|
018
|
OTHER
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
21
|
11
|
—
|
—
|
$311,750.02
|
$1,046,762.13
|
$979,084.25
|
2026-05-09
|
|
007
|
OTHER
|
Lung Transplant
|
20
|
10
|
—
|
—
|
$93,491.51
|
$761,042.50
|
$689,964.24
|
2026-05-09
|
|
004
|
OTHER
|
Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…
|
22
|
11
|
—
|
—
|
$2,005.00
|
$324,581.20
|
$295,105.03
|
2026-05-09
|
|
001
|
OTHER
|
Heart Transplant Or Implant Of Heart Assist System With Mcc
|
20
|
10
|
—
|
—
|
$202,313.22
|
$306,996.84
|
$286,883.22
|
2026-05-09
|
|
002
|
OTHER
|
Heart Transplant Or Implant Of Heart Assist System Without Mcc
|
20
|
10
|
—
|
—
|
$81,807.78
|
$249,430.85
|
$227,631.80
|
2026-05-09
|
|
969
|
OTHER
|
HIV With Extensive O.r. Procedures With Mcc
|
22
|
11
|
—
|
—
|
$2,005.00
|
$238,596.50
|
$217,730.24
|
2026-05-09
|
|
003
|
OTHER
|
Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…
|
22
|
11
|
—
|
—
|
$2,005.00
|
$224,958.50
|
$211,287.02
|
2026-05-09
|
|
006
|
OTHER
|
Liver Transplant Without Mcc
|
20
|
10
|
—
|
—
|
$33,475.94
|
$190,409.06
|
$174,210.46
|
2026-05-09
|
|
161-4
|
OTHER
|
Implantable Heart Assist Systems
|
6
|
5
|
—
|
—
|
$171,802.78
|
$180,392.92
|
$171,802.78
|
2026-05-09
|
|
008
|
OTHER
|
Simultaneous Pancreas And Kidney Transplant
|
20
|
10
|
—
|
—
|
$40,461.34
|
$183,663.00
|
$168,276.57
|
2026-05-09
|
|
631-4
|
OTHER
|
Neonate Birth Weight > 2499 Grams With Other Major Procedure
|
6
|
5
|
—
|
—
|
$162,480.09
|
$170,604.09
|
$162,480.09
|
2026-05-09
|
|
583-4
|
OTHER
|
Neonate With Ecmo
|
6
|
5
|
—
|
—
|
$162,072.19
|
$170,175.80
|
$162,072.19
|
2026-05-09
|
|
207
|
OTHER
|
Respiratory System Diagnosis With Ventilator Support >96 Hours
|
22
|
11
|
—
|
—
|
$2,005.00
|
$172,794.43
|
$158,317.51
|
2026-05-09
|
|
841-3
|
OTHER
|
Extensive Third Degree Burns With Skin Graft
|
6
|
5
|
—
|
—
|
$157,367.16
|
$165,235.52
|
$157,367.16
|
2026-05-09
|
|
927
|
OTHER
|
Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft
|
22
|
11
|
—
|
—
|
$2,005.00
|
$323,801.30
|
$155,682.50
|
2026-05-09
|
|
570
|
OTHER
|
Skin Debridement With Mcc
|
22
|
11
|
—
|
—
|
$2,005.00
|
$169,694.33
|
$155,352.44
|
2026-05-09
|
|
268
|
OTHER
|
Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc
|
22
|
11
|
—
|
—
|
$2,005.00
|
$167,256.08
|
$153,083.79
|
2026-05-09
|
|
630-4
|
OTHER
|
Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure
|
6
|
5
|
—
|
—
|
$146,858.12
|
$154,201.03
|
$146,858.12
|
2026-05-09
|
|
005
|
OTHER
|
Liver Transplant With Mcc Or Intestinal Transplant
|
20
|
10
|
—
|
—
|
$74,434.70
|
$158,453.10
|
$140,789.21
|
2026-05-09
|
|
588-4
|
OTHER
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
6
|
5
|
—
|
—
|
$130,888.25
|
$137,432.66
|
$130,888.25
|
2026-05-09
|
|
583-3
|
OTHER
|
Neonate With Ecmo
|
6
|
5
|
—
|
—
|
$127,432.12
|
$133,803.73
|
$127,432.12
|
2026-05-09
|
|
002-4
|
OTHER
|
Heart And/or Lung Transplant
|
6
|
5
|
—
|
—
|
$127,385.26
|
$133,754.52
|
$127,385.26
|
2026-05-09
|
|
837
|
OTHER
|
Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot…
|
22
|
11
|
—
|
—
|
$2,005.00
|
$139,157.28
|
$127,188.96
|
2026-05-09
|
|
163
|
OTHER
|
Major Chest Procedures With Mcc
|
22
|
11
|
—
|
—
|
$2,005.00
|
$135,828.15
|
$124,041.83
|
2026-05-09
|
|
583-2
|
OTHER
|
Neonate With Ecmo
|
6
|
5
|
—
|
—
|
$116,269.72
|
$122,083.21
|
$116,269.72
|
2026-05-09
|
|
653
|
OTHER
|
Major Bladder Procedures With Mcc
|
22
|
11
|
—
|
—
|
$2,005.00
|
$127,095.32
|
$116,125.00
|
2026-05-09
|
|
011-3
|
OTHER
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
6
|
5
|
—
|
—
|
$113,926.86
|
$119,623.20
|
$113,926.86
|
2026-05-09
|
|
583-1
|
OTHER
|
Neonate With Ecmo
|
6
|
5
|
—
|
—
|
$112,667.13
|
$118,300.49
|
$112,667.13
|
2026-05-09
|
|
020
|
OTHER
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc
|
22
|
11
|
—
|
—
|
$2,005.00
|
$114,649.78
|
$108,947.91
|
2026-05-09
|
|
160-4
|
OTHER
|
Major Cardiothoracic Repair Of Heart Anomaly
|
6
|
5
|
—
|
—
|
$105,273.01
|
$110,536.66
|
$105,273.01
|
2026-05-09
|
|
841-4
|
OTHER
|
Extensive Third Degree Burns With Skin Graft
|
6
|
5
|
—
|
—
|
$104,086.13
|
$109,290.44
|
$104,086.13
|
2026-05-09
|
|
007-4
|
OTHER
|
Allogeneic Bone Marrow Transplant
|
6
|
5
|
—
|
—
|
$103,237.18
|
$108,399.04
|
$103,237.18
|
2026-05-09
|
|
161-3
|
OTHER
|
Implantable Heart Assist Systems
|
6
|
5
|
—
|
—
|
$103,033.06
|
$108,184.71
|
$103,033.06
|
2026-05-09
|
|
609-4
|
OTHER
|
Neonate Birth Weight 1500-2499 Grams With Major Procedure
|
6
|
5
|
—
|
—
|
$101,345.03
|
$106,412.28
|
$101,345.03
|
2026-05-09
|
|
471
|
OTHER
|
Cervical Spinal Fusion With Mcc
|
22
|
11
|
—
|
—
|
$2,005.00
|
$111,400.66
|
$101,340.03
|
2026-05-09
|
|
589-1
|
OTHER
|
Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …
|
6
|
5
|
—
|
—
|
$101,067.91
|
$106,121.31
|
$101,067.91
|
2026-05-09
|
|
326
|
OTHER
|
Stomach, Esophageal And Duodenal Procedures With Mcc
|
22
|
11
|
—
|
—
|
$2,005.00
|
$108,696.08
|
$98,876.62
|
2026-05-09
|
|
461
|
OTHER
|
Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc
|
22
|
11
|
—
|
—
|
$2,005.00
|
$106,871.84
|
$98,528.07
|
2026-05-09
|
|
010
|
OTHER
|
Pancreas Transplant
|
20
|
10
|
—
|
—
|
$51,803.60
|
$105,408.12
|
$96,348.43
|
2026-05-09
|
|
021
|
OTHER
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc
|
22
|
11
|
—
|
—
|
$2,005.00
|
$104,987.12
|
$95,535.93
|
2026-05-09
|
|
009-4
|
OTHER
|
Extracorporeal Membrane Oxygenation (ecmo)
|
6
|
5
|
—
|
—
|
$93,913.36
|
$98,609.03
|
$93,913.36
|
2026-05-09
|
|
215
|
OTHER
|
Other Heart Assist System Implant
|
22
|
11
|
—
|
—
|
$2,005.00
|
$98,783.19
|
$92,440.11
|
2026-05-09
|
|
588-3
|
OTHER
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
6
|
5
|
—
|
—
|
$91,229.48
|
$95,790.95
|
$91,229.48
|
2026-05-09
|
|
161-2
|
OTHER
|
Implantable Heart Assist Systems
|
6
|
5
|
—
|
—
|
$89,892.32
|
$94,386.94
|
$89,892.32
|
2026-05-09
|
|
022
|
OTHER
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/…
|
22
|
11
|
—
|
—
|
$2,005.00
|
$98,156.67
|
$89,186.01
|
2026-05-09
|
|
456
|
OTHER
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
22
|
11
|
—
|
—
|
$2,005.00
|
$101,725.19
|
$88,939.37
|
2026-05-09
|
|
009-3
|
OTHER
|
Extracorporeal Membrane Oxygenation (ecmo)
|
6
|
5
|
—
|
—
|
$88,684.73
|
$93,118.97
|
$88,684.73
|
2026-05-09
|
|
591-4
|
OTHER
|
Neonate Birth Weight 500-749 Grams Without Major Procedure
|
6
|
5
|
—
|
—
|
$87,596.65
|
$91,976.48
|
$87,596.65
|
2026-05-09
|
|
588-2
|
OTHER
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
6
|
5
|
—
|
—
|
$86,010.65
|
$90,311.18
|
$86,010.65
|
2026-05-09
|
|
002-3
|
OTHER
|
Heart And/or Lung Transplant
|
6
|
5
|
—
|
—
|
$85,570.86
|
$89,849.40
|
$85,570.86
|
2026-05-09
|
|
231
|
OTHER
|
Coronary Bypass With Ptca With Mcc
|
22
|
11
|
—
|
—
|
$2,005.00
|
$105,695.10
|
$84,638.42
|
2026-05-09
|
|
216
|
OTHER
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
22
|
11
|
—
|
—
|
$2,005.00
|
$102,352.02
|
$84,161.63
|
2026-05-09
|
|
593-4
|
OTHER
|
Neonate Birth Weight 750-999 Grams Without Major Procedure
|
6
|
5
|
—
|
—
|
$83,952.88
|
$88,150.52
|
$83,952.88
|
2026-05-09
|
|
014
|
OTHER
|
Allogeneic Bone Marrow Transplant
|
20
|
10
|
—
|
—
|
$76,938.27
|
$145,095.70
|
$83,265.13
|
2026-05-09
|
|
011-4
|
OTHER
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
6
|
5
|
—
|
—
|
$83,112.45
|
$87,268.07
|
$83,112.45
|
2026-05-09
|
|
356
|
OTHER
|
Other Digestive System O.r. Procedures With Mcc
|
22
|
11
|
—
|
—
|
$2,005.00
|
$90,093.81
|
$81,465.38
|
2026-05-09
|
|
001-4
|
OTHER
|
Liver Transplant And/or Intestinal Transplant
|
6
|
5
|
—
|
—
|
$80,906.13
|
$84,951.44
|
$80,906.13
|
2026-05-09
|
|
002-2
|
OTHER
|
Heart And/or Lung Transplant
|
6
|
5
|
—
|
—
|
$78,960.72
|
$82,908.76
|
$78,960.72
|
2026-05-09
|
|
004-4
|
OTHER
|
Tracheostomy With Mv >96 Hours With Extensive Procedure
|
6
|
5
|
—
|
—
|
$78,557.20
|
$82,485.06
|
$78,557.20
|
2026-05-09
|
|
219
|
OTHER
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
22
|
11
|
—
|
—
|
$2,005.00
|
$84,410.49
|
$76,444.14
|
2026-05-09
|
|
007-3
|
OTHER
|
Allogeneic Bone Marrow Transplant
|
6
|
5
|
—
|
—
|
$75,646.26
|
$79,428.57
|
$75,646.26
|
2026-05-09
|
|
161-1
|
OTHER
|
Implantable Heart Assist Systems
|
6
|
5
|
—
|
—
|
$74,549.29
|
$78,276.75
|
$74,549.29
|
2026-05-09
|
|
212
|
OTHER
|
Hip & Femur Procedures Except Major Joint Age 0-17
|
22
|
11
|
—
|
—
|
$2,005.00
|
$161,214.12
|
$73,944.54
|
2026-05-09
|
|
842-4
|
OTHER
|
Burns With Skin Graft Except Extensive Third Degree Burns
|
6
|
5
|
—
|
—
|
$72,388.54
|
$76,007.97
|
$72,388.54
|
2026-05-09
|
|
453
|
OTHER
|
Combined Anterior And Posterior Spinal Fusion With Mcc
|
14
|
10
|
—
|
—
|
$2,005.00
|
$75,774.86
|
$72,131.19
|
2026-05-09
|
|
591-3
|
OTHER
|
Neonate Birth Weight 500-749 Grams Without Major Procedure
|
6
|
5
|
—
|
—
|
$72,093.09
|
$75,697.74
|
$72,093.09
|
2026-05-09
|
|
602-4
|
OTHER
|
Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…
|
6
|
5
|
—
|
—
|
$71,470.27
|
$75,043.78
|
$71,470.27
|
2026-05-09
|
|
593-3
|
OTHER
|
Neonate Birth Weight 750-999 Grams Without Major Procedure
|
6
|
5
|
—
|
—
|
$70,590.09
|
$74,119.59
|
$70,590.09
|
2026-05-09
|
|
589-3
|
OTHER
|
Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …
|
6
|
5
|
—
|
—
|
$69,650.10
|
$73,132.61
|
$69,650.10
|
2026-05-09
|
|
023
|
OTHER
|
Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…
|
22
|
11
|
—
|
—
|
$2,005.00
|
$76,498.15
|
$68,973.36
|
2026-05-09
|
|
347
|
OTHER
|
Anal And Stomal Procedures With Mcc
|
22
|
11
|
—
|
—
|
$2,005.00
|
$75,017.27
|
$67,516.27
|
2026-05-09
|
|
863-4
|
OTHER
|
Neonatal Aftercare
|
6
|
5
|
—
|
—
|
$67,301.12
|
$70,666.18
|
$67,301.12
|
2026-05-09
|
|
607-4
|
OTHER
|
Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…
|
6
|
5
|
—
|
—
|
$66,611.11
|
$69,941.67
|
$66,611.11
|
2026-05-09
|
|
970
|
OTHER
|
HIV With Extensive O.r. Procedures Without Mcc
|
22
|
11
|
—
|
—
|
$2,005.00
|
$73,803.67
|
$66,371.12
|
2026-05-09
|
|
197
|
OTHER
|
Interstitial Lung Disease With Cc
|
22
|
11
|
—
|
—
|
$2,005.00
|
$73,735.24
|
$66,252.90
|
2026-05-09
|
|
303-4
|
OTHER
|
Dorsal And Lumbar Fusion Procedure For Curvature Of Back
|
6
|
5
|
—
|
—
|
$65,959.00
|
$69,256.95
|
$65,959.00
|
2026-05-09
|
|
162-4
|
OTHER
|
Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis
|
6
|
5
|
—
|
—
|
$65,926.24
|
$69,222.55
|
$65,926.24
|
2026-05-09
|
|
591-2
|
OTHER
|
Neonate Birth Weight 500-749 Grams Without Major Procedure
|
6
|
5
|
—
|
—
|
$65,757.79
|
$69,045.68
|
$65,757.79
|
2026-05-09
|
|
004-3
|
OTHER
|
Tracheostomy With Mv >96 Hours With Extensive Procedure
|
6
|
5
|
—
|
—
|
$65,569.13
|
$68,847.59
|
$65,569.13
|
2026-05-09
|
|
630-3
|
OTHER
|
Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure
|
6
|
5
|
—
|
—
|
$65,271.78
|
$68,535.37
|
$65,271.78
|
2026-05-09
|
|
005-4
|
OTHER
|
Tracheostomy With Mv >96 Hours Without Extensive Procedure
|
6
|
5
|
—
|
—
|
$64,970.07
|
$68,218.57
|
$64,970.07
|
2026-05-09
|
|
011-2
|
OTHER
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
6
|
5
|
—
|
—
|
$64,291.83
|
$67,506.42
|
$64,291.83
|
2026-05-09
|
|
006-4
|
OTHER
|
Pancreas Transplant
|
6
|
5
|
—
|
—
|
$62,895.46
|
$66,040.23
|
$62,895.46
|
2026-05-09
|
|
602-3
|
OTHER
|
Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…
|
6
|
5
|
—
|
—
|
$62,841.61
|
$65,983.69
|
$62,841.61
|
2026-05-09
|
|
950-4
|
OTHER
|
Extensive O.r. Procedure Unrelated To Principal Diagnosis
|
6
|
5
|
—
|
—
|
$62,479.29
|
$65,603.25
|
$62,479.29
|
2026-05-09
|
|
611-4
|
OTHER
|
Neonate Birth Weight 1500-1999 Grams With Major Anomaly
|
6
|
5
|
—
|
—
|
$62,001.95
|
$65,102.05
|
$62,001.95
|
2026-05-09
|
|
593-2
|
OTHER
|
Neonate Birth Weight 750-999 Grams Without Major Procedure
|
6
|
5
|
—
|
—
|
$61,309.96
|
$64,375.46
|
$61,309.96
|
2026-05-09
|
|
001-3
|
OTHER
|
Liver Transplant And/or Intestinal Transplant
|
6
|
5
|
—
|
—
|
$61,285.07
|
$64,349.32
|
$61,285.07
|
2026-05-09
|
|
588-1
|
OTHER
|
Female Reproductive System Reconstructive Procedures
|
6
|
5
|
—
|
—
|
$61,141.29
|
$64,198.35
|
$61,141.29
|
2026-05-09
|
|
007-2
|
OTHER
|
Allogeneic Bone Marrow Transplant
|
6
|
5
|
—
|
—
|
$60,708.55
|
$63,743.98
|
$60,708.55
|
2026-05-09
|
|
603-4
|
OTHER
|
Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition
|
6
|
5
|
—
|
—
|
$60,508.00
|
$63,533.40
|
$60,508.00
|
2026-05-09
|
|
440-4
|
OTHER
|
Kidney Transplant
|
6
|
5
|
—
|
—
|
$60,437.58
|
$63,459.46
|
$60,437.58
|
2026-05-09
|
|
008-4
|
OTHER
|
Autologous Bone Marrow Transplant Or T-cell Immunotherapy
|
6
|
5
|
—
|
—
|
$60,286.61
|
$63,300.94
|
$60,286.61
|
2026-05-09
|
|
030-4
|
OTHER
|
Percutaneous Intracranial And Extracranial Vascular Procedures
|
6
|
5
|
—
|
—
|
$60,212.48
|
$63,223.10
|
$60,212.48
|
2026-05-09
|
|
609-3
|
OTHER
|
Neonate Birth Weight 1500-2499 Grams With Major Procedure
|
6
|
5
|
—
|
—
|
$59,560.12
|
$62,538.13
|
$59,560.12
|
2026-05-09
|
|
006-3
|
OTHER
|
Pancreas Transplant
|
6
|
5
|
—
|
—
|
$59,055.99
|
$62,008.79
|
$59,055.99
|
2026-05-09
|
|
849
|
OTHER
|
Radiotherapy
|
22
|
11
|
—
|
—
|
$2,005.00
|
$65,375.09
|
$58,513.76
|
2026-05-09
|
|
163-4
|
OTHER
|
Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis
|
6
|
5
|
—
|
—
|
$57,996.91
|
$60,896.76
|
$57,996.91
|
2026-05-09
|
|
005-3
|
OTHER
|
Tracheostomy With Mv >96 Hours Without Extensive Procedure
|
6
|
5
|
—
|
—
|
$57,156.86
|
$60,014.70
|
$57,156.86
|
2026-05-09
|
|
602-2
|
OTHER
|
Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…
|
6
|
5
|
—
|
—
|
$56,727.36
|
$59,563.73
|
$56,727.36
|
2026-05-09
|
|
607-3
|
OTHER
|
Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…
|
6
|
5
|
—
|
—
|
$56,725.22
|
$59,561.48
|
$56,725.22
|
2026-05-09
|
|
589-2
|
OTHER
|
Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …
|
6
|
5
|
—
|
—
|
$55,667.81
|
$58,451.20
|
$55,667.81
|
2026-05-09
|
|
006-2
|
OTHER
|
Pancreas Transplant
|
6
|
5
|
—
|
—
|
$55,613.31
|
$58,393.98
|
$55,613.31
|
2026-05-09
|
|
227-4
|
OTHER
|
Hernia Procedures Except Inguinal, Femoral And Umbilical
|
6
|
5
|
—
|
—
|
$55,577.11
|
$58,355.97
|
$55,577.11
|
2026-05-09
|
|
178-4
|
OTHER
|
External Heart Assist Systems
|
6
|
5
|
—
|
—
|
$55,150.28
|
$57,907.79
|
$55,150.28
|
2026-05-09
|
|
023-4
|
OTHER
|
Spinal Procedures
|
6
|
5
|
—
|
—
|
$55,004.89
|
$57,755.13
|
$55,004.89
|
2026-05-09
|
|
650
|
OTHER
|
Kidney Transplant With Hemodialysis With Mcc
|
21
|
11
|
—
|
—
|
$33,940.86
|
$68,010.81
|
$54,759.58
|
2026-05-09
|
|
612-4
|
OTHER
|
Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other…
|
6
|
5
|
—
|
—
|
$54,205.97
|
$56,916.27
|
$54,205.97
|
2026-05-09
|
|
633-4
|
OTHER
|
Neonate Birth Weight > 2499 Grams With Major Anomaly
|
6
|
5
|
—
|
—
|
$54,063.80
|
$56,766.99
|
$54,063.80
|
2026-05-09
|
|
002-1
|
OTHER
|
Heart And/or Lung Transplant
|
6
|
5
|
—
|
—
|
$53,818.32
|
$56,509.24
|
$53,818.32
|
2026-05-09
|
|
613-4
|
OTHER
|
Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection
|
6
|
5
|
—
|
—
|
$53,795.59
|
$56,485.37
|
$53,795.59
|
2026-05-09
|
|
004-2
|
OTHER
|
Tracheostomy With Mv >96 Hours With Extensive Procedure
|
6
|
5
|
—
|
—
|
$53,652.19
|
$56,334.80
|
$53,652.19
|
2026-05-09
|
|
007-1
|
OTHER
|
Allogeneic Bone Marrow Transplant
|
6
|
5
|
—
|
—
|
$53,590.34
|
$56,269.86
|
$53,590.34
|
2026-05-09
|
|
020-4
|
OTHER
|
Open Craniotomy For Trauma
|
6
|
5
|
—
|
—
|
$53,470.52
|
$56,144.05
|
$53,470.52
|
2026-05-09
|
|
277
|
OTHER
|
Cellulitis Age >17 W Cc
|
22
|
11
|
—
|
—
|
$2,005.00
|
$61,458.97
|
$53,409.75
|
2026-05-09
|
|
621-4
|
OTHER
|
Neonate Birth Weight 2000-2499 Grams With Major Anomaly
|
6
|
5
|
—
|
—
|
$53,158.62
|
$55,816.55
|
$53,158.62
|
2026-05-09
|
|
233
|
OTHER
|
Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc
|
22
|
11
|
—
|
—
|
$2,005.00
|
$72,980.66
|
$53,096.02
|
2026-05-09
|
|
165-4
|
OTHER
|
Coronary Bypass With Ami Or Complex Principal Diagnosis
|
6
|
5
|
—
|
—
|
$52,104.10
|
$54,709.31
|
$52,104.10
|
2026-05-09
|
|
957
|
OTHER
|
Other O.r. Procedures For Multiple Significant Trauma With Mcc
|
22
|
11
|
—
|
—
|
$2,005.00
|
$85,621.68
|
$51,820.99
|
2026-05-09
|
|
011
|
OTHER
|
Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc
|
22
|
11
|
—
|
—
|
$2,005.00
|
$62,354.44
|
$51,810.36
|
2026-05-09
|
|
802
|
OTHER
|
Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc
|
22
|
11
|
—
|
—
|
$2,005.00
|
$54,327.51
|
$51,703.47
|
2026-05-09
|
|
001-2
|
OTHER
|
Liver Transplant And/or Intestinal Transplant
|
6
|
5
|
—
|
—
|
$51,415.43
|
$53,986.20
|
$51,415.43
|
2026-05-09
|
|
167-4
|
OTHER
|
Other Cardiothoracic And Thoracic Vascular Procedures
|
6
|
5
|
—
|
—
|
$51,052.18
|
$53,604.79
|
$51,052.18
|
2026-05-09
|
|
009-2
|
OTHER
|
Extracorporeal Membrane Oxygenation (ecmo)
|
6
|
5
|
—
|
—
|
$50,907.54
|
$53,452.92
|
$50,907.54
|
2026-05-09
|
|
011-1
|
OTHER
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
6
|
5
|
—
|
—
|
$50,457.53
|
$52,980.41
|
$50,457.53
|
2026-05-09
|
|
485
|
OTHER
|
Knee Procedures With Principal Diagnosis Of Infection With Mcc
|
22
|
11
|
—
|
—
|
$2,005.00
|
$54,690.70
|
$50,173.54
|
2026-05-09
|
|
019
|
OTHER
|
Simultaneous Pancreas And Kidney Transplant With Hemodialysis
|
21
|
11
|
—
|
—
|
$46,551.82
|
$112,963.31
|
$49,682.13
|
2026-05-09
|
|
183-4
|
OTHER
|
Percutaneous Structural Cardiac Procedures
|
6
|
5
|
—
|
—
|
$49,635.71
|
$52,117.50
|
$49,635.71
|
2026-05-09
|
|
910-4
|
OTHER
|
Craniotomy For Multiple Significant Trauma
|
6
|
5
|
—
|
—
|
$49,489.63
|
$51,964.11
|
$49,489.63
|
2026-05-09
|
|
323-4
|
OTHER
|
Non-elective Or Complex Hip Joint Replacement
|
6
|
5
|
—
|
—
|
$48,705.51
|
$51,140.79
|
$48,705.51
|
2026-05-09
|
|
432
|
OTHER
|
Cirrhosis And Alcoholic Hepatitis With Mcc
|
22
|
11
|
—
|
—
|
$2,005.00
|
$55,164.59
|
$48,637.98
|
2026-05-09
|
|
745
|
OTHER
|
D&c, Conization, Laparoscopy And Tubal Interruption Without Cc/mcc
|
22
|
11
|
—
|
—
|
$2,005.00
|
$55,348.16
|
$48,606.53
|
2026-05-09
|
|
631-3
|
OTHER
|
Neonate Birth Weight > 2499 Grams With Other Major Procedure
|
6
|
5
|
—
|
—
|
$48,537.49
|
$50,964.36
|
$48,537.49
|
2026-05-09
|
|
275
|
OTHER
|
Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc
|
22
|
11
|
—
|
—
|
$2,005.00
|
$92,412.32
|
$48,493.12
|
2026-05-09
|
|
162-3
|
OTHER
|
Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis
|
6
|
5
|
—
|
—
|
$48,483.37
|
$50,907.54
|
$48,483.37
|
2026-05-09
|
|
870
|
OTHER
|
Septicemia Or Severe Sepsis With Mv >96 Hours
|
22
|
11
|
—
|
—
|
$2,005.00
|
$77,607.24
|
$48,136.04
|
2026-05-09
|
|
680-4
|
OTHER
|
Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms
|
6
|
5
|
—
|
—
|
$48,104.47
|
$50,509.69
|
$48,104.47
|
2026-05-09
|
|
651
|
OTHER
|
Kidney Transplant With Hemodialysis Without Mcc
|
21
|
11
|
—
|
—
|
$26,753.32
|
$52,578.91
|
$47,708.60
|
2026-05-09
|
|
928
|
OTHER
|
Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc
|
22
|
11
|
—
|
—
|
$2,005.00
|
$65,450.89
|
$47,557.52
|
2026-05-09
|
|
955
|
OTHER
|
Craniotomy For Multiple Significant Trauma
|
22
|
11
|
—
|
—
|
$2,005.00
|
$89,278.18
|
$47,236.62
|
2026-05-09
|
|
608-4
|
OTHER
|
Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition
|
6
|
5
|
—
|
—
|
$47,189.50
|
$49,548.97
|
$47,189.50
|
2026-05-09
|
|
625-4
|
OTHER
|
Neonate Birth Weight 2000-2499 Grams With Other Significant Condition
|
6
|
5
|
—
|
—
|
$47,121.03
|
$49,477.08
|
$47,121.03
|
2026-05-09
|
|
911-4
|
OTHER
|
Extensive Abdominal Or Thoracic Procedures For Multiple Significant Trauma
|
6
|
5
|
—
|
—
|
$47,072.11
|
$49,425.72
|
$47,072.11
|
2026-05-09
|
|
895
|
OTHER
|
Alcohol, Drug Abuse Or Dependence With Rehabilitation Therapy
|
21
|
10
|
—
|
—
|
$2,005.00
|
$56,610.53
|
$46,871.33
|
2026-05-09
|
|
232-4
|
OTHER
|
Gastric Fundoplication
|
6
|
5
|
—
|
—
|
$46,608.39
|
$48,938.81
|
$46,608.39
|
2026-05-09
|
|
304-4
|
OTHER
|
Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back
|
6
|
5
|
—
|
—
|
$46,517.14
|
$48,843.00
|
$46,517.14
|
2026-05-09
|
|
166-4
|
OTHER
|
Coronary Bypass Without Ami Or Complex Principal Diagnosis
|
6
|
5
|
—
|
—
|
$46,450.62
|
$48,773.15
|
$46,450.62
|
2026-05-09
|
|
055-4
|
OTHER
|
Head Trauma With Coma > 1 Hour Or Hemorrhage
|
6
|
5
|
—
|
—
|
$46,072.88
|
$48,376.52
|
$46,072.88
|
2026-05-09
|
|
179-4
|
OTHER
|
Defibrillator Implants
|
6
|
5
|
—
|
—
|
$45,844.77
|
$48,137.01
|
$45,844.77
|
2026-05-09
|
|
303-3
|
OTHER
|
Dorsal And Lumbar Fusion Procedure For Curvature Of Back
|
6
|
5
|
—
|
—
|
$45,774.99
|
$48,063.74
|
$45,774.99
|
2026-05-09
|
|
160-3
|
OTHER
|
Major Cardiothoracic Repair Of Heart Anomaly
|
6
|
5
|
—
|
—
|
$45,712.38
|
$47,998.00
|
$45,712.38
|
2026-05-09
|
|
091-4
|
OTHER
|
Other Major Head And Neck Procedures
|
6
|
5
|
—
|
—
|
$45,577.39
|
$47,856.26
|
$45,577.39
|
2026-05-09
|
|
008-3
|
OTHER
|
Autologous Bone Marrow Transplant Or T-cell Immunotherapy
|
6
|
5
|
—
|
—
|
$45,522.07
|
$47,798.17
|
$45,522.07
|
2026-05-09
|
|
001-1
|
OTHER
|
Liver Transplant And/or Intestinal Transplant
|
6
|
5
|
—
|
—
|
$45,169.80
|
$47,428.29
|
$45,169.80
|
2026-05-09
|
|
850-4
|
OTHER
|
Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal…
|
6
|
5
|
—
|
—
|
$44,876.98
|
$47,120.83
|
$44,876.98
|
2026-05-09
|
|
021-4
|
OTHER
|
Open Craniotomy Except Trauma
|
6
|
5
|
—
|
—
|
$44,813.72
|
$47,054.41
|
$44,813.72
|
2026-05-09
|
|
217
|
OTHER
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
22
|
11
|
—
|
—
|
$2,005.00
|
$67,145.19
|
$44,719.30
|
2026-05-09
|
|
178-3
|
OTHER
|
External Heart Assist Systems
|
6
|
5
|
—
|
—
|
$44,500.04
|
$46,725.04
|
$44,500.04
|
2026-05-09
|
|
218
|
OTHER
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
22
|
11
|
—
|
—
|
$2,005.00
|
$60,981.38
|
$44,453.80
|
2026-05-09
|
|
603-3
|
OTHER
|
Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition
|
6
|
5
|
—
|
—
|
$44,328.52
|
$46,544.95
|
$44,328.52
|
2026-05-09
|
|
573
|
OTHER
|
Skin Graft For Skin Ulcer Or Cellulitis With Mcc
|
22
|
11
|
—
|
—
|
$2,005.00
|
$87,397.70
|
$44,292.22
|
2026-05-09
|
|
602-1
|
OTHER
|
Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…
|
6
|
5
|
—
|
—
|
$44,234.61
|
$46,446.34
|
$44,234.61
|
2026-05-09
|
|
440-3
|
OTHER
|
Kidney Transplant
|
6
|
5
|
—
|
—
|
$44,124.40
|
$46,330.62
|
$44,124.40
|
2026-05-09
|
|
222-4
|
OTHER
|
Other Stomach, Esophageal And Duodenal Procedures
|
6
|
5
|
—
|
—
|
$44,013.47
|
$46,214.14
|
$44,013.47
|
2026-05-09
|
|
459
|
OTHER
|
Spinal Fusion Except Cervical With Mcc
|
14
|
10
|
—
|
—
|
$2,005.00
|
$47,602.05
|
$43,977.11
|
2026-05-09
|
|
511-4
|
OTHER
|
Uterine And Adnexa Procedures For Ovarian And Adnexal Malignancy
|
6
|
5
|
—
|
—
|
$43,896.88
|
$46,091.72
|
$43,896.88
|
2026-05-09
|
|
912-4
|
OTHER
|
Musculoskeletal And Other Procedures For Multiple Significant Trauma
|
6
|
5
|
—
|
—
|
$43,767.02
|
$45,955.37
|
$43,767.02
|
2026-05-09
|
|
269
|
OTHER
|
Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc
|
22
|
11
|
—
|
—
|
$2,005.00
|
$47,193.67
|
$43,674.18
|
2026-05-09
|
|
005-2
|
OTHER
|
Tracheostomy With Mv >96 Hours Without Extensive Procedure
|
6
|
5
|
—
|
—
|
$43,633.33
|
$45,815.00
|
$43,633.33
|
2026-05-09
|
|
232
|
OTHER
|
Coronary Bypass With Ptca Without Mcc
|
22
|
11
|
—
|
—
|
$2,005.00
|
$71,189.72
|
$43,278.99
|
2026-05-09
|
|
690-4
|
OTHER
|
Acute Leukemia
|
6
|
5
|
—
|
—
|
$42,999.44
|
$45,149.41
|
$42,999.44
|
2026-05-09
|
|
793-4
|
OTHER
|
Moderately Extensive O.r. Procedures For Other Complications Of Treatment
|
6
|
5
|
—
|
—
|
$42,669.73
|
$44,803.22
|
$42,669.73
|
2026-05-09
|
|
607-2
|
OTHER
|
Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…
|
6
|
5
|
—
|
—
|
$42,367.51
|
$44,485.89
|
$42,367.51
|
2026-05-09
|
|
260-4
|
OTHER
|
Major Pancreas, Liver And Shunt Procedures
|
6
|
5
|
—
|
—
|
$41,812.53
|
$43,903.16
|
$41,812.53
|
2026-05-09
|
|
163-3
|
OTHER
|
Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis
|
6
|
5
|
—
|
—
|
$41,693.84
|
$43,778.53
|
$41,693.84
|
2026-05-09
|
|
266
|
OTHER
|
Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc
|
22
|
11
|
—
|
—
|
$2,005.00
|
$66,398.97
|
$41,681.06
|
2026-05-09
|
|
009-1
|
OTHER
|
Extracorporeal Membrane Oxygenation (ecmo)
|
6
|
5
|
—
|
—
|
$41,600.58
|
$43,680.61
|
$41,600.58
|
2026-05-09
|
|
440-2
|
OTHER
|
Kidney Transplant
|
6
|
5
|
—
|
—
|
$41,417.74
|
$43,488.63
|
$41,417.74
|
2026-05-09
|
|
169-4
|
OTHER
|
Major Abdominal Vascular Procedures
|
6
|
5
|
—
|
—
|
$41,414.07
|
$43,484.77
|
$41,414.07
|
2026-05-09
|
|
239
|
OTHER
|
Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc
|
22
|
11
|
—
|
—
|
$2,005.00
|
$47,594.13
|
$41,390.16
|
2026-05-09
|
|
634-4
|
OTHER
|
Neonate Birth Weight > 2499 Grams With Respiratory Distress Syndrome Or Other Ma…
|
6
|
5
|
—
|
—
|
$41,298.07
|
$43,362.97
|
$41,298.07
|
2026-05-09
|
|
333
|
OTHER
|
Rectal Resection With Cc
|
22
|
11
|
—
|
—
|
$2,005.00
|
$47,506.14
|
$41,013.59
|
2026-05-09
|
|
327
|
OTHER
|
Stomach, Esophageal And Duodenal Procedures With Cc
|
22
|
11
|
—
|
—
|
$2,005.00
|
$47,201.49
|
$40,990.36
|
2026-05-09
|
|
028
|
OTHER
|
Spinal Procedures With Mcc
|
22
|
11
|
—
|
—
|
$2,005.00
|
$60,966.46
|
$40,864.57
|
2026-05-09
|
|
027-1
|
OTHER
|
Other Open Craniotomy
|
6
|
5
|
—
|
—
|
$40,853.65
|
$42,896.33
|
$40,853.65
|
2026-05-09
|
|
276
|
OTHER
|
Non-maligant Breast Disorders
|
22
|
11
|
—
|
—
|
$2,005.00
|
$79,636.97
|
$40,853.01
|
2026-05-09
|
|
740-4
|
OTHER
|
Mental Illness Diagnosis With O.r. Procedure
|
6
|
5
|
—
|
—
|
$40,749.53
|
$42,787.01
|
$40,749.53
|
2026-05-09
|
|
040
|
OTHER
|
Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc
|
22
|
11
|
—
|
—
|
$2,005.00
|
$46,708.93
|
$40,741.06
|
2026-05-09
|
|
608-3
|
OTHER
|
Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition
|
6
|
5
|
—
|
—
|
$40,734.53
|
$42,771.26
|
$40,734.53
|
2026-05-09
|
|
454
|
OTHER
|
Combined Anterior And Posterior Spinal Fusion With Cc
|
14
|
10
|
—
|
—
|
$2,005.00
|
$43,898.57
|
$40,558.33
|
2026-05-09
|
|
457
|
OTHER
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
22
|
11
|
—
|
—
|
$2,005.00
|
$73,980.60
|
$40,557.28
|
2026-05-09
|
|
790
|
OTHER
|
Extreme Immaturity Or Respiratory Distress Syndrome, Neonate
|
20
|
10
|
—
|
—
|
$34,909.90
|
$97,382.17
|
$40,424.03
|
2026-05-09
|
|
120-4
|
OTHER
|
Major Respiratory And Chest Procedures
|
6
|
5
|
—
|
—
|
$40,310.63
|
$42,326.16
|
$40,310.63
|
2026-05-09
|
|
681-4
|
OTHER
|
Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms
|
6
|
5
|
—
|
—
|
$40,245.42
|
$42,257.69
|
$40,245.42
|
2026-05-09
|
|
016
|
OTHER
|
Autologous Bone Marrow Transplant With Cc/mcc
|
20
|
10
|
—
|
—
|
$35,444.88
|
$45,191.30
|
$40,203.58
|
2026-05-09
|
|
312-4
|
OTHER
|
Skin Graft, Except Hand, For Musculoskeletal And Connective Tissue Diagnoses
|
6
|
5
|
—
|
—
|
$40,169.77
|
$42,178.26
|
$40,169.77
|
2026-05-09
|
|
235
|
OTHER
|
Coronary Bypass Without Cardiac Catheterization With Mcc
|
22
|
11
|
—
|
—
|
$2,005.00
|
$55,772.74
|
$39,914.82
|
2026-05-09
|
|
820
|
OTHER
|
Lymphoma And Leukemia With Major O.r. Procedures With Mcc
|
22
|
11
|
—
|
—
|
$2,005.00
|
$71,040.48
|
$39,888.99
|
2026-05-09
|
|
130-4
|
OTHER
|
Respiratory System Diagnosis With Ventilator Support > 96 Hours
|
6
|
5
|
—
|
—
|
$39,836.52
|
$41,828.35
|
$39,836.52
|
2026-05-09
|
|
220-4
|
OTHER
|
Major Stomach, Esophageal And Duodenal Procedures
|
6
|
5
|
—
|
—
|
$39,705.44
|
$41,690.71
|
$39,705.44
|
2026-05-09
|
|
695-4
|
OTHER
|
Chemotherapy For Acute Leukemia
|
6
|
5
|
—
|
—
|
$39,575.66
|
$41,554.44
|
$39,575.66
|
2026-05-09
|
|
446-4
|
OTHER
|
Urethral And Transurethral Procedures
|
6
|
5
|
—
|
—
|
$39,509.87
|
$41,485.36
|
$39,509.87
|
2026-05-09
|
|
004-1
|
OTHER
|
Tracheostomy With Mv >96 Hours With Extensive Procedure
|
6
|
5
|
—
|
—
|
$39,461.54
|
$41,434.62
|
$39,461.54
|
2026-05-09
|
|
650-4
|
OTHER
|
Splenectomy
|
6
|
5
|
—
|
—
|
$39,225.02
|
$41,186.27
|
$39,225.02
|
2026-05-09
|
|
089-4
|
OTHER
|
Major Cranial Or Facial Bone Procedures
|
6
|
5
|
—
|
—
|
$39,126.98
|
$41,083.33
|
$39,126.98
|
2026-05-09
|
|
951-4
|
OTHER
|
Moderately Extensive O.r. Procedure Unrelated To Principal Diagnosis
|
6
|
5
|
—
|
—
|
$39,109.66
|
$41,065.14
|
$39,109.66
|
2026-05-09
|
|
361-4
|
OTHER
|
Skin Graft For Skin And Subcutaneous Tissue Diagnoses
|
6
|
5
|
—
|
—
|
$39,083.29
|
$41,037.45
|
$39,083.29
|
2026-05-09
|
|
261-4
|
OTHER
|
Major Biliary Tract Procedures
|
6
|
5
|
—
|
—
|
$38,878.51
|
$40,822.44
|
$38,878.51
|
2026-05-09
|
|
609-2
|
OTHER
|
Neonate Birth Weight 1500-2499 Grams With Major Procedure
|
6
|
5
|
—
|
—
|
$38,863.52
|
$40,806.70
|
$38,863.52
|
2026-05-09
|
|
165-3
|
OTHER
|
Coronary Bypass With Ami Or Complex Principal Diagnosis
|
6
|
5
|
—
|
—
|
$38,719.39
|
$40,655.36
|
$38,719.39
|
2026-05-09
|
|
463
|
OTHER
|
Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …
|
22
|
11
|
—
|
—
|
$2,005.00
|
$54,459.39
|
$38,648.69
|
2026-05-09
|
|
006-1
|
OTHER
|
Pancreas Transplant
|
6
|
5
|
—
|
—
|
$38,628.09
|
$40,559.49
|
$38,628.09
|
2026-05-09
|
|
959
|
OTHER
|
Other O.r. Procedures For Multiple Significant Trauma Without Cc/mcc
|
22
|
11
|
—
|
—
|
$2,005.00
|
$41,384.36
|
$38,177.47
|
2026-05-09
|
|
240-4
|
OTHER
|
Digestive Malignancy
|
6
|
5
|
—
|
—
|
$38,091.58
|
$39,996.16
|
$38,091.58
|
2026-05-09
|
|
324-3
|
OTHER
|
Elective Hip Joint Replacement
|
6
|
5
|
—
|
—
|
$37,998.45
|
$39,898.37
|
$37,998.45
|
2026-05-09
|
|
027-4
|
OTHER
|
Other Open Craniotomy
|
6
|
5
|
—
|
—
|
$37,995.68
|
$39,895.46
|
$37,995.68
|
2026-05-09
|
|
623-4
|
OTHER
|
Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection
|
6
|
5
|
—
|
—
|
$37,973.98
|
$39,872.68
|
$37,973.98
|
2026-05-09
|
|
503
|
OTHER
|
Foot Procedures With Mcc
|
22
|
11
|
—
|
—
|
$2,005.00
|
$43,691.19
|
$37,918.38
|
2026-05-09
|
|
278
|
OTHER
|
Cellulitis Age >17 Without Cc
|
22
|
11
|
—
|
—
|
$2,005.00
|
$68,592.86
|
$37,631.55
|
2026-05-09
|
|
630-2
|
OTHER
|
Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure
|
6
|
5
|
—
|
—
|
$37,623.78
|
$39,504.97
|
$37,623.78
|
2026-05-09
|
|
612-3
|
OTHER
|
Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other…
|
6
|
5
|
—
|
—
|
$37,537.04
|
$39,413.89
|
$37,537.04
|
2026-05-09
|
|
131-1
|
OTHER
|
Cystic Fibrosis - Pulmonary Disease
|
6
|
5
|
—
|
—
|
$37,369.45
|
$39,237.92
|
$37,369.45
|
2026-05-09
|
|
834
|
OTHER
|
Acute Leukemia Without Major O.r. Procedures With Mcc
|
22
|
11
|
—
|
—
|
$2,005.00
|
$101,620.72
|
$37,340.24
|
2026-05-09
|
|
092-4
|
OTHER
|
Facial Bone Procedures Except Major Cranial Or Facial Bone Procedures
|
6
|
5
|
—
|
—
|
$37,297.71
|
$39,162.60
|
$37,297.71
|
2026-05-09
|
|
593-1
|
OTHER
|
Neonate Birth Weight 750-999 Grams Without Major Procedure
|
6
|
5
|
—
|
—
|
$37,221.38
|
$39,082.45
|
$37,221.38
|
2026-05-09
|
|
405
|
OTHER
|
Pancreas, Liver And Shunt Procedures With Mcc
|
22
|
11
|
—
|
—
|
$2,005.00
|
$64,667.73
|
$37,208.36
|
2026-05-09
|
|
234
|
OTHER
|
Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc
|
22
|
11
|
—
|
—
|
$2,005.00
|
$56,936.85
|
$37,155.32
|
2026-05-09
|
|
401-4
|
OTHER
|
Adrenal Procedures
|
6
|
5
|
—
|
—
|
$36,993.15
|
$38,842.81
|
$36,993.15
|
2026-05-09
|
|
613-3
|
OTHER
|
Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection
|
6
|
5
|
—
|
—
|
$36,842.51
|
$38,684.64
|
$36,842.51
|
2026-05-09
|
|
140
|
OTHER
|
Major Head And Neck Procedures With Mcc
|
22
|
11
|
—
|
—
|
$2,005.00
|
$59,697.88
|
$36,820.25
|
2026-05-09
|
|
183-3
|
OTHER
|
Percutaneous Structural Cardiac Procedures
|
6
|
5
|
—
|
—
|
$36,655.01
|
$38,487.76
|
$36,655.01
|
2026-05-09
|
|
162-2
|
OTHER
|
Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis
|
6
|
5
|
—
|
—
|
$36,653.38
|
$38,486.05
|
$36,653.38
|
2026-05-09
|
|
017
|
OTHER
|
Autologous Bone Marrow Transplant Without Cc/mcc
|
20
|
10
|
—
|
—
|
$32,842.68
|
$49,569.74
|
$36,611.07
|
2026-05-09
|
|
441-4
|
OTHER
|
Major Bladder Procedures
|
6
|
5
|
—
|
—
|
$36,484.48
|
$38,308.70
|
$36,484.48
|
2026-05-09
|
|
384-4
|
OTHER
|
Contusion, Open Wound And Other Trauma To Skin And Subcutaneous Tissue
|
6
|
5
|
—
|
—
|
$36,372.61
|
$38,191.24
|
$36,372.61
|
2026-05-09
|
|
220
|
OTHER
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
22
|
11
|
—
|
—
|
$2,005.00
|
$55,563.80
|
$36,272.21
|
2026-05-09
|
|
178-2
|
OTHER
|
External Heart Assist Systems
|
6
|
5
|
—
|
—
|
$36,232.75
|
$38,044.39
|
$36,232.75
|
2026-05-09
|
|
603-2
|
OTHER
|
Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition
|
6
|
5
|
—
|
—
|
$36,168.84
|
$37,977.28
|
$36,168.84
|
2026-05-09
|
|
270
|
OTHER
|
Other Major Cardiovascular Procedures With Mcc
|
22
|
11
|
—
|
—
|
$2,005.00
|
$53,116.19
|
$35,888.10
|
2026-05-09
|
|
4251001
|
OTHER
|
Des W/atherectomy
|
3
|
3
|
$59,541.00
|
$50,609.85
|
$20,839.35
|
$35,724.60
|
$35,724.60
|
2026-05-09
|
|
4251006
|
OTHER
|
Cto, Dest Stent
|
3
|
3
|
$59,541.00
|
$50,609.85
|
$20,839.35
|
$35,724.60
|
$35,724.60
|
2026-05-09
|
|
466
|
OTHER
|
Revision Of Hip Or Knee Replacement With Mcc
|
22
|
11
|
—
|
—
|
$2,005.00
|
$48,101.57
|
$35,406.08
|
2026-05-09
|
|
440-1
|
OTHER
|
Kidney Transplant
|
6
|
5
|
—
|
—
|
$35,189.96
|
$36,949.46
|
$35,189.96
|
2026-05-09
|
|
622-4
|
OTHER
|
Neonate Birth Weight 2000-2499 Grams With Respiratory Distress Syndrome Or Other…
|
6
|
5
|
—
|
—
|
$35,151.48
|
$36,909.05
|
$35,151.48
|
2026-05-09
|
|
321-4
|
OTHER
|
Spinal Fusion And Other Back And Neck Procedures Except For Disc Procedures
|
6
|
5
|
—
|
—
|
$35,041.27
|
$36,793.33
|
$35,041.27
|
2026-05-09
|
|
022-4
|
OTHER
|
Ventricular Shunt Procedures
|
6
|
5
|
—
|
—
|
$35,018.44
|
$36,769.36
|
$35,018.44
|
2026-05-09
|
|
792-4
|
OTHER
|
Extensive O.r. Procedures For Other Complications Of Treatment
|
6
|
5
|
—
|
—
|
$34,914.10
|
$36,659.81
|
$34,914.10
|
2026-05-09
|
|
179-3
|
OTHER
|
Defibrillator Implants
|
6
|
5
|
—
|
—
|
$34,912.80
|
$36,658.44
|
$34,912.80
|
2026-05-09
|
|
710-4
|
OTHER
|
Infectious And Parasitic Diseases Including HIV With O.r. Procedure
|
6
|
5
|
—
|
—
|
$34,911.15
|
$36,656.71
|
$34,911.15
|
2026-05-09
|
|
908
|
OTHER
|
Other O.r. Procedures For Injuries With Cc
|
22
|
11
|
—
|
—
|
$2,005.00
|
$40,871.24
|
$34,894.40
|
2026-05-09
|
|
324-4
|
OTHER
|
Elective Hip Joint Replacement
|
6
|
5
|
—
|
—
|
$34,822.02
|
$36,563.12
|
$34,822.02
|
2026-05-09
|
|
842-3
|
OTHER
|
Burns With Skin Graft Except Extensive Third Degree Burns
|
6
|
5
|
—
|
—
|
$34,559.33
|
$36,287.30
|
$34,559.33
|
2026-05-09
|
|
651-4
|
OTHER
|
Other Procedures Of Blood And Blood-forming Organs
|
6
|
5
|
—
|
—
|
$34,553.46
|
$36,281.13
|
$34,553.46
|
2026-05-09
|
|
165-1
|
OTHER
|
Coronary Bypass With Ami Or Complex Principal Diagnosis
|
6
|
5
|
—
|
—
|
$34,388.14
|
$36,107.55
|
$34,388.14
|
2026-05-09
|
|
304-3
|
OTHER
|
Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back
|
6
|
5
|
—
|
—
|
$34,291.95
|
$36,006.55
|
$34,291.95
|
2026-05-09
|
|
160-2
|
OTHER
|
Major Cardiothoracic Repair Of Heart Anomaly
|
6
|
5
|
—
|
—
|
$34,247.60
|
$35,959.98
|
$34,247.60
|
2026-05-09
|
|
614-4
|
OTHER
|
Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition
|
6
|
5
|
—
|
—
|
$34,218.18
|
$35,929.09
|
$34,218.18
|
2026-05-09
|
|
170-4
|
OTHER
|
Permanent Cardiac Pacemaker Implant With Ami, Heart Failure Or Shock
|
6
|
5
|
—
|
—
|
$34,158.91
|
$35,866.86
|
$34,158.91
|
2026-05-09
|
|
841
|
OTHER
|
Lymphoma And Non-acute Leukemia With Cc
|
22
|
11
|
—
|
—
|
$2,005.00
|
$40,234.81
|
$34,137.22
|
2026-05-09
|
|
181-4
|
OTHER
|
Lower Extremity Arterial Procedures
|
6
|
5
|
—
|
—
|
$34,083.26
|
$35,787.42
|
$34,083.26
|
2026-05-09
|
|
166-3
|
OTHER
|
Coronary Bypass Without Ami Or Complex Principal Diagnosis
|
6
|
5
|
—
|
—
|
$34,078.70
|
$35,782.64
|
$34,078.70
|
2026-05-09
|
|
221
|
OTHER
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
22
|
11
|
—
|
—
|
$2,005.00
|
$45,991.83
|
$34,075.42
|
2026-05-09
|
|
130-3
|
OTHER
|
Respiratory System Diagnosis With Ventilator Support > 96 Hours
|
6
|
5
|
—
|
—
|
$33,930.39
|
$35,626.91
|
$33,930.39
|
2026-05-09
|
|
181-3
|
OTHER
|
Lower Extremity Arterial Procedures
|
6
|
5
|
—
|
—
|
$33,886.88
|
$35,581.22
|
$33,886.88
|
2026-05-09
|
|
051-4
|
OTHER
|
Viral Meningitis
|
6
|
5
|
—
|
—
|
$33,885.72
|
$35,580.01
|
$33,885.72
|
2026-05-09
|
|
314
|
OTHER
|
Other Circulatory System Diagnoses With Mcc
|
22
|
11
|
—
|
—
|
$2,005.00
|
$39,751.05
|
$33,882.36
|
2026-05-09
|
|
576
|
OTHER
|
Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc
|
22
|
11
|
—
|
—
|
$2,005.00
|
$81,681.62
|
$33,827.47
|
2026-05-09
|
|
121-4
|
OTHER
|
Other Respiratory And Chest Procedures
|
6
|
5
|
—
|
—
|
$33,789.14
|
$35,478.60
|
$33,789.14
|
2026-05-09
|
|
512-4
|
OTHER
|
Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy
|
6
|
5
|
—
|
—
|
$33,775.45
|
$35,464.22
|
$33,775.45
|
2026-05-09
|
|
228
|
OTHER
|
Other Cardiothoracic Procedures With Mcc
|
22
|
11
|
—
|
—
|
$2,005.00
|
$76,458.06
|
$33,652.07
|
2026-05-09
|
|
853
|
OTHER
|
Infectious And Parasitic Diseases With O.r. Procedures With Mcc
|
22
|
11
|
—
|
—
|
$2,005.00
|
$50,623.80
|
$33,592.25
|
2026-05-09
|
|
230-4
|
OTHER
|
Major Small Bowel Procedures
|
6
|
5
|
—
|
—
|
$33,586.33
|
$35,265.65
|
$33,586.33
|
2026-05-09
|
|
097-4
|
OTHER
|
Tonsil And Adenoid Procedures
|
6
|
5
|
—
|
—
|
$33,469.46
|
$35,142.93
|
$33,469.46
|
2026-05-09
|
|
673
|
OTHER
|
Other Kidney And Urinary Tract Procedures With Mcc
|
22
|
11
|
—
|
—
|
$2,005.00
|
$38,339.60
|
$33,421.61
|
2026-05-09
|
|
023-3
|
OTHER
|
Spinal Procedures
|
6
|
5
|
—
|
—
|
$33,409.61
|
$35,080.09
|
$33,409.61
|
2026-05-09
|
|
652
|
OTHER
|
Kidney Transplant
|
20
|
10
|
—
|
—
|
$23,314.76
|
$61,085.86
|
$33,394.90
|
2026-05-09
|
|
008-2
|
OTHER
|
Autologous Bone Marrow Transplant Or T-cell Immunotherapy
|
6
|
5
|
—
|
—
|
$33,304.60
|
$34,969.83
|
$33,304.60
|
2026-05-09
|
|
548-3
|
OTHER
|
Postpartum And Post Abortion Diagnosis With O.r. Procedure
|
6
|
5
|
—
|
—
|
$33,304.25
|
$34,969.46
|
$33,304.25
|
2026-05-09
|
|
518-3
|
OTHER
|
Other Female Reproductive System And Related Procedures
|
6
|
5
|
—
|
—
|
$33,296.26
|
$34,961.07
|
$33,296.26
|
2026-05-09
|
|
303-2
|
OTHER
|
Dorsal And Lumbar Fusion Procedure For Curvature Of Back
|
6
|
5
|
—
|
—
|
$33,292.21
|
$34,956.82
|
$33,292.21
|
2026-05-09
|
|
405-4
|
OTHER
|
Other Procedures For Endocrine, Nutritional And Metabolic Disorders
|
6
|
5
|
—
|
—
|
$33,210.04
|
$34,870.54
|
$33,210.04
|
2026-05-09
|
|
264-4
|
OTHER
|
Other Hepatobiliary, Pancreas And Abdominal Procedures
|
6
|
5
|
—
|
—
|
$33,144.82
|
$34,802.06
|
$33,144.82
|
2026-05-09
|
|
519-3
|
OTHER
|
Uterine And Adnexa Procedures For Leiomyoma
|
6
|
5
|
—
|
—
|
$33,115.34
|
$34,771.11
|
$33,115.34
|
2026-05-09
|
|
823
|
OTHER
|
Lymphoma And Non-acute Leukemia With Other Procedures With Mcc
|
22
|
11
|
—
|
—
|
$2,005.00
|
$53,489.30
|
$33,089.24
|
2026-05-09
|
|
176-4
|
OTHER
|
Insertion, Revision And Replacements Of Pacemaker And Other Cardiac Devices
|
6
|
5
|
—
|
—
|
$32,891.13
|
$34,535.69
|
$32,891.13
|
2026-05-09
|
|
404-4
|
OTHER
|
Thyroid, Parathyroid And Thyroglossal Procedures
|
6
|
5
|
—
|
—
|
$32,812.88
|
$34,453.52
|
$32,812.88
|
2026-05-09
|
|
288
|
OTHER
|
Acute And Subacute Endocarditis With Mcc
|
22
|
11
|
—
|
—
|
$2,005.00
|
$37,791.54
|
$32,768.08
|
2026-05-09
|
|
200-4
|
OTHER
|
Cardiac Structural And Valvular Disorders
|
6
|
5
|
—
|
—
|
$32,725.37
|
$34,361.64
|
$32,725.37
|
2026-05-09
|
|
403-4
|
OTHER
|
Procedures For Obesity
|
6
|
5
|
—
|
—
|
$32,720.92
|
$34,356.97
|
$32,720.92
|
2026-05-09
|
|
863-3
|
OTHER
|
Neonatal Aftercare
|
6
|
5
|
—
|
—
|
$32,639.47
|
$34,271.44
|
$32,639.47
|
2026-05-09
|
|
178-1
|
OTHER
|
External Heart Assist Systems
|
6
|
5
|
—
|
—
|
$32,609.41
|
$34,239.88
|
$32,609.41
|
2026-05-09
|
|
841-1
|
OTHER
|
Chemotherapy For Acute Leukemia
|
6
|
5
|
—
|
—
|
$32,565.06
|
$34,193.31
|
$32,565.06
|
2026-05-09
|
|
841-2
|
OTHER
|
Extensive Third Degree Burns With Skin Graft
|
6
|
5
|
—
|
—
|
$32,565.06
|
$34,193.31
|
$32,565.06
|
2026-05-09
|
|
167-3
|
OTHER
|
Other Cardiothoracic And Thoracic Vascular Procedures
|
6
|
5
|
—
|
—
|
$32,405.28
|
$34,025.54
|
$32,405.28
|
2026-05-09
|
|
267
|
OTHER
|
Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc
|
22
|
11
|
—
|
—
|
$2,005.00
|
$59,802.35
|
$32,383.49
|
2026-05-09
|
|
711-4
|
OTHER
|
Post-operative, Post-trauma, Other Device Infections With O.r. Procedure
|
6
|
5
|
—
|
—
|
$32,197.90
|
$33,807.80
|
$32,197.90
|
2026-05-09
|
|
029-4
|
OTHER
|
Other Percutaneous Intracranial Procedures
|
6
|
5
|
—
|
—
|
$31,982.04
|
$33,581.14
|
$31,982.04
|
2026-05-09
|
|
484-4
|
OTHER
|
Other Male Reproductive System And Related Procedures
|
6
|
5
|
—
|
—
|
$31,979.43
|
$33,578.40
|
$31,979.43
|
2026-05-09
|
|
910-3
|
OTHER
|
Craniotomy For Multiple Significant Trauma
|
6
|
5
|
—
|
—
|
$31,946.82
|
$33,544.16
|
$31,946.82
|
2026-05-09
|
|
981
|
OTHER
|
Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc
|
22
|
11
|
—
|
—
|
$2,005.00
|
$58,503.92
|
$31,914.40
|
2026-05-09
|