Hospital

ESKENAZI HEALTH

Indianapolis, IN · CCN 150024 · Rates published

45,126 distinct procedures filed

23 distinct payers

1,318,367 rate rows

2026-05-27 last MRF observed

Data quality

1,303,316 of 1,318,367 rate rows are consumer-grade (98.9%)

15,051 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	10,134
no usable negotiated amount (only an out-of-band fallback) — excluded from medians	3,655
per-diem day rate — not a per-procedure price	800
placeholder amount (≤ $0.02) — excluded from medians	407
exceeds 10× this hospital's gross charge — excluded from medians	55

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

Source MRF file	https://www.eskenazihealth.edu/docs/default-source/pricing/356005697_eskenazihealth_standardcharges.csv
Found on page	https://www.eskenazihealth.edu/cms-hpt.txt
Discovered via	Discovered by HANK (automated)
Last fetch	not_modified · 2026-05-19
Content fingerprint	ae69b686b57fc52e… · 278,855,406 bytes · first seen 2026-05-14

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
018 OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	14	$286,778.31	$1,340,327.09	$615,980.42	nat. median $424,868 1.4× median
007 OTHER	Lung Transplant	11	$121,487.57	$934,531.40	$466,340.50	nat. median $141,082 outlier · 3.3×
001 OTHER	Heart Transplant Or Implant Of Heart Assist System With Mcc	11	$215,002.94	$585,122.63	$254,947.25	nat. median $263,894 1.0× median
927 OTHER	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	12	$180,394.58	$494,961.10	$209,831.98	nat. median $146,562 1.4× median
003 OTHER	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…	14	$162,971.67	$448,492.09	$199,228.15	nat. median $218,232 0.9× median
004 OTHER	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…	14	$107,448.34	$402,089.44	$183,645.82	nat. median $150,232 1.2× median
002 OTHER	Heart Transplant Or Implant Of Heart Assist System Without Mcc	11	$102,439.13	$302,973.52	$143,511.08	nat. median $117,167 1.2× median
969 OTHER	HIV With Extensive O.r. Procedures With Mcc	14	$48,091.68	$279,089.43	$130,984.23	nat. median $64,729 outlier · 2.0×
30237890006 OTHER	Sipuleucel-t 50 Million Cell/250 Ml Suspension 250	23	$48,872.12	$250,415.00	$124,706.67	nat. median $62,565 2.0× median
014 OTHER	Allogeneic Bone Marrow Transplant	13	$38,882.04	$279,551.05	$120,412.44	nat. median $105,808 1.1× median
006 OTHER	Liver Transplant Without Mcc	11	$45,078.17	$216,708.02	$105,886.04	nat. median $50,611 outlier · 2.1×
008 OTHER	Simultaneous Pancreas And Kidney Transplant	11	$50,580.47	$209,735.00	$101,563.86	nat. median $59,265 1.7× median
212 OTHER	Hip & Femur Procedures Except Major Joint Age 0-17	14	$82,840.16	$234,771.46	$101,269.69	nat. median $90,581 1.1× median
005 OTHER	Liver Transplant With Mcc Or Intestinal Transplant	11	$83,366.50	$229,812.61	$98,530.61	nat. median $104,489 0.9× median
215 OTHER	Other Heart Assist System Implant	14	$80,565.72	$228,705.25	$98,489.27	nat. median $92,359 1.1× median
27093 OTHER	Pack Penumbra Starter	11	$57,950.10	$152,100.00	$97,800.30	nat. median $198 outlier · 494.1×
453 OTHER	Combined Anterior And Posterior Spinal Fusion With Mcc	11	$67,387.53	$193,549.21	$82,778.34	nat. median $65,342 1.3× median
231 OTHER	Coronary Bypass With Ptca With Mcc	14	$64,437.82	$185,690.18	$79,465.54	nat. median $74,989 1.1× median
456 OTHER	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	14	$64,402.08	$185,594.86	$79,425.36	nat. median $76,493 1.0× median
020 OTHER	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc	14	$61,298.78	$177,317.97	$75,936.42	nat. median $82,426 0.9× median
010 OTHER	Pancreas Transplant	11	$60,865.51	$175,531.14	$75,183.22	nat. median $67,882 1.1× median
019 OTHER	Simultaneous Pancreas And Kidney Transplant With Hemodialysis	14	$16,368.90	$174,604.28	$74,792.52	nat. median $67,495 1.1× median
233 OTHER	Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc	14	$59,438.02	$172,355.02	$73,844.39	nat. median $68,249 1.1× median
957 OTHER	Other O.r. Procedures For Multiple Significant Trauma With Mcc	14	$56,759.79	$165,211.91	$70,833.37	nat. median $68,309 1.0× median
837 OTHER	Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot…	14	$38,076.10	$153,352.92	$69,831.63	nat. median $38,617 1.8× median
275 OTHER	Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc	14	$53,739.38	$157,156.06	$67,437.60	nat. median $29,655 outlier · 2.3×
163 OTHER	Major Chest Procedures With Mcc	14	$35,049.60	$148,104.61	$67,239.82	nat. median $47,944 1.4× median
870 OTHER	Septicemia Or Severe Sepsis With Mv >96 Hours	14	$52,899.10	$154,914.98	$66,492.92	nat. median $54,603 1.2× median
653 OTHER	Major Bladder Procedures With Mcc	14	$42,390.76	$139,818.98	$66,120.33	nat. median $54,646 1.2× median
955 OTHER	Craniotomy For Multiple Significant Trauma	14	$51,924.24	$152,314.88	$65,396.91	nat. median $62,467 1.0× median
928 OTHER	Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc	12	$50,788.16	$149,284.84	$64,119.66	nat. median $46,003 1.4× median
459 OTHER	Spinal Fusion Except Cervical With Mcc	11	$50,436.09	$148,339.71	$63,721.26	nat. median $50,246 1.3× median
016 OTHER	Autologous Bone Marrow Transplant With Cc/mcc	13	$45,900.70	$136,243.82	$63,372.21	nat. median $60,768 1.0× median
276 OTHER	Non-maligant Breast Disorders	14	$47,103.89	$139,458.43	$59,977.55	nat. median $3,947 outlier · 15.2×
573 OTHER	Skin Graft For Skin Ulcer Or Cellulitis With Mcc	14	$46,828.62	$138,724.22	$59,668.06	nat. median $54,881 1.1× median
232 OTHER	Coronary Bypass With Ptca Without Mcc	14	$46,452.20	$137,720.33	$59,244.89	nat. median $56,351 1.1× median
028 OTHER	Spinal Procedures With Mcc	14	$46,230.16	$137,128.06	$58,995.23	nat. median $61,887 1.0× median
017 OTHER	Autologous Bone Marrow Transplant Without Cc/mcc	13	$18,898.13	$136,243.82	$58,622.50	nat. median $51,368 1.1× median
266 OTHER	Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc	14	$45,555.66	$135,329.09	$58,236.92	nat. median $58,866 1.0× median
471 OTHER	Cervical Spinal Fusion With Mcc	14	$36,936.22	$117,838.77	$56,991.40	nat. median $399 outlier · 142.7×
820 OTHER	Lymphoma And Leukemia With Major O.r. Procedures With Mcc	14	$44,274.34	$131,911.70	$56,796.39	nat. median $45,972 1.2× median
457 OTHER	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	14	$43,643.95	$130,230.34	$56,087.65	nat. median $52,731 1.1× median
023 OTHER	Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…	14	$43,383.12	$129,534.66	$55,794.40	nat. median $59,073 0.9× median
326 OTHER	Stomach, Esophageal And Duodenal Procedures With Mcc	14	$38,622.09	$118,720.05	$55,417.59	nat. median $45,545 1.2× median
021 OTHER	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc	14	$42,031.08	$126,848.38	$54,743.62	nat. median $58,177 0.9× median
405 OTHER	Pancreas, Liver And Shunt Procedures With Mcc	14	$41,281.30	$123,928.85	$53,431.39	nat. median $49,246 1.1× median
463 OTHER	Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective…	14	$41,070.66	$123,367.05	$53,194.58	nat. median $48,651 1.1× median
011 OTHER	Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc	14	$41,031.88	$123,263.64	$53,150.99	nat. median $56,278 0.9× median
576 OTHER	Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc	14	$12,730.44	$123,251.45	$53,145.85	nat. median $43,664 1.2× median
234 OTHER	Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc	14	$40,456.24	$121,728.31	$52,503.80	nat. median $50,947 1.0× median

Other procedures at this hospital

Browse this hospital's 45,126 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

826	OTHER	Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. …	27	23	$78.65	$78.65	$29.97	$110,680.94	$36,315.84	2026-05-27
458	OTHER	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	27	23	$79.53	$79.53	$30.30	$101,402.19	$32,836.74	2026-05-27
570	OTHER	Skin Debridement With Mcc	27	23	$167.20	$167.20	$63.70	$186,775.97	$27,982.82	2026-05-27
799	OTHER	Splenectomy With Mcc	27	23	$167.92	$167.92	$63.98	$110,261.15	$36,158.44	2026-05-27
461	OTHER	Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc	27	23	$169.29	$169.29	$64.50	$138,663.72	$48,241.00	2026-05-27
793	OTHER	Full Term Neonate With Major Problems	27	23	$321.75	$321.75	$122.59	$98,410.65	$31,713.61	2026-05-27
834	OTHER	Acute Leukemia Without Major O.r. Procedures With Mcc	27	23	$338.25	$338.25	$128.87	$125,928.62	$42,031.08	2026-05-27
518	OTHER	Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost…	27	23	$407.07	$407.07	$155.09	$86,515.53	$27,254.95	2026-05-27
356	OTHER	Other Digestive System O.r. Procedures With Mcc	27	23	$432.16	$432.16	$164.65	$101,269.68	$33,890.37	2026-05-27
273	OTHER	Percutaneous And Other Intracardiac Procedures With Mcc	27	23	$440.00	$440.00	$167.64	$93,133.40	$29,736.34	2026-05-27
791	OTHER	Prematurity With Major Problems	27	23	$445.50	$445.50	$169.74	$96,167.51	$30,872.58	2026-05-27
616	OTHER	Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With…	27	23	$606.22	$606.22	$230.97	$92,214.65	$29,391.85	2026-05-27
114872	OTHER	Hc Insert Sc/dc Icd Generator	48	23	$75,240.00	$75,240.00	$308.59	$75,240.00	$37,469.52	2026-05-27
114862	OTHER	Hc Insert Pulse Gen W/dual Leads	48	23	$60,192.00	$60,192.00	$320.60	$61,100.63	$29,975.62	2026-05-27
114864	OTHER	Hc Insert Pulse Gen W/multi Leads	48	23	$80,191.00	$80,191.00	$344.04	$85,279.34	$39,935.12	2026-05-27
114984	OTHER	Hc Ep Ablate Supravent Arrhyt	48	23	$56,000.40	$56,000.40	$708.04	$61,564.61	$27,888.20	2026-05-27
114878	OTHER	Hc Ins/rep Defib W/lead(s)	48	23	$61,924.00	$61,924.00	$780.31	$85,279.34	$30,838.15	2026-05-27
114990	OTHER	Hc Tx Atrial Fib Pulm Vein Isol	48	23	$77,994.15	$77,994.15	$802.69	$77,994.15	$38,841.09	2026-05-27
876	OTHER	O.r. Procedures With Principal Diagnosis Of Mental Illness	15	14	—	—	$1,754.66	$93,524.82	$36,529.56	2026-05-27
153	OTHER	Inogen Crtd Df1	52	23	$60,000.00	$60,000.00	$5,411.96	$60,000.00	$29,100.00	2026-05-27
197	OTHER	Interstitial Lung Disease With Cc	15	14	—	—	$7,528.23	$61,340.18	$29,481.31	2026-05-27
152	OTHER	Inogen X4 Crtd Df1	46	23	$63,000.00	$63,000.00	$8,629.33	$63,000.00	$31,374.00	2026-05-27
576	OTHER	Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc	15	14	—	—	$12,730.44	$123,251.45	$53,145.85	2026-05-27
278	OTHER	Cellulitis Age >17 Without Cc	15	14	—	—	$14,430.94	$115,301.12	$49,794.56	2026-05-27
019	OTHER	Simultaneous Pancreas And Kidney Transplant With Hemodialysis	15	14	—	—	$16,368.90	$174,604.28	$74,792.52	2026-05-27
173	OTHER	Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary…	15	14	—	—	$16,442.06	$76,062.45	$33,254.35	2026-05-27
68099	OTHER	Cranial Models Ips Complex	12	11	$44,886.75	$44,886.75	$17,101.85	$44,886.75	$28,862.18	2026-05-27
51734	OTHER	Stent Pipeline Embolization 4.75m X10mm	12	11	$44,940.00	$44,940.00	$17,122.14	$44,940.00	$28,896.42	2026-05-27
51678	OTHER	Pipeline Flex Embolization Device	12	11	$44,940.00	$44,940.00	$17,122.14	$44,940.00	$28,896.42	2026-05-27
827	OTHER	Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. …	15	14	—	—	$17,945.32	$61,688.93	$27,195.51	2026-05-27
330	OTHER	Major Small And Large Bowel Procedures With Cc	15	14	—	—	$17,974.21	$61,766.00	$27,227.99	2026-05-27
347	OTHER	Anal And Stomal Procedures With Mcc	15	14	—	—	$17,997.79	$66,268.51	$29,519.62	2026-05-27
473	OTHER	Cervical Spinal Fusion Without Cc/mcc	15	14	—	—	$18,002.35	$61,841.01	$27,259.61	2026-05-27
417	OTHER	Laparoscopic Cholecystectomy Without C.d.e. With Mcc	15	14	—	—	$18,071.55	$62,025.62	$27,337.43	2026-05-27
095	OTHER	Bacterial And Tuberculous Infections Of Nervous System With Cc	15	14	—	—	$18,228.96	$62,445.41	$27,514.38	2026-05-27
096	OTHER	Bacterial And Tuberculous Infections Of Nervous System Without Cc/mcc	15	14	—	—	$18,228.96	$62,445.41	$27,514.38	2026-05-27
493	OTHER	Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Cc	15	14	—	—	$18,257.85	$62,522.50	$27,546.88	2026-05-27
350	OTHER	Inguinal And Femoral Hernia Procedures With Mcc	15	14	—	—	$18,392.45	$62,881.46	$27,698.19	2026-05-27
327	OTHER	Stomach, Esophageal And Duodenal Procedures With Cc	15	14	—	—	$18,463.93	$63,072.10	$27,778.55	2026-05-27
982	OTHER	Extensive O.r. Procedures Unrelated To Principal Diagnosis With Cc	15	14	—	—	$18,617.53	$63,481.84	$27,951.27	2026-05-27
51507	OTHER	Stent Pipeline Flex Embolization 207cm	12	11	$48,915.00	$48,915.00	$18,636.62	$48,915.00	$31,452.35	2026-05-27
027	OTHER	Craniotomy And Endovascular Intracranial Procedures Without Cc/mcc	15	14	—	—	$18,765.82	$63,877.31	$28,117.97	2026-05-27
397	OTHER	Coagulation Disorders	15	14	—	—	$18,841.86	$64,080.10	$28,203.45	2026-05-27
017	OTHER	Autologous Bone Marrow Transplant Without Cc/mcc	14	13	—	—	$18,898.13	$136,243.82	$58,622.50	2026-05-27
272	OTHER	Other Major Cardiovascular Procedures Without Cc/mcc	15	14	—	—	$19,027.40	$64,574.99	$28,412.06	2026-05-27
55555444947	OTHER	Metronidazole 0.025 Mg/ml 10 Ml	12	11	$50,000.00	$50,000.00	$19,050.00	$50,000.00	$32,150.00	2026-05-27
164	OTHER	Major Chest Procedures With Cc	15	14	—	—	$19,139.95	$64,875.16	$28,538.59	2026-05-27
498	OTHER	Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur With Cc…	15	14	—	—	$19,200.02	$65,035.36	$28,606.12	2026-05-27
483	OTHER	Major Joint Or Limb Reattachment Procedures Of Upper Extremities	15	14	—	—	$19,377.20	$65,507.93	$28,805.32	2026-05-27
253	OTHER	Other Vascular Procedures With Cc	15	14	—	—	$19,413.70	$65,605.29	$28,846.36	2026-05-27
987	OTHER	Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc	15	14	—	—	$19,484.65	$84,866.61	$36,965.55	2026-05-27
659	OTHER	Kidney And Ureter Procedures For Non-neoplasm With Mcc	15	14	—	—	$19,651.71	$66,240.11	$29,113.96	2026-05-27
255	OTHER	Upper Limb And Toe Amputation For Circulatory System Disorders With Mcc	15	14	—	—	$19,896.57	$66,893.15	$29,389.23	2026-05-27
468	OTHER	Revision Of Hip Or Knee Replacement Without Cc/mcc	15	14	—	—	$19,948.28	$67,031.07	$29,447.37	2026-05-27
959	OTHER	Other O.r. Procedures For Multiple Significant Trauma Without Cc/mcc	15	14	—	—	$20,104.93	$67,448.90	$29,623.50	2026-05-27
503	OTHER	Foot Procedures With Mcc	15	14	—	—	$20,125.46	$67,503.64	$29,646.57	2026-05-27
013	OTHER	Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy Without Cc/mcc	15	14	—	—	$20,151.32	$67,572.58	$29,675.63	2026-05-27
970	OTHER	HIV With Extensive O.r. Procedures Without Mcc	15	14	—	—	$20,176.41	$68,953.41	$30,969.00	2026-05-27
577	OTHER	Skin Graft Except For Skin Ulcer Or Cellulitis With Cc	15	14	—	—	$20,248.65	$67,832.20	$29,785.07	2026-05-27
849	OTHER	Radiotherapy	15	14	—	—	$20,311.77	$68,382.35	$30,050.83	2026-05-27
344	OTHER	Minor Small And Large Bowel Procedures With Mcc	15	14	—	—	$20,489.71	$68,475.13	$30,056.08	2026-05-27
061	OTHER	Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A…	15	14	—	—	$20,557.38	$68,655.64	$30,132.17	2026-05-27
963	OTHER	Other Multiple Significant Trauma With Mcc	15	14	—	—	$20,658.52	$68,925.39	$30,245.88	2026-05-27
38677	OTHER	Antegrade Tibia 8.5dia 50x215mm Distr	22	18	$54,075.00	$54,075.00	$20,726.95	$26,929.35	$26,929.35	2026-05-27
38829	OTHER	Retro Femur Strght 12.5dia 50x275mm	22	18	$54,075.00	$54,075.00	$20,726.95	$26,929.35	$26,929.35	2026-05-27
38690	OTHER	Retro Femur 10deg 10.7dia 80x245mm	22	18	$54,075.00	$54,075.00	$20,726.95	$26,929.35	$26,929.35	2026-05-27
38842	OTHER	Antegrade Tibia 10.7 Dia 80x365mm	22	18	$54,075.00	$54,075.00	$20,726.95	$26,929.35	$26,929.35	2026-05-27
38831	OTHER	Retro Femur Strght 12.5dia 50x335mm	22	18	$54,075.00	$54,075.00	$20,726.95	$26,929.35	$26,929.35	2026-05-27
38853	OTHER	Antegrade Femur 12.5 Dia 80x305mm	22	18	$54,075.00	$54,075.00	$20,726.95	$26,929.35	$26,929.35	2026-05-27
38815	OTHER	Retro Femur Straight 8.5dia 50x215mm	22	18	$54,075.00	$54,075.00	$20,726.95	$26,929.35	$26,929.35	2026-05-27
38855	OTHER	Antegrade Femur 12.5 Dia 80x365mm	22	18	$54,075.00	$54,075.00	$20,726.95	$26,929.35	$26,929.35	2026-05-27
38650	OTHER	Ante Femur Piriformis 12.5dia 50x215mm	22	18	$54,075.00	$54,075.00	$20,726.95	$26,929.35	$26,929.35	2026-05-27
38646	OTHER	Ante Femur Piriformis 10.7dia 50x275mm	22	18	$54,075.00	$54,075.00	$20,726.95	$26,929.35	$26,929.35	2026-05-27
38827	OTHER	Retro Femur Strght 12.5dia 50x230mm	22	18	$54,075.00	$54,075.00	$20,726.95	$26,929.35	$26,929.35	2026-05-27
38701	OTHER	Retro Femur 10deg 12.5dia 80x365mm	22	18	$54,075.00	$54,075.00	$20,726.95	$26,929.35	$26,929.35	2026-05-27
38841	OTHER	Antegrade Tibia 10.7 Dia 80x335mm	22	18	$54,075.00	$54,075.00	$20,726.95	$26,929.35	$26,929.35	2026-05-27
38832	OTHER	Retro Femur Strght 12.5dia 50x365mm	22	18	$54,075.00	$54,075.00	$20,726.95	$26,929.35	$26,929.35	2026-05-27
38692	OTHER	Retro Femur 10deg 10.7dia 80x305mm	22	18	$54,075.00	$54,075.00	$20,726.95	$26,929.35	$26,929.35	2026-05-27
38705	OTHER	Retro Femur 10deg 8.5dia 80x275mm	22	18	$54,075.00	$54,075.00	$20,726.95	$26,929.35	$26,929.35	2026-05-27
38844	OTHER	Antegrade Tibia 12.5 Dia 50x215mm	22	18	$54,075.00	$54,075.00	$20,726.95	$26,929.35	$26,929.35	2026-05-27
38648	OTHER	Ante Femur Piriformis 10.7dia 50x335mm	22	18	$54,075.00	$54,075.00	$20,726.95	$26,929.35	$26,929.35	2026-05-27
38826	OTHER	Retro Femur Strght 12.5dia 50x215mm	22	18	$54,075.00	$54,075.00	$20,726.95	$26,929.35	$26,929.35	2026-05-27
38837	OTHER	Antegrade Tibia 10.7 Dia 50x230mm	22	18	$54,075.00	$54,075.00	$20,726.95	$26,929.35	$26,929.35	2026-05-27
38663	OTHER	Antegrade Femur 107dia 80x245mm Distr	22	18	$54,075.00	$54,075.00	$20,726.95	$26,929.35	$26,929.35	2026-05-27
38819	OTHER	Retro Femur Strght 10.7dia 50x215mm	22	18	$54,075.00	$54,075.00	$20,726.95	$26,929.35	$26,929.35	2026-05-27
38839	OTHER	Antegrade Tibia 10.7 Dia 80x275mm	22	18	$54,075.00	$54,075.00	$20,726.95	$26,929.35	$26,929.35	2026-05-27
38822	OTHER	Retro Femur Strght 10.7dia 80x275mm	22	18	$54,075.00	$54,075.00	$20,726.95	$26,929.35	$26,929.35	2026-05-27
38830	OTHER	Retro Femur Strght 12.5dia 50x305mm	22	18	$54,075.00	$54,075.00	$20,726.95	$26,929.35	$26,929.35	2026-05-27
38696	OTHER	Retro Femur 10deg 12.5dia 50x230mm	22	18	$54,075.00	$54,075.00	$20,726.95	$26,929.35	$26,929.35	2026-05-27
38659	OTHER	Ante Femur Piriformis 8.5dia 50x245mm	22	18	$54,075.00	$54,075.00	$20,726.95	$26,929.35	$26,929.35	2026-05-27
38835	OTHER	Antegrade Tibia 10.7 Dia 50x195mm	22	18	$54,075.00	$54,075.00	$20,726.95	$26,929.35	$26,929.35	2026-05-27
38824	OTHER	Retro Femur Strght 10.7dia 80x335mm	22	18	$54,075.00	$54,075.00	$20,726.95	$26,929.35	$26,929.35	2026-05-27
38664	OTHER	Antegrade Femur 107dia 80x275mm Distr	22	18	$54,075.00	$54,075.00	$20,726.95	$26,929.35	$26,929.35	2026-05-27
38670	OTHER	Antegrade Femur 8.5dia 50x215mm Distr	22	18	$54,075.00	$54,075.00	$20,726.95	$26,929.35	$26,929.35	2026-05-27
38647	OTHER	Ante Femur Piriformis 10.7dia 50x305mm	22	18	$54,075.00	$54,075.00	$20,726.95	$26,929.35	$26,929.35	2026-05-27
38843	OTHER	Antegrade Tibia 12.5 Dia 50x195mm	22	18	$54,075.00	$54,075.00	$20,726.95	$26,929.35	$26,929.35	2026-05-27
38700	OTHER	Retro Femur 10deg 12.5dia 80x335mm	22	18	$54,075.00	$54,075.00	$20,726.95	$26,929.35	$26,929.35	2026-05-27
38658	OTHER	Ante Femur Piriformis 8.5dia 50x230mm	22	18	$54,075.00	$54,075.00	$20,726.95	$26,929.35	$26,929.35	2026-05-27
38667	OTHER	Antegrade Femur 107dia 80x365mm Distr	22	18	$54,075.00	$54,075.00	$20,726.95	$26,929.35	$26,929.35	2026-05-27
38854	OTHER	Antegrade Femur 12.5 Dia 80x335mm	22	18	$54,075.00	$54,075.00	$20,726.95	$26,929.35	$26,929.35	2026-05-27
38645	OTHER	Ante Femur Piriformis 10.7dia 50x245mm	22	18	$54,075.00	$54,075.00	$20,726.95	$26,929.35	$26,929.35	2026-05-27
38661	OTHER	Antegrade Femur 107dia 50x215mm Distr	22	18	$54,075.00	$54,075.00	$20,726.95	$26,929.35	$26,929.35	2026-05-27
38671	OTHER	Antegrade Femur 8.5dia 50x230mm Distr	22	18	$54,075.00	$54,075.00	$20,726.95	$26,929.35	$26,929.35	2026-05-27
38674	OTHER	Antegrade Tibia 8.5 Dia 80x245mm Distr	22	18	$54,075.00	$54,075.00	$20,726.95	$26,929.35	$26,929.35	2026-05-27
38852	OTHER	Antegrade Femur 12.5 Dia 80x275mm	22	18	$54,075.00	$54,075.00	$20,726.95	$26,929.35	$26,929.35	2026-05-27
619	OTHER	O.r. Procedures For Obesity With Mcc	15	14	—	—	$20,733.04	$69,124.13	$30,329.65	2026-05-27
5451	OTHER	Impl Peek Priority Cust Lrg	31	20	$54,108.00	$54,108.00	$20,739.60	$54,108.00	$26,945.78	2026-05-27
411	OTHER	Cholecystectomy With C.d.e. With Mcc	15	14	—	—	$20,808.32	$69,324.92	$30,414.29	2026-05-27
73742	OTHER	MRI Surescan Cobalt Xt Hf Quad Crt-d	31	20	$54,384.00	$54,384.00	$20,845.39	$54,384.00	$27,083.23	2026-05-27
56201	OTHER	Defib Crtd Compia MRI Df1	31	20	$54,434.46	$54,434.46	$20,864.73	$54,434.46	$27,108.36	2026-05-27
324	OTHER	Urinary Stones Without Cc	15	14	—	—	$21,060.87	$78,628.06	$34,335.83	2026-05-27
279	OTHER	Cellulitis Age 0-17	15	14	—	—	$21,133.95	$78,816.69	$34,415.34	2026-05-27
44570	OTHER	Lead Quadra Assura Mp Crt-d	31	20	$55,500.00	$55,500.00	$21,273.15	$55,500.00	$27,639.00	2026-05-27
44577	OTHER	Qrda Asra Mp Crt-d 40 Df4 Mrln Pkg	31	20	$55,500.00	$55,500.00	$21,273.15	$55,500.00	$27,639.00	2026-05-27
44571	OTHER	Connector Quarda Assura Mp Crt-d Df4	31	20	$55,500.00	$55,500.00	$21,273.15	$55,500.00	$27,639.00	2026-05-27
48604	OTHER	Dynagen Crt-d Df4/is1	31	20	$55,500.00	$55,500.00	$21,273.15	$55,500.00	$27,639.00	2026-05-27
44576	OTHER	Quarda Assura Mp Crt-d Merlin Pkg	31	20	$55,500.00	$55,500.00	$21,273.15	$55,500.00	$27,639.00	2026-05-27
48605	OTHER	Dynagen Crt-d Df1/is1	31	20	$55,500.00	$55,500.00	$21,273.15	$55,500.00	$27,639.00	2026-05-27
68427	OTHER	Implantable Pulse Generator Kit Alpha	31	20	$55,500.00	$55,500.00	$21,273.15	$55,500.00	$27,639.00	2026-05-27
58016	OTHER	Bone Prosthesis Peek Implant Sd800.441	31	20	$55,656.00	$55,656.00	$21,332.94	$55,656.00	$27,716.69	2026-05-27
258	OTHER	Cardiac Pacemaker Device Replacement With Mcc	15	14	—	—	$21,333.78	$70,726.37	$31,005.04	2026-05-27
406	OTHER	Pancreas, Liver And Shunt Procedures With Cc	15	14	—	—	$21,355.83	$70,785.17	$31,029.83	2026-05-27
51390	OTHER	Defibrilator Crtd Claria MRI Quad US Df4	31	20	$55,802.16	$55,802.16	$21,388.97	$55,802.16	$27,789.48	2026-05-27
56203	OTHER	Defib Crtd Amplia MRI Quad Df1	31	20	$55,802.16	$55,802.16	$21,388.97	$55,802.16	$27,789.48	2026-05-27
51389	OTHER	Defibrilator Crtd Claria MRI Quad US Df1	31	20	$55,802.16	$55,802.16	$21,388.97	$55,802.16	$27,789.48	2026-05-27
56202	OTHER	Defib Crtd Amplia MRI Quad Crtd	31	20	$55,802.16	$55,802.16	$21,388.97	$55,802.16	$27,789.48	2026-05-27
56205	OTHER	Defib Crtd Amplia MRI Df1	31	20	$55,802.16	$55,802.16	$21,388.97	$55,802.16	$27,789.48	2026-05-27
654	OTHER	Major Bladder Procedures With Cc	15	14	—	—	$21,460.01	$71,063.02	$31,146.95	2026-05-27
79486	OTHER	Stent Pipe Flex Embo W Shield 4.5x12mm	31	20	$56,259.00	$56,259.00	$21,564.07	$56,259.00	$28,016.98	2026-05-27
79499	OTHER	Flex Embolization Device W/shield	31	20	$56,259.00	$56,259.00	$21,564.07	$56,259.00	$28,016.98	2026-05-27
74310	OTHER	Stent Embo Device Shield Tech	31	20	$56,259.00	$56,259.00	$21,564.07	$56,259.00	$28,016.98	2026-05-27
79546	OTHER	Pipeline Flex Embo W Shield 4.25x12mm	31	20	$56,259.00	$56,259.00	$21,564.07	$56,259.00	$28,016.98	2026-05-27
321	OTHER	Kidney & Urinary Tract Infections Age >17 Without Cc	15	14	—	—	$21,647.84	$71,564.00	$31,358.13	2026-05-27
325	OTHER	Coronary Intravascular Lithotripsy Without Intraluminal Device	15	14	—	—	$21,764.18	$71,874.29	$31,488.92	2026-05-27
462	OTHER	Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without Mcc	15	14	—	—	$21,777.11	$71,908.78	$31,503.46	2026-05-27
625	OTHER	Thyroid, Parathyroid And Thyroglossal Procedures With Mcc	15	14	—	—	$21,802.20	$71,975.72	$31,531.68	2026-05-27
420	OTHER	Hepatobiliary Diagnostic Procedures With Mcc	15	14	—	—	$21,833.19	$85,410.20	$37,194.69	2026-05-27
38936	OTHER	Kit Precision Pulse Generator / Chargin	31	20	$57,000.00	$57,000.00	$21,848.10	$57,000.00	$28,386.00	2026-05-27
66074	OTHER	Pulse Generator Kit	31	20	$57,000.00	$57,000.00	$21,848.10	$57,000.00	$28,386.00	2026-05-27
66667	OTHER	Pulse Generator Kit	31	20	$57,000.00	$57,000.00	$21,848.10	$57,000.00	$28,386.00	2026-05-27
70140	OTHER	Zenith Alpha Thoracic Endovasc Graft	31	20	$57,162.00	$57,162.00	$21,910.19	$57,162.00	$28,466.68	2026-05-27
240	OTHER	Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc	15	14	—	—	$22,145.16	$72,890.42	$31,917.25	2026-05-27
800	OTHER	Splenectomy With Cc	15	14	—	—	$22,157.32	$72,922.85	$31,930.92	2026-05-27
521	OTHER	Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc	15	14	—	—	$22,164.17	$72,941.12	$31,938.62	2026-05-27
668	OTHER	Transurethral Procedures With Mcc	15	14	—	—	$22,176.33	$72,973.55	$31,952.29	2026-05-27
353	OTHER	Hernia Procedures Except Inguinal And Femoral With Mcc	15	14	—	—	$22,303.32	$73,312.24	$32,095.06	2026-05-27
480	OTHER	Hip And Femur Procedures Except Major Joint With Mcc	15	14	—	—	$22,364.16	$73,474.53	$32,163.47	2026-05-27
464	OTHER	Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …	15	14	—	—	$22,421.95	$73,628.64	$32,228.43	2026-05-27
23421	OTHER	Defibrilator Vitality Ds Vr	31	20	$58,500.00	$58,500.00	$22,423.05	$58,500.00	$29,133.00	2026-05-27
48602	OTHER	Dynagen X4 Crt-d Df4/is4	31	20	$58,500.00	$58,500.00	$22,423.05	$58,500.00	$29,133.00	2026-05-27
48603	OTHER	Dynagen X4 Crt-d Df1/is4	31	20	$58,500.00	$58,500.00	$22,423.05	$58,500.00	$29,133.00	2026-05-27
38825	OTHER	Fem Nail 10.7dia 80x365mm	31	20	$58,680.00	$58,680.00	$22,492.04	$58,680.00	$29,222.64	2026-05-27
974	OTHER	HIV With Major Related Condition With Mcc	15	14	—	—	$22,707.87	$74,391.22	$32,549.88	2026-05-27
57947	OTHER	Cage Spinal Fus Base Ti 10x34x24mm 10de	31	20	$59,250.00	$59,250.00	$22,710.52	$59,250.00	$29,506.50	2026-05-27
00310453530	OTHER	Tremelimumab-actl 20 Mg/ml Solution 15 Ml Vial	43	23	$59,870.00	$59,870.00	$22,810.47	$59,870.00	$29,815.26	2026-05-27
5092	OTHER	Pace- Makr Inogen El Dr	31	20	$60,000.00	$60,000.00	$22,998.00	$60,000.00	$29,880.00	2026-05-27
5091	OTHER	Pace Makr Inogen El Dr Df4	31	20	$60,000.00	$60,000.00	$22,998.00	$60,000.00	$29,880.00	2026-05-27
8257	OTHER	Icd Biv Unify Crt-d40 Sj4 Conn	31	20	$60,000.00	$60,000.00	$22,998.00	$60,000.00	$29,880.00	2026-05-27
5761	OTHER	Inogen Crtd Df4	31	20	$60,000.00	$60,000.00	$22,998.00	$60,000.00	$29,880.00	2026-05-27
66534	OTHER	Graft Tag Thoracic 21mmx21mmx10cm 18fr	31	20	$60,435.00	$60,435.00	$23,164.74	$60,435.00	$30,096.63	2026-05-27
61755001001	OTHER	Inj Evinacumab-dgnb 5 Mg	43	23	$60,845.00	$60,845.00	$23,181.94	$60,845.00	$30,300.81	2026-05-27
026	OTHER	Craniotomy And Endovascular Intracranial Procedures With Cc	15	14	—	—	$23,258.42	$75,859.64	$33,168.86	2026-05-27
56165	OTHER	Defib Crtd Dual Cham Viva S	31	20	$60,912.00	$60,912.00	$23,347.57	$60,912.00	$30,334.18	2026-05-27
79575	OTHER	Stent Pl Flex Embo Dev W Sh 475mmx30mm	31	20	$61,236.00	$61,236.00	$23,471.76	$61,236.00	$30,495.53	2026-05-27
77926	OTHER	Stent Pipeline Embo Device Wshield Ped2	31	20	$61,236.00	$61,236.00	$23,471.76	$61,236.00	$30,495.53	2026-05-27
50286	OTHER	Evera S Dr Defibrillator	31	20	$61,500.00	$61,500.00	$23,572.95	$61,500.00	$30,627.00	2026-05-27
50633021011	OTHER	Glucarpidase Inj Per 10 Units	40	23	$61,961.00	$61,961.00	$23,607.14	$61,961.00	$30,856.58	2026-05-27
229	OTHER	Other Cardiothoracic Procedures Without Mcc	15	14	—	—	$23,621.14	$76,827.07	$33,576.66	2026-05-27
662	OTHER	Minor Bladder Procedures With Mcc	15	14	—	—	$23,722.28	$77,096.80	$33,690.36	2026-05-27
500	OTHER	Soft Tissue Procedures With Mcc	15	14	—	—	$24,095.65	$78,092.61	$34,110.12	2026-05-27
939	OTHER	O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc	15	14	—	—	$24,135.95	$78,200.12	$34,155.44	2026-05-27
5760	OTHER	Inogen X4 Crtd Df4	31	20	$63,000.00	$63,000.00	$24,147.90	$63,000.00	$31,374.00	2026-05-27
62101	OTHER	Vigilant X4 Crt-d G247	31	20	$63,009.00	$63,009.00	$24,151.35	$63,009.00	$31,378.48	2026-05-27
929	OTHER	Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/mcc	12	12	—	—	$24,184.62	$78,329.90	$34,210.14	2026-05-27
5611	OTHER	Eve MRI S Dr Devi W/ot Optivol	31	20	$63,300.00	$63,300.00	$24,262.89	$63,300.00	$31,523.40	2026-05-27
485	OTHER	Knee Procedures With Principal Diagnosis Of Infection With Mcc	15	14	—	—	$24,480.43	$79,118.84	$34,542.70	2026-05-27
56168	OTHER	Defib Crtd Viva Quad S	31	20	$63,937.80	$63,937.80	$24,507.36	$63,937.80	$31,841.02	2026-05-27
5446	OTHER	Impl Peek Priority Cust Xlg	31	20	$64,023.00	$64,023.00	$24,540.02	$64,023.00	$31,883.45	2026-05-27
171	OTHER	Emblem S-icd Pulse Generator	31	20	$64,500.00	$64,500.00	$24,722.85	$64,500.00	$32,121.00	2026-05-27
5351	OTHER	Viva Quad S Crt-d Df1 Lead Adapt	31	20	$64,500.00	$64,500.00	$24,722.85	$64,500.00	$32,121.00	2026-05-27
5352	OTHER	Viva Quad S Crt-d Df4 Adapt	31	20	$64,500.00	$64,500.00	$24,722.85	$64,500.00	$32,121.00	2026-05-27
656	OTHER	Kidney And Ureter Procedures For Neoplasm With Mcc	15	14	—	—	$24,774.71	$79,903.74	$34,873.56	2026-05-27
579	OTHER	Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc	15	14	—	—	$24,785.36	$79,932.16	$34,885.54	2026-05-27
469	OTHER	Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc…	15	14	—	—	$24,856.08	$80,120.75	$34,965.04	2026-05-27
56163	OTHER	Defibrill Crtd Biventricular Viva Xt	31	20	$65,266.08	$65,266.08	$25,016.49	$65,266.08	$32,502.51	2026-05-27
56164	OTHER	Defibrilltor Crtd Device Viva Xt	31	20	$65,266.08	$65,266.08	$25,016.49	$65,266.08	$32,502.51	2026-05-27
47581	OTHER	Crt-d Dtba1d4 Viva Xt Is1/df4 US	31	20	$65,400.00	$65,400.00	$25,067.82	$65,400.00	$32,569.20	2026-05-27
67854	OTHER	Implant Peek Large	31	20	$65,841.00	$65,841.00	$25,236.86	$65,841.00	$32,788.82	2026-05-27
037	OTHER	Extracranial Procedures With Mcc	15	14	—	—	$25,253.02	$81,179.49	$35,411.33	2026-05-27
029	OTHER	Spinal Procedures With Cc Or Spinal Neurostimulators	15	14	—	—	$25,525.25	$81,905.57	$35,717.39	2026-05-27
5349	OTHER	Viva Quad Xt Df1 Rv Lead	31	20	$66,900.00	$66,900.00	$25,642.77	$66,900.00	$33,316.20	2026-05-27
5350	OTHER	Viva Quad Xt Df4 Rv Lead	31	20	$66,900.00	$66,900.00	$25,642.77	$66,900.00	$33,316.20	2026-05-27
242	OTHER	Permanent Cardiac Pacemaker Implant With Mcc	15	14	—	—	$25,793.68	$82,621.48	$36,019.17	2026-05-27
56167	OTHER	Defib Crtd Is4/df4 Viva Quad Xt	31	20	$67,950.72	$67,950.72	$26,045.51	$67,950.72	$33,839.46	2026-05-27
467	OTHER	Revision Of Hip Or Knee Replacement With Cc	15	14	—	—	$26,046.15	$83,294.80	$36,302.99	2026-05-27
252	OTHER	Other Vascular Procedures With Mcc	15	14	—	—	$26,085.69	$83,400.32	$36,347.47	2026-05-27
665	OTHER	Prostatectomy With Mcc	15	14	—	—	$26,110.02	$83,465.20	$36,374.82	2026-05-27
271	OTHER	Other Major Cardiovascular Procedures With Cc	15	14	—	—	$26,192.15	$83,684.24	$36,467.15	2026-05-27
332	OTHER	Rectal Resection With Mcc	15	14	—	—	$26,376.93	$84,177.09	$36,674.90	2026-05-27
651	OTHER	Kidney Transplant With Hemodialysis Without Mcc	15	14	—	—	$26,405.83	$84,254.16	$36,707.39	2026-05-27
264	OTHER	Other Circulatory System O.r. Procedures	15	14	—	—	$26,577.68	$84,712.50	$36,900.59	2026-05-27
408	OTHER	Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With…	15	14	—	—	$26,624.83	$84,838.25	$36,953.60	2026-05-27
414	OTHER	Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc	15	14	—	—	$26,643.84	$84,888.96	$36,974.97	2026-05-27
5353	OTHER	Compia MRI Quad	31	20	$69,540.00	$69,540.00	$26,654.68	$69,540.00	$34,630.92	2026-05-27
495	OTHER	Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit…	15	14	—	—	$26,771.59	$85,229.69	$37,118.60	2026-05-27
022	OTHER	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/…	15	14	—	—	$26,846.11	$98,557.17	$43,900.71	2026-05-27
10009	OTHER	Graft Aortoiliac Artery	31	20	$70,185.00	$70,185.00	$26,901.91	$70,185.00	$34,952.13	2026-05-27
492	OTHER	Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc	15	14	—	—	$27,004.28	$85,850.30	$37,380.21	2026-05-27
48601	OTHER	Emblem S-icd MRI Pulse Generator	31	20	$70,692.00	$70,692.00	$27,096.24	$70,692.00	$35,204.62	2026-05-27
78961	OTHER	Pacemaker Emblem S-icd MRI System	31	20	$70,692.00	$70,692.00	$27,096.24	$70,692.00	$35,204.62	2026-05-27
265	OTHER	Aicd Lead Procedures	15	14	—	—	$27,125.95	$86,174.82	$37,517.00	2026-05-27
097	OTHER	Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc	15	14	—	—	$27,258.27	$86,527.70	$37,665.75	2026-05-27
802	OTHER	Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc	15	14	—	—	$27,259.79	$86,531.76	$37,667.46	2026-05-27
65976	OTHER	Vigilant El Icd Df4-vr	31	20	$71,208.00	$71,208.00	$27,294.03	$71,208.00	$35,461.58	2026-05-27
335	OTHER	Peritoneal Adhesiolysis With Mcc	15	14	—	—	$27,553.31	$87,314.62	$37,997.46	2026-05-27
094	OTHER	Bacterial And Tuberculous Infections Of Nervous System With Mcc	15	14	—	—	$27,745.70	$87,827.75	$38,213.76	2026-05-27
622	OTHER	Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor…	15	14	—	—	$28,455.18	$89,720.03	$39,011.41	2026-05-27
040	OTHER	Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc	15	14	—	—	$28,684.07	$90,330.49	$39,268.73	2026-05-27
024	OTHER	Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…	15	14	—	—	$28,909.15	$90,930.82	$39,521.79	2026-05-27
5630	OTHER	Tiss Matrix Xcm Bio Thick-s 1000 Sq Cm	31	20	$75,735.60	$75,735.60	$29,029.46	$75,735.60	$37,716.33	2026-05-27
956	OTHER	Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma	15	14	—	—	$29,066.56	$91,350.63	$39,698.75	2026-05-27
166	OTHER	Other Respiratory System O.r. Procedures With Mcc	15	14	—	—	$29,278.72	$91,916.50	$39,937.28	2026-05-27
904	OTHER	Skin Grafts For Injuries With Cc/mcc	15	14	—	—	$29,360.85	$92,135.53	$40,029.61	2026-05-27
034	OTHER	Carotid Artery Stent Procedures With Mcc	15	14	—	—	$29,570.72	$92,695.33	$40,265.58	2026-05-27
62154	OTHER	Nail Ferur Str 13.0x400 Ant	31	20	$77,250.00	$77,250.00	$29,609.92	$77,250.00	$38,470.50	2026-05-27
736	OTHER	Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc	15	14	—	—	$29,942.57	$93,687.10	$40,683.64	2026-05-27
628	OTHER	Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc	15	14	—	—	$30,004.17	$93,851.36	$40,752.88	2026-05-27
739	OTHER	Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc…	15	14	—	—	$30,271.84	$94,565.26	$41,053.81	2026-05-27
907	OTHER	Other O.r. Procedures For Injuries With Mcc	15	14	—	—	$30,293.13	$94,622.03	$41,077.74	2026-05-27
55555044965	OTHER	Penicillin V Potassium 0.5 Mg/ml 20 Ml	12	11	$80,000.00	$80,000.00	$30,480.00	$80,000.00	$51,440.00	2026-05-27
423	OTHER	Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc	15	14	—	—	$30,929.61	$96,319.62	$41,793.32	2026-05-27
012	OTHER	Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc	15	14	—	—	$31,205.64	$97,055.84	$42,103.66	2026-05-27
958	OTHER	Other O.r. Procedures For Multiple Significant Trauma With Cc	15	14	—	—	$31,252.03	$97,179.54	$42,155.80	2026-05-27
269	OTHER	Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc	15	14	—	—	$31,639.09	$98,211.90	$42,590.97	2026-05-27
031	OTHER	Ventricular Shunt Procedures With Mcc	15	14	—	—	$31,866.45	$98,818.31	$42,846.59	2026-05-27
323	OTHER	Urinary Stones W Cc, &/or Esw Lithotripsy	15	14	—	—	$32,389.63	$100,213.67	$43,434.77	2026-05-27
933	OTHER	Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft	12	12	—	—	$32,902.92	$101,582.68	$44,011.85	2026-05-27
77925	OTHER	Defibilator Resonate Hf Icd El Df4-dr	31	20	$86,808.00	$86,808.00	$33,273.51	$86,808.00	$43,230.38	2026-05-27
319	OTHER	Other Endovascular Cardiac Valve Procedures With Mcc	15	14	—	—	$33,404.04	$102,919.24	$44,575.25	2026-05-27
901	OTHER	Wound Debridements For Injuries With Mcc	15	14	—	—	$33,690.72	$103,683.85	$44,897.55	2026-05-27
025	OTHER	Craniotomy And Endovascular Intracranial Procedures With Mcc	15	14	—	—	$34,008.58	$104,531.61	$45,254.91	2026-05-27
474	OTHER	Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc	15	14	—	—	$34,102.87	$104,783.11	$45,360.92	2026-05-27
856	OTHER	Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc	15	14	—	—	$34,307.42	$105,328.69	$45,590.90	2026-05-27
74095	OTHER	Strattice Firm 25x40	31	20	$89,880.00	$89,880.00	$34,451.00	$89,880.00	$44,760.24	2026-05-27
56166	OTHER	Defib Crtd Dual Df4 Conn Viva S	31	20	$90,912.00	$90,912.00	$34,846.57	$90,912.00	$45,274.18	2026-05-27
329	OTHER	Major Small And Large Bowel Procedures With Mcc	15	14	—	—	$34,918.05	$106,957.29	$46,277.40	2026-05-27
650	OTHER	Kidney Transplant With Hemodialysis With Mcc	15	14	—	—	$35,035.15	$107,269.63	$46,409.06	2026-05-27
163	OTHER	Major Chest Procedures With Mcc	15	14	—	—	$35,049.60	$148,104.61	$67,239.82	2026-05-27
277	OTHER	Cellulitis Age >17 W Cc	15	14	—	—	$35,374.30	$108,174.19	$46,790.36	2026-05-27
823	OTHER	Lymphoma And Non-acute Leukemia With Other Procedures With Mcc	15	14	—	—	$35,584.18	$108,733.95	$47,026.31	2026-05-27
981	OTHER	Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc	15	14	—	—	$36,149.94	$110,242.91	$47,662.38	2026-05-27
471	OTHER	Cervical Spinal Fusion With Mcc	15	14	—	—	$36,936.22	$117,838.77	$56,991.40	2026-05-27
228	OTHER	Other Cardiothoracic Procedures With Mcc	15	14	—	—	$37,894.36	$114,895.46	$49,623.56	2026-05-27
837	OTHER	Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot…	15	14	—	—	$38,076.10	$153,352.92	$69,831.63	2026-05-27
326	OTHER	Stomach, Esophageal And Duodenal Procedures With Mcc	15	14	—	—	$38,622.09	$118,720.05	$55,417.59	2026-05-27
466	OTHER	Revision Of Hip Or Knee Replacement With Mcc	15	14	—	—	$38,740.71	$117,152.79	$50,575.09	2026-05-27
014	OTHER	Allogeneic Bone Marrow Transplant	14	13	—	—	$38,882.04	$279,551.05	$120,412.44	2026-05-27
270	OTHER	Other Major Cardiovascular Procedures With Mcc	15	14	—	—	$39,032.72	$117,931.64	$50,903.40	2026-05-27
234	OTHER	Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc	15	14	—	—	$40,456.24	$121,728.31	$52,503.80	2026-05-27
011	OTHER	Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc	15	14	—	—	$41,031.88	$123,263.64	$53,150.99	2026-05-27
463	OTHER	Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …	15	14	—	—	$41,070.66	$123,367.05	$53,194.58	2026-05-27
405	OTHER	Pancreas, Liver And Shunt Procedures With Mcc	15	14	—	—	$41,281.30	$123,928.85	$53,431.39	2026-05-27
021	OTHER	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc	15	14	—	—	$42,031.08	$126,848.38	$54,743.62	2026-05-27
653	OTHER	Major Bladder Procedures With Mcc	15	14	—	—	$42,390.76	$139,818.98	$66,120.33	2026-05-27
023	OTHER	Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…	15	14	—	—	$43,383.12	$129,534.66	$55,794.40	2026-05-27
457	OTHER	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	15	14	—	—	$43,643.95	$130,230.34	$56,087.65	2026-05-27
820	OTHER	Lymphoma And Leukemia With Major O.r. Procedures With Mcc	15	14	—	—	$44,274.34	$131,911.70	$56,796.39	2026-05-27
006	OTHER	Liver Transplant Without Mcc	12	11	—	—	$45,078.17	$216,708.02	$105,886.04	2026-05-27
266	OTHER	Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc	15	14	—	—	$45,555.66	$135,329.09	$58,236.92	2026-05-27
016	OTHER	Autologous Bone Marrow Transplant With Cc/mcc	14	13	—	—	$45,900.70	$136,243.82	$63,372.21	2026-05-27
028	OTHER	Spinal Procedures With Mcc	15	14	—	—	$46,230.16	$137,128.06	$58,995.23	2026-05-27
232	OTHER	Coronary Bypass With Ptca Without Mcc	15	14	—	—	$46,452.20	$137,720.33	$59,244.89	2026-05-27
573	OTHER	Skin Graft For Skin Ulcer Or Cellulitis With Mcc	15	14	—	—	$46,828.62	$138,724.22	$59,668.06	2026-05-27
276	OTHER	Non-maligant Breast Disorders	15	14	—	—	$47,103.89	$139,458.43	$59,977.55	2026-05-27
969	OTHER	HIV With Extensive O.r. Procedures With Mcc	15	14	—	—	$48,091.68	$279,089.43	$130,984.23	2026-05-27
30237890006	OTHER	Sipuleucel-t 50 Million Cell/250 Ml Suspension 250	43	23	$250,415.00	$250,415.00	$48,872.12	$250,415.00	$124,706.67	2026-05-27
459	OTHER	Spinal Fusion Except Cervical With Mcc	12	11	—	—	$50,436.09	$148,339.71	$63,721.26	2026-05-27
008	OTHER	Simultaneous Pancreas And Kidney Transplant	12	11	—	—	$50,580.47	$209,735.00	$101,563.86	2026-05-27
928	OTHER	Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc	12	12	—	—	$50,788.16	$149,284.84	$64,119.66	2026-05-27
955	OTHER	Craniotomy For Multiple Significant Trauma	15	14	—	—	$51,924.24	$152,314.88	$65,396.91	2026-05-27
870	OTHER	Septicemia Or Severe Sepsis With Mv >96 Hours	15	14	—	—	$52,899.10	$154,914.98	$66,492.92	2026-05-27
275	OTHER	Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc	15	14	—	—	$53,739.38	$157,156.06	$67,437.60	2026-05-27
957	OTHER	Other O.r. Procedures For Multiple Significant Trauma With Mcc	15	14	—	—	$56,759.79	$165,211.91	$70,833.37	2026-05-27
27093	OTHER	Pack Penumbra Starter	12	11	$152,100.00	$152,100.00	$57,950.10	$152,100.00	$97,800.30	2026-05-27
233	OTHER	Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc	15	14	—	—	$59,438.02	$172,355.02	$73,844.39	2026-05-27
010	OTHER	Pancreas Transplant	12	11	—	—	$60,865.51	$175,531.14	$75,183.22	2026-05-27
020	OTHER	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc	15	14	—	—	$61,298.78	$177,317.97	$75,936.42	2026-05-27
456	OTHER	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	15	14	—	—	$64,402.08	$185,594.86	$79,425.36	2026-05-27
231	OTHER	Coronary Bypass With Ptca With Mcc	15	14	—	—	$64,437.82	$185,690.18	$79,465.54	2026-05-27
453	OTHER	Combined Anterior And Posterior Spinal Fusion With Mcc	12	11	—	—	$67,387.53	$193,549.21	$82,778.34	2026-05-27
215	OTHER	Other Heart Assist System Implant	15	14	—	—	$80,565.72	$228,705.25	$98,489.27	2026-05-27
212	OTHER	Hip & Femur Procedures Except Major Joint Age 0-17	15	14	—	—	$82,840.16	$234,771.46	$101,269.69	2026-05-27
005	OTHER	Liver Transplant With Mcc Or Intestinal Transplant	12	11	—	—	$83,366.50	$229,812.61	$98,530.61	2026-05-27
002	OTHER	Heart Transplant Or Implant Of Heart Assist System Without Mcc	12	11	—	—	$102,439.13	$302,973.52	$143,511.08	2026-05-27
004	OTHER	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…	15	14	—	—	$107,448.34	$402,089.44	$183,645.82	2026-05-27
007	OTHER	Lung Transplant	12	11	—	—	$121,487.57	$934,531.40	$466,340.50	2026-05-27
003	OTHER	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…	15	14	—	—	$162,971.67	$448,492.09	$199,228.15	2026-05-27
927	OTHER	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	12	12	—	—	$180,394.58	$494,961.10	$209,831.98	2026-05-27
001	OTHER	Heart Transplant Or Implant Of Heart Assist System With Mcc	12	11	—	—	$215,002.94	$585,122.63	$254,947.25	2026-05-27
018	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	15	14	—	—	$286,778.31	$1,340,327.09	$615,980.42	2026-05-27

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