Hospital

CHILDREN'S HOSPITALS & CLINICS OF MN

Minneapolis, MN · CCN 243302 · Rates published

25,382 distinct procedures filed

26 distinct payers

733,638 rate rows

2026-05-14 last MRF observed

Data quality

725,931 of 733,638 rate rows are consumer-grade (98.9%)

7,707 rows are marked excluded from the consumer medians — these stay visible in the raw drill-down with the same reason shown here, so nothing is silently hidden.

Excluded — reason	Rows
placeholder amount (≤ $0.02) — excluded from medians	5,708
per-diem day rate — not a per-procedure price	787
template filing: same amount across many unrelated codes — excluded	666
exceeds 10× this hospital's gross charge — excluded from medians	546

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

Source MRF file	https://www.childrensmn.org/applications/pricetransparency/411754276_childrens-health-care_standardcharges.csv
Found on page	https://www.childrensmn.org/your-visit/after-your-visit/billing-and-financial-matters/price-transparency/
Discovered via	CMS hospital list
Last fetch	not_modified · 2026-05-18
Content fingerprint	1acbce9fa3caa761… · 159,023,486 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
18 OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	9	$4,150.72	$1,140,025.92	$821,730.69	nat. median $386,529 outlier · 2.1×
1 OTHER	Heart Transplant Or Implant Of Heart Assist System With Mcc	9	$4,150.72	$739,830.96	$533,270.16	nat. median $239,422 outlier · 2.2×
161-4 OTHER	Implantable Heart Assist Systems	8	$191,941.15	$752,140.28	$487,506.32	nat. median $202,242 outlier · 2.4×
631-4 OTHER	Neonate Birth Weight > 2499 Grams With Other Major Procedure	8	$146,610.83	$440,701.24	$411,870.32	nat. median $203,379 outlier · 2.0×
927 OTHER	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	9	$4,150.72	$563,653.20	$406,281.23	nat. median $146,562 outlier · 2.8×
3 OTHER	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…	9	$4,150.72	$560,345.28	$403,896.88	nat. median $181,005 outlier · 2.2×
630-4 OTHER	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure	8	$157,759.74	$444,314.32	$367,445.49	nat. median $210,669 1.7× median
583-4 OTHER	Neonate With Ecmo	8	$224,978.00	$1,171,778.39	$328,391.03	nat. median $309,400 1.1× median
588-4 OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	8	$224,978.00	$1,071,246.49	$284,751.33	nat. median $267,493 1.1× median
583-3 OTHER	Neonate With Ecmo	8	$224,978.00	$996,454.15	$283,603.60	nat. median $259,487 1.1× median
4 OTHER	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…	9	$4,150.72	$365,676.96	$263,579.96	nat. median $134,983 2.0× median
002-4 OTHER	Heart And/or Lung Transplant	8	$223,960.00	$781,307.40	$258,525.42	nat. median $216,800 1.2× median
160-4 OTHER	Major Cardiothoracic Repair Of Heart Anomaly	8	$111,984.77	$385,980.09	$257,745.52	nat. median $106,926 outlier · 2.4×
7 OTHER	Lung Transplant	9	$4,150.72	$341,885.28	$246,430.91	nat. median $169,933 1.5× median
583-2 OTHER	Neonate With Ecmo	8	$222,942.00	$662,874.01	$236,955.11	nat. median $191,347 1.2× median
583-1 OTHER	Neonate With Ecmo	8	$182,209.21	$542,354.12	$231,859.68	nat. median $171,226 1.4× median
14 OTHER	Allogeneic Bone Marrow Transplant	9	$4,150.72	$317,272.56	$228,690.06	nat. median $100,915 outlier · 2.3×
011-3 OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	8	$83,428.05	$234,966.65	$220,565.95	nat. median $171,094 1.3× median
589-1 OTHER	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational…	8	$97,421.25	$1,054,090.44	$219,727.80	nat. median $86,371 outlier · 2.5×
161-3 OTHER	Implantable Heart Assist Systems	8	$129,872.59	$659,132.20	$215,816.00	nat. median $152,491 1.4× median
2 OTHER	Heart Transplant Or Implant Of Heart Assist System Without Mcc	9	$4,150.72	$299,159.52	$215,634.18	nat. median $111,558 1.9× median
007-4 OTHER	Allogeneic Bone Marrow Transplant	8	$152,499.55	$597,918.53	$213,039.48	nat. median $172,311 1.2× median
841-4 OTHER	Extensive Third Degree Burns With Skin Graft	8	$181,958.06	$787,629.01	$205,025.20	nat. median $151,691 1.4× median
609-4 OTHER	Neonate Birth Weight 1500-2499 Grams With Major Procedure	8	$167,970.00	$621,129.44	$197,949.90	nat. median $169,856 1.2× median
5 OTHER	Liver Transplant With Mcc Or Intestinal Transplant	9	$4,150.72	$272,197.20	$196,199.74	nat. median $94,894 outlier · 2.1×
841-3 OTHER	Extensive Third Degree Burns With Skin Graft	8	$58,230.40	$359,626.64	$189,864.45	nat. median $61,016 outlier · 3.1×
161-2 OTHER	Implantable Heart Assist Systems	8	$104,250.77	$529,224.90	$188,474.21	nat. median $109,992 1.7× median
163-4 OTHER	Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis	8	$63,682.03	$213,571.83	$171,160.46	nat. median $70,285 outlier · 2.4×
591-4 OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure	8	$122,160.00	$966,453.89	$169,785.57	nat. median $156,696 1.1× median
588-3 OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	8	$134,376.00	$539,310.24	$167,635.82	nat. median $165,000 1.0× median
002-3 OTHER	Heart And/or Lung Transplant	8	$142,520.00	$509,595.01	$166,717.46	nat. median $133,471 1.2× median
009-3 OTHER	Extracorporeal Membrane Oxygenation (ecmo)	8	$65,393.06	$235,054.34	$166,688.05	nat. median $87,912 1.9× median
588-2 OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	8	$132,340.00	$524,967.86	$164,000.33	nat. median $153,523 1.1× median
593-4 OTHER	Neonate Birth Weight 750-999 Grams Without Major Procedure	8	$123,178.00	$659,523.19	$162,733.35	nat. median $151,250 1.1× median
231 OTHER	Coronary Bypass With Ptca With Mcc	9	$4,150.72	$222,549.36	$160,413.58	nat. median $74,989 outlier · 2.1×
456 OTHER	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	9	$4,150.72	$221,849.76	$159,909.31	nat. median $76,493 outlier · 2.1×
178-4 OTHER	External Heart Assist Systems	8	$61,027.17	$379,753.49	$159,644.68	nat. median $67,533 outlier · 2.4×
863-4 OTHER	Neonatal Aftercare	8	$91,792.56	$299,384.97	$157,162.42	nat. median $108,047 1.5× median
609-3 OTHER	Neonate Birth Weight 1500-2499 Grams With Major Procedure	8	$80,714.12	$271,186.19	$155,587.90	nat. median $83,785 1.9× median
71517H243 OTHER	HeartMate 3 Lvad Implant Kit, Includes Controller - Backup	10	$51,714.10	$243,246.00	$151,420.64	nat. median $151,421 1.0× median
71501H243 OTHER	HeartMate 3 Lvad Implant Kit Includes Controller	10	$51,714.10	$243,246.00	$151,420.64	nat. median $151,421 1.0× median
71517H244 OTHER	HeartMate 3 Lvad Implant Kit, Incl Controller - Backup-vad	10	$51,714.10	$243,246.00	$151,420.64	nat. median $151,421 1.0× median
71501H244 OTHER	HeartMate 3 Lvad Implant Kit Includes Controller-vad	10	$51,714.10	$243,246.00	$151,420.64	nat. median $151,421 1.0× median
009-4 OTHER	Extracorporeal Membrane Oxygenation (ecmo)	8	$141,502.00	$414,102.13	$149,992.12	nat. median $150,954 1.0× median
20 OTHER	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc	9	$4,150.72	$207,736.32	$149,736.34	nat. median $74,209 outlier · 2.0×
001-4 OTHER	Liver Transplant And/or Intestinal Transplant	8	$122,160.00	$458,875.95	$146,820.62	nat. median $124,561 1.2× median
219 OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	9	$4,150.72	$202,707.12	$146,111.29	nat. median $72,612 outlier · 2.0×
002-2 OTHER	Heart And/or Lung Transplant	8	$130,226.75	$366,770.43	$146,103.36	nat. median $106,681 1.4× median
233 OTHER	Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc	9	$4,150.72	$201,833.28	$145,481.43	nat. median $68,249 outlier · 2.1×
957 OTHER	Other O.r. Procedures For Multiple Significant Trauma With Mcc	9	$4,150.72	$201,165.36	$144,999.99	nat. median $68,309 outlier · 2.1×

Other procedures at this hospital

Browse this hospital's 25,382 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

001-2	OTHER	Liver Transplant And/or Intestinal Transplant	10	8	—	—	$76,449.70	$252,352.91	$92,108.64	2026-05-14
001-3	OTHER	Liver Transplant And/or Intestinal Transplant	10	8	—	—	$93,656.00	$369,478.13	$99,275.36	2026-05-14
001-4	OTHER	Liver Transplant And/or Intestinal Transplant	10	8	—	—	$122,160.00	$458,875.95	$146,820.62	2026-05-14
002-1	OTHER	Heart And/or Lung Transplant	10	8	—	—	$50,900.00	$301,522.62	$80,761.32	2026-05-14
002-2	OTHER	Heart And/or Lung Transplant	10	8	—	—	$130,226.75	$366,770.43	$146,103.36	2026-05-14
002-3	OTHER	Heart And/or Lung Transplant	10	8	—	—	$142,520.00	$509,595.01	$166,717.46	2026-05-14
002-4	OTHER	Heart And/or Lung Transplant	10	8	—	—	$223,960.00	$781,307.40	$258,525.42	2026-05-14
004-1	OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	10	8	—	—	$44,166.19	$124,389.59	$73,958.95	2026-05-14
004-2	OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	10	8	—	—	$52,117.99	$186,279.27	$74,110.40	2026-05-14
004-3	OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	10	8	—	—	$84,460.49	$269,275.09	$96,439.81	2026-05-14
004-4	OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	10	8	—	—	$111,980.00	$516,720.53	$127,255.07	2026-05-14
005-3	OTHER	Tracheostomy With Mv >96 Hours Without Extensive Procedure	10	8	—	—	$60,687.92	$332,498.52	$83,089.16	2026-05-14
005-4	OTHER	Tracheostomy With Mv >96 Hours Without Extensive Procedure	10	8	—	—	$87,855.94	$408,222.66	$94,959.04	2026-05-14
006-2	OTHER	Pancreas Transplant	10	8	—	—	$83,243.56	$295,602.96	$91,721.80	2026-05-14
006-3	OTHER	Pancreas Transplant	10	8	—	—	$86,530.00	$359,864.16	$98,275.74	2026-05-14
006-4	OTHER	Pancreas Transplant	10	8	—	—	$86,530.00	$455,181.64	$119,464.96	2026-05-14
007-1	OTHER	Allogeneic Bone Marrow Transplant	10	8	—	—	$68,133.66	$234,531.81	$135,990.01	2026-05-14
007-2	OTHER	Allogeneic Bone Marrow Transplant	10	8	—	—	$59,766.25	$297,367.90	$123,992.40	2026-05-14
007-3	OTHER	Allogeneic Bone Marrow Transplant	10	8	—	—	$74,532.10	$377,520.82	$137,092.66	2026-05-14
007-4	OTHER	Allogeneic Bone Marrow Transplant	10	8	—	—	$152,499.55	$597,918.53	$213,039.48	2026-05-14
008-2	OTHER	Autologous Bone Marrow Transplant Or T-cell Immunotherapy	10	8	—	—	$32,490.32	$91,827.81	$84,978.33	2026-05-14
008-3	OTHER	Autologous Bone Marrow Transplant Or T-cell Immunotherapy	10	8	—	—	$38,565.76	$127,740.41	$105,000.23	2026-05-14
008-4	OTHER	Autologous Bone Marrow Transplant Or T-cell Immunotherapy	10	8	—	—	$75,585.32	$225,805.79	$123,992.40	2026-05-14
009-3	OTHER	Extracorporeal Membrane Oxygenation (ecmo)	10	8	—	—	$65,393.06	$235,054.34	$166,688.05	2026-05-14
009-4	OTHER	Extracorporeal Membrane Oxygenation (ecmo)	10	8	—	—	$141,502.00	$414,102.13	$149,992.12	2026-05-14
011-3	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	10	8	—	—	$83,428.05	$234,966.65	$220,565.95	2026-05-14
011-4	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	10	8	—	—	$50,921.37	$437,287.46	$104,875.32	2026-05-14
020-4	OTHER	Open Craniotomy For Trauma	10	8	—	—	$44,958.29	$156,553.08	$106,022.58	2026-05-14
021-3	OTHER	Open Craniotomy Except Trauma	10	8	—	—	$31,009.15	$98,796.20	$81,531.76	2026-05-14
021-4	OTHER	Open Craniotomy Except Trauma	10	8	—	—	$50,181.54	$212,873.89	$119,660.54	2026-05-14
022-4	OTHER	Ventricular Shunt Procedures	10	8	—	—	$38,886.54	$180,370.57	$86,284.85	2026-05-14
023-3	OTHER	Spinal Procedures	10	8	—	—	$29,182.09	$99,333.35	$75,125.55	2026-05-14
023-4	OTHER	Spinal Procedures	10	8	—	—	$46,072.11	$229,101.80	$115,455.76	2026-05-14
027-4	OTHER	Other Open Craniotomy	10	8	—	—	$47,038.13	$173,632.39	$94,002.33	2026-05-14
029-4	OTHER	Other Percutaneous Intracranial Procedures	10	8	—	—	$33,012.87	$148,959.83	$86,349.47	2026-05-14
030-4	OTHER	Percutaneous Intracranial And Extracranial Vascular Procedures	10	8	—	—	$37,004.78	$131,540.69	$90,314.52	2026-05-14
089-4	OTHER	Major Cranial Or Facial Bone Procedures	10	8	—	—	$41,783.83	$192,038.15	$103,327.00	2026-05-14
091-3	OTHER	Other Major Head And Neck Procedures	10	8	—	—	$31,906.43	$120,782.98	$82,442.76	2026-05-14
091-4	OTHER	Other Major Head And Neck Procedures	10	8	—	—	$51,014.51	$170,741.99	$129,796.25	2026-05-14
092-4	OTHER	Facial Bone Procedures Except Major Cranial Or Facial Bone Procedures	10	8	—	—	$43,270.91	$156,863.68	$94,448.45	2026-05-14
098-4	OTHER	Other Ear, Nose, Mouth And Throat Procedures	10	8	—	—	$30,841.38	$111,863.30	$73,780.92	2026-05-14
1	OTHER	Heart Transplant Or Implant Of Heart Assist System With Mcc	10	9	—	—	$4,150.72	$739,830.96	$533,270.16	2026-05-14
10	OTHER	Pancreas Transplant	10	9	—	—	$4,150.72	$189,438.48	$136,547.26	2026-05-14
11	OTHER	Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc	10	9	—	—	$4,150.72	$143,988.24	$103,786.73	2026-05-14
12	OTHER	Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc	10	9	—	—	$4,150.72	$111,302.40	$80,226.77	2026-05-14
120-4	OTHER	Major Respiratory And Chest Procedures	10	8	—	—	$48,140.13	$225,411.15	$108,453.31	2026-05-14
121-4	OTHER	Other Respiratory And Chest Procedures	10	8	—	—	$38,155.56	$140,661.35	$91,694.56	2026-05-14
130-3	OTHER	Respiratory System Diagnosis With Ventilator Support > 96 Hours	10	8	—	—	$30,941.90	$143,105.95	$86,416.17	2026-05-14
130-4	OTHER	Respiratory System Diagnosis With Ventilator Support > 96 Hours	10	8	—	—	$40,559.13	$184,868.78	$98,160.65	2026-05-14
14	OTHER	Allogeneic Bone Marrow Transplant	10	9	—	—	$4,150.72	$317,272.56	$228,690.06	2026-05-14
16	OTHER	Autologous Bone Marrow Transplant With Cc/mcc	10	9	—	—	$4,150.72	$156,544.08	$112,836.97	2026-05-14
160-2	OTHER	Major Cardiothoracic Repair Of Heart Anomaly	10	8	—	—	$28,369.07	$93,234.93	$84,815.33	2026-05-14
160-3	OTHER	Major Cardiothoracic Repair Of Heart Anomaly	10	8	—	—	$39,970.26	$112,572.20	$103,327.00	2026-05-14
160-4	OTHER	Major Cardiothoracic Repair Of Heart Anomaly	10	8	—	—	$111,984.77	$385,980.09	$257,745.52	2026-05-14
161-1	OTHER	Implantable Heart Assist Systems	10	8	—	—	$99,326.11	$502,765.48	$127,318.50	2026-05-14
161-2	OTHER	Implantable Heart Assist Systems	10	8	—	—	$104,250.77	$529,224.90	$188,474.21	2026-05-14
161-3	OTHER	Implantable Heart Assist Systems	10	8	—	—	$129,872.59	$659,132.20	$215,816.00	2026-05-14
161-4	OTHER	Implantable Heart Assist Systems	10	8	—	—	$191,941.15	$752,140.28	$487,506.32	2026-05-14
162-1	OTHER	Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis	10	8	—	—	$31,247.15	$100,517.29	$91,702.92	2026-05-14
162-2	OTHER	Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis	10	8	—	—	$36,327.01	$115,754.93	$106,727.21	2026-05-14
162-3	OTHER	Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis	10	8	—	—	$48,839.32	$155,460.50	$101,260.46	2026-05-14
162-4	OTHER	Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis	10	8	—	—	$76,450.07	$263,322.55	$116,459.20	2026-05-14
163	OTHER	Major Chest Procedures With Mcc	10	9	—	—	$4,150.72	$118,319.52	$85,284.71	2026-05-14
163-1	OTHER	Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis	10	8	—	—	$26,773.34	$90,669.46	$76,985.09	2026-05-14
163-2	OTHER	Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis	10	8	—	—	$30,515.43	$104,354.10	$88,926.13	2026-05-14
163-3	OTHER	Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis	10	8	—	—	$40,639.69	$125,153.30	$116,915.54	2026-05-14
163-4	OTHER	Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis	10	8	—	—	$63,682.03	$213,571.83	$171,160.46	2026-05-14
165-1	OTHER	Coronary Bypass With Ami Or Complex Principal Diagnosis	10	8	—	—	$27,732.70	$96,969.14	$84,871.42	2026-05-14
165-2	OTHER	Coronary Bypass With Ami Or Complex Principal Diagnosis	10	8	—	—	$31,120.02	$112,597.78	$92,964.14	2026-05-14
165-3	OTHER	Coronary Bypass With Ami Or Complex Principal Diagnosis	10	8	—	—	$39,801.55	$139,093.74	$113,129.24	2026-05-14
165-4	OTHER	Coronary Bypass With Ami Or Complex Principal Diagnosis	10	8	—	—	$59,472.83	$213,663.18	$136,144.08	2026-05-14
166-2	OTHER	Coronary Bypass Without Ami Or Complex Principal Diagnosis	10	8	—	—	$26,574.52	$88,915.48	$79,699.32	2026-05-14
166-3	OTHER	Coronary Bypass Without Ami Or Complex Principal Diagnosis	10	8	—	—	$33,456.33	$110,507.62	$96,326.75	2026-05-14
166-4	OTHER	Coronary Bypass Without Ami Or Complex Principal Diagnosis	10	8	—	—	$52,081.04	$208,437.80	$132,689.80	2026-05-14
167-4	OTHER	Other Cardiothoracic And Thoracic Vascular Procedures	10	8	—	—	$64,115.15	$220,207.69	$130,238.21	2026-05-14
169-3	OTHER	Major Abdominal Vascular Procedures	10	8	—	—	$28,986.22	$111,417.50	$81,427.54	2026-05-14
169-4	OTHER	Major Abdominal Vascular Procedures	10	8	—	—	$45,897.69	$208,079.70	$104,351.24	2026-05-14
17	OTHER	Autologous Bone Marrow Transplant Without Cc/mcc	10	9	—	—	$4,150.72	$143,412.72	$103,371.89	2026-05-14
170-4	OTHER	Permanent Cardiac Pacemaker Implant With Ami, Heart Failure Or Shock	10	8	—	—	$33,662.54	$183,852.94	$85,761.41	2026-05-14
171-4	OTHER	Permanent Cardiac Pacemaker Implant Without Ami, Heart Failure Or Shock	10	8	—	—	$29,025.40	$116,975.40	$76,409.72	2026-05-14
174-4	OTHER	Percutaneous Cardiac Intervention With Ami	10	8	—	—	$29,470.34	$108,505.17	$78,431.85	2026-05-14
175-4	OTHER	Percutaneous Cardiac Intervention Without Ami	10	8	—	—	$33,181.38	$121,071.66	$86,916.50	2026-05-14
176-4	OTHER	Insertion, Revision And Replacements Of Pacemaker And Other Cardiac Devices	10	8	—	—	$41,086.85	$176,643.38	$77,042.02	2026-05-14
178-1	OTHER	External Heart Assist Systems	10	8	—	—	$36,660.35	$182,446.11	$95,747.21	2026-05-14
178-2	OTHER	External Heart Assist Systems	10	8	—	—	$43,212.52	$195,575.33	$101,260.46	2026-05-14
178-3	OTHER	External Heart Assist Systems	10	8	—	—	$44,952.37	$218,614.50	$129,456.44	2026-05-14
178-4	OTHER	External Heart Assist Systems	10	8	—	—	$61,027.17	$379,753.49	$159,644.68	2026-05-14
179-2	OTHER	Defibrillator Implants	10	8	—	—	$29,175.43	$115,996.10	$80,445.65	2026-05-14
179-3	OTHER	Defibrillator Implants	10	8	—	—	$35,795.60	$143,120.57	$97,861.05	2026-05-14
179-4	OTHER	Defibrillator Implants	10	8	—	—	$49,457.96	$193,909.05	$132,560.55	2026-05-14
18	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	10	9	—	—	$4,150.72	$1,140,025.92	$821,730.69	2026-05-14
180-4	OTHER	Other Circulatory System Procedures	10	8	—	—	$29,615.20	$148,466.53	$75,667.57	2026-05-14
181-4	OTHER	Lower Extremity Arterial Procedures	10	8	—	—	$39,954.54	$206,391.50	$93,921.02	2026-05-14
182-4	OTHER	Other Peripheral Vascular And Related Procedures	10	8	—	—	$36,474.10	$210,359.86	$75,790.27	2026-05-14
183-1	OTHER	Percutaneous Structural Cardiac Procedures	10	8	—	—	$27,964.04	$102,362.61	$77,041.38	2026-05-14
183-2	OTHER	Percutaneous Structural Cardiac Procedures	10	8	—	—	$29,324.73	$110,047.21	$81,644.35	2026-05-14
183-3	OTHER	Percutaneous Structural Cardiac Procedures	10	8	—	—	$35,618.21	$122,602.73	$99,816.49	2026-05-14
183-4	OTHER	Percutaneous Structural Cardiac Procedures	10	8	—	—	$53,183.78	$188,760.41	$118,826.05	2026-05-14
19	OTHER	Simultaneous Pancreas And Kidney Transplant With Hemodialysis	10	9	—	—	$4,150.72	$188,353.44	$135,765.16	2026-05-14
2	OTHER	Heart Transplant Or Implant Of Heart Assist System Without Mcc	10	9	—	—	$4,150.72	$299,159.52	$215,634.18	2026-05-14
20	OTHER	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc	10	9	—	—	$4,150.72	$207,736.32	$149,736.34	2026-05-14
207	OTHER	Respiratory System Diagnosis With Ventilator Support >96 Hours	10	9	—	—	$4,150.72	$178,884.66	$128,940.07	2026-05-14
21	OTHER	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc	10	9	—	—	$4,150.72	$139,756.32	$100,736.35	2026-05-14
217	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	10	9	—	—	$4,150.72	$173,587.92	$125,122.17	2026-05-14
219	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	10	9	—	—	$4,150.72	$202,707.12	$146,111.29	2026-05-14
220-4	OTHER	Major Stomach, Esophageal And Duodenal Procedures	10	8	—	—	$46,199.24	$238,533.06	$72,449.84	2026-05-14
221	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	10	9	—	—	$4,150.72	$133,061.28	$95,910.57	2026-05-14
222-4	OTHER	Other Stomach, Esophageal And Duodenal Procedures	10	8	—	—	$31,696.52	$163,218.18	$76,928.79	2026-05-14
224-4	OTHER	Peritoneal Adhesiolysis	10	8	—	—	$30,409.74	$114,782.93	$77,247.75	2026-05-14
227-4	OTHER	Hernia Procedures Except Inguinal, Femoral And Umbilical	10	8	—	—	$30,884.98	$127,926.77	$76,449.33	2026-05-14
228	OTHER	Other Cardiothoracic Procedures With Mcc	10	9	—	—	$4,150.72	$130,611.36	$94,144.67	2026-05-14
229-4	OTHER	Other Digestive System And Abdominal Procedures	10	8	—	—	$32,203.55	$119,664.83	$77,994.07	2026-05-14
23	OTHER	Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…	10	9	—	—	$4,150.72	$151,279.92	$109,042.57	2026-05-14
230-4	OTHER	Major Small Bowel Procedures	10	8	—	—	$38,086.82	$141,388.52	$78,486.73	2026-05-14
231	OTHER	Coronary Bypass With Ptca With Mcc	10	9	—	—	$4,150.72	$222,549.36	$160,413.58	2026-05-14
231-4	OTHER	Major Large Bowel Procedures	10	8	—	—	$32,849.53	$138,805.06	$82,351.03	2026-05-14
232	OTHER	Coronary Bypass With Ptca Without Mcc	10	9	—	—	$4,150.72	$160,052.64	$115,365.94	2026-05-14
233	OTHER	Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc	10	9	—	—	$4,150.72	$201,833.28	$145,481.43	2026-05-14
234	OTHER	Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc	10	9	—	—	$4,150.72	$144,215.28	$103,950.38	2026-05-14
23499H200	OTHER	Histrelin La Implant 50 Mg Inj	27	17	$151,224.00	$151,224.00	$10,166.02	$151,224.00	$75,174.64	2026-05-14
235	OTHER	Coronary Bypass Without Cardiac Catheterization With Mcc	10	9	—	—	$4,150.72	$154,931.04	$111,674.29	2026-05-14
236	OTHER	Coronary Bypass Without Cardiac Catheterization Without Mcc	10	9	—	—	$4,150.72	$110,584.32	$79,709.18	2026-05-14
239	OTHER	Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc	10	9	—	—	$4,150.72	$129,932.88	$93,655.62	2026-05-14
24	OTHER	Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…	10	9	—	—	$4,150.72	$103,274.16	$74,440.01	2026-05-14
245	OTHER	Aicd Generator Procedures	10	9	—	—	$4,150.72	$120,447.36	$86,818.46	2026-05-14
25	OTHER	Craniotomy And Endovascular Intracranial Procedures With Mcc	10	9	—	—	$4,150.72	$120,032.88	$86,519.70	2026-05-14
260-4	OTHER	Major Pancreas, Liver And Shunt Procedures	10	8	—	—	$47,753.58	$192,480.30	$113,200.13	2026-05-14
261-4	OTHER	Major Biliary Tract Procedures	10	8	—	—	$41,392.84	$150,889.21	$100,270.95	2026-05-14
264-4	OTHER	Other Hepatobiliary, Pancreas And Abdominal Procedures	10	8	—	—	$38,421.64	$116,175.15	$86,616.32	2026-05-14
266	OTHER	Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc	10	9	—	—	$4,150.72	$161,789.76	$116,618.06	2026-05-14
267	OTHER	Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc	10	9	—	—	$4,150.72	$125,685.12	$90,593.83	2026-05-14
268	OTHER	Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc	10	9	—	—	$4,150.72	$181,576.56	$130,880.39	2026-05-14
269	OTHER	Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc	10	9	—	—	$4,150.72	$111,492.48	$80,363.78	2026-05-14
270	OTHER	Other Major Cardiovascular Procedures With Mcc	10	9	—	—	$4,150.72	$139,294.32	$100,403.35	2026-05-14
273	OTHER	Percutaneous And Other Intracardiac Procedures With Mcc	10	9	—	—	$4,150.72	$108,913.20	$78,504.64	2026-05-14
275	OTHER	Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc	10	9	—	—	$4,150.72	$188,242.56	$135,685.23	2026-05-14
276	OTHER	Non-maligant Breast Disorders	10	9	—	—	$4,150.72	$158,574.24	$114,300.31	2026-05-14
277	OTHER	Cellulitis Age >17 W Cc	10	9	—	—	$4,150.72	$121,928.40	$87,885.99	2026-05-14
278	OTHER	Cellulitis Age >17 Without Cc	10	9	—	—	$4,150.72	$146,947.68	$105,919.89	2026-05-14
28	OTHER	Spinal Procedures With Mcc	10	9	—	—	$4,150.72	$158,619.12	$114,332.66	2026-05-14
3	OTHER	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…	10	9	—	—	$4,150.72	$560,345.28	$403,896.88	2026-05-14
303-1	OTHER	Dorsal And Lumbar Fusion Procedure For Curvature Of Back	10	8	—	—	$30,620.38	$97,287.05	$78,581.95	2026-05-14
303-2	OTHER	Dorsal And Lumbar Fusion Procedure For Curvature Of Back	10	8	—	—	$38,460.81	$123,636.85	$89,063.70	2026-05-14
303-3	OTHER	Dorsal And Lumbar Fusion Procedure For Curvature Of Back	10	8	—	—	$54,810.55	$168,224.31	$119,158.15	2026-05-14
303-4	OTHER	Dorsal And Lumbar Fusion Procedure For Curvature Of Back	10	8	—	—	$96,516.18	$296,896.52	$127,046.40	2026-05-14
304-3	OTHER	Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back	10	8	—	—	$36,270.84	$127,396.93	$76,224.80	2026-05-14
304-4	OTHER	Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back	10	8	—	—	$56,392.24	$199,134.43	$102,695.84	2026-05-14
305-4	OTHER	Amputation Of Lower Limb Except Toes	10	8	—	—	$30,907.90	$141,932.98	$75,254.81	2026-05-14
309-4	OTHER	Other Significant Hip And Femur Surgery	10	8	—	—	$31,989.95	$129,834.22	$76,311.73	2026-05-14
31	OTHER	Ventricular Shunt Procedures With Mcc	10	9	—	—	$4,150.72	$118,285.20	$85,259.98	2026-05-14
312-4	OTHER	Skin Graft, Except Hand, For Musculoskeletal And Connective Tissue Diagnoses	10	8	—	—	$52,810.54	$180,458.27	$104,796.78	2026-05-14
315-4	OTHER	Shoulder, Upper Arm And Forearm Procedures Except Joint Replacement	10	8	—	—	$32,773.36	$92,302.84	$74,074.88	2026-05-14
319	OTHER	Other Endovascular Cardiac Valve Procedures With Mcc	10	9	—	—	$4,150.72	$124,068.62	$89,428.66	2026-05-14
321-4	OTHER	Spinal Fusion And Other Back And Neck Procedures Except For Disc Procedures	10	8	—	—	$38,094.95	$164,782.14	$96,591.50	2026-05-14
323	OTHER	Urinary Stones W Cc, &/or Esw Lithotripsy	10	9	—	—	$4,150.72	$120,301.72	$86,713.48	2026-05-14
323-4	OTHER	Non-elective Or Complex Hip Joint Replacement	10	8	—	—	$26,544.96	$117,128.88	$73,595.39	2026-05-14
325-4	OTHER	Non-elective Or Complex Knee Joint Replacement	10	8	—	—	$34,462.99	$131,175.28	$80,645.79	2026-05-14
329	OTHER	Major Small And Large Bowel Procedures With Mcc	10	9	—	—	$4,150.72	$121,347.60	$87,467.35	2026-05-14
34	OTHER	Carotid Artery Stent Procedures With Mcc	10	9	—	—	$4,150.72	$102,186.48	$73,656.01	2026-05-14
356	OTHER	Other Digestive System O.r. Procedures With Mcc	10	9	—	—	$4,150.72	$115,969.92	$83,591.12	2026-05-14
361-4	OTHER	Skin Graft For Skin And Subcutaneous Tissue Diagnoses	10	8	—	—	$51,167.51	$164,749.25	$91,961.03	2026-05-14
4	OTHER	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…	10	9	—	—	$4,150.72	$365,676.96	$263,579.96	2026-05-14
40	OTHER	Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc	10	9	—	—	$4,150.72	$101,935.68	$73,475.24	2026-05-14
401-4	OTHER	Adrenal Procedures	10	8	—	—	$36,145.93	$173,964.92	$109,182.96	2026-05-14
403-4	OTHER	Procedures For Obesity	10	8	—	—	$36,065.37	$164,548.27	$87,858.77	2026-05-14
404-4	OTHER	Thyroid, Parathyroid And Thyroglossal Procedures	10	8	—	—	$38,125.26	$151,514.06	$82,661.60	2026-05-14
405	OTHER	Pancreas, Liver And Shunt Procedures With Mcc	10	9	—	—	$4,150.72	$144,421.20	$104,098.80	2026-05-14
405-4	OTHER	Other Procedures For Endocrine, Nutritional And Metabolic Disorders	10	8	—	—	$36,662.57	$156,045.16	$88,540.46	2026-05-14
423	OTHER	Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc	10	9	—	—	$4,150.72	$109,639.20	$79,027.93	2026-05-14
440-1	OTHER	Kidney Transplant	10	8	—	—	$52,368.55	$184,726.27	$99,248.39	2026-05-14
440-2	OTHER	Kidney Transplant	10	8	—	—	$56,766.60	$206,018.78	$108,634.20	2026-05-14
440-3	OTHER	Kidney Transplant	10	8	—	—	$64,946.27	$234,323.52	$125,857.83	2026-05-14
440-4	OTHER	Kidney Transplant	10	8	—	—	$91,620.00	$293,048.74	$101,042.14	2026-05-14
441-4	OTHER	Major Bladder Procedures	10	8	—	—	$42,190.34	$139,305.67	$95,060.84	2026-05-14
442-4	OTHER	Kidney And Urinary Tract Procedures For Malignancy	10	8	—	—	$33,771.93	$141,552.95	$83,729.02	2026-05-14
444-4	OTHER	Renal Dialysis Access Device Procedures	10	8	—	—	$31,247.15	$151,104.80	$74,729.45	2026-05-14
44496H230	OTHER	Heart Transplant Organ-sur	18	10	$141,431.00	$141,431.00	$30,068.23	$141,431.00	$88,040.80	2026-05-14
44496H243	OTHER	Heart Transplant Organ	18	10	$141,431.00	$141,431.00	$30,068.23	$141,431.00	$88,040.80	2026-05-14
44496H290	OTHER	Heart Transplant Organ - Cvsur	18	10	$141,431.00	$141,431.00	$30,068.23	$141,431.00	$88,040.80	2026-05-14
45100H243	OTHER	Heart Transplant Organ W SherpaPak	18	10	$184,231.00	$184,231.00	$39,167.51	$184,231.00	$114,683.80	2026-05-14
456	OTHER	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	10	9	—	—	$4,150.72	$221,849.76	$159,909.31	2026-05-14
457	OTHER	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	10	9	—	—	$4,150.72	$157,425.84	$113,472.54	2026-05-14
458	OTHER	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	10	9	—	—	$4,150.72	$110,156.64	$79,400.90	2026-05-14
461	OTHER	Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc	10	9	—	—	$4,150.72	$145,807.20	$105,097.83	2026-05-14
463	OTHER	Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …	10	9	—	—	$4,150.72	$150,466.80	$108,456.47	2026-05-14
466	OTHER	Revision Of Hip Or Knee Replacement With Mcc	10	9	—	—	$4,150.72	$137,422.56	$99,054.18	2026-05-14
471	OTHER	Cervical Spinal Fusion With Mcc	10	9	—	—	$4,150.72	$127,477.68	$91,885.91	2026-05-14
484-4	OTHER	Other Male Reproductive System And Related Procedures	10	8	—	—	$30,055.71	$133,915.86	$73,887.24	2026-05-14
5	OTHER	Liver Transplant With Mcc Or Intestinal Transplant	10	9	—	—	$4,150.72	$272,197.20	$196,199.74	2026-05-14
510-4	OTHER	Pelvic Evisceration, Radical Hysterectomy And Other Radical Gynecological Proced…	5	3	—	—	$40,096.45	$162,001.36	$74,584.93	2026-05-14
511-4	OTHER	Uterine And Adnexa Procedures For Ovarian And Adnexal Malignancy	10	8	—	—	$38,205.82	$125,248.31	$92,409.63	2026-05-14
512-4	OTHER	Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy	10	8	—	—	$33,795.58	$135,845.23	$83,694.87	2026-05-14
518-4	OTHER	Other Female Reproductive System And Related Procedures	10	8	—	—	$37,353.63	$147,180.28	$74,366.71	2026-05-14
519-4	OTHER	Uterine And Adnexa Procedures For Leiomyoma	10	8	—	—	$31,636.65	$105,534.38	$75,519.54	2026-05-14
573	OTHER	Skin Graft For Skin Ulcer Or Cellulitis With Mcc	10	9	—	—	$4,150.72	$172,956.96	$124,667.38	2026-05-14
576	OTHER	Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc	10	9	—	—	$4,150.72	$129,391.68	$93,265.52	2026-05-14
583-1	OTHER	Neonate With Ecmo	10	8	—	—	$182,209.21	$542,354.12	$231,859.68	2026-05-14
583-2	OTHER	Neonate With Ecmo	10	8	—	—	$222,942.00	$662,874.01	$236,955.11	2026-05-14
583-3	OTHER	Neonate With Ecmo	10	8	—	—	$224,978.00	$996,454.15	$283,603.60	2026-05-14
583-4	OTHER	Neonate With Ecmo	10	8	—	—	$224,978.00	$1,171,778.39	$328,391.03	2026-05-14
588-1	OTHER	Female Reproductive System Reconstructive Procedures	10	8	—	—	$50,900.00	$349,161.27	$89,218.69	2026-05-14
588-2	OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	10	8	—	—	$132,340.00	$524,967.86	$164,000.33	2026-05-14
588-3	OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	10	8	—	—	$134,376.00	$539,310.24	$167,635.82	2026-05-14
588-4	OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	10	8	—	—	$224,978.00	$1,071,246.49	$284,751.33	2026-05-14
589-1	OTHER	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …	10	8	—	—	$97,421.25	$1,054,090.44	$219,727.80	2026-05-14
589-3	OTHER	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …	10	8	—	—	$59,581.60	$644,669.22	$93,879.96	2026-05-14
591-2	OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure	10	8	—	—	$81,440.00	$333,181.84	$95,134.77	2026-05-14
591-3	OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure	10	8	—	—	$92,638.00	$438,380.04	$127,072.98	2026-05-14
591-4	OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure	10	8	—	—	$122,160.00	$966,453.89	$169,785.57	2026-05-14
593-2	OTHER	Neonate Birth Weight 750-999 Grams Without Major Procedure	10	8	—	—	$80,422.00	$488,207.50	$98,030.79	2026-05-14
593-3	OTHER	Neonate Birth Weight 750-999 Grams Without Major Procedure	10	8	—	—	$100,782.00	$509,229.60	$121,075.57	2026-05-14
593-4	OTHER	Neonate Birth Weight 750-999 Grams Without Major Procedure	10	8	—	—	$123,178.00	$659,523.19	$162,733.35	2026-05-14
6	OTHER	Liver Transplant Without Mcc	10	9	—	—	$4,150.72	$122,416.80	$88,238.03	2026-05-14
602-2	OTHER	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	10	8	—	—	$81,440.00	$362,038.36	$86,326.40	2026-05-14
602-3	OTHER	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	10	8	—	—	$93,656.00	$511,221.09	$101,111.49	2026-05-14
602-4	OTHER	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	10	8	—	—	$101,800.00	$676,726.74	$126,369.13	2026-05-14
603-3	OTHER	Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition	10	8	—	—	$79,125.86	$225,564.62	$84,697.60	2026-05-14
603-4	OTHER	Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition	10	8	—	—	$81,440.00	$467,134.24	$126,501.53	2026-05-14
607-2	OTHER	Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…	10	8	—	—	$56,349.22	$248,676.87	$80,931.00	2026-05-14
607-3	OTHER	Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…	10	8	—	—	$76,295.23	$400,450.37	$92,800.88	2026-05-14
607-4	OTHER	Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…	10	8	—	—	$101,800.00	$536,109.24	$109,570.34	2026-05-14
608-3	OTHER	Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition	10	8	—	—	$55,446.04	$219,655.92	$75,535.60	2026-05-14
608-4	OTHER	Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition	10	8	—	—	$69,634.71	$224,665.71	$75,535.60	2026-05-14
609-2	OTHER	Neonate Birth Weight 1500-2499 Grams With Major Procedure	10	8	—	—	$44,531.89	$154,086.55	$99,628.87	2026-05-14
609-3	OTHER	Neonate Birth Weight 1500-2499 Grams With Major Procedure	10	8	—	—	$80,714.12	$271,186.19	$155,587.90	2026-05-14
609-4	OTHER	Neonate Birth Weight 1500-2499 Grams With Major Procedure	10	8	—	—	$167,970.00	$621,129.44	$197,949.90	2026-05-14
611-4	OTHER	Neonate Birth Weight 1500-1999 Grams With Major Anomaly	10	8	—	—	$89,327.06	$377,820.46	$100,354.44	2026-05-14
612-3	OTHER	Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other…	10	8	—	—	$49,045.90	$264,597.83	$74,110.40	2026-05-14
612-4	OTHER	Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other…	10	8	—	—	$78,726.15	$323,787.12	$96,038.12	2026-05-14
621-4	OTHER	Neonate Birth Weight 2000-2499 Grams With Major Anomaly	10	8	—	—	$75,617.84	$366,006.72	$95,284.80	2026-05-14
622-4	OTHER	Neonate Birth Weight 2000-2499 Grams With Respiratory Distress Syndrome Or Other…	10	8	—	—	$47,040.64	$155,986.69	$75,428.71	2026-05-14
623-4	OTHER	Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection	10	8	—	—	$52,979.57	$197,040.63	$82,480.30	2026-05-14
625-4	OTHER	Neonate Birth Weight 2000-2499 Grams With Other Significant Condition	10	8	—	—	$58,506.80	$164,778.48	$78,348.45	2026-05-14
630-2	OTHER	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure	10	8	—	—	$55,980.69	$157,663.93	$78,606.97	2026-05-14
630-3	OTHER	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure	10	8	—	—	$89,675.23	$252,561.19	$102,512.60	2026-05-14
630-4	OTHER	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure	10	8	—	—	$157,759.74	$444,314.32	$367,445.49	2026-05-14
631-3	OTHER	Neonate Birth Weight > 2499 Grams With Other Major Procedure	10	8	—	—	$58,631.36	$165,129.28	$119,589.67	2026-05-14
631-4	OTHER	Neonate Birth Weight > 2499 Grams With Other Major Procedure	10	8	—	—	$146,610.83	$440,701.24	$411,870.32	2026-05-14
633-4	OTHER	Neonate Birth Weight > 2499 Grams With Major Anomaly	10	8	—	—	$74,855.90	$324,225.61	$143,824.06	2026-05-14
634-4	OTHER	Neonate Birth Weight > 2499 Grams With Respiratory Distress Syndrome Or Other Ma…	10	8	—	—	$44,515.56	$132,417.67	$81,469.24	2026-05-14
650	OTHER	Kidney Transplant With Hemodialysis With Mcc	10	9	—	—	$4,150.72	$130,698.92	$94,207.79	2026-05-14
650-4	OTHER	Splenectomy	10	8	—	—	$34,635.20	$144,191.22	$84,485.76	2026-05-14
651	OTHER	Kidney Transplant With Hemodialysis Without Mcc	10	9	—	—	$4,150.72	$103,021.24	$74,257.71	2026-05-14
651-4	OTHER	Other Procedures Of Blood And Blood-forming Organs	10	8	—	—	$39,758.68	$179,698.22	$92,862.01	2026-05-14
653	OTHER	Major Bladder Procedures With Mcc	10	9	—	—	$4,150.72	$137,184.96	$98,882.92	2026-05-14
673	OTHER	Other Kidney And Urinary Tract Procedures With Mcc	10	9	—	—	$4,150.72	$110,922.24	$79,952.75	2026-05-14
680-4	OTHER	Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms	10	8	—	—	$58,118.05	$233,589.05	$100,444.88	2026-05-14
681-4	OTHER	Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms	10	8	—	—	$52,956.88	$239,333.31	$103,256.21	2026-05-14
690-4	OTHER	Acute Leukemia	10	8	—	—	$52,459.46	$246,060.53	$108,661.77	2026-05-14
695-4	OTHER	Chemotherapy For Acute Leukemia	10	8	—	—	$46,488.97	$180,882.15	$87,827.95	2026-05-14
7	OTHER	Lung Transplant	10	9	—	—	$4,150.72	$341,885.28	$246,430.91	2026-05-14
710-4	OTHER	Infectious And Parasitic Diseases Including HIV With O.r. Procedure	10	8	—	—	$35,800.77	$161,522.67	$88,951.15	2026-05-14
711-4	OTHER	Post-operative, Post-trauma, Other Device Infections With O.r. Procedure	10	8	—	—	$34,414.21	$141,399.48	$85,995.07	2026-05-14
71378H230	OTHER	Implant 50000-75000	18	10	$132,998.00	$132,998.00	$28,275.37	$132,998.00	$79,732.30	2026-05-14
71443H243	OTHER	Vad Heartware Hvad Sterile Implant Set	18	10	$216,919.00	$216,919.00	$46,116.98	$216,919.00	$135,032.08	2026-05-14
71443H244	OTHER	Vad Heartware Hvad Sterile Implant Set-vad	18	10	$216,919.00	$216,919.00	$46,116.98	$216,919.00	$135,032.08	2026-05-14
71444H243	OTHER	Vad Heartware Implant Kit	18	10	$193,672.00	$193,672.00	$41,174.67	$193,672.00	$116,106.36	2026-05-14
71444H244	OTHER	Vad Heartware Implant Kit-vad	18	10	$193,672.00	$193,672.00	$41,174.67	$193,672.00	$116,106.36	2026-05-14
71501H243	OTHER	HeartMate 3 Lvad Implant Kit Includes Controller	18	10	$243,246.00	$243,246.00	$51,714.10	$243,246.00	$151,420.64	2026-05-14
71501H244	OTHER	HeartMate 3 Lvad Implant Kit Includes Controller-vad	18	10	$243,246.00	$243,246.00	$51,714.10	$243,246.00	$151,420.64	2026-05-14
71517H243	OTHER	HeartMate 3 Lvad Implant Kit, Includes Controller - Backup	18	10	$243,246.00	$243,246.00	$51,714.10	$243,246.00	$151,420.64	2026-05-14
71517H244	OTHER	HeartMate 3 Lvad Implant Kit, Incl Controller - Backup-vad	18	10	$243,246.00	$243,246.00	$51,714.10	$243,246.00	$151,420.64	2026-05-14
71809H244	OTHER	HeartMate 3 Left Ventricular Assist Sys (lvas) Implant Kit	18	10	$216,261.00	$216,261.00	$45,977.09	$216,261.00	$134,622.48	2026-05-14
71828H244	OTHER	Vad Automated Impella Controller	18	10	$136,576.00	$136,576.00	$29,036.06	$136,576.00	$85,018.56	2026-05-14
740-4	OTHER	Mental Illness Diagnosis With O.r. Procedure	10	8	—	—	$52,740.32	$181,247.56	$84,728.14	2026-05-14
750-4	OTHER	Schizophrenia	10	8	—	—	$36,764.26	$123,600.30	$72,845.96	2026-05-14
754-4	OTHER	Depression Except Major Depressive Disorder	10	8	—	—	$22,092.82	$142,336.80	$97,623.62	2026-05-14
758-4	OTHER	Behavioral Disorders	10	8	—	—	$13,782.72	$93,676.36	$78,490.51	2026-05-14
791	OTHER	Prematurity With Major Problems	10	9	—	—	$4,150.72	$112,840.20	$81,335.21	2026-05-14
792-4	OTHER	Extensive O.r. Procedures For Other Complications Of Treatment	10	8	—	—	$40,173.32	$148,831.94	$93,401.93	2026-05-14
793	OTHER	Full Term Neonate With Major Problems	10	9	—	—	$4,150.72	$115,914.88	$83,551.45	2026-05-14
799	OTHER	Splenectomy With Mcc	10	9	—	—	$4,150.72	$119,562.96	$86,180.98	2026-05-14
8	OTHER	Simultaneous Pancreas And Kidney Transplant	10	9	—	—	$4,150.72	$147,961.44	$106,650.61	2026-05-14
823	OTHER	Lymphoma And Non-acute Leukemia With Other Procedures With Mcc	10	9	—	—	$4,150.72	$121,038.72	$87,244.71	2026-05-14
826	OTHER	Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. …	10	9	—	—	$4,150.72	$123,493.92	$89,014.42	2026-05-14
837	OTHER	Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot…	10	9	—	—	$4,150.72	$133,559.54	$96,269.71	2026-05-14
841-3	OTHER	Extensive Third Degree Burns With Skin Graft	10	8	—	—	$58,230.40	$359,626.64	$189,864.45	2026-05-14
841-4	OTHER	Extensive Third Degree Burns With Skin Graft	10	8	—	—	$181,958.06	$787,629.01	$205,025.20	2026-05-14
842-3	OTHER	Burns With Skin Graft Except Extensive Third Degree Burns	10	8	—	—	$34,409.04	$154,020.78	$77,787.68	2026-05-14
842-4	OTHER	Burns With Skin Graft Except Extensive Third Degree Burns	10	8	—	—	$93,187.11	$265,803.69	$127,046.40	2026-05-14
850-4	OTHER	Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal…	10	8	—	—	$60,004.99	$207,009.04	$113,679.61	2026-05-14
853	OTHER	Infectious And Parasitic Diseases With O.r. Procedures With Mcc	10	9	—	—	$4,150.72	$130,379.04	$93,977.21	2026-05-14
856	OTHER	Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc	10	9	—	—	$4,150.72	$120,085.68	$86,557.76	2026-05-14
863-4	OTHER	Neonatal Aftercare	10	8	—	—	$91,792.56	$299,384.97	$157,162.42	2026-05-14
876	OTHER	O.r. Procedures With Principal Diagnosis Of Mental Illness	10	9	—	—	$4,150.72	$102,033.36	$73,545.65	2026-05-14
901	OTHER	Wound Debridements For Injuries With Mcc	10	9	—	—	$4,150.72	$110,790.24	$79,857.60	2026-05-14
907	OTHER	Other O.r. Procedures For Injuries With Mcc	10	9	—	—	$4,150.72	$101,357.52	$73,058.50	2026-05-14
910-3	OTHER	Craniotomy For Multiple Significant Trauma	10	8	—	—	$36,101.59	$102,918.04	$81,348.33	2026-05-14
910-4	OTHER	Craniotomy For Multiple Significant Trauma	10	8	—	—	$53,835.67	$175,901.60	$137,371.98	2026-05-14
911-4	OTHER	Extensive Abdominal Or Thoracic Procedures For Multiple Significant Trauma	10	8	—	—	$50,489.01	$184,119.69	$131,899.68	2026-05-14
912-4	OTHER	Musculoskeletal And Other Procedures For Multiple Significant Trauma	10	8	—	—	$47,215.51	$197,691.06	$125,920.85	2026-05-14
927	OTHER	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	10	9	—	—	$4,150.72	$563,653.20	$406,281.23	2026-05-14
933	OTHER	Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft	10	9	—	—	$4,150.72	$108,258.76	$78,032.91	2026-05-14
950-4	OTHER	Extensive O.r. Procedure Unrelated To Principal Diagnosis	10	8	—	—	$44,375.13	$223,416.00	$107,857.08	2026-05-14
951-4	OTHER	Moderately Extensive O.r. Procedure Unrelated To Principal Diagnosis	10	8	—	—	$33,304.81	$144,337.38	$81,998.74	2026-05-14
955	OTHER	Craniotomy For Multiple Significant Trauma	10	9	—	—	$4,150.72	$177,701.04	$128,086.91	2026-05-14
957	OTHER	Other O.r. Procedures For Multiple Significant Trauma With Mcc	10	9	—	—	$4,150.72	$201,165.36	$144,999.99	2026-05-14
958	OTHER	Other O.r. Procedures For Multiple Significant Trauma With Cc	10	9	—	—	$4,150.72	$111,246.96	$80,186.81	2026-05-14
969	OTHER	HIV With Extensive O.r. Procedures With Mcc	10	9	—	—	$4,150.72	$161,602.32	$116,482.95	2026-05-14
981	OTHER	Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc	10	9	—	—	$4,150.72	$123,863.52	$89,280.82	2026-05-14

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