Hospital

Vibra Hospital Of Central Dakotas Llc

Mandan, ND · CCN 352005 · Rates published

5,224 distinct procedures filed

60 distinct payers

547,937 rate rows

2026-05-22 last MRF observed

Data quality

478,403 of 547,937 rate rows are consumer-grade (87.3%)

69,534 rows are marked excluded from the consumer medians — these stay visible in the raw drill-down with the same reason shown here, so nothing is silently hidden.

Excluded — reason	Rows
template filing: same amount across many unrelated codes — excluded	69,532
placeholder amount (≤ $0.02) — excluded from medians	2

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

Source MRF file	https://vhcentraldakotas.com/wp-content/uploads/sites/25/2025/09/462632340_vibra-hospital-of-central-dakota_standardcharges.csv
Found on page	https://vhcentraldakotas.com/about-us/price-transparency/
Discovered via	Discovered by HANK
Last fetch	not_modified · 2026-05-18
Content fingerprint	d0c7f71cade2d038… · 8,238,244 bytes · first seen 2026-05-09

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…	18	$159,702.86	$159,702.86	$159,702.86	nat. median $181,005 0.9× median
4 OTHER	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…	18	$131,354.32	$131,354.32	$131,354.32	nat. median $134,983 1.0× median
163 OTHER	Major Chest Procedures With Mcc	18	$108,405.72	$108,405.72	$108,405.72	nat. median $47,944 outlier · 2.3×
165 OTHER	Major Chest Procedures Without Cc/mcc	18	$108,405.72	$108,405.72	$108,405.72	nat. median $19,105 outlier · 5.7×
164 OTHER	Major Chest Procedures With Cc	18	$108,405.72	$108,405.72	$108,405.72	nat. median $24,249 outlier · 4.5×
166 OTHER	Other Respiratory System O.r. Procedures With Mcc	18	$107,020.30	$107,020.30	$107,020.30	nat. median $38,129 outlier · 2.8×
11 OTHER	Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc	18	$107,020.30	$107,020.30	$107,020.30	nat. median $49,519 outlier · 2.2×
140 OTHER	Major Head And Neck Procedures With Mcc	18	$107,020.30	$107,020.30	$107,020.30	nat. median $37,242 outlier · 2.9×
981 OTHER	Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc	18	$107,006.58	$107,006.58	$107,006.58	nat. median $33,955 outlier · 3.2×
68875010201 OTHER	Gattex	33	$17.36	$99,999.99	$99,999.99	nat. median $100,000 1.0× median
870 OTHER	Septicemia Or Severe Sepsis With Mv >96 Hours	18	$94,743.55	$94,743.55	$94,743.55	nat. median $54,603 1.7× median
207 OTHER	Respiratory System Diagnosis With Ventilator Support >96 Hours	21	$30,533.31	$88,913.81	$88,913.81	nat. median $66,849 1.3× median
167 OTHER	Other Respiratory System O.r. Procedures With Cc	18	$72,119.59	$72,119.59	$72,119.59	nat. median $18,396 outlier · 3.9×
173 OTHER	Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary…	18	$72,119.59	$72,119.59	$72,119.59	nat. median $25,789 outlier · 2.8×
12 OTHER	Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc	18	$72,119.59	$72,119.59	$72,119.59	nat. median $39,504 1.8× median
168 OTHER	Other Respiratory System O.r. Procedures Without Cc/mcc	18	$72,119.59	$72,119.59	$72,119.59	nat. median $12,971 outlier · 5.6×
853 OTHER	Infectious And Parasitic Diseases With O.r. Procedures With Mcc	18	$69,325.89	$69,325.89	$69,325.89	nat. median $39,509 1.8× median
40 OTHER	Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc	18	$67,167.74	$67,167.74	$67,167.74	nat. median $35,347 1.9× median
799 OTHER	Splenic Procedures With Mcc	18	$63,820.79	$63,820.79	$63,820.79	nat. median $43,209 1.5× median
356 OTHER	Other Digestive System O.r. Procedures With Mcc	18	$63,820.79	$63,820.79	$63,820.79	nat. median $43,743 1.5× median
573 OTHER	Skin Graft For Skin Ulcer Or Cellulitis With Mcc	18	$63,578.45	$63,578.45	$63,578.45	nat. median $54,881 1.2× median
582 OTHER	Mastectomy For Malignancy With Cc/mcc	18	$62,023.86	$62,023.86	$62,023.86	nat. median $18,095 outlier · 3.4×
579 OTHER	Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc	18	$62,023.86	$62,023.86	$62,023.86	nat. median $30,752 outlier · 2.0×
856 OTHER	Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc	18	$61,616.92	$61,616.92	$61,616.92	nat. median $32,385 1.9× median
205 OTHER	Other Respiratory System Diagnoses With Mcc	21	$21,415.88	$59,961.73	$59,961.73	nat. median $17,709 outlier · 3.4×
622 OTHER	Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor…	18	$59,787.98	$59,787.98	$59,787.98	nat. median $31,621 1.9× median
619 OTHER	O.r. Procedures For Obesity With Mcc	18	$59,787.98	$59,787.98	$59,787.98	nat. median $26,261 outlier · 2.3×
551 OTHER	Medical Back Problems With Mcc	21	$21,415.88	$59,710.25	$59,710.25	nat. median $15,276 outlier · 3.9×
64 OTHER	Intracranial Hemorrhage Or Cerebral Infarction With Mcc	18	$59,477.06	$59,477.06	$59,477.06	nat. median $19,110 outlier · 3.1×
61 OTHER	Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A…	18	$59,477.06	$59,477.06	$59,477.06	nat. median $26,323 outlier · 2.3×
901 OTHER	Wound Debridements For Injuries With Mcc	18	$58,667.75	$58,667.75	$58,667.75	nat. median $29,541 2.0× median
245 OTHER	Aicd Generator Procedures	18	$58,096.21	$58,096.21	$58,096.21	nat. median $43,285 1.3× median
263 OTHER	Vein Ligation And Stripping	18	$58,096.21	$58,096.21	$58,096.21	nat. median $26,524 outlier · 2.2×
264 OTHER	Other Circulatory System O.r. Procedures	18	$58,096.21	$58,096.21	$58,096.21	nat. median $32,470 1.8× median
215 OTHER	Other Heart Assist System Implant	18	$57,716.71	$57,716.71	$57,716.71	nat. median $92,359 0.6× median
254 OTHER	Other Vascular Procedures Without Cc/mcc	18	$57,716.71	$57,716.71	$57,716.71	nat. median $16,771 outlier · 3.4×
216 OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	18	$57,716.71	$57,716.71	$57,716.71	nat. median $90,130 0.6× median
253 OTHER	Other Vascular Procedures With Cc	18	$57,716.71	$57,716.71	$57,716.71	nat. median $24,609 outlier · 2.3×
255 OTHER	Upper Limb And Toe Amputation For Circulatory System Disorders With Mcc	18	$57,716.71	$57,716.71	$57,716.71	nat. median $21,899 outlier · 2.6×
212 OTHER	Concomitant Aortic And Mitral Valve Procedures	18	$57,716.71	$57,716.71	$57,716.71	nat. median $90,581 0.6× median
252 OTHER	Other Vascular Procedures With Mcc	18	$57,716.71	$57,716.71	$57,716.71	nat. median $25,377 outlier · 2.3×
220 OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	18	$57,716.71	$57,716.71	$57,716.71	nat. median $50,021 1.2× median
22 OTHER	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/…	18	$57,716.71	$57,716.71	$57,716.71	nat. median $36,392 1.6× median
251 OTHER	Percutaneous Cardiovascular Procedures Without Intraluminal Device Without Mcc	18	$57,716.71	$57,716.71	$57,716.71	nat. median $11,991 outlier · 4.8×
256 OTHER	Upper Limb And Toe Amputation For Circulatory System Disorders With Cc	18	$57,716.71	$57,716.71	$57,716.71	nat. median $16,548 outlier · 3.5×
257 OTHER	Upper Limb And Toe Amputation For Circulatory System Disorders Without Cc/mcc	18	$57,716.71	$57,716.71	$57,716.71	nat. median $9,847 outlier · 5.9×
217 OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	18	$57,716.71	$57,716.71	$57,716.71	nat. median $60,727 1.0× median
218 OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	18	$57,716.71	$57,716.71	$57,716.71	nat. median $56,507 1.0× median
242 OTHER	Permanent Cardiac Pacemaker Implant With Mcc	18	$57,716.71	$57,716.71	$57,716.71	nat. median $31,203 1.8× median
25 OTHER	Craniotomy And Endovascular Intracranial Procedures With Mcc	18	$57,716.71	$57,716.71	$57,716.71	nat. median $42,589 1.4× median

Other procedures at this hospital

Browse this hospital's 5,224 published procedures. Use the slice to choose what to show, then sort or filter any column.

Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
Code	Type	Description	Rate rows	Payers	Gross	Cash	Min $	Max $	Avg median	Last observed

441	OTHER	Disorders Of Liver Except Malignancy, Cirrhosis Or Alcoholic Hepatitis With Mcc	46	21	$42,573.10	$42,573.10	$41,721.64	$56,554.95	$42,573.10	2026-05-22
198	OTHER	Interstitial Lung Disease Without Cc/mcc*	36	18	$43,185.80	$43,185.80	$43,185.80	$43,185.80	$43,185.80	2026-05-22
283	OTHER	Acute Myocardial Infarction, Expired With Mcc	36	18	$43,185.80	$43,185.80	$43,185.80	$43,185.80	$43,185.80	2026-05-22
902	OTHER	Wound Debridements For Injuries With Cc	36	18	$43,185.80	$43,185.80	$43,185.80	$43,185.80	$43,185.80	2026-05-22
577	OTHER	Skin Graft Except For Skin Ulcer Or Cellulitis With Cc*	36	18	$43,185.80	$43,185.80	$43,185.80	$43,185.80	$43,185.80	2026-05-22
578	OTHER	Skin Graft Except For Skin Ulcer Or Cellulitis Without Cc/mcc*	36	18	$43,185.80	$43,185.80	$43,185.80	$43,185.80	$43,185.80	2026-05-22
670	OTHER	Transurethral Procedures Without Cc/mcc	36	18	$43,185.80	$43,185.80	$43,185.80	$43,185.80	$43,185.80	2026-05-22
669	OTHER	Transurethral Procedures With Cc	36	18	$43,185.80	$43,185.80	$43,185.80	$43,185.80	$43,185.80	2026-05-22
671	OTHER	Urethral Procedures With Cc/mcc	36	18	$43,185.80	$43,185.80	$43,185.80	$43,185.80	$43,185.80	2026-05-22
854	OTHER	Infectious And Parasitic Diseases With O.r. Procedures With Cc	36	18	$43,185.80	$43,185.80	$43,185.80	$43,185.80	$43,185.80	2026-05-22
155	OTHER	Other Ear, Nose, Mouth And Throat Diagnoses With Cc	36	18	$43,185.80	$43,185.80	$43,185.80	$43,185.80	$43,185.80	2026-05-22
154	OTHER	Other Ear, Nose, Mouth And Throat Diagnoses With Mcc	36	18	$43,185.80	$43,185.80	$43,185.80	$43,185.80	$43,185.80	2026-05-22
574	OTHER	Skin Graft For Skin Ulcer Or Cellulitis With Cc	36	18	$43,185.80	$43,185.80	$43,185.80	$43,185.80	$43,185.80	2026-05-22
152	OTHER	Otitis Media And Uri With Mcc	36	18	$43,185.80	$43,185.80	$43,185.80	$43,185.80	$43,185.80	2026-05-22
668	OTHER	Transurethral Procedures With Mcc	36	18	$43,185.80	$43,185.80	$43,185.80	$43,185.80	$43,185.80	2026-05-22
672	OTHER	Urethral Procedures Without Cc/mcc	36	18	$43,185.80	$43,185.80	$43,185.80	$43,185.80	$43,185.80	2026-05-22
903	OTHER	Wound Debridements For Injuries Without Cc/mcc	36	18	$43,185.80	$43,185.80	$43,185.80	$43,185.80	$43,185.80	2026-05-22
904	OTHER	Skin Grafts For Injuries With Cc/mcc	36	18	$43,185.80	$43,185.80	$43,185.80	$43,185.80	$43,185.80	2026-05-22
664	OTHER	Minor Bladder Procedures Without Cc/mcc	36	18	$43,185.80	$43,185.80	$43,185.80	$43,185.80	$43,185.80	2026-05-22
663	OTHER	Minor Bladder Procedures With Cc	36	18	$43,185.80	$43,185.80	$43,185.80	$43,185.80	$43,185.80	2026-05-22
145	OTHER	Other Ear, Nose, Mouth And Throat O.r. Procedures Without Cc/mcc	36	18	$43,185.80	$43,185.80	$43,185.80	$43,185.80	$43,185.80	2026-05-22
144	OTHER	Other Ear, Nose, Mouth And Throat O.r. Procedures With Cc	36	18	$43,185.80	$43,185.80	$43,185.80	$43,185.80	$43,185.80	2026-05-22
922	OTHER	Other Injury, Poisoning And Toxic Effect Diagnoses With Mcc	36	18	$43,185.80	$43,185.80	$43,185.80	$43,185.80	$43,185.80	2026-05-22
662	OTHER	Minor Bladder Procedures With Mcc	36	18	$43,185.80	$43,185.80	$43,185.80	$43,185.80	$43,185.80	2026-05-22
157	OTHER	Dental And Oral Diseases With Mcc	36	18	$43,185.80	$43,185.80	$43,185.80	$43,185.80	$43,185.80	2026-05-22
435	OTHER	Malignancy Of Hepatobiliary System Or Pancreas With Mcc	36	18	$43,185.80	$43,185.80	$43,185.80	$43,185.80	$43,185.80	2026-05-22
326	OTHER	Stomach, Esophageal And Duodenal Procedures With Mcc	36	18	$43,185.80	$43,185.80	$43,185.80	$43,185.80	$43,185.80	2026-05-22
576	OTHER	Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc*	36	18	$43,185.80	$43,185.80	$43,185.80	$43,185.80	$43,185.80	2026-05-22
575	OTHER	Skin Graft For Skin Ulcer Or Cellulitis Without Cc/mcc	36	18	$43,185.80	$43,185.80	$43,185.80	$43,185.80	$43,185.80	2026-05-22
488	OTHER	Knee Procedures Without Principal Diagnosis Of Infection With Cc/mcc	36	18	$43,185.80	$43,185.80	$43,185.80	$43,185.80	$43,185.80	2026-05-22
115	OTHER	Extraocular Procedures Except Orbit	36	18	$43,185.80	$43,185.80	$43,185.80	$43,185.80	$43,185.80	2026-05-22
661	OTHER	Kidney And Ureter Procedures For Non-neoplasm Without Cc/mcc*	36	18	$43,185.80	$43,185.80	$43,185.80	$43,185.80	$43,185.80	2026-05-22
114	OTHER	Orbital Procedures Without Cc/mcc	36	18	$43,185.80	$43,185.80	$43,185.80	$43,185.80	$43,185.80	2026-05-22
501	OTHER	Soft Tissue Procedures With Cc	36	18	$43,185.80	$43,185.80	$43,185.80	$43,185.80	$43,185.80	2026-05-22
667	OTHER	Prostatectomy Without Cc/mcc	36	18	$43,185.80	$43,185.80	$43,185.80	$43,185.80	$43,185.80	2026-05-22
196	OTHER	Interstitial Lung Disease With Mcc*	36	18	$43,185.80	$43,185.80	$43,185.80	$43,185.80	$43,185.80	2026-05-22
660	OTHER	Kidney And Ureter Procedures For Non-neoplasm With Cc*	36	18	$43,185.80	$43,185.80	$43,185.80	$43,185.80	$43,185.80	2026-05-22
386	OTHER	Inflammatory Bowel Disease With Cc	36	18	$43,185.80	$43,185.80	$43,185.80	$43,185.80	$43,185.80	2026-05-22
113	OTHER	Orbital Procedures With Cc/mcc	36	18	$43,185.80	$43,185.80	$43,185.80	$43,185.80	$43,185.80	2026-05-22
709	OTHER	Penis Procedures With Cc/mcc	36	18	$43,185.80	$43,185.80	$43,185.80	$43,185.80	$43,185.80	2026-05-22
659	OTHER	Kidney And Ureter Procedures For Non-neoplasm With Mcc*	36	18	$43,185.80	$43,185.80	$43,185.80	$43,185.80	$43,185.80	2026-05-22
818	OTHER	Other Antepartum Diagnoses With O.r. Procedures With Cc	36	18	$43,185.80	$43,185.80	$43,185.80	$43,185.80	$43,185.80	2026-05-22
905	OTHER	Skin Grafts For Injuries Without Cc/mcc	36	18	$43,185.80	$43,185.80	$43,185.80	$43,185.80	$43,185.80	2026-05-22
143	OTHER	Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc	36	18	$43,185.80	$43,185.80	$43,185.80	$43,185.80	$43,185.80	2026-05-22
142	OTHER	Major Head And Neck Procedures Without Cc/mcc	36	18	$43,185.80	$43,185.80	$43,185.80	$43,185.80	$43,185.80	2026-05-22
141	OTHER	Major Head And Neck Procedures With Cc	36	18	$43,185.80	$43,185.80	$43,185.80	$43,185.80	$43,185.80	2026-05-22
658	OTHER	Kidney And Ureter Procedures For Neoplasm Without Cc/mcc	36	18	$43,185.80	$43,185.80	$43,185.80	$43,185.80	$43,185.80	2026-05-22
277	OTHER	Cardiac Defibrillator Implant Without Mcc	36	18	$43,185.80	$43,185.80	$43,185.80	$43,185.80	$43,185.80	2026-05-22
312	OTHER	Syncope And Collapse	36	18	$43,185.80	$43,185.80	$43,185.80	$43,185.80	$43,185.80	2026-05-22
139	OTHER	Salivary Gland Procedures	36	18	$43,185.80	$43,185.80	$43,185.80	$43,185.80	$43,185.80	2026-05-22
927	OTHER	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	36	18	$43,185.80	$43,185.80	$43,185.80	$43,185.80	$43,185.80	2026-05-22
138	OTHER	Mouth Procedures Without Cc/mcc	36	18	$43,185.80	$43,185.80	$43,185.80	$43,185.80	$43,185.80	2026-05-22
928	OTHER	Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc	36	18	$43,185.80	$43,185.80	$43,185.80	$43,185.80	$43,185.80	2026-05-22
137	OTHER	Mouth Procedures With Cc/mcc	36	18	$43,185.80	$43,185.80	$43,185.80	$43,185.80	$43,185.80	2026-05-22
656	OTHER	Kidney And Ureter Procedures For Neoplasm With Mcc	36	18	$43,185.80	$43,185.80	$43,185.80	$43,185.80	$43,185.80	2026-05-22
260	OTHER	Cardiac Pacemaker Revision Except Device Replacement With Mcc	36	18	$43,185.80	$43,185.80	$43,185.80	$43,185.80	$43,185.80	2026-05-22
77	OTHER	Hypertensive Encephalopathy With Mcc	36	18	$43,185.80	$43,185.80	$43,185.80	$43,185.80	$43,185.80	2026-05-22
136	OTHER	Sinus And Mastoid Procedures Without Cc/mcc	36	18	$43,185.80	$43,185.80	$43,185.80	$43,185.80	$43,185.80	2026-05-22
929	OTHER	Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/mcc	36	18	$43,185.80	$43,185.80	$43,185.80	$43,185.80	$43,185.80	2026-05-22
657	OTHER	Kidney And Ureter Procedures For Neoplasm With Cc	36	18	$43,185.80	$43,185.80	$43,185.80	$43,185.80	$43,185.80	2026-05-22
940	OTHER	O.r. Procedures With Diagnoses Of Other Contact With Health Services With Cc	36	18	$43,185.80	$43,185.80	$43,185.80	$43,185.80	$43,185.80	2026-05-22
279	OTHER	Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures …	36	18	$43,185.80	$43,185.80	$43,185.80	$43,185.80	$43,185.80	2026-05-22
135	OTHER	Sinus And Mastoid Procedures With Cc/mcc	36	18	$43,185.80	$43,185.80	$43,185.80	$43,185.80	$43,185.80	2026-05-22
374	OTHER	Digestive Malignancy With Mcc*	36	18	$43,185.80	$43,185.80	$43,185.80	$43,185.80	$43,185.80	2026-05-22
655	OTHER	Major Bladder Procedures Without Cc/mcc	36	18	$43,185.80	$43,185.80	$43,185.80	$43,185.80	$43,185.80	2026-05-22
276	OTHER	Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator	36	18	$43,185.80	$43,185.80	$43,185.80	$43,185.80	$43,185.80	2026-05-22
941	OTHER	O.r. Procedures With Diagnoses Of Other Contact With Health Services Without Cc/…	36	18	$43,185.80	$43,185.80	$43,185.80	$43,185.80	$43,185.80	2026-05-22
625	OTHER	Thyroid, Parathyroid And Thyroglossal Procedures With Mcc	36	18	$43,185.80	$43,185.80	$43,185.80	$43,185.80	$43,185.80	2026-05-22
628	OTHER	Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc	36	18	$43,185.80	$43,185.80	$43,185.80	$43,185.80	$43,185.80	2026-05-22
717	OTHER	Other Male Reproductive System O.r. Procedures Except Malignancy With Cc/mcc	36	18	$43,185.80	$43,185.80	$43,185.80	$43,185.80	$43,185.80	2026-05-22
319	OTHER	Other Endovascular Cardiac Valve Procedures With Mcc	36	18	$43,185.80	$43,185.80	$43,185.80	$43,185.80	$43,185.80	2026-05-22
197	OTHER	Interstitial Lung Disease With Cc*	36	18	$43,185.80	$43,185.80	$43,185.80	$43,185.80	$43,185.80	2026-05-22
13	OTHER	Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy Without Cc/mcc	36	18	$43,185.80	$43,185.80	$43,185.80	$43,185.80	$43,185.80	2026-05-22
617	OTHER	Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With…	36	18	$43,185.80	$43,185.80	$43,185.80	$43,185.80	$43,185.80	2026-05-22
715	OTHER	Other Male Reproductive System O.r. Procedures For Malignancy With Cc/mcc	36	18	$43,185.80	$43,185.80	$43,185.80	$43,185.80	$43,185.80	2026-05-22
545	OTHER	Connective Tissue Disorders With Mcc	36	18	$43,185.80	$43,185.80	$43,185.80	$43,185.80	$43,185.80	2026-05-22
615	OTHER	Adrenal And Pituitary Procedures Without Cc/mcc	36	18	$43,185.80	$43,185.80	$43,185.80	$43,185.80	$43,185.80	2026-05-22
614	OTHER	Adrenal And Pituitary Procedures With Cc/mcc	36	18	$43,185.80	$43,185.80	$43,185.80	$43,185.80	$43,185.80	2026-05-22
304	OTHER	Hypertension With Mcc	36	18	$43,185.80	$43,185.80	$43,185.80	$43,185.80	$43,185.80	2026-05-22
306	OTHER	Cardiac Congenital And Valvular Disorders With Mcc	36	18	$43,185.80	$43,185.80	$43,185.80	$43,185.80	$43,185.80	2026-05-22
604	OTHER	Trauma To The Skin, Subcutaneous Tissue And Breast With Mcc	36	18	$43,185.80	$43,185.80	$43,185.80	$43,185.80	$43,185.80	2026-05-22
616	OTHER	Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With…	36	18	$43,185.80	$43,185.80	$43,185.80	$43,185.80	$43,185.80	2026-05-22
387	OTHER	Inflammatory Bowel Disease Without Cc/mcc	36	18	$43,185.80	$43,185.80	$43,185.80	$43,185.80	$43,185.80	2026-05-22
117	OTHER	Intraocular Procedures Without Cc/mcc	36	18	$43,185.80	$43,185.80	$43,185.80	$43,185.80	$43,185.80	2026-05-22
606	OTHER	Minor Skin Disorders With Mcc	36	18	$43,185.80	$43,185.80	$43,185.80	$43,185.80	$43,185.80	2026-05-22
711	OTHER	Testes Procedures With Cc/mcc	36	18	$43,185.80	$43,185.80	$43,185.80	$43,185.80	$43,185.80	2026-05-22
78	OTHER	Hypertensive Encephalopathy With Cc	36	18	$43,185.80	$43,185.80	$43,185.80	$43,185.80	$43,185.80	2026-05-22
278	OTHER	Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures …	36	18	$43,185.80	$43,185.80	$43,185.80	$43,185.80	$43,185.80	2026-05-22
707	OTHER	Major Male Pelvic Procedures With Cc/mcc	36	18	$43,185.80	$43,185.80	$43,185.80	$43,185.80	$43,185.80	2026-05-22
116	OTHER	Intraocular Procedures With Cc/mcc	36	18	$43,185.80	$43,185.80	$43,185.80	$43,185.80	$43,185.80	2026-05-22
713	OTHER	Transurethral Prostatectomy With Cc/mcc	36	18	$43,185.80	$43,185.80	$43,185.80	$43,185.80	$43,185.80	2026-05-22
934	OTHER	Full Thickness Burn Without Skin Graft Or Inhalation Injury	36	18	$43,185.80	$43,185.80	$43,185.80	$43,185.80	$43,185.80	2026-05-22
623	OTHER	Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor…	36	18	$43,377.83	$43,377.83	$43,377.83	$43,377.83	$43,377.83	2026-05-22
620	OTHER	O.r. Procedures For Obesity With Cc	36	18	$43,377.83	$43,377.83	$43,377.83	$43,377.83	$43,377.83	2026-05-22
464	OTHER	Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …	36	18	$43,606.45	$43,606.45	$43,606.45	$43,606.45	$43,606.45	2026-05-22
380	OTHER	Complicated Peptic Ulcer With Mcc	36	18	$43,789.35	$43,789.35	$43,789.35	$43,789.35	$43,789.35	2026-05-22
414	OTHER	Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc	36	18	$43,789.35	$43,789.35	$43,789.35	$43,789.35	$43,789.35	2026-05-22
411	OTHER	Cholecystectomy With C.d.e. With Mcc	36	18	$43,789.35	$43,789.35	$43,789.35	$43,789.35	$43,789.35	2026-05-22
417	OTHER	Laparoscopic Cholecystectomy Without C.d.e. With Mcc	36	18	$43,789.35	$43,789.35	$43,789.35	$43,789.35	$43,789.35	2026-05-22
539	OTHER	Osteomyelitis With Mcc*	46	21	$44,319.74	$44,319.74	$43,022.73	$53,718.92	$44,319.74	2026-05-22
640	OTHER	Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes With M…	46	21	$44,735.82	$44,735.82	$12,937.85	$56,554.95	$44,735.82	2026-05-22
189	OTHER	Pulmonary Edema And Respiratory Failure	46	21	$44,749.54	$44,749.54	$27,023.21	$70,667.93	$44,749.54	2026-05-22
388	OTHER	Gastrointestinal Obstruction With Mcc	36	18	$45,179.34	$45,179.34	$45,179.34	$45,179.34	$45,179.34	2026-05-22
393	OTHER	Other Digestive System Diagnoses With Mcc	46	21	$46,455.02	$46,455.02	$45,525.93	$56,554.95	$46,455.02	2026-05-22
288	OTHER	Acute And Subacute Endocarditis With Mcc	46	21	$46,592.19	$46,592.19	$21,415.88	$46,592.19	$46,592.19	2026-05-22
674	OTHER	Other Kidney And Urinary Tract Procedures With Cc*	36	18	$47,849.59	$47,849.59	$47,849.59	$47,849.59	$47,849.59	2026-05-22
675	OTHER	Other Kidney And Urinary Tract Procedures Without Cc/mcc*	36	18	$47,849.59	$47,849.59	$47,849.59	$47,849.59	$47,849.59	2026-05-22
666	OTHER	Prostatectomy With Cc	36	18	$47,849.59	$47,849.59	$47,849.59	$47,849.59	$47,849.59	2026-05-22
654	OTHER	Major Bladder Procedures With Cc	36	18	$47,849.59	$47,849.59	$47,849.59	$47,849.59	$47,849.59	2026-05-22
438	OTHER	Disorders Of Pancreas Except Malignancy With Mcc	45	21	$47,904.46	$47,904.46	$47,904.46	$56,554.95	$47,904.46	2026-05-22
426	OTHER	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	36	18	$48,608.60	$48,608.60	$48,608.60	$48,608.60	$48,608.60	2026-05-22
429	OTHER	Combined Anterior And Posterior Cervical Spinal Fusion With Mcc	36	18	$48,608.60	$48,608.60	$48,608.60	$48,608.60	$48,608.60	2026-05-22
427	OTHER	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	36	18	$48,608.60	$48,608.60	$48,608.60	$48,608.60	$48,608.60	2026-05-22
448	OTHER	Multiple Level Spinal Fusion Except Cervical Without Mcc	36	18	$48,608.60	$48,608.60	$48,608.60	$48,608.60	$48,608.60	2026-05-22
53	OTHER	Spinal Disorders And Injuries Without Cc/mcc	36	18	$48,608.60	$48,608.60	$48,608.60	$48,608.60	$48,608.60	2026-05-22
52	OTHER	Spinal Disorders And Injuries With Cc/mcc	36	18	$48,608.60	$48,608.60	$48,608.60	$48,608.60	$48,608.60	2026-05-22
447	OTHER	Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall…	36	18	$48,608.60	$48,608.60	$48,608.60	$48,608.60	$48,608.60	2026-05-22
94	OTHER	Bacterial And Tuberculous Infections Of Nervous System With Mcc*	36	18	$48,978.96	$48,978.96	$48,978.96	$48,978.96	$48,978.96	2026-05-22
919	OTHER	Complications Of Treatment With Mcc	46	21	$49,033.82	$49,033.82	$42,762.20	$49,033.82	$49,033.82	2026-05-22
82	OTHER	Traumatic Stupor And Coma >1 Hour With Mcc*	36	18	$49,056.69	$49,056.69	$49,056.69	$49,056.69	$49,056.69	2026-05-22
583	OTHER	Mastectomy For Malignancy Without Cc/mcc	36	18	$50,972.50	$50,972.50	$50,972.50	$50,972.50	$50,972.50	2026-05-22
581	OTHER	Other Skin, Subcutaneous Tissue And Breast Procedures Without Cc/mcc	36	18	$50,972.50	$50,972.50	$50,972.50	$50,972.50	$50,972.50	2026-05-22
580	OTHER	Other Skin, Subcutaneous Tissue And Breast Procedures With Cc	36	18	$50,972.50	$50,972.50	$50,972.50	$50,972.50	$50,972.50	2026-05-22
55292070255	OTHER	Hemin For Injection	96	33	$51,333.70	$51,333.70	$17.36	$51,333.70	$51,333.70	2026-05-22
974	OTHER	HIV With Major Related Condition With Mcc*	36	18	$52,106.44	$52,106.44	$52,106.44	$52,106.44	$52,106.44	2026-05-22
570	OTHER	Skin Debridement With Mcc*	36	18	$53,830.21	$53,830.21	$53,830.21	$53,830.21	$53,830.21	2026-05-22
208	OTHER	Respiratory System Diagnosis With Ventilator Support <=96 Hours	46	21	$53,990.25	$53,990.25	$4,043.46	$53,990.25	$53,990.25	2026-05-22
939	OTHER	O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc	36	18	$54,200.57	$54,200.57	$54,200.57	$54,200.57	$54,200.57	2026-05-22
665	OTHER	Prostatectomy With Mcc	36	18	$54,735.54	$54,735.54	$54,735.54	$54,735.54	$54,735.54	2026-05-22
673	OTHER	Other Kidney And Urinary Tract Procedures With Mcc*	36	18	$54,735.54	$54,735.54	$54,735.54	$54,735.54	$54,735.54	2026-05-22
653	OTHER	Major Bladder Procedures With Mcc	36	18	$54,735.54	$54,735.54	$54,735.54	$54,735.54	$54,735.54	2026-05-22
28	OTHER	Spinal Procedures With Mcc	36	18	$54,822.41	$54,822.41	$54,822.41	$54,822.41	$54,822.41	2026-05-22
29	OTHER	Spinal Procedures With Cc Or Spinal Neurostimulators	36	18	$54,822.41	$54,822.41	$54,822.41	$54,822.41	$54,822.41	2026-05-22
515	OTHER	Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc	36	18	$54,822.41	$54,822.41	$54,822.41	$54,822.41	$54,822.41	2026-05-22
500	OTHER	Soft Tissue Procedures With Mcc	36	18	$56,317.57	$56,317.57	$56,317.57	$56,317.57	$56,317.57	2026-05-22
955	OTHER	Craniotomy For Multiple Significant Trauma	36	18	$57,492.66	$57,492.66	$57,492.66	$57,492.66	$57,492.66	2026-05-22
956	OTHER	Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma	36	18	$57,492.66	$57,492.66	$57,492.66	$57,492.66	$57,492.66	2026-05-22
907	OTHER	Other O.r. Procedures For Injuries With Mcc*	36	18	$57,492.66	$57,492.66	$57,492.66	$57,492.66	$57,492.66	2026-05-22
822	OTHER	Lymphoma And Leukemia With Major O.r. Procedures Without Cc/mcc	36	18	$57,492.66	$57,492.66	$57,492.66	$57,492.66	$57,492.66	2026-05-22
957	OTHER	Other O.r. Procedures For Multiple Significant Trauma With Mcc	36	18	$57,492.66	$57,492.66	$57,492.66	$57,492.66	$57,492.66	2026-05-22
908	OTHER	Other O.r. Procedures For Injuries With Cc*	36	18	$57,492.66	$57,492.66	$57,492.66	$57,492.66	$57,492.66	2026-05-22
958	OTHER	Other O.r. Procedures For Multiple Significant Trauma With Cc	36	18	$57,492.66	$57,492.66	$57,492.66	$57,492.66	$57,492.66	2026-05-22
828	OTHER	Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. …	36	18	$57,492.66	$57,492.66	$57,492.66	$57,492.66	$57,492.66	2026-05-22
463	OTHER	Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …	36	18	$57,661.84	$57,661.84	$57,661.84	$57,661.84	$57,661.84	2026-05-22
221	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
736	OTHER	Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
218	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
219	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
970	OTHER	HIV With Extensive O.r. Procedures Without Mcc	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
231	OTHER	Coronary Bypass With Ptca With Mcc	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
826	OTHER	Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. …	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
562	OTHER	Fracture, Sprain, Strain And Dislocation Except Femur, Hip, Pelvis And Thigh Wit…	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
739	OTHER	Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc…	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
275	OTHER	Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
33	OTHER	Ventricular Shunt Procedures Without Cc/mcc	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
784	OTHER	Cesarean Section With Sterilization With Cc	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
493	OTHER	Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Cc	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
748	OTHER	Female Reproductive System Reconstructive Procedures	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
21	OTHER	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
269	OTHER	Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
242	OTHER	Permanent Cardiac Pacemaker Implant With Mcc	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
783	OTHER	Cesarean Section With Sterilization With Mcc	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
239	OTHER	Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
498	OTHER	Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur With Cc…	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
787	OTHER	Cesarean Section Without Sterilization With Cc	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
737	OTHER	Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Cc	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
474	OTHER	Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
273	OTHER	Percutaneous And Other Intracardiac Procedures With Mcc	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
817	OTHER	Other Antepartum Diagnoses With O.r. Procedures With Mcc	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
483	OTHER	Major Joint Or Limb Reattachment Procedures Of Upper Extremities	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
241	OTHER	Amputation For Circulatory System Disorders Except Upper Limb And Toe Without Cc…	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
843	OTHER	Other Myeloproliferative Disorders Or Poorly Differentiated Neoplastic Diagnoses…	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
969	OTHER	HIV With Extensive O.r. Procedures With Mcc	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
23	OTHER	Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
254	OTHER	Other Vascular Procedures Without Cc/mcc	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
519	OTHER	Back And Neck Procedures Except Spinal Fusion With Cc	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
229	OTHER	Other Cardiothoracic Procedures Without Mcc	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
734	OTHER	Pelvic Evisceration, Radical Hysterectomy And Radical Vulvectomy With Cc/mcc	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
693	OTHER	Urinary Stones With Mcc	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
466	OTHER	Revision Of Hip Or Knee Replacement With Mcc	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
744	OTHER	D&c, Conization, Laparoscopy And Tubal Interruption With Cc/mcc	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
469	OTHER	Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc…	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
353	OTHER	Hernia Procedures Except Inguinal And Femoral With Mcc	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
495	OTHER	Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit…	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
492	OTHER	Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
251	OTHER	Percutaneous Cardiovascular Procedures Without Intraluminal Device Without Mcc	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
643	OTHER	Endocrine Disorders With Mcc*	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
917	OTHER	Poisoning And Toxic Effects Of Drugs With Mcc	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
73	OTHER	Cranial And Peripheral Nerve Disorders With Mcc	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
41	OTHER	Peripheral, Cranial Nerve And Other Nervous System Procedures With Cc Or Periphe…	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
216	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
267	OTHER	Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
233	OTHER	Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
256	OTHER	Upper Limb And Toe Amputation For Circulatory System Disorders With Cc	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
217	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
385	OTHER	Inflammatory Bowel Disease With Mcc	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
240	OTHER	Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
39	OTHER	Extracranial Procedures Without Cc/mcc	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
228	OTHER	Other Cardiothoracic Procedures With Mcc	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
499	OTHER	Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur Without…	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
272	OTHER	Other Major Cardiovascular Procedures Without Cc/mcc	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
918	OTHER	Poisoning And Toxic Effects Of Drugs Without Mcc	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
202	OTHER	Bronchitis And Asthma With Cc/mcc	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
25	OTHER	Craniotomy And Endovascular Intracranial Procedures With Mcc	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
252	OTHER	Other Vascular Procedures With Mcc	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
274	OTHER	Percutaneous And Other Intracardiac Procedures Without Mcc	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
740	OTHER	Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Cc	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
212	OTHER	Concomitant Aortic And Mitral Valve Procedures	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
743	OTHER	Uterine And Adnexa Procedures For Non-malignancy Without Cc/mcc	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
746	OTHER	Vagina, Cervix And Vulva Procedures With Cc/mcc	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
22	OTHER	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/…	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
35	OTHER	Carotid Artery Stent Procedures With Cc	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
266	OTHER	Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
963	OTHER	Other Multiple Significant Trauma With Mcc	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
257	OTHER	Upper Limb And Toe Amputation For Circulatory System Disorders Without Cc/mcc	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
477	OTHER	Biopsies Of Musculoskeletal System And Connective Tissue With Mcc	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
786	OTHER	Cesarean Section Without Sterilization With Mcc	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
823	OTHER	Lymphoma And Non-acute Leukemia With Other Procedures With Mcc	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
38	OTHER	Extracranial Procedures With Cc	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
747	OTHER	Vagina, Cervix And Vulva Procedures Without Cc/mcc	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
271	OTHER	Other Major Cardiovascular Procedures With Cc	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
423	OTHER	Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
820	OTHER	Lymphoma And Leukemia With Major O.r. Procedures With Mcc	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
485	OTHER	Knee Procedures With Principal Diagnosis Of Infection With Mcc	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
738	OTHER	Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy Without Cc/mcc	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
821	OTHER	Lymphoma And Leukemia With Major O.r. Procedures With Cc	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
234	OTHER	Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
215	OTHER	Other Heart Assist System Implant	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
31	OTHER	Ventricular Shunt Procedures With Mcc	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
344	OTHER	Minor Small And Large Bowel Procedures With Mcc	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
236	OTHER	Coronary Bypass Without Cardiac Catheterization Without Mcc	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
37	OTHER	Extracranial Procedures With Mcc	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
34	OTHER	Carotid Artery Stent Procedures With Mcc	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
232	OTHER	Coronary Bypass With Ptca Without Mcc	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
829	OTHER	Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce…	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
329	OTHER	Major Small And Large Bowel Procedures With Mcc	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
220	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
518	OTHER	Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost…	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
24	OTHER	Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
27	OTHER	Craniotomy And Endovascular Intracranial Procedures Without Cc/mcc	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
36	OTHER	Carotid Artery Stent Procedures Without Cc/mcc	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
827	OTHER	Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. …	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
20	OTHER	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
742	OTHER	Uterine And Adnexa Procedures For Non-malignancy With Cc/mcc	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
754	OTHER	Malignancy, Female Reproductive System With Mcc	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
405	OTHER	Pancreas, Liver And Shunt Procedures With Mcc	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
235	OTHER	Coronary Bypass Without Cardiac Catheterization With Mcc	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
54	OTHER	Nervous System Neoplasms With Mcc	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
258	OTHER	Cardiac Pacemaker Device Replacement With Mcc	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
749	OTHER	Other Female Reproductive System O.r. Procedures With Cc/mcc	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
750	OTHER	Other Female Reproductive System O.r. Procedures Without Cc/mcc	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
755	OTHER	Malignancy, Female Reproductive System With Cc	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
735	OTHER	Pelvic Evisceration, Radical Hysterectomy And Radical Vulvectomy Without Cc/mcc	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
250	OTHER	Percutaneous Cardiovascular Procedures Without Intraluminal Device With Mcc	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
850	OTHER	Acute Leukemia With Other Procedures	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
741	OTHER	Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy Without…	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
32	OTHER	Ventricular Shunt Procedures With Cc	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
745	OTHER	D&c, Conization, Laparoscopy And Tubal Interruption Without Cc/mcc	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
42	OTHER	Peripheral, Cranial Nerve And Other Nervous System Procedures Without Cc/mcc	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
26	OTHER	Craniotomy And Endovascular Intracranial Procedures With Cc	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
253	OTHER	Other Vascular Procedures With Cc	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
268	OTHER	Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
857	OTHER	Postoperative Or Post-traumatic Infections With O.r. Procedures With Cc	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
808	OTHER	Major Hematological And Immunological Diagnoses Except Sickle Cell Crisis And Co…	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
255	OTHER	Upper Limb And Toe Amputation For Circulatory System Disorders With Mcc	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
824	OTHER	Lymphoma And Non-acute Leukemia With Other Procedures With Cc	36	18	$57,716.71	$57,716.71	$57,716.71	$57,716.71	$57,716.71	2026-05-22
263	OTHER	Vein Ligation And Stripping	36	18	$58,096.21	$58,096.21	$58,096.21	$58,096.21	$58,096.21	2026-05-22
264	OTHER	Other Circulatory System O.r. Procedures	36	18	$58,096.21	$58,096.21	$58,096.21	$58,096.21	$58,096.21	2026-05-22
245	OTHER	Aicd Generator Procedures	36	18	$58,096.21	$58,096.21	$58,096.21	$58,096.21	$58,096.21	2026-05-22
901	OTHER	Wound Debridements For Injuries With Mcc	36	18	$58,667.75	$58,667.75	$58,667.75	$58,667.75	$58,667.75	2026-05-22
64	OTHER	Intracranial Hemorrhage Or Cerebral Infarction With Mcc	36	18	$59,477.06	$59,477.06	$59,477.06	$59,477.06	$59,477.06	2026-05-22
61	OTHER	Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A…	36	18	$59,477.06	$59,477.06	$59,477.06	$59,477.06	$59,477.06	2026-05-22
551	OTHER	Medical Back Problems With Mcc	45	21	$59,710.25	$59,710.25	$21,415.88	$59,710.25	$59,710.25	2026-05-22
619	OTHER	O.r. Procedures For Obesity With Mcc	36	18	$59,787.98	$59,787.98	$59,787.98	$59,787.98	$59,787.98	2026-05-22
622	OTHER	Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor…	36	18	$59,787.98	$59,787.98	$59,787.98	$59,787.98	$59,787.98	2026-05-22
205	OTHER	Other Respiratory System Diagnoses With Mcc	45	21	$59,961.73	$59,961.73	$21,415.88	$59,961.73	$59,961.73	2026-05-22
856	OTHER	Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc	36	18	$61,616.92	$61,616.92	$61,616.92	$61,616.92	$61,616.92	2026-05-22
579	OTHER	Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc	36	18	$62,023.86	$62,023.86	$62,023.86	$62,023.86	$62,023.86	2026-05-22
582	OTHER	Mastectomy For Malignancy With Cc/mcc	36	18	$62,023.86	$62,023.86	$62,023.86	$62,023.86	$62,023.86	2026-05-22
573	OTHER	Skin Graft For Skin Ulcer Or Cellulitis With Mcc	36	18	$63,578.45	$63,578.45	$63,578.45	$63,578.45	$63,578.45	2026-05-22
356	OTHER	Other Digestive System O.r. Procedures With Mcc	36	18	$63,820.79	$63,820.79	$63,820.79	$63,820.79	$63,820.79	2026-05-22
799	OTHER	Splenic Procedures With Mcc	36	18	$63,820.79	$63,820.79	$63,820.79	$63,820.79	$63,820.79	2026-05-22
40	OTHER	Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc	36	18	$67,167.74	$67,167.74	$67,167.74	$67,167.74	$67,167.74	2026-05-22
853	OTHER	Infectious And Parasitic Diseases With O.r. Procedures With Mcc	36	18	$69,325.89	$69,325.89	$69,325.89	$69,325.89	$69,325.89	2026-05-22
168	OTHER	Other Respiratory System O.r. Procedures Without Cc/mcc	36	18	$72,119.59	$72,119.59	$72,119.59	$72,119.59	$72,119.59	2026-05-22
173	OTHER	Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary…	36	18	$72,119.59	$72,119.59	$72,119.59	$72,119.59	$72,119.59	2026-05-22
167	OTHER	Other Respiratory System O.r. Procedures With Cc	36	18	$72,119.59	$72,119.59	$72,119.59	$72,119.59	$72,119.59	2026-05-22
12	OTHER	Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc	36	18	$72,119.59	$72,119.59	$72,119.59	$72,119.59	$72,119.59	2026-05-22
207	OTHER	Respiratory System Diagnosis With Ventilator Support >96 Hours	46	21	$88,913.81	$88,913.81	$30,533.31	$88,913.81	$88,913.81	2026-05-22
870	OTHER	Septicemia Or Severe Sepsis With Mv >96 Hours	36	18	$94,743.55	$94,743.55	$94,743.55	$94,743.55	$94,743.55	2026-05-22
68875010201	OTHER	Gattex	96	33	$99,999.99	$99,999.99	$17.36	$99,999.99	$99,999.99	2026-05-22
981	OTHER	Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc	36	18	$107,006.58	$107,006.58	$107,006.58	$107,006.58	$107,006.58	2026-05-22
140	OTHER	Major Head And Neck Procedures With Mcc	36	18	$107,020.30	$107,020.30	$107,020.30	$107,020.30	$107,020.30	2026-05-22
11	OTHER	Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc	36	18	$107,020.30	$107,020.30	$107,020.30	$107,020.30	$107,020.30	2026-05-22
166	OTHER	Other Respiratory System O.r. Procedures With Mcc	36	18	$107,020.30	$107,020.30	$107,020.30	$107,020.30	$107,020.30	2026-05-22
165	OTHER	Major Chest Procedures Without Cc/mcc	36	18	$108,405.72	$108,405.72	$108,405.72	$108,405.72	$108,405.72	2026-05-22
163	OTHER	Major Chest Procedures With Mcc	36	18	$108,405.72	$108,405.72	$108,405.72	$108,405.72	$108,405.72	2026-05-22
164	OTHER	Major Chest Procedures With Cc	36	18	$108,405.72	$108,405.72	$108,405.72	$108,405.72	$108,405.72	2026-05-22
4	OTHER	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…	36	18	$131,354.32	$131,354.32	$131,354.32	$131,354.32	$131,354.32	2026-05-22
3	OTHER	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…	36	18	$159,702.86	$159,702.86	$159,702.86	$159,702.86	$159,702.86	2026-05-22

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