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

7,992 distinct procedures filed
42 distinct payers
90,063 rate rows
2026-07-05 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/fortmyers.csv
Found on page https://www.selectspecialtyhospitals.com/locations-and-tours/fl/fort-myers/fort-myers/
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-10-20
Content fingerprint 60ef0eecb7e22815… · 3,022,705 bytes · first seen 2026-05-13

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
277
OTHER 		Cardiac Defibrillator Implant Without Mcc 31 $1,920.00 $1,920.00 $1,920.00 nat. median
$45,658
outlier · 0.0×
399
OTHER 		Appendix Procedures Without Cc/mcc 31 $1,920.00 $1,920.00 $1,920.00 nat. median
$12,086
outlier · 0.2×
219
OTHER 		Cardiac Valve And Other Major Cardiothoracic Procedures Without Card 31 $1,920.00 $1,920.00 $1,920.00 nat. median
$65,520
outlier · 0.0×
276
OTHER 		Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimula 31 $1,920.00 $1,920.00 $1,920.00 nat. median
$1,920
1.0× median
333
OTHER 		Rectal Resection With Cc 31 $1,920.00 $1,920.00 $1,920.00 nat. median
$2,155
0.9× median
398
OTHER 		Appendix Procedures With Cc 31 $1,920.00 $1,920.00 $1,920.00 nat. median
$16,228
outlier · 0.1×
176
OTHER 		Pulmonary Embolism Without Mcc 31 $1,920.00 $1,920.00 $1,920.00 nat. median
$7,606
outlier · 0.3×
218
OTHER 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac 31 $1,920.00 $1,920.00 $1,920.00 nat. median
$48,723
outlier · 0.0×
247
OTHER 		Percutaneous Cardiovascular Procedures With Drug-eluting Stent Witho 31 $1,920.00 $1,920.00 $1,920.00 nat. median
$11,580
outlier · 0.2×
275
OTHER 		Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 31 $1,920.00 $1,920.00 $1,920.00 nat. median
$20,020
outlier · 0.1×
304
OTHER 		Hypertension With Mcc 31 $1,920.00 $1,920.00 $1,920.00 nat. median
$9,898
outlier · 0.2×
332
OTHER 		Rectal Resection With Mcc 31 $1,920.00 $1,920.00 $1,920.00 nat. median
$32,174
outlier · 0.1×
368
OTHER 		Major Esophageal Disorders With Mcc 31 $1,920.00 $1,920.00 $1,920.00 nat. median
$15,755
outlier · 0.1×
397
OTHER 		Appendix Procedures With Mcc 31 $1,920.00 $1,920.00 $1,920.00 nat. median
$22,610
outlier · 0.1×
14
OTHER 		Allogeneic Bone Marrow Transplant 31 $1,920.00 $1,920.00 $1,920.00 nat. median
$114,398
outlier · 0.0×
175
OTHER 		Pulmonary Embolism With Mcc Or Acute Cor Pulmonale 31 $1,920.00 $1,920.00 $1,920.00 nat. median
$13,634
outlier · 0.1×
200
OTHER 		Pneumothorax With Cc 31 $1,920.00 $1,920.00 $1,920.00 nat. median
$9,155
outlier · 0.2×
217
OTHER 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac 31 $1,920.00 $1,920.00 $1,920.00 nat. median
$59,013
outlier · 0.0×
232
OTHER 		Coronary Bypass With Ptca Without Mcc 31 $1,920.00 $1,920.00 $1,920.00 nat. median
$52,548
outlier · 0.0×
246
OTHER 		Percutaneous Cardiovascular Procedures With Drug-eluting Stent With 31 $1,920.00 $1,920.00 $1,920.00 nat. median
$21,587
outlier · 0.1×
260
OTHER 		Cardiac Pacemaker Revision Except Device Replacement With Mcc 31 $1,920.00 $1,920.00 $1,920.00 nat. median
$187
outlier · 10.3×
274
OTHER 		Percutaneous And Other Intracardiac Procedures Without Mcc 31 $1,920.00 $1,920.00 $1,920.00 nat. median
$384
outlier · 5.0×
290
OTHER 		Acute And Subacute Endocarditis Without Cc/mcc 31 $1,920.00 $1,920.00 $1,920.00 nat. median
$9,018
outlier · 0.2×
303
OTHER 		Atherosclerosis Without Mcc 31 $1,920.00 $1,920.00 $1,920.00 nat. median
$5,925
outlier · 0.3×
318
OTHER 		Percutaneous Coronary Atherectomy Without Intraluminal Device 31 $1,920.00 $1,920.00 $1,920.00 nat. median
$22,183
outlier · 0.1×
331
OTHER 		Major Small And Large Bowel Procedures Without Cc/mcc 31 $1,920.00 $1,920.00 $1,920.00 nat. median
$10,583
outlier · 0.2×
347
OTHER 		Anal And Stomal Procedures With Mcc 31 $1,920.00 $1,920.00 $1,920.00 nat. median
$22,982
outlier · 0.1×
360
OTHER 		Percutaneous Coronary Atherectomy With Intraluminal Device Without M 31 $1,920.00 $1,920.00 $1,920.00 nat. median
$3,247
0.6× median
381
OTHER 		Complicated Peptic Ulcer With Cc 31 $1,920.00 $1,920.00 $1,920.00 nat. median
$9,509
outlier · 0.2×
395
OTHER 		Other Digestive System Diagnoses Without Cc/mcc 31 $1,920.00 $1,920.00 $1,920.00 nat. median
$6,684
outlier · 0.3×
122
OTHER 		Acute Major Eye Infections Without Cc/mcc 31 $1,920.00 $1,920.00 $1,920.00 nat. median
$6,754
outlier · 0.3×
139
OTHER 		Salivary Gland Procedures 31 $1,920.00 $1,920.00 $1,920.00 nat. median
$11,769
outlier · 0.2×
153
OTHER 		Otitis Media And Uri Without Mcc 31 $1,920.00 $1,920.00 $1,920.00 nat. median
$7,085
outlier · 0.3×
173
OTHER 		Ultrasound Accelerated And Other Thrombolysis With Principal Diagnos 31 $1,920.00 $1,920.00 $1,920.00 nat. median
$24,561
outlier · 0.1×
19
OTHER 		Simultaneous Pancreas And Kidney Transplant With Hemodialysis 31 $1,920.00 $1,920.00 $1,920.00 nat. median
$71,460
outlier · 0.0×
20
OTHER 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage 31 $1,920.00 $1,920.00 $1,920.00 nat. median
$80,730
outlier · 0.0×
207
OTHER 		Respiratory System Diagnosis With Ventilator Support >96 Hours 31 $1,920.00 $64,107.88 $1,920.00 nat. median
$64,908
outlier · 0.0×
216
OTHER 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac 31 $1,920.00 $1,920.00 $1,920.00 nat. median
$73,813
outlier · 0.0×
225
OTHER 		Cardiac Defibrillator Implant With Cardiac Catheterization Without A 31 $1,920.00 $1,920.00 $1,920.00 nat. median
$36,728
outlier · 0.1×
231
OTHER 		Coronary Bypass With Ptca With Mcc 31 $1,920.00 $1,920.00 $1,920.00 nat. median
$67,297
outlier · 0.0×
239
OTHER 		Amputation For Circulatory System Disorders Except Upper Limb And To 31 $1,920.00 $1,920.00 $1,920.00 nat. median
$46,546
outlier · 0.0×
245
OTHER 		Aicd Generator Procedures 31 $1,920.00 $1,920.00 $1,920.00 nat. median
$45,213
outlier · 0.0×
253
OTHER 		Other Vascular Procedures With Cc 31 $1,920.00 $1,920.00 $1,920.00 nat. median
$23,428
outlier · 0.1×
26
OTHER 		Craniotomy And Endovascular Intracranial Procedures With Cc 31 $1,920.00 $1,920.00 $1,920.00 nat. median
$32,628
outlier · 0.1×
267
OTHER 		Endovascular Cardiac Valve Replacement And Supplement Procedures Wit 31 $1,920.00 $1,920.00 $1,920.00 nat. median
$44,296
outlier · 0.0×
273
OTHER 		Percutaneous And Other Intracardiac Procedures With Mcc 31 $1,920.00 $1,920.00 $1,920.00 nat. median
$34,143
outlier · 0.1×
283
OTHER 		Acute Myocardial Infarction, Expired With Mcc 31 $1,920.00 $1,920.00 $1,920.00 nat. median
$18,682
outlier · 0.1×
29
OTHER 		Spinal Procedures With Cc Or Spinal Neurostimulators 31 $1,920.00 $1,920.00 $1,920.00 nat. median
$34,805
outlier · 0.1×
297
OTHER 		Cardiac Arrest, Unexplained With Cc 31 $1,920.00 $1,920.00 $1,920.00 nat. median
$6,914
outlier · 0.3×
302
OTHER 		Atherosclerosis With Mcc 31 $1,920.00 $1,920.00 $1,920.00 nat. median
$87
outlier · 22.0×

Other procedures at this hospital

Browse this hospital's 7,992 published procedures. Use the slice to choose what to show, then sort or filter any column.

Slice
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
             
277 OTHER Cardiac Defibrillator Implant Without Mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
399 OTHER Appendix Procedures Without Cc/mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
219 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures Without Card 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
276 OTHER Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimula 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
333 OTHER Rectal Resection With Cc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
398 OTHER Appendix Procedures With Cc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
176 OTHER Pulmonary Embolism Without Mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
218 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
247 OTHER Percutaneous Cardiovascular Procedures With Drug-eluting Stent Witho 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
275 OTHER Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
304 OTHER Hypertension With Mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
332 OTHER Rectal Resection With Mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
368 OTHER Major Esophageal Disorders With Mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
397 OTHER Appendix Procedures With Mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
14 OTHER Allogeneic Bone Marrow Transplant 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
175 OTHER Pulmonary Embolism With Mcc Or Acute Cor Pulmonale 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
200 OTHER Pneumothorax With Cc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
217 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
232 OTHER Coronary Bypass With Ptca Without Mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
246 OTHER Percutaneous Cardiovascular Procedures With Drug-eluting Stent With 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
260 OTHER Cardiac Pacemaker Revision Except Device Replacement With Mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
274 OTHER Percutaneous And Other Intracardiac Procedures Without Mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
290 OTHER Acute And Subacute Endocarditis Without Cc/mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
303 OTHER Atherosclerosis Without Mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
318 OTHER Percutaneous Coronary Atherectomy Without Intraluminal Device 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
331 OTHER Major Small And Large Bowel Procedures Without Cc/mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
347 OTHER Anal And Stomal Procedures With Mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
360 OTHER Percutaneous Coronary Atherectomy With Intraluminal Device Without M 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
381 OTHER Complicated Peptic Ulcer With Cc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
395 OTHER Other Digestive System Diagnoses Without Cc/mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
122 OTHER Acute Major Eye Infections Without Cc/mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
139 OTHER Salivary Gland Procedures 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
153 OTHER Otitis Media And Uri Without Mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
173 OTHER Ultrasound Accelerated And Other Thrombolysis With Principal Diagnos 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
19 OTHER Simultaneous Pancreas And Kidney Transplant With Hemodialysis 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
20 OTHER Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
207 OTHER Respiratory System Diagnosis With Ventilator Support >96 Hours 66 31 — — $1,920.00 $64,107.88 $1,920.00 2026-05-23
216 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
225 OTHER Cardiac Defibrillator Implant With Cardiac Catheterization Without A 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
231 OTHER Coronary Bypass With Ptca With Mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
239 OTHER Amputation For Circulatory System Disorders Except Upper Limb And To 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
245 OTHER Aicd Generator Procedures 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
253 OTHER Other Vascular Procedures With Cc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
26 OTHER Craniotomy And Endovascular Intracranial Procedures With Cc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
267 OTHER Endovascular Cardiac Valve Replacement And Supplement Procedures Wit 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
273 OTHER Percutaneous And Other Intracardiac Procedures With Mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
283 OTHER Acute Myocardial Infarction, Expired With Mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
29 OTHER Spinal Procedures With Cc Or Spinal Neurostimulators 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
297 OTHER Cardiac Arrest, Unexplained With Cc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
302 OTHER Atherosclerosis With Mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
310 OTHER Cardiac Arrhythmia And Conduction Disorders Without Cc/mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
317 OTHER Concomitant Left Atrial Appendage Closure And Cardiac Ablation 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
324 OTHER Coronary Intravascular Lithotripsy With Intraluminal Device Without 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
330 OTHER Major Small And Large Bowel Procedures With Cc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
34 OTHER Carotid Artery Stent Procedures With Mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
346 OTHER Minor Small And Large Bowel Procedures Without Cc/mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
353 OTHER Hernia Procedures Except Inguinal And Femoral With Mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
36 OTHER Carotid Artery Stent Procedures Without Cc/mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
374 OTHER Digestive Malignancy With Mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
380 OTHER Complicated Peptic Ulcer With Mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
388 OTHER Gastrointestinal Obstruction With Mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
394 OTHER Other Digestive System Diagnoses With Cc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
11 OTHER Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
121 OTHER Acute Major Eye Infections With Cc/mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
131 OTHER Cranial/facial Procedures W Cc/mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
138 OTHER Mouth Procedures Without Cc/mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
146 OTHER Ear, Nose, Mouth And Throat Malignancy With Mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
152 OTHER Otitis Media And Uri With Mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
16 OTHER Autologous Bone Marrow Transplant With Cc/mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
17 OTHER Autologous Bone Marrow Transplant Without Cc/mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
182 OTHER Respiratory Neoplasms Without Cc/mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
189 OTHER Pulmonary Edema And Respiratory Failure 66 31 — — $1,920.00 $53,992.06 $1,920.00 2026-05-23
196 OTHER Interstitial Lung Disease With Mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
2 OTHER Heart Transplant Or Implant Of Heart Assist System Without Mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
203 OTHER Bronchitis And Asthma Without Cc/mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
206 OTHER Other Respiratory System Diagnoses Without Mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
21 OTHER Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
215 OTHER Other Heart Assist System Implant 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
221 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures Without Card 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
224 OTHER Cardiac Defibrillator Implant With Cardiac Catheterization Without A 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
228 OTHER Other Cardiothoracic Procedures With Mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
230 OTHER Other Cardiothoracic Procedures Without Cc/mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
235 OTHER Coronary Bypass Without Cardiac Catheterization With Mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
238 OTHER Major Cardiovasc Procedures Without Mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
241 OTHER Amputation For Circulatory System Disorders Except Upper Limb And To 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
244 OTHER Permanent Cardiac Pacemaker Implant Without Cc/mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
25 OTHER Craniotomy And Endovascular Intracranial Procedures With Mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
252 OTHER Other Vascular Procedures With Mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
256 OTHER Upper Limb And Toe Amputation For Circulatory System Disorders With 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
259 OTHER Cardiac Pacemaker Device Replacement Without Mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
263 OTHER Vein Ligation And Stripping 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
266 OTHER Endovascular Cardiac Valve Replacement And Supplement Procedures Wit 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
27 OTHER Craniotomy And Endovascular Intracranial Procedures Without Cc/mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
272 OTHER Other Major Cardiovascular Procedures Without Cc/mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
28 OTHER Spinal Procedures With Mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
282 OTHER Acute Myocardial Infarction, Discharged Alive Without Cc/mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
286 OTHER Circulatory Disorders Except Ami, With Cardiac Catheterization With 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
289 OTHER Acute And Subacute Endocarditis With Cc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
293 OTHER Heart Failure And Shock Without Cc/mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
296 OTHER Cardiac Arrest, Unexplained With Mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
3 OTHER Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
301 OTHER Peripheral Vascular Disorders Without Cc/mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
307 OTHER Cardiac Congenital And Valvular Disorders Without Mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
31 OTHER Ventricular Shunt Procedures With Mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
313 OTHER Chest Pain 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
316 OTHER Other Circulatory System Diagnoses Without Cc/mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
320 OTHER Other Endovascular Cardiac Valve Procedures Without Mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
323 OTHER Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
327 OTHER Stomach, Esophageal And Duodenal Procedures With Cc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
33 OTHER Ventricular Shunt Procedures Without Cc/mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
336 OTHER Peritoneal Adhesiolysis With Cc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
339 OTHER Appendectomy With Complicated Principal Diagnosis With Cc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
342 OTHER Appendectomy Without Complicated Principal Diagnosis With Cc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
345 OTHER Minor Small And Large Bowel Procedures With Cc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
35 OTHER Carotid Artery Stent Procedures With Cc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
352 OTHER Inguinal And Femoral Hernia Procedures Without Cc/mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
356 OTHER Other Digestive System O.r. Procedures With Mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
359 OTHER Percutaneous Coronary Atherectomy With Intraluminal Device With Mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
370 OTHER Major Esophageal Disorders Without Cc/mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
373 OTHER Major Gastrointestinal Disorders And Peritoneal Infections Without C 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
377 OTHER Gastrointestinal Hemorrhage With Mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
38 OTHER Extracranial Procedures With Cc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
384 OTHER Uncomplicated Peptic Ulcer Without Mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
387 OTHER Inflammatory Bowel Disease Without Cc/mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
390 OTHER Gastrointestinal Obstruction Without Cc/mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
393 OTHER Other Digestive System Diagnoses With Mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
100 OTHER Seizures With Mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
103 OTHER Headaches Without Mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
115 OTHER Extraocular Procedures Except Orbit 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
12 OTHER Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
125 OTHER Other Disorders Of The Eye Without Mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
130 OTHER Major Head & Neck Procedures Without Cc/mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
134 OTHER Other Ear, Nose, Mouth & Throat O.r. Procedures Without Cc/mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
137 OTHER Mouth Procedures With Cc/mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
142 OTHER Major Head And Neck Procedures Without Cc/mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
145 OTHER Other Ear, Nose, Mouth And Throat O.r. Procedures Without Cc/mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
149 OTHER Dysequilibrium 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
151 OTHER Epistaxis Without Mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
156 OTHER Other Ear, Nose, Mouth And Throat Diagnoses Without Cc/mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
159 OTHER Dental And Oral Diseases Without Cc/mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
165 OTHER Major Chest Procedures Without Cc/mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
168 OTHER Other Respiratory System O.r. Procedures Without Cc/mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
179 OTHER Respiratory Infections And Inflammations Without Cc/mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
181 OTHER Respiratory Neoplasms With Cc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
185 OTHER Major Chest Trauma Without Cc/mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
188 OTHER Pleural Effusion Without Cc/mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
192 OTHER Chronic Obstructive Pulmonary Disease Without Cc/mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
195 OTHER Simple Pneumonia And Pleurisy Without Cc/mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
198 OTHER Interstitial Lung Disease Without Cc/mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
199 OTHER Pneumothorax With Mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
201 OTHER Pneumothorax Without Cc/mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
202 OTHER Bronchitis And Asthma With Cc/mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
204 OTHER Respiratory Signs And Symptoms 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
205 OTHER Other Respiratory System Diagnoses With Mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
208 OTHER Respiratory System Diagnosis With Ventilator Support <=96 Hours 66 31 — — $1,920.00 $53,012.68 $1,920.00 2026-05-23
209 OTHER Complex Aortic Arch Procedures 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
212 OTHER Concomitant Aortic And Mitral Valve Procedures 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
213 OTHER Endovascular Abdominal Aorta With Iliac Branch Procedures 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
22 OTHER Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
220 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures Without Card 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
222 OTHER Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
223 OTHER Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
226 OTHER Cardiac Defibrillator Implant Without Cardiac Catheterization With M 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
227 OTHER Cardiac Defibrillator Implant Without Cardiac Catheterization Withou 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
229 OTHER Other Cardiothoracic Procedures Without Mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
23 OTHER Craniotomy With Major Device Implant Or Acute Complex Cns Principal 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
233 OTHER Coronary Bypass With Cardiac Catheterization Or Open Ablation With M 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
234 OTHER Coronary Bypass With Cardiac Catheterization Or Open Ablation Withou 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
236 OTHER Coronary Bypass Without Cardiac Catheterization Without Mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
237 OTHER Major Cardiovasc Procedures W Mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
24 OTHER Craniotomy With Major Device Implant Or Acute Complex Cns Principal 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
240 OTHER Amputation For Circulatory System Disorders Except Upper Limb And To 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
242 OTHER Permanent Cardiac Pacemaker Implant With Mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
243 OTHER Permanent Cardiac Pacemaker Implant With Cc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
248 OTHER Percutaneous Cardiovascular Procedures With Non-drug-eluting Stent W 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
249 OTHER Percutaneous Cardiovascular Procedures With Non-drug-eluting Stent W 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
250 OTHER Percutaneous Cardiovascular Procedures Without Intraluminal Device W 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
251 OTHER Percutaneous Cardiovascular Procedures Without Intraluminal Device W 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
254 OTHER Other Vascular Procedures Without Cc/mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
255 OTHER Upper Limb And Toe Amputation For Circulatory System Disorders With 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
257 OTHER Upper Limb And Toe Amputation For Circulatory System Disorders Witho 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
258 OTHER Cardiac Pacemaker Device Replacement With Mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
261 OTHER Cardiac Pacemaker Revision Except Device Replacement With Cc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
262 OTHER Cardiac Pacemaker Revision Except Device Replacement Without Cc/mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
264 OTHER Other Circulatory System O.r. Procedures 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
265 OTHER Aicd Lead Procedures 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
268 OTHER Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
269 OTHER Aortic And Heart Assist Procedures Except Pulsation Balloon Without 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
270 OTHER Other Major Cardiovascular Procedures With Mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
271 OTHER Other Major Cardiovascular Procedures With Cc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
278 OTHER Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
279 OTHER Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
280 OTHER Acute Myocardial Infarction, Discharged Alive With Mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
281 OTHER Acute Myocardial Infarction, Discharged Alive With Cc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
284 OTHER Acute Myocardial Infarction, Expired With Cc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
285 OTHER Acute Myocardial Infarction, Expired Without Cc/mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
287 OTHER Circulatory Disorders Except Ami, With Cardiac Catheterization Witho 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
288 OTHER Acute And Subacute Endocarditis With Mcc 66 31 — — $1,920.00 $23,466.44 $1,920.00 2026-05-23
291 OTHER Heart Failure And Shock With Mcc 66 31 — — $1,920.00 $35,921.96 $1,920.00 2026-05-23
292 OTHER Heart Failure And Shock With Cc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
294 OTHER Deep Vein Thrombophlebitis With Cc/mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
295 OTHER Deep Vein Thrombophlebitis Without Cc/mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
298 OTHER Cardiac Arrest, Unexplained Without Cc/mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
299 OTHER Peripheral Vascular Disorders With Mcc 66 31 — — $1,920.00 $34,362.28 $1,920.00 2026-05-23
30 OTHER Spinal Procedures Without Cc/mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
300 OTHER Peripheral Vascular Disorders With Cc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
305 OTHER Hypertension Without Mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
306 OTHER Cardiac Congenital And Valvular Disorders With Mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
308 OTHER Cardiac Arrhythmia And Conduction Disorders With Mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
309 OTHER Cardiac Arrhythmia And Conduction Disorders With Cc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
311 OTHER Angina Pectoris 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
312 OTHER Syncope And Collapse 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
314 OTHER Other Circulatory System Diagnoses With Mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
315 OTHER Other Circulatory System Diagnoses With Cc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
319 OTHER Other Endovascular Cardiac Valve Procedures With Mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
32 OTHER Ventricular Shunt Procedures With Cc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
321 OTHER Percutaneous Cardiovascular Procedures With Intraluminal Device With 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
322 OTHER Percutaneous Cardiovascular Procedures With Intraluminal Device With 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
325 OTHER Coronary Intravascular Lithotripsy Without Intraluminal Device 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
326 OTHER Stomach, Esophageal And Duodenal Procedures With Mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
328 OTHER Stomach, Esophageal And Duodenal Procedures Without Cc/mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
329 OTHER Major Small And Large Bowel Procedures With Mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
334 OTHER Rectal Resection Without Cc/mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
335 OTHER Peritoneal Adhesiolysis With Mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
337 OTHER Peritoneal Adhesiolysis Without Cc/mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
338 OTHER Appendectomy With Complicated Principal Diagnosis With Mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
340 OTHER Appendectomy With Complicated Principal Diagnosis Without Cc/mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
341 OTHER Appendectomy Without Complicated Principal Diagnosis With Mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
343 OTHER Appendectomy Without Complicated Principal Diagnosis Without Cc/mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
344 OTHER Minor Small And Large Bowel Procedures With Mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
348 OTHER Anal And Stomal Procedures With Cc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
349 OTHER Anal And Stomal Procedures Without Cc/mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
350 OTHER Inguinal And Femoral Hernia Procedures With Mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
351 OTHER Inguinal And Femoral Hernia Procedures With Cc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
354 OTHER Hernia Procedures Except Inguinal And Femoral With Cc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
355 OTHER Hernia Procedures Except Inguinal And Femoral Without Cc/mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
357 OTHER Other Digestive System O.r. Procedures With Cc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
358 OTHER Other Digestive System O.r. Procedures Without Cc/mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
369 OTHER Major Esophageal Disorders With Cc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
37 OTHER Extracranial Procedures With Mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
371 OTHER Major Gastrointestinal Disorders And Peritoneal Infections With Mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
372 OTHER Major Gastrointestinal Disorders And Peritoneal Infections With Cc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
375 OTHER Digestive Malignancy With Cc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
376 OTHER Digestive Malignancy Without Cc/mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
378 OTHER Gastrointestinal Hemorrhage With Cc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
379 OTHER Gastrointestinal Hemorrhage Without Cc/mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
382 OTHER Complicated Peptic Ulcer Without Cc/mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
383 OTHER Uncomplicated Peptic Ulcer With Mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
385 OTHER Inflammatory Bowel Disease With Mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
386 OTHER Inflammatory Bowel Disease With Cc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
389 OTHER Gastrointestinal Obstruction With Cc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
39 OTHER Extracranial Procedures Without Cc/mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
391 OTHER Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders W 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
392 OTHER Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders W 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
1 OTHER Heart Transplant Or Implant Of Heart Assist System With Mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
10 OTHER Pancreas Transplant 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
101 OTHER Seizures Without Mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
102 OTHER Headaches With Mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
113 OTHER Orbital Procedures With Cc/mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
114 OTHER Orbital Procedures Without Cc/mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
116 OTHER Intraocular Procedures With Cc/mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
117 OTHER Intraocular Procedures Without Cc/mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
123 OTHER Neurological Eye Disorders 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
124 OTHER Other Disorders Of The Eye With Mcc Or Thrombolytic Agent 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
129 OTHER Major Head & Neck Procedures W Cc/mcc Or Major Device 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
13 OTHER Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
132 OTHER Cranial/facial Procedures Without Cc/mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
133 OTHER Other Ear, Nose, Mouth & Throat O.r. Procedures W Cc/mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
135 OTHER Sinus And Mastoid Procedures With Cc/mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
136 OTHER Sinus And Mastoid Procedures Without Cc/mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
140 OTHER Major Head And Neck Procedures With Mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
141 OTHER Major Head And Neck Procedures With Cc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
143 OTHER Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
144 OTHER Other Ear, Nose, Mouth And Throat O.r. Procedures With Cc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
147 OTHER Ear, Nose, Mouth And Throat Malignancy With Cc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
148 OTHER Ear, Nose, Mouth And Throat Malignancy Without Cc/mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
15 OTHER Autologous Bone Marrow Transplant 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
150 OTHER Epistaxis With Mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
154 OTHER Other Ear, Nose, Mouth And Throat Diagnoses With Mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
155 OTHER Other Ear, Nose, Mouth And Throat Diagnoses With Cc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
157 OTHER Dental And Oral Diseases With Mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
158 OTHER Dental And Oral Diseases With Cc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
163 OTHER Major Chest Procedures With Mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
164 OTHER Major Chest Procedures With Cc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
166 OTHER Other Respiratory System O.r. Procedures With Mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
167 OTHER Other Respiratory System O.r. Procedures With Cc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
177 OTHER Respiratory Infections And Inflammations With Mcc 66 31 — — $1,920.00 $11,818.62 $1,920.00 2026-05-23
178 OTHER Respiratory Infections And Inflammations With Cc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
18 OTHER Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
180 OTHER Respiratory Neoplasms With Mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
183 OTHER Major Chest Trauma With Mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
184 OTHER Major Chest Trauma With Cc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
186 OTHER Pleural Effusion With Mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
187 OTHER Pleural Effusion With Cc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
190 OTHER Chronic Obstructive Pulmonary Disease With Mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
191 OTHER Chronic Obstructive Pulmonary Disease With Cc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
193 OTHER Simple Pneumonia And Pleurisy With Mcc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
194 OTHER Simple Pneumonia And Pleurisy With Cc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
197 OTHER Interstitial Lung Disease With Cc 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
4 OTHER Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, M 66 31 — — $1,920.00 $1,920.00 $1,920.00 2026-05-23
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