Hospital

AVITA ONTARIO

Ontario, OH · CCN 360365 · Rates published

4,079 distinct procedures filed

15 distinct payers

188,580 rate rows

2026-05-14 last MRF observed

Data quality

137,193 of 188,580 rate rows are consumer-grade (72.8%)

51,387 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
per-diem day rate — not a per-procedure price	31,645
exceeds 10× this hospital's gross charge — excluded from medians	19,598
template filing: same amount across many unrelated codes — excluded	144

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

Source MRF file	https://avitahealth.org/?sdm_process_download=1&download_id=2723
Found on page	https://avitahealth.org/your-bill/#pricing-information
Discovered via	Discovered by HANK
Last fetch	not_modified · 2026-05-15
Content fingerprint	93a49688c9543a08… · 50,057,470 bytes · first seen 2026-05-14

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
5884 OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure ?	10	$3,518.05	$321,369.26	$102,838.16	nat. median $243,175 outlier · 0.4×
5833 OTHER	Neonate With Ecmo ?	10	$3,518.05	$310,886.87	$100,478.64	nat. median $252,069 outlier · 0.4×
5834 OTHER	Neonate With Ecmo ?	10	$3,518.05	$310,886.87	$100,478.64	nat. median $372,748 outlier · 0.3×
5832 OTHER	Neonate With Ecmo ?	10	$3,518.05	$295,730.54	$95,580.11	nat. median $152,272 0.6× median
1614 OTHER	Implantable Heart Assist Systems ?	10	$3,518.05	$294,585.92	$95,210.17	nat. median $194,298 outlier · 0.5×
5831 OTHER	Neonate With Ecmo ?	10	$1,274.76	$295,730.54	$94,633.77	nat. median $139,037 0.7× median
1612 OTHER	Implantable Heart Assist Systems ?	10	$3,518.05	$228,052.84	$73,706.68	nat. median $84,765 0.9× median
1613 OTHER	Implantable Heart Assist Systems ?	10	$3,518.05	$228,052.84	$73,706.68	nat. median $79 outlier · 936.3×
1611 OTHER	Implantable Heart Assist Systems ?	10	$3,518.05	$228,052.84	$72,976.91	nat. median $80,527 0.9× median
74 OTHER	Allogeneic Bone Marrow Transplant ?	15	$12.94	$221,539.96	$70,892.79	nat. median $10,670 outlier · 6.6×
8412 OTHER	Extensive Third Degree Burns With Skin Graft ?	10	$3,518.05	$206,236.33	$66,655.58	nat. median $31,007 outlier · 2.1×
8413 OTHER	Extensive Third Degree Burns With Skin Graft ?	10	$3,518.05	$206,236.33	$66,655.58	nat. median $60,098 1.1× median
8414 OTHER	Extensive Third Degree Burns With Skin Graft ?	10	$3,518.05	$206,236.33	$66,655.58	nat. median $161,322 outlier · 0.4×
8411 OTHER	Extensive Third Degree Burns With Skin Graft ?	10	$3,518.05	$206,236.33	$65,995.63	nat. median $32,121 outlier · 2.1×
6094 OTHER	Neonate Birth Weight 1500-2499 Grams With Major Procedure ?	10	$3,518.05	$206,220.99	$65,990.72	nat. median $170,784 outlier · 0.4×
6304 OTHER	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure ?	10	$3,518.05	$200,144.31	$64,046.18	nat. median $164,743 outlier · 0.4×
6314 OTHER	Neonate Birth Weight > 2499 Grams With Other Major Procedure ?	10	$3,518.05	$176,697.04	$56,543.05	nat. median $163,675 outlier · 0.3×
5883 OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure ?	10	$3,518.05	$162,482.06	$52,514.20	nat. median $163,694 outlier · 0.3×
5881 OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure ?	10	$3,518.05	$175,200.30	$49,956.18	nat. median $14,014 outlier · 3.6×
5882 OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure ?	10	$3,518.05	$154,567.41	$49,956.18	nat. median $119,369 outlier · 0.4×
5934 OTHER	Neonate Birth Weight 750-999 Grams Without Major Procedure ?	10	$3,518.05	$149,802.51	$48,416.17	nat. median $129,842 outlier · 0.4×
5914 OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure ?	10	$3,518.05	$139,088.83	$44,508.43	nat. median $149,152 outlier · 0.3×
1604 OTHER	Major Cardiothoracic Repair Of Heart Anomaly ?	10	$3,518.05	$127,967.32	$40,949.54	nat. median $44,507 0.9× median
5362 OTHER	Laparoscopy Fundoplasty	14	$1,267.69	$93,472.50	$36,925.60	nat. median $11,212 outlier · 3.3×
23 OTHER	Heart And/or Lung Transplant ?	15	$29.89	$115,014.56	$36,804.66	nat. median $56,822 0.6× median
22 OTHER	Heart And/or Lung Transplant ?	15	$34.16	$115,014.56	$36,804.66	nat. median $36,392 1.0× median
94 OTHER	Extracorporeal Membrane Oxygenation (ecmo) ?	15	$12.94	$114,829.82	$36,745.54	nat. median $34,661 1.1× median
73 OTHER	Allogeneic Bone Marrow Transplant ?	15	$12.94	$108,269.99	$34,646.40	nat. median $14,946 outlier · 2.3×
44 OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure ?	10	$18.30	$104,306.63	$33,378.12	nat. median $33,835 1.0× median
6024 OTHER	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	10	$3,518.05	$102,621.42	$33,167.24	nat. median $99,381 outlier · 0.3×
6074 OTHER	Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…	10	$3,518.05	$101,494.89	$32,803.15	nat. median $85,400 outlier · 0.4×
8504 OTHER	Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal…	10	$3,518.05	$98,287.21	$31,451.91	nat. median $54,391 0.6× median
3034 OTHER	Dorsal And Lumbar Fusion Procedure For Curvature Of Back ?	10	$3,518.05	$95,315.36	$30,805.92	nat. median $71,896 outlier · 0.4×
8514 OTHER	Gender Related Procedures ?	10	$3,518.05	$95,127.17	$30,440.69	nat. median $74,802 outlier · 0.4×
5933 OTHER	Neonate Birth Weight 750-999 Grams Without Major Procedure ?	10	$3,518.05	$93,841.60	$30,329.61	nat. median $87,090 outlier · 0.3×
48000080 OTHER	Hc Insert/replace Subq Implantable Defibrillator System With Insertion Subq Electr…	15	$71.50	$42,486.40	$30,240.32	nat. median $407 outlier · 74.3×
6303 OTHER	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure ?	10	$3,518.05	$88,565.39	$28,624.33	nat. median $84,422 outlier · 0.3×
49000113 OTHER	Hc Insert/replace Single Or Dual Icd Leads & Generator	15	$3,518.05	$39,845.21	$27,852.60	nat. median $33,604 0.8× median
84 OTHER	Autologous Bone Marrow Transplant ?	15	$12.94	$86,943.20	$27,821.82	nat. median $10,032 outlier · 2.8×
49000441 OTHER	Hc Insert Icd Generator With Existing Multi Leads	15	$845.25	$39,845.21	$27,773.31	nat. median $33,148 0.8× median
71 OTHER	Allogeneic Bone Marrow Transplant ?	15	$12.94	$86,728.22	$27,753.03	nat. median $10,918 outlier · 2.5×
72 OTHER	Allogeneic Bone Marrow Transplant ?	15	$12.94	$86,728.22	$27,753.03	nat. median $8,165 outlier · 3.4×
6334 OTHER	Neonate Birth Weight > 2499 Grams With Major Anomaly ?	10	$3,518.05	$86,358.41	$27,634.69	nat. median $61,540 outlier · 0.4×
8424 OTHER	Burns With Skin Graft Except Extensive Third Degree Burns ?	10	$3,518.05	$86,277.12	$27,608.68	nat. median $91,349 outlier · 0.3×
6093 OTHER	Neonate Birth Weight 1500-2499 Grams With Major Procedure ?	10	$3,518.05	$83,982.60	$27,143.17	nat. median $3 outlier · 8699.7×
49000459 OTHER	Hc Replacement Icd Multi Lead Generator Only	15	$215.60	$39,845.21	$27,043.19	nat. median $32,277 0.8× median
6023 OTHER	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	10	$3,518.05	$83,020.10	$26,832.10	nat. median $75,452 outlier · 0.4×
48100137 OTHER	Hc Rhc With Rad Supervision With Pulm Angio Inj With Insert Of Implantable Pulm Artery…	15	$554.44	$39,845.21	$26,202.66	nat. median $10,909 outlier · 2.4×
5114 OTHER	Uterine And Adnexa Procedures For Ovarian And Adnexal Malignancy ?	14	$911.91	$95,581.72	$25,935.13	nat. median $8,090 outlier · 3.2×
6091 OTHER	Neonate Birth Weight 1500-2499 Grams With Major Procedure ?	10	$3,518.05	$79,898.46	$25,823.18	nat. median $94 outlier · 274.4×

Other procedures at this hospital

Browse this hospital's 4,079 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

3174	OTHER	Tendon, Muscle And Other Soft Tissue Procedures ?	20	10	$29,153.96	$24,780.87	$3,518.05	$29,153.96	$9,329.27	2026-05-14
3042	OTHER	Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back ?	20	10	$28,903.09	$24,567.63	$3,518.05	$28,903.09	$9,341.48	2026-05-14
4444	OTHER	Renal Dialysis Access Device Procedures?	20	10	$29,034.30	$24,679.16	$3,518.05	$29,034.30	$9,341.81	2026-05-14
3134	OTHER	Knee And Lower Leg Procedures Except Foot ?	20	10	$28,970.81	$24,625.19	$3,518.05	$28,970.81	$9,363.36	2026-05-14
48000042	OTHER	Hc Ep Evaluation Comprehensive With Induction Ra & Rv	29	15	$15,388.00	$13,079.80	$107.14	$22,123.52	$9,386.06	2026-05-14
5373	OTHER	Drain Bl W/cath Insertion	185	14	$16,313.67	$13,866.62	$449.81	$35,124.39	$9,514.34	2026-05-14
1693	OTHER	Major Abdominal Vascular Procedures ?	20	10	$29,499.16	$25,074.29	$3,518.05	$29,499.16	$9,534.13	2026-05-14
924	OTHER	Facial Bone Procedures Except Major Cranial Or Facial Bone Procedures ?	20	10	$29,666.63	$25,216.64	$3,518.05	$29,666.63	$9,588.26	2026-05-14
1652	OTHER	Coronary Bypass With Ami Or Complex Principal Diagnosis ?	20	10	$29,759.14	$25,295.27	$3,518.05	$29,759.14	$9,618.15	2026-05-14
1651	OTHER	Coronary Bypass With Ami Or Complex Principal Diagnosis ?	20	10	$29,759.14	$25,295.27	$3,518.05	$38,506.43	$9,618.15	2026-05-14
3464	OTHER	Connective Tissue Disorders ?	20	10	$30,125.23	$25,606.45	$3,518.05	$30,125.23	$9,640.07	2026-05-14
4424	OTHER	Kidney And Urinary Tract Procedures For Malignancy ?	20	10	$29,891.98	$25,408.18	$3,518.05	$29,891.98	$9,661.08	2026-05-14
5376	OTHER	Male Sling Procedure	57	14	$51,410.38	$43,698.82	$1,267.69	$55,835.41	$9,671.50	2026-05-14
8513	OTHER	Gender Related Procedures ?	20	10	$30,015.39	$25,513.08	$3,518.05	$30,015.39	$9,700.97	2026-05-14
303	OTHER	Percutaneous Intracranial And Extracranial Vascular Procedures ?	20	10	$30,039.97	$25,533.97	$3,518.05	$30,039.97	$9,708.92	2026-05-14
3104	OTHER	Vertebral And Intervertebral Spinal Procedures Including Disc Procedures?	20	10	$30,046.70	$25,539.70	$3,518.05	$30,046.70	$9,711.09	2026-05-14
1804	OTHER	Other Circulatory System Procedures ?	20	10	$30,405.72	$25,844.86	$3,518.05	$30,405.72	$9,729.83	2026-05-14
48100069	OTHER	Hc Atherectomy Fem/pop Artery Each Vessel	28	15	$15,293.00	$12,999.05	$3,385.90	$15,395.18	$9,733.69	2026-05-14
5091	OTHER	Biopsy/removal Lymph Nodes	90	14	$24,876.35	$21,144.90	$383.23	$42,084.64	$9,753.27	2026-05-14
1314	OTHER	Cystic Fibrosis - Pulmonary Disease ?	20	10	$30,204.69	$25,673.99	$3,518.05	$30,204.69	$9,762.15	2026-05-14
7934	OTHER	Moderately Extensive O.r. Procedures For Other Complications Of Treatment ?	20	10	$30,633.54	$26,038.51	$3,518.05	$30,633.54	$9,900.76	2026-05-14
48100094	OTHER	Hc Atherectomy With Or Without Angioplasty Single Major Artery/branch	29	15	$31,115.00	$26,447.75	$119.57	$26,447.75	$9,906.59	2026-05-14
48100102	OTHER	Hc Revascularize Acute Occl During Ami With Or Without Non-des Atherectomy Angioplasty…	29	15	$27,561.00	$23,426.85	$112.99	$23,426.85	$9,906.59	2026-05-14
48100111	OTHER	Hc Insertion Des With Atherectomy With Or Without Angioplasty Single Major Artery/branch	29	15	$35,217.00	$29,934.45	$21.63	$29,934.45	$9,906.59	2026-05-14
48100097	OTHER	Hc Insertion Non-des With Or Without Angioplasty Each Addl Branch Major Artery	29	15	$22,126.00	$18,807.10	$119.57	$18,807.10	$9,906.59	2026-05-14
48100096	OTHER	Hc Insertion Non-des With Or Without Angioplasty Single Major Artery/branch	29	15	$27,475.00	$23,353.75	$119.57	$23,353.75	$9,906.59	2026-05-14
48100100	OTHER	Hc Revascularize Cabg With Or Without Non-des Atherectomy Angioplasty Distal Protect S…	29	15	$28,561.00	$24,276.85	$112.99	$24,276.85	$9,906.59	2026-05-14
48100115	OTHER	Hc Revascularize Acute Occl During Ami With Or Without Des Atherectomy Angioplasty Asp…	29	15	$35,171.00	$29,895.35	$86.05	$29,895.35	$9,906.59	2026-05-14
48100113	OTHER	Hc Revascularize Cabg With Or Without Des Atherectomy Angioplasty Distal Protect Sgl V…	29	15	$32,590.00	$27,701.50	$21.63	$27,701.50	$9,906.59	2026-05-14
48100110	OTHER	Hc Insertion Des With Or Without Angioplasty Each Addl Branch Major Artery	29	15	$26,637.00	$22,641.45	$21.63	$22,641.45	$9,906.59	2026-05-14
48100104	OTHER	Hc Revascularize Chronic Total Occl With Or Without Non-des Atherectomy Angioplasty Ea…	29	15	$23,791.00	$20,222.35	$16.46	$20,222.35	$9,906.59	2026-05-14
48100101	OTHER	Hc Revascularize Cabg With Or Without Non-des Atherectomy Angioplasty Distal Protect E…	29	15	$23,563.00	$20,028.55	$112.99	$20,028.55	$9,906.59	2026-05-14
48100098	OTHER	Hc Insertion Non-des W/atherectomy With Or Without Angioplasty Single Major Artery/bra…	29	15	$31,257.00	$26,568.45	$112.99	$26,568.45	$9,906.59	2026-05-14
48100117	OTHER	Hc Revascularize Chronic Total Occl With Or Without Des Atherectomy Angioplasty Ea Add…	29	15	$27,449.00	$23,331.65	$554.44	$23,331.65	$9,906.59	2026-05-14
48100092	OTHER	Hc Ptca Single Major Artery/branch	29	15	$19,553.00	$16,620.05	$119.57	$16,620.05	$9,906.59	2026-05-14
48100095	OTHER	Hc Atherectomy With Or Without Angioplasty Each Addl Branch Of Major Artery	29	15	$23,358.00	$19,854.30	$119.57	$19,854.30	$9,906.59	2026-05-14
1763	OTHER	Insertion, Revision And Replacements Of Pacemaker And Other Cardiac Devices ?	20	10	$31,006.12	$26,355.20	$3,518.05	$31,006.12	$9,921.96	2026-05-14
1663	OTHER	Coronary Bypass Without Ami Or Complex Principal Diagnosis ?	20	10	$30,852.66	$26,224.76	$3,518.05	$30,852.66	$9,971.58	2026-05-14
2224	OTHER	Other Stomach, Esophageal And Duodenal Procedures ?	20	10	$31,222.48	$26,539.11	$3,518.05	$31,222.48	$9,991.19	2026-05-14
48100109	OTHER	Hc Insertion Des With Or Without Angioplasty Single Major Artery/branch	29	15	$32,085.00	$27,272.25	$16.46	$27,272.25	$9,996.35	2026-05-14
913	OTHER	Other Major Head And Neck Procedures ?	20	10	$30,988.27	$26,340.03	$3,518.05	$30,988.27	$10,015.41	2026-05-14
49000221	OTHER	Hc Transcath Place Intravasc Stent Cerv/carotid With Embolic Protection	29	15	$16,514.00	$14,036.90	$252.45	$14,036.98	$10,072.88	2026-05-14
1632	OTHER	Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis?	20	10	$31,266.74	$26,576.73	$3,518.05	$31,266.74	$10,105.41	2026-05-14
6333	OTHER	Neonate Birth Weight > 2499 Grams With Major Anomaly ?	20	10	$31,630.97	$26,886.32	$3,518.05	$31,630.97	$10,121.91	2026-05-14
984	OTHER	Other Ear, Nose, Mouth, Throat, Craniofacial, And Neck Procedures ?	20	10	$31,681.03	$26,928.88	$3,518.05	$31,681.03	$10,137.93	2026-05-14
6112	OTHER	Neonate Birth Weight 1500-1999 Grams With Major Anomaly ?	20	10	$31,827.71	$27,053.55	$3,518.05	$31,827.71	$10,184.87	2026-05-14
233	OTHER	Spinal Procedures ?	20	10	$31,523.88	$26,795.30	$3,518.05	$31,523.88	$10,188.51	2026-05-14
1754	OTHER	Percutaneous Cardiac Intervention Without Ami ?	20	10	$31,540.07	$26,809.06	$3,518.05	$31,540.07	$10,193.75	2026-05-14
4034	OTHER	Procedures For Obesity ?	20	10	$31,880.86	$27,098.73	$3,518.05	$31,880.86	$10,201.88	2026-05-14
49000094	OTHER	Hc Insert Pm Generator Only With Existing Dual Leads	28	15	$16,483.00	$14,010.55	$3,518.05	$14,010.55	$10,219.13	2026-05-14
48100112	OTHER	Hc Insertion Des With Atherectomy With Or Without Angioplasty Each Addl Branch Major Art…	29	15	$28,253.00	$24,015.05	$21.63	$24,015.05	$10,248.70	2026-05-14
8154	OTHER	Other Injury, Poisoning And Toxic Effect Diagnoses ?	20	10	$32,070.31	$27,259.76	$3,518.05	$32,070.31	$10,262.50	2026-05-14
1601	OTHER	Major Cardiothoracic Repair Of Heart Anomaly ?	20	10	$32,095.79	$27,281.42	$3,518.05	$32,095.79	$10,270.65	2026-05-14
6614	OTHER	Coagulation And Platelet Disorders ?	20	10	$32,099.14	$27,284.27	$3,518.05	$32,099.14	$10,271.72	2026-05-14
3613	OTHER	Skin Graft For Skin And Subcutaneous Tissue Diagnoses ?	20	10	$32,136.94	$27,316.40	$3,518.05	$32,136.94	$10,283.82	2026-05-14
2613	OTHER	Major Biliary Tract Procedures ?	20	10	$32,364.38	$27,509.72	$3,518.05	$32,364.38	$10,356.60	2026-05-14
893	OTHER	Major Cranial Or Facial Bone Procedures ?	20	10	$32,044.37	$27,237.71	$3,518.05	$32,044.37	$10,356.74	2026-05-14
3614	OTHER	Skin Graft For Skin And Subcutaneous Tissue Diagnoses ?	20	10	$32,136.94	$27,316.40	$3,518.05	$32,136.94	$10,386.66	2026-05-14
6914	OTHER	Lymphoma, Myeloma And Non-acute Leukemia ?	20	10	$32,155.67	$27,332.32	$3,518.05	$32,155.67	$10,392.71	2026-05-14
2484	OTHER	Major Gastrointestinal And Peritoneal Infections ?	20	10	$32,553.38	$27,670.37	$3,518.05	$32,553.38	$10,417.08	2026-05-14
2314	OTHER	Major Large Bowel Procedures ?	20	10	$32,235.07	$27,399.81	$3,518.05	$32,235.07	$10,418.38	2026-05-14
244	OTHER	Open Extracranial Vascular Procedures ?	20	10	$32,586.23	$27,698.30	$3,518.05	$32,586.23	$10,427.59	2026-05-14
2274	OTHER	Hernia Procedures Except Inguinal, Femoral And Umbilical ?	20	10	$32,766.21	$27,851.28	$3,518.05	$32,766.21	$10,485.19	2026-05-14
6082	OTHER	Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition ?	20	10	$32,753.45	$27,840.43	$3,518.05	$32,753.45	$10,585.92	2026-05-14
3094	OTHER	Other Significant Hip And Femur Surgery ?	20	10	$32,762.46	$27,848.09	$3,518.05	$32,762.46	$10,588.83	2026-05-14
49000089	OTHER	Hc Insert/replace Pm With Transvenous Electrode Ventricle	28	15	$18,021.00	$15,317.85	$2,626.40	$15,317.85	$10,637.51	2026-05-14
49000103	OTHER	Hc Insert Left Vent Pacing Electrode Previously Implanted Pm Or Icd	28	15	$19,567.00	$16,631.95	$2,472.75	$16,631.95	$10,637.51	2026-05-14
49000104	OTHER	Hc Insert Left Vent Pacing Electrode During Implant Of Pm Or Icd	28	15	$19,728.00	$16,768.80	$3,518.05	$16,768.80	$10,637.51	2026-05-14
49000095	OTHER	Hc Upgrade Single To Dual Pm	28	15	$22,380.00	$19,023.00	$3,518.05	$19,023.00	$10,637.51	2026-05-14
49000088	OTHER	Hc Insert/replace Pm With Transvenous Electrode Atrial	28	15	$17,543.00	$14,911.55	$3,518.05	$14,911.55	$10,637.51	2026-05-14
49000439	OTHER	Hc Insert Pm Pulse Generator Only With Multi Leads	29	15	$18,428.00	$15,663.80	$100.70	$15,663.80	$10,637.51	2026-05-14
49000739	OTHER	Hc Insert/replace Micra Transcatheter Pacing Study	29	15	$35,331.00	$30,031.35	$30.45	$30,031.35	$10,637.51	2026-05-14
49000456	OTHER	Hc Replacement Pm Multi Lead Generator Only	29	15	$21,628.00	$18,383.80	$923.36	$18,383.80	$10,637.51	2026-05-14
49000460	OTHER	Hc Replacement Pm Single Lead Generator Only	29	15	$17,646.00	$14,999.10	$923.36	$14,999.10	$10,637.51	2026-05-14
49000090	OTHER	Hc Insert/replace Pm With Transvenous Electrode Atrial & Ventricle	28	15	$20,836.00	$17,710.60	$2,626.40	$17,710.60	$10,637.51	2026-05-14
8632	OTHER	Neonatal Aftercare ?	20	10	$33,423.95	$28,410.36	$3,518.05	$33,423.95	$10,695.66	2026-05-14
48100099	OTHER	Hc Insertion Non-des With Atherectomy With Or Without Angioplasty Each Addl Branch Major…	29	15	$17,412.00	$14,800.20	$112.99	$14,800.20	$10,713.98	2026-05-14
2614	OTHER	Major Biliary Tract Procedures ?	20	10	$33,163.56	$28,189.03	$3,518.05	$33,163.56	$10,718.47	2026-05-14
494	OTHER	Bacterial And Tuberculous Infections Of Nervous System ?	20	10	$33,597.77	$28,558.10	$3,518.05	$33,597.77	$10,751.29	2026-05-14
2234	OTHER	Other Small And Large Bowel Procedures ?	20	10	$33,642.46	$28,596.09	$3,518.05	$33,642.46	$10,765.59	2026-05-14
4403	OTHER	Kidney Transplant ?	20	10	$33,784.34	$28,716.69	$3,518.05	$33,784.34	$10,810.99	2026-05-14
1791	OTHER	Defibrillator Implants ?	20	10	$33,501.66	$28,476.41	$3,518.05	$44,500.89	$10,827.74	2026-05-14
4404	OTHER	Kidney Transplant ?	20	10	$33,784.34	$28,716.69	$3,518.05	$33,784.34	$10,919.10	2026-05-14
48100103	OTHER	Hc Revascularize Chronic Total Occl With Or Without Non-des Atherectomy Angioplasty Sg…	29	15	$29,282.00	$24,889.70	$16.46	$24,889.70	$10,939.95	2026-05-14
9103	OTHER	Craniotomy For Multiple Significant Trauma ?	20	10	$34,212.17	$29,080.34	$3,518.05	$34,212.17	$10,947.89	2026-05-14
5374	OTHER	Cystoscopy And Treatment	161	14	$21,969.15	$18,673.78	$383.23	$44,236.04	$10,978.72	2026-05-14
5375	OTHER	Removal Of Bladder Stone	137	14	$29,391.38	$24,982.67	$425.77	$47,048.57	$11,011.09	2026-05-14
213	OTHER	Open Craniotomy Except Trauma ?	20	10	$34,091.22	$28,977.54	$3,518.05	$34,091.22	$11,018.28	2026-05-14
5341	OTHER	Prp I/hern Init Reduc >5 Yr	120	14	$28,190.91	$23,962.27	$570.80	$37,227.12	$11,132.16	2026-05-14
1673	OTHER	Other Cardiothoracic And Thoracic Vascular Procedures ?	20	10	$34,493.12	$29,319.15	$3,518.05	$34,493.12	$11,148.17	2026-05-14
1714	OTHER	Permanent Cardiac Pacemaker Implant Without Ami, Heart Failure Or Shock ?	20	10	$34,879.64	$29,647.69	$3,518.05	$34,879.64	$11,161.48	2026-05-14
6312	OTHER	Neonate Birth Weight > 2499 Grams With Other Major Procedure ?	20	10	$34,597.55	$29,407.92	$3,518.05	$34,597.55	$11,181.93	2026-05-14
6311	OTHER	Neonate Birth Weight > 2499 Grams With Other Major Procedure ?	20	10	$34,597.55	$29,407.92	$3,518.05	$112,791.32	$11,181.93	2026-05-14
734	OTHER	Orbit And Eye Procedures ?	20	10	$34,954.80	$29,711.58	$3,518.05	$34,954.80	$11,185.54	2026-05-14
48100114	OTHER	Hc Revascularize Cabg With Or Without Des Atherectomy Angioplasty Distal Protect Ea Ad…	29	15	$26,119.00	$22,201.15	$86.05	$22,201.15	$11,229.75	2026-05-14
3234	OTHER	Non-elective Or Complex Hip Joint Replacement ?	20	10	$34,924.69	$29,685.99	$3,518.05	$34,924.69	$11,287.66	2026-05-14
1792	OTHER	Defibrillator Implants ?	20	10	$35,028.49	$29,774.22	$3,518.05	$35,028.49	$11,321.21	2026-05-14
1653	OTHER	Coronary Bypass With Ami Or Complex Principal Diagnosis ?	20	10	$35,165.22	$29,890.44	$3,518.05	$35,165.22	$11,365.40	2026-05-14
6964	OTHER	Other Chemotherapy ?	20	10	$35,572.80	$30,236.88	$3,518.05	$35,572.80	$11,383.30	2026-05-14
5463	OTHER	Implant Neuroelectrodes	34	14	$135,142.20	$114,870.87	$5,762.28	$135,142.20	$11,384.04	2026-05-14
8624	OTHER	Other Aftercare And Convalescence ?	20	10	$35,676.51	$30,325.03	$3,518.05	$35,676.51	$11,416.48	2026-05-14
6032	OTHER	Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition ?	20	10	$35,560.95	$30,226.81	$3,518.05	$35,560.95	$11,493.30	2026-05-14
49000455	OTHER	Hc Replacement Pm Dual Lead Generator Only	29	15	$18,782.00	$15,964.70	$923.36	$16,255.28	$11,504.46	2026-05-14
6021	OTHER	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	20	10	$35,733.88	$30,373.80	$3,518.05	$84,421.20	$11,549.19	2026-05-14
1303	OTHER	Respiratory System Diagnosis With Ventilator Support > 96 Hours ?	20	10	$35,912.44	$30,525.57	$3,518.05	$35,912.44	$11,606.90	2026-05-14
2244	OTHER	Peritoneal Adhesiolysis ?	20	10	$36,366.43	$30,911.47	$3,518.05	$36,366.43	$11,637.26	2026-05-14
1602	OTHER	Major Cardiothoracic Repair Of Heart Anomaly ?	20	10	$36,385.72	$30,927.86	$3,518.05	$36,385.72	$11,759.86	2026-05-14
7504	OTHER	Schizophrenia?	20	10	$36,775.82	$31,259.45	$3,518.05	$36,775.82	$11,768.26	2026-05-14
5113	OTHER	Knee Arthroscopy/surgery	582	14	$18,157.66	$15,434.01	$129.97	$69,055.32	$11,781.35	2026-05-14
6071	OTHER	Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…	20	10	$37,224.27	$31,640.63	$3,518.05	$37,224.27	$12,030.89	2026-05-14
6143	OTHER	Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition…	20	10	$37,613.38	$31,971.37	$3,518.05	$37,613.38	$12,036.28	2026-05-14
4414	OTHER	Major Bladder Procedures ?	20	10	$37,607.97	$31,966.77	$3,518.05	$37,607.97	$12,154.90	2026-05-14
6144	OTHER	Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition…	20	10	$37,613.38	$31,971.37	$3,518.05	$37,613.38	$12,156.65	2026-05-14
9524	OTHER	Non-extensive O.r. Procedure Unrelated To Principal Diagnosis ?	20	10	$38,147.28	$32,425.19	$3,518.05	$38,147.28	$12,207.13	2026-05-14
48100075	OTHER	Hc Atherectomy & Stent Insertion Tibial/peroneal Artery Initial Vessel	29	15	$20,366.00	$17,311.10	$135.12	$17,311.10	$12,321.43	2026-05-14
48100116	OTHER	Hc Revascularize Chronic Total Occl With Or Without Des Atherectomy Angioplasty Sgl Ve…	29	15	$34,163.00	$29,038.55	$86.05	$29,038.55	$12,325.95	2026-05-14
6122	OTHER	Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other…	20	10	$38,165.01	$32,440.26	$3,518.05	$38,165.01	$12,334.93	2026-05-14
1622	OTHER	Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis ?	20	10	$38,172.41	$32,446.55	$3,518.05	$38,172.41	$12,337.32	2026-05-14
3254	OTHER	Non-elective Or Complex Knee Joint Replacement ?	20	10	$38,173.36	$32,447.36	$3,518.05	$38,173.36	$12,337.63	2026-05-14
48100071	OTHER	Hc Atherectomy & Stent Insertion Fem/pop Artery Each Vessel	28	15	$20,366.00	$17,311.10	$1,041.48	$17,311.10	$12,371.94	2026-05-14
48100077	OTHER	Hc Atherectomy Tibial/peroneal Artery Each Addl Vessel	29	15	$20,462.00	$17,392.70	$119.22	$17,392.70	$12,379.51	2026-05-14
8503	OTHER	Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal…	20	10	$38,789.97	$32,971.47	$3,518.05	$38,789.97	$12,412.79	2026-05-14
434	OTHER	Multiple Sclerosis, Other Demyelinating Disease And Inflammatory Neuropathies ?	20	10	$38,986.83	$33,138.81	$3,518.05	$38,986.83	$12,475.79	2026-05-14
1214	OTHER	Other Respiratory And Chest Procedures ?	20	10	$39,099.78	$33,234.81	$3,518.05	$39,099.78	$12,637.05	2026-05-14
3031	OTHER	Dorsal And Lumbar Fusion Procedure For Curvature Of Back ?	20	10	$39,613.00	$33,671.05	$3,518.05	$39,613.00	$12,676.16	2026-05-14
7114	OTHER	Post-operative, Post-trauma, Other Device Infections With O.r. Procedure ?	20	10	$39,624.21	$33,680.58	$3,518.05	$39,624.21	$12,679.75	2026-05-14
81	OTHER	Autologous Bone Marrow Transplant ?	29	15	$39,815.33	$33,843.03	$12.94	$39,815.33	$12,740.91	2026-05-14
82	OTHER	Autologous Bone Marrow Transplant ?	29	15	$39,815.33	$33,843.03	$12.94	$39,815.33	$12,740.91	2026-05-14
1324	OTHER	Bpd And Other Chronic Respiratory Diseases Arising In Perinatal Period?	20	10	$40,274.63	$34,233.44	$3,518.05	$40,274.63	$12,887.88	2026-05-14
1793	OTHER	Defibrillator Implants ?	20	10	$40,010.22	$34,008.69	$3,518.05	$40,010.22	$12,931.31	2026-05-14
48100073	OTHER	Hc Atherectomy Tibial/peroneal Artery Initial Vessel	29	15	$21,385.00	$18,177.25	$135.12	$18,177.25	$12,937.93	2026-05-14
1764	OTHER	Insertion, Revision And Replacements Of Pacemaker And Other Cardiac Devices ?	20	10	$40,088.57	$34,075.28	$3,518.05	$40,088.57	$12,956.62	2026-05-14
7104	OTHER	Infectious And Parasitic Diseases Including HIV With O.r. Procedure ?	20	10	$40,612.08	$34,520.27	$3,518.05	$40,612.08	$12,995.87	2026-05-14
49001009	OTHER	Hc Cch Insj Stablj Dev Without Dcmprn Lumbar Single Level	29	15	$20,633.00	$17,538.05	$159.95	$17,538.05	$12,998.79	2026-05-14
9514	OTHER	Moderately Extensive O.r. Procedure Unrelated To Principal Diagnosis ?	20	10	$40,778.75	$34,661.94	$3,518.05	$40,778.75	$13,049.20	2026-05-14
5115	OTHER	Neck Spine Fuse&remov Bel C2	98	14	$97,591.01	$82,952.36	$1,544.92	$298,319.72	$13,116.76	2026-05-14
4474	OTHER	Other Kidney, Urinary Tract And Related Procedures ?	20	10	$41,017.45	$34,864.83	$3,518.05	$41,017.45	$13,125.58	2026-05-14
1633	OTHER	Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis?	20	10	$40,615.01	$34,522.76	$3,518.05	$40,615.01	$13,126.77	2026-05-14
2294	OTHER	Other Digestive System And Abdominal Procedures ?	20	10	$41,081.94	$34,919.65	$3,518.05	$41,081.94	$13,146.22	2026-05-14
6213	OTHER	Neonate Birth Weight 2000-2499 Grams With Major Anomaly ?	20	10	$41,145.01	$34,973.26	$3,518.05	$41,145.01	$13,166.40	2026-05-14
2644	OTHER	Other Hepatobiliary, Pancreas And Abdominal Procedures ?	20	10	$41,420.83	$35,207.71	$3,518.05	$41,420.83	$13,254.67	2026-05-14
42	OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure ?	29	15	$41,441.09	$35,224.93	$57.94	$41,441.09	$13,261.15	2026-05-14
41	OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure ?	29	15	$41,441.09	$35,224.93	$116.71	$41,441.09	$13,261.15	2026-05-14
3043	OTHER	Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back ?	20	10	$41,107.45	$34,941.33	$3,518.05	$41,107.45	$13,285.92	2026-05-14
5377	OTHER	Insert Multi-comp Penis Pros	34	14	$87,325.66	$74,226.81	$3,848.04	$87,325.66	$13,479.22	2026-05-14
48100070	OTHER	Hc Insertion Stent Fem/pop Artery Each Vessel	28	15	$21,385.00	$18,177.25	$3,385.90	$18,177.25	$13,509.40	2026-05-14
1824	OTHER	Other Peripheral Vascular And Related Procedures ?	20	10	$42,348.40	$35,996.14	$3,518.05	$42,348.40	$13,551.49	2026-05-14
4054	OTHER	Other Procedures For Endocrine, Nutritional And Metabolic Disorders ?	20	10	$42,538.17	$36,157.44	$3,518.05	$42,538.17	$13,612.21	2026-05-14
3214	OTHER	Spinal Fusion And Other Back And Neck Procedures Except For Disc Procedures ?	20	10	$42,828.80	$36,404.48	$3,518.05	$42,828.80	$13,842.27	2026-05-14
504	OTHER	Non-bacterial Infections Of Nervous System Except Viral Meningitis ?	20	10	$43,313.01	$36,816.06	$3,518.05	$43,313.01	$13,860.16	2026-05-14
1814	OTHER	Lower Extremity Arterial Procedures ?	20	10	$43,124.00	$36,655.40	$3,518.05	$43,124.00	$13,937.67	2026-05-14
6113	OTHER	Neonate Birth Weight 1500-1999 Grams With Major Anomaly ?	20	10	$43,169.88	$36,694.40	$3,518.05	$43,169.88	$13,952.51	2026-05-14
9124	OTHER	Musculoskeletal And Other Procedures For Multiple Significant Trauma ?	20	10	$43,657.07	$37,108.51	$3,518.05	$43,657.07	$13,970.26	2026-05-14
294	OTHER	Other Percutaneous Intracranial Procedures ?	20	10	$43,326.16	$36,827.24	$3,518.05	$43,326.16	$14,003.01	2026-05-14
48100196	OTHER	Hc Revasc Intravascular Lithotripsy And Arthrectomy W Stent	29	15	$35,042.00	$29,785.70	$554.44	$29,785.70	$14,235.02	2026-05-14
274	OTHER	Other Open Craniotomy ?	20	10	$44,516.91	$37,839.37	$3,518.05	$44,516.91	$14,245.41	2026-05-14
1694	OTHER	Major Abdominal Vascular Procedures ?	20	10	$44,442.26	$37,775.92	$3,518.05	$44,442.26	$14,363.74	2026-05-14
2604	OTHER	Major Pancreas, Liver And Shunt Procedures ?	20	10	$44,972.26	$38,226.42	$3,518.05	$44,972.26	$14,391.12	2026-05-14
304	OTHER	Percutaneous Intracranial And Extracranial Vascular Procedures ?	20	10	$44,566.30	$37,881.36	$3,518.05	$44,566.30	$14,403.83	2026-05-14
1664	OTHER	Coronary Bypass Without Ami Or Complex Principal Diagnosis ?	20	10	$45,148.51	$38,376.23	$3,518.05	$45,148.51	$14,591.99	2026-05-14
2304	OTHER	Major Small Bowel Procedures ?	20	10	$45,623.69	$38,780.14	$3,518.05	$45,623.69	$14,599.58	2026-05-14
894	OTHER	Major Cranial Or Facial Bone Procedures ?	20	10	$45,179.79	$38,402.82	$3,518.05	$45,179.79	$14,602.10	2026-05-14
8423	OTHER	Burns With Skin Graft Except Extensive Third Degree Burns ?	20	10	$45,472.98	$38,652.03	$3,518.05	$45,472.98	$14,660.51	2026-05-14
204	OTHER	Open Craniotomy For Trauma ?	20	10	$45,498.36	$38,673.61	$3,518.05	$45,498.36	$14,705.07	2026-05-14
5415	OTHER	Anterior Colporrhaphy	106	14	$23,996.41	$20,396.95	$425.77	$60,765.54	$14,824.74	2026-05-14
6804	OTHER	Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms ?	20	10	$46,331.56	$39,381.83	$3,518.05	$46,331.56	$14,974.36	2026-05-14
6123	OTHER	Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other…	20	10	$46,486.70	$39,513.70	$3,518.05	$46,486.70	$15,024.50	2026-05-14
93	OTHER	Extracorporeal Membrane Oxygenation (ecmo) ?	29	15	$47,256.37	$40,167.91	$12.94	$47,256.37	$15,122.04	2026-05-14
91	OTHER	Extracorporeal Membrane Oxygenation (ecmo) ?	29	15	$47,256.37	$40,167.91	$12.94	$47,256.37	$15,122.04	2026-05-14
92	OTHER	Extracorporeal Membrane Oxygenation (ecmo) ?	29	15	$47,256.37	$40,167.91	$12.94	$47,256.37	$15,122.04	2026-05-14
1783	OTHER	External Heart Assist Systems ?	20	10	$46,958.93	$39,915.09	$3,518.05	$46,958.93	$15,177.12	2026-05-14
1782	OTHER	External Heart Assist Systems ?	20	10	$46,958.93	$39,915.09	$3,518.05	$46,958.93	$15,177.12	2026-05-14
1781	OTHER	External Heart Assist Systems ?	20	10	$46,958.93	$39,915.09	$3,518.05	$46,958.93	$15,177.12	2026-05-14
1304	OTHER	Respiratory System Diagnosis With Ventilator Support > 96 Hours ?	20	10	$47,016.59	$39,964.10	$3,518.05	$47,016.59	$15,195.76	2026-05-14
234	OTHER	Spinal Procedures ?	20	10	$47,054.31	$39,996.16	$3,518.05	$47,054.31	$15,207.95	2026-05-14
264	OTHER	Other Nervous System And Related Procedures ?	20	10	$48,034.80	$40,829.58	$3,518.05	$48,034.80	$15,371.14	2026-05-14
9114	OTHER	Extensive Abdominal Or Thoracic Procedures For Multiple Significant Trauma ?	20	10	$48,362.36	$41,108.01	$3,518.05	$48,362.36	$15,475.96	2026-05-14
49000110	OTHER	Hc Insert Icd Generator With Existing Single Lead	28	15	$25,377.00	$21,570.45	$1,991.15	$39,845.21	$15,733.23	2026-05-14
1831	OTHER	Percutaneous Structural Cardiac Procedures ?	20	10	$48,754.21	$41,441.08	$3,518.05	$48,754.21	$15,757.36	2026-05-14
1654	OTHER	Coronary Bypass With Ami Or Complex Principal Diagnosis ?	20	10	$48,966.89	$41,621.86	$3,518.05	$48,966.89	$15,826.10	2026-05-14
1623	OTHER	Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis ?	20	10	$49,052.33	$41,694.48	$3,518.05	$49,052.33	$15,853.72	2026-05-14
6224	OTHER	Neonate Birth Weight 2000-2499 Grams With Respiratory Distress Syndrome Or Other…	20	10	$49,663.93	$42,214.34	$3,518.05	$49,663.93	$15,892.46	2026-05-14
3032	OTHER	Dorsal And Lumbar Fusion Procedure For Curvature Of Back ?	20	10	$49,335.33	$41,935.03	$3,518.05	$49,335.33	$15,945.18	2026-05-14
6903	OTHER	Acute Leukemia ?	20	10	$49,942.95	$42,451.51	$3,518.05	$49,942.95	$15,981.74	2026-05-14
2204	OTHER	Major Stomach, Esophageal And Duodenal Procedures ?	20	10	$50,252.48	$42,714.61	$3,518.05	$50,252.48	$16,080.79	2026-05-14
6344	OTHER	Neonate Birth Weight > 2499 Grams With Respiratory Distress Syndrome Or Other Ma…	20	10	$50,256.43	$42,717.97	$3,518.05	$50,256.43	$16,082.06	2026-05-14
6072	OTHER	Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…	20	10	$49,987.38	$42,489.27	$3,518.05	$49,987.38	$16,155.92	2026-05-14
1832	OTHER	Percutaneous Structural Cardiac Procedures ?	20	10	$50,156.05	$42,632.64	$3,518.05	$50,156.05	$16,210.44	2026-05-14
6084	OTHER	Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition ?	20	10	$50,405.53	$42,844.70	$3,518.05	$50,405.53	$16,291.07	2026-05-14
6083	OTHER	Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition ?	20	10	$50,405.53	$42,844.70	$3,518.05	$50,405.53	$16,291.07	2026-05-14
3124	OTHER	Skin Graft, Except Hand, For Musculoskeletal And Connective Tissue Diagnoses ?	20	10	$51,601.81	$43,861.54	$3,518.05	$51,601.81	$16,512.58	2026-05-14
1603	OTHER	Major Cardiothoracic Repair Of Heart Anomaly ?	20	10	$52,629.67	$44,735.22	$3,518.05	$52,629.67	$17,009.90	2026-05-14
6604	OTHER	Major Hematologic Or Immunologic Diagnoses Except Sickle Cell Crisis And Coagula…	20	10	$53,413.56	$45,401.53	$3,518.05	$53,413.56	$17,092.34	2026-05-14
1204	OTHER	Major Respiratory And Chest Procedures ?	20	10	$53,568.73	$45,533.42	$3,518.05	$53,568.73	$17,141.99	2026-05-14
214	OTHER	Open Craniotomy Except Trauma ?	20	10	$53,872.40	$45,791.54	$3,518.05	$53,872.40	$17,411.56	2026-05-14
1674	OTHER	Other Cardiothoracic And Thoracic Vascular Procedures ?	20	10	$53,969.09	$45,873.73	$3,518.05	$53,969.09	$17,442.81	2026-05-14
1794	OTHER	Defibrillator Implants ?	20	10	$54,323.52	$46,174.99	$3,518.05	$54,323.52	$17,557.36	2026-05-14
5116	OTHER	Cerv Artific Diskectomy	35	14	$137,871.88	$117,191.10	$3,848.04	$137,871.88	$17,913.59	2026-05-14
1833	OTHER	Percutaneous Structural Cardiac Procedures ?	20	10	$55,827.26	$47,453.17	$3,518.05	$55,827.26	$18,043.37	2026-05-14
5165	OTHER	Excise Parotid Gland/lesion	154	14	$40,394.98	$34,335.73	$523.59	$57,914.52	$18,116.88	2026-05-14
9104	OTHER	Craniotomy For Multiple Significant Trauma ?	20	10	$56,238.95	$47,803.11	$3,518.05	$56,238.95	$18,176.42	2026-05-14
2004	OTHER	Cardiac Structural And Valvular Disorders?	20	10	$56,985.16	$48,437.39	$3,518.05	$56,985.16	$18,235.25	2026-05-14
3044	OTHER	Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back ?	20	10	$56,583.42	$48,095.91	$3,518.05	$56,583.42	$18,287.76	2026-05-14
6301	OTHER	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure ?	20	10	$58,130.07	$49,410.56	$3,518.05	$58,130.07	$18,601.62	2026-05-14
914	OTHER	Other Major Head And Neck Procedures ?	20	10	$58,402.69	$49,642.29	$3,518.05	$58,402.69	$18,688.86	2026-05-14
6302	OTHER	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure ?	20	10	$58,130.07	$49,410.56	$3,518.05	$58,130.07	$18,787.64	2026-05-14
5911	OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure ?	20	10	$58,292.02	$49,548.22	$3,518.05	$58,292.02	$18,839.99	2026-05-14
5912	OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure ?	20	10	$58,292.02	$49,548.22	$3,518.05	$58,292.02	$18,839.99	2026-05-14
8633	OTHER	Neonatal Aftercare ?	20	10	$59,748.33	$50,786.08	$3,518.05	$59,748.33	$19,119.47	2026-05-14
5931	OTHER	Neonate Birth Weight 750-999 Grams Without Major Procedure ?	20	10	$59,471.70	$50,550.95	$3,518.05	$78,383.51	$19,221.25	2026-05-14
5932	OTHER	Neonate Birth Weight 750-999 Grams Without Major Procedure ?	20	10	$59,471.70	$50,550.95	$3,518.05	$59,471.70	$19,221.25	2026-05-14
6034	OTHER	Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition ?	20	10	$59,851.72	$50,873.96	$3,518.05	$59,851.72	$19,344.07	2026-05-14
6033	OTHER	Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition ?	20	10	$59,851.72	$50,873.96	$3,518.05	$59,851.72	$19,344.07	2026-05-14
6022	OTHER	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	20	10	$60,818.16	$51,695.44	$3,518.05	$60,818.16	$19,656.43	2026-05-14
9504	OTHER	Extensive O.r. Procedure Unrelated To Principal Diagnosis ?	20	10	$61,823.08	$52,549.62	$3,518.05	$61,823.08	$19,783.39	2026-05-14
5464	OTHER	Inc For Vagus N Elect Impl	19	11	$98,095.61	$83,381.27	$5,762.28	$98,095.61	$19,820.31	2026-05-14
5361	OTHER	Remove Armpit Lymph Nodes	298	14	$34,168.39	$29,043.13	$523.59	$59,100.19	$19,986.42	2026-05-14
7924	OTHER	Extensive O.r. Procedures For Other Complications Of Treatment ?	20	10	$63,608.70	$54,067.40	$3,518.05	$63,608.70	$20,354.78	2026-05-14
114	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies ?	29	15	$64,760.17	$55,046.14	$12.94	$64,760.17	$20,723.25	2026-05-14
113	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies ?	29	15	$64,760.17	$55,046.14	$12.94	$64,760.17	$20,723.25	2026-05-14
112	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies ?	29	15	$64,760.17	$55,046.14	$12.94	$64,760.17	$20,723.25	2026-05-14
111	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies ?	29	15	$64,760.17	$55,046.14	$12.94	$64,760.17	$20,723.25	2026-05-14
83	OTHER	Autologous Bone Marrow Transplant ?	29	15	$65,377.87	$55,571.19	$12.94	$65,377.87	$20,920.92	2026-05-14
224	OTHER	Ventricular Shunt Procedures ?	20	10	$65,711.13	$55,854.46	$3,518.05	$65,711.13	$21,027.56	2026-05-14
6313	OTHER	Neonate Birth Weight > 2499 Grams With Other Major Procedure ?	20	10	$67,237.41	$57,151.80	$3,518.05	$67,237.41	$21,515.97	2026-05-14
5892	OTHER	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …	20	10	$67,010.60	$56,959.01	$3,518.05	$67,010.60	$21,657.82	2026-05-14
5891	OTHER	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …	20	10	$67,010.60	$56,959.01	$3,518.05	$181,107.65	$21,657.82	2026-05-14
1624	OTHER	Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis ?	20	10	$67,560.74	$57,426.63	$3,518.05	$67,560.74	$21,835.64	2026-05-14
6954	OTHER	Chemotherapy For Acute Leukemia ?	20	10	$68,890.57	$58,556.98	$3,518.05	$68,890.57	$22,044.98	2026-05-14
1634	OTHER	Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis?	20	10	$68,328.33	$58,079.08	$3,518.05	$68,328.33	$22,083.72	2026-05-14
6814	OTHER	Other? O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms ?	20	10	$69,283.53	$58,891.00	$3,518.05	$69,283.53	$22,170.73	2026-05-14
5893	OTHER	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …	20	10	$70,433.59	$59,868.55	$3,518.05	$70,433.59	$22,764.14	2026-05-14
5894	OTHER	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …	20	10	$70,433.59	$59,868.55	$3,518.05	$70,433.59	$22,764.14	2026-05-14
6073	OTHER	Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…	20	10	$71,408.14	$60,696.92	$3,518.05	$71,408.14	$23,079.11	2026-05-14
3033	OTHER	Dorsal And Lumbar Fusion Procedure For Curvature Of Back ?	20	10	$71,561.65	$60,827.40	$3,518.05	$71,561.65	$23,128.72	2026-05-14
49000440	OTHER	Hc Insert Icd Generator W/existing Dual Leads	29	15	$37,931.00	$32,241.35	$923.36	$39,845.21	$23,136.39	2026-05-14
54	OTHER	Tracheostomy With Mv >96 Hours Without Extensive Procedure ?	29	15	$73,720.45	$62,662.38	$12.94	$73,720.45	$23,590.54	2026-05-14
5092	OTHER	Exc Skin Abd	82	14	$48,893.12	$41,559.15	$523.59	$118,103.26	$23,698.60	2026-05-14
6124	OTHER	Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other…	20	10	$74,453.26	$63,285.27	$3,518.05	$74,453.26	$24,063.29	2026-05-14
49000457	OTHER	Hc Replacement Icd Single Lead Generator Only	29	15	$39,941.00	$33,949.85	$923.36	$39,845.21	$24,362.41	2026-05-14
5913	OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure ?	20	10	$77,174.66	$65,598.46	$3,518.05	$77,174.66	$24,942.85	2026-05-14
6214	OTHER	Neonate Birth Weight 2000-2499 Grams With Major Anomaly ?	20	10	$78,193.41	$66,464.40	$3,518.05	$78,193.41	$25,021.89	2026-05-14
43	OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure ?	29	15	$79,106.49	$67,240.52	$57.94	$79,106.49	$25,314.08	2026-05-14
49000458	OTHER	Hc Replacement Icd Dual Lead Generator Only	29	15	$41,524.00	$35,295.40	$923.36	$39,845.21	$25,327.98	2026-05-14
6904	OTHER	Acute Leukemia ?	20	10	$78,657.63	$66,858.99	$3,518.05	$78,657.63	$25,422.14	2026-05-14
6114	OTHER	Neonate Birth Weight 1500-1999 Grams With Major Anomaly ?	20	10	$79,626.68	$67,682.68	$3,518.05	$79,626.68	$25,480.54	2026-05-14
1784	OTHER	External Heart Assist Systems ?	20	10	$78,965.30	$67,120.51	$3,518.05	$78,965.30	$25,521.58	2026-05-14
8634	OTHER	Neonatal Aftercare ?	20	10	$78,991.55	$67,142.82	$3,518.05	$78,991.55	$25,530.07	2026-05-14
1834	OTHER	Percutaneous Structural Cardiac Procedures ?	20	10	$79,258.94	$67,370.10	$3,518.05	$79,258.94	$25,616.49	2026-05-14
6091	OTHER	Neonate Birth Weight 1500-2499 Grams With Major Procedure ?	20	10	$79,898.46	$67,913.69	$3,518.05	$79,898.46	$25,823.18	2026-05-14
6092	OTHER	Neonate Birth Weight 1500-2499 Grams With Major Procedure ?	20	10	$79,898.46	$67,913.69	$3,518.05	$79,898.46	$25,823.18	2026-05-14
5114	OTHER	Uterine And Adnexa Procedures For Ovarian And Adnexal Malignancy ?	454	14	$39,990.62	$33,992.03	$911.91	$95,581.72	$25,935.13	2026-05-14
48100137	OTHER	Hc Rhc With Rad Supervision With Pulm Angio Inj With Insert Of Implantable Pulm Artery…	29	15	$42,958.00	$36,514.30	$554.44	$39,845.21	$26,202.66	2026-05-14
6023	OTHER	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	20	10	$83,020.10	$70,567.09	$3,518.05	$83,020.10	$26,832.10	2026-05-14
49000459	OTHER	Hc Replacement Icd Multi Lead Generator Only	29	15	$44,336.00	$37,685.60	$215.60	$39,845.21	$27,043.19	2026-05-14
6093	OTHER	Neonate Birth Weight 1500-2499 Grams With Major Procedure ?	20	10	$83,982.60	$71,385.21	$3,518.05	$83,982.60	$27,143.17	2026-05-14
8424	OTHER	Burns With Skin Graft Except Extensive Third Degree Burns ?	20	10	$86,277.12	$73,335.55	$3,518.05	$86,277.12	$27,608.68	2026-05-14
6334	OTHER	Neonate Birth Weight > 2499 Grams With Major Anomaly ?	20	10	$86,358.41	$73,404.65	$3,518.05	$86,358.41	$27,634.69	2026-05-14
71	OTHER	Allogeneic Bone Marrow Transplant ?	29	15	$86,728.22	$73,718.99	$12.94	$86,728.22	$27,753.03	2026-05-14
72	OTHER	Allogeneic Bone Marrow Transplant ?	29	15	$86,728.22	$73,718.99	$12.94	$86,728.22	$27,753.03	2026-05-14
49000441	OTHER	Hc Insert Icd Generator With Existing Multi Leads	29	15	$45,533.00	$38,703.05	$845.25	$39,845.21	$27,773.31	2026-05-14
84	OTHER	Autologous Bone Marrow Transplant ?	29	15	$86,943.20	$73,901.72	$12.94	$86,943.20	$27,821.82	2026-05-14
49000113	OTHER	Hc Insert/replace Single Or Dual Icd Leads & Generator	28	15	$44,925.00	$38,186.25	$3,518.05	$39,845.21	$27,852.60	2026-05-14
6303	OTHER	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure ?	20	10	$88,565.39	$75,280.58	$3,518.05	$88,565.39	$28,624.33	2026-05-14
48000080	OTHER	Hc Insert/replace Subq Implantable Defibrillator System With Insertion Subq Electr…	29	15	$49,984.00	$42,486.40	$71.50	$42,486.40	$30,240.32	2026-05-14
5933	OTHER	Neonate Birth Weight 750-999 Grams Without Major Procedure ?	20	10	$93,841.60	$79,765.36	$3,518.05	$93,841.60	$30,329.61	2026-05-14
8514	OTHER	Gender Related Procedures ?	20	10	$95,127.17	$80,858.09	$3,518.05	$95,127.17	$30,440.69	2026-05-14
3034	OTHER	Dorsal And Lumbar Fusion Procedure For Curvature Of Back ?	20	10	$95,315.36	$81,018.06	$3,518.05	$95,315.36	$30,805.92	2026-05-14
8504	OTHER	Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal…	20	10	$98,287.21	$83,544.13	$3,518.05	$98,287.21	$31,451.91	2026-05-14
6074	OTHER	Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…	20	10	$101,494.89	$86,270.66	$3,518.05	$101,494.89	$32,803.15	2026-05-14
6024	OTHER	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	20	10	$102,621.42	$87,228.21	$3,518.05	$102,621.42	$33,167.24	2026-05-14
44	OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure ?	20	10	$104,306.63	$88,660.64	$18.30	$104,306.63	$33,378.12	2026-05-14
73	OTHER	Allogeneic Bone Marrow Transplant ?	29	15	$108,269.99	$92,029.49	$12.94	$108,269.99	$34,646.40	2026-05-14
94	OTHER	Extracorporeal Membrane Oxygenation (ecmo) ?	29	15	$114,829.82	$97,605.35	$12.94	$114,829.82	$36,745.54	2026-05-14
22	OTHER	Heart And/or Lung Transplant ?	29	15	$115,014.56	$97,762.38	$34.16	$115,014.56	$36,804.66	2026-05-14
23	OTHER	Heart And/or Lung Transplant ?	29	15	$115,014.56	$97,762.38	$29.89	$115,014.56	$36,804.66	2026-05-14
5362	OTHER	Laparoscopy Fundoplasty	130	14	$58,612.07	$49,820.26	$1,267.69	$93,472.50	$36,925.60	2026-05-14
1604	OTHER	Major Cardiothoracic Repair Of Heart Anomaly ?	20	10	$127,967.32	$108,772.22	$3,518.05	$127,967.32	$40,949.54	2026-05-14
5914	OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure ?	20	10	$139,088.83	$118,225.51	$3,518.05	$139,088.83	$44,508.43	2026-05-14
5934	OTHER	Neonate Birth Weight 750-999 Grams Without Major Procedure ?	20	10	$149,802.51	$127,332.13	$3,518.05	$149,802.51	$48,416.17	2026-05-14
5882	OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure ?	20	10	$154,567.41	$131,382.30	$3,518.05	$154,567.41	$49,956.18	2026-05-14
5881	OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure ?	20	10	$154,567.41	$131,382.30	$3,518.05	$175,200.30	$49,956.18	2026-05-14
5883	OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure ?	20	10	$162,482.06	$138,109.75	$3,518.05	$162,482.06	$52,514.20	2026-05-14
6314	OTHER	Neonate Birth Weight > 2499 Grams With Other Major Procedure ?	20	10	$176,697.04	$150,192.48	$3,518.05	$176,697.04	$56,543.05	2026-05-14
6304	OTHER	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure ?	20	10	$200,144.31	$170,122.66	$3,518.05	$200,144.31	$64,046.18	2026-05-14
6094	OTHER	Neonate Birth Weight 1500-2499 Grams With Major Procedure ?	20	10	$206,220.99	$175,287.84	$3,518.05	$206,220.99	$65,990.72	2026-05-14
8411	OTHER	Extensive Third Degree Burns With Skin Graft ?	20	10	$206,236.33	$175,300.88	$3,518.05	$206,236.33	$65,995.63	2026-05-14
8413	OTHER	Extensive Third Degree Burns With Skin Graft ?	20	10	$206,236.33	$175,300.88	$3,518.05	$206,236.33	$66,655.58	2026-05-14
8412	OTHER	Extensive Third Degree Burns With Skin Graft ?	20	10	$206,236.33	$175,300.88	$3,518.05	$206,236.33	$66,655.58	2026-05-14
8414	OTHER	Extensive Third Degree Burns With Skin Graft ?	20	10	$206,236.33	$175,300.88	$3,518.05	$206,236.33	$66,655.58	2026-05-14
74	OTHER	Allogeneic Bone Marrow Transplant ?	29	15	$221,539.96	$188,308.97	$12.94	$221,539.96	$70,892.79	2026-05-14
1611	OTHER	Implantable Heart Assist Systems ?	20	10	$228,052.84	$193,844.91	$3,518.05	$228,052.84	$72,976.91	2026-05-14
1612	OTHER	Implantable Heart Assist Systems ?	20	10	$228,052.84	$193,844.91	$3,518.05	$228,052.84	$73,706.68	2026-05-14
1613	OTHER	Implantable Heart Assist Systems ?	20	10	$228,052.84	$193,844.91	$3,518.05	$228,052.84	$73,706.68	2026-05-14
5831	OTHER	Neonate With Ecmo ?	20	10	$295,730.54	$251,370.96	$1,274.76	$295,730.54	$94,633.77	2026-05-14
1614	OTHER	Implantable Heart Assist Systems ?	20	10	$294,585.92	$250,398.03	$3,518.05	$294,585.92	$95,210.17	2026-05-14
5832	OTHER	Neonate With Ecmo ?	20	10	$295,730.54	$251,370.96	$3,518.05	$295,730.54	$95,580.11	2026-05-14
5833	OTHER	Neonate With Ecmo ?	20	10	$310,886.87	$264,253.84	$3,518.05	$310,886.87	$100,478.64	2026-05-14
5834	OTHER	Neonate With Ecmo ?	20	10	$310,886.87	$264,253.84	$3,518.05	$310,886.87	$100,478.64	2026-05-14
5884	OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure ?	20	10	$321,369.26	$273,163.87	$3,518.05	$321,369.26	$102,838.16	2026-05-14

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