|
J022500000
|
OTHER
|
Vutrisiran 25mg/0.5ml Syringe
|
90
|
51
|
$363,380.83
|
$345,211.79
|
$4,929.41
|
$345,211.79
|
$205,310.17
|
2026-05-09
|
|
J182300000
|
OTHER
|
Inebilizumab-cdon 100mg/10ml
|
90
|
51
|
$142,335.40
|
$135,218.63
|
$487.62
|
$142,335.40
|
$80,490.67
|
2026-05-09
|
|
J235100000
|
OTHER
|
Ocrelizumab Hyal-ocsq 920mg Vl
|
91
|
51
|
$125,688.58
|
$119,404.15
|
$46.30
|
$119,404.15
|
$71,014.05
|
2026-05-09
|
|
J934700000
|
OTHER
|
Tremelimumab-actl 300mg/15ml
|
92
|
51
|
$123,538.09
|
$117,361.19
|
$140.73
|
$117,361.19
|
$69,799.02
|
2026-05-09
|
|
J922800000
|
OTHER
|
Ipilimumab 200mg Vial
|
92
|
51
|
$94,117.37
|
$89,411.50
|
$183.48
|
$89,411.50
|
$53,176.31
|
2026-05-09
|
|
583-4
|
OTHER
|
Neonate With Ecmo
|
13
|
13
|
—
|
—
|
$463,247.07
|
$833,703.28
|
$645,786.83
|
2026-05-09
|
|
002-4
|
OTHER
|
Heart And/or Lung Transplant
|
13
|
13
|
—
|
—
|
$403,093.82
|
$751,591.30
|
$630,988.28
|
2026-05-09
|
|
583-3
|
OTHER
|
Neonate With Ecmo
|
13
|
13
|
—
|
—
|
$299,768.96
|
$660,308.87
|
$527,119.66
|
2026-05-09
|
|
588-4
|
OTHER
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
13
|
13
|
—
|
—
|
$372,130.02
|
$683,863.13
|
$518,765.65
|
2026-05-09
|
|
161-4
|
OTHER
|
Implantable Heart Assist Systems
|
13
|
13
|
—
|
—
|
$329,002.58
|
$653,854.07
|
$458,644.10
|
2026-05-09
|
|
583-2
|
OTHER
|
Neonate With Ecmo
|
13
|
13
|
—
|
—
|
$260,305.32
|
$486,914.45
|
$390,105.83
|
2026-05-09
|
|
609-4
|
OTHER
|
Neonate Birth Weight 1500-2499 Grams With Major Procedure
|
13
|
13
|
—
|
—
|
$246,174.83
|
$427,947.32
|
$358,424.90
|
2026-05-09
|
|
161-3
|
OTHER
|
Implantable Heart Assist Systems
|
13
|
13
|
—
|
—
|
$153,530.20
|
$500,920.00
|
$351,367.01
|
2026-05-09
|
|
588-3
|
OTHER
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
13
|
13
|
—
|
—
|
$239,740.43
|
$440,570.29
|
$334,208.72
|
2026-05-09
|
|
588-2
|
OTHER
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
13
|
13
|
—
|
—
|
$153,523.37
|
$431,403.74
|
$327,255.35
|
2026-05-09
|
|
630-4
|
OTHER
|
Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure
|
13
|
13
|
—
|
—
|
$215,493.03
|
$496,373.25
|
$325,610.28
|
2026-05-09
|
|
583-1
|
OTHER
|
Neonate With Ecmo
|
13
|
13
|
—
|
—
|
$224,152.63
|
$420,781.56
|
$312,478.64
|
2026-05-09
|
|
001-4
|
OTHER
|
Liver Transplant And/or Intestinal Transplant
|
13
|
13
|
—
|
—
|
$211,035.71
|
$403,367.38
|
$305,960.81
|
2026-05-09
|
|
841-4
|
OTHER
|
Extensive Third Degree Burns With Skin Graft
|
13
|
13
|
—
|
—
|
$210,180.94
|
$461,100.88
|
$304,721.55
|
2026-05-09
|
|
002-3
|
OTHER
|
Heart And/or Lung Transplant
|
13
|
13
|
—
|
—
|
$218,360.70
|
$390,193.62
|
$304,404.44
|
2026-05-09
|
|
004-4
|
OTHER
|
Tracheostomy With Mv >96 Hours With Extensive Procedure
|
13
|
13
|
—
|
—
|
$213,720.00
|
$409,737.87
|
$297,935.10
|
2026-05-09
|
|
603-4
|
OTHER
|
Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition
|
13
|
13
|
—
|
—
|
$210,026.36
|
$358,515.37
|
$292,786.01
|
2026-05-09
|
|
161-2
|
OTHER
|
Implantable Heart Assist Systems
|
13
|
13
|
—
|
—
|
$96,762.39
|
$402,195.57
|
$282,117.96
|
2026-05-09
|
|
006-4
|
OTHER
|
Pancreas Transplant
|
13
|
13
|
—
|
—
|
$200,370.07
|
$356,219.52
|
$279,324.71
|
2026-05-09
|
|
591-4
|
OTHER
|
Neonate Birth Weight 500-749 Grams Without Major Procedure
|
13
|
13
|
—
|
—
|
$191,347.07
|
$438,429.78
|
$277,416.11
|
2026-05-09
|
|
160-4
|
OTHER
|
Major Cardiothoracic Repair Of Heart Anomaly
|
13
|
13
|
—
|
—
|
$201,314.73
|
$295,262.39
|
$276,674.02
|
2026-05-09
|
|
161-1
|
OTHER
|
Implantable Heart Assist Systems
|
13
|
13
|
—
|
—
|
$72,192.37
|
$382,083.68
|
$268,011.82
|
2026-05-09
|
|
593-4
|
OTHER
|
Neonate Birth Weight 750-999 Grams Without Major Procedure
|
13
|
13
|
—
|
—
|
$168,455.05
|
$446,007.84
|
$244,227.12
|
2026-05-09
|
|
002-2
|
OTHER
|
Heart And/or Lung Transplant
|
13
|
13
|
—
|
—
|
$155,370.44
|
$289,566.75
|
$216,593.24
|
2026-05-09
|
|
588-1
|
OTHER
|
Female Reproductive System Reconstructive Procedures
|
13
|
13
|
—
|
—
|
$138,170.52
|
$283,966.22
|
$215,412.90
|
2026-05-09
|
|
607-4
|
OTHER
|
Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…
|
13
|
13
|
—
|
—
|
$152,780.74
|
$245,557.77
|
$212,983.08
|
2026-05-09
|
|
631-4
|
OTHER
|
Neonate Birth Weight > 2499 Grams With Other Major Procedure
|
13
|
13
|
—
|
—
|
$146,589.69
|
$410,847.86
|
$212,526.58
|
2026-05-09
|
|
602-4
|
OTHER
|
Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…
|
13
|
13
|
—
|
—
|
$140,471.30
|
$319,699.46
|
$203,656.11
|
2026-05-09
|
|
004-3
|
OTHER
|
Tracheostomy With Mv >96 Hours With Extensive Procedure
|
13
|
13
|
—
|
—
|
$142,153.16
|
$280,394.59
|
$198,167.78
|
2026-05-09
|
|
609-3
|
OTHER
|
Neonate Birth Weight 1500-2499 Grams With Major Procedure
|
13
|
13
|
—
|
—
|
$126,498.40
|
$213,205.09
|
$192,851.44
|
2026-05-09
|
|
005-4
|
OTHER
|
Tracheostomy With Mv >96 Hours Without Extensive Procedure
|
13
|
13
|
—
|
—
|
$137,915.05
|
$270,025.32
|
$192,259.67
|
2026-05-09
|
|
593-3
|
OTHER
|
Neonate Birth Weight 750-999 Grams Without Major Procedure
|
13
|
13
|
—
|
—
|
$131,219.90
|
$286,812.86
|
$190,243.38
|
2026-05-09
|
|
006-3
|
OTHER
|
Pancreas Transplant
|
13
|
13
|
—
|
—
|
$133,284.74
|
$250,475.45
|
$185,804.80
|
2026-05-09
|
|
002-1
|
OTHER
|
Heart And/or Lung Transplant
|
13
|
13
|
—
|
—
|
$133,194.77
|
$248,235.80
|
$185,679.37
|
2026-05-09
|
|
001-3
|
OTHER
|
Liver Transplant And/or Intestinal Transplant
|
13
|
13
|
—
|
—
|
$132,518.79
|
$233,198.95
|
$184,737.03
|
2026-05-09
|
|
303-4
|
OTHER
|
Dorsal And Lumbar Fusion Procedure For Curvature Of Back
|
13
|
13
|
—
|
—
|
$123,449.65
|
$249,295.22
|
$178,978.02
|
2026-05-09
|
|
591-3
|
OTHER
|
Neonate Birth Weight 500-749 Grams Without Major Procedure
|
13
|
13
|
—
|
—
|
$120,751.52
|
$280,567.64
|
$175,066.26
|
2026-05-09
|
|
602-3
|
OTHER
|
Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…
|
13
|
13
|
—
|
—
|
$120,872.64
|
$252,091.26
|
$168,501.79
|
2026-05-09
|
|
842-4
|
OTHER
|
Burns With Skin Graft Except Extensive Third Degree Burns
|
13
|
13
|
—
|
—
|
$114,920.37
|
$259,029.68
|
$166,612.22
|
2026-05-09
|
|
630-3
|
OTHER
|
Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure
|
13
|
13
|
—
|
—
|
$102,336.40
|
$239,836.42
|
$162,074.26
|
2026-05-09
|
|
006-2
|
OTHER
|
Pancreas Transplant
|
13
|
13
|
—
|
—
|
$114,614.68
|
$217,437.11
|
$159,777.92
|
2026-05-09
|
|
589-1
|
OTHER
|
Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …
|
13
|
13
|
—
|
—
|
$111,122.09
|
$283,115.08
|
$157,089.19
|
2026-05-09
|
|
440-4
|
OTHER
|
Kidney Transplant
|
13
|
13
|
—
|
—
|
$108,192.92
|
$236,998.22
|
$156,858.72
|
2026-05-09
|
|
001-2
|
OTHER
|
Liver Transplant And/or Intestinal Transplant
|
13
|
13
|
—
|
—
|
$111,470.13
|
$195,448.07
|
$155,394.27
|
2026-05-09
|
|
863-4
|
OTHER
|
Neonatal Aftercare
|
13
|
13
|
—
|
—
|
$110,734.17
|
$182,940.32
|
$154,368.31
|
2026-05-09
|
|
004-2
|
OTHER
|
Tracheostomy With Mv >96 Hours With Extensive Procedure
|
13
|
13
|
—
|
—
|
$107,203.18
|
$192,772.86
|
$149,445.96
|
2026-05-09
|
|
593-2
|
OTHER
|
Neonate Birth Weight 750-999 Grams Without Major Procedure
|
13
|
13
|
—
|
—
|
$101,568.13
|
$227,325.85
|
$147,254.07
|
2026-05-09
|
|
611-4
|
OTHER
|
Neonate Birth Weight 1500-1999 Grams With Major Anomaly
|
13
|
13
|
—
|
—
|
$101,517.38
|
$203,186.27
|
$147,180.48
|
2026-05-09
|
|
091-4
|
OTHER
|
Other Major Head And Neck Procedures
|
13
|
13
|
—
|
—
|
$105,154.49
|
$169,075.28
|
$146,589.99
|
2026-05-09
|
|
602-2
|
OTHER
|
Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…
|
13
|
13
|
—
|
—
|
$103,554.53
|
$192,354.16
|
$144,359.58
|
2026-05-09
|
|
841-3
|
OTHER
|
Extensive Third Degree Burns With Skin Graft
|
13
|
13
|
—
|
—
|
$101,831.14
|
$169,218.60
|
$141,957.09
|
2026-05-09
|
|
613-4
|
OTHER
|
Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection
|
13
|
13
|
—
|
—
|
$100,584.16
|
$175,072.04
|
$140,218.75
|
2026-05-09
|
|
603-3
|
OTHER
|
Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition
|
13
|
13
|
—
|
—
|
$100,182.73
|
$174,465.06
|
$139,659.14
|
2026-05-09
|
|
220-4
|
OTHER
|
Major Stomach, Esophageal And Duodenal Procedures
|
13
|
13
|
—
|
—
|
$99,103.01
|
$151,323.88
|
$138,153.97
|
2026-05-09
|
|
167-4
|
OTHER
|
Other Cardiothoracic And Thoracic Vascular Procedures
|
13
|
13
|
—
|
—
|
$92,871.59
|
$199,592.98
|
$134,645.77
|
2026-05-09
|
|
001-1
|
OTHER
|
Liver Transplant And/or Intestinal Transplant
|
13
|
13
|
—
|
—
|
$96,424.49
|
$173,532.11
|
$134,419.99
|
2026-05-09
|
|
680-4
|
OTHER
|
Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms
|
13
|
13
|
—
|
—
|
$92,223.30
|
$178,829.15
|
$133,705.87
|
2026-05-09
|
|
005-3
|
OTHER
|
Tracheostomy With Mv >96 Hours Without Extensive Procedure
|
13
|
13
|
—
|
—
|
$94,007.82
|
$198,842.67
|
$131,051.05
|
2026-05-09
|
|
589-2
|
OTHER
|
Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …
|
13
|
13
|
—
|
—
|
$92,247.68
|
$257,379.92
|
$130,409.42
|
2026-05-09
|
|
608-4
|
OTHER
|
Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition
|
13
|
13
|
—
|
—
|
$89,326.75
|
$196,528.56
|
$129,307.07
|
2026-05-09
|
|
006-1
|
OTHER
|
Pancreas Transplant
|
13
|
13
|
—
|
—
|
$91,707.66
|
$170,915.90
|
$127,844.52
|
2026-05-09
|
|
690-4
|
OTHER
|
Acute Leukemia
|
13
|
13
|
—
|
—
|
$90,926.72
|
$174,105.07
|
$126,755.85
|
2026-05-09
|
|
312-4
|
OTHER
|
Skin Graft, Except Hand, For Musculoskeletal And Connective Tissue Diagnoses
|
13
|
13
|
—
|
—
|
$86,895.09
|
$195,503.52
|
$125,981.01
|
2026-05-09
|
|
621-4
|
OTHER
|
Neonate Birth Weight 2000-2499 Grams With Major Anomaly
|
13
|
13
|
—
|
—
|
$88,839.96
|
$146,394.97
|
$123,846.82
|
2026-05-09
|
|
162-4
|
OTHER
|
Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis
|
13
|
13
|
—
|
—
|
$85,356.27
|
$260,760.42
|
$123,750.01
|
2026-05-09
|
|
633-4
|
OTHER
|
Neonate Birth Weight > 2499 Grams With Major Anomaly
|
13
|
13
|
—
|
—
|
$87,836.38
|
$133,058.24
|
$122,447.78
|
2026-05-09
|
|
910-4
|
OTHER
|
Craniotomy For Multiple Significant Trauma
|
13
|
13
|
—
|
—
|
$84,003.16
|
$213,576.16
|
$121,788.28
|
2026-05-09
|
|
303-3
|
OTHER
|
Dorsal And Lumbar Fusion Procedure For Curvature Of Back
|
13
|
13
|
—
|
—
|
$83,724.01
|
$188,757.22
|
$121,383.55
|
2026-05-09
|
|
740-4
|
OTHER
|
Mental Illness Diagnosis With O.r. Procedure
|
13
|
13
|
—
|
—
|
$76,853.02
|
$155,707.64
|
$120,630.65
|
2026-05-09
|
|
440-3
|
OTHER
|
Kidney Transplant
|
13
|
13
|
—
|
—
|
$84,181.96
|
$156,219.08
|
$117,353.37
|
2026-05-09
|
|
361-4
|
OTHER
|
Skin Graft For Skin And Subcutaneous Tissue Diagnoses
|
13
|
13
|
—
|
—
|
$81,075.48
|
$143,938.94
|
$113,022.79
|
2026-05-09
|
|
163-4
|
OTHER
|
Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis
|
13
|
13
|
—
|
—
|
$77,917.08
|
$221,891.11
|
$112,964.64
|
2026-05-09
|
|
608-3
|
OTHER
|
Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition
|
13
|
13
|
—
|
—
|
$80,889.76
|
$148,072.60
|
$112,763.88
|
2026-05-09
|
|
614-4
|
OTHER
|
Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition
|
13
|
13
|
—
|
—
|
$80,830.92
|
$140,690.47
|
$112,681.87
|
2026-05-09
|
|
612-4
|
OTHER
|
Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other…
|
13
|
13
|
—
|
—
|
$77,327.62
|
$178,441.35
|
$112,110.04
|
2026-05-09
|
|
591-2
|
OTHER
|
Neonate Birth Weight 500-749 Grams Without Major Procedure
|
13
|
13
|
—
|
—
|
$79,021.02
|
$222,643.82
|
$111,666.64
|
2026-05-09
|
|
440-2
|
OTHER
|
Kidney Transplant
|
13
|
13
|
—
|
—
|
$80,018.83
|
$133,982.76
|
$111,549.78
|
2026-05-09
|
|
651-4
|
OTHER
|
Other Procedures Of Blood And Blood-forming Organs
|
13
|
13
|
—
|
—
|
$77,342.62
|
$138,978.77
|
$109,773.59
|
2026-05-09
|
|
092-4
|
OTHER
|
Facial Bone Procedures Except Major Cranial Or Facial Bone Procedures
|
13
|
13
|
—
|
—
|
$78,027.82
|
$133,755.14
|
$108,774.22
|
2026-05-09
|
|
510-4
|
OTHER
|
Pelvic Evisceration, Radical Hysterectomy And Other Radical Gynecological Proced…
|
13
|
13
|
—
|
—
|
$77,894.01
|
$135,578.89
|
$108,587.68
|
2026-05-09
|
|
440-1
|
OTHER
|
Kidney Transplant
|
13
|
13
|
—
|
—
|
$77,333.39
|
$119,637.20
|
$107,806.15
|
2026-05-09
|
|
005-2
|
OTHER
|
Tracheostomy With Mv >96 Hours Without Extensive Procedure
|
13
|
13
|
—
|
—
|
$77,248.03
|
$145,549.13
|
$107,687.15
|
2026-05-09
|
|
441-4
|
OTHER
|
Major Bladder Procedures
|
13
|
13
|
—
|
—
|
$73,831.24
|
$159,731.71
|
$107,040.96
|
2026-05-09
|
|
631-3
|
OTHER
|
Neonate Birth Weight > 2499 Grams With Other Major Procedure
|
13
|
13
|
—
|
—
|
$75,778.42
|
$157,775.88
|
$105,638.45
|
2026-05-09
|
|
004-1
|
OTHER
|
Tracheostomy With Mv >96 Hours With Extensive Procedure
|
13
|
13
|
—
|
—
|
$73,959.28
|
$128,730.68
|
$105,513.50
|
2026-05-09
|
|
160-3
|
OTHER
|
Major Cardiothoracic Repair Of Heart Anomaly
|
13
|
13
|
—
|
—
|
$75,277.78
|
$148,519.40
|
$104,940.54
|
2026-05-09
|
|
021-4
|
OTHER
|
Open Craniotomy Except Trauma
|
13
|
13
|
—
|
—
|
$72,301.64
|
$174,883.45
|
$104,823.34
|
2026-05-09
|
|
589-3
|
OTHER
|
Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …
|
13
|
13
|
—
|
—
|
$73,375.59
|
$196,619.54
|
$103,728.04
|
2026-05-09
|
|
630-2
|
OTHER
|
Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure
|
13
|
13
|
—
|
—
|
$56,407.60
|
$152,166.92
|
$103,358.18
|
2026-05-09
|
|
120-4
|
OTHER
|
Major Respiratory And Chest Procedures
|
13
|
13
|
—
|
—
|
$71,133.11
|
$146,709.70
|
$103,129.19
|
2026-05-09
|
|
304-4
|
OTHER
|
Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back
|
13
|
13
|
—
|
—
|
$68,929.84
|
$191,345.33
|
$99,934.89
|
2026-05-09
|
|
089-4
|
OTHER
|
Major Cranial Or Facial Bone Procedures
|
13
|
13
|
—
|
—
|
$68,867.55
|
$170,241.46
|
$99,844.58
|
2026-05-09
|
|
401-4
|
OTHER
|
Adrenal Procedures
|
13
|
13
|
—
|
—
|
$68,775.27
|
$157,431.50
|
$99,710.79
|
2026-05-09
|
|
303-2
|
OTHER
|
Dorsal And Lumbar Fusion Procedure For Curvature Of Back
|
13
|
13
|
—
|
—
|
$69,796.15
|
$137,141.31
|
$97,298.91
|
2026-05-09
|
|
005-1
|
OTHER
|
Tracheostomy With Mv >96 Hours Without Extensive Procedure
|
13
|
13
|
—
|
—
|
$69,440.86
|
$120,865.21
|
$96,803.62
|
2026-05-09
|
|
950-4
|
OTHER
|
Extensive O.r. Procedure Unrelated To Principal Diagnosis
|
13
|
13
|
—
|
—
|
$66,731.20
|
$148,820.09
|
$96,747.28
|
2026-05-09
|
|
607-3
|
OTHER
|
Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…
|
13
|
13
|
—
|
—
|
$66,461.26
|
$191,030.60
|
$96,355.93
|
2026-05-09
|
|
404-4
|
OTHER
|
Thyroid, Parathyroid And Thyroglossal Procedures
|
13
|
13
|
—
|
—
|
$68,476.50
|
$130,534.76
|
$95,459.26
|
2026-05-09
|
|
511-4
|
OTHER
|
Uterine And Adnexa Procedures For Ovarian And Adnexal Malignancy
|
13
|
13
|
—
|
—
|
$65,503.83
|
$122,391.09
|
$94,967.83
|
2026-05-09
|
|
611-3
|
OTHER
|
Neonate Birth Weight 1500-1999 Grams With Major Anomaly
|
13
|
13
|
—
|
—
|
$67,355.26
|
$121,542.44
|
$93,896.20
|
2026-05-09
|
|
423-4
|
OTHER
|
Inborn Errors Of Metabolism
|
13
|
13
|
—
|
—
|
$51,906.99
|
$98,739.40
|
$93,251.36
|
2026-05-09
|
|
026-4
|
OTHER
|
Other Nervous System And Related Procedures
|
13
|
13
|
—
|
—
|
$64,218.78
|
$124,298.67
|
$93,104.76
|
2026-05-09
|
|
176-4
|
OTHER
|
Insertion, Revision And Replacements Of Pacemaker And Other Cardiac Devices
|
13
|
13
|
—
|
—
|
$66,210.95
|
$139,054.98
|
$92,300.98
|
2026-05-09
|
|
681-4
|
OTHER
|
Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms
|
13
|
13
|
—
|
—
|
$63,523.20
|
$152,490.08
|
$92,096.30
|
2026-05-09
|
|
169-4
|
OTHER
|
Major Abdominal Vascular Procedures
|
13
|
13
|
—
|
—
|
$63,463.21
|
$171,196.91
|
$92,009.33
|
2026-05-09
|
|
260-4
|
OTHER
|
Major Pancreas, Liver And Shunt Procedures
|
13
|
13
|
—
|
—
|
$63,418.22
|
$157,728.11
|
$91,944.11
|
2026-05-09
|
|
911-4
|
OTHER
|
Extensive Abdominal Or Thoracic Procedures For Multiple Significant Trauma
|
13
|
13
|
—
|
—
|
$62,607.28
|
$170,710.76
|
$90,768.40
|
2026-05-09
|
|
622-4
|
OTHER
|
Neonate Birth Weight 2000-2499 Grams With Respiratory Distress Syndrome Or Other…
|
13
|
13
|
—
|
—
|
$61,701.75
|
$117,402.39
|
$89,455.56
|
2026-05-09
|
|
165-4
|
OTHER
|
Coronary Bypass With Ami Or Complex Principal Diagnosis
|
13
|
13
|
—
|
—
|
$61,645.23
|
$202,914.51
|
$89,373.62
|
2026-05-09
|
|
614-3
|
OTHER
|
Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition
|
13
|
13
|
—
|
—
|
$63,652.39
|
$107,930.32
|
$88,734.24
|
2026-05-09
|
|
022-4
|
OTHER
|
Ventricular Shunt Procedures
|
13
|
13
|
—
|
—
|
$61,096.15
|
$176,029.80
|
$88,577.55
|
2026-05-09
|
|
850-4
|
OTHER
|
Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal…
|
13
|
13
|
—
|
—
|
$60,732.78
|
$162,395.68
|
$88,050.74
|
2026-05-09
|
|
405-4
|
OTHER
|
Other Procedures For Endocrine, Nutritional And Metabolic Disorders
|
13
|
13
|
—
|
—
|
$60,457.08
|
$121,812.22
|
$87,651.03
|
2026-05-09
|
|
130-4
|
OTHER
|
Respiratory System Diagnosis With Ventilator Support > 96 Hours
|
13
|
13
|
—
|
—
|
$60,031.43
|
$139,226.40
|
$87,033.91
|
2026-05-09
|
|
514-4
|
OTHER
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
13
|
13
|
—
|
—
|
$59,940.30
|
$107,111.56
|
$86,767.17
|
2026-05-09
|
|
512-4
|
OTHER
|
Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy
|
13
|
13
|
—
|
—
|
$62,051.28
|
$108,680.62
|
$86,502.22
|
2026-05-09
|
|
612-3
|
OTHER
|
Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other…
|
13
|
13
|
—
|
—
|
$61,487.20
|
$125,493.44
|
$85,715.86
|
2026-05-09
|
|
020-4
|
OTHER
|
Open Craniotomy For Trauma
|
13
|
13
|
—
|
—
|
$58,602.19
|
$161,570.07
|
$84,961.80
|
2026-05-09
|
|
623-4
|
OTHER
|
Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection
|
13
|
13
|
—
|
—
|
$60,926.57
|
$106,044.74
|
$84,934.33
|
2026-05-09
|
|
613-3
|
OTHER
|
Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection
|
13
|
13
|
—
|
—
|
$60,798.53
|
$114,163.12
|
$84,755.83
|
2026-05-09
|
|
362-4
|
OTHER
|
Mastectomy Procedures
|
13
|
13
|
—
|
—
|
$60,735.09
|
$105,713.15
|
$84,667.39
|
2026-05-09
|
|
912-4
|
OTHER
|
Musculoskeletal And Other Procedures For Multiple Significant Trauma
|
13
|
13
|
—
|
—
|
$58,366.87
|
$171,695.11
|
$84,620.62
|
2026-05-09
|
|
166-4
|
OTHER
|
Coronary Bypass Without Ami Or Complex Principal Diagnosis
|
13
|
13
|
—
|
—
|
$57,723.20
|
$182,909.41
|
$83,687.42
|
2026-05-09
|
|
264-4
|
OTHER
|
Other Hepatobiliary, Pancreas And Abdominal Procedures
|
13
|
13
|
—
|
—
|
$57,114.12
|
$136,799.29
|
$82,804.39
|
2026-05-09
|
|
480-4
|
OTHER
|
Major Male Pelvic Procedures
|
13
|
13
|
—
|
—
|
$56,990.69
|
$118,734.74
|
$82,625.44
|
2026-05-09
|
|
162-3
|
OTHER
|
Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis
|
13
|
13
|
—
|
—
|
$56,000.95
|
$178,598.71
|
$81,190.51
|
2026-05-09
|
|
711-4
|
OTHER
|
Post-operative, Post-trauma, Other Device Infections With O.r. Procedure
|
13
|
13
|
—
|
—
|
$55,944.43
|
$128,079.38
|
$81,108.57
|
2026-05-09
|
|
170-4
|
OTHER
|
Permanent Cardiac Pacemaker Implant With Ami, Heart Failure Or Shock
|
13
|
13
|
—
|
—
|
$55,937.51
|
$120,716.27
|
$81,098.53
|
2026-05-09
|
|
484-4
|
OTHER
|
Other Male Reproductive System And Related Procedures
|
13
|
13
|
—
|
—
|
$55,352.66
|
$102,307.31
|
$80,250.62
|
2026-05-09
|
|
483-4
|
OTHER
|
Penis, Testes And Scrotal Procedures
|
13
|
13
|
—
|
—
|
$57,257.16
|
$111,757.60
|
$79,819.01
|
2026-05-09
|
|
609-2
|
OTHER
|
Neonate Birth Weight 1500-2499 Grams With Major Procedure
|
13
|
13
|
—
|
—
|
$57,145.27
|
$101,270.39
|
$79,663.02
|
2026-05-09
|
|
222-4
|
OTHER
|
Other Stomach, Esophageal And Duodenal Procedures
|
13
|
13
|
—
|
—
|
$54,359.47
|
$119,672.85
|
$78,810.67
|
2026-05-09
|
|
625-4
|
OTHER
|
Neonate Birth Weight 2000-2499 Grams With Other Significant Condition
|
13
|
13
|
—
|
—
|
$56,127.84
|
$97,693.13
|
$78,244.69
|
2026-05-09
|
|
609-1
|
OTHER
|
Neonate Birth Weight 1500-2499 Grams With Major Procedure
|
13
|
13
|
—
|
—
|
$55,273.07
|
$96,206.58
|
$77,053.10
|
2026-05-09
|
|
309-4
|
OTHER
|
Other Significant Hip And Femur Surgery
|
13
|
13
|
—
|
—
|
$52,773.35
|
$113,261.08
|
$76,511.11
|
2026-05-09
|
|
261-4
|
OTHER
|
Major Biliary Tract Procedures
|
13
|
13
|
—
|
—
|
$52,558.79
|
$138,639.09
|
$76,200.04
|
2026-05-09
|
|
759-4
|
OTHER
|
Eating Disorders
|
13
|
13
|
—
|
—
|
$43,906.43
|
$110,464.38
|
$76,192.54
|
2026-05-09
|
|
317-4
|
OTHER
|
Tendon, Muscle And Other Soft Tissue Procedures
|
13
|
13
|
—
|
—
|
$52,223.11
|
$107,238.94
|
$75,713.37
|
2026-05-09
|
|
607-2
|
OTHER
|
Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…
|
13
|
13
|
—
|
—
|
$51,710.94
|
$147,920.85
|
$74,970.82
|
2026-05-09
|
|
650-4
|
OTHER
|
Splenectomy
|
13
|
13
|
—
|
—
|
$51,676.33
|
$119,783.32
|
$74,920.65
|
2026-05-09
|
|
023-4
|
OTHER
|
Spinal Procedures
|
13
|
13
|
—
|
—
|
$51,407.55
|
$161,979.79
|
$74,530.98
|
2026-05-09
|
|
690-3
|
OTHER
|
Acute Leukemia
|
13
|
13
|
—
|
—
|
$53,421.64
|
$83,833.72
|
$74,472.12
|
2026-05-09
|
|
710-4
|
OTHER
|
Infectious And Parasitic Diseases Including HIV With O.r. Procedure
|
13
|
13
|
—
|
—
|
$50,726.97
|
$122,919.82
|
$73,544.25
|
2026-05-09
|
|
621-3
|
OTHER
|
Neonate Birth Weight 2000-2499 Grams With Major Anomaly
|
13
|
13
|
—
|
—
|
$52,364.99
|
$85,932.86
|
$72,999.11
|
2026-05-09
|
|
910-3
|
OTHER
|
Craniotomy For Multiple Significant Trauma
|
13
|
13
|
—
|
—
|
$50,052.14
|
$107,666.18
|
$72,565.89
|
2026-05-09
|
|
518-4
|
OTHER
|
Other Female Reproductive System And Related Procedures
|
13
|
13
|
—
|
—
|
$50,007.16
|
$100,101.38
|
$72,500.66
|
2026-05-09
|
|
167-3
|
OTHER
|
Other Cardiothoracic And Thoracic Vascular Procedures
|
13
|
13
|
—
|
—
|
$49,954.09
|
$124,316.01
|
$72,423.74
|
2026-05-09
|
|
073-4
|
OTHER
|
Orbit And Eye Procedures
|
13
|
13
|
—
|
—
|
$49,886.03
|
$100,708.61
|
$72,325.06
|
2026-05-09
|
|
445-4
|
OTHER
|
Other Bladder Procedures
|
13
|
13
|
—
|
—
|
$51,597.89
|
$87,588.00
|
$71,929.73
|
2026-05-09
|
|
519-4
|
OTHER
|
Uterine And Adnexa Procedures For Leiomyoma
|
13
|
13
|
—
|
—
|
$51,291.05
|
$97,819.58
|
$71,501.98
|
2026-05-09
|
|
951-4
|
OTHER
|
Moderately Extensive O.r. Procedure Unrelated To Principal Diagnosis
|
13
|
13
|
—
|
—
|
$49,052.02
|
$110,611.15
|
$71,115.91
|
2026-05-09
|
|
447-4
|
OTHER
|
Other Kidney, Urinary Tract And Related Procedures
|
13
|
13
|
—
|
—
|
$48,677.12
|
$117,965.19
|
$70,572.38
|
2026-05-09
|
|
403-4
|
OTHER
|
Procedures For Obesity
|
13
|
13
|
—
|
—
|
$48,551.39
|
$148,836.94
|
$70,390.08
|
2026-05-09
|
|
634-4
|
OTHER
|
Neonate Birth Weight > 2499 Grams With Respiratory Distress Syndrome Or Other Ma…
|
13
|
13
|
—
|
—
|
$48,268.77
|
$117,863.36
|
$69,980.34
|
2026-05-09
|
|
229-4
|
OTHER
|
Other Digestive System And Abdominal Procedures
|
13
|
13
|
—
|
—
|
$47,640.09
|
$111,102.92
|
$69,068.88
|
2026-05-09
|
|
175-4
|
OTHER
|
Percutaneous Cardiac Intervention Without Ami
|
13
|
13
|
—
|
—
|
$47,617.02
|
$112,940.73
|
$69,035.43
|
2026-05-09
|
|
636-4
|
OTHER
|
Neonate Birth Weight > 2499 Grams With Congenital Or Perinatal Infection
|
13
|
13
|
—
|
—
|
$47,539.73
|
$99,808.92
|
$68,923.38
|
2026-05-09
|
|
121-4
|
OTHER
|
Other Respiratory And Chest Procedures
|
13
|
13
|
—
|
—
|
$47,364.39
|
$119,954.74
|
$68,669.18
|
2026-05-09
|
|
163-3
|
OTHER
|
Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis
|
13
|
13
|
—
|
—
|
$47,300.95
|
$147,718.52
|
$68,577.19
|
2026-05-09
|
|
130-3
|
OTHER
|
Respiratory System Diagnosis With Ventilator Support > 96 Hours
|
13
|
13
|
—
|
—
|
$47,011.41
|
$107,483.51
|
$67,878.27
|
2026-05-09
|
|
049-4
|
OTHER
|
Bacterial And Tuberculous Infections Of Nervous System
|
13
|
13
|
—
|
—
|
$46,315.82
|
$94,481.18
|
$67,148.95
|
2026-05-09
|
|
304-3
|
OTHER
|
Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back
|
13
|
13
|
—
|
—
|
$46,254.69
|
$129,312.37
|
$67,060.32
|
2026-05-09
|
|
091-3
|
OTHER
|
Other Major Head And Neck Procedures
|
13
|
13
|
—
|
—
|
$47,873.11
|
$107,916.27
|
$66,737.22
|
2026-05-09
|
|
603-2
|
OTHER
|
Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition
|
13
|
13
|
—
|
—
|
$45,988.22
|
$105,184.81
|
$66,673.99
|
2026-05-09
|
|
313-4
|
OTHER
|
Knee And Lower Leg Procedures Except Foot
|
13
|
13
|
—
|
—
|
$45,915.55
|
$107,570.63
|
$66,568.63
|
2026-05-09
|
|
952-4
|
OTHER
|
Non-extensive O.r. Procedure Unrelated To Principal Diagnosis
|
13
|
13
|
—
|
—
|
$45,809.42
|
$95,099.41
|
$66,414.76
|
2026-05-09
|
|
310-4
|
OTHER
|
Vertebral And Intervertebral Spinal Procedures Including Disc Procedures
|
13
|
13
|
—
|
—
|
$45,682.53
|
$98,893.04
|
$66,230.80
|
2026-05-09
|
|
180-4
|
OTHER
|
Other Circulatory System Procedures
|
13
|
13
|
—
|
—
|
$45,613.32
|
$101,863.31
|
$66,130.46
|
2026-05-09
|
|
513-4
|
OTHER
|
Uterine And Adnexa Procedures For Non-malignancy Except Leiomyoma
|
13
|
13
|
—
|
—
|
$45,478.35
|
$88,786.21
|
$65,934.78
|
2026-05-09
|
|
098-4
|
OTHER
|
Other Ear, Nose, Mouth And Throat Procedures
|
13
|
13
|
—
|
—
|
$46,751.86
|
$90,785.90
|
$65,839.88
|
2026-05-09
|
|
444-4
|
OTHER
|
Renal Dialysis Access Device Procedures
|
13
|
13
|
—
|
—
|
$45,316.86
|
$94,860.55
|
$65,700.64
|
2026-05-09
|
|
305-4
|
OTHER
|
Amputation Of Lower Limb Except Toes
|
13
|
13
|
—
|
—
|
$45,083.84
|
$108,031.49
|
$65,362.82
|
2026-05-09
|
|
623-3
|
OTHER
|
Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection
|
13
|
13
|
—
|
—
|
$46,884.52
|
$87,447.50
|
$65,359.09
|
2026-05-09
|
|
740-3
|
OTHER
|
Mental Illness Diagnosis With O.r. Procedure
|
13
|
13
|
—
|
—
|
$46,959.95
|
$78,255.43
|
$65,197.13
|
2026-05-09
|
|
050-4
|
OTHER
|
Non-bacterial Infections Of Nervous System Except Viral Meningitis
|
13
|
13
|
—
|
—
|
$44,901.58
|
$99,913.11
|
$65,098.58
|
2026-05-09
|
|
160-2
|
OTHER
|
Major Cardiothoracic Repair Of Heart Anomaly
|
13
|
13
|
—
|
—
|
$44,531.29
|
$96,257.16
|
$64,561.73
|
2026-05-09
|
|
692-4
|
OTHER
|
Radiotherapy
|
13
|
13
|
—
|
—
|
$44,462.08
|
$91,086.59
|
$64,461.38
|
2026-05-09
|
|
024-4
|
OTHER
|
Open Extracranial Vascular Procedures
|
13
|
13
|
—
|
—
|
$44,310.97
|
$135,812.67
|
$64,242.30
|
2026-05-09
|
|
043-4
|
OTHER
|
Multiple Sclerosis, Other Demyelinating Disease And Inflammatory Neuropathies
|
13
|
13
|
—
|
—
|
$44,289.05
|
$84,061.34
|
$64,210.53
|
2026-05-09
|
|
363-4
|
OTHER
|
Breast Procedures Except Mastectomy
|
13
|
13
|
—
|
—
|
$43,978.75
|
$95,120.42
|
$63,760.65
|
2026-05-09
|
|
162-2
|
OTHER
|
Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis
|
13
|
13
|
—
|
—
|
$43,532.33
|
$141,547.54
|
$63,113.43
|
2026-05-09
|
|
750-4
|
OTHER
|
Schizophrenia
|
13
|
13
|
—
|
—
|
$20,604.25
|
$90,838.65
|
$62,655.73
|
2026-05-09
|
|
303-1
|
OTHER
|
Dorsal And Lumbar Fusion Procedure For Curvature Of Back
|
13
|
13
|
—
|
—
|
$43,090.52
|
$114,179.98
|
$62,472.89
|
2026-05-09
|
|
165-3
|
OTHER
|
Coronary Bypass With Ami Or Complex Principal Diagnosis
|
13
|
13
|
—
|
—
|
$42,869.04
|
$149,865.45
|
$62,151.79
|
2026-05-09
|
|
631-2
|
OTHER
|
Neonate Birth Weight > 2499 Grams With Other Major Procedure
|
13
|
13
|
—
|
—
|
$34,251.55
|
$96,762.98
|
$62,081.81
|
2026-05-09
|
|
910-2
|
OTHER
|
Craniotomy For Multiple Significant Trauma
|
13
|
13
|
—
|
—
|
$44,458.62
|
$95,633.32
|
$61,977.28
|
2026-05-09
|
|
131-4
|
OTHER
|
Cystic Fibrosis - Pulmonary Disease
|
13
|
13
|
—
|
—
|
$43,989.13
|
$70,884.78
|
$61,322.79
|
2026-05-09
|
|
227-4
|
OTHER
|
Hernia Procedures Except Inguinal, Femoral And Umbilical
|
13
|
13
|
—
|
—
|
$42,284.20
|
$104,575.06
|
$61,303.88
|
2026-05-09
|
|
089-3
|
OTHER
|
Major Cranial Or Facial Bone Procedures
|
13
|
13
|
—
|
—
|
$42,220.75
|
$104,381.16
|
$61,211.90
|
2026-05-09
|
|
165-2
|
OTHER
|
Coronary Bypass With Ami Or Complex Principal Diagnosis
|
13
|
13
|
—
|
—
|
$42,113.47
|
$124,644.79
|
$61,056.36
|
2026-05-09
|
|
381-4
|
OTHER
|
Major Skin Disorders
|
13
|
13
|
—
|
—
|
$43,778.03
|
$80,183.56
|
$61,028.51
|
2026-05-09
|
|
097-4
|
OTHER
|
Tonsil And Adenoid Procedures
|
13
|
13
|
—
|
—
|
$42,035.04
|
$99,531.93
|
$60,848.73
|
2026-05-09
|
|
321-4
|
OTHER
|
Spinal Fusion And Other Back And Neck Procedures Except For Disc Procedures
|
13
|
13
|
—
|
—
|
$41,862.00
|
$147,664.31
|
$60,691.78
|
2026-05-09
|
|
612-2
|
OTHER
|
Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other…
|
13
|
13
|
—
|
—
|
$43,241.64
|
$97,181.69
|
$60,280.75
|
2026-05-09
|
|
625-3
|
OTHER
|
Neonate Birth Weight 2000-2499 Grams With Other Significant Condition
|
13
|
13
|
—
|
—
|
$42,879.43
|
$69,625.85
|
$59,775.81
|
2026-05-09
|
|
660-4
|
OTHER
|
Major Hematologic Or Immunologic Diagnoses Except Sickle Cell Crisis And Coagula…
|
13
|
13
|
—
|
—
|
$42,833.28
|
$77,692.73
|
$59,711.49
|
2026-05-09
|
|
442-4
|
OTHER
|
Kidney And Urinary Tract Procedures For Malignancy
|
13
|
13
|
—
|
—
|
$41,107.59
|
$115,734.43
|
$59,598.02
|
2026-05-09
|
|
165-1
|
OTHER
|
Coronary Bypass With Ami Or Complex Principal Diagnosis
|
13
|
13
|
—
|
—
|
$41,445.57
|
$102,357.89
|
$59,151.07
|
2026-05-09
|
|
691-4
|
OTHER
|
Lymphoma, Myeloma And Non-acute Leukemia
|
13
|
13
|
—
|
—
|
$40,754.60
|
$88,630.53
|
$59,086.26
|
2026-05-09
|
|
863-3
|
OTHER
|
Neonatal Aftercare
|
13
|
13
|
—
|
—
|
$40,699.23
|
$117,380.68
|
$59,005.99
|
2026-05-09
|
|
316-4
|
OTHER
|
Hand And Wrist Procedures
|
13
|
13
|
—
|
—
|
$40,662.32
|
$84,595.25
|
$58,952.47
|
2026-05-09
|
|
752-4
|
OTHER
|
Disorders Of Personality And Impulse Control
|
13
|
13
|
—
|
—
|
$16,075.00
|
$85,050.43
|
$58,663.33
|
2026-05-09
|
|
170-3
|
OTHER
|
Permanent Cardiac Pacemaker Implant With Ami, Heart Failure Or Shock
|
13
|
13
|
—
|
—
|
$41,547.09
|
$85,854.17
|
$57,918.47
|
2026-05-09
|
|
842-3
|
OTHER
|
Burns With Skin Graft Except Extensive Third Degree Burns
|
13
|
13
|
—
|
—
|
$39,783.32
|
$96,099.80
|
$57,678.10
|
2026-05-09
|
|
130-2
|
OTHER
|
Respiratory System Diagnosis With Ventilator Support > 96 Hours
|
13
|
13
|
—
|
—
|
$41,164.11
|
$87,807.19
|
$57,384.58
|
2026-05-09
|
|
130-1
|
OTHER
|
Respiratory System Diagnosis With Ventilator Support > 96 Hours
|
13
|
13
|
—
|
—
|
$41,158.34
|
$87,787.53
|
$57,376.54
|
2026-05-09
|
|
607-1
|
OTHER
|
Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…
|
13
|
13
|
—
|
—
|
$40,776.52
|
$70,349.65
|
$56,844.27
|
2026-05-09
|
|
401-3
|
OTHER
|
Adrenal Procedures
|
13
|
13
|
—
|
—
|
$39,255.00
|
$79,112.75
|
$56,632.95
|
2026-05-09
|
|
639-4
|
OTHER
|
Neonate Birth Weight > 2499 Grams With Other Significant Condition
|
13
|
13
|
—
|
—
|
$40,339.33
|
$78,392.27
|
$56,234.80
|
2026-05-09
|
|
315-4
|
OTHER
|
Shoulder, Upper Arm And Forearm Procedures Except Joint Replacement
|
13
|
13
|
—
|
—
|
$38,562.88
|
$102,397.23
|
$55,908.68
|
2026-05-09
|
|
023-3
|
OTHER
|
Spinal Procedures
|
13
|
13
|
—
|
—
|
$38,356.39
|
$99,533.74
|
$55,609.32
|
2026-05-09
|
|
462-4
|
OTHER
|
Nephritis And Nephrosis
|
13
|
13
|
—
|
—
|
$39,722.18
|
$70,339.62
|
$55,374.48
|
2026-05-09
|
|
613-2
|
OTHER
|
Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection
|
13
|
13
|
—
|
—
|
$39,702.57
|
$70,926.93
|
$55,347.14
|
2026-05-09
|
|
021-3
|
OTHER
|
Open Craniotomy Except Trauma
|
13
|
13
|
—
|
—
|
$37,931.89
|
$102,397.23
|
$54,993.87
|
2026-05-09
|
|
226-4
|
OTHER
|
Anal And Perineal Procedures
|
13
|
13
|
—
|
—
|
$37,901.90
|
$74,006.79
|
$54,950.39
|
2026-05-09
|
|
169-3
|
OTHER
|
Major Abdominal Vascular Procedures
|
13
|
13
|
—
|
—
|
$37,733.48
|
$105,232.63
|
$54,706.22
|
2026-05-09
|
|
162-1
|
OTHER
|
Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis
|
13
|
13
|
—
|
—
|
$37,532.76
|
$120,792.15
|
$54,415.22
|
2026-05-09
|
|
910-1
|
OTHER
|
Craniotomy For Multiple Significant Trauma
|
13
|
13
|
—
|
—
|
$38,863.95
|
$83,600.48
|
$54,261.64
|
2026-05-09
|
|
482-4
|
OTHER
|
Transurethral Prostatectomy
|
13
|
13
|
—
|
—
|
$37,342.43
|
$73,014.83
|
$54,139.27
|
2026-05-09
|
|
626-4
|
OTHER
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
13
|
13
|
—
|
—
|
$37,464.70
|
$65,208.37
|
$54,138.73
|
2026-05-09
|
|
320-4
|
OTHER
|
Other Musculoskeletal System And Connective Tissue Procedures
|
13
|
13
|
—
|
—
|
$37,325.13
|
$99,955.26
|
$54,114.19
|
2026-05-09
|
|
224-4
|
OTHER
|
Peritoneal Adhesiolysis
|
13
|
13
|
—
|
—
|
$37,004.44
|
$103,754.51
|
$53,649.26
|
2026-05-09
|
|
661-4
|
OTHER
|
Coagulation And Platelet Disorders
|
13
|
13
|
—
|
—
|
$38,317.17
|
$89,202.69
|
$53,415.83
|
2026-05-09
|
|
171-4
|
OTHER
|
Permanent Cardiac Pacemaker Implant Without Ami, Heart Failure Or Shock
|
13
|
13
|
—
|
—
|
$36,770.27
|
$96,403.29
|
$53,309.76
|
2026-05-09
|
|
040-4
|
OTHER
|
Spinal Disorders And Injuries
|
13
|
13
|
—
|
—
|
$36,561.48
|
$92,168.63
|
$53,007.05
|
2026-05-09
|
|
220-3
|
OTHER
|
Major Stomach, Esophageal And Duodenal Procedures
|
13
|
13
|
—
|
—
|
$36,387.30
|
$84,724.52
|
$52,754.52
|
2026-05-09
|
|
007-4
|
OTHER
|
Allogeneic Bone Marrow Transplant
|
10
|
10
|
—
|
—
|
$251,414.26
|
$413,666.39
|
$350,482.56
|
2026-05-09
|
|
009-4
|
OTHER
|
Extracorporeal Membrane Oxygenation (ecmo)
|
10
|
10
|
—
|
—
|
$197,298.19
|
$401,144.59
|
$275,042.38
|
2026-05-09
|
|
011-4
|
OTHER
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
10
|
10
|
—
|
—
|
$186,471.06
|
$430,142.01
|
$259,948.87
|
2026-05-09
|
|
008-4
|
OTHER
|
Autologous Bone Marrow Transplant Or T-cell Immunotherapy
|
10
|
10
|
—
|
—
|
$161,322.71
|
$233,886.61
|
$224,890.97
|
2026-05-09
|
|
007-3
|
OTHER
|
Allogeneic Bone Marrow Transplant
|
10
|
10
|
—
|
—
|
$126,924.12
|
$243,784.61
|
$176,937.81
|
2026-05-09
|
|
011-3
|
OTHER
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
10
|
10
|
—
|
—
|
$122,732.15
|
$211,726.98
|
$171,094.02
|
2026-05-09
|
|
007-2
|
OTHER
|
Allogeneic Bone Marrow Transplant
|
10
|
10
|
—
|
—
|
$114,877.69
|
$190,690.58
|
$160,144.56
|
2026-05-09
|
|
007-1
|
OTHER
|
Allogeneic Bone Marrow Transplant
|
10
|
10
|
—
|
—
|
$105,027.60
|
$169,794.67
|
$146,413.11
|
2026-05-09
|
|
178-4
|
OTHER
|
External Heart Assist Systems
|
10
|
10
|
—
|
—
|
$97,571.11
|
$220,410.19
|
$136,018.43
|
2026-05-09
|
|
009-3
|
OTHER
|
Extracorporeal Membrane Oxygenation (ecmo)
|
10
|
10
|
—
|
—
|
$94,104.72
|
$184,884.91
|
$131,186.13
|
2026-05-09
|
|
011-2
|
OTHER
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
10
|
10
|
—
|
—
|
$93,079.22
|
$134,946.80
|
$129,756.54
|
2026-05-09
|
|
183-4
|
OTHER
|
Percutaneous Structural Cardiac Procedures
|
10
|
10
|
—
|
—
|
$82,094.05
|
$188,085.61
|
$114,442.73
|
2026-05-09
|
|
179-4
|
OTHER
|
Defibrillator Implants
|
10
|
10
|
—
|
—
|
$81,361.55
|
$179,573.82
|
$113,421.59
|
2026-05-09
|
|
008-3
|
OTHER
|
Autologous Bone Marrow Transplant Or T-cell Immunotherapy
|
10
|
10
|
—
|
—
|
$79,532.04
|
$131,765.59
|
$110,871.17
|
2026-05-09
|
|
009-2
|
OTHER
|
Extracorporeal Membrane Oxygenation (ecmo)
|
10
|
10
|
—
|
—
|
$77,474.12
|
$134,848.27
|
$108,002.34
|
2026-05-09
|
|
178-3
|
OTHER
|
External Heart Assist Systems
|
10
|
10
|
—
|
—
|
$72,182.83
|
$163,058.86
|
$100,626.04
|
2026-05-09
|
|
695-4
|
OTHER
|
Chemotherapy For Acute Leukemia
|
10
|
10
|
—
|
—
|
$69,860.75
|
$137,374.54
|
$97,388.96
|
2026-05-09
|
|
178-2
|
OTHER
|
External Heart Assist Systems
|
10
|
10
|
—
|
—
|
$67,251.44
|
$151,919.62
|
$93,751.47
|
2026-05-09
|
|
008-2
|
OTHER
|
Autologous Bone Marrow Transplant Or T-cell Immunotherapy
|
10
|
10
|
—
|
—
|
$66,237.48
|
$110,245.84
|
$92,337.96
|
2026-05-09
|
|
792-4
|
OTHER
|
Extensive O.r. Procedures For Other Complications Of Treatment
|
10
|
10
|
—
|
—
|
$64,128.80
|
$133,106.00
|
$89,398.38
|
2026-05-09
|
|
232-4
|
OTHER
|
Gastric Fundoplication
|
10
|
10
|
—
|
—
|
$64,014.60
|
$111,420.46
|
$89,239.18
|
2026-05-09
|
|
009-1
|
OTHER
|
Extracorporeal Membrane Oxygenation (ecmo)
|
10
|
10
|
—
|
—
|
$63,582.03
|
$110,667.36
|
$88,636.15
|
2026-05-09
|
|
027-4
|
OTHER
|
Other Open Craniotomy
|
10
|
10
|
—
|
—
|
$63,373.24
|
$140,819.73
|
$88,345.08
|
2026-05-09
|
|
183-3
|
OTHER
|
Percutaneous Structural Cardiac Procedures
|
10
|
10
|
—
|
—
|
$60,777.77
|
$132,122.47
|
$84,726.89
|
2026-05-09
|
|
178-1
|
OTHER
|
External Heart Assist Systems
|
10
|
10
|
—
|
—
|
$59,982.98
|
$135,500.21
|
$83,618.92
|
2026-05-09
|
|
179-3
|
OTHER
|
Defibrillator Implants
|
10
|
10
|
—
|
—
|
$58,944.79
|
$130,936.61
|
$82,171.64
|
2026-05-09
|
|
230-4
|
OTHER
|
Major Small Bowel Procedures
|
10
|
10
|
—
|
—
|
$58,129.24
|
$135,629.48
|
$81,034.72
|
2026-05-09
|
|
029-4
|
OTHER
|
Other Percutaneous Intracranial Procedures
|
10
|
10
|
—
|
—
|
$56,338.94
|
$114,165.94
|
$78,538.97
|
2026-05-09
|
|
181-4
|
OTHER
|
Lower Extremity Arterial Procedures
|
10
|
10
|
—
|
—
|
$53,721.56
|
$141,547.54
|
$74,890.22
|
2026-05-09
|
|
182-4
|
OTHER
|
Other Peripheral Vascular And Related Procedures
|
10
|
10
|
—
|
—
|
$50,457.04
|
$120,258.23
|
$70,339.33
|
2026-05-09
|
|
183-2
|
OTHER
|
Percutaneous Structural Cardiac Procedures
|
10
|
10
|
—
|
—
|
$49,265.43
|
$113,471.84
|
$68,678.18
|
2026-05-09
|
|
030-4
|
OTHER
|
Percutaneous Intracranial And Extracranial Vascular Procedures
|
10
|
10
|
—
|
—
|
$48,440.64
|
$124,650.42
|
$67,528.39
|
2026-05-09
|
|
183-1
|
OTHER
|
Percutaneous Structural Cardiac Procedures
|
10
|
10
|
—
|
—
|
$46,896.05
|
$110,310.48
|
$65,375.17
|
2026-05-09
|
|
008-1
|
OTHER
|
Autologous Bone Marrow Transplant Or T-cell Immunotherapy
|
10
|
10
|
—
|
—
|
$44,853.13
|
$82,844.56
|
$62,527.24
|
2026-05-09
|
|
325-4
|
OTHER
|
Non-elective Or Complex Knee Joint Replacement
|
10
|
10
|
—
|
—
|
$44,555.52
|
$122,337.70
|
$62,112.36
|
2026-05-09
|
|
548-4
|
OTHER
|
Postpartum And Post Abortion Diagnosis With O.r. Procedure
|
10
|
10
|
—
|
—
|
$43,956.83
|
$96,510.08
|
$61,277.76
|
2026-05-09
|
|
322-4
|
OTHER
|
Shoulder And Elbow Joint Replacement
|
10
|
10
|
—
|
—
|
$43,446.97
|
$95,169.65
|
$60,566.99
|
2026-05-09
|
|
011-1
|
OTHER
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
10
|
10
|
—
|
—
|
$43,426.20
|
$75,583.26
|
$60,538.04
|
2026-05-09
|
|
793-4
|
OTHER
|
Moderately Extensive O.r. Procedures For Other Complications Of Treatment
|
10
|
10
|
—
|
—
|
$43,272.79
|
$104,808.30
|
$60,324.16
|
2026-05-09
|
|
179-2
|
OTHER
|
Defibrillator Implants
|
10
|
10
|
—
|
—
|
$42,790.60
|
$106,682.64
|
$59,651.99
|
2026-05-09
|
|
794-4
|
OTHER
|
Non-extensive O.r. Procedures For Other Complications Of Treatment
|
10
|
10
|
—
|
—
|
$41,261.01
|
$78,151.69
|
$57,519.66
|
2026-05-09
|
|
027-3
|
OTHER
|
Other Open Craniotomy
|
10
|
10
|
—
|
—
|
$39,956.35
|
$85,407.37
|
$55,700.92
|
2026-05-09
|
|
179-1
|
OTHER
|
Defibrillator Implants
|
10
|
10
|
—
|
—
|
$37,934.20
|
$94,138.35
|
$52,881.94
|
2026-05-09
|
|
547-4
|
OTHER
|
Antepartum With O.r. Procedure
|
10
|
10
|
—
|
—
|
$37,866.13
|
$67,102.38
|
$52,787.07
|
2026-05-09
|
|
681
|
OTHER
|
Neonate, Birth Weight >2499 Grams, With Significant O.r. Procedures, With Multip…
|
1
|
1
|
—
|
—
|
$1,548,662.86
|
$1,548,662.86
|
$1,548,662.86
|
2026-05-09
|
|
633
|
OTHER
|
Neonate, Birth Weight 1000-1499 Grams, With Significant O.r. Procedures, Dischar…
|
1
|
1
|
—
|
—
|
$657,409.26
|
$657,409.26
|
$657,409.26
|
2026-05-09
|
|
636
|
OTHER
|
Neonate, Birth Weight 1500-1999 Grams, With Significant O.r. Procedures, With Mu…
|
1
|
1
|
—
|
—
|
$603,686.99
|
$603,686.99
|
$603,686.99
|
2026-05-09
|
|
634
|
OTHER
|
Neonate, Birth Weight 1000-1499 Grams, Without Significant O.r. Procedures, Disc…
|
1
|
1
|
—
|
—
|
$545,869.47
|
$545,869.47
|
$545,869.47
|
2026-05-09
|
|
613
|
OTHER
|
Neonate, Birth Weight <750 Grams, Died
|
1
|
1
|
—
|
—
|
$431,029.59
|
$431,029.59
|
$431,029.59
|
2026-05-09
|
|
632
|
OTHER
|
Neonate, Birth Weight 750-999 Grams, Died
|
1
|
1
|
—
|
—
|
$310,651.34
|
$310,651.34
|
$310,651.34
|
2026-05-09
|
|
360
|
OTHER
|
Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc
|
1
|
1
|
—
|
—
|
$236,885.23
|
$236,885.23
|
$236,885.23
|
2026-05-09
|
|
608
|
OTHER
|
Bpd And Other Chronic Respiratory Diseases Arising In Perinatal Period
|
1
|
1
|
—
|
—
|
$197,741.62
|
$197,741.62
|
$197,741.62
|
2026-05-09
|
|
635
|
OTHER
|
Neonate, Birth Weight 1000-1499 Grams, Died
|
1
|
1
|
—
|
—
|
$192,469.53
|
$192,469.53
|
$192,469.53
|
2026-05-09
|
|
318
|
OTHER
|
Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc
|
1
|
1
|
—
|
—
|
$163,385.96
|
$163,385.96
|
$163,385.96
|
2026-05-09
|
|
362
|
OTHER
|
Cardiac Defibrillator Implant Without Mcc
|
1
|
1
|
—
|
—
|
$142,841.40
|
$142,841.40
|
$142,841.40
|
2026-05-09
|
|
647
|
OTHER
|
Neonate, Birth Weight 1500-1999 Grams, Without Significant O.r. Procedures, With…
|
1
|
1
|
—
|
—
|
$128,000.24
|
$128,000.24
|
$128,000.24
|
2026-05-09
|
|
317
|
OTHER
|
Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc
|
1
|
1
|
—
|
—
|
$119,341.71
|
$119,341.71
|
$119,341.71
|
2026-05-09
|
|
213
|
OTHER
|
Splenic Procedures Age 0-17
|
1
|
1
|
—
|
—
|
$113,461.55
|
$113,461.55
|
$113,461.55
|
2026-05-09
|
|
162
|
OTHER
|
Lower Extremity And Humerus Procedures Except Hip, Foot And Femur Age 0-17
|
1
|
1
|
—
|
—
|
$108,023.98
|
$108,023.98
|
$108,023.98
|
2026-05-09
|
|
648
|
OTHER
|
Neonate, Birth Weight 1500-1999 Grams, Without Significant O.r. Procedures, With…
|
1
|
1
|
—
|
—
|
$97,753.80
|
$97,753.80
|
$97,753.80
|
2026-05-09
|
|
396
|
OTHER
|
Major Head And Neck Procedures With Mcc
|
1
|
1
|
—
|
—
|
$83,882.70
|
$83,882.70
|
$83,882.70
|
2026-05-09
|
|
402
|
OTHER
|
Other Ear, Nose, Mouth And Throat O.r. Procedures Age >17 Without Cc/mcc
|
1
|
1
|
—
|
—
|
$80,976.20
|
$80,976.20
|
$80,976.20
|
2026-05-09
|
|
691
|
OTHER
|
Kidney Transplant With Hemodialysis With Mcc
|
1
|
1
|
—
|
—
|
$79,643.71
|
$79,643.71
|
$79,643.71
|
2026-05-09
|
|
104
|
OTHER
|
Craniotomy, Ventricular Shunt And Endovascular Intracranial Procedures Age 0-17
|
1
|
1
|
—
|
—
|
$75,527.80
|
$75,527.80
|
$75,527.80
|
2026-05-09
|
|
106
|
OTHER
|
Concussion Age 0-17
|
1
|
1
|
—
|
—
|
$71,820.09
|
$71,820.09
|
$71,820.09
|
2026-05-09
|
|
677
|
OTHER
|
Neonate, Birth Weight 2000-2499 Grams, Without Significant O.r. Procedures, With…
|
1
|
1
|
—
|
—
|
$71,384.63
|
$71,384.63
|
$71,384.63
|
2026-05-09
|
|
898
|
OTHER
|
Alcohol, Drug Abuse Or Dependence Without Rehabilitation Therapy Age >21 Without…
|
1
|
1
|
—
|
—
|
$67,004.46
|
$67,004.46
|
$67,004.46
|
2026-05-09
|
|
105
|
OTHER
|
Traumatic Stupor And Coma <1 Hour Age 0-17
|
1
|
1
|
—
|
—
|
$65,015.87
|
$65,015.87
|
$65,015.87
|
2026-05-09
|
|
631
|
OTHER
|
Neonate, Birth Weight 750-999 Grams, Discharged Alive
|
1
|
1
|
—
|
—
|
$64,158.99
|
$64,158.99
|
$64,158.99
|
2026-05-09
|