Hospital

MEMORIAL HOSPITAL

Fremont, OH · CCN 360156 · Rates published

4,000 distinct procedures filed

19 distinct payers

131,452 rate rows

2026-05-22 last MRF observed

Data quality

125,255 of 131,452 rate rows are consumer-grade (95.3%)

6,197 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
no usable negotiated amount (only an out-of-band fallback) — excluded from medians	3,548
per-diem day rate — not a per-procedure price	2,623
exceeds 10× this hospital's gross charge — excluded from medians	23
placeholder amount (≤ $0.02) — excluded from medians	3

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

Source MRF file	https://promedica.canto.com/direct/document/iv7b8eefop09bbb9orb32ecg1k/UYFX29YHAkqRGin3-GbHZyuFCFY/original?content-type=text%2Fcsv&name=344430849_memorial-hospital_standardcharges+4.csv
Found on page	https://www.promedica.org/cms-hpt.txt
Discovered via	Discovered by HANK (automated)
Last fetch	success · 2026-05-19
Content fingerprint	4d9d1ea525263b3d… · 26,607,688 bytes · first seen 2026-05-18

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
018 OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	10	$237,505.40	$1,169,113.49	$607,366.41	nat. median $424,868 1.4× median
007 OTHER	Lung Transplant	9	$71,226.10	$820,761.78	$426,404.48	nat. median $141,082 outlier · 3.0×
588-4 OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	8	$1,600.00	$414,143.69	$376,494.26	nat. median $267,493 1.4× median
583-3 OTHER	Neonate With Ecmo	8	$1,600.00	$400,630.75	$364,209.77	nat. median $259,487 1.4× median
583-4 OTHER	Neonate With Ecmo	8	$1,600.00	$400,630.75	$364,209.77	nat. median $309,400 1.2× median
583-2 OTHER	Neonate With Ecmo	8	$1,600.00	$381,093.88	$346,448.98	nat. median $191,347 1.8× median
583-1 OTHER	Neonate With Ecmo	8	$1,600.00	$381,093.88	$346,448.98	nat. median $171,226 outlier · 2.0×
161-4 OTHER	Implantable Heart Assist Systems	8	$1,600.00	$337,196.39	$306,542.17	nat. median $202,242 1.5× median
002-4 OTHER	Heart And/or Lung Transplant	8	$1,600.00	$296,589.32	$269,626.65	nat. median $216,800 1.2× median
609-4 OTHER	Neonate Birth Weight 1500-2499 Grams With Major Procedure	8	$1,600.00	$265,710.05	$241,554.59	nat. median $169,856 1.4× median
161-3 OTHER	Implantable Heart Assist Systems	8	$1,600.00	$261,020.76	$237,291.60	nat. median $152,491 1.6× median
161-1 OTHER	Implantable Heart Assist Systems	8	$1,600.00	$261,020.76	$237,291.60	nat. median $101,352 outlier · 2.3×
161-2 OTHER	Implantable Heart Assist Systems	8	$1,600.00	$261,020.76	$237,291.60	nat. median $109,992 outlier · 2.2×
630-4 OTHER	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure	8	$1,600.00	$257,876.84	$234,433.49	nat. median $210,669 1.1× median
007-4 OTHER	Allogeneic Bone Marrow Transplant	8	$1,600.00	$253,563.85	$230,512.59	nat. median $172,311 1.3× median
841-1 OTHER	Chemotherapy For Acute Leukemia	8	$1,600.00	$236,042.98	$214,584.53	nat. median $20,206 outlier · 10.6×
841-3 OTHER	Extensive Third Degree Burns With Skin Graft	8	$1,600.00	$236,042.98	$214,584.53	nat. median $61,016 outlier · 3.5×
841-4 OTHER	Extensive Third Degree Burns With Skin Graft	8	$1,600.00	$236,042.98	$214,584.53	nat. median $151,691 1.4× median
841-2 OTHER	Extensive Third Degree Burns With Skin Graft	8	$1,600.00	$236,042.98	$214,584.53	nat. median $28,587 outlier · 7.5×
631-4 OTHER	Neonate Birth Weight > 2499 Grams With Other Major Procedure	8	$1,600.00	$227,651.83	$206,956.21	nat. median $203,379 1.0× median
588-3 OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	8	$1,600.00	$209,327.17	$190,297.43	nat. median $165,000 1.2× median
001 OTHER	Heart Transplant Or Implant Of Heart Assist System With Mcc	9	$154,131.45	$359,753.00	$186,919.40	nat. median $263,894 0.7× median
004 OTHER	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…	10	$76,182.70	$349,768.98	$181,732.89	nat. median $150,232 1.2× median
588-1 OTHER	Female Reproductive System Reconstructive Procedures	8	$1,600.00	$199,124.74	$181,022.49	nat. median $75,325 outlier · 2.4×
588-2 OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	8	$1,600.00	$199,124.74	$181,022.49	nat. median $153,523 1.2× median
593-4 OTHER	Neonate Birth Weight 750-999 Grams Without Major Procedure	8	$1,600.00	$192,982.39	$175,438.54	nat. median $151,250 1.2× median
591-4 OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure	8	$1,600.00	$179,171.42	$162,883.11	nat. median $156,696 1.0× median
754-4 OTHER	Depression Except Major Depressive Disorder	8	$1,600.00	$157,631.47	$143,301.34	nat. median $15,955 outlier · 9.0×
927 OTHER	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	9	$117,427.75	$274,420.05	$142,590.59	nat. median $146,562 1.0× median
003 OTHER	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…	10	$116,738.60	$323,590.91	$141,758.28	nat. median $218,232 0.6× median
002 OTHER	Heart Transplant Or Implant Of Heart Assist System Without Mcc	9	$62,324.90	$266,837.31	$138,651.51	nat. median $117,167 1.2× median
160-4 OTHER	Major Cardiothoracic Repair Of Heart Anomaly	8	$1,600.00	$146,430.68	$133,118.80	nat. median $106,926 1.2× median
969 OTHER	HIV With Extensive O.r. Procedures With Mcc	10	$33,667.15	$248,978.81	$129,374.37	nat. median $64,729 2.0× median
602-4 OTHER	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	8	$1,600.00	$132,163.12	$120,148.29	nat. median $125,000 1.0× median
002-1 OTHER	Heart And/or Lung Transplant	8	$1,600.00	$131,600.16	$119,636.51	nat. median $57,500 outlier · 2.1×
002-3 OTHER	Heart And/or Lung Transplant	8	$1,600.00	$131,600.16	$119,636.51	nat. median $133,471 0.9× median
002-2 OTHER	Heart And/or Lung Transplant	8	$1,600.00	$131,600.16	$119,636.51	nat. median $106,681 1.1× median
009-4 OTHER	Extracorporeal Membrane Oxygenation (ecmo)	8	$1,600.00	$131,389.43	$119,444.94	nat. median $150,954 0.8× median
607-4 OTHER	Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…	8	$1,600.00	$130,710.07	$118,827.34	nat. median $100,015 1.2× median
007-3 OTHER	Allogeneic Bone Marrow Transplant	8	$1,600.00	$123,878.34	$112,616.67	nat. median $104,111 1.1× median
593-3 OTHER	Neonate Birth Weight 750-999 Grams Without Major Procedure	8	$1,600.00	$120,844.80	$109,858.91	nat. median $112,711 1.0× median
004-4 OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	8	$1,600.00	$119,340.57	$108,491.43	nat. median $110,000 1.0× median
630-3 OTHER	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure	8	$1,600.00	$114,043.17	$103,675.61	nat. median $95,000 1.1× median
850-4 OTHER	Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal…	8	$1,600.00	$112,448.63	$102,226.03	nat. median $54,797 1.9× median
006 OTHER	Liver Transplant Without Mcc	9	$25,503.50	$195,356.68	$101,518.71	nat. median $50,611 outlier · 2.0×
633-4 OTHER	Neonate Birth Weight > 2499 Grams With Major Anomaly	8	$1,600.00	$111,198.29	$101,089.35	nat. median $74,597 1.4× median
303-4 OTHER	Dorsal And Lumbar Fusion Procedure For Curvature Of Back	8	$1,600.00	$109,046.82	$99,133.47	nat. median $108,000 0.9× median
008 OTHER	Simultaneous Pancreas And Kidney Transplant	9	$30,825.30	$189,588.95	$98,522.49	nat. median $59,265 1.7× median
609-3 OTHER	Neonate Birth Weight 1500-2499 Grams With Major Procedure	8	$1,600.00	$108,136.66	$98,306.05	nat. median $83,785 1.2× median
602-3 OTHER	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	8	$1,600.00	$106,894.34	$97,176.67	nat. median $99,067 1.0× median

Other procedures at this hospital

Browse this hospital's 4,000 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

018	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	14	10	—	—	$237,505.40	$1,169,113.49	$607,366.41	2026-05-22
007	OTHER	Lung Transplant	13	9	—	—	$71,226.10	$820,761.78	$426,404.48	2026-05-22
588-4	OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	8	8	—	—	$1,600.00	$414,143.69	$376,494.26	2026-05-22
583-4	OTHER	Neonate With Ecmo	8	8	—	—	$1,600.00	$400,630.75	$364,209.77	2026-05-22
583-3	OTHER	Neonate With Ecmo	8	8	—	—	$1,600.00	$400,630.75	$364,209.77	2026-05-22
583-1	OTHER	Neonate With Ecmo	8	8	—	—	$1,600.00	$381,093.88	$346,448.98	2026-05-22
583-2	OTHER	Neonate With Ecmo	8	8	—	—	$1,600.00	$381,093.88	$346,448.98	2026-05-22
161-4	OTHER	Implantable Heart Assist Systems	8	8	—	—	$1,600.00	$337,196.39	$306,542.17	2026-05-22
002-4	OTHER	Heart And/or Lung Transplant	8	8	—	—	$1,600.00	$296,589.32	$269,626.65	2026-05-22
609-4	OTHER	Neonate Birth Weight 1500-2499 Grams With Major Procedure	8	8	—	—	$1,600.00	$265,710.05	$241,554.59	2026-05-22
161-2	OTHER	Implantable Heart Assist Systems	8	8	—	—	$1,600.00	$261,020.76	$237,291.60	2026-05-22
161-1	OTHER	Implantable Heart Assist Systems	8	8	—	—	$1,600.00	$261,020.76	$237,291.60	2026-05-22
161-3	OTHER	Implantable Heart Assist Systems	8	8	—	—	$1,600.00	$261,020.76	$237,291.60	2026-05-22
630-4	OTHER	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure	8	8	—	—	$1,600.00	$257,876.84	$234,433.49	2026-05-22
007-4	OTHER	Allogeneic Bone Marrow Transplant	8	8	—	—	$1,600.00	$253,563.85	$230,512.59	2026-05-22
841-2	OTHER	Extensive Third Degree Burns With Skin Graft	8	8	—	—	$1,600.00	$236,042.98	$214,584.53	2026-05-22
841-4	OTHER	Extensive Third Degree Burns With Skin Graft	8	8	—	—	$1,600.00	$236,042.98	$214,584.53	2026-05-22
841-1	OTHER	Chemotherapy For Acute Leukemia	8	8	—	—	$1,600.00	$236,042.98	$214,584.53	2026-05-22
841-3	OTHER	Extensive Third Degree Burns With Skin Graft	8	8	—	—	$1,600.00	$236,042.98	$214,584.53	2026-05-22
631-4	OTHER	Neonate Birth Weight > 2499 Grams With Other Major Procedure	8	8	—	—	$1,600.00	$227,651.83	$206,956.21	2026-05-22
588-3	OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	8	8	—	—	$1,600.00	$209,327.17	$190,297.43	2026-05-22
001	OTHER	Heart Transplant Or Implant Of Heart Assist System With Mcc	13	9	—	—	$154,131.45	$359,753.00	$186,919.40	2026-05-22
004	OTHER	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…	14	10	—	—	$76,182.70	$349,768.98	$181,732.89	2026-05-22
588-2	OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	8	8	—	—	$1,600.00	$199,124.74	$181,022.49	2026-05-22
588-1	OTHER	Female Reproductive System Reconstructive Procedures	8	8	—	—	$1,600.00	$199,124.74	$181,022.49	2026-05-22
593-4	OTHER	Neonate Birth Weight 750-999 Grams Without Major Procedure	8	8	—	—	$1,600.00	$192,982.39	$175,438.54	2026-05-22
591-4	OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure	8	8	—	—	$1,600.00	$179,171.42	$162,883.11	2026-05-22
754-4	OTHER	Depression Except Major Depressive Disorder	8	8	—	—	$1,600.00	$157,631.47	$143,301.34	2026-05-22
927	OTHER	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	13	9	—	—	$117,427.75	$274,420.05	$142,590.59	2026-05-22
003	OTHER	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…	14	10	—	—	$116,738.60	$323,590.91	$141,758.28	2026-05-22
002	OTHER	Heart Transplant Or Implant Of Heart Assist System Without Mcc	13	9	—	—	$62,324.90	$266,837.31	$138,651.51	2026-05-22
160-4	OTHER	Major Cardiothoracic Repair Of Heart Anomaly	8	8	—	—	$1,600.00	$146,430.68	$133,118.80	2026-05-22
969	OTHER	HIV With Extensive O.r. Procedures With Mcc	14	10	—	—	$33,667.15	$248,978.81	$129,374.37	2026-05-22
602-4	OTHER	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	8	8	—	—	$1,600.00	$132,163.12	$120,148.29	2026-05-22
002-3	OTHER	Heart And/or Lung Transplant	8	8	—	—	$1,600.00	$131,600.16	$119,636.51	2026-05-22
002-2	OTHER	Heart And/or Lung Transplant	8	8	—	—	$1,600.00	$131,600.16	$119,636.51	2026-05-22
002-1	OTHER	Heart And/or Lung Transplant	8	8	—	—	$1,600.00	$131,600.16	$119,636.51	2026-05-22
009-4	OTHER	Extracorporeal Membrane Oxygenation (ecmo)	8	8	—	—	$1,600.00	$131,389.43	$119,444.94	2026-05-22
607-4	OTHER	Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…	8	8	—	—	$1,600.00	$130,710.07	$118,827.34	2026-05-22
007-3	OTHER	Allogeneic Bone Marrow Transplant	8	8	—	—	$1,600.00	$123,878.34	$112,616.67	2026-05-22
593-3	OTHER	Neonate Birth Weight 750-999 Grams Without Major Procedure	8	8	—	—	$1,600.00	$120,844.80	$109,858.91	2026-05-22
004-4	OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	8	8	—	—	$1,600.00	$119,340.57	$108,491.43	2026-05-22
630-3	OTHER	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure	8	8	—	—	$1,600.00	$114,043.17	$103,675.61	2026-05-22
850-4	OTHER	Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal…	8	8	—	—	$1,600.00	$112,448.63	$102,226.03	2026-05-22
006	OTHER	Liver Transplant Without Mcc	13	9	—	—	$25,503.50	$195,356.68	$101,518.71	2026-05-22
633-4	OTHER	Neonate Birth Weight > 2499 Grams With Major Anomaly	8	8	—	—	$1,600.00	$111,198.29	$101,089.35	2026-05-22
303-4	OTHER	Dorsal And Lumbar Fusion Procedure For Curvature Of Back	8	8	—	—	$1,600.00	$109,046.82	$99,133.47	2026-05-22
008	OTHER	Simultaneous Pancreas And Kidney Transplant	13	9	—	—	$30,825.30	$189,588.95	$98,522.49	2026-05-22
609-3	OTHER	Neonate Birth Weight 1500-2499 Grams With Major Procedure	8	8	—	—	$1,600.00	$108,136.66	$98,306.05	2026-05-22
602-3	OTHER	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	8	8	—	—	$1,600.00	$106,894.34	$97,176.67	2026-05-22
001-4	OTHER	Liver Transplant And/or Intestinal Transplant	8	8	—	—	$1,600.00	$104,771.96	$95,247.24	2026-05-22
609-1	OTHER	Neonate Birth Weight 1500-2499 Grams With Major Procedure	8	8	—	—	$1,600.00	$102,871.36	$93,519.42	2026-05-22
609-2	OTHER	Neonate Birth Weight 1500-2499 Grams With Major Procedure	8	8	—	—	$1,600.00	$102,871.36	$93,519.42	2026-05-22
611-4	OTHER	Neonate Birth Weight 1500-1999 Grams With Major Anomaly	8	8	—	—	$1,600.00	$102,521.14	$93,201.04	2026-05-22
207	OTHER	Respiratory System Diagnosis With Ventilator Support >96 Hours	14	10	—	—	$35,390.85	$178,445.26	$92,733.56	2026-05-22
621-4	OTHER	Neonate Birth Weight 2000-2499 Grams With Major Anomaly	8	8	—	—	$1,600.00	$100,673.73	$91,521.57	2026-05-22
008-4	OTHER	Autologous Bone Marrow Transplant Or T-cell Immunotherapy	8	8	—	—	$1,600.00	$99,461.52	$90,419.56	2026-05-22
591-3	OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure	8	8	—	—	$1,600.00	$99,360.16	$90,327.42	2026-05-22
007-1	OTHER	Allogeneic Bone Marrow Transplant	8	8	—	—	$1,600.00	$99,214.65	$90,195.14	2026-05-22
007-2	OTHER	Allogeneic Bone Marrow Transplant	8	8	—	—	$1,600.00	$99,214.65	$90,195.14	2026-05-22
268	OTHER	Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc	14	10	—	—	$37,828.45	$172,848.70	$89,826.25	2026-05-22
842-4	OTHER	Burns With Skin Graft Except Extensive Third Degree Burns	8	8	—	—	$1,600.00	$98,698.86	$89,726.24	2026-05-22
570	OTHER	Skin Debridement With Mcc	14	10	—	—	$16,176.05	$171,086.65	$88,910.90	2026-05-22
612-4	OTHER	Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other…	8	8	—	—	$1,600.00	$95,851.98	$87,138.16	2026-05-22
607-3	OTHER	Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…	8	8	—	—	$1,600.00	$91,926.34	$83,569.40	2026-05-22
589-3	OTHER	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …	8	8	—	—	$1,600.00	$90,669.98	$82,427.25	2026-05-22
589-4	OTHER	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …	8	8	—	—	$1,600.00	$90,669.98	$82,427.25	2026-05-22
183-4	OTHER	Percutaneous Structural Cardiac Procedures	8	8	—	—	$1,600.00	$90,662.96	$82,420.87	2026-05-22
004-3	OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	8	8	—	—	$1,600.00	$90,488.34	$82,262.13	2026-05-22
863-4	OTHER	Neonatal Aftercare	8	8	—	—	$1,600.00	$90,356.89	$82,142.63	2026-05-22
178-4	OTHER	External Heart Assist Systems	8	8	—	—	$1,600.00	$90,326.79	$82,115.26	2026-05-22
690-4	OTHER	Acute Leukemia	8	8	—	—	$1,600.00	$89,974.56	$81,795.05	2026-05-22
005	OTHER	Liver Transplant With Mcc Or Intestinal Transplant	13	9	—	—	$56,707.75	$155,328.24	$80,724.72	2026-05-22
014	OTHER	Allogeneic Bone Marrow Transplant	13	9	—	—	$38,882.04	$155,083.87	$80,597.77	2026-05-22
480-4	OTHER	Major Male Pelvic Procedures	8	8	—	—	$1,600.00	$87,250.66	$79,318.78	2026-05-22
631-3	OTHER	Neonate Birth Weight > 2499 Grams With Other Major Procedure	8	8	—	—	$1,600.00	$86,549.66	$78,681.51	2026-05-22
589-2	OTHER	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …	8	8	—	—	$1,600.00	$86,258.66	$78,416.96	2026-05-22
589-1	OTHER	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …	8	8	—	—	$1,600.00	$86,258.66	$78,416.96	2026-05-22
005-4	OTHER	Tracheostomy With Mv >96 Hours Without Extensive Procedure	8	8	—	—	$1,600.00	$84,321.92	$76,656.29	2026-05-22
303-3	OTHER	Dorsal And Lumbar Fusion Procedure For Curvature Of Back	8	8	—	—	$1,600.00	$81,850.34	$74,409.40	2026-05-22
212	OTHER	Hip & Femur Procedures Except Major Joint Age 0-17	14	10	—	—	$59,807.55	$165,782.18	$72,999.95	2026-05-22
837	OTHER	Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot…	14	10	—	—	$26,423.65	$139,354.57	$72,426.70	2026-05-22
681-4	OTHER	Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms	8	8	—	—	$1,600.00	$79,242.27	$72,038.43	2026-05-22
695-4	OTHER	Chemotherapy For Acute Leukemia	8	8	—	—	$1,600.00	$78,791.71	$71,628.83	2026-05-22
602-2	OTHER	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	8	8	—	—	$1,600.00	$78,274.92	$71,159.02	2026-05-22
163-4	OTHER	Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis	8	8	—	—	$1,600.00	$78,148.48	$71,044.07	2026-05-22
163	OTHER	Major Chest Procedures With Mcc	14	10	—	—	$24,649.90	$135,299.06	$70,319.95	2026-05-22
162-4	OTHER	Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis	8	8	—	—	$1,600.00	$77,269.42	$70,244.93	2026-05-22
603-3	OTHER	Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition	8	8	—	—	$1,600.00	$77,029.59	$70,026.90	2026-05-22
603-4	OTHER	Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition	8	8	—	—	$1,600.00	$77,029.59	$70,026.90	2026-05-22
593-2	OTHER	Neonate Birth Weight 750-999 Grams Without Major Procedure	8	8	—	—	$1,600.00	$76,539.89	$69,581.72	2026-05-22
593-1	OTHER	Neonate Birth Weight 750-999 Grams Without Major Procedure	8	8	—	—	$1,600.00	$76,539.89	$69,581.72	2026-05-22
022-4	OTHER	Ventricular Shunt Procedures	8	8	—	—	$1,600.00	$75,152.07	$68,320.06	2026-05-22
591-1	OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure	8	8	—	—	$1,600.00	$75,018.60	$68,198.73	2026-05-22
591-2	OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure	8	8	—	—	$1,600.00	$75,018.60	$68,198.73	2026-05-22
630-2	OTHER	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure	8	8	—	—	$1,600.00	$74,809.88	$68,008.98	2026-05-22
630-1	OTHER	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure	8	8	—	—	$1,600.00	$74,809.88	$68,008.98	2026-05-22
008-3	OTHER	Autologous Bone Marrow Transplant Or T-cell Immunotherapy	8	8	—	—	$1,600.00	$74,770.74	$67,973.40	2026-05-22
011-4	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	8	8	—	—	$1,600.00	$74,063.29	$67,330.26	2026-05-22
011-3	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	8	8	—	—	$1,600.00	$74,063.29	$67,330.26	2026-05-22
011-2	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	8	8	—	—	$1,600.00	$74,063.29	$67,330.26	2026-05-22
011-1	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	8	8	—	—	$1,600.00	$74,063.29	$67,330.26	2026-05-22
215	OTHER	Other Heart Assist System Implant	14	10	—	—	$54,763.50	$151,800.44	$66,908.03	2026-05-22
792-4	OTHER	Extensive O.r. Procedures For Other Complications Of Treatment	8	8	—	—	$1,600.00	$72,744.71	$66,131.55	2026-05-22
216	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	14	10	—	—	$53,805.40	$149,144.66	$65,750.86	2026-05-22
653	OTHER	Major Bladder Procedures With Mcc	14	10	—	—	$28,580.20	$126,430.61	$65,712.96	2026-05-22
950-4	OTHER	Extensive O.r. Procedure Unrelated To Principal Diagnosis	8	8	—	—	$1,600.00	$70,700.61	$64,273.28	2026-05-22
863-3	OTHER	Neonatal Aftercare	8	8	—	—	$1,600.00	$68,325.36	$62,113.96	2026-05-22
091-4	OTHER	Other Major Head And Neck Procedures	8	8	—	—	$1,600.00	$66,784.00	$60,712.73	2026-05-22
020	OTHER	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc	14	10	—	—	$43,278.40	$119,964.58	$60,018.22	2026-05-22
453	OTHER	Combined Anterior And Posterior Spinal Fusion With Mcc	10	9	—	—	$59,291.59	$114,721.63	$59,630.37	2026-05-22
200-4	OTHER	Cardiac Structural And Valvular Disorders	8	8	—	—	$1,600.00	$65,161.36	$59,237.60	2026-05-22
608-4	OTHER	Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition	8	8	—	—	$1,600.00	$64,852.29	$58,956.63	2026-05-22
608-3	OTHER	Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition	8	8	—	—	$1,600.00	$64,852.29	$58,956.63	2026-05-22
304-4	OTHER	Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back	8	8	—	—	$1,600.00	$64,701.77	$58,819.79	2026-05-22
634-4	OTHER	Neonate Birth Weight > 2499 Grams With Respiratory Distress Syndrome Or Other Ma…	8	8	—	—	$1,600.00	$64,660.62	$58,782.38	2026-05-22
607-2	OTHER	Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…	8	8	—	—	$1,600.00	$64,313.41	$58,466.74	2026-05-22
910-4	OTHER	Craniotomy For Multiple Significant Trauma	8	8	—	—	$1,600.00	$64,307.40	$58,461.27	2026-05-22
622-4	OTHER	Neonate Birth Weight 2000-2499 Grams With Respiratory Distress Syndrome Or Other…	8	8	—	—	$1,600.00	$63,896.97	$58,088.15	2026-05-22
183-3	OTHER	Percutaneous Structural Cardiac Procedures	8	8	—	—	$1,600.00	$63,835.76	$58,032.51	2026-05-22
231	OTHER	Coronary Bypass With Ptca With Mcc	14	10	—	—	$46,364.45	$128,518.88	$56,764.09	2026-05-22
456	OTHER	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	14	10	—	—	$46,218.70	$128,114.88	$56,588.06	2026-05-22
179-4	OTHER	Defibrillator Implants	8	8	—	—	$1,600.00	$62,113.78	$56,467.07	2026-05-22
471	OTHER	Cervical Spinal Fusion With Mcc	14	10	—	—	$26,557.85	$108,618.84	$56,460.09	2026-05-22
167-4	OTHER	Other Cardiothoracic And Thoracic Vascular Procedures	8	8	—	—	$1,600.00	$61,708.36	$56,098.51	2026-05-22
021-4	OTHER	Open Craniotomy Except Trauma	8	8	—	—	$1,600.00	$61,597.99	$55,998.17	2026-05-22
120-4	OTHER	Major Respiratory And Chest Procedures	8	8	—	—	$1,600.00	$61,249.77	$55,681.61	2026-05-22
005-3	OTHER	Tracheostomy With Mv >96 Hours Without Extensive Procedure	8	8	—	—	$1,600.00	$61,093.23	$55,539.30	2026-05-22
660-4	OTHER	Major Hematologic Or Immunologic Diagnoses Except Sickle Cell Crisis And Coagula…	8	8	—	—	$1,600.00	$61,072.15	$55,520.14	2026-05-22
326	OTHER	Stomach, Esophageal And Duodenal Procedures With Mcc	14	10	—	—	$27,430.70	$105,801.26	$54,996.41	2026-05-22
160-3	OTHER	Major Cardiothoracic Repair Of Heart Anomaly	8	8	—	—	$1,600.00	$60,175.04	$54,704.58	2026-05-22
010	OTHER	Pancreas Transplant	13	9	—	—	$39,466.35	$104,638.72	$54,392.50	2026-05-22
612-3	OTHER	Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other…	8	8	—	—	$1,600.00	$59,801.74	$54,365.22	2026-05-22
461	OTHER	Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc	14	10	—	—	$30,376.50	$104,386.78	$54,261.62	2026-05-22
312-4	OTHER	Skin Graft, Except Hand, For Musculoskeletal And Connective Tissue Diagnoses	8	8	—	—	$1,600.00	$58,997.95	$53,634.50	2026-05-22
021	OTHER	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc	14	10	—	—	$29,115.90	$102,037.99	$53,041.47	2026-05-22
220-4	OTHER	Major Stomach, Esophageal And Duodenal Procedures	8	8	—	—	$1,600.00	$57,452.58	$52,229.62	2026-05-22
183-2	OTHER	Percutaneous Structural Cardiac Procedures	8	8	—	—	$1,600.00	$57,342.20	$52,129.27	2026-05-22
690-3	OTHER	Acute Leukemia	8	8	—	—	$1,600.00	$57,098.35	$51,907.59	2026-05-22
219	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	14	10	—	—	$42,230.65	$117,060.29	$51,771.50	2026-05-22
233	OTHER	Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc	14	10	—	—	$42,048.60	$116,555.66	$51,551.63	2026-05-22
957	OTHER	Other O.r. Procedures For Multiple Significant Trauma With Mcc	14	10	—	—	$41,909.45	$116,169.95	$51,383.56	2026-05-22
303-2	OTHER	Dorsal And Lumbar Fusion Procedure For Curvature Of Back	8	8	—	—	$1,600.00	$56,402.94	$51,275.40	2026-05-22
162-3	OTHER	Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis	8	8	—	—	$1,600.00	$56,078.81	$50,980.74	2026-05-22
165-4	OTHER	Coronary Bypass With Ami Or Complex Principal Diagnosis	8	8	—	—	$1,600.00	$55,981.48	$50,892.25	2026-05-22
183-1	OTHER	Percutaneous Structural Cardiac Procedures	8	8	—	—	$1,600.00	$55,737.63	$50,670.57	2026-05-22
611-3	OTHER	Neonate Birth Weight 1500-1999 Grams With Major Anomaly	8	8	—	—	$1,600.00	$55,525.89	$50,478.08	2026-05-22
911-4	OTHER	Extensive Abdominal Or Thoracic Procedures For Multiple Significant Trauma	8	8	—	—	$1,600.00	$55,289.07	$50,262.79	2026-05-22
026-4	OTHER	Other Nervous System And Related Procedures	8	8	—	—	$1,600.00	$54,913.76	$49,921.60	2026-05-22
030-4	OTHER	Percutaneous Intracranial And Extracranial Vascular Procedures	8	8	—	—	$1,600.00	$54,106.61	$49,187.83	2026-05-22
009-1	OTHER	Extracorporeal Membrane Oxygenation (ecmo)	8	8	—	—	$1,600.00	$54,022.67	$49,111.52	2026-05-22
009-3	OTHER	Extracorporeal Membrane Oxygenation (ecmo)	8	8	—	—	$1,600.00	$54,022.67	$49,111.52	2026-05-22
009-2	OTHER	Extracorporeal Membrane Oxygenation (ecmo)	8	8	—	—	$1,600.00	$54,022.67	$49,111.52	2026-05-22
023-4	OTHER	Spinal Procedures	8	8	—	—	$1,600.00	$53,790.86	$48,900.78	2026-05-22
130-4	OTHER	Respiratory System Diagnosis With Ventilator Support > 96 Hours	8	8	—	—	$1,600.00	$53,747.72	$48,861.56	2026-05-22
178-2	OTHER	External Heart Assist Systems	8	8	—	—	$1,600.00	$53,682.49	$48,802.26	2026-05-22
178-1	OTHER	External Heart Assist Systems	8	8	—	—	$1,600.00	$53,682.49	$48,802.26	2026-05-22
178-3	OTHER	External Heart Assist Systems	8	8	—	—	$1,600.00	$53,682.49	$48,802.26	2026-05-22
928	OTHER	Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc	13	9	—	—	$39,449.85	$93,128.18	$48,413.00	2026-05-22
019	OTHER	Simultaneous Pancreas And Kidney Transplant With Hemodialysis	14	10	—	—	$16,368.90	$108,771.26	$48,159.92	2026-05-22
680-4	OTHER	Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms	8	8	—	—	$1,600.00	$52,963.99	$48,149.08	2026-05-22
275	OTHER	Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc	14	10	—	—	$39,217.20	$108,707.23	$48,132.01	2026-05-22
621-3	OTHER	Neonate Birth Weight 2000-2499 Grams With Major Anomaly	8	8	—	—	$1,600.00	$52,914.82	$48,104.38	2026-05-22
022	OTHER	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/…	14	10	—	—	$17,475.70	$92,067.57	$47,862.03	2026-05-22
230-4	OTHER	Major Small Bowel Procedures	8	8	—	—	$1,600.00	$52,153.18	$47,411.98	2026-05-22
020-4	OTHER	Open Craniotomy For Trauma	8	8	—	—	$1,600.00	$52,009.67	$47,281.52	2026-05-22
842-3	OTHER	Burns With Skin Graft Except Extensive Third Degree Burns	8	8	—	—	$1,600.00	$51,980.58	$47,255.07	2026-05-22
089-4	OTHER	Major Cranial Or Facial Bone Procedures	8	8	—	—	$1,600.00	$51,645.41	$46,950.37	2026-05-22
166-4	OTHER	Coronary Bypass Without Ami Or Complex Principal Diagnosis	7	7	—	—	$46,917.53	$51,609.28	$46,917.53	2026-05-22
260-4	OTHER	Major Pancreas, Liver And Shunt Procedures	8	8	—	—	$1,600.00	$51,407.59	$46,734.17	2026-05-22
870	OTHER	Septicemia Or Severe Sepsis With Mv >96 Hours	14	10	—	—	$38,014.90	$105,374.54	$46,679.94	2026-05-22
027-4	OTHER	Other Open Craniotomy	8	8	—	—	$1,600.00	$50,885.77	$46,259.79	2026-05-22
169-4	OTHER	Major Abdominal Vascular Procedures	8	8	—	—	$1,600.00	$50,800.48	$46,182.25	2026-05-22
955	OTHER	Craniotomy For Multiple Significant Trauma	14	10	—	—	$37,021.05	$102,619.66	$45,479.61	2026-05-22
912-4	OTHER	Musculoskeletal And Other Procedures For Multiple Significant Trauma	8	8	—	—	$1,600.00	$49,901.35	$45,364.86	2026-05-22
029-4	OTHER	Other Percutaneous Intracranial Procedures	8	8	—	—	$1,600.00	$49,523.03	$45,020.94	2026-05-22
050-4	OTHER	Non-bacterial Infections Of Nervous System Except Viral Meningitis	8	8	—	—	$1,600.00	$49,507.99	$45,007.26	2026-05-22
459	OTHER	Spinal Fusion Except Cervical With Mcc	10	9	—	—	$44,560.09	$86,218.07	$44,823.33	2026-05-22
181-4	OTHER	Lower Extremity Arterial Procedures	8	8	—	—	$1,600.00	$49,291.23	$44,810.21	2026-05-22
612-2	OTHER	Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other…	8	8	—	—	$1,600.00	$49,073.48	$44,612.25	2026-05-22
321-4	OTHER	Spinal Fusion And Other Back And Neck Procedures Except For Disc Procedures	8	8	—	—	$1,600.00	$48,953.06	$44,502.78	2026-05-22
218	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	14	10	—	—	$36,164.15	$100,244.39	$44,444.69	2026-05-22
217	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	14	10	—	—	$36,164.15	$100,244.39	$44,444.69	2026-05-22
573	OTHER	Skin Graft For Skin Ulcer Or Cellulitis With Mcc	14	10	—	—	$36,032.70	$99,880.02	$44,285.95	2026-05-22
405-4	OTHER	Other Procedures For Endocrine, Nutritional And Metabolic Disorders	8	8	—	—	$1,600.00	$48,620.90	$44,200.82	2026-05-22
750-4	OTHER	Schizophrenia	8	8	—	—	$1,600.00	$48,503.50	$44,094.09	2026-05-22
182-4	OTHER	Other Peripheral Vascular And Related Procedures	8	8	—	—	$1,600.00	$48,403.15	$44,002.86	2026-05-22
614-4	OTHER	Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition	8	8	—	—	$1,600.00	$48,363.01	$43,966.37	2026-05-22
614-3	OTHER	Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition	8	8	—	—	$1,600.00	$48,363.01	$43,966.37	2026-05-22
356	OTHER	Other Digestive System O.r. Procedures With Mcc	14	10	—	—	$24,160.40	$84,509.60	$43,935.81	2026-05-22
607-1	OTHER	Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…	8	8	—	—	$1,600.00	$47,861.26	$43,510.24	2026-05-22
004-2	OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	8	8	—	—	$1,600.00	$47,364.54	$43,058.67	2026-05-22
004-1	OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	8	8	—	—	$1,600.00	$47,364.54	$43,058.67	2026-05-22
264-4	OTHER	Other Hepatobiliary, Pancreas And Abdominal Procedures	8	8	—	—	$1,600.00	$47,341.46	$43,037.69	2026-05-22
304-3	OTHER	Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back	8	8	—	—	$1,600.00	$46,982.21	$42,711.10	2026-05-22
229-4	OTHER	Other Digestive System And Abdominal Procedures	8	8	—	—	$1,600.00	$46,953.10	$42,684.64	2026-05-22
447-4	OTHER	Other Kidney, Urinary Tract And Related Procedures	8	8	—	—	$1,600.00	$46,879.86	$42,618.05	2026-05-22
951-4	OTHER	Moderately Extensive O.r. Procedure Unrelated To Principal Diagnosis	8	8	—	—	$1,600.00	$46,605.90	$42,369.00	2026-05-22
227-4	OTHER	Hernia Procedures Except Inguinal, Femoral And Umbilical	8	8	—	—	$1,600.00	$46,522.31	$42,293.01	2026-05-22
163-3	OTHER	Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis	8	8	—	—	$1,600.00	$46,419.25	$42,199.32	2026-05-22
710-4	OTHER	Infectious And Parasitic Diseases Including HIV With O.r. Procedure	8	8	—	—	$1,600.00	$46,415.24	$42,195.67	2026-05-22
132-4	OTHER	Bpd And Other Chronic Respiratory Diseases Arising In Perinatal Period	8	8	—	—	$1,600.00	$46,028.90	$41,844.45	2026-05-22
602-1	OTHER	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	8	8	—	—	$1,600.00	$45,939.59	$41,763.26	2026-05-22
176-4	OTHER	Insertion, Revision And Replacements Of Pacemaker And Other Cardiac Devices	8	8	—	—	$1,600.00	$45,816.16	$41,651.05	2026-05-22
179-3	OTHER	Defibrillator Implants	8	8	—	—	$1,600.00	$45,726.85	$41,569.86	2026-05-22
603-2	OTHER	Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition	8	8	—	—	$1,600.00	$45,716.81	$41,560.74	2026-05-22
266	OTHER	Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc	14	10	—	—	$33,706.20	$93,431.14	$41,476.13	2026-05-22
454	OTHER	Combined Anterior And Posterior Spinal Fusion With Cc	10	9	—	—	$41,149.99	$79,619.96	$41,395.74	2026-05-22
008-2	OTHER	Autologous Bone Marrow Transplant Or T-cell Immunotherapy	8	8	—	—	$1,600.00	$45,503.07	$41,366.43	2026-05-22
008-1	OTHER	Autologous Bone Marrow Transplant Or T-cell Immunotherapy	8	8	—	—	$1,600.00	$45,503.07	$41,366.43	2026-05-22
711-4	OTHER	Post-operative, Post-trauma, Other Device Infections With O.r. Procedure	8	8	—	—	$1,600.00	$45,284.32	$41,167.56	2026-05-22
303-1	OTHER	Dorsal And Lumbar Fusion Procedure For Curvature Of Back	8	8	—	—	$1,600.00	$45,271.27	$41,155.70	2026-05-22
232	OTHER	Coronary Bypass With Ptca Without Mcc	14	10	—	—	$33,344.30	$92,427.97	$41,039.04	2026-05-22
028	OTHER	Spinal Procedures With Mcc	14	10	—	—	$33,045.65	$91,600.14	$40,678.34	2026-05-22
276	OTHER	Non-maligant Breast Disorders	14	10	—	—	$33,036.30	$91,574.22	$40,667.05	2026-05-22
121-4	OTHER	Other Respiratory And Chest Procedures	8	8	—	—	$1,600.00	$44,684.22	$40,622.02	2026-05-22
043-4	OTHER	Multiple Sclerosis, Other Demyelinating Disease And Inflammatory Neuropathies	8	8	—	—	$1,600.00	$44,554.77	$40,504.34	2026-05-22
631-1	OTHER	Neonate Birth Weight > 2499 Grams With Other Major Procedure	8	8	—	—	$1,600.00	$44,475.50	$40,432.27	2026-05-22
631-2	OTHER	Neonate Birth Weight > 2499 Grams With Other Major Procedure	8	8	—	—	$1,600.00	$44,475.50	$40,432.27	2026-05-22
457	OTHER	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	14	10	—	—	$32,797.05	$90,911.04	$40,378.11	2026-05-22
001-3	OTHER	Liver Transplant And/or Intestinal Transplant	8	8	—	—	$1,600.00	$44,413.28	$40,375.71	2026-05-22
850-3	OTHER	Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal…	8	8	—	—	$1,600.00	$44,328.99	$40,299.08	2026-05-22
790	OTHER	Extreme Immaturity Or Respiratory Distress Syndrome, Neonate	13	9	—	—	$5,125.05	$77,410.36	$40,247.89	2026-05-22
016	OTHER	Autologous Bone Marrow Transplant With Cc/mcc	13	9	—	—	$32,613.35	$77,233.91	$40,156.23	2026-05-22
235	OTHER	Coronary Bypass Without Cardiac Catheterization With Mcc	14	10	—	—	$32,277.30	$89,470.33	$39,750.37	2026-05-22
820	OTHER	Lymphoma And Leukemia With Major O.r. Procedures With Mcc	14	10	—	—	$32,256.40	$89,412.39	$39,725.12	2026-05-22
325-4	OTHER	Non-elective Or Complex Knee Joint Replacement	8	8	—	—	$1,600.00	$43,623.55	$39,657.77	2026-05-22
162-2	OTHER	Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis	8	8	—	—	$1,600.00	$43,622.54	$39,656.85	2026-05-22
952-4	OTHER	Non-extensive O.r. Procedure Unrelated To Principal Diagnosis	8	8	—	—	$1,600.00	$43,593.44	$39,630.40	2026-05-22
441-4	OTHER	Major Bladder Procedures	8	8	—	—	$1,600.00	$42,976.30	$39,069.36	2026-05-22
023	OTHER	Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…	14	10	—	—	$31,516.65	$87,361.86	$38,831.68	2026-05-22
463	OTHER	Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …	14	10	—	—	$31,347.25	$86,892.30	$38,627.10	2026-05-22
608-2	OTHER	Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition	8	8	—	—	$1,600.00	$42,098.24	$38,271.13	2026-05-22
160-2	OTHER	Major Cardiothoracic Repair Of Heart Anomaly	8	8	—	—	$1,600.00	$41,576.43	$37,796.75	2026-05-22
224-4	OTHER	Peritoneal Adhesiolysis	8	8	—	—	$1,600.00	$41,554.36	$37,776.69	2026-05-22
278	OTHER	Cellulitis Age >17 Without Cc	14	10	—	—	$14,430.94	$84,860.06	$37,741.64	2026-05-22
130-3	OTHER	Respiratory System Diagnosis With Ventilator Support > 96 Hours	8	8	—	—	$1,600.00	$41,034.54	$37,304.13	2026-05-22
834	OTHER	Acute Leukemia Without Major O.r. Procedures With Mcc	14	10	—	—	$30,194.45	$83,696.82	$37,234.80	2026-05-22
611-2	OTHER	Neonate Birth Weight 1500-1999 Grams With Major Anomaly	8	8	—	—	$1,600.00	$40,905.10	$37,186.45	2026-05-22
405	OTHER	Pancreas, Liver And Shunt Procedures With Mcc	14	10	—	—	$30,087.75	$83,401.05	$37,105.94	2026-05-22
862-4	OTHER	Other Aftercare And Convalescence	8	8	—	—	$1,600.00	$40,764.61	$37,058.74	2026-05-22
234	OTHER	Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc	14	10	—	—	$30,044.85	$83,282.14	$37,054.13	2026-05-22
011	OTHER	Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc	14	10	—	—	$29,997.55	$83,151.03	$36,997.01	2026-05-22
633-3	OTHER	Neonate Birth Weight > 2499 Grams With Major Anomaly	8	8	—	—	$1,600.00	$40,651.22	$36,955.65	2026-05-22
696-4	OTHER	Other Chemotherapy	8	8	—	—	$1,600.00	$40,646.20	$36,951.09	2026-05-22
017	OTHER	Autologous Bone Marrow Transplant Without Cc/mcc	13	9	—	—	$18,898.13	$70,873.63	$36,852.19	2026-05-22
165-3	OTHER	Coronary Bypass With Ami Or Complex Principal Diagnosis	8	8	—	—	$1,600.00	$40,179.58	$36,526.89	2026-05-22
179-2	OTHER	Defibrillator Implants	8	8	—	—	$1,600.00	$40,023.04	$36,384.58	2026-05-22
073-4	OTHER	Orbit And Eye Procedures	8	8	—	—	$1,600.00	$39,938.75	$36,307.95	2026-05-22
323-4	OTHER	Non-elective Or Complex Hip Joint Replacement	8	8	—	—	$1,600.00	$39,903.62	$36,276.02	2026-05-22
171-4	OTHER	Permanent Cardiac Pacemaker Implant Without Ami, Heart Failure Or Shock	8	8	—	—	$1,600.00	$39,852.44	$36,229.49	2026-05-22
220	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	14	10	—	—	$29,330.40	$81,301.74	$36,191.25	2026-05-22
167-3	OTHER	Other Cardiothoracic And Thoracic Vascular Procedures	8	8	—	—	$1,600.00	$39,409.91	$35,827.19	2026-05-22
270	OTHER	Other Major Cardiovascular Procedures With Mcc	14	10	—	—	$29,019.65	$80,440.36	$35,815.95	2026-05-22
910-3	OTHER	Craniotomy For Multiple Significant Trauma	8	8	—	—	$1,600.00	$39,087.79	$35,534.35	2026-05-22
021-3	OTHER	Open Craniotomy Except Trauma	8	8	—	—	$1,600.00	$38,949.31	$35,408.46	2026-05-22
466	OTHER	Revision Of Hip Or Knee Replacement With Mcc	14	10	—	—	$28,629.70	$79,359.45	$35,344.99	2026-05-22
440-4	OTHER	Kidney Transplant	8	8	—	—	$1,600.00	$38,598.09	$35,089.17	2026-05-22
440-3	OTHER	Kidney Transplant	8	8	—	—	$1,600.00	$38,598.09	$35,089.17	2026-05-22
223-4	OTHER	Other Small And Large Bowel Procedures	8	8	—	—	$1,600.00	$38,435.52	$34,941.38	2026-05-22
049-4	OTHER	Bacterial And Tuberculous Infections Of Nervous System	8	8	—	—	$1,600.00	$38,384.35	$34,894.86	2026-05-22
179-1	OTHER	Defibrillator Implants	8	8	—	—	$1,600.00	$38,274.96	$34,795.42	2026-05-22
863-2	OTHER	Neonatal Aftercare	8	8	—	—	$1,600.00	$38,185.65	$34,714.23	2026-05-22
261-4	OTHER	Major Biliary Tract Procedures	8	8	—	—	$1,600.00	$37,887.62	$34,443.29	2026-05-22
221	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	14	10	—	—	$27,721.10	$76,840.87	$34,247.63	2026-05-22
758-4	OTHER	Behavioral Disorders	8	8	—	—	$1,600.00	$37,483.22	$34,075.65	2026-05-22
309-4	OTHER	Other Significant Hip And Femur Surgery	8	8	—	—	$1,600.00	$37,428.02	$34,025.47	2026-05-22
347	OTHER	Anal And Stomal Procedures With Mcc	14	10	—	—	$12,625.80	$65,421.63	$34,019.98	2026-05-22
024-4	OTHER	Open Extracranial Vascular Procedures	8	8	—	—	$1,600.00	$37,226.32	$33,842.11	2026-05-22
758-3	OTHER	Behavioral Disorders	8	8	—	—	$1,600.00	$37,199.23	$33,817.48	2026-05-22
248-4	OTHER	Major Gastrointestinal And Peritoneal Infections	8	8	—	—	$1,600.00	$37,189.19	$33,808.35	2026-05-22
228	OTHER	Other Cardiothoracic Procedures With Mcc	14	10	—	—	$27,210.70	$75,426.08	$33,631.20	2026-05-22
261-3	OTHER	Major Biliary Tract Procedures	8	8	—	—	$1,600.00	$36,972.44	$33,611.31	2026-05-22
853	OTHER	Infectious And Parasitic Diseases With O.r. Procedures With Mcc	14	10	—	—	$27,162.30	$75,291.92	$33,572.73	2026-05-22
970	OTHER	HIV With Extensive O.r. Procedures Without Mcc	14	10	—	—	$14,505.70	$64,464.15	$33,522.59	2026-05-22
005-1	OTHER	Tracheostomy With Mv >96 Hours Without Extensive Procedure	8	8	—	—	$1,600.00	$36,853.03	$33,502.75	2026-05-22
005-2	OTHER	Tracheostomy With Mv >96 Hours Without Extensive Procedure	8	8	—	—	$1,600.00	$36,853.03	$33,502.75	2026-05-22
231-4	OTHER	Major Large Bowel Procedures	8	8	—	—	$1,600.00	$36,824.92	$33,477.20	2026-05-22
239	OTHER	Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc	14	10	—	—	$27,069.35	$75,034.27	$33,460.49	2026-05-22
10001772	OTHER	Pbb Spinal Infusion Pumprevision C1772	29	11	$53,183.00	$34,568.95 35% off	$14,757.65	$47,864.70	$33,398.92	2026-05-22
691-4	OTHER	Lymphoma, Myeloma And Non-acute Leukemia	8	8	—	—	$1,600.00	$36,733.61	$33,394.19	2026-05-22
361-4	OTHER	Skin Graft For Skin And Subcutaneous Tissue Diagnoses	8	8	—	—	$1,600.00	$36,712.53	$33,375.03	2026-05-22
361-3	OTHER	Skin Graft For Skin And Subcutaneous Tissue Diagnoses	8	8	—	—	$1,600.00	$36,712.53	$33,375.03	2026-05-22
661-4	OTHER	Coagulation And Platelet Disorders	8	8	—	—	$1,600.00	$36,668.38	$33,334.89	2026-05-22
160-1	OTHER	Major Cardiothoracic Repair Of Heart Anomaly	8	8	—	—	$1,600.00	$36,665.37	$33,332.15	2026-05-22
576	OTHER	Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc	14	10	—	—	$12,730.44	$74,721.73	$33,324.30	2026-05-22
815-4	OTHER	Other Injury, Poisoning And Toxic Effect Diagnoses	8	8	—	—	$1,600.00	$36,636.27	$33,305.70	2026-05-22
089-3	OTHER	Major Cranial Or Facial Bone Procedures	8	8	—	—	$1,600.00	$36,606.16	$33,278.33	2026-05-22
403-4	OTHER	Procedures For Obesity	8	8	—	—	$1,600.00	$36,418.51	$33,107.74	2026-05-22
098-4	OTHER	Other Ear, Nose, Mouth And Throat Procedures	8	8	—	—	$1,600.00	$36,189.71	$32,899.74	2026-05-22
175-4	OTHER	Percutaneous Cardiac Intervention Without Ami	8	8	—	—	$1,600.00	$36,029.16	$32,753.78	2026-05-22
023-3	OTHER	Spinal Procedures	8	8	—	—	$1,600.00	$36,010.10	$32,736.45	2026-05-22
197	OTHER	Interstitial Lung Disease With Cc	14	10	—	—	$5,220.05	$62,473.75	$32,488.62	2026-05-22
163-2	OTHER	Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis	8	8	—	—	$1,600.00	$35,716.08	$32,469.16	2026-05-22
222-4	OTHER	Other Stomach, Esophageal And Duodenal Procedures	8	8	—	—	$1,600.00	$35,664.89	$32,422.63	2026-05-22
267	OTHER	Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc	14	10	—	—	$26,184.40	$72,581.25	$32,391.67	2026-05-22
176-3	OTHER	Insertion, Revision And Replacements Of Pacemaker And Other Cardiac Devices	8	8	—	—	$1,600.00	$35,417.03	$32,197.30	2026-05-22
091-3	OTHER	Other Major Head And Neck Procedures	8	8	—	—	$1,600.00	$35,396.97	$32,179.06	2026-05-22
166-3	OTHER	Coronary Bypass Without Ami Or Complex Principal Diagnosis	7	7	—	—	$32,037.66	$35,241.43	$32,037.66	2026-05-22
650	OTHER	Kidney Transplant With Hemodialysis With Mcc	14	10	—	—	$25,857.70	$71,675.66	$31,997.11	2026-05-22

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