|
A9543
|
OTHER
|
Hc Yttrium Y-90 Zevalin Per Tx Dose Up To 40mci
|
54
|
37
|
$94,628.00
|
$9,462.80
90% off
|
$95.27
|
$214,674.14
|
$141,684.93
|
2026-05-09
|
|
209
|
OTHER
|
Complex Aortic Arch Procedures
|
43
|
32
|
$14,422.00
|
$1,442.20
90% off
|
$10,907.50
|
$260,031.32
|
$104,937.37
|
2026-05-09
|
|
23
|
OTHER
|
Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…
|
42
|
26
|
—
|
—
|
$40,538.00
|
$234,192.33
|
$92,606.43
|
2026-05-09
|
|
231
|
OTHER
|
Coronary Bypass With Ptca With Mcc
|
42
|
26
|
—
|
—
|
$18,818.32
|
$221,495.79
|
$82,811.30
|
2026-05-09
|
|
234
|
OTHER
|
Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc
|
42
|
26
|
—
|
—
|
$43,312.69
|
$135,741.96
|
$77,701.74
|
2026-05-09
|
|
233
|
OTHER
|
Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc
|
42
|
26
|
—
|
—
|
$42,997.05
|
$201,421.42
|
$75,140.89
|
2026-05-09
|
|
24
|
OTHER
|
Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…
|
42
|
26
|
—
|
—
|
$31,955.33
|
$370,027.51
|
$67,148.90
|
2026-05-09
|
|
232
|
OTHER
|
Coronary Bypass With Ptca Without Mcc
|
42
|
26
|
—
|
—
|
$25,551.55
|
$162,462.07
|
$59,671.01
|
2026-05-09
|
|
264
|
OTHER
|
Other Circulatory System O.r. Procedures
|
41
|
26
|
—
|
—
|
$26,454.84
|
$83,298.60
|
$53,083.69
|
2026-05-09
|
|
274
|
OTHER
|
Splint Orthopedic Large 20in 19-22in Knee Contact Closure Alternate Strap Foam P…
|
42
|
26
|
$106.45
|
$10.65
90% off
|
$26,761.11
|
$79,928.51
|
$52,297.10
|
2026-05-09
|
|
14
|
OTHER
|
Allogeneic Bone Marrow Transplant
|
40
|
25
|
—
|
—
|
$104,089.26
|
$315,153.31
|
$191,396.23
|
2026-05-09
|
|
219
|
OTHER
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
39
|
25
|
—
|
—
|
$65,612.53
|
$572,962.60
|
$122,605.32
|
2026-05-09
|
|
212
|
OTHER
|
Concomitant Aortic And Mitral Valve Procedures
|
34
|
25
|
—
|
—
|
$29,358.56
|
$249,815.05
|
$100,829.72
|
2026-05-09
|
|
21
|
OTHER
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc
|
40
|
25
|
—
|
—
|
$47,849.56
|
$208,486.48
|
$97,075.33
|
2026-05-09
|
|
11
|
OTHER
|
Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc
|
40
|
25
|
—
|
—
|
$40,860.91
|
$129,549.81
|
$81,886.31
|
2026-05-09
|
|
12
|
OTHER
|
Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc
|
40
|
25
|
—
|
—
|
$31,212.60
|
$110,250.61
|
$66,357.88
|
2026-05-09
|
|
573
|
OTHER
|
Skin Graft For Skin Ulcer Or Cellulitis With Mcc
|
40
|
25
|
—
|
—
|
$14,065.00
|
$150,507.93
|
$63,266.49
|
2026-05-09
|
|
94
|
OTHER
|
Bacterial And Tuberculous Infections Of Nervous System With Mcc
|
40
|
25
|
—
|
—
|
$29,593.29
|
$246,544.75
|
$62,418.75
|
2026-05-09
|
|
22
|
OTHER
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/…
|
40
|
25
|
—
|
—
|
$28,869.98
|
$168,554.76
|
$57,458.12
|
2026-05-09
|
|
463
|
OTHER
|
Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …
|
40
|
25
|
—
|
—
|
$11,721.63
|
$135,338.47
|
$55,091.98
|
2026-05-09
|
|
213
|
OTHER
|
Endovascular Abdominal Aorta With Iliac Branch Procedures
|
34
|
25
|
—
|
—
|
$43,519.28
|
$131,106.90
|
$53,874.12
|
2026-05-09
|
|
461
|
OTHER
|
Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc
|
40
|
25
|
—
|
—
|
$7,781.28
|
$124,762.47
|
$53,398.34
|
2026-05-09
|
|
221
|
OTHER
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
40
|
25
|
—
|
—
|
$15,963.64
|
$121,506.35
|
$48,765.58
|
2026-05-09
|
|
61
|
OTHER
|
Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A…
|
40
|
25
|
—
|
—
|
$23,525.73
|
$99,963.06
|
$48,469.64
|
2026-05-09
|
|
166
|
OTHER
|
Other Respiratory System O.r. Procedures With Mcc
|
38
|
25
|
—
|
—
|
$30,881.90
|
$92,249.26
|
$48,299.91
|
2026-05-09
|
|
1
|
OTHER
|
Heart Transplant Or Implant Of Heart Assist System With Mcc
|
37
|
24
|
—
|
—
|
$234,812.61
|
$696,500.34
|
$276,859.00
|
2026-05-09
|
|
3
|
OTHER
|
Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…
|
38
|
24
|
—
|
—
|
$154,691.32
|
$487,615.01
|
$236,126.75
|
2026-05-09
|
|
215
|
OTHER
|
Other Heart Assist System Implant
|
38
|
24
|
—
|
—
|
$89,668.49
|
$339,832.23
|
$168,128.42
|
2026-05-09
|
|
216
|
OTHER
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
38
|
24
|
—
|
—
|
$84,958.01
|
$258,996.77
|
$144,475.84
|
2026-05-09
|
|
870
|
OTHER
|
Septicemia Or Severe Sepsis With Mv >96 Hours
|
38
|
24
|
—
|
—
|
$52,332.98
|
$166,019.65
|
$109,152.77
|
2026-05-09
|
|
426
|
OTHER
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
31
|
24
|
—
|
—
|
$99,212.10
|
$253,194.44
|
$107,149.06
|
2026-05-09
|
|
266
|
OTHER
|
Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc
|
38
|
24
|
—
|
—
|
$55,334.15
|
$189,654.24
|
$99,417.39
|
2026-05-09
|
|
268
|
OTHER
|
Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc
|
38
|
24
|
—
|
—
|
$56,648.45
|
$176,789.98
|
$97,577.96
|
2026-05-09
|
|
217
|
OTHER
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
38
|
24
|
—
|
—
|
$52,886.87
|
$167,799.76
|
$95,694.37
|
2026-05-09
|
|
457
|
OTHER
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
37
|
24
|
—
|
—
|
$52,961.80
|
$172,594.19
|
$94,240.57
|
2026-05-09
|
|
235
|
OTHER
|
Coronary Bypass Without Cardiac Catheterization With Mcc
|
38
|
24
|
—
|
—
|
$49,118.78
|
$153,218.68
|
$85,832.31
|
2026-05-09
|
|
20
|
OTHER
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc
|
37
|
24
|
—
|
—
|
$67,379.30
|
$274,936.01
|
$84,062.00
|
2026-05-09
|
|
228
|
OTHER
|
Other Cardiothoracic Procedures With Mcc
|
38
|
24
|
—
|
—
|
$44,743.10
|
$173,427.55
|
$83,893.31
|
2026-05-09
|
|
220
|
OTHER
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
38
|
24
|
—
|
—
|
$43,984.69
|
$137,274.17
|
$81,633.91
|
2026-05-09
|
|
267
|
OTHER
|
Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc
|
38
|
24
|
—
|
—
|
$43,069.70
|
$154,226.09
|
$78,512.05
|
2026-05-09
|
|
239
|
OTHER
|
Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc
|
37
|
24
|
—
|
—
|
$39,169.10
|
$124,193.66
|
$77,897.08
|
2026-05-09
|
|
270
|
OTHER
|
Other Major Cardiovascular Procedures With Mcc
|
38
|
24
|
—
|
—
|
$42,206.54
|
$133,487.15
|
$74,539.32
|
2026-05-09
|
|
427
|
OTHER
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
31
|
24
|
—
|
—
|
$65,110.90
|
$190,672.83
|
$70,319.77
|
2026-05-09
|
|
275
|
OTHER
|
Selox 53cm Actv Ster
|
31
|
24
|
$5,322.50
|
$532.25
90% off
|
$59,164.07
|
$163,809.53
|
$68,179.14
|
2026-05-09
|
|
955
|
OTHER
|
Craniotomy For Multiple Significant Trauma
|
37
|
24
|
—
|
—
|
$51,218.68
|
$160,787.45
|
$66,812.98
|
2026-05-09
|
|
317
|
OTHER
|
Concomitant Left Atrial Appendage Closure And Cardiac Ablation
|
32
|
24
|
—
|
—
|
$54,489.63
|
$153,611.64
|
$64,562.85
|
2026-05-09
|
|
853
|
OTHER
|
Infectious And Parasitic Diseases With O.r. Procedures With Mcc
|
38
|
24
|
—
|
—
|
$40,276.06
|
$160,607.49
|
$63,646.46
|
2026-05-09
|
|
236
|
OTHER
|
Coronary Bypass Without Cardiac Catheterization Without Mcc
|
38
|
24
|
—
|
—
|
$33,240.01
|
$103,544.38
|
$62,581.28
|
2026-05-09
|
|
269
|
OTHER
|
Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc
|
38
|
24
|
—
|
—
|
$35,144.42
|
$109,467.53
|
$61,378.82
|
2026-05-09
|
|
97
|
OTHER
|
Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc
|
38
|
24
|
—
|
—
|
$30,566.67
|
$546,671.17
|
$59,144.81
|
2026-05-09
|
|
25
|
OTHER
|
Craniotomy And Endovascular Intracranial Procedures With Mcc
|
38
|
24
|
—
|
—
|
$36,586.98
|
$112,806.23
|
$58,638.27
|
2026-05-09
|
|
276
|
OTHER
|
Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator
|
31
|
24
|
$10.54
|
$1.05
90% off
|
$54,241.85
|
$137,992.02
|
$58,581.20
|
2026-05-09
|
|
428
|
OTHER
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
31
|
24
|
—
|
—
|
$40,867.16
|
$129,156.45
|
$53,840.38
|
2026-05-09
|
|
229
|
OTHER
|
Other Cardiothoracic Procedures Without Mcc
|
38
|
24
|
—
|
—
|
$28,619.78
|
$122,587.60
|
$53,662.10
|
2026-05-09
|
|
260
|
OTHER
|
Cardiac Pacemaker Revision Except Device Replacement With Mcc
|
38
|
24
|
—
|
—
|
$29,194.98
|
$95,453.45
|
$52,500.51
|
2026-05-09
|
|
673
|
OTHER
|
Other Kidney And Urinary Tract Procedures With Mcc
|
38
|
24
|
—
|
—
|
$28,208.56
|
$109,263.00
|
$52,113.57
|
2026-05-09
|
|
652
|
OTHER
|
Kidney Transplant
|
37
|
24
|
—
|
—
|
$25,918.06
|
$406,790.96
|
$51,340.11
|
2026-05-09
|
|
326
|
OTHER
|
Stomach, Esophageal And Duodenal Procedures With Mcc
|
37
|
24
|
—
|
—
|
$42,615.82
|
$138,608.59
|
$49,612.00
|
2026-05-09
|
|
252
|
OTHER
|
Other Vascular Procedures With Mcc
|
38
|
24
|
—
|
—
|
$27,048.64
|
$85,967.45
|
$47,849.33
|
2026-05-09
|
|
329
|
OTHER
|
Major Small And Large Bowel Procedures With Mcc
|
38
|
24
|
—
|
—
|
$9,735.62
|
$131,667.48
|
$47,288.62
|
2026-05-09
|
|
18
|
OTHER
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
31
|
23
|
—
|
—
|
$304,062.04
|
$992,055.74
|
$410,890.92
|
2026-05-09
|
|
927
|
OTHER
|
Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft
|
58
|
23
|
—
|
—
|
$1.62
|
$484,836.03
|
$192,803.06
|
2026-05-09
|
|
4
|
OTHER
|
Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…
|
36
|
23
|
—
|
—
|
$96,621.50
|
$318,213.75
|
$172,234.94
|
2026-05-09
|
|
7
|
OTHER
|
Lung Transplant
|
36
|
23
|
—
|
—
|
$94,278.05
|
$297,510.12
|
$162,028.16
|
2026-05-09
|
|
2
|
OTHER
|
Heart Transplant Or Implant Of Heart Assist System Without Mcc
|
36
|
23
|
—
|
—
|
$101,997.52
|
$353,983.44
|
$154,130.52
|
2026-05-09
|
|
5
|
OTHER
|
Liver Transplant With Mcc Or Intestinal Transplant
|
36
|
23
|
—
|
—
|
$83,273.53
|
$397,994.00
|
$132,295.06
|
2026-05-09
|
|
456
|
OTHER
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
36
|
23
|
—
|
—
|
$70,035.51
|
$240,649.77
|
$107,923.85
|
2026-05-09
|
|
957
|
OTHER
|
Other O.r. Procedures For Multiple Significant Trauma With Mcc
|
36
|
23
|
—
|
—
|
$60,445.86
|
$200,387.64
|
$97,911.33
|
2026-05-09
|
|
429
|
OTHER
|
Combined Anterior And Posterior Cervical Spinal Fusion With Mcc
|
30
|
23
|
—
|
—
|
$81,172.35
|
$206,981.14
|
$86,854.41
|
2026-05-09
|
|
850
|
OTHER
|
Acute Leukemia With Other Procedures
|
30
|
23
|
—
|
—
|
$78,032.71
|
$198,938.16
|
$83,494.99
|
2026-05-09
|
|
218
|
OTHER
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
36
|
23
|
—
|
—
|
$41,893.75
|
$155,734.57
|
$82,045.12
|
2026-05-09
|
|
207
|
OTHER
|
Respiratory System Diagnosis With Ventilator Support >96 Hours
|
36
|
23
|
—
|
—
|
$46,644.18
|
$147,826.94
|
$80,562.33
|
2026-05-09
|
|
969
|
OTHER
|
HIV With Extensive O.r. Procedures With Mcc
|
36
|
23
|
—
|
—
|
$47,141.06
|
$147,648.92
|
$78,760.41
|
2026-05-09
|
|
28
|
OTHER
|
Spinal Procedures With Mcc
|
36
|
23
|
—
|
—
|
$47,406.60
|
$141,744.23
|
$77,129.11
|
2026-05-09
|
|
16
|
OTHER
|
Autologous Bone Marrow Transplant With Cc/mcc
|
36
|
23
|
—
|
—
|
$53,552.23
|
$172,457.06
|
$76,311.93
|
2026-05-09
|
|
8
|
OTHER
|
Simultaneous Pancreas And Kidney Transplant
|
36
|
23
|
—
|
—
|
$44,203.81
|
$164,816.00
|
$72,157.41
|
2026-05-09
|
|
405
|
OTHER
|
Pancreas, Liver And Shunt Procedures With Mcc
|
36
|
23
|
—
|
—
|
$46,677.59
|
$141,857.63
|
$70,443.70
|
2026-05-09
|
|
10
|
OTHER
|
Pancreas Transplant
|
36
|
23
|
—
|
—
|
$29,467.84
|
$206,724.00
|
$69,257.01
|
2026-05-09
|
|
19
|
OTHER
|
Simultaneous Pancreas And Kidney Transplant With Hemodialysis
|
31
|
23
|
—
|
—
|
$54,264.27
|
$160,894.01
|
$68,219.06
|
2026-05-09
|
|
466
|
OTHER
|
Revision Of Hip Or Knee Replacement With Mcc
|
36
|
23
|
—
|
—
|
$43,537.51
|
$134,845.31
|
$67,055.94
|
2026-05-09
|
|
653
|
OTHER
|
Major Bladder Procedures With Mcc
|
36
|
23
|
—
|
—
|
$44,386.26
|
$144,755.91
|
$66,940.93
|
2026-05-09
|
|
17
|
OTHER
|
Autologous Bone Marrow Transplant Without Cc/mcc
|
36
|
23
|
—
|
—
|
$39,344.22
|
$122,729.03
|
$65,721.03
|
2026-05-09
|
|
928
|
OTHER
|
Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc
|
58
|
23
|
—
|
—
|
$1.73
|
$164,781.31
|
$65,022.77
|
2026-05-09
|
|
447
|
OTHER
|
Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall…
|
30
|
23
|
—
|
—
|
$60,295.16
|
$153,499.07
|
$64,515.82
|
2026-05-09
|
|
576
|
OTHER
|
Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc
|
36
|
23
|
—
|
—
|
$41,216.87
|
$128,713.82
|
$63,168.53
|
2026-05-09
|
|
837
|
OTHER
|
Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot…
|
36
|
23
|
—
|
—
|
$43,459.80
|
$141,725.77
|
$61,930.21
|
2026-05-09
|
|
6
|
OTHER
|
Liver Transplant Without Mcc
|
36
|
23
|
—
|
—
|
$38,216.08
|
$397,994.00
|
$59,792.25
|
2026-05-09
|
|
245
|
OTHER
|
Aicd Generator Procedures
|
36
|
23
|
—
|
—
|
$41,290.46
|
$132,179.10
|
$58,838.90
|
2026-05-09
|
|
31
|
OTHER
|
Ventricular Shunt Procedures With Mcc
|
36
|
23
|
—
|
—
|
$35,563.91
|
$110,311.44
|
$57,792.30
|
2026-05-09
|
|
430
|
OTHER
|
Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc
|
30
|
23
|
—
|
—
|
$52,094.06
|
$132,489.90
|
$55,740.64
|
2026-05-09
|
|
790
|
OTHER
|
Extreme Immaturity Or Respiratory Distress Syndrome, Neonate
|
58
|
23
|
—
|
—
|
$0.12
|
$144,684.70
|
$53,944.37
|
2026-05-09
|
|
458
|
OTHER
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
36
|
23
|
—
|
—
|
$37,794.80
|
$135,056.29
|
$53,857.59
|
2026-05-09
|
|
278
|
OTHER
|
Bone Substitute 5cc (pick This To Document Serial And Lot # From Kit 402.202 Mm …
|
30
|
23
|
$0.11
|
$9.58
|
$50,292.42
|
$127,874.54
|
$53,812.88
|
2026-05-09
|
|
820
|
OTHER
|
Lymphoma And Leukemia With Major O.r. Procedures With Mcc
|
58
|
23
|
—
|
—
|
$25.64
|
$143,561.26
|
$53,235.06
|
2026-05-09
|
|
450
|
OTHER
|
Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically …
|
30
|
23
|
—
|
—
|
$48,170.62
|
$122,439.03
|
$51,542.57
|
2026-05-09
|
|
1142
|
OTHER
|
Supprelin La Implant
|
28
|
23
|
—
|
—
|
$6,458.14
|
$148,687.03
|
$50,801.40
|
2026-05-09
|
|
802
|
OTHER
|
Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc
|
36
|
23
|
—
|
—
|
$30,209.09
|
$91,528.32
|
$50,026.71
|
2026-05-09
|
|
40
|
OTHER
|
Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc
|
36
|
23
|
—
|
—
|
$32,238.12
|
$103,594.49
|
$49,878.13
|
2026-05-09
|
|
834
|
OTHER
|
Acute Leukemia With Mcc
|
58
|
23
|
—
|
—
|
$104.53
|
$145,251.70
|
$49,856.21
|
2026-05-09
|
|
956
|
OTHER
|
Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma
|
36
|
23
|
—
|
—
|
$31,350.26
|
$99,786.37
|
$48,623.21
|
2026-05-09
|
|
876
|
OTHER
|
O.r. Procedures With Principal Diagnosis Of Mental Illness
|
36
|
23
|
—
|
—
|
$26,564.80
|
$88,789.89
|
$48,108.13
|
2026-05-09
|
|
518
|
OTHER
|
Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost…
|
36
|
23
|
—
|
—
|
$29,195.78
|
$85,858.49
|
$47,403.66
|
2026-05-09
|
|
495
|
OTHER
|
Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit…
|
36
|
23
|
—
|
—
|
$29,602.25
|
$91,307.78
|
$46,868.65
|
2026-05-09
|
|
904
|
OTHER
|
Skin Grafts For Injuries With Cc/mcc
|
36
|
23
|
—
|
—
|
$30,312.53
|
$85,076.07
|
$46,856.08
|
2026-05-09
|
|
9194
|
OTHER
|
Tisagenlecleucel Car-pos T
|
24
|
21
|
—
|
—
|
$555,210.52
|
$1,735,032.86
|
$595,694.62
|
2026-05-09
|
|
9498
|
OTHER
|
Ciltacabtagene Car-pos T
|
24
|
21
|
—
|
—
|
$553,039.35
|
$1,728,247.97
|
$593,365.14
|
2026-05-09
|
|
9422
|
OTHER
|
Idecabtagene Vicleucel Car
|
24
|
21
|
—
|
—
|
$552,477.17
|
$1,726,491.15
|
$592,761.96
|
2026-05-09
|
|
9413
|
OTHER
|
Lisocabtagene Mara Car Pos T
|
24
|
21
|
—
|
—
|
$542,130.81
|
$1,694,158.78
|
$581,661.18
|
2026-05-09
|
|
9035
|
OTHER
|
Axicabtagene Ciloleucel Car+
|
24
|
21
|
—
|
—
|
$513,519.96
|
$1,604,749.88
|
$550,964.13
|
2026-05-09
|
|
9391
|
OTHER
|
Brexucabtagene Car Pos T
|
24
|
21
|
—
|
—
|
$483,172.29
|
$1,509,913.40
|
$518,403.60
|
2026-05-09
|
|
1643
|
OTHER
|
Y90 Ibritumomab, Rx
|
24
|
21
|
—
|
—
|
$68,695.73
|
$214,674.14
|
$73,704.79
|
2026-05-09
|
|
5244
|
OTHER
|
Transplt Allo Hct/donor
|
24
|
21
|
—
|
—
|
$62,050.05
|
$193,906.41
|
$66,574.53
|
2026-05-09
|
|
9273
|
OTHER
|
Sipuleucel-t Auto Cd54+
|
24
|
21
|
—
|
—
|
$57,720.04
|
$180,375.12
|
$61,928.79
|
2026-05-09
|
|
1580
|
OTHER
|
Implt/rpl Crtd Sns Dev Total
|
24
|
21
|
—
|
—
|
$47,212.94
|
$147,540.44
|
$50,655.55
|
2026-05-09
|
|
9141
|
OTHER
|
Inj Onase Abepar-xioi Treat
|
18
|
18
|
—
|
—
|
$2,506,049.97
|
$4,568,320.26
|
$2,649,625.75
|
2026-05-09
|
|
9138
|
OTHER
|
Inj, Hemgenix, Per Tx Dose
|
17
|
17
|
—
|
—
|
$3,853,477.39
|
$4,415,442.85
|
$4,054,179.34
|
2026-05-09
|
|
773
|
OTHER
|
Inj, Beqvez, Per Tx Dose
|
17
|
17
|
—
|
—
|
$3,782,239.10
|
$4,333,815.64
|
$3,979,230.72
|
2026-05-09
|
|
C2621
|
OTHER
|
Generator Pulse Single-chamber Evia Sr
|
9
|
6
|
$31,402.75
|
$3,140.28
90% off
|
$7,230.62
|
$68,867.50
|
$68,867.50
|
2026-05-09
|
|
5834
|
OTHER
|
Neonate W Ecmo
|
6
|
5
|
—
|
—
|
$420,590.95
|
$555,194.02
|
$508,922.03
|
2026-05-09
|
|
5833
|
OTHER
|
Neonate W Ecmo
|
6
|
5
|
—
|
—
|
$366,280.57
|
$483,502.52
|
$443,205.58
|
2026-05-09
|
|
5884
|
OTHER
|
Neonate Bwt <1500g W Major Procedure
|
6
|
5
|
—
|
—
|
$313,706.61
|
$414,103.15
|
$379,590.21
|
2026-05-09
|
|
1614
|
OTHER
|
Cardiac Defibrillator & Heart Assist Implant
|
6
|
5
|
—
|
—
|
$289,349.77
|
$381,951.30
|
$350,118.02
|
2026-05-09
|
|
5832
|
OTHER
|
Neonate W Ecmo
|
6
|
5
|
—
|
—
|
$229,849.89
|
$303,409.48
|
$278,122.17
|
2026-05-09
|
|
6304
|
OTHER
|
Neonate Birthwt >2499g W Major Cardiovascular Procedure
|
6
|
5
|
—
|
—
|
$213,225.90
|
$281,465.27
|
$258,006.88
|
2026-05-09
|
|
8414
|
OTHER
|
Extensive 3rd Degree Burns W Skin Graft
|
6
|
5
|
—
|
—
|
$207,815.81
|
$274,323.77
|
$251,460.58
|
2026-05-09
|
|
5934
|
OTHER
|
Neonate Birthwt 750-999g Without Major Procedure
|
6
|
5
|
—
|
—
|
$206,227.31
|
$272,226.90
|
$249,538.47
|
2026-05-09
|
|
5914
|
OTHER
|
Neonate Birthwt 500-749g Without Major Procedure
|
6
|
5
|
—
|
—
|
$204,169.90
|
$269,511.04
|
$247,048.96
|
2026-05-09
|
|
5883
|
OTHER
|
Neonate Bwt <1500g W Major Procedure
|
6
|
5
|
—
|
—
|
$201,202.54
|
$265,594.04
|
$243,458.42
|
2026-05-09
|
|
6314
|
OTHER
|
Neonate Birthwt >2499g W Other Major Procedure
|
6
|
5
|
—
|
—
|
$200,576.11
|
$264,767.13
|
$242,700.42
|
2026-05-09
|
|
6094
|
OTHER
|
Neonate Bwt 1500-2499g W Major Procedure
|
6
|
5
|
—
|
—
|
$198,282.42
|
$261,739.38
|
$239,925.02
|
2026-05-09
|
|
5882
|
OTHER
|
Neonate Bwt <1500g W Major Procedure
|
6
|
5
|
—
|
—
|
$195,851.87
|
$258,530.98
|
$236,984.02
|
2026-05-09
|
|
5831
|
OTHER
|
Neonate W Ecmo
|
6
|
5
|
—
|
—
|
$186,135.53
|
$245,705.08
|
$225,227.08
|
2026-05-09
|
|
44
|
OTHER
|
Tracheostomy W Mv 96+ Hours W Extensive Procedure Or Ecmo
|
6
|
5
|
—
|
—
|
$183,317.21
|
$241,984.81
|
$221,816.87
|
2026-05-09
|
|
1612
|
OTHER
|
Cardiac Defibrillator & Heart Assist Implant
|
6
|
5
|
—
|
—
|
$175,833.95
|
$232,106.65
|
$212,761.99
|
2026-05-09
|
|
1611
|
OTHER
|
Cardiac Defibrillator & Heart Assist Implant
|
6
|
5
|
—
|
—
|
$167,243.28
|
$220,766.69
|
$202,367.15
|
2026-05-09
|
|
6034
|
OTHER
|
Neonate Birthwt 1000-1249g W Or Without Other Significant Condition
|
6
|
5
|
—
|
—
|
$154,700.14
|
$204,209.33
|
$187,189.74
|
2026-05-09
|
|
6024
|
OTHER
|
Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom
|
6
|
5
|
—
|
—
|
$148,810.28
|
$196,434.51
|
$180,062.91
|
2026-05-09
|
|
5933
|
OTHER
|
Neonate Birthwt 750-999g Without Major Procedure
|
6
|
5
|
—
|
—
|
$138,907.33
|
$183,362.29
|
$168,080.18
|
2026-05-09
|
|
5913
|
OTHER
|
Neonate Birthwt 500-749g Without Major Procedure
|
6
|
5
|
—
|
—
|
$133,670.53
|
$176,449.54
|
$161,743.56
|
2026-05-09
|
|
1604
|
OTHER
|
Major Cardiothoracic Repair Of Heart Anomaly
|
6
|
5
|
—
|
—
|
$131,935.44
|
$174,159.16
|
$159,644.08
|
2026-05-09
|
|
5881
|
OTHER
|
Neonate Bwt <1500g W Major Procedure
|
6
|
5
|
—
|
—
|
$130,263.34
|
$171,951.94
|
$157,620.81
|
2026-05-09
|
|
43
|
OTHER
|
Tracheostomy W Mv 96+ Hours W Extensive Procedure Or Ecmo
|
6
|
5
|
—
|
—
|
$121,161.37
|
$159,937.04
|
$146,607.28
|
2026-05-09
|
|
6074
|
OTHER
|
Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom
|
6
|
5
|
—
|
—
|
$115,678.62
|
$152,699.62
|
$139,973.05
|
2026-05-09
|
|
6303
|
OTHER
|
Neonate Birthwt >2499g W Major Cardiovascular Procedure
|
6
|
5
|
—
|
—
|
$115,504.08
|
$152,469.22
|
$139,761.86
|
2026-05-09
|
|
3034
|
OTHER
|
Dorsal & Lumbar Fusion Proc For Curvature Of Back
|
6
|
5
|
—
|
—
|
$114,605.07
|
$151,282.50
|
$138,674.04
|
2026-05-09
|
|
8424
|
OTHER
|
Burns With Skin Graft Except Extensive 3rd Degree Burns
|
6
|
5
|
—
|
—
|
$113,433.35
|
$149,735.79
|
$137,256.24
|
2026-05-09
|
|
1624
|
OTHER
|
Cardiac Valve Procedures W Ami Or Complex Pdx
|
6
|
5
|
—
|
—
|
$112,828.78
|
$148,937.73
|
$136,524.70
|
2026-05-09
|
|
6023
|
OTHER
|
Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom
|
6
|
5
|
—
|
—
|
$112,415.57
|
$148,392.29
|
$136,024.71
|
2026-05-09
|
|
5932
|
OTHER
|
Neonate Birthwt 750-999g Without Major Procedure
|
6
|
5
|
—
|
—
|
$108,003.92
|
$142,568.76
|
$130,686.54
|
2026-05-09
|
|
4404
|
OTHER
|
Kidney Transplant
|
6
|
5
|
—
|
—
|
$106,352.43
|
$140,388.74
|
$128,688.20
|
2026-05-09
|
|
8514
|
OTHER
|
Gender Related Procedures
|
6
|
5
|
—
|
—
|
$99,862.76
|
$131,822.16
|
$120,835.60
|
2026-05-09
|
|
1634
|
OTHER
|
Cardiac Valve Procedures Without Ami Or Complex Pdx
|
6
|
5
|
—
|
—
|
$95,462.04
|
$126,013.06
|
$115,510.65
|
2026-05-09
|
|
8634
|
OTHER
|
Neonatal Aftercare
|
6
|
5
|
—
|
—
|
$92,144.48
|
$121,633.77
|
$111,496.35
|
2026-05-09
|
|
1784
|
OTHER
|
External Heart Assist Systems
|
6
|
5
|
—
|
—
|
$91,724.05
|
$121,078.79
|
$110,987.62
|
2026-05-09
|
|
1654
|
OTHER
|
Coronary Bypass W Ami Or Complex Pdx
|
6
|
5
|
—
|
—
|
$88,422.25
|
$116,720.31
|
$106,992.39
|
2026-05-09
|
|
1674
|
OTHER
|
Other Cardiothoracic & Thoracic Vascular Procedures
|
6
|
5
|
—
|
—
|
$88,258.71
|
$116,504.42
|
$106,794.50
|
2026-05-09
|
|
6114
|
OTHER
|
Neonate Birthwt 1500-1999g W Major Anomaly
|
6
|
5
|
—
|
—
|
$87,735.21
|
$115,813.39
|
$106,161.06
|
2026-05-09
|
|
6022
|
OTHER
|
Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom
|
6
|
5
|
—
|
—
|
$87,210.59
|
$115,120.88
|
$105,526.26
|
2026-05-09
|
|
6073
|
OTHER
|
Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom
|
6
|
5
|
—
|
—
|
$87,049.43
|
$114,908.14
|
$105,331.26
|
2026-05-09
|
|
6093
|
OTHER
|
Neonate Bwt 1500-2499g W Major Procedure
|
6
|
5
|
—
|
—
|
$86,484.80
|
$114,162.81
|
$104,648.04
|
2026-05-09
|
|
6124
|
OTHER
|
Neonate Bwt 1500-1999g W Resp Dist Synd/oth Maj Resp Cond
|
6
|
5
|
—
|
—
|
$84,330.48
|
$111,319.03
|
$102,041.27
|
2026-05-09
|
|
112
|
OTHER
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
6
|
5
|
—
|
—
|
$83,574.41
|
$110,321.00
|
$101,126.43
|
2026-05-09
|
|
3044
|
OTHER
|
Dorsal & Lumbar Fusion Proc Except For Curvature Of Back
|
6
|
5
|
—
|
—
|
$83,242.42
|
$109,882.76
|
$100,724.71
|
2026-05-09
|
|
1834
|
OTHER
|
Percutaneous Structural Cardiac Procedures
|
6
|
5
|
—
|
—
|
$82,001.68
|
$108,244.94
|
$99,223.39
|
2026-05-09
|
|
5912
|
OTHER
|
Neonate Birthwt 500-749g Without Major Procedure
|
6
|
5
|
—
|
—
|
$79,013.72
|
$104,300.74
|
$95,607.92
|
2026-05-09
|
|
1794
|
OTHER
|
Defibrillator Implants
|
6
|
5
|
—
|
—
|
$78,579.92
|
$103,728.10
|
$95,083.01
|
2026-05-09
|
|
3033
|
OTHER
|
Dorsal & Lumbar Fusion Proc For Curvature Of Back
|
6
|
5
|
—
|
—
|
$78,354.57
|
$103,430.63
|
$94,810.33
|
2026-05-09
|
|
6804
|
OTHER
|
Major O.r. Procedures For Lymphatic/hematopoietic/other Neoplasms
|
6
|
5
|
—
|
—
|
$76,792.69
|
$101,368.91
|
$92,920.43
|
2026-05-09
|
|
1623
|
OTHER
|
Cardiac Valve Procedures W Ami Or Complex Pdx
|
6
|
5
|
—
|
—
|
$76,419.50
|
$100,876.28
|
$92,468.86
|
2026-05-09
|
|
6033
|
OTHER
|
Neonate Birthwt 1000-1249g W Or Without Other Significant Condition
|
6
|
5
|
—
|
—
|
$74,700.17
|
$98,606.71
|
$90,388.45
|
2026-05-09
|
|
5891
|
OTHER
|
Neonate Bwt <500g Or Ga <24 Weeks
|
6
|
5
|
—
|
—
|
$74,640.82
|
$98,528.36
|
$90,316.63
|
2026-05-09
|
|
8504
|
OTHER
|
Procedure W Diag Of Rehab, Aftercare Or Oth Contact W Health Service
|
6
|
5
|
—
|
—
|
$73,287.41
|
$96,741.81
|
$88,678.98
|
2026-05-09
|
|
6134
|
OTHER
|
Neonate Birthwt 1500-1999g W Congenital/perinatal Infection
|
6
|
5
|
—
|
—
|
$71,479.58
|
$94,355.42
|
$86,491.48
|
2026-05-09
|
|
1783
|
OTHER
|
External Heart Assist Systems
|
6
|
5
|
—
|
—
|
$70,283.69
|
$92,776.80
|
$85,044.43
|
2026-05-09
|
|
9124
|
OTHER
|
Musculoskeletal & Other Procedures For Multiple Significant Trauma
|
6
|
5
|
—
|
—
|
$70,006.21
|
$92,410.52
|
$84,708.68
|
2026-05-09
|
|
6214
|
OTHER
|
Neonate Bwt 2000-2499g W Major Anomaly
|
6
|
5
|
—
|
—
|
$68,526.74
|
$90,457.57
|
$82,918.49
|
2026-05-09
|
|
8413
|
OTHER
|
Extensive 3rd Degree Burns W Skin Graft
|
6
|
5
|
—
|
—
|
$68,313.51
|
$90,176.10
|
$82,660.48
|
2026-05-09
|
|
214
|
OTHER
|
Craniotomy Except For Trauma
|
6
|
5
|
—
|
—
|
$68,297.75
|
$90,155.29
|
$82,641.40
|
2026-05-09
|
|
1204
|
OTHER
|
Major Respiratory & Chest Procedures
|
6
|
5
|
—
|
—
|
$66,991.56
|
$88,431.08
|
$81,060.90
|
2026-05-09
|
|
4403
|
OTHER
|
Kidney Transplant
|
6
|
5
|
—
|
—
|
$66,457.27
|
$87,725.80
|
$80,414.40
|
2026-05-09
|
|
6814
|
OTHER
|
Other O.r. Procedures For Lymphatic/hematopoietic/other Neoplasms
|
6
|
5
|
—
|
—
|
$65,806.59
|
$86,866.89
|
$79,627.07
|
2026-05-09
|
|
2204
|
OTHER
|
Major Stomach, Esophageal & Duodenal Procedures
|
6
|
5
|
—
|
—
|
$65,785.99
|
$86,839.69
|
$79,602.14
|
2026-05-09
|
|
6313
|
OTHER
|
Neonate Birthwt >2499g W Other Major Procedure
|
6
|
5
|
—
|
—
|
$65,778.70
|
$86,830.07
|
$79,593.33
|
2026-05-09
|
|
6904
|
OTHER
|
Acute Leukemia
|
6
|
5
|
—
|
—
|
$65,304.96
|
$86,204.71
|
$79,020.08
|
2026-05-09
|
|
2604
|
OTHER
|
Major Pancreas, Liver & Shunt Procedures
|
6
|
5
|
—
|
—
|
$65,292.83
|
$86,188.71
|
$79,005.42
|
2026-05-09
|
|
6334
|
OTHER
|
Neonate Birthwt >2499g W Major Anomaly
|
6
|
5
|
—
|
—
|
$64,485.90
|
$85,123.53
|
$78,029.01
|
2026-05-09
|
|
3124
|
OTHER
|
Skin Graft, Except Hand, For Musculoskeletal & Connective Tissue Diagnoses
|
6
|
5
|
—
|
—
|
$64,204.78
|
$84,752.44
|
$77,688.85
|
2026-05-09
|
|
1653
|
OTHER
|
Coronary Bypass W Ami Or Complex Pdx
|
6
|
5
|
—
|
—
|
$63,462.03
|
$83,771.98
|
$76,790.10
|
2026-05-09
|
|
3614
|
OTHER
|
Skin Graft For Skin & Subcutaneous Tissue Diagnoses
|
6
|
5
|
—
|
—
|
$63,361.47
|
$83,639.25
|
$76,668.43
|
2026-05-09
|
|
6072
|
OTHER
|
Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom
|
6
|
5
|
—
|
—
|
$63,331.14
|
$83,599.20
|
$76,631.73
|
2026-05-09
|
|
4414
|
OTHER
|
Major Bladder Procedures
|
6
|
5
|
—
|
—
|
$63,177.26
|
$83,396.08
|
$76,445.54
|
2026-05-09
|
|
6084
|
OTHER
|
Neonate Bwt 1250-1499g W Or Without Other Significant Condition
|
6
|
5
|
—
|
—
|
$63,176.07
|
$83,394.51
|
$76,444.10
|
2026-05-09
|
|
1633
|
OTHER
|
Cardiac Valve Procedures Without Ami Or Complex Pdx
|
6
|
5
|
—
|
—
|
$62,885.28
|
$83,010.65
|
$76,092.23
|
2026-05-09
|
|
1304
|
OTHER
|
Respiratory System Diagnosis W Ventilator Support 96+ Hours
|
6
|
5
|
—
|
—
|
$62,483.00
|
$82,479.63
|
$75,605.46
|
2026-05-09
|
|
1782
|
OTHER
|
External Heart Assist Systems
|
6
|
5
|
—
|
—
|
$62,381.19
|
$82,345.24
|
$75,482.27
|
2026-05-09
|
|
1603
|
OTHER
|
Major Cardiothoracic Repair Of Heart Anomaly
|
6
|
5
|
—
|
—
|
$62,318.19
|
$82,262.09
|
$75,406.05
|
2026-05-09
|
|
6083
|
OTHER
|
Neonate Bwt 1250-1499g W Or Without Other Significant Condition
|
6
|
5
|
—
|
—
|
$61,766.88
|
$81,534.33
|
$74,738.95
|
2026-05-09
|
|
6144
|
OTHER
|
Neonate Bwt 1500-1999g W Or Without Other Significant Condition
|
6
|
5
|
—
|
—
|
$59,862.15
|
$79,020.02
|
$72,434.19
|
2026-05-09
|
|
1622
|
OTHER
|
Cardiac Valve Procedures W Ami Or Complex Pdx
|
6
|
5
|
—
|
—
|
$59,707.08
|
$78,815.33
|
$72,246.56
|
2026-05-09
|
|
2614
|
OTHER
|
Major Biliary Tract Procedures
|
6
|
5
|
—
|
—
|
$59,402.97
|
$78,413.90
|
$71,878.58
|
2026-05-09
|
|
1814
|
OTHER
|
Lower Extremity Arterial Procedures
|
6
|
5
|
—
|
—
|
$58,868.61
|
$77,708.53
|
$71,232.01
|
2026-05-09
|
|
7404
|
OTHER
|
Mental Illness Diagnosis W O.r. Procedure
|
6
|
5
|
—
|
—
|
$58,751.04
|
$77,553.32
|
$71,089.73
|
2026-05-09
|
|
4402
|
OTHER
|
Kidney Transplant
|
6
|
5
|
—
|
—
|
$58,429.97
|
$77,129.50
|
$70,701.24
|
2026-05-09
|
|
1764
|
OTHER
|
Cardiac Pacemaker & Defibrillator Device Replacement
|
6
|
5
|
—
|
—
|
$58,255.50
|
$76,899.19
|
$70,490.12
|
2026-05-09
|
|
4014
|
OTHER
|
Pituitary & Adrenal Procedures
|
6
|
5
|
—
|
—
|
$58,061.61
|
$76,643.26
|
$70,255.51
|
2026-05-09
|
|
5104
|
OTHER
|
Pelvic Evisceration, Radical Hysterectomy & Other Radical GYN Procs
|
6
|
5
|
—
|
—
|
$57,144.39
|
$75,432.49
|
$69,145.66
|
2026-05-09
|
|
1781
|
OTHER
|
External Heart Assist Systems
|
6
|
5
|
—
|
—
|
$57,029.33
|
$75,280.61
|
$69,006.43
|
2026-05-09
|
|
3032
|
OTHER
|
Dorsal & Lumbar Fusion Proc For Curvature Of Back
|
6
|
5
|
—
|
—
|
$56,858.43
|
$75,055.01
|
$68,799.64
|
2026-05-09
|
|
6302
|
OTHER
|
Neonate Birthwt >2499g W Major Cardiovascular Procedure
|
6
|
5
|
—
|
—
|
$56,353.22
|
$74,388.12
|
$68,188.33
|
2026-05-09
|
|
6954
|
OTHER
|
Chemotherapy For Acute Leukemia
|
6
|
5
|
—
|
—
|
$56,170.26
|
$74,146.61
|
$67,966.95
|
2026-05-09
|
|
7924
|
OTHER
|
Extensive O.r. Procedures For Other Complications Of Treatment
|
6
|
5
|
—
|
—
|
$55,885.50
|
$73,770.71
|
$67,622.38
|
2026-05-09
|
|
2304
|
OTHER
|
Major Small Bowel Procedures
|
6
|
5
|
—
|
—
|
$55,353.59
|
$73,068.58
|
$66,978.76
|
2026-05-09
|
|
3214
|
OTHER
|
Cervical Spinal Fusion & Other Back/neck Proc Exc Disc Excis/decomp
|
6
|
5
|
—
|
—
|
$55,000.99
|
$72,603.14
|
$66,552.11
|
2026-05-09
|
|
1793
|
OTHER
|
Defibrillator Implants
|
6
|
5
|
—
|
—
|
$54,844.67
|
$72,396.78
|
$66,362.96
|
2026-05-09
|
|
1833
|
OTHER
|
Percutaneous Structural Cardiac Procedures
|
6
|
5
|
—
|
—
|
$54,773.19
|
$72,302.43
|
$66,276.47
|
2026-05-09
|
|
924
|
OTHER
|
Facial Bone Procedures Except Major Cranial/facial Bone Procedures
|
6
|
5
|
—
|
—
|
$54,618.06
|
$72,097.65
|
$66,088.76
|
2026-05-09
|
|
5892
|
OTHER
|
Neonate Bwt <500g Or Ga <24 Weeks
|
6
|
5
|
—
|
—
|
$54,359.99
|
$71,756.99
|
$65,776.49
|
2026-05-09
|
|
3043
|
OTHER
|
Dorsal & Lumbar Fusion Proc Except For Curvature Of Back
|
6
|
5
|
—
|
—
|
$54,160.08
|
$71,493.10
|
$65,534.59
|
2026-05-09
|
|
2324
|
OTHER
|
Gastric Fundoplication
|
6
|
5
|
—
|
—
|
$53,408.85
|
$70,501.45
|
$64,625.59
|
2026-05-09
|
|
1673
|
OTHER
|
Other Cardiothoracic & Thoracic Vascular Procedures
|
6
|
5
|
—
|
—
|
$53,393.08
|
$70,480.64
|
$64,606.51
|
2026-05-09
|
|
6123
|
OTHER
|
Neonate Bwt 1500-1999g W Resp Dist Synd/oth Maj Resp Cond
|
6
|
5
|
—
|
—
|
$53,036.84
|
$70,010.40
|
$64,175.46
|
2026-05-09
|
|
1663
|
OTHER
|
Coronary Bypass Without Ami Or Complex Pdx
|
6
|
5
|
—
|
—
|
$52,929.01
|
$69,868.05
|
$64,044.98
|
2026-05-09
|
|
1652
|
OTHER
|
Coronary Bypass W Ami Or Complex Pdx
|
6
|
5
|
—
|
—
|
$52,787.25
|
$69,680.93
|
$63,873.46
|
2026-05-09
|
|
6113
|
OTHER
|
Neonate Birthwt 1500-1999g W Major Anomaly
|
6
|
5
|
—
|
—
|
$52,638.21
|
$69,484.19
|
$63,693.11
|
2026-05-09
|
|
4401
|
OTHER
|
Kidney Transplant
|
6
|
5
|
—
|
—
|
$52,391.07
|
$69,157.95
|
$63,394.07
|
2026-05-09
|
|
3254
|
OTHER
|
Non-elective Or Complex Knee Joint Replacement
|
6
|
5
|
—
|
—
|
$51,880.96
|
$68,484.59
|
$62,776.82
|
2026-05-09
|
|
1621
|
OTHER
|
Cardiac Valve Procedures W Ami Or Complex Pdx
|
6
|
5
|
—
|
—
|
$51,847.04
|
$68,439.82
|
$62,735.79
|
2026-05-09
|
|
2644
|
OTHER
|
Other Hepatobiliary, Pancreas & Abdominal Procedures
|
6
|
5
|
—
|
—
|
$51,542.87
|
$68,038.30
|
$62,367.73
|
2026-05-09
|
|
6133
|
OTHER
|
Neonate Birthwt 1500-1999g W Congenital/perinatal Infection
|
6
|
5
|
—
|
—
|
$51,284.80
|
$67,697.63
|
$62,055.46
|
2026-05-09
|
|
4054
|
OTHER
|
Other Procedures For Endocrine, Nutritional & Metabolic Disorders
|
6
|
5
|
—
|
—
|
$50,995.20
|
$67,315.35
|
$61,705.03
|
2026-05-09
|
|
4044
|
OTHER
|
Thyroid, Parathyroid & Thyroglossal Procedures
|
6
|
5
|
—
|
—
|
$50,807.40
|
$67,067.46
|
$61,477.81
|
2026-05-09
|
|
7104
|
OTHER
|
Infectious & Parasitic Diseases Including HIV W O.r. Procedure
|
6
|
5
|
—
|
—
|
$50,734.74
|
$66,971.54
|
$61,389.88
|
2026-05-09
|
|
5124
|
OTHER
|
Uterine & Adnexa Procedures For Non-ovarian & Non-adnexal Malig
|
6
|
5
|
—
|
—
|
$50,711.69
|
$66,941.11
|
$61,361.99
|
2026-05-09
|
|
6514
|
OTHER
|
Other Procedures Of Blood & Blood-forming Organs
|
6
|
5
|
—
|
—
|
$50,572.32
|
$66,757.14
|
$61,193.35
|
2026-05-09
|
|
1754
|
OTHER
|
Percutaneous Coronary Intervention Without Ami
|
6
|
5
|
—
|
—
|
$50,148.25
|
$66,197.36
|
$60,680.22
|
2026-05-09
|
|
1632
|
OTHER
|
Cardiac Valve Procedures Without Ami Or Complex Pdx
|
6
|
5
|
—
|
—
|
$50,147.06
|
$66,195.78
|
$60,678.77
|
2026-05-09
|
|
51
|
OTHER
|
Tracheostomy W Mv 96+ Hours Without Extensive Procedure
|
6
|
5
|
—
|
—
|
$49,902.30
|
$65,872.70
|
$60,382.61
|
2026-05-09
|
|
4034
|
OTHER
|
Procedures For Obesity
|
6
|
5
|
—
|
—
|
$49,676.95
|
$65,575.23
|
$60,109.94
|
2026-05-09
|
|
2314
|
OTHER
|
Major Large Bowel Procedures
|
6
|
5
|
—
|
—
|
$49,254.08
|
$65,017.02
|
$59,598.25
|
2026-05-09
|
|
6092
|
OTHER
|
Neonate Bwt 1500-2499g W Major Procedure
|
6
|
5
|
—
|
—
|
$49,140.14
|
$64,866.62
|
$59,460.39
|
2026-05-09
|
|
8633
|
OTHER
|
Neonatal Aftercare
|
6
|
5
|
—
|
—
|
$49,073.51
|
$64,778.66
|
$59,379.76
|
2026-05-09
|
|
6504
|
OTHER
|
Splenectomy
|
6
|
5
|
—
|
—
|
$48,777.88
|
$64,388.42
|
$59,022.04
|
2026-05-09
|
|
4474
|
OTHER
|
Other Kidney, Urinary Tract & Related Procedures
|
6
|
5
|
—
|
—
|
$48,605.85
|
$64,161.34
|
$58,813.89
|
2026-05-09
|
|
5144
|
OTHER
|
Female Reproductive System Reconstructive Procedures
|
6
|
5
|
—
|
—
|
$48,580.35
|
$64,127.68
|
$58,783.03
|
2026-05-09
|
|
4424
|
OTHER
|
Kidney & Urinary Tract Procedures For Malignancy
|
6
|
5
|
—
|
—
|
$48,404.68
|
$63,895.79
|
$58,570.47
|
2026-05-09
|
|
224
|
OTHER
|
Ventricular Shunt Procedures
|
6
|
5
|
—
|
—
|
$48,063.02
|
$63,444.78
|
$58,157.05
|
2026-05-09
|
|
1303
|
OTHER
|
Respiratory System Diagnosis W Ventilator Support 96+ Hours
|
6
|
5
|
—
|
—
|
$47,796.47
|
$63,092.92
|
$57,834.51
|
2026-05-09
|
|
3031
|
OTHER
|
Dorsal & Lumbar Fusion Proc For Curvature Of Back
|
6
|
5
|
—
|
—
|
$47,772.22
|
$63,060.92
|
$57,805.18
|
2026-05-09
|
|
3094
|
OTHER
|
Other Significant Hip & Femur Surgery
|
6
|
5
|
—
|
—
|
$47,498.39
|
$62,699.45
|
$57,473.83
|
2026-05-09
|
|
6224
|
OTHER
|
Neonate Bwt 2000-2499g W Resp Dist Synd/oth Maj Resp Cond
|
6
|
5
|
—
|
—
|
$47,229.38
|
$62,344.36
|
$57,148.34
|
2026-05-09
|
|
294
|
OTHER
|
Other Percutaneous Intracranial Procedures
|
6
|
5
|
—
|
—
|
$47,157.91
|
$62,250.01
|
$57,061.85
|
2026-05-09
|
|
3134
|
OTHER
|
Knee & Lower Leg Procedures Except Foot
|
6
|
5
|
—
|
—
|
$47,123.93
|
$62,205.15
|
$57,020.74
|
2026-05-09
|
|
2294
|
OTHER
|
Other Digestive System & Abdominal Procedures
|
6
|
5
|
—
|
—
|
$46,955.55
|
$61,982.88
|
$56,816.99
|
2026-05-09
|
|
4804
|
OTHER
|
Major Male Pelvic Procedures
|
6
|
5
|
—
|
—
|
$46,672.04
|
$61,608.65
|
$56,473.95
|
2026-05-09
|
|
6143
|
OTHER
|
Neonate Bwt 1500-1999g W Or Without Other Significant Condition
|
6
|
5
|
—
|
—
|
$46,420.00
|
$61,275.94
|
$56,168.97
|
2026-05-09
|
|
7114
|
OTHER
|
Post-op, Post-trauma, Other Device Infections W O.r. Procedure
|
6
|
5
|
—
|
—
|
$46,266.12
|
$61,072.82
|
$55,982.78
|
2026-05-09
|
|
1831
|
OTHER
|
Percutaneous Structural Cardiac Procedures
|
6
|
5
|
—
|
—
|
$46,194.65
|
$60,978.47
|
$55,896.29
|
2026-05-09
|
|
2244
|
OTHER
|
Peritoneal Adhesiolysis
|
6
|
5
|
—
|
—
|
$46,014.08
|
$60,740.11
|
$55,677.80
|
2026-05-09
|
|
5893
|
OTHER
|
Neonate Bwt <500g Or Ga <24 Weeks
|
6
|
5
|
—
|
—
|
$45,649.36
|
$60,258.67
|
$55,236.49
|
2026-05-09
|
|
3104
|
OTHER
|
Intervertebral Disc Excision & Decompression
|
6
|
5
|
—
|
—
|
$45,462.76
|
$60,012.36
|
$55,010.70
|
2026-05-09
|
|
1651
|
OTHER
|
Coronary Bypass W Ami Or Complex Pdx
|
6
|
5
|
—
|
—
|
$45,460.38
|
$60,009.21
|
$55,007.82
|
2026-05-09
|
|
6254
|
OTHER
|
Neonate Bwt 2000-2499g W Other Significant Condition
|
6
|
5
|
—
|
—
|
$45,399.77
|
$59,929.20
|
$54,934.47
|
2026-05-09
|
|
893
|
OTHER
|
Major Cranial/facial Bone Procedures
|
6
|
5
|
—
|
—
|
$45,379.17
|
$59,902.01
|
$54,909.55
|
2026-05-09
|
|
6234
|
OTHER
|
Neonate Bwt 2000-2499g W Congenital/perinatal Infection
|
6
|
5
|
—
|
—
|
$45,201.05
|
$59,666.89
|
$54,694.02
|
2026-05-09
|
|
1792
|
OTHER
|
Defibrillator Implants
|
6
|
5
|
—
|
—
|
$45,144.08
|
$59,591.69
|
$54,625.09
|
2026-05-09
|
|
1744
|
OTHER
|
Percutaneous Coronary Intervention W Ami
|
6
|
5
|
—
|
—
|
$45,064.13
|
$59,486.15
|
$54,528.35
|
2026-05-09
|
|
1631
|
OTHER
|
Cardiac Valve Procedures Without Ami Or Complex Pdx
|
6
|
5
|
—
|
—
|
$44,886.01
|
$59,251.03
|
$54,312.82
|
2026-05-09
|
|
6091
|
OTHER
|
Neonate Bwt 1500-2499g W Major Procedure
|
6
|
5
|
—
|
—
|
$44,575.81
|
$58,841.55
|
$53,937.47
|
2026-05-09
|
|
4844
|
OTHER
|
Other Male Reproductive System & Related Procedures
|
6
|
5
|
—
|
—
|
$44,488.57
|
$58,726.39
|
$53,831.91
|
2026-05-09
|
|
1693
|
OTHER
|
Major Abdominal Vascular Procedures
|
6
|
5
|
—
|
—
|
$44,438.89
|
$58,660.81
|
$53,771.79
|
2026-05-09
|
|
6082
|
OTHER
|
Neonate Bwt 1250-1499g W Or Without Other Significant Condition
|
6
|
5
|
—
|
—
|
$44,417.10
|
$58,632.05
|
$53,745.43
|
2026-05-09
|
|
3154
|
OTHER
|
Shoulder, Upper Arm & Forearm Procedures Except Joint Replacement
|
6
|
5
|
—
|
—
|
$44,285.02
|
$58,457.69
|
$53,585.60
|
2026-05-09
|
|
3054
|
OTHER
|
Amputation Of Lower Limb Except Toes
|
6
|
5
|
—
|
—
|
$44,074.24
|
$58,179.46
|
$53,330.57
|
2026-05-09
|
|
7934
|
OTHER
|
Moderately Extensive O.r. Procedures For Other Complications Of Treatment
|
6
|
5
|
—
|
—
|
$44,071.79
|
$58,176.23
|
$53,327.60
|
2026-05-09
|
|
2224
|
OTHER
|
Other Stomach, Esophageal & Duodenal Procedures
|
6
|
5
|
—
|
—
|
$43,842.80
|
$57,873.95
|
$53,050.51
|
2026-05-09
|
|
3204
|
OTHER
|
Other Musculoskeletal System & Connective Tissue Procedures
|
6
|
5
|
—
|
—
|
$43,782.19
|
$57,793.94
|
$52,977.18
|
2026-05-09
|
|
984
|
OTHER
|
Other Ear, Nose, Mouth & Throat Procedures
|
6
|
5
|
—
|
—
|
$43,740.99
|
$57,739.56
|
$52,927.32
|
2026-05-09
|
|
1714
|
OTHER
|
Perm Cardiac Pacemaker Implant Without Ami, Heart Failure Or Shock
|
6
|
5
|
—
|
—
|
$43,652.56
|
$57,622.83
|
$52,820.32
|
2026-05-09
|
|
3224
|
OTHER
|
Shoulder & Elbow Joint Replacement
|
6
|
5
|
—
|
—
|
$43,535.05
|
$57,467.71
|
$52,678.13
|
2026-05-09
|
|
2274
|
OTHER
|
Hernia Procedures Except Inguinal, Femoral & Umbilical
|
6
|
5
|
—
|
—
|
$43,440.52
|
$57,342.93
|
$52,563.76
|
2026-05-09
|
|
2234
|
OTHER
|
Other Small & Large Bowel Procedures
|
6
|
5
|
—
|
—
|
$43,289.03
|
$57,142.96
|
$52,380.45
|
2026-05-09
|
|
7524
|
OTHER
|
Disorders Of Personality & Impulse Control
|
6
|
5
|
—
|
—
|
$42,867.41
|
$56,586.41
|
$51,870.29
|
2026-05-09
|
|
7594
|
OTHER
|
Eating Disorders
|
6
|
5
|
—
|
—
|
$42,626.30
|
$56,268.13
|
$51,578.53
|
2026-05-09
|
|
3634
|
OTHER
|
Breast Procedures Except Mastectomy
|
6
|
5
|
—
|
—
|
$42,145.27
|
$55,633.15
|
$50,996.47
|
2026-05-09
|
|
3624
|
OTHER
|
Mastectomy Procedures
|
6
|
5
|
—
|
—
|
$42,091.94
|
$55,562.76
|
$50,931.95
|
2026-05-09
|
|
6344
|
OTHER
|
Neonate, Birthwt >2499g W Resp Dist Synd/oth Maj Resp Cond
|
6
|
5
|
—
|
—
|
$41,827.78
|
$55,214.06
|
$50,612.31
|
2026-05-09
|
|
111
|
OTHER
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
6
|
5
|
—
|
—
|
$41,768.43
|
$55,135.71
|
$50,540.49
|
2026-05-09
|
|
1804
|
OTHER
|
Other Circulatory System Procedures
|
6
|
5
|
—
|
—
|
$41,734.51
|
$55,090.94
|
$50,499.45
|
2026-05-09
|
|
3234
|
OTHER
|
Non-elective Or Complex Hip Joint Replacement
|
6
|
5
|
—
|
—
|
$41,705.43
|
$55,052.56
|
$50,464.27
|
2026-05-09
|
|
6122
|
OTHER
|
Neonate Bwt 1500-1999g W Resp Dist Synd/oth Maj Resp Cond
|
6
|
5
|
—
|
—
|
$41,560.04
|
$54,860.63
|
$50,288.33
|
2026-05-09
|
|
3244
|
OTHER
|
Elective Hip Joint Replacement
|
6
|
5
|
—
|
—
|
$41,377.08
|
$54,619.12
|
$50,066.96
|
2026-05-09
|
|
8423
|
OTHER
|
Burns With Skin Graft Except Extensive 3rd Degree Burns
|
6
|
5
|
—
|
—
|
$40,482.84
|
$53,438.69
|
$48,984.91
|
2026-05-09
|
|
1602
|
OTHER
|
Major Cardiothoracic Repair Of Heart Anomaly
|
6
|
5
|
—
|
—
|
$40,345.92
|
$53,257.96
|
$48,819.24
|
2026-05-09
|
|
1302
|
OTHER
|
Respiratory System Diagnosis W Ventilator Support 96+ Hours
|
6
|
5
|
—
|
—
|
$40,267.16
|
$53,153.99
|
$48,723.93
|
2026-05-09
|
|
4444
|
OTHER
|
Renal Dialysis Access Device Procedure Only
|
6
|
5
|
—
|
—
|
$40,225.96
|
$53,099.61
|
$48,674.08
|
2026-05-09
|
|
1661
|
OTHER
|
Coronary Bypass Without Ami Or Complex Pdx
|
6
|
5
|
—
|
—
|
$40,154.49
|
$53,005.26
|
$48,587.60
|
2026-05-09
|
|
3174
|
OTHER
|
Tendon, Muscle & Other Soft Tissue Procedures
|
6
|
5
|
—
|
—
|
$40,047.84
|
$52,864.48
|
$48,458.56
|
2026-05-09
|
|
1791
|
OTHER
|
Defibrillator Implants
|
6
|
5
|
—
|
—
|
$39,944.84
|
$52,728.52
|
$48,333.92
|
2026-05-09
|
|
4434
|
OTHER
|
Kidney & Urinary Tract Procedures For Nonmalignancy
|
6
|
5
|
—
|
—
|
$39,032.45
|
$51,524.13
|
$47,229.91
|
2026-05-09
|
|
3042
|
OTHER
|
Dorsal & Lumbar Fusion Proc Except For Curvature Of Back
|
6
|
5
|
—
|
—
|
$38,947.66
|
$51,412.21
|
$47,127.32
|
2026-05-09
|