|
5834
|
OTHER
|
Screw Extern Fixat 6mm Lg 190mm Schanz 50mm Thread Self-tap Blunt Trocar Spade P…
|
20
|
20
|
$267.58
|
$267.58
|
$186,122.36
|
$510,037.89
|
$464,147.84
|
2026-05-23
|
|
5884
|
OTHER
|
Screw Bone Lcp Tomofix 5x46mm Compress Lck Headed Full Thread Self-tap Ti-6al-7n…
|
20
|
20
|
$589.88
|
$589.88
|
$137,553.06
|
$985,179.64
|
$284,281.77
|
2026-05-23
|
|
0114
|
OTHER
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
14
|
14
|
—
|
—
|
$44,395.77
|
$280,952.43
|
$265,756.21
|
2026-05-23
|
|
0024
|
OTHER
|
Heart And/or Lung Transplant
|
16
|
16
|
—
|
—
|
$110,630.07
|
$354,421.44
|
$265,580.17
|
2026-05-23
|
|
5833
|
OTHER
|
Plate Bone Dcp 10x73mm 6-hole 3.3mm Sm Dynamic Compress Lck Cortic Ss Pelvic F/3…
|
20
|
20
|
$1,001.00
|
$1,001.00
|
$7,751.73
|
$447,993.91
|
$264,347.14
|
2026-05-23
|
|
5832
|
OTHER
|
Plate Bone Lc-dcp 16x103mm 6-hole 4.8mm Broad Dynamic Compress Lck Ss Limit-cont…
|
20
|
20
|
$690.00
|
$690.00
|
$99,677.25
|
$308,249.04
|
$202,970.17
|
2026-05-23
|
|
1614
|
OTHER
|
Implantable Heart Assist Systems
|
20
|
20
|
—
|
—
|
$146,262.70
|
$348,983.12
|
$198,188.51
|
2026-05-23
|
|
6094
|
OTHER
|
Neonate Birth Weight 1500-2499 Grams With Major Procedure
|
20
|
20
|
—
|
—
|
$95,519.63
|
$604,890.84
|
$198,066.63
|
2026-05-23
|
|
0113
|
OTHER
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
14
|
14
|
—
|
—
|
$44,395.77
|
$197,779.25
|
$197,779.25
|
2026-05-23
|
|
0094
|
OTHER
|
Extracorporeal Membrane Oxygenation (ecmo)
|
14
|
14
|
—
|
—
|
$78,872.77
|
$211,086.86
|
$194,288.55
|
2026-05-23
|
|
6314
|
OTHER
|
Screw Bone Lcp 7.3/8.2x90mm Cannul Compress Lck 32mm Thread Self-drilling/tappin…
|
20
|
20
|
$800.75
|
$800.75
|
$63,020.17
|
$493,410.24
|
$190,504.44
|
2026-05-23
|
|
5883
|
OTHER
|
Screw Bone Lcp Tomofix 5x38mm Compress Lck Headed Full Thread Self-tap Ti-6al-7n…
|
20
|
20
|
$737.50
|
$737.50
|
$98,337.84
|
$744,555.28
|
$188,622.82
|
2026-05-23
|
|
5914
|
OTHER
|
Plate Bone Lcp 73mm 3-hole 110deg Pre-contoured Compress Lck Ss Hip F/3.5mm Scre…
|
20
|
20
|
$1,704.73
|
$1,704.73
|
$95,576.86
|
$696,970.92
|
$186,417.91
|
2026-05-23
|
|
5831
|
OTHER
|
Washer Ortho 13mm Round Thread Spike Ss F/6.5/7/7.3mm Lg Cannul Screw Ns
|
20
|
20
|
$85.70
|
$85.70
|
$89,473.85
|
$203,437.06
|
$182,190.70
|
2026-05-23
|
|
8414
|
OTHER
|
Screw Spinal Expedium 7x40mm Lck Fully/dual Lead Thread Polyaxial Self-tap 1-inn…
|
20
|
20
|
$2,000.00
|
$2,000.00
|
$102,954.93
|
$392,739.88
|
$176,293.37
|
2026-05-23
|
|
6304
|
OTHER
|
Screw Bone Lcp 4/5x24mm Cannul Compress Lck 1/2 Long Thread Self-drilling/tappin…
|
20
|
20
|
$597.50
|
$597.50
|
$91,070.64
|
$377,586.24
|
$172,768.05
|
2026-05-23
|
|
5934
|
OTHER
|
Screw Interference Cannul 8x20mm Ti Round Head Without Sheath F/graft Fixat Strl Acl…
|
20
|
20
|
$237.50
|
$237.50
|
$83,467.24
|
$689,442.36
|
$163,897.60
|
2026-05-23
|
|
0112
|
OTHER
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
14
|
14
|
—
|
—
|
$25,064.16
|
$157,232.16
|
$157,232.16
|
2026-05-23
|
|
5882
|
OTHER
|
Screw Bone Lcp Tomofix 5x34mm Compress Lck Headed Full Thread Self-tap Ti-6al-7n…
|
20
|
20
|
$589.88
|
$589.88
|
$96,299.13
|
$476,422.72
|
$156,891.68
|
2026-05-23
|
|
0074
|
OTHER
|
Allogeneic Bone Marrow Transplant
|
12
|
12
|
—
|
—
|
$88,623.98
|
$162,303.01
|
$156,363.25
|
2026-05-23
|
|
1613
|
OTHER
|
Implantable Heart Assist Systems
|
20
|
20
|
—
|
—
|
$73,273.53
|
$169,234.82
|
$155,185.89
|
2026-05-23
|
|
0044
|
OTHER
|
Tracheostomy With Mv >96 Hours With Extensive Procedure
|
18
|
18
|
—
|
—
|
$71,626.37
|
$372,470.68
|
$149,312.63
|
2026-05-23
|
|
0014
|
OTHER
|
Liver Transplant And/or Intestinal Transplant
|
16
|
16
|
—
|
—
|
$62,864.54
|
$304,713.64
|
$147,827.57
|
2026-05-23
|
|
0023
|
OTHER
|
Heart And/or Lung Transplant
|
16
|
16
|
—
|
—
|
$69,196.26
|
$207,807.56
|
$144,666.38
|
2026-05-23
|
|
5913
|
OTHER
|
Plate Bone Lcp 73mm 3-hole 100deg Pre-contoured Compress Lck Ss Hip F/3.5mm Scre…
|
20
|
20
|
$1,704.73
|
$1,704.73
|
$52,943.96
|
$488,487.72
|
$140,591.88
|
2026-05-23
|
|
5881
|
OTHER
|
Screw Bone Lcp 3.5/6x18mm Compress Lck Full Thread Self-tap Lo-pro Cortic Ti 2.5…
|
20
|
20
|
$71.25
|
$71.25
|
$63,379.94
|
$428,741.84
|
$139,060.19
|
2026-05-23
|
|
5892
|
OTHER
|
Screw Bone Lcp 4.5/8x44mm Compress Lck Full Thread Self-drilling/tapping Cortic …
|
20
|
20
|
$69.88
|
$69.88
|
$24,764.35
|
$486,653.84
|
$132,514.36
|
2026-05-23
|
|
5891
|
OTHER
|
Screw Bone Lcp 4.5/8x40mm Compress Lck Full Thread Self-drilling/tapping Cortic …
|
20
|
20
|
$73.88
|
$73.88
|
$29,801.16
|
$563,966.36
|
$132,514.36
|
2026-05-23
|
|
5893
|
OTHER
|
Screw Bone Lcp 4.5/8x48mm Compress Lck Full Thread Self-drilling/tapping Cortic …
|
20
|
20
|
$73.88
|
$73.88
|
$19,667.57
|
$293,034.72
|
$132,514.36
|
2026-05-23
|
|
0093
|
OTHER
|
Extracorporeal Membrane Oxygenation (ecmo)
|
14
|
14
|
—
|
—
|
$32,342.97
|
$130,574.16
|
$130,574.16
|
2026-05-23
|
|
6024
|
OTHER
|
Screw Bone Lcp 5/4.4x55mm Compress Lck Full Thread Self-tap Ss T25 Stardrive Rec…
|
20
|
20
|
$393.68
|
$393.68
|
$53,634.99
|
$608,751.64
|
$123,469.38
|
2026-05-23
|
|
5912
|
OTHER
|
Screw Bone 4x46mm Cannul 15mm Short Thread Ss Prox Humeral Revers Cut Flute Ns P…
|
20
|
20
|
$465.30
|
$465.30
|
$29,981.05
|
$358,089.20
|
$120,587.29
|
2026-05-23
|
|
5933
|
OTHER
|
Screw Interference Cannul 7x25mm Ti Alloy Round Head W/2mm Nitinol Gw Disp Sheat…
|
20
|
20
|
$287.50
|
$287.50
|
$9,067.49
|
$575,838.32
|
$119,895.92
|
2026-05-23
|
|
1612
|
OTHER
|
Implantable Heart Assist Systems
|
20
|
20
|
—
|
—
|
$45,631.01
|
$165,223.08
|
$114,186.66
|
2026-05-23
|
|
1611
|
OTHER
|
Implantable Heart Assist Systems
|
20
|
20
|
—
|
—
|
$29,893.69
|
$156,924.91
|
$114,186.66
|
2026-05-23
|
|
1604
|
OTHER
|
Major Cardiothoracic Repair Of Heart Anomaly
|
20
|
20
|
—
|
—
|
$66,378.04
|
$280,308.30
|
$113,770.64
|
2026-05-23
|
|
0022
|
OTHER
|
Heart And/or Lung Transplant
|
16
|
16
|
—
|
—
|
$52,886.57
|
$141,884.40
|
$109,546.43
|
2026-05-23
|
|
0054
|
OTHER
|
Tracheostomy With Mv >96 Hours Without Extensive Procedure
|
18
|
18
|
—
|
—
|
$50,565.50
|
$316,489.08
|
$104,016.98
|
2026-05-23
|
|
0043
|
OTHER
|
Tracheostomy With Mv >96 Hours With Extensive Procedure
|
18
|
18
|
—
|
—
|
$54,274.10
|
$254,812.80
|
$102,962.24
|
2026-05-23
|
|
0073
|
OTHER
|
Allogeneic Bone Marrow Transplant
|
12
|
12
|
—
|
—
|
$48,689.23
|
$99,448.97
|
$99,448.97
|
2026-05-23
|
|
8424
|
OTHER
|
Connector Spinal Expedium Open Dual Side/side Ss F/5.5mm Rod Ns
|
20
|
20
|
$1,725.00
|
$1,725.00
|
$51,507.44
|
$290,621.72
|
$98,698.92
|
2026-05-23
|
|
0064
|
OTHER
|
Pancreas Transplant
|
16
|
16
|
—
|
—
|
$18,768.71
|
$238,500.92
|
$96,560.86
|
2026-05-23
|
|
5932
|
OTHER
|
Guidepin Ortho 2.4mm Breakaway Femur Tibial F/osteotomy Disp
|
20
|
20
|
$92.50
|
$92.50
|
$40,754.16
|
$468,218.52
|
$96,435.98
|
2026-05-23
|
|
6074
|
OTHER
|
Screw Bone Expert 4/3.3x36mm Cannul Compress Lck Fully/dual Lead Thread Self-tap…
|
20
|
20
|
$490.28
|
$490.28
|
$40,199.01
|
$478,546.16
|
$95,442.18
|
2026-05-23
|
|
6303
|
OTHER
|
Screw Bone Lcp 4/5x20mm Cannul Compress Lck 1/2 Long Thread Self-drilling/tappin…
|
20
|
20
|
$597.50
|
$597.50
|
$44,126.01
|
$139,760.96
|
$95,233.79
|
2026-05-23
|
|
0021
|
OTHER
|
Heart And/or Lung Transplant
|
16
|
16
|
—
|
—
|
$52,886.57
|
$96,821.91
|
$93,630.58
|
2026-05-23
|
|
8513
|
OTHER
|
Screw Spinal Expedium 5x25mm Polyaxial Pedicle Ss Thoracolum Extend Tab F/6.35mm…
|
11
|
11
|
$2,000.00
|
$2,000.00
|
$20,471.23
|
$91,075.04
|
$91,075.04
|
2026-05-23
|
|
8514
|
OTHER
|
Screw Spinal Expedium 5x45mm Polyaxial Pedicle Ss Thoracolum Extend Tab F/6.35mm…
|
11
|
11
|
$1,976.25
|
$1,976.25
|
$48,940.69
|
$91,075.04
|
$91,075.04
|
2026-05-23
|
|
6034
|
OTHER
|
Nail IM Fassier-duval 4.8mm Std 404mm Short Thread Tibial Humeral Ss F/osteogene…
|
20
|
20
|
$6,500.00
|
$6,500.00
|
$41,016.09
|
$520,821.92
|
$90,306.93
|
2026-05-23
|
|
6023
|
OTHER
|
Screw Bone Lcp 7.3/8.2x85mm Cannul Compress Lck 32mm Thread Self-drilling/tappin…
|
20
|
20
|
$800.75
|
$800.75
|
$37,006.57
|
$513,872.48
|
$85,726.89
|
2026-05-23
|
|
6114
|
OTHER
|
Neonate Birth Weight 1500-1999 Grams With Major Anomaly
|
20
|
20
|
—
|
—
|
$31,312.41
|
$348,919.80
|
$79,380.43
|
2026-05-23
|
|
6134
|
OTHER
|
Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection
|
20
|
20
|
—
|
—
|
$17,457.27
|
$322,280.28
|
$78,650.69
|
2026-05-23
|
|
8634
|
OTHER
|
Wedge Bone Graft 22x22x6mm Allograft Evans Frz-dry Cort/canc Pre-shaped F/osteot…
|
20
|
20
|
$2,697.90
|
$2,697.90
|
$39,460.59
|
$448,142.36
|
$77,637.33
|
2026-05-23
|
|
0111
|
OTHER
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
14
|
14
|
—
|
—
|
$16,849.35
|
$77,437.22
|
$77,437.22
|
2026-05-23
|
|
0013
|
OTHER
|
Liver Transplant And/or Intestinal Transplant
|
16
|
16
|
—
|
—
|
$26,563.71
|
$120,843.04
|
$76,748.86
|
2026-05-23
|
|
1624
|
OTHER
|
Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis
|
20
|
20
|
—
|
—
|
$46,324.00
|
$202,498.96
|
$76,458.47
|
2026-05-23
|
|
3034
|
OTHER
|
Suture Chromic Gut 3-0 27in 1/2 Circ CT-2 Taper Point Natural Brown Undyed 1 Str…
|
20
|
20
|
$7.60
|
$7.60
|
$51,627.37
|
$155,107.64
|
$76,089.08
|
2026-05-23
|
|
0053
|
OTHER
|
Tracheostomy With Mv >96 Hours Without Extensive Procedure
|
18
|
18
|
—
|
—
|
$36,595.34
|
$231,068.88
|
$75,487.99
|
2026-05-23
|
|
4404
|
OTHER
|
Screw Bone Lcp 3.5/6x20mm Compress Lck Full Thread Self-tap Lo-pro Cortic Ss 2.5…
|
18
|
18
|
$82.55
|
$82.55
|
$23,066.34
|
$201,533.76
|
$74,867.34
|
2026-05-23
|
|
0063
|
OTHER
|
Pancreas Transplant
|
16
|
16
|
—
|
—
|
$18,768.71
|
$98,064.32
|
$74,415.20
|
2026-05-23
|
|
5931
|
OTHER
|
Screw Bone Unilock 3x14mm Lck Self-drilling/tapping Ti Sternal F/intramedullary …
|
20
|
20
|
$695.00
|
$695.00
|
$959.39
|
$186,090.56
|
$73,391.31
|
2026-05-23
|
|
0072
|
OTHER
|
Allogeneic Bone Marrow Transplant
|
12
|
12
|
—
|
—
|
$39,874.80
|
$74,160.45
|
$70,032.26
|
2026-05-23
|
|
0084
|
OTHER
|
Autologous Bone Marrow Transplant
|
12
|
12
|
—
|
—
|
$47,430.02
|
$104,143.50
|
$69,545.52
|
2026-05-23
|
|
6093
|
OTHER
|
Neonate Birth Weight 1500-2499 Grams With Major Procedure
|
20
|
20
|
—
|
—
|
$41,074.04
|
$367,162.08
|
$68,707.45
|
2026-05-23
|
|
6022
|
OTHER
|
Screw Bone Lcp 7.3/8.2x80mm Cannul Compress Lck 32mm Thread Self-drilling/tappin…
|
20
|
20
|
$619.93
|
$619.93
|
$29,647.89
|
$424,977.56
|
$68,500.56
|
2026-05-23
|
|
1634
|
OTHER
|
Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis
|
20
|
20
|
—
|
—
|
$44,521.63
|
$173,639.48
|
$66,904.17
|
2026-05-23
|
|
0042
|
OTHER
|
Tracheostomy With Mv >96 Hours With Extensive Procedure
|
18
|
18
|
—
|
—
|
$28,338.65
|
$198,831.20
|
$65,796.77
|
2026-05-23
|
|
2994
|
OTHER
|
Guidepin Ortho 2.4mm 9in Partial Thread Trocar Tip F/cannulated Screw System
|
11
|
11
|
$44.43
|
$44.43
|
$35,226.85
|
$65,554.53
|
$65,554.53
|
2026-05-23
|
|
0092
|
OTHER
|
Extracorporeal Membrane Oxygenation (ecmo)
|
14
|
14
|
—
|
—
|
$30,100.97
|
$65,534.97
|
$65,534.97
|
2026-05-23
|
|
6073
|
OTHER
|
Hook Spinal Veptr Ii Std Extend Vert Expand Ti Prox Thoracolum Rib Ns
|
20
|
20
|
$3,747.48
|
$3,747.48
|
$27,198.83
|
$419,089.84
|
$65,437.17
|
2026-05-23
|
|
0062
|
OTHER
|
Pancreas Transplant
|
16
|
16
|
—
|
—
|
$18,768.71
|
$78,470.76
|
$64,154.48
|
2026-05-23
|
|
216
|
OTHER
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
10
|
10
|
—
|
—
|
$26,101.40
|
$106,162.10
|
$63,833.23
|
2026-05-23
|
|
1784
|
OTHER
|
External Heart Assist Devices
|
16
|
16
|
—
|
—
|
$35,086.10
|
$75,025.49
|
$63,620.35
|
2026-05-23
|
|
6124
|
OTHER
|
Wire Bone Fixat 1.4mmx4in Kirschner Temp Dbl-end Diamond Point Ss Ns
|
20
|
20
|
$7.38
|
$7.38
|
$31,420.14
|
$370,057.68
|
$62,531.01
|
2026-05-23
|
|
6334
|
OTHER
|
Screw Bone Lcp 3.5/6x20mm Compress Lck Self-tap Var Ang Lo-pro Cortic Ss T15 Sta…
|
20
|
20
|
$93.73
|
$93.73
|
$22,183.40
|
$229,910.64
|
$62,367.00
|
2026-05-23
|
|
0071
|
OTHER
|
Allogeneic Bone Marrow Transplant
|
12
|
12
|
—
|
—
|
$37,896.05
|
$67,801.62
|
$61,820.83
|
2026-05-23
|
|
6214
|
OTHER
|
Neonate Birth Weight 2000-2499 Grams With Major Anomaly
|
20
|
20
|
—
|
—
|
$16,964.67
|
$233,288.84
|
$61,322.80
|
2026-05-23
|
|
850
|
OTHER
|
Procedure With Diagnosis Of Rehabilitation; Aftercare Or Other Contact With Heal…
|
10
|
10
|
—
|
—
|
$24,913.58
|
$101,330.90
|
$60,573.44
|
2026-05-23
|
|
1654
|
OTHER
|
Coronary Bypass With Ami Or Complex Principal Diagnosis
|
20
|
20
|
—
|
—
|
$32,085.49
|
$165,338.76
|
$60,106.32
|
2026-05-23
|
|
0012
|
OTHER
|
Liver Transplant And/or Intestinal Transplant
|
16
|
16
|
—
|
—
|
$19,121.77
|
$82,717.64
|
$59,311.88
|
2026-05-23
|
|
1674
|
OTHER
|
Expander Tissue Softspan 13.7x10.5cm 4-7cm Lo-pro 200-400ml Silicone Smooth Remo…
|
20
|
20
|
$1,625.00
|
$1,625.00
|
$36,965.29
|
$179,527.20
|
$58,892.85
|
2026-05-23
|
|
8413
|
OTHER
|
Screw Spinal Expedium 7x35mm Lck Fully/dual Lead Thread Polyaxial Self-tap 1-inn…
|
20
|
20
|
$2,000.00
|
$2,000.00
|
$37,472.09
|
$250,952.00
|
$57,332.56
|
2026-05-23
|
|
1834
|
OTHER
|
Drain Wound Blake Jackson-pratt 19fr 10mmx20cm Round 4-channel Flute Hubless W/1…
|
16
|
16
|
$260.53
|
$260.53
|
$31,578.27
|
$80,313.13
|
$57,258.84
|
2026-05-23
|
|
9104
|
OTHER
|
Plate Bone Lorenz Long 2/2-hole 1mm L-shaped Ti Silver F/2mm Screw Lt Cmf
|
20
|
20
|
$547.50
|
$547.50
|
$30,678.50
|
$176,728.12
|
$57,090.32
|
2026-05-23
|
|
6313
|
OTHER
|
Screw Bone Lcp 7.3/8.2x55mm Cannul Compress Lck 32mm Thread Self-drilling/tappin…
|
20
|
20
|
$687.83
|
$687.83
|
$18,108.55
|
$220,065.60
|
$55,991.95
|
2026-05-23
|
|
1623
|
OTHER
|
Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis
|
20
|
20
|
—
|
—
|
$33,579.57
|
$127,695.96
|
$55,929.51
|
2026-05-23
|
|
456
|
OTHER
|
Spinal Fus Exc Cerv With Spinal Curv/malig/infec Or Ext Fus With Comorbity
|
10
|
10
|
—
|
—
|
$20,610.45
|
$93,161.20
|
$55,867.04
|
2026-05-23
|
|
6804
|
OTHER
|
Screw Bone Lcp 2.7/5x24mm Compress Lck Full Thread Self-tap Cortic Ss 2.5mm Sm H…
|
20
|
20
|
$133.00
|
$133.00
|
$31,706.26
|
$237,053.12
|
$55,492.42
|
2026-05-23
|
|
6084
|
OTHER
|
Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition
|
20
|
20
|
—
|
—
|
$25,101.64
|
$426,135.80
|
$54,436.93
|
2026-05-23
|
|
6254
|
OTHER
|
Neonate Birth Weight 2000-2499 Grams With Other Significant Condition
|
20
|
20
|
—
|
—
|
$11,025.62
|
$194,487.80
|
$54,357.94
|
2026-05-23
|
|
9114
|
OTHER
|
Plate Bone Lorenz 8-hole 0.6mm Curve Ti Silver F/1.5mm Screw Orbital Ns
|
20
|
20
|
$745.00
|
$745.00
|
$33,104.61
|
$162,925.76
|
$54,301.52
|
2026-05-23
|
|
3044
|
OTHER
|
Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back
|
20
|
20
|
—
|
—
|
$21,748.64
|
$171,419.52
|
$53,661.31
|
2026-05-23
|
|
1794
|
OTHER
|
Defibrillator Implants
|
16
|
16
|
—
|
—
|
$29,166.21
|
$67,181.92
|
$52,885.68
|
2026-05-23
|
|
3033
|
OTHER
|
Suture Ethibond Excel 4-0 Sh Taper Point Braided Green 26in
|
20
|
20
|
$30.73
|
$30.73
|
$16,138.93
|
$82,717.64
|
$52,805.18
|
2026-05-23
|
|
1603
|
OTHER
|
Guidewire Ortho 1.25mm 150mm Thread Single-end Trocar Point Cobalt Ss F/3.5/4mm …
|
20
|
20
|
$81.88
|
$81.88
|
$35,596.45
|
$100,284.28
|
$52,732.96
|
2026-05-23
|
|
0914
|
OTHER
|
Other Major Head And Neck Procedures
|
18
|
18
|
—
|
—
|
$30,849.86
|
$185,221.88
|
$52,577.23
|
2026-05-23
|
|
6144
|
OTHER
|
Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition
|
20
|
20
|
—
|
—
|
$25,703.10
|
$351,429.32
|
$52,478.68
|
2026-05-23
|
|
1664
|
OTHER
|
Coronary Bypass Without Ami Or Complex Principal Diagnosis
|
20
|
20
|
—
|
—
|
$30,891.52
|
$155,879.80
|
$52,387.92
|
2026-05-23
|
|
0011
|
OTHER
|
Liver Transplant And/or Intestinal Transplant
|
16
|
16
|
—
|
—
|
$19,121.77
|
$73,644.76
|
$52,107.04
|
2026-05-23
|
|
8504
|
OTHER
|
Screw Spinal Expedium 6x80mm Lck Dual Lead Polyaxial Thread 1-innie Pedicle Ss T…
|
20
|
20
|
$1,750.00
|
$1,750.00
|
$23,565.11
|
$303,941.48
|
$51,769.25
|
2026-05-23
|
|
0214
|
OTHER
|
Open Craniotomy Except Trauma
|
18
|
18
|
—
|
—
|
$36,898.91
|
$178,562.00
|
$51,696.28
|
2026-05-23
|
|
1783
|
OTHER
|
External Heart Assist Devices
|
16
|
16
|
—
|
—
|
$28,310.24
|
$71,166.19
|
$51,334.42
|
2026-05-23
|
|
2993
|
OTHER
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical
|
11
|
11
|
—
|
—
|
$27,546.01
|
$51,260.69
|
$51,260.69
|
2026-05-23
|
|
6033
|
OTHER
|
Nail IM Fassier-duval 4.8mm Std 409mm Long Thread Femur Ss F/osteogenesis Imperf…
|
20
|
20
|
$6,875.00
|
$6,875.00
|
$34,534.04
|
$467,542.88
|
$51,136.56
|
2026-05-23
|
|
4403
|
OTHER
|
Screw Bone Lcp 3.5/6x18mm Compress Lck Full Thread Self-tap Lo-pro Cortic Ss 2.5…
|
18
|
18
|
$82.55
|
$82.55
|
$23,066.34
|
$109,069.67
|
$50,901.09
|
2026-05-23
|
|
9124
|
OTHER
|
Plate Bone Lorenz Reg 49mm 8-hole Ti Silver F/2mm Screw Cranfac
|
20
|
20
|
$1,207.50
|
$1,207.50
|
$29,864.34
|
$171,998.64
|
$50,488.83
|
2026-05-23
|
|
0052
|
OTHER
|
Tracheostomy With Mv >96 Hours Without Extensive Procedure
|
18
|
18
|
—
|
—
|
$22,016.83
|
$187,924.44
|
$50,334.60
|
2026-05-23
|
|
3004
|
OTHER
|
Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical
|
11
|
11
|
—
|
—
|
$26,874.06
|
$50,010.36
|
$50,010.36
|
2026-05-23
|
|
6021
|
OTHER
|
Screw Bone Lcp 4.5/6.5x64mm Cannul Compress Lck Full Thread Self-drilling/tappin…
|
20
|
20
|
$508.00
|
$508.00
|
$8,454.66
|
$242,554.76
|
$49,689.04
|
2026-05-23
|
|
6904
|
OTHER
|
Acute Leukemia
|
20
|
20
|
—
|
—
|
$34,213.44
|
$239,948.72
|
$49,603.36
|
2026-05-23
|
|
0083
|
OTHER
|
Autologous Bone Marrow Transplant
|
12
|
12
|
—
|
—
|
$32,362.74
|
$51,342.71
|
$48,949.61
|
2026-05-23
|
|
6072
|
OTHER
|
Nail IM Expert 9x360mm 120deg Helical Flute Cannul Lck Antegrad Reconstruct Rt L…
|
20
|
20
|
$4,359.18
|
$4,359.18
|
$20,549.65
|
$345,734.64
|
$48,874.38
|
2026-05-23
|
|
2604
|
OTHER
|
Major Pancreas, Liver And Shunt Procedures
|
20
|
20
|
—
|
—
|
$21,217.95
|
$210,510.12
|
$48,234.16
|
2026-05-23
|
|
1633
|
OTHER
|
Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis
|
20
|
20
|
—
|
—
|
$27,770.14
|
$89,281.00
|
$48,097.24
|
2026-05-23
|
|
0091
|
OTHER
|
Extracorporeal Membrane Oxygenation (ecmo)
|
14
|
14
|
—
|
—
|
$24,704.39
|
$63,339.11
|
$47,989.66
|
2026-05-23
|
|
1694
|
OTHER
|
Major Abdominal Vascular Procedures
|
20
|
20
|
—
|
—
|
$30,113.94
|
$156,941.52
|
$47,774.50
|
2026-05-23
|
|
0234
|
OTHER
|
Spinal Procedures
|
18
|
18
|
—
|
—
|
$30,041.01
|
$195,742.56
|
$47,136.55
|
2026-05-23
|
|
7404
|
OTHER
|
Hook Spinal Cd Horizon Solera Lg Narrow Blade Ti Medial F/5.5mm Rod Ns
|
18
|
18
|
$1,450.00
|
$1,450.00
|
$14,670.85
|
$233,771.44
|
$47,007.90
|
2026-05-23
|
|
6083
|
OTHER
|
Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition
|
20
|
20
|
—
|
—
|
$21,667.83
|
$371,312.44
|
$46,990.60
|
2026-05-23
|
|
1204
|
OTHER
|
Suture Nylon Ethilon 4-0 18in 3/8 Circ Fs-2 Revers Cut Pliabilized Black 1 Stran…
|
20
|
20
|
$4.78
|
$4.78
|
$27,910.40
|
$187,152.28
|
$46,501.60
|
2026-05-23
|
|
6814
|
OTHER
|
Screw Bone Lcp 3.5/6x50mm Compress Lck Full Thread Self-tap Lo-pro Cortic Ss 2.5…
|
20
|
20
|
$82.55
|
$82.55
|
$27,822.30
|
$242,361.72
|
$46,426.37
|
2026-05-23
|
|
3124
|
OTHER
|
Dressing Biological E-z Derm Adherent 3x4in Patch Porcine Xenograft Strl 10/ca
|
20
|
20
|
$653.60
|
$653.60
|
$30,267.20
|
$317,068.20
|
$46,339.10
|
2026-05-23
|
|
1304
|
OTHER
|
Respiratory System Diagnosis With Ventilator Support > 96 Hours
|
20
|
20
|
—
|
—
|
$25,514.51
|
$189,854.84
|
$45,954.67
|
2026-05-23
|
|
2204
|
OTHER
|
Guidewire Ortho 1.25mm 150mm Non-threaded Cobalt Ss Ns
|
20
|
20
|
$76.43
|
$76.43
|
$25,839.80
|
$203,174.60
|
$45,803.46
|
2026-05-23
|
|
6954
|
OTHER
|
Screw Bone Pro-pak 4.5x36mm Cannul Compress Headless 14mm Long/dual Lead Thread
|
18
|
18
|
$962.15
|
$962.15
|
$30,743.15
|
$60,945.25
|
$45,653.75
|
2026-05-23
|
|
0041
|
OTHER
|
Tracheostomy With Mv >96 Hours With Extensive Procedure
|
18
|
18
|
—
|
—
|
$28,338.65
|
$221,030.80
|
$45,522.10
|
2026-05-23
|
|
0204
|
OTHER
|
Open Craniotomy For Trauma
|
18
|
18
|
—
|
—
|
$30,400.78
|
$163,022.28
|
$45,163.25
|
2026-05-23
|
|
0894
|
OTHER
|
Major Cranial Or Facial Bone Procedures
|
18
|
18
|
—
|
—
|
$30,913.25
|
$157,713.68
|
$45,136.16
|
2026-05-23
|
|
3614
|
OTHER
|
Skin Graft For Skin And Subcutaneous Tissue Diagnoses
|
20
|
20
|
—
|
—
|
$21,932.34
|
$275,757.64
|
$45,085.76
|
2026-05-23
|
|
4284
|
OTHER
|
Catheter Foley 2 Way Standard Tip Sterile Cysto-care 18fr 15ml
|
11
|
11
|
$7.85
|
$7.85
|
$24,198.22
|
$45,030.84
|
$45,030.84
|
2026-05-23
|
|
2614
|
OTHER
|
Major Biliary Tract Procedures
|
20
|
20
|
—
|
—
|
$22,639.05
|
$192,460.88
|
$44,849.53
|
2026-05-23
|
|
9504
|
OTHER
|
Extensive O.r. Procedure Unrelated To Principal Diagnosis
|
20
|
20
|
—
|
—
|
$26,496.12
|
$218,231.72
|
$44,842.76
|
2026-05-23
|
|
6092
|
OTHER
|
Neonate Birth Weight 1500-2499 Grams With Major Procedure
|
20
|
20
|
—
|
—
|
$22,605.71
|
$213,405.72
|
$44,832.23
|
2026-05-23
|
|
1653
|
OTHER
|
Coronary Bypass With Ami Or Complex Principal Diagnosis
|
20
|
20
|
—
|
—
|
$24,017.48
|
$101,635.56
|
$44,665.97
|
2026-05-23
|
|
0061
|
OTHER
|
Pancreas Transplant
|
16
|
16
|
—
|
—
|
$18,768.71
|
$59,202.80
|
$44,560.65
|
2026-05-23
|
|
6234
|
OTHER
|
Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection
|
20
|
20
|
—
|
—
|
$12,243.51
|
$264,271.76
|
$43,806.08
|
2026-05-23
|
|
0274
|
OTHER
|
Other Open Craniotomy
|
14
|
14
|
—
|
—
|
$30,456.38
|
$74,051.74
|
$43,508.92
|
2026-05-23
|
|
6302
|
OTHER
|
Screw Bone Lcp 4/5x18mm Cannul Compress Lck 1/2 Long Thread Self-drilling/tappin…
|
20
|
20
|
$597.50
|
$597.50
|
$20,507.04
|
$97,175.91
|
$43,402.10
|
2026-05-23
|
|
4402
|
OTHER
|
Screw Bone Lcp 3.5/6x16mm Compress Lck Full Thread Self-tap Lo-pro Cortic Ss 2.5…
|
18
|
18
|
$82.55
|
$82.55
|
$12,656.92
|
$88,292.67
|
$43,378.02
|
2026-05-23
|
|
6123
|
OTHER
|
Wire Bone Fixat 0.9mmx4in Kirschner Temp Dbl-end Diamond Point Ss Ns
|
20
|
20
|
$7.38
|
$7.38
|
$28,541.96
|
$313,593.48
|
$43,302.04
|
2026-05-23
|
|
0924
|
OTHER
|
Facial Bone Procedures Except Major Cranial Or Facial Bone Procedures
|
18
|
18
|
—
|
—
|
$20,231.03
|
$136,189.72
|
$43,025.94
|
2026-05-23
|
|
4014
|
OTHER
|
Adrenal Procedures
|
20
|
20
|
—
|
—
|
$8,416.62
|
$236,667.04
|
$42,674.61
|
2026-05-23
|
|
5204
|
OTHER
|
Other GYN Procedures For Malignancy
|
11
|
11
|
—
|
—
|
$22,847.54
|
$42,517.38
|
$42,517.38
|
2026-05-23
|
|
6133
|
OTHER
|
Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection
|
20
|
20
|
—
|
—
|
$17,457.27
|
$275,468.08
|
$42,500.83
|
2026-05-23
|
|
6113
|
OTHER
|
Neonate Birth Weight 1500-1999 Grams With Major Anomaly
|
20
|
20
|
—
|
—
|
$16,527.30
|
$302,397.16
|
$42,333.82
|
2026-05-23
|
|
1622
|
OTHER
|
Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis
|
20
|
20
|
—
|
—
|
$26,088.14
|
$88,701.88
|
$42,282.66
|
2026-05-23
|
|
4414
|
OTHER
|
Screw Spinal Expedium 6x40mm Lck Fully/dual Lead Thread Polyaxial Self-tap 1-inn…
|
20
|
20
|
$1,976.25
|
$1,976.25
|
$25,699.48
|
$212,054.44
|
$42,087.82
|
2026-05-23
|
|
1782
|
OTHER
|
External Heart Assist Devices
|
16
|
16
|
—
|
—
|
$23,051.36
|
$69,217.32
|
$41,797.42
|
2026-05-23
|
|
6032
|
OTHER
|
Nail IM Fassier-duval 4mm Std 333mm Short Thread Tibial Humeral Ss F/osteogenesi…
|
20
|
20
|
$6,500.00
|
$6,500.00
|
$21,142.08
|
$349,402.40
|
$41,723.70
|
2026-05-23
|
|
1833
|
OTHER
|
Percutaneous Structural Cardiac Procedures
|
16
|
16
|
—
|
—
|
$22,946.06
|
$51,658.22
|
$41,607.84
|
2026-05-23
|
|
5114
|
OTHER
|
Uterine And Adnexa Procedures For Ovarian And Adnexal Malignancy
|
20
|
20
|
—
|
—
|
$13,105.33
|
$171,612.56
|
$40,727.64
|
2026-05-23
|
|
4401
|
OTHER
|
Screw Bone Lcp 3.5/6x14mm Compress Lck Full Thread Self-tap Lo-pro Cortic Ss 2.5…
|
18
|
18
|
$82.55
|
$82.55
|
$12,656.92
|
$53,486.23
|
$40,594.49
|
2026-05-23
|
|
6224
|
OTHER
|
Neonate Birth Weight 2000-2499 Grams With Respiratory Distress Syndrome Or Other…
|
20
|
20
|
—
|
—
|
$25,783.70
|
$220,548.20
|
$40,550.10
|
2026-05-23
|
|
3214
|
OTHER
|
Drain Wound Hemovac 15frx3/16in Round 4-channel Full Flute F/closed Suction W/tr…
|
20
|
20
|
$32.70
|
$32.70
|
$23,034.16
|
$167,944.80
|
$40,422.96
|
2026-05-23
|
|
0224
|
OTHER
|
Ventricular Shunt Procedures
|
18
|
18
|
—
|
—
|
$27,282.76
|
$176,535.08
|
$40,396.63
|
2026-05-23
|
|
7924
|
OTHER
|
Kit Catheter Intrathecal Ascenda Indura 4-layer Sutureless Pump Conn 2-attached …
|
16
|
16
|
$500.00
|
$500.00
|
$27,122.20
|
$173,460.81
|
$40,276.26
|
2026-05-23
|
|
1793
|
OTHER
|
Defibrillator Implants
|
16
|
16
|
—
|
—
|
$22,211.55
|
$52,571.54
|
$40,274.76
|
2026-05-23
|
|
8423
|
OTHER
|
Hook Spinal Expedium 10mm Lt Offst Ss Pedicle F/5.5mm Rod Ns
|
20
|
20
|
$1,375.00
|
$1,375.00
|
$22,636.41
|
$167,462.20
|
$39,867.00
|
2026-05-23
|
|
6514
|
OTHER
|
Other Procedures Of Blood And Blood-forming Organs
|
20
|
20
|
—
|
—
|
$10,513.23
|
$234,157.52
|
$39,860.23
|
2026-05-23
|
|
8633
|
OTHER
|
Screw Bone Pediloc 3.5x65mm Cannul Lck Full Thread Self-tap Cortic Ss T15 Hexalo…
|
20
|
20
|
$813.45
|
$813.45
|
$21,744.47
|
$267,553.44
|
$39,715.79
|
2026-05-23
|
|
3043
|
OTHER
|
Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back
|
20
|
20
|
—
|
—
|
$23,145.20
|
$71,038.72
|
$39,558.56
|
2026-05-23
|
|
0304
|
OTHER
|
Percutaneous Intracranial And Extracranial Vascular Procedures
|
14
|
14
|
—
|
—
|
$30,490.78
|
$54,302.04
|
$39,435.18
|
2026-05-23
|
|
1704
|
OTHER
|
Guidewire Ortho 2.8mm 450mm Thread Trocar Tip Cobalt Ss F/6.5/7.3mm Cannul Screw…
|
20
|
20
|
$215.63
|
$215.63
|
$13,954.47
|
$159,064.96
|
$39,405.09
|
2026-05-23
|
|
1814
|
OTHER
|
Lower Extremity Vascular Procedures
|
18
|
18
|
—
|
—
|
$26,476.83
|
$63,200.39
|
$39,317.82
|
2026-05-23
|
|
1663
|
OTHER
|
Coronary Bypass Without Ami Or Complex Principal Diagnosis
|
20
|
20
|
—
|
—
|
$21,047.59
|
$82,621.12
|
$39,312.55
|
2026-05-23
|
|
457
|
OTHER
|
Spinal Fus Exc Cerv With Spinal Curv/malig/infec Or Ext Fus With Complication
|
10
|
10
|
—
|
—
|
$15,522.21
|
$63,133.40
|
$39,193.42
|
2026-05-23
|
|
1214
|
OTHER
|
Other Respiratory And Chest Procedures
|
20
|
20
|
—
|
—
|
$22,983.07
|
$186,959.24
|
$38,978.53
|
2026-05-23
|
|
5124
|
OTHER
|
Tray Needle Epidural Tuohy Contin Anesth Perifix 18ga 2in Ped Wing W/25ga Ndl 20…
|
20
|
20
|
$71.80
|
$71.80
|
$9,493.89
|
$157,327.60
|
$38,962.73
|
2026-05-23
|
|
2304
|
OTHER
|
Major Small Bowel Procedures
|
16
|
16
|
—
|
—
|
$26,091.06
|
$74,831.84
|
$38,744.56
|
2026-05-23
|
|
1602
|
OTHER
|
Major Cardiothoracic Repair Of Heart Anomaly
|
20
|
20
|
—
|
—
|
$23,642.28
|
$59,552.84
|
$38,533.01
|
2026-05-23
|
|
0082
|
OTHER
|
Autologous Bone Marrow Transplant
|
12
|
12
|
—
|
—
|
$17,928.67
|
$42,760.27
|
$38,419.57
|
2026-05-23
|
|
3032
|
OTHER
|
Suture Ethibond Excel 3-0 18in 1/2 Circ Sh Ctrl Release Taper Point Green 8 Stra…
|
20
|
20
|
$28.28
|
$28.28
|
$24,011.60
|
$55,112.92
|
$38,405.27
|
2026-05-23
|
|
4054
|
OTHER
|
Other Procedures For Endocrine, Nutritional And Metabolic Disorders
|
20
|
20
|
—
|
—
|
$21,826.20
|
$205,684.12
|
$38,310.48
|
2026-05-23
|
|
2644
|
OTHER
|
Kit Instrument Maxillofacial Splint Planning Pt Specific Proplan Trumatch F/orth…
|
20
|
20
|
$12,140.00
|
$12,140.00
|
$17,068.40
|
$207,324.96
|
$38,235.25
|
2026-05-23
|
|
7104
|
OTHER
|
Screw Spinal Expedium 4.35x25mm Lck Dual Lead Polyaxial Thread 1-innie Pedicle S…
|
20
|
20
|
$1,750.00
|
$1,750.00
|
$19,224.50
|
$175,666.40
|
$38,097.58
|
2026-05-23
|
|
1764
|
OTHER
|
Insertion, Revision And Replacements Of Pacemaker And Other Cardiac Devices
|
20
|
20
|
—
|
—
|
$26,444.33
|
$128,950.72
|
$37,942.60
|
2026-05-23
|
|
4044
|
OTHER
|
Thyroid, Parathyroid And Thyroglossal Procedures
|
20
|
20
|
—
|
—
|
$13,169.08
|
$158,099.76
|
$37,852.33
|
2026-05-23
|
|
6344
|
OTHER
|
Endcap Spinal Veptr Ii Sm Hook Extend Ti Thoracolum Rib Ns
|
20
|
20
|
$3,507.75
|
$3,507.75
|
$14,425.93
|
$215,529.16
|
$37,829.76
|
2026-05-23
|
|
4034
|
OTHER
|
Procedures For Obesity
|
20
|
20
|
—
|
—
|
$21,755.51
|
$180,202.84
|
$37,746.25
|
2026-05-23
|
|
2992
|
OTHER
|
Kit Distraction Patient Specific Instrument And Planning Sd900.006
|
13
|
13
|
$11,455.00
|
$11,455.00
|
$19,907.06
|
$37,701.11
|
$37,701.11
|
2026-05-23
|
|
1781
|
OTHER
|
External Heart Assist Devices
|
16
|
16
|
—
|
—
|
$20,746.18
|
$55,551.85
|
$37,617.61
|
2026-05-23
|
|
8412
|
OTHER
|
Screw Spinal Expedium 6x55mm Lck Fully/dual Lead Thread Polyaxial Self-tap 1-inn…
|
20
|
20
|
$2,000.00
|
$2,000.00
|
$11,033.03
|
$141,813.35
|
$37,566.45
|
2026-05-23
|
|
8411
|
OTHER
|
Screw Spinal Expedium 5x50mm Polyaxial 1-innie Pedicle Ss Thoracolum Extend Tab …
|
20
|
20
|
$2,000.00
|
$2,000.00
|
$9,713.86
|
$212,344.00
|
$37,566.45
|
2026-05-23
|
|
1673
|
OTHER
|
Expander Tissue Softspan 3.6x4.1cm 3.6-4cm Lo-pro 30-60ml Silicone Smooth Lg Rem…
|
20
|
20
|
$1,750.00
|
$1,750.00
|
$21,910.76
|
$88,315.80
|
$37,382.13
|
2026-05-23
|
|
7114
|
OTHER
|
Screw Spinal Expedium 4.35x35mm Lck Polyaxial Thread Dual Lead Pedicle Ti Taper …
|
20
|
20
|
$1,750.00
|
$1,750.00
|
$22,477.93
|
$201,533.76
|
$37,142.90
|
2026-05-23
|
|
0294
|
OTHER
|
Other Percutaneous Intracranial Procedures
|
14
|
14
|
—
|
—
|
$22,425.83
|
$58,986.76
|
$36,893.89
|
2026-05-23
|
|
4844
|
OTHER
|
Other Male Reproductive System And Related Procedures
|
20
|
20
|
—
|
—
|
$9,173.43
|
$152,405.08
|
$36,890.88
|
2026-05-23
|
|
9103
|
OTHER
|
Plate Bone Lorenz Long 2/2-hole 1mm L-shaped Ti Silver F/2mm Screw Lt Maxillofac…
|
20
|
20
|
$547.50
|
$547.50
|
$23,360.86
|
$102,021.64
|
$36,853.26
|
2026-05-23
|
|
0264
|
OTHER
|
Other Nervous System And Related Procedures
|
18
|
18
|
—
|
—
|
$26,383.32
|
$203,078.08
|
$36,665.19
|
2026-05-23
|
|
0213
|
OTHER
|
Open Craniotomy Except Trauma
|
18
|
18
|
—
|
—
|
$23,277.57
|
$100,187.76
|
$36,380.81
|
2026-05-23
|
|
1754
|
OTHER
|
Percutaneous Cardiac Intervention Without Ami
|
20
|
20
|
—
|
—
|
$21,521.34
|
$100,187.76
|
$36,270.23
|
2026-05-23
|
|
1652
|
OTHER
|
Coronary Bypass With Ami Or Complex Principal Diagnosis
|
20
|
20
|
—
|
—
|
$20,295.00
|
$78,953.36
|
$36,015.19
|
2026-05-23
|
|
6091
|
OTHER
|
Neonate Birth Weight 1500-2499 Grams With Major Procedure
|
20
|
20
|
—
|
—
|
$21,466.43
|
$186,669.68
|
$36,012.18
|
2026-05-23
|
|
4474
|
OTHER
|
Screw Bone Eight-plate 4.5x32mm Cannul Solid Cortic Ti Blue F/guided Growth Syst…
|
20
|
20
|
$329.00
|
$329.00
|
$20,048.68
|
$172,481.24
|
$35,924.92
|
2026-05-23
|
|
4424
|
OTHER
|
Screw Spinal Expedium 6x45mm Lck Fully/dual Lead Thread Self-tap Uniplanar Pedic…
|
20
|
20
|
$1,750.00
|
$1,750.00
|
$20,386.13
|
$161,381.44
|
$35,812.07
|
2026-05-23
|
|
1632
|
OTHER
|
Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis
|
20
|
20
|
—
|
—
|
$21,333.05
|
$62,834.52
|
$35,497.61
|
2026-05-23
|
|
6504
|
OTHER
|
Rod Extern Fixat Ilizarov 80mm Thread Slot Ss Foot Ankle F/small Bone System Ns
|
20
|
20
|
$719.00
|
$719.00
|
$15,104.17
|
$150,957.28
|
$35,481.06
|
2026-05-23
|
|
6143
|
OTHER
|
Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition
|
20
|
20
|
—
|
—
|
$18,168.52
|
$275,371.56
|
$35,443.44
|
2026-05-23
|
|
1621
|
OTHER
|
Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis
|
20
|
20
|
—
|
—
|
$18,675.77
|
$77,312.52
|
$35,232.79
|
2026-05-23
|
|
9514
|
OTHER
|
Hook Spinal Expedium Isola 8mm Close Wide Blade Ti Pedicle F/5.5mm Rod Ns
|
20
|
20
|
$1,450.00
|
$1,450.00
|
$20,396.38
|
$190,530.48
|
$35,161.32
|
2026-05-23
|
|
0913
|
OTHER
|
Other Major Head And Neck Procedures
|
18
|
18
|
—
|
—
|
$21,141.13
|
$92,659.20
|
$35,131.23
|
2026-05-23
|
|
6071
|
OTHER
|
Screw Bone Expert 4/3.3x58mm Cannul Compress Lck Fully/dual Lead Thread Self-tap…
|
20
|
20
|
$490.28
|
$490.28
|
$13,671.36
|
$242,168.68
|
$34,939.39
|
2026-05-23
|
|
1303
|
OTHER
|
Wire Bone Fixat 1.6x150mm Kirschner Temp Trocar Point Ss Ns F/hand Surg
|
20
|
20
|
$22.98
|
$22.98
|
$22,762.56
|
$139,857.48
|
$34,668.56
|
2026-05-23
|
|
0434
|
OTHER
|
Multiple Sclerosis, Other Demyelinating Disease And Inflammatory Neuropathies
|
18
|
18
|
—
|
—
|
$18,648.21
|
$159,354.52
|
$34,621.17
|
2026-05-23
|
|
5144
|
OTHER
|
Female Reproductive System Reconstructive Procedures
|
20
|
20
|
—
|
—
|
$5,918.07
|
$150,378.16
|
$34,445.13
|
2026-05-23
|
|
2314
|
OTHER
|
Major Large Bowel Procedures
|
16
|
16
|
—
|
—
|
$21,999.93
|
$57,002.17
|
$34,202.13
|
2026-05-23
|
|
1824
|
OTHER
|
Other Peripheral Vascular And Related Procedures
|
18
|
18
|
—
|
—
|
$22,906.44
|
$46,706.33
|
$34,016.31
|
2026-05-23
|
|
2224
|
OTHER
|
Other Stomach, Esophageal And Duodenal Procedures
|
20
|
20
|
—
|
—
|
$21,106.66
|
$175,762.92
|
$33,971.17
|
2026-05-23
|
|
2294
|
OTHER
|
Other Digestive System And Abdominal Procedures
|
20
|
20
|
—
|
—
|
$17,043.38
|
$169,875.20
|
$33,726.68
|
2026-05-23
|
|
5184
|
OTHER
|
Other Female Reproductive System And Related Procedures
|
20
|
20
|
—
|
—
|
$10,454.09
|
$176,438.56
|
$33,672.51
|
2026-05-23
|
|
0893
|
OTHER
|
Major Cranial Or Facial Bone Procedures
|
18
|
18
|
—
|
—
|
$21,868.37
|
$84,648.04
|
$33,656.71
|
2026-05-23
|
|
4444
|
OTHER
|
Screw Spinal Expedium 6x30mm Lck Fully/dual Lead Thread Polyaxial Self-tap 1-inn…
|
20
|
20
|
$1,750.00
|
$1,750.00
|
$13,903.07
|
$156,072.84
|
$33,642.42
|
2026-05-23
|
|
6903
|
OTHER
|
Acute Leukemia
|
20
|
20
|
—
|
—
|
$20,590.20
|
$141,112.24
|
$33,507.00
|
2026-05-23
|
|
4834
|
OTHER
|
Penis, Testes And Scrotal Procedures
|
20
|
20
|
—
|
—
|
$12,308.69
|
$190,144.40
|
$33,488.95
|
2026-05-23
|
|
1693
|
OTHER
|
Suture Polysorb 4-0 30in 1/2 Circ Cv-22 Taper Point Undyed Gl-884 Coat Braid Lac…
|
20
|
20
|
$31.85
|
$31.85
|
$20,115.76
|
$86,771.48
|
$33,394.91
|
2026-05-23
|
|
1832
|
OTHER
|
Percutaneous Structural Cardiac Procedures
|
16
|
16
|
—
|
—
|
$18,394.07
|
$42,688.45
|
$33,352.03
|
2026-05-23
|
|
3134
|
OTHER
|
Knee And Lower Leg Procedures Except Foot
|
20
|
20
|
—
|
—
|
$19,751.84
|
$160,223.20
|
$33,302.37
|
2026-05-23
|
|
1792
|
OTHER
|
Defibrillator Implants
|
16
|
16
|
—
|
—
|
$18,364.36
|
$47,279.78
|
$33,298.61
|
2026-05-23
|
|
3031
|
OTHER
|
Suture Deknatel Tevdek 4-0 30in 1/2 Circ T-3 Dbl-arm Taper Needle Point Green 7-…
|
20
|
20
|
$8.73
|
$8.73
|
$22,117.72
|
$51,481.05
|
$33,291.09
|
2026-05-23
|
|
3094
|
OTHER
|
Other Significant Hip And Femur Surgery
|
20
|
20
|
—
|
—
|
$18,273.13
|
$182,133.24
|
$33,217.36
|
2026-05-23
|
|
5194
|
OTHER
|
Uterine And Adnexa Procedures For Leiomyoma
|
20
|
20
|
—
|
—
|
$13,225.43
|
$143,332.20
|
$32,977.38
|
2026-05-23
|
|
6233
|
OTHER
|
Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection
|
20
|
20
|
—
|
—
|
$12,243.51
|
$180,685.44
|
$32,946.53
|
2026-05-23
|
|
5134
|
OTHER
|
Uterine And Adnexa Procedures For Non-malignancy Except Leiomyoma
|
20
|
20
|
—
|
—
|
$11,042.51
|
$145,552.16
|
$32,858.51
|
2026-05-23
|
|
3154
|
OTHER
|
Shoulder, Upper Arm And Forearm Procedures Except Joint Replacement
|
20
|
20
|
—
|
—
|
$19,010.72
|
$142,173.96
|
$32,711.06
|
2026-05-23
|
|
458
|
OTHER
|
Spinal Fus Exc Cerv With Spinal Curv/malig/infec Or Ext Fus Without Complication…
|
10
|
10
|
—
|
—
|
$11,678.03
|
$47,498.00
|
$32,672.65
|
2026-05-23
|
|
3254
|
OTHER
|
Non-elective Or Complex Knee Joint Replacement
|
16
|
16
|
—
|
—
|
$21,971.75
|
$56,175.38
|
$32,665.17
|
2026-05-23
|
|
0984
|
OTHER
|
Other Ear, Nose, Mouth, Throat, Craniofacial, And Neck Procedures
|
18
|
18
|
—
|
—
|
$19,487.68
|
$141,015.72
|
$32,588.43
|
2026-05-23
|
|
2324
|
OTHER
|
Allograft Human Tissue Readigraft Cryoskin 1.5:1 Meshed 154sqcm Skin Cryopreserv…
|
16
|
16
|
$763.00
|
$763.00
|
$16,685.98
|
$65,558.54
|
$32,577.15
|
2026-05-23
|
|
2274
|
OTHER
|
Hernia Procedures Except Inguinal, Femoral And Umbilical
|
20
|
20
|
—
|
—
|
$18,237.68
|
$145,069.56
|
$32,557.59
|
2026-05-23
|
|
0233
|
OTHER
|
Spinal Procedures
|
18
|
18
|
—
|
—
|
$20,746.89
|
$99,705.16
|
$32,466.56
|
2026-05-23
|
|
6082
|
OTHER
|
Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition
|
20
|
20
|
—
|
—
|
$14,969.13
|
$289,946.08
|
$32,463.55
|
2026-05-23
|
|
2234
|
OTHER
|
Other Small And Large Bowel Procedures
|
20
|
20
|
—
|
—
|
$19,524.25
|
$189,854.84
|
$32,457.53
|
2026-05-23
|
|
1804
|
OTHER
|
Other Circulatory System Procedures
|
20
|
20
|
—
|
—
|
$18,633.87
|
$153,370.28
|
$32,323.62
|
2026-05-23
|
|
1651
|
OTHER
|
Coronary Bypass With Ami Or Complex Principal Diagnosis
|
20
|
20
|
—
|
—
|
$20,295.00
|
$65,247.52
|
$32,272.47
|
2026-05-23
|
|
6312
|
OTHER
|
Screw Bone Lcp 7.3/8.2x100mm Cannul Compress Lck 16mm Thread Self-drilling/tappi…
|
20
|
20
|
$797.50
|
$797.50
|
$7,555.22
|
$85,613.24
|
$32,252.91
|
2026-05-23
|
|
1744
|
OTHER
|
Rod Extern Fixat 4x100mm Connecting Carbon Fiber Dist Radial F/small Fixator Sys…
|
20
|
20
|
$115.50
|
$115.50
|
$15,253.24
|
$82,910.68
|
$32,237.11
|
2026-05-23
|
|
3054
|
OTHER
|
Amputation Of Lower Limb Except Toes
|
20
|
20
|
—
|
—
|
$18,109.96
|
$191,881.76
|
$32,055.05
|
2026-05-23
|
|
1714
|
OTHER
|
Permanent Cardiac Pacemaker Implant Without Ami, Heart Failure Or Shock
|
20
|
20
|
—
|
—
|
$22,272.54
|
$127,695.96
|
$32,044.52
|
2026-05-23
|
|
9524
|
OTHER
|
Hook Spinal Expedium Isola 8mm Open Wide Blade Ti Pedicle F/5.5mm Rod Ns
|
20
|
20
|
$1,450.00
|
$1,450.00
|
$19,158.30
|
$182,905.40
|
$32,025.71
|
2026-05-23
|
|
9123
|
OTHER
|
Plate Bone Lorenz Reg 32mm 8-hole Strt Ti Silver F/1.5mm Screw Midface Ns
|
20
|
20
|
$945.00
|
$945.00
|
$16,408.37
|
$95,168.72
|
$32,024.96
|
2026-05-23
|
|
0504
|
OTHER
|
Non-bacterial Infections Of Nervous System Except Viral Meningitis
|
18
|
18
|
—
|
—
|
$20,866.81
|
$150,474.68
|
$31,967.78
|
2026-05-23
|
|
2244
|
OTHER
|
Suture Silk Sofsilk 2-0 18in 3/8 Circ C-15 Revers Cut Black Ss-685g Wax Coat Bra…
|
20
|
20
|
$30.15
|
$30.15
|
$20,027.34
|
$168,523.92
|
$31,955.74
|
2026-05-23
|
|
4234
|
OTHER
|
Suture Monocryl 4-0 27in 1/2 Circ V-20 Sh Single-arm Taper Point Ethalloy Undyed…
|
20
|
20
|
$13.75
|
$13.75
|
$10,935.09
|
$145,166.08
|
$31,874.50
|
2026-05-23
|
|
7934
|
OTHER
|
Screw Bone Lcp 2.7/5x28mm Compress Lck Full Thread Self-tap Cortic Ss T8 Stardri…
|
16
|
16
|
$105.63
|
$105.63
|
$20,896.71
|
$45,133.13
|
$31,784.97
|
2026-05-23
|
|
1662
|
OTHER
|
Coronary Bypass Without Ami Or Complex Principal Diagnosis
|
20
|
20
|
—
|
—
|
$17,351.06
|
$59,070.24
|
$31,478.78
|
2026-05-23
|
|
0244
|
OTHER
|
Open Extracranial Vascular Procedures
|
18
|
18
|
—
|
—
|
$22,241.34
|
$131,363.72
|
$31,340.36
|
2026-05-23
|
|
9113
|
OTHER
|
Plate Bone Lorenz 6-hole Curve Ti Silver F/2mm Screw Orbital
|
20
|
20
|
$595.00
|
$595.00
|
$11,787.85
|
$76,829.92
|
$31,301.49
|
2026-05-23
|
|
6914
|
OTHER
|
Lymphoma, Myeloma And Non-acute Leukemia
|
20
|
20
|
—
|
—
|
$19,167.68
|
$153,080.72
|
$31,231.27
|
2026-05-23
|
|
0203
|
OTHER
|
Open Craniotomy For Trauma
|
18
|
18
|
—
|
—
|
$15,470.22
|
$95,940.88
|
$31,183.13
|
2026-05-23
|
|
3104
|
OTHER
|
Vertebral And Intervertebral Spinal Procedures Including Disc Procedures
|
20
|
20
|
—
|
—
|
$20,492.96
|
$156,651.96
|
$31,004.08
|
2026-05-23
|
|
3204
|
OTHER
|
Allograft Human Tissue 1:1 Meshed 103sqcm Cryopreserv Skin
|
20
|
20
|
$437.50
|
$437.50
|
$19,468.79
|
$177,982.88
|
$30,989.78
|
2026-05-23
|
|
0734
|
OTHER
|
Orbit And Eye Procedures
|
18
|
18
|
—
|
—
|
$19,187.42
|
$179,044.60
|
$30,955.93
|
2026-05-23
|
|
6213
|
OTHER
|
Neonate Birth Weight 2000-2499 Grams With Major Anomaly
|
20
|
20
|
—
|
—
|
$8,522.73
|
$205,105.00
|
$30,861.89
|
2026-05-23
|
|
4434
|
OTHER
|
Screw Spinal Expedium 5x30mm Lck Fully/dual Lead Thread Polyaxial Self-tap 1-inn…
|
20
|
20
|
$1,750.00
|
$1,750.00
|
$14,000.34
|
$169,103.04
|
$30,560.97
|
2026-05-23
|
|
0273
|
OTHER
|
Other Open Craniotomy
|
14
|
14
|
—
|
—
|
$16,964.20
|
$44,416.21
|
$30,553.44
|
2026-05-23
|
|
1774
|
OTHER
|
Cardiac Pacemaker And Defibrillator Revision Except Device Replacement
|
20
|
20
|
—
|
—
|
$17,571.47
|
$150,571.20
|
$30,359.35
|
2026-05-23
|
|
6122
|
OTHER
|
Wire Bone Fixat 0.7mmx4in Kirschner Temp Dbl-end Diamond Point Ss Ns
|
20
|
20
|
$7.38
|
$7.38
|
$15,361.67
|
$235,701.84
|
$30,323.99
|
2026-05-23
|
|
3213
|
OTHER
|
Spinal Fusion And Other Back And Neck Procedures Except For Disc Procedures
|
20
|
20
|
—
|
—
|
$18,214.13
|
$83,972.40
|
$30,290.14
|
2026-05-23
|
|
6803
|
OTHER
|
Screw Bone Lcp 2.7/5x22mm Compress Lck Full Thread Self-tap Cortic Ss 2.5mm Sm H…
|
20
|
20
|
$137.00
|
$137.00
|
$17,149.16
|
$114,376.20
|
$30,226.19
|
2026-05-23
|
|
1631
|
OTHER
|
Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis
|
20
|
20
|
—
|
—
|
$19,352.31
|
$54,726.84
|
$29,749.98
|
2026-05-23
|
|
3174
|
OTHER
|
Tendon, Muscle And Other Soft Tissue Procedures
|
20
|
20
|
—
|
—
|
$17,580.84
|
$196,707.76
|
$29,664.97
|
2026-05-23
|
|
1203
|
OTHER
|
Major Respiratory And Chest Procedures
|
20
|
20
|
—
|
—
|
$18,002.85
|
$109,839.76
|
$29,333.20
|
2026-05-23
|
|
8503
|
OTHER
|
Screw Spinal Expedium 6x75mm Lck Dual Lead Polyaxial Thread 1-innie Pedicle Ss T…
|
20
|
20
|
$1,750.00
|
$1,750.00
|
$14,690.71
|
$156,265.88
|
$29,183.49
|
2026-05-23
|
|
2634
|
OTHER
|
Cholecystectomy
|
20
|
20
|
—
|
—
|
$15,209.18
|
$133,583.68
|
$29,030.02
|
2026-05-23
|
|
4413
|
OTHER
|
Screw Spinal Expedium 6x35mm Lck Fully/dual Lead Thread Polyaxial Self-tap 1-inn…
|
20
|
20
|
$2,000.00
|
$2,000.00
|
$16,681.15
|
$96,037.40
|
$28,898.37
|
2026-05-23
|
|
8904
|
OTHER
|
Post Fixat 4.5x42.5mm Self-tap Lo-pro Reconstruct Ti Bicortical F/collateral Lig…
|
20
|
20
|
$357.50
|
$357.50
|
$13,653.92
|
$146,227.80
|
$28,741.14
|
2026-05-23
|
|
3244
|
OTHER
|
Elective Hip Joint Replacement
|
16
|
16
|
—
|
—
|
$17,468.14
|
$43,204.86
|
$28,646.35
|
2026-05-23
|
|
2603
|
OTHER
|
Major Pancreas, Liver And Shunt Procedures
|
20
|
20
|
—
|
—
|
$15,553.19
|
$104,434.64
|
$28,536.51
|
2026-05-23
|
|
3123
|
OTHER
|
Dressing Biological E-z Derm Roll 3x12in Porcine Xenograft Strl 4/ca
|
20
|
20
|
$222.95
|
$222.95
|
$17,441.58
|
$178,272.44
|
$28,455.26
|
2026-05-23
|
|
7594
|
OTHER
|
Plate Bone Lcp 79mm 3-hole 130deg Pre-contoured Compress Lck Ss Hip F/5mm Screw …
|
18
|
18
|
$2,493.40
|
$2,493.40
|
$12,643.04
|
$222,285.56
|
$28,443.22
|
2026-05-23
|
|
1302
|
OTHER
|
Guidewire Ortho 3.2mm 400mm Thread Ti F/femoral Tibial Nail Ns
|
20
|
20
|
$248.98
|
$248.98
|
$17,417.15
|
$121,904.76
|
$28,419.15
|
2026-05-23
|
|
8512
|
OTHER
|
Screw Spinal Expedium 4.35x45mm Polyaxial Pedicle Ss Thoracolum Extend Tab F/6.3…
|
14
|
14
|
$2,000.00
|
$2,000.00
|
$15,132.82
|
$28,161.11
|
$28,161.11
|
2026-05-23
|
|
0954
|
OTHER
|
Cleft Lip And Palate Repair
|
18
|
18
|
—
|
—
|
$8,390.67
|
$105,785.92
|
$28,080.61
|
2026-05-23
|
|
3224
|
OTHER
|
Allograft Human Tissue Frz-dry Rt Patellar Ligament
|
21
|
21
|
$1,312.50
|
$1,312.50
|
$14,494.62
|
$39,397.75
|
$28,047.63
|
2026-05-23
|
|
1601
|
OTHER
|
Major Cardiothoracic Repair Of Heart Anomaly
|
20
|
20
|
—
|
—
|
$17,448.97
|
$45,364.40
|
$27,759.35
|
2026-05-23
|
|
0494
|
OTHER
|
Bacterial And Tuberculous Infections Of Nervous System
|
18
|
18
|
—
|
—
|
$18,408.36
|
$154,528.52
|
$27,562.27
|
2026-05-23
|
|
6924
|
OTHER
|
Nail IM Fassier-duval 4mm Std 333mm Short Thread Femur Ss F/osteogenesis Imperfe…
|
20
|
20
|
$6,187.50
|
$6,187.50
|
$16,415.22
|
$152,598.12
|
$27,404.29
|
2026-05-23
|
|
2203
|
OTHER
|
Major Stomach, Esophageal And Duodenal Procedures
|
20
|
20
|
—
|
—
|
$15,820.41
|
$117,947.44
|
$27,283.92
|
2026-05-23
|
|
1672
|
OTHER
|
Suture Pds Plus 6-0 Tf Taper Point Monofilament Violet 27in
|
20
|
20
|
$8.35
|
$8.35
|
$14,744.45
|
$56,271.16
|
$27,253.21
|
2026-05-23
|
|
6223
|
OTHER
|
Neonate Birth Weight 2000-2499 Grams With Respiratory Distress Syndrome Or Other…
|
20
|
20
|
—
|
—
|
$16,009.88
|
$190,916.56
|
$27,195.90
|
2026-05-23
|
|
1924
|
OTHER
|
Cardiac Catheterization For Other Non-coronary Conditions
|
20
|
20
|
—
|
—
|
$15,300.31
|
$70,845.68
|
$27,002.56
|
2026-05-23
|
|
2284
|
OTHER
|
Inguinal, Femoral And Umbilical Hernia Procedures
|
20
|
20
|
—
|
—
|
$17,577.98
|
$127,502.92
|
$26,978.48
|
2026-05-23
|
|
7584
|
OTHER
|
Nail IM Fassier-duval 6.4x407mm Male Long Thread Femur Ss F/osteogenesis Imperfe…
|
16
|
16
|
$3,500.00
|
$3,500.00
|
$6,475.91
|
$415,036.00
|
$26,952.90
|
2026-05-23
|
|
9503
|
OTHER
|
Connector Extern Fixat Long 50mm Extend Ilizarov Taylor Spatial Frame
|
20
|
20
|
$371.25
|
$371.25
|
$16,920.88
|
$112,542.32
|
$26,939.36
|
2026-05-23
|
|
1763
|
OTHER
|
Insertion, Revision And Replacements Of Pacemaker And Other Cardiac Devices
|
20
|
20
|
—
|
—
|
$14,930.56
|
$43,144.44
|
$26,914.54
|
2026-05-23
|
|
907
|
OTHER
|
Other O.r. Procedures For Injuries With Comorbity
|
10
|
10
|
—
|
—
|
$10,773.92
|
$43,820.70
|
$26,904.20
|
2026-05-23
|
|
1703
|
OTHER
|
Permanent Cardiac Pacemaker Implant With Ami, Heart Failure Or Shock
|
20
|
20
|
—
|
—
|
$13,954.47
|
$86,964.52
|
$26,733.98
|
2026-05-23
|
|
1661
|
OTHER
|
Coronary Bypass Without Ami Or Complex Principal Diagnosis
|
20
|
20
|
—
|
—
|
$14,956.15
|
$48,549.56
|
$26,720.73
|
2026-05-23
|
|
0051
|
OTHER
|
Tracheostomy With Mv >96 Hours Without Extensive Procedure
|
18
|
18
|
—
|
—
|
$22,016.83
|
$267,746.48
|
$26,709.13
|
2026-05-23
|
|
4013
|
OTHER
|
Adrenal Procedures
|
20
|
20
|
—
|
—
|
$8,416.62
|
$81,559.40
|
$26,700.13
|
2026-05-23
|
|
3634
|
OTHER
|
Breast Procedures Except Mastectomy
|
20
|
20
|
—
|
—
|
$15,120.46
|
$164,663.12
|
$26,609.10
|
2026-05-23
|
|
3164
|
OTHER
|
Guide Spring Wire Component Straight Soft Tip On One End J Tip On Other Marked A…
|
20
|
20
|
$30.00
|
$30.00
|
$13,382.34
|
$138,023.60
|
$26,509.79
|
2026-05-23
|
|
1692
|
OTHER
|
Major Abdominal Vascular Procedures
|
20
|
20
|
—
|
—
|
$12,992.47
|
$55,016.40
|
$26,451.87
|
2026-05-23
|
|
6394
|
OTHER
|
Neonate Birth Weight > 2499 Grams With Other Significant Condition
|
20
|
20
|
—
|
—
|
$14,755.92
|
$159,547.56
|
$26,339.02
|
2026-05-23
|
|
0212
|
OTHER
|
Open Craniotomy Except Trauma
|
18
|
18
|
—
|
—
|
$14,683.52
|
$55,981.60
|
$26,337.52
|
2026-05-23
|
|
3144
|
OTHER
|
Foot And Toe Procedures
|
20
|
20
|
—
|
—
|
$13,375.10
|
$152,405.08
|
$26,308.18
|
2026-05-23
|
|
9304
|
OTHER
|
Screw Spinal Expedium 5x40mm Lck Fully/dual Lead Thread Polyaxial Self-tap 1-inn…
|
20
|
20
|
$2,000.00
|
$2,000.00
|
$13,417.74
|
$108,778.04
|
$26,210.38
|
2026-05-23
|
|
3084
|
OTHER
|
Rod Extern Fixat 4x140mm Connecting Carbon Fiber Dist Radial F/small Fixator Sys…
|
20
|
20
|
$158.40
|
$158.40
|
$17,775.51
|
$122,097.80
|
$26,123.11
|
2026-05-23
|
|
4454
|
OTHER
|
Other Bladder Procedures
|
20
|
20
|
—
|
—
|
$11,239.86
|
$149,123.40
|
$26,030.57
|
2026-05-23
|
|
6112
|
OTHER
|
Neonate Birth Weight 1500-1999 Grams With Major Anomaly
|
20
|
20
|
—
|
—
|
$13,030.41
|
$205,008.48
|
$26,006.50
|
2026-05-23
|