Hospital

Penn Medicine Lancaster General Health

Lancaster, PA · CCN 397013 · Rates published

14,822 distinct procedures filed

58 distinct payers

973,685 rate rows

2026-05-27 last MRF observed

Data quality

923,026 of 973,685 rate rows are consumer-grade (94.8%)

50,659 rows are marked excluded from the consumer medians — these stay visible in the raw drill-down with the same reason shown here, so nothing is silently hidden.

Excluded — reason	Rows
no usable negotiated amount (only an out-of-band fallback) — excluded from medians	15,367
placeholder amount (≤ $0.02) — excluded from medians	15,084
exceeds 10× this hospital's gross charge — excluded from medians	10,204
template filing: same amount across many unrelated codes — excluded	7,589
per-diem day rate — not a per-procedure price	2,415

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

Source MRF file	https://www1.pennmedicine.org/images/pricing/231365353_Lancaster-General-Hospital_standardcharges.csv
Found on page	https://www.pennmedicine.org/patient-resources/policies/pricing-transparency
Discovered via	CMS hospital list
Last fetch	not_modified · 2026-05-17
Content fingerprint	9047c37e50bba5d6… · 591,932,928 bytes · first seen 2026-05-09

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
8900003 OTHER	Hc Breyanzi Up To 110m Car Positive Cells	50	$328,240.00	$3,780,630.00	$1,686,603.73	nat. median $1,686,604 1.0× median
8900001 OTHER	Hc Kymriah Up To 600m Car Positive Cells	50	$427,047.70	$3,780,630.00	$1,667,425.25	nat. median $380 outlier · 4388.5×
18 OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	25	$203,700.00	$2,615,836.22	$812,080.81	nat. median $386,529 outlier · 2.1×
67457084744Q5114 OTHER	Trastuzumab-dkst 420 Mg IV Solr	50	$32.05	$2,734,845.24	$793,461.24	nat. median $2,995 outlier · 264.9×
59572077501J0896 OTHER	Luspatercept-aamt 75 Mg Sc Solr	51	$41.96	$2,211,568.54	$625,190.48	nat. median $9,773 outlier · 64.0×
7 OTHER	Lung Transplant	24	$24,589.85	$1,850,949.84	$571,279.60	nat. median $169,933 outlier · 3.4×
583-4 OTHER	Neonate With Ecmo	10	$490,067.20	$673,356.69	$526,822.24	nat. median $309,400 1.7× median
588-4 OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	10	$300,156.89	$412,418.24	$322,668.66	nat. median $267,493 1.2× median
583-3 OTHER	Neonate With Ecmo	10	$279,109.05	$383,498.31	$300,042.22	nat. median $259,487 1.2× median
011-4 OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	10	$280,596.80	$385,542.51	$294,626.65	nat. median $105,647 outlier · 2.8×
002-4 OTHER	Heart And/or Lung Transplant	9	$78,278.00	$385,287.12	$291,627.37	nat. median $216,800 1.3× median
681 OTHER	Neonate, Birth Weight >2499 Grams, With Significant O.r. Procedures, With Multip…	1	$273,815.51	$273,815.51	$273,815.51	nat. median $0
1 OTHER	Heart Transplant Or Implant Of Heart Assist System With Mcc	26	$11,631.41	$778,350.64	$251,004.80	nat. median $239,422 1.0× median
4 OTHER	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…	28	$8,178.38	$795,065.47	$249,548.05	nat. median $134,983 1.8× median
583-2 OTHER	Neonate With Ecmo	10	$214,304.61	$294,456.45	$230,377.46	nat. median $191,347 1.2× median
609-4 OTHER	Neonate Birth Weight 1500-2499 Grams With Major Procedure	10	$209,127.25	$287,342.70	$224,811.79	nat. median $169,856 1.3× median
161-4 OTHER	Implantable Heart Assist Systems	10	$209,255.93	$287,519.51	$219,718.73	nat. median $202,242 1.1× median
011-3 OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	10	$208,823.82	$286,925.79	$219,265.01	nat. median $171,094 1.3× median
631-4 OTHER	Neonate Birth Weight > 2499 Grams With Other Major Procedure	10	$201,142.76	$276,371.95	$216,228.47	nat. median $203,379 1.1× median
588-3 OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	10	$199,904.42	$274,670.45	$214,897.26	nat. median $165,000 1.3× median
009-4 OTHER	Extracorporeal Membrane Oxygenation (ecmo)	10	$173,209.32	$281,861.69	$214,369.40	nat. median $150,954 1.4× median
583-1 OTHER	Neonate With Ecmo	10	$192,364.75	$264,310.89	$206,792.11	nat. median $171,226 1.2× median
3 OTHER	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…	30	$11,924.58	$624,937.75	$206,545.77	nat. median $181,005 1.1× median
591-4 OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure	10	$174,165.25	$270,443.46	$205,685.29	nat. median $156,696 1.3× median
2 OTHER	Heart Transplant Or Implant Of Heart Assist System Without Mcc	26	$15,976.37	$610,538.87	$200,097.95	nat. median $111,558 1.8× median
630-4 OTHER	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure	10	$182,415.92	$250,641.10	$196,097.11	nat. median $210,669 0.9× median
841-4 OTHER	Extensive Third Degree Burns With Skin Graft	10	$186,138.10	$255,755.40	$195,445.00	nat. median $151,691 1.3× median
593-4 OTHER	Neonate Birth Weight 750-999 Grams Without Major Procedure	10	$173,050.12	$237,772.40	$186,028.88	nat. median $151,250 1.2× median
588-2 OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	10	$171,296.26	$235,362.59	$184,143.49	nat. median $153,523 1.2× median
969 OTHER	HIV With Extensive O.r. Procedures With Mcc	27	$13,512.46	$573,228.74	$177,189.50	nat. median $64,729 outlier · 2.7×
927 OTHER	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	27	$13,922.23	$908,208.82	$175,908.92	nat. median $146,562 1.2× median
011-2 OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	10	$166,012.46	$228,102.60	$174,313.09	nat. median $52,878 outlier · 3.3×
007-4 OTHER	Allogeneic Bone Marrow Transplant	9	$165,095.02	$226,842.04	$173,349.78	nat. median $172,311 1.0× median
161-3 OTHER	Implantable Heart Assist Systems	10	$163,851.91	$225,133.99	$172,044.51	nat. median $152,491 1.1× median
004-4 OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	10	$157,650.67	$216,613.44	$165,533.21	nat. median $110,000 1.5× median
001-4 OTHER	Liver Transplant And/or Intestinal Transplant	9	$56,636.00	$214,459.01	$162,326.00	nat. median $124,561 1.3× median
591-3 OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure	10	$148,442.94	$203,961.92	$159,576.16	nat. median $99,157 1.6× median
002-3 OTHER	Heart And/or Lung Transplant	9	$78,278.00	$209,872.95	$158,854.76	nat. median $133,471 1.2× median
588-1 OTHER	Female Reproductive System Reconstructive Procedures	10	$146,825.71	$201,739.83	$157,837.64	nat. median $75,325 outlier · 2.1×
589-3 OTHER	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational…	10	$139,914.35	$192,243.56	$150,407.92	nat. median $87,000 1.7× median
589-2 OTHER	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational…	10	$139,914.35	$192,243.56	$150,407.92	nat. median $49,980 outlier · 3.0×
589-1 OTHER	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational…	10	$139,914.35	$192,243.56	$150,407.92	nat. median $86,371 1.7× median
009-3 OTHER	Extracorporeal Membrane Oxygenation (ecmo)	10	$76,584.17	$189,428.84	$144,069.77	nat. median $87,912 1.6× median
602-4 OTHER	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	10	$130,364.26	$179,121.66	$140,141.59	nat. median $125,000 1.1× median
6 OTHER	Liver Transplant Without Mcc	24	$11,474.28	$453,841.84	$139,663.88	nat. median $52,924 outlier · 2.6×
8700004 OTHER	Hc Car-t Cell Admin Autologous	40	$181.92	$204,239.71	$137,150.05	nat. median $137,150 1.0× median
591-2 OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure	10	$127,321.24	$174,940.50	$136,870.33	nat. median $80,000 1.7× median
8 OTHER	Simultaneous Pancreas And Kidney Transplant	24	$10,914.63	$440,414.57	$135,881.18	nat. median $57,589 outlier · 2.4×
593-3 OTHER	Neonate Birth Weight 750-999 Grams Without Major Procedure	10	$126,591.25	$173,937.51	$133,975.37	nat. median $112,711 1.2× median
207 OTHER	Respiratory System Diagnosis With Ventilator Support >96 Hours	27	$7,250.50	$415,012.06	$130,198.24	nat. median $66,849 1.9× median

Other procedures at this hospital

Browse this hospital's 14,822 published procedures. Use the slice to choose what to show, then sort or filter any column.

Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
Code	Type	Description	Rate rows	Payers	Gross	Cash	Min $	Max $	Avg median	Last observed

8900003	OTHER	Hc Breyanzi Up To 110m Car Positive Cells	71	50	$3,750,000.00	$3,750,000.00	$328,240.00	$3,780,630.00	$1,686,603.73	2026-05-27
8900001	OTHER	Hc Kymriah Up To 600m Car Positive Cells	71	50	$3,750,000.00	$3,750,000.00	$427,047.70	$3,780,630.00	$1,667,425.25	2026-05-27
18	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	28	25	—	—	$203,700.00	$2,615,836.22	$812,080.81	2026-05-27
67457084744Q5114	OTHER	Trastuzumab-dkst 420 Mg IV Solr	72	50	$2,712,688.00	$2,712,688.00	$32.05	$2,734,845.24	$793,461.24	2026-05-27
59572077501J0896	OTHER	Luspatercept-aamt 75 Mg Sc Solr	73	51	$2,193,650.80	$2,193,650.80	$41.96	$2,211,568.54	$625,190.48	2026-05-27
7	OTHER	Lung Transplant	26	24	—	—	$24,589.85	$1,850,949.84	$571,279.60	2026-05-27
583-4	OTHER	Neonate With Ecmo	10	10	—	—	$490,067.20	$673,356.69	$526,822.24	2026-05-27
588-4	OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	10	10	—	—	$300,156.89	$412,418.24	$322,668.66	2026-05-27
583-3	OTHER	Neonate With Ecmo	10	10	—	—	$279,109.05	$383,498.31	$300,042.22	2026-05-27
011-4	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	10	10	—	—	$280,596.80	$385,542.51	$294,626.65	2026-05-27
002-4	OTHER	Heart And/or Lung Transplant	9	9	—	—	$78,278.00	$385,287.12	$291,627.37	2026-05-27
681	OTHER	Neonate, Birth Weight >2499 Grams, With Significant O.r. Procedures, With Multip…	1	1	—	—	$273,815.51	$273,815.51	$273,815.51	2026-05-27
1	OTHER	Heart Transplant Or Implant Of Heart Assist System With Mcc	31	26	—	—	$11,631.41	$778,350.64	$251,004.80	2026-05-27
4	OTHER	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…	32	28	—	—	$8,178.38	$795,065.47	$249,548.05	2026-05-27
583-2	OTHER	Neonate With Ecmo	10	10	—	—	$214,304.61	$294,456.45	$230,377.46	2026-05-27
609-4	OTHER	Neonate Birth Weight 1500-2499 Grams With Major Procedure	10	10	—	—	$209,127.25	$287,342.70	$224,811.79	2026-05-27
161-4	OTHER	Implantable Heart Assist Systems	10	10	—	—	$209,255.93	$287,519.51	$219,718.73	2026-05-27
011-3	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	10	10	—	—	$208,823.82	$286,925.79	$219,265.01	2026-05-27
631-4	OTHER	Neonate Birth Weight > 2499 Grams With Other Major Procedure	10	10	—	—	$201,142.76	$276,371.95	$216,228.47	2026-05-27
588-3	OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	10	10	—	—	$199,904.42	$274,670.45	$214,897.26	2026-05-27
009-4	OTHER	Extracorporeal Membrane Oxygenation (ecmo)	10	10	—	—	$173,209.32	$281,861.69	$214,369.40	2026-05-27
583-1	OTHER	Neonate With Ecmo	10	10	—	—	$192,364.75	$264,310.89	$206,792.11	2026-05-27
3	OTHER	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…	36	30	—	—	$11,924.58	$624,937.75	$206,545.77	2026-05-27
591-4	OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure	10	10	—	—	$174,165.25	$270,443.46	$205,685.29	2026-05-27
2	OTHER	Heart Transplant Or Implant Of Heart Assist System Without Mcc	31	26	—	—	$15,976.37	$610,538.87	$200,097.95	2026-05-27
630-4	OTHER	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure	10	10	—	—	$182,415.92	$250,641.10	$196,097.11	2026-05-27
841-4	OTHER	Extensive Third Degree Burns With Skin Graft	10	10	—	—	$186,138.10	$255,755.40	$195,445.00	2026-05-27
593-4	OTHER	Neonate Birth Weight 750-999 Grams Without Major Procedure	10	10	—	—	$173,050.12	$237,772.40	$186,028.88	2026-05-27
588-2	OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	10	10	—	—	$171,296.26	$235,362.59	$184,143.49	2026-05-27
969	OTHER	HIV With Extensive O.r. Procedures With Mcc	32	27	—	—	$13,512.46	$573,228.74	$177,189.50	2026-05-27
927	OTHER	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	32	27	—	—	$13,922.23	$908,208.82	$175,908.92	2026-05-27
011-2	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	10	10	—	—	$166,012.46	$228,102.60	$174,313.09	2026-05-27
007-4	OTHER	Allogeneic Bone Marrow Transplant	9	9	—	—	$165,095.02	$226,842.04	$173,349.78	2026-05-27
161-3	OTHER	Implantable Heart Assist Systems	10	10	—	—	$163,851.91	$225,133.99	$172,044.51	2026-05-27
004-4	OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	10	10	—	—	$157,650.67	$216,613.44	$165,533.21	2026-05-27
001-4	OTHER	Liver Transplant And/or Intestinal Transplant	9	9	—	—	$56,636.00	$214,459.01	$162,326.00	2026-05-27
591-3	OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure	10	10	—	—	$148,442.94	$203,961.92	$159,576.16	2026-05-27
002-3	OTHER	Heart And/or Lung Transplant	9	9	—	—	$78,278.00	$209,872.95	$158,854.76	2026-05-27
588-1	OTHER	Female Reproductive System Reconstructive Procedures	10	10	—	—	$146,825.71	$201,739.83	$157,837.64	2026-05-27
589-1	OTHER	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …	10	10	—	—	$139,914.35	$192,243.56	$150,407.92	2026-05-27
589-3	OTHER	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …	10	10	—	—	$139,914.35	$192,243.56	$150,407.92	2026-05-27
589-2	OTHER	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …	10	10	—	—	$139,914.35	$192,243.56	$150,407.92	2026-05-27
009-3	OTHER	Extracorporeal Membrane Oxygenation (ecmo)	10	10	—	—	$76,584.17	$189,428.84	$144,069.77	2026-05-27
602-4	OTHER	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	10	10	—	—	$130,364.26	$179,121.66	$140,141.59	2026-05-27
6	OTHER	Liver Transplant Without Mcc	26	24	—	—	$11,474.28	$453,841.84	$139,663.88	2026-05-27
8700004	OTHER	Hc Car-t Cell Admin Autologous	57	40	$202,585.00	$202,585.00	$181.92	$204,239.71	$137,150.05	2026-05-27
591-2	OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure	10	10	—	—	$127,321.24	$174,940.50	$136,870.33	2026-05-27
8	OTHER	Simultaneous Pancreas And Kidney Transplant	26	24	—	—	$10,914.63	$440,414.57	$135,881.18	2026-05-27
593-3	OTHER	Neonate Birth Weight 750-999 Grams Without Major Procedure	10	10	—	—	$126,591.25	$173,937.51	$133,975.37	2026-05-27
207	OTHER	Respiratory System Diagnosis With Ventilator Support >96 Hours	32	27	—	—	$7,250.50	$415,012.06	$130,198.24	2026-05-27
2705068	OTHER	Hc Heartmate 3	56	40	$164,500.00	$164,500.00	$5,000.00	$180,950.00	$129,527.30	2026-05-27
268	OTHER	Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc	32	27	—	—	$5,076.35	$402,240.71	$129,289.33	2026-05-27
161-1	OTHER	Implantable Heart Assist Systems	10	10	—	—	$120,563.17	$165,654.87	$126,591.34	2026-05-27
161-2	OTHER	Implantable Heart Assist Systems	10	10	—	—	$120,563.17	$165,654.88	$126,591.33	2026-05-27
160-4	OTHER	Major Cardiothoracic Repair Of Heart Anomaly	10	10	—	—	$120,123.92	$165,051.33	$126,130.11	2026-05-27
570	OTHER	Skin Debridement With Mcc	32	27	—	—	$3,360.22	$400,338.21	$122,015.20	2026-05-27
006-4	OTHER	Pancreas Transplant	9	9	—	—	$101,953.10	$140,084.46	$121,018.78	2026-05-27
002-2	OTHER	Heart And/or Lung Transplant	9	9	—	—	$51,393.00	$158,923.12	$120,290.37	2026-05-27
005-4	OTHER	Tracheostomy With Mv >96 Hours Without Extensive Procedure	10	10	—	—	$109,825.58	$150,901.33	$114,767.74	2026-05-27
004-3	OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	10	10	—	—	$108,711.95	$149,371.19	$114,147.55	2026-05-27
5	OTHER	Liver Transplant With Mcc Or Intestinal Transplant	26	24	—	—	$9,073.33	$361,196.48	$111,960.17	2026-05-27
233	OTHER	Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc	37	29	—	—	$14,262.50	$210,330.85	$111,821.17	2026-05-27
2705067	OTHER	Hc Pump Heart Implant	56	40	$141,372.00	$141,372.00	$5,000.00	$155,509.20	$111,316.32	2026-05-27
007-3	OTHER	Allogeneic Bone Marrow Transplant	9	9	—	—	$105,002.48	$144,274.35	$110,252.61	2026-05-27
593-2	OTHER	Neonate Birth Weight 750-999 Grams Without Major Procedure	10	10	—	—	$101,821.24	$141,459.07	$109,457.83	2026-05-27
842-4	OTHER	Burns With Skin Graft Except Extensive Third Degree Burns	10	10	—	—	$104,210.55	$143,186.22	$109,421.08	2026-05-27
630-3	OTHER	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure	10	10	—	—	$100,551.92	$138,159.24	$108,093.31	2026-05-27
002-1	OTHER	Heart And/or Lung Transplant	9	9	—	—	$102,228.73	$140,463.18	$107,340.16	2026-05-27
607-4	OTHER	Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…	10	10	—	—	$93,285.52	$138,461.55	$105,306.69	2026-05-27
603-4	OTHER	Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition	10	10	—	—	$95,349.94	$131,011.65	$102,501.18	2026-05-27
837	OTHER	Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot…	33	28	—	—	$4,564.13	$328,263.65	$101,102.33	2026-05-27
163	OTHER	Major Chest Procedures With Mcc	37	30	—	—	$10,595.60	$319,343.51	$97,453.75	2026-05-27
602-3	OTHER	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	10	10	—	—	$90,514.12	$124,367.21	$97,302.68	2026-05-27
2700868	OTHER	Hc Cv Heartmate 2 Lvas	109	40	$114,297.00	$114,297.00	$5,000.00	$172,466.80	$97,152.45	2026-05-27
2703388	OTHER	Hc Heart Mate Iii	56	40	$121,159.00	$121,159.00	$5,000.00	$133,274.90	$95,400.60	2026-05-27
006-3	OTHER	Pancreas Transplant	9	9	—	—	$78,570.76	$122,964.00	$94,284.91	2026-05-27
216	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	34	27	—	—	$11,947.24	$287,080.39	$94,187.08	2026-05-27
653	OTHER	Major Bladder Procedures With Mcc	33	27	—	—	$6,688.15	$299,099.42	$94,092.47	2026-05-27
14	OTHER	Allogeneic Bone Marrow Transplant	26	24	—	—	$7,197.30	$307,415.62	$93,756.58	2026-05-27
71336100301J0225	OTHER	Vutrisiran Sodium 25 Mg/0.5ml Sc Sosy	73	51	$328,226.15	$328,226.15	$4,959.46	$330,907.10	$93,544.45	2026-05-27
4901454	OTHER	Hc Uni Revsc Evasc Fpvt St Athrc Uni Cplx Les 1st Vsl	54	37	$112,620.00	$112,620.00	$1,250.00	$113,539.88	$91,689.57	2026-05-27
611-4	OTHER	Neonate Birth Weight 1500-1999 Grams With Major Anomaly	10	10	—	—	$83,813.26	$115,160.16	$90,099.25	2026-05-27
613-4	OTHER	Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection	10	10	—	—	$83,042.77	$114,101.50	$89,270.97	2026-05-27
20	OTHER	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc	33	27	—	—	$10,000.96	$321,573.57	$88,677.22	2026-05-27
50242055401C9399	OTHER	Ocrelizumab-hyaluronidase-ocsq 920-23000 Mg-ut/23m	55	37	$108,496.30	$108,496.30	$5,000.00	$109,382.50	$87,697.56	2026-05-27
863-4	OTHER	Neonatal Aftercare	10	10	—	—	$81,972.82	$112,631.39	$86,071.46	2026-05-27
011-1	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	10	10	—	—	$81,761.53	$112,341.08	$85,849.61	2026-05-27
212	OTHER	Hip & Femur Procedures Except Major Joint Age 0-17	32	27	—	—	$6,399.27	$452,178.82	$85,616.38	2026-05-27
4800244	OTHER	Hc Rf Ablation Of Afib/pvi	119	51	$119,843.00	$119,843.00	$853.60	$126,862.82	$85,190.29	2026-05-27
162-4	OTHER	Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis	10	10	—	—	$80,728.13	$110,921.16	$84,764.54	2026-05-27
303-4	OTHER	Dorsal And Lumbar Fusion Procedure For Curvature Of Back	10	10	—	—	$80,338.11	$110,385.29	$84,355.02	2026-05-27
001-3	OTHER	Liver Transplant And/or Intestinal Transplant	9	9	—	—	$56,636.00	$111,342.45	$84,276.12	2026-05-27
005-3	OTHER	Tracheostomy With Mv >96 Hours Without Extensive Procedure	10	10	—	—	$79,703.46	$109,513.26	$83,688.63	2026-05-27
593-1	OTHER	Neonate Birth Weight 750-999 Grams Without Major Procedure	10	10	—	—	$77,489.69	$106,471.53	$83,301.42	2026-05-27
440-4	OTHER	Kidney Transplant	9	9	—	—	$67,343.00	$108,612.85	$83,000.55	2026-05-27
326	OTHER	Stomach, Esophageal And Duodenal Procedures With Mcc	33	27	—	—	$7,767.04	$458,326.54	$82,824.02	2026-05-27
471	OTHER	Cervical Spinal Fusion With Mcc	32	27	—	—	$10,682.36	$259,377.33	$81,321.69	2026-05-27
4800241	OTHER	Hc Rf Ablation Of Aflutter/svt/wpw	119	51	$114,369.00	$114,369.00	$853.60	$125,392.29	$81,298.90	2026-05-27
2703387	OTHER	Hc Heart Mate Ii	56	40	$103,000.00	$103,000.00	$5,000.00	$113,300.00	$81,102.20	2026-05-27
215	OTHER	Other Heart Assist System Implant	32	27	—	—	$70,257.42	$298,078.71	$80,545.46	2026-05-27
4901470	OTHER	Hc Uni Revsc Evasc Tpvt St Athrc Uni Cplx Les 1st Vsl	54	37	$98,920.00	$98,920.00	$1,250.00	$99,727.98	$80,535.72	2026-05-27
21	OTHER	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc	33	27	—	—	$8,174.31	$244,389.09	$79,867.67	2026-05-27
461	OTHER	Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc	32	27	—	—	$14,037.19	$267,405.88	$79,834.85	2026-05-27
4901311	OTHER	Hc Ir-atherectomy And Stent Fem/pop Artery Bilateral	148	54	$162,554.00	$162,554.00	$853.60	$163,881.74	$78,854.57	2026-05-27
2703389	OTHER	Hc Heartware	56	40	$99,450.00	$99,450.00	$5,000.00	$109,395.00	$78,306.93	2026-05-27
609-3	OTHER	Neonate Birth Weight 1500-2499 Grams With Major Procedure	10	10	—	—	$72,544.27	$99,676.47	$77,985.09	2026-05-27
4800242	OTHER	Hc Rf Ablation Of Vt Includes 3d Mapping	118	51	$100,966.00	$100,966.00	$853.60	$125,392.29	$77,934.64	2026-05-27
602-2	OTHER	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	10	10	—	—	$72,325.83	$99,376.34	$77,750.27	2026-05-27
007-2	OTHER	Allogeneic Bone Marrow Transplant	9	9	—	—	$73,943.06	$101,598.43	$77,640.21	2026-05-27
10	OTHER	Pancreas Transplant	26	24	—	—	$22,974.91	$249,238.81	$77,239.05	2026-05-27
008-4	OTHER	Autologous Bone Marrow Transplant Or T-cell Immunotherapy	9	9	—	—	$73,429.14	$100,892.29	$77,100.60	2026-05-27
4800204	OTHER	Hc Insert/replace Icd Single Or Dual System With Lea	116	51	$95,721.00	$95,721.00	$853.60	$116,071.81	$76,616.98	2026-05-27
2701865	OTHER	Hc Cv Heartmate Xve Lvad	55	40	$93,397.00	$93,397.00	$5,000.00	$102,736.70	$76,585.54	2026-05-27
607-3	OTHER	Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…	10	10	—	—	$69,091.36	$94,932.15	$74,273.22	2026-05-27
163-4	OTHER	Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis	10	10	—	—	$70,640.29	$97,060.38	$74,172.30	2026-05-27
4901315	OTHER	Hc Ir-atherectomy And Stent Tibial/peroneal Artery Bilateral	148	54	$152,186.00	$152,186.00	$853.60	$153,429.06	$74,095.30	2026-05-27
4800369	OTHER	Hc Ccm-d Insert Pg Dual Transvns Electrds/leads	116	50	$95,721.00	$95,721.00	$1,250.00	$116,071.81	$74,056.45	2026-05-27
4800267	OTHER	Hc Insert/replace Subcutaneous Icd W Subcu Lead	116	51	$91,236.00	$91,236.00	$1,250.00	$116,071.81	$73,027.20	2026-05-27
004-2	OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	10	10	—	—	$69,471.05	$95,453.85	$72,944.60	2026-05-27
009-2	OTHER	Extracorporeal Membrane Oxygenation (ecmo)	10	10	—	—	$69,194.62	$95,074.04	$72,654.36	2026-05-27
2704965	OTHER	Hc Implantab/insertab Device Noc Lvl 69	56	40	$91,500.00	$91,500.00	$5,000.00	$100,650.00	$72,047.10	2026-05-27
006-2	OTHER	Pancreas Transplant	9	9	—	—	$55,621.00	$93,071.31	$71,123.91	2026-05-27
4900930	OTHER	Hc Ss-aneurysm Repair Abd/iliac	54	36	$87,207.00	$87,207.00	$1,100.00	$87,919.31	$70,999.58	2026-05-27
612-4	OTHER	Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other…	10	10	—	—	$66,022.91	$90,716.08	$70,974.64	2026-05-27
4800203	OTHER	Hc Removal Icd Multi Lead System With Replacement	118	51	$91,506.00	$91,506.00	$853.60	$116,071.81	$70,795.33	2026-05-27
178-4	OTHER	External Heart Assist Systems	10	10	—	—	$67,173.09	$92,296.43	$70,531.74	2026-05-27
4901452	OTHER	Hc Uni Revsc Evasc Fpvt St Athrc Uni Sf Les 1st Vsl	54	37	$86,631.00	$86,631.00	$1,250.00	$87,338.60	$70,530.63	2026-05-27
456	OTHER	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	32	27	—	—	$14,332.64	$285,322.24	$70,123.87	2026-05-27
22	OTHER	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/…	32	27	—	—	$25,118.94	$223,146.88	$70,087.25	2026-05-27
453	OTHER	Combined Anterior And Posterior Spinal Fusion With Mcc	28	27	—	—	$24,577.98	$273,655.62	$69,708.45	2026-05-27
2704964	OTHER	Hc Implantab/insertab Device Noc Lvl 68	56	40	$88,500.00	$88,500.00	$5,000.00	$97,350.00	$69,684.90	2026-05-27
621-4	OTHER	Neonate Birth Weight 2000-2499 Grams With Major Anomaly	10	10	—	—	$64,747.24	$88,963.29	$69,603.29	2026-05-27
957	OTHER	Other O.r. Procedures For Multiple Significant Trauma With Mcc	34	28	—	—	$10,018.00	$255,287.05	$69,033.14	2026-05-27
633-4	OTHER	Neonate Birth Weight > 2499 Grams With Major Anomaly	10	10	—	—	$54,063.80	$90,478.15	$68,812.99	2026-05-27
50633021011C9293	OTHER	Glucarpidase 1000 Units IV Solr	56	38	$95,994.15	$95,994.15	$440.98	$96,778.23	$68,722.21	2026-05-27
8700008	OTHER	Hc Car-t Cell Admin Autologous	76	55	$202,585.00	$202,585.00	$132.07	$204,239.71	$68,637.94	2026-05-27
007-1	OTHER	Allogeneic Bone Marrow Transplant	9	9	—	—	$65,273.08	$89,685.79	$68,536.74	2026-05-27
4800377	OTHER	Hc Ccm-d Pg Only Remove Replacement	116	50	$91,063.00	$91,063.00	$1,250.00	$96,396.99	$68,262.96	2026-05-27
231	OTHER	Coronary Bypass With Ptca With Mcc	32	27	—	—	$13,773.28	$296,457.17	$68,066.90	2026-05-27
4800202	OTHER	Hc Removal Icd Dual Lead System With Replacement	117	51	$91,506.00	$91,506.00	$853.60	$96,865.79	$67,791.57	2026-05-27
4800201	OTHER	Hc Removal Icd Single Lead System With Replacement	117	51	$91,063.00	$91,063.00	$853.60	$96,396.99	$67,791.57	2026-05-27
4800358	OTHER	Hc Insert/replace Ev Icd W Substernal Electrode Le	117	50	$89,472.00	$89,472.00	$1,250.00	$116,071.81	$67,533.47	2026-05-27
4800326	OTHER	Hc Insert/replace Optimizer Smart Ipg Dual System	117	51	$89,460.00	$89,460.00	$1,250.00	$116,071.81	$67,524.41	2026-05-27
2704963	OTHER	Hc Implantab/insertab Device Noc Lvl 67	56	40	$85,500.00	$85,500.00	$5,000.00	$94,050.00	$67,322.70	2026-05-27
356	OTHER	Other Digestive System O.r. Procedures With Mcc	33	27	—	—	$7,513.43	$205,579.10	$67,202.53	2026-05-27
165-4	OTHER	Coronary Bypass With Ami Or Complex Principal Diagnosis	10	10	—	—	$63,462.83	$87,198.49	$66,635.97	2026-05-27
4900397	OTHER	Hc Ir-atherectomy And Stent Fem/pop Artery Unilate	120	51	$80,964.00	$80,964.00	$853.60	$109,917.12	$66,390.48	2026-05-27
001-2	OTHER	Liver Transplant And/or Intestinal Transplant	9	9	—	—	$56,636.00	$86,045.98	$65,755.24	2026-05-27
219	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	35	28	—	—	$13,914.27	$236,428.00	$65,293.85	2026-05-27
167-4	OTHER	Other Cardiothoracic And Thoracic Vascular Procedures	10	10	—	—	$62,181.60	$85,438.07	$65,290.68	2026-05-27
2704962	OTHER	Hc Implantab/insertab Device Noc Lvl 66	56	40	$82,500.00	$82,500.00	$5,000.00	$90,750.00	$64,960.50	2026-05-27
4800198	OTHER	Hc Insert Icd With Existing Single Lead	116	51	$81,028.00	$81,028.00	$488.70	$109,917.12	$64,856.28	2026-05-27
4800199	OTHER	Hc Insert Icd With Existing Dual Leads	117	51	$81,470.00	$81,470.00	$853.60	$109,917.12	$64,568.61	2026-05-27
4800200	OTHER	Hc Insert Icd With Existing Multi Leads	117	51	$81,470.00	$81,470.00	$853.60	$116,071.81	$64,568.61	2026-05-27
4800332	OTHER	Hc Removal Optimizer Smart Ipg W Replacement	117	51	$85,521.00	$85,521.00	$1,250.00	$90,530.46	$64,551.25	2026-05-27
440-3	OTHER	Kidney Transplant	9	9	—	—	$53,743.56	$73,844.12	$63,793.84	2026-05-27
841-3	OTHER	Extensive Third Degree Burns With Skin Graft	10	10	—	—	$60,534.18	$83,174.50	$63,560.89	2026-05-27
631-3	OTHER	Neonate Birth Weight > 2499 Grams With Other Major Procedure	10	10	—	—	$59,118.71	$81,229.62	$63,552.61	2026-05-27
183-4	OTHER	Percutaneous Structural Cardiac Procedures	10	10	—	—	$60,456.34	$83,067.55	$63,479.15	2026-05-27
955	OTHER	Craniotomy For Multiple Significant Trauma	32	27	—	—	$50,546.10	$250,410.45	$63,455.29	2026-05-27
910-4	OTHER	Craniotomy For Multiple Significant Trauma	10	10	—	—	$60,278.41	$82,823.07	$63,292.33	2026-05-27
4800370	OTHER	Hc Ccm-d Insert Pulse Generator Only	116	50	$81,470.00	$81,470.00	$1,250.00	$86,242.72	$63,031.08	2026-05-27
2704961	OTHER	Hc Implantab/insertab Device Noc Lvl 65	56	40	$79,500.00	$79,500.00	$5,000.00	$87,450.00	$62,598.30	2026-05-27
162-3	OTHER	Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis	10	10	—	—	$59,052.77	$81,139.04	$62,005.41	2026-05-27
4901468	OTHER	Hc Uni Revsc Evasc Tpvt St Athrc Uni Sf Les 1st Vsl	54	37	$76,092.00	$76,092.00	$1,250.00	$76,713.52	$61,950.30	2026-05-27
608-4	OTHER	Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition	10	10	—	—	$57,476.85	$78,973.70	$61,787.62	2026-05-27
680-4	OTHER	Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms	10	10	—	—	$58,591.28	$80,504.94	$61,520.84	2026-05-27
625-4	OTHER	Neonate Birth Weight 2000-2499 Grams With Other Significant Condition	10	10	—	—	$57,393.45	$78,859.11	$60,263.12	2026-05-27
2704960	OTHER	Hc Implantab/insertab Device Noc Lvl 64	56	40	$76,500.00	$76,500.00	$5,000.00	$84,150.00	$60,236.10	2026-05-27
911-4	OTHER	Extensive Abdominal Or Thoracic Procedures For Multiple Significant Trauma	10	10	—	—	$57,333.87	$144,419.42	$60,200.57	2026-05-27
614-4	OTHER	Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition	10	10	—	—	$55,409.24	$76,132.79	$59,564.93	2026-05-27
304-4	OTHER	Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back	10	10	—	—	$56,657.91	$77,848.47	$59,490.80	2026-05-27
166-4	OTHER	Coronary Bypass Without Ami Or Complex Principal Diagnosis	10	10	—	—	$56,576.89	$77,737.15	$59,405.73	2026-05-27
266	OTHER	Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc	32	27	—	—	$44,899.70	$186,238.06	$59,232.53	2026-05-27
234	OTHER	Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc	35	29	—	—	$14,027.55	$180,476.04	$58,906.12	2026-05-27
179-4	OTHER	Defibrillator Implants	10	10	—	—	$55,838.97	$76,723.24	$58,630.92	2026-05-27
303-3	OTHER	Dorsal And Lumbar Fusion Procedure For Curvature Of Back	10	10	—	—	$55,753.97	$76,606.46	$58,541.67	2026-05-27
160-3	OTHER	Major Cardiothoracic Repair Of Heart Anomaly	10	10	—	—	$55,677.72	$76,501.69	$58,461.61	2026-05-27
091-4	OTHER	Other Major Head And Neck Procedures	10	10	—	—	$55,513.30	$76,275.76	$58,288.96	2026-05-27
603-3	OTHER	Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition	10	10	—	—	$53,992.18	$74,185.74	$58,041.60	2026-05-27
602-1	OTHER	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	10	10	—	—	$53,877.80	$74,028.57	$57,918.64	2026-05-27
2704959	OTHER	Hc Implantab/insertab Device Noc Lvl 63	56	40	$73,500.00	$73,500.00	$5,000.00	$80,850.00	$57,873.90	2026-05-27
001-1	OTHER	Liver Transplant And/or Intestinal Transplant	9	9	—	—	$55,016.85	$75,593.64	$57,767.69	2026-05-27
275	OTHER	Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc	32	27	—	—	$12,010.39	$259,201.19	$57,655.08	2026-05-27
4800327	OTHER	Hc Insert Optimizer Smart Ipg Sys W Existing Dual	117	51	$76,140.00	$76,140.00	$1,250.00	$82,253.77	$57,470.47	2026-05-27
850-4	OTHER	Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal…	10	10	—	—	$54,660.20	$75,103.60	$57,393.21	2026-05-27
2701745	OTHER	Hc Cv Thor Vent Assist Device	53	36	$69,952.00	$69,952.00	$5,000.00	$70,523.37	$57,360.64	2026-05-27
8700005	OTHER	Hc Bld Drv T Lymphcyt Car-t Collection	58	42	$115,763.00	$115,763.00	$73.22	$115,763.00	$57,302.68	2026-05-27
021-4	OTHER	Open Craniotomy Except Trauma	10	10	—	—	$54,583.15	$74,997.73	$57,039.40	2026-05-27
178-3	OTHER	External Heart Assist Systems	10	10	—	—	$54,201.08	$74,472.77	$56,911.14	2026-05-27
928	OTHER	Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc	32	27	—	—	$4,986.49	$184,124.56	$56,521.74	2026-05-27
23	OTHER	Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…	35	28	—	—	$8,929.73	$179,163.61	$56,445.41	2026-05-27
912-4	OTHER	Musculoskeletal And Other Procedures For Multiple Significant Trauma	10	10	—	—	$53,308.27	$73,246.04	$55,973.68	2026-05-27
870	OTHER	Septicemia Or Severe Sepsis With Mv >96 Hours	32	27	—	—	$7,957.39	$217,675.42	$55,903.61	2026-05-27
005-2	OTHER	Tracheostomy With Mv >96 Hours Without Extensive Procedure	10	10	—	—	$53,145.43	$73,022.30	$55,802.70	2026-05-27
2705275	OTHER	Hc Connective Tissue Human Lvl 62	56	40	$70,500.00	$70,500.00	$5,000.00	$77,550.00	$55,511.70	2026-05-27
2704958	OTHER	Hc Implantab/insertab Device Noc Lvl 62	56	40	$70,500.00	$70,500.00	$5,000.00	$77,550.00	$55,511.70	2026-05-27
2705193	OTHER	Hc Graft Vasc Lvl 62	56	40	$70,500.00	$70,500.00	$5,000.00	$77,550.00	$55,511.70	2026-05-27
19	OTHER	Simultaneous Pancreas And Kidney Transplant With Hemodialysis	27	25	—	—	$7,518.29	$183,155.02	$55,501.52	2026-05-27
607-2	OTHER	Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…	10	10	—	—	$51,603.66	$70,903.89	$55,473.94	2026-05-27
690-4	OTHER	Acute Leukemia	10	10	—	—	$52,373.36	$71,961.46	$54,992.03	2026-05-27
440-2	OTHER	Kidney Transplant	9	9	—	—	$45,800.38	$67,343.00	$54,960.45	2026-05-27
008-3	OTHER	Autologous Bone Marrow Transplant Or T-cell Immunotherapy	9	9	—	—	$51,683.09	$71,013.03	$54,267.25	2026-05-27
260-4	OTHER	Major Pancreas, Liver And Shunt Procedures	10	10	—	—	$50,927.70	$69,975.11	$53,474.08	2026-05-27
608-3	OTHER	Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition	10	10	—	—	$49,614.69	$68,171.03	$53,335.79	2026-05-27
163-3	OTHER	Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis	10	10	—	—	$50,783.13	$69,776.47	$53,322.29	2026-05-27
2702394	OTHER	Hc Tavi Valve	55	40	$65,000.00	$65,000.00	$5,000.00	$71,500.00	$53,300.00	2026-05-27
217	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	32	27	—	—	$12,888.79	$230,783.00	$53,207.53	2026-05-27
009-1	OTHER	Extracorporeal Membrane Oxygenation (ecmo)	10	10	—	—	$50,669.54	$69,620.40	$53,203.02	2026-05-27
2704957	OTHER	Hc Implantab/insertab Device Noc Lvl 61	56	40	$67,500.00	$67,500.00	$5,000.00	$74,250.00	$53,149.50	2026-05-27
2705244	OTHER	Hc Prosthetic Implant Nos Lvl 61	56	40	$67,500.00	$67,500.00	$5,000.00	$74,250.00	$53,149.50	2026-05-27
2705297	OTHER	Hc Generator Neurostim Non-rechrge Lvl 61	56	40	$67,500.00	$67,500.00	$5,000.00	$74,250.00	$53,149.50	2026-05-27
169-4	OTHER	Major Abdominal Vascular Procedures	10	10	—	—	$50,442.37	$69,308.26	$52,964.49	2026-05-27
023-4	OTHER	Spinal Procedures	10	10	—	—	$49,768.79	$68,382.76	$52,257.23	2026-05-27
4901465	OTHER	Hc Uni Revsc Evasc Tpvt St Plmt Uni Cplx Les 1st Vsl	54	37	$64,111.00	$64,111.00	$1,250.00	$64,634.66	$52,195.97	2026-05-27
4901450	OTHER	Hc Uni Revsc Evasc Fpvt St Plmt Uni Cplx Les 1st Vsl	54	37	$64,111.00	$64,111.00	$1,250.00	$64,634.66	$52,195.97	2026-05-27
970	OTHER	HIV With Extensive O.r. Procedures Without Mcc	32	27	—	—	$5,452.90	$161,572.83	$51,970.18	2026-05-27
218	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	32	27	—	—	$19,408.38	$171,042.65	$51,856.78	2026-05-27
573	OTHER	Skin Graft For Skin Ulcer Or Cellulitis With Mcc	32	27	—	—	$7,813.17	$245,136.01	$51,785.77	2026-05-27
459	OTHER	Spinal Fusion Except Cervical With Mcc	25	25	—	—	$16,615.43	$176,973.88	$51,628.35	2026-05-27
120-4	OTHER	Major Respiratory And Chest Procedures	10	10	—	—	$49,098.38	$67,461.61	$51,553.30	2026-05-27
347	OTHER	Anal And Stomal Procedures With Mcc	32	27	—	—	$6,068.01	$163,896.02	$51,488.37	2026-05-27
681-4	OTHER	Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms	10	10	—	—	$49,018.95	$67,352.48	$51,469.90	2026-05-27
4901212	OTHER	Hc Ir Dialysis Circuit Mech Thromb With Periph Ste	117	54	$68,189.00	$68,189.00	$410.24	$73,557.95	$51,469.06	2026-05-27
440-1	OTHER	Kidney Transplant	9	9	—	—	$42,861.40	$67,343.00	$51,433.68	2026-05-27
312-4	OTHER	Skin Graft, Except Hand, For Musculoskeletal And Connective Tissue Diagnoses	10	10	—	—	$48,926.81	$67,225.87	$51,373.15	2026-05-27
130-4	OTHER	Respiratory System Diagnosis With Ventilator Support > 96 Hours	10	10	—	—	$48,520.92	$66,668.17	$50,946.96	2026-05-27
609-2	OTHER	Neonate Birth Weight 1500-2499 Grams With Major Procedure	10	10	—	—	$47,335.79	$65,039.80	$50,885.98	2026-05-27
2705066	OTHER	Hc Prosthetic Implantnos Lvl 60	56	40	$64,500.00	$64,500.00	$5,000.00	$70,950.00	$50,787.30	2026-05-27
2704756	OTHER	Hc Generator Neurostim Non-rechrge Lvl 60	56	40	$64,500.00	$64,500.00	$5,000.00	$70,950.00	$50,787.30	2026-05-27
2704956	OTHER	Hc Implantab/insertab Device Noc Lvl 60	56	40	$64,500.00	$64,500.00	$5,000.00	$70,950.00	$50,787.30	2026-05-27
220-4	OTHER	Major Stomach, Esophageal And Duodenal Procedures	10	10	—	—	$48,361.26	$66,448.79	$50,779.32	2026-05-27
695-4	OTHER	Chemotherapy For Acute Leukemia	10	10	—	—	$48,203.19	$66,231.61	$50,613.35	2026-05-27
004-1	OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	10	10	—	—	$48,064.18	$66,040.61	$50,467.39	2026-05-27
4900929	OTHER	Hc Ss-aneurysm Repair Abd Aorta	54	36	$61,516.00	$61,516.00	$1,100.00	$62,018.46	$50,083.25	2026-05-27
020-4	OTHER	Open Craniotomy For Trauma	10	10	—	—	$47,685.29	$65,520.02	$50,069.56	2026-05-27
089-4	OTHER	Major Cranial Or Facial Bone Procedures	10	10	—	—	$47,656.70	$65,480.73	$50,039.53	2026-05-27
361-4	OTHER	Skin Graft For Skin And Subcutaneous Tissue Diagnoses	10	10	—	—	$47,603.48	$65,407.60	$49,983.65	2026-05-27
261-4	OTHER	Major Biliary Tract Procedures	10	10	—	—	$47,354.06	$65,064.90	$49,721.76	2026-05-27
623-4	OTHER	Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection	10	10	—	—	$46,252.34	$63,551.13	$49,721.27	2026-05-27
950-4	OTHER	Extensive O.r. Procedure Unrelated To Principal Diagnosis	10	10	—	—	$47,346.91	$65,055.08	$49,714.26	2026-05-27
4901446	OTHER	Hc Uni Revsc Evasc Fpvt Athrc Uni Cplx Les 1st Vsl	54	37	$60,818.00	$60,818.00	$1,250.00	$61,314.76	$49,514.98	2026-05-27
4901461	OTHER	Hc Uni Revsc Evasc Tpvt Athrc Uni Cplx Les 1st Vsl	54	37	$60,818.00	$60,818.00	$1,250.00	$61,314.76	$49,514.98	2026-05-27
006-1	OTHER	Pancreas Transplant	9	9	—	—	$47,049.05	$64,645.80	$49,401.50	2026-05-27
165-3	OTHER	Coronary Bypass With Ami Or Complex Principal Diagnosis	10	10	—	—	$47,160.25	$64,798.60	$49,282.46	2026-05-27
630-2	OTHER	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure	10	10	—	—	$45,825.79	$62,965.05	$49,262.73	2026-05-27
2701440	OTHER	Hc Ort Gnz Carticel Autolog	55	40	$60,000.00	$60,000.00	$5,000.00	$66,000.00	$49,200.00	2026-05-27
612-3	OTHER	Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other…	10	10	—	—	$45,720.15	$62,819.89	$49,149.16	2026-05-27
232	OTHER	Coronary Bypass With Ptca Without Mcc	32	27	—	—	$13,663.51	$199,675.33	$49,099.66	2026-05-27
235	OTHER	Coronary Bypass Without Cardiac Catheterization With Mcc	35	29	—	—	$14,782.97	$156,433.28	$48,544.87	2026-05-27
4800015	OTHER	Hc Insert Cardiac Venous Lead	108	38	$59,167.00	$59,167.00	$369.56	$62,632.44	$48,516.94	2026-05-27
2704955	OTHER	Hc Implantab/insertab Device Noc Lvl 59	56	40	$61,500.00	$61,500.00	$5,000.00	$67,650.00	$48,425.10	2026-05-27
2705065	OTHER	Hc Prosthetic Implantnos Lvl 59	56	40	$61,500.00	$61,500.00	$5,000.00	$67,650.00	$48,425.10	2026-05-27
2704755	OTHER	Hc Generator Neurostim Non-rechrge Lvl 59	56	40	$61,500.00	$61,500.00	$5,000.00	$67,650.00	$48,425.10	2026-05-27
454	OTHER	Combined Anterior And Posterior Spinal Fusion With Cc	29	27	—	—	$28,315.17	$157,243.45	$48,272.55	2026-05-27
613-3	OTHER	Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection	10	10	—	—	$44,874.20	$61,657.55	$48,239.76	2026-05-27
027-4	OTHER	Other Open Craniotomy	10	10	—	—	$45,938.59	$63,120.03	$48,235.52	2026-05-27
197	OTHER	Interstitial Lung Disease With Cc	32	27	—	—	$4,635.20	$163,282.52	$48,210.95	2026-05-27
611-3	OTHER	Neonate Birth Weight 1500-1999 Grams With Major Anomaly	10	10	—	—	$44,697.86	$61,415.26	$48,050.21	2026-05-27
092-4	OTHER	Facial Bone Procedures Except Major Cranial Or Facial Bone Procedures	10	10	—	—	$45,428.64	$62,419.35	$47,700.07	2026-05-27
28	OTHER	Spinal Procedures With Mcc	32	27	—	—	$8,297.00	$171,000.78	$47,535.33	2026-05-27
276	OTHER	Non-maligant Breast Disorders	32	27	—	—	$19,190.58	$223,368.47	$47,522.03	2026-05-27
820	OTHER	Lymphoma And Leukemia With Major O.r. Procedures With Mcc	34	27	—	—	$7,391.72	$199,256.73	$47,514.85	2026-05-27
603-2	OTHER	Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition	10	10	—	—	$44,053.67	$67,537.11	$47,357.69	2026-05-27
401-4	OTHER	Adrenal Procedures	10	10	—	—	$45,057.69	$61,909.66	$47,310.57	2026-05-27
2702838	OTHER	Hc Cv Corevalve	56	40	$60,000.00	$60,000.00	$5,000.00	$66,000.00	$47,244.00	2026-05-27
457	OTHER	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	32	27	—	—	$16,432.51	$207,503.28	$47,181.60	2026-05-27
463	OTHER	Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …	33	27	—	—	$6,881.08	$152,749.54	$47,161.52	2026-05-27
790	OTHER	Extreme Immaturity Or Respiratory Distress Syndrome, Neonate	36	29	—	—	$3,142.31	$246,696.89	$47,028.21	2026-05-27
162-2	OTHER	Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis	10	10	—	—	$44,643.85	$61,341.05	$46,876.04	2026-05-27
16	OTHER	Autologous Bone Marrow Transplant With Cc/mcc	27	25	—	—	$5,581.74	$159,252.30	$46,815.41	2026-05-27
441-4	OTHER	Major Bladder Procedures	10	10	—	—	$44,438.12	$61,058.37	$46,660.03	2026-05-27
4901314	OTHER	Hc Ir-atherectomy Tibial/peroneal Artery Bilateral	148	54	$94,007.00	$94,007.00	$853.60	$109,917.12	$46,658.40	2026-05-27
4900398	OTHER	Hc Ir-atherectomy And Stent Tibial/peroneal Artery	72	51	$76,092.00	$76,092.00	$853.60	$109,917.12	$46,519.83	2026-05-27
2702217	OTHER	Hc Neu Neurostimulator Nonrecharg	56	40	$59,000.00	$59,000.00	$5,000.00	$64,900.00	$46,456.60	2026-05-27
4901313	OTHER	Hc Ir-atherectomy Tibial/peroneal Artery Bilateral	148	54	$93,568.00	$93,568.00	$853.60	$109,917.12	$46,440.51	2026-05-27
178-2	OTHER	External Heart Assist Systems	10	10	—	—	$44,131.51	$60,637.09	$46,338.09	2026-05-27
2705299	OTHER	Hc Gen, Neuro, Imp Led, Ex Cntr Lvl 62	72	52	$70,500.00	$70,500.00	$5,000.00	$149,096.22	$46,142.88	2026-05-27
183-3	OTHER	Percutaneous Structural Cardiac Procedures	10	10	—	—	$43,931.35	$60,362.06	$46,127.91	2026-05-27
2704954	OTHER	Hc Implantab/insertab Device Noc Lvl 58	56	40	$58,500.00	$58,500.00	$5,000.00	$64,350.00	$46,062.90	2026-05-27
2705064	OTHER	Hc Prosthetic Implantnos Lvl 58	56	40	$58,500.00	$58,500.00	$5,000.00	$64,350.00	$46,062.90	2026-05-27
2704754	OTHER	Hc Generator Neurostim Non-rechrge Lvl 58	56	40	$58,500.00	$58,500.00	$5,000.00	$64,350.00	$46,062.90	2026-05-27
2705277	OTHER	Hc Generator Neurostim Hf Rechrge Bat Sys Lvl 58	56	40	$58,500.00	$58,500.00	$5,000.00	$64,350.00	$46,062.90	2026-05-27
622-4	OTHER	Neonate Birth Weight 2000-2499 Grams With Respiratory Distress Syndrome Or Other…	10	10	—	—	$42,814.53	$58,827.55	$46,025.62	2026-05-27
220	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	36	29	—	—	$15,625.69	$163,887.35	$45,973.39	2026-05-27
4800285	OTHER	Hc Cardiomems Insertion	116	51	$56,169.00	$56,169.00	$1,250.00	$106,067.20	$45,729.99	2026-05-27
4901310	OTHER	Hc Fem Pop Art Bilateral Stent	146	54	$94,007.00	$94,007.00	$702.16	$94,774.85	$45,584.75	2026-05-27
4901309	OTHER	Hc Ir-atherectomy Fem/pop Artery Bilateral	146	54	$93,568.00	$93,568.00	$853.60	$94,332.26	$45,371.87	2026-05-27
849	OTHER	Radiotherapy	32	27	—	—	$5,380.55	$140,785.65	$45,162.51	2026-05-27
511-4	OTHER	Uterine And Adnexa Procedures For Ovarian And Adnexal Malignancy	10	10	—	—	$43,001.99	$59,085.12	$45,152.09	2026-05-27
321-4	OTHER	Spinal Fusion And Other Back And Neck Procedures Except For Disc Procedures	10	10	—	—	$42,680.29	$58,643.10	$44,814.31	2026-05-27
022-4	OTHER	Ventricular Shunt Procedures	10	10	—	—	$42,652.49	$125,166.25	$44,785.12	2026-05-27
792-4	OTHER	Extensive O.r. Procedures For Other Complications Of Treatment	10	10	—	—	$42,525.40	$58,430.28	$44,651.67	2026-05-27
179-3	OTHER	Defibrillator Implants	10	10	—	—	$42,523.81	$58,428.10	$44,650.00	2026-05-27
4800391	OTHER	Hc Perq Tcat Plmt Ntrac St 2+les 2+st 2+c Segments	55	37	$54,984.00	$54,984.00	$1,250.00	$55,433.11	$44,443.57	2026-05-27
405	OTHER	Pancreas, Liver And Shunt Procedures With Mcc	32	27	—	—	$7,989.95	$181,382.23	$44,355.65	2026-05-27
11	OTHER	Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc	32	27	—	—	$9,793.74	$174,893.83	$44,224.26	2026-05-27
842-3	OTHER	Burns With Skin Graft Except Extensive Third Degree Burns	10	10	—	—	$42,093.29	$57,836.56	$44,197.96	2026-05-27
651-4	OTHER	Other Procedures Of Blood And Blood-forming Organs	10	10	—	—	$42,086.14	$57,826.74	$44,190.45	2026-05-27
4800271	OTHER	Hc Removal W Replacement Subcutaneous Icd Only	71	51	$84,387.00	$84,387.00	$853.60	$85,076.27	$44,064.52	2026-05-27

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