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Hospital facility prices. What the hospital charges for the facility side of care — the surgeon’s and anesthesiologist’s fees are billed separately and are not included. How we scope prices →

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Hospital

SAINT ROSE DOMINICAN HOSPITALS - ROSE DE LIMA

Henderson, NV · CCN 290012 · Rates published

9,088 distinct procedures filed
14 distinct payers
295,960 rate rows
2026-02-28 last MRF observed
Data quality

265,987 of 295,960 rate rows are consumer-grade (89.9%)

29,973 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 — reasonRows
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 21,400
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 6,300
template filing: same amount across many unrelated codes — excluded 1,768
per-diem day rate — not a per-procedure price 385
exceeds 10× this hospital's gross charge — excluded from medians 70
below 25% of the Medicare reference for this DRG — likely a mislabeled per-diem; excluded from rankings 22
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 16
placeholder amount (≤ $0.02) — excluded from medians 12
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://www.dignityhealth.org/content/dam/dignity-health/documents/pricing-procedure-spreadsheets-2020/941196203_St-Rose-Dominican-Rose-de-Lima_standardcharges.csv
Discovered viaDiscovered by HANK
Last fetch success · 2026-10-07

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
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 6 $319,668.13 $1,081,528.00 $319,668.13 nat. median
$359,358
0.9× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 6 $243,723.82 $807,811.00 $243,723.82 nat. median
$249,124
1.0× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 6 $208,351.57 $680,322.00 $208,351.57 nat. median
$198,433
1.0× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face Mouth… 8 $4,139.00 $690,698.00 $190,120.80 nat. median
$190,557
1.0× median
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face Mouth And Neck… 8 $4,139.00 $455,382.00 $132,022.94 nat. median
$126,722
1.0× median
14
MS_DRG 		Allogeneic Bone Marrow Transplant 6 $123,841.69 $375,733.00 $123,841.69 nat. median
$110,192
1.1× median
7
MS_DRG 		Lung Transplant 6 $123,579.12 $374,787.00 $123,579.12 nat. median
$117,894
1.0× median
230
MS_DRG 		No Active Code Description 1 $64,648.00 $109,568.00 $109,568.00 nat. median
$12,593
outlier · 8.7×
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 6 $107,274.70 $316,023.00 $107,274.70 nat. median
$103,967
1.0× median
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 6 $106,273.73 $312,415.00 $106,273.73 nat. median
$97,414
1.1× median
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 6 $104,328.27 $305,403.00 $104,328.27 nat. median
$94,964
1.1× median
215
MS_DRG 		Other Heart Assist System Implant 6 $64,648.00 $303,838.00 $103,893.83 nat. median
$93,917
1.1× median
426
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 7 $4,139.00 $300,414.00 $102,943.78 nat. median
$93,270
1.1× median
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 6 $64,648.00 $276,774.00 $96,384.93 nat. median
$90,581
1.1× median
850
MS_DRG 		Acute Leukemia With Other Procedures 6 $92,890.28 $264,179.00 $92,890.28 nat. median
$78,262
1.2× median
231
MS_DRG 		Coronary Bypass With Ptca With Mcc 6 $64,648.00 $243,015.00 $87,018.11 nat. median
$77,043
1.1× median
456
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature Malignancy Infection Or Exte… 6 $16,657.00 $242,880.00 $86,980.71 nat. median
$77,696
1.1× median
429
MS_DRG 		Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 7 $4,139.00 $239,192.00 $85,957.46 nat. median
$78,037
1.1× median
61799
CPT 		Srs Cran Les Complex Addl 3 $286.69 $96,332.00 $84,724.00 nat. median
$1,954
outlier · 43.4×
20
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 6 $83,733.52 $259,793.00 $83,733.52 nat. median
$74,460
1.1× median
10
MS_DRG 		Pancreas Transplant 6 $83,032.52 $228,650.00 $83,032.52 nat. median
$64,903
1.3× median
19
MS_DRG 		Simultaneous Pancreas And Kidney Transplant With Hemodialysis 6 $82,668.89 $227,339.00 $82,668.89 nat. median
$66,660
1.2× median
233
MS_DRG 		Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 6 $64,648.00 $224,159.00 $81,786.47 nat. median
$71,758
1.1× median
219
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 6 $64,648.00 $221,896.00 $81,158.67 nat. median
$72,473
1.1× median
957
MS_DRG 		Other O.r. Procedures For Multiple Significant Trauma With Mcc 6 $78,984.06 $240,556.00 $78,984.06 nat. median
$68,004
1.2× median
61800
CPT 		Apply Srs Headframe Add-on 4 $145.56 $96,332.00 $77,208.50 nat. median
$1,440
outlier · 53.6×
427
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 7 $4,139.00 $203,691.00 $76,107.65 nat. median
$63,648
1.2× median
275
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 6 $61,783.00 $202,667.00 $75,823.59 nat. median
$66,649
1.1× median
870
MS_DRG 		Septicemia Or Severe Sepsis With Mv >96 Hours 6 $74,944.36 $199,499.00 $74,944.36 nat. median
$62,721
1.2× median
955
MS_DRG 		Craniotomy For Multiple Significant Trauma 6 $73,924.29 $220,062.00 $73,924.29 nat. median
$61,711
1.2× median
447
MS_DRG 		Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 6 $72,940.82 $192,277.00 $72,940.82 nat. median
$60,543
1.2× median
928
MS_DRG 		Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 6 $72,735.53 $191,537.00 $72,735.53 nat. median
$61,329
1.2× median
268
MS_DRG 		Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 6 $72,645.62 $191,213.00 $72,645.62 nat. median
$63,896
1.1× median
207
MS_DRG 		Respiratory System Diagnosis With Ventilator Support >96 Hours 8 $4,139.00 $185,466.00 $71,051.07 nat. median
$59,384
1.2× median
217
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 6 $64,648.00 $185,200.00 $70,977.07 nat. median
$62,038
1.1× median
969
MS_DRG 		HIV With Extensive O.r. Procedures With Mcc 6 $69,914.03 $181,368.00 $69,914.03 nat. median
$58,216
1.2× median
63620
CPT 		Srs Spinal Lesion 4 $1,056.67 $96,332.00 $69,693.00 nat. median
$3,813
outlier · 18.3×
63621
CPT 		Srs Spinal Lesion Addl 4 $238.35 $96,332.00 $69,693.00 nat. median
$2,300
outlier · 30.3×
61796
CPT 		Srs Cranial Lesion Simple 4 $958.35 $96,332.00 $69,693.00 nat. median
$3,757
outlier · 18.5×
61798
CPT 		Srs Cranial Lesion Complex 4 $1,308.68 $96,332.00 $69,693.00 nat. median
$3,873
outlier · 18.0×
61797
CPT 		Srs Cran Les Simple Addl 4 $208.05 $96,332.00 $69,693.00 nat. median
$1,495
outlier · 46.6×
DB20HZZ
OTHER 		Cyber Knife Radiosurgery Ip 5 $46,280.00 $91,773.00 $69,026.50 nat. median
$52,036
1.3× median
DB20JZZ
OTHER 		Gamma Knife - Ip 5 $46,280.00 $91,773.00 $69,026.50 nat. median
$51,212
1.3× median
276
MS_DRG 		Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 7 $12,048.00 $177,643.00 $68,880.43 nat. median
$56,686
1.2× median
317
MS_DRG 		Concomitant Left Atrial Appendage Closure And Cardiac Ablation 6 $68,816.78 $177,414.00 $68,816.78 nat. median
$57,560
1.2× median
573
MS_DRG 		Skin Graft For Skin Ulcer Or Cellulitis With Mcc 6 $68,592.39 $176,605.00 $68,592.39 nat. median
$58,118
1.2× median
461
MS_DRG 		Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 6 $68,421.32 $175,988.00 $68,421.32 nat. median
$53,342
1.3× median
232
MS_DRG 		Coronary Bypass With Ptca Without Mcc 6 $64,648.00 $175,185.00 $68,198.53 nat. median
$57,804
1.2× median
28
MS_DRG 		Spinal Procedures With Mcc 6 $67,966.19 $195,930.00 $67,966.19 nat. median
$54,505
1.2× median
17
MS_DRG 		Autologous Bone Marrow Transplant Without Cc/mcc 6 $67,619.27 $173,098.00 $67,619.27 nat. median
$50,898
1.3× median

Other procedures at this hospital

Browse this hospital's 9,088 published procedures. Use the slice to choose what to show, then sort or filter any column.

Slice
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
             
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 7 6 — — $243,723.82 $807,811.00 $243,723.82 2026-02-28
10 MS_DRG Pancreas Transplant 14 6 — — $83,032.52 $228,650.00 $83,032.52 2026-02-28
11 MS_DRG Tracheostomy For Face Mouth And Neck Diagnoses Or Laryngectomy With Mcc 14 6 — — $62,526.88 $154,744.00 $62,526.88 2026-02-28
12 MS_DRG Tracheostomy For Face Mouth And Neck Diagnoses Or Laryngectomy With Cc 14 6 — — $52,245.01 $117,686.00 $52,245.01 2026-02-28
14 MS_DRG Allogeneic Bone Marrow Transplant 14 6 — — $123,841.69 $375,733.00 $123,841.69 2026-02-28
140 MS_DRG Major Head And Neck Procedures With Mcc 14 6 — — $53,243.60 $121,285.00 $53,243.60 2026-02-28
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 14 6 — — $67,619.27 $173,098.00 $67,619.27 2026-02-28
163 MS_DRG Major Chest Procedures With Mcc 14 6 — — $56,267.21 $132,183.00 $56,267.21 2026-02-28
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 14 6 — — $50,228.74 $110,419.00 $50,228.74 2026-02-28
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 14 6 — — $67,619.27 $173,098.00 $67,619.27 2026-02-28
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 14 6 — — $319,668.13 $1,081,528.00 $319,668.13 2026-02-28
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 14 6 — — $82,668.89 $227,339.00 $82,668.89 2026-02-28
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 7 6 — — $107,274.70 $316,023.00 $107,274.70 2026-02-28
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 14 6 — — $83,733.52 $259,793.00 $83,733.52 2026-02-28
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 18 8 — — $4,139.00 $185,466.00 $71,051.07 2026-02-28
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 14 6 — — $63,572.41 $178,134.00 $63,572.41 2026-02-28
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 14 6 — — $106,273.73 $312,415.00 $106,273.73 2026-02-28
215 MS_DRG Other Heart Assist System Implant 20 6 — — $64,648.00 $303,838.00 $103,893.83 2026-02-28
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 20 6 — — $64,648.00 $276,774.00 $96,384.93 2026-02-28
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 20 6 — — $64,648.00 $185,200.00 $70,977.07 2026-02-28
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 20 6 — — $64,648.00 $170,614.00 $66,930.21 2026-02-28
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 20 6 — — $64,648.00 $221,896.00 $81,158.67 2026-02-28
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 14 6 — — $47,683.34 $113,778.00 $47,683.34 2026-02-28
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 20 6 — — $61,737.55 $151,899.00 $62,354.93 2026-02-28
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 20 6 — — $56,135.12 $131,707.00 $56,696.48 2026-02-28
228 MS_DRG Other Cardiothoracic Procedures With Mcc 20 6 — — $59,243.87 $142,911.00 $59,836.31 2026-02-28
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 14 6 — — $64,987.14 $183,864.00 $64,987.14 2026-02-28
230 MS_DRG No Active Code Description 6 1 — — $64,648.00 $109,568.00 $109,568.00 2026-02-28
231 MS_DRG Coronary Bypass With Ptca With Mcc 20 6 — — $64,648.00 $243,015.00 $87,018.11 2026-02-28
232 MS_DRG Coronary Bypass With Ptca Without Mcc 20 6 — — $64,648.00 $175,185.00 $68,198.53 2026-02-28
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 20 6 — — $64,648.00 $224,159.00 $81,786.47 2026-02-28
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 20 6 — — $61,924.54 $152,573.00 $62,543.79 2026-02-28
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 20 6 — — $64,648.00 $168,747.00 $66,412.21 2026-02-28
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 20 6 — — $52,311.85 $117,927.00 $52,834.97 2026-02-28
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 14 6 — — $59,670.36 $144,448.00 $59,670.36 2026-02-28
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 14 6 — — $49,842.04 $122,521.00 $49,842.04 2026-02-28
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 14 6 — — $46,582.11 $97,276.00 $46,582.11 2026-02-28
245 MS_DRG Aicd Generator Procedures 18 8 — — $4,139.00 $140,144.00 $58,476.03 2026-02-28
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 14 6 — — $55,177.91 $144,133.00 $55,177.91 2026-02-28
252 MS_DRG Other Vascular Procedures With Mcc 14 6 — — $46,887.65 $98,377.00 $46,887.65 2026-02-28
260 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Mcc 18 8 — — $4,139.00 $97,683.00 $46,695.10 2026-02-28
264 MS_DRG Other Circulatory System O.r. Procedures 14 6 — — $47,402.46 $100,232.00 $47,402.46 2026-02-28
265 MS_DRG Aicd Lead Procedures 14 6 — — $47,976.15 $102,300.00 $47,976.15 2026-02-28
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 14 6 — — $67,260.42 $171,804.00 $67,260.42 2026-02-28
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 14 6 — — $57,027.09 $134,921.00 $57,027.09 2026-02-28
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 14 6 — — $72,645.62 $191,213.00 $72,645.62 2026-02-28
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 14 6 — — $52,698.55 $119,321.00 $52,698.55 2026-02-28
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 14 6 — — $60,435.02 $147,204.00 $60,435.02 2026-02-28
271 MS_DRG Other Major Cardiovascular Procedures With Cc 14 6 — — $46,999.05 $98,779.00 $46,999.05 2026-02-28
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 14 6 — — $50,706.15 $112,140.00 $50,706.15 2026-02-28
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 20 6 — — $61,783.00 $202,667.00 $75,823.59 2026-02-28
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 22 7 — — $12,048.00 $177,643.00 $68,880.43 2026-02-28
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 22 7 — — $12,295.00 $133,407.00 $56,606.97 2026-02-28
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 14 6 — — $59,403.01 $143,485.00 $59,403.01 2026-02-28
28 MS_DRG Spinal Procedures With Mcc 14 6 — — $67,966.19 $195,930.00 $67,966.19 2026-02-28
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 14 6 — — $46,301.23 $108,180.00 $46,301.23 2026-02-28
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face Mouth … 9 8 — — $4,139.00 $690,698.00 $190,120.80 2026-02-28
31 MS_DRG Ventricular Shunt Procedures With Mcc 14 6 — — $52,936.46 $135,055.00 $52,936.46 2026-02-28
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 14 6 — — $68,816.78 $177,414.00 $68,816.78 2026-02-28
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 14 6 — — $54,545.34 $125,977.00 $54,545.34 2026-02-28
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 20 6 — — $33,349.00 $122,151.00 $53,483.90 2026-02-28
326 MS_DRG Stomach Esophageal And Duodenal Procedures With Mcc 14 6 — — $60,005.34 $145,656.00 $60,005.34 2026-02-28
32701 CPT Thorax Stereo Rad Targetw/tx 8 3 — — $212.09 $91,924.00 $47,339.50 2026-02-28
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 14 6 — — $56,129.55 $131,687.00 $56,129.55 2026-02-28
332 MS_DRG Rectal Resection With Mcc 14 6 — — $47,192.40 $99,475.00 $47,192.40 2026-02-28
335 MS_DRG Peritoneal Adhesiolysis With Mcc 14 6 — — $48,423.33 $103,912.00 $48,423.33 2026-02-28
34 MS_DRG Carotid Artery Stent Procedures With Mcc 14 6 — — $50,534.29 $111,520.00 $50,534.29 2026-02-28
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 14 6 — — $53,534.02 $122,332.00 $53,534.02 2026-02-28
38240 CPT Transplt Allo Hct/donor 18 7 — — $212.54 $66,670.18 $65,362.92 2026-02-28
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face Mouth And Neck… 18 8 — — $4,139.00 $455,382.00 $132,022.94 2026-02-28
40 MS_DRG Peripheral Cranial Nerve And Other Nervous System Procedures With Mcc 14 6 — — $49,606.52 $121,567.00 $49,606.52 2026-02-28
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 16 7 — — $4,139.00 $112,194.00 $50,721.27 2026-02-28
405 MS_DRG Pancreas Liver And Shunt Procedures With Mcc 14 6 — — $62,787.86 $155,684.00 $62,787.86 2026-02-28
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 14 6 — — $47,451.80 $100,410.00 $47,451.80 2026-02-28
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 14 6 — — $47,471.69 $100,482.00 $47,471.69 2026-02-28
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 14 6 — — $47,676.18 $101,219.00 $47,676.18 2026-02-28
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 14 6 — — $51,956.18 $116,645.00 $51,956.18 2026-02-28
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 16 7 — — $4,139.00 $300,414.00 $102,943.78 2026-02-28
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 16 7 — — $4,139.00 $203,691.00 $76,107.65 2026-02-28
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 16 7 — — $4,139.00 $157,847.00 $63,387.81 2026-02-28
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 16 7 — — $4,139.00 $239,192.00 $85,957.46 2026-02-28
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 16 7 — — $4,139.00 $156,883.00 $63,120.46 2026-02-28
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 14 6 — — $72,940.82 $192,277.00 $72,940.82 2026-02-28
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 14 6 — — $52,084.28 $117,107.00 $52,084.28 2026-02-28
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 14 6 — — $60,571.08 $147,695.00 $60,571.08 2026-02-28
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature Malignancy Infection Or Exte… 18 6 — — $16,657.00 $242,880.00 $86,980.71 2026-02-28
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature Malignancy Infection Or Exte… 18 6 — — $16,657.00 $164,595.00 $65,260.06 2026-02-28
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature Malignancy Infection Or Exte… 18 6 — — $16,657.00 $123,832.00 $53,950.17 2026-02-28
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 14 6 — — $68,421.32 $175,988.00 $68,421.32 2026-02-28
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 14 6 — — $62,567.46 $154,890.00 $62,567.46 2026-02-28
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 18 8 — — $4,139.00 $146,103.00 $60,129.47 2026-02-28
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 18 8 — — $4,139.00 $98,228.00 $46,846.28 2026-02-28
471 MS_DRG Cervical Spinal Fusion With Mcc 18 6 — — $16,657.00 $156,541.00 $58,241.31 2026-02-28
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 14 6 — — $55,276.58 $128,612.00 $55,276.58 2026-02-28
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 14 6 — — $46,956.08 $110,832.00 $46,956.08 2026-02-28
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip Foot And Femur With Mcc 18 6 — — $16,657.00 $101,841.00 $47,848.84 2026-02-28
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 14 6 — — $47,605.36 $100,964.00 $47,605.36 2026-02-28
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 14 6 — — $104,328.27 $305,403.00 $104,328.27 2026-02-28
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 18 6 — — $16,657.00 $102,782.00 $48,109.83 2026-02-28
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 14 6 — — $68,592.39 $176,605.00 $68,592.39 2026-02-28
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 14 6 — — $47,162.17 $99,366.00 $47,162.17 2026-02-28
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 14 6 — — $62,522.10 $154,726.00 $62,522.10 2026-02-28
6 MS_DRG Liver Transplant Without Mcc 14 6 — — $58,176.86 $139,065.00 $58,176.86 2026-02-28
616 MS_DRG Amputation Of Lower Limb For Endocrine Nutritional And Metabolic Disorders With … 14 6 — — $50,345.71 $110,840.00 $50,345.71 2026-02-28
61796 CPT Srs Cranial Lesion Simple 14 4 — — $958.35 $96,332.00 $69,693.00 2026-02-28
61797 CPT Srs Cran Les Simple Addl 14 4 — — $208.05 $96,332.00 $69,693.00 2026-02-28
61798 CPT Srs Cranial Lesion Complex 14 4 — — $1,308.68 $96,332.00 $69,693.00 2026-02-28
61799 CPT Srs Cran Les Complex Addl 10 3 — — $286.69 $96,332.00 $84,724.00 2026-02-28
61800 CPT Apply Srs Headframe Add-on 12 4 — — $145.56 $96,332.00 $77,208.50 2026-02-28
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine Nutritional And Metabolic Disord… 14 6 — — $49,367.01 $107,313.00 $49,367.01 2026-02-28
628 MS_DRG Other Endocrine Nutritional And Metabolic O.r. Procedures With Mcc 14 6 — — $50,987.83 $113,155.00 $50,987.83 2026-02-28
63620 CPT Srs Spinal Lesion 14 4 — — $1,056.67 $96,332.00 $69,693.00 2026-02-28
63621 CPT Srs Spinal Lesion Addl 14 4 — — $238.35 $96,332.00 $69,693.00 2026-02-28
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 14 6 — — $56,252.09 $132,128.00 $56,252.09 2026-02-28
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 14 6 — — $47,222.64 $99,584.00 $47,222.64 2026-02-28
653 MS_DRG Major Bladder Procedures With Mcc 14 6 — — $63,948.77 $159,868.00 $63,948.77 2026-02-28
665 MS_DRG Prostatectomy With Mcc 14 6 — — $46,913.12 $98,469.00 $46,913.12 2026-02-28
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 14 6 — — $52,928.51 $120,149.00 $52,928.51 2026-02-28
7 MS_DRG Lung Transplant 14 6 — — $123,579.12 $374,787.00 $123,579.12 2026-02-28
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 14 6 — — $50,923.38 $112,922.00 $50,923.38 2026-02-28
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 14 6 — — $51,267.91 $114,164.00 $51,267.91 2026-02-28
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome Neonate 14 6 — — $66,894.40 $170,485.00 $66,894.40 2026-02-28
791 MS_DRG Prematurity With Major Problems 14 6 — — $51,896.50 $116,430.00 $51,896.50 2026-02-28
793 MS_DRG Full Term Neonate With Major Problems 14 6 — — $52,776.53 $119,602.00 $52,776.53 2026-02-28
799 MS_DRG Splenic Procedures With Mcc 14 6 — — $57,425.73 $136,358.00 $57,425.73 2026-02-28
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 14 6 — — $62,886.53 $156,040.00 $62,886.53 2026-02-28
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 14 6 — — $48,116.19 $102,805.00 $48,116.19 2026-02-28
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 14 6 — — $65,919.68 $166,972.00 $65,919.68 2026-02-28
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 14 6 — — $56,826.58 $134,199.00 $56,826.58 2026-02-28
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 14 6 — — $57,590.44 $136,952.00 $57,590.44 2026-02-28
834 MS_DRG Acute Leukemia With Mcc 14 6 — — $63,572.41 $158,512.00 $63,572.41 2026-02-28
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 14 6 — — $59,434.04 $143,596.00 $59,434.04 2026-02-28
850 MS_DRG Acute Leukemia With Other Procedures 14 6 — — $92,890.28 $264,179.00 $92,890.28 2026-02-28
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 14 6 — — $59,387.10 $143,427.00 $59,387.10 2026-02-28
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 14 6 — — $55,490.62 $129,384.00 $55,490.62 2026-02-28
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 14 6 — — $74,944.36 $199,499.00 $74,944.36 2026-02-28
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 14 6 — — $50,859.72 $112,693.00 $50,859.72 2026-02-28
901 MS_DRG Wound Debridements For Injuries With Mcc 14 6 — — $54,845.32 $127,058.00 $54,845.32 2026-02-28
904 MS_DRG Skin Grafts For Injuries With Cc/mcc 14 6 — — $50,314.68 $110,729.00 $50,314.68 2026-02-28
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 14 6 — — $51,290.19 $114,245.00 $51,290.19 2026-02-28
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 14 6 — — $208,351.57 $680,322.00 $208,351.57 2026-02-28
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 14 6 — — $72,735.53 $191,537.00 $72,735.53 2026-02-28
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 14 6 — — $54,020.99 $124,087.00 $54,020.99 2026-02-28
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 14 6 — — $48,624.64 $117,590.00 $48,624.64 2026-02-28
955 MS_DRG Craniotomy For Multiple Significant Trauma 14 6 — — $73,924.29 $220,062.00 $73,924.29 2026-02-28
956 MS_DRG Limb Reattachment Hip And Femur Procedures For Multiple Significant Trauma 14 6 — — $50,006.75 $109,619.00 $50,006.75 2026-02-28
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 14 6 — — $78,984.06 $240,556.00 $78,984.06 2026-02-28
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 14 6 — — $52,293.55 $132,451.00 $52,293.55 2026-02-28
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 14 6 — — $69,914.03 $181,368.00 $69,914.03 2026-02-28
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 14 6 — — $48,114.60 $115,524.00 $48,114.60 2026-02-28
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 14 6 — — $57,418.57 $136,332.00 $57,418.57 2026-02-28
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 14 6 — — $47,462.94 $100,450.00 $47,462.94 2026-02-28
D020DZZ OTHER Cyber Knife Radiosurgery Ip 12 4 — — $46,280.00 $46,280.00 $46,280.00 2026-02-28
D020HZZ OTHER Cyber Knife Radiosurgery Ip 19 5 — — $46,280.00 $91,773.00 $46,280.00 2026-02-28
D020JZZ OTHER Cyber Knife Radiosurgery Ip 19 5 — — $46,280.00 $91,773.00 $46,280.00 2026-02-28
D021DZZ OTHER Cyber Knife Radiosurgery Ip 12 4 — — $46,280.00 $46,280.00 $46,280.00 2026-02-28
D021HZZ OTHER Cyber Knife Radiosurgery Ip 19 5 — — $46,280.00 $91,773.00 $46,280.00 2026-02-28
D021JZZ OTHER Cyber Knife Radiosurgery Ip 19 5 — — $46,280.00 $91,773.00 $46,280.00 2026-02-28
D026DZZ OTHER Cyber Knife Radiosurgery Ip 12 4 — — $46,280.00 $46,280.00 $46,280.00 2026-02-28
D026HZZ OTHER Cyber Knife Radiosurgery Ip 19 5 — — $46,280.00 $91,773.00 $46,280.00 2026-02-28
D026JZZ OTHER Cyber Knife Radiosurgery Ip 19 5 — — $46,280.00 $91,773.00 $46,280.00 2026-02-28
D027DZZ OTHER Cyber Knife Radiosurgery Ip 12 4 — — $46,280.00 $46,280.00 $46,280.00 2026-02-28
D027HZZ OTHER Cyber Knife Radiosurgery Ip 19 5 — — $46,280.00 $91,773.00 $46,280.00 2026-02-28
D027JZZ OTHER Cyber Knife Radiosurgery Ip 19 5 — — $46,280.00 $91,773.00 $46,280.00 2026-02-28
D720DZZ OTHER Cyber Knife Radiosurgery Ip 12 4 — — $46,280.00 $46,280.00 $46,280.00 2026-02-28
D720HZZ OTHER Cyber Knife Radiosurgery Ip 19 5 — — $46,280.00 $91,773.00 $46,280.00 2026-02-28
D720JZZ OTHER Cyber Knife Radiosurgery Ip 19 5 — — $46,280.00 $91,773.00 $46,280.00 2026-02-28
D721DZZ OTHER Cyber Knife Radiosurgery Ip 12 4 — — $46,280.00 $46,280.00 $46,280.00 2026-02-28
D721HZZ OTHER Cyber Knife Radiosurgery Ip 19 5 — — $46,280.00 $91,773.00 $46,280.00 2026-02-28
D721JZZ OTHER Cyber Knife Radiosurgery Ip 19 5 — — $46,280.00 $91,773.00 $46,280.00 2026-02-28
D722DZZ OTHER Cyber Knife Radiosurgery Ip 12 4 — — $46,280.00 $46,280.00 $46,280.00 2026-02-28
D722HZZ OTHER Cyber Knife Radiosurgery Ip 19 5 — — $46,280.00 $91,773.00 $46,280.00 2026-02-28
D722JZZ OTHER Cyber Knife Radiosurgery Ip 19 5 — — $46,280.00 $91,773.00 $46,280.00 2026-02-28
D723DZZ OTHER Cyber Knife Radiosurgery Ip 12 4 — — $46,280.00 $46,280.00 $46,280.00 2026-02-28
D723HZZ OTHER Cyber Knife Radiosurgery Ip 19 5 — — $46,280.00 $91,773.00 $46,280.00 2026-02-28
D723JZZ OTHER Cyber Knife Radiosurgery Ip 19 5 — — $46,280.00 $91,773.00 $46,280.00 2026-02-28
D724DZZ OTHER Cyber Knife Radiosurgery Ip 12 4 — — $46,280.00 $46,280.00 $46,280.00 2026-02-28
D724HZZ OTHER Cyber Knife Radiosurgery Ip 19 5 — — $46,280.00 $91,773.00 $46,280.00 2026-02-28
D724JZZ OTHER Cyber Knife Radiosurgery Ip 19 5 — — $46,280.00 $91,773.00 $46,280.00 2026-02-28
D725DZZ OTHER Cyber Knife Radiosurgery Ip 12 4 — — $46,280.00 $46,280.00 $46,280.00 2026-02-28
D725HZZ OTHER Cyber Knife Radiosurgery Ip 19 5 — — $46,280.00 $91,773.00 $46,280.00 2026-02-28
D725JZZ OTHER Cyber Knife Radiosurgery Ip 19 5 — — $46,280.00 $91,773.00 $46,280.00 2026-02-28
D726DZZ OTHER Cyber Knife Radiosurgery Ip 12 4 — — $46,280.00 $46,280.00 $46,280.00 2026-02-28
D726HZZ OTHER Cyber Knife Radiosurgery Ip 19 5 — — $46,280.00 $91,773.00 $46,280.00 2026-02-28
D726JZZ OTHER Cyber Knife Radiosurgery Ip 19 5 — — $46,280.00 $91,773.00 $46,280.00 2026-02-28
D727DZZ OTHER Cyber Knife Radiosurgery Ip 12 4 — — $46,280.00 $46,280.00 $46,280.00 2026-02-28
D727HZZ OTHER Cyber Knife Radiosurgery Ip 19 5 — — $46,280.00 $91,773.00 $46,280.00 2026-02-28
D727JZZ OTHER Cyber Knife Radiosurgery Ip 19 5 — — $46,280.00 $91,773.00 $46,280.00 2026-02-28
D728DZZ OTHER Cyber Knife Radiosurgery Ip 12 4 — — $46,280.00 $46,280.00 $46,280.00 2026-02-28
D728HZZ OTHER Cyber Knife Radiosurgery Ip 19 5 — — $46,280.00 $91,773.00 $46,280.00 2026-02-28
D728JZZ OTHER Cyber Knife Radiosurgery Ip 19 5 — — $46,280.00 $91,773.00 $46,280.00 2026-02-28
D820DZZ OTHER Cyber Knife Radiosurgery Ip 12 4 — — $46,280.00 $46,280.00 $46,280.00 2026-02-28
D820HZZ OTHER Cyber Knife Radiosurgery Ip 19 5 — — $46,280.00 $91,773.00 $46,280.00 2026-02-28
D820JZZ OTHER Cyber Knife Radiosurgery Ip 19 5 — — $46,280.00 $91,773.00 $46,280.00 2026-02-28
D920DZZ OTHER Cyber Knife Radiosurgery Ip 12 4 — — $46,280.00 $46,280.00 $46,280.00 2026-02-28
D920HZZ OTHER Cyber Knife Radiosurgery Ip 19 5 — — $46,280.00 $91,773.00 $46,280.00 2026-02-28
D920JZZ OTHER Cyber Knife Radiosurgery Ip 19 5 — — $46,280.00 $91,773.00 $46,280.00 2026-02-28
D921DZZ OTHER Cyber Knife Radiosurgery Ip 12 4 — — $46,280.00 $46,280.00 $46,280.00 2026-02-28
D921HZZ OTHER Cyber Knife Radiosurgery Ip 19 5 — — $46,280.00 $91,773.00 $46,280.00 2026-02-28
D921JZZ OTHER Cyber Knife Radiosurgery Ip 19 5 — — $46,280.00 $91,773.00 $46,280.00 2026-02-28
D924DZZ OTHER Cyber Knife Radiosurgery Ip 12 4 — — $46,280.00 $46,280.00 $46,280.00 2026-02-28
D924HZZ OTHER Cyber Knife Radiosurgery Ip 19 5 — — $46,280.00 $91,773.00 $46,280.00 2026-02-28
D924JZZ OTHER Cyber Knife Radiosurgery Ip 19 5 — — $46,280.00 $91,773.00 $46,280.00 2026-02-28
D925DZZ OTHER Cyber Knife Radiosurgery Ip 12 4 — — $46,280.00 $46,280.00 $46,280.00 2026-02-28
D925HZZ OTHER Cyber Knife Radiosurgery Ip 19 5 — — $46,280.00 $91,773.00 $46,280.00 2026-02-28
D925JZZ OTHER Cyber Knife Radiosurgery Ip 19 5 — — $46,280.00 $91,773.00 $46,280.00 2026-02-28
D926DZZ OTHER Cyber Knife Radiosurgery Ip 12 4 — — $46,280.00 $46,280.00 $46,280.00 2026-02-28
D926HZZ OTHER Cyber Knife Radiosurgery Ip 19 5 — — $46,280.00 $91,773.00 $46,280.00 2026-02-28
D926JZZ OTHER Cyber Knife Radiosurgery Ip 19 5 — — $46,280.00 $91,773.00 $46,280.00 2026-02-28
D927DZZ OTHER Cyber Knife Radiosurgery Ip 12 4 — — $46,280.00 $46,280.00 $46,280.00 2026-02-28
D927HZZ OTHER Cyber Knife Radiosurgery Ip 19 5 — — $46,280.00 $91,773.00 $46,280.00 2026-02-28
D927JZZ OTHER Cyber Knife Radiosurgery Ip 19 5 — — $46,280.00 $91,773.00 $46,280.00 2026-02-28
D928DZZ OTHER Cyber Knife Radiosurgery Ip 12 4 — — $46,280.00 $46,280.00 $46,280.00 2026-02-28
D928HZZ OTHER Cyber Knife Radiosurgery Ip 19 5 — — $46,280.00 $91,773.00 $46,280.00 2026-02-28
D928JZZ OTHER Cyber Knife Radiosurgery Ip 19 5 — — $46,280.00 $91,773.00 $46,280.00 2026-02-28
D929DZZ OTHER Cyber Knife Radiosurgery Ip 12 4 — — $46,280.00 $46,280.00 $46,280.00 2026-02-28
D929HZZ OTHER Cyber Knife Radiosurgery Ip 19 5 — — $46,280.00 $91,773.00 $46,280.00 2026-02-28
D929JZZ OTHER Cyber Knife Radiosurgery Ip 19 5 — — $46,280.00 $91,773.00 $46,280.00 2026-02-28
D92BDZZ OTHER Cyber Knife Radiosurgery Ip 12 4 — — $46,280.00 $46,280.00 $46,280.00 2026-02-28
D92BHZZ OTHER Cyber Knife Radiosurgery Ip 19 5 — — $46,280.00 $91,773.00 $46,280.00 2026-02-28
D92BJZZ OTHER Cyber Knife Radiosurgery Ip 19 5 — — $46,280.00 $91,773.00 $46,280.00 2026-02-28
D92CDZZ OTHER Cyber Knife Radiosurgery Ip 12 4 — — $46,280.00 $46,280.00 $46,280.00 2026-02-28
D92CHZZ OTHER Cyber Knife Radiosurgery Ip 19 5 — — $46,280.00 $91,773.00 $46,280.00 2026-02-28
D92CJZZ OTHER Cyber Knife Radiosurgery Ip 19 5 — — $46,280.00 $91,773.00 $46,280.00 2026-02-28
D92DDZZ OTHER Cyber Knife Radiosurgery Ip 12 4 — — $46,280.00 $46,280.00 $46,280.00 2026-02-28
D92DHZZ OTHER Cyber Knife Radiosurgery Ip 19 5 — — $46,280.00 $91,773.00 $46,280.00 2026-02-28
D92DJZZ OTHER Cyber Knife Radiosurgery Ip 19 5 — — $46,280.00 $91,773.00 $46,280.00 2026-02-28
DB20DZZ OTHER Cyber Knife Radiosurgery Ip 12 4 — — $46,280.00 $46,280.00 $46,280.00 2026-02-28
DB20HZZ OTHER Cyber Knife Radiosurgery Ip 18 5 — — $46,280.00 $91,773.00 $69,026.50 2026-02-28
DB20JZZ OTHER Gamma Knife - Ip 18 5 — — $46,280.00 $91,773.00 $69,026.50 2026-02-28
DB21DZZ OTHER Cyber Knife Radiosurgery Ip 12 4 — — $46,280.00 $46,280.00 $46,280.00 2026-02-28
DB21HZZ OTHER Cyber Knife Radiosurgery Ip 19 5 — — $46,280.00 $91,773.00 $46,280.00 2026-02-28
DB21JZZ OTHER Cyber Knife Radiosurgery Ip 19 5 — — $46,280.00 $91,773.00 $46,280.00 2026-02-28
DB22DZZ OTHER Cyber Knife Radiosurgery Ip 12 4 — — $46,280.00 $46,280.00 $46,280.00 2026-02-28
DB22HZZ OTHER Cyber Knife Radiosurgery Ip 19 5 — — $46,280.00 $91,773.00 $46,280.00 2026-02-28
DB22JZZ OTHER Cyber Knife Radiosurgery Ip 19 5 — — $46,280.00 $91,773.00 $46,280.00 2026-02-28
DB25DZZ OTHER Cyber Knife Radiosurgery Ip 12 4 — — $46,280.00 $46,280.00 $46,280.00 2026-02-28
DB25HZZ OTHER Cyber Knife Radiosurgery Ip 19 5 — — $46,280.00 $91,773.00 $46,280.00 2026-02-28
DB25JZZ OTHER Cyber Knife Radiosurgery Ip 19 5 — — $46,280.00 $91,773.00 $46,280.00 2026-02-28
DB26DZZ OTHER Cyber Knife Radiosurgery Ip 12 4 — — $46,280.00 $46,280.00 $46,280.00 2026-02-28
DB26HZZ OTHER Cyber Knife Radiosurgery Ip 19 5 — — $46,280.00 $91,773.00 $46,280.00 2026-02-28
DB26JZZ OTHER Cyber Knife Radiosurgery Ip 19 5 — — $46,280.00 $91,773.00 $46,280.00 2026-02-28
DB27DZZ OTHER Cyber Knife Radiosurgery Ip 12 4 — — $46,280.00 $46,280.00 $46,280.00 2026-02-28
DB27HZZ OTHER Cyber Knife Radiosurgery Ip 19 5 — — $46,280.00 $91,773.00 $46,280.00 2026-02-28
DB27JZZ OTHER Cyber Knife Radiosurgery Ip 19 5 — — $46,280.00 $91,773.00 $46,280.00 2026-02-28
DB28DZZ OTHER Cyber Knife Radiosurgery Ip 12 4 — — $46,280.00 $46,280.00 $46,280.00 2026-02-28
DB28HZZ OTHER Cyber Knife Radiosurgery Ip 19 5 — — $46,280.00 $91,773.00 $46,280.00 2026-02-28
DB28JZZ OTHER Cyber Knife Radiosurgery Ip 19 5 — — $46,280.00 $91,773.00 $46,280.00 2026-02-28
DD20DZZ OTHER Cyber Knife Radiosurgery Ip 12 4 — — $46,280.00 $46,280.00 $46,280.00 2026-02-28
DD20HZZ OTHER Cyber Knife Radiosurgery Ip 19 5 — — $46,280.00 $91,773.00 $46,280.00 2026-02-28
DD20JZZ OTHER Cyber Knife Radiosurgery Ip 19 5 — — $46,280.00 $91,773.00 $46,280.00 2026-02-28
DD21DZZ OTHER Cyber Knife Radiosurgery Ip 12 4 — — $46,280.00 $46,280.00 $46,280.00 2026-02-28
DD21HZZ OTHER Cyber Knife Radiosurgery Ip 19 5 — — $46,280.00 $91,773.00 $46,280.00 2026-02-28
DD21JZZ OTHER Cyber Knife Radiosurgery Ip 19 5 — — $46,280.00 $91,773.00 $46,280.00 2026-02-28
DD22DZZ OTHER Cyber Knife Radiosurgery Ip 12 4 — — $46,280.00 $46,280.00 $46,280.00 2026-02-28
DD22HZZ OTHER Cyber Knife Radiosurgery Ip 19 5 — — $46,280.00 $91,773.00 $46,280.00 2026-02-28
DD22JZZ OTHER Cyber Knife Radiosurgery Ip 19 5 — — $46,280.00 $91,773.00 $46,280.00 2026-02-28
DD23DZZ OTHER Cyber Knife Radiosurgery Ip 12 4 — — $46,280.00 $46,280.00 $46,280.00 2026-02-28
DD23HZZ OTHER Cyber Knife Radiosurgery Ip 19 5 — — $46,280.00 $91,773.00 $46,280.00 2026-02-28
DD23JZZ OTHER Cyber Knife Radiosurgery Ip 19 5 — — $46,280.00 $91,773.00 $46,280.00 2026-02-28
DD24DZZ OTHER Cyber Knife Radiosurgery Ip 12 4 — — $46,280.00 $46,280.00 $46,280.00 2026-02-28
DD24HZZ OTHER Cyber Knife Radiosurgery Ip 19 5 — — $46,280.00 $91,773.00 $46,280.00 2026-02-28
DD24JZZ OTHER Cyber Knife Radiosurgery Ip 19 5 — — $46,280.00 $91,773.00 $46,280.00 2026-02-28
DD25DZZ OTHER Cyber Knife Radiosurgery Ip 12 4 — — $46,280.00 $46,280.00 $46,280.00 2026-02-28
DD25HZZ OTHER Cyber Knife Radiosurgery Ip 19 5 — — $46,280.00 $91,773.00 $46,280.00 2026-02-28
DD25JZZ OTHER Cyber Knife Radiosurgery Ip 19 5 — — $46,280.00 $91,773.00 $46,280.00 2026-02-28
DD27DZZ OTHER Cyber Knife Radiosurgery Ip 12 4 — — $46,280.00 $46,280.00 $46,280.00 2026-02-28
DD27HZZ OTHER Cyber Knife Radiosurgery Ip 19 5 — — $46,280.00 $91,773.00 $46,280.00 2026-02-28
DD27JZZ OTHER Cyber Knife Radiosurgery Ip 19 5 — — $46,280.00 $91,773.00 $46,280.00 2026-02-28
DF20DZZ OTHER Cyber Knife Radiosurgery Ip 12 4 — — $46,280.00 $46,280.00 $46,280.00 2026-02-28
DF20HZZ OTHER Cyber Knife Radiosurgery Ip 19 5 — — $46,280.00 $91,773.00 $46,280.00 2026-02-28
DF20JZZ OTHER Cyber Knife Radiosurgery Ip 19 5 — — $46,280.00 $91,773.00 $46,280.00 2026-02-28
DF21DZZ OTHER Cyber Knife Radiosurgery Ip 12 4 — — $46,280.00 $46,280.00 $46,280.00 2026-02-28
DF21HZZ OTHER Cyber Knife Radiosurgery Ip 19 5 — — $46,280.00 $91,773.00 $46,280.00 2026-02-28
DF21JZZ OTHER Cyber Knife Radiosurgery Ip 19 5 — — $46,280.00 $91,773.00 $46,280.00 2026-02-28
DF22DZZ OTHER Cyber Knife Radiosurgery Ip 12 4 — — $46,280.00 $46,280.00 $46,280.00 2026-02-28
DF22HZZ OTHER Cyber Knife Radiosurgery Ip 19 5 — — $46,280.00 $91,773.00 $46,280.00 2026-02-28
DF22JZZ OTHER Cyber Knife Radiosurgery Ip 19 5 — — $46,280.00 $91,773.00 $46,280.00 2026-02-28
DF23DZZ OTHER Cyber Knife Radiosurgery Ip 12 4 — — $46,280.00 $46,280.00 $46,280.00 2026-02-28
DF23HZZ OTHER Cyber Knife Radiosurgery Ip 19 5 — — $46,280.00 $91,773.00 $46,280.00 2026-02-28
DF23JZZ OTHER Cyber Knife Radiosurgery Ip 19 5 — — $46,280.00 $91,773.00 $46,280.00 2026-02-28
DG20DZZ OTHER Cyber Knife Radiosurgery Ip 12 4 — — $46,280.00 $46,280.00 $46,280.00 2026-02-28
DG20HZZ OTHER Cyber Knife Radiosurgery Ip 19 5 — — $46,280.00 $91,773.00 $46,280.00 2026-02-28
DG20JZZ OTHER Cyber Knife Radiosurgery Ip 19 5 — — $46,280.00 $91,773.00 $46,280.00 2026-02-28
DG21DZZ OTHER Cyber Knife Radiosurgery Ip 12 4 — — $46,280.00 $46,280.00 $46,280.00 2026-02-28
DG21HZZ OTHER Cyber Knife Radiosurgery Ip 19 5 — — $46,280.00 $91,773.00 $46,280.00 2026-02-28
DG21JZZ OTHER Cyber Knife Radiosurgery Ip 19 5 — — $46,280.00 $91,773.00 $46,280.00 2026-02-28
DG22DZZ OTHER Cyber Knife Radiosurgery Ip 12 4 — — $46,280.00 $46,280.00 $46,280.00 2026-02-28
DG22HZZ OTHER Cyber Knife Radiosurgery Ip 19 5 — — $46,280.00 $91,773.00 $46,280.00 2026-02-28
DG22JZZ OTHER Cyber Knife Radiosurgery Ip 19 5 — — $46,280.00 $91,773.00 $46,280.00 2026-02-28
DG24DZZ OTHER Cyber Knife Radiosurgery Ip 12 4 — — $46,280.00 $46,280.00 $46,280.00 2026-02-28
DG24HZZ OTHER Cyber Knife Radiosurgery Ip 19 5 — — $46,280.00 $91,773.00 $46,280.00 2026-02-28
DG24JZZ OTHER Cyber Knife Radiosurgery Ip 19 5 — — $46,280.00 $91,773.00 $46,280.00 2026-02-28
DG25DZZ OTHER Cyber Knife Radiosurgery Ip 12 4 — — $46,280.00 $46,280.00 $46,280.00 2026-02-28
DG25HZZ OTHER Cyber Knife Radiosurgery Ip 19 5 — — $46,280.00 $91,773.00 $46,280.00 2026-02-28
DG25JZZ OTHER Cyber Knife Radiosurgery Ip 19 5 — — $46,280.00 $91,773.00 $46,280.00 2026-02-28
DM20DZZ OTHER Cyber Knife Radiosurgery Ip 12 4 — — $46,280.00 $46,280.00 $46,280.00 2026-02-28
DM20HZZ OTHER Cyber Knife Radiosurgery Ip 19 5 — — $46,280.00 $91,773.00 $46,280.00 2026-02-28
DM20JZZ OTHER Cyber Knife Radiosurgery Ip 19 5 — — $46,280.00 $91,773.00 $46,280.00 2026-02-28
DM21DZZ OTHER Cyber Knife Radiosurgery Ip 12 4 — — $46,280.00 $46,280.00 $46,280.00 2026-02-28
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