Price Transparencybeta Hospital negotiated rates

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

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Hospital

Select Specialty Hospital-fort Myers

Fort Myers, FL · CCN 102029 · Rates published

829 distinct procedures filed
42 distinct payers
90,063 rate rows
2026-05-23 last MRF observed
Data quality

54,714 of 90,063 rate rows are consumer-grade (60.8%)

35,349 rows are marked excluded from the consumer medians — these stay visible in the raw drill-down with the same reason shown here, so nothing is silently hidden.

Excluded — reasonRows
per-diem day rate — not a per-procedure price 28,186
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 7,163
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://resources.selectmedical.com/pricing-transparency/critical-illness-recovery/83-3307316_Select_Specialty_Hospital-Fort_Myers_standardcharges.csv
Found on page https://www.selectspecialtyhospitals.com/patients-and-caregivers/admissions/price-transparency/
Discovered viaDiscovered by HANK
Last fetch Latest re-check couldn't be parsed — showing last good data · 2026-09-20
Content fingerprint 70e23ee2b1790911… · 91,204,735 bytes · first seen 2026-05-18

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
207
OTHER 		Respiratory System Diagnosis With Ventilator Support >96 Hours 39 $1,303.00 $2,400.00 $97,082.99 nat. median
$32,441
outlier · 3.0×
166
OTHER 		Other Respiratory System O.r. Procedures With Mcc 39 $1,303.00 $2,242.00 $69,768.00 nat. median
$27,663
outlier · 2.5×
949
OTHER 		Aftercare With Cc/mcc 39 $1,303.00 $2,242.00 $68,251.65 nat. median
$5
outlier · 15066.6×
438
OTHER 		Disorders Of Pancreas Except Malignancy With Mcc 39 $1,303.00 $2,242.00 $61,096.50 nat. median
$9,131
outlier · 6.7×
559
OTHER 		Aftercare, Musculoskeletal System And Connective Tissue With Mcc 39 $1,303.00 $2,242.00 $56,800.28 nat. median
$13,399
outlier · 4.2×
177
OTHER 		Respiratory Infections And Inflammations With Mcc 39 $1,303.00 $2,242.00 $55,981.81 nat. median
$13,701
outlier · 4.1×
862
OTHER 		Postoperative And Post-traumatic Infections With Mcc 39 $1,303.00 $2,242.00 $55,432.07 nat. median
$1,841
outlier · 30.1×
539
OTHER 		Osteomyelitis With Mcc 39 $1,303.00 $2,242.00 $49,944.56 nat. median
$353
outlier · 141.6×
208
OTHER 		Respiratory System Diagnosis With Ventilator Support <=96 Hours 39 $1,303.00 $2,400.00 $48,604.87 nat. median
$10,764
outlier · 4.5×
288
OTHER 		Acute And Subacute Endocarditis With Mcc 39 $1,303.00 $2,242.00 $48,500.72 nat. median
$29,851
1.6× median
603
OTHER 		Cellulitis Without Mcc 39 $1,303.00 $2,242.00 $47,262.00 nat. median
$2,374
outlier · 19.9×
391
OTHER 		Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders W 39 $1,303.00 $2,242.00 $47,136.00 nat. median
$5,575
outlier · 8.5×
540
OTHER 		Osteomyelitis With Cc 39 $1,303.00 $2,242.00 $45,243.00 nat. median
$336
outlier · 134.6×
641
OTHER 		Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electro 39 $1,303.00 $2,242.00 $44,121.00 nat. median
$3,520
outlier · 12.5×
291
OTHER 		Heart Failure And Shock With Mcc 39 $1,303.00 $2,242.00 $42,997.48 nat. median
$5,294
outlier · 8.1×
393
OTHER 		Other Digestive System Diagnoses With Mcc 39 $1,303.00 $2,242.00 $42,740.00 nat. median
$7,577
outlier · 5.6×
314
OTHER 		Other Circulatory System Diagnoses With Mcc 39 $1,303.00 $2,242.00 $40,673.64 nat. median
$9,440
outlier · 4.3×
919
OTHER 		Complications Of Treatment With Mcc 39 $1,303.00 $2,242.00 $40,442.61 nat. median
$7,449
outlier · 5.4×
189
OTHER 		Pulmonary Edema And Respiratory Failure 39 $1,303.00 $2,242.00 $37,887.32 nat. median
$4,199
outlier · 9.0×
592
OTHER 		Skin Ulcers With Mcc 39 $1,303.00 $2,242.00 $37,818.00 nat. median
$11,309
outlier · 3.3×
637
OTHER 		Diabetes With Mcc 39 $1,303.00 $2,242.00 $35,177.65 nat. median
$5,738
outlier · 6.1×
299
OTHER 		Peripheral Vascular Disorders With Mcc 39 $1,303.00 $2,242.00 $34,362.28 nat. median
$7,302
outlier · 4.7×
100
OTHER 		Seizures With Mcc 39 $1,303.00 $2,242.00 $31,388.38 nat. median
$127
outlier · 246.8×
432
OTHER 		Cirrhosis And Alcoholic Hepatitis With Mcc 39 $1,303.00 $2,242.00 $31,287.14 nat. median
$10,562
outlier · 3.0×
871
OTHER 		Septicemia Or Severe Sepsis Without Mv >96 Hours With Mcc 39 $1,303.00 $2,400.00 $27,781.00 nat. median
$12
outlier · 2382.6×
371
OTHER 		Major Gastrointestinal Disorders And Peritoneal Infections With Mcc 39 $1,303.00 $2,242.00 $27,496.00 nat. median
$5,978
outlier · 4.6×
557
OTHER 		Tendonitis, Myositis And Bursitis With Mcc 39 $1,303.00 $2,242.00 $24,371.15 nat. median
$4,367
outlier · 5.6×
638
OTHER 		Diabetes With Cc 39 $1,303.00 $2,242.00 $18,247.10 nat. median
$3,587
outlier · 5.1×
682
OTHER 		Renal Failure With Mcc 39 $1,303.00 $2,242.00 $10,549.38 nat. median
$6,544
1.6× median
683
OTHER 		Renal Failure With Cc 39 $1,303.00 $2,242.00 $7,919.37 nat. median
$3,742
outlier · 2.1×
933
OTHER 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Sk 39 $1,303.00 $2,400.00 $1,800.18 nat. median
$0
927
OTHER 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin 39 $1,303.00 $2,400.00 $1,800.18 nat. median
$2
outlier · 1118.1×
870
OTHER 		Septicemia Or Severe Sepsis With Mv >96 Hours 39 $1,303.00 $2,400.00 $1,800.18 nat. median
$93
outlier · 19.4×
3
OTHER 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except 39 $1,303.00 $2,400.00 $1,800.18 nat. median
$10,971
outlier · 0.2×
4
OTHER 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, M 39 $1,303.00 $2,400.00 $1,800.18 nat. median
$7,428
outlier · 0.2×
872
OTHER 		Septicemia Or Severe Sepsis Without Mv >96 Hours Without Mcc 39 $1,303.00 $2,400.00 $1,800.18 nat. median
$29
outlier · 62.6×
14
OTHER 		Allogeneic Bone Marrow Transplant 39 $1,303.00 $2,242.00 $1,782.53 nat. median
$6,714
outlier · 0.3×
139
OTHER 		Salivary Gland Procedures 39 $1,303.00 $2,242.00 $1,782.53 nat. median
$6,757
outlier · 0.3×
122
OTHER 		Acute Major Eye Infections Without Cc/mcc 39 $1,303.00 $2,242.00 $1,782.53 nat. median
$2,068
0.9× median
138
OTHER 		Mouth Procedures Without Cc/mcc 39 $1,303.00 $2,242.00 $1,782.53 nat. median
$3,744
outlier · 0.5×
137
OTHER 		Mouth Procedures With Cc/mcc 39 $1,303.00 $2,242.00 $1,782.53 nat. median
$6,845
outlier · 0.3×
121
OTHER 		Acute Major Eye Infections With Cc/mcc 39 $1,303.00 $2,242.00 $1,782.53 nat. median
$2,667
0.7× median
11
OTHER 		Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With 39 $1,303.00 $2,242.00 $1,782.53 nat. median
$10,484
outlier · 0.2×
136
OTHER 		Sinus And Mastoid Procedures Without Cc/mcc 39 $1,303.00 $2,242.00 $1,782.53 nat. median
$5,942
outlier · 0.3×
135
OTHER 		Sinus And Mastoid Procedures With Cc/mcc 39 $1,303.00 $2,242.00 $1,782.53 nat. median
$14,449
outlier · 0.1×
12
OTHER 		Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With 39 $1,303.00 $2,242.00 $1,782.53 nat. median
$8,318
outlier · 0.2×
157
OTHER 		Dental And Oral Diseases With Mcc 39 $1,303.00 $2,242.00 $1,782.53 nat. median
$9,807
outlier · 0.2×
134
OTHER 		Other Ear, Nose, Mouth & Throat O.r. Procedures Without Cc/mcc 39 $1,303.00 $2,242.00 $1,782.53 —
156
OTHER 		Other Ear, Nose, Mouth And Throat Diagnoses Without Cc/mcc 39 $1,303.00 $2,242.00 $1,782.53 nat. median
$3,390
0.5× median
155
OTHER 		Other Ear, Nose, Mouth And Throat Diagnoses With Cc 39 $1,303.00 $2,242.00 $1,782.53 nat. median
$3,906
outlier · 0.5×

Other procedures at this hospital

Browse this hospital's 829 published procedures. Use the slice to choose what to show, then sort or filter any column.

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Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
Code Type Description Rate rows Payers Gross Cash Min $ Max $ Avg median Last observed
             
207 OTHER Respiratory System Diagnosis With Ventilator Support >96 Hours 100 39 — — $1,303.00 $2,400.00 $97,082.99 2026-05-23
166 OTHER Other Respiratory System O.r. Procedures With Mcc 100 39 — — $1,303.00 $2,242.00 $69,768.00 2026-05-23
949 OTHER Aftercare With Cc/mcc 100 39 — — $1,303.00 $2,242.00 $68,251.65 2026-05-23
438 OTHER Disorders Of Pancreas Except Malignancy With Mcc 100 39 — — $1,303.00 $2,242.00 $61,096.50 2026-05-23
559 OTHER Aftercare, Musculoskeletal System And Connective Tissue With Mcc 100 39 — — $1,303.00 $2,242.00 $56,800.28 2026-05-23
177 OTHER Respiratory Infections And Inflammations With Mcc 100 39 — — $1,303.00 $2,242.00 $55,981.81 2026-05-23
862 OTHER Postoperative And Post-traumatic Infections With Mcc 100 39 — — $1,303.00 $2,242.00 $55,432.07 2026-05-23
539 OTHER Osteomyelitis With Mcc 100 39 — — $1,303.00 $2,242.00 $49,944.56 2026-05-23
208 OTHER Respiratory System Diagnosis With Ventilator Support <=96 Hours 100 39 — — $1,303.00 $2,400.00 $48,604.87 2026-05-23
288 OTHER Acute And Subacute Endocarditis With Mcc 100 39 — — $1,303.00 $2,242.00 $48,500.72 2026-05-23
603 OTHER Cellulitis Without Mcc 100 39 — — $1,303.00 $2,242.00 $47,262.00 2026-05-23
391 OTHER Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders W 100 39 — — $1,303.00 $2,242.00 $47,136.00 2026-05-23
540 OTHER Osteomyelitis With Cc 100 39 — — $1,303.00 $2,242.00 $45,243.00 2026-05-23
641 OTHER Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electro 100 39 — — $1,303.00 $2,242.00 $44,121.00 2026-05-23
291 OTHER Heart Failure And Shock With Mcc 100 39 — — $1,303.00 $2,242.00 $42,997.48 2026-05-23
393 OTHER Other Digestive System Diagnoses With Mcc 100 39 — — $1,303.00 $2,242.00 $42,740.00 2026-05-23
314 OTHER Other Circulatory System Diagnoses With Mcc 100 39 — — $1,303.00 $2,242.00 $40,673.64 2026-05-23
919 OTHER Complications Of Treatment With Mcc 100 39 — — $1,303.00 $2,242.00 $40,442.61 2026-05-23
189 OTHER Pulmonary Edema And Respiratory Failure 100 39 — — $1,303.00 $2,242.00 $37,887.32 2026-05-23
592 OTHER Skin Ulcers With Mcc 100 39 — — $1,303.00 $2,242.00 $37,818.00 2026-05-23
637 OTHER Diabetes With Mcc 100 39 — — $1,303.00 $2,242.00 $35,177.65 2026-05-23
299 OTHER Peripheral Vascular Disorders With Mcc 100 39 — — $1,303.00 $2,242.00 $34,362.28 2026-05-23
100 OTHER Seizures With Mcc 100 39 — — $1,303.00 $2,242.00 $31,388.38 2026-05-23
432 OTHER Cirrhosis And Alcoholic Hepatitis With Mcc 100 39 — — $1,303.00 $2,242.00 $31,287.14 2026-05-23
871 OTHER Septicemia Or Severe Sepsis Without Mv >96 Hours With Mcc 100 39 — — $1,303.00 $2,400.00 $27,781.00 2026-05-23
371 OTHER Major Gastrointestinal Disorders And Peritoneal Infections With Mcc 100 39 — — $1,303.00 $2,242.00 $27,496.00 2026-05-23
557 OTHER Tendonitis, Myositis And Bursitis With Mcc 100 39 — — $1,303.00 $2,242.00 $24,371.15 2026-05-23
638 OTHER Diabetes With Cc 100 39 — — $1,303.00 $2,242.00 $18,247.10 2026-05-23
682 OTHER Renal Failure With Mcc 100 39 — — $1,303.00 $2,242.00 $10,549.38 2026-05-23
683 OTHER Renal Failure With Cc 100 39 — — $1,303.00 $2,242.00 $7,919.37 2026-05-23
3 OTHER Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except 100 39 — — $1,303.00 $2,400.00 $1,800.18 2026-05-23
872 OTHER Septicemia Or Severe Sepsis Without Mv >96 Hours Without Mcc 100 39 — — $1,303.00 $2,400.00 $1,800.18 2026-05-23
927 OTHER Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin 100 39 — — $1,303.00 $2,400.00 $1,800.18 2026-05-23
870 OTHER Septicemia Or Severe Sepsis With Mv >96 Hours 100 39 — — $1,303.00 $2,400.00 $1,800.18 2026-05-23
933 OTHER Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Sk 100 39 — — $1,303.00 $2,400.00 $1,800.18 2026-05-23
4 OTHER Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, M 100 39 — — $1,303.00 $2,400.00 $1,800.18 2026-05-23
14 OTHER Allogeneic Bone Marrow Transplant 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
139 OTHER Salivary Gland Procedures 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
122 OTHER Acute Major Eye Infections Without Cc/mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
138 OTHER Mouth Procedures Without Cc/mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
137 OTHER Mouth Procedures With Cc/mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
121 OTHER Acute Major Eye Infections With Cc/mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
11 OTHER Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
136 OTHER Sinus And Mastoid Procedures Without Cc/mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
135 OTHER Sinus And Mastoid Procedures With Cc/mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
12 OTHER Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
158 OTHER Dental And Oral Diseases With Cc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
157 OTHER Dental And Oral Diseases With Mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
134 OTHER Other Ear, Nose, Mouth & Throat O.r. Procedures Without Cc/mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
156 OTHER Other Ear, Nose, Mouth And Throat Diagnoses Without Cc/mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
159 OTHER Dental And Oral Diseases Without Cc/mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
16 OTHER Autologous Bone Marrow Transplant With Cc/mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
163 OTHER Major Chest Procedures With Mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
164 OTHER Major Chest Procedures With Cc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
165 OTHER Major Chest Procedures Without Cc/mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
224 OTHER Cardiac Defibrillator Implant With Cardiac Catheterization Without A 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
167 OTHER Other Respiratory System O.r. Procedures With Cc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
168 OTHER Other Respiratory System O.r. Procedures Without Cc/mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
17 OTHER Autologous Bone Marrow Transplant Without Cc/mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
173 OTHER Ultrasound Accelerated And Other Thrombolysis With Principal Diagnos 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
175 OTHER Pulmonary Embolism With Mcc Or Acute Cor Pulmonale 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
176 OTHER Pulmonary Embolism Without Mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
205 OTHER Other Respiratory System Diagnoses With Mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
155 OTHER Other Ear, Nose, Mouth And Throat Diagnoses With Cc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
133 OTHER Other Ear, Nose, Mouth & Throat O.r. Procedures W Cc/mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
117 OTHER Intraocular Procedures Without Cc/mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
103 OTHER Headaches Without Mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
154 OTHER Other Ear, Nose, Mouth And Throat Diagnoses With Mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
153 OTHER Otitis Media And Uri Without Mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
132 OTHER Cranial/facial Procedures Without Cc/mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
152 OTHER Otitis Media And Uri With Mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
151 OTHER Epistaxis Without Mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
131 OTHER Cranial/facial Procedures W Cc/mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
116 OTHER Intraocular Procedures With Cc/mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
150 OTHER Epistaxis With Mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
15 OTHER Autologous Bone Marrow Transplant 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
130 OTHER Major Head & Neck Procedures Without Cc/mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
194 OTHER Simple Pneumonia And Pleurisy With Cc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
193 OTHER Simple Pneumonia And Pleurisy With Mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
149 OTHER Dysequilibrium 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
192 OTHER Chronic Obstructive Pulmonary Disease Without Cc/mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
191 OTHER Chronic Obstructive Pulmonary Disease With Cc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
195 OTHER Simple Pneumonia And Pleurisy Without Cc/mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
196 OTHER Interstitial Lung Disease With Mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
197 OTHER Interstitial Lung Disease With Cc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
198 OTHER Interstitial Lung Disease Without Cc/mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
199 OTHER Pneumothorax With Mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
2 OTHER Heart Transplant Or Implant Of Heart Assist System Without Mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
20 OTHER Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
200 OTHER Pneumothorax With Cc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
201 OTHER Pneumothorax Without Cc/mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
202 OTHER Bronchitis And Asthma With Cc/mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
203 OTHER Bronchitis And Asthma Without Cc/mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
204 OTHER Respiratory Signs And Symptoms 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
292 OTHER Heart Failure And Shock With Cc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
206 OTHER Other Respiratory System Diagnoses Without Mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
295 OTHER Deep Vein Thrombophlebitis Without Cc/mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
297 OTHER Cardiac Arrest, Unexplained With Cc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
209 OTHER Complex Aortic Arch Procedures 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
21 OTHER Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
212 OTHER Concomitant Aortic And Mitral Valve Procedures 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
213 OTHER Endovascular Abdominal Aorta With Iliac Branch Procedures 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
215 OTHER Other Heart Assist System Implant 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
216 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
217 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
218 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
219 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures Without Card 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
22 OTHER Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
220 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures Without Card 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
221 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures Without Card 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
222 OTHER Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
223 OTHER Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
323 OTHER Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
225 OTHER Cardiac Defibrillator Implant With Cardiac Catheterization Without A 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
226 OTHER Cardiac Defibrillator Implant Without Cardiac Catheterization With M 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
227 OTHER Cardiac Defibrillator Implant Without Cardiac Catheterization Withou 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
228 OTHER Other Cardiothoracic Procedures With Mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
229 OTHER Other Cardiothoracic Procedures Without Mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
23 OTHER Craniotomy With Major Device Implant Or Acute Complex Cns Principal 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
230 OTHER Other Cardiothoracic Procedures Without Cc/mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
231 OTHER Coronary Bypass With Ptca With Mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
232 OTHER Coronary Bypass With Ptca Without Mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
233 OTHER Coronary Bypass With Cardiac Catheterization Or Open Ablation With M 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
234 OTHER Coronary Bypass With Cardiac Catheterization Or Open Ablation Withou 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
235 OTHER Coronary Bypass Without Cardiac Catheterization With Mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
236 OTHER Coronary Bypass Without Cardiac Catheterization Without Mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
148 OTHER Ear, Nose, Mouth And Throat Malignancy Without Cc/mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
13 OTHER Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
115 OTHER Extraocular Procedures Except Orbit 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
102 OTHER Headaches With Mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
190 OTHER Chronic Obstructive Pulmonary Disease With Mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
19 OTHER Simultaneous Pancreas And Kidney Transplant With Hemodialysis 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
147 OTHER Ear, Nose, Mouth And Throat Malignancy With Cc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
257 OTHER Upper Limb And Toe Amputation For Circulatory System Disorders Witho 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
146 OTHER Ear, Nose, Mouth And Throat Malignancy With Mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
129 OTHER Major Head & Neck Procedures W Cc/mcc Or Major Device 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
1 OTHER Heart Transplant Or Implant Of Heart Assist System With Mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
187 OTHER Pleural Effusion With Cc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
186 OTHER Pleural Effusion With Mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
145 OTHER Other Ear, Nose, Mouth And Throat O.r. Procedures Without Cc/mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
251 OTHER Percutaneous Cardiovascular Procedures Without Intraluminal Device W 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
185 OTHER Major Chest Trauma Without Cc/mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
114 OTHER Orbital Procedures Without Cc/mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
144 OTHER Other Ear, Nose, Mouth And Throat O.r. Procedures With Cc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
184 OTHER Major Chest Trauma With Cc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
125 OTHER Other Disorders Of The Eye Without Mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
252 OTHER Other Vascular Procedures With Mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
253 OTHER Other Vascular Procedures With Cc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
254 OTHER Other Vascular Procedures Without Cc/mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
255 OTHER Upper Limb And Toe Amputation For Circulatory System Disorders With 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
188 OTHER Pleural Effusion Without Cc/mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
256 OTHER Upper Limb And Toe Amputation For Circulatory System Disorders With 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
101 OTHER Seizures Without Mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
258 OTHER Cardiac Pacemaker Device Replacement With Mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
259 OTHER Cardiac Pacemaker Device Replacement Without Mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
26 OTHER Craniotomy And Endovascular Intracranial Procedures With Cc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
260 OTHER Cardiac Pacemaker Revision Except Device Replacement With Mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
261 OTHER Cardiac Pacemaker Revision Except Device Replacement With Cc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
262 OTHER Cardiac Pacemaker Revision Except Device Replacement Without Cc/mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
263 OTHER Vein Ligation And Stripping 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
264 OTHER Other Circulatory System O.r. Procedures 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
265 OTHER Aicd Lead Procedures 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
266 OTHER Endovascular Cardiac Valve Replacement And Supplement Procedures Wit 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
267 OTHER Endovascular Cardiac Valve Replacement And Supplement Procedures Wit 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
268 OTHER Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
269 OTHER Aortic And Heart Assist Procedures Except Pulsation Balloon Without 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
27 OTHER Craniotomy And Endovascular Intracranial Procedures Without Cc/mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
270 OTHER Other Major Cardiovascular Procedures With Mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
271 OTHER Other Major Cardiovascular Procedures With Cc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
272 OTHER Other Major Cardiovascular Procedures Without Cc/mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
273 OTHER Percutaneous And Other Intracardiac Procedures With Mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
274 OTHER Percutaneous And Other Intracardiac Procedures Without Mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
275 OTHER Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
276 OTHER Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimula 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
277 OTHER Cardiac Defibrillator Implant Without Mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
278 OTHER Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
279 OTHER Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
28 OTHER Spinal Procedures With Mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
280 OTHER Acute Myocardial Infarction, Discharged Alive With Mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
281 OTHER Acute Myocardial Infarction, Discharged Alive With Cc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
282 OTHER Acute Myocardial Infarction, Discharged Alive Without Cc/mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
283 OTHER Acute Myocardial Infarction, Expired With Mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
284 OTHER Acute Myocardial Infarction, Expired With Cc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
285 OTHER Acute Myocardial Infarction, Expired Without Cc/mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
286 OTHER Circulatory Disorders Except Ami, With Cardiac Catheterization With 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
287 OTHER Circulatory Disorders Except Ami, With Cardiac Catheterization Witho 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
10 OTHER Pancreas Transplant 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
289 OTHER Acute And Subacute Endocarditis With Cc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
29 OTHER Spinal Procedures With Cc Or Spinal Neurostimulators 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
290 OTHER Acute And Subacute Endocarditis Without Cc/mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
397 OTHER Appendix Procedures With Mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
250 OTHER Percutaneous Cardiovascular Procedures Without Intraluminal Device W 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
293 OTHER Heart Failure And Shock Without Cc/mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
294 OTHER Deep Vein Thrombophlebitis With Cc/mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
25 OTHER Craniotomy And Endovascular Intracranial Procedures With Mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
296 OTHER Cardiac Arrest, Unexplained With Mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
183 OTHER Major Chest Trauma With Mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
298 OTHER Cardiac Arrest, Unexplained Without Cc/mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
249 OTHER Percutaneous Cardiovascular Procedures With Non-drug-eluting Stent W 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
248 OTHER Percutaneous Cardiovascular Procedures With Non-drug-eluting Stent W 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
30 OTHER Spinal Procedures Without Cc/mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
300 OTHER Peripheral Vascular Disorders With Cc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
301 OTHER Peripheral Vascular Disorders Without Cc/mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
302 OTHER Atherosclerosis With Mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
303 OTHER Atherosclerosis Without Mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
304 OTHER Hypertension With Mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
305 OTHER Hypertension Without Mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
306 OTHER Cardiac Congenital And Valvular Disorders With Mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
307 OTHER Cardiac Congenital And Valvular Disorders Without Mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
308 OTHER Cardiac Arrhythmia And Conduction Disorders With Mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
309 OTHER Cardiac Arrhythmia And Conduction Disorders With Cc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
31 OTHER Ventricular Shunt Procedures With Mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
310 OTHER Cardiac Arrhythmia And Conduction Disorders Without Cc/mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
311 OTHER Angina Pectoris 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
312 OTHER Syncope And Collapse 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
313 OTHER Chest Pain 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
182 OTHER Respiratory Neoplasms Without Cc/mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
315 OTHER Other Circulatory System Diagnoses With Cc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
316 OTHER Other Circulatory System Diagnoses Without Cc/mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
317 OTHER Concomitant Left Atrial Appendage Closure And Cardiac Ablation 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
318 OTHER Percutaneous Coronary Atherectomy Without Intraluminal Device 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
319 OTHER Other Endovascular Cardiac Valve Procedures With Mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
32 OTHER Ventricular Shunt Procedures With Cc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
320 OTHER Other Endovascular Cardiac Valve Procedures Without Mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
321 OTHER Percutaneous Cardiovascular Procedures With Intraluminal Device With 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
322 OTHER Percutaneous Cardiovascular Procedures With Intraluminal Device With 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
143 OTHER Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
324 OTHER Coronary Intravascular Lithotripsy With Intraluminal Device Without 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
325 OTHER Coronary Intravascular Lithotripsy Without Intraluminal Device 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
326 OTHER Stomach, Esophageal And Duodenal Procedures With Mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
327 OTHER Stomach, Esophageal And Duodenal Procedures With Cc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
328 OTHER Stomach, Esophageal And Duodenal Procedures Without Cc/mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
329 OTHER Major Small And Large Bowel Procedures With Mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
33 OTHER Ventricular Shunt Procedures Without Cc/mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
330 OTHER Major Small And Large Bowel Procedures With Cc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
331 OTHER Major Small And Large Bowel Procedures Without Cc/mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
332 OTHER Rectal Resection With Mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
333 OTHER Rectal Resection With Cc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
334 OTHER Rectal Resection Without Cc/mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
335 OTHER Peritoneal Adhesiolysis With Mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
336 OTHER Peritoneal Adhesiolysis With Cc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
337 OTHER Peritoneal Adhesiolysis Without Cc/mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
338 OTHER Appendectomy With Complicated Principal Diagnosis With Mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
339 OTHER Appendectomy With Complicated Principal Diagnosis With Cc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
34 OTHER Carotid Artery Stent Procedures With Mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
340 OTHER Appendectomy With Complicated Principal Diagnosis Without Cc/mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
341 OTHER Appendectomy Without Complicated Principal Diagnosis With Mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
342 OTHER Appendectomy Without Complicated Principal Diagnosis With Cc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
343 OTHER Appendectomy Without Complicated Principal Diagnosis Without Cc/mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
344 OTHER Minor Small And Large Bowel Procedures With Mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
345 OTHER Minor Small And Large Bowel Procedures With Cc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
346 OTHER Minor Small And Large Bowel Procedures Without Cc/mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
347 OTHER Anal And Stomal Procedures With Mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
348 OTHER Anal And Stomal Procedures With Cc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
247 OTHER Percutaneous Cardiovascular Procedures With Drug-eluting Stent Witho 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
246 OTHER Percutaneous Cardiovascular Procedures With Drug-eluting Stent With 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
181 OTHER Respiratory Neoplasms With Cc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
245 OTHER Aicd Generator Procedures 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
244 OTHER Permanent Cardiac Pacemaker Implant Without Cc/mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
142 OTHER Major Head And Neck Procedures Without Cc/mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
392 OTHER Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders W 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
394 OTHER Other Digestive System Diagnoses With Cc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
243 OTHER Permanent Cardiac Pacemaker Implant With Cc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
388 OTHER Gastrointestinal Obstruction With Mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
18 OTHER Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
242 OTHER Permanent Cardiac Pacemaker Implant With Mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
386 OTHER Inflammatory Bowel Disease With Cc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
389 OTHER Gastrointestinal Obstruction With Cc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
141 OTHER Major Head And Neck Procedures With Cc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
387 OTHER Inflammatory Bowel Disease Without Cc/mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
241 OTHER Amputation For Circulatory System Disorders Except Upper Limb And To 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
180 OTHER Respiratory Neoplasms With Mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
384 OTHER Uncomplicated Peptic Ulcer Without Mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
124 OTHER Other Disorders Of The Eye With Mcc Or Thrombolytic Agent 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
352 OTHER Inguinal And Femoral Hernia Procedures Without Cc/mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
353 OTHER Hernia Procedures Except Inguinal And Femoral With Mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
354 OTHER Hernia Procedures Except Inguinal And Femoral With Cc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
355 OTHER Hernia Procedures Except Inguinal And Femoral Without Cc/mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
356 OTHER Other Digestive System O.r. Procedures With Mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
357 OTHER Other Digestive System O.r. Procedures With Cc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
358 OTHER Other Digestive System O.r. Procedures Without Cc/mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
359 OTHER Percutaneous Coronary Atherectomy With Intraluminal Device With Mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
36 OTHER Carotid Artery Stent Procedures Without Cc/mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
360 OTHER Percutaneous Coronary Atherectomy With Intraluminal Device Without M 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
368 OTHER Major Esophageal Disorders With Mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
369 OTHER Major Esophageal Disorders With Cc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
37 OTHER Extracranial Procedures With Mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
370 OTHER Major Esophageal Disorders Without Cc/mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
240 OTHER Amputation For Circulatory System Disorders Except Upper Limb And To 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
372 OTHER Major Gastrointestinal Disorders And Peritoneal Infections With Cc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
373 OTHER Major Gastrointestinal Disorders And Peritoneal Infections Without C 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
374 OTHER Digestive Malignancy With Mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
375 OTHER Digestive Malignancy With Cc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
376 OTHER Digestive Malignancy Without Cc/mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
377 OTHER Gastrointestinal Hemorrhage With Mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
378 OTHER Gastrointestinal Hemorrhage With Cc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
379 OTHER Gastrointestinal Hemorrhage Without Cc/mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
38 OTHER Extracranial Procedures With Cc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
380 OTHER Complicated Peptic Ulcer With Mcc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
351 OTHER Inguinal And Femoral Hernia Procedures With Cc 100 39 — — $1,303.00 $2,242.00 $1,782.53 2026-05-23
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