Hospital

CARY MEDICAL CENTER

Caribou, ME · CCN 200031 · Rates published

1,384 distinct procedures filed

11 distinct payers

19,208 rate rows

2026-05-14 last MRF observed

Data quality

19,080 of 19,208 rate rows are consumer-grade (99.3%)

128 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
no usable negotiated amount (only an out-of-band fallback) — excluded from medians	128

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

Source MRF file	https://www.carymedicalcenter.org/wp-content/uploads/2025/06/010530375_cary-medical-center_standardcharges.csv
Found on page	https://www.carymedicalcenter.org/finance-billing/hospital-pricing/
Discovered via	CMS hospital list
Last fetch	not_modified · 2026-10-21
Content fingerprint	4ae3cd2db54fc5f1… · 2,304,694 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
207 OTHER	Respiratory System Diagnosis With Ventilator Support >96 Hours	7	$55,082.68	$58,202.32	$58,202.32	nat. median $64,908 0.9× median
463 OTHER	Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective…	7	$48,789.18	$51,552.39	$51,552.39	nat. median $44,713 1.2× median
853 OTHER	Infectious And Parasitic Diseases With O.r. Procedures With Mcc	7	$42,275.68	$44,669.99	$44,669.99	nat. median $17,401 outlier · 2.6×
576 OTHER	Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc	7	$41,955.53	$44,331.71	$44,331.71	nat. median $42,860 1.0× median
981 OTHER	Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc	7	$40,163.01	$42,437.67	$42,437.67	nat. median $435 outlier · 97.6×
329 OTHER	Major Small And Large Bowel Procedures With Mcc	7	$39,347.22	$41,575.67	$41,575.67	nat. median $40,136 1.0× median
793 OTHER	Full Term Neonate With Major Problems	7	$35,692.84	$37,714.33	$37,714.33	nat. median $28,407 1.3× median
791 OTHER	Prematurity With Major Problems	7	$34,746.08	$36,713.95	$36,713.95	nat. median $29,904 1.2× median
166 OTHER	Other Respiratory System O.r. Procedures With Mcc	7	$31,995.67	$33,807.76	$33,807.76	nat. median $39,056 0.9× median
579 OTHER	Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc	7	$27,722.39	$29,292.46	$29,292.46	nat. median $29,531 1.0× median
485 OTHER	Knee Procedures With Principal Diagnosis Of Infection With Mcc	7	$27,624.80	$29,189.35	$29,189.35	nat. median $31,597 0.9× median
480 OTHER	Hip And Femur Procedures Except Major Joint With Mcc	7	$24,930.03	$26,341.96	$26,341.96	nat. median $1,155 outlier · 22.8×
521 OTHER	Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc	7	$24,569.65	$25,961.16	$25,961.16	nat. median $394 outlier · 65.8×
208 OTHER	Respiratory System Diagnosis With Ventilator Support <=96 Hours	7	$23,529.58	$24,862.19	$24,862.19	nat. median $25,481 1.0× median
95 OTHER	Bacterial And Tuberculous Infections Of Nervous System With Cc	7	$22,078.61	$23,329.05	$23,329.05	nat. median $25,900 0.9× median
659 OTHER	Kidney And Ureter Procedures For Non-neoplasm With Mcc	7	$21,750.75	$22,982.62	$22,982.62	nat. median $24,294 0.9× median
982 OTHER	Extensive O.r. Procedures Unrelated To Principal Diagnosis With Cc	7	$21,045.39	$22,237.31	$22,237.31	nat. median $369 outlier · 60.3×
792 OTHER	Prematurity Without Major Problems	7	$20,965.78	$22,153.19	$22,153.19	nat. median $13,434 1.6× median
330 OTHER	Major Small And Large Bowel Procedures With Cc	7	$20,520.65	$21,682.85	$21,682.85	nat. median $22,073 1.0× median
56 OTHER	Degenerative Nervous System Disorders With Mcc	7	$19,886.33	$21,012.61	$21,012.61	nat. median $24,850 0.8× median
85 OTHER	Traumatic Stupor And Coma <1 Hour With Mcc	7	$19,448.05	$20,549.50	$20,549.50	nat. median $23,685 0.9× median
629 OTHER	Other Endocrine, Nutritional And Metabolic O.r. Procedures With Cc	7	$18,651.09	$19,707.40	$19,707.40	nat. median $21,005 0.9× median
522 OTHER	Hip Replacement With Principal Diagnosis Of Hip Fracture Without Mcc	7	$18,128.05	$19,154.75	$19,154.75	nat. median $16,898 1.1× median
146 OTHER	Ear, Nose, Mouth And Throat Malignancy With Mcc	7	$18,125.49	$19,152.03	$19,152.03	nat. median $19,340 1.0× median
336 OTHER	Peritoneal Adhesiolysis With Cc	7	$18,051.01	$19,073.34	$19,073.34	nat. median $20,264 0.9× median
481 OTHER	Hip And Femur Procedures Except Major Joint With Cc	7	$17,929.46	$18,944.90	$18,944.90	nat. median $6,372 outlier · 3.0×
511 OTHER	Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Cc	7	$17,800.20	$18,808.32	$18,808.32	nat. median $17,981 1.0× median
64 OTHER	Intracranial Hemorrhage Or Cerebral Infarction With Mcc	7	$17,214.67	$18,189.64	$18,189.64	nat. median $21,243 0.9× median
494 OTHER	Lower Extremity And Humerus Procedures Except Hip, Foot And Femur Without Cc/mcc	7	$17,176.15	$18,148.94	$18,148.94	nat. median $18,505 1.0× median
707 OTHER	Major Male Pelvic Procedures With Cc/mcc	7	$17,123.08	$18,092.86	$18,092.86	nat. median $762 outlier · 23.8×
283 OTHER	Acute Myocardial Infarction, Expired With Mcc	7	$16,956.15	$17,916.48	$17,916.48	nat. median $18,681 1.0× median
539 OTHER	Osteomyelitis With Mcc	7	$16,861.14	$17,816.08	$17,816.08	nat. median $16,425 1.1× median
432 OTHER	Cirrhosis And Alcoholic Hepatitis With Mcc	7	$16,848.30	$17,802.51	$17,802.51	nat. median $17,266 1.0× median
871 OTHER	Septicemia Or Severe Sepsis Without Mv >96 Hours With Mcc	7	$16,628.30	$17,570.05	$17,570.05	nat. median $8,295 outlier · 2.1×
470 OTHER	Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity Without…	7	$16,511.88	$17,447.04	$17,447.04	nat. median $1,920 outlier · 9.1×
58562 CPT	Hysteroscopy Remove Fb	11	$3,029.31	$31,562.99	$17,296.15	nat. median $3,331 outlier · 5.2×
504 OTHER	Foot Procedures With Cc	7	$16,000.83	$16,907.05	$16,907.05	nat. median $15,186 1.1× median
23472 CPT	Reconstruct Shoulder Joint	11	$16,408.20	$17,337.49	$16,872.85	nat. median $16,677 1.0× median
377 OTHER	Gastrointestinal Hemorrhage With Mcc	7	$15,648.15	$16,534.39	$16,534.39	nat. median $16,827 1.0× median
IP OTHER	Inpatient Paid Claims	6	$12,883.07	$28,061.34	$16,524.65	nat. median $18,494 0.9× median
862 OTHER	Postoperative And Post-traumatic Infections With Mcc	7	$15,611.34	$16,495.50	$16,495.50	nat. median $2,877 outlier · 5.7×
57460 CPT	Bx Of Cervix W/scope Leep	11	$3,029.31	$29,847.39	$16,438.35	nat. median $3,032 outlier · 5.4×
789 OTHER	Neonates, Died Or Transferred To Another Acute Care Facility	7	$15,427.29	$16,301.03	$16,301.03	nat. median $14,124 1.2× median
441 OTHER	Disorders Of Liver Except Malignancy, Cirrhosis Or Alcoholic Hepatitis With Mcc	7	$15,363.09	$16,233.19	$16,233.19	nat. median $15,281 1.1× median
371 OTHER	Major Gastrointestinal Disorders And Peritoneal Infections With Mcc	7	$15,178.19	$16,037.82	$16,037.82	nat. median $16,160 1.0× median
180 OTHER	Respiratory Neoplasms With Mcc	7	$15,117.41	$15,973.60	$15,973.60	nat. median $16,396 1.0× median
199 OTHER	Pneumothorax With Mcc	7	$15,101.15	$15,956.41	$15,956.41	nat. median $16,769 1.0× median
666 OTHER	Prostatectomy With Cc	7	$14,974.46	$15,822.54	$15,822.54	nat. median $15,870 1.0× median
418 OTHER	Laparoscopic Cholecystectomy Without C.d.e. With Cc	7	$14,480.53	$15,300.64	$15,300.64	nat. median $15,859 1.0× median
331 OTHER	Major Small And Large Bowel Procedures Without Cc/mcc	7	$14,406.05	$15,221.95	$15,221.95	nat. median $10,583 1.4× median

Other procedures at this hospital

Browse this hospital's 1,384 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

101	OTHER	Seizures Without Mcc	7	7	—	—	$7,726.49	$8,164.08	$8,164.08	2026-05-14
115	OTHER	Extraocular Procedures Except Orbit	7	7	—	—	$13,139.14	$13,883.28	$13,883.28	2026-05-14
11604	CPT	Exc Tr-ext Mal+marg 3.1-4 Cm	15	11	—	—	$662.67	$7,693.01	$4,177.84	2026-05-14
123	OTHER	Neurological Eye Disorders	7	7	—	—	$6,836.22	$7,223.39	$7,223.39	2026-05-14
13152	CPT	Cmplx Rpr E/n/e/l 2.6-7.5 Cm	15	11	—	—	$691.63	$8,003.71	$4,347.67	2026-05-14
146	OTHER	Ear, Nose, Mouth And Throat Malignancy With Mcc	7	7	—	—	$18,125.49	$19,152.03	$19,152.03	2026-05-14
15100	CPT	Splt Agrft T/a/l 1st 100sqcm	15	11	—	—	$1,930.82	$7,693.01	$4,811.91	2026-05-14
15120	CPT	Splt Agrft F/s/n/h/f/g/m 1st	14	11	—	—	$3,316.23	$3,504.05	$3,410.14	2026-05-14
153	OTHER	Otitis Media And Uri Without Mcc	7	7	—	—	$6,319.18	$6,677.07	$6,677.07	2026-05-14
15830	CPT	Exc Excessive Skin Abdomen	15	11	—	—	$6,213.89	$6,565.82	$6,389.85	2026-05-14
166	OTHER	Other Respiratory System O.r. Procedures With Mcc	7	7	—	—	$31,995.67	$33,807.76	$33,807.76	2026-05-14
175	OTHER	Pulmonary Embolism With Mcc Or Acute Cor Pulmonale	7	7	—	—	$11,758.37	$12,424.31	$12,424.31	2026-05-14
176	OTHER	Pulmonary Embolism Without Mcc	7	7	—	—	$6,891.01	$7,281.28	$7,281.28	2026-05-14
177	OTHER	Respiratory Infections And Inflammations With Mcc	7	7	—	—	$13,377.11	$14,134.73	$14,134.73	2026-05-14
178	OTHER	Respiratory Infections And Inflammations With Cc	7	7	—	—	$8,354.81	$8,827.99	$8,827.99	2026-05-14
180	OTHER	Respiratory Neoplasms With Mcc	7	7	—	—	$15,117.41	$15,973.60	$15,973.60	2026-05-14
181	OTHER	Respiratory Neoplasms With Cc	7	7	—	—	$9,168.03	$9,687.27	$9,687.27	2026-05-14
183	OTHER	Major Chest Trauma With Mcc	7	7	—	—	$13,096.34	$13,838.06	$13,838.06	2026-05-14
184	OTHER	Major Chest Trauma With Cc	7	7	—	—	$9,108.97	$9,624.86	$9,624.86	2026-05-14
189	OTHER	Pulmonary Edema And Respiratory Failure	7	7	—	—	$10,575.34	$11,174.28	$11,174.28	2026-05-14
190	OTHER	Chronic Obstructive Pulmonary Disease With Mcc	7	7	—	—	$9,482.20	$10,019.23	$10,019.23	2026-05-14
191	OTHER	Chronic Obstructive Pulmonary Disease With Cc	7	7	—	—	$7,216.30	$7,625.00	$7,625.00	2026-05-14
19101	CPT	Biopsy Of Breast Open	14	11	—	—	$3,664.07	$3,871.59	$3,767.83	2026-05-14
19120	CPT	Removal Of Breast Lesion	14	11	—	—	$3,664.07	$3,871.59	$3,767.83	2026-05-14
19125	CPT	Excision Breast Lesion	14	11	—	—	$3,664.07	$3,871.59	$3,767.83	2026-05-14
192	OTHER	Chronic Obstructive Pulmonary Disease Without Cc/mcc	7	7	—	—	$5,495.68	$5,806.94	$5,806.94	2026-05-14
193	OTHER	Simple Pneumonia And Pleurisy With Mcc	7	7	—	—	$11,251.60	$11,888.84	$11,888.84	2026-05-14
19301	CPT	Partial Mastectomy	14	11	—	—	$3,664.07	$3,871.59	$3,767.83	2026-05-14
19303	CPT	Mast Simple Complete	14	11	—	—	$6,213.89	$6,565.82	$6,389.85	2026-05-14
19307	CPT	Mast Mod Rad	14	11	—	—	$6,213.89	$6,565.82	$6,389.85	2026-05-14
194	OTHER	Simple Pneumonia And Pleurisy With Cc	7	7	—	—	$6,898.71	$7,289.42	$7,289.42	2026-05-14
195	OTHER	Simple Pneumonia And Pleurisy Without Cc/mcc	7	7	—	—	$5,380.12	$5,684.83	$5,684.83	2026-05-14
197	OTHER	Interstitial Lung Disease With Cc	7	7	—	—	$8,124.54	$8,584.68	$8,584.68	2026-05-14
199	OTHER	Pneumothorax With Mcc	7	7	—	—	$15,101.15	$15,956.41	$15,956.41	2026-05-14
200	OTHER	Pneumothorax With Cc	7	7	—	—	$9,410.29	$9,943.25	$9,943.25	2026-05-14
201	OTHER	Pneumothorax Without Cc/mcc	7	7	—	—	$6,121.44	$6,468.13	$6,468.13	2026-05-14
204	OTHER	Respiratory Signs And Symptoms	7	7	—	—	$6,911.55	$7,302.99	$7,302.99	2026-05-14
207	OTHER	Respiratory System Diagnosis With Ventilator Support >96 Hours	7	7	—	—	$55,082.68	$58,202.32	$58,202.32	2026-05-14
208	OTHER	Respiratory System Diagnosis With Ventilator Support <=96 Hours	7	7	—	—	$23,529.58	$24,862.19	$24,862.19	2026-05-14
22901	CPT	Exc Abdl Tum Deep 5 Cm/>	15	11	—	—	$2,718.24	$4,160.44	$3,439.34	2026-05-14
23405	CPT	Incision Of Tendon & Muscle	14	11	—	—	$6,790.39	$7,174.97	$6,982.68	2026-05-14
23410	CPT	Repair Rotator Cuff Acute	14	11	—	—	$6,790.39	$7,174.97	$6,982.68	2026-05-14
23412	CPT	Repair Rotator Cuff Chronic	14	11	—	—	$6,790.39	$7,174.97	$6,982.68	2026-05-14
23420	CPT	Repair Of Shoulder	14	11	—	—	$6,790.39	$7,174.97	$6,982.68	2026-05-14
23430	CPT	Repair Biceps Tendon	14	11	—	—	$6,790.39	$7,174.97	$6,982.68	2026-05-14
23472	CPT	Reconstruct Shoulder Joint	14	11	—	—	$16,408.20	$17,337.49	$16,872.85	2026-05-14
23515	CPT	Optx Clavicular Fx W/int Fix	14	11	—	—	$6,790.39	$7,174.97	$6,982.68	2026-05-14
23630	CPT	Optx Gr Hmrl Tbrs Fx Int Fix	14	11	—	—	$6,790.39	$7,174.97	$6,982.68	2026-05-14
25607	CPT	Optx Dst Rd Xartc Fx/epi Sep	14	11	—	—	$6,790.39	$7,174.97	$6,982.68	2026-05-14
25609	CPT	Optx Dst Rd Xart Fx/ep Sep3+	14	11	—	—	$6,790.39	$7,174.97	$6,982.68	2026-05-14
25810	CPT	Arthrd Wrst Iliac/oth Agrft	14	11	—	—	$12,014.48	$12,694.92	$12,354.70	2026-05-14
27130	CPT	Total Hip Arthroplasty	14	11	—	—	$12,014.48	$12,694.92	$12,354.70	2026-05-14
27447	CPT	Total Knee Arthroplasty	14	11	—	—	$12,014.48	$12,694.92	$12,354.70	2026-05-14
27650	CPT	Repair Achilles Tendon	14	11	—	—	$6,790.39	$7,174.97	$6,982.68	2026-05-14
27792	CPT	Treatment Of Ankle Fracture	14	11	—	—	$6,790.39	$7,174.97	$6,982.68	2026-05-14
27814	CPT	Treatment Of Ankle Fracture	14	11	—	—	$6,790.39	$7,174.97	$6,982.68	2026-05-14
27822	CPT	Treatment Of Ankle Fracture	14	11	—	—	$6,790.39	$7,174.97	$6,982.68	2026-05-14
280	OTHER	Acute Myocardial Infarction, Discharged Alive With Mcc	7	7	—	—	$13,731.51	$14,509.20	$14,509.20	2026-05-14
281	OTHER	Acute Myocardial Infarction, Discharged Alive With Cc	7	7	—	—	$7,867.73	$8,313.33	$8,313.33	2026-05-14
282	OTHER	Acute Myocardial Infarction, Discharged Alive Without Cc/mcc	7	7	—	—	$6,189.92	$6,540.49	$6,540.49	2026-05-14
283	OTHER	Acute Myocardial Infarction, Expired With Mcc	7	7	—	—	$16,956.15	$17,916.48	$17,916.48	2026-05-14
291	OTHER	Heart Failure And Shock With Mcc	7	7	—	—	$10,989.66	$11,612.06	$11,612.06	2026-05-14
292	OTHER	Heart Failure And Shock With Cc	7	7	—	—	$7,267.66	$7,679.27	$7,679.27	2026-05-14
29856	CPT	Tibial Arthroscopy/surgery	14	11	—	—	$12,014.48	$12,694.92	$12,354.70	2026-05-14
29888	CPT	Arthrs Aid Acl Rpr/agmntj	14	11	—	—	$6,790.39	$7,174.97	$6,982.68	2026-05-14
300	OTHER	Peripheral Vascular Disorders With Cc	7	7	—	—	$9,138.07	$9,655.61	$9,655.61	2026-05-14
303	OTHER	Atherosclerosis Without Mcc	7	7	—	—	$5,762.76	$6,089.14	$6,089.14	2026-05-14
305	OTHER	Hypertension Without Mcc	7	7	—	—	$6,463.85	$6,829.93	$6,829.93	2026-05-14
308	OTHER	Cardiac Arrhythmia And Conduction Disorders With Mcc	7	7	—	—	$10,306.55	$10,890.27	$10,890.27	2026-05-14
309	OTHER	Cardiac Arrhythmia And Conduction Disorders With Cc	7	7	—	—	$6,297.78	$6,654.46	$6,654.46	2026-05-14
310	OTHER	Cardiac Arrhythmia And Conduction Disorders Without Cc/mcc	7	7	—	—	$4,845.96	$5,120.42	$5,120.42	2026-05-14
312	OTHER	Syncope And Collapse	7	7	—	—	$7,461.12	$7,883.68	$7,883.68	2026-05-14
313	OTHER	Chest Pain	7	7	—	—	$6,163.38	$6,512.45	$6,512.45	2026-05-14
315	OTHER	Other Circulatory System Diagnoses With Cc	7	7	—	—	$8,246.09	$8,713.12	$8,713.12	2026-05-14
329	OTHER	Major Small And Large Bowel Procedures With Mcc	7	7	—	—	$39,347.22	$41,575.67	$41,575.67	2026-05-14
330	OTHER	Major Small And Large Bowel Procedures With Cc	7	7	—	—	$20,520.65	$21,682.85	$21,682.85	2026-05-14
331	OTHER	Major Small And Large Bowel Procedures Without Cc/mcc	7	7	—	—	$14,406.05	$15,221.95	$15,221.95	2026-05-14
336	OTHER	Peritoneal Adhesiolysis With Cc	7	7	—	—	$18,051.01	$19,073.34	$19,073.34	2026-05-14
337	OTHER	Peritoneal Adhesiolysis Without Cc/mcc	7	7	—	—	$13,139.99	$13,884.19	$13,884.19	2026-05-14
346	OTHER	Minor Small And Large Bowel Procedures Without Cc/mcc	7	7	—	—	$10,154.18	$10,729.26	$10,729.26	2026-05-14
351	OTHER	Inguinal And Femoral Hernia Procedures With Cc	7	7	—	—	$13,050.11	$13,789.21	$13,789.21	2026-05-14
36561	CPT	Insert Tunneled Cv Cath	16	11	—	—	$2,954.78	$9,644.23	$6,299.51	2026-05-14
368	OTHER	Major Esophageal Disorders With Mcc	7	7	—	—	$13,627.07	$14,398.85	$14,398.85	2026-05-14
371	OTHER	Major Gastrointestinal Disorders And Peritoneal Infections With Mcc	7	7	—	—	$15,178.19	$16,037.82	$16,037.82	2026-05-14
372	OTHER	Major Gastrointestinal Disorders And Peritoneal Infections With Cc	7	7	—	—	$8,740.02	$9,235.02	$9,235.02	2026-05-14
373	OTHER	Major Gastrointestinal Disorders And Peritoneal Infections Without Cc/mcc	7	7	—	—	$6,226.73	$6,579.39	$6,579.39	2026-05-14
375	OTHER	Digestive Malignancy With Cc	7	7	—	—	$10,354.49	$10,940.92	$10,940.92	2026-05-14
377	OTHER	Gastrointestinal Hemorrhage With Mcc	7	7	—	—	$15,648.15	$16,534.39	$16,534.39	2026-05-14
378	OTHER	Gastrointestinal Hemorrhage With Cc	7	7	—	—	$8,395.04	$8,870.50	$8,870.50	2026-05-14
379	OTHER	Gastrointestinal Hemorrhage Without Cc/mcc	7	7	—	—	$5,396.39	$5,702.01	$5,702.01	2026-05-14
381	OTHER	Complicated Peptic Ulcer With Cc	7	7	—	—	$9,275.04	$9,800.34	$9,800.34	2026-05-14
382	OTHER	Complicated Peptic Ulcer Without Cc/mcc	7	7	—	—	$6,853.34	$7,241.48	$7,241.48	2026-05-14
38222	CPT	Dx Bone Marrow Bx & Aspir	15	11	—	—	$2,718.24	$7,223.23	$4,970.73	2026-05-14
383	OTHER	Uncomplicated Peptic Ulcer With Mcc	7	7	—	—	$11,819.15	$12,488.53	$12,488.53	2026-05-14
38500	CPT	Biopsy/removal Lymph Nodes	14	11	—	—	$3,664.07	$3,871.59	$3,767.83	2026-05-14
38510	CPT	Biopsy/removal Lymph Nodes	14	11	—	—	$3,664.07	$3,871.59	$3,767.83	2026-05-14
38525	CPT	Biopsy/removal Lymph Nodes	15	11	—	—	$3,664.07	$6,311.73	$4,987.90	2026-05-14
38531	CPT	Open Bx/exc Inguinofem Nodes	15	11	—	—	$3,664.07	$9,513.98	$6,589.02	2026-05-14
387	OTHER	Inflammatory Bowel Disease Without Cc/mcc	7	7	—	—	$5,832.10	$6,162.41	$6,162.41	2026-05-14
388	OTHER	Gastrointestinal Obstruction With Mcc	7	7	—	—	$12,641.79	$13,357.76	$13,357.76	2026-05-14
389	OTHER	Gastrointestinal Obstruction With Cc	7	7	—	—	$6,760.89	$7,143.80	$7,143.80	2026-05-14
390	OTHER	Gastrointestinal Obstruction Without Cc/mcc	7	7	—	—	$4,656.78	$4,920.52	$4,920.52	2026-05-14
391	OTHER	Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders With Mcc	7	7	—	—	$10,856.97	$11,471.86	$11,471.86	2026-05-14
392	OTHER	Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders Without Mcc	7	7	—	—	$6,673.58	$7,051.54	$7,051.54	2026-05-14
394	OTHER	Other Digestive System Diagnoses With Cc	7	7	—	—	$8,009.83	$8,463.47	$8,463.47	2026-05-14
395	OTHER	Other Digestive System Diagnoses Without Cc/mcc	7	7	—	—	$5,555.61	$5,870.25	$5,870.25	2026-05-14
398	OTHER	Appendix Procedures With Cc	7	7	—	—	$12,956.80	$13,690.62	$13,690.62	2026-05-14
418	OTHER	Laparoscopic Cholecystectomy Without C.d.e. With Cc	7	7	—	—	$14,480.53	$15,300.64	$15,300.64	2026-05-14
419	OTHER	Laparoscopic Cholecystectomy Without C.d.e. Without Cc/mcc	7	7	—	—	$11,691.60	$12,353.76	$12,353.76	2026-05-14
432	OTHER	Cirrhosis And Alcoholic Hepatitis With Mcc	7	7	—	—	$16,848.30	$17,802.51	$17,802.51	2026-05-14
43280	CPT	Laparoscopy Fundoplasty	15	11	—	—	$9,947.43	$10,510.81	$10,229.12	2026-05-14
43281	CPT	Lap Paraesophag Hern Repair	15	11	—	—	$9,947.43	$18,077.45	$14,012.44	2026-05-14
43282	CPT	Lap Paraesoph Her Rpr W/mesh	15	11	—	—	$9,947.43	$10,510.81	$10,229.12	2026-05-14
433	OTHER	Cirrhosis And Alcoholic Hepatitis With Cc	7	7	—	—	$9,041.34	$9,553.40	$9,553.40	2026-05-14
439	OTHER	Disorders Of Pancreas Except Malignancy With Cc	7	7	—	—	$7,200.89	$7,608.71	$7,608.71	2026-05-14
440	OTHER	Disorders Of Pancreas Except Malignancy Without Cc/mcc	7	7	—	—	$5,319.34	$5,620.61	$5,620.61	2026-05-14
441	OTHER	Disorders Of Liver Except Malignancy, Cirrhosis Or Alcoholic Hepatitis With Mcc	7	7	—	—	$15,363.09	$16,233.19	$16,233.19	2026-05-14
44180	CPT	Lap Enterolysis	14	11	—	—	$5,657.42	$5,977.83	$5,817.62	2026-05-14
442	OTHER	Disorders Of Liver Except Malignancy, Cirrhosis Or Alcoholic Hepatitis With Cc	7	7	—	—	$8,263.21	$8,731.21	$8,731.21	2026-05-14
443	OTHER	Disorders Of Liver Except Malignancy, Cirrhosis Or Alcoholic Hepatitis Without C…	7	7	—	—	$5,989.61	$6,328.84	$6,328.84	2026-05-14
445	OTHER	Disorders Of The Biliary Tract With Cc	7	7	—	—	$9,368.34	$9,898.93	$9,898.93	2026-05-14
44970	CPT	Laparoscopy Appendectomy	14	11	—	—	$5,657.42	$14,411.39	$8,006.12	2026-05-14
44979	CPT	Unlisted Laps Px Appendix	14	11	—	—	$5,657.42	$5,977.83	$5,817.62	2026-05-14
46080	CPT	Sphnctrotmy Anal Div Sphnctr	15	11	—	—	$2,597.47	$7,907.27	$5,428.95	2026-05-14
463	OTHER	Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …	7	7	—	—	$48,789.18	$51,552.39	$51,552.39	2026-05-14
470	OTHER	Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity Without …	7	7	—	—	$16,511.88	$17,447.04	$17,447.04	2026-05-14
47562	CPT	Laparoscopic Cholecystectomy	17	11	—	—	$5,657.42	$18,430.00	$12,647.82	2026-05-14
47563	CPT	Laparo Cholecystectomy/graph	15	11	—	—	$5,657.42	$18,430.00	$12,043.71	2026-05-14
480	OTHER	Hip And Femur Procedures Except Major Joint With Mcc	7	7	—	—	$24,930.03	$26,341.96	$26,341.96	2026-05-14
481	OTHER	Hip And Femur Procedures Except Major Joint With Cc	7	7	—	—	$17,929.46	$18,944.90	$18,944.90	2026-05-14
485	OTHER	Knee Procedures With Principal Diagnosis Of Infection With Mcc	7	7	—	—	$27,624.80	$29,189.35	$29,189.35	2026-05-14
489	OTHER	Knee Procedures Without Principal Diagnosis Of Infection Without Cc/mcc	7	7	—	—	$9,560.09	$10,101.54	$10,101.54	2026-05-14
49320	CPT	Diag Laparo Separate Proc	14	11	—	—	$5,657.42	$5,977.83	$5,817.62	2026-05-14
49321	CPT	Laparoscopy Biopsy	14	11	—	—	$5,657.42	$5,977.83	$5,817.62	2026-05-14
49322	CPT	Laparoscopy Aspiration	14	11	—	—	$5,657.42	$5,977.83	$5,817.62	2026-05-14
49329	CPT	Unlstd Laps Px Abd Pertm&omn	14	11	—	—	$5,657.42	$5,977.83	$5,817.62	2026-05-14
494	OTHER	Lower Extremity And Humerus Procedures Except Hip, Foot And Femur Without Cc/mcc	7	7	—	—	$17,176.15	$18,148.94	$18,148.94	2026-05-14
49505	CPT	Prp I/hern Init Reduc >5 Yr	14	11	—	—	$3,350.55	$3,540.31	$3,445.43	2026-05-14
49507	CPT	Prp I/hern Init Block >5 Yr	14	11	—	—	$3,350.55	$3,540.31	$3,445.43	2026-05-14
49520	CPT	Rerepair Ing Hernia Reduce	14	11	—	—	$3,350.55	$3,540.31	$3,445.43	2026-05-14
49591	CPT	Rpr Aa Hrn 1st < 3 Cm Rdc	14	11	—	—	$3,350.55	$3,540.31	$3,445.43	2026-05-14
49592	CPT	Rpr Aa Hrn 1st < 3 Ncr/strn	14	11	—	—	$5,657.42	$5,977.83	$5,817.62	2026-05-14
49594	CPT	Rpr Aa Hrn 1st 3-10 Ncr/strn	14	11	—	—	$5,657.42	$5,977.83	$5,817.62	2026-05-14
49613	CPT	Rpr Aa Hrn Rcr < 3 Rdc	14	11	—	—	$3,350.55	$3,540.31	$3,445.43	2026-05-14
49614	CPT	Rpr Aa Hrn Rcr < 3 Ncr/strn	14	11	—	—	$5,657.42	$5,977.83	$5,817.62	2026-05-14
49650	CPT	Lap Ing Hernia Repair Init	28	11	—	—	$5,657.42	$8,966.75	$7,231.98	2026-05-14
49651	CPT	Lap Ing Hernia Repair Recur	14	11	—	—	$5,657.42	$5,977.83	$5,817.62	2026-05-14
504	OTHER	Foot Procedures With Cc	7	7	—	—	$16,000.83	$16,907.05	$16,907.05	2026-05-14
50553	CPT	Kidney Endoscopy	14	11	—	—	$5,017.59	$5,301.76	$5,159.68	2026-05-14
511	OTHER	Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Cc	7	7	—	—	$17,800.20	$18,808.32	$18,808.32	2026-05-14
514	OTHER	Hand Or Wrist Procedures, Except Major Thumb Or Joint Procedures Without Cc/mcc	7	7	—	—	$8,751.15	$9,246.78	$9,246.78	2026-05-14
521	OTHER	Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc	7	7	—	—	$24,569.65	$25,961.16	$25,961.16	2026-05-14
522	OTHER	Hip Replacement With Principal Diagnosis Of Hip Fracture Without Mcc	7	7	—	—	$18,128.05	$19,154.75	$19,154.75	2026-05-14
52234	CPT	Cystoscopy And Treatment	15	11	—	—	$3,298.69	$8,387.49	$5,843.09	2026-05-14
52240	CPT	Cystoscopy And Treatment	14	11	—	—	$5,017.59	$5,301.76	$5,159.68	2026-05-14
52341	CPT	Cysto W/ureter Stricture Tx	14	11	—	—	$3,298.69	$3,485.51	$3,392.10	2026-05-14
52344	CPT	Cysto/uretero Stricture Tx	14	11	—	—	$3,298.69	$3,485.51	$3,392.10	2026-05-14
52351	CPT	Cystouretero & Or Pyeloscope	14	11	—	—	$3,298.69	$3,485.51	$3,392.10	2026-05-14
52352	CPT	Cystouretero W/stone Remove	14	11	—	—	$3,298.69	$3,485.51	$3,392.10	2026-05-14
52353	CPT	Cystouretero W/lithotripsy	14	11	—	—	$5,017.59	$5,301.76	$5,159.68	2026-05-14
52356	CPT	Cysto/uretero W/lithotripsy	15	11	—	—	$4,920.13	$5,301.76	$5,110.94	2026-05-14
52601	CPT	Prostatectomy (turp)	14	11	—	—	$4,920.13	$5,301.76	$5,110.94	2026-05-14
52648	CPT	Laser Surgery Of Prostate	15	11	—	—	$4,920.13	$5,301.76	$5,110.94	2026-05-14
536	OTHER	Fractures Of Hip And Pelvis Without Mcc	7	7	—	—	$6,913.26	$7,304.80	$7,304.80	2026-05-14
537	OTHER	Sprains, Strains, And Dislocations Of Hip, Pelvis And Thigh With Cc/mcc	7	7	—	—	$8,169.05	$8,631.71	$8,631.71	2026-05-14
539	OTHER	Osteomyelitis With Mcc	7	7	—	—	$16,861.14	$17,816.08	$17,816.08	2026-05-14
54	OTHER	Nervous System Neoplasms With Mcc	7	7	—	—	$13,070.65	$13,810.92	$13,810.92	2026-05-14
540	OTHER	Osteomyelitis With Cc	7	7	—	—	$11,096.66	$11,725.13	$11,725.13	2026-05-14
54435	CPT	Revision Of Penis	14	11	—	—	$3,298.69	$3,485.51	$3,392.10	2026-05-14
54520	CPT	Removal Of Testis	14	11	—	—	$3,298.69	$3,485.51	$3,392.10	2026-05-14
546	OTHER	Connective Tissue Disorders With Cc	7	7	—	—	$9,873.40	$10,432.59	$10,432.59	2026-05-14
55040	CPT	Removal Of Hydrocele	14	11	—	—	$3,350.55	$3,540.31	$3,445.43	2026-05-14
55110	CPT	Explore Scrotum	14	11	—	—	$3,298.69	$3,485.51	$3,392.10	2026-05-14
552	OTHER	Medical Back Problems Without Mcc	7	7	—	—	$8,228.97	$8,695.03	$8,695.03	2026-05-14
554	OTHER	Bone Diseases And Arthropathies Without Mcc	7	7	—	—	$7,105.87	$7,508.31	$7,508.31	2026-05-14
55520	CPT	Removal Of Sperm Cord Lesion	14	11	—	—	$3,298.69	$3,485.51	$3,392.10	2026-05-14
557	OTHER	Tendonitis, Myositis And Bursitis With Mcc	7	7	—	—	$12,728.24	$13,449.12	$13,449.12	2026-05-14
55725	CPT	Drainage Of Prostate Abscess	14	11	—	—	$3,298.69	$3,485.51	$3,392.10	2026-05-14
558	OTHER	Tendonitis, Myositis And Bursitis Without Mcc	7	7	—	—	$7,646.02	$8,079.06	$8,079.06	2026-05-14
56	OTHER	Degenerative Nervous System Disorders With Mcc	7	7	—	—	$19,886.33	$21,012.61	$21,012.61	2026-05-14
561	OTHER	Aftercare, Musculoskeletal System And Connective Tissue Without Cc/mcc	7	7	—	—	$6,881.59	$7,271.33	$7,271.33	2026-05-14
563	OTHER	Fracture, Sprain, Strain And Dislocation Except Femur, Hip, Pelvis And Thigh Wit…	7	7	—	—	$7,665.71	$8,099.86	$8,099.86	2026-05-14
564	OTHER	Other Musculoskeletal System And Connective Tissue Diagnoses With Mcc	7	7	—	—	$13,213.61	$13,961.97	$13,961.97	2026-05-14
565	OTHER	Other Musculoskeletal System And Connective Tissue Diagnoses With Cc	7	7	—	—	$8,341.11	$8,813.52	$8,813.52	2026-05-14
57	OTHER	Degenerative Nervous System Disorders Without Mcc	7	7	—	—	$11,090.67	$11,718.79	$11,718.79	2026-05-14
57288	CPT	Repair Bladder Defect	14	11	—	—	$4,681.31	$4,946.44	$4,813.88	2026-05-14
57460	CPT	Bx Of Cervix W/scope Leep	15	11	—	—	$3,029.31	$29,847.39	$16,438.35	2026-05-14
576	OTHER	Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc	7	7	—	—	$41,955.53	$44,331.71	$44,331.71	2026-05-14
579	OTHER	Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc	7	7	—	—	$27,722.39	$29,292.46	$29,292.46	2026-05-14
58120	CPT	Dilation And Curettage	15	11	—	—	$3,029.31	$15,928.07	$9,478.69	2026-05-14
58550	CPT	Laparo-asst Vag Hysterectomy	14	11	—	—	$5,657.42	$5,977.83	$5,817.62	2026-05-14
58562	CPT	Hysteroscopy Remove Fb	15	11	—	—	$3,029.31	$31,562.99	$17,296.15	2026-05-14
58573	CPT	Tlh W/t/o Uterus Over 250 G	15	11	—	—	$9,947.43	$17,319.84	$13,633.64	2026-05-14
58660	CPT	Laparoscopy Lysis	14	11	—	—	$5,657.42	$5,977.83	$5,817.62	2026-05-14
58661	CPT	Laparoscopy Remove Adnexa	14	11	—	—	$5,657.42	$5,977.83	$5,817.62	2026-05-14
58662	CPT	Laparoscopy Excise Lesions	14	11	—	—	$5,657.42	$5,977.83	$5,817.62	2026-05-14
58670	CPT	Laparoscopy Tubal Cautery	14	11	—	—	$5,657.42	$5,977.83	$5,817.62	2026-05-14
58679	CPT	Unlisted Laps Px Ovidct Ovry	14	11	—	—	$5,657.42	$5,977.83	$5,817.62	2026-05-14
59	OTHER	Multiple Sclerosis And Cerebellar Ataxia With Cc	7	7	—	—	$10,622.42	$11,224.03	$11,224.03	2026-05-14
596	OTHER	Major Skin Disorders Without Mcc	7	7	—	—	$9,266.48	$9,791.29	$9,791.29	2026-05-14
60220	CPT	Partial Removal Of Thyroid	14	11	—	—	$5,657.42	$5,977.83	$5,817.62	2026-05-14
60240	CPT	Removal Of Thyroid	14	11	—	—	$5,657.42	$5,977.83	$5,817.62	2026-05-14
603	OTHER	Cellulitis Without Mcc	7	7	—	—	$7,455.13	$7,877.35	$7,877.35	2026-05-14
605	OTHER	Trauma To The Skin, Subcutaneous Tissue And Breast Without Mcc	7	7	—	—	$7,841.19	$8,285.29	$8,285.29	2026-05-14
607	OTHER	Minor Skin Disorders Without Mcc	7	7	—	—	$7,759.02	$8,198.45	$8,198.45	2026-05-14
629	OTHER	Other Endocrine, Nutritional And Metabolic O.r. Procedures With Cc	7	7	—	—	$18,651.09	$19,707.40	$19,707.40	2026-05-14
637	OTHER	Diabetes With Mcc	7	7	—	—	$12,298.52	$12,995.05	$12,995.05	2026-05-14
638	OTHER	Diabetes With Cc	7	7	—	—	$7,671.70	$8,106.19	$8,106.19	2026-05-14
639	OTHER	Diabetes Without Cc/mcc	7	7	—	—	$5,317.63	$5,618.80	$5,618.80	2026-05-14
64	OTHER	Intracranial Hemorrhage Or Cerebral Infarction With Mcc	7	7	—	—	$17,214.67	$18,189.64	$18,189.64	2026-05-14
640	OTHER	Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes With M…	7	7	—	—	$11,433.08	$12,080.60	$12,080.60	2026-05-14
641	OTHER	Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes Withou…	7	7	—	—	$6,661.59	$7,038.87	$7,038.87	2026-05-14
642	OTHER	Inborn And Other Disorders Of Metabolism	7	7	—	—	$12,173.54	$12,863.00	$12,863.00	2026-05-14
644	OTHER	Endocrine Disorders With Cc	7	7	—	—	$8,774.26	$9,271.20	$9,271.20	2026-05-14
645	OTHER	Endocrine Disorders Without Cc/mcc	7	7	—	—	$6,576.84	$6,949.33	$6,949.33	2026-05-14
65	OTHER	Intracranial Hemorrhage Or Cerebral Infarction With Cc Or Tpa In 24 Hours	7	7	—	—	$8,648.43	$9,138.24	$9,138.24	2026-05-14
65779	CPT	Cover Eye W/membrane Suture	14	11	—	—	$3,679.01	$3,887.38	$3,783.20	2026-05-14
659	OTHER	Kidney And Ureter Procedures For Non-neoplasm With Mcc	7	7	—	—	$21,750.75	$22,982.62	$22,982.62	2026-05-14
66	OTHER	Intracranial Hemorrhage Or Cerebral Infarction Without Cc/mcc	7	7	—	—	$5,858.64	$6,190.45	$6,190.45	2026-05-14
660	OTHER	Kidney And Ureter Procedures For Non-neoplasm With Cc	7	7	—	—	$11,314.09	$11,954.87	$11,954.87	2026-05-14
66180	CPT	Aqueous Shunt Eye W/graft	14	11	—	—	$4,979.69	$5,261.72	$5,120.70	2026-05-14
666	OTHER	Prostatectomy With Cc	7	7	—	—	$14,974.46	$15,822.54	$15,822.54	2026-05-14
66989	CPT	Xcpsl Ctrc Rmvl Cplx Insj 1+	14	11	—	—	$4,979.69	$5,261.72	$5,120.70	2026-05-14
66991	CPT	Xcapsl Ctrc Rmvl Insj 1+	14	11	—	—	$4,979.69	$5,261.72	$5,120.70	2026-05-14
67036	CPT	Removal Of Inner Eye Fluid	14	11	—	—	$3,868.07	$4,087.14	$3,977.61	2026-05-14
67312	CPT	Revise Two Eye Muscles	14	11	—	—	$3,679.01	$3,887.38	$3,783.20	2026-05-14
68	OTHER	Precerebral Occlusion Without Infarction Without Mcc	7	7	—	—	$7,399.49	$7,818.56	$7,818.56	2026-05-14
682	OTHER	Renal Failure With Mcc	7	7	—	—	$12,677.74	$13,395.75	$13,395.75	2026-05-14
683	OTHER	Renal Failure With Cc	7	7	—	—	$7,497.07	$7,921.67	$7,921.67	2026-05-14
684	OTHER	Renal Failure Without Cc/mcc	7	7	—	—	$5,138.72	$5,429.76	$5,429.76	2026-05-14
689	OTHER	Kidney And Urinary Tract Infections With Mcc	7	7	—	—	$9,932.46	$10,495.00	$10,495.00	2026-05-14
69	OTHER	Transient Ischemia Without Thrombolytic	7	7	—	—	$6,837.93	$7,225.20	$7,225.20	2026-05-14
690	OTHER	Kidney And Urinary Tract Infections Without Mcc	7	7	—	—	$6,929.53	$7,321.99	$7,321.99	2026-05-14
696	OTHER	Kidney And Urinary Tract Signs And Symptoms Without Mcc	7	7	—	—	$5,898.02	$6,232.05	$6,232.05	2026-05-14
698	OTHER	Other Kidney And Urinary Tract Diagnoses With Mcc	7	7	—	—	$14,162.09	$14,964.17	$14,964.17	2026-05-14
699	OTHER	Other Kidney And Urinary Tract Diagnoses With Cc	7	7	—	—	$8,688.66	$9,180.75	$9,180.75	2026-05-14
70	OTHER	Other Cerebrovascular Disorders With Mcc	7	7	—	—	$14,251.11	$15,058.24	$15,058.24	2026-05-14
707	OTHER	Major Male Pelvic Procedures With Cc/mcc	7	7	—	—	$17,123.08	$18,092.86	$18,092.86	2026-05-14
71	OTHER	Other Cerebrovascular Disorders With Cc	7	7	—	—	$8,782.82	$9,280.24	$9,280.24	2026-05-14
713	OTHER	Transurethral Prostatectomy With Cc/mcc	7	7	—	—	$12,869.49	$13,598.36	$13,598.36	2026-05-14
72	OTHER	Other Cerebrovascular Disorders Without Cc/mcc	7	7	—	—	$6,473.27	$6,839.88	$6,839.88	2026-05-14
728	OTHER	Inflammation Of The Male Reproductive System Without Mcc	7	7	—	—	$6,944.08	$7,337.36	$7,337.36	2026-05-14
74	OTHER	Cranial And Peripheral Nerve Disorders Without Mcc	7	7	—	—	$8,823.91	$9,323.66	$9,323.66	2026-05-14
755	OTHER	Malignancy, Female Reproductive System With Cc	7	7	—	—	$9,311.85	$9,839.23	$9,839.23	2026-05-14
761	OTHER	Menstrual And Other Female Reproductive System Disorders Without Cc/mcc	7	7	—	—	$4,883.63	$5,160.21	$5,160.21	2026-05-14
768	OTHER	Vaginal Delivery With O.r. Procedures Except Sterilization And/or D&c	7	7	—	—	$9,173.17	$9,692.70	$9,692.70	2026-05-14
784	OTHER	Cesarean Section With Sterilization With Cc	7	7	—	—	$9,074.73	$9,588.68	$9,588.68	2026-05-14
785	OTHER	Cesarean Section With Sterilization Without Cc/mcc	7	7	—	—	$8,199.01	$8,663.37	$8,663.37	2026-05-14
786	OTHER	Cesarean Section Without Sterilization With Mcc	7	7	—	—	$14,120.14	$14,919.85	$14,919.85	2026-05-14
787	OTHER	Cesarean Section Without Sterilization With Cc	7	7	—	—	$9,560.09	$10,101.54	$10,101.54	2026-05-14
788	OTHER	Cesarean Section Without Sterilization Without Cc/mcc	7	7	—	—	$8,207.57	$8,672.41	$8,672.41	2026-05-14
789	OTHER	Neonates, Died Or Transferred To Another Acute Care Facility	7	7	—	—	$15,427.29	$16,301.03	$16,301.03	2026-05-14
791	OTHER	Prematurity With Major Problems	7	7	—	—	$34,746.08	$36,713.95	$36,713.95	2026-05-14
792	OTHER	Prematurity Without Major Problems	7	7	—	—	$20,965.78	$22,153.19	$22,153.19	2026-05-14
793	OTHER	Full Term Neonate With Major Problems	7	7	—	—	$35,692.84	$37,714.33	$37,714.33	2026-05-14
794	OTHER	Neonate With Other Significant Problems	7	7	—	—	$12,634.08	$13,349.62	$13,349.62	2026-05-14
797	OTHER	Vaginal Delivery With Sterilization And/or D&c With Cc	7	7	—	—	$8,563.68	$9,048.69	$9,048.69	2026-05-14
805	OTHER	Vaginal Delivery Without Sterilization Or D&c With Mcc	7	7	—	—	$9,238.23	$9,761.44	$9,761.44	2026-05-14
806	OTHER	Vaginal Delivery Without Sterilization Or D&c With Cc	7	7	—	—	$6,454.43	$6,819.98	$6,819.98	2026-05-14
807	OTHER	Vaginal Delivery Without Sterilization Or D&c Without Cc/mcc	7	7	—	—	$5,771.32	$6,098.19	$6,098.19	2026-05-14
809	OTHER	Major Hematological And Immunological Diagnoses Except Sickle Cell Crisis And Co…	7	7	—	—	$10,836.43	$11,450.16	$11,450.16	2026-05-14
81	OTHER	Nontraumatic Stupor And Coma Without Mcc	7	7	—	—	$7,666.57	$8,100.77	$8,100.77	2026-05-14
811	OTHER	Red Blood Cell Disorders With Mcc	7	7	—	—	$12,021.17	$12,701.99	$12,701.99	2026-05-14
812	OTHER	Red Blood Cell Disorders Without Mcc	7	7	—	—	$7,860.03	$8,305.18	$8,305.18	2026-05-14
813	OTHER	Coagulation Disorders	7	7	—	—	$13,056.96	$13,796.45	$13,796.45	2026-05-14
81455	CPT	So/hl 51/>gsap Dna/dna&rna	14	11	—	—	$2,763.11	$28,577.92	$9,295.06	2026-05-14
815	OTHER	Reticuloendothelial And Immunity Disorders With Cc	7	7	—	—	$8,680.10	$9,171.70	$9,171.70	2026-05-14
83	OTHER	Traumatic Stupor And Coma >1 Hour With Cc	7	7	—	—	$11,948.41	$12,625.11	$12,625.11	2026-05-14
832	OTHER	Other Antepartum Diagnoses Without O.r. Procedures With Cc	7	7	—	—	$6,177.08	$6,526.92	$6,526.92	2026-05-14
833	OTHER	Other Antepartum Diagnoses Without O.r. Procedures Without Cc/mcc	7	7	—	—	$4,476.16	$4,729.67	$4,729.67	2026-05-14
84	OTHER	Traumatic Stupor And Coma >1 Hour Without Cc/mcc	7	7	—	—	$8,181.89	$8,645.28	$8,645.28	2026-05-14
841	OTHER	Lymphoma And Non-acute Leukemia With Cc	7	7	—	—	$13,965.20	$14,756.13	$14,756.13	2026-05-14
847	OTHER	Chemotherapy Without Acute Leukemia As Secondary Diagnosis With Cc	7	7	—	—	$11,198.53	$11,832.76	$11,832.76	2026-05-14
85	OTHER	Traumatic Stupor And Coma <1 Hour With Mcc	7	7	—	—	$19,448.05	$20,549.50	$20,549.50	2026-05-14
853	OTHER	Infectious And Parasitic Diseases With O.r. Procedures With Mcc	7	7	—	—	$42,275.68	$44,669.99	$44,669.99	2026-05-14
86	OTHER	Traumatic Stupor And Coma <1 Hour With Cc	7	7	—	—	$11,151.45	$11,783.01	$11,783.01	2026-05-14
862	OTHER	Postoperative And Post-traumatic Infections With Mcc	7	7	—	—	$15,611.34	$16,495.50	$16,495.50	2026-05-14
863	OTHER	Postoperative And Post-traumatic Infections Without Mcc	7	7	—	—	$8,542.28	$9,026.08	$9,026.08	2026-05-14
864	OTHER	Fever And Inflammatory Conditions	7	7	—	—	$7,598.94	$8,029.31	$8,029.31	2026-05-14
866	OTHER	Viral Illness Without Mcc	7	7	—	—	$7,444.00	$7,865.59	$7,865.59	2026-05-14
871	OTHER	Septicemia Or Severe Sepsis Without Mv >96 Hours With Mcc	7	7	—	—	$16,628.30	$17,570.05	$17,570.05	2026-05-14
872	OTHER	Septicemia Or Severe Sepsis Without Mv >96 Hours Without Mcc	7	7	—	—	$8,759.71	$9,255.82	$9,255.82	2026-05-14
880	OTHER	Acute Adjustment Reaction And Psychosocial Dysfunction	7	7	—	—	$8,219.56	$8,685.08	$8,685.08	2026-05-14
884	OTHER	Organic Disturbances And Intellectual Disability	7	7	—	—	$13,772.60	$14,552.62	$14,552.62	2026-05-14
885	OTHER	Psychoses	7	7	—	—	$11,956.97	$12,634.16	$12,634.16	2026-05-14
894	OTHER	Alcohol, Drug Abuse Or Dependence, Left Ama	7	7	—	—	$5,280.82	$5,579.90	$5,579.90	2026-05-14
897	OTHER	Alcohol, Drug Abuse Or Dependence Without Rehabilitation Therapy Without Mcc	7	7	—	—	$7,556.99	$7,984.99	$7,984.99	2026-05-14
917	OTHER	Poisoning And Toxic Effects Of Drugs With Mcc	7	7	—	—	$13,425.91	$14,186.29	$14,186.29	2026-05-14
918	OTHER	Poisoning And Toxic Effects Of Drugs Without Mcc	7	7	—	—	$7,337.00	$7,752.53	$7,752.53	2026-05-14
92	OTHER	Other Disorders Of Nervous System With Cc	7	7	—	—	$8,757.14	$9,253.11	$9,253.11	2026-05-14
948	OTHER	Signs And Symptoms Without Mcc	7	7	—	—	$6,852.48	$7,240.58	$7,240.58	2026-05-14
949	OTHER	Aftercare With Cc/mcc	7	7	—	—	$10,184.14	$10,760.92	$10,760.92	2026-05-14
95	OTHER	Bacterial And Tuberculous Infections Of Nervous System With Cc	7	7	—	—	$22,078.61	$23,329.05	$23,329.05	2026-05-14
951	OTHER	Other Factors Influencing Health Status	7	7	—	—	$4,759.50	$5,029.06	$5,029.06	2026-05-14
964	OTHER	Other Multiple Significant Trauma With Cc	7	7	—	—	$13,119.45	$13,862.48	$13,862.48	2026-05-14
981	OTHER	Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc	7	7	—	—	$40,163.01	$42,437.67	$42,437.67	2026-05-14
982	OTHER	Extensive O.r. Procedures Unrelated To Principal Diagnosis With Cc	7	7	—	—	$21,045.39	$22,237.31	$22,237.31	2026-05-14
988	OTHER	Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Cc	7	7	—	—	$14,069.64	$14,866.48	$14,866.48	2026-05-14
IP	OTHER	Inpatient Paid Claims	6	6	—	—	$12,883.07	$28,061.34	$16,524.65	2026-05-14
J1950	HCPCS	Leuprolide Acetate /3.75 Mg	15	11	—	—	$1,615.64	$28,615.00	$15,115.32	2026-05-14

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