|
6
|
—
|
—
|
$88,854.73
|
$99,517.30
|
$93,297.47
|
2026-05-18
|
|
009-4
|
OTHER
|
Extracorporeal Membrane Oxygenation (ecmo)
|
10
|
6
|
—
|
—
|
$87,176.41
|
$97,637.58
|
$91,535.23
|
2026-05-18
|
|
589-3
|
OTHER
|
Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …
|
10
|
6
|
—
|
—
|
$87,000.00
|
$97,440.00
|
$91,350.00
|
2026-05-18
|
|
455
|
OTHER
|
Combined Anterior And Posterior Spinal Fusion Without Cc/mcc
|
10
|
7
|
—
|
—
|
$32,012.94
|
$146,158.35
|
$89,085.65
|
2026-05-18
|
|
611-4
|
OTHER
|
Neonate Birth Weight 1500-1999 Grams With Major Anomaly
|
10
|
6
|
—
|
—
|
$82,276.96
|
$92,150.20
|
$86,390.81
|
2026-05-18
|
|
583-1
|
OTHER
|
Neonate With Ecmo
|
10
|
6
|
—
|
—
|
$81,748.00
|
$91,557.76
|
$85,835.40
|
2026-05-18
|
|
863-4
|
OTHER
|
Neonatal Aftercare
|
10
|
6
|
—
|
—
|
$80,469.81
|
$90,126.19
|
$84,493.30
|
2026-05-18
|
|
591-2
|
OTHER
|
Neonate Birth Weight 500-749 Grams Without Major Procedure
|
10
|
6
|
—
|
—
|
$80,000.00
|
$89,600.00
|
$84,000.00
|
2026-05-18
|
|
603-4
|
OTHER
|
Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition
|
10
|
6
|
—
|
—
|
$80,000.00
|
$89,600.00
|
$84,000.00
|
2026-05-18
|
|
841-4
|
OTHER
|
Extensive Third Degree Burns With Skin Graft
|
10
|
6
|
—
|
—
|
$79,102.08
|
$88,594.33
|
$83,057.18
|
2026-05-18
|
|
303-4
|
OTHER
|
Dorsal And Lumbar Fusion Procedure For Curvature Of Back
|
10
|
6
|
—
|
—
|
$78,865.22
|
$88,329.05
|
$82,808.48
|
2026-05-18
|
|
609-3
|
OTHER
|
Neonate Birth Weight 1500-2499 Grams With Major Procedure
|
10
|
6
|
—
|
—
|
$71,214.11
|
$79,759.80
|
$74,774.82
|
2026-05-18
|
|
509
|
OTHER
|
Arthroscopy
|
10
|
7
|
—
|
—
|
$12,230.99
|
$136,252.68
|
$74,241.84
|
2026-05-18
|
|
007-4
|
OTHER
|
Allogeneic Bone Marrow Transplant
|
10
|
6
|
—
|
—
|
$70,159.56
|
$78,578.71
|
$73,667.54
|
2026-05-18
|
|
161-3
|
OTHER
|
Implantable Heart Assist Systems
|
10
|
6
|
—
|
—
|
$69,631.31
|
$77,987.07
|
$73,112.88
|
2026-05-18
|
|
607-3
|
OTHER
|
Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…
|
10
|
6
|
—
|
—
|
$67,824.78
|
$75,963.75
|
$71,216.02
|
2026-05-18
|
|
004-4
|
OTHER
|
Tracheostomy With Mv >96 Hours With Extensive Procedure
|
10
|
6
|
—
|
—
|
$66,996.16
|
$75,035.70
|
$70,345.97
|
2026-05-18
|
|
001-4
|
OTHER
|
Liver Transplant And/or Intestinal Transplant
|
10
|
6
|
—
|
—
|
$66,329.56
|
$74,289.11
|
$69,646.04
|
2026-05-18
|
|
593-2
|
OTHER
|
Neonate Birth Weight 750-999 Grams Without Major Procedure
|
10
|
6
|
—
|
—
|
$65,770.67
|
$73,663.15
|
$69,059.20
|
2026-05-18
|
|
002-3
|
OTHER
|
Heart And/or Lung Transplant
|
10
|
6
|
—
|
—
|
$64,911.19
|
$72,700.53
|
$68,156.75
|
2026-05-18
|
|
612-4
|
OTHER
|
Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other…
|
10
|
6
|
—
|
—
|
$64,812.32
|
$72,589.80
|
$68,052.94
|
2026-05-18
|
|
633-4
|
OTHER
|
Neonate Birth Weight > 2499 Grams With Major Anomaly
|
10
|
6
|
—
|
—
|
$64,642.15
|
$72,399.21
|
$67,874.26
|
2026-05-18
|
|
621-4
|
OTHER
|
Neonate Birth Weight 2000-2499 Grams With Major Anomaly
|
10
|
6
|
—
|
—
|
$63,560.52
|
$71,187.78
|
$66,738.55
|
2026-05-18
|
|
613-4
|
OTHER
|
Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection
|
10
|
6
|
—
|
—
|
$62,000.00
|
$69,440.00
|
$65,100.00
|
2026-05-18
|
|
589-1
|
OTHER
|
Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …
|
10
|
6
|
—
|
—
|
$59,458.71
|
$66,593.76
|
$62,431.65
|
2026-05-18
|
|
009-3
|
OTHER
|
Extracorporeal Membrane Oxygenation (ecmo)
|
10
|
6
|
—
|
—
|
$58,588.00
|
$65,618.56
|
$61,517.40
|
2026-05-18
|
|
631-3
|
OTHER
|
Neonate Birth Weight > 2499 Grams With Other Major Procedure
|
10
|
6
|
—
|
—
|
$58,035.32
|
$64,999.56
|
$60,937.09
|
2026-05-18
|
|
608-4
|
OTHER
|
Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition
|
10
|
6
|
—
|
—
|
$56,423.25
|
$63,194.04
|
$59,244.41
|
2026-05-18
|
|
625-4
|
OTHER
|
Neonate Birth Weight 2000-2499 Grams With Other Significant Condition
|
10
|
6
|
—
|
—
|
$56,341.07
|
$63,102.00
|
$59,158.12
|
2026-05-18
|
|
603-3
|
OTHER
|
Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition
|
10
|
6
|
—
|
—
|
$53,002.38
|
$59,362.67
|
$55,652.50
|
2026-05-18
|
|
841-3
|
OTHER
|
Extensive Third Degree Burns With Skin Graft
|
10
|
6
|
—
|
—
|
$51,928.36
|
$58,159.76
|
$54,524.78
|
2026-05-18
|
|
161-1
|
OTHER
|
Implantable Heart Assist Systems
|
10
|
6
|
—
|
—
|
$51,234.90
|
$57,383.09
|
$53,796.65
|
2026-05-18
|
|
161-2
|
OTHER
|
Implantable Heart Assist Systems
|
10
|
6
|
—
|
—
|
$51,234.90
|
$57,383.09
|
$53,796.65
|
2026-05-18
|
|
160-4
|
OTHER
|
Major Cardiothoracic Repair Of Heart Anomaly
|
10
|
6
|
—
|
—
|
$51,048.39
|
$57,174.20
|
$53,600.81
|
2026-05-18
|
|
460
|
OTHER
|
Spinal Fusion Except Cervical Without Mcc
|
10
|
7
|
—
|
—
|
$25,432.37
|
$79,728.89
|
$52,580.63
|
2026-05-18
|
|
011-4
|
OTHER
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
10
|
6
|
—
|
—
|
$50,021.00
|
$56,023.52
|
$52,522.05
|
2026-05-18
|
|
588-1
|
OTHER
|
Female Reproductive System Reconstructive Procedures
|
10
|
6
|
—
|
—
|
$50,000.00
|
$56,000.00
|
$52,500.00
|
2026-05-18
|
|
011-2
|
OTHER
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
10
|
6
|
—
|
—
|
$50,000.00
|
$56,000.00
|
$52,500.00
|
2026-05-18
|
|
002-2
|
OTHER
|
Heart And/or Lung Transplant
|
10
|
6
|
—
|
—
|
$49,153.16
|
$55,051.54
|
$51,610.82
|
2026-05-18
|
|
608-3
|
OTHER
|
Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition
|
10
|
6
|
—
|
—
|
$48,704.91
|
$54,549.50
|
$51,140.16
|
2026-05-18
|
|
602-2
|
OTHER
|
Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…
|
10
|
6
|
—
|
—
|
$46,718.58
|
$52,324.81
|
$49,054.51
|
2026-05-18
|
|
005-4
|
OTHER
|
Tracheostomy With Mv >96 Hours Without Extensive Procedure
|
10
|
6
|
—
|
—
|
$46,671.82
|
$52,272.44
|
$49,005.41
|
2026-05-18
|
|
004-3
|
OTHER
|
Tracheostomy With Mv >96 Hours With Extensive Procedure
|
10
|
6
|
—
|
—
|
$46,198.91
|
$51,742.78
|
$48,508.86
|
2026-05-18
|
|
623-4
|
OTHER
|
Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection
|
10
|
6
|
—
|
—
|
$45,404.40
|
$50,852.93
|
$47,674.62
|
2026-05-18
|
|
612-3
|
OTHER
|
Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other…
|
10
|
6
|
—
|
—
|
$44,882.27
|
$50,268.14
|
$47,126.38
|
2026-05-18
|
|
754-4
|
OTHER
|
Depression Except Major Depressive Disorder
|
10
|
6
|
—
|
—
|
$44,649.00
|
$50,006.88
|
$46,881.45
|
2026-05-18
|
|
007-3
|
OTHER
|
Allogeneic Bone Marrow Transplant
|
10
|
6
|
—
|
—
|
$44,622.06
|
$49,976.71
|
$46,853.16
|
2026-05-18
|
|
842-4
|
OTHER
|
Burns With Skin Graft Except Extensive Third Degree Burns
|
10
|
6
|
—
|
—
|
$44,285.71
|
$49,600.00
|
$46,500.00
|
2026-05-18
|
|
613-3
|
OTHER
|
Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection
|
10
|
6
|
—
|
—
|
$44,052.16
|
$49,338.42
|
$46,254.77
|
2026-05-18
|
|
002-1
|
OTHER
|
Heart And/or Lung Transplant
|
10
|
6
|
—
|
—
|
$43,443.38
|
$48,656.59
|
$45,615.55
|
2026-05-18
|
|
006-4
|
OTHER
|
Pancreas Transplant
|
10
|
6
|
—
|
—
|
$43,326.23
|
$48,525.38
|
$45,492.54
|
2026-05-18
|
|
622-4
|
OTHER
|
Neonate Birth Weight 2000-2499 Grams With Respiratory Distress Syndrome Or Other…
|
10
|
6
|
—
|
—
|
$42,030.02
|
$47,073.62
|
$44,131.52
|
2026-05-18
|
|
634-4
|
OTHER
|
Neonate Birth Weight > 2499 Grams With Respiratory Distress Syndrome Or Other Ma…
|
10
|
6
|
—
|
—
|
$39,210.14
|
$43,915.36
|
$41,170.65
|
2026-05-18
|