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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

Vibra Hospital Of Fargo

Fargo, ND · CCN 352004 · Rates published

9,895 distinct procedures filed
89 distinct payers
458,553 rate rows
2026-08-31 last MRF observed
Data quality

403,178 of 458,553 rate rows are consumer-grade (87.9%)

55,375 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
template filing: same amount across many unrelated codes — excluded 54,688
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 616
per-diem day rate — not a per-procedure price 40
placeholder amount (≤ $0.02) — excluded from medians 29
percent-of-charges filed in the dollar field — excluded from medians 2
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://vhfargo.com/wp-content/uploads/sites/28/2026/08/462632428_vibra-hospital-of-fargo_standardcharges.csv
Found on page https://vhfargo.com/about-us/price-transparency/
Discovered viaCMS hospital list
Last fetch not_modified · 2026-10-01
Content fingerprint 4a00ad72fc0b541d… · 11,956,598 bytes · first seen 2026-08-31

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
3
OTHER 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 25 $156,488.27 $156,488.27 $156,488.27 nat. median
$202,706
0.8× median
4
OTHER 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 25 $128,710.35 $128,710.35 $128,710.35 nat. median
$141,414
0.9× median
974
OTHER 		HIV With Major Related Condition With Mcc* 25 $111,044.49 $111,044.49 $111,044.49 nat. median
$28,494
outlier · 3.9×
977
OTHER 		HIV With Or Without Other Related Condition 25 $106,761.31 $106,761.31 $106,761.31 nat. median
$13,261
outlier · 8.1×
164
OTHER 		Major Chest Procedures With Cc 25 $106,223.67 $106,223.67 $106,223.67 nat. median
$19,172
outlier · 5.5×
280
LOCAL 		Acute Myocardial Infarction, Discharged Alive W Mcc 9 $106,223.67 $106,223.67 $106,223.67 nat. median
$900
outlier · 118.0×
163
OTHER 		Major Chest Procedures With Mcc 25 $106,223.67 $106,223.67 $106,223.67 nat. median
$47,193
outlier · 2.3×
165
OTHER 		Major Chest Procedures Without Cc/mcc 25 $106,223.67 $106,223.67 $106,223.67 nat. median
$18,295
outlier · 5.8×
140
OTHER 		Major Head And Neck Procedures With Mcc 25 $104,866.14 $104,866.14 $104,866.14 nat. median
$29,006
outlier · 3.6×
166
OTHER 		Other Respiratory System O.r. Procedures With Mcc 27 $21,415.88 $104,866.14 $104,866.14 nat. median
$39,056
outlier · 2.7×
11
OTHER 		Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 25 $104,866.14 $104,866.14 $104,866.14 nat. median
$55,593
1.9× median
959
OTHER 		Other O.r. Procedures For Multiple Significant Trauma Without Cc/mcc 25 $104,852.70 $104,852.70 $104,852.70 nat. median
$24,323
outlier · 4.3×
68875010201
NDC 		Gattex 8 $99,999.99 $99,999.99 $99,999.99 nat. median
$100,000
1.0× median
68875010201
OTHER 		Gattex 38 $12.79 $536,382.41 $99,999.99 nat. median
$100,000
1.0× median
857
OTHER 		Postoperative Or Post-traumatic Infections With O.r. Procedures With Cc 25 $92,836.51 $92,836.51 $92,836.51 nat. median
$19,458
outlier · 4.8×
207
OTHER 		Respiratory System Diagnosis With Ventilator Support >96 Hours 27 $28,615.74 $87,124.11 $87,124.11 nat. median
$64,908
1.3× median
12
OTHER 		Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 25 $70,667.93 $70,667.93 $70,667.93 nat. median
$43,469
1.6× median
173
OTHER 		Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary… 25 $70,667.93 $70,667.93 $70,667.93 nat. median
$24,561
outlier · 2.9×
167
OTHER 		Other Respiratory System O.r. Procedures With Cc 27 $47,993.08 $70,667.93 $70,667.93 nat. median
$17,601
outlier · 4.0×
168
OTHER 		Other Respiratory System O.r. Procedures Without Cc/mcc 25 $70,667.93 $70,667.93 $70,667.93 nat. median
$12,305
outlier · 5.7×
842
OTHER 		Lymphoma And Non-acute Leukemia Without Cc/mcc 25 $67,930.46 $67,930.46 $67,930.46 nat. median
$136
outlier · 499.4×
40
OTHER 		Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 25 $65,815.76 $65,815.76 $65,815.76 nat. median
$39,896
1.6× median
790
OTHER 		Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 25 $62,536.17 $62,536.17 $62,536.17 nat. median
$3,991
outlier · 15.7×
356
OTHER 		Other Digestive System O.r. Procedures With Mcc 25 $62,536.17 $62,536.17 $62,536.17 nat. median
$42,777
1.5× median
561
OTHER 		Aftercare, Musculoskeletal System And Connective Tissue Without Cc/mcc* 25 $62,298.71 $62,298.71 $62,298.71 nat. median
$7,514
outlier · 8.3×
573
OTHER 		Skin Graft For Skin Ulcer Or Cellulitis With Mcc 25 $60,775.41 $60,775.41 $60,775.41 nat. median
$50,394
1.2× median
570
OTHER 		Skin Debridement With Mcc* 25 $60,775.41 $60,775.41 $60,775.41 nat. median
$30,505
2.0× median
845
OTHER 		Other Myeloproliferative Disorders Or Poorly Differentiated Neoplastic Diagnoses… 25 $60,376.66 $60,376.66 $60,376.66 nat. median
$17,146
outlier · 3.5×
205
OTHER 		Other Respiratory System Diagnoses With Mcc 27 $20,274.23 $58,754.79 $58,754.79 nat. median
$14,633
outlier · 4.0×
604
OTHER 		Trauma To The Skin, Subcutaneous Tissue And Breast With Mcc 25 $58,584.53 $58,584.53 $58,584.53 nat. median
$11,636
outlier · 5.0×
607
OTHER 		Minor Skin Disorders Without Mcc 25 $58,584.53 $58,584.53 $58,584.53 nat. median
$8,482
outlier · 6.9×
542
OTHER 		Pathological Fractures And Musculoskeletal And Connective Tissue Malignancy With… 25 $58,508.37 $58,508.37 $58,508.37 nat. median
$14,203
outlier · 4.1×
981
LOCAL 		Extensive O.r. Procedure Unrelated To Principal Diagnosis W Mcc 9 $58,508.37 $58,508.37 $58,508.37 nat. median
$701
outlier · 83.4×
64
OTHER 		Intracranial Hemorrhage Or Cerebral Infarction With Mcc 25 $58,279.87 $58,279.87 $58,279.87 nat. median
$21,243
outlier · 2.7×
61
OTHER 		Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A… 25 $58,279.87 $58,279.87 $58,279.87 nat. median
$29,141
2.0× median
863
OTHER 		Postoperative And Post-traumatic Infections Without Mcc 25 $57,486.86 $57,486.86 $57,486.86 nat. median
$4,272
outlier · 13.5×
964
OTHER 		Other Multiple Significant Trauma With Cc 25 $57,038.83 $57,038.83 $57,038.83 nat. median
$26
outlier · 2224.6×
245
OTHER 		Aicd Generator Procedures 25 $56,926.82 $56,926.82 $56,926.82 nat. median
$45,084
1.3× median
263
OTHER 		Vein Ligation And Stripping 25 $56,926.82 $56,926.82 $56,926.82 nat. median
$24,720
outlier · 2.3×
264
OTHER 		Other Circulatory System O.r. Procedures 25 $56,926.82 $56,926.82 $56,926.82 nat. median
$31,369
1.8× median
559
LOCAL 		Aftercare, Musculoskeletal System & Connective Tissue W Mcc 9 $56,554.95 $56,554.95 $56,554.95 nat. median
$33,655
1.7× median
393
LOCAL 		Other Digestive System Diagnoses W Mcc 9 $56,554.95 $56,554.95 $56,554.95 nat. median
$47,648
1.2× median
233
OTHER 		Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 25 $56,554.95 $56,554.95 $56,554.95 nat. median
$61,105
0.9× median
234
OTHER 		Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 25 $56,554.95 $56,554.95 $56,554.95 nat. median
$48,723
1.2× median
23
OTHER 		Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 25 $56,554.95 $56,554.95 $56,554.95 nat. median
$60,033
0.9× median
231
OTHER 		Coronary Bypass With Ptca With Mcc 25 $56,554.95 $56,554.95 $56,554.95 nat. median
$67,297
0.8× median
229
OTHER 		Other Cardiothoracic Procedures Without Mcc 25 $56,554.95 $56,554.95 $56,554.95 nat. median
$31,547
1.8× median
872
LOCAL 		Septicemia Or Severe Sepsis Without Mv >96 Hours Without Mcc 9 $56,554.95 $56,554.95 $56,554.95 nat. median
$1,942
outlier · 29.1×
871
LOCAL 		Septicemia Or Severe Sepsis Without Mv >96 Hours W Mcc 9 $56,554.95 $56,554.95 $56,554.95 nat. median
$2,166
outlier · 26.1×
232
OTHER 		Coronary Bypass With Ptca Without Mcc 25 $56,554.95 $56,554.95 $56,554.95 nat. median
$52,336
1.1× median

Other procedures at this hospital

Browse this hospital's 9,895 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
             
11 OTHER Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 26 25 $104,866.14 $104,866.14 $104,866.14 $104,866.14 $104,866.14 2026-05-08
113 OTHER Orbital Procedures With Cc/mcc 26 25 $42,316.53 $42,316.53 $42,316.53 $42,316.53 $42,316.53 2026-05-08
114 OTHER Orbital Procedures Without Cc/mcc 26 25 $42,316.53 $42,316.53 $42,316.53 $42,316.53 $42,316.53 2026-05-08
115 OTHER Extraocular Procedures Except Orbit 26 25 $42,316.53 $42,316.53 $42,316.53 $42,316.53 $42,316.53 2026-05-08
116 OTHER Intraocular Procedures With Cc/mcc 26 25 $42,316.53 $42,316.53 $42,316.53 $42,316.53 $42,316.53 2026-05-08
117 OTHER Intraocular Procedures Without Cc/mcc 26 25 $42,316.53 $42,316.53 $42,316.53 $42,316.53 $42,316.53 2026-05-08
12 OTHER Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 26 25 $70,667.93 $70,667.93 $70,667.93 $70,667.93 $70,667.93 2026-05-08
13 OTHER Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy Without Cc/mcc 26 25 $42,316.53 $42,316.53 $42,316.53 $42,316.53 $42,316.53 2026-05-08
135 OTHER Sinus And Mastoid Procedures With Cc/mcc 26 25 $42,316.53 $42,316.53 $42,316.53 $42,316.53 $42,316.53 2026-05-08
136 OTHER Sinus And Mastoid Procedures Without Cc/mcc 26 25 $42,316.53 $42,316.53 $42,316.53 $42,316.53 $42,316.53 2026-05-08
138 OTHER Mouth Procedures Without Cc/mcc 26 25 $42,316.53 $42,316.53 $42,316.53 $42,316.53 $42,316.53 2026-05-08
139 OTHER Salivary Gland Procedures 26 25 $42,316.53 $42,316.53 $42,316.53 $42,316.53 $42,316.53 2026-05-08
140 OTHER Major Head And Neck Procedures With Mcc 26 25 $104,866.14 $104,866.14 $104,866.14 $104,866.14 $104,866.14 2026-05-08
141 OTHER Major Head And Neck Procedures With Cc 26 25 $42,316.53 $42,316.53 $42,316.53 $42,316.53 $42,316.53 2026-05-08
142 OTHER Major Head And Neck Procedures Without Cc/mcc 26 25 $42,316.53 $42,316.53 $42,316.53 $42,316.53 $42,316.53 2026-05-08
143 OTHER Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 26 25 $42,316.53 $42,316.53 $42,316.53 $42,316.53 $42,316.53 2026-05-08
152 OTHER Otitis Media And Uri With Mcc 39 27 $42,316.53 $42,316.53 $28,615.74 $52,588.00 $42,316.53 2026-05-09
154 OTHER Other Ear, Nose, Mouth And Throat Diagnoses With Mcc 26 25 $42,316.53 $42,316.53 $42,316.53 $42,316.53 $42,316.53 2026-05-08
155 OTHER Other Ear, Nose, Mouth And Throat Diagnoses With Cc 26 25 $42,316.53 $42,316.53 $42,316.53 $42,316.53 $42,316.53 2026-05-08
157 OTHER Dental And Oral Diseases With Mcc 26 25 $42,316.53 $42,316.53 $42,316.53 $42,316.53 $42,316.53 2026-05-08
163 OTHER Major Chest Procedures With Mcc 26 25 $106,223.67 $106,223.67 $106,223.67 $106,223.67 $106,223.67 2026-05-08
164 OTHER Major Chest Procedures With Cc 26 25 $106,223.67 $106,223.67 $106,223.67 $106,223.67 $106,223.67 2026-05-08
165 OTHER Major Chest Procedures Without Cc/mcc 26 25 $106,223.67 $106,223.67 $106,223.67 $106,223.67 $106,223.67 2026-05-08
166 OTHER Other Respiratory System O.r. Procedures With Mcc 38 27 $104,866.14 $104,866.14 $21,415.88 $104,866.14 $104,866.14 2026-05-09
167 OTHER Other Respiratory System O.r. Procedures With Cc 38 27 $70,667.93 $70,667.93 $47,993.08 $70,667.93 $70,667.93 2026-05-09
167 LOCAL Other Resp System O.r. Procedures W Cc 11 9 $684,019.58 — $47,993.08 $47,993.08 $47,993.08 2026-08-31
168 OTHER Other Respiratory System O.r. Procedures Without Cc/mcc 26 25 $70,667.93 $70,667.93 $70,667.93 $70,667.93 $70,667.93 2026-05-08
173 OTHER Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary… 26 25 $70,667.93 $70,667.93 $70,667.93 $70,667.93 $70,667.93 2026-05-08
189 OTHER Pulmonary Edema And Respiratory Failure 40 27 $43,848.79 $43,848.79 $21,415.88 $52,191.60 $43,848.79 2026-05-09
196 OTHER Interstitial Lung Disease With Mcc* 26 25 $42,316.53 $42,316.53 $42,316.53 $42,316.53 $42,316.53 2026-05-08
197 OTHER Interstitial Lung Disease With Cc* 26 25 $42,316.53 $42,316.53 $42,316.53 $42,316.53 $42,316.53 2026-05-08
198 OTHER Interstitial Lung Disease Without Cc/mcc* 26 25 $42,316.53 $42,316.53 $42,316.53 $42,316.53 $42,316.53 2026-05-08
20 OTHER Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 26 25 $56,554.95 $56,554.95 $56,554.95 $56,554.95 $56,554.95 2026-05-08
202 OTHER Bronchitis And Asthma With Cc/mcc 26 25 $56,554.95 $56,554.95 $56,554.95 $56,554.95 $56,554.95 2026-05-08
205 OTHER Other Respiratory System Diagnoses With Mcc 38 27 $58,754.79 $58,754.79 $20,274.23 $58,754.79 $58,754.79 2026-05-09
205 LOCAL Other Respiratory System Diagnoses W Mcc 11 9 $249,706.32 — $42,316.53 $42,316.53 $42,316.53 2026-08-31
207 OTHER Respiratory System Diagnosis With Ventilator Support >96 Hours 40 27 $87,124.11 $87,124.11 $28,615.74 $87,124.11 $87,124.11 2026-05-09
208 OTHER Respiratory System Diagnosis With Ventilator Support <=96 Hours 39 27 $52,903.50 $52,903.50 $28,615.74 $52,903.50 $52,903.50 2026-05-09
21 OTHER Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 26 25 $56,554.95 $56,554.95 $56,554.95 $56,554.95 $56,554.95 2026-05-08
212 OTHER Concomitant Aortic And Mitral Valve Procedures 26 25 $56,554.95 $56,554.95 $56,554.95 $56,554.95 $56,554.95 2026-05-08
215 OTHER Other Heart Assist System Implant 26 25 $56,554.95 $56,554.95 $56,554.95 $56,554.95 $56,554.95 2026-05-08
216 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 26 25 $56,554.95 $56,554.95 $56,554.95 $56,554.95 $56,554.95 2026-05-08
217 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 26 25 $56,554.95 $56,554.95 $56,554.95 $56,554.95 $56,554.95 2026-05-08
218 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 26 25 $56,554.95 $56,554.95 $56,554.95 $56,554.95 $56,554.95 2026-05-08
219 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 26 25 $56,554.95 $56,554.95 $56,554.95 $56,554.95 $56,554.95 2026-05-08
22 OTHER Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 26 25 $56,554.95 $56,554.95 $56,554.95 $56,554.95 $56,554.95 2026-05-08
220 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 26 25 $56,554.95 $56,554.95 $56,554.95 $56,554.95 $56,554.95 2026-05-08
221 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 26 25 $56,554.95 $56,554.95 $56,554.95 $56,554.95 $56,554.95 2026-05-08
228 OTHER Other Cardiothoracic Procedures With Mcc 26 25 $56,554.95 $56,554.95 $56,554.95 $56,554.95 $56,554.95 2026-05-08
229 OTHER Other Cardiothoracic Procedures Without Mcc 26 25 $56,554.95 $56,554.95 $56,554.95 $56,554.95 $56,554.95 2026-05-08
23 OTHER Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 26 25 $56,554.95 $56,554.95 $56,554.95 $56,554.95 $56,554.95 2026-05-08
231 OTHER Coronary Bypass With Ptca With Mcc 26 25 $56,554.95 $56,554.95 $56,554.95 $56,554.95 $56,554.95 2026-05-08
232 OTHER Coronary Bypass With Ptca Without Mcc 26 25 $56,554.95 $56,554.95 $56,554.95 $56,554.95 $56,554.95 2026-05-08
233 OTHER Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 26 25 $56,554.95 $56,554.95 $56,554.95 $56,554.95 $56,554.95 2026-05-08
234 OTHER Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 26 25 $56,554.95 $56,554.95 $56,554.95 $56,554.95 $56,554.95 2026-05-08
235 OTHER Coronary Bypass Without Cardiac Catheterization With Mcc 26 25 $56,554.95 $56,554.95 $56,554.95 $56,554.95 $56,554.95 2026-05-08
236 OTHER Coronary Bypass Without Cardiac Catheterization Without Mcc 26 25 $56,554.95 $56,554.95 $56,554.95 $56,554.95 $56,554.95 2026-05-08
239 OTHER Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 26 25 $56,554.95 $56,554.95 $56,554.95 $56,554.95 $56,554.95 2026-05-08
24 OTHER Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 26 25 $56,554.95 $56,554.95 $56,554.95 $56,554.95 $56,554.95 2026-05-08
240 OTHER Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc 26 25 $56,554.95 $56,554.95 $56,554.95 $56,554.95 $56,554.95 2026-05-08
241 OTHER Amputation For Circulatory System Disorders Except Upper Limb And Toe Without Cc… 26 25 $56,554.95 $56,554.95 $56,554.95 $56,554.95 $56,554.95 2026-05-08
242 OTHER Permanent Cardiac Pacemaker Implant With Mcc 26 25 $56,554.95 $56,554.95 $56,554.95 $56,554.95 $56,554.95 2026-05-08
245 OTHER Aicd Generator Procedures 26 25 $56,926.82 $56,926.82 $56,926.82 $56,926.82 $56,926.82 2026-05-08
25 OTHER Craniotomy And Endovascular Intracranial Procedures With Mcc 26 25 $56,554.95 $56,554.95 $56,554.95 $56,554.95 $56,554.95 2026-05-08
251 OTHER Percutaneous Cardiovascular Procedures Without Intraluminal Device Without Mcc 26 25 $56,554.95 $56,554.95 $56,554.95 $56,554.95 $56,554.95 2026-05-08
252 OTHER Other Vascular Procedures With Mcc 26 25 $56,554.95 $56,554.95 $56,554.95 $56,554.95 $56,554.95 2026-05-08
253 OTHER Other Vascular Procedures With Cc 26 25 $56,554.95 $56,554.95 $56,554.95 $56,554.95 $56,554.95 2026-05-08
254 OTHER Other Vascular Procedures Without Cc/mcc 26 25 $56,554.95 $56,554.95 $56,554.95 $56,554.95 $56,554.95 2026-05-08
255 OTHER Upper Limb And Toe Amputation For Circulatory System Disorders With Mcc 26 25 $56,554.95 $56,554.95 $56,554.95 $56,554.95 $56,554.95 2026-05-08
256 OTHER Upper Limb And Toe Amputation For Circulatory System Disorders With Cc 26 25 $56,554.95 $56,554.95 $56,554.95 $56,554.95 $56,554.95 2026-05-08
257 OTHER Upper Limb And Toe Amputation For Circulatory System Disorders Without Cc/mcc 26 25 $56,554.95 $56,554.95 $56,554.95 $56,554.95 $56,554.95 2026-05-08
258 OTHER Cardiac Pacemaker Device Replacement With Mcc 26 25 $56,554.95 $56,554.95 $56,554.95 $56,554.95 $56,554.95 2026-05-08
26 OTHER Craniotomy And Endovascular Intracranial Procedures With Cc 26 25 $56,554.95 $56,554.95 $56,554.95 $56,554.95 $56,554.95 2026-05-08
260 OTHER Cardiac Pacemaker Revision Except Device Replacement With Mcc 26 25 $42,316.53 $42,316.53 $42,316.53 $42,316.53 $42,316.53 2026-05-08
263 OTHER Vein Ligation And Stripping 26 25 $56,926.82 $56,926.82 $56,926.82 $56,926.82 $56,926.82 2026-05-08
264 OTHER Other Circulatory System O.r. Procedures 26 25 $56,926.82 $56,926.82 $56,926.82 $56,926.82 $56,926.82 2026-05-08
266 OTHER Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 26 25 $56,554.95 $56,554.95 $56,554.95 $56,554.95 $56,554.95 2026-05-08
267 OTHER Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 26 25 $56,554.95 $56,554.95 $56,554.95 $56,554.95 $56,554.95 2026-05-08
268 OTHER Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 26 25 $56,554.95 $56,554.95 $56,554.95 $56,554.95 $56,554.95 2026-05-08
269 OTHER Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 26 25 $56,554.95 $56,554.95 $56,554.95 $56,554.95 $56,554.95 2026-05-08
27 OTHER Craniotomy And Endovascular Intracranial Procedures Without Cc/mcc 26 25 $56,554.95 $56,554.95 $56,554.95 $56,554.95 $56,554.95 2026-05-08
273 OTHER Percutaneous And Other Intracardiac Procedures With Mcc 26 25 $56,554.95 $56,554.95 $56,554.95 $56,554.95 $56,554.95 2026-05-08
274 OTHER Percutaneous And Other Intracardiac Procedures Without Mcc 26 25 $56,554.95 $56,554.95 $56,554.95 $56,554.95 $56,554.95 2026-05-08
275 OTHER Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 26 25 $56,554.95 $56,554.95 $56,554.95 $56,554.95 $56,554.95 2026-05-08
276 OTHER Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 26 25 $42,316.53 $42,316.53 $42,316.53 $42,316.53 $42,316.53 2026-05-08
277 OTHER Cardiac Defibrillator Implant Without Mcc 26 25 $42,316.53 $42,316.53 $42,316.53 $42,316.53 $42,316.53 2026-05-08
278 OTHER Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 26 25 $42,316.53 $42,316.53 $42,316.53 $42,316.53 $42,316.53 2026-05-08
279 OTHER Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 26 25 $42,316.53 $42,316.53 $42,316.53 $42,316.53 $42,316.53 2026-05-08
28 OTHER Spinal Procedures With Mcc 26 25 $53,718.92 $53,718.92 $53,718.92 $53,718.92 $53,718.92 2026-05-08
280 LOCAL Acute Myocardial Infarction, Discharged Alive W Mcc 11 9 $868,652.78 — $106,223.67 $106,223.67 $106,223.67 2026-08-31
288 OTHER Acute And Subacute Endocarditis With Mcc 38 27 $45,654.36 $45,654.36 $31,496.58 $45,654.36 $45,654.36 2026-05-09
29 OTHER Spinal Procedures With Cc Or Spinal Neurostimulators 26 25 $53,718.92 $53,718.92 $53,718.92 $53,718.92 $53,718.92 2026-05-08
3 OTHER Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 26 25 $156,488.27 $156,488.27 $156,488.27 $156,488.27 $156,488.27 2026-05-08
304 OTHER Hypertension With Mcc 26 25 $42,316.53 $42,316.53 $42,316.53 $42,316.53 $42,316.53 2026-05-08
31 OTHER Ventricular Shunt Procedures With Mcc 26 25 $56,554.95 $56,554.95 $56,554.95 $56,554.95 $56,554.95 2026-05-08
314 LOCAL Other Circulatory System Diagnoses W Mcc 11 9 $239,740.71 — $42,316.53 $42,316.53 $42,316.53 2026-08-31
319 OTHER Other Endovascular Cardiac Valve Procedures With Mcc 26 25 $42,316.53 $42,316.53 $42,316.53 $42,316.53 $42,316.53 2026-05-08
32 OTHER Ventricular Shunt Procedures With Cc 26 25 $56,554.95 $56,554.95 $56,554.95 $56,554.95 $56,554.95 2026-05-08
326 OTHER Stomach, Esophageal And Duodenal Procedures With Mcc 26 25 $42,316.53 $42,316.53 $42,316.53 $42,316.53 $42,316.53 2026-05-08
329 OTHER Major Small And Large Bowel Procedures With Mcc 26 25 $56,554.95 $56,554.95 $56,554.95 $56,554.95 $56,554.95 2026-05-08
33 OTHER Ventricular Shunt Procedures Without Cc/mcc 26 25 $56,554.95 $56,554.95 $56,554.95 $56,554.95 $56,554.95 2026-05-08
34 OTHER Carotid Artery Stent Procedures With Mcc 26 25 $56,554.95 $56,554.95 $56,554.95 $56,554.95 $56,554.95 2026-05-08
344 OTHER Minor Small And Large Bowel Procedures With Mcc 26 25 $56,554.95 $56,554.95 $56,554.95 $56,554.95 $56,554.95 2026-05-08
35 OTHER Carotid Artery Stent Procedures With Cc 26 25 $56,554.95 $56,554.95 $56,554.95 $56,554.95 $56,554.95 2026-05-08
353 OTHER Hernia Procedures Except Inguinal And Femoral With Mcc 26 25 $56,554.95 $56,554.95 $56,554.95 $56,554.95 $56,554.95 2026-05-08
356 OTHER Other Digestive System O.r. Procedures With Mcc 26 25 $62,536.17 $62,536.17 $62,536.17 $62,536.17 $62,536.17 2026-05-08
36 OTHER Carotid Artery Stent Procedures Without Cc/mcc 26 25 $56,554.95 $56,554.95 $56,554.95 $56,554.95 $56,554.95 2026-05-08
37 OTHER Extracranial Procedures With Mcc 26 25 $56,554.95 $56,554.95 $56,554.95 $56,554.95 $56,554.95 2026-05-08
374 OTHER Digestive Malignancy With Mcc* 26 25 $42,316.53 $42,316.53 $42,316.53 $42,316.53 $42,316.53 2026-05-08
38 OTHER Extracranial Procedures With Cc 26 25 $56,554.95 $56,554.95 $56,554.95 $56,554.95 $56,554.95 2026-05-08
380 OTHER Complicated Peptic Ulcer With Mcc 26 25 $42,907.93 $42,907.93 $42,907.93 $42,907.93 $42,907.93 2026-05-08
385 OTHER Inflammatory Bowel Disease With Mcc 39 36 $56,554.95 $56,554.95 $89.86 $56,554.95 $56,554.95 2026-07-31
386 OTHER Inflammatory Bowel Disease With Cc 39 36 $42,316.53 $42,316.53 $680.32 $42,316.53 $42,316.53 2026-07-31
387 OTHER Inflammatory Bowel Disease Without Cc/mcc 39 36 $42,316.53 $42,316.53 $26.75 $42,316.53 $42,316.53 2026-07-31
388 OTHER Gastrointestinal Obstruction With Mcc 26 25 $44,269.94 $44,269.94 $44,269.94 $44,269.94 $44,269.94 2026-05-08
39 OTHER Extracranial Procedures Without Cc/mcc 26 25 $56,554.95 $56,554.95 $56,554.95 $56,554.95 $56,554.95 2026-05-08
393 LOCAL Other Digestive System Diagnoses W Mcc 11 9 $103,712.55 — $56,554.95 $56,554.95 $56,554.95 2026-08-31
393 OTHER Other Digestive System Diagnoses With Mcc 38 27 $45,519.95 $45,519.95 $16,189.65 $56,554.95 $45,519.95 2026-05-09
4 OTHER Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 26 25 $128,710.35 $128,710.35 $128,710.35 $128,710.35 $128,710.35 2026-05-08
40 OTHER Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 26 25 $65,815.76 $65,815.76 $65,815.76 $65,815.76 $65,815.76 2026-05-08
405 OTHER Pancreas, Liver And Shunt Procedures With Mcc 26 25 $56,554.95 $56,554.95 $56,554.95 $56,554.95 $56,554.95 2026-05-08
41 OTHER Peripheral, Cranial Nerve And Other Nervous System Procedures With Cc Or Periphe… 26 25 $56,554.95 $56,554.95 $56,554.95 $56,554.95 $56,554.95 2026-05-08
411 OTHER Cholecystectomy With C.d.e. With Mcc 26 25 $42,907.93 $42,907.93 $42,907.93 $42,907.93 $42,907.93 2026-05-08
414 OTHER Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 26 25 $42,907.93 $42,907.93 $42,907.93 $42,907.93 $42,907.93 2026-05-08
417 OTHER Laparoscopic Cholecystectomy Without C.d.e. With Mcc 26 25 $42,907.93 $42,907.93 $42,907.93 $42,907.93 $42,907.93 2026-05-08
42 OTHER Peripheral, Cranial Nerve And Other Nervous System Procedures Without Cc/mcc 26 25 $56,554.95 $56,554.95 $56,554.95 $56,554.95 $56,554.95 2026-05-08
423 OTHER Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 51 38 $56,554.95 $56,554.95 $18.69 $56,554.95 $56,554.95 2026-07-31
423 LOCAL Other Hepatobiliary Or Pancreas O.r. Procedures W Mcc 11 9 $458,547.66 — $42,316.53 $42,316.53 $42,316.53 2026-08-31
429 OTHER Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 26 25 $42,316.53 $42,316.53 $42,316.53 $42,316.53 $42,316.53 2026-05-08
433 OTHER Cirrhosis And Alcoholic Hepatitis With Cc 39 36 $46,940.21 $46,940.21 $19.97 $46,940.21 $46,940.21 2026-07-31
438 LOCAL Disorders Of Pancreas Except Malignancy W Mcc 11 9 $533,264.64 — $56,554.95 $56,554.95 $56,554.95 2026-08-31
444 LOCAL Disorders Of The Biliary Tract W Mcc 11 9 $247,471.03 — $56,554.95 $56,554.95 $56,554.95 2026-08-31
447 OTHER Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 26 25 $56,501.19 $56,501.19 $56,501.19 $56,501.19 $56,501.19 2026-05-08
448 OTHER Multiple Level Spinal Fusion Except Cervical Without Mcc 26 25 $42,728.72 $42,728.72 $42,728.72 $42,728.72 $42,728.72 2026-05-08
451 OTHER Single Level Spinal Fusion Except Cervical Without Mcc 26 25 $56,554.95 $56,554.95 $56,554.95 $56,554.95 $56,554.95 2026-05-08
458 OTHER Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 26 25 $56,554.95 $56,554.95 $56,554.95 $56,554.95 $56,554.95 2026-05-08
465 OTHER Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 26 25 $56,554.95 $56,554.95 $56,554.95 $56,554.95 $56,554.95 2026-05-08
468 OTHER Revision Of Hip Or Knee Replacement Without Cc/mcc 26 25 $56,554.95 $56,554.95 $56,554.95 $56,554.95 $56,554.95 2026-05-08
474 OTHER Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 26 25 $56,554.95 $56,554.95 $56,554.95 $56,554.95 $56,554.95 2026-05-08
475 OTHER Amputation For Musculoskeletal System And Connective Tissue Disorders With Cc 26 25 $56,554.95 $56,554.95 $56,554.95 $56,554.95 $56,554.95 2026-05-08
481 OTHER Hip And Femur Procedures Except Major Joint With Cc 26 25 $56,554.95 $56,554.95 $56,554.95 $56,554.95 $56,554.95 2026-05-08
487 OTHER Knee Procedures With Principal Diagnosis Of Infection Without Cc/mcc 26 25 $56,554.95 $56,554.95 $56,554.95 $56,554.95 $56,554.95 2026-05-08
488 OTHER Knee Procedures Without Principal Diagnosis Of Infection With Cc/mcc 26 25 $56,554.95 $56,554.95 $56,554.95 $56,554.95 $56,554.95 2026-05-08
489 OTHER Knee Procedures Without Principal Diagnosis Of Infection Without Cc/mcc 26 25 $55,183.98 $55,183.98 $55,183.98 $55,183.98 $55,183.98 2026-05-08
506 OTHER Major Thumb Or Joint Procedures 26 25 $53,718.92 $53,718.92 $53,718.92 $53,718.92 $53,718.92 2026-05-08
509 OTHER Arthroscopy 26 25 $56,554.95 $56,554.95 $56,554.95 $56,554.95 $56,554.95 2026-05-08
52 OTHER Spinal Disorders And Injuries With Cc/mcc 26 25 $47,630.18 $47,630.18 $47,630.18 $47,630.18 $47,630.18 2026-05-08
520 OTHER Back And Neck Procedures Except Spinal Fusion Without Cc/mcc 26 25 $43,427.65 $43,427.65 $43,427.65 $43,427.65 $43,427.65 2026-05-08
53 OTHER Spinal Disorders And Injuries Without Cc/mcc 26 25 $47,630.18 $47,630.18 $47,630.18 $47,630.18 $47,630.18 2026-05-08
536 OTHER Fractures Of Hip And Pelvis Without Mcc 26 25 $42,316.53 $42,316.53 $42,316.53 $42,316.53 $42,316.53 2026-05-08
54 OTHER Nervous System Neoplasms With Mcc 26 25 $56,554.95 $56,554.95 $56,554.95 $56,554.95 $56,554.95 2026-05-08
542 OTHER Pathological Fractures And Musculoskeletal And Connective Tissue Malignancy With… 26 25 $58,508.37 $58,508.37 $58,508.37 $58,508.37 $58,508.37 2026-05-08
55292070255 NDC Hemin For Injection 12 8 $51,333.70 — $51,333.70 $51,333.70 $51,333.70 2026-08-31
55292070255 OTHER Hemin For Injection 63 38 $51,333.70 $51,333.70 $12.79 $51,333.70 $51,333.70 2026-05-09
553 OTHER Bone Diseases And Arthropathies With Mcc 26 25 $56,554.95 $56,554.95 $56,554.95 $56,554.95 $56,554.95 2026-05-08
558 OTHER Tendonitis, Myositis And Bursitis Without Mcc 26 25 $52,746.69 $52,746.69 $52,746.69 $52,746.69 $52,746.69 2026-05-08
559 LOCAL Aftercare, Musculoskeletal System & Connective Tissue W Mcc 11 9 $290,038.87 — $56,554.95 $56,554.95 $56,554.95 2026-08-31
56 LOCAL Degenerative Nervous System Disorders W Mcc 11 9 $76,663.71 — $56,554.95 $56,554.95 $56,554.95 2026-08-31
561 OTHER Aftercare, Musculoskeletal System And Connective Tissue Without Cc/mcc* 26 25 $62,298.71 $62,298.71 $62,298.71 $62,298.71 $62,298.71 2026-05-08
562 OTHER Fracture, Sprain, Strain And Dislocation Except Femur, Hip, Pelvis And Thigh Wit… 26 25 $42,316.53 $42,316.53 $42,316.53 $42,316.53 $42,316.53 2026-05-08
563 OTHER Fracture, Sprain, Strain And Dislocation Except Femur, Hip, Pelvis And Thigh Wit… 26 25 $42,316.53 $42,316.53 $42,316.53 $42,316.53 $42,316.53 2026-05-08
564 OTHER Other Musculoskeletal System And Connective Tissue Diagnoses With Mcc 26 25 $42,316.53 $42,316.53 $42,316.53 $42,316.53 $42,316.53 2026-05-08
565 OTHER Other Musculoskeletal System And Connective Tissue Diagnoses With Cc 26 25 $42,316.53 $42,316.53 $42,316.53 $42,316.53 $42,316.53 2026-05-08
566 OTHER Other Musculoskeletal System And Connective Tissue Diagnoses Without Cc/mcc 26 25 $42,316.53 $42,316.53 $42,316.53 $42,316.53 $42,316.53 2026-05-08
57 LOCAL Degenerative Nervous System Disorders Without Mcc 11 9 $162,155.61 — $56,554.95 $56,554.95 $56,554.95 2026-08-31
570 OTHER Skin Debridement With Mcc* 26 25 $60,775.41 $60,775.41 $60,775.41 $60,775.41 $60,775.41 2026-05-08
571 OTHER Skin Debridement With Cc* 26 25 $49,946.50 $49,946.50 $49,946.50 $49,946.50 $49,946.50 2026-05-08
572 OTHER Skin Debridement Without Cc/mcc* 26 25 $49,946.50 $49,946.50 $49,946.50 $49,946.50 $49,946.50 2026-05-08
573 OTHER Skin Graft For Skin Ulcer Or Cellulitis With Mcc 26 25 $60,775.41 $60,775.41 $60,775.41 $60,775.41 $60,775.41 2026-05-08
574 OTHER Skin Graft For Skin Ulcer Or Cellulitis With Cc 38 27 $49,946.50 $49,946.50 $40,031.57 $49,946.50 $49,946.50 2026-05-09
595 OTHER Major Skin Disorders With Mcc 26 25 $42,316.53 $42,316.53 $42,316.53 $42,316.53 $42,316.53 2026-05-08
597 OTHER Malignant Breast Disorders With Mcc 26 25 $42,316.53 $42,316.53 $42,316.53 $42,316.53 $42,316.53 2026-05-08
600 OTHER Non-malignant Breast Disorders With Cc/mcc* 26 25 $42,316.53 $42,316.53 $42,316.53 $42,316.53 $42,316.53 2026-05-08
601 OTHER Non-malignant Breast Disorders Without Cc/mcc* 26 25 $42,316.53 $42,316.53 $42,316.53 $42,316.53 $42,316.53 2026-05-08
602 OTHER Cellulitis With Mcc 26 25 $42,316.53 $42,316.53 $42,316.53 $42,316.53 $42,316.53 2026-05-08
604 OTHER Trauma To The Skin, Subcutaneous Tissue And Breast With Mcc 26 25 $58,584.53 $58,584.53 $58,584.53 $58,584.53 $58,584.53 2026-05-08
605 OTHER Trauma To The Skin, Subcutaneous Tissue And Breast Without Mcc 26 25 $42,504.70 $42,504.70 $42,504.70 $42,504.70 $42,504.70 2026-05-08
607 OTHER Minor Skin Disorders Without Mcc 26 25 $58,584.53 $58,584.53 $58,584.53 $58,584.53 $58,584.53 2026-05-08
61 OTHER Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A… 26 25 $58,279.87 $58,279.87 $58,279.87 $58,279.87 $58,279.87 2026-05-08
614 OTHER Adrenal And Pituitary Procedures With Cc/mcc 26 25 $42,504.70 $42,504.70 $42,504.70 $42,504.70 $42,504.70 2026-05-08
616 OTHER Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 26 25 $42,316.53 $42,316.53 $42,316.53 $42,316.53 $42,316.53 2026-05-08
619 OTHER O.r. Procedures For Obesity With Mcc 26 25 $42,316.53 $42,316.53 $42,316.53 $42,316.53 $42,316.53 2026-05-08
625 OTHER Thyroid, Parathyroid And Thyroglossal Procedures With Mcc 26 25 $43,835.35 $43,835.35 $43,835.35 $43,835.35 $43,835.35 2026-05-08
628 OTHER Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 38 27 $56,554.95 $56,554.95 $21,415.88 $113,283.10 $56,554.95 2026-05-09
637 OTHER Diabetes With Mcc 38 27 $53,633.79 $53,633.79 $9,896.34 $53,633.79 $53,633.79 2026-05-09
637 LOCAL Diabetes W Mcc 11 9 $170,939.80 — $42,316.53 $42,316.53 $42,316.53 2026-08-31
638 OTHER Diabetes With Cc 26 25 $46,886.45 $46,886.45 $46,886.45 $46,886.45 $46,886.45 2026-05-08
639 OTHER Diabetes Without Cc/mcc 26 25 $42,316.53 $42,316.53 $42,316.53 $42,316.53 $42,316.53 2026-05-08
64 OTHER Intracranial Hemorrhage Or Cerebral Infarction With Mcc 26 25 $58,279.87 $58,279.87 $58,279.87 $58,279.87 $58,279.87 2026-05-08
640 OTHER Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes With M… 38 27 $42,316.53 $42,316.53 $25,683.20 $42,316.53 $42,316.53 2026-05-09
641 OTHER Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes Withou… 26 25 $42,316.53 $42,316.53 $42,316.53 $42,316.53 $42,316.53 2026-05-08
642 OTHER Inborn And Other Disorders Of Metabolism 26 25 $42,316.53 $42,316.53 $42,316.53 $42,316.53 $42,316.53 2026-05-08
643 OTHER Endocrine Disorders With Mcc* 26 25 $42,316.53 $42,316.53 $42,316.53 $42,316.53 $42,316.53 2026-05-08
644 OTHER Endocrine Disorders With Cc* 26 25 $42,316.53 $42,316.53 $42,316.53 $42,316.53 $42,316.53 2026-05-08
645 OTHER Endocrine Disorders Without Cc/mcc* 26 25 $42,316.53 $42,316.53 $42,316.53 $42,316.53 $42,316.53 2026-05-08
653 OTHER Major Bladder Procedures With Mcc 26 25 $42,316.53 $42,316.53 $42,316.53 $42,316.53 $42,316.53 2026-05-08
654 OTHER Major Bladder Procedures With Cc 26 25 $42,316.53 $42,316.53 $42,316.53 $42,316.53 $42,316.53 2026-05-08
655 OTHER Major Bladder Procedures Without Cc/mcc 26 25 $42,316.53 $42,316.53 $42,316.53 $42,316.53 $42,316.53 2026-05-08
656 OTHER Kidney And Ureter Procedures For Neoplasm With Mcc 26 25 $53,633.79 $53,633.79 $53,633.79 $53,633.79 $53,633.79 2026-05-08
657 OTHER Kidney And Ureter Procedures For Neoplasm With Cc 26 25 $46,886.45 $46,886.45 $46,886.45 $46,886.45 $46,886.45 2026-05-08
658 OTHER Kidney And Ureter Procedures For Neoplasm Without Cc/mcc 26 25 $42,316.53 $42,316.53 $42,316.53 $42,316.53 $42,316.53 2026-05-08
659 OTHER Kidney And Ureter Procedures For Non-neoplasm With Mcc* 26 25 $42,316.53 $42,316.53 $42,316.53 $42,316.53 $42,316.53 2026-05-08
660 OTHER Kidney And Ureter Procedures For Non-neoplasm With Cc* 26 25 $42,316.53 $42,316.53 $42,316.53 $42,316.53 $42,316.53 2026-05-08
661 OTHER Kidney And Ureter Procedures For Non-neoplasm Without Cc/mcc* 26 25 $42,316.53 $42,316.53 $42,316.53 $42,316.53 $42,316.53 2026-05-08
662 OTHER Minor Bladder Procedures With Mcc 26 25 $42,316.53 $42,316.53 $42,316.53 $42,316.53 $42,316.53 2026-05-08
663 OTHER Minor Bladder Procedures With Cc 26 25 $42,316.53 $42,316.53 $42,316.53 $42,316.53 $42,316.53 2026-05-08
664 OTHER Minor Bladder Procedures Without Cc/mcc 26 25 $53,633.79 $53,633.79 $53,633.79 $53,633.79 $53,633.79 2026-05-08
665 OTHER Prostatectomy With Mcc 26 25 $46,886.45 $46,886.45 $46,886.45 $46,886.45 $46,886.45 2026-05-08
666 OTHER Prostatectomy With Cc 26 25 $46,886.45 $46,886.45 $46,886.45 $46,886.45 $46,886.45 2026-05-08
675 OTHER Other Kidney And Urinary Tract Procedures Without Cc/mcc* 26 25 $56,554.95 $56,554.95 $56,554.95 $56,554.95 $56,554.95 2026-05-08
68875010201 NDC Gattex 12 8 $99,999.99 — $99,999.99 $99,999.99 $99,999.99 2026-08-31
68875010201 OTHER Gattex 63 38 $99,999.99 $99,999.99 $12.79 $536,382.41 $99,999.99 2026-05-09
694 OTHER Urinary Stones Without Mcc 26 25 $42,316.53 $42,316.53 $42,316.53 $42,316.53 $42,316.53 2026-05-08
696 OTHER Kidney And Urinary Tract Signs And Symptoms Without Mcc 26 25 $42,316.53 $42,316.53 $42,316.53 $42,316.53 $42,316.53 2026-05-08
698 OTHER Other Kidney And Urinary Tract Diagnoses With Mcc 26 25 $42,316.53 $42,316.53 $42,316.53 $42,316.53 $42,316.53 2026-05-08
70 LOCAL Nonspecific Cerebrovascular Disorders W Mcc 11 9 $249,909.01 — $56,554.95 $56,554.95 $56,554.95 2026-08-31
700 OTHER Other Kidney And Urinary Tract Diagnoses Without Cc/mcc 26 25 $42,316.53 $42,316.53 $42,316.53 $42,316.53 $42,316.53 2026-05-08
708 OTHER Major Male Pelvic Procedures Without Cc/mcc 26 25 $42,316.53 $42,316.53 $42,316.53 $42,316.53 $42,316.53 2026-05-08
71 LOCAL Nonspecific Cerebrovascular Disorders W Cc 11 9 $243,860.09 — $56,554.95 $56,554.95 $56,554.95 2026-08-31
722 OTHER Malignancy, Male Reproductive System With Mcc 26 25 $56,554.95 $56,554.95 $56,554.95 $56,554.95 $56,554.95 2026-05-08
723 OTHER Malignancy, Male Reproductive System With Cc 26 25 $56,554.95 $56,554.95 $56,554.95 $56,554.95 $56,554.95 2026-05-08
724 OTHER Malignancy, Male Reproductive System Without Cc/mcc 26 25 $56,554.95 $56,554.95 $56,554.95 $56,554.95 $56,554.95 2026-05-08
725 OTHER Benign Prostatic Hypertrophy With Mcc 26 25 $56,554.95 $56,554.95 $56,554.95 $56,554.95 $56,554.95 2026-05-08
726 OTHER Benign Prostatic Hypertrophy Without Mcc 26 25 $56,554.95 $56,554.95 $56,554.95 $56,554.95 $56,554.95 2026-05-08
727 OTHER Inflammation Of The Male Reproductive System With Mcc 26 25 $56,554.95 $56,554.95 $56,554.95 $56,554.95 $56,554.95 2026-05-08
728 OTHER Inflammation Of The Male Reproductive System Without Mcc 26 25 $56,554.95 $56,554.95 $56,554.95 $56,554.95 $56,554.95 2026-05-08
729 OTHER Other Male Reproductive System Diagnoses With Cc/mcc 26 25 $56,554.95 $56,554.95 $56,554.95 $56,554.95 $56,554.95 2026-05-08
73 OTHER Cranial And Peripheral Nerve Disorders With Mcc 26 25 $56,554.95 $56,554.95 $56,554.95 $56,554.95 $56,554.95 2026-05-08
734 OTHER Pelvic Evisceration, Radical Hysterectomy And Radical Vulvectomy With Cc/mcc 26 25 $56,554.95 $56,554.95 $56,554.95 $56,554.95 $56,554.95 2026-05-08
735 OTHER Pelvic Evisceration, Radical Hysterectomy And Radical Vulvectomy Without Cc/mcc 26 25 $56,554.95 $56,554.95 $56,554.95 $56,554.95 $56,554.95 2026-05-08
736 OTHER Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 26 25 $56,554.95 $56,554.95 $56,554.95 $56,554.95 $56,554.95 2026-05-08
737 OTHER Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Cc 26 25 $56,554.95 $56,554.95 $56,554.95 $56,554.95 $56,554.95 2026-05-08
738 OTHER Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy Without Cc/mcc 26 25 $56,554.95 $56,554.95 $56,554.95 $56,554.95 $56,554.95 2026-05-08
739 OTHER Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 26 25 $56,554.95 $56,554.95 $56,554.95 $56,554.95 $56,554.95 2026-05-08
741 OTHER Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy Without… 26 25 $56,554.95 $56,554.95 $56,554.95 $56,554.95 $56,554.95 2026-05-08
742 OTHER Uterine And Adnexa Procedures For Non-malignancy With Cc/mcc 26 25 $56,554.95 $56,554.95 $56,554.95 $56,554.95 $56,554.95 2026-05-08
743 OTHER Uterine And Adnexa Procedures For Non-malignancy Without Cc/mcc 26 25 $56,554.95 $56,554.95 $56,554.95 $56,554.95 $56,554.95 2026-05-08
758 OTHER Infections, Female Reproductive System With Cc 26 25 $56,554.95 $56,554.95 $56,554.95 $56,554.95 $56,554.95 2026-05-08
759 OTHER Infections, Female Reproductive System Without Cc/mcc 26 25 $56,554.95 $56,554.95 $56,554.95 $56,554.95 $56,554.95 2026-05-08
761 OTHER Menstrual And Other Female Reproductive System Disorders Without Cc/mcc 26 25 $56,554.95 $56,554.95 $56,554.95 $56,554.95 $56,554.95 2026-05-08
768 OTHER Vaginal Delivery With O.r. Procedures Except Sterilization And/or D&c 26 25 $56,554.95 $56,554.95 $56,554.95 $56,554.95 $56,554.95 2026-05-08
77 OTHER Hypertensive Encephalopathy With Mcc 26 25 $42,316.53 $42,316.53 $42,316.53 $42,316.53 $42,316.53 2026-05-08
78 OTHER Hypertensive Encephalopathy With Cc 26 25 $42,316.53 $42,316.53 $42,316.53 $42,316.53 $42,316.53 2026-05-08
790 OTHER Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 26 25 $62,536.17 $62,536.17 $62,536.17 $62,536.17 $62,536.17 2026-05-08
799 OTHER Splenic Procedures With Mcc 26 25 $56,554.95 $56,554.95 $56,554.95 $56,554.95 $56,554.95 2026-05-08
808 OTHER Major Hematological And Immunological Diagnoses Except Sickle Cell Crisis And Co… 26 25 $56,554.95 $56,554.95 $56,554.95 $56,554.95 $56,554.95 2026-05-08
809 OTHER Major Hematological And Immunological Diagnoses Except Sickle Cell Crisis And Co… 26 25 $42,316.53 $42,316.53 $42,316.53 $42,316.53 $42,316.53 2026-05-08
811 OTHER Red Blood Cell Disorders With Mcc 26 25 $56,554.95 $56,554.95 $56,554.95 $56,554.95 $56,554.95 2026-05-08
812 OTHER Red Blood Cell Disorders Without Mcc 26 25 $56,554.95 $56,554.95 $56,554.95 $56,554.95 $56,554.95 2026-05-08
813 OTHER Coagulation Disorders 38 27 $56,335.42 $56,335.42 $10,963.71 $56,335.42 $56,335.42 2026-05-09
814 OTHER Reticuloendothelial And Immunity Disorders With Mcc* 26 25 $56,554.95 $56,554.95 $56,554.95 $56,554.95 $56,554.95 2026-05-08
815 OTHER Reticuloendothelial And Immunity Disorders With Cc* 26 25 $56,554.95 $56,554.95 $56,554.95 $56,554.95 $56,554.95 2026-05-08
817 OTHER Other Antepartum Diagnoses With O.r. Procedures With Mcc 26 25 $56,554.95 $56,554.95 $56,554.95 $56,554.95 $56,554.95 2026-05-08
818 OTHER Other Antepartum Diagnoses With O.r. Procedures With Cc 26 25 $56,554.95 $56,554.95 $56,554.95 $56,554.95 $56,554.95 2026-05-08
819 OTHER Other Antepartum Diagnoses With O.r. Procedures Without Cc/mcc 26 25 $56,335.42 $56,335.42 $56,335.42 $56,335.42 $56,335.42 2026-05-08
82 OTHER Traumatic Stupor And Coma >1 Hour With Mcc* 26 25 $48,069.25 $48,069.25 $48,069.25 $48,069.25 $48,069.25 2026-05-08
820 OTHER Lymphoma And Leukemia With Major O.r. Procedures With Mcc 26 25 $56,554.95 $56,554.95 $56,554.95 $56,554.95 $56,554.95 2026-05-08
834 OTHER Acute Leukemia With Mcc 26 25 $56,554.95 $56,554.95 $56,554.95 $56,554.95 $56,554.95 2026-05-08
841 OTHER Lymphoma And Non-acute Leukemia With Cc 26 25 $56,554.95 $56,554.95 $56,554.95 $56,554.95 $56,554.95 2026-05-08
842 OTHER Lymphoma And Non-acute Leukemia Without Cc/mcc 26 25 $67,930.46 $67,930.46 $67,930.46 $67,930.46 $67,930.46 2026-05-08
843 OTHER Other Myeloproliferative Disorders Or Poorly Differentiated Neoplastic Diagnoses… 26 25 $42,316.53 $42,316.53 $42,316.53 $42,316.53 $42,316.53 2026-05-08
845 OTHER Other Myeloproliferative Disorders Or Poorly Differentiated Neoplastic Diagnoses… 26 25 $60,376.66 $60,376.66 $60,376.66 $60,376.66 $60,376.66 2026-05-08
846 OTHER Chemotherapy Without Acute Leukemia As Secondary Diagnosis With Mcc 26 25 $56,554.95 $56,554.95 $56,554.95 $56,554.95 $56,554.95 2026-05-08
857 OTHER Postoperative Or Post-traumatic Infections With O.r. Procedures With Cc 26 25 $92,836.51 $92,836.51 $92,836.51 $92,836.51 $92,836.51 2026-05-08
863 OTHER Postoperative And Post-traumatic Infections Without Mcc 26 25 $57,486.86 $57,486.86 $57,486.86 $57,486.86 $57,486.86 2026-05-08
864 OTHER Fever And Inflammatory Conditions 26 25 $42,316.53 $42,316.53 $42,316.53 $42,316.53 $42,316.53 2026-05-08
865 OTHER Viral Illness With Mcc 26 25 $42,316.53 $42,316.53 $42,316.53 $42,316.53 $42,316.53 2026-05-08
866 OTHER Viral Illness Without Mcc 26 25 $42,316.53 $42,316.53 $42,316.53 $42,316.53 $42,316.53 2026-05-08
867 OTHER Other Infectious And Parasitic Diseases Diagnoses With Mcc 26 25 $42,316.53 $42,316.53 $42,316.53 $42,316.53 $42,316.53 2026-05-08
869 OTHER Other Infectious And Parasitic Diseases Diagnoses Without Cc/mcc 26 25 $56,335.42 $56,335.42 $56,335.42 $56,335.42 $56,335.42 2026-05-08
870 OTHER Septicemia Or Severe Sepsis With Mv >96 Hours 26 25 $56,335.42 $56,335.42 $56,335.42 $56,335.42 $56,335.42 2026-05-08
871 LOCAL Septicemia Or Severe Sepsis Without Mv >96 Hours W Mcc 11 9 $230,294.84 — $56,554.95 $56,554.95 $56,554.95 2026-08-31
872 LOCAL Septicemia Or Severe Sepsis Without Mv >96 Hours Without Mcc 11 9 $13,253.05 — $56,554.95 $56,554.95 $56,554.95 2026-08-31
904 OTHER Skin Grafts For Injuries With Cc/mcc 26 25 $56,554.95 $56,554.95 $56,554.95 $56,554.95 $56,554.95 2026-05-08
905 OTHER Skin Grafts For Injuries Without Cc/mcc 26 25 $56,554.95 $56,554.95 $56,554.95 $56,554.95 $56,554.95 2026-05-08
906 OTHER Hand Procedures For Injuries 26 25 $48,046.85 $48,046.85 $48,046.85 $48,046.85 $48,046.85 2026-05-08
909 OTHER Other O.r. Procedures For Injuries Without Cc/mcc* 26 25 $42,316.53 $42,316.53 $42,316.53 $42,316.53 $42,316.53 2026-05-08
914 OTHER Traumatic Injury Without Mcc 26 25 $42,316.53 $42,316.53 $42,316.53 $42,316.53 $42,316.53 2026-05-08
915 OTHER Allergic Reactions With Mcc 26 25 $42,316.53 $42,316.53 $42,316.53 $42,316.53 $42,316.53 2026-05-08
918 OTHER Poisoning And Toxic Effects Of Drugs Without Mcc 26 25 $42,316.53 $42,316.53 $42,316.53 $42,316.53 $42,316.53 2026-05-08
920 OTHER Complications Of Treatment With Cc 38 27 $53,109.60 $53,109.60 $21,415.88 $53,109.60 $53,109.60 2026-05-09
922 OTHER Other Injury, Poisoning And Toxic Effect Diagnoses With Mcc 26 25 $42,316.53 $42,316.53 $42,316.53 $42,316.53 $42,316.53 2026-05-08
934 OTHER Full Thickness Burn Without Skin Graft Or Inhalation Injury 26 25 $56,335.42 $56,335.42 $56,335.42 $56,335.42 $56,335.42 2026-05-08
935 OTHER Non-extensive Burns 26 25 $56,335.42 $56,335.42 $56,335.42 $56,335.42 $56,335.42 2026-05-08
939 OTHER O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 26 25 $56,335.42 $56,335.42 $56,335.42 $56,335.42 $56,335.42 2026-05-08
94 OTHER Bacterial And Tuberculous Infections Of Nervous System With Mcc* 26 25 $47,993.08 $47,993.08 $47,993.08 $47,993.08 $47,993.08 2026-05-08
940 OTHER O.r. Procedures With Diagnoses Of Other Contact With Health Services With Cc 26 25 $56,335.42 $56,335.42 $56,335.42 $56,335.42 $56,335.42 2026-05-08
947 OTHER Signs And Symptoms With Mcc 26 25 $56,554.95 $56,554.95 $56,554.95 $56,554.95 $56,554.95 2026-05-08
950 OTHER Aftercare Without Cc/mcc 26 25 $56,554.95 $56,554.95 $56,554.95 $56,554.95 $56,554.95 2026-05-08
951 OTHER Other Factors Influencing Health Status 26 25 $56,554.95 $56,554.95 $56,554.95 $56,554.95 $56,554.95 2026-05-08
955 OTHER Craniotomy For Multiple Significant Trauma 26 25 $51,057.61 $51,057.61 $51,057.61 $51,057.61 $51,057.61 2026-05-08
959 OTHER Other O.r. Procedures For Multiple Significant Trauma Without Cc/mcc 26 25 $104,852.70 $104,852.70 $104,852.70 $104,852.70 $104,852.70 2026-05-08
963 OTHER Other Multiple Significant Trauma With Mcc 26 25 $46,563.86 $46,563.86 $46,563.86 $46,563.86 $46,563.86 2026-05-08
964 OTHER Other Multiple Significant Trauma With Cc 26 25 $57,038.83 $57,038.83 $57,038.83 $57,038.83 $57,038.83 2026-05-08
974 OTHER HIV With Major Related Condition With Mcc* 26 25 $111,044.49 $111,044.49 $111,044.49 $111,044.49 $111,044.49 2026-05-08
975 OTHER HIV With Major Related Condition With Cc* 26 25 $55,434.88 $55,434.88 $55,434.88 $55,434.88 $55,434.88 2026-05-08
976 OTHER HIV With Major Related Condition Without Cc/mcc* 26 25 $46,563.86 $46,563.86 $46,563.86 $46,563.86 $46,563.86 2026-05-08
977 OTHER HIV With Or Without Other Related Condition 26 25 $106,761.31 $106,761.31 $106,761.31 $106,761.31 $106,761.31 2026-05-08
981 LOCAL Extensive O.r. Procedure Unrelated To Principal Diagnosis W Mcc 11 9 $412,453.61 — $58,508.37 $58,508.37 $58,508.37 2026-08-31
981 OTHER Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 39 27 $46,563.86 $46,563.86 $25,919.92 $89,569.08 $46,563.86 2026-05-09
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