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Hospital facility prices. What the hospital charges for the facility side of care — the surgeon’s and anesthesiologist’s fees are billed separately and are not included. How we scope prices →

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Hospital

St. Mary Rehabilitation Hospital

Langhorne, PA · CCN 393055 · Rates published

9,189 distinct procedures filed
27 distinct payers
262,474 rate rows
2026-03-16 last MRF observed
Data quality

67,928 of 262,474 rate rows are consumer-grade (25.9%)

194,546 rows are marked excluded from the consumer medians — these stay visible in the raw drill-down with the same reason shown here, so nothing is silently hidden.

Excluded — reasonRows
per-diem day rate — not a per-procedure price 194,465
placeholder amount (≤ $0.02) — excluded from medians 81
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://www.stmaryrehabilitationhospital.com/docs/irfstmaryrehabilitationhospitallibraries/mar2026/273938747_st-mary-rehabilitation-hospital_standardcharges.csv.zip
Found on page https://www.stmaryrehabilitationhospital.com/patient-experience/financial-assistance
Discovered viaCMS hospital list
Last fetch Latest re-check couldn't be parsed — showing last good data · 2026-05-19
Content fingerprint 8f0a9cce3682bb39… · 1,658,698 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
B0407
OTHER 		Traumatic Spinal Cord Injury M <24.50 And A >=61.50 7 $87,066.75 $152,366.81 $89,678.75 nat. median
$86,320
1.0× median
B1904
OTHER 		Guillain-barré M <38.50 7 $81,511.75 $142,645.56 $83,957.10 nat. median
$80,609
1.0× median
C0407
OTHER 		Traumatic Spinal Cord Injury M <24.50 And A >=61.50 7 $71,166.23 $124,540.91 $73,301.22 nat. median
$71,021
1.0× median
D0407
OTHER 		Traumatic Spinal Cord Injury M <24.50 And A >=61.50 7 $69,293.44 $121,263.52 $71,372.24 nat. median
$68,708
1.0× median
B1806
OTHER 		Major Multiple Trauma With Brain Or Spinal Cord Injury M <30.50 7 $68,993.79 $120,739.13 $71,063.60 nat. median
$68,402
1.0× median
B0406
OTHER 		Traumatic Spinal Cord Injury M >=24.50 And M <31.50 And A >=61.50 7 $63,579.01 $111,263.27 $65,486.38 nat. median
$62,870
1.0× median
A0407
OTHER 		Traumatic Spinal Cord Injury M <24.50 And A >=61.50 7 $62,703.12 $109,730.46 $64,584.21 nat. median
$62,810
1.0× median
B0404
OTHER 		Traumatic Spinal Cord Injury M <31.50 And A <61.50 7 $61,014.72 $106,775.76 $62,845.16 nat. median
$60,491
1.0× median
B0505
OTHER 		Non-traumatic Spinal Cord Injury M <39.50 7 $60,010.13 $105,017.73 $61,810.44 nat. median
$59,495
1.0× median
C1904
OTHER 		Guillain-barré M <38.50 7 $57,607.19 $100,812.59 $59,335.41 nat. median
$57,113
1.0× median
C1806
OTHER 		Major Multiple Trauma With Brain Or Spinal Cord Injury M <30.50 7 $56,443.18 $98,775.56 $58,136.47 nat. median
$55,837
1.0× median
74080531
CDM 		Occ/emb Tumor/organ Infar 7 $56,399.93 $56,399.93 $56,399.93 nat. median
$55,326
1.0× median
74080529
CDM 		Occ/emb Non Hemorr Venous 7 $56,399.93 $56,399.93 $56,399.93 nat. median
$55,326
1.0× median
74080532
CDM 		Occ/emb Hemorrhag/lymph 7 $56,399.93 $56,399.93 $56,399.93 nat. median
$55,326
1.0× median
74080530
CDM 		Occ/emb Non Hemorr Art 7 $56,399.93 $56,399.93 $56,399.93 nat. median
$55,326
1.0× median
B0106
OTHER 		Stroke M <41.50 And A <84.50 7 $54,407.11 $95,212.45 $56,039.33 nat. median
$54,065
1.0× median
B1903
OTHER 		Guillain-barré M >=38.50 And M <51.50 7 $53,008.76 $92,765.33 $54,599.02 nat. median
$52,554
1.0× median
B0205
OTHER 		Traumatic Brain Injury M <35.50 7 $52,338.39 $91,592.19 $53,908.55 nat. median
$51,964
1.0× median
C0406
OTHER 		Traumatic Spinal Cord Injury M >=24.50 And M <31.50 And A >=61.50 7 $51,967.68 $90,943.43 $53,526.71 nat. median
$51,880
1.0× median
D1806
OTHER 		Major Multiple Trauma With Brain Or Spinal Cord Injury M <30.50 7 $51,923.50 $90,866.12 $53,481.20 nat. median
$51,478
1.0× median
D0406
OTHER 		Traumatic Spinal Cord Injury M >=24.50 And M <31.50 And A >=61.50 7 $50,600.06 $88,550.10 $52,118.06 nat. median
$50,515
1.0× median
A1904
OTHER 		Guillain-barré M <38.50 7 $50,094.88 $87,666.04 $51,597.73 nat. median
$50,010
1.0× median
D1904
OTHER 		Guillain-barré M <38.50 7 $50,079.51 $87,639.15 $51,581.90 nat. median
$49,901
1.0× median
C0404
OTHER 		Traumatic Spinal Cord Injury M <31.50 And A <61.50 7 $49,872.07 $87,276.12 $51,368.23 nat. median
$49,743
1.0× median
B1705
OTHER 		Major Multiple Trauma Without Brain Or Spinal Cord Injury M <36.50 7 $49,090.29 $85,908.02 $50,563.00 nat. median
$48,669
1.0× median
B2102
OTHER 		Burns M <52.50 7 $48,886.69 $85,551.70 $50,353.29 nat. median
$48,467
1.0× median
A1806
OTHER 		Major Multiple Trauma With Brain Or Spinal Cord Injury M <30.50 7 $48,734.94 $85,286.15 $50,196.99 nat. median
$48,628
1.0× median
D0404
OTHER 		Traumatic Spinal Cord Injury M <31.50 And A <61.50 7 $48,560.15 $84,980.26 $50,016.95 nat. median
$48,434
1.0× median
B0405
OTHER 		Traumatic Spinal Cord Injury M >=31.50 And M <41.50 7 $48,329.65 $84,576.89 $49,779.54 nat. median
$47,915
1.0× median
C0106
OTHER 		Stroke M <41.50 And A <84.50 7 $48,314.28 $84,550.00 $49,763.71 nat. median
$47,971
1.0× median
B0105
OTHER 		Stroke M <41.50 And A >=84.50 7 $48,300.84 $84,526.47 $49,749.86 nat. median
$47,979
1.0× median
B1805
OTHER 		Major Multiple Trauma With Brain Or Spinal Cord Injury M >=30.50 And M <40.50 7 $47,620.87 $83,336.52 $49,049.50 nat. median
$47,212
1.0× median
B0604
OTHER 		Neurological M <43.50 7 $47,056.15 $82,348.26 $48,467.83 nat. median
$46,755
1.0× median
74080268
CDM 		Insert Tips 7 $48,288.18 $48,288.18 $48,288.18 nat. median
$47,368
1.0× median
C0505
OTHER 		Non-traumatic Spinal Cord Injury M <39.50 7 $46,116.87 $80,704.52 $47,500.38 nat. median
$45,787
1.0× median
A0406
OTHER 		Traumatic Spinal Cord Injury M >=24.50 And M <31.50 And A >=61.50 7 $45,788.41 $80,129.72 $47,162.06 nat. median
$45,990
1.0× median
74080483
CDM 		Revise Tips 7 $47,034.04 $47,034.04 $47,034.04 nat. median
$46,138
1.0× median
B0305
OTHER 		Non-traumatic Brain Injury M <42.50 And A <78.50 7 $45,521.42 $79,662.48 $46,887.06 nat. median
$45,142
1.0× median
B1004
OTHER 		Amputation Lower Extremity M <47.50 7 $45,396.57 $79,443.99 $46,758.46 nat. median
$45,008
1.0× median
B1504
OTHER 		Pulmonary M <45.50 7 $44,995.11 $78,741.45 $46,344.97 nat. median
$44,609
1.0× median
B0704
OTHER 		Fracture Of Lower Extremity M <41.50 7 $44,063.52 $77,111.16 $45,385.42 nat. median
$43,748
1.0× median
B1304
OTHER 		Rheumatoid Other Arthritis M <44.50 And A >=64.50 7 $44,009.74 $77,017.04 $45,330.03 nat. median
$43,632
1.0× median
A0404
OTHER 		Traumatic Spinal Cord Injury M <31.50 And A <61.50 7 $43,942.51 $76,899.39 $45,260.78 nat. median
$43,915
1.0× median
B1305
OTHER 		Rheumatoid Other Arthritis M <51.50 And A <64.50 7 $43,923.30 $76,865.77 $45,241.00 nat. median
$43,434
1.0× median
D0106
OTHER 		Stroke M <41.50 And A <84.50 7 $43,773.48 $76,603.58 $45,086.68 nat. median
$43,510
1.0× median
B0904
OTHER 		Other Orthopedic M <44.5 7 $43,183.79 $75,571.62 $44,479.30 nat. median
$42,813
1.0× median
D0505
OTHER 		Non-traumatic Spinal Cord Injury M <39.50 7 $42,903.35 $75,080.86 $44,190.45 nat. median
$42,599
1.0× median
C0105
OTHER 		Stroke M <41.50 And A >=84.50 7 $42,891.82 $75,060.69 $44,178.58 nat. median
$42,585
1.0× median
B2005
OTHER 		Miscellaneous M <46.50 And A <77.50 7 $42,484.61 $74,348.06 $43,759.15 nat. median
$42,136
1.0× median
B0504
OTHER 		Non-traumatic Spinal Cord Injury M >=39.50 And M <48.50 7 $42,236.82 $73,914.44 $43,503.93 nat. median
$41,890
1.0× median

Other procedures at this hospital

Browse this hospital's 9,189 published procedures. Use the slice to choose what to show, then sort or filter any column.

Slice
Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
Code Type Description Rate rows Payers Gross Cash Min $ Max $ Avg median Last observed
             
36224 CPT Place Cath Int Carotid Art Bi 7 7 $35,853.69 $35,853.69 $35,853.69 $35,853.69 $35,853.69 2026-03-16
36226 CPT Place Cath Vertebral Art Bi 7 7 $29,036.88 $29,036.88 $29,036.88 $29,036.88 $29,036.88 2026-03-16
36901 CPT Intro Dial Graft 7 7 $28,319.15 $28,319.15 $28,319.15 $28,319.15 $28,319.15 2026-03-16
74080268 CDM Insert Tips 7 7 $48,288.18 $48,288.18 $48,288.18 $48,288.18 $48,288.18 2026-03-16
74080468 CDM Revas Fem Pop Atherectomy 7 7 $25,905.35 $25,905.35 $25,905.35 $25,905.35 $25,905.35 2026-03-16
74080469 CDM Revas Fem Pop Stent Ather 7 7 $25,905.35 $25,905.35 $25,905.35 $25,905.35 $25,905.35 2026-03-16
74080471 CDM Revas Femoral Poplt Stent 7 7 $25,905.35 $25,905.35 $25,905.35 $25,905.35 $25,905.35 2026-03-16
74080477 CDM Revas Tib Peron Ather Add 7 7 $26,002.81 $26,002.81 $26,002.81 $26,002.81 $26,002.81 2026-03-16
74080478 CDM Revas Tib Peron Ather Ini 7 7 $26,002.81 $26,002.81 $26,002.81 $26,002.81 $26,002.81 2026-03-16
74080479 CDM Revas Tib Peron Stent Ini 7 7 $26,002.81 $26,002.81 $26,002.81 $26,002.81 $26,002.81 2026-03-16
74080481 CDM Revas Tib Pr Stnt Ath Ini 7 7 $26,002.81 $26,002.81 $26,002.81 $26,002.81 $26,002.81 2026-03-16
74080483 CDM Revise Tips 7 7 $47,034.04 $47,034.04 $47,034.04 $47,034.04 $47,034.04 2026-03-16
74080525 CDM Stnt Plc Transcth Art Ini 7 7 $38,869.80 $38,869.80 $38,869.80 $38,869.80 $38,869.80 2026-03-16
74080527 CDM Stnt Plc Transc Vein Ini 7 7 $39,032.60 $39,032.60 $39,032.60 $39,032.60 $39,032.60 2026-03-16
74080529 CDM Occ/emb Non Hemorr Venous 7 7 $56,399.93 $56,399.93 $56,399.93 $56,399.93 $56,399.93 2026-03-16
74080530 CDM Occ/emb Non Hemorr Art 7 7 $56,399.93 $56,399.93 $56,399.93 $56,399.93 $56,399.93 2026-03-16
74080531 CDM Occ/emb Tumor/organ Infar 7 7 $56,399.93 $56,399.93 $56,399.93 $56,399.93 $56,399.93 2026-03-16
74080532 CDM Occ/emb Hemorrhag/lymph 7 7 $56,399.93 $56,399.93 $56,399.93 $56,399.93 $56,399.93 2026-03-16
74080547 CDM Verteb Augm Thorac W Imag 7 7 $38,769.13 $38,769.13 $38,769.13 $38,769.13 $38,769.13 2026-03-16
74080548 CDM Verteb Augm Lumbar W Imag 7 7 $38,769.13 $38,769.13 $38,769.13 $38,769.13 $38,769.13 2026-03-16
74080549 CDM Verteb Augm Ea Add W Imag 7 7 $38,769.13 $38,769.13 $38,769.13 $38,769.13 $38,769.13 2026-03-16
74080580 CDM Plc Stent Bile Duct Ex Ea 7 7 $24,053.59 $24,053.59 $24,053.59 $24,053.59 $24,053.59 2026-03-16
74080581 CDM Plc Stnt Bile Duct New Ea 7 7 $24,053.59 $24,053.59 $24,053.59 $24,053.59 $24,053.59 2026-03-16
74080582 CDM Pl St Bile Duct Cth Nw Ea 7 7 $24,053.59 $24,053.59 $24,053.59 $24,053.59 $24,053.59 2026-03-16
74080659 CDM Plc Stent Bile Duct Ex Ea 7 7 $24,053.59 $24,053.59 $24,053.59 $24,053.59 $24,053.59 2026-03-16
74080660 CDM Plc Stnt Bile Duct New Ea 7 7 $24,053.59 $24,053.59 $24,053.59 $24,053.59 $24,053.59 2026-03-16
74080661 CDM Pl St Bile Duct Cth Nw Ea 7 7 $24,053.59 $24,053.59 $24,053.59 $24,053.59 $24,053.59 2026-03-16
76085035 CDM Sm153 Lexidron To 150mci 7 7 $41,825.76 $41,825.76 $41,825.76 $41,825.76 $41,825.76 2026-03-16
76085037 CDM Strontium Sr-89 Thera/mci 7 7 $38,865.52 $38,865.52 $38,865.52 $38,865.52 $38,865.52 2026-03-16
76085057 CDM In111 Satumomab Dx To 6mc 7 7 $24,275.29 $24,275.29 $24,275.29 $24,275.29 $24,275.29 2026-03-16
77020083 CDM Liver Tumor Ablat Rf Perc 7 7 $25,297.02 $25,297.02 $25,297.02 $25,297.02 $25,297.02 2026-03-16
A0103 OTHER Stroke M >=50.50 And M <63.50 7 7 $23,157.36 $23,157.36 $23,157.36 $40,525.38 $23,852.08 2026-03-16
A0104 OTHER Stroke M >=41.50 And M <50.50 7 7 $29,576.72 $29,576.72 $29,576.72 $51,759.27 $30,464.03 2026-03-16
A0105 OTHER Stroke M <41.50 And A >=84.50 7 7 $36,860.46 $36,860.46 $36,860.46 $64,505.80 $37,966.27 2026-03-16
A0106 OTHER Stroke M <41.50 And A <84.50 7 7 $41,520.36 $41,520.36 $41,520.36 $72,660.63 $42,765.97 2026-03-16
A0204 OTHER Traumatic Brain Injury M >=35.50 And M <49.50 7 7 $27,842.23 $27,842.23 $27,842.23 $48,723.90 $28,677.49 2026-03-16
A0205 OTHER Traumatic Brain Injury M <35.50 7 7 $35,719.49 $35,719.49 $35,719.49 $62,509.12 $36,791.08 2026-03-16
A0303 OTHER Non-traumatic Brain Injury M >=42.50 And M <52.50 7 7 $24,265.67 $24,265.67 $24,265.67 $42,464.92 $24,993.64 2026-03-16
A0304 OTHER Non-traumatic Brain Injury M <42.50 And A >=78.50 7 7 $28,745.01 $28,745.01 $28,745.01 $50,303.77 $29,607.36 2026-03-16
A0305 OTHER Non-traumatic Brain Injury M <42.50 And A <78.50 7 7 $31,487.94 $31,487.94 $31,487.94 $55,103.89 $32,432.57 2026-03-16
A0402 OTHER Traumatic Spinal Cord Injury M >=47.50 And M <56.50 7 7 $23,495.42 $23,495.42 $23,495.42 $41,116.99 $24,200.28 2026-03-16
A0403 OTHER Traumatic Spinal Cord Injury M >=41.50 And M <47.50 7 7 $27,118.08 $27,118.08 $27,118.08 $47,456.64 $27,931.62 2026-03-16
A0404 OTHER Traumatic Spinal Cord Injury M <31.50 And A <61.50 7 7 $43,942.51 $43,942.51 $43,942.51 $76,899.39 $45,260.78 2026-03-16
A0405 OTHER Traumatic Spinal Cord Injury M >=31.50 And M <41.50 7 7 $34,807.11 $34,807.11 $34,807.11 $60,912.44 $35,851.32 2026-03-16
A0406 OTHER Traumatic Spinal Cord Injury M >=24.50 And M <31.50 And A >=61.50 7 7 $45,788.41 $45,788.41 $45,788.41 $80,129.72 $47,162.06 2026-03-16
A0407 OTHER Traumatic Spinal Cord Injury M <24.50 And A >=61.50 7 7 $62,703.12 $62,703.12 $62,703.12 $109,730.46 $64,584.21 2026-03-16
A0503 OTHER Non-traumatic Spinal Cord Injury M >=48.50 And M <53.50 7 7 $23,287.97 $23,287.97 $23,287.97 $40,753.95 $23,986.61 2026-03-16
A0504 OTHER Non-traumatic Spinal Cord Injury M >=39.50 And M <48.50 7 7 $27,826.86 $27,826.86 $27,826.86 $48,697.01 $28,661.67 2026-03-16
A0505 OTHER Non-traumatic Spinal Cord Injury M <39.50 7 7 $39,538.08 $39,538.08 $39,538.08 $69,191.63 $40,724.22 2026-03-16
A0603 OTHER Neurological M >=43.50 And M <52.50 7 7 $23,839.25 $23,839.25 $23,839.25 $41,718.68 $24,554.42 2026-03-16
A0604 OTHER Neurological M <43.50 7 7 $30,149.13 $30,149.13 $30,149.13 $52,760.97 $31,053.60 2026-03-16
A0703 OTHER Fracture Of Lower Extremity M >=41.50 And M <52.50 7 7 $24,763.16 $24,763.16 $24,763.16 $43,335.53 $25,506.05 2026-03-16
A0704 OTHER Fracture Of Lower Extremity M <41.50 7 7 $30,575.55 $30,575.55 $30,575.55 $53,507.21 $31,492.82 2026-03-16
A0804 OTHER Replacement Of Lower-extremity Joint M >=42.50 And M <51.50 7 7 $22,746.30 $22,746.30 $22,746.30 $39,806.03 $23,428.69 2026-03-16
A0805 OTHER Replacement Of Lower-extremity Joint M <42.50 7 7 $28,330.12 $28,330.12 $28,330.12 $49,577.70 $29,180.02 2026-03-16
A0903 OTHER Other Orthopedic M >=44.50 And M <51.50 7 7 $23,408.98 $23,408.98 $23,408.98 $40,965.72 $24,111.25 2026-03-16
A0904 OTHER Other Orthopedic M <44.5 7 7 $28,187.97 $28,187.97 $28,187.97 $49,328.96 $29,033.61 2026-03-16
A1003 OTHER Amputation Lower Extremity M >=47.50 And M <55.50 7 7 $23,898.79 $23,898.79 $23,898.79 $41,822.89 $24,615.76 2026-03-16
A1004 OTHER Amputation Lower Extremity M <47.50 7 7 $31,789.50 $31,789.50 $31,789.50 $55,631.63 $32,743.19 2026-03-16
A1103 OTHER Amputation Non-lower Extremity M <52.50 7 7 $26,486.13 $26,486.13 $26,486.13 $46,350.73 $27,280.72 2026-03-16
A1203 OTHER Osteoarthritis M <49.50 And A >=74.50 7 7 $26,307.50 $26,307.50 $26,307.50 $46,038.12 $27,096.72 2026-03-16
A1204 OTHER Osteoarthritis M <49.50 And A <74.50 7 7 $27,083.51 $27,083.51 $27,083.51 $47,396.13 $27,896.01 2026-03-16
A1304 OTHER Rheumatoid Other Arthritis M <44.50 And A >=64.50 7 7 $29,284.76 $29,284.76 $29,284.76 $51,248.33 $30,163.30 2026-03-16
A1305 OTHER Rheumatoid Other Arthritis M <51.50 And A <64.50 7 7 $29,227.14 $29,227.14 $29,227.14 $51,147.49 $30,103.95 2026-03-16
A1404 OTHER Cardiac M <45.50 7 7 $28,245.60 $28,245.60 $28,245.60 $49,429.80 $29,092.97 2026-03-16
A1503 OTHER Pulmonary M >=45.50 And M <56.50 7 7 $25,827.29 $25,827.29 $25,827.29 $45,197.76 $26,602.11 2026-03-16
A1504 OTHER Pulmonary M <45.50 7 7 $32,388.80 $32,388.80 $32,388.80 $56,680.40 $33,360.46 2026-03-16
A1604 OTHER Pain Syndrome M <43.50 7 7 $28,616.32 $28,616.32 $28,616.32 $50,078.55 $29,474.81 2026-03-16
A1703 OTHER Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=41.50 And M <50.50 7 7 $24,815.02 $24,815.02 $24,815.02 $43,426.29 $25,559.47 2026-03-16
A1704 OTHER Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=36.50 And M <41.50 7 7 $28,554.85 $28,554.85 $28,554.85 $49,970.99 $29,411.50 2026-03-16
A1705 OTHER Major Multiple Trauma Without Brain Or Spinal Cord Injury M <36.50 7 7 $33,241.64 $33,241.64 $33,241.64 $58,172.87 $34,238.89 2026-03-16
A1803 OTHER Major Multiple Trauma With Brain Or Spinal Cord Injury M >=45.50 And M <55.50 7 7 $24,006.36 $24,006.36 $24,006.36 $42,011.13 $24,726.55 2026-03-16
A1804 OTHER Major Multiple Trauma With Brain Or Spinal Cord Injury M >=40.50 And M <45.50 7 7 $28,038.15 $28,038.15 $28,038.15 $49,066.76 $28,879.30 2026-03-16
A1805 OTHER Major Multiple Trauma With Brain Or Spinal Cord Injury M >=30.50 And M <40.50 7 7 $33,637.33 $33,637.33 $33,637.33 $58,865.33 $34,646.45 2026-03-16
A1806 OTHER Major Multiple Trauma With Brain Or Spinal Cord Injury M <30.50 7 7 $48,734.94 $48,734.94 $48,734.94 $85,286.15 $50,196.99 2026-03-16
A1902 OTHER Guillain-barré M >=51.50 And M <66.50 7 7 $23,024.82 $23,024.82 $23,024.82 $40,293.44 $23,715.57 2026-03-16
A1903 OTHER Guillain-barré M >=38.50 And M <51.50 7 7 $32,577.04 $32,577.04 $32,577.04 $57,009.82 $33,554.35 2026-03-16
A1904 OTHER Guillain-barré M <38.50 7 7 $50,094.88 $50,094.88 $50,094.88 $87,666.04 $51,597.73 2026-03-16
A2004 OTHER Miscellaneous M <46.50 And A >=77.50 7 7 $27,711.61 $27,711.61 $27,711.61 $48,495.32 $28,542.96 2026-03-16
A2005 OTHER Miscellaneous M <46.50 And A <77.50 7 7 $29,006.24 $29,006.24 $29,006.24 $50,760.92 $29,876.43 2026-03-16
A2102 OTHER Burns M <52.50 7 7 $29,722.71 $29,722.71 $29,722.71 $52,014.74 $30,614.39 2026-03-16
A5102 OTHER Expired, Orthopedic, Length Of Stay Is 14 Days Or More 7 7 $39,347.92 $39,347.92 $39,347.92 $68,858.85 $40,528.35 2026-03-16
A5104 OTHER Expired, Not Orthopedic, Length Of Stay Is 16 Days Or More 7 7 $42,029.37 $42,029.37 $42,029.37 $73,551.41 $43,290.26 2026-03-16
B0102 OTHER Stroke M >=63.50 And M <72.50 7 7 $23,637.56 $23,637.56 $23,637.56 $41,365.73 $24,346.69 2026-03-16
B0103 OTHER Stroke M >=50.50 And M <63.50 7 7 $30,345.05 $30,345.05 $30,345.05 $53,103.84 $31,255.40 2026-03-16
B0104 OTHER Stroke M >=41.50 And M <50.50 7 7 $38,756.30 $38,756.30 $38,756.30 $67,823.53 $39,918.99 2026-03-16
B0105 OTHER Stroke M <41.50 And A >=84.50 7 7 $48,300.84 $48,300.84 $48,300.84 $84,526.47 $49,749.86 2026-03-16
B0106 OTHER Stroke M <41.50 And A <84.50 7 7 $54,407.11 $54,407.11 $54,407.11 $95,212.45 $56,039.33 2026-03-16
B0202 OTHER Traumatic Brain Injury M >=61.50 And M <73.50 7 7 $26,624.43 $26,624.43 $26,624.43 $46,592.75 $27,423.16 2026-03-16
B0203 OTHER Traumatic Brain Injury M >=49.50 And M <61.50 7 7 $33,101.42 $33,101.42 $33,101.42 $57,927.49 $34,094.46 2026-03-16
B0204 OTHER Traumatic Brain Injury M >=35.50 And M <49.50 7 7 $40,796.21 $40,796.21 $40,796.21 $71,393.37 $42,020.10 2026-03-16
B0205 OTHER Traumatic Brain Injury M <35.50 7 7 $52,338.39 $52,338.39 $52,338.39 $91,592.19 $53,908.55 2026-03-16
B0301 OTHER Non-traumatic Brain Injury M >=65.50 7 7 $22,932.62 $22,932.62 $22,932.62 $40,132.09 $23,620.60 2026-03-16
B0302 OTHER Non-traumatic Brain Injury M >=52.50 And M <65.50 7 7 $29,667.00 $29,667.00 $29,667.00 $51,917.26 $30,557.01 2026-03-16
B0303 OTHER Non-traumatic Brain Injury M >=42.50 And M <52.50 7 7 $35,077.94 $35,077.94 $35,077.94 $61,386.40 $36,130.28 2026-03-16
B0304 OTHER Non-traumatic Brain Injury M <42.50 And A >=78.50 7 7 $41,556.85 $41,556.85 $41,556.85 $72,724.49 $42,803.56 2026-03-16
B0305 OTHER Non-traumatic Brain Injury M <42.50 And A <78.50 7 7 $45,521.42 $45,521.42 $45,521.42 $79,662.48 $46,887.06 2026-03-16
B0401 OTHER Traumatic Spinal Cord Injury M >=56.50 7 7 $26,023.22 $26,023.22 $26,023.22 $45,540.63 $26,803.91 2026-03-16
B0402 OTHER Traumatic Spinal Cord Injury M >=47.50 And M <56.50 7 7 $32,625.06 $32,625.06 $32,625.06 $57,093.85 $33,603.81 2026-03-16
B0403 OTHER Traumatic Spinal Cord Injury M >=41.50 And M <47.50 7 7 $37,655.68 $37,655.68 $37,655.68 $65,897.43 $38,785.35 2026-03-16
B0404 OTHER Traumatic Spinal Cord Injury M <31.50 And A <61.50 7 7 $61,014.72 $61,014.72 $61,014.72 $106,775.76 $62,845.16 2026-03-16
B0405 OTHER Traumatic Spinal Cord Injury M >=31.50 And M <41.50 7 7 $48,329.65 $48,329.65 $48,329.65 $84,576.89 $49,779.54 2026-03-16
B0406 OTHER Traumatic Spinal Cord Injury M >=24.50 And M <31.50 And A >=61.50 7 7 $63,579.01 $63,579.01 $63,579.01 $111,263.27 $65,486.38 2026-03-16
B0407 OTHER Traumatic Spinal Cord Injury M <24.50 And A >=61.50 7 7 $87,066.75 $87,066.75 $87,066.75 $152,366.81 $89,678.75 2026-03-16
B0501 OTHER Non-traumatic Spinal Cord Injury M >=60.50 7 7 $25,143.48 $25,143.48 $25,143.48 $44,001.09 $25,897.79 2026-03-16
B0502 OTHER Non-traumatic Spinal Cord Injury M >=53.50 And M <60.50 7 7 $31,215.18 $31,215.18 $31,215.18 $54,626.57 $32,151.64 2026-03-16
B0503 OTHER Non-traumatic Spinal Cord Injury M >=48.50 And M <53.50 7 7 $35,346.86 $35,346.86 $35,346.86 $61,857.00 $36,407.26 2026-03-16
B0504 OTHER Non-traumatic Spinal Cord Injury M >=39.50 And M <48.50 7 7 $42,236.82 $42,236.82 $42,236.82 $73,914.44 $43,503.93 2026-03-16
B0505 OTHER Non-traumatic Spinal Cord Injury M <39.50 7 7 $60,010.13 $60,010.13 $60,010.13 $105,017.73 $61,810.44 2026-03-16
B0601 OTHER Neurological M >=64.50 7 7 $25,153.09 $25,153.09 $25,153.09 $44,017.90 $25,907.68 2026-03-16
B0602 OTHER Neurological M >=52.50 And M <64.50 7 7 $31,288.17 $31,288.17 $31,288.17 $54,754.30 $32,226.82 2026-03-16
B0603 OTHER Neurological M >=43.50 And M <52.50 7 7 $37,206.21 $37,206.21 $37,206.21 $65,110.86 $38,322.39 2026-03-16
B0604 OTHER Neurological M <43.50 7 7 $47,056.15 $47,056.15 $47,056.15 $82,348.26 $48,467.83 2026-03-16
B0701 OTHER Fracture Of Lower Extremity M >=61.50 7 7 $23,566.49 $23,566.49 $23,566.49 $41,241.36 $24,273.49 2026-03-16
B0702 OTHER Fracture Of Lower Extremity M >=52.50 And M <61.50 7 7 $29,129.17 $29,129.17 $29,129.17 $50,976.06 $30,003.05 2026-03-16
B0703 OTHER Fracture Of Lower Extremity M >=41.50 And M <52.50 7 7 $35,684.92 $35,684.92 $35,684.92 $62,448.61 $36,755.47 2026-03-16
B0704 OTHER Fracture Of Lower Extremity M <41.50 7 7 $44,063.52 $44,063.52 $44,063.52 $77,111.16 $45,385.42 2026-03-16
B0802 OTHER Replacement Of Lower-extremity Joint M >=57.50 And M <63.50 7 7 $25,792.72 $25,792.72 $25,792.72 $45,137.26 $26,566.50 2026-03-16
B0803 OTHER Replacement Of Lower-extremity Joint M >=51.50 And M <57.50 7 7 $28,385.82 $28,385.82 $28,385.82 $49,675.18 $29,237.39 2026-03-16
B0804 OTHER Replacement Of Lower-extremity Joint M >=42.50 And M <51.50 7 7 $32,246.66 $32,246.66 $32,246.66 $56,431.65 $33,214.06 2026-03-16
B0805 OTHER Replacement Of Lower-extremity Joint M <42.50 7 7 $40,164.26 $40,164.26 $40,164.26 $70,287.46 $41,369.19 2026-03-16
B0901 OTHER Other Orthopedic M >=63.50 7 7 $23,789.31 $23,789.31 $23,789.31 $41,631.29 $24,502.99 2026-03-16
B0902 OTHER Other Orthopedic M >=51.50 And M <63.50 7 7 $30,220.20 $30,220.20 $30,220.20 $52,885.35 $31,126.80 2026-03-16
B0903 OTHER Other Orthopedic M >=44.50 And M <51.50 7 7 $35,861.63 $35,861.63 $35,861.63 $62,757.86 $36,937.48 2026-03-16
B0904 OTHER Other Orthopedic M <44.5 7 7 $43,183.79 $43,183.79 $43,183.79 $75,571.62 $44,479.30 2026-03-16
B1001 OTHER Amputation Lower Extremity M >=64.50 7 7 $23,604.91 $23,604.91 $23,604.91 $41,308.59 $24,313.06 2026-03-16
B1002 OTHER Amputation Lower Extremity M >=55.50 And M <64.50 7 7 $28,675.86 $28,675.86 $28,675.86 $50,182.76 $29,536.14 2026-03-16
B1003 OTHER Amputation Lower Extremity M >=47.50 And M <55.50 7 7 $34,129.06 $34,129.06 $34,129.06 $59,725.85 $35,152.93 2026-03-16
B1004 OTHER Amputation Lower Extremity M <47.50 7 7 $45,396.57 $45,396.57 $45,396.57 $79,443.99 $46,758.46 2026-03-16
B1101 OTHER Amputation Non-lower Extremity M >=58.50 7 7 $25,977.12 $25,977.12 $25,977.12 $45,459.95 $26,756.43 2026-03-16
B1102 OTHER Amputation Non-lower Extremity M >=52.50 And M <58.50 7 7 $29,665.08 $29,665.08 $29,665.08 $51,913.89 $30,555.03 2026-03-16
B1103 OTHER Amputation Non-lower Extremity M <52.50 7 7 $37,156.26 $37,156.26 $37,156.26 $65,023.46 $38,270.95 2026-03-16
B1201 OTHER Osteoarthritis M >=61.50 7 7 $25,445.05 $25,445.05 $25,445.05 $44,528.84 $26,208.40 2026-03-16
B1202 OTHER Osteoarthritis M >=49.50 And M <61.50 7 7 $29,918.63 $29,918.63 $29,918.63 $52,357.60 $30,816.19 2026-03-16
B1203 OTHER Osteoarthritis M <49.50 And A >=74.50 7 7 $40,049.01 $40,049.01 $40,049.01 $70,085.77 $41,250.48 2026-03-16
B1204 OTHER Osteoarthritis M <49.50 And A <74.50 7 7 $41,230.32 $41,230.32 $41,230.32 $72,153.05 $42,467.22 2026-03-16
B1301 OTHER Rheumatoid Other Arthritis M >=62.50 7 7 $24,062.06 $24,062.06 $24,062.06 $42,108.61 $24,783.92 2026-03-16
B1302 OTHER Rheumatoid Other Arthritis M >=51.50 And M <62.50 7 7 $29,503.73 $29,503.73 $29,503.73 $51,631.53 $30,388.85 2026-03-16
B1303 OTHER Rheumatoid Other Arthritis M >=44.50 And M <51.50 And A >=64.50 7 7 $34,098.33 $34,098.33 $34,098.33 $59,672.07 $35,121.28 2026-03-16
B1304 OTHER Rheumatoid Other Arthritis M <44.50 And A >=64.50 7 7 $44,009.74 $44,009.74 $44,009.74 $77,017.04 $45,330.03 2026-03-16
B1305 OTHER Rheumatoid Other Arthritis M <51.50 And A <64.50 7 7 $43,923.30 $43,923.30 $43,923.30 $76,865.77 $45,241.00 2026-03-16
B1402 OTHER Cardiac M >=55.50 And M <68.50 7 7 $27,344.74 $27,344.74 $27,344.74 $47,853.29 $28,165.08 2026-03-16
B1403 OTHER Cardiac M >=45.50 And M <55.50 7 7 $33,051.48 $33,051.48 $33,051.48 $57,840.09 $34,043.03 2026-03-16
B1404 OTHER Cardiac M <45.50 7 7 $41,236.08 $41,236.08 $41,236.08 $72,163.14 $42,473.16 2026-03-16
B1501 OTHER Pulmonary M >=68.50 7 7 $25,168.45 $25,168.45 $25,168.45 $44,044.79 $25,923.51 2026-03-16
B1502 OTHER Pulmonary M >=56.50 And M <68.50 7 7 $30,775.31 $30,775.31 $30,775.31 $53,856.80 $31,698.57 2026-03-16
B1503 OTHER Pulmonary M >=45.50 And M <56.50 7 7 $35,880.84 $35,880.84 $35,880.84 $62,791.48 $36,957.27 2026-03-16
B1504 OTHER Pulmonary M <45.50 7 7 $44,995.11 $44,995.11 $44,995.11 $78,741.45 $46,344.97 2026-03-16
B1602 OTHER Pain Syndrome M >=58.50 And M <65.50 7 7 $24,294.48 $24,294.48 $24,294.48 $42,515.34 $25,023.32 2026-03-16
B1603 OTHER Pain Syndrome M >=43.50 And M <58.50 7 7 $29,421.14 $29,421.14 $29,421.14 $51,486.99 $30,303.77 2026-03-16
B1604 OTHER Pain Syndrome M <43.50 7 7 $38,510.44 $38,510.44 $38,510.44 $67,393.27 $39,665.75 2026-03-16
B1701 OTHER Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=57.50 7 7 $25,337.48 $25,337.48 $25,337.48 $44,340.60 $26,097.61 2026-03-16
B1702 OTHER Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=50.50 And M <57.50 7 7 $31,232.47 $31,232.47 $31,232.47 $54,656.82 $32,169.44 2026-03-16
B1703 OTHER Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=41.50 And M <50.50 7 7 $36,645.33 $36,645.33 $36,645.33 $64,129.32 $37,744.69 2026-03-16
B1704 OTHER Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=36.50 And M <41.50 7 7 $42,167.67 $42,167.67 $42,167.67 $73,793.43 $43,432.70 2026-03-16
B1705 OTHER Major Multiple Trauma Without Brain Or Spinal Cord Injury M <36.50 7 7 $49,090.29 $49,090.29 $49,090.29 $85,908.02 $50,563.00 2026-03-16
B1802 OTHER Major Multiple Trauma With Brain Or Spinal Cord Injury M >=55.50 And M <67.50 7 7 $27,319.77 $27,319.77 $27,319.77 $47,809.59 $28,139.36 2026-03-16
B1803 OTHER Major Multiple Trauma With Brain Or Spinal Cord Injury M >=45.50 And M <55.50 7 7 $33,986.92 $33,986.92 $33,986.92 $59,477.11 $35,006.53 2026-03-16
B1804 OTHER Major Multiple Trauma With Brain Or Spinal Cord Injury M >=40.50 And M <45.50 7 7 $39,693.66 $39,693.66 $39,693.66 $69,463.91 $40,884.47 2026-03-16
B1805 OTHER Major Multiple Trauma With Brain Or Spinal Cord Injury M >=30.50 And M <40.50 7 7 $47,620.87 $47,620.87 $47,620.87 $83,336.52 $49,049.50 2026-03-16
B1806 OTHER Major Multiple Trauma With Brain Or Spinal Cord Injury M <30.50 7 7 $68,993.79 $68,993.79 $68,993.79 $120,739.13 $71,063.60 2026-03-16
B1901 OTHER Guillain-barré M >=66.50 7 7 $25,752.38 $25,752.38 $25,752.38 $45,066.67 $26,524.95 2026-03-16
B1902 OTHER Guillain-barré M >=51.50 And M <66.50 7 7 $37,465.52 $37,465.52 $37,465.52 $65,564.65 $38,589.48 2026-03-16
B1903 OTHER Guillain-barré M >=38.50 And M <51.50 7 7 $53,008.76 $53,008.76 $53,008.76 $92,765.33 $54,599.02 2026-03-16
B1904 OTHER Guillain-barré M <38.50 7 7 $81,511.75 $81,511.75 $81,511.75 $142,645.56 $83,957.10 2026-03-16
B2001 OTHER Miscellaneous M >=66.50 7 7 $22,826.98 $22,826.98 $22,826.98 $39,947.21 $23,511.79 2026-03-16
B2002 OTHER Miscellaneous M >=55.50 And M <66.50 7 7 $28,341.64 $28,341.64 $28,341.64 $49,597.87 $29,191.89 2026-03-16
B2003 OTHER Miscellaneous M >=46.50 And M <55.50 7 7 $33,280.06 $33,280.06 $33,280.06 $58,240.10 $34,278.46 2026-03-16
B2004 OTHER Miscellaneous M <46.50 And A >=77.50 7 7 $40,588.76 $40,588.76 $40,588.76 $71,030.34 $41,806.43 2026-03-16
B2005 OTHER Miscellaneous M <46.50 And A <77.50 7 7 $42,484.61 $42,484.61 $42,484.61 $74,348.06 $43,759.15 2026-03-16
B2101 OTHER Burns M >=52.50 7 7 $30,850.23 $30,850.23 $30,850.23 $53,987.90 $31,775.73 2026-03-16
B2102 OTHER Burns M <52.50 7 7 $48,886.69 $48,886.69 $48,886.69 $85,551.70 $50,353.29 2026-03-16
C0103 OTHER Stroke M >=50.50 And M <63.50 7 7 $26,947.13 $26,947.13 $26,947.13 $47,157.47 $27,755.54 2026-03-16
C0104 OTHER Stroke M >=41.50 And M <50.50 7 7 $34,417.18 $34,417.18 $34,417.18 $60,230.07 $35,449.70 2026-03-16
C0105 OTHER Stroke M <41.50 And A >=84.50 7 7 $42,891.82 $42,891.82 $42,891.82 $75,060.69 $44,178.58 2026-03-16
C0106 OTHER Stroke M <41.50 And A <84.50 7 7 $48,314.28 $48,314.28 $48,314.28 $84,550.00 $49,763.71 2026-03-16
C0203 OTHER Traumatic Brain Injury M >=49.50 And M <61.50 7 7 $26,319.02 $26,319.02 $26,319.02 $46,058.29 $27,108.59 2026-03-16
C0204 OTHER Traumatic Brain Injury M >=35.50 And M <49.50 7 7 $32,436.82 $32,436.82 $32,436.82 $56,764.43 $33,409.92 2026-03-16
C0205 OTHER Traumatic Brain Injury M <35.50 7 7 $41,614.48 $41,614.48 $41,614.48 $72,825.34 $42,862.91 2026-03-16
C0302 OTHER Non-traumatic Brain Injury M >=52.50 And M <65.50 7 7 $23,512.71 $23,512.71 $23,512.71 $41,147.24 $24,218.09 2026-03-16
C0303 OTHER Non-traumatic Brain Injury M >=42.50 And M <52.50 7 7 $27,801.89 $27,801.89 $27,801.89 $48,653.31 $28,635.95 2026-03-16
C0304 OTHER Non-traumatic Brain Injury M <42.50 And A >=78.50 7 7 $32,936.23 $32,936.23 $32,936.23 $57,638.41 $33,924.32 2026-03-16
C0305 OTHER Non-traumatic Brain Injury M <42.50 And A <78.50 7 7 $36,078.69 $36,078.69 $36,078.69 $63,137.70 $37,161.05 2026-03-16
C0402 OTHER Traumatic Spinal Cord Injury M >=47.50 And M <56.50 7 7 $26,666.69 $26,666.69 $26,666.69 $46,666.70 $27,466.69 2026-03-16
C0403 OTHER Traumatic Spinal Cord Injury M >=41.50 And M <47.50 7 7 $30,779.16 $30,779.16 $30,779.16 $53,863.52 $31,702.53 2026-03-16
C0404 OTHER Traumatic Spinal Cord Injury M <31.50 And A <61.50 7 7 $49,872.07 $49,872.07 $49,872.07 $87,276.12 $51,368.23 2026-03-16
C0405 OTHER Traumatic Spinal Cord Injury M >=31.50 And M <41.50 7 7 $39,503.50 $39,503.50 $39,503.50 $69,131.13 $40,688.61 2026-03-16
C0406 OTHER Traumatic Spinal Cord Injury M >=24.50 And M <31.50 And A >=61.50 7 7 $51,967.68 $51,967.68 $51,967.68 $90,943.43 $53,526.71 2026-03-16
C0407 OTHER Traumatic Spinal Cord Injury M <24.50 And A >=61.50 7 7 $71,166.23 $71,166.23 $71,166.23 $124,540.91 $73,301.22 2026-03-16
C0502 OTHER Non-traumatic Spinal Cord Injury M >=53.50 And M <60.50 7 7 $23,989.07 $23,989.07 $23,989.07 $41,980.87 $24,708.74 2026-03-16
C0503 OTHER Non-traumatic Spinal Cord Injury M >=48.50 And M <53.50 7 7 $27,164.18 $27,164.18 $27,164.18 $47,537.31 $27,979.11 2026-03-16
C0504 OTHER Non-traumatic Spinal Cord Injury M >=39.50 And M <48.50 7 7 $32,457.95 $32,457.95 $32,457.95 $56,801.41 $33,431.69 2026-03-16
C0505 OTHER Non-traumatic Spinal Cord Injury M <39.50 7 7 $46,116.87 $46,116.87 $46,116.87 $80,704.52 $47,500.38 2026-03-16
C0602 OTHER Neurological M >=52.50 And M <64.50 7 7 $23,697.11 $23,697.11 $23,697.11 $41,469.94 $24,408.02 2026-03-16
C0603 OTHER Neurological M >=43.50 And M <52.50 7 7 $28,178.37 $28,178.37 $28,178.37 $49,312.15 $29,023.72 2026-03-16
C0604 OTHER Neurological M <43.50 7 7 $35,636.90 $35,636.90 $35,636.90 $62,364.57 $36,706.01 2026-03-16
C0702 OTHER Fracture Of Lower Extremity M >=52.50 And M <61.50 7 7 $23,289.89 $23,289.89 $23,289.89 $40,757.31 $23,988.59 2026-03-16
C0703 OTHER Fracture Of Lower Extremity M >=41.50 And M <52.50 7 7 $28,531.80 $28,531.80 $28,531.80 $49,930.65 $29,387.75 2026-03-16
C0704 OTHER Fracture Of Lower Extremity M <41.50 7 7 $35,231.61 $35,231.61 $35,231.61 $61,655.31 $36,288.56 2026-03-16
C0803 OTHER Replacement Of Lower-extremity Joint M >=51.50 And M <57.50 7 7 $23,908.40 $23,908.40 $23,908.40 $41,839.69 $24,625.65 2026-03-16
C0804 OTHER Replacement Of Lower-extremity Joint M >=42.50 And M <51.50 7 7 $27,160.34 $27,160.34 $27,160.34 $47,530.59 $27,975.15 2026-03-16
C0805 OTHER Replacement Of Lower-extremity Joint M <42.50 7 7 $33,827.49 $33,827.49 $33,827.49 $59,198.11 $34,842.32 2026-03-16
C0902 OTHER Other Orthopedic M >=51.50 And M <63.50 7 7 $22,890.36 $22,890.36 $22,890.36 $40,058.14 $23,577.08 2026-03-16
C0903 OTHER Other Orthopedic M >=44.50 And M <51.50 7 7 $27,162.26 $27,162.26 $27,162.26 $47,533.95 $27,977.13 2026-03-16
C0904 OTHER Other Orthopedic M <44.5 7 7 $32,709.58 $32,709.58 $32,709.58 $57,241.76 $33,690.86 2026-03-16
C1002 OTHER Amputation Lower Extremity M >=55.50 And M <64.50 7 7 $23,827.72 $23,827.72 $23,827.72 $41,698.51 $24,542.55 2026-03-16
C1003 OTHER Amputation Lower Extremity M >=47.50 And M <55.50 7 7 $28,358.93 $28,358.93 $28,358.93 $49,628.12 $29,209.70 2026-03-16
C1004 OTHER Amputation Lower Extremity M <47.50 7 7 $37,720.98 $37,720.98 $37,720.98 $66,011.72 $38,852.61 2026-03-16
C1101 OTHER Amputation Non-lower Extremity M >=58.50 7 7 $24,594.13 $24,594.13 $24,594.13 $43,039.72 $25,331.95 2026-03-16
C1102 OTHER Amputation Non-lower Extremity M >=52.50 And M <58.50 7 7 $28,084.25 $28,084.25 $28,084.25 $49,147.44 $28,926.78 2026-03-16
C1103 OTHER Amputation Non-lower Extremity M <52.50 7 7 $35,175.90 $35,175.90 $35,175.90 $61,557.83 $36,231.18 2026-03-16
C1202 OTHER Osteoarthritis M >=49.50 And M <61.50 7 7 $23,745.13 $23,745.13 $23,745.13 $41,553.97 $24,457.48 2026-03-16
C1203 OTHER Osteoarthritis M <49.50 And A >=74.50 7 7 $31,785.66 $31,785.66 $31,785.66 $55,624.91 $32,739.23 2026-03-16
C1204 OTHER Osteoarthritis M <49.50 And A <74.50 7 7 $32,724.94 $32,724.94 $32,724.94 $57,268.65 $33,706.69 2026-03-16
C1302 OTHER Rheumatoid Other Arthritis M >=51.50 And M <62.50 7 7 $23,587.62 $23,587.62 $23,587.62 $41,278.34 $24,295.25 2026-03-16
C1303 OTHER Rheumatoid Other Arthritis M >=44.50 And M <51.50 And A >=64.50 7 7 $27,260.22 $27,260.22 $27,260.22 $47,705.39 $28,078.03 2026-03-16
C1304 OTHER Rheumatoid Other Arthritis M <44.50 And A >=64.50 7 7 $35,185.51 $35,185.51 $35,185.51 $61,574.64 $36,241.07 2026-03-16
C1305 OTHER Rheumatoid Other Arthritis M <51.50 And A <64.50 7 7 $35,114.44 $35,114.44 $35,114.44 $61,450.27 $36,167.87 2026-03-16
C1403 OTHER Cardiac M >=45.50 And M <55.50 7 7 $26,624.43 $26,624.43 $26,624.43 $46,592.75 $27,423.16 2026-03-16
C1404 OTHER Cardiac M <45.50 7 7 $33,218.59 $33,218.59 $33,218.59 $58,132.54 $34,215.15 2026-03-16
C1502 OTHER Pulmonary M >=56.50 And M <68.50 7 7 $24,745.87 $24,745.87 $24,745.87 $43,305.28 $25,488.25 2026-03-16
C1503 OTHER Pulmonary M >=45.50 And M <56.50 7 7 $28,850.66 $28,850.66 $28,850.66 $50,488.65 $29,716.18 2026-03-16
C1504 OTHER Pulmonary M <45.50 7 7 $36,178.57 $36,178.57 $36,178.57 $63,312.50 $37,263.93 2026-03-16
C1603 OTHER Pain Syndrome M >=43.50 And M <58.50 7 7 $26,367.04 $26,367.04 $26,367.04 $46,142.32 $27,158.05 2026-03-16
C1604 OTHER Pain Syndrome M <43.50 7 7 $34,513.22 $34,513.22 $34,513.22 $60,398.14 $35,548.62 2026-03-16
C1702 OTHER Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=50.50 And M <57.50 7 7 $24,742.03 $24,742.03 $24,742.03 $43,298.55 $25,484.29 2026-03-16
C1703 OTHER Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=41.50 And M <50.50 7 7 $29,031.21 $29,031.21 $29,031.21 $50,804.62 $29,902.15 2026-03-16
C1704 OTHER Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=36.50 And M <41.50 7 7 $33,406.83 $33,406.83 $33,406.83 $58,461.96 $34,409.04 2026-03-16
C1705 OTHER Major Multiple Trauma Without Brain Or Spinal Cord Injury M <36.50 7 7 $38,890.76 $38,890.76 $38,890.76 $68,058.83 $40,057.48 2026-03-16
C1803 OTHER Major Multiple Trauma With Brain Or Spinal Cord Injury M >=45.50 And M <55.50 7 7 $27,803.81 $27,803.81 $27,803.81 $48,656.67 $28,637.93 2026-03-16
C1804 OTHER Major Multiple Trauma With Brain Or Spinal Cord Injury M >=40.50 And M <45.50 7 7 $32,473.32 $32,473.32 $32,473.32 $56,828.30 $33,447.51 2026-03-16
C1805 OTHER Major Multiple Trauma With Brain Or Spinal Cord Injury M >=30.50 And M <40.50 7 7 $38,957.99 $38,957.99 $38,957.99 $68,176.48 $40,126.73 2026-03-16
C1806 OTHER Major Multiple Trauma With Brain Or Spinal Cord Injury M <30.50 7 7 $56,443.18 $56,443.18 $56,443.18 $98,775.56 $58,136.47 2026-03-16
C1902 OTHER Guillain-barré M >=51.50 And M <66.50 7 7 $26,478.45 $26,478.45 $26,478.45 $46,337.28 $27,272.80 2026-03-16
C1903 OTHER Guillain-barré M >=38.50 And M <51.50 7 7 $37,463.60 $37,463.60 $37,463.60 $65,561.29 $38,587.50 2026-03-16
C1904 OTHER Guillain-barré M <38.50 7 7 $57,607.19 $57,607.19 $57,607.19 $100,812.59 $59,335.41 2026-03-16
C2002 OTHER Miscellaneous M >=55.50 And M <66.50 7 7 $22,729.02 $22,729.02 $22,729.02 $39,775.78 $23,410.89 2026-03-16
C2003 OTHER Miscellaneous M >=46.50 And M <55.50 7 7 $26,689.74 $26,689.74 $26,689.74 $46,707.04 $27,490.43 2026-03-16
C2004 OTHER Miscellaneous M <46.50 And A >=77.50 7 7 $32,550.15 $32,550.15 $32,550.15 $56,962.76 $33,526.65 2026-03-16
C2005 OTHER Miscellaneous M <46.50 And A <77.50 7 7 $34,071.43 $34,071.43 $34,071.43 $59,625.01 $35,093.58 2026-03-16
C2101 OTHER Burns M >=52.50 7 7 $25,936.78 $25,936.78 $25,936.78 $45,389.36 $26,714.88 2026-03-16
C2102 OTHER Burns M <52.50 7 7 $41,099.70 $41,099.70 $41,099.70 $71,924.47 $42,332.69 2026-03-16
D0103 OTHER Stroke M >=50.50 And M <63.50 7 7 $24,413.57 $24,413.57 $24,413.57 $42,723.75 $25,145.98 2026-03-16
D0104 OTHER Stroke M >=41.50 And M <50.50 7 7 $31,182.53 $31,182.53 $31,182.53 $54,569.42 $32,118.00 2026-03-16
D0105 OTHER Stroke M <41.50 And A >=84.50 7 7 $38,860.03 $38,860.03 $38,860.03 $68,005.05 $40,025.83 2026-03-16
D0106 OTHER Stroke M <41.50 And A <84.50 7 7 $43,773.48 $43,773.48 $43,773.48 $76,603.58 $45,086.68 2026-03-16
D0203 OTHER Traumatic Brain Injury M >=49.50 And M <61.50 7 7 $24,044.77 $24,044.77 $24,044.77 $42,078.36 $24,766.12 2026-03-16
D0204 OTHER Traumatic Brain Injury M >=35.50 And M <49.50 7 7 $29,634.35 $29,634.35 $29,634.35 $51,860.11 $30,523.38 2026-03-16
D0205 OTHER Traumatic Brain Injury M <35.50 7 7 $38,018.71 $38,018.71 $38,018.71 $66,532.74 $39,159.27 2026-03-16
D0303 OTHER Non-traumatic Brain Injury M >=42.50 And M <52.50 7 7 $25,919.49 $25,919.49 $25,919.49 $45,359.11 $26,697.08 2026-03-16
D0304 OTHER Non-traumatic Brain Injury M <42.50 And A >=78.50 7 7 $30,704.24 $30,704.24 $30,704.24 $53,732.43 $31,625.37 2026-03-16
D0305 OTHER Non-traumatic Brain Injury M <42.50 And A <78.50 7 7 $33,635.41 $33,635.41 $33,635.41 $58,861.97 $34,644.47 2026-03-16
D0402 OTHER Traumatic Spinal Cord Injury M >=47.50 And M <56.50 7 7 $25,965.59 $25,965.59 $25,965.59 $45,439.78 $26,744.56 2026-03-16
D0403 OTHER Traumatic Spinal Cord Injury M >=41.50 And M <47.50 7 7 $29,968.57 $29,968.57 $29,968.57 $52,445.00 $30,867.63 2026-03-16
D0404 OTHER Traumatic Spinal Cord Injury M <31.50 And A <61.50 7 7 $48,560.15 $48,560.15 $48,560.15 $84,980.26 $50,016.95 2026-03-16
D0405 OTHER Traumatic Spinal Cord Injury M >=31.50 And M <41.50 7 7 $38,464.34 $38,464.34 $38,464.34 $67,312.60 $39,618.27 2026-03-16
D0406 OTHER Traumatic Spinal Cord Injury M >=24.50 And M <31.50 And A >=61.50 7 7 $50,600.06 $50,600.06 $50,600.06 $88,550.10 $52,118.06 2026-03-16
D0407 OTHER Traumatic Spinal Cord Injury M <24.50 And A >=61.50 7 7 $69,293.44 $69,293.44 $69,293.44 $121,263.52 $71,372.24 2026-03-16
D0503 OTHER Non-traumatic Spinal Cord Injury M >=48.50 And M <53.50 7 7 $25,270.26 $25,270.26 $25,270.26 $44,222.95 $26,028.36 2026-03-16
D0504 OTHER Non-traumatic Spinal Cord Injury M >=39.50 And M <48.50 7 7 $30,195.23 $30,195.23 $30,195.23 $52,841.65 $31,101.08 2026-03-16
D0505 OTHER Non-traumatic Spinal Cord Injury M <39.50 7 7 $42,903.35 $42,903.35 $42,903.35 $75,080.86 $44,190.45 2026-03-16
D0603 OTHER Neurological M >=43.50 And M <52.50 7 7 $26,539.91 $26,539.91 $26,539.91 $46,444.85 $27,336.11 2026-03-16
D0604 OTHER Neurological M <43.50 7 7 $33,566.26 $33,566.26 $33,566.26 $58,740.95 $34,573.25 2026-03-16
D0703 OTHER Fracture Of Lower Extremity M >=41.50 And M <52.50 7 7 $27,098.87 $27,098.87 $27,098.87 $47,423.03 $27,911.84 2026-03-16
D0704 OTHER Fracture Of Lower Extremity M <41.50 7 7 $33,460.61 $33,460.61 $33,460.61 $58,556.08 $34,464.43 2026-03-16
D0804 OTHER Replacement Of Lower-extremity Joint M >=42.50 And M <51.50 7 7 $24,277.19 $24,277.19 $24,277.19 $42,485.09 $25,005.51 2026-03-16
D0805 OTHER Replacement Of Lower-extremity Joint M <42.50 7 7 $30,237.49 $30,237.49 $30,237.49 $52,915.60 $31,144.61 2026-03-16
D0903 OTHER Other Orthopedic M >=44.50 And M <51.50 7 7 $25,658.26 $25,658.26 $25,658.26 $44,901.96 $26,428.01 2026-03-16
D0904 OTHER Other Orthopedic M <44.5 7 7 $30,898.25 $30,898.25 $30,898.25 $54,071.93 $31,825.19 2026-03-16
D1003 OTHER Amputation Lower Extremity M >=47.50 And M <55.50 7 7 $25,738.93 $25,738.93 $25,738.93 $45,043.14 $26,511.10 2026-03-16
D1004 OTHER Amputation Lower Extremity M <47.50 7 7 $34,236.62 $34,236.62 $34,236.62 $59,914.09 $35,263.72 2026-03-16
D1102 OTHER Amputation Non-lower Extremity M >=52.50 And M <58.50 7 7 $24,167.71 $24,167.71 $24,167.71 $42,293.49 $24,892.74 2026-03-16
D1103 OTHER Amputation Non-lower Extremity M <52.50 7 7 $30,272.06 $30,272.06 $30,272.06 $52,976.11 $31,180.22 2026-03-16
D1203 OTHER Osteoarthritis M <49.50 And A >=74.50 7 7 $28,405.03 $28,405.03 $28,405.03 $49,708.80 $29,257.18 2026-03-16
D1204 OTHER Osteoarthritis M <49.50 And A <74.50 7 7 $29,244.42 $29,244.42 $29,244.42 $51,177.74 $30,121.76 2026-03-16
D1303 OTHER Rheumatoid Other Arthritis M >=44.50 And M <51.50 And A >=64.50 7 7 $24,978.29 $24,978.29 $24,978.29 $43,712.01 $25,727.64 2026-03-16
D1304 OTHER Rheumatoid Other Arthritis M <44.50 And A >=64.50 7 7 $32,238.98 $32,238.98 $32,238.98 $56,418.21 $33,206.15 2026-03-16
D1305 OTHER Rheumatoid Other Arthritis M <51.50 And A <64.50 7 7 $32,173.67 $32,173.67 $32,173.67 $56,303.92 $33,138.88 2026-03-16
D1403 OTHER Cardiac M >=45.50 And M <55.50 7 7 $24,617.18 $24,617.18 $24,617.18 $43,080.06 $25,355.69 2026-03-16
D1404 OTHER Cardiac M <45.50 7 7 $30,715.77 $30,715.77 $30,715.77 $53,752.60 $31,637.24 2026-03-16
D1502 OTHER Pulmonary M >=56.50 And M <68.50 7 7 $23,174.65 $23,174.65 $23,174.65 $40,555.63 $23,869.88 2026-03-16
D1503 OTHER Pulmonary M >=45.50 And M <56.50 7 7 $27,018.20 $27,018.20 $27,018.20 $47,281.85 $27,828.74 2026-03-16
D1504 OTHER Pulmonary M <45.50 7 7 $33,881.27 $33,881.27 $33,881.27 $59,292.23 $34,897.71 2026-03-16
D1603 OTHER Pain Syndrome M >=43.50 And M <58.50 7 7 $24,119.69 $24,119.69 $24,119.69 $42,209.45 $24,843.28 2026-03-16
D1604 OTHER Pain Syndrome M <43.50 7 7 $31,570.53 $31,570.53 $31,570.53 $55,248.43 $32,517.65 2026-03-16
D1702 OTHER Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=50.50 And M <57.50 7 7 $22,972.96 $22,972.96 $22,972.96 $40,202.68 $23,662.15 2026-03-16
D1703 OTHER Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=41.50 And M <50.50 7 7 $26,954.81 $26,954.81 $26,954.81 $47,170.92 $27,763.46 2026-03-16
D1704 OTHER Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=36.50 And M <41.50 7 7 $31,017.34 $31,017.34 $31,017.34 $54,280.34 $31,947.86 2026-03-16
D1705 OTHER Major Multiple Trauma Without Brain Or Spinal Cord Injury M <36.50 7 7 $36,109.42 $36,109.42 $36,109.42 $63,191.48 $37,192.70 2026-03-16
D1803 OTHER Major Multiple Trauma With Brain Or Spinal Cord Injury M >=45.50 And M <55.50 7 7 $25,577.59 $25,577.59 $25,577.59 $44,760.78 $26,344.91 2026-03-16
D1804 OTHER Major Multiple Trauma With Brain Or Spinal Cord Injury M >=40.50 And M <45.50 7 7 $29,872.53 $29,872.53 $29,872.53 $52,276.93 $30,768.71 2026-03-16
D1805 OTHER Major Multiple Trauma With Brain Or Spinal Cord Injury M >=30.50 And M <40.50 7 7 $35,838.58 $35,838.58 $35,838.58 $62,717.52 $36,913.74 2026-03-16
D1806 OTHER Major Multiple Trauma With Brain Or Spinal Cord Injury M <30.50 7 7 $51,923.50 $51,923.50 $51,923.50 $90,866.12 $53,481.20 2026-03-16
D1902 OTHER Guillain-barré M >=51.50 And M <66.50 7 7 $23,019.06 $23,019.06 $23,019.06 $40,283.35 $23,709.63 2026-03-16
D1903 OTHER Guillain-barré M >=38.50 And M <51.50 7 7 $32,569.36 $32,569.36 $32,569.36 $56,996.37 $33,546.44 2026-03-16
D1904 OTHER Guillain-barré M <38.50 7 7 $50,079.51 $50,079.51 $50,079.51 $87,639.15 $51,581.90 2026-03-16
D2003 OTHER Miscellaneous M >=46.50 And M <55.50 7 7 $24,820.78 $24,820.78 $24,820.78 $43,436.37 $25,565.41 2026-03-16
D2004 OTHER Miscellaneous M <46.50 And A >=77.50 7 7 $30,272.06 $30,272.06 $30,272.06 $52,976.11 $31,180.22 2026-03-16
D2005 OTHER Miscellaneous M <46.50 And A <77.50 7 7 $31,685.78 $31,685.78 $31,685.78 $55,450.12 $32,636.35 2026-03-16
D2102 OTHER Burns M <52.50 7 7 $30,994.29 $30,994.29 $30,994.29 $54,240.00 $31,924.12 2026-03-16
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