Hospital

ELKHART GENERAL HOSPITAL

Elkhart, IN · CCN 150018 · Rates published

23,302 distinct procedures filed

20 distinct payers

603,084 rate rows

2026-05-13 last MRF observed

Data quality

592,305 of 603,084 rate rows are consumer-grade (98.2%)

10,779 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	7,725
per-diem day rate — not a per-procedure price	1,917
percent-of-charges filed in the dollar field — excluded from medians	560
no usable negotiated amount (only an out-of-band fallback) — excluded from medians	407
placeholder amount (≤ $0.02) — excluded from medians	170

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

Source MRF file	https://www.dropbox.com/scl/fi/o2rm6e68gmssfvbu6m6ay/350877574_Elkhart-General-Hospital_standardcharges.csv?rlkey=q4n32hy0ct1wi5rs6ikidhd5k&st=v00lg33y&dl=1
Found on page	https://www.beaconhealthsystem.org/hospital-chargemaster/
Discovered via	CMS hospital list
Last fetch	not_modified · 2026-05-18
Content fingerprint	9e1d72cc6fc5ce09… · 114,607,122 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
J3391 OTHER	Inj- Atidarsagene Autotemcel	7	$2,414,680.00	$4,730,250.00	$4,505,000.00	nat. median $4,505,000 1.0× median
C9172 OTHER	Inj- Beqvez- Per Tx Dose	6	$3,675,000.00	$3,675,000.00	$3,675,000.00	nat. median $3,675,000 1.0× median
J1414 OTHER	Inj- Beqvez- Per Tx Dose	6	$3,675,000.00	$3,675,000.00	$3,675,000.00	nat. median $3,710,000 1.0× median
J1411 OTHER	Inj- Hemgenix- Per Tx Dose	10	$1,975,302.94	$3,869,530.00	$3,675,000.00	nat. median $3,685,267 1.0× median
J1413 OTHER	Inj Delandistrogene Mox Rokl	11	$1,777,623.95	$4,974,693.89	$3,360,000.00	nat. median $3,327,860 1.0× median
J3394 OTHER	Inj- Lovotibeglogene Autotem	8	$1,741,166.91	$4,872,668.58	$3,248,445.72	nat. median $3,286,000 1.0× median
J3393 OTHER	Inj- Betibeglogene Autotemce	9	$1,578,916.64	$4,713,184.00	$2,945,740.00	nat. median $2,968,000 1.0× median
J3392 OTHER	Inj- Exagamglogene Autotem	10	$1,249,952.00	$4,430,800.00	$2,332,000.00	nat. median $2,332,000 1.0× median
J3399 OTHER	Inj Onase Abepar-xioi Treat	11	$1,315,939.29	$4,664,710.16	$2,231,250.00	nat. median $2,472,216 0.9× median
Q2057 OTHER	Afamitresgene Autoleucel	11	$413,052.32	$1,464,178.00	$763,350.00	nat. median $770,620 1.0× median
114 OTHER	Extracorporeal Membrane Oxygenation (ecmo)	7	$145,701.73	$647,979.12	$647,979.12	nat. median $10,012 outlier · 64.7×
Q2042 OTHER	Tisagenlecleucel Car-pos T	10	$317,165.24	$1,124,279.78	$591,726.20	nat. median $591,726 1.0× median
5833 OTHER	Neonate With Ecmo	7	$189,725.36	$588,944.20	$588,944.20	nat. median $252,069 outlier · 2.3×
5834 OTHER	Neonate With Ecmo	7	$191,228.48	$588,944.20	$588,944.20	nat. median $372,748 1.6× median
Q2056 OTHER	Ciltacabtagene Car-pos T	11	$303,305.76	$1,075,151.01	$583,075.96	nat. median $583,076 1.0× median
5831 OTHER	Neonate With Ecmo	7	$76,786.44	$558,502.30	$558,502.30	nat. median $139,037 outlier · 4.0×
5832 OTHER	Neonate With Ecmo	7	$105,432.07	$558,502.30	$558,502.30	nat. median $152,272 outlier · 3.7×
Q2054 OTHER	Lisocabtagene Mara Car Pos T	11	$301,520.47	$1,068,822.56	$557,917.92	nat. median $562,538 1.0× median
Q2055 OTHER	Idecabtagene Vicleucel Car	11	$298,722.41	$1,058,904.07	$554,728.05	nat. median $558,082 1.0× median
Q2058 OTHER	Obecbtge Autol Up To 400 Mil	11	$149,142.00	$551,250.00	$551,250.00	nat. median $281,111 2.0× median
24 OTHER	Heart And/or Lung Transplant	7	$550.00	$537,458.68	$537,458.68	nat. median $27,988 outlier · 19.2×
Q2041 OTHER	Axicabtagene Ciloleucel Car+	11	$285,811.37	$1,013,137.32	$528,759.00	nat. median $533,230 1.0× median
5884 OTHER	Neonate Bwt <1500g W Major Procedure	7	$191,242.03	$503,124.62	$503,124.62	nat. median $243,175 outlier · 2.1×
MS-018 OTHER	Chimeric Antigen Receptor (car) T-cell Immunotherapy	12	$333,847.89	$1,006,920.12	$492,425.64	nat. median $309,559 1.6× median
Q2053 OTHER	Brexucabtagene Car Pos T	11	$262,267.27	$929,678.76	$485,100.00	nat. median $489,720 1.0× median
6314 OTHER	Neonate Birthwt >2499g W Other Major Procedure	7	$155,895.97	$469,136.53	$469,136.53	nat. median $163,675 outlier · 2.9×
5883 OTHER	Neonate Bwt <1500g W Major Procedure	7	$123,561.93	$396,403.43	$396,403.43	nat. median $163,694 outlier · 2.4×
113 OTHER	Extracorporeal Membrane Oxygenation (ecmo)	7	$85,202.81	$378,177.99	$378,177.99	nat. median $18,223 outlier · 20.8×
74 OTHER	Allogeneic Bone Marrow Transplant	7	$119,598.28	$333,375.47	$333,375.47	nat. median $10,670 outlier · 31.2×
5914 OTHER	Neonate Birthwt 500-749g Without Major Procedure	7	$111,225.09	$332,614.53	$332,614.53	nat. median $149,152 outlier · 2.2×
14 OTHER	Liver Transplant And/or Intestinal Transplant	7	$550.00	$328,688.97	$328,688.97	nat. median $100,915 outlier · 3.3×
MS-001 OTHER	Heart Transplant Or Implant Of Heart Assist System With Mcc	12	$217,394.18	$653,450.65	$320,656.41	nat. median $224,278 1.4× median
5934 OTHER	Neonate Birthwt 750-999g Without Major Procedure	7	$112,321.89	$317,330.38	$317,330.38	nat. median $129,842 outlier · 2.4×
112 OTHER	Extracorporeal Membrane Oxygenation (ecmo)	7	$73,235.91	$304,837.81	$304,837.81	nat. median $3,671 outlier · 83.0×
1613 OTHER	Implantable Heart Assist Systems	7	$79,670.23	$303,870.59	$303,870.59	nat. median $79 outlier · 3860.1×
1612 OTHER	Implantable Heart Assist Systems	7	$67,714.74	$303,851.24	$303,851.24	nat. median $84,765 outlier · 3.6×
1611 OTHER	Implantable Heart Assist Systems	7	$55,181.08	$302,838.59	$302,838.59	nat. median $80,527 outlier · 3.8×
23 OTHER	Heart And/or Lung Transplant	7	$550.00	$295,712.02	$295,712.02	nat. median $56,822 outlier · 5.2×
5882 OTHER	Neonate Bwt <1500g W Major Procedure	7	$106,436.25	$294,207.35	$294,207.35	nat. median $119,369 outlier · 2.5×
5881 OTHER	Neonate Bwt <1500g W Major Procedure	7	$91,308.53	$294,207.35	$294,207.35	nat. median $14,014 outlier · 21.0×
J3403 OTHER	Revakinagene- Per Implant	10	$138,020.00	$489,250.00	$257,500.00	nat. median $265,000 1.0× median
6094 OTHER	Neonate Bwt 1500-2499g W Major Procedure	7	$126,015.66	$250,369.68	$250,369.68	nat. median $170,784 1.5× median
6024 OTHER	Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom	7	$53,773.57	$245,243.37	$245,243.37	nat. median $99,381 outlier · 2.5×
22 OTHER	Heart And/or Lung Transplant	7	$550.00	$243,586.70	$243,586.70	nat. median $36,392 outlier · 6.7×
MS-003 OTHER	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face- Mouth…	12	$164,092.83	$494,921.15	$242,036.93	nat. median $169,886 1.4× median
6304 OTHER	Neonate Birthwt >2499g W Major Cardiovascular Procedure	7	$143,255.28	$235,523.02	$235,523.02	nat. median $164,743 1.4× median
MS-927 OTHER	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	12	$149,814.18	$497,842.85	$231,267.88	nat. median $175,322 1.3× median
54 OTHER	Tracheostomy With Mv >96 Hours Without Extensive Procedure	7	$56,977.58	$228,748.68	$228,748.68	nat. median $14,610 outlier · 15.7×
6074 OTHER	Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom	7	$40,099.04	$219,132.78	$219,132.78	nat. median $85,400 outlier · 2.6×
21 OTHER	Heart And/or Lung Transplant	7	$550.00	$217,018.03	$217,018.03	nat. median $55,888 outlier · 3.9×

Other procedures at this hospital

Browse this hospital's 23,302 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

1414	OTHER	Carmustine 7.7 Mg Implant Dev (per Box, Qty #8)	46	19	$104,632.00	$68,010.80 35% off	$9,675.54	$136,021.60	$62,779.20	2026-05-13
Q0480	OTHER	Driver Pneumatic Vad- Rep	31	11	—	—	$58,277.79	$206,581.72	$72,648.53	2026-05-13
A9604	OTHER	Sm 153 Lexidronam	31	11	—	—	$2,312.79	$66,678.38	$66,678.38	2026-05-13
Q2043	OTHER	Sipuleucel-t Auto Cd54+	31	11	—	—	$29,625.96	$105,017.41	$65,732.65	2026-05-13
J9029	OTHER	Instill Adstiladrin- Tx Dose	30	11	—	—	$33,951.46	$120,350.33	$63,945.00	2026-05-13
J3399	OTHER	Inj Onase Abepar-xioi Treat	29	11	—	—	$1,315,939.29	$4,664,710.16	$2,231,250.00	2026-05-13
Q2056	OTHER	Ciltacabtagene Car-pos T	29	11	—	—	$303,305.76	$1,075,151.01	$583,075.96	2026-05-13
Q2054	OTHER	Lisocabtagene Mara Car Pos T	29	11	—	—	$301,520.47	$1,068,822.56	$557,917.92	2026-05-13
Q2055	OTHER	Idecabtagene Vicleucel Car	29	11	—	—	$298,722.41	$1,058,904.07	$554,728.05	2026-05-13
Q2041	OTHER	Axicabtagene Ciloleucel Car+	29	11	—	—	$285,811.37	$1,013,137.32	$528,759.00	2026-05-13
Q2053	OTHER	Brexucabtagene Car Pos T	29	11	—	—	$262,267.27	$929,678.76	$485,100.00	2026-05-13
Q2057	OTHER	Afamitresgene Autoleucel	28	11	—	—	$413,052.32	$1,464,178.00	$763,350.00	2026-05-13
Q2058	OTHER	Obecbtge Autol Up To 400 Mil	28	11	—	—	$149,142.00	$551,250.00	$551,250.00	2026-05-13
5633213	OTHER	System Sapien 3 Ultra Resilia Thv 23mm	28	18	$99,999.00	$64,999.35 35% off	$19,999.80	$129,998.70	$69,999.30	2026-05-13
5626838	OTHER	Valve Evolut Fx 26mm	28	18	$99,999.00	$64,999.35 35% off	$19,999.80	$129,998.70	$69,999.30	2026-05-13
5627184	OTHER	Stent Tag Conform Thoracic Sg Ac 28mmx28mmx10cm 20fr	28	18	$99,999.00	$64,999.35 35% off	$19,999.80	$129,998.70	$69,999.30	2026-05-13
5627181	OTHER	Stent Tag Conform Thoracic Sg Ac 26mmx26mmx10cm 20fr	28	18	$99,999.00	$64,999.35 35% off	$19,999.80	$129,998.70	$69,999.30	2026-05-13
5639959	OTHER	Defibrillator Cobalt Xt Hf Quad Crt D MRI Surescan	28	18	$99,999.00	$64,999.35 35% off	$19,999.80	$129,998.70	$69,999.30	2026-05-13
5623411	OTHER	MRI Sensor Adaptivestim Intellis	28	18	$99,999.00	$64,999.35 35% off	$19,999.80	$129,998.70	$69,999.30	2026-05-13
5627328	OTHER	Valve Heart Sapien Ultra 20mm (thv) W/commander System	28	18	$99,999.00	$64,999.35 35% off	$19,999.80	$129,998.70	$69,999.30	2026-05-13
5662812	OTHER	Plug Vascular Amplatzer Amulet 25mm	28	18	$99,999.00	$64,999.35 35% off	$19,999.80	$129,998.70	$69,999.30	2026-05-13
5627329	OTHER	Valve Heart Sapien Ultra 23mm (thv) W/commander System	28	18	$99,999.00	$64,999.35 35% off	$19,999.80	$129,998.70	$69,999.30	2026-05-13
5628992	OTHER	Defib Vigilant Cd X4 Crt-d Ra:is-1 Rv:df4 Lv:isr	28	18	$99,999.00	$64,999.35 35% off	$19,999.80	$129,998.70	$69,999.30	2026-05-13
5633769	OTHER	Catheter Mitraclip G4 Steerable Guide	28	18	$99,999.00	$64,999.35 35% off	$19,999.80	$129,998.70	$69,999.30	2026-05-13
5623956	OTHER	System Proclaim 5 Elite Generator	28	18	$99,999.00	$64,999.35 35% off	$19,999.80	$129,998.70	$69,999.30	2026-05-13
5629148	OTHER	Generator Implantable Pulse	28	18	$99,999.00	$64,999.35 35% off	$19,999.80	$129,998.70	$69,999.30	2026-05-13
5639620	OTHER	Wm Flx Pro Device Header	28	18	$99,999.00	$64,999.35 35% off	$19,999.80	$129,998.70	$69,999.30	2026-05-13
5633730	OTHER	Defibrillator Cobalt Xt Hf Quad Crt-d MRI Surescan	28	18	$99,999.00	$64,999.35 35% off	$19,999.80	$129,998.70	$69,999.30	2026-05-13
5633214	OTHER	System Sapien 3 Ultra Resilia Thv 26mm	28	18	$99,999.00	$64,999.35 35% off	$19,999.80	$129,998.70	$69,999.30	2026-05-13
5633215	OTHER	System Sapien 3 Ultra Resilia Thv 29mm	28	18	$99,999.00	$64,999.35 35% off	$19,999.80	$129,998.70	$69,999.30	2026-05-13
5627330	OTHER	Valve Heart Sapien Ultra 26mm (thv) W/commander System	28	18	$99,999.00	$64,999.35 35% off	$19,999.80	$129,998.70	$69,999.30	2026-05-13
5628610	OTHER	Mitraclip G4 System	28	18	$99,999.00	$64,999.35 35% off	$19,999.80	$129,998.70	$69,999.30	2026-05-13
5661906	OTHER	Defibrillator Cobalt Xt Hf Crt-d MRI Surescan Dual Chamber	28	18	$99,999.00	$64,999.35 35% off	$19,999.80	$129,998.70	$69,999.30	2026-05-13
5639863	OTHER	Defibrillator System Aurora Ev-icd Dvea3e4	28	18	$99,999.00	$64,999.35 35% off	$19,999.80	$129,998.70	$69,999.30	2026-05-13
5627143	OTHER	Device Impella Cp Smart Assit Cp C8 Optical	28	18	$99,999.00	$64,999.35 35% off	$19,999.80	$129,998.70	$69,999.30	2026-05-13
5628581	OTHER	Crtd Cobalt Quad Hf MRI Is4 Df1	28	18	$99,960.00	$64,974.00 35% off	$19,992.00	$129,948.00	$69,972.00	2026-05-13
5627693	OTHER	Conduit Konect Resilia Aortic Valved 23mm	28	18	$96,000.00	$62,400.00 35% off	$19,200.00	$124,800.00	$67,200.00	2026-05-13
5627694	OTHER	Conduit Konect Resilia Aortic Valved 27mm	28	18	$96,000.00	$62,400.00 35% off	$19,200.00	$124,800.00	$67,200.00	2026-05-13
5627414	OTHER	Valve Heart Conduit Konect Resilia Aortic 25mm	28	18	$96,000.00	$62,400.00 35% off	$19,200.00	$124,800.00	$67,200.00	2026-05-13
8022	OTHER	Polatuzumab Vedotin-piiq 140 Mg/7 Ml Inj	28	18	$94,740.29	$61,581.19 35% off	$18,948.06	$123,162.38	$66,318.20	2026-05-13
5640238	OTHER	Micra Av2 Pacemaker System	28	18	$94,500.00	$61,425.00 35% off	$18,900.00	$122,850.00	$66,150.00	2026-05-13
50070224	OTHER	Ipilimumab 200 Mg/40 Ml Inj	28	18	$92,151.00	$59,898.15 35% off	$18,430.20	$119,796.30	$64,505.70	2026-05-13
J1413	OTHER	Inj Delandistrogene Mox Rokl	26	11	—	—	$1,777,623.95	$4,974,693.89	$3,360,000.00	2026-05-13
J1411	OTHER	Inj- Hemgenix- Per Tx Dose	24	10	—	—	$1,975,302.94	$3,869,530.00	$3,675,000.00	2026-05-13
62	OTHER	Methylphenidate 5 Mg Tab	23	8	$25.00	$16.25 35% off	$25.00	$171,455.28	$171,455.28	2026-05-13
2004	OTHER	Simethicone 80 Mg Chew Tab	23	8	$25.00	$16.25 35% off	$25.00	$107,954.58	$107,954.58	2026-05-13
2244	OTHER	Penicillin V Potassium 500 Mg Tab	23	8	$25.00	$16.25 35% off	$25.00	$66,397.62	$66,397.62	2026-05-13
1603	OTHER	Indomethacin 25 Mg Cap	23	8	$25.00	$16.25 35% off	$25.00	$65,226.10	$65,226.10	2026-05-13
3123	OTHER	Megestrol 40 Mg Tab	23	8	$25.00	$16.25 35% off	$25.00	$61,869.17	$61,869.17	2026-05-13
234	OTHER	Spinal Procedures	19	7	—	—	$67.20	$90,204.57	$90,204.57	2026-05-13
233	OTHER	Spinal Procedures	19	7	—	—	$67.20	$66,407.89	$66,407.89	2026-05-13
264	OTHER	Other Nervous System And Related Procedures	19	7	—	—	$67.20	$65,432.59	$65,432.59	2026-05-13
403	OTHER	Spinal Disorders And Injuries	19	7	—	—	$233.00	$62,277.48	$62,277.48	2026-05-13
5833	OTHER	Neonate With Ecmo	18	7	—	—	$189,725.36	$588,944.20	$588,944.20	2026-05-13
5834	OTHER	Neonate With Ecmo	18	7	—	—	$191,228.48	$588,944.20	$588,944.20	2026-05-13
5832	OTHER	Neonate With Ecmo	18	7	—	—	$105,432.07	$558,502.30	$558,502.30	2026-05-13
5831	OTHER	Neonate With Ecmo	18	7	—	—	$76,786.44	$558,502.30	$558,502.30	2026-05-13
24	OTHER	Heart And/or Lung Transplant	18	7	—	—	$550.00	$537,458.68	$537,458.68	2026-05-13
5884	OTHER	Neonate Bwt <1500g W Major Procedure	18	7	—	—	$191,242.03	$503,124.62	$503,124.62	2026-05-13
MS-018	OTHER	Chimeric Antigen Receptor (car) T-cell Immunotherapy	18	12	—	—	$333,847.89	$1,006,920.12	$492,425.64	2026-05-13
6314	OTHER	Neonate Birthwt >2499g W Other Major Procedure	18	7	—	—	$155,895.97	$469,136.53	$469,136.53	2026-05-13
5883	OTHER	Neonate Bwt <1500g W Major Procedure	18	7	—	—	$123,561.93	$396,403.43	$396,403.43	2026-05-13
74	OTHER	Allogeneic Bone Marrow Transplant	18	7	—	—	$119,598.28	$333,375.47	$333,375.47	2026-05-13
5914	OTHER	Neonate Birthwt 500-749g Without Major Procedure	18	7	—	—	$111,225.09	$332,614.53	$332,614.53	2026-05-13
14	OTHER	Liver Transplant And/or Intestinal Transplant	18	7	—	—	$550.00	$328,688.97	$328,688.97	2026-05-13
MS-001	OTHER	Heart Transplant Or Implant Of Heart Assist System With Mcc	18	12	—	—	$217,394.18	$653,450.65	$320,656.41	2026-05-13
5934	OTHER	Neonate Birthwt 750-999g Without Major Procedure	18	7	—	—	$112,321.89	$317,330.38	$317,330.38	2026-05-13
1613	OTHER	Implantable Heart Assist Systems	18	7	—	—	$79,670.23	$303,870.59	$303,870.59	2026-05-13
1612	OTHER	Implantable Heart Assist Systems	18	7	—	—	$67,714.74	$303,851.24	$303,851.24	2026-05-13
1611	OTHER	Implantable Heart Assist Systems	18	7	—	—	$55,181.08	$302,838.59	$302,838.59	2026-05-13
23	OTHER	Heart And/or Lung Transplant	18	7	—	—	$550.00	$295,712.02	$295,712.02	2026-05-13
5882	OTHER	Neonate Bwt <1500g W Major Procedure	18	7	—	—	$106,436.25	$294,207.35	$294,207.35	2026-05-13
5881	OTHER	Neonate Bwt <1500g W Major Procedure	18	7	—	—	$91,308.53	$294,207.35	$294,207.35	2026-05-13
6094	OTHER	Neonate Bwt 1500-2499g W Major Procedure	18	7	—	—	$126,015.66	$250,369.68	$250,369.68	2026-05-13
6024	OTHER	Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom	18	7	—	—	$53,773.57	$245,243.37	$245,243.37	2026-05-13
22	OTHER	Heart And/or Lung Transplant	18	7	—	—	$550.00	$243,586.70	$243,586.70	2026-05-13
MS-003	OTHER	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face- Mouth…	18	12	—	—	$164,092.83	$494,921.15	$242,036.93	2026-05-13
6304	OTHER	Neonate Birthwt >2499g W Major Cardiovascular Procedure	18	7	—	—	$143,255.28	$235,523.02	$235,523.02	2026-05-13
MS-927	OTHER	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	18	12	—	—	$149,814.18	$497,842.85	$231,267.88	2026-05-13
54	OTHER	Tracheostomy With Mv >96 Hours Without Extensive Procedure	18	7	—	—	$56,977.58	$228,748.68	$228,748.68	2026-05-13
6074	OTHER	Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom	18	7	—	—	$40,099.04	$219,132.78	$219,132.78	2026-05-13
21	OTHER	Heart And/or Lung Transplant	18	7	—	—	$550.00	$217,018.03	$217,018.03	2026-05-13
43	OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	18	7	—	—	$58,476.04	$199,957.70	$199,957.70	2026-05-13
5933	OTHER	Neonate Birthwt 750-999g Without Major Procedure	18	7	—	—	$77,554.92	$191,842.30	$191,842.30	2026-05-13
8504	OTHER	Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal…	18	7	—	—	$42,394.61	$186,758.52	$186,758.52	2026-05-13
1624	OTHER	Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis	18	7	—	—	$52,231.92	$181,159.91	$181,159.91	2026-05-13
13	OTHER	Liver Transplant And/or Intestinal Transplant	18	7	—	—	$550.00	$180,772.13	$180,772.13	2026-05-13
3034	OTHER	Dorsal And Lumbar Fusion Procedure For Curvature Of Back	18	7	—	—	$61,207.09	$180,120.92	$180,120.92	2026-05-13
6023	OTHER	Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom	18	7	—	—	$38,067.27	$172,990.93	$172,990.93	2026-05-13
63	OTHER	Pancreas Transplant	18	7	—	—	$550.00	$171,455.28	$171,455.28	2026-05-13
64	OTHER	Pancreas Transplant	18	7	—	—	$550.00	$171,455.28	$171,455.28	2026-05-13
6334	OTHER	Neonate Birthwt >2499g W Major Anomaly	18	7	—	—	$23,234.04	$169,641.18	$169,641.18	2026-05-13
5932	OTHER	Neonate Birthwt 750-999g Without Major Procedure	18	7	—	—	$51,043.03	$167,555.65	$167,555.65	2026-05-13
53	OTHER	Tracheostomy With Mv >96 Hours Without Extensive Procedure	18	7	—	—	$48,741.23	$166,227.07	$166,227.07	2026-05-13
84	OTHER	Autologous Bone Marrow Transplant Or T-cell Immunotherapy	18	7	—	—	$60,975.04	$166,222.61	$166,222.61	2026-05-13
83	OTHER	Autologous Bone Marrow Transplant Or T-cell Immunotherapy	18	7	—	—	$31,380.38	$166,061.36	$166,061.36	2026-05-13
MS-004	OTHER	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face- Mouth And Nec…	18	12	—	—	$107,085.70	$322,981.68	$157,951.40	2026-05-13
6093	OTHER	Neonate Bwt 1500-2499g W Major Procedure	18	7	—	—	$46,744.84	$157,422.04	$157,422.04	2026-05-13
6124	OTHER	Neonate Bwt 1500-1999g W Resp Dist Synd/oth Maj Resp Cond	18	7	—	—	$45,731.81	$153,859.46	$153,859.46	2026-05-13
6114	OTHER	Neonate Birthwt 1500-1999g W Major Anomaly	18	7	—	—	$30,569.75	$163,952.35	$152,229.56	2026-05-13
6092	OTHER	Neonate Bwt 1500-2499g W Major Procedure	18	7	—	—	$25,356.86	$151,921.76	$151,921.76	2026-05-13
6091	OTHER	Neonate Bwt 1500-2499g W Major Procedure	18	7	—	—	$24,854.77	$150,780.11	$150,780.11	2026-05-13
8634	OTHER	Neonatal Aftercare	18	7	—	—	$47,431.11	$150,117.29	$150,117.29	2026-05-13
6214	OTHER	Neonate Bwt 2000-2499g W Major Anomaly	18	7	—	—	$18,372.36	$149,016.91	$149,016.91	2026-05-13
5913	OTHER	Neonate Birthwt 500-749g Without Major Procedure	18	7	—	—	$85,641.94	$147,993.49	$147,993.49	2026-05-13
3033	OTHER	Dorsal And Lumbar Fusion Procedure For Curvature Of Back	18	7	—	—	$41,842.57	$142,378.87	$142,378.87	2026-05-13
9504	OTHER	Extensive Procedure Unrelated To Principal Diagnosis	18	7	—	—	$29,589.50	$141,031.91	$141,031.91	2026-05-13
4404	OTHER	Kidney Transplant	18	7	—	—	$550.00	$140,057.84	$140,057.84	2026-05-13
4403	OTHER	Kidney Transplant	18	7	—	—	$550.00	$138,967.79	$138,967.79	2026-05-13
4402	OTHER	Kidney Transplant	18	7	—	—	$550.00	$138,883.94	$138,883.94	2026-05-13
4401	OTHER	Kidney Transplant	18	7	—	—	$550.00	$138,825.89	$138,825.89	2026-05-13
MS-014	OTHER	Allogeneic Bone Marrow Transplant	18	12	—	—	$92,910.84	$280,228.83	$137,043.48	2026-05-13
6022	OTHER	Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom	18	7	—	—	$30,631.14	$135,568.66	$135,568.66	2026-05-13
6073	OTHER	Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom	18	7	—	—	$27,567.62	$134,562.75	$134,562.75	2026-05-13
5893	OTHER	Neonate Bwt <500g Or Ga <24 Weeks	18	7	—	—	$66,187.58	$134,367.74	$134,367.74	2026-05-13
5894	OTHER	Neonate Bwt <500g Or Ga <24 Weeks	18	7	—	—	$2,750.35	$134,367.74	$134,367.74	2026-05-13
9124	OTHER	Musculoskeletal And Other Procedures For Multiple Significant Trauma	18	7	—	—	$32,246.68	$132,125.87	$132,125.87	2026-05-13
1674	OTHER	Other Cardiothoracic And Thoracic Vascular Procedures	18	7	—	—	$48,694.40	$131,273.94	$131,273.94	2026-05-13
9114	OTHER	Extensive Abdominal/thoracic Procedures For Mult Significant Trauma	18	7	—	—	$36,996.49	$131,271.86	$131,271.86	2026-05-13
MS-002	OTHER	Heart Transplant Or Implant Of Heart Assist System Without Mcc	18	12	—	—	$87,606.57	$264,230.61	$129,219.69	2026-05-13
5891	OTHER	Neonate Bwt <500g Or Ga <24 Weeks	18	7	—	—	$66,187.58	$127,924.41	$127,924.41	2026-05-13
5892	OTHER	Neonate Bwt <500g Or Ga <24 Weeks	18	7	—	—	$66,187.58	$127,924.41	$127,924.41	2026-05-13
9104	OTHER	Craniotomy For Multiple Significant Trauma	18	7	—	—	$24,446.34	$127,441.76	$127,441.76	2026-05-13
MS-426	OTHER	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	18	12	—	—	$85,205.32	$256,988.15	$125,677.85	2026-05-13
224	OTHER	Ventricular Shunt Procedures	18	7	—	—	$23,019.16	$124,923.91	$124,923.91	2026-05-13
MS-212	OTHER	Testes Procedures Age 0-17	18	12	—	—	$84,068.08	$253,558.13	$124,000.41	2026-05-13
71	OTHER	Allogeneic Bone Marrow Transplant	18	7	—	—	$53,522.26	$142,486.60	$122,893.92	2026-05-13
12	OTHER	Liver Transplant And/or Intestinal Transplant	18	7	—	—	$550.00	$120,077.11	$120,077.11	2026-05-13
93	OTHER	Extracorporeal Membrane Oxygenation (ecmo)	18	7	—	—	$44,033.55	$132,078.56	$119,929.30	2026-05-13
6814	OTHER	Other O.r. Procedures For Lymphatic/hematopoietic/other Neoplasms	18	7	—	—	$35,699.91	$116,133.18	$116,133.18	2026-05-13
6034	OTHER	Neonate Birthwt 1000-1249g W Or Without Other Significant Condition	18	7	—	—	$87,585.96	$115,963.34	$115,963.34	2026-05-13
6033	OTHER	Neonate Birthwt 1000-1249g W Or Without Other Significant Condition	18	7	—	—	$46,075.73	$115,169.99	$115,169.99	2026-05-13
42	OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	18	7	—	—	$36,169.22	$114,623.02	$114,623.02	2026-05-13
8633	OTHER	Neonatal Aftercare	18	7	—	—	$22,729.35	$113,807.97	$113,807.97	2026-05-13
MS-215	OTHER	Other Heart Assist System Implant	18	12	—	—	$76,977.94	$232,173.54	$113,542.46	2026-05-13
5931	OTHER	Neonate Birthwt 750-999g Without Major Procedure	18	7	—	—	$8,959.61	$112,777.42	$112,777.42	2026-05-13
5912	OTHER	Neonate Birthwt 500-749g Without Major Procedure	18	7	—	—	$64,711.84	$112,195.05	$112,195.05	2026-05-13
6344	OTHER	Neonate, Birthwt >2499g W Resp Dist Synd/oth Maj Resp Cond	18	7	—	—	$15,012.26	$111,911.47	$111,911.47	2026-05-13
204	OTHER	Open Craniotomy For Trauma	18	7	—	—	$40,164.08	$111,739.26	$111,739.26	2026-05-13
MS-216	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	18	12	—	—	$75,631.21	$228,111.61	$111,556.04	2026-05-13
6954	OTHER	Chemotherapy For Acute Leukemia	18	7	—	—	$35,222.27	$111,363.86	$111,363.86	2026-05-13
6804	OTHER	Major O.r. Procedures For Lymphatic/hematopoietic/other Neoplasms	18	7	—	—	$43,524.18	$111,276.39	$111,276.39	2026-05-13
3044	OTHER	Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back	18	7	—	—	$34,018.82	$111,053.89	$111,053.89	2026-05-13
2604	OTHER	Major Pancreas, Liver And Shunt Procedures	18	7	—	—	$23,815.73	$110,819.19	$110,819.19	2026-05-13
6123	OTHER	Neonate Bwt 1500-1999g W Resp Dist Synd/oth Maj Resp Cond	18	7	—	—	$28,865.77	$109,899.76	$109,899.76	2026-05-13
5911	OTHER	Neonate Birthwt 500-749g Without Major Procedure	18	7	—	—	$36,248.30	$109,627.95	$109,627.95	2026-05-13
6072	OTHER	Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom	18	7	—	—	$20,735.04	$104,674.53	$104,674.53	2026-05-13
1694	OTHER	Major Abdominal Vascular Procedures	18	7	—	—	$32,592.68	$104,651.81	$104,651.81	2026-05-13
MS-429	OTHER	Combined Anterior And Posterior Cervical Spinal Fusion With Mcc	18	12	—	—	$69,653.55	$210,082.43	$102,738.99	2026-05-13
7104	OTHER	Infectious And Parasitic Diseases Including HIV With O.r. Procedure	18	7	—	—	$20,558.66	$101,277.72	$101,277.72	2026-05-13
3032	OTHER	Dorsal And Lumbar Fusion Procedure For Curvature Of Back	18	7	—	—	$27,182.60	$101,038.94	$101,038.94	2026-05-13
2304	OTHER	Major Small Bowel Procedures	18	7	—	—	$28,956.30	$100,576.91	$100,576.91	2026-05-13
6224	OTHER	Neonate Bwt 2000-2499g W Resp Dist Synd/oth Maj Resp Cond	18	7	—	—	$27,796.55	$98,064.99	$98,064.99	2026-05-13
6084	OTHER	Neonate Bwt 1250-1499g W Or Without Other Significant Condition	18	7	—	—	$27,905.81	$97,374.00	$97,374.00	2026-05-13
2204	OTHER	Major Stomach, Esophageal And Duodenal Procedures	18	7	—	—	$29,416.76	$97,069.40	$97,069.40	2026-05-13
3214	OTHER	Spinal Fusion And Other Back And Neck Procedures Except For Disc Procedures	18	7	—	—	$24,592.02	$97,040.10	$97,040.10	2026-05-13
6083	OTHER	Neonate Bwt 1250-1499g W Or Without Other Significant Condition	18	7	—	—	$22,331.84	$96,948.30	$96,948.30	2026-05-13
3213	OTHER	Spinal Fusion And Other Back And Neck Procedures Except For Disc Procedures	18	7	—	—	$17,756.32	$96,872.40	$96,872.40	2026-05-13
6301	OTHER	Neonate Birthwt >2499g W Major Cardiovascular Procedure	18	7	—	—	$18,470.69	$96,758.04	$96,758.04	2026-05-13
6303	OTHER	Neonate Birthwt >2499g W Major Cardiovascular Procedure	18	7	—	—	$48,672.85	$96,758.04	$96,758.04	2026-05-13
6302	OTHER	Neonate Birthwt >2499g W Major Cardiovascular Procedure	18	7	—	—	$38,465.30	$96,758.04	$96,758.04	2026-05-13
MS-231	OTHER	Coronary Bypass With Ptca With Mcc	18	12	—	—	$65,171.87	$196,565.20	$96,128.51	2026-05-13
MS-456	OTHER	Spinal Fusion Except Cervical With Spinal Curvature- Malignancy- Infection Or Ex…	18	12	—	—	$64,967.00	$195,947.29	$95,826.32	2026-05-13
6903	OTHER	Acute Leukemia	18	7	—	—	$26,825.15	$95,802.54	$95,802.54	2026-05-13
6904	OTHER	Acute Leukemia	18	7	—	—	$40,625.59	$95,802.54	$95,802.54	2026-05-13
6113	OTHER	Neonate Birthwt 1500-1999g W Major Anomaly	18	7	—	—	$18,905.66	$94,985.80	$94,985.80	2026-05-13
MS-850	OTHER	Acute Leukemia With Other Procedures	18	12	—	—	$60,762.79	$201,918.93	$93,799.40	2026-05-13
6021	OTHER	Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom	18	7	—	—	$11,077.75	$95,180.70	$93,687.08	2026-05-13
7114	OTHER	Post-operative, Post-trauma, Other Device Infections With O.r. Procedure	18	7	—	—	$23,616.46	$93,332.37	$93,332.37	2026-05-13
9514	OTHER	Moderately Extensive Procedure Unrelated To Principal Diagnosis	18	7	—	—	$21,947.34	$93,047.62	$93,047.62	2026-05-13
52	OTHER	Tracheostomy With Mv >96 Hours Without Extensive Procedure	18	7	—	—	$21,580.53	$92,323.37	$92,323.37	2026-05-13
1204	OTHER	Major Respiratory And Chest Procedures	18	7	—	—	$32,551.57	$92,232.30	$92,232.30	2026-05-13
3031	OTHER	Dorsal And Lumbar Fusion Procedure For Curvature Of Back	18	7	—	—	$25,075.90	$98,772.21	$90,448.37	2026-05-13
MS-020	OTHER	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc	18	12	—	—	$60,834.00	$183,481.69	$89,730.15	2026-05-13
1623	OTHER	Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis	18	7	—	—	$35,834.14	$89,298.56	$89,298.56	2026-05-13
92	OTHER	Extracorporeal Membrane Oxygenation (ecmo)	18	7	—	—	$32,078.10	$132,078.56	$88,620.13	2026-05-13
91	OTHER	Extracorporeal Membrane Oxygenation (ecmo)	18	7	—	—	$29,816.88	$132,078.56	$88,491.13	2026-05-13
1653	OTHER	Coronary Bypass With Ami Or Complex Principal Diagnosis	18	7	—	—	$28,977.63	$87,793.50	$87,793.50	2026-05-13
304	OTHER	Percutaneous Intracranial And Extracranial Vascular Procedures	18	7	—	—	$65.90	$87,568.42	$87,568.42	2026-05-13
MS-219	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	18	12	—	—	$59,361.22	$179,039.68	$87,557.80	2026-05-13
MS-233	OTHER	Coronary Bypass With Cardiac Catheterization With Mcc	18	12	—	—	$59,105.33	$178,267.87	$87,180.36	2026-05-13
9304	OTHER	Multiple Significant Trauma Without O.r. Procedure	18	7	—	—	$14,722.45	$85,912.30	$85,912.30	2026-05-13
274	OTHER	Other Open Craniotomy	18	7	—	—	$486.63	$84,403.30	$84,403.30	2026-05-13
7924	OTHER	Extensive Or Procedures For Other Complications Of Treatment	18	7	—	—	$30,512.52	$83,239.52	$83,239.52	2026-05-13
MS-957	OTHER	Other O.r. Procedures For Multiple Significant Trauma With Mcc	18	12	—	—	$53,468.03	$177,677.93	$82,538.50	2026-05-13
MS-427	OTHER	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	18	12	—	—	$55,807.27	$168,320.57	$82,315.73	2026-05-13
MS-019	OTHER	Simultaneous Pancreas And Kidney Transplant With Hemodialysis	18	12	—	—	$55,157.87	$166,361.89	$81,357.85	2026-05-13
MS-275	OTHER	Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc	18	12	—	—	$55,125.39	$166,263.96	$81,309.96	2026-05-13
4054	OTHER	Other Procedures For Endocrine, Nutritional And Metabolic Disorders	18	7	—	—	$27,323.08	$80,814.58	$80,814.58	2026-05-13
82	OTHER	Autologous Bone Marrow Transplant Or T-cell Immunotherapy	18	7	—	—	$23,253.29	$80,603.23	$80,603.23	2026-05-13
81	OTHER	Autologous Bone Marrow Transplant Or T-cell Immunotherapy	18	7	—	—	$15,486.25	$80,551.63	$80,551.63	2026-05-13
6313	OTHER	Neonate Birthwt >2499g W Other Major Procedure	18	7	—	—	$40,551.18	$79,950.34	$79,950.34	2026-05-13
6902	OTHER	Acute Leukemia	18	7	—	—	$15,827.57	$79,314.45	$79,314.45	2026-05-13
6144	OTHER	Neonate Bwt 1500-1999g W Or Without Other Significant Condition	18	7	—	—	$27,969.81	$78,591.47	$78,591.47	2026-05-13
1214	OTHER	Other Respiratory And Chest Procedures	18	7	—	—	$25,467.69	$78,448.14	$78,448.14	2026-05-13
MS-268	OTHER	Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc	18	12	—	—	$53,173.31	$160,376.26	$78,430.62	2026-05-13
41	OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	18	7	—	—	$32,379.35	$113,049.42	$78,058.12	2026-05-13
4474	OTHER	Other Kidney, Urinary Tract And Related Procedures	18	7	—	—	$21,665.33	$77,900.70	$77,900.70	2026-05-13
MS-928	OTHER	Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc	18	12	—	—	$50,330.07	$167,250.29	$77,694.44	2026-05-13
554	OTHER	Head Trauma With Coma > 1 Hour Or Hemorrhage	18	7	—	—	$14,718.81	$77,121.40	$77,121.40	2026-05-13
6143	OTHER	Neonate Bwt 1500-1999g W Or Without Other Significant Condition	18	7	—	—	$21,158.56	$76,940.27	$76,940.27	2026-05-13
1633	OTHER	Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis	18	7	—	—	$28,699.27	$76,935.52	$76,935.52	2026-05-13
2644	OTHER	Other Hepatobiliary, Pancreas And Abdominal Procedures	18	7	—	—	$27,160.74	$76,544.35	$76,544.35	2026-05-13
MS-317	OTHER	Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc	18	12	—	—	$51,693.58	$155,913.27	$76,248.04	2026-05-13
3124	OTHER	Skin Graft, Except Hand, For Musculoskeletal And Connective Tissue Diagnoses	18	7	—	—	$38,754.59	$87,926.72	$76,239.22	2026-05-13
MS-447	OTHER	Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall…	18	12	—	—	$51,655.71	$155,799.01	$76,192.18	2026-05-13
6223	OTHER	Neonate Bwt 2000-2499g W Resp Dist Synd/oth Maj Resp Cond	18	7	—	—	$16,653.81	$75,527.18	$75,527.18	2026-05-13
3134	OTHER	Knee And Lower Leg Procedures Except Foot	18	7	—	—	$24,015.01	$75,266.96	$75,266.96	2026-05-13
MS-218	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	18	12	—	—	$50,833.91	$153,320.35	$74,980.01	2026-05-13
MS-217	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	18	12	—	—	$50,833.91	$153,320.35	$74,980.01	2026-05-13
MS-870	OTHER	Septicemia Or Severe Sepsis With Mv >96 Hours	18	12	—	—	$48,499.36	$161,166.73	$74,868.38	2026-05-13
MS-573	OTHER	Skin Graft For Skin Ulcer Or Cellulitis With Mcc	18	12	—	—	$50,649.11	$152,763.06	$74,707.44	2026-05-13
3084	OTHER	Hip And Femur Fracture Repair	18	7	—	—	$22,327.68	$74,569.02	$74,569.02	2026-05-13
MS-207	OTHER	Respiratory System Diagnosis With Ventilator Support >96 Hours	18	12	—	—	$49,746.90	$150,041.89	$73,376.68	2026-05-13
MS-955	OTHER	Craniotomy For Multiple Significant Trauma	18	12	—	—	$47,231.41	$156,953.23	$72,911.04	2026-05-13
6082	OTHER	Neonate Bwt 1250-1499g W Or Without Other Significant Condition	18	7	—	—	$16,863.49	$71,420.76	$71,420.76	2026-05-13
1824	OTHER	Other Peripheral Vascular Procedures	18	7	—	—	$27,752.84	$70,195.10	$70,195.10	2026-05-13
6213	OTHER	Neonate Bwt 2000-2499g W Major Anomaly	18	7	—	—	$9,319.14	$70,070.79	$70,070.79	2026-05-13
MS-266	OTHER	Endovascular Cardiac Valve Replacement W Mcc	18	12	—	—	$47,378.89	$142,899.70	$69,883.86	2026-05-13
4424	OTHER	Kidney And Urinary Tract Procedures For Malignancy	18	7	—	—	$26,639.40	$69,722.43	$69,722.43	2026-05-13
6122	OTHER	Neonate Bwt 1500-1999g W Resp Dist Synd/oth Maj Resp Cond	18	7	—	—	$17,277.12	$69,137.09	$69,137.09	2026-05-13
MS-232	OTHER	Coronary Bypass With Ptca Without Mcc	18	12	—	—	$46,870.19	$141,365.40	$69,133.53	2026-05-13
6953	OTHER	Chemotherapy For Acute Leukemia	18	7	—	—	$13,224.51	$69,037.41	$69,037.41	2026-05-13
6032	OTHER	Neonate Birthwt 1000-1249g W Or Without Other Significant Condition	18	7	—	—	$23,566.51	$84,467.93	$68,755.81	2026-05-13
2064	OTHER	Malfunction,reaction,complication Of Cardiac/vasc Device Or Procedure	18	7	—	—	$12,402.43	$68,672.66	$68,672.66	2026-05-13
MS-028	OTHER	Spinal Procedures With Mcc	18	12	—	—	$46,450.40	$140,099.26	$68,514.34	2026-05-13
MS-276	OTHER	Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator	18	12	—	—	$46,437.25	$140,059.62	$68,494.95	2026-05-13
MS-457	OTHER	Spinal Fusion Except Cervical With Spinal Curvature- Malignancy- Infection Or Ex…	18	12	—	—	$46,100.95	$139,045.30	$67,998.90	2026-05-13
MS-016	OTHER	Autologous Bone Marrow Transplant With Cc/mcc	18	12	—	—	$45,842.73	$138,266.49	$67,618.02	2026-05-13
MS-235	OTHER	Coronary Bypass Without Cardiac Catheterization With Mcc	18	12	—	—	$45,370.37	$136,841.78	$66,921.30	2026-05-13
6071	OTHER	Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom	18	7	—	—	$11,620.42	$66,705.33	$66,705.33	2026-05-13
1673	OTHER	Other Cardiothoracic And Thoracic Vascular Procedures	18	7	—	—	$24,467.15	$66,541.14	$66,541.14	2026-05-13
MS-969	OTHER	HIV With Extensive O.r. Procedures With Mcc	18	12	—	—	$42,952.51	$142,734.15	$66,305.71	2026-05-13
1924	OTHER	Cardiac Catheterization For Other Non-coronary Conditions	18	7	—	—	$16,830.71	$66,086.72	$66,086.72	2026-05-13
1804	OTHER	Other Circulatory System Procedures	18	7	—	—	$19,458.22	$65,886.11	$65,886.11	2026-05-13
MS-430	OTHER	Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc	18	12	—	—	$44,585.68	$134,475.05	$65,763.88	2026-05-13
MS-023	OTHER	Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…	18	12	—	—	$44,301.15	$133,616.96	$65,344.19	2026-05-13
2294	OTHER	Other Digestive System And Abdominal Procedures	18	7	—	—	$18,574.23	$65,179.74	$65,179.74	2026-05-13
3054	OTHER	Amputation Of Lower Limb Except Toes	18	7	—	—	$19,890.07	$65,173.95	$65,173.95	2026-05-13
9123	OTHER	Musculoskeletal And Other Procedures For Multiple Significant Trauma	18	7	—	—	$19,371.85	$65,116.56	$65,116.56	2026-05-13
2804	OTHER	Alcoholic Liver Disease	18	7	—	—	$13,078.30	$65,080.29	$65,080.29	2026-05-13
MS-463	OTHER	Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …	18	12	—	—	$44,063.04	$132,898.78	$64,992.99	2026-05-13
6333	OTHER	Neonate Birthwt >2499g W Major Anomaly	18	7	—	—	$9,158.36	$64,851.31	$64,851.31	2026-05-13
6112	OTHER	Neonate Birthwt 1500-1999g W Major Anomaly	18	7	—	—	$13,897.78	$72,122.13	$64,275.23	2026-05-13
2234	OTHER	Other Small And Large Bowel Procedures	18	7	—	—	$21,494.68	$64,136.78	$64,136.78	2026-05-13
MS-428	OTHER	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	18	12	—	—	$43,463.90	$131,091.66	$64,109.26	2026-05-13
9103	OTHER	Craniotomy For Multiple Significant Trauma	18	7	—	—	$27,767.93	$63,841.42	$63,841.42	2026-05-13
494	OTHER	Bacterial And Tuberculous Infections Of Nervous System	18	7	—	—	$20,608.61	$63,777.03	$63,777.03	2026-05-13
8632	OTHER	Neonatal Aftercare	18	7	—	—	$13,048.65	$63,739.24	$63,739.24	2026-05-13
MS-820	OTHER	Lymphoma And Leukemia With Major O.r. Procedures With Mcc	18	12	—	—	$41,152.68	$136,753.18	$63,527.31	2026-05-13
9113	OTHER	Extensive Abdominal/thoracic Procedures For Mult Significant Trauma	18	7	—	—	$16,366.60	$63,495.98	$63,495.98	2026-05-13
MS-278	OTHER	Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures …	18	12	—	—	$43,032.50	$129,790.54	$63,472.94	2026-05-13
2614	OTHER	Major Biliary Tract Procedures	18	7	—	—	$30,126.45	$62,708.61	$62,708.61	2026-05-13
1663	OTHER	Coronary Bypass Without Ami Or Complex Principal Diagnosis	18	7	—	—	$21,101.85	$62,661.22	$62,661.22	2026-05-13
1754	OTHER	Percutaneous Coronary Intervention Without Ami	18	7	—	—	$23,422.39	$64,568.53	$62,534.12	2026-05-13
MS-405	OTHER	Pancreas- Liver And Shunt Procedures With Mcc	18	12	—	—	$42,292.65	$127,559.04	$62,381.67	2026-05-13
MS-234	OTHER	Coronary Bypass With Cardiac Catheterization Without Mcc	18	12	—	—	$42,232.33	$127,377.16	$62,292.69	2026-05-13
MS-011	OTHER	Tracheostomy For Facemouth & Neck Diagnoses W Mcc	18	12	—	—	$42,165.85	$127,176.63	$62,194.63	2026-05-13
MS-017	OTHER	Autologous Bone Marrow Transplant Without Cc/mcc	18	12	—	—	$41,997.32	$126,668.31	$61,946.04	2026-05-13
6312	OTHER	Neonate Birthwt >2499g W Other Major Procedure	18	7	—	—	$12,286.41	$61,660.06	$61,660.06	2026-05-13
504	OTHER	Non-bacterial Infections Of Nervous System Except Viral Meningitis	18	7	—	—	$33,133.27	$61,559.03	$61,559.03	2026-05-13
3614	OTHER	Skin Graft For Skin And Subcutaneous Tissue Diagnoses	18	7	—	—	$38,350.47	$61,349.82	$61,349.82	2026-05-13
114	OTHER	Extracorporeal Membrane Oxygenation (ecmo)	17	7	—	—	$145,701.73	$647,979.12	$647,979.12	2026-05-13
113	OTHER	Extracorporeal Membrane Oxygenation (ecmo)	17	7	—	—	$85,202.81	$378,177.99	$378,177.99	2026-05-13
112	OTHER	Extracorporeal Membrane Oxygenation (ecmo)	17	7	—	—	$73,235.91	$304,837.81	$304,837.81	2026-05-13
8514	OTHER	Gender Related Procedures	17	7	—	—	$56,851.14	$180,152.55	$180,152.55	2026-05-13
MS-007	OTHER	Lung Transplant	17	12	—	—	$100,118.50	$301,967.84	$135,159.98	2026-05-13
111	OTHER	Extracorporeal Membrane Oxygenation (ecmo)	17	7	—	—	$33,694.67	$122,184.42	$122,184.42	2026-05-13
MS-209	OTHER	Kidney And Urinary Tract Signs And Symptoms Age 0-17	17	12	—	—	$87,506.08	$263,927.48	$118,133.21	2026-05-13
1834	OTHER	Percutaneous Structural Cardiac Procedures	17	7	—	—	$33,035.45	$113,743.82	$113,743.82	2026-05-13
MS-005	OTHER	Liver Transplant With Mcc Or Intestinal Transplant	17	12	—	—	$79,710.87	$240,416.32	$107,609.68	2026-05-13
1783	OTHER	External Heart Assist Systems	17	7	—	—	$28,006.75	$90,339.64	$90,339.64	2026-05-13
MS-010	OTHER	Pancreas Transplant	17	12	—	—	$55,475.62	$167,320.25	$74,892.09	2026-05-13
1833	OTHER	Percutaneous Structural Cardiac Procedures	17	7	—	—	$22,305.82	$74,455.37	$74,455.37	2026-05-13
1782	OTHER	External Heart Assist Systems	17	7	—	—	$26,944.82	$73,715.50	$73,715.50	2026-05-13
1793	OTHER	Defibrillator Implants	17	7	—	—	$22,414.57	$67,549.46	$67,549.46	2026-05-13
293	OTHER	Other Percutaneous Intracranial Procedures	17	7	—	—	$21,364.60	$66,238.49	$66,238.49	2026-05-13
1781	OTHER	External Heart Assist Systems	17	7	—	—	$22,942.67	$63,427.05	$63,427.05	2026-05-13
J1414	OTHER	Inj- Beqvez- Per Tx Dose	15	6	—	—	$3,675,000.00	$3,675,000.00	$3,675,000.00	2026-05-13
C9172	OTHER	Inj- Beqvez- Per Tx Dose	15	6	—	—	$3,675,000.00	$3,675,000.00	$3,675,000.00	2026-05-13
3004	OTHER	Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical	15	6	—	—	$129,752.55	$129,752.55	$129,752.55	2026-05-13
2994	OTHER	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical	15	6	—	—	$115,017.12	$115,017.12	$115,017.12	2026-05-13
2992	OTHER	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical	15	6	—	—	$90,231.60	$90,231.60	$90,231.60	2026-05-13
4484	OTHER	Other Kidney, Urinary Tract And Related Percutaneous Procedures	15	6	—	—	$74,022.53	$74,022.53	$74,022.53	2026-05-13
5204	OTHER	Other GYN Procedures For Malignancy	15	6	—	—	$73,420.43	$73,420.43	$73,420.43	2026-05-13
L8702	OTHER	Ewhf S/d Uprt Micro Sensor	15	10	—	—	$36,154.63	$128,160.05	$67,452.66	2026-05-13
4854	OTHER	Prostatectomy Procedures	15	6	—	—	$63,155.40	$63,155.40	$63,155.40	2026-05-13
J3392	OTHER	Inj- Exagamglogene Autotem	13	10	—	—	$1,249,952.00	$4,430,800.00	$2,332,000.00	2026-05-13
Q2042	OTHER	Tisagenlecleucel Car-pos T	13	10	—	—	$317,165.24	$1,124,279.78	$591,726.20	2026-05-13
J3403	OTHER	Revakinagene- Per Implant	13	10	—	—	$138,020.00	$489,250.00	$257,500.00	2026-05-13
J3402	OTHER	Inj. Remestemcel-l-rknd/ Td	13	10	—	—	$110,223.04	$390,716.00	$205,640.00	2026-05-13
J3393	OTHER	Inj- Betibeglogene Autotemce	11	9	—	—	$1,578,916.64	$4,713,184.00	$2,945,740.00	2026-05-13
J3394	OTHER	Inj- Lovotibeglogene Autotem	10	8	—	—	$1,741,166.91	$4,872,668.58	$3,248,445.72	2026-05-13
J3391	OTHER	Inj- Atidarsagene Autotemcel	9	7	—	—	$2,414,680.00	$4,730,250.00	$4,505,000.00	2026-05-13
8414	OTHER	Extensive Third Degree Burns With Skin Graft	2	2	—	—	$136,869.12	$136,869.12	$136,869.12	2026-05-13
8424	OTHER	Burns With Skin Graft Except Extensive Third Degree Burns	2	2	—	—	$88,230.96	$88,230.96	$88,230.96	2026-05-13
104	OTHER	Head Trauma With Deep Coma	1	1	—	—	$104,064.07	$104,064.07	$104,064.07	2026-05-13
103	OTHER	Head Trauma With Deep Coma	1	1	—	—	$96,681.47	$96,681.47	$96,681.47	2026-05-13
102	OTHER	Head Trauma With Deep Coma	1	1	—	—	$96,681.47	$96,681.47	$96,681.47	2026-05-13
101	OTHER	Head Trauma With Deep Coma	1	1	—	—	$96,681.47	$96,681.47	$96,681.47	2026-05-13

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