Hospital

KING'S DAUGHTERS MEDICAL CENTER-BROOKHAVEN

Brookhaven, MS · CCN 250057 · Rates published

7,048 distinct procedures filed

14 distinct payers

149,973 rate rows

2026-05-13 last MRF observed

Data quality

104,896 of 149,973 rate rows are consumer-grade (69.9%)

45,077 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	44,261
exceeds 10× this hospital's gross charge — excluded from medians	762
per-diem day rate — not a per-procedure price	40
placeholder amount (≤ $0.02) — excluded from medians	14

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

Source MRF file	https://www.kdmc.org/documents/640333594_Kings_Daughters_Medical_Center_StandardCharges.csv
Discovered via	Discovered by HANK (automated)
Last fetch	not_modified · 2026-05-18
Content fingerprint	809f356abaf5ec21… · 31,512,827 bytes · first seen 2026-05-13

Top 50 most expensive offerings

Outliers are flagged where this hospital's filed rate is ≥2× or ≤0.5× the national median for the same code.

Code	Description	Payers	Min $	Max $	Avg median	vs national
018 OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	13	$186,976.70	$368,427.00	$299,775.15	nat. median $424,868 0.7× median
001 OTHER	Heart Transplant Or Implant Of Heart Assist System With Mcc	13	$137,525.40	$270,986.00	$206,200.78	nat. median $263,894 0.8× median
927 OTHER	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	13	$133,770.40	$263,587.00	$198,678.70	nat. median $146,562 1.4× median
003 OTHER	Ecmo Or Trach With Mv >96 Hrs Or Pdx Exc Face; Mouth & Neck With Maj O.r.	13	$108,200.52	$213,203.00	$160,701.76	nat. median $218,232 0.7× median
004 OTHER	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…	13	$74,602.50	$147,000.00	$110,801.25	nat. median $150,232 0.7× median
007 OTHER	Lung Transplant	13	$62,251.98	$122,664.00	$94,556.85	nat. median $141,082 0.7× median
002 OTHER	Heart Transplant Or Implant Of Heart Assist System Without Mcc	13	$62,138.81	$122,441.00	$92,289.90	nat. median $117,167 0.8× median
014 OTHER	Allogeneic Bone Marrow Transplant	13	$58,164.07	$114,609.00	$88,046.26	nat. median $105,808 0.8× median
209 OTHER	Complex Aortic Arch Procedures	10	$83,284.11	$83,284.11	$83,284.11	nat. median $23,389 outlier · 3.6×
212 OTHER	Concomitant Aortic And Mitral Valve Procedures	13	$54,661.30	$107,707.00	$81,184.15	nat. median $90,581 0.9× median
426 OTHER	Non-hypovolemic Sodium Disorders	10	$81,094.35	$81,094.35	$81,094.35	nat. median $80,273 1.0× median
005 OTHER	Liver Transplant With Mcc Or Intestinal Transplant	13	$52,526.25	$103,500.00	$78,013.12	nat. median $104,489 0.7× median
215 OTHER	Other Heart Assist System Implant	13	$51,840.11	$102,148.00	$76,994.05	nat. median $92,359 0.8× median
216 OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	13	$49,254.40	$97,053.00	$73,153.70	nat. median $90,130 0.8× median
429 OTHER	Combined Anterior And Posterior Cervical Spinal Fusion With Mcc	10	$66,292.93	$66,292.93	$66,292.93	nat. median $62,997 1.1× median
850 OTHER	Acute Leukemia With Other Procedures	10	$63,716.89	$63,716.89	$63,716.89	nat. median $407 outlier · 156.5×
020 OTHER	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc	13	$42,895.93	$84,524.00	$63,709.96	nat. median $82,426 0.8× median
456 OTHER	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	13	$42,779.20	$84,294.00	$63,536.60	nat. median $76,493 0.8× median
231 OTHER	Coronary Bypass With Ptca With Comorbity	13	$41,184.64	$81,152.00	$62,027.48	nat. median $74,989 0.8× median
019 OTHER	Simultaneous Pancreas And Kidney Transplant With Hemodialysis	13	$40,567.01	$79,935.00	$60,251.00	nat. median $67,495 0.9× median
233 OTHER	Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc	13	$39,582.97	$77,996.00	$58,789.49	nat. median $68,249 0.9× median
219 OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	13	$39,134.34	$77,112.00	$58,123.17	nat. median $72,612 0.8× median
957 OTHER	Other O.r. Procedures For Multiple Significant Trauma With Mcc	13	$36,704.94	$72,325.00	$55,694.43	nat. median $68,309 0.8× median
427 OTHER	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	10	$53,114.70	$53,114.70	$53,114.70	nat. median $51,811 1.0× median
275 OTHER	Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc	13	$35,706.68	$70,358.00	$53,032.34	nat. median $29,655 1.8× median
928 OTHER	Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc	13	$35,117.48	$69,197.00	$52,776.95	nat. median $46,003 1.1× median
870 OTHER	Septicemia Or Severe Sepsis With Mv >96 Hours	13	$35,346.87	$84,816.92	$52,497.93	nat. median $54,603 1.0× median
207 OTHER	Respiratory System Diagnosis With Ventilator Support >96 Hours	13	$35,058.10	$69,080.00	$52,069.05	nat. median $66,849 0.8× median
969 OTHER	HIV With Extensive O.r. Procedures With Mcc	13	$34,878.44	$68,726.00	$51,802.22	nat. median $64,729 0.8× median
268 OTHER	Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc	13	$34,787.60	$68,547.00	$51,667.30	nat. median $67,670 0.8× median
461 OTHER	Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc	13	$34,603.89	$68,185.00	$51,394.44	nat. median $53,999 1.0× median
317 OTHER	Concomitant Left Atrial Appendage Closure And Cardiac Ablation	10	$49,199.48	$49,199.48	$49,199.48	nat. median $48,503 1.0× median
447 OTHER	Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall…	10	$49,163.43	$49,163.43	$49,163.43	nat. median $54,322 0.9× median
217 OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	13	$32,303.90	$63,653.00	$48,381.27	nat. median $60,727 0.8× median
955 OTHER	Craniotomy For Multiple Significant Trauma	13	$30,907.76	$60,902.00	$48,055.80	nat. median $62,467 0.8× median
573 OTHER	Skin Graft For Skin Ulcer Or Cellulitis With Mcc	13	$31,556.86	$62,181.00	$47,883.84	nat. median $54,881 0.9× median
266 OTHER	Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc	13	$31,698.96	$62,461.00	$47,079.98	nat. median $58,866 0.8× median
276 OTHER	Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator	13	$31,516.76	$62,102.00	$46,809.38	nat. median $3,947 outlier · 11.9×
017 OTHER	Autologous Bone Marrow Transplant Without Cc/mcc	13	$31,348.28	$61,770.00	$46,559.14	nat. median $51,368 0.9× median
016 OTHER	Autologous Bone Marrow Transplant With Cc/mcc	13	$31,348.28	$61,770.00	$46,559.14	nat. median $60,768 0.8× median
021 OTHER	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc	13	$31,167.60	$61,414.00	$46,290.80	nat. median $58,177 0.8× median
218 OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	13	$28,910.75	$56,967.00	$45,977.66	nat. median $56,507 0.8× median
457 OTHER	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	13	$30,832.15	$60,753.00	$45,792.57	nat. median $52,731 0.9× median
820 OTHER	Lymphoma And Leukemia With Major O.r. Procedures With Mcc	13	$30,687.00	$60,467.00	$45,577.00	nat. median $45,972 1.0× median
028 OTHER	Spinal Procedures With Comorbity	13	$30,582.46	$60,261.00	$45,421.73	nat. median $61,887 0.7× median
790 OTHER	Extreme Immaturity Or Respiratory Distress Syndrome; Neonate	13	$30,450.51	$60,001.00	$45,225.75	nat. median $42,495 1.1× median
232 OTHER	Coronary Bypass With Ptca Without Mcc	13	$30,189.14	$59,486.00	$44,837.57	nat. median $56,351 0.8× median
235 OTHER	Coronary Bypass Without Cardiac Catheterization With Mcc	13	$29,844.04	$58,806.00	$44,325.02	nat. median $56,120 0.8× median
576 OTHER	Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc	13	$28,841.73	$56,831.00	$42,836.36	nat. median $43,664 1.0× median
023 OTHER	Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…	13	$28,769.16	$56,688.00	$42,728.58	nat. median $59,073 0.7× median

Other procedures at this hospital

Browse this hospital's 7,048 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	OTHER	Heart Transplant Or Implant Of Heart Assist System With Mcc	20	13	—	—	$137,525.40	$270,986.00	$206,200.78	2026-05-13
002	OTHER	Heart Transplant Or Implant Of Heart Assist System Without Mcc	20	13	—	—	$62,138.81	$122,441.00	$92,289.90	2026-05-13
003	OTHER	Ecmo Or Trach With Mv >96 Hrs Or Pdx Exc Face; Mouth & Neck With Maj O.r.	20	13	—	—	$108,200.52	$213,203.00	$160,701.76	2026-05-13
004	OTHER	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…	20	13	—	—	$74,602.50	$147,000.00	$110,801.25	2026-05-13
005	OTHER	Liver Transplant With Mcc Or Intestinal Transplant	20	13	—	—	$52,526.25	$103,500.00	$78,013.12	2026-05-13
006	OTHER	Liver Transplant Without Mcc	20	13	—	—	$24,547.27	$48,369.00	$36,458.14	2026-05-13
007	OTHER	Lung Transplant	20	13	—	—	$62,251.98	$122,664.00	$94,556.85	2026-05-13
008	OTHER	Simultaneous Pancreas And Kidney Transplant	20	13	—	—	$26,703.13	$52,617.00	$40,742.79	2026-05-13
010	OTHER	Pancreas Transplant	20	13	—	—	$24,429.02	$52,799.03	$40,756.41	2026-05-13
011	OTHER	Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc	20	13	—	—	$26,168.22	$51,563.00	$39,785.99	2026-05-13
012	OTHER	Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc	20	13	—	—	$20,324.87	$40,049.00	$30,827.47	2026-05-13
013	OTHER	Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy Without Cc/mcc	20	13	—	—	$13,629.93	$26,857.00	$20,873.65	2026-05-13
014	OTHER	Allogeneic Bone Marrow Transplant	20	13	—	—	$58,164.07	$114,609.00	$88,046.26	2026-05-13
016	OTHER	Autologous Bone Marrow Transplant With Cc/mcc	20	13	—	—	$31,348.28	$61,770.00	$46,559.14	2026-05-13
017	OTHER	Autologous Bone Marrow Transplant Without Cc/mcc	20	13	—	—	$31,348.28	$61,770.00	$46,559.14	2026-05-13
018	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	20	13	—	—	$186,976.70	$368,427.00	$299,775.15	2026-05-13
019	OTHER	Simultaneous Pancreas And Kidney Transplant With Hemodialysis	20	13	—	—	$40,567.01	$79,935.00	$60,251.00	2026-05-13
020	OTHER	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc	20	13	—	—	$42,895.93	$84,524.00	$63,709.96	2026-05-13
021	OTHER	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc	20	13	—	—	$31,167.60	$61,414.00	$46,290.80	2026-05-13
022	OTHER	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/…	20	13	—	—	$17,644.25	$34,767.00	$26,205.62	2026-05-13
023	OTHER	Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…	20	13	—	—	$28,769.16	$56,688.00	$42,728.58	2026-05-13
024	OTHER	Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…	20	13	—	—	$19,228.16	$37,888.00	$28,783.88	2026-05-13
025	OTHER	Craniotomy And Endovascular Intracranial Procedures With Mcc	20	13	—	—	$22,411.20	$44,160.00	$33,454.77	2026-05-13
026	OTHER	Craniotomy And Endovascular Intracranial Procedures With Cc	20	13	—	—	$14,986.98	$29,531.00	$22,732.93	2026-05-13
027	OTHER	Craniotomy And Endovascular Intracranial Procedures Without Cc/mcc	20	13	—	—	$12,346.97	$24,329.00	$18,563.57	2026-05-13
028	OTHER	Spinal Procedures With Comorbity	20	13	—	—	$30,582.46	$60,261.00	$45,421.73	2026-05-13
029	OTHER	Spinal Procedures With Cc Or Spinal Neurostimulators	20	13	—	—	$17,398.11	$34,282.00	$25,840.06	2026-05-13
030	OTHER	Spinal Procedures Without Cc/mcc	20	13	—	—	$11,768.92	$23,190.00	$17,479.46	2026-05-13
031	OTHER	Ventricular Shunt Procedures With Mcc	20	13	—	—	$20,891.75	$41,166.00	$32,227.77	2026-05-13
032	OTHER	Ventricular Shunt Procedures With Cc	20	13	—	—	$10,930.54	$21,538.00	$16,234.27	2026-05-13
034	OTHER	Carotid Artery Stent Procedures With Mcc	20	13	—	—	$19,799.61	$39,014.00	$29,406.81	2026-05-13
035	OTHER	Carotid Artery Stent Procedures With Cc	20	13	—	—	$11,669.96	$22,995.00	$17,589.12	2026-05-13
037	OTHER	Extracranial Procedures With Mcc	20	13	—	—	$17,131.17	$33,756.00	$25,443.58	2026-05-13
040	OTHER	Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc	20	13	—	—	$19,541.29	$38,505.00	$29,023.15	2026-05-13
041	OTHER	Peripheral, Cranial Nerve And Other Nervous System Procedures With Cc Or Periphe…	20	13	—	—	$11,320.80	$22,307.00	$16,813.90	2026-05-13
056	OTHER	Degenerative Nervous System Disorders With Comorbity	20	13	—	—	$12,149.55	$23,940.00	$18,044.78	2026-05-13
061	OTHER	Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A…	20	13	—	—	$14,224.21	$28,028.00	$21,126.10	2026-05-13
0627T	OTHER	Injection Of Cell Or Tissue-based Material Into Spinal Disc Of Lower Back Access…	20	13	$15,000.00	$4,500.00 70% off	$10,455.00	$27,132.59	$18,793.79	2026-05-13
080	OTHER	Nontraumatic Stupor And Coma With Mcc	20	13	—	—	$11,209.15	$22,087.00	$16,648.08	2026-05-13
082	OTHER	Traumatic Stupor And Coma >1 Hour With Mcc	20	13	—	—	$11,562.37	$22,783.00	$17,172.69	2026-05-13
085	OTHER	Traumatic Stupor And Coma <1 Hour With Mcc	20	13	—	—	$11,534.46	$22,728.00	$17,131.23	2026-05-13
094	OTHER	Bacterial And Tuberculous Infections Of Nervous System With Mcc	20	13	—	—	$18,385.20	$36,227.00	$27,306.10	2026-05-13
095	OTHER	Bacterial And Tuberculous Infections Of Nervous System With Cc	20	13	—	—	$12,099.81	$23,842.00	$18,607.29	2026-05-13
096	OTHER	Bacterial And Tuberculous Infections Of Nervous System Without Cc/mcc	20	13	—	—	$11,061.98	$21,797.00	$17,825.18	2026-05-13
097	OTHER	Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc	20	13	—	—	$18,457.27	$36,369.00	$27,413.13	2026-05-13
098	OTHER	Non-bacterial Infection Of Nervous System Except Viral Meningitis With Cc	20	13	—	—	$10,934.09	$21,545.00	$16,682.86	2026-05-13
113	OTHER	Orbital Procedures With Cc/mcc	20	13	—	—	$12,724.55	$25,073.00	$18,898.78	2026-05-13
135	OTHER	Sinus And Mastoid Procedures With Cc/mcc	20	13	—	—	$13,459.41	$26,521.00	$19,990.21	2026-05-13
140	OTHER	Major Head And Neck Procedures With Mcc	20	13	—	—	$19,173.86	$37,781.00	$30,141.46	2026-05-13
141	OTHER	Major Head And Neck Procedures With Cc	20	13	—	—	$10,513.88	$20,717.00	$15,947.51	2026-05-13
143	OTHER	Other Ear; Nose; Mouth And Throat O.r. Procedures With Mcc	20	13	—	—	$16,877.42	$33,256.00	$26,502.56	2026-05-13
146	OTHER	Ear, Nose, Mouth And Throat Malignancy With Mcc	20	13	—	—	$10,713.32	$21,110.00	$15,911.66	2026-05-13
163	OTHER	Major Chest Procedures With Mcc	20	13	—	—	$23,921.52	$47,136.00	$35,528.76	2026-05-13
164	OTHER	Major Chest Procedures With Cc	20	13	—	—	$12,943.28	$25,504.00	$19,223.64	2026-05-13
166	OTHER	Other Respiratory System O.r. Procedures With Mcc	20	13	—	—	$20,593.34	$40,578.00	$30,585.67	2026-05-13
173	OTHER	Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary…	20	13	—	—	$15,605.62	$30,750.00	$23,177.81	2026-05-13
207	OTHER	Respiratory System Diagnosis With Ventilator Support >96 Hours	20	13	—	—	$35,058.10	$69,080.00	$52,069.05	2026-05-13
208	OTHER	Respiratory System Diagnosis With Ventilator Support <=96 Hours	20	13	—	—	$13,721.78	$32,722.16	$20,379.89	2026-05-13
209	OTHER	Complex Aortic Arch Procedures	12	10	—	—	$83,284.11	$83,284.11	$83,284.11	2026-05-13
212	OTHER	Concomitant Aortic And Mitral Valve Procedures	20	13	—	—	$54,661.30	$107,707.00	$81,184.15	2026-05-13
213	OTHER	Endovascular Abdominal Aorta With Iliac Branch Procedures	12	10	—	—	$41,991.55	$41,991.55	$41,991.55	2026-05-13
215	OTHER	Other Heart Assist System Implant	20	13	—	—	$51,840.11	$102,148.00	$76,994.05	2026-05-13
216	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	20	13	—	—	$49,254.40	$97,053.00	$73,153.70	2026-05-13
217	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	20	13	—	—	$32,303.90	$63,653.00	$48,381.27	2026-05-13
218	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	20	13	—	—	$28,910.75	$56,967.00	$45,977.66	2026-05-13
219	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	20	13	—	—	$39,134.34	$77,112.00	$58,123.17	2026-05-13
220	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	20	13	—	—	$26,616.35	$52,446.00	$39,531.18	2026-05-13
221	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	20	13	—	—	$23,591.64	$46,486.00	$36,321.55	2026-05-13
228	OTHER	Other Cardiothoracic Procedures With Mcc	20	13	—	—	$25,571.40	$50,387.00	$37,979.20	2026-05-13
229	OTHER	Other Cardiothoracic Procedures Without Mcc	20	13	—	—	$16,136.47	$31,796.00	$23,966.24	2026-05-13
231	OTHER	Coronary Bypass With Ptca With Comorbity	20	13	—	—	$41,184.64	$81,152.00	$62,027.48	2026-05-13
232	OTHER	Coronary Bypass With Ptca Without Mcc	20	13	—	—	$30,189.14	$59,486.00	$44,837.57	2026-05-13
233	OTHER	Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc	20	13	—	—	$39,582.97	$77,996.00	$58,789.49	2026-05-13
234	OTHER	Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc	20	13	—	—	$26,379.34	$51,979.00	$39,976.74	2026-05-13
235	OTHER	Coronary Bypass Without Cardiac Catheterization With Mcc	20	13	—	—	$29,844.04	$58,806.00	$44,325.02	2026-05-13
236	OTHER	Coronary Bypass Without Cardiac Catheterization Without Mcc	20	13	—	—	$20,509.09	$40,412.00	$30,821.32	2026-05-13
239	OTHER	Amputation For Circ Sys Disorders Exc Upper Limb & Toe With Comorbity	20	13	—	—	$24,394.51	$48,068.00	$36,231.25	2026-05-13
240	OTHER	Amputation For Circ Sys Disorders Exc Upper Limb & Toe With Complication	20	13	—	—	$14,256.69	$28,092.00	$21,174.35	2026-05-13
242	OTHER	Permanent Cardiac Pacemaker Implant With Mcc	20	13	—	—	$17,534.63	$34,551.00	$26,042.81	2026-05-13
243	OTHER	Permanent Cardiac Pacemaker Implant With Cc	20	13	—	—	$11,558.82	$22,776.00	$17,167.41	2026-05-13
245	OTHER	Aicd Generator Procedures	20	13	—	—	$22,996.86	$45,314.00	$34,155.43	2026-05-13
250	OTHER	Percutaneous Cardiovascular Procedures Without Intraluminal Device With Mcc	20	13	—	—	$11,930.31	$23,508.00	$17,719.15	2026-05-13
252	OTHER	Other Vascular Procedures With Comorbity	20	13	—	—	$17,020.54	$33,538.00	$25,660.12	2026-05-13
253	OTHER	Other Vascular Procedures With Cc	20	13	—	—	$12,946.83	$25,511.00	$19,228.92	2026-05-13
255	OTHER	Upper Limb & Toe Amputation For Circ System Disorders With Comorbity	20	13	—	—	$13,943.05	$27,474.00	$20,708.53	2026-05-13
258	OTHER	Cardiac Pacemaker Device Replacement With Mcc	20	13	—	—	$13,746.14	$27,086.00	$21,918.88	2026-05-13
260	OTHER	Cardiac Pacemaker Revision Except Device Replacement With Mcc	20	13	—	—	$16,824.64	$33,152.00	$24,988.32	2026-05-13
263	OTHER	Vein Ligation And Stripping	20	13	—	—	$14,337.89	$28,252.00	$22,053.20	2026-05-13
264	OTHER	Other Circulatory System O.r. Procedures	20	13	—	—	$16,574.95	$32,660.00	$24,617.47	2026-05-13
265	OTHER	Aicd Lead Procedures	20	13	—	—	$17,935.56	$35,341.00	$26,638.28	2026-05-13
266	OTHER	Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc	20	13	—	—	$31,698.96	$62,461.00	$47,079.98	2026-05-13
267	OTHER	Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc	20	13	—	—	$24,767.02	$48,802.00	$36,784.51	2026-05-13
268	OTHER	Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc	20	13	—	—	$34,787.60	$68,547.00	$51,667.30	2026-05-13
269	OTHER	Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc	20	13	—	—	$21,104.90	$41,586.00	$31,345.45	2026-05-13
270	OTHER	Other Major Cardiovascular Procedures With Mcc	20	13	—	—	$25,663.77	$50,569.00	$38,751.71	2026-05-13
271	OTHER	Other Major Cardiovascular Procedures With Cc	20	13	—	—	$17,540.22	$34,562.00	$26,167.37	2026-05-13
27130	OTHER	Replacement Of Thigh Bone And Hip Joint With Prosthesis	60	13	$13,493.00	$4,047.90 70% off	$11,796.78	$27,132.59	$19,464.69	2026-05-13
272	OTHER	Other Major Cardiovascular Procedures Without Cc/mcc	20	13	—	—	$12,380.46	$24,395.00	$18,722.40	2026-05-13
273	OTHER	Percutaneous And Other Intracardiac Procedures With Mcc	20	13	—	—	$19,777.28	$38,970.00	$30,081.85	2026-05-13
274	OTHER	Percutaneous And Other Intracardiac Procedures Without Mcc	20	13	—	—	$16,447.06	$32,408.00	$24,427.53	2026-05-13
27446	OTHER	Replacement Of Knee Joint On Side Of Knee	20	13	$5,257.34	$1,577.20 70% off	$11,796.78	$27,132.59	$19,464.69	2026-05-13
27447	OTHER	Replacement Of Knee Joint; Both Sides Of Knee	60	13	$13,493.00	$4,047.90 70% off	$9,903.03	$27,132.59	$19,464.69	2026-05-13
275	OTHER	Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc	20	13	—	—	$35,706.68	$70,358.00	$53,032.34	2026-05-13
276	OTHER	Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator	20	13	—	—	$31,516.76	$62,102.00	$46,809.38	2026-05-13
277	OTHER	Cardiac Defibrillator Implant Without Mcc	20	13	—	—	$24,270.68	$47,824.00	$36,047.34	2026-05-13
278	OTHER	Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures …	20	13	—	—	$22,636.53	$44,604.00	$36,934.34	2026-05-13
279	OTHER	Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures …	20	13	—	—	$16,243.04	$32,006.00	$25,508.70	2026-05-13
286	OTHER	Circulatory Disorders Except Ami, With Cardiac Catheterization With Mcc	20	13	—	—	$10,939.67	$21,556.00	$16,281.86	2026-05-13
288	OTHER	Acute And Subacute Endocarditis With Mcc	20	13	—	—	$13,159.48	$25,930.00	$19,873.08	2026-05-13
29867	OTHER	Repair Of Knee Cartilage And Bone With Donor Cartilage Graft Using An Endoscope	20	13	$3,953.00	$1,185.90 70% off	$2,826.40	$27,132.59	$18,244.48	2026-05-13
29889	OTHER	Repair Of Posterior Cruciate Ligament Of Knee Using An Endoscope	40	13	$9,644.00	$2,893.20 70% off	$3,501.00	$27,132.59	$15,316.80	2026-05-13
314	OTHER	Other Circulatory System Diagnoses With Comorbity	20	13	—	—	$10,624.51	$20,935.00	$15,779.75	2026-05-13
317	OTHER	Concomitant Left Atrial Appendage Closure And Cardiac Ablation	12	10	—	—	$49,199.48	$49,199.48	$49,199.48	2026-05-13
318	OTHER	Percutaneous Coronary Atherectomy Without Intraluminal Device	12	10	—	—	$17,822.64	$17,822.64	$17,822.64	2026-05-13
319	OTHER	Other Endovascular Cardiac Valve Procedures With Mcc	20	13	—	—	$22,136.64	$43,619.00	$32,877.82	2026-05-13
320	OTHER	Other Endovascular Cardiac Valve Procedures Without Mcc	20	13	—	—	$11,296.95	$22,260.00	$17,362.47	2026-05-13
321	OTHER	Percutaneous Cardiovascular Procedures With Intraluminal Device With Mcc Or 4+ A…	20	13	—	—	$14,589.10	$28,747.00	$21,668.05	2026-05-13
323	OTHER	Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc	20	13	—	—	$21,010.50	$41,400.00	$31,754.00	2026-05-13
324	OTHER	Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc	20	13	—	—	$15,065.64	$29,686.00	$22,945.99	2026-05-13
325	OTHER	Coronary Intravascular Lithotripsy Without Intraluminal Device	20	13	—	—	$13,419.82	$26,443.00	$21,896.12	2026-05-13
326	OTHER	Stomach; Esophageal & Duodenal Proc With Comorbity	20	13	—	—	$25,775.92	$50,790.00	$38,282.96	2026-05-13
327	OTHER	Stomach, Esophageal And Duodenal Procedures With Cc	20	13	—	—	$12,674.30	$24,974.00	$18,824.15	2026-05-13
329	OTHER	Major Small & Large Bowel Procedures With Comorbity	20	13	—	—	$22,922.76	$45,168.00	$34,045.38	2026-05-13
330	OTHER	Major Small & Large Bowel Procedures With Complication	20	13	—	—	$12,038.41	$28,819.34	$17,879.71	2026-05-13
332	OTHER	Rectal Resection With Mcc	20	13	—	—	$18,410.07	$36,276.00	$27,343.03	2026-05-13
333	OTHER	Rectal Resection With Cc	20	13	—	—	$10,553.46	$20,795.00	$16,570.03	2026-05-13
335	OTHER	Peritoneal Adhesiolysis With Comorbity	20	13	—	—	$18,143.12	$35,750.00	$26,946.56	2026-05-13
336	OTHER	Peritoneal Adhesiolysis With Complication	20	13	—	—	$10,684.40	$26,639.55	$15,868.70	2026-05-13
344	OTHER	Minor Small And Large Bowel Procedures With Mcc	20	13	—	—	$13,907.53	$27,404.00	$20,655.76	2026-05-13
347	OTHER	Anal And Stomal Procedures With Mcc	20	13	—	—	$12,936.68	$25,491.00	$19,213.84	2026-05-13
350	OTHER	Inguinal And Femoral Hernia Procedures With Mcc	20	13	—	—	$12,180.00	$24,000.00	$18,335.49	2026-05-13
353	OTHER	Hernia Procedures Except Inguinal And Femoral With Mcc	20	13	—	—	$14,840.82	$29,243.00	$22,041.91	2026-05-13
356	OTHER	Other Digestive System O.r. Procedures With Comorbity	20	13	—	—	$21,714.40	$42,787.00	$32,322.37	2026-05-13
357	OTHER	Other Digestive System O.r. Procedures With Complication	20	13	—	—	$11,148.76	$21,968.00	$16,957.22	2026-05-13
359	OTHER	Percutaneous Coronary Atherectomy With Intraluminal Device With Mcc	12	10	—	—	$25,301.34	$25,301.34	$25,301.34	2026-05-13
360	OTHER	Percutaneous Coronary Atherectomy With Intraluminal Device Without Mcc	12	10	—	—	$17,764.50	$17,764.50	$17,764.50	2026-05-13
36903	OTHER	Intro Cath Dialysis Circuit	11	8	$833.00	$249.90 70% off	$8,728.34	$17,502.11	$17,502.11	2026-05-13
36905	OTHER	Removal And/or Dissolving Of Blood Clot In Hemodialysis Circuit And Balloon Dila…	20	13	$18,785.00	$5,635.50 70% off	$8,728.34	$24,396.88	$16,706.56	2026-05-13
36906	OTHER	Removal And/or Dissolving Of Blood Clot In Hemodialysis Circuit And Balloon Dila…	20	13	$28,473.00	$8,541.90 70% off	$14,863.00	$38,741.13	$26,802.06	2026-05-13
374	OTHER	Digestive Malignancy With Mcc	20	13	—	—	$10,652.42	$20,990.00	$15,821.21	2026-05-13
397	OTHER	Appendix Procedures With Mcc	20	13	—	—	$11,401.50	$22,466.00	$17,403.00	2026-05-13
402	OTHER	Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical	12	10	—	—	$29,582.96	$29,582.96	$29,582.96	2026-05-13
405	OTHER	Pancreas, Liver And Shunt Procedures With Mcc	20	13	—	—	$27,938.89	$55,052.00	$41,495.44	2026-05-13
406	OTHER	Pancreas, Liver And Shunt Procedures With Cc	20	13	—	—	$14,653.56	$28,874.00	$21,763.78	2026-05-13
407	OTHER	Pancreas, Liver And Shunt Procedures Without Cc/mcc	20	13	—	—	$10,916.32	$21,510.00	$16,331.88	2026-05-13
408	OTHER	Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With…	20	13	—	—	$18,890.16	$37,222.00	$28,056.08	2026-05-13
409	OTHER	Biliary Tract Proc Except Only Cholecyst With Or Without C.d.e. With Complicatio…	20	13	—	—	$9,933.30	$19,573.00	$15,496.02	2026-05-13
411	OTHER	Cholecystectomy With C.d.e. With Mcc	20	13	—	—	$14,618.54	$28,805.00	$23,169.37	2026-05-13
412	OTHER	Cholecystectomy With C.d.e. With Cc	20	13	—	—	$10,380.91	$20,455.00	$15,470.28	2026-05-13
414	OTHER	Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc	20	13	—	—	$17,890.39	$35,252.00	$26,571.19	2026-05-13
415	OTHER	Cholecystectomy Except By Laparoscope Without C.d.e. With Cc	20	13	—	—	$10,027.18	$19,758.00	$15,159.87	2026-05-13
417	OTHER	Laparoscopic Cholecystectomy Without C.d.e. With Mcc	20	13	—	—	$11,762.84	$23,178.00	$17,559.20	2026-05-13
420	OTHER	Hepatobiliary Diagnostic Procedures With Comorbity	20	13	—	—	$16,244.06	$32,008.00	$24,776.24	2026-05-13
423	OTHER	Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc	20	13	—	—	$19,847.82	$39,109.00	$30,236.19	2026-05-13
424	OTHER	Other Hepatobiliary Or Pancreas O.r. Procedures With Cc	20	13	—	—	$10,593.05	$20,873.00	$16,032.20	2026-05-13
426	OTHER	Non-hypovolemic Sodium Disorders	12	10	—	—	$81,094.35	$81,094.35	$81,094.35	2026-05-13
427	OTHER	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	12	10	—	—	$53,114.70	$53,114.70	$53,114.70	2026-05-13
428	OTHER	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	12	10	—	—	$41,366.86	$41,366.86	$41,366.86	2026-05-13
429	OTHER	Combined Anterior And Posterior Cervical Spinal Fusion With Mcc	12	10	—	—	$66,292.93	$66,292.93	$66,292.93	2026-05-13
430	OTHER	Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc	12	10	—	—	$42,434.52	$42,434.52	$42,434.52	2026-05-13
447	OTHER	Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall…	12	10	—	—	$49,163.43	$49,163.43	$49,163.43	2026-05-13
448	OTHER	Multiple Level Spinal Fusion Except Cervical Without Mcc	12	10	—	—	$31,203.95	$31,203.95	$31,203.95	2026-05-13
450	OTHER	Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically …	12	10	—	—	$39,215.38	$39,215.38	$39,215.38	2026-05-13
451	OTHER	Single Level Spinal Fusion Except Cervical Without Mcc	12	10	—	—	$23,769.39	$23,769.39	$23,769.39	2026-05-13
456	OTHER	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	20	13	—	—	$42,779.20	$84,294.00	$63,536.60	2026-05-13
457	OTHER	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	20	13	—	—	$30,832.15	$60,753.00	$45,792.57	2026-05-13
458	OTHER	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	20	13	—	—	$22,994.82	$45,310.00	$34,152.41	2026-05-13
461	OTHER	Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc	20	13	—	—	$34,603.89	$68,185.00	$51,394.44	2026-05-13
462	OTHER	Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without Mcc	20	13	—	—	$14,444.97	$28,463.00	$21,453.99	2026-05-13
463	OTHER	Wnd Debrid & Skn Grft Exc Hand; For Musculo-conn Tiss Dis With Comorbity	20	13	—	—	$28,743.28	$56,637.00	$42,690.14	2026-05-13
464	OTHER	Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …	20	13	—	—	$15,232.11	$30,014.00	$22,918.06	2026-05-13
466	OTHER	Revision Of Hip Or Knee Replacement With Comorbity	20	13	—	—	$26,322.00	$51,866.00	$39,094.00	2026-05-13
467	OTHER	Revision Of Hip Or Knee Replacement With Cc	20	13	—	—	$17,692.97	$34,863.00	$26,277.99	2026-05-13
468	OTHER	Revision Of Hip Or Knee Replacement Without Cc/mcc	20	13	—	—	$13,548.22	$26,696.00	$20,219.88	2026-05-13
469	OTHER	Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Com…	20	13	—	—	$16,898.74	$33,298.00	$25,098.37	2026-05-13
471	OTHER	Cervical Spinal Fusion With Mcc	20	13	—	—	$24,963.92	$49,190.00	$37,076.96	2026-05-13
472	OTHER	Cervical Spinal Fusion With Cc	20	13	—	—	$14,998.66	$29,554.00	$22,276.33	2026-05-13
473	OTHER	Cervical Spinal Fusion Without Cc/mcc	20	13	—	—	$12,487.54	$24,606.00	$18,546.77	2026-05-13
474	OTHER	Amputation For Musculoskeletal Sys & Conn Tissue Dis With Comorbity	20	13	—	—	$21,836.71	$43,028.00	$32,432.35	2026-05-13
475	OTHER	Amputation For Musculoskeletal System And Connective Tissue Disorders With Cc	20	13	—	—	$10,884.35	$21,447.00	$16,574.74	2026-05-13
477	OTHER	Biopsies Of Musculoskeletal System And Connective Tissue With Mcc	20	13	—	—	$17,097.68	$33,690.00	$25,419.06	2026-05-13
478	OTHER	Biopsies Of Musculoskeletal System And Connective Tissue With Cc	20	13	—	—	$12,097.28	$23,837.00	$18,094.87	2026-05-13
480	OTHER	Hip And Femur Procedures Except Major Joint With Mcc	20	13	—	—	$14,965.67	$29,489.00	$22,227.33	2026-05-13
481	OTHER	Hip And Femur Procedures Except Major Joint With Cc	20	13	—	—	$10,530.12	$20,749.00	$15,639.56	2026-05-13
483	OTHER	Major Joint Or Limb Reattachment Procedures Of Upper Extremities	20	13	—	—	$12,607.32	$24,842.00	$19,698.69	2026-05-13
485	OTHER	Knee Procedures With Principal Diagnosis Of Infection With Mcc	20	13	—	—	$16,717.05	$32,940.00	$24,828.53	2026-05-13
486	OTHER	Knee Procedures With Principal Diagnosis Of Infection With Cc	20	13	—	—	$10,192.12	$20,083.00	$15,373.94	2026-05-13
488	OTHER	Knee Procedures Without Principal Diagnosis Of Infection With Cc/mcc	20	13	—	—	$10,691.00	$21,066.00	$15,878.50	2026-05-13
492	OTHER	Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc	20	13	—	—	$17,570.16	$34,621.00	$26,748.67	2026-05-13
493	OTHER	Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Cc	20	13	—	—	$12,188.63	$24,017.00	$18,515.65	2026-05-13
495	OTHER	Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit…	20	13	—	—	$18,174.59	$35,812.00	$26,993.29	2026-05-13
498	OTHER	Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur With Cc…	20	13	—	—	$13,250.83	$26,110.00	$21,084.63	2026-05-13
500	OTHER	Soft Tissue Procedures With Mcc	20	13	—	—	$16,457.21	$32,428.00	$24,442.60	2026-05-13
503	OTHER	Foot Procedures With Comorbity	20	13	—	—	$13,610.64	$26,819.00	$20,525.43	2026-05-13
507	OTHER	Major Shoulder Or Elbow Joint Procedures With Cc/mcc	20	13	—	—	$10,818.38	$21,317.00	$16,067.69	2026-05-13
510	OTHER	Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Mcc	20	13	—	—	$13,807.04	$27,206.00	$21,517.40	2026-05-13
511	OTHER	Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Cc	20	13	—	—	$10,118.54	$19,938.00	$15,275.44	2026-05-13
515	OTHER	Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc	20	13	—	—	$16,044.61	$31,615.00	$23,829.81	2026-05-13
516	OTHER	Other Musculoskeletal System And Connective Tissue O.r. Procedures With Cc	20	13	—	—	$10,357.06	$20,408.00	$15,382.53	2026-05-13
518	OTHER	Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost…	20	13	—	—	$18,532.89	$36,518.00	$27,525.44	2026-05-13
521	OTHER	Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc	20	13	—	—	$15,195.56	$29,942.00	$22,568.78	2026-05-13
522	OTHER	Hip Replacement With Principal Diagnosis Of Hip Fracture Without Mcc	20	13	—	—	$10,719.42	$21,122.00	$15,920.71	2026-05-13
545	OTHER	Connective Tissue Disorders With Comorbity	20	13	—	—	$12,652.99	$24,932.00	$18,792.49	2026-05-13
570	OTHER	Skin Debridement With Mcc	20	13	—	—	$14,830.16	$29,222.00	$22,026.08	2026-05-13
573	OTHER	Skin Graft For Skin Ulcer Or Cellulitis With Mcc	20	13	—	—	$31,556.86	$62,181.00	$47,883.84	2026-05-13
574	OTHER	Skin Graft For Skin Ulcer Or Cellulitis With Cc	20	13	—	—	$17,284.44	$34,058.00	$25,671.22	2026-05-13
575	OTHER	Skin Graft For Skin Ulcer Or Cellulitis Without Cc/mcc	20	13	—	—	$10,383.45	$20,460.00	$15,421.73	2026-05-13
576	OTHER	Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc	20	13	—	—	$28,841.73	$56,831.00	$42,836.36	2026-05-13
577	OTHER	Skin Graft Except For Skin Ulcer Or Cellulitis With Cc	20	13	—	—	$13,444.18	$26,491.00	$19,967.59	2026-05-13
579	OTHER	Other Skin; Subcut Tiss & Breast Proc With Comorbity	20	13	—	—	$16,961.66	$33,422.00	$25,191.83	2026-05-13
584	OTHER	Breast Biopsy, Local Excision And Other Breast Procedures With Cc/mcc	20	13	—	—	$9,939.89	$19,586.00	$15,366.33	2026-05-13
592	OTHER	Skin Ulcers With Mcc	20	13	—	—	$10,607.26	$20,901.00	$15,754.13	2026-05-13
595	OTHER	Major Skin Disorders With Comorbity	20	13	—	—	$11,038.12	$21,750.00	$16,394.06	2026-05-13
614	OTHER	Adrenal & Pituitary Procedures With Complication/comorbity	20	13	—	—	$11,430.93	$22,524.00	$16,977.47	2026-05-13
616	OTHER	Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With…	20	13	—	—	$20,085.33	$39,577.00	$29,831.17	2026-05-13
619	OTHER	O.r. Procedures For Obesity With Mcc	20	13	—	—	$13,136.64	$25,885.00	$20,522.51	2026-05-13
622	OTHER	Skin Grafts & Wound Debrid For Endoc; Nutrit & Metab Dis With Comorbity	20	13	—	—	$19,414.92	$38,256.00	$28,835.46	2026-05-13
62362	OTHER	Insertion Of Programmable Spinal Canal Drug Infusion Pump	20	13	$3,924.00	$1,177.20 70% off	$2,652.00	$38,090.67	$20,371.33	2026-05-13
625	OTHER	Thyroid, Parathyroid And Thyroglossal Procedures With Mcc	20	13	—	—	$14,825.09	$29,212.00	$22,222.00	2026-05-13
628	OTHER	Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc	20	13	—	—	$20,373.59	$40,145.00	$30,259.29	2026-05-13
629	OTHER	Other Endocrine, Nutritional And Metabolic O.r. Procedures With Cc	20	13	—	—	$11,483.71	$22,628.00	$17,055.85	2026-05-13
63685	OTHER	Insertion Of Spinal Neurostimulator Generator Or Receiver	9	6	$4,036.66	$1,211.00 70% off	$2,652.00	$38,277.21	$28,353.49	2026-05-13
64582	OTHER	Insertion Of Hypoglossal Nerve Neurostimulator Electrode And Generator And Breat…	20	13	$45,700.00	$13,710.00 70% off	$14,863.00	$65,213.03	$40,038.01	2026-05-13
650	OTHER	Kidney Transplant With Hemodialysis With Mcc	20	13	—	—	$22,824.81	$44,975.00	$34,497.22	2026-05-13
651	OTHER	Kidney Transplant With Hemodialysis Without Mcc	20	13	—	—	$17,551.38	$34,584.00	$26,860.35	2026-05-13
652	OTHER	Kidney Transplant	20	13	—	—	$15,247.33	$30,044.00	$23,371.71	2026-05-13
653	OTHER	Major Bladder Procedures With Mcc	20	13	—	—	$27,474.02	$54,136.00	$40,805.01	2026-05-13
654	OTHER	Major Bladder Procedures With Cc	20	13	—	—	$13,892.81	$27,375.00	$20,633.90	2026-05-13
655	OTHER	Major Bladder Procedures Without Cc/mcc	20	13	—	—	$10,697.08	$21,078.00	$15,887.54	2026-05-13
656	OTHER	Kidney And Ureter Procedures For Neoplasm With Mcc	20	13	—	—	$15,923.32	$31,376.00	$23,649.66	2026-05-13
659	OTHER	Kidney And Ureter Procedures For Non-neoplasm With Mcc	20	13	—	—	$13,138.67	$25,889.00	$19,513.83	2026-05-13
662	OTHER	Minor Bladder Procedures With Comorbity	20	13	—	—	$15,208.25	$29,967.00	$22,587.62	2026-05-13
665	OTHER	Prostatectomy With Mcc	20	13	—	—	$15,677.18	$30,891.00	$23,284.09	2026-05-13
668	OTHER	Transurethral Procedures With Mcc	20	13	—	—	$14,301.35	$28,180.00	$21,485.46	2026-05-13
673	OTHER	Other Kidney & Urinary Tract Procedures With Comorbity	20	13	—	—	$18,767.35	$36,980.00	$29,600.75	2026-05-13
674	OTHER	Other Kidney & Urinary Tract Procedures With Complication	20	13	—	—	$12,089.66	$25,223.22	$17,955.83	2026-05-13
709	OTHER	Penis Procedures With Cc/mcc	20	13	—	—	$10,759.00	$21,200.00	$16,669.38	2026-05-13
711	OTHER	Testes Procedures With Complication/comorbity	20	13	—	—	$10,773.72	$21,229.00	$16,001.36	2026-05-13
715	OTHER	Other Male Reproductive System O.r. Procedures For Malignancy With Cc/mcc	20	13	—	—	$11,203.06	$22,075.00	$16,639.03	2026-05-13
734	OTHER	Pelvic Evisceration, Radical Hysterectomy And Radical Vulvectomy With Cc/mcc	20	13	—	—	$11,031.02	$21,736.00	$16,383.51	2026-05-13
736	OTHER	Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc	20	13	—	—	$19,727.54	$38,872.00	$29,299.77	2026-05-13
739	OTHER	Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc…	20	13	—	—	$18,352.72	$36,163.00	$27,257.86	2026-05-13
749	OTHER	Other Female Reproductive System O.r. Procedures With Complication/comorbity	20	13	—	—	$12,774.79	$25,172.00	$18,973.40	2026-05-13
790	OTHER	Extreme Immaturity Or Respiratory Distress Syndrome; Neonate	20	13	—	—	$30,450.51	$60,001.00	$45,225.75	2026-05-13
791	OTHER	Prematurity With Major Problems	20	13	—	—	$20,795.83	$40,977.00	$30,886.42	2026-05-13
792	OTHER	Prematurity Without Major Problems	20	13	—	—	$12,547.94	$24,725.00	$18,636.47	2026-05-13
793	OTHER	Full Term Neonate With Major Problems	20	13	—	—	$21,362.20	$42,093.00	$31,727.60	2026-05-13
799	OTHER	Splenic Procedures With Mcc	20	13	—	—	$25,144.60	$49,546.00	$37,345.30	2026-05-13
800	OTHER	Splenic Procedures With Cc	20	13	—	—	$14,299.83	$28,177.00	$21,238.42	2026-05-13
802	OTHER	Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc	20	13	—	—	$17,205.77	$33,903.00	$27,623.77	2026-05-13
808	OTHER	Major Hematol/immun Diag Exc Sickle Cell Crisis & Coagul With Comorbity	20	13	—	—	$11,114.76	$21,901.00	$16,507.88	2026-05-13
814	OTHER	Reticuloendothelial And Immunity Disorders With Mcc	20	13	—	—	$10,800.11	$21,281.00	$16,040.56	2026-05-13
817	OTHER	Other Antepartum Diagnoses With O.r. Procedure With Comorbity	20	13	—	—	$11,444.12	$22,550.00	$16,997.06	2026-05-13
820	OTHER	Lymphoma And Leukemia With Major O.r. Procedures With Mcc	20	13	—	—	$30,687.00	$60,467.00	$45,577.00	2026-05-13
821	OTHER	Lymphoma And Leukemia With Major O.r. Procedures With Cc	20	13	—	—	$11,327.91	$22,321.00	$16,824.46	2026-05-13
823	OTHER	Lymphoma And Non-acute Leukemia With Other Procedures With Mcc	20	13	—	—	$22,847.14	$45,019.00	$33,933.07	2026-05-13
824	OTHER	Lymphoma And Non-acute Leukemia With Other Procedures With Cc	20	13	—	—	$11,331.97	$22,329.00	$16,830.49	2026-05-13
826	OTHER	Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. …	20	13	—	—	$22,273.16	$43,888.00	$33,994.67	2026-05-13
827	OTHER	Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. …	20	13	—	—	$11,759.79	$23,172.00	$17,465.90	2026-05-13
829	OTHER	Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce…	20	13	—	—	$16,005.54	$31,538.00	$23,771.77	2026-05-13
834	OTHER	Acute Leukemia With Mcc	20	13	—	—	$28,414.92	$55,990.00	$42,202.46	2026-05-13
835	OTHER	Acute Leukemia With Cc	20	13	—	—	$11,345.16	$22,355.00	$16,850.08	2026-05-13
837	OTHER	Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot…	20	13	—	—	$24,139.74	$47,566.00	$35,852.87	2026-05-13
838	OTHER	Chemotherapy With Acute Leukemia As Secondary Diagnosis With Cc Or High Dose Che…	20	13	—	—	$9,908.43	$19,524.00	$15,146.53	2026-05-13
840	OTHER	Lymphoma & Non-acute Leukemia With Comorbity	20	13	—	—	$15,860.39	$31,252.00	$23,802.49	2026-05-13
846	OTHER	Chemotherapy Without Acute Leukemia As Secondary Diagnosis With Mcc	20	13	—	—	$12,403.30	$24,440.00	$18,884.93	2026-05-13
849	OTHER	Radiotherapy	20	13	—	—	$13,658.86	$26,914.00	$20,286.43	2026-05-13
850	OTHER	Acute Leukemia With Other Procedures	12	10	—	—	$63,716.89	$63,716.89	$63,716.89	2026-05-13
853	OTHER	Infectious & Parasitic Diseases With O.r. Procedure With Comorbity	20	13	—	—	$25,371.45	$63,272.20	$37,682.22	2026-05-13
854	OTHER	Infectious & Parasitic Diseases With O.r. Procedure With Complication	20	13	—	—	$10,343.86	$20,382.00	$15,362.93	2026-05-13
856	OTHER	Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc	20	13	—	—	$22,474.13	$44,284.00	$33,469.49	2026-05-13
857	OTHER	Postoperative Or Post-traumatic Infections With O.r. Proc With Complication	20	13	—	—	$10,838.68	$21,357.00	$16,097.84	2026-05-13
867	OTHER	Other Infectious & Parasitic Diseases Diagnoses With Comorbity	20	13	—	—	$10,618.42	$20,923.00	$15,770.71	2026-05-13
870	OTHER	Septicemia Or Severe Sepsis With Mv >96 Hours	20	13	—	—	$35,346.87	$84,816.92	$52,497.93	2026-05-13
876	OTHER	O.r. Procedures With Principal Diagnosis Of Mental Illness	12	8	—	—	$18,937.36	$37,315.00	$28,438.06	2026-05-13
886	OTHER	Behavioral And Developmental Disorders	12	8	—	—	$8,534.63	$16,817.00	$15,270.13	2026-05-13
901	OTHER	Wound Debridements For Injuries With Mcc	20	13	—	—	$21,963.58	$43,278.00	$32,620.79	2026-05-13
904	OTHER	Skin Grafts For Injuries With Cc/mcc	20	13	—	—	$16,525.21	$32,562.00	$25,966.74	2026-05-13
907	OTHER	Other O.r. Procedures For Injuries With Comorbity	20	13	—	—	$18,876.46	$37,195.00	$28,249.70	2026-05-13
927	OTHER	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	20	13	—	—	$133,770.40	$263,587.00	$198,678.70	2026-05-13
928	OTHER	Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc	20	13	—	—	$35,117.48	$69,197.00	$52,776.95	2026-05-13
929	OTHER	Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/mcc	20	13	—	—	$16,318.66	$32,155.00	$24,236.83	2026-05-13
933	OTHER	Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft	20	13	—	—	$15,387.40	$30,320.00	$25,106.47	2026-05-13
934	OTHER	Full Thickness Burn Without Skin Graft Or Inhalation Injury	20	13	—	—	$10,619.44	$20,925.00	$16,135.60	2026-05-13
935	OTHER	Non-extensive Burns	20	13	—	—	$10,358.58	$20,411.00	$15,384.79	2026-05-13
939	OTHER	O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc	20	13	—	—	$16,317.65	$32,153.00	$25,646.22	2026-05-13
940	OTHER	O.r. Procedures With Diagnoses Of Other Contact With Health Services With Cc	20	13	—	—	$10,995.50	$21,666.00	$16,883.65	2026-05-13
955	OTHER	Craniotomy For Multiple Significant Trauma	20	13	—	—	$30,907.76	$60,902.00	$48,055.80	2026-05-13
956	OTHER	Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma	20	13	—	—	$19,681.87	$38,782.00	$29,231.94	2026-05-13
957	OTHER	Other O.r. Procedures For Multiple Significant Trauma With Mcc	20	13	—	—	$36,704.94	$72,325.00	$55,694.43	2026-05-13
958	OTHER	Other O.r. Procedures For Multiple Significant Trauma With Cc	20	13	—	—	$20,527.36	$40,448.00	$30,972.35	2026-05-13
959	OTHER	Other O.r. Procedures For Multiple Significant Trauma Without Cc/mcc	20	13	—	—	$12,851.93	$25,324.00	$20,516.56	2026-05-13
963	OTHER	Other Multiple Significant Trauma With Mcc	20	13	—	—	$13,876.57	$27,343.00	$20,609.78	2026-05-13
969	OTHER	HIV With Extensive O.r. Procedures With Mcc	20	13	—	—	$34,878.44	$68,726.00	$51,802.22	2026-05-13
970	OTHER	HIV With Extensive O.r. Procedures Without Mcc	20	13	—	—	$12,202.33	$24,044.00	$18,898.67	2026-05-13
974	OTHER	HIV With Major Related Condition With Comorbity	20	13	—	—	$14,801.24	$29,165.00	$21,983.12	2026-05-13
981	OTHER	Extensive O.r. Procedure Unrelated To Principal Diagnosis With Comorbity	20	13	—	—	$24,057.53	$47,404.00	$35,730.76	2026-05-13
982	OTHER	Extensive O.r. Procedures Unrelated To Principal Diagnosis With Cc	20	13	—	—	$12,616.45	$24,860.00	$18,738.22	2026-05-13
987	OTHER	Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc	20	13	—	—	$17,136.75	$33,767.00	$25,451.88	2026-05-13
C9781	OTHER	Arthroscopy; Shoulder; Surgical; With Implantation Of Subacromial Spacer (e.g.; …	19	12	$2,685.00	$805.50 70% off	$10,455.00	$18,793.79	$18,793.79	2026-05-13

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