Hospital

WOMEN & INFANTS HOSPITAL OF RHODE ISLAND

Providence, RI · CCN 410010 · Rates published

15,091 distinct procedures filed

31 distinct payers

361,595 rate rows

2026-02-28 last MRF observed

Data quality

276,554 of 361,595 rate rows are consumer-grade (76.5%)

85,041 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	57,705
per-diem day rate — not a per-procedure price	24,666
professional (physician) fee — not the facility price	1,224
placeholder amount (≤ $0.02) — excluded from medians	661
template filing: same amount across many unrelated codes — excluded	412
exceeds 10× this hospital's gross charge — excluded from medians	373

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

Source MRF file	https://www.carenewengland.org/hubfs/050258937_Women-and-Infants-Hospital_standardcharges.csv?hsLang=en
Found on page	https://www.carenewengland.org/price-transparency
Discovered via	CMS hospital list
Last fetch	not_modified · 2026-05-17
Content fingerprint	3cdc6ec289bfbc5a… · 43,266,505 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
588-4 OTHER	Neonate Bwt <1500g W Major Procedure	4	$287,612.08	$984,575.36	$511,065.00	nat. median $267,493 1.9× median
583-4 OTHER	Neonate W Ecmo	4	$378,197.00	$697,728.13	$474,617.00	nat. median $309,400 1.5× median
583-3 OTHER	Neonate W Ecmo	3	$262,129.19	$579,100.18	$415,338.24	nat. median $259,487 1.6× median
002-4 OTHER	Heart &/or Lung Transplant	3	$346,148.00	$1,099,608.41	$369,804.87	nat. median $216,800 1.7× median
591-4 OTHER	Neonate Birthwt 500-749g Without Major Procedure	4	$193,095.60	$628,527.22	$369,055.00	nat. median $156,696 outlier · 2.4×
003-4 OTHER	Bone Marrow Transplant	2	$242,956.44	$1,107,844.98	$352,529.24	nat. median $310,814 1.1× median
609-4 OTHER	Neonate Bwt 1500-2499g W Major Procedure	4	$137,844.71	$627,388.77	$346,348.00	nat. median $169,856 outlier · 2.0×
161-4 OTHER	Cardiac Defibrillator & Heart Assist Implant	3	$307,088.02	$990,901.77	$336,710.52	nat. median $202,242 1.7× median
18 OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	14	$67.38	$588,394.52	$336,532.84	nat. median $386,529 0.9× median
007-4 OTHER	Allogeneic Bone Marrow Transplant	1	$291,670.00	$374,901.00	$333,285.50	nat. median $172,311 1.9× median
593-4 OTHER	Neonate Birthwt 750-999g Without Major Procedure	4	$165,591.83	$597,433.80	$331,483.00	nat. median $151,250 outlier · 2.2×
588-3 OTHER	Neonate Bwt <1500g W Major Procedure	4	$200,743.61	$808,245.59	$328,811.00	nat. median $165,000 2.0× median
841-4 OTHER	Extensive 3rd Degree Burns W Skin Graft	3	$262,265.00	$856,935.31	$318,170.67	nat. median $151,691 outlier · 2.1×
583-2 OTHER	Neonate W Ecmo	3	$246,561.64	$570,622.93	$308,489.00	nat. median $191,347 1.6× median
009-4 OTHER	Extracorporeal Membrane Oxygenation (ecmo)	1	$243,001.00	$312,343.00	$277,672.00	nat. median $150,954 1.8× median
001-4 OTHER	Liver Transplant &/or Intestinal Transplant	3	$238,932.00	$794,156.32	$274,821.95	nat. median $124,561 outlier · 2.2×
583-1 OTHER	Neonate W Ecmo	3	$221,905.90	$570,622.93	$271,630.50	nat. median $171,226 1.6× median
630-4 OTHER	Neonate Birthwt >2499g W Major Cardiovascular Procedure	4	$132,941.35	$492,180.71	$268,782.00	nat. median $210,669 1.3× median
602-4 OTHER	Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom	4	$154,290.58	$485,090.23	$268,467.00	nat. median $125,000 outlier · 2.1×
603-4 OTHER	Neonate Birthwt 1000-1249g W Or Without Other Significant Condition	4	$187,608.43	$517,050.86	$263,557.00	nat. median $107,050 outlier · 2.5×
612 OTHER	Neonate, Birth Weight <750 Grams, Discharged Alive	1	$237,150.80	$285,105.09	$261,127.95	nat. median $2,164 outlier · 120.7×
591-3 OTHER	Neonate Birthwt 500-749g Without Major Procedure	4	$160,353.21	$436,900.97	$254,978.00	nat. median $99,157 outlier · 2.6×
1 OTHER	Heart Transplant Or Implant Of Heart Assist System With Mcc	14	$67.38	$387,720.53	$253,492.18	nat. median $239,422 1.1× median
633 OTHER	Neonate, Birth Weight 1000-1499 Grams, With Significant O.r. Procedures, Dischar…	1	$195,515.27	$311,127.21	$253,321.24	nat. median $4,769 outlier · 53.1×
593-3 OTHER	Neonate Birthwt 750-999g Without Major Procedure	4	$146,389.84	$497,571.15	$241,976.00	nat. median $112,711 outlier · 2.1×
631-4 OTHER	Neonate Birthwt >2499g W Other Major Procedure	4	$137,271.35	$408,405.35	$238,367.00	nat. median $203,379 1.2× median
004-4 OTHER	Tracheostomy W Mv 96+ Hours W Extensive Procedure Or Ecmo	3	$175,860.18	$750,329.84	$234,545.09	nat. median $110,000 outlier · 2.1×
002-3 OTHER	Heart &/or Lung Transplant	3	$210,158.00	$698,530.39	$233,340.82	nat. median $133,471 1.7× median
589-2 OTHER	Neonate Bwt <500g Or Ga <24 Weeks	4	$183,604.00	$376,566.97	$221,490.50	nat. median $49,980 outlier · 4.4×
589-1 OTHER	Neonate Bwt <500g Or Ga <24 Weeks	4	$189,438.00	$376,566.97	$220,937.00	nat. median $86,371 outlier · 2.6×
006-4 OTHER	Pancreas Transplant	3	$187,423.30	$358,237.17	$220,287.11	nat. median $92,449 outlier · 2.4×
607-4 OTHER	Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom	4	$126,614.49	$406,995.66	$220,131.00	nat. median $100,015 outlier · 2.2×
593-2 OTHER	Neonate Birthwt 750-999g Without Major Procedure	4	$112,921.61	$430,746.47	$208,502.00	nat. median $89,334 outlier · 2.3×
927 OTHER	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	14	$67.38	$322,222.04	$201,621.82	nat. median $146,562 1.4× median
003-3 OTHER	Bone Marrow Transplant	2	$149,332.91	$541,588.65	$200,530.36	nat. median $164,570 1.2× median
636 OTHER	Neonate, Birth Weight 1500-1999 Grams, With Significant O.r. Procedures, With Mu…	1	$182,813.14	$217,616.72	$200,214.93	nat. median $53 outlier · 3812.2×
631 OTHER	Neonate, Birth Weight 750-999 Grams, Discharged Alive	1	$190,465.19	$206,732.43	$198,598.81	nat. median $5,302 outlier · 37.5×
588-2 OTHER	Neonate Bwt <1500g W Major Procedure	4	$138,951.76	$788,093.51	$196,721.00	nat. median $153,523 1.3× median
160-4 OTHER	Major Cardiothoracic Repair Of Heart Anomaly	3	$146,740.10	$372,635.88	$194,896.12	nat. median $106,926 1.8× median
3 OTHER	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…	14	$67.38	$297,719.13	$194,880.41	nat. median $181,005 1.1× median
007-3 OTHER	Allogeneic Bone Marrow Transplant	1	$168,942.00	$217,151.00	$193,046.50	nat. median $104,111 1.9× median
602-3 OTHER	Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom	4	$123,738.26	$420,595.93	$186,311.00	nat. median $99,067 1.9× median
588-1 OTHER	Neonate Bwt <1500g W Major Procedure	4	$130,875.56	$788,093.51	$185,430.00	nat. median $75,325 outlier · 2.5×
161-3 OTHER	Cardiac Defibrillator & Heart Assist Implant	3	$81,123.34	$417,619.91	$181,924.02	nat. median $152,491 1.2× median
611-4 OTHER	Neonate Birthwt 1500-1999g W Major Anomaly	4	$132,892.26	$310,326.79	$178,408.50	nat. median $93,000 1.9× median
842-4 OTHER	Full Thickness Burns W Skin Graft	3	$144,322.00	$416,710.68	$177,474.35	nat. median $83,517 outlier · 2.1×
608-4 OTHER	Neonate Bwt 1250-1499g W Or Without Other Significant Condition	4	$141,637.91	$299,534.44	$175,225.50	nat. median $67,929 outlier · 2.6×
002-2 OTHER	Heart &/or Lung Transplant	3	$159,365.92	$439,964.85	$170,676.92	nat. median $106,681 1.6× median
008-4 OTHER	Autologous Bone Marrow Transplant	1	$143,770.00	$184,796.00	$164,283.00	nat. median $81,385 outlier · 2.0×
005-4 OTHER	Tracheostomy W Mv 96+ Hours Without Extensive Procedure	3	$113,678.78	$537,714.87	$163,242.24	nat. median $88,000 1.9× median

Other procedures at this hospital

Browse this hospital's 15,091 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

588-4	OTHER	Neonate Bwt <1500g W Major Procedure	7	4	—	—	$287,612.08	$984,575.36	$511,065.00	2026-02-28
583-4	OTHER	Neonate W Ecmo	7	4	—	—	$378,197.00	$697,728.13	$474,617.00	2026-02-28
583-3	OTHER	Neonate W Ecmo	6	3	—	—	$262,129.19	$579,100.18	$415,338.24	2026-02-28
002-4	OTHER	Heart &/or Lung Transplant	8	3	—	—	$346,148.00	$1,099,608.41	$369,804.87	2026-02-28
591-4	OTHER	Neonate Birthwt 500-749g Without Major Procedure	7	4	—	—	$193,095.60	$628,527.22	$369,055.00	2026-02-28
003-4	OTHER	Bone Marrow Transplant	6	2	—	—	$242,956.44	$1,107,844.98	$352,529.24	2026-02-28
609-4	OTHER	Neonate Bwt 1500-2499g W Major Procedure	7	4	—	—	$137,844.71	$627,388.77	$346,348.00	2026-02-28
161-4	OTHER	Cardiac Defibrillator & Heart Assist Implant	8	3	—	—	$307,088.02	$990,901.77	$336,710.52	2026-02-28
18	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	31	14	—	—	$67.38	$588,394.52	$336,532.84	2026-02-28
007-4	OTHER	Allogeneic Bone Marrow Transplant	2	1	—	—	$291,670.00	$374,901.00	$333,285.50	2024-12-31
593-4	OTHER	Neonate Birthwt 750-999g Without Major Procedure	7	4	—	—	$165,591.83	$597,433.80	$331,483.00	2026-02-28
588-3	OTHER	Neonate Bwt <1500g W Major Procedure	7	4	—	—	$200,743.61	$808,245.59	$328,811.00	2026-02-28
841-4	OTHER	Extensive 3rd Degree Burns W Skin Graft	8	3	—	—	$262,265.00	$856,935.31	$318,170.67	2026-02-28
583-2	OTHER	Neonate W Ecmo	6	3	—	—	$246,561.64	$570,622.93	$308,489.00	2026-02-28
009-4	OTHER	Extracorporeal Membrane Oxygenation (ecmo)	2	1	—	—	$243,001.00	$312,343.00	$277,672.00	2024-12-31
001-4	OTHER	Liver Transplant &/or Intestinal Transplant	8	3	—	—	$238,932.00	$794,156.32	$274,821.95	2026-02-28
583-1	OTHER	Neonate W Ecmo	6	3	—	—	$221,905.90	$570,622.93	$271,630.50	2026-02-28
630-4	OTHER	Neonate Birthwt >2499g W Major Cardiovascular Procedure	7	4	—	—	$132,941.35	$492,180.71	$268,782.00	2026-02-28
602-4	OTHER	Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom	7	4	—	—	$154,290.58	$485,090.23	$268,467.00	2026-02-28
603-4	OTHER	Neonate Birthwt 1000-1249g W Or Without Other Significant Condition	7	4	—	—	$187,608.43	$517,050.86	$263,557.00	2026-02-28
612	OTHER	Neonate, Birth Weight <750 Grams, Discharged Alive	2	1	—	—	$237,150.80	$285,105.09	$261,127.95	2026-02-28
591-3	OTHER	Neonate Birthwt 500-749g Without Major Procedure	7	4	—	—	$160,353.21	$436,900.97	$254,978.00	2026-02-28
1	OTHER	Heart Transplant Or Implant Of Heart Assist System With Mcc	31	14	—	—	$67.38	$387,720.53	$253,492.18	2026-02-28
633	OTHER	Neonate, Birth Weight 1000-1499 Grams, With Significant O.r. Procedures, Dischar…	2	1	—	—	$195,515.27	$311,127.21	$253,321.24	2026-02-28
593-3	OTHER	Neonate Birthwt 750-999g Without Major Procedure	7	4	—	—	$146,389.84	$497,571.15	$241,976.00	2026-02-28
631-4	OTHER	Neonate Birthwt >2499g W Other Major Procedure	7	4	—	—	$137,271.35	$408,405.35	$238,367.00	2026-02-28
004-4	OTHER	Tracheostomy W Mv 96+ Hours W Extensive Procedure Or Ecmo	8	3	—	—	$175,860.18	$750,329.84	$234,545.09	2026-02-28
002-3	OTHER	Heart &/or Lung Transplant	8	3	—	—	$210,158.00	$698,530.39	$233,340.82	2026-02-28
589-2	OTHER	Neonate Bwt <500g Or Ga <24 Weeks	7	4	—	—	$183,604.00	$376,566.97	$221,490.50	2026-02-28
589-1	OTHER	Neonate Bwt <500g Or Ga <24 Weeks	7	4	—	—	$189,438.00	$376,566.97	$220,937.00	2026-02-28
006-4	OTHER	Pancreas Transplant	8	3	—	—	$187,423.30	$358,237.17	$220,287.11	2026-02-28
607-4	OTHER	Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom	7	4	—	—	$126,614.49	$406,995.66	$220,131.00	2026-02-28
593-2	OTHER	Neonate Birthwt 750-999g Without Major Procedure	7	4	—	—	$112,921.61	$430,746.47	$208,502.00	2026-02-28
927	OTHER	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	32	14	—	—	$67.38	$322,222.04	$201,621.82	2026-02-28
003-3	OTHER	Bone Marrow Transplant	6	2	—	—	$149,332.91	$541,588.65	$200,530.36	2026-02-28
636	OTHER	Neonate, Birth Weight 1500-1999 Grams, With Significant O.r. Procedures, With Mu…	2	1	—	—	$182,813.14	$217,616.72	$200,214.93	2026-02-28
631	OTHER	Neonate, Birth Weight 750-999 Grams, Discharged Alive	2	1	—	—	$190,465.19	$206,732.43	$198,598.81	2026-02-28
588-2	OTHER	Neonate Bwt <1500g W Major Procedure	7	4	—	—	$138,951.76	$788,093.51	$196,721.00	2026-02-28
160-4	OTHER	Major Cardiothoracic Repair Of Heart Anomaly	8	3	—	—	$146,740.10	$372,635.88	$194,896.12	2026-02-28
3	OTHER	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…	31	14	—	—	$67.38	$297,719.13	$194,880.41	2026-02-28
007-3	OTHER	Allogeneic Bone Marrow Transplant	2	1	—	—	$168,942.00	$217,151.00	$193,046.50	2024-12-31
602-3	OTHER	Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom	7	4	—	—	$123,738.26	$420,595.93	$186,311.00	2026-02-28
588-1	OTHER	Neonate Bwt <1500g W Major Procedure	7	4	—	—	$130,875.56	$788,093.51	$185,430.00	2026-02-28
161-3	OTHER	Cardiac Defibrillator & Heart Assist Implant	8	3	—	—	$81,123.34	$417,619.91	$181,924.02	2026-02-28
611-4	OTHER	Neonate Birthwt 1500-1999g W Major Anomaly	7	4	—	—	$132,892.26	$310,326.79	$178,408.50	2026-02-28
842-4	OTHER	Full Thickness Burns W Skin Graft	8	3	—	—	$144,322.00	$416,710.68	$177,474.35	2026-02-28
608-4	OTHER	Neonate Bwt 1250-1499g W Or Without Other Significant Condition	7	4	—	—	$141,637.91	$299,534.44	$175,225.50	2026-02-28
002-2	OTHER	Heart &/or Lung Transplant	8	3	—	—	$159,365.92	$439,964.85	$170,676.92	2026-02-28
008-4	OTHER	Autologous Bone Marrow Transplant	2	1	—	—	$143,770.00	$184,796.00	$164,283.00	2024-12-31
005-4	OTHER	Tracheostomy W Mv 96+ Hours Without Extensive Procedure	8	3	—	—	$113,678.78	$537,714.87	$163,242.24	2026-02-28
609-3	OTHER	Neonate Bwt 1500-2499g W Major Procedure	7	4	—	—	$104,476.74	$287,607.47	$162,621.00	2026-02-28
002-1	OTHER	Heart &/or Lung Transplant	8	3	—	—	$130,769.00	$408,894.35	$161,045.64	2026-02-28
603-3	OTHER	Neonate Birthwt 1000-1249g W Or Without Other Significant Condition	7	4	—	—	$100,477.81	$369,136.49	$160,147.00	2026-02-28
863-4	OTHER	Neonatal Aftercare	8	3	—	—	$132,070.33	$202,888.49	$159,444.42	2026-02-28
303-4	OTHER	Dorsal & Lumbar Fusion Proc For Curvature Of Back	8	3	—	—	$107,177.51	$451,505.98	$157,122.44	2026-02-28
602-2	OTHER	Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom	7	4	—	—	$82,105.06	$341,557.74	$157,031.00	2026-02-28
004-3	OTHER	Tracheostomy W Mv 96+ Hours W Extensive Procedure Or Ecmo	8	3	—	—	$135,150.21	$428,679.68	$154,479.13	2026-02-28
006-3	OTHER	Pancreas Transplant	8	3	—	—	$122,891.32	$261,163.35	$152,989.28	2026-02-28
440-4	OTHER	Kidney Transplant	8	3	—	—	$130,841.00	$433,558.21	$151,631.59	2026-02-28
007-2	OTHER	Allogeneic Bone Marrow Transplant	2	1	—	—	$130,597.00	$167,864.00	$149,230.50	2024-12-31
591-2	OTHER	Neonate Birthwt 500-749g Without Major Procedure	7	4	—	—	$59,529.99	$255,189.00	$148,339.70	2026-02-28
589-3	OTHER	Neonate Bwt <500g Or Ga <24 Weeks	7	4	—	—	$95,315.88	$214,543.00	$144,601.86	2026-02-28
621-4	OTHER	Neonate Bwt 2000-2499g W Major Anomaly	7	4	—	—	$83,214.19	$260,326.70	$144,553.00	2026-02-28
612-4	OTHER	Neonate Bwt 1500-1999g W Resp Dist Synd/oth Maj Resp Cond	7	4	—	—	$111,511.00	$275,848.58	$143,331.00	2026-02-28
162-4	OTHER	Cardiac Valve Procedures W Cardiac Catheterization	8	3	—	—	$112,121.61	$434,200.02	$141,049.82	2026-02-28
607-3	OTHER	Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom	7	4	—	—	$91,034.51	$314,785.12	$140,826.00	2026-02-28
001-3	OTHER	Liver Transplant &/or Intestinal Transplant	8	3	—	—	$119,777.97	$404,210.66	$140,613.20	2026-02-28
178-4	OTHER	External Heart Assist Systems	2	1	—	—	$121,838.00	$156,606.00	$139,222.00	2024-12-31
910-4	OTHER	Craniotomy For Multiple Significant Trauma	8	3	—	—	$81,326.99	$303,522.84	$138,138.66	2026-02-28
009-3	OTHER	Extracorporeal Membrane Oxygenation (ecmo)	2	1	—	—	$119,386.00	$153,454.00	$136,420.00	2024-12-31
613-4	OTHER	Neonate Birthwt 1500-1999g W Congenital/perinatal Infection	7	4	—	—	$119,330.97	$224,503.75	$134,390.00	2026-02-28
173-4	OTHER	Other Vascular Procedures	4	2	—	—	$57,189.26	$284,283.80	$133,842.07	2026-02-28
4	OTHER	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…	26	13	—	—	$67.38	$200,104.54	$132,378.41	2026-02-28
006-2	OTHER	Pancreas Transplant	8	3	—	—	$106,477.76	$209,959.87	$129,058.34	2026-02-28
850-4	OTHER	Procedure W Diag Of Rehab, Aftercare Or Oth Contact W Health Service	8	3	—	—	$66,202.27	$393,529.10	$128,800.55	2026-02-28
630-3	OTHER	Neonate Birthwt >2499g W Major Cardiovascular Procedure	7	4	—	—	$92,871.58	$236,121.28	$128,483.00	2026-02-28
693-4	OTHER	Chemotherapy	4	2	—	—	$60,599.16	$265,018.03	$128,414.46	2026-02-28
004-2	OTHER	Tracheostomy W Mv 96+ Hours W Extensive Procedure Or Ecmo	8	3	—	—	$105,020.86	$331,999.35	$127,235.02	2026-02-28
090-4	OTHER	Major Larynx & Trachea Procedures	6	2	—	—	$108,582.06	$200,577.21	$127,045.82	2026-02-28
63600973	OTHER	Sipuleucel-t Susp 250 Ml	31	15	$174,982.50	$61,243.88 65% off	$43,300.08	$210,723.57	$127,011.82	2024-12-31
183-4	OTHER	Percutaneous Structural Cardiac Procedures	2	1	—	—	$110,200.00	$141,647.00	$125,923.50	2024-12-31
304-4	OTHER	Dorsal & Lumbar Fusion Proc Except For Curvature Of Back	8	3	—	—	$82,265.89	$396,230.06	$124,815.58	2026-02-28
312-4	OTHER	Skin Graft, Except Hand, For Musculoskeletal & Connective Tissue Diagnoses	8	3	—	—	$104,044.00	$508,810.48	$124,530.92	2026-02-28
161-2	OTHER	Cardiac Defibrillator & Heart Assist Implant	8	3	—	—	$46,196.10	$254,623.00	$124,420.19	2026-02-28
14	OTHER	Allogeneic Bone Marrow Transplant	31	14	—	—	$67.38	$183,612.13	$122,408.09	2026-02-28
7	OTHER	Lung Transplant	31	14	—	—	$67.38	$188,174.42	$122,120.98	2026-02-28
003-2	OTHER	Bone Marrow Transplant	6	2	—	—	$89,290.40	$381,793.14	$122,111.46	2026-02-28
614-4	OTHER	Neonate Bwt 1500-1999g W Or Without Other Significant Condition	7	4	—	—	$104,497.00	$210,788.87	$121,444.50	2026-02-28
163-4	OTHER	Cardiac Valve Procedures Without Cardiac Catheterization	8	3	—	—	$98,940.48	$364,101.33	$120,389.29	2026-02-28
007-1	OTHER	Allogeneic Bone Marrow Transplant	2	1	—	—	$105,320.00	$135,374.00	$120,347.00	2024-12-31
680-4	OTHER	Major O.r. Procedures For Lymphatic/hematopoietic/other Neoplasms	8	3	—	—	$78,023.62	$454,928.96	$120,118.96	2026-02-28
631-3	OTHER	Neonate Birthwt >2499g W Other Major Procedure	7	4	—	—	$76,327.54	$220,488.61	$119,277.00	2026-02-28
167-4	OTHER	Other Cardiothoracic Procedures	8	3	—	—	$107,038.90	$263,203.39	$119,137.76	2026-02-28
681	OTHER	Neonate, Birth Weight >2499 Grams, With Significant O.r. Procedures, With Multip…	2	1	—	—	$112,219.40	$124,518.91	$118,369.15	2026-02-28
608-3	OTHER	Neonate Bwt 1250-1499g W Or Without Other Significant Condition	7	4	—	—	$71,546.36	$292,978.81	$117,490.00	2026-02-28
021-4	OTHER	Craniotomy Except For Trauma	8	3	—	—	$80,336.92	$330,562.92	$117,130.23	2026-02-28
260-4	OTHER	Major Pancreas, Liver & Shunt Procedures	8	3	—	—	$84,017.32	$319,491.69	$114,283.80	2026-02-28
911-4	OTHER	Extensive Abdominal/thoracic Procedures For Mult Significant Trauma	8	3	—	—	$73,271.68	$274,232.59	$113,002.92	2026-02-28
022-4	OTHER	Ventricular Shunt Procedures	8	3	—	—	$43,343.90	$298,548.80	$112,076.76	2026-02-28
844-4	OTHER	Partial Thickness Burns W Or Without Skin Graft	8	3	—	—	$40,235.00	$236,564.44	$111,359.33	2026-02-28
690-4	OTHER	Acute Leukemia	8	3	—	—	$81,407.41	$370,194.71	$111,152.74	2026-02-28
303-3	OTHER	Dorsal & Lumbar Fusion Proc For Curvature Of Back	8	3	—	—	$71,458.64	$264,273.07	$110,944.82	2026-02-28
179-4	OTHER	Defibrillator Implants	2	1	—	—	$96,882.00	$124,528.00	$110,705.00	2024-12-31
633-4	OTHER	Neonate Birthwt >2499g W Major Anomaly	7	4	—	—	$67,300.96	$196,703.43	$110,527.50	2026-02-28
005-3	OTHER	Tracheostomy W Mv 96+ Hours Without Extensive Procedure	8	3	—	—	$78,671.13	$369,774.48	$110,441.14	2026-02-28
607-2	OTHER	Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom	7	4	—	—	$58,334.95	$271,371.19	$110,405.00	2026-02-28
001-2	OTHER	Liver Transplant &/or Intestinal Transplant	8	3	—	—	$103,541.00	$404,210.66	$110,014.17	2026-02-28
912-4	OTHER	Musculoskeletal & Other Procedures For Multiple Significant Trauma	8	3	—	—	$56,126.08	$299,897.37	$108,733.28	2026-02-28
220-4	OTHER	Major Stomach, Esophageal & Duodenal Procedures	8	3	—	—	$86,076.00	$304,283.07	$108,445.39	2026-02-28
006-1	OTHER	Pancreas Transplant	8	3	—	—	$87,819.60	$209,959.87	$108,147.79	2026-02-28
023-4	OTHER	Spinal Procedures	8	3	—	—	$63,252.94	$319,300.67	$108,021.68	2026-02-28
841-3	OTHER	Extensive 3rd Degree Burns W Skin Graft	8	3	—	—	$95,956.24	$291,263.49	$107,899.27	2026-02-28
089-4	OTHER	Major Cranial/facial Bone Procedures	8	3	—	—	$71,329.13	$289,502.33	$106,883.11	2026-02-28
611-3	OTHER	Neonate Birthwt 1500-1999g W Major Anomaly	7	4	—	—	$64,355.80	$222,647.08	$106,242.00	2026-02-28
165-4	OTHER	Coronary Bypass W Cardiac Cath Or Percutaneous Cardiac Procedure	8	3	—	—	$70,281.62	$324,595.61	$106,062.37	2026-02-28
232-4	OTHER	Gastric Fundoplication	2	1	—	—	$92,166.00	$118,466.00	$105,316.00	2024-12-31
622-4	OTHER	Neonate Bwt 2000-2499g W Resp Dist Synd/oth Maj Resp Cond	7	4	—	—	$67,849.26	$185,456.46	$104,904.00	2026-02-28
2	OTHER	Heart Transplant Or Implant Of Heart Assist System Without Mcc	31	14	—	—	$67.38	$166,749.99	$104,293.05	2026-02-28
603-2	OTHER	Neonate Birthwt 1000-1249g W Or Without Other Significant Condition	7	4	—	—	$74,797.52	$281,674.54	$104,260.00	2026-02-28
591-1	OTHER	Neonate Birthwt 500-749g Without Major Procedure	6	3	—	—	$45,270.51	$183,992.00	$103,299.72	2026-02-28
212	OTHER	Concomitant Aortic And Mitral Valve Procedures	31	14	—	—	$67.38	$160,690.95	$103,198.55	2026-02-28
008-3	OTHER	Autologous Bone Marrow Transplant	2	1	—	—	$90,295.00	$116,061.00	$103,178.00	2024-12-31
651-4	OTHER	Other Procedures Of Blood & Blood-forming Organs	8	3	—	—	$79,402.39	$271,829.63	$102,622.55	2026-02-28
004-1	OTHER	Tracheostomy W Mv 96+ Hours W Extensive Procedure Or Ecmo	8	3	—	—	$92,078.00	$331,999.35	$102,044.20	2026-02-28
5	OTHER	Liver Transplant With Mcc Or Intestinal Transplant	31	14	—	—	$67.38	$153,229.99	$101,071.31	2026-02-28
001-1	OTHER	Liver Transplant &/or Intestinal Transplant	8	3	—	—	$98,621.94	$404,210.66	$100,928.24	2026-02-28
169-4	OTHER	Major Thoracic & Abdominal Vascular Procedures	8	3	—	—	$76,266.97	$294,128.72	$100,194.02	2026-02-28
020-4	OTHER	Craniotomy For Trauma	8	3	—	—	$69,307.21	$278,664.14	$99,909.38	2026-02-28
634	OTHER	Neonate, Birth Weight 1000-1499 Grams, Without Significant O.r. Procedures, Disc…	2	1	—	—	$88,028.65	$111,517.90	$99,773.27	2026-02-28
426	OTHER	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	26	13	—	—	$67.38	$162,638.26	$99,557.44	2026-02-28
215	OTHER	Other Heart Assist System Implant	31	14	—	—	$67.38	$150,894.40	$99,033.57	2026-02-28
027-4	OTHER	Other Open Craniotomy	2	1	—	—	$86,076.00	$110,638.00	$98,357.00	2024-12-31
401-4	OTHER	Pituitary & Adrenal Procedures	8	3	—	—	$60,853.00	$389,395.54	$98,245.24	2026-02-28
950-4	OTHER	Extensive Procedure Unrelated To Principal Diagnosis	8	3	—	—	$60,862.35	$351,750.30	$97,489.92	2026-02-28
681-4	OTHER	Other O.r. Procedures For Lymphatic/hematopoietic/other Neoplasms	8	3	—	—	$61,208.04	$347,383.70	$97,423.43	2026-02-28
623-4	OTHER	Neonate Bwt 2000-2499g W Congenital/perinatal Infection	7	4	—	—	$76,105.09	$169,063.56	$97,261.50	2026-02-28
178-3	OTHER	External Heart Assist Systems	2	1	—	—	$84,958.00	$109,201.00	$97,079.50	2024-12-31
612-3	OTHER	Neonate Bwt 1500-1999g W Resp Dist Synd/oth Maj Resp Cond	7	4	—	—	$62,067.56	$222,016.73	$96,915.00	2026-02-28
403-4	OTHER	Procedures For Obesity	8	3	—	—	$74,457.00	$309,356.43	$96,461.41	2026-02-28
609-2	OTHER	Neonate Bwt 1500-2499g W Major Procedure	7	4	—	—	$68,269.10	$169,732.11	$95,935.00	2026-02-28
161-1	OTHER	Cardiac Defibrillator & Heart Assist Implant	8	3	—	—	$32,887.56	$214,479.00	$95,833.49	2026-02-28
841-2	OTHER	Extensive 3rd Degree Burns W Skin Graft	8	3	—	—	$73,659.00	$291,263.49	$95,202.98	2026-02-28
440-3	OTHER	Kidney Transplant	8	3	—	—	$84,675.00	$218,337.79	$94,802.64	2026-02-28
613-3	OTHER	Neonate Birthwt 1500-1999g W Congenital/perinatal Infection	7	4	—	—	$65,133.87	$211,426.86	$93,794.00	2026-02-28
609-1	OTHER	Neonate Bwt 1500-2499g W Major Procedure	7	4	—	—	$62,164.69	$169,732.11	$92,614.50	2026-02-28
166-4	OTHER	Coronary Bypass Without Cardiac Cath Or Percutaneous Cardiac Procedure	8	3	—	—	$69,686.32	$349,087.55	$92,450.76	2026-02-28
216	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	31	14	—	—	$67.38	$146,244.28	$92,385.73	2026-02-28
091-4	OTHER	Other Major Head & Neck Procedures	8	3	—	—	$79,542.67	$174,366.13	$90,666.43	2026-02-28
073-4	OTHER	Eye Procedures Except Orbit	8	3	—	—	$64,945.00	$109,864.19	$90,231.54	2026-02-28
634-4	OTHER	Neonate, Birthwt >2499g W Resp Dist Synd/oth Maj Resp Cond	7	4	—	—	$43,838.94	$156,964.67	$90,105.00	2026-02-28
792-4	OTHER	Extensive Or Procedures For Other Complications Of Treatment	2	1	—	—	$78,813.00	$101,302.00	$90,057.50	2024-12-31
162-3	OTHER	Cardiac Valve Procedures W Cardiac Catheterization	8	3	—	—	$63,563.12	$221,298.52	$89,972.99	2026-02-28
321-4	OTHER	Cervical Spinal Fusion & Other Back/neck Proc Exc Disc Excis/decomp	8	3	—	—	$51,925.58	$371,719.01	$89,946.90	2026-02-28
009-2	OTHER	Extracorporeal Membrane Oxygenation (ecmo)	2	1	—	—	$78,519.00	$100,926.00	$89,722.50	2024-12-31
441-4	OTHER	Major Bladder Procedures	8	3	—	—	$75,458.62	$323,655.82	$89,341.46	2026-02-28
625-4	OTHER	Neonate Bwt 2000-2499g W Other Significant Condition	7	4	—	—	$65,716.63	$120,538.11	$89,251.14	2026-02-28
361-4	OTHER	Skin Graft For Skin & Subcutaneous Tissue Diagnoses	8	3	—	—	$86,416.73	$390,167.24	$88,862.40	2026-02-28
850	OTHER	Acute Leukemia With Other Procedures	26	13	—	—	$67.38	$132,846.79	$88,564.53	2026-02-28
510-4	OTHER	Pelvic Evisceration, Radical Hysterectomy & Other Radical GYN Procs	8	3	—	—	$68,374.00	$264,597.80	$88,483.59	2026-02-28
365	OTHER	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	1	1	—	—	$88,388.55	$88,388.55	$88,388.55	2026-02-28
120-4	OTHER	Major Respiratory & Chest Procedures	8	3	—	—	$70,881.09	$264,567.24	$88,381.37	2026-02-28
030-4	OTHER	Percutaneous Intracranial And Extracranial Vascular Procedures	2	1	—	—	$77,059.00	$99,048.00	$88,053.50	2024-12-31
003-1	OTHER	Bone Marrow Transplant	6	2	—	—	$72,442.44	$332,992.63	$87,242.80	2026-02-28
230-4	OTHER	Major Small Bowel Procedures	2	1	—	—	$76,169.00	$97,904.00	$87,036.50	2024-12-31
009-1	OTHER	Extracorporeal Membrane Oxygenation (ecmo)	2	1	—	—	$76,148.00	$97,877.00	$87,012.50	2024-12-31
710-4	OTHER	Infectious & Parasitic Diseases Including HIV W O.r. Procedure	8	3	—	—	$52,989.80	$275,279.36	$86,673.52	2026-02-28
841-1	OTHER	Extensive 3rd Degree Burns W Skin Graft	8	3	—	—	$73,087.00	$291,263.49	$86,155.17	2026-02-28
632	OTHER	Neonate, Birth Weight 750-999 Grams, Died	2	1	—	—	$70,694.20	$101,459.95	$86,077.07	2026-02-28
183-3	OTHER	Percutaneous Structural Cardiac Procedures	2	1	—	—	$75,234.00	$96,703.00	$85,968.50	2024-12-31
005-2	OTHER	Tracheostomy W Mv 96+ Hours Without Extensive Procedure	8	3	—	—	$73,359.41	$247,360.60	$85,649.74	2026-02-28
423-4	OTHER	Inborn Errors Of Metabolism	8	3	—	—	$48,539.27	$200,871.37	$85,635.06	2026-02-28
695-4	OTHER	Chemotherapy For Acute Leukemia	4	2	—	—	$72,009.27	$124,564.00	$85,503.76	2026-02-28
221-4	OTHER	Major Small & Large Bowel Procedures	6	2	—	—	$53,120.35	$270,901.29	$85,250.30	2026-02-28
264-4	OTHER	Other Hepatobiliary, Pancreas & Abdominal Procedures	8	3	—	—	$54,860.29	$307,369.88	$84,323.39	2026-02-28
711-4	OTHER	Post-op, Post-trauma, Other Device Infections W O.r. Procedure	8	3	—	—	$55,960.02	$265,281.63	$84,111.74	2026-02-28
614-3	OTHER	Neonate Bwt 1500-1999g W Or Without Other Significant Condition	7	4	—	—	$51,478.58	$205,558.88	$84,081.00	2026-02-28
440-2	OTHER	Kidney Transplant	8	3	—	—	$70,003.16	$181,979.99	$83,924.37	2026-02-28
178-2	OTHER	External Heart Assist Systems	2	1	—	—	$72,917.00	$93,724.00	$83,320.50	2024-12-31
008-2	OTHER	Autologous Bone Marrow Transplant	2	1	—	—	$72,663.00	$93,398.00	$83,030.50	2024-12-31
121-4	OTHER	Other Respiratory & Chest Procedures	8	3	—	—	$68,781.00	$276,203.87	$82,403.89	2026-02-28
231	OTHER	Coronary Bypass With Ptca With Mcc	31	14	—	—	$67.38	$128,334.55	$82,143.66	2026-02-28
791-4	OTHER	O.r. Procedure For Other Complications Of Treatment	6	2	—	—	$64,929.17	$275,378.68	$82,119.24	2026-02-28
456	OTHER	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	31	14	—	—	$67.38	$127,983.74	$82,102.77	2026-02-28
405-4	OTHER	Other Procedures For Endocrine, Nutritional & Metabolic Disorders	8	3	—	—	$75,566.19	$328,954.57	$81,834.61	2026-02-28
650-4	OTHER	Splenectomy	8	3	—	—	$63,755.00	$248,827.60	$81,587.06	2026-02-28
608-2	OTHER	Neonate Bwt 1250-1499g W Or Without Other Significant Condition	7	4	—	—	$48,329.78	$233,821.46	$81,376.00	2026-02-28
429	OTHER	Combined Anterior And Posterior Cervical Spinal Fusion With Mcc	25	13	—	—	$67.38	$136,008.64	$80,983.90	2026-02-28
026-4	OTHER	Other Nervous System & Related Procedures	8	3	—	—	$45,875.48	$293,490.73	$80,838.36	2026-02-28
179-3	OTHER	Defibrillator Implants	2	1	—	—	$70,369.00	$90,450.00	$80,409.50	2024-12-31
514-4	OTHER	Female Reproductive System Reconstructive Procedures	8	3	—	—	$46,434.96	$186,514.69	$80,338.29	2026-02-28
602-1	OTHER	Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom	7	4	—	—	$61,850.00	$282,140.62	$79,499.00	2026-02-28
440-1	OTHER	Kidney Transplant	8	3	—	—	$63,970.83	$156,540.61	$79,430.40	2026-02-28
024-4	OTHER	Extracranial Vascular Procedures	8	3	—	—	$51,360.57	$269,228.00	$79,400.78	2026-02-28
181-4	OTHER	Lower Extremity Arterial Procedures	4	2	—	—	$77,198.00	$99,228.00	$79,343.99	2026-02-28
20	OTHER	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc	31	14	—	—	$67.38	$120,906.69	$78,552.15	2026-02-28
160-3	OTHER	Major Cardiothoracic Repair Of Heart Anomaly	8	3	—	—	$63,868.08	$159,168.98	$78,453.06	2026-02-28
130-4	OTHER	Respiratory System Diagnosis W Ventilator Support 96+ Hours	8	3	—	—	$55,956.89	$239,509.89	$78,445.23	2026-02-28
630-2	OTHER	Neonate Birthwt >2499g W Major Cardiovascular Procedure	7	4	—	—	$48,299.49	$146,649.86	$77,752.50	2026-02-28
029-4	OTHER	Other Percutaneous Intracranial Procedures	2	1	—	—	$68,013.00	$87,421.00	$77,717.00	2024-12-31
635	OTHER	Neonate, Birth Weight 1000-1499 Grams, Died	2	1	—	—	$62,067.45	$92,742.62	$77,405.04	2026-02-28
546-4	OTHER	Other O.r. Proc For Obstetric Diagnoses Except Delivery Diagnoses	6	2	—	—	$54,899.41	$78,529.23	$77,249.21	2026-02-28
480-4	OTHER	Major Male Pelvic Procedures	8	3	—	—	$59,341.36	$99,518.82	$77,017.50	2026-02-28
447-4	OTHER	Other Kidney, Urinary Tract & Related Procedures	8	3	—	—	$50,285.90	$318,135.48	$76,853.37	2026-02-28
005-1	OTHER	Tracheostomy W Mv 96+ Hours Without Extensive Procedure	8	3	—	—	$69,060.00	$242,783.89	$76,853.37	2026-02-28
233	OTHER	Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc	31	14	—	—	$67.38	$117,946.67	$76,423.17	2026-02-28
178-1	OTHER	External Heart Assist Systems	2	1	—	—	$66,842.00	$85,916.00	$76,379.00	2024-12-31
303-2	OTHER	Dorsal & Lumbar Fusion Proc For Curvature Of Back	8	3	—	—	$51,395.03	$189,968.24	$76,241.60	2026-02-28
404-4	OTHER	Thyroid, Parathyroid & Thyroglossal Procedures	8	3	—	—	$61,024.80	$93,127.45	$76,131.97	2026-02-28
219	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	31	14	—	—	$67.38	$118,384.85	$75,736.71	2026-02-28
231-4	OTHER	Major Large Bowel Procedures	2	1	—	—	$66,131.00	$85,002.00	$75,566.50	2024-12-31
621-3	OTHER	Neonate Bwt 2000-2499g W Major Anomaly	7	4	—	—	$50,034.20	$128,618.04	$75,378.00	2026-02-28
092-4	OTHER	Facial Bone Procedures Except Major Cranial/facial Bone Procedures	8	3	—	—	$65,326.00	$103,309.00	$75,003.20	2026-02-28
481-4	OTHER	Penis Procedures	6	2	—	—	$61,024.80	$146,626.93	$74,918.67	2026-02-28
261-4	OTHER	Major Biliary Tract Procedures	8	3	—	—	$58,022.68	$272,895.49	$74,770.29	2026-02-28
10	OTHER	Pancreas Transplant	31	14	—	—	$67.38	$116,678.47	$74,487.61	2026-02-28
692-4	OTHER	Radiotherapy	8	3	—	—	$52,888.16	$118,612.67	$74,380.81	2026-02-28
222-4	OTHER	Other Stomach, Esophageal & Duodenal Procedures	8	3	—	—	$59,325.00	$219,930.85	$74,291.58	2026-02-28
607-1	OTHER	Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom	7	4	—	—	$51,381.46	$225,221.97	$74,233.00	2026-02-28
740-4	OTHER	Mental Illness Diagnosis W O.r. Procedure	8	3	—	—	$54,342.16	$91,088.13	$74,219.98	2026-02-28
483-4	OTHER	Testes & Scrotal Procedures	8	3	—	—	$53,603.00	$134,990.30	$74,170.96	2026-02-28
19	OTHER	Simultaneous Pancreas And Kidney Transplant With Hemodialysis	31	14	—	—	$67.38	$116,082.06	$74,124.89	2026-02-28
223-4	OTHER	Other Small & Large Bowel Procedures	8	3	—	—	$55,045.14	$231,834.91	$74,006.95	2026-02-28
957	OTHER	Other O.r. Procedures For Multiple Significant Trauma With Mcc	32	14	—	—	$67.38	$117,611.75	$73,358.90	2026-02-28
325-4	OTHER	Non-elective Or Complex Knee Joint Replacement	2	1	—	—	$63,651.00	$81,815.00	$72,733.00	2024-12-31
183-2	OTHER	Percutaneous Structural Cardiac Procedures	2	1	—	—	$63,270.00	$81,324.00	$72,297.00	2024-12-31
870	OTHER	Septicemia Or Severe Sepsis With Mv >96 Hours	32	14	—	—	$67.38	$108,237.90	$72,158.60	2026-02-28
928	OTHER	Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc	32	14	—	—	$67.38	$111,691.70	$72,156.98	2026-02-28
163-3	OTHER	Cardiac Valve Procedures Without Cardiac Catheterization	8	3	—	—	$48,951.18	$179,603.76	$72,072.51	2026-02-28
636-4	OTHER	Neonate Birthwt >2499g W Congenital/perinatal Infection	7	4	—	—	$53,576.50	$82,801.18	$72,006.94	2026-02-28
612-2	OTHER	Neonate Bwt 1500-1999g W Resp Dist Synd/oth Maj Resp Cond	7	4	—	—	$44,382.01	$151,719.39	$71,602.00	2026-02-28
843-4	OTHER	Extensive 3rd Degree Or Full Thickness Burns Without Skin Graft	8	3	—	—	$61,868.00	$129,492.89	$71,485.79	2026-02-28
951-4	OTHER	Moderately Extensive Procedure Unrelated To Principal Diagnosis	8	3	—	—	$55,620.60	$263,906.32	$71,302.85	2026-02-28
955	OTHER	Craniotomy For Multiple Significant Trauma	32	14	—	—	$67.38	$107,572.14	$70,890.76	2026-02-28
910-3	OTHER	Craniotomy For Multiple Significant Trauma	8	3	—	—	$58,603.00	$164,253.80	$70,875.89	2026-02-28
165-3	OTHER	Coronary Bypass W Cardiac Cath Or Percutaneous Cardiac Procedure	8	3	—	—	$45,764.78	$186,002.77	$70,422.05	2026-02-28
304-3	OTHER	Dorsal & Lumbar Fusion Proc Except For Curvature Of Back	8	3	—	—	$42,317.27	$209,822.34	$70,271.28	2026-02-28
623-3	OTHER	Neonate Bwt 2000-2499g W Congenital/perinatal Infection	7	4	—	—	$48,936.56	$154,733.61	$70,234.00	2026-02-28
427	OTHER	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	26	13	—	—	$67.38	$112,299.32	$70,213.71	2026-02-28
176-4	OTHER	Cardiac Pacemaker & Defibrillator Device Replacement	8	3	—	—	$59,055.57	$130,199.64	$69,990.37	2026-02-28
275	OTHER	Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc	31	14	—	—	$67.38	$111,131.73	$69,903.11	2026-02-28
317-4	OTHER	Tendon, Muscle & Other Soft Tissue Procedures	8	3	—	—	$57,297.87	$259,207.36	$69,737.32	2026-02-28
229-4	OTHER	Other Digestive System & Abdominal Procedures	8	3	—	—	$47,512.02	$228,438.66	$69,594.99	2026-02-28
511-4	OTHER	Uterine & Adnexa Procedures For Ovarian & Adnexal Malignancy	8	3	—	—	$54,491.62	$237,702.89	$69,594.99	2026-02-28
182-4	OTHER	Other Peripheral Vascular Procedures	4	2	—	—	$68,304.00	$87,796.00	$69,594.99	2026-02-28
008-1	OTHER	Autologous Bone Marrow Transplant	2	1	—	—	$60,859.00	$78,226.00	$69,542.50	2024-12-31
593-1	OTHER	Neonate Birthwt 750-999g Without Major Procedure	6	3	—	—	$42,356.00	$428,729.35	$69,408.52	2026-02-28
573	OTHER	Skin Graft For Skin Ulcer Or Cellulitis With Mcc	31	14	—	—	$67.38	$103,466.91	$68,977.94	2026-02-28
793-4	OTHER	Moderately Extensive Or Procedures For Other Complications Of Treatment	2	1	—	—	$60,306.00	$77,515.00	$68,910.50	2024-12-31
863-3	OTHER	Neonatal Aftercare	8	3	—	—	$34,517.84	$140,197.37	$68,883.39	2026-02-28
183-1	OTHER	Percutaneous Structural Cardiac Procedures	2	1	—	—	$60,187.00	$77,362.00	$68,774.50	2024-12-31
162-2	OTHER	Cardiac Valve Procedures W Cardiac Catheterization	8	3	—	—	$45,112.04	$163,069.51	$68,659.90	2026-02-28
207	OTHER	Respiratory System Diagnosis With Ventilator Support >96 Hours	31	14	—	—	$67.38	$101,922.03	$67,948.02	2026-02-28
224-4	OTHER	Peritoneal Adhesiolysis	8	3	—	—	$41,398.22	$193,425.61	$67,887.14	2026-02-28
093-4	OTHER	Sinus & Mastoid Procedures	6	2	—	—	$48,555.36	$95,366.15	$67,744.82	2026-02-28
613-2	OTHER	Neonate Birthwt 1500-1999g W Congenital/perinatal Infection	7	4	—	—	$43,190.38	$132,541.49	$67,462.00	2026-02-28
366	OTHER	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	1	1	—	—	$67,270.60	$67,270.60	$67,270.60	2026-02-28
447	OTHER	Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall…	25	13	—	—	$67.38	$105,190.50	$66,750.97	2026-02-28
179-2	OTHER	Defibrillator Implants	2	1	—	—	$58,409.00	$75,077.00	$66,743.00	2024-12-31
444-4	OTHER	Renal Dialysis Access Device Procedure Only	8	3	—	—	$35,168.49	$261,533.92	$66,525.61	2026-02-28
268	OTHER	Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc	31	14	—	—	$67.38	$107,789.13	$66,428.18	2026-02-28
631-2	OTHER	Neonate Birthwt >2499g W Other Major Procedure	7	4	—	—	$38,021.73	$139,356.90	$66,056.00	2026-02-28
320-4	OTHER	Other Musculoskeletal System & Connective Tissue Procedures	8	3	—	—	$48,769.46	$241,553.75	$65,752.33	2026-02-28
070-4	OTHER	Orbital Procedures	6	2	—	—	$56,816.19	$86,185.97	$65,668.40	2026-02-28
484-4	OTHER	Other Male Reproductive System & Related Procedures	8	3	—	—	$38,438.61	$79,995.00	$65,603.46	2026-02-28
303-1	OTHER	Dorsal & Lumbar Fusion Proc For Curvature Of Back	8	3	—	—	$45,120.39	$164,498.30	$65,183.04	2026-02-28
969	OTHER	HIV With Extensive O.r. Procedures With Mcc	32	14	—	—	$67.38	$97,773.23	$65,182.15	2026-02-28
362-4	OTHER	Mastectomy Procedures	8	3	—	—	$45,148.00	$112,137.27	$65,071.71	2026-02-28
309-4	OTHER	Hip & Femur Procedures For Non-trauma Except Joint Replacement	8	3	—	—	$56,576.21	$251,631.70	$64,898.40	2026-02-28
217	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	31	14	—	—	$67.38	$103,783.30	$64,603.72	2026-02-28
262-4	OTHER	Cholecystectomy Except Laparoscopic	6	2	—	—	$30,152.32	$191,828.72	$64,471.44	2026-02-28
170-4	OTHER	Permanent Cardiac Pacemaker Implant W Ami, Heart Failure Or Shock	8	3	—	—	$45,325.09	$164,964.37	$64,329.12	2026-02-28
021-3	OTHER	Craniotomy Except For Trauma	8	3	—	—	$41,106.84	$182,625.62	$64,044.47	2026-02-28
790	OTHER	Extreme Immaturity Or Respiratory Distress Syndrome, Neonate	27	13	—	—	$67.38	$172,594.61	$63,613.01	2026-02-28
030-3	OTHER	Percutaneous Intracranial And Extracranial Vascular Procedures	2	1	—	—	$55,611.00	$71,480.00	$63,545.50	2024-12-31
16	OTHER	Autologous Bone Marrow Transplant With Cc/mcc	31	14	—	—	$67.38	$95,236.82	$63,491.22	2026-02-28
611-2	OTHER	Neonate Birthwt 1500-1999g W Major Anomaly	7	4	—	—	$36,248.38	$164,666.39	$63,104.00	2026-02-28
952-4	OTHER	Nonextensive Procedure Unrelated To Principal Diagnosis	8	3	—	—	$45,495.33	$258,114.75	$63,048.22	2026-02-28
548-4	OTHER	Other O.r. Proc For Obstetric Diagnoses Except Delivery Diagnoses	2	1	—	—	$55,159.00	$70,899.00	$63,029.00	2024-12-31
313-4	OTHER	Knee & Lower Leg Procedures Except Foot	8	3	—	—	$46,874.95	$277,552.44	$62,621.26	2026-02-28
842-3	OTHER	Full Thickness Burns W Skin Graft	8	3	—	—	$60,744.23	$180,600.86	$62,563.40	2026-02-28
625-3	OTHER	Neonate Bwt 2000-2499g W Other Significant Condition	7	4	—	—	$42,542.86	$120,538.11	$62,498.00	2026-02-28
820	OTHER	Lymphoma And Leukemia With Major O.r. Procedures With Mcc	32	14	—	—	$67.38	$94,377.68	$62,472.95	2026-02-28
442-4	OTHER	Kidney & Urinary Tract Procedures For Malignancy	8	3	—	—	$57,439.91	$271,608.05	$62,336.62	2026-02-28
276	OTHER	Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator	31	14	—	—	$67.38	$96,254.83	$62,311.17	2026-02-28
317	OTHER	Concomitant Left Atrial Appendage Closure And Cardiac Ablation	26	13	—	—	$67.38	$105,255.37	$62,241.57	2026-02-28
305-4	OTHER	Amputation Of Lower Limb Except Toes	8	3	—	—	$43,986.19	$255,127.27	$62,078.56	2026-02-28
167-3	OTHER	Other Cardiothoracic Procedures	8	3	—	—	$47,996.62	$137,129.67	$62,070.99	2026-02-28
177-4	OTHER	Cardiac Pacemaker & Defibrillator Revision Except Device Replacement	8	3	—	—	$47,268.68	$279,569.55	$62,051.98	2026-02-28
613	OTHER	Neonate, Birth Weight <750 Grams, Died	2	1	—	—	$39,972.15	$84,112.60	$62,042.38	2026-02-28
050-4	OTHER	Non-bacterial Infections Of Nervous System Exc Viral Meningitis	8	3	—	—	$38,882.30	$194,216.41	$61,633.35	2026-02-28
232	OTHER	Coronary Bypass With Ptca Without Mcc	31	14	—	—	$67.38	$96,996.16	$61,565.55	2026-02-28
049-4	OTHER	Bacterial & Tuberculous Infections Of Nervous System	8	3	—	—	$44,700.55	$198,036.71	$61,482.69	2026-02-28
180-4	OTHER	Other Circulatory System Procedures	8	3	—	—	$43,702.12	$223,304.18	$61,482.69	2026-02-28
463	OTHER	Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …	31	14	—	—	$67.38	$92,189.43	$61,459.62	2026-02-28
162-1	OTHER	Cardiac Valve Procedures W Cardiac Catheterization	8	3	—	—	$40,056.19	$140,778.06	$61,376.24	2026-02-28
28	OTHER	Spinal Procedures With Mcc	31	14	—	—	$67.38	$96,277.33	$61,311.50	2026-02-28
443-4	OTHER	Kidney & Urinary Tract Procedures For Nonmalignancy	8	3	—	—	$40,234.78	$218,758.02	$61,189.98	2026-02-28
173-3	OTHER	Other Vascular Procedures	4	2	—	—	$27,076.62	$128,033.53	$60,938.84	2026-02-28
17	OTHER	Autologous Bone Marrow Transplant Without Cc/mcc	31	14	—	—	$67.38	$91,398.24	$60,932.16	2026-02-28
519-4	OTHER	Uterine & Adnexa Procedures For Leiomyoma	8	3	—	—	$48,118.41	$167,948.03	$60,609.61	2026-02-28

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