Hospital

STEPHENS COUNTY HOSPITAL

Toccoa, GA · CCN 110032 · Rates published

9,080 distinct procedures filed

10 distinct payers

86,088 rate rows

2026-05-06 last MRF observed

Data quality

83,993 of 86,088 rate rows are consumer-grade (97.6%)

2,095 rows are marked excluded from the consumer medians — these stay visible in the raw drill-down with the same reason shown here, so nothing is silently hidden.

Excluded — reason	Rows
template filing: same amount across many unrelated codes — excluded	1,988
percent-of-charges filed in the dollar field — excluded from medians	76
placeholder amount (≤ $0.02) — excluded from medians	16
exceeds 10× this hospital's gross charge — excluded from medians	12
no usable negotiated amount (only an out-of-band fallback) — excluded from medians	3

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

Source MRF file	https://stephenscountyhospital.pg.quadax.revenuemasters.com/cdm-files/586001667_stephens-county-hospital_standardcharges.csv
Found on page	https://stephenscountyhospital.pg.quadax.revenuemasters.com/disclaimer
Discovered via	Discovered by HANK
Last fetch	not_modified · 2026-05-15
Content fingerprint	9993c39929e29eb7… · 17,854,622 bytes · first seen 2026-05-05

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
18 OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	2	$271,980.15	$277,419.75	$274,699.95	nat. median $386,529 0.7× median
1 OTHER	Heart Transplant Or Implant Of Heart Assist System With Mcc	2	$177,664.80	$181,218.10	$179,441.45	nat. median $239,422 0.7× median
927 OTHER	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	2	$136,144.36	$138,867.25	$137,505.80	nat. median $146,562 0.9× median
3 OTHER	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…	2	$135,364.78	$138,072.08	$136,718.43	nat. median $181,005 0.8× median
4 OTHER	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…	2	$89,486.61	$91,276.34	$90,381.48	nat. median $134,983 0.7× median
7 OTHER	Lung Transplant	2	$83,879.54	$85,557.13	$84,718.33	nat. median $169,933 outlier · 0.5×
14 OTHER	Allogeneic Bone Marrow Transplant	2	$78,078.97	$79,640.55	$78,859.76	nat. median $100,915 0.8× median
2 OTHER	Heart Transplant Or Implant Of Heart Assist System Without Mcc	2	$73,810.21	$75,286.41	$74,548.31	nat. median $111,558 0.7× median
209 OTHER	Complex Aortic Arch Procedures	2	$73,729.33	$75,203.92	$74,466.62	nat. median $23,389 outlier · 3.2×
212 OTHER	Concomitant Aortic And Mitral Valve Procedures	2	$70,962.49	$72,381.74	$71,672.12	nat. median $90,581 0.8× median
215 OTHER	Other Heart Assist System Implant	2	$65,256.50	$66,561.63	$65,909.07	nat. median $92,359 0.7× median
216 OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	2	$64,172.66	$65,456.11	$64,814.39	nat. median $90,130 0.7× median
429 OTHER	Combined Anterior And Posterior Cervical Spinal Fusion With Mcc	2	$59,361.99	$60,549.23	$59,955.61	nat. median $62,997 1.0× median
850 OTHER	Acute Leukemia With Other Procedures	2	$57,183.74	$58,327.41	$57,755.57	nat. median $407 outlier · 141.8×
231 OTHER	Coronary Bypass With Ptca With Mcc	2	$55,755.22	$56,870.32	$56,312.77	nat. median $74,989 0.8× median
4427702 OTHER	Reconstruct Ankle Joint	10	$21,540.50	$67,000.00	$55,285.05	nat. median $55,285 1.0× median
4406170 OTHER	Insj Iris Prosth W/rmvl&insj	10	$21,259.19	$66,125.00	$54,563.04	nat. median $54,563 1.0× median
20 OTHER	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc	2	$52,264.18	$53,309.46	$52,786.82	nat. median $74,209 0.7× median
219 OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	2	$51,078.94	$52,100.52	$51,589.73	nat. median $72,612 0.7× median
233 OTHER	Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc	2	$50,872.99	$51,890.45	$51,381.72	nat. median $68,249 0.8× median
957 OTHER	Other O.r. Procedures For Multiple Significant Trauma With Mcc	2	$50,715.58	$51,729.89	$51,222.74	nat. median $68,309 0.7× median
10 OTHER	Pancreas Transplant	2	$47,951.86	$48,910.90	$48,431.38	nat. median $62,879 0.8× median
928 OTHER	Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc	2	$47,933.20	$48,891.86	$48,412.53	nat. median $46,003 1.1× median
19 OTHER	Simultaneous Pancreas And Kidney Transplant With Hemodialysis	2	$47,696.15	$48,650.07	$48,173.11	nat. median $61,133 0.8× median
275 OTHER	Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc	2	$47,670.03	$48,623.43	$48,146.73	nat. median $29,655 1.6× median
870 OTHER	Septicemia Or Severe Sepsis With Mv >96 Hours	2	$46,309.95	$47,236.15	$46,773.05	nat. median $54,603 0.9× median
268 OTHER	Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc	2	$46,099.02	$47,021.00	$46,560.01	nat. median $67,670 0.7× median
955 OTHER	Craniotomy For Multiple Significant Trauma	2	$45,185.66	$46,089.37	$45,637.51	nat. median $62,467 0.7× median
218 OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	2	$44,216.31	$45,100.64	$44,658.47	nat. median $56,507 0.8× median
217 OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	2	$44,216.31	$45,100.64	$44,658.47	nat. median $60,727 0.7× median
573 OTHER	Skin Graft For Skin Ulcer Or Cellulitis With Mcc	2	$44,067.61	$44,948.96	$44,508.29	nat. median $54,881 0.8× median
207 OTHER	Respiratory System Diagnosis With Ventilator Support >96 Hours	2	$43,341.53	$44,208.36	$43,774.94	nat. median $66,849 0.7× median
4423474 OTHER	Revis Reconst Shoulder Joint	10	$16,878.75	$52,500.00	$43,320.38	nat. median $43,320 1.0× median
4427759 OTHER	Treatment Of Tibia Fracture	10	$16,798.38	$52,250.00	$43,114.09	nat. median $43,114 1.0× median
4423615 OTHER	Optx Prox Humrl Fx W/int Fix	10	$16,782.30	$52,200.00	$43,072.83	nat. median $43,073 1.0× median
4423472 OTHER	Reconstruct Shoulder Joint	10	$16,774.26	$52,175.00	$43,052.20	nat. median $43,052 1.0× median
4424430 OTHER	Repair Of Humerus	10	$16,718.00	$52,000.00	$42,907.80	nat. median $42,908 1.0× median
4424516 OTHER	Treat Humerus Fracture	10	$16,718.00	$52,000.00	$42,907.80	nat. median $42,908 1.0× median
4423473 OTHER	Revis Reconst Shoulder Joint	10	$16,396.50	$51,000.00	$42,082.65	nat. median $42,083 1.0× median
266 OTHER	Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc	2	$41,435.80	$42,264.52	$41,850.16	nat. median $58,866 0.7× median
969 OTHER	HIV With Extensive O.r. Procedures With Mcc	2	$41,391.62	$42,219.45	$41,805.54	nat. median $64,729 0.6× median
232 OTHER	Coronary Bypass With Ptca Without Mcc	2	$41,026.40	$41,846.93	$41,436.67	nat. median $56,351 0.7× median
28 OTHER	Spinal Procedures With Mcc	2	$40,688.57	$41,502.34	$41,095.46	nat. median $52,701 0.8× median
276 OTHER	Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator	2	$40,677.99	$41,491.55	$41,084.77	nat. median $3,947 outlier · 10.4×
790 OTHER	Extreme Immaturity Or Respiratory Distress Syndrome, Neonate	2	$40,285.38	$41,091.09	$40,688.24	nat. median $42,495 1.0× median
16 OTHER	Autologous Bone Marrow Transplant With Cc/mcc	2	$40,199.52	$41,003.51	$40,601.51	nat. median $50,271 0.8× median
235 OTHER	Coronary Bypass Without Cardiac Catheterization With Mcc	2	$39,819.38	$40,615.77	$40,217.57	nat. median $56,120 0.7× median
820 OTHER	Lymphoma And Leukemia With Major O.r. Procedures With Mcc	2	$39,795.73	$40,591.64	$40,193.68	nat. median $45,972 0.9× median
4427130 OTHER	Total Hip Arthrosplasty	10	$15,432.00	$48,000.00	$39,607.20	nat. median $39,607 1.0× median
23 OTHER	Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…	2	$38,958.90	$39,738.08	$39,348.49	nat. median $56,822 0.7× median

Other procedures at this hospital

Browse this hospital's 9,080 published procedures. Use the slice to choose what to show, then sort or filter any column.

Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
Code	Type	Description	Rate rows	Payers	Gross	Cash	Min $	Max $	Avg median	Last observed

288	OTHER	Acute And Subacute Endocarditis With Mcc	2	2	—	—	$20,143.62	$20,546.49	$20,345.06	2026-05-06
835	OTHER	Acute Leukemia With Cc	2	2	—	—	$16,283.62	$16,609.29	$16,446.46	2026-05-06
834	OTHER	Acute Leukemia With Mcc	2	2	—	—	$37,463.20	$38,212.46	$37,837.83	2026-05-06
850	OTHER	Acute Leukemia With Other Procedures	2	2	—	—	$57,183.74	$58,327.41	$57,755.57	2026-05-06
614	OTHER	Adrenal And Pituitary Procedures With Cc/mcc	2	2	—	—	$16,943.13	$17,281.99	$17,112.56	2026-05-06
245	OTHER	Aicd Generator Procedures	2	2	—	—	$31,692.49	$32,326.34	$32,009.42	2026-05-06
265	OTHER	Aicd Lead Procedures	2	2	—	—	$25,817.88	$26,334.24	$26,076.06	2026-05-06
14	OTHER	Allogeneic Bone Marrow Transplant	2	2	—	—	$78,078.97	$79,640.55	$78,859.76	2026-05-06
240	OTHER	Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc	2	2	—	—	$21,041.42	$21,462.25	$21,251.83	2026-05-06
239	OTHER	Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc	2	2	—	—	$33,927.98	$34,606.54	$34,267.26	2026-05-06
475	OTHER	Amputation For Musculoskeletal System And Connective Tissue Disorders With Cc	2	2	—	—	$17,465.14	$17,814.44	$17,639.79	2026-05-06
474	OTHER	Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc	2	2	—	—	$30,015.71	$30,616.02	$30,315.86	2026-05-06
616	OTHER	Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With…	2	2	—	—	$25,004.07	$25,504.15	$25,254.11	2026-05-06
4429895	OTHER	Ankle Arthroscopy/surgery	10	10	$20,850.00	$12,510.00 40% off	$6,703.28	$20,850.00	$17,204.38	2026-05-06
268	OTHER	Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc	2	2	—	—	$46,099.02	$47,021.00	$46,560.01	2026-05-06
269	OTHER	Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc	2	2	—	—	$29,582.06	$30,173.70	$29,877.88	2026-05-06
4444950	OTHER	Appendectomy	10	10	$26,000.00	$15,600.00 40% off	$8,359.00	$26,000.00	$21,453.90	2026-05-06
4420692	OTHER	Appl Mltpln Uni Ext Fixj Sys	10	10	$45,225.00	$27,135.00 40% off	$14,539.84	$45,225.00	$37,317.41	2026-05-06
4420690	OTHER	Apply Bone Fixation Device	10	10	$26,475.00	$15,885.00 40% off	$8,511.71	$26,475.00	$21,845.85	2026-05-06
16	OTHER	Autologous Bone Marrow Transplant With Cc/mcc	2	2	—	—	$40,199.52	$41,003.51	$40,601.51	2026-05-06
17	OTHER	Autologous Bone Marrow Transplant Without Cc/mcc	2	2	—	—	$37,104.81	$37,846.91	$37,475.86	2026-05-06
518	OTHER	Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost…	2	2	—	—	$26,558.90	$27,090.08	$26,824.49	2026-05-06
95	OTHER	Bacterial And Tuberculous Infections Of Nervous System With Cc	2	2	—	—	$19,353.46	$19,740.53	$19,546.99	2026-05-06
94	OTHER	Bacterial And Tuberculous Infections Of Nervous System With Mcc	2	2	—	—	$25,203.17	$25,707.23	$25,455.20	2026-05-06
96	OTHER	Bacterial And Tuberculous Infections Of Nervous System Without Cc/mcc	2	2	—	—	$19,353.46	$19,740.53	$19,546.99	2026-05-06
886	OTHER	Behavioral And Developmental Disorders	2	2	—	—	$16,218.29	$16,542.66	$16,380.48	2026-05-06
462	OTHER	Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without Mcc	2	2	—	—	$19,856.18	$20,253.30	$20,054.74	2026-05-06
478	OTHER	Biopsies Of Musculoskeletal System And Connective Tissue With Cc	2	2	—	—	$18,606.83	$18,978.97	$18,792.90	2026-05-06
477	OTHER	Biopsies Of Musculoskeletal System And Connective Tissue With Mcc	2	2	—	—	$24,799.99	$25,295.99	$25,047.99	2026-05-06
584	OTHER	Breast Biopsy, Local Excision And Other Breast Procedures With Cc/mcc	2	2	—	—	$16,625.19	$16,957.69	$16,791.44	2026-05-06
275	OTHER	Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc	2	2	—	—	$47,670.03	$48,623.43	$48,146.73	2026-05-06
276	OTHER	Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator	2	2	—	—	$40,677.99	$41,491.55	$41,084.77	2026-05-06
277	OTHER	Cardiac Defibrillator Implant Without Mcc	2	2	—	—	$32,041.52	$32,682.35	$32,361.93	2026-05-06
258	OTHER	Cardiac Pacemaker Device Replacement With Mcc	2	2	—	—	$22,855.69	$23,312.80	$23,084.24	2026-05-06
260	OTHER	Cardiac Pacemaker Revision Except Device Replacement With Mcc	2	2	—	—	$23,544.44	$24,015.33	$23,779.89	2026-05-06
216	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	2	2	—	—	$64,172.66	$65,456.11	$64,814.39	2026-05-06
217	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	2	2	—	—	$44,216.31	$45,100.64	$44,658.47	2026-05-06
218	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	2	2	—	—	$44,216.31	$45,100.64	$44,658.47	2026-05-06
219	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	2	2	—	—	$51,078.94	$52,100.52	$51,589.73	2026-05-06
220	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	2	2	—	—	$36,485.74	$37,215.45	$36,850.60	2026-05-06
221	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	2	2	—	—	$34,665.26	$35,358.57	$35,011.92	2026-05-06
35	OTHER	Carotid Artery Stent Procedures With Cc	2	2	—	—	$18,179.41	$18,543.00	$18,361.21	2026-05-06
34	OTHER	Carotid Artery Stent Procedures With Mcc	2	2	—	—	$27,388.89	$27,936.67	$27,662.78	2026-05-06
472	OTHER	Cervical Spinal Fusion With Cc	2	2	—	—	$21,636.22	$22,068.94	$21,852.58	2026-05-06
471	OTHER	Cervical Spinal Fusion With Mcc	2	2	—	—	$33,349.35	$34,016.34	$33,682.85	2026-05-06
473	OTHER	Cervical Spinal Fusion Without Cc/mcc	2	2	—	—	$18,495.46	$18,865.37	$18,680.42	2026-05-06
783	OTHER	Cesarean Section With Sterilization With Mcc	2	2	—	—	$18,581.33	$18,952.96	$18,767.15	2026-05-06
837	OTHER	Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot…	2	2	—	—	$33,197.53	$33,861.48	$33,529.51	2026-05-06
838	OTHER	Chemotherapy With Acute Leukemia As Secondary Diagnosis With Cc Or High Dose Che…	2	2	—	—	$16,293.59	$16,619.46	$16,456.53	2026-05-06
846	OTHER	Chemotherapy Without Acute Leukemia As Secondary Diagnosis With Mcc	2	2	—	—	$19,436.20	$19,824.92	$19,630.56	2026-05-06
18	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	2	2	—	—	$271,980.15	$277,419.75	$274,699.95	2026-05-06
286	OTHER	Circulatory Disorders Except Ami, With Cardiac Catheterization With Mcc	2	2	—	—	$17,073.80	$17,415.28	$17,244.54	2026-05-06
429	OTHER	Combined Anterior And Posterior Cervical Spinal Fusion With Mcc	2	2	—	—	$59,361.99	$60,549.23	$59,955.61	2026-05-06
209	OTHER	Complex Aortic Arch Procedures	2	2	—	—	$73,729.33	$75,203.92	$74,466.62	2026-05-06
212	OTHER	Concomitant Aortic And Mitral Valve Procedures	2	2	—	—	$70,962.49	$72,381.74	$71,672.12	2026-05-06
545	OTHER	Connective Tissue Disorders With Mcc	2	2	—	—	$18,746.82	$19,121.76	$18,934.29	2026-05-06
233	OTHER	Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc	2	2	—	—	$50,872.99	$51,890.45	$51,381.72	2026-05-06
234	OTHER	Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc	2	2	—	—	$37,293.96	$38,039.84	$37,666.90	2026-05-06
231	OTHER	Coronary Bypass With Ptca With Mcc	2	2	—	—	$55,755.22	$56,870.32	$56,312.77	2026-05-06
232	OTHER	Coronary Bypass With Ptca Without Mcc	2	2	—	—	$41,026.40	$41,846.93	$41,436.67	2026-05-06
235	OTHER	Coronary Bypass Without Cardiac Catheterization With Mcc	2	2	—	—	$39,819.38	$40,615.77	$40,217.57	2026-05-06
236	OTHER	Coronary Bypass Without Cardiac Catheterization Without Mcc	2	2	—	—	$29,368.03	$29,955.39	$29,661.71	2026-05-06
4428299	OTHER	Correction Hallux Vlgus	10	10	$26,500.00	$15,900.00 40% off	$8,519.75	$26,500.00	$21,866.47	2026-05-06
4428297	OTHER	Correction Hallux Vlgus	10	10	$26,500.00	$15,900.00 40% off	$8,519.75	$26,500.00	$21,866.47	2026-05-06
26	OTHER	Craniotomy And Endovascular Intracranial Procedures With Cc	2	2	—	—	$22,650.99	$23,104.01	$22,877.50	2026-05-06
25	OTHER	Craniotomy And Endovascular Intracranial Procedures With Mcc	2	2	—	—	$31,594.81	$32,226.71	$31,910.76	2026-05-06
27	OTHER	Craniotomy And Endovascular Intracranial Procedures Without Cc/mcc	2	2	—	—	$19,003.17	$19,383.23	$19,193.20	2026-05-06
955	OTHER	Craniotomy For Multiple Significant Trauma	2	2	—	—	$45,185.66	$46,089.37	$45,637.51	2026-05-06
23	OTHER	Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…	2	2	—	—	$38,958.90	$39,738.08	$39,348.49	2026-05-06
24	OTHER	Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…	2	2	—	—	$27,645.22	$28,198.12	$27,921.67	2026-05-06
56	OTHER	Degenerative Nervous System Disorders With Mcc	2	2	—	—	$17,760.06	$18,115.26	$17,937.66	2026-05-06
4449320	OTHER	Diag Laparo Separate Proc	10	10	$22,000.00	$13,200.00 40% off	$7,073.00	$22,000.00	$18,153.30	2026-05-06
146	OTHER	Ear, Nose, Mouth And Throat Malignancy With Mcc	2	2	—	—	$16,480.22	$16,809.82	$16,645.02	2026-05-06
3	OTHER	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…	2	2	—	—	$135,364.78	$138,072.08	$136,718.43	2026-05-06
213	OTHER	Endovascular Abdominal Aorta With Iliac Branch Procedures	2	2	—	—	$38,813.32	$39,589.59	$39,201.46	2026-05-06
266	OTHER	Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc	2	2	—	—	$41,435.80	$42,264.52	$41,850.16	2026-05-06
267	OTHER	Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc	2	2	—	—	$32,926.89	$33,585.43	$33,256.16	2026-05-06
927	OTHER	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	2	2	—	—	$136,144.36	$138,867.25	$137,505.80	2026-05-06
933	OTHER	Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft	2	2	—	—	$27,535.09	$28,085.79	$27,810.44	2026-05-06
982	OTHER	Extensive O.r. Procedures Unrelated To Principal Diagnosis With Cc	2	2	—	—	$18,602.48	$18,974.53	$18,788.50	2026-05-06
981	OTHER	Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc	2	2	—	—	$32,497.58	$33,147.53	$32,822.56	2026-05-06
37	OTHER	Extracranial Procedures With Mcc	2	2	—	—	$23,788.96	$24,264.74	$24,026.85	2026-05-06
790	OTHER	Extreme Immaturity Or Respiratory Distress Syndrome, Neonate	2	2	—	—	$40,285.38	$41,091.09	$40,688.24	2026-05-06
503	OTHER	Foot Procedures With Mcc	2	2	—	—	$20,671.83	$21,085.27	$20,878.55	2026-05-06
793	OTHER	Full Term Neonate With Major Problems	2	2	—	—	$29,248.57	$29,833.54	$29,541.06	2026-05-06
928	OTHER	Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc	2	2	—	—	$47,933.20	$48,891.86	$48,412.53	2026-05-06
929	OTHER	Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/mcc	2	2	—	—	$23,345.34	$23,812.25	$23,578.79	2026-05-06
934	OTHER	Full Thickness Burn Without Skin Graft Or Inhalation Injury	2	2	—	—	$17,060.10	$17,401.30	$17,230.70	2026-05-06
4425825	OTHER	Fuse Hand Bones With Graft	10	10	$26,500.00	$15,900.00 40% off	$8,519.75	$26,500.00	$21,866.47	2026-05-06
4428750	OTHER	Fusion Of Big Toe Joint	10	10	$26,500.00	$15,900.00 40% off	$8,519.75	$26,500.00	$21,866.47	2026-05-06
1	OTHER	Heart Transplant Or Implant Of Heart Assist System With Mcc	2	2	—	—	$177,664.80	$181,218.10	$179,441.45	2026-05-06
2	OTHER	Heart Transplant Or Implant Of Heart Assist System Without Mcc	2	2	—	—	$73,810.21	$75,286.41	$74,548.31	2026-05-06
481	OTHER	Hip And Femur Procedures Except Major Joint With Cc	2	2	—	—	$16,337.75	$16,664.51	$16,501.13	2026-05-06
480	OTHER	Hip And Femur Procedures Except Major Joint With Mcc	2	2	—	—	$21,425.93	$21,854.45	$21,640.19	2026-05-06
521	OTHER	Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc	2	2	—	—	$21,163.98	$21,587.26	$21,375.62	2026-05-06
522	OTHER	Hip Replacement With Principal Diagnosis Of Hip Fracture Without Mcc	2	2	—	—	$16,482.09	$16,811.73	$16,646.91	2026-05-06
969	OTHER	HIV With Extensive O.r. Procedures With Mcc	2	2	—	—	$41,391.62	$42,219.45	$41,805.54	2026-05-06
970	OTHER	HIV With Extensive O.r. Procedures Without Mcc	2	2	—	—	$19,715.55	$20,109.86	$19,912.71	2026-05-06
974	OTHER	HIV With Major Related Condition With Mcc	2	2	—	—	$21,262.30	$21,687.55	$21,474.92	2026-05-06
4423405	OTHER	Incision Of Tendon & Muscle	10	10	$27,250.00	$16,350.00 40% off	$8,760.88	$27,250.00	$22,485.34	2026-05-06
853	OTHER	Infectious And Parasitic Diseases With O.r. Procedures With Mcc	2	2	—	—	$34,033.13	$34,713.79	$34,373.46	2026-05-06
4406170	OTHER	Insj Iris Prosth W/rmvl&insj	10	10	$66,125.00	$39,675.00 40% off	$21,259.19	$66,125.00	$54,563.04	2026-05-06
21	OTHER	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc	2	2	—	—	$36,243.10	$36,967.96	$36,605.53	2026-05-06
20	OTHER	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc	2	2	—	—	$52,264.18	$53,309.46	$52,786.82	2026-05-06
22	OTHER	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/…	2	2	—	—	$23,075.31	$23,536.82	$23,306.07	2026-05-06
61	OTHER	Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A…	2	2	—	—	$20,460.31	$20,869.52	$20,664.92	2026-05-06
656	OTHER	Kidney And Ureter Procedures For Neoplasm With Mcc	2	2	—	—	$23,115.14	$23,577.44	$23,346.29	2026-05-06
659	OTHER	Kidney And Ureter Procedures For Non-neoplasm With Mcc	2	2	—	—	$19,115.15	$19,497.45	$19,306.30	2026-05-06
652	OTHER	Kidney Transplant	2	2	—	—	$23,399.48	$23,867.47	$23,633.47	2026-05-06
650	OTHER	Kidney Transplant With Hemodialysis With Mcc	2	2	—	—	$32,557.31	$33,208.46	$32,882.89	2026-05-06
651	OTHER	Kidney Transplant With Hemodialysis Without Mcc	2	2	—	—	$26,362.91	$26,890.17	$26,626.54	2026-05-06
4429888	OTHER	Knee Arthroscopy/surgery	10	10	$26,500.00	$15,900.00 40% off	$8,519.75	$26,500.00	$21,866.47	2026-05-06
486	OTHER	Knee Procedures With Principal Diagnosis Of Infection With Cc	2	2	—	—	$16,316.60	$16,642.93	$16,479.76	2026-05-06
485	OTHER	Knee Procedures With Principal Diagnosis Of Infection With Mcc	2	2	—	—	$23,384.54	$23,852.23	$23,618.39	2026-05-06
4444180	OTHER	Lap Enterolysis	10	10	$20,850.00	$12,510.00 40% off	$6,703.28	$20,850.00	$17,204.38	2026-05-06
4444213	OTHER	Lap Mobil Splenic Fl Add-on	10	10	$20,850.00	$12,510.00 40% off	$6,703.28	$20,850.00	$17,204.38	2026-05-06
4447563	OTHER	Laparo Cholecystectomy/graph	10	10	$22,000.00	$13,200.00 40% off	$7,073.00	$22,000.00	$18,153.30	2026-05-06
4447562	OTHER	Laparoscopic Cholecystectomy	10	10	$20,850.00	$12,510.00 40% off	$6,703.28	$20,850.00	$17,204.38	2026-05-06
4444970	OTHER	Laparoscopy Appendectomy	10	10	$23,500.00	$14,100.00 40% off	$7,555.25	$23,500.00	$19,391.03	2026-05-06
4458660	OTHER	Laparoscopy Lysis	10	10	$23,350.00	$14,010.00 40% off	$7,507.03	$23,350.00	$19,267.25	2026-05-06
9390	OTHER	Level 3 Neurostimulator & Related Proced	10	10	$23,546.25	$14,127.75 40% off	$7,570.12	$23,546.25	$19,429.19	2026-05-06
9370	OTHER	Level 3 Pacemaker And Similar Procedures	10	10	$25,223.00	$15,133.80 40% off	$8,109.19	$25,223.00	$20,812.76	2026-05-06
9550	OTHER	Level 5 Musculoskelatal Procedures	10	10	$26,191.75	$15,715.05 40% off	$8,420.65	$26,191.75	$21,612.12	2026-05-06
956	OTHER	Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma	2	2	—	—	$26,718.80	$27,253.18	$26,985.99	2026-05-06
6	OTHER	Liver Transplant Without Mcc	2	2	—	—	$32,156.63	$32,799.76	$32,478.19	2026-05-06
495	OTHER	Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit…	2	2	—	—	$25,864.54	$26,381.83	$26,123.19	2026-05-06
498	OTHER	Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur With Cc…	2	2	—	—	$22,076.10	$22,517.62	$22,296.86	2026-05-06
493	OTHER	Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Cc	2	2	—	—	$19,085.29	$19,467.00	$19,276.15	2026-05-06
492	OTHER	Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc	2	2	—	—	$26,150.13	$26,673.13	$26,411.63	2026-05-06
7	OTHER	Lung Transplant	2	2	—	—	$83,879.54	$85,557.13	$84,718.33	2026-05-06
821	OTHER	Lymphoma And Leukemia With Major O.r. Procedures With Cc	2	2	—	—	$17,234.31	$17,579.00	$17,406.65	2026-05-06
820	OTHER	Lymphoma And Leukemia With Major O.r. Procedures With Mcc	2	2	—	—	$39,795.73	$40,591.64	$40,193.68	2026-05-06
840	OTHER	Lymphoma And Non-acute Leukemia With Mcc	2	2	—	—	$23,433.07	$23,901.73	$23,667.40	2026-05-06
824	OTHER	Lymphoma And Non-acute Leukemia With Other Procedures With Cc	2	2	—	—	$17,402.31	$17,750.36	$17,576.33	2026-05-06
823	OTHER	Lymphoma And Non-acute Leukemia With Other Procedures With Mcc	2	2	—	—	$31,831.86	$32,468.50	$32,150.18	2026-05-06
654	OTHER	Major Bladder Procedures With Cc	2	2	—	—	$20,722.87	$21,137.33	$20,930.10	2026-05-06
653	OTHER	Major Bladder Procedures With Mcc	2	2	—	—	$35,637.10	$36,349.84	$35,993.47	2026-05-06
655	OTHER	Major Bladder Procedures Without Cc/mcc	2	2	—	—	$16,475.26	$16,804.77	$16,640.01	2026-05-06
164	OTHER	Major Chest Procedures With Cc	2	2	—	—	$19,010.01	$19,390.21	$19,200.11	2026-05-06
163	OTHER	Major Chest Procedures With Mcc	2	2	—	—	$31,191.02	$31,814.84	$31,502.93	2026-05-06
141	OTHER	Major Head And Neck Procedures With Cc	2	2	—	—	$16,876.55	$17,214.08	$17,045.32	2026-05-06
140	OTHER	Major Head And Neck Procedures With Mcc	2	2	—	—	$29,844.00	$30,440.88	$30,142.44	2026-05-06
808	OTHER	Major Hematological And Immunological Diagnoses Except Sickle Cell Crisis And Co…	2	2	—	—	$17,043.30	$17,384.17	$17,213.74	2026-05-06
469	OTHER	Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc…	2	2	—	—	$22,178.14	$22,621.70	$22,399.92	2026-05-06
483	OTHER	Major Joint Or Limb Reattachment Procedures Of Upper Extremities	2	2	—	—	$20,552.38	$20,963.43	$20,757.90	2026-05-06
595	OTHER	Major Skin Disorders With Mcc	2	2	—	—	$16,500.76	$16,830.78	$16,665.77	2026-05-06
662	OTHER	Minor Bladder Procedures With Mcc	2	2	—	—	$22,354.20	$22,801.28	$22,577.74	2026-05-06
826	OTHER	Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. …	2	2	—	—	$32,410.48	$33,058.69	$32,734.58	2026-05-06
827	OTHER	Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. …	2	2	—	—	$17,686.02	$18,039.74	$17,862.88	2026-05-06
829	OTHER	Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce…	2	2	—	—	$22,967.07	$23,426.41	$23,196.74	2026-05-06
98	OTHER	Non-bacterial Infection Of Nervous System Except Viral Meningitis With Cc	2	2	—	—	$17,584.61	$17,936.30	$17,760.46	2026-05-06
97	OTHER	Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc	2	2	—	—	$25,778.07	$26,293.63	$26,035.85	2026-05-06
987	OTHER	Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc	2	2	—	—	$24,636.98	$25,129.72	$24,883.35	2026-05-06
619	OTHER	O.r. Procedures For Obesity With Mcc	2	2	—	—	$21,271.00	$21,696.42	$21,483.71	2026-05-06
940	OTHER	O.r. Procedures With Diagnoses Of Other Contact With Health Services With Cc	2	2	—	—	$17,845.92	$18,202.84	$18,024.38	2026-05-06
939	OTHER	O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc	2	2	—	—	$25,881.97	$26,399.61	$26,140.79	2026-05-06
876	OTHER	O.r. Procedures With Principal Diagnosis Of Mental Illness	2	2	—	—	$27,352.79	$27,899.85	$27,626.32	2026-05-06
4423515	OTHER	Optx Clavicular Fx W/int Fix	10	10	$26,500.00	$15,900.00 40% off	$8,519.75	$26,500.00	$21,866.47	2026-05-06
4427766	OTHER	Optx Medial Ankle Fx	10	10	$26,500.00	$15,900.00 40% off	$8,519.75	$26,500.00	$21,866.47	2026-05-06
4423615	OTHER	Optx Prox Humrl Fx W/int Fix	10	10	$52,200.00	$31,320.00 40% off	$16,782.30	$52,200.00	$43,072.83	2026-05-06
113	OTHER	Orbital Procedures With Cc/mcc	2	2	—	—	$17,934.26	$18,292.95	$18,113.60	2026-05-06
817	OTHER	Other Antepartum Diagnoses With O.r. Procedures With Mcc	2	2	—	—	$17,501.85	$17,851.89	$17,676.87	2026-05-06
228	OTHER	Other Cardiothoracic Procedures With Mcc	2	2	—	—	$34,087.87	$34,769.63	$34,428.75	2026-05-06
229	OTHER	Other Cardiothoracic Procedures Without Mcc	2	2	—	—	$22,901.73	$23,359.76	$23,130.74	2026-05-06
264	OTHER	Other Circulatory System O.r. Procedures	2	2	—	—	$24,090.72	$24,572.53	$24,331.62	2026-05-06
143	OTHER	Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc	2	2	—	—	$26,616.77	$27,149.11	$26,882.94	2026-05-06
629	OTHER	Other Endocrine, Nutritional And Metabolic O.r. Procedures With Cc	2	2	—	—	$16,862.24	$17,199.48	$17,030.86	2026-05-06
628	OTHER	Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc	2	2	—	—	$26,493.56	$27,023.43	$26,758.50	2026-05-06
749	OTHER	Other Female Reproductive System O.r. Procedures With Cc/mcc	2	2	—	—	$19,281.28	$19,666.91	$19,474.10	2026-05-06
215	OTHER	Other Heart Assist System Implant	2	2	—	—	$65,256.50	$66,561.63	$65,909.07	2026-05-06
867	OTHER	Other Infectious And Parasitic Diseases Diagnoses With Mcc	2	2	—	—	$16,329.67	$16,656.26	$16,492.97	2026-05-06
674	OTHER	Other Kidney And Urinary Tract Procedures With Cc	2	2	—	—	$17,856.49	$18,213.62	$18,035.06	2026-05-06
673	OTHER	Other Kidney And Urinary Tract Procedures With Mcc	2	2	—	—	$29,447.67	$30,036.62	$29,742.14	2026-05-06
271	OTHER	Other Major Cardiovascular Procedures With Cc	2	2	—	—	$25,432.75	$25,941.41	$25,687.08	2026-05-06
270	OTHER	Other Major Cardiovascular Procedures With Mcc	2	2	—	—	$36,134.21	$36,856.89	$36,495.55	2026-05-06
272	OTHER	Other Major Cardiovascular Procedures Without Cc/mcc	2	2	—	—	$19,190.44	$19,574.25	$19,382.35	2026-05-06
715	OTHER	Other Male Reproductive System O.r. Procedures For Malignancy With Cc/mcc	2	2	—	—	$17,226.23	$17,570.75	$17,398.49	2026-05-06
963	OTHER	Other Multiple Significant Trauma With Mcc	2	2	—	—	$20,315.34	$20,721.65	$20,518.50	2026-05-06
516	OTHER	Other Musculoskeletal System And Connective Tissue O.r. Procedures With Cc	2	2	—	—	$16,235.71	$16,560.42	$16,398.06	2026-05-06
515	OTHER	Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc	2	2	—	—	$23,134.42	$23,597.11	$23,365.76	2026-05-06
907	OTHER	Other O.r. Procedures For Injuries With Mcc	2	2	—	—	$27,193.52	$27,737.39	$27,465.46	2026-05-06
958	OTHER	Other O.r. Procedures For Multiple Significant Trauma With Cc	2	2	—	—	$29,524.20	$30,114.68	$29,819.44	2026-05-06
957	OTHER	Other O.r. Procedures For Multiple Significant Trauma With Mcc	2	2	—	—	$50,715.58	$51,729.89	$51,222.74	2026-05-06
959	OTHER	Other O.r. Procedures For Multiple Significant Trauma Without Cc/mcc	2	2	—	—	$21,623.78	$22,056.26	$21,840.02	2026-05-06
802	OTHER	Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc	2	2	—	—	$28,094.43	$28,656.32	$28,375.38	2026-05-06
166	OTHER	Other Respiratory System O.r. Procedures With Mcc	2	2	—	—	$26,561.39	$27,092.62	$26,827.00	2026-05-06
579	OTHER	Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc	2	2	—	—	$23,455.48	$23,924.59	$23,690.03	2026-05-06
253	OTHER	Other Vascular Procedures With Cc	2	2	—	—	$19,455.49	$19,844.60	$19,650.04	2026-05-06
252	OTHER	Other Vascular Procedures With Mcc	2	2	—	—	$25,009.67	$25,509.86	$25,259.76	2026-05-06
344	OTHER	P/t Neuromusculare Re-ed Iii	3	2	$100.00	$60.00 40% off	$100.00	$19,763.37	$19,375.85	2026-05-06
10	OTHER	Pancreas Transplant	2	2	—	—	$47,951.86	$48,910.90	$48,431.38	2026-05-06
734	OTHER	Pelvic Evisceration, Radical Hysterectomy And Radical Vulvectomy With Cc/mcc	2	2	—	—	$16,558.63	$16,889.80	$16,724.22	2026-05-06
709	OTHER	Penis Procedures With Cc/mcc	2	2	—	—	$17,784.94	$18,140.64	$17,962.79	2026-05-06
273	OTHER	Percutaneous And Other Intracardiac Procedures With Mcc	2	2	—	—	$28,974.18	$29,553.66	$29,263.92	2026-05-06
274	OTHER	Percutaneous And Other Intracardiac Procedures Without Mcc	2	2	—	—	$23,786.48	$24,262.21	$24,024.35	2026-05-06
250	OTHER	Percutaneous Cardiovascular Procedures Without Intraluminal Device With Mcc	2	2	—	—	$16,885.27	$17,222.98	$17,054.12	2026-05-06
41	OTHER	Peripheral, Cranial Nerve And Other Nervous System Procedures With Cc Or Periphe…	2	2	—	—	$16,986.07	$17,325.79	$17,155.93	2026-05-06
40	OTHER	Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc	2	2	—	—	$27,329.77	$27,876.37	$27,603.07	2026-05-06
243	OTHER	Permanent Cardiac Pacemaker Implant With Cc	2	2	—	—	$16,564.22	$16,895.50	$16,729.86	2026-05-06
242	OTHER	Permanent Cardiac Pacemaker Implant With Mcc	2	2	—	—	$23,171.14	$23,634.56	$23,402.85	2026-05-06
857	OTHER	Postoperative Or Post-traumatic Infections With O.r. Procedures With Cc	2	2	—	—	$16,630.18	$16,962.78	$16,796.48	2026-05-06
856	OTHER	Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc	2	2	—	—	$31,607.25	$32,239.40	$31,923.33	2026-05-06
791	OTHER	Prematurity With Major Problems	2	2	—	—	$28,560.44	$29,131.65	$28,846.04	2026-05-06
792	OTHER	Prematurity Without Major Problems	2	2	—	—	$18,544.62	$18,915.51	$18,730.06	2026-05-06
665	OTHER	Prostatectomy With Mcc	2	2	—	—	$22,725.66	$23,180.17	$22,952.92	2026-05-06
849	OTHER	Radiotherapy	2	2	—	—	$20,164.15	$20,567.43	$20,365.79	2026-05-06
4427702	OTHER	Reconstruct Ankle Joint	10	10	$67,000.00	$40,200.00 40% off	$21,540.50	$67,000.00	$55,285.05	2026-05-06
4423472	OTHER	Reconstruct Shoulder Joint	10	10	$52,175.00	$31,305.00 40% off	$16,774.26	$52,175.00	$43,052.20	2026-05-06
4427427	OTHER	Reconstruction Knee	10	10	$28,500.00	$17,100.00 40% off	$9,162.75	$28,500.00	$23,516.78	2026-05-06
4420900	OTHER	Removal Of Bone For Graft	10	10	$26,500.00	$15,900.00 40% off	$8,519.75	$26,500.00	$21,866.47	2026-05-06
4420924	OTHER	Removal Of Tendon For Graft	10	10	$28,000.00	$16,800.00 40% off	$9,002.00	$28,000.00	$23,104.20	2026-05-06
4427650	OTHER	Repair Achilles Tendon	10	10	$28,500.00	$17,100.00 40% off	$9,162.75	$28,500.00	$23,516.78	2026-05-06
4427654	OTHER	Repair Of Achilles Tendon	10	10	$27,250.00	$16,350.00 40% off	$8,760.88	$27,250.00	$22,485.34	2026-05-06
4424430	OTHER	Repair Of Humerus	10	10	$52,000.00	$31,200.00 40% off	$16,718.00	$52,000.00	$42,907.80	2026-05-06
4427659	OTHER	Repair Of Leg Tendon Each	10	10	$28,500.00	$17,100.00 40% off	$9,162.75	$28,500.00	$23,516.78	2026-05-06
4428322	OTHER	Repair Of Metatarsals	10	10	$27,275.00	$16,365.00 40% off	$8,768.91	$27,275.00	$22,505.97	2026-05-06
4424342	OTHER	Repair Of Ruptured Tendon	10	10	$28,500.00	$17,100.00 40% off	$9,162.75	$28,500.00	$23,516.78	2026-05-06
4443840	OTHER	Repair Of Stomach Lesion	10	10	$20,850.00	$12,510.00 40% off	$6,703.28	$20,850.00	$17,204.38	2026-05-06
4427385	OTHER	Repair Of Thigh Muscle	10	10	$26,500.00	$15,900.00 40% off	$8,519.75	$26,500.00	$21,866.47	2026-05-06
4427722	OTHER	Repair/graft Of Tibia	10	10	$26,500.00	$15,900.00 40% off	$8,519.75	$26,500.00	$21,866.47	2026-05-06
4425405	OTHER	Repair/graft Radius Or Ulna	10	10	$27,300.00	$16,380.00 40% off	$8,776.95	$27,300.00	$22,526.60	2026-05-06
208	OTHER	Respiratory System Diagnosis With Ventilator Support <=96 Hours	2	2	—	—	$20,408.04	$20,816.20	$20,612.12	2026-05-06
207	OTHER	Respiratory System Diagnosis With Ventilator Support >96 Hours	2	2	—	—	$43,341.53	$44,208.36	$43,774.94	2026-05-06
814	OTHER	Reticuloendothelial And Immunity Disorders With Mcc	2	2	—	—	$16,538.10	$16,868.86	$16,703.48	2026-05-06
4423474	OTHER	Revis Reconst Shoulder Joint	10	10	$52,500.00	$31,500.00 40% off	$16,878.75	$52,500.00	$43,320.38	2026-05-06
4423473	OTHER	Revis Reconst Shoulder Joint	10	10	$51,000.00	$30,600.00 40% off	$16,396.50	$51,000.00	$42,082.65	2026-05-06
4427134	OTHER	Revise Hip Joint Replacement	10	10	$27,275.00	$16,365.00 40% off	$8,768.91	$27,275.00	$22,505.97	2026-05-06
4427138	OTHER	Revise Hip Joint Replacement	10	10	$20,850.00	$12,510.00 40% off	$6,703.28	$20,850.00	$17,204.38	2026-05-06
467	OTHER	Revision Of Hip Or Knee Replacement With Cc	2	2	—	—	$25,247.96	$25,752.92	$25,500.44	2026-05-06
466	OTHER	Revision Of Hip Or Knee Replacement With Mcc	2	2	—	—	$35,693.09	$36,406.95	$36,050.02	2026-05-06
468	OTHER	Revision Of Hip Or Knee Replacement Without Cc/mcc	2	2	—	—	$20,403.69	$20,811.76	$20,607.72	2026-05-06
4449594	OTHER	Rpr Aa Hrn 1st 3-10 Ncr/strn	10	10	$20,850.00	$12,510.00 40% off	$6,703.28	$20,850.00	$17,204.38	2026-05-06
4449592	OTHER	Rpr Aa Hrn 1st < 3 Ncr/strn	10	10	$20,850.00	$12,510.00 40% off	$6,703.28	$20,850.00	$17,204.38	2026-05-06
4449616	OTHER	Rpr Aa Hrn Rcr 3-10 Ncr/strn	10	10	$24,500.00	$14,700.00 40% off	$7,876.75	$24,500.00	$20,216.17	2026-05-06
4449614	OTHER	Rpr Aa Hrn Rcr < 3 Ncr/strn	10	10	$20,850.00	$12,510.00 40% off	$6,703.28	$20,850.00	$17,204.38	2026-05-06
4449618	OTHER	Rpr Aa Hrn Rcr>10 Ncr/strn	10	10	$27,500.00	$16,500.00 40% off	$8,841.25	$27,500.00	$22,691.62	2026-05-06
4449617	OTHER	Rpr Aa Hrn Rcr>10rdc	10	10	$27,500.00	$16,500.00 40% off	$8,841.25	$27,500.00	$22,691.62	2026-05-06
870	OTHER	Septicemia Or Severe Sepsis With Mv >96 Hours	2	2	—	—	$46,309.95	$47,236.15	$46,773.05	2026-05-06
4429806	OTHER	Sho Arthrs Srg Capsulorraphy	10	10	$26,500.00	$15,900.00 40% off	$8,519.75	$26,500.00	$21,866.47	2026-05-06
4429807	OTHER	Sho Arthrs Srg Rpr Slap Les	10	10	$26,500.00	$15,900.00 40% off	$8,519.75	$26,500.00	$21,866.47	2026-05-06
4429827	OTHER	Sho Arthrs Srg Rt8tr Cuf Rpr	10	10	$28,500.00	$17,100.00 40% off	$9,162.75	$28,500.00	$23,516.78	2026-05-06
511	OTHER	Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Cc	2	2	—	—	$16,243.81	$16,568.69	$16,406.25	2026-05-06
510	OTHER	Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Mcc	2	2	—	—	$22,099.12	$22,541.10	$22,320.11	2026-05-06
8	OTHER	Simultaneous Pancreas And Kidney Transplant	2	2	—	—	$38,176.82	$38,940.36	$38,558.59	2026-05-06
19	OTHER	Simultaneous Pancreas And Kidney Transplant With Hemodialysis	2	2	—	—	$47,696.15	$48,650.07	$48,173.11	2026-05-06
135	OTHER	Sinus And Mastoid Procedures With Cc/mcc	2	2	—	—	$16,807.50	$17,143.65	$16,975.58	2026-05-06
570	OTHER	Skin Debridement With Mcc	2	2	—	—	$21,605.11	$22,037.21	$21,821.16	2026-05-06
577	OTHER	Skin Graft Except For Skin Ulcer Or Cellulitis With Cc	2	2	—	—	$19,798.32	$20,194.29	$19,996.31	2026-05-06
576	OTHER	Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc	2	2	—	—	$33,800.42	$34,476.43	$34,138.43	2026-05-06
574	OTHER	Skin Graft For Skin Ulcer Or Cellulitis With Cc	2	2	—	—	$24,904.52	$25,402.61	$25,153.57	2026-05-06
573	OTHER	Skin Graft For Skin Ulcer Or Cellulitis With Mcc	2	2	—	—	$44,067.61	$44,948.96	$44,508.29	2026-05-06
622	OTHER	Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor…	2	2	—	—	$25,450.80	$25,959.82	$25,705.31	2026-05-06
904	OTHER	Skin Grafts For Injuries With Cc/mcc	2	2	—	—	$26,159.46	$26,682.65	$26,421.06	2026-05-06
500	OTHER	Soft Tissue Procedures With Mcc	2	2	—	—	$22,996.92	$23,456.86	$23,226.89	2026-05-06
29	OTHER	Spinal Procedures With Cc Or Spinal Neurostimulators	2	2	—	—	$24,532.46	$25,023.11	$24,777.78	2026-05-06
28	OTHER	Spinal Procedures With Mcc	2	2	—	—	$40,688.57	$41,502.34	$41,095.46	2026-05-06
30	OTHER	Spinal Procedures Without Cc/mcc	2	2	—	—	$16,964.29	$17,303.58	$17,133.94	2026-05-06
800	OTHER	Splenic Procedures With Cc	2	2	—	—	$20,785.70	$21,201.41	$20,993.56	2026-05-06
799	OTHER	Splenic Procedures With Mcc	2	2	—	—	$31,484.06	$32,113.74	$31,798.90	2026-05-06
711	OTHER	Testes Procedures With Cc/mcc	2	2	—	—	$16,271.18	$16,596.60	$16,433.89	2026-05-06
625	OTHER	Thyroid, Parathyroid And Thyroglossal Procedures With Mcc	2	2	—	—	$22,096.63	$22,538.56	$22,317.60	2026-05-06
4427130	OTHER	Total Hip Arthrosplasty	10	10	$48,000.00	$28,800.00 40% off	$15,432.00	$48,000.00	$39,607.20	2026-05-06
12	OTHER	Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc	2	2	—	—	$29,537.26	$30,128.01	$29,832.63	2026-05-06
11	OTHER	Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc	2	2	—	—	$37,240.45	$37,985.26	$37,612.85	2026-05-06
13	OTHER	Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy Without Cc/mcc	2	2	—	—	$21,236.17	$21,660.89	$21,448.53	2026-05-06
4	OTHER	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…	2	2	—	—	$89,486.61	$91,276.34	$90,381.48	2026-05-06
668	OTHER	Transurethral Procedures With Mcc	2	2	—	—	$21,473.84	$21,903.32	$21,688.58	2026-05-06
85	OTHER	Traumatic Stupor And Coma <1 Hour With Mcc	2	2	—	—	$17,441.49	$17,790.32	$17,615.90	2026-05-06
82	OTHER	Traumatic Stupor And Coma >1 Hour With Mcc	2	2	—	—	$17,526.73	$17,877.26	$17,701.99	2026-05-06
4424635	OTHER	Treat Elbow Fracture	10	10	$28,000.00	$16,800.00 40% off	$9,002.00	$28,000.00	$23,104.20	2026-05-06
4425545	OTHER	Treat Fracture Of Ulna	10	10	$26,500.00	$15,900.00 40% off	$8,519.75	$26,500.00	$21,866.47	2026-05-06
4425575	OTHER	Treat Fracture Radius/ulna	10	10	$27,275.00	$16,365.00 40% off	$8,768.91	$27,275.00	$22,505.97	2026-05-06
4425607	OTHER	Treat Fx Rad Extra-articul	10	10	$26,500.00	$15,900.00 40% off	$8,519.75	$26,500.00	$21,866.47	2026-05-06
4425608	OTHER	Treat Fx Rad Intra-articul	10	10	$26,500.00	$15,900.00 40% off	$8,519.75	$26,500.00	$21,866.47	2026-05-06
4425609	OTHER	Treat Fx Radial 3+ Frag	10	10	$26,500.00	$15,900.00 40% off	$8,519.75	$26,500.00	$21,866.47	2026-05-06
4428415	OTHER	Treat Heel Fracture	10	10	$29,750.00	$17,850.00 40% off	$9,564.63	$29,750.00	$24,548.22	2026-05-06
4424516	OTHER	Treat Humerus Fracture	10	10	$52,000.00	$31,200.00 40% off	$16,718.00	$52,000.00	$42,907.80	2026-05-06
4424515	OTHER	Treat Humerus Fracture	10	10	$45,000.00	$27,000.00 40% off	$14,467.50	$45,000.00	$37,131.75	2026-05-06
4427829	OTHER	Treat Lower Leg Joint	10	10	$26,500.00	$15,900.00 40% off	$8,519.75	$26,500.00	$21,866.47	2026-05-06
4428485	OTHER	Treat Metatarsal Fracture	10	10	$26,500.00	$15,900.00 40% off	$8,519.75	$26,500.00	$21,866.47	2026-05-06
4427235	OTHER	Treat Thigh Fracture	10	10	$26,500.00	$15,900.00 40% off	$8,519.75	$26,500.00	$21,866.47	2026-05-06
4424685	OTHER	Treat Ulnar Fracture	10	10	$28,000.00	$16,800.00 40% off	$9,002.00	$28,000.00	$23,104.20	2026-05-06
4427756	OTHER	Treatment Of Tibia Fracture	10	10	$24,500.00	$14,700.00 40% off	$7,876.75	$24,500.00	$20,216.17	2026-05-06
4427823	OTHER	Treatment Of Ankle Fracture	10	10	$27,500.00	$16,500.00 40% off	$8,841.25	$27,500.00	$22,691.62	2026-05-06
4427792	OTHER	Treatment Of Ankle Fracture	10	10	$26,500.00	$15,900.00 40% off	$8,519.75	$26,500.00	$21,866.47	2026-05-06
4427814	OTHER	Treatment Of Ankle Fracture	10	10	$26,500.00	$15,900.00 40% off	$8,519.75	$26,500.00	$21,866.47	2026-05-06
4427822	OTHER	Treatment Of Ankle Fracture	10	10	$26,500.00	$15,900.00 40% off	$8,519.75	$26,500.00	$21,866.47	2026-05-06
4427759	OTHER	Treatment Of Tibia Fracture	10	10	$52,250.00	$31,350.00 40% off	$16,798.38	$52,250.00	$43,114.09	2026-05-06
278	OTHER	Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures …	2	2	—	—	$37,937.91	$38,696.67	$38,317.29	2026-05-06
279	OTHER	Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures …	2	2	—	—	$25,744.46	$26,259.35	$26,001.90	2026-05-06
173	OTHER	Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary…	2	2	—	—	$21,824.74	$22,261.23	$22,042.99	2026-05-06
255	OTHER	Upper Limb And Toe Amputation For Circulatory System Disorders With Mcc	2	2	—	—	$20,088.87	$20,490.65	$20,289.76	2026-05-06
739	OTHER	Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc…	2	2	—	—	$25,597.63	$26,109.58	$25,853.61	2026-05-06
736	OTHER	Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc	2	2	—	—	$25,545.98	$26,056.90	$25,801.44	2026-05-06
263	OTHER	Vein Ligation And Stripping	2	2	—	—	$22,328.71	$22,775.28	$22,551.99	2026-05-06
32	OTHER	Ventricular Shunt Procedures With Cc	2	2	—	—	$16,564.84	$16,896.14	$16,730.49	2026-05-06
31	OTHER	Ventricular Shunt Procedures With Mcc	2	2	—	—	$31,182.91	$31,806.57	$31,494.74	2026-05-06
464	OTHER	Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …	2	2	—	—	$22,685.21	$23,138.91	$22,912.06	2026-05-06
901	OTHER	Wound Debridements For Injuries With Mcc	2	2	—	—	$29,416.55	$30,004.88	$29,710.72	2026-05-06
4466991	OTHER	Xcapsl Ctrc Rmvl Insj 1+	10	10	$19,925.00	$11,955.00 40% off	$6,405.89	$19,925.00	$16,441.11	2026-05-06

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