Hospital

MC DONOUGH DISTRICT HOSPITAL

Macomb, IL · CCN 140089 · Rates published

26,692 distinct procedures filed

31 distinct payers

1,443,832 rate rows

2026-05-24 last MRF observed

Data quality

1,416,728 of 1,443,832 rate rows are consumer-grade (98.1%)

27,104 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
placeholder amount (≤ $0.02) — excluded from medians	17,016
template filing: same amount across many unrelated codes — excluded	8,080
per-diem day rate — not a per-procedure price	1,556
percent-of-charges filed in the dollar field — excluded from medians	440
no usable negotiated amount (only an out-of-band fallback) — excluded from medians	12

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

Source MRF file	https://www.mdh.org/documents/376016777_mcdonough-county-hospital-district_standardcharges.csv
Found on page	https://www.mdh.org/patients-visitors/financial-services/
Discovered via	CMS hospital list
Last fetch	not_modified · 2026-05-16
Content fingerprint	0d63042ced8bed7d… · 144,999,553 bytes · first seen 2026-05-09

Top 50 most expensive offerings

Outliers are flagged where this hospital's filed rate is ≥2× or ≤0.5× the national median for the same code.

Code	Description	Payers	Min $	Max $	Avg median	vs national
J3391 OTHER	Inj- Atidarsagene Autotemcel	8	$4,505,000.00	$4,505,000.00	$4,505,000.00	nat. median $4,505,000 1.0× median
J3399 OTHER	Inj Onase Abepar-xioi Treat	8	$2,455,110.61	$2,455,110.61	$2,455,110.61	nat. median $2,472,216 1.0× median
Q2057 OTHER	Afamitresgene Autoleucel	20	$56,281.85	$770,620.00	$616,496.00	nat. median $770,620 0.8× median
Q2042 OTHER	Tisagenlecleucel Car-pos T	21	$56,281.85	$591,726.20	$591,726.20	nat. median $591,726 1.0× median
Q2056 OTHER	Ciltacabtagene Car-pos T	21	$56,281.85	$565,868.95	$565,868.95	nat. median $583,076 1.0× median
Q2054 OTHER	Lisocabtagene Mara Car Pos T	21	$56,281.85	$562,538.19	$562,538.19	nat. median $562,538 1.0× median
Q2055 OTHER	Idecabtagene Vicleucel Car	21	$56,281.85	$557,317.93	$557,317.93	nat. median $558,082 1.0× median
Q2041 OTHER	Axicabtagene Ciloleucel Car+	21	$56,281.85	$533,230.17	$533,230.17	nat. median $533,230 1.0× median
Q2053 OTHER	Brexucabtagene Car Pos T	21	$56,281.85	$489,304.61	$489,304.61	nat. median $489,720 1.0× median
MS-633 OTHER	Neonate- Birth Weight 1000-1499 Grams- With Significant O.r. Procedures- Dischar…	1	$325,996.97	$325,996.97	$325,996.97	nat. median $297,836 1.1× median
MS-018 OTHER	Chimeric Antigen Receptor (car) T-cell Immunotherapy	9	$307,281.58	$431,828.00	$307,281.58	nat. median $309,559 1.0× median
MS-612 OTHER	Neonate- Birth Weight <750 Grams- Discharged Alive	1	$298,731.17	$298,731.17	$298,731.17	nat. median $272,926 1.1× median
Q2058 OTHER	Obecbtge Autol Up To 400 Mil	8	$278,250.00	$278,250.00	$278,250.00	nat. median $281,111 1.0× median
J3403 OTHER	Revakinagene- Per Implant	8	$257,500.00	$257,500.00	$257,500.00	nat. median $265,000 1.0× median
MS-631 OTHER	Neonate- Birth Weight 750-999 Grams- Discharged Alive	1	$216,612.84	$216,612.84	$216,612.84	nat. median $197,901 1.1× median
J3402 OTHER	Inj. Remestemcel-l-rknd/ Td	11	$123,384.00	$205,640.00	$205,640.00	nat. median $205,640 1.0× median
MS-001 OTHER	Heart Transplant Or Implant Of Heart Assist System With Mcc	9	$199,413.38	$368,197.56	$199,413.38	nat. median $224,278 0.9× median
MS-636 OTHER	Neonate- Birth Weight 1500-1999 Grams- With Significant O.r. Procedures- With Mu…	1	$191,550.37	$191,550.37	$191,550.37	nat. median $183,596 1.0× median
MS-927 OTHER	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	9	$151,926.59	$252,256.11	$151,926.59	nat. median $175,322 0.9× median
MS-003 OTHER	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face- Mouth…	9	$151,034.97	$247,677.96	$151,034.97	nat. median $169,886 0.9× median
0024 OTHER	Heart And/or Lung Transplant	4	$132,985.16	$132,985.16	$132,985.16	nat. median $235,636 0.6× median
MS-681 OTHER	Neonate- Birth Weight >2499 Grams- With Significant O.r. Procedures- With Multip…	1	$130,470.06	$130,470.06	$130,470.06	nat. median $119,200 1.1× median
5834 OTHER	Neonate With Ecmo	14	$117,715.01	$175,708.64	$117,715.01	nat. median $372,748 outlier · 0.3×
MS-634 OTHER	Neonate- Birth Weight 1000-1499 Grams- Without Significant O.r. Procedures- Disc…	1	$116,847.70	$116,847.70	$116,847.70	nat. median $106,754 1.1× median
Q0480 OTHER	Driver Pneumatic Vad- Rep	8	$108,727.20	$108,727.22	$108,727.22	nat. median $109,316 1.0× median
MS-632 OTHER	Neonate- Birth Weight 750-999 Grams- Died	1	$106,309.05	$106,309.05	$106,309.05	nat. median $97,126 1.1× median
MS-004 OTHER	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face- Mouth And Nec…	9	$98,564.24	$158,919.92	$98,564.24	nat. median $107,587 0.9× median
5884 OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	14	$96,558.28	$144,128.74	$96,558.28	nat. median $243,175 outlier · 0.4×
5833 OTHER	Neonate With Ecmo	14	$93,232.53	$139,164.60	$93,232.53	nat. median $252,069 outlier · 0.4×
MS-365 OTHER	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	1	$92,612.92	$92,612.92	$92,612.92	nat. median $84,613 1.1× median
1614 OTHER	Implantable Heart Assist Systems	14	$92,321.14	$137,804.19	$92,321.14	nat. median $194,298 outlier · 0.5×
MS-007 OTHER	Lung Transplant	9	$92,151.46	$129,502.00	$92,151.46	nat. median $95,292 1.0× median
0114 OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	4	$90,655.25	$90,655.25	$90,655.25	nat. median $125,206 0.7× median
24 OTHER	Heart And/or Lung Transplant	10	$89,092.60	$89,092.60	$89,092.60	nat. median $27,988 outlier · 3.2×
0074 OTHER	Allogeneic Bone Marrow Transplant	4	$87,182.94	$87,182.94	$87,182.94	nat. median $147,645 0.6× median
0044 OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	4	$86,355.10	$86,355.10	$86,355.10	nat. median $138,863 0.6× median
MS-014 OTHER	Allogeneic Bone Marrow Transplant	9	$85,517.37	$120,179.00	$85,517.37	nat. median $91,600 0.9× median
0014 OTHER	Liver Transplant And/or Intestinal Transplant	4	$85,012.34	$85,012.34	$85,012.34	nat. median $147,828 0.6× median
0094 OTHER	Extracorporeal Membrane Oxygenation (ecmo)	4	$84,543.87	$84,543.87	$84,543.87	nat. median $165,362 0.5× median
0023 OTHER	Heart And/or Lung Transplant	4	$82,236.08	$82,236.08	$82,236.08	nat. median $133,752 0.6× median
MS-002 OTHER	Heart Transplant Or Implant Of Heart Assist System Without Mcc	9	$80,635.19	$117,178.20	$80,635.19	nat. median $91,287 0.9× median
MS-209 OTHER	Kidney And Urinary Tract Signs And Symptoms Age 0-17	9	$5,096.41	$113,188.00	$80,542.69	nat. median $81,783 1.0× median
MS-426 OTHER	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	9	$19,453.54	$110,212.00	$78,425.02	nat. median $84,247 0.9× median
MS-212 OTHER	Testes Procedures Age 0-17	9	$77,378.28	$115,839.91	$77,378.28	nat. median $87,208 0.9× median
0064 OTHER	Pancreas Transplant	4	$75,075.77	$75,075.77	$75,075.77	nat. median $102,085 0.7× median
MS-005 OTHER	Liver Transplant With Mcc Or Intestinal Transplant	9	$73,367.79	$130,567.78	$73,367.79	nat. median $85,046 0.9× median
MS-215 OTHER	Other Heart Assist System Implant	9	$70,852.35	$101,608.28	$70,852.35	nat. median $80,736 0.9× median
1613 OTHER	Implantable Heart Assist Systems	14	$70,727.56	$105,572.17	$70,727.56	nat. median $79 outlier · 898.5×
MS-366 OTHER	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	1	$70,485.68	$70,485.68	$70,485.68	nat. median $64,397 1.1× median
6304 OTHER	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure	14	$70,085.59	$104,613.99	$70,085.59	nat. median $164,743 outlier · 0.4×

Other procedures at this hospital

Browse this hospital's 26,692 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

J3391	OTHER	Inj- Atidarsagene Autotemcel	16	8	—	—	$4,505,000.00	$4,505,000.00	$4,505,000.00	2026-05-24
J3399	OTHER	Inj Onase Abepar-xioi Treat	16	8	—	—	$2,455,110.61	$2,455,110.61	$2,455,110.61	2026-05-24
Q2057	OTHER	Afamitresgene Autoleucel	44	20	—	—	$56,281.85	$770,620.00	$616,496.00	2026-05-24
Q2042	OTHER	Tisagenlecleucel Car-pos T	46	21	—	—	$56,281.85	$591,726.20	$591,726.20	2026-05-24
Q2056	OTHER	Ciltacabtagene Car-pos T	46	21	—	—	$56,281.85	$565,868.95	$565,868.95	2026-05-24
Q2054	OTHER	Lisocabtagene Mara Car Pos T	46	21	—	—	$56,281.85	$562,538.19	$562,538.19	2026-05-24
Q2055	OTHER	Idecabtagene Vicleucel Car	46	21	—	—	$56,281.85	$557,317.93	$557,317.93	2026-05-24
Q2041	OTHER	Axicabtagene Ciloleucel Car+	46	21	—	—	$56,281.85	$533,230.17	$533,230.17	2026-05-24
Q2053	OTHER	Brexucabtagene Car Pos T	46	21	—	—	$56,281.85	$489,304.61	$489,304.61	2026-05-24
MS-633	OTHER	Neonate- Birth Weight 1000-1499 Grams- With Significant O.r. Procedures- Dischar…	2	1	—	—	$325,996.97	$325,996.97	$325,996.97	2026-05-24
MS-018	OTHER	Chimeric Antigen Receptor (car) T-cell Immunotherapy	22	9	—	—	$307,281.58	$431,828.00	$307,281.58	2026-05-24
MS-612	OTHER	Neonate- Birth Weight <750 Grams- Discharged Alive	2	1	—	—	$298,731.17	$298,731.17	$298,731.17	2026-05-24
Q2058	OTHER	Obecbtge Autol Up To 400 Mil	16	8	—	—	$278,250.00	$278,250.00	$278,250.00	2026-05-24
J3403	OTHER	Revakinagene- Per Implant	16	8	—	—	$257,500.00	$257,500.00	$257,500.00	2026-05-24
MS-631	OTHER	Neonate- Birth Weight 750-999 Grams- Discharged Alive	2	1	—	—	$216,612.84	$216,612.84	$216,612.84	2026-05-24
J3402	OTHER	Inj. Remestemcel-l-rknd/ Td	26	11	—	—	$123,384.00	$205,640.00	$205,640.00	2026-05-24
MS-001	OTHER	Heart Transplant Or Implant Of Heart Assist System With Mcc	22	9	—	—	$199,413.38	$368,197.56	$199,413.38	2026-05-24
MS-636	OTHER	Neonate- Birth Weight 1500-1999 Grams- With Significant O.r. Procedures- With Mu…	2	1	—	—	$191,550.37	$191,550.37	$191,550.37	2026-05-24
MS-927	OTHER	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	22	9	—	—	$151,926.59	$252,256.11	$151,926.59	2026-05-24
MS-003	OTHER	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face- Mouth…	22	9	—	—	$151,034.97	$247,677.96	$151,034.97	2026-05-24
0024	OTHER	Heart And/or Lung Transplant	8	4	—	—	$132,985.16	$132,985.16	$132,985.16	2026-05-24
MS-681	OTHER	Neonate- Birth Weight >2499 Grams- With Significant O.r. Procedures- With Multip…	2	1	—	—	$130,470.06	$130,470.06	$130,470.06	2026-05-24
5834	OTHER	Neonate With Ecmo	28	14	—	—	$117,715.01	$175,708.64	$117,715.01	2026-05-24
MS-634	OTHER	Neonate- Birth Weight 1000-1499 Grams- Without Significant O.r. Procedures- Disc…	2	1	—	—	$116,847.70	$116,847.70	$116,847.70	2026-05-24
Q0480	OTHER	Driver Pneumatic Vad- Rep	16	8	—	—	$108,727.20	$108,727.22	$108,727.22	2026-05-24
MS-632	OTHER	Neonate- Birth Weight 750-999 Grams- Died	2	1	—	—	$106,309.05	$106,309.05	$106,309.05	2026-05-24
MS-004	OTHER	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face- Mouth And Nec…	22	9	—	—	$98,564.24	$158,919.92	$98,564.24	2026-05-24
5884	OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	28	14	—	—	$96,558.28	$144,128.74	$96,558.28	2026-05-24
5833	OTHER	Neonate With Ecmo	28	14	—	—	$93,232.53	$139,164.60	$93,232.53	2026-05-24
MS-365	OTHER	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	2	1	—	—	$92,612.92	$92,612.92	$92,612.92	2026-05-24
1614	OTHER	Implantable Heart Assist Systems	28	14	—	—	$92,321.14	$137,804.19	$92,321.14	2026-05-24
MS-007	OTHER	Lung Transplant	22	9	—	—	$92,151.46	$129,502.00	$92,151.46	2026-05-24
0114	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	8	4	—	—	$90,655.25	$90,655.25	$90,655.25	2026-05-24
24	OTHER	Heart And/or Lung Transplant	20	10	—	—	$89,092.60	$89,092.60	$89,092.60	2026-05-24
0074	OTHER	Allogeneic Bone Marrow Transplant	8	4	—	—	$87,182.94	$87,182.94	$87,182.94	2026-05-24
0044	OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	8	4	—	—	$86,355.10	$86,355.10	$86,355.10	2026-05-24
MS-014	OTHER	Allogeneic Bone Marrow Transplant	22	9	—	—	$85,517.37	$120,179.00	$85,517.37	2026-05-24
0014	OTHER	Liver Transplant And/or Intestinal Transplant	8	4	—	—	$85,012.34	$85,012.34	$85,012.34	2026-05-24
0094	OTHER	Extracorporeal Membrane Oxygenation (ecmo)	8	4	—	—	$84,543.87	$84,543.87	$84,543.87	2026-05-24
0023	OTHER	Heart And/or Lung Transplant	8	4	—	—	$82,236.08	$82,236.08	$82,236.08	2026-05-24
MS-002	OTHER	Heart Transplant Or Implant Of Heart Assist System Without Mcc	22	9	—	—	$80,635.19	$117,178.20	$80,635.19	2026-05-24
MS-209	OTHER	Kidney And Urinary Tract Signs And Symptoms Age 0-17	22	9	—	—	$5,096.41	$113,188.00	$80,542.69	2026-05-24
MS-426	OTHER	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	22	9	—	—	$19,453.54	$110,212.00	$78,425.02	2026-05-24
MS-212	OTHER	Testes Procedures Age 0-17	22	9	—	—	$77,378.28	$115,839.91	$77,378.28	2026-05-24
0064	OTHER	Pancreas Transplant	8	4	—	—	$75,075.77	$75,075.77	$75,075.77	2026-05-24
MS-005	OTHER	Liver Transplant With Mcc Or Intestinal Transplant	22	9	—	—	$73,367.79	$130,567.78	$73,367.79	2026-05-24
MS-215	OTHER	Other Heart Assist System Implant	22	9	—	—	$70,852.35	$101,608.28	$70,852.35	2026-05-24
1613	OTHER	Implantable Heart Assist Systems	28	14	—	—	$70,727.56	$105,572.17	$70,727.56	2026-05-24
MS-366	OTHER	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	2	1	—	—	$70,485.68	$70,485.68	$70,485.68	2026-05-24
6304	OTHER	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure	28	14	—	—	$70,085.59	$104,613.99	$70,085.59	2026-05-24
MS-216	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	22	9	—	—	$69,612.77	$109,950.30	$69,612.77	2026-05-24
5832	OTHER	Neonate With Ecmo	28	14	—	—	$68,750.05	$102,620.55	$68,750.05	2026-05-24
L8702	OTHER	Ewhf S/d Uprt Micro Sensor	16	8	—	—	$67,452.66	$67,452.66	$67,452.66	2026-05-24
MS-647	OTHER	Neonate- Birth Weight 1500-1999 Grams- Without Significant O.r. Procedures- With…	2	1	—	—	$65,169.89	$65,169.89	$65,169.89	2026-05-24
8414	OTHER	Extensive Third Degree Burns With Skin Graft	28	14	—	—	$65,105.29	$97,180.01	$65,105.29	2026-05-24
MS-635	OTHER	Neonate- Birth Weight 1000-1499 Grams- Died	2	1	—	—	$65,033.86	$65,033.86	$65,033.86	2026-05-24
MS-429	OTHER	Combined Anterior And Posterior Cervical Spinal Fusion With Mcc	22	9	—	—	$64,110.81	$90,096.00	$64,110.81	2026-05-24
J9029	OTHER	Instill Adstiladrin- Tx Dose	46	21	—	—	$26,951.36	$63,342.28	$63,342.28	2026-05-24
5934	OTHER	Neonate Birth Weight 750-999 Grams Without Major Procedure	28	14	—	—	$62,974.22	$93,999.37	$62,974.22	2026-05-24
5883	OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	28	14	—	—	$62,206.47	$92,853.22	$62,206.47	2026-05-24
MS-850	OTHER	Acute Leukemia With Other Procedures	22	9	—	—	$61,619.55	$91,887.73	$61,619.55	2026-05-24
0022	OTHER	Heart And/or Lung Transplant	8	4	—	—	$61,028.10	$61,028.10	$61,028.10	2026-05-24
5882	OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	28	14	—	—	$60,912.19	$90,921.35	$60,912.19	2026-05-24
5914	OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure	28	14	—	—	$60,812.21	$90,771.92	$60,812.21	2026-05-24
114	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	20	10	—	—	$60,734.04	$60,734.04	$60,734.04	2026-05-24
MS-646	OTHER	Neonate- Birth Weight 1500-1999 Grams- With Significant O.r. Procedures- Without…	2	1	—	—	$60,682.75	$60,682.75	$60,682.75	2026-05-24
6094	OTHER	Neonate Birth Weight 1500-2499 Grams With Major Procedure	28	14	—	—	$60,424.16	$90,192.90	$60,424.16	2026-05-24
MS-231	OTHER	Coronary Bypass With Ptca With Mcc	22	9	—	—	$56,753.15	$84,299.00	$59,985.76	2026-05-24
MS-456	OTHER	Spinal Fusion Except Cervical With Spinal Curvature- Malignancy- Infection Or Ex…	22	9	—	—	$59,797.19	$84,034.00	$59,797.19	2026-05-24
5831	OTHER	Neonate With Ecmo	28	14	—	—	$59,412.39	$88,682.70	$59,412.39	2026-05-24
0043	OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	8	4	—	—	$59,095.15	$59,095.15	$59,095.15	2026-05-24
74	OTHER	Allogeneic Bone Marrow Transplant	20	10	—	—	$58,407.76	$58,407.76	$58,407.76	2026-05-24
6314	OTHER	Neonate Birth Weight > 2499 Grams With Other Major Procedure	28	14	—	—	$58,009.80	$86,589.16	$58,009.80	2026-05-24
44	OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	20	10	—	—	$57,853.07	$57,853.07	$57,853.07	2026-05-24
14	OTHER	Liver Transplant And/or Intestinal Transplant	20	10	—	—	$56,953.59	$56,953.59	$56,953.59	2026-05-24
0054	OTHER	Tracheostomy With Mv >96 Hours Without Extensive Procedure	8	4	—	—	$56,909.79	$56,909.79	$56,909.79	2026-05-24
1612	OTHER	Implantable Heart Assist Systems	28	14	—	—	$56,788.14	$84,765.32	$56,788.14	2026-05-24
94	OTHER	Extracorporeal Membrane Oxygenation (ecmo)	20	10	—	—	$56,639.74	$56,639.74	$56,639.74	2026-05-24
C9301	OTHER	Obecabtagene Car Pos T	20	10	—	—	$56,281.85	$56,281.85	$56,281.85	2026-05-24
J3393	OTHER	Inj, Betibeglogene Autotemce	36	18	—	—	$56,281.85	$2,945,740.00	$56,281.85	2026-05-24
J3392	OTHER	Inj, Exagamglogene Autotem	36	18	—	—	$56,281.85	$2,332,000.00	$56,281.85	2026-05-24
J3394	OTHER	Inj, Lovotibeglogene Autotem	36	18	—	—	$56,281.85	$3,248,445.72	$56,281.85	2026-05-24
C9076	OTHER	Lisocabtagene Car Pos T	20	10	—	—	$56,281.85	$56,281.85	$56,281.85	2026-05-24
C9073	OTHER	Brexucabtagene Autoleucel Ca	20	10	—	—	$56,281.85	$56,281.85	$56,281.85	2026-05-24
C9081	OTHER	Idecabtagene Car Pos T	20	10	—	—	$56,281.85	$56,281.85	$56,281.85	2026-05-24
C9098	OTHER	Ciltacabtagene Car Pos T	20	10	—	—	$56,281.85	$56,281.85	$56,281.85	2026-05-24
MS-020	OTHER	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc	22	9	—	—	$55,993.06	$124,762.46	$55,993.06	2026-05-24
23	OTHER	Heart And/or Lung Transplant	20	10	—	—	$55,093.52	$55,093.52	$55,093.52	2026-05-24
MS-219	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	22	9	—	—	$54,637.50	$76,783.00	$54,637.50	2026-05-24
MS-233	OTHER	Coronary Bypass With Cardiac Catheterization With Mcc	22	9	—	—	$54,401.96	$76,452.00	$54,401.96	2026-05-24
MS-957	OTHER	Other O.r. Procedures For Multiple Significant Trauma With Mcc	22	9	—	—	$54,221.93	$76,199.00	$54,221.93	2026-05-24
MS-367	OTHER	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	2	1	—	—	$54,011.43	$54,011.43	$54,011.43	2026-05-24
1611	OTHER	Implantable Heart Assist Systems	28	14	—	—	$53,948.43	$80,526.75	$53,948.43	2026-05-24
0063	OTHER	Pancreas Transplant	8	4	—	—	$52,789.33	$52,789.33	$52,789.33	2026-05-24
0021	OTHER	Heart And/or Lung Transplant	8	4	—	—	$52,317.26	$52,317.26	$52,317.26	2026-05-24
MS-403	OTHER	Concomitant Left Atrial Appendage Closure And Cardiac Ablation	2	1	—	—	$51,665.36	$51,665.36	$51,665.36	2026-05-24
0073	OTHER	Allogeneic Bone Marrow Transplant	8	4	—	—	$51,379.23	$51,379.23	$51,379.23	2026-05-24
MS-427	OTHER	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	22	9	—	—	$14,583.21	$72,186.00	$51,366.35	2026-05-24
MS-010	OTHER	Pancreas Transplant	22	9	—	—	$51,061.08	$84,780.54	$51,061.08	2026-05-24
MS-928	OTHER	Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc	22	9	—	—	$32,958.07	$71,727.00	$51,039.73	2026-05-24
MS-019	OTHER	Simultaneous Pancreas And Kidney Transplant With Hemodialysis	22	9	—	—	$50,768.62	$84,294.85	$50,768.62	2026-05-24
MS-275	OTHER	Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc	22	9	—	—	$50,738.73	$71,304.00	$50,738.73	2026-05-24
6034	OTHER	Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition	28	14	—	—	$50,620.70	$75,559.73	$50,620.70	2026-05-24
MS-691	OTHER	Urinary Stones W Esw Lithotripsy W Cc/mcc	2	1	—	—	$50,339.52	$50,339.52	$50,339.52	2026-05-24
64	OTHER	Pancreas Transplant	20	10	—	—	$50,296.53	$50,296.53	$50,296.53	2026-05-24
MS-870	OTHER	Septicemia Or Severe Sepsis With Mv >96 Hours	22	9	—	—	$49,183.21	$72,964.91	$49,183.21	2026-05-24
0013	OTHER	Liver Transplant And/or Intestinal Transplant	8	4	—	—	$49,148.14	$49,148.14	$49,148.14	2026-05-24
MS-268	OTHER	Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc	22	9	—	—	$14,454.84	$68,779.00	$48,941.99	2026-05-24
L7181	OTHER	Electronic Elbo Simultaneous	16	8	—	—	$48,370.76	$48,370.76	$48,370.76	2026-05-24
Q2043	OTHER	Sipuleucel-t Auto Cd54+	50	22	—	—	$26,951.36	$55,272.32	$48,125.58	2026-05-24
MS-955	OTHER	Craniotomy For Multiple Significant Trauma	22	9	—	—	$47,897.38	$95,892.06	$47,897.38	2026-05-24
MS-317	OTHER	Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc	22	9	—	—	$47,580.02	$68,559.19	$47,580.02	2026-05-24
MS-447	OTHER	Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall…	22	9	—	—	$47,545.15	$102,649.59	$47,545.15	2026-05-24
L7180	OTHER	Electronic Elbow Sequential	16	8	—	—	$46,980.38	$46,980.38	$46,980.38	2026-05-24
MS-217	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	22	9	—	—	$46,788.73	$65,753.00	$46,788.73	2026-05-24
MS-218	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	22	9	—	—	$46,788.73	$65,753.00	$46,788.73	2026-05-24
MS-573	OTHER	Skin Graft For Skin Ulcer Or Cellulitis With Mcc	22	9	—	—	$46,618.67	$65,514.00	$46,618.67	2026-05-24
0062	OTHER	Pancreas Transplant	8	4	—	—	$45,826.34	$45,826.34	$45,826.34	2026-05-24
MS-207	OTHER	Respiratory System Diagnosis With Ventilator Support >96 Hours	22	9	—	—	$45,788.25	$64,423.63	$45,788.25	2026-05-24
MS-648	OTHER	Neonate- Birth Weight 1500-1999 Grams- Without Significant O.r. Procedures- With…	2	1	—	—	$45,428.96	$45,428.96	$45,428.96	2026-05-24
A9607	OTHER	Lutetium Lu 177 Vipivotide	36	18	—	—	$255.84	$45,156.22	$45,156.22	2026-05-24
A9543	OTHER	Y90 Ibritumomab, Rx	36	18	—	—	$45,156.22	$56,824.55	$45,156.22	2026-05-24
A9513	OTHER	Lutetium Lu 177 Dotatat Ther	36	18	—	—	$316.99	$45,156.22	$45,156.22	2026-05-24
6024	OTHER	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	28	14	—	—	$45,140.07	$67,378.93	$45,140.07	2026-05-24
0113	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	8	4	—	—	$44,622.94	$44,622.94	$44,622.94	2026-05-24
MS-361	OTHER	Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator	2	1	—	—	$44,592.65	$44,592.65	$44,592.65	2026-05-24
0084	OTHER	Autologous Bone Marrow Transplant	8	4	—	—	$44,102.25	$44,102.25	$44,102.25	2026-05-24
MS-266	OTHER	Endovascular Cardiac Valve Replacement W Mcc	22	9	—	—	$40,239.62	$61,284.00	$43,608.67	2026-05-24
MS-969	OTHER	HIV With Extensive O.r. Procedures With Mcc	22	9	—	—	$43,558.15	$67,249.65	$43,558.15	2026-05-24
MS-232	OTHER	Coronary Bypass With Ptca Without Mcc	22	9	—	—	$43,140.45	$64,957.22	$43,140.45	2026-05-24
MS-677	OTHER	Neonate- Birth Weight 2000-2499 Grams- Without Significant O.r. Procedures- With…	2	1	—	—	$43,032.11	$43,032.11	$43,032.11	2026-05-24
MS-028	OTHER	Spinal Procedures With Mcc	22	9	—	—	$42,585.70	$60,083.00	$42,754.06	2026-05-24
MS-276	OTHER	Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator	22	9	—	—	$36,091.60	$60,066.00	$42,741.96	2026-05-24
MS-457	OTHER	Spinal Fusion Except Cervical With Spinal Curvature- Malignancy- Infection Or Ex…	22	9	—	—	$42,432.42	$60,825.49	$42,432.42	2026-05-24
MS-790	OTHER	Extreme Immaturity Or Respiratory Distress Syndrome- Neonate	22	9	—	—	$7,036.31	$59,435.00	$42,292.95	2026-05-24
MS-016	OTHER	Autolous Bone Marrow Transplant With Cc/mcc	22	9	—	—	$42,194.75	$59,297.00	$42,194.75	2026-05-24
0053	OTHER	Tracheostomy With Mv >96 Hours Without Extensive Procedure	8	4	—	—	$41,907.53	$41,907.53	$41,907.53	2026-05-24
MS-613	OTHER	Neonate- Birth Weight <750 Grams- Died	2	1	—	—	$41,882.54	$41,882.54	$41,882.54	2026-05-24
MS-235	OTHER	Coronary Bypass Without Cardiac Catheterization With Mcc	22	9	—	—	$41,759.98	$58,686.00	$41,759.98	2026-05-24
MS-820	OTHER	Lymphoma And Leukemia With Major O.r. Procedures With Mcc	22	9	—	—	$41,732.94	$58,648.00	$41,732.94	2026-05-24
MS-362	OTHER	Cardiac Defibrillator Implant Without Mcc	2	1	—	—	$41,591.32	$41,591.32	$41,591.32	2026-05-24
MS-396	OTHER	Major Head And Neck Procedures With Mcc	2	1	—	—	$41,347.04	$41,347.04	$41,347.04	2026-05-24
0012	OTHER	Liver Transplant And/or Intestinal Transplant	8	4	—	—	$41,192.04	$41,192.04	$41,192.04	2026-05-24
MS-430	OTHER	Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc	22	9	—	—	$41,037.72	$57,671.00	$41,037.72	2026-05-24
59379	OTHER	Amputation Finger/th	40	17	$45,530.00	$27,318.00 40% off	$10,927.20	$45,530.00	$40,977.00	2026-05-24
22	OTHER	Heart And/or Lung Transplant	20	10	—	—	$40,885.47	$40,885.47	$40,885.47	2026-05-24
MS-023	OTHER	Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…	22	9	—	—	$40,775.86	$60,634.85	$40,775.86	2026-05-24
0042	OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	8	4	—	—	$40,628.14	$40,628.14	$40,628.14	2026-05-24
MS-213	OTHER	Splenic Procedures Age 0-17	22	9	—	—	$17,669.80	$57,069.00	$40,609.35	2026-05-24
MS-463	OTHER	Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …	22	9	—	—	$40,556.69	$56,995.00	$40,556.69	2026-05-24
5933	OTHER	Neonate Birth Weight 750-999 Grams Without Major Procedure	28	14	—	—	$40,496.64	$60,447.64	$40,496.64	2026-05-24
J9226	OTHER	Supprelin La Implant	50	22	—	—	$26,951.36	$45,020.65	$40,225.59	2026-05-24
0072	OTHER	Allogeneic Bone Marrow Transplant	8	4	—	—	$40,189.20	$40,189.20	$40,189.20	2026-05-24
5881	OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	28	14	—	—	$40,094.71	$59,847.73	$40,094.71	2026-05-24
MS-428	OTHER	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	22	9	—	—	$11,080.86	$56,220.00	$40,005.21	2026-05-24
MS-008	OTHER	Simultaneous Pancreas/kidney Transplant	22	9	—	—	$39,881.40	$57,857.69	$39,881.40	2026-05-24
MS-278	OTHER	Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures …	22	9	—	—	$31,261.51	$55,662.00	$39,608.15	2026-05-24
43	OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	20	10	—	—	$39,590.41	$39,590.41	$39,590.41	2026-05-24
MS-461	OTHER	Bilateral Or Multiple Major Joint Procs Of Lower Extremity W Mcc	22	9	—	—	$39,300.74	$65,254.19	$39,300.74	2026-05-24
MS-834	OTHER	Acute Leukemia Without Major O.r. Procedures With Mcc	22	9	—	—	$39,065.21	$87,238.69	$39,065.21	2026-05-24
1604	OTHER	Major Cardiothoracic Repair Of Heart Anomaly	28	14	—	—	$39,065.08	$58,310.89	$39,065.08	2026-05-24
0093	OTHER	Extracorporeal Membrane Oxygenation (ecmo)	8	4	—	—	$38,965.63	$38,965.63	$38,965.63	2026-05-24
MS-405	OTHER	Pancreas- Liver And Shunt Procedures With Mcc	22	9	—	—	$38,927.16	$54,705.00	$38,927.16	2026-05-24
MS-234	OTHER	Coronary Bypass With Cardiac Catheterization Without Mcc	22	9	—	—	$38,871.66	$61,659.88	$38,871.66	2026-05-24
MS-011	OTHER	Tracheostomy For Facemouth & Neck Diagnoses W Mcc	22	9	—	—	$38,810.46	$63,128.45	$38,810.46	2026-05-24
L2006	OTHER	Kaf Sng/dbl Swg/stn Mcpr Cus	16	8	—	—	$38,762.63	$38,762.63	$38,762.63	2026-05-24
MS-017	OTHER	Autolous Bone Marrow Transplant Without Cc/mcc	22	9	—	—	$38,655.34	$64,182.22	$38,655.34	2026-05-24
54	OTHER	Tracheostomy With Mv >96 Hours Without Extensive Procedure	20	10	—	—	$38,126.31	$38,126.31	$38,126.31	2026-05-24
MS-220	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	22	9	—	—	$37,947.31	$53,328.00	$37,947.31	2026-05-24
MS-450	OTHER	Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically …	22	9	—	—	$37,924.54	$58,394.15	$37,924.54	2026-05-24
MS-021	OTHER	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc	22	9	—	—	$37,669.80	$52,938.00	$37,669.80	2026-05-24
MS-270	OTHER	Other Major Cardiovascular Procedures With Mcc	22	9	—	—	$3,498.51	$52,763.00	$37,545.27	2026-05-24
MS-404	OTHER	Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical	2	1	—	—	$37,471.08	$37,471.08	$37,471.08	2026-05-24
MS-466	OTHER	Revision Of Hip Or Knee Replacement With Mcc	22	9	—	—	$37,040.76	$52,054.00	$37,040.76	2026-05-24
0452T	OTHER	Insj/rplcmt Dev Vasc Seal	20	10	—	—	$37,031.81	$37,031.81	$37,031.81	2026-05-24
0454T	OTHER	Insj/rplcmt Subq Electrode	20	10	—	—	$37,031.81	$37,031.81	$37,031.81	2026-05-24
0453T	OTHER	Insj/rplcmt Mech-elec Ntrfce	20	10	—	—	$37,031.81	$37,031.81	$37,031.81	2026-05-24
0451T	OTHER	Insj/rplcmt Aortic Ventr Sys	20	10	—	—	$37,031.81	$37,031.81	$37,031.81	2026-05-24
0459T	OTHER	Relocaj Rplcmt Aortic Ventr	20	10	—	—	$37,031.81	$37,031.81	$37,031.81	2026-05-24
MS-653	OTHER	Major Bladder Procedures With Mcc	22	9	—	—	$34,996.64	$51,964.00	$36,976.71	2026-05-24
1624	OTHER	Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis	28	14	—	—	$36,818.15	$54,957.05	$36,818.15	2026-05-24
0011	OTHER	Liver Transplant And/or Intestinal Transplant	8	4	—	—	$36,573.21	$36,573.21	$36,573.21	2026-05-24
0061	OTHER	Pancreas Transplant	8	4	—	—	$36,021.56	$36,021.56	$36,021.56	2026-05-24
MS-221	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	22	9	—	—	$35,865.22	$50,402.00	$35,865.22	2026-05-24
0071	OTHER	Allogeneic Bone Marrow Transplant	8	4	—	—	$35,785.35	$35,785.35	$35,785.35	2026-05-24
0914	OTHER	Other Major Head And Neck Procedures	8	4	—	—	$35,633.75	$35,633.75	$35,633.75	2026-05-24
5913	OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure	28	14	—	—	$35,626.64	$53,178.58	$35,626.64	2026-05-24
6023	OTHER	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	28	14	—	—	$35,594.11	$53,129.97	$35,594.11	2026-05-24
MS-326	OTHER	Stomach- Esophageal And Duodenal Procedures With Mcc	22	9	—	—	$35,489.50	$49,874.00	$35,489.50	2026-05-24
MS-608	OTHER	Bpd And Other Chronic Respiratory Diseases Arising In Perinatal Period	2	1	—	—	$35,440.18	$35,440.18	$35,440.18	2026-05-24
63	OTHER	Pancreas Transplant	20	10	—	—	$35,365.96	$35,365.96	$35,365.96	2026-05-24
MS-228	OTHER	Other Cardiothoracic Procedures With Mcc	22	9	—	—	$35,204.87	$61,900.33	$35,204.87	2026-05-24
3034	OTHER	Dorsal And Lumbar Fusion Procedure For Curvature Of Back	28	14	—	—	$35,199.32	$52,540.51	$35,199.32	2026-05-24
MS-853	OTHER	Infectious And Parasitic Diseases With O.r. Procedures With Mcc	22	9	—	—	$35,142.25	$49,386.00	$35,142.25	2026-05-24
21	OTHER	Heart And/or Lung Transplant	20	10	—	—	$35,049.74	$35,049.74	$35,049.74	2026-05-24
MS-239	OTHER	Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc	22	9	—	—	$35,021.99	$49,217.00	$35,021.99	2026-05-24
MS-576	OTHER	Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc	22	9	—	—	$34,876.12	$57,371.04	$34,876.12	2026-05-24
6074	OTHER	Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…	28	14	—	—	$34,671.61	$51,753.00	$34,671.61	2026-05-24
73	OTHER	Allogeneic Bone Marrow Transplant	20	10	—	—	$34,421.25	$34,421.25	$34,421.25	2026-05-24
MS-471	OTHER	Cervical Spinal Fusion With Mcc	22	9	—	—	$34,360.22	$48,287.00	$34,360.22	2026-05-24
L8701	OTHER	Ewh S/d Uprt Micro Sensor	16	8	—	—	$34,284.44	$34,284.44	$34,284.44	2026-05-24
MS-837	OTHER	Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot…	22	9	—	—	$34,186.59	$48,740.67	$34,186.59	2026-05-24
0234	OTHER	Spinal Procedures	8	4	—	—	$34,138.31	$34,138.31	$34,138.31	2026-05-24
MS-267	OTHER	Endovascular Cardiac Valve Replacement Without Mcc	22	9	—	—	$3,876.91	$47,608.00	$33,877.06	2026-05-24
6303	OTHER	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure	28	14	—	—	$33,863.78	$50,547.07	$33,863.78	2026-05-24
MS-364	OTHER	Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures …	2	1	—	—	$33,815.46	$33,815.46	$33,815.46	2026-05-24
0214	OTHER	Open Craniotomy Except Trauma	8	4	—	—	$33,670.56	$33,670.56	$33,670.56	2026-05-24
4404	OTHER	Kidney Transplant	28	14	—	—	$33,463.04	$49,948.97	$33,463.04	2026-05-24
MS-650	OTHER	Kidney Transplant With Hemodialysis With Mcc	22	9	—	—	$25,348.90	$47,014.00	$33,454.38	2026-05-24
MS-981	OTHER	Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc	22	9	—	—	$33,386.06	$53,625.37	$33,386.06	2026-05-24
MS-826	OTHER	Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. …	22	9	—	—	$33,286.44	$50,102.90	$33,286.44	2026-05-24
MS-006	OTHER	Liver Transplant Without Mcc	22	9	—	—	$32,996.12	$63,520.26	$32,996.12	2026-05-24
13	OTHER	Liver Transplant And/or Intestinal Transplant	20	10	—	—	$32,926.60	$32,926.60	$32,926.60	2026-05-24
8424	OTHER	Burns With Skin Graft Except Extensive Third Degree Burns	28	14	—	—	$32,902.40	$49,112.13	$32,902.40	2026-05-24
MS-277	OTHER	Other Major Cardiovascular Procedures With Mcc	22	9	—	—	$32,864.47	$51,324.32	$32,864.47	2026-05-24
MS-329	OTHER	Major Small And Large Bowel Procedures With Mcc	22	9	—	—	$32,707.92	$45,965.00	$32,707.92	2026-05-24
MS-823	OTHER	Lymphoma And Non-acute Leukemia With Other Procedures With Mcc	22	9	—	—	$32,624.67	$50,937.30	$32,624.67	2026-05-24
MS-245	OTHER	Aicd Generator Procedures	22	9	—	—	$32,465.28	$51,963.28	$32,465.28	2026-05-24
MS-856	OTHER	Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc	22	9	—	—	$32,367.79	$45,487.00	$32,367.79	2026-05-24
MS-025	OTHER	Craniotomy And Endovascular Intracranial Procedures With Mcc	22	9	—	—	$32,353.56	$45,467.00	$32,353.56	2026-05-24
MS-799	OTHER	Splenic Procedures With Mcc	22	9	—	—	$32,226.89	$50,559.86	$32,226.89	2026-05-24
5932	OTHER	Neonate Birth Weight 750-999 Grams Without Major Procedure	28	14	—	—	$32,097.35	$47,910.52	$32,097.35	2026-05-24
MS-649	OTHER	Neonate- Birth Weight 1500-1999 Grams- Without Significant O.r. Procedures- With…	2	1	—	—	$32,013.51	$32,013.51	$32,013.51	2026-05-24
MS-163	OTHER	Major Chest Procedures With Mcc	22	9	—	—	$31,891.74	$44,818.00	$31,891.74	2026-05-24
MS-031	OTHER	Ventricular Shunt Procedures With Mcc	22	9	—	—	$23,692.57	$44,805.00	$31,882.49	2026-05-24
MS-319	OTHER	Other Endovascular Cardiac Valve Procedures With Mcc	22	9	—	—	$31,757.25	$46,710.72	$31,757.25	2026-05-24
0894	OTHER	Major Cranial/facial Bone Procedures	8	4	—	—	$31,677.13	$31,677.13	$31,677.13	2026-05-24
72318	OTHER	Guselkumab 200 Mg/20 Ml Sol [mdh]	40	17	$34,959.46	$20,975.68 40% off	$8,390.27	$34,959.46	$31,463.51	2026-05-24
1634	OTHER	Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis	28	14	—	—	$31,329.99	$46,765.09	$31,329.99	2026-05-24
MS-356	OTHER	Other Digestive System O.r. Procedures With Mcc	22	9	—	—	$31,165.71	$43,928.00	$31,258.43	2026-05-24
1784	OTHER	External Heart Assist Systems	28	14	—	—	$31,120.89	$46,452.89	$31,120.89	2026-05-24
0204	OTHER	Open Craniotomy For Trauma	8	4	—	—	$31,063.54	$31,063.54	$31,063.54	2026-05-24
MS-692	OTHER	Urinary Stones W Esw Lithotripsy Without Cc/mcc	2	1	—	—	$30,949.21	$30,949.21	$30,949.21	2026-05-24
MS-676	OTHER	Neonate- Birth Weight 2000-2499 Grams- With Significant O.r. Procedures- Without…	2	1	—	—	$30,935.80	$30,935.80	$30,935.80	2026-05-24
MS-363	OTHER	Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures …	2	1	—	—	$30,926.22	$30,926.22	$30,926.22	2026-05-24
MS-323	OTHER	Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc	22	9	—	—	$30,793.05	$50,667.15	$30,793.05	2026-05-24
62	OTHER	Pancreas Transplant	20	10	—	—	$30,701.10	$30,701.10	$30,701.10	2026-05-24
0052	OTHER	Tracheostomy With Mv >96 Hours Without Extensive Procedure	8	4	—	—	$30,675.37	$30,675.37	$30,675.37	2026-05-24
MS-474	OTHER	Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc	22	9	—	—	$30,547.56	$55,259.67	$30,547.56	2026-05-24
MS-140	OTHER	Major Head And Neck Procedures With Mcc	22	9	—	—	$4,993.91	$42,653.00	$30,351.16	2026-05-24
MS-448	OTHER	Multiple Level Spinal Fusion Except Cervical Without Mcc	22	9	—	—	$30,176.82	$42,408.00	$30,176.82	2026-05-24
6093	OTHER	Neonate Birth Weight 1500-2499 Grams With Major Procedure	28	14	—	—	$30,103.56	$44,934.41	$30,103.56	2026-05-24
MS-269	OTHER	Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc	22	9	—	—	$6,570.73	$42,232.00	$30,051.58	2026-05-24
MS-012	OTHER	Tracheostomy For Facemouth & Neck Diagnoses W Cc	22	9	—	—	$30,000.35	$42,160.00	$30,000.35	2026-05-24
MS-958	OTHER	Other O.r. Procedures For Multiple Significant Trauma With Cc	22	9	—	—	$29,985.41	$49,529.08	$29,985.41	2026-05-24
MS-673	OTHER	Other Kidney And Urinary Tract Procedures With Mcc	22	9	—	—	$28,450.82	$42,016.00	$29,897.88	2026-05-24
113	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	20	10	—	—	$29,894.86	$29,894.86	$29,894.86	2026-05-24
MS-901	OTHER	Wound Debridements For Injuries With Mcc	22	9	—	—	$29,862.30	$41,966.00	$29,862.30	2026-05-24
S2235	OTHER	Implant Auditory Brain Imp	22	11	—	—	$14,086.02	$29,857.85	$29,857.85	2026-05-24
MS-236	OTHER	Coronary Bypass Without Cardiac Catheterization Without Mcc	22	9	—	—	$29,806.80	$46,821.85	$29,806.80	2026-05-24
MS-458	OTHER	Spinal Fusion Except Cervical With Spinal Curvature- Malignancy- Infection Or Ex…	22	9	—	—	$29,691.52	$46,821.85	$29,691.52	2026-05-24
0274	OTHER	Other Open Craniotomy	8	4	—	—	$29,678.65	$29,678.65	$29,678.65	2026-05-24
MS-793	OTHER	Full Term Neonate With Major Problems	22	9	—	—	$29,670.18	$44,347.41	$29,670.18	2026-05-24
72222	OTHER	Risankizumab Rzaa 60 mg/mL Sol [mdh]	40	17	$32,941.04	$19,764.62 40% off	$7,905.85	$32,941.04	$29,646.94	2026-05-24
MS-423	OTHER	Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc	22	9	—	—	$29,552.05	$58,534.02	$29,552.05	2026-05-24
84	OTHER	Autologous Bone Marrow Transplant	20	10	—	—	$29,546.10	$29,546.10	$29,546.10	2026-05-24
MS-273	OTHER	Percutaneous Intracardiac Procedures W Mcc	22	9	—	—	$29,356.37	$47,930.22	$29,356.37	2026-05-24
L5856	OTHER	Elec Knee-shin Swing/stance	16	8	—	—	$28,980.18	$28,980.18	$28,980.18	2026-05-24
L6700	OTHER	Ue Add Ext Power Myoel	16	8	—	—	$28,931.56	$28,931.56	$28,931.56	2026-05-24
MS-791	OTHER	Prematurity With Major Problems	22	9	—	—	$2,778.12	$40,590.00	$28,883.16	2026-05-24
L6880	OTHER	Elec Hand Ind Art Digits	16	8	—	—	$28,843.34	$28,843.34	$28,843.34	2026-05-24
1654	OTHER	Coronary Bypass With Ami Or Complex Principal Diagnosis	28	14	—	—	$28,650.58	$42,765.61	$28,650.58	2026-05-24
MS-402	OTHER	Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical	22	9	—	—	$11,816.59	$40,205.00	$28,609.21	2026-05-24
J9266	OTHER	Pegaspargase Injection	30	12	—	—	$17,054.44	$28,424.06	$28,424.06	2026-05-24
0092	OTHER	Extracorporeal Membrane Oxygenation (ecmo)	8	4	—	—	$28,420.15	$28,420.15	$28,420.15	2026-05-24
MS-802	OTHER	Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc	22	9	—	—	$28,350.19	$39,841.00	$28,350.19	2026-05-24
MS-104	OTHER	Craniotomy- Ventricular Shunt And Endovascular Intracranial Procedures Age 0-17	2	1	—	—	$28,239.10	$28,239.10	$28,239.10	2026-05-24
0924	OTHER	Facial Bone Procedures Except Major Cranial/facial Bone Procedures	8	4	—	—	$28,189.69	$28,189.69	$28,189.69	2026-05-24
1674	OTHER	Other Cardiothoracic And Thoracic Vascular Procedures	28	14	—	—	$28,181.60	$42,065.61	$28,181.60	2026-05-24
53	OTHER	Tracheostomy With Mv >96 Hours Without Extensive Procedure	20	10	—	—	$28,075.66	$28,075.66	$28,075.66	2026-05-24
MS-024	OTHER	Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…	22	9	—	—	$27,836.43	$39,119.00	$27,836.43	2026-05-24
33249	OTHER	Insj/rplcmt Defib W/lead(s)	66	22	—	—	$447.34	$35,794.57	$27,818.07	2026-05-24
0614T	OTHER	Rmvl&rplcmt Ss Impl Dfb Pg	34	17	—	—	$25,059.64	$27,818.07	$27,818.07	2026-05-24
0915T	OTHER	Insj Perm Ccm-d Sys Pg&eltrd	36	18	—	—	$27,818.07	$35,794.57	$27,818.07	2026-05-24
0923T	OTHER	Rmvl&rplcmt Perm Ccm-d Pg	36	18	—	—	$23,398.36	$27,818.07	$27,818.07	2026-05-24
33270	OTHER	Ins/rep Subq Defibrillator	66	22	—	—	$274.94	$35,794.57	$27,818.07	2026-05-24
0916T	OTHER	Insj Perm Ccm-d Sys Pg Only	36	18	—	—	$23,398.36	$27,818.07	$27,818.07	2026-05-24
0571T	OTHER	Insj/rplcmt Icds Ss Eltrd	34	17	—	—	$27,818.07	$35,794.57	$27,818.07	2026-05-24
0409T	OTHER	Insj/rplc Car Modulj Pls Gn	34	17	—	—	$25,059.64	$27,818.07	$27,818.07	2026-05-24
33231	OTHER	Insrt Pulse Gen W/mult Leads	66	22	—	—	$196.29	$35,794.57	$27,818.07	2026-05-24
33264	OTHER	Rmvl & Rplcmt Dfb Gen Mlt Ld	66	22	—	—	$197.72	$35,794.57	$27,818.07	2026-05-24
0520T	OTHER	Rmv&rplcmt Pg Wcs Lv Battery	36	18	—	—	$10,909.27	$27,818.07	$27,818.07	2026-05-24
33289	OTHER	Tcat Impl Wrls P-art Prs Snr	66	22	—	—	$196.62	$31,738.29	$27,818.07	2026-05-24
0414T	OTHER	Rmvl & Rpl Car Modulj Pls Gn	34	17	—	—	$25,059.64	$27,818.07	$27,818.07	2026-05-24
G0448	OTHER	Place Perm Pacing Cardiovert	20	10	—	—	$27,818.07	$27,818.07	$27,818.07	2026-05-24
0083	OTHER	Autologous Bone Marrow Transplant	8	4	—	—	$27,770.55	$27,770.55	$27,770.55	2026-05-24
MS-933	OTHER	Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft	22	9	—	—	$27,710.48	$46,010.45	$27,710.48	2026-05-24
12	OTHER	Liver Transplant And/or Intestinal Transplant	20	10	—	—	$27,596.36	$27,596.36	$27,596.36	2026-05-24
MS-609	OTHER	Other Respiratory Problems After Birth	2	1	—	—	$27,572.36	$27,572.36	$27,572.36	2026-05-24
MS-034	OTHER	Carotid Artery Stent Procedures With Mcc	22	9	—	—	$27,543.25	$41,350.87	$27,543.25	2026-05-24
MS-876	OTHER	O.r. Procedures With Principal Diagnosis Of Mental Illness	22	9	—	—	$27,501.98	$38,649.00	$27,501.98	2026-05-24
MS-040	OTHER	Peripheral- Cranial Nerve And Other Nervous System Procedures With Mcc	22	9	—	—	$27,475.65	$47,931.18	$27,475.65	2026-05-24
MS-907	OTHER	Other O.r. Procedures For Injuries With Mcc	22	9	—	—	$27,319.82	$38,393.00	$27,319.82	2026-05-24
42	OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	20	10	—	—	$27,218.63	$27,218.63	$27,218.63	2026-05-24
6022	OTHER	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	28	14	—	—	$27,159.51	$40,539.92	$27,159.51	2026-05-24
0041	OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	8	4	—	—	$27,131.04	$27,131.04	$27,131.04	2026-05-24
3044	OTHER	Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back	28	14	—	—	$27,017.07	$40,327.47	$27,017.07	2026-05-24
6073	OTHER	Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…	28	14	—	—	$26,972.63	$40,260.86	$26,972.63	2026-05-24
J9600	OTHER	Porfimer Sodium Injection	36	18	—	—	$24,228.42	$26,951.36	$26,951.36	2026-05-24
J2840	OTHER	Inj Sebelipase Alfa 1 Mg	36	18	—	—	$539.91	$26,951.36	$26,951.36	2026-05-24

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