|
41094475
|
OTHER
|
Ch Generator Ans 3609 Genes Xpipg
|
16
|
7
|
$76,380.00
|
$76,380.00
|
$53,466.00
|
$53,466.00
|
$53,466.00
|
2026-05-22
|
|
22653175
|
OTHER
|
Ch Neurostimulator 68,500-68,999.00
|
16
|
7
|
$68,630.00
|
$68,630.00
|
$48,041.00
|
$48,041.00
|
$48,041.00
|
2026-05-22
|
|
41197138
|
OTHER
|
Ch Restore Sensor Ipg
|
16
|
7
|
$67,890.00
|
$67,890.00
|
$47,523.00
|
$47,523.00
|
$47,523.00
|
2026-05-22
|
|
41110933
|
OTHER
|
Ch Spine Orif 65,000.-65,999.99
|
16
|
7
|
$67,080.00
|
$67,080.00
|
$46,956.00
|
$46,956.00
|
$46,956.00
|
2026-05-22
|
|
41110842
|
OTHER
|
Spine Orif 61,000,-61,499.99
|
16
|
7
|
$61,410.00
|
$61,410.00
|
$42,987.00
|
$42,987.00
|
$42,987.00
|
2026-05-22
|
|
41110768
|
OTHER
|
Ch Spine Orif 57,000.-57,499.99
|
16
|
7
|
$56,340.00
|
$56,340.00
|
$39,438.00
|
$39,438.00
|
$39,438.00
|
2026-05-22
|
|
22653350
|
OTHER
|
Ch Orbital Pros Implant
|
16
|
7
|
$49,450.00
|
$49,450.00
|
$36,469.38
|
$36,469.38
|
$36,469.38
|
2026-05-22
|
|
18
|
OTHER
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
40
|
15
|
—
|
—
|
$287,566.71
|
$722,622.13
|
$329,287.43
|
2026-05-22
|
|
002-4
|
OTHER
|
Heart &/or Lung Transplant
|
36
|
9
|
—
|
—
|
$241,357.85
|
$702,927.54
|
$277,867.22
|
2026-05-22
|
|
1
|
OTHER
|
Heart Transplant Or Implant Of Heart Assist System With Mcc
|
40
|
15
|
—
|
—
|
$214,788.23
|
$539,738.15
|
$245,950.10
|
2026-05-22
|
|
927
|
OTHER
|
Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft
|
40
|
15
|
—
|
—
|
$180,890.51
|
$454,557.08
|
$207,134.44
|
2026-05-22
|
|
583-4
|
OTHER
|
Neonate W Ecmo
|
36
|
9
|
—
|
—
|
$178,029.22
|
$517,438.43
|
$204,733.60
|
2026-05-22
|
|
588-4
|
OTHER
|
Neonate Bwt <1500g W Major Procedure
|
36
|
9
|
—
|
—
|
$174,910.86
|
$508,342.96
|
$201,147.49
|
2026-05-22
|
|
588-3
|
OTHER
|
Neonate Bwt <1500g W Major Procedure
|
36
|
9
|
—
|
—
|
$174,910.86
|
$508,342.96
|
$201,147.49
|
2026-05-22
|
|
3
|
OTHER
|
Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…
|
40
|
15
|
—
|
—
|
$163,419.71
|
$410,654.96
|
$187,128.94
|
2026-05-22
|
|
161-4
|
OTHER
|
Cardiac Defibrillator & Heart Assist Implant
|
36
|
9
|
—
|
—
|
$160,038.06
|
$464,962.72
|
$184,043.77
|
2026-05-22
|
|
003-4
|
OTHER
|
Bone Marrow Transplant
|
36
|
9
|
—
|
—
|
$155,407.14
|
$451,455.49
|
$178,718.21
|
2026-05-22
|
|
591-4
|
OTHER
|
Neonate Birthwt 500-749g Without Major Procedure
|
36
|
9
|
—
|
—
|
$134,439.90
|
$390,299.30
|
$154,605.89
|
2026-05-22
|
|
588-1
|
OTHER
|
Neonate Bwt <1500g W Major Procedure
|
36
|
9
|
—
|
—
|
$133,956.44
|
$388,889.15
|
$154,049.90
|
2026-05-22
|
|
588-2
|
OTHER
|
Neonate Bwt <1500g W Major Procedure
|
36
|
9
|
—
|
—
|
$133,956.44
|
$388,889.15
|
$154,049.90
|
2026-05-22
|
|
841-4
|
OTHER
|
Extensive 3rd Degree Burns W Skin Graft
|
36
|
9
|
—
|
—
|
$130,046.58
|
$377,485.07
|
$149,553.57
|
2026-05-22
|
|
004-4
|
OTHER
|
Tracheostomy W Mv 96+ Hours W Extensive Procedure Or Ecmo
|
36
|
9
|
—
|
—
|
$125,444.67
|
$364,062.45
|
$144,261.37
|
2026-05-22
|
|
001-4
|
OTHER
|
Liver Transplant &/or Intestinal Transplant
|
36
|
9
|
—
|
—
|
$121,530.67
|
$352,646.28
|
$139,760.27
|
2026-05-22
|
|
593-4
|
OTHER
|
Neonate Birthwt 750-999g Without Major Procedure
|
36
|
9
|
—
|
—
|
$121,050.65
|
$351,246.21
|
$139,208.25
|
2026-05-22
|
|
609-4
|
OTHER
|
Neonate Bwt 1500-2499g W Major Procedure
|
36
|
9
|
—
|
—
|
$110,886.12
|
$321,598.81
|
$127,519.04
|
2026-05-22
|
|
4
|
OTHER
|
Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…
|
40
|
15
|
—
|
—
|
$107,743.73
|
$270,747.61
|
$123,375.39
|
2026-05-22
|
|
602-4
|
OTHER
|
Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom
|
36
|
9
|
—
|
—
|
$105,066.57
|
$304,624.63
|
$120,826.55
|
2026-05-22
|
|
002-3
|
OTHER
|
Heart &/or Lung Transplant
|
36
|
9
|
—
|
—
|
$104,701.90
|
$303,560.98
|
$120,407.18
|
2026-05-22
|
|
841-3
|
OTHER
|
Extensive 3rd Degree Burns W Skin Graft
|
36
|
9
|
—
|
—
|
$101,760.35
|
$294,981.22
|
$117,024.40
|
2026-05-22
|
|
583-3
|
OTHER
|
Neonate W Ecmo
|
36
|
9
|
—
|
—
|
$101,411.57
|
$293,963.90
|
$116,623.30
|
2026-05-22
|
|
583-2
|
OTHER
|
Neonate W Ecmo
|
36
|
9
|
—
|
—
|
$99,526.74
|
$288,466.33
|
$114,455.75
|
2026-05-22
|
|
583-1
|
OTHER
|
Neonate W Ecmo
|
36
|
9
|
—
|
—
|
$99,526.74
|
$288,466.33
|
$114,455.75
|
2026-05-22
|
|
14
|
OTHER
|
Allogeneic Bone Marrow Transplant
|
40
|
15
|
—
|
—
|
$99,903.52
|
$251,046.08
|
$114,397.71
|
2026-05-22
|
|
7
|
OTHER
|
Lung Transplant
|
40
|
15
|
—
|
—
|
$99,651.89
|
$250,413.76
|
$114,109.57
|
2026-05-22
|
|
603-4
|
OTHER
|
Neonate Birthwt 1000-1249g W Or Without Other Significant Condition
|
36
|
9
|
—
|
—
|
$96,835.21
|
$280,615.82
|
$111,360.49
|
2026-05-22
|
|
005-4
|
OTHER
|
Tracheostomy W Mv 96+ Hours Without Extensive Procedure
|
36
|
9
|
—
|
—
|
$95,866.21
|
$277,789.48
|
$110,246.14
|
2026-05-22
|
|
593-3
|
OTHER
|
Neonate Birthwt 750-999g Without Major Procedure
|
36
|
9
|
—
|
—
|
$94,681.72
|
$274,334.61
|
$108,883.98
|
2026-05-22
|
|
002-2
|
OTHER
|
Heart &/or Lung Transplant
|
36
|
9
|
—
|
—
|
$89,348.39
|
$258,778.64
|
$102,750.65
|
2026-05-22
|
|
607-4
|
OTHER
|
Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom
|
36
|
9
|
—
|
—
|
$85,893.68
|
$248,702.11
|
$98,777.74
|
2026-05-22
|
|
630-4
|
OTHER
|
Neonate Birthwt >2499g W Major Cardiovascular Procedure
|
36
|
9
|
—
|
—
|
$85,091.82
|
$246,363.28
|
$97,855.59
|
2026-05-22
|
|
589-2
|
OTHER
|
Neonate Bwt <500g Or Ga <24 Weeks
|
36
|
9
|
—
|
—
|
$84,466.08
|
$244,538.14
|
$97,135.98
|
2026-05-22
|
|
589-1
|
OTHER
|
Neonate Bwt <500g Or Ga <24 Weeks
|
36
|
9
|
—
|
—
|
$84,466.08
|
$244,538.14
|
$97,135.98
|
2026-05-22
|
|
002-1
|
OTHER
|
Heart &/or Lung Transplant
|
36
|
9
|
—
|
—
|
$84,198.10
|
$243,756.51
|
$96,827.82
|
2026-05-22
|
|
2
|
OTHER
|
Heart Transplant Or Implant Of Heart Assist System Without Mcc
|
40
|
15
|
—
|
—
|
$84,027.14
|
$211,150.57
|
$96,217.96
|
2026-05-22
|
|
212
|
OTHER
|
Concomitant Aortic And Mitral Valve Procedures
|
40
|
15
|
—
|
—
|
$83,067.90
|
$208,740.09
|
$95,119.54
|
2026-05-22
|
|
003-3
|
OTHER
|
Bone Marrow Transplant
|
36
|
9
|
—
|
—
|
$82,284.95
|
$238,176.35
|
$94,627.70
|
2026-05-22
|
|
591-3
|
OTHER
|
Neonate Birthwt 500-749g Without Major Procedure
|
36
|
9
|
—
|
—
|
$82,227.63
|
$238,009.15
|
$94,561.77
|
2026-05-22
|
|
5
|
OTHER
|
Liver Transplant With Mcc Or Intestinal Transplant
|
40
|
15
|
—
|
—
|
$81,203.54
|
$204,055.18
|
$92,984.70
|
2026-05-22
|
|
215
|
OTHER
|
Other Heart Assist System Implant
|
40
|
15
|
—
|
—
|
$80,787.21
|
$203,008.98
|
$92,507.97
|
2026-05-22
|
|
090-4
|
OTHER
|
Major Larynx & Trachea Procedures
|
36
|
9
|
—
|
—
|
$78,191.37
|
$226,236.41
|
$89,920.08
|
2026-05-22
|
|
602-3
|
OTHER
|
Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom
|
36
|
9
|
—
|
—
|
$77,719.65
|
$224,860.50
|
$89,377.60
|
2026-05-22
|
|
593-2
|
OTHER
|
Neonate Birthwt 750-999g Without Major Procedure
|
36
|
9
|
—
|
—
|
$77,581.52
|
$224,457.60
|
$89,218.74
|
2026-05-22
|
|
591-2
|
OTHER
|
Neonate Birthwt 500-749g Without Major Procedure
|
36
|
9
|
—
|
—
|
$76,751.34
|
$222,036.18
|
$88,264.04
|
2026-05-22
|
|
303-4
|
OTHER
|
Dorsal & Lumbar Fusion Proc For Curvature Of Back
|
36
|
9
|
—
|
—
|
$75,871.43
|
$219,469.70
|
$87,252.14
|
2026-05-22
|
|
593-1
|
OTHER
|
Neonate Birthwt 750-999g Without Major Procedure
|
36
|
9
|
—
|
—
|
$75,238.09
|
$217,622.41
|
$86,523.80
|
2026-05-22
|
|
216
|
OTHER
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
40
|
15
|
—
|
—
|
$73,591.33
|
$184,926.56
|
$84,268.10
|
2026-05-22
|
|
631-4
|
OTHER
|
Neonate Birthwt >2499g W Other Major Procedure
|
36
|
9
|
—
|
—
|
$73,239.30
|
$211,792.44
|
$84,225.20
|
2026-05-22
|
|
440-4
|
OTHER
|
Kidney Transplant
|
36
|
9
|
—
|
—
|
$72,346.27
|
$209,187.69
|
$83,198.21
|
2026-05-22
|
|
004-3
|
OTHER
|
Tracheostomy W Mv 96+ Hours W Extensive Procedure Or Ecmo
|
36
|
9
|
—
|
—
|
$70,181.03
|
$202,872.24
|
$80,708.18
|
2026-05-22
|
|
160-4
|
OTHER
|
Major Cardiothoracic Repair Of Heart Anomaly
|
36
|
9
|
—
|
—
|
$69,305.96
|
$200,319.87
|
$79,701.85
|
2026-05-22
|
|
161-3
|
OTHER
|
Cardiac Defibrillator & Heart Assist Implant
|
36
|
9
|
—
|
—
|
$68,585.59
|
$198,218.74
|
$78,873.43
|
2026-05-22
|
|
361-4
|
OTHER
|
Skin Graft For Skin & Subcutaneous Tissue Diagnoses
|
36
|
9
|
—
|
—
|
$66,934.21
|
$193,402.07
|
$76,974.34
|
2026-05-22
|
|
602-2
|
OTHER
|
Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom
|
36
|
9
|
—
|
—
|
$66,129.58
|
$191,055.18
|
$76,049.02
|
2026-05-22
|
|
162-4
|
OTHER
|
Cardiac Valve Procedures W Ami Or Complex Pdx
|
36
|
9
|
—
|
—
|
$65,443.75
|
$189,054.78
|
$75,260.32
|
2026-05-22
|
|
005-3
|
OTHER
|
Tracheostomy W Mv 96+ Hours Without Extensive Procedure
|
36
|
9
|
—
|
—
|
$64,393.94
|
$185,992.74
|
$74,053.03
|
2026-05-22
|
|
231
|
OTHER
|
Coronary Bypass With Ptca With Mcc
|
40
|
15
|
—
|
—
|
$64,614.97
|
$162,370.01
|
$73,989.43
|
2026-05-22
|
|
456
|
OTHER
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
40
|
15
|
—
|
—
|
$64,579.13
|
$162,279.95
|
$73,948.40
|
2026-05-22
|
|
304-4
|
OTHER
|
Dorsal & Lumbar Fusion Proc Except For Curvature Of Back
|
36
|
9
|
—
|
—
|
$64,045.15
|
$184,975.42
|
$73,651.92
|
2026-05-22
|
|
607-3
|
OTHER
|
Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom
|
36
|
9
|
—
|
—
|
$63,816.54
|
$184,308.62
|
$73,389.02
|
2026-05-22
|
|
312-4
|
OTHER
|
Skin Graft, Except Hand, For Musculoskeletal & Connective Tissue Diagnoses
|
36
|
9
|
—
|
—
|
$62,802.65
|
$181,351.33
|
$72,223.04
|
2026-05-22
|
|
603-3
|
OTHER
|
Neonate Birthwt 1000-1249g W Or Without Other Significant Condition
|
36
|
9
|
—
|
—
|
$62,638.27
|
$180,871.88
|
$72,034.01
|
2026-05-22
|
|
681-4
|
OTHER
|
Other O.r. Procedures For Lymphatic/hematopoietic/other Neoplasms
|
36
|
9
|
—
|
—
|
$62,587.85
|
$180,724.82
|
$71,976.02
|
2026-05-22
|
|
680-4
|
OTHER
|
Major O.r. Procedures For Lymphatic/hematopoietic/other Neoplasms
|
36
|
9
|
—
|
—
|
$62,415.87
|
$180,223.21
|
$71,778.26
|
2026-05-22
|
|
591-1
|
OTHER
|
Neonate Birthwt 500-749g Without Major Procedure
|
36
|
9
|
—
|
—
|
$62,022.88
|
$179,076.96
|
$71,326.32
|
2026-05-22
|
|
20
|
OTHER
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc
|
40
|
15
|
—
|
—
|
$61,467.30
|
$154,460.27
|
$70,385.09
|
2026-05-22
|
|
690-4
|
OTHER
|
Acute Leukemia
|
36
|
9
|
—
|
—
|
$61,081.51
|
$176,331.20
|
$70,256.71
|
2026-05-22
|
|
10
|
OTHER
|
Pancreas Transplant
|
40
|
15
|
—
|
—
|
$60,795.52
|
$152,772.17
|
$69,615.85
|
2026-05-22
|
|
842-4
|
OTHER
|
Burns With Skin Graft Except Extensive 3rd Degree Burns
|
36
|
9
|
—
|
—
|
$60,284.48
|
$174,006.47
|
$69,394.10
|
2026-05-22
|
|
19
|
OTHER
|
Simultaneous Pancreas And Kidney Transplant With Hemodialysis
|
40
|
15
|
—
|
—
|
$60,447.05
|
$151,896.50
|
$69,216.82
|
2026-05-22
|
|
233
|
OTHER
|
Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc
|
40
|
15
|
—
|
—
|
$59,601.42
|
$149,771.53
|
$68,248.51
|
2026-05-22
|
|
612-4
|
OTHER
|
Neonate Bwt 1500-1999g W Resp Dist Synd/oth Maj Resp Cond
|
36
|
9
|
—
|
—
|
$59,151.09
|
$170,700.67
|
$68,167.47
|
2026-05-22
|
|
219
|
OTHER
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
40
|
15
|
—
|
—
|
$58,999.79
|
$148,259.71
|
$67,559.59
|
2026-05-22
|
|
405-4
|
OTHER
|
Other Procedures For Endocrine, Nutritional & Metabolic Disorders
|
36
|
9
|
—
|
—
|
$58,560.57
|
$168,978.27
|
$67,528.37
|
2026-05-22
|
|
001-3
|
OTHER
|
Liver Transplant &/or Intestinal Transplant
|
36
|
9
|
—
|
—
|
$58,411.39
|
$168,543.14
|
$67,366.91
|
2026-05-22
|
|
611-4
|
OTHER
|
Neonate Birthwt 1500-1999g W Major Anomaly
|
36
|
9
|
—
|
—
|
$57,356.05
|
$165,464.99
|
$66,224.74
|
2026-05-22
|
|
950-4
|
OTHER
|
Extensive Procedure Unrelated To Principal Diagnosis
|
36
|
9
|
—
|
—
|
$56,669.53
|
$163,462.57
|
$65,481.74
|
2026-05-22
|
|
023-4
|
OTHER
|
Spinal Procedures
|
36
|
9
|
—
|
—
|
$56,447.14
|
$162,813.90
|
$65,241.04
|
2026-05-22
|
|
957
|
OTHER
|
Other O.r. Procedures For Multiple Significant Trauma With Mcc
|
40
|
15
|
—
|
—
|
$56,915.83
|
$143,022.95
|
$65,173.29
|
2026-05-22
|
|
003-2
|
OTHER
|
Bone Marrow Transplant
|
36
|
9
|
—
|
—
|
$54,226.65
|
$156,337.29
|
$62,837.86
|
2026-05-22
|
|
006-4
|
OTHER
|
Pancreas Transplant
|
36
|
9
|
—
|
—
|
$53,386.11
|
$153,885.64
|
$61,928.17
|
2026-05-22
|
|
447-4
|
OTHER
|
Other Kidney, Urinary Tract & Related Procedures
|
36
|
9
|
—
|
—
|
$53,328.78
|
$153,718.44
|
$61,866.12
|
2026-05-22
|
|
850-4
|
OTHER
|
Procedure W Diag Of Rehab, Aftercare Or Oth Contact W Health Service
|
36
|
9
|
—
|
—
|
$53,301.84
|
$153,639.87
|
$61,836.97
|
2026-05-22
|
|
275
|
OTHER
|
Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc
|
40
|
15
|
—
|
—
|
$53,887.11
|
$135,412.13
|
$61,705.16
|
2026-05-22
|
|
912-4
|
OTHER
|
Musculoskeletal & Other Procedures For Multiple Significant Trauma
|
36
|
9
|
—
|
—
|
$52,955.82
|
$152,630.61
|
$61,462.48
|
2026-05-22
|
|
512-4
|
OTHER
|
Uterine & Adnexa Procedures For Non-ovarian & Non-adnexal Malig
|
36
|
9
|
—
|
—
|
$52,450.25
|
$151,155.99
|
$60,915.32
|
2026-05-22
|
|
870
|
OTHER
|
Septicemia Or Severe Sepsis With Mv >96 Hours
|
40
|
15
|
—
|
—
|
$53,044.53
|
$133,294.82
|
$60,740.33
|
2026-05-22
|
|
607-2
|
OTHER
|
Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom
|
36
|
9
|
—
|
—
|
$52,277.59
|
$150,652.37
|
$60,728.44
|
2026-05-22
|
|
260-4
|
OTHER
|
Major Pancreas, Liver & Shunt Procedures
|
36
|
9
|
—
|
—
|
$51,919.13
|
$149,606.84
|
$60,340.49
|
2026-05-22
|
|
695-4
|
OTHER
|
Chemotherapy For Acute Leukemia #
|
36
|
9
|
—
|
—
|
$51,644.94
|
$148,807.09
|
$60,043.74
|
2026-05-22
|
|
092-4
|
OTHER
|
Facial Bone Procedures Except Major Cranial/facial Bone Procedures
|
36
|
9
|
—
|
—
|
$51,414.25
|
$148,134.24
|
$59,794.07
|
2026-05-22
|
|
955
|
OTHER
|
Craniotomy For Multiple Significant Trauma
|
40
|
15
|
—
|
—
|
$52,066.98
|
$130,838.35
|
$59,620.96
|
2026-05-22
|
|
006-3
|
OTHER
|
Pancreas Transplant
|
36
|
9
|
—
|
—
|
$51,143.51
|
$147,344.56
|
$59,501.07
|
2026-05-22
|
|
609-3
|
OTHER
|
Neonate Bwt 1500-2499g W Major Procedure
|
36
|
9
|
—
|
—
|
$50,928.72
|
$146,718.05
|
$59,268.59
|
2026-05-22
|
|
021-4
|
OTHER
|
Craniotomy Except For Trauma
|
36
|
9
|
—
|
—
|
$50,640.71
|
$145,878.00
|
$58,956.89
|
2026-05-22
|
|
004-2
|
OTHER
|
Tracheostomy W Mv 96+ Hours W Extensive Procedure Or Ecmo
|
36
|
9
|
—
|
—
|
$50,276.04
|
$144,814.35
|
$58,562.21
|
2026-05-22
|
|
004-1
|
OTHER
|
Tracheostomy W Mv 96+ Hours W Extensive Procedure Or Ecmo
|
36
|
9
|
—
|
—
|
$50,276.04
|
$144,814.35
|
$58,562.21
|
2026-05-22
|
|
169-4
|
OTHER
|
Major Abdominal Vascular Procedures
|
36
|
9
|
—
|
—
|
$50,236.67
|
$144,699.52
|
$58,519.60
|
2026-05-22
|
|
910-4
|
OTHER
|
Craniotomy For Multiple Significant Trauma
|
36
|
9
|
—
|
—
|
$50,233.91
|
$144,691.46
|
$58,516.62
|
2026-05-22
|
|
608-4
|
OTHER
|
Neonate Bwt 1250-1499g W Or Without Other Significant Condition
|
36
|
9
|
—
|
—
|
$50,233.21
|
$144,689.45
|
$58,515.87
|
2026-05-22
|
|
928
|
OTHER
|
Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc
|
40
|
15
|
—
|
—
|
$50,927.78
|
$127,975.67
|
$58,316.48
|
2026-05-22
|
|
268
|
OTHER
|
Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc
|
40
|
15
|
—
|
—
|
$50,841.62
|
$127,759.15
|
$58,217.82
|
2026-05-22
|
|
220-4
|
OTHER
|
Major Stomach, Esophageal & Duodenal Procedures
|
36
|
9
|
—
|
—
|
$49,579.15
|
$142,781.72
|
$57,807.99
|
2026-05-22
|
|
841-2
|
OTHER
|
Extensive 3rd Degree Burns W Skin Graft
|
36
|
9
|
—
|
—
|
$49,539.10
|
$142,664.88
|
$57,764.64
|
2026-05-22
|
|
165-4
|
OTHER
|
Coronary Bypass W Ami Or Complex Pdx
|
36
|
9
|
—
|
—
|
$49,502.49
|
$142,558.11
|
$57,725.02
|
2026-05-22
|
|
321-4
|
OTHER
|
Cervical Spinal Fusion & Other Back/neck Proc Exc Disc Excis/decomp
|
36
|
9
|
—
|
—
|
$49,416.85
|
$142,308.31
|
$57,632.33
|
2026-05-22
|
|
163-4
|
OTHER
|
Cardiac Valve Procedures Without Ami Or Complex Pdx
|
36
|
9
|
—
|
—
|
$49,298.05
|
$141,961.82
|
$57,503.76
|
2026-05-22
|
|
303-3
|
OTHER
|
Dorsal & Lumbar Fusion Proc For Curvature Of Back
|
36
|
9
|
—
|
—
|
$48,890.56
|
$140,773.26
|
$57,062.74
|
2026-05-22
|
|
401-4
|
OTHER
|
Pituitary & Adrenal Procedures
|
36
|
9
|
—
|
—
|
$48,888.49
|
$140,767.22
|
$57,060.51
|
2026-05-22
|
|
207
|
OTHER
|
Respiratory System Diagnosis With Ventilator Support >96 Hours
|
40
|
15
|
—
|
—
|
$49,313.53
|
$123,919.25
|
$56,468.03
|
2026-05-22
|
|
603-2
|
OTHER
|
Neonate Birthwt 1000-1249g W Or Without Other Significant Condition
|
36
|
9
|
—
|
—
|
$48,272.41
|
$138,970.28
|
$56,393.74
|
2026-05-22
|
|
217
|
OTHER
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
40
|
15
|
—
|
—
|
$49,242.62
|
$123,741.05
|
$56,386.83
|
2026-05-22
|
|
310-4
|
OTHER
|
Intervertebral Disc Excision & Decompression
|
36
|
9
|
—
|
—
|
$47,883.57
|
$137,836.12
|
$55,972.90
|
2026-05-22
|
|
608-3
|
OTHER
|
Neonate Bwt 1250-1499g W Or Without Other Significant Condition
|
36
|
9
|
—
|
—
|
$47,755.11
|
$137,461.42
|
$55,833.87
|
2026-05-22
|
|
089-4
|
OTHER
|
Major Cranial/facial Bone Procedures
|
36
|
9
|
—
|
—
|
$47,720.57
|
$137,360.70
|
$55,796.50
|
2026-05-22
|
|
024-4
|
OTHER
|
Extracranial Vascular Procedures
|
36
|
9
|
—
|
—
|
$47,547.91
|
$136,857.07
|
$55,609.62
|
2026-05-22
|
|
621-4
|
OTHER
|
Neonate Bwt 2000-2499g W Major Anomaly
|
36
|
9
|
—
|
—
|
$47,537.55
|
$136,826.85
|
$55,598.41
|
2026-05-22
|
|
441-4
|
OTHER
|
Major Bladder Procedures
|
36
|
9
|
—
|
—
|
$47,338.63
|
$136,246.68
|
$55,383.13
|
2026-05-22
|
|
969
|
OTHER
|
HIV With Extensive O.r. Procedures With Mcc
|
40
|
15
|
—
|
—
|
$48,223.90
|
$121,181.11
|
$55,220.31
|
2026-05-22
|
|
020-4
|
OTHER
|
Craniotomy For Trauma
|
36
|
9
|
—
|
—
|
$46,832.38
|
$134,770.05
|
$54,835.22
|
2026-05-22
|
|
167-4
|
OTHER
|
Other Cardiothoracic & Thoracic Vascular Procedures
|
36
|
9
|
—
|
—
|
$46,426.26
|
$133,585.52
|
$54,395.70
|
2026-05-22
|
|
003-1
|
OTHER
|
Bone Marrow Transplant
|
36
|
9
|
—
|
—
|
$46,387.59
|
$133,472.71
|
$54,353.83
|
2026-05-22
|
|
181-4
|
OTHER
|
Lower Extremity Arterial Procedures #
|
36
|
9
|
—
|
—
|
$46,324.74
|
$133,289.39
|
$54,285.82
|
2026-05-22
|
|
791-4
|
OTHER
|
O.r. Procedure For Other Complications Of Treatment
|
36
|
9
|
—
|
—
|
$46,284.68
|
$133,172.55
|
$54,242.46
|
2026-05-22
|
|
221-4
|
OTHER
|
Major Small & Large Bowel Procedures
|
36
|
9
|
—
|
—
|
$46,268.10
|
$133,124.20
|
$54,224.52
|
2026-05-22
|
|
276
|
OTHER
|
Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator
|
40
|
15
|
—
|
—
|
$47,233.39
|
$118,692.08
|
$54,086.09
|
2026-05-22
|
|
33240
|
OTHER
|
Insert Pulse Generator
|
2
|
1
|
—
|
—
|
$53,868.00
|
$53,868.00
|
$53,868.00
|
2026-05-22
|
|
33249
|
OTHER
|
Eltrd/insert Pace-defib
|
2
|
1
|
—
|
—
|
$53,868.00
|
$53,868.00
|
$53,868.00
|
2026-05-22
|
|
573
|
OTHER
|
Skin Graft For Skin Ulcer Or Cellulitis With Mcc
|
40
|
15
|
—
|
—
|
$46,957.35
|
$117,998.44
|
$53,770.02
|
2026-05-22
|
|
461
|
OTHER
|
Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc
|
40
|
15
|
—
|
—
|
$46,793.41
|
$117,586.47
|
$53,582.29
|
2026-05-22
|
|
602-1
|
OTHER
|
Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom
|
36
|
9
|
—
|
—
|
$45,469.69
|
$130,795.44
|
$53,360.42
|
2026-05-22
|
|
911-4
|
OTHER
|
Extensive Abdominal/thoracic Procedures For Mult Significant Trauma
|
36
|
9
|
—
|
—
|
$45,453.12
|
$130,747.09
|
$53,342.49
|
2026-05-22
|
|
232
|
OTHER
|
Coronary Bypass With Ptca Without Mcc
|
40
|
15
|
—
|
—
|
$46,579.91
|
$117,049.96
|
$53,337.81
|
2026-05-22
|
|
313-4
|
OTHER
|
Knee & Lower Leg Procedures Except Foot
|
36
|
9
|
—
|
—
|
$45,321.89
|
$130,364.34
|
$53,200.46
|
2026-05-22
|
|
28
|
OTHER
|
Spinal Procedures With Mcc
|
40
|
15
|
—
|
—
|
$46,357.25
|
$116,490.45
|
$53,082.85
|
2026-05-22
|
|
510-4
|
OTHER
|
Pelvic Evisceration, Radical Hysterectomy & Other Radical GYN Procs
|
36
|
9
|
—
|
—
|
$44,893.68
|
$129,115.35
|
$52,737.01
|
2026-05-22
|
|
16
|
OTHER
|
Autologous Bone Marrow Transplant With Cc/mcc
|
40
|
15
|
—
|
—
|
$46,024.80
|
$115,655.03
|
$52,702.16
|
2026-05-22
|
|
17
|
OTHER
|
Autologous Bone Marrow Transplant Without Cc/mcc
|
40
|
15
|
—
|
—
|
$46,024.80
|
$115,655.03
|
$52,702.16
|
2026-05-22
|
|
442-4
|
OTHER
|
Kidney & Urinary Tract Procedures For Malignancy
|
36
|
9
|
—
|
—
|
$44,662.99
|
$128,442.51
|
$52,487.35
|
2026-05-22
|
|
266
|
OTHER
|
Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc
|
40
|
15
|
—
|
—
|
$45,680.90
|
$114,790.86
|
$52,308.37
|
2026-05-22
|
|
612-3
|
OTHER
|
Neonate Bwt 1500-1999g W Resp Dist Synd/oth Maj Resp Cond
|
36
|
9
|
—
|
—
|
$44,435.76
|
$127,779.74
|
$52,241.43
|
2026-05-22
|
|
177-4
|
OTHER
|
Cardiac Pacemaker & Defibrillator Revision Except Device Replacement
|
36
|
9
|
—
|
—
|
$44,377.75
|
$127,610.52
|
$52,178.64
|
2026-05-22
|
|
691-4
|
OTHER
|
Lymphoma, Myeloma & Non-acute Leukemia
|
36
|
9
|
—
|
—
|
$44,365.32
|
$127,574.26
|
$52,165.18
|
2026-05-22
|
|
710-4
|
OTHER
|
Infectious & Parasitic Diseases Including HIV W O.r. Procedure
|
36
|
9
|
—
|
—
|
$44,279.67
|
$127,324.46
|
$52,072.49
|
2026-05-22
|
|
317-4
|
OTHER
|
Tendon, Muscle & Other Soft Tissue Procedures
|
36
|
9
|
—
|
—
|
$44,263.10
|
$127,276.11
|
$52,054.56
|
2026-05-22
|
|
218
|
OTHER
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
40
|
15
|
—
|
—
|
$45,364.46
|
$113,995.67
|
$51,946.02
|
2026-05-22
|
|
305-4
|
OTHER
|
Amputation Of Lower Limb Except Toes
|
36
|
9
|
—
|
—
|
$44,151.21
|
$126,949.76
|
$51,933.46
|
2026-05-22
|
|
790
|
OTHER
|
Extreme Immaturity Or Respiratory Distress Syndrome, Neonate
|
40
|
15
|
—
|
—
|
$45,330.14
|
$113,909.44
|
$51,906.72
|
2026-05-22
|
|
026-4
|
OTHER
|
Other Nervous System & Related Procedures
|
36
|
9
|
—
|
—
|
$43,972.33
|
$126,428.01
|
$51,739.86
|
2026-05-22
|
|
951-4
|
OTHER
|
Moderately Extensive Procedure Unrelated To Principal Diagnosis
|
36
|
9
|
—
|
—
|
$43,966.80
|
$126,411.89
|
$51,733.88
|
2026-05-22
|
|
182-4
|
OTHER
|
Other Peripheral Vascular Procedures #
|
36
|
9
|
—
|
—
|
$43,945.39
|
$126,349.44
|
$51,710.71
|
2026-05-22
|
|
611-3
|
OTHER
|
Neonate Birthwt 1500-1999g W Major Anomaly
|
36
|
9
|
—
|
—
|
$43,902.57
|
$126,224.54
|
$51,664.36
|
2026-05-22
|
|
166-4
|
OTHER
|
Coronary Bypass Without Ami Or Complex Pdx
|
36
|
9
|
—
|
—
|
$43,663.60
|
$125,527.52
|
$51,405.74
|
2026-05-22
|
|
235
|
OTHER
|
Coronary Bypass Without Cardiac Catheterization With Mcc
|
40
|
15
|
—
|
—
|
$44,868.06
|
$112,748.27
|
$51,377.60
|
2026-05-22
|
|
511-4
|
OTHER
|
Uterine & Adnexa Procedures For Ovarian & Adnexal Malignancy
|
36
|
9
|
—
|
—
|
$43,630.45
|
$125,430.83
|
$51,369.85
|
2026-05-22
|
|
444-4
|
OTHER
|
Renal Dialysis Access Device Procedure Only
|
36
|
9
|
—
|
—
|
$43,350.73
|
$124,614.96
|
$51,067.12
|
2026-05-22
|
|
001-1
|
OTHER
|
Liver Transplant &/or Intestinal Transplant
|
36
|
9
|
—
|
—
|
$43,194.64
|
$124,159.68
|
$50,898.19
|
2026-05-22
|
|
001-2
|
OTHER
|
Liver Transplant &/or Intestinal Transplant
|
36
|
9
|
—
|
—
|
$43,194.64
|
$124,159.68
|
$50,898.19
|
2026-05-22
|
|
820
|
OTHER
|
Lymphoma And Leukemia With Major O.r. Procedures With Mcc
|
40
|
15
|
—
|
—
|
$44,396.06
|
$111,562.20
|
$50,837.12
|
2026-05-22
|
|
264-4
|
OTHER
|
Other Hepatobiliary, Pancreas & Abdominal Procedures
|
36
|
9
|
—
|
—
|
$43,134.55
|
$123,984.42
|
$50,833.15
|
2026-05-22
|
|
261-4
|
OTHER
|
Major Biliary Tract Procedures
|
36
|
9
|
—
|
—
|
$43,037.86
|
$123,702.39
|
$50,728.51
|
2026-05-22
|
|
161-2
|
OTHER
|
Cardiac Defibrillator & Heart Assist Implant
|
36
|
9
|
—
|
—
|
$42,948.07
|
$123,440.50
|
$50,631.33
|
2026-05-22
|
|
120-4
|
OTHER
|
Major Respiratory & Chest Procedures
|
36
|
9
|
—
|
—
|
$42,693.90
|
$122,699.17
|
$50,356.26
|
2026-05-22
|
|
130-4
|
OTHER
|
Respiratory System Diagnosis W Ventilator Support 96+ Hours
|
36
|
9
|
—
|
—
|
$42,569.58
|
$122,336.56
|
$50,221.71
|
2026-05-22
|
|
690-3
|
OTHER
|
Acute Leukemia
|
36
|
9
|
—
|
—
|
$42,501.21
|
$122,137.12
|
$50,147.71
|
2026-05-22
|
|
457
|
OTHER
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
40
|
15
|
—
|
—
|
$43,763.93
|
$109,973.73
|
$50,113.28
|
2026-05-22
|
|
121-4
|
OTHER
|
Other Respiratory & Chest Procedures
|
36
|
9
|
—
|
—
|
$42,461.15
|
$122,020.28
|
$50,104.35
|
2026-05-22
|
|
262-4
|
OTHER
|
Cholecystectomy Except Laparoscopic
|
36
|
9
|
—
|
—
|
$42,436.98
|
$121,949.77
|
$50,078.18
|
2026-05-22
|
|
519-4
|
OTHER
|
Uterine & Adnexa Procedures For Leiomyoma
|
36
|
9
|
—
|
—
|
$42,403.83
|
$121,853.08
|
$50,042.31
|
2026-05-22
|
|
607-1
|
OTHER
|
Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom
|
36
|
9
|
—
|
—
|
$42,351.33
|
$121,699.97
|
$49,985.50
|
2026-05-22
|
|
711-4
|
OTHER
|
Post-op, Post-trauma, Other Device Infections W O.r. Procedure
|
36
|
9
|
—
|
—
|
$42,314.73
|
$121,593.21
|
$49,945.88
|
2026-05-22
|
|
23
|
OTHER
|
Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…
|
40
|
15
|
—
|
—
|
$43,502.39
|
$109,316.51
|
$49,813.80
|
2026-05-22
|
|
518-4
|
OTHER
|
Other Female Reproductive System & Related Procedures
|
36
|
9
|
—
|
—
|
$41,914.14
|
$120,424.80
|
$49,512.33
|
2026-05-22
|
|
049-4
|
OTHER
|
Bacterial & Tuberculous Infections Of Nervous System
|
36
|
9
|
—
|
—
|
$41,842.31
|
$120,215.29
|
$49,434.60
|
2026-05-22
|
|
171-4
|
OTHER
|
Perm Cardiac Pacemaker Implant Without Ami, Heart Failure Or Shock
|
36
|
9
|
—
|
—
|
$41,816.76
|
$120,140.75
|
$49,406.94
|
2026-05-22
|
|
952-4
|
OTHER
|
Nonextensive Procedure Unrelated To Principal Diagnosis
|
36
|
9
|
—
|
—
|
$41,594.36
|
$119,492.08
|
$49,166.25
|
2026-05-22
|
|
630-3
|
OTHER
|
Neonate Birthwt >2499g W Major Cardiovascular Procedure
|
36
|
9
|
—
|
—
|
$41,552.23
|
$119,369.20
|
$49,120.65
|
2026-05-22
|
|
043-4
|
OTHER
|
Multiple Sclerosis & Other Demyelinating Diseases
|
36
|
9
|
—
|
—
|
$41,498.36
|
$119,212.07
|
$49,062.35
|
2026-05-22
|
|
381-4
|
OTHER
|
Major Skin Disorders
|
36
|
9
|
—
|
—
|
$41,395.45
|
$118,911.91
|
$48,950.97
|
2026-05-22
|
|
653
|
OTHER
|
Major Bladder Procedures With Mcc
|
40
|
15
|
—
|
—
|
$42,507.30
|
$106,815.97
|
$48,674.34
|
2026-05-22
|
|
005-2
|
OTHER
|
Tracheostomy W Mv 96+ Hours Without Extensive Procedure
|
36
|
9
|
—
|
—
|
$40,986.58
|
$117,719.32
|
$48,508.46
|
2026-05-22
|
|
834
|
OTHER
|
Acute Leukemia With Mcc
|
40
|
15
|
—
|
—
|
$42,146.63
|
$105,909.65
|
$48,261.34
|
2026-05-22
|
|
21
|
OTHER
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc
|
40
|
15
|
—
|
—
|
$42,146.63
|
$105,909.65
|
$48,261.34
|
2026-05-22
|
|
229-4
|
OTHER
|
Other Digestive System & Abdominal Procedures
|
36
|
9
|
—
|
—
|
$40,594.28
|
$116,575.09
|
$48,083.88
|
2026-05-22
|
|
308-4
|
OTHER
|
Hip And Femur Fracture Repair
|
36
|
9
|
—
|
—
|
$40,469.96
|
$116,212.48
|
$47,949.33
|
2026-05-22
|
|
309-4
|
OTHER
|
Other Significant Hip And Femur Surgery
|
36
|
9
|
—
|
—
|
$40,306.27
|
$115,735.04
|
$47,772.18
|
2026-05-22
|
|
162-3
|
OTHER
|
Cardiac Valve Procedures W Ami Or Complex Pdx
|
36
|
9
|
—
|
—
|
$40,248.26
|
$115,565.82
|
$47,709.39
|
2026-05-22
|
|
8
|
OTHER
|
Simultaneous Pancreas And Kidney Transplant
|
40
|
15
|
—
|
—
|
$41,489.34
|
$104,257.95
|
$47,508.69
|
2026-05-22
|
|
650-4
|
OTHER
|
Splenectomy
|
36
|
9
|
—
|
—
|
$40,015.50
|
$114,886.93
|
$47,457.49
|
2026-05-22
|
|
005-1
|
OTHER
|
Tracheostomy W Mv 96+ Hours Without Extensive Procedure
|
36
|
9
|
—
|
—
|
$39,967.85
|
$114,747.93
|
$47,405.91
|
2026-05-22
|
|
405
|
OTHER
|
Pancreas, Liver And Shunt Procedures With Mcc
|
40
|
15
|
—
|
—
|
$41,394.79
|
$104,020.35
|
$47,400.42
|
2026-05-22
|
|
608-2
|
OTHER
|
Neonate Bwt 1250-1499g W Or Without Other Significant Condition
|
36
|
9
|
—
|
—
|
$39,898.09
|
$114,544.47
|
$47,330.42
|
2026-05-22
|
|
440-3
|
OTHER
|
Kidney Transplant
|
36
|
9
|
—
|
—
|
$39,804.16
|
$114,270.50
|
$47,228.75
|
2026-05-22
|
|
463
|
OTHER
|
Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …
|
40
|
15
|
—
|
—
|
$41,183.57
|
$103,489.59
|
$47,158.56
|
2026-05-22
|
|
11
|
OTHER
|
Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc
|
40
|
15
|
—
|
—
|
$41,144.68
|
$103,391.87
|
$47,114.03
|
2026-05-22
|
|
576
|
OTHER
|
Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc
|
40
|
15
|
—
|
—
|
$41,140.11
|
$103,380.37
|
$47,108.79
|
2026-05-22
|
|
223-4
|
OTHER
|
Other Small & Large Bowel Procedures
|
36
|
9
|
—
|
—
|
$39,155.62
|
$112,378.88
|
$46,526.86
|
2026-05-22
|
|
234
|
OTHER
|
Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc
|
40
|
15
|
—
|
—
|
$40,567.46
|
$101,941.36
|
$46,453.06
|
2026-05-22
|
|
224-4
|
OTHER
|
Peritoneal Adhesiolysis
|
36
|
9
|
—
|
—
|
$39,087.25
|
$112,179.45
|
$46,452.86
|
2026-05-22
|
|
220
|
OTHER
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
40
|
15
|
—
|
—
|
$40,388.27
|
$101,491.08
|
$46,247.87
|
2026-05-22
|
|
222-4
|
OTHER
|
Other Stomach, Esophageal & Duodenal Procedures
|
36
|
9
|
—
|
—
|
$38,848.28
|
$111,482.43
|
$46,194.22
|
2026-05-22
|
|
403-4
|
OTHER
|
Procedures For Obesity
|
36
|
9
|
—
|
—
|
$13,323.00
|
$109,751.97
|
$46,049.85
|
2026-05-22
|
|
423-4
|
OTHER
|
Inborn Errors Of Metabolism
|
36
|
9
|
—
|
—
|
$38,187.31
|
$109,554.55
|
$45,478.88
|
2026-05-22
|
|
022-4
|
OTHER
|
Ventricular Shunt Procedures
|
36
|
9
|
—
|
—
|
$37,836.45
|
$108,531.19
|
$45,099.15
|
2026-05-22
|
|
841-1
|
OTHER
|
Extensive 3rd Degree Burns W Skin Graft
|
36
|
9
|
—
|
—
|
$37,693.48
|
$108,114.19
|
$44,944.42
|
2026-05-22
|
|
633-4
|
OTHER
|
Neonate Birthwt >2499g W Major Anomaly
|
36
|
9
|
—
|
—
|
$37,604.39
|
$107,854.32
|
$44,847.99
|
2026-05-22
|
|
270
|
OTHER
|
Other Major Cardiovascular Procedures With Mcc
|
40
|
15
|
—
|
—
|
$39,140.02
|
$98,354.39
|
$44,818.53
|
2026-05-22
|
|
050-4
|
OTHER
|
Non-bacterial Infections Of Nervous System Exc Viral Meningitis
|
36
|
9
|
—
|
—
|
$37,553.28
|
$107,705.24
|
$44,792.68
|
2026-05-22
|
|
304-3
|
OTHER
|
Dorsal & Lumbar Fusion Proc Except For Curvature Of Back
|
36
|
9
|
—
|
—
|
$37,422.74
|
$107,324.50
|
$44,651.40
|
2026-05-22
|
|
364-4
|
OTHER
|
Other Skin, Subcutaneous Tissue & Related Procedures
|
36
|
9
|
—
|
—
|
$37,296.35
|
$106,955.85
|
$44,514.61
|
2026-05-22
|
|
466
|
OTHER
|
Revision Of Hip Or Knee Replacement With Mcc
|
40
|
15
|
—
|
—
|
$38,847.22
|
$97,618.60
|
$44,483.25
|
2026-05-22
|
|
863-4
|
OTHER
|
Neonatal Aftercare
|
36
|
9
|
—
|
—
|
$37,225.21
|
$106,748.35
|
$44,437.62
|
2026-05-22
|
|
303-2
|
OTHER
|
Dorsal & Lumbar Fusion Proc For Curvature Of Back
|
36
|
9
|
—
|
—
|
$37,152.00
|
$106,534.82
|
$44,358.39
|
2026-05-22
|
|
326
|
OTHER
|
Stomach, Esophageal And Duodenal Procedures With Mcc
|
40
|
15
|
—
|
—
|
$38,728.27
|
$97,319.68
|
$44,347.03
|
2026-05-22
|
|
227-4
|
OTHER
|
Hernia Procedures Except Inguinal, Femoral & Umbilical
|
36
|
9
|
—
|
—
|
$37,050.47
|
$106,238.69
|
$44,248.51
|
2026-05-22
|
|
239
|
OTHER
|
Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc
|
40
|
15
|
—
|
—
|
$38,407.25
|
$96,513.00
|
$43,979.44
|
2026-05-22
|
|
837
|
OTHER
|
Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot…
|
40
|
15
|
—
|
—
|
$38,180.78
|
$95,943.91
|
$43,720.12
|
2026-05-22
|
|
278
|
OTHER
|
Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures …
|
40
|
15
|
—
|
—
|
$38,151.04
|
$95,869.18
|
$43,686.06
|
2026-05-22
|
|
853
|
OTHER
|
Infectious And Parasitic Diseases With O.r. Procedures With Mcc
|
40
|
15
|
—
|
—
|
$38,135.79
|
$95,830.86
|
$43,668.60
|
2026-05-22
|
|
613-4
|
OTHER
|
Neonate Birthwt 1500-1999g W Congenital/perinatal Infection
|
36
|
9
|
—
|
—
|
$36,390.20
|
$104,312.82
|
$43,533.90
|
2026-05-22
|
|
228
|
OTHER
|
Other Cardiothoracic Procedures With Mcc
|
40
|
15
|
—
|
—
|
$37,998.54
|
$95,485.96
|
$43,511.43
|
2026-05-22
|
|
603-1
|
OTHER
|
Neonate Birthwt 1000-1249g W Or Without Other Significant Condition
|
36
|
9
|
—
|
—
|
$36,363.26
|
$104,234.26
|
$43,504.75
|
2026-05-22
|
|
622-4
|
OTHER
|
Neonate Bwt 2000-2499g W Resp Dist Synd/oth Maj Resp Cond
|
36
|
9
|
—
|
—
|
$36,327.35
|
$104,129.51
|
$43,465.88
|
2026-05-22
|
|
315-4
|
OTHER
|
Shoulder, Upper Arm & Forearm Procedures Except Joint Replacement
|
36
|
9
|
—
|
—
|
$36,081.47
|
$103,412.34
|
$43,199.78
|
2026-05-22
|
|
844-4
|
OTHER
|
Partial Thickness Burns Without Skin Graft
|
36
|
9
|
—
|
—
|
$35,710.58
|
$102,330.56
|
$42,798.38
|
2026-05-22
|
|
443-4
|
OTHER
|
Kidney & Urinary Tract Procedures For Nonmalignancy
|
36
|
9
|
—
|
—
|
$35,628.39
|
$102,090.83
|
$42,709.42
|
2026-05-22
|
|
245
|
OTHER
|
Aicd Generator Procedures
|
40
|
15
|
—
|
—
|
$37,262.71
|
$93,636.90
|
$42,668.85
|
2026-05-22
|
|
006-2
|
OTHER
|
Pancreas Transplant
|
36
|
9
|
—
|
—
|
$35,542.75
|
$101,841.03
|
$42,616.74
|
2026-05-22
|
|
006-1
|
OTHER
|
Pancreas Transplant
|
36
|
9
|
—
|
—
|
$35,542.75
|
$101,841.03
|
$42,616.74
|
2026-05-22
|
|
613-3
|
OTHER
|
Neonate Birthwt 1500-1999g W Congenital/perinatal Infection
|
36
|
9
|
—
|
—
|
$35,489.57
|
$101,685.92
|
$42,559.18
|
2026-05-22
|
|
614-3
|
OTHER
|
Neonate Bwt 1500-1999g W Or Without Other Significant Condition
|
36
|
9
|
—
|
—
|
$35,409.45
|
$101,452.23
|
$42,472.46
|
2026-05-22
|
|
614-4
|
OTHER
|
Neonate Bwt 1500-1999g W Or Without Other Significant Condition
|
36
|
9
|
—
|
—
|
$35,409.45
|
$101,452.23
|
$42,472.46
|
2026-05-22
|
|
301-4
|
OTHER
|
Hip Joint Replacement
|
36
|
9
|
—
|
—
|
$37,697.00
|
$101,024.15
|
$42,437.67
|
2026-05-22
|
|
471
|
OTHER
|
Cervical Spinal Fusion With Mcc
|
40
|
15
|
—
|
—
|
$37,037.76
|
$93,071.65
|
$42,411.27
|
2026-05-22
|
|
6
|
OTHER
|
Liver Transplant Without Mcc
|
40
|
15
|
—
|
—
|
$36,976.00
|
$92,916.44
|
$42,340.55
|
2026-05-22
|
|
320-4
|
OTHER
|
Other Musculoskeletal System & Connective Tissue Procedures
|
36
|
9
|
—
|
—
|
$35,184.98
|
$100,797.52
|
$42,221.98
|
2026-05-22
|
|
660-4
|
OTHER
|
Major Hematologic/immunologic Diag Exc Sickle Cell Crisis & Coagul
|
36
|
9
|
—
|
—
|
$35,008.17
|
$100,281.81
|
$42,009.81
|
2026-05-22
|
|
826
|
OTHER
|
Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. …
|
40
|
15
|
—
|
—
|
$36,414.02
|
$91,504.26
|
$41,697.04
|
2026-05-22
|
|
799
|
OTHER
|
Splenic Procedures With Mcc
|
40
|
15
|
—
|
—
|
$36,256.18
|
$91,107.63
|
$41,516.30
|
2026-05-22
|
|
981
|
OTHER
|
Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc
|
40
|
15
|
—
|
—
|
$36,249.32
|
$91,090.38
|
$41,508.44
|
2026-05-22
|
|
175-4
|
OTHER
|
Percutaneous Coronary Intervention Without Ami
|
38
|
9
|
—
|
—
|
$15,811.00
|
$98,926.05
|
$41,452.03
|
2026-05-22
|
|
631-3
|
OTHER
|
Neonate Birthwt >2499g W Other Major Procedure
|
36
|
9
|
—
|
—
|
$34,303.69
|
$98,227.02
|
$41,164.43
|
2026-05-22
|
|
346-4
|
OTHER
|
Connective Tissue Disorders
|
36
|
9
|
—
|
—
|
$34,293.33
|
$98,196.80
|
$41,152.00
|
2026-05-22
|
|
267
|
OTHER
|
Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc
|
40
|
15
|
—
|
—
|
$35,874.16
|
$90,147.65
|
$41,078.85
|
2026-05-22
|
|
165-3
|
OTHER
|
Coronary Bypass W Ami Or Complex Pdx
|
36
|
9
|
—
|
—
|
$34,202.86
|
$97,932.90
|
$41,043.43
|
2026-05-22
|
|
823
|
OTHER
|
Lymphoma And Non-acute Leukemia With Other Procedures With Mcc
|
40
|
15
|
—
|
—
|
$35,682.01
|
$89,664.79
|
$40,858.82
|
2026-05-22
|
|
180-4
|
OTHER
|
Other Circulatory System Procedures
|
36
|
9
|
—
|
—
|
$33,910.71
|
$97,080.77
|
$40,692.85
|
2026-05-22
|
|
170-4
|
OTHER
|
Permanent Cardiac Pacemaker Implant W Ami, Heart Failure Or Shock
|
36
|
9
|
—
|
—
|
$33,865.12
|
$96,947.81
|
$40,638.15
|
2026-05-22
|
|
277
|
OTHER
|
Cardiac Defibrillator Implant Without Mcc
|
40
|
15
|
—
|
—
|
$35,471.55
|
$89,135.94
|
$40,617.83
|
2026-05-22
|
|
513-4
|
OTHER
|
Uterine & Adnexa Procedures For Non-malignancy Except Leiomyoma
|
36
|
9
|
—
|
—
|
$33,789.84
|
$96,728.23
|
$40,547.81
|
2026-05-22
|
|
160-3
|
OTHER
|
Major Cardiothoracic Repair Of Heart Anomaly
|
36
|
9
|
—
|
—
|
$33,641.35
|
$96,295.11
|
$40,369.61
|
2026-05-22
|
|
163
|
OTHER
|
Major Chest Procedures With Mcc
|
40
|
15
|
—
|
—
|
$35,145.96
|
$88,317.76
|
$40,245.00
|
2026-05-22
|
|
650
|
OTHER
|
Kidney Transplant With Hemodialysis With Mcc
|
40
|
15
|
—
|
—
|
$35,131.47
|
$88,281.35
|
$40,228.41
|
2026-05-22
|
|
221
|
OTHER
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
40
|
15
|
—
|
—
|
$35,019.38
|
$87,999.68
|
$40,100.06
|
2026-05-22
|
|
329
|
OTHER
|
Major Small And Large Bowel Procedures With Mcc
|
40
|
15
|
—
|
—
|
$35,014.04
|
$87,986.27
|
$40,093.95
|
2026-05-22
|
|
856
|
OTHER
|
Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc
|
40
|
15
|
—
|
—
|
$34,401.74
|
$86,447.62
|
$39,392.81
|
2026-05-22
|
|
440-2
|
OTHER
|
Kidney Transplant
|
36
|
9
|
—
|
—
|
$32,711.02
|
$93,581.58
|
$39,253.22
|
2026-05-22
|
|
474
|
OTHER
|
Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc
|
40
|
15
|
—
|
—
|
$34,196.62
|
$85,932.19
|
$39,157.93
|
2026-05-22
|
|
25
|
OTHER
|
Craniotomy And Endovascular Intracranial Procedures With Mcc
|
40
|
15
|
—
|
—
|
$34,102.07
|
$85,694.59
|
$39,049.66
|
2026-05-22
|
|
901
|
OTHER
|
Wound Debridements For Injuries With Mcc
|
40
|
15
|
—
|
—
|
$33,783.34
|
$84,893.65
|
$38,684.69
|
2026-05-22
|
|
661-4
|
OTHER
|
Coagulation & Platelet Disorders
|
36
|
9
|
—
|
—
|
$32,163.32
|
$91,984.08
|
$38,595.98
|
2026-05-22
|
|
612-2
|
OTHER
|
Neonate Bwt 1500-1999g W Resp Dist Synd/oth Maj Resp Cond
|
36
|
9
|
—
|
—
|
$32,052.81
|
$91,661.76
|
$38,463.38
|
2026-05-22
|
|
163-3
|
OTHER
|
Cardiac Valve Procedures Without Ami Or Complex Pdx
|
36
|
9
|
—
|
—
|
$32,021.73
|
$91,571.11
|
$38,426.08
|
2026-05-22
|
|
319
|
OTHER
|
Other Endovascular Cardiac Valve Procedures With Mcc
|
40
|
15
|
—
|
—
|
$33,495.87
|
$84,171.28
|
$38,355.51
|
2026-05-22
|
|
312-3
|
OTHER
|
Skin Graft, Except Hand, For Musculoskeletal & Connective Tissue Diagnoses
|
36
|
9
|
—
|
—
|
$31,898.10
|
$91,210.52
|
$38,277.73
|
2026-05-22
|
|
302-4
|
OTHER
|
Knee Joint Replacement
|
36
|
9
|
—
|
—
|
$32,985.00
|
$90,829.45
|
$38,218.39
|
2026-05-22
|
|
162-2
|
OTHER
|
Cardiac Valve Procedures W Ami Or Complex Pdx
|
36
|
9
|
—
|
—
|
$31,583.16
|
$90,291.90
|
$37,899.79
|
2026-05-22
|
|
933
|
OTHER
|
Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft
|
40
|
15
|
—
|
—
|
$32,993.37
|
$82,908.55
|
$37,780.11
|
2026-05-22
|
|
193-4
|
OTHER
|
Acute & Subacute Endocarditis
|
36
|
9
|
—
|
—
|
$31,459.53
|
$89,931.31
|
$37,751.44
|
2026-05-22
|
|
458
|
OTHER
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
40
|
15
|
—
|
—
|
$32,925.51
|
$82,738.02
|
$37,702.40
|
2026-05-22
|
|
228-4
|
OTHER
|
Inguinal, Femoral & Umbilical Hernia Procedures
|
36
|
9
|
—
|
—
|
$31,401.52
|
$89,762.09
|
$37,681.82
|
2026-05-22
|
|
303-1
|
OTHER
|
Dorsal & Lumbar Fusion Proc For Curvature Of Back
|
36
|
9
|
—
|
—
|
$31,152.88
|
$89,036.87
|
$37,383.45
|
2026-05-22
|
|
356
|
OTHER
|
Other Digestive System O.r. Procedures With Mcc
|
40
|
15
|
—
|
—
|
$32,526.71
|
$81,735.89
|
$37,245.75
|
2026-05-22
|
|
589-3
|
OTHER
|
Neonate Bwt <500g Or Ga <24 Weeks
|
36
|
9
|
—
|
—
|
$31,015.43
|
$88,635.99
|
$37,218.52
|
2026-05-22
|
|
323
|
OTHER
|
Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc
|
40
|
15
|
—
|
—
|
$32,478.67
|
$81,615.17
|
$37,190.74
|
2026-05-22
|
|
696-4
|
OTHER
|
Other Chemotherapy #
|
36
|
9
|
—
|
—
|
$30,977.45
|
$88,525.19
|
$37,172.94
|
2026-05-22
|
|
140
|
OTHER
|
Major Head And Neck Procedures With Mcc
|
40
|
15
|
—
|
—
|
$32,248.39
|
$81,036.50
|
$36,927.05
|
2026-05-22
|
|
842-3
|
OTHER
|
Burns With Skin Graft Except Extensive 3rd Degree Burns
|
36
|
9
|
—
|
—
|
$30,764.03
|
$87,902.71
|
$36,916.84
|
2026-05-22
|
|
021-3
|
OTHER
|
Craniotomy Except For Trauma
|
36
|
9
|
—
|
—
|
$30,545.78
|
$87,266.13
|
$36,654.94
|
2026-05-22
|
|
31
|
OTHER
|
Ventricular Shunt Procedures With Mcc
|
40
|
15
|
—
|
—
|
$31,954.06
|
$80,296.88
|
$36,590.01
|
2026-05-22
|
|
673
|
OTHER
|
Other Kidney And Urinary Tract Procedures With Mcc
|
40
|
15
|
—
|
—
|
$31,946.43
|
$80,277.72
|
$36,581.28
|
2026-05-22
|
|
546-4
|
OTHER
|
Other O.r. Proc For Obstetric Diagnoses Except Delivery Diagnoses
|
36
|
9
|
—
|
—
|
$30,378.64
|
$86,778.62
|
$36,454.37
|
2026-05-22
|
|
793
|
OTHER
|
Full Term Neonate With Major Problems
|
40
|
15
|
—
|
—
|
$31,800.79
|
$79,911.74
|
$36,414.51
|
2026-05-22
|
|
023-3
|
OTHER
|
Spinal Procedures
|
36
|
9
|
—
|
—
|
$30,300.59
|
$86,550.98
|
$36,360.71
|
2026-05-22
|
|
269
|
OTHER
|
Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc
|
40
|
15
|
—
|
—
|
$31,726.07
|
$79,723.96
|
$36,328.94
|
2026-05-22
|
|
130-3
|
OTHER
|
Respiratory System Diagnosis W Ventilator Support 96+ Hours
|
36
|
9
|
—
|
—
|
$30,183.18
|
$86,208.51
|
$36,219.82
|
2026-05-22
|
|
483-4
|
OTHER
|
Testes & Scrotal Procedures
|
36
|
9
|
—
|
—
|
$30,173.51
|
$86,180.31
|
$36,208.21
|
2026-05-22
|
|
33214
|
OTHER
|
Upgrade Of Pacemaker System
|
2
|
1
|
—
|
—
|
$36,160.00
|
$36,160.00
|
$36,160.00
|
2026-05-22
|
|
33208
|
OTHER
|
Insertion Of Heart Pacemaker
|
2
|
1
|
—
|
—
|
$36,160.00
|
$36,160.00
|
$36,160.00
|
2026-05-22
|
|
33206
|
OTHER
|
Insertion Of Heart Pacemaker
|
2
|
1
|
—
|
—
|
$36,160.00
|
$36,160.00
|
$36,160.00
|
2026-05-22
|
|
33207
|
OTHER
|
Insertion Of Heart Pacemaker
|
2
|
1
|
—
|
—
|
$36,160.00
|
$36,160.00
|
$36,160.00
|
2026-05-22
|