Price Transparencybeta Hospital negotiated rates

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

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Hospital

AVERA ST LUKES

Aberdeen, SD · CCN 430014 · Rates published

Your selected procedure

You selected 93306 (CPT)

TTE W Doppler Complete

This hospital’s price: $2,982 across 5 payers · range $1,272-$3,605

Source: https://www.avera.org/app/files/public/552f58d0-bf09-4093-b27e-8b2b093f53ab/460224598_avera-st-lukes-hospital_standardcharges.csv · observed 2026-05-09

This is the facility’s filed rate for this code. The comparison board’s estimate also adds the surgeon and anesthesia fees, so it is usually higher.

3,927 distinct procedures filed
6 distinct payers
35,705 rate rows
2026-05-09 last MRF observed
Data quality

35,383 of 35,705 rate rows are consumer-grade (99.1%)

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

Excluded — reasonRows
per-diem day rate — not a per-procedure price 254
placeholder amount (≤ $0.02) — excluded from medians 34
exceeds 10× this hospital's gross charge — excluded from medians 19
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 8
percent-of-charges filed in the dollar field — excluded from medians 6
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 1
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://www.avera.org/app/files/public/552f58d0-bf09-4093-b27e-8b2b093f53ab/460224598_avera-st-lukes-hospital_standardcharges.csv
Discovered viaDiscovered by HANK (automated)
Last fetch Latest re-check couldn't be parsed — showing last good data · 2026-10-21
Content fingerprint 2f57463b7ecc7aff… · 13,805,471 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
5834
OTHER 		Neonate With Ecmo 1 $938,433.34 $938,433.34 $938,433.34 nat. median
$372,748
outlier · 2.5×
5833
OTHER 		Neonate With Ecmo 1 $817,254.97 $817,254.97 $817,254.97 nat. median
$241,478
outlier · 3.4×
5894
OTHER 		Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational… 1 $773,951.70 $773,951.70 $773,951.70 nat. median
$2,022
outlier · 382.8×
5884
OTHER 		Neonate Birth Weight < 1500 Grams With Major Procedure 1 $753,932.31 $753,932.31 $753,932.31 nat. median
$243,175
outlier · 3.1×
1614
OTHER 		Implantable Heart Assist Systems 1 $750,689.01 $750,689.01 $750,689.01 nat. median
$188,156
outlier · 4.0×
5893
OTHER 		Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational… 1 $703,591.30 $703,591.30 $703,591.30 nat. median
$47,115
outlier · 14.9×
5892
OTHER 		Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational… 1 $639,628.45 $639,628.45 $639,628.45 nat. median
$70,935
outlier · 9.0×
5914
OTHER 		Neonate Birth Weight 500-749 Grams Without Major Procedure 1 $563,644.22 $563,644.22 $563,644.22 nat. median
$157,493
outlier · 3.6×
1613
OTHER 		Implantable Heart Assist Systems 1 $552,288.45 $552,288.45 $552,288.45 nat. median
$78
outlier · 7086.1×
5832
OTHER 		Neonate With Ecmo 1 $512,847.45 $512,847.45 $512,847.45 nat. median
$183,648
outlier · 2.8×
6094
OTHER 		Neonate Birth Weight 1500-2499 Grams With Major Procedure 1 $505,616.82 $505,616.82 $505,616.82 nat. median
$163,006
outlier · 3.1×
5934
OTHER 		Neonate Birth Weight 750-999 Grams Without Major Procedure 1 $474,224.70 $474,224.70 $474,224.70 nat. median
$151,840
outlier · 3.1×
5883
OTHER 		Neonate Birth Weight < 1500 Grams With Major Procedure 1 $426,219.71 $426,219.71 $426,219.71 nat. median
$168,056
outlier · 2.5×
5831
OTHER 		Neonate With Ecmo 1 $415,311.22 $415,311.22 $415,311.22 nat. median
$144,202
outlier · 2.9×
5891
OTHER 		Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational… 1 $415,251.86 $415,251.86 $415,251.86 nat. median
$81,201
outlier · 5.1×
5882
OTHER 		Neonate Birth Weight < 1500 Grams With Major Procedure 1 $414,885.14 $414,885.14 $414,885.14 nat. median
$138,777
outlier · 3.0×
8414
OTHER 		Extensive Third Degree Burns With Skin Graft 1 $412,782.29 $412,782.29 $412,782.29 nat. median
$140,709
outlier · 2.9×
1612
OTHER 		Implantable Heart Assist Systems 1 $392,326.22 $392,326.22 $392,326.22 nat. median
$96,189
outlier · 4.1×
6024
OTHER 		Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 1 $388,673.81 $388,673.81 $388,673.81 nat. median
$119,134
outlier · 3.3×
44
OTHER 		Tracheostomy With Mv >96 Hours With Extensive Procedure 1 $378,903.65 $378,903.65 $378,903.65 nat. median
$57,853
outlier · 6.5×
5933
OTHER 		Neonate Birth Weight 750-999 Grams Without Major Procedure 1 $375,601.00 $375,601.00 $375,601.00 nat. median
$109,130
outlier · 3.4×
18
OTHER 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 2 $267,733.36 $483,172.35 $375,452.85 nat. median
$380,401
1.0× median
1611
OTHER 		Implantable Heart Assist Systems 1 $373,156.87 $373,156.87 $373,156.87 nat. median
$67,062
outlier · 5.6×
6074
OTHER 		Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 1 $353,514.81 $353,514.81 $353,514.81 nat. median
$81,519
outlier · 4.3×
6034
OTHER 		Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 1 $345,171.27 $345,171.27 $345,171.27 nat. median
$114,956
outlier · 3.0×
5913
OTHER 		Neonate Birth Weight 500-749 Grams Without Major Procedure 1 $341,166.97 $341,166.97 $341,166.97 nat. median
$96,248
outlier · 3.5×
4404
OTHER 		Kidney Transplant 1 $331,129.72 $331,129.72 $331,129.72 nat. median
$72,322
outlier · 4.6×
8424
OTHER 		Burns With Skin Graft Except Extensive Third Degree Burns 1 $324,096.22 $324,096.22 $324,096.22 nat. median
$71,111
outlier · 4.6×
5881
OTHER 		Neonate Birth Weight < 1500 Grams With Major Procedure 1 $290,647.90 $290,647.90 $290,647.90 nat. median
$14,030
outlier · 20.7×
1604
OTHER 		Major Cardiothoracic Repair Of Heart Anomaly 1 $289,524.40 $289,524.40 $289,524.40 nat. median
$2,886
outlier · 100.3×
3034
OTHER 		Dorsal And Lumbar Fusion Procedure For Curvature Of Back 1 $255,236.64 $255,236.64 $255,236.64 nat. median
$76,075
outlier · 3.4×
43
OTHER 		Tracheostomy With Mv >96 Hours With Extensive Procedure 1 $253,244.03 $253,244.03 $253,244.03 nat. median
$58,476
outlier · 4.3×
5932
OTHER 		Neonate Birth Weight 750-999 Grams Without Major Procedure 1 $252,557.21 $252,557.21 $252,557.21 nat. median
$82,954
outlier · 3.0×
1
OTHER 		Heart Transplant Or Implant Of Heart Assist System With Mcc 2 $173,748.18 $313,559.42 $243,653.80 nat. median
$225,321
1.1× median
6124
OTHER 		Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other… 1 $243,071.11 $243,071.11 $243,071.11 nat. median
$61,723
outlier · 3.9×
6023
OTHER 		Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 1 $242,905.76 $242,905.76 $242,905.76 nat. median
$95,081
outlier · 2.6×
1784
OTHER 		External Heart Assist Systems 1 $234,320.57 $234,320.57 $234,320.57 nat. median
$58,679
outlier · 4.0×
5931
OTHER 		Neonate Birth Weight 750-999 Grams Without Major Procedure 1 $229,597.66 $229,597.66 $229,597.66 nat. median
$13
outlier · 17661.4×
8514
OTHER 		Gender Related Procedures 1 $222,816.42 $222,816.42 $222,816.42 nat. median
$70,568
outlier · 3.2×
9114
OTHER 		Extensive Abdominal Or Thoracic Procedures For Multiple Significant Trauma 1 $218,750.64 $218,750.64 $218,750.64 nat. median
$24
outlier · 9107.0×
1624
OTHER 		Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 1 $213,152.25 $213,152.25 $213,152.25 nat. median
$13
outlier · 16396.3×
6114
OTHER 		Neonate Birth Weight 1500-1999 Grams With Major Anomaly 1 $211,878.25 $211,878.25 $211,878.25 nat. median
$70,034
outlier · 3.0×
6314
OTHER 		Neonate Birth Weight > 2499 Grams With Other Major Procedure 1 $209,298.45 $209,298.45 $209,298.45 nat. median
$156,971
1.3× median
4403
OTHER 		Kidney Transplant 1 $206,915.80 $206,915.80 $206,915.80 nat. median
$44,545
outlier · 4.6×
8634
OTHER 		Neonatal Aftercare 1 $205,540.05 $205,540.05 $205,540.05 nat. median
$72,646
outlier · 2.8×
6304
OTHER 		Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 1 $201,412.80 $201,412.80 $201,412.80 nat. median
$177,388
1.1× median
1834
OTHER 		Percutaneous Structural Cardiac Procedures 1 $198,735.49 $198,735.49 $198,735.49 nat. median
$51,138
outlier · 3.9×
6904
OTHER 		Acute Leukemia 1 $195,952.19 $195,952.19 $195,952.19 nat. median
$44,543
outlier · 4.4×
9104
OTHER 		Craniotomy For Multiple Significant Trauma 1 $194,536.17 $194,536.17 $194,536.17 nat. median
$1,020
outlier · 190.7×
1674
OTHER 		Other Cardiothoracic And Thoracic Vascular Procedures 1 $193,266.41 $193,266.41 $193,266.41 nat. median
$60,908
outlier · 3.2×

Other procedures at this hospital

Browse this hospital's 3,927 published procedures. Use the slice to choose what to show, then sort or filter any column.

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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
             
5834 OTHER Neonate With Ecmo 1 1 — — $938,433.34 $938,433.34 $938,433.34 2026-05-09
5833 OTHER Neonate With Ecmo 1 1 — — $817,254.97 $817,254.97 $817,254.97 2026-05-09
5894 OTHER Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 1 1 — — $773,951.70 $773,951.70 $773,951.70 2026-05-09
5884 OTHER Neonate Birth Weight < 1500 Grams With Major Procedure 1 1 — — $753,932.31 $753,932.31 $753,932.31 2026-05-09
1614 OTHER Implantable Heart Assist Systems 1 1 — — $750,689.01 $750,689.01 $750,689.01 2026-05-09
5893 OTHER Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 1 1 — — $703,591.30 $703,591.30 $703,591.30 2026-05-09
5892 OTHER Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 1 1 — — $639,628.45 $639,628.45 $639,628.45 2026-05-09
5914 OTHER Neonate Birth Weight 500-749 Grams Without Major Procedure 1 1 — — $563,644.22 $563,644.22 $563,644.22 2026-05-09
1613 OTHER Implantable Heart Assist Systems 1 1 — — $552,288.45 $552,288.45 $552,288.45 2026-05-09
5832 OTHER Neonate With Ecmo 1 1 — — $512,847.45 $512,847.45 $512,847.45 2026-05-09
6094 OTHER Neonate Birth Weight 1500-2499 Grams With Major Procedure 1 1 — — $505,616.82 $505,616.82 $505,616.82 2026-05-09
5934 OTHER Neonate Birth Weight 750-999 Grams Without Major Procedure 1 1 — — $474,224.70 $474,224.70 $474,224.70 2026-05-09
5883 OTHER Neonate Birth Weight < 1500 Grams With Major Procedure 1 1 — — $426,219.71 $426,219.71 $426,219.71 2026-05-09
5831 OTHER Neonate With Ecmo 1 1 — — $415,311.22 $415,311.22 $415,311.22 2026-05-09
5891 OTHER Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 1 1 — — $415,251.86 $415,251.86 $415,251.86 2026-05-09
5882 OTHER Neonate Birth Weight < 1500 Grams With Major Procedure 1 1 — — $414,885.14 $414,885.14 $414,885.14 2026-05-09
8414 OTHER Extensive Third Degree Burns With Skin Graft 1 1 — — $412,782.29 $412,782.29 $412,782.29 2026-05-09
1612 OTHER Implantable Heart Assist Systems 1 1 — — $392,326.22 $392,326.22 $392,326.22 2026-05-09
6024 OTHER Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 1 1 — — $388,673.81 $388,673.81 $388,673.81 2026-05-09
44 OTHER Tracheostomy With Mv >96 Hours With Extensive Procedure 1 1 — — $378,903.65 $378,903.65 $378,903.65 2026-05-09
5933 OTHER Neonate Birth Weight 750-999 Grams Without Major Procedure 1 1 — — $375,601.00 $375,601.00 $375,601.00 2026-05-09
18 OTHER Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 2 2 — — $267,733.36 $483,172.35 $375,452.85 2026-05-09
1611 OTHER Implantable Heart Assist Systems 1 1 — — $373,156.87 $373,156.87 $373,156.87 2026-05-09
6074 OTHER Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 1 1 — — $353,514.81 $353,514.81 $353,514.81 2026-05-09
6034 OTHER Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 1 1 — — $345,171.27 $345,171.27 $345,171.27 2026-05-09
5913 OTHER Neonate Birth Weight 500-749 Grams Without Major Procedure 1 1 — — $341,166.97 $341,166.97 $341,166.97 2026-05-09
4404 OTHER Kidney Transplant 1 1 — — $331,129.72 $331,129.72 $331,129.72 2026-05-09
8424 OTHER Burns With Skin Graft Except Extensive Third Degree Burns 1 1 — — $324,096.22 $324,096.22 $324,096.22 2026-05-09
5881 OTHER Neonate Birth Weight < 1500 Grams With Major Procedure 1 1 — — $290,647.90 $290,647.90 $290,647.90 2026-05-09
1604 OTHER Major Cardiothoracic Repair Of Heart Anomaly 1 1 — — $289,524.40 $289,524.40 $289,524.40 2026-05-09
3034 OTHER Dorsal And Lumbar Fusion Procedure For Curvature Of Back 1 1 — — $255,236.64 $255,236.64 $255,236.64 2026-05-09
43 OTHER Tracheostomy With Mv >96 Hours With Extensive Procedure 1 1 — — $253,244.03 $253,244.03 $253,244.03 2026-05-09
5932 OTHER Neonate Birth Weight 750-999 Grams Without Major Procedure 1 1 — — $252,557.21 $252,557.21 $252,557.21 2026-05-09
1 OTHER Heart Transplant Or Implant Of Heart Assist System With Mcc 2 2 — — $173,748.18 $313,559.42 $243,653.80 2026-05-09
6124 OTHER Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other… 1 1 — — $243,071.11 $243,071.11 $243,071.11 2026-05-09
6023 OTHER Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 1 1 — — $242,905.76 $242,905.76 $242,905.76 2026-05-09
1784 OTHER External Heart Assist Systems 1 1 — — $234,320.57 $234,320.57 $234,320.57 2026-05-09
5931 OTHER Neonate Birth Weight 750-999 Grams Without Major Procedure 1 1 — — $229,597.66 $229,597.66 $229,597.66 2026-05-09
8514 OTHER Gender Related Procedures 1 1 — — $222,816.42 $222,816.42 $222,816.42 2026-05-09
9114 OTHER Extensive Abdominal Or Thoracic Procedures For Multiple Significant Trauma 1 1 — — $218,750.64 $218,750.64 $218,750.64 2026-05-09
1624 OTHER Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 1 1 — — $213,152.25 $213,152.25 $213,152.25 2026-05-09
6114 OTHER Neonate Birth Weight 1500-1999 Grams With Major Anomaly 1 1 — — $211,878.25 $211,878.25 $211,878.25 2026-05-09
6314 OTHER Neonate Birth Weight > 2499 Grams With Other Major Procedure 1 1 — — $209,298.45 $209,298.45 $209,298.45 2026-05-09
4403 OTHER Kidney Transplant 1 1 — — $206,915.80 $206,915.80 $206,915.80 2026-05-09
8634 OTHER Neonatal Aftercare 1 1 — — $205,540.05 $205,540.05 $205,540.05 2026-05-09
6304 OTHER Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 1 1 — — $201,412.80 $201,412.80 $201,412.80 2026-05-09
1834 OTHER Percutaneous Structural Cardiac Procedures 1 1 — — $198,735.49 $198,735.49 $198,735.49 2026-05-09
6904 OTHER Acute Leukemia 1 1 — — $195,952.19 $195,952.19 $195,952.19 2026-05-09
9104 OTHER Craniotomy For Multiple Significant Trauma 1 1 — — $194,536.17 $194,536.17 $194,536.17 2026-05-09
1674 OTHER Other Cardiothoracic And Thoracic Vascular Procedures 1 1 — — $193,266.41 $193,266.41 $193,266.41 2026-05-09
6022 OTHER Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 1 1 — — $188,443.86 $188,443.86 $188,443.86 2026-05-09
6093 OTHER Neonate Birth Weight 1500-2499 Grams With Major Procedure 1 1 — — $188,407.82 $188,407.82 $188,407.82 2026-05-09
3 OTHER Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 2 2 — — $131,596.24 $237,488.76 $184,542.50 2026-05-09
4402 OTHER Kidney Transplant 1 1 — — $183,171.92 $183,171.92 $183,171.92 2026-05-09
8504 OTHER Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal… 1 1 — — $181,891.56 $181,891.56 $181,891.56 2026-05-09
6303 OTHER Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 1 1 — — $181,272.58 $181,272.58 $181,272.58 2026-05-09
2244 OTHER Peritoneal Adhesiolysis 1 1 — — $177,454.82 $177,454.82 $177,454.82 2026-05-09
5912 OTHER Neonate Birth Weight 500-749 Grams Without Major Procedure 1 1 — — $176,297.41 $176,297.41 $176,297.41 2026-05-09
2204 OTHER Major Stomach, Esophageal And Duodenal Procedures 1 1 — — $175,220.55 $175,220.55 $175,220.55 2026-05-09
3033 OTHER Dorsal And Lumbar Fusion Procedure For Curvature Of Back 1 1 — — $173,208.86 $173,208.86 $173,208.86 2026-05-09
214 OTHER Open Craniotomy Except Trauma 1 1 — — $171,544.82 $171,544.82 $171,544.82 2026-05-09
1634 OTHER Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis 1 1 — — $171,385.83 $171,385.83 $171,385.83 2026-05-09
4414 OTHER Major Bladder Procedures 1 1 — — $167,411.21 $167,411.21 $167,411.21 2026-05-09
6073 OTHER Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 1 1 — — $167,050.84 $167,050.84 $167,050.84 2026-05-09
6033 OTHER Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 1 1 — — $166,673.51 $166,673.51 $166,673.51 2026-05-09
3044 OTHER Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back 1 1 — — $164,072.52 $164,072.52 $164,072.52 2026-05-09
5911 OTHER Neonate Birth Weight 500-749 Grams Without Major Procedure 1 1 — — $160,269.60 $160,269.60 $160,269.60 2026-05-09
927 OTHER Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 2 2 — — $114,267.24 $206,215.51 $160,241.38 2026-05-09
1824 OTHER Other Peripheral Vascular And Related Procedures 1 1 — — $160,047.02 $160,047.02 $160,047.02 2026-05-09
1783 OTHER External Heart Assist Systems 1 1 — — $159,703.61 $159,703.61 $159,703.61 2026-05-09
6134 OTHER Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection 1 1 — — $159,487.39 $159,487.39 $159,487.39 2026-05-09
2604 OTHER Major Pancreas, Liver And Shunt Procedures 1 1 — — $158,012.01 $158,012.01 $158,012.01 2026-05-09
6334 OTHER Neonate Birth Weight > 2499 Grams With Major Anomaly 1 1 — — $156,203.82 $156,203.82 $156,203.82 2026-05-09
1694 OTHER Major Abdominal Vascular Procedures 1 1 — — $154,153.98 $154,153.98 $154,153.98 2026-05-09
6224 OTHER Neonate Birth Weight 2000-2499 Grams With Respiratory Distress Syndrome Or Other… 1 1 — — $150,910.68 $150,910.68 $150,910.68 2026-05-09
1304 OTHER Respiratory System Diagnosis With Ventilator Support > 96 Hours 1 1 — — $150,047.92 $150,047.92 $150,047.92 2026-05-09
8413 OTHER Extensive Third Degree Burns With Skin Graft 1 1 — — $149,437.42 $149,437.42 $149,437.42 2026-05-09
9504 OTHER Extensive O.r. Procedure Unrelated To Principal Diagnosis 2 1 — — $117,000.00 $181,620.22 $149,310.11 2026-05-09
1794 OTHER Defibrillator Implants 1 1 — — $146,456.98 $146,456.98 $146,456.98 2026-05-09
3094 OTHER Other Significant Hip And Femur Surgery 2 1 — — $136,720.74 $155,369.92 $146,045.33 2026-05-09
6804 OTHER Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 1 1 — — $145,170.26 $145,170.26 $145,170.26 2026-05-09
3124 OTHER Skin Graft, Except Hand, For Musculoskeletal And Connective Tissue Diagnoses 1 1 — — $143,256.08 $143,256.08 $143,256.08 2026-05-09
6113 OTHER Neonate Birth Weight 1500-1999 Grams With Major Anomaly 1 1 — — $142,931.75 $142,931.75 $142,931.75 2026-05-09
9514 OTHER Moderately Extensive O.r. Procedure Unrelated To Principal Diagnosis 1 1 — — $142,350.93 $142,350.93 $142,350.93 2026-05-09
3614 OTHER Skin Graft For Skin And Subcutaneous Tissue Diagnoses 1 1 — — $141,373.70 $141,373.70 $141,373.70 2026-05-09
6084 OTHER Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 1 1 — — $140,960.34 $140,960.34 $140,960.34 2026-05-09
6814 OTHER Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 1 1 — — $140,712.32 $140,712.32 $140,712.32 2026-05-09
1664 OTHER Coronary Bypass Without Ami Or Complex Principal Diagnosis 1 1 — — $140,703.84 $140,703.84 $140,703.84 2026-05-09
3254 OTHER Non-elective Or Complex Knee Joint Replacement 1 1 — — $140,589.38 $140,589.38 $140,589.38 2026-05-09
6214 OTHER Neonate Birth Weight 2000-2499 Grams With Major Anomaly 1 1 — — $139,236.94 $139,236.94 $139,236.94 2026-05-09
1782 OTHER External Heart Assist Systems 1 1 — — $139,186.07 $139,186.07 $139,186.07 2026-05-09
1814 OTHER Lower Extremity Arterial Procedures 1 1 — — $138,637.04 $138,637.04 $138,637.04 2026-05-09
6083 OTHER Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 1 1 — — $137,816.68 $137,816.68 $137,816.68 2026-05-09
7114 OTHER Post-operative, Post-trauma, Other Device Infections With O.r. Procedure 1 1 — — $135,323.79 $135,323.79 $135,323.79 2026-05-09
14 OTHER Allogeneic Bone Marrow Transplant 3 3 — — $74,510.98 $392,553.04 $134,468.28 2026-05-09
3032 OTHER Dorsal And Lumbar Fusion Procedure For Curvature Of Back 1 1 — — $133,801.78 $133,801.78 $133,801.78 2026-05-09
6144 OTHER Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition 1 1 — — $133,566.48 $133,566.48 $133,566.48 2026-05-09
9103 OTHER Craniotomy For Multiple Significant Trauma 1 1 — — $133,201.87 $133,201.87 $133,201.87 2026-05-09
294 OTHER Other Percutaneous Intracranial Procedures 1 1 — — $133,201.87 $133,201.87 $133,201.87 2026-05-09
2614 OTHER Major Biliary Tract Procedures 1 1 — — $133,142.52 $133,142.52 $133,142.52 2026-05-09
1623 OTHER Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 1 1 — — $132,099.58 $132,099.58 $132,099.58 2026-05-09
1214 OTHER Other Respiratory And Chest Procedures 1 1 — — $131,455.16 $131,455.16 $131,455.16 2026-05-09
7404 OTHER Mental Illness Diagnosis With O.r. Procedure 1 1 — — $131,086.31 $131,086.31 $131,086.31 2026-05-09
1781 OTHER External Heart Assist Systems 1 1 — — $130,973.96 $130,973.96 $130,973.96 2026-05-09
1654 OTHER Coronary Bypass With Ami Or Complex Principal Diagnosis 1 1 — — $130,948.53 $130,948.53 $130,948.53 2026-05-09
924 OTHER Facial Bone Procedures Except Major Cranial Or Facial Bone Procedures 1 1 — — $130,863.73 $130,863.73 $130,863.73 2026-05-09
1204 OTHER Major Respiratory And Chest Procedures 1 1 — — $130,448.25 $130,448.25 $130,448.25 2026-05-09
4014 OTHER Adrenal Procedures 1 1 — — $129,549.46 $129,549.46 $129,549.46 2026-05-09
1714 OTHER Permanent Cardiac Pacemaker Implant Without Ami, Heart Failure Or Shock 1 1 — — $128,567.99 $128,567.99 $128,567.99 2026-05-09
3234 OTHER Non-elective Or Complex Hip Joint Replacement 1 1 — — $128,353.89 $128,353.89 $128,353.89 2026-05-09
5104 OTHER Pelvic Evisceration, Radical Hysterectomy And Other Radical Gynecological Proced… 1 1 — — $127,501.73 $127,501.73 $127,501.73 2026-05-09
9124 OTHER Musculoskeletal And Other Procedures For Multiple Significant Trauma 2 1 — — $114,061.91 $138,961.37 $126,511.64 2026-05-09
4034 OTHER Procedures For Obesity 1 1 — — $125,920.36 $125,920.36 $125,920.36 2026-05-09
7104 OTHER Infectious And Parasitic Diseases Including HIV With O.r. Procedure 2 1 — — $125,208.11 $125,208.11 $125,208.11 2026-05-09
3043 OTHER Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back 1 1 — — $124,830.78 $124,830.78 $124,830.78 2026-05-09
1764 OTHER Insertion, Revision And Replacements Of Pacemaker And Other Cardiac Devices 1 1 — — $123,548.30 $123,548.30 $123,548.30 2026-05-09
1303 OTHER Respiratory System Diagnosis With Ventilator Support > 96 Hours 1 1 — — $122,320.94 $122,320.94 $122,320.94 2026-05-09
5114 OTHER Uterine And Adnexa Procedures For Ovarian And Adnexal Malignancy 1 1 — — $122,246.75 $122,246.75 $122,246.75 2026-05-09
6344 OTHER Neonate Birth Weight > 2499 Grams With Respiratory Distress Syndrome Or Other Ma… 1 1 — — $122,168.31 $122,168.31 $122,168.31 2026-05-09
1833 OTHER Percutaneous Structural Cardiac Procedures 1 1 — — $121,947.85 $121,947.85 $121,947.85 2026-05-09
6123 OTHER Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other… 1 1 — — $121,108.41 $121,108.41 $121,108.41 2026-05-09
4 OTHER Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 2 2 — — $85,878.68 $154,983.31 $120,430.99 2026-05-09
2324 OTHER Gastric Fundoplication 1 1 — — $119,166.68 $119,166.68 $119,166.68 2026-05-09
2644 OTHER Other Hepatobiliary, Pancreas And Abdominal Procedures 1 1 — — $118,255.16 $118,255.16 $118,255.16 2026-05-09
4401 OTHER Kidney Transplant 1 1 — — $117,814.24 $117,814.24 $117,814.24 2026-05-09
6072 OTHER Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 1 1 — — $117,055.36 $117,055.36 $117,055.36 2026-05-09
1704 OTHER Permanent Cardiac Pacemaker Implant With Ami, Heart Failure Or Shock 1 1 — — $116,489.37 $116,489.37 $116,489.37 2026-05-09
6302 OTHER Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 1 1 — — $116,408.82 $116,408.82 $116,408.82 2026-05-09
6082 OTHER Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 1 1 — — $116,010.29 $116,010.29 $116,010.29 2026-05-09
5184 OTHER Other Female Reproductive System And Related Procedures 1 1 — — $115,675.37 $115,675.37 $115,675.37 2026-05-09
8423 OTHER Burns With Skin Graft Except Extensive Third Degree Burns 1 1 — — $115,664.77 $115,664.77 $115,664.77 2026-05-09
6133 OTHER Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection 1 1 — — $114,428.92 $114,428.92 $114,428.92 2026-05-09
6313 OTHER Neonate Birth Weight > 2499 Grams With Other Major Procedure 1 1 — — $114,414.09 $114,414.09 $114,414.09 2026-05-09
4474 OTHER Other Kidney, Urinary Tract And Related Procedures 1 1 — — $113,369.02 $113,369.02 $113,369.02 2026-05-09
4044 OTHER Thyroid, Parathyroid And Thyroglossal Procedures 1 1 — — $113,362.66 $113,362.66 $113,362.66 2026-05-09
4054 OTHER Other Procedures For Endocrine, Nutritional And Metabolic Disorders 1 1 — — $113,309.67 $113,309.67 $113,309.67 2026-05-09
6514 OTHER Other Procedures Of Blood And Blood-forming Organs 1 1 — — $112,839.07 $112,839.07 $112,839.07 2026-05-09
7 OTHER Lung Transplant 2 2 — — $80,291.24 $144,899.79 $112,595.52 2026-05-09
3214 OTHER Spinal Fusion And Other Back And Neck Procedures Except For Disc Procedures 1 1 — — $112,523.22 $112,523.22 $112,523.22 2026-05-09
5124 OTHER Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy 1 1 — — $111,957.24 $111,957.24 $111,957.24 2026-05-09
51 OTHER Tracheostomy With Mv >96 Hours Without Extensive Procedure 1 1 — — $111,342.50 $111,342.50 $111,342.50 2026-05-09
3104 OTHER Vertebral And Intervertebral Spinal Procedures Including Disc Procedures 1 1 — — $111,276.78 $111,276.78 $111,276.78 2026-05-09
2304 OTHER Major Small Bowel Procedures 1 1 — — $110,526.37 $110,526.37 $110,526.37 2026-05-09
6092 OTHER Neonate Birth Weight 1500-2499 Grams With Major Procedure 1 1 — — $110,511.53 $110,511.53 $110,511.53 2026-05-09
6112 OTHER Neonate Birth Weight 1500-1999 Grams With Major Anomaly 1 1 — — $110,320.75 $110,320.75 $110,320.75 2026-05-09
1793 OTHER Defibrillator Implants 1 1 — — $109,640.30 $109,640.30 $109,640.30 2026-05-09
1653 OTHER Coronary Bypass With Ami Or Complex Principal Diagnosis 1 1 — — $109,443.15 $109,443.15 $109,443.15 2026-05-09
5144 OTHER Female Reproductive System Reconstructive Procedures 1 1 — — $108,393.85 $108,393.85 $108,393.85 2026-05-09
1633 OTHER Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis 1 1 — — $107,630.73 $107,630.73 $107,630.73 2026-05-09
3031 OTHER Dorsal And Lumbar Fusion Procedure For Curvature Of Back 1 1 — — $107,361.51 $107,361.51 $107,361.51 2026-05-09
6143 OTHER Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition 1 1 — — $106,748.89 $106,748.89 $106,748.89 2026-05-09
8633 OTHER Neonatal Aftercare 1 1 — — $106,380.04 $106,380.04 $106,380.04 2026-05-09
7934 OTHER Moderately Extensive O.r. Procedures For Other Complications Of Treatment 1 1 — — $106,011.20 $106,011.20 $106,011.20 2026-05-09
1622 OTHER Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 1 1 — — $105,303.18 $105,303.18 $105,303.18 2026-05-09
3134 OTHER Knee And Lower Leg Procedures Except Foot 1 1 — — $103,692.14 $103,692.14 $103,692.14 2026-05-09
2224 OTHER Other Stomach, Esophageal And Duodenal Procedures 1 1 — — $103,399.60 $103,399.60 $103,399.60 2026-05-09
3154 OTHER Shoulder, Upper Arm And Forearm Procedures Except Joint Replacement 1 1 — — $102,914.17 $102,914.17 $102,914.17 2026-05-09
9524 OTHER Non-extensive O.r. Procedure Unrelated To Principal Diagnosis 1 1 — — $102,543.21 $102,543.21 $102,543.21 2026-05-09
4804 OTHER Major Male Pelvic Procedures 1 1 — — $102,231.59 $102,231.59 $102,231.59 2026-05-09
6504 OTHER Splenic Procedures 1 1 — — $102,184.96 $102,184.96 $102,184.96 2026-05-09
1754 OTHER Percutaneous Cardiac Intervention Without Ami 2 1 — — $101,905.15 $101,905.15 $101,905.15 2026-05-09
4424 OTHER Kidney And Urinary Tract Procedures For Malignancy 1 1 — — $101,466.35 $101,466.35 $101,466.35 2026-05-09
6254 OTHER Neonate Birth Weight 2000-2499 Grams With Other Significant Condition 1 1 — — $101,296.76 $101,296.76 $101,296.76 2026-05-09
6234 OTHER Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection 1 1 — — $100,853.72 $100,853.72 $100,853.72 2026-05-09
6903 OTHER Acute Leukemia 1 1 — — $100,446.72 $100,446.72 $100,446.72 2026-05-09
984 OTHER Other Ear, Nose, Mouth, Throat, Craniofacial, And Neck Procedures 1 1 — — $100,408.57 $100,408.57 $100,408.57 2026-05-09
1832 OTHER Percutaneous Structural Cardiac Procedures 1 1 — — $100,355.57 $100,355.57 $100,355.57 2026-05-09
6091 OTHER Neonate Birth Weight 1500-2499 Grams With Major Procedure 1 1 — — $99,458.90 $99,458.90 $99,458.90 2026-05-09
4844 OTHER Other Male Reproductive System And Related Procedures 1 1 — — $99,263.87 $99,263.87 $99,263.87 2026-05-09
4444 OTHER Renal Dialysis Access Device Procedures 1 1 — — $98,892.91 $98,892.91 $98,892.91 2026-05-09
224 OTHER Ventricular Shunt Procedures 1 1 — — $98,803.88 $98,803.88 $98,803.88 2026-05-09
2 OTHER Heart Transplant Or Implant Of Heart Assist System Without Mcc 2 2 — — $70,257.16 $126,791.51 $98,524.33 2026-05-09
209 OTHER Complex Aortic Arch Procedures 2 2 — — $70,176.56 $126,646.05 $98,411.30 2026-05-09
1831 OTHER Percutaneous Structural Cardiac Procedures 1 1 — — $98,218.81 $98,218.81 $98,218.81 2026-05-09
3084 OTHER Hip And Femur Fracture Repair 1 1 — — $98,061.95 $98,061.95 $98,061.95 2026-05-09
8503 OTHER Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal… 1 1 — — $97,593.47 $97,593.47 $97,593.47 2026-05-09
7924 OTHER Extensive O.r. Procedures For Other Complications Of Treatment 1 1 — — $97,555.32 $97,555.32 $97,555.32 2026-05-09
2314 OTHER Major Large Bowel Procedures 1 1 — — $97,243.71 $97,243.71 $97,243.71 2026-05-09
5194 OTHER Uterine And Adnexa Procedures For Leiomyoma 1 1 — — $97,161.03 $97,161.03 $97,161.03 2026-05-09
3224 OTHER Shoulder And Elbow Joint Replacement 1 1 — — $97,135.60 $97,135.60 $97,135.60 2026-05-09
2274 OTHER Hernia Procedures Except Inguinal, Femoral And Umbilical 1 1 — — $96,925.74 $96,925.74 $96,925.74 2026-05-09
3244 OTHER Elective Hip Joint Replacement 1 1 — — $96,747.67 $96,747.67 $96,747.67 2026-05-09
426 OTHER Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 2 2 — — $68,331.44 $123,316.21 $95,823.83 2026-05-09
7524 OTHER Disorders Of Personality And Impulse Control 1 1 — — $95,647.50 $95,647.50 $95,647.50 2026-05-09
7754 OTHER Alcohol Abuse And Dependence 1 1 — — $95,255.33 $95,255.33 $95,255.33 2026-05-09
7594 OTHER Eating Disorders 1 1 — — $95,109.07 $95,109.07 $95,109.07 2026-05-09
6122 OTHER Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other… 1 1 — — $94,901.33 $94,901.33 $94,901.33 2026-05-09
4234 OTHER Inborn Errors Of Metabolism 1 1 — — $94,282.34 $94,282.34 $94,282.34 2026-05-09
1792 OTHER Defibrillator Implants 1 1 — — $94,146.68 $94,146.68 $94,146.68 2026-05-09
3634 OTHER Breast Procedures Except Mastectomy 1 1 — — $94,036.45 $94,036.45 $94,036.45 2026-05-09
1603 OTHER Major Cardiothoracic Repair Of Heart Anomaly 1 1 — — $93,991.93 $93,991.93 $93,991.93 2026-05-09
3624 OTHER Mastectomy Procedures 1 1 — — $93,915.62 $93,915.62 $93,915.62 2026-05-09
3204 OTHER Other Musculoskeletal System And Connective Tissue Procedures 1 1 — — $93,237.28 $93,237.28 $93,237.28 2026-05-09
1791 OTHER Defibrillator Implants 1 1 — — $92,321.53 $92,321.53 $92,321.53 2026-05-09
1621 OTHER Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 1 1 — — $91,441.81 $91,441.81 $91,441.81 2026-05-09
1823 OTHER Other Peripheral Vascular And Related Procedures 1 1 — — $91,102.64 $91,102.64 $91,102.64 2026-05-09
2234 OTHER Other Small And Large Bowel Procedures 1 1 — — $90,521.82 $90,521.82 $90,521.82 2026-05-09
3054 OTHER Amputation Of Lower Limb Except Toes 1 1 — — $89,858.32 $89,858.32 $89,858.32 2026-05-09
5 OTHER Liver Transplant With Mcc Or Intestinal Transplant 2 2 — — $63,925.10 $115,364.18 $89,644.64 2026-05-09
3042 OTHER Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back 2 1 — — $88,145.52 $88,145.52 $88,145.52 2026-05-09
1663 OTHER Coronary Bypass Without Ami Or Complex Principal Diagnosis 1 1 — — $88,126.45 $88,126.45 $88,126.45 2026-05-09
3103 OTHER Vertebral And Intervertebral Spinal Procedures Including Disc Procedures 1 1 — — $87,704.61 $87,704.61 $87,704.61 2026-05-09
6954 OTHER Chemotherapy For Acute Leukemia 1 1 — — $87,297.60 $87,297.60 $87,297.60 2026-05-09
2294 OTHER Other Digestive System And Abdominal Procedures 1 1 — — $86,928.76 $86,928.76 $86,928.76 2026-05-09
3123 OTHER Skin Graft, Except Hand, For Musculoskeletal And Connective Tissue Diagnoses 1 1 — — $86,797.33 $86,797.33 $86,797.33 2026-05-09
215 OTHER Other Heart Assist System Implant 2 2 — — $61,733.40 $111,408.87 $86,571.13 2026-05-09
1302 OTHER Respiratory System Diagnosis With Ventilator Support > 96 Hours 1 1 — — $86,394.57 $86,394.57 $86,394.57 2026-05-09
6253 OTHER Neonate Birth Weight 2000-2499 Grams With Other Significant Condition 1 1 — — $86,068.12 $86,068.12 $86,068.12 2026-05-09
4233 OTHER Inborn Errors Of Metabolism 1 1 — — $85,711.99 $85,711.99 $85,711.99 2026-05-09
4694 OTHER Acute Kidney Injury 1 1 — — $85,697.15 $85,697.15 $85,697.15 2026-05-09
1203 OTHER Major Respiratory And Chest Procedures 2 1 — — $85,673.84 $85,673.84 $85,673.84 2026-05-09
233 OTHER Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 3 3 — — $47,400.24 $102,142.56 $85,542.14 2026-05-09
1652 OTHER Coronary Bypass With Ami Or Complex Principal Diagnosis 1 1 — — $85,357.99 $85,357.99 $85,357.99 2026-05-09
6233 OTHER Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection 1 1 — — $85,224.44 $85,224.44 $85,224.44 2026-05-09
1774 OTHER Cardiac Pacemaker And Defibrillator Revision Except Device Replacement 1 1 — — $85,116.33 $85,116.33 $85,116.33 2026-05-09
4434 OTHER Kidney And Urinary Tract Procedures For Non-malignancy 1 1 — — $85,065.45 $85,065.45 $85,065.45 2026-05-09
1632 OTHER Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis 1 1 — — $85,061.21 $85,061.21 $85,061.21 2026-05-09
216 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 2 2 — — $60,653.36 $109,459.75 $85,056.55 2026-05-09
6914 OTHER Lymphoma, Myeloma And Non-acute Leukemia 1 1 — — $84,823.80 $84,823.80 $84,823.80 2026-05-09
4454 OTHER Other Bladder Procedures 1 1 — — $84,817.44 $84,817.44 $84,817.44 2026-05-09
7234 OTHER Viral Illness 1 1 — — $83,702.42 $83,702.42 $83,702.42 2026-05-09
5484 OTHER Postpartum And Post Abortion Diagnosis With O.r. Procedure 1 1 — — $83,689.70 $83,689.70 $83,689.70 2026-05-09
6032 OTHER Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 1 1 — — $83,592.19 $83,592.19 $83,592.19 2026-05-09
4834 OTHER Penis, Testes And Scrotal Procedures 1 1 — — $83,524.36 $83,524.36 $83,524.36 2026-05-09
6142 OTHER Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition 1 1 — — $83,333.58 $83,333.58 $83,333.58 2026-05-09
6924 OTHER Radiotherapy 1 1 — — $83,138.56 $83,138.56 $83,138.56 2026-05-09
893 OTHER Major Cranial Or Facial Bone Procedures 1 1 — — $82,865.10 $82,865.10 $82,865.10 2026-05-09
9123 OTHER Musculoskeletal And Other Procedures For Multiple Significant Trauma 1 1 — — $82,706.12 $82,706.12 $82,706.12 2026-05-09
3644 OTHER Other Skin, Subcutaneous Tissue And Related Procedures 1 1 — — $82,148.61 $82,148.61 $82,148.61 2026-05-09
2794 OTHER Hepatic Coma And Other Major Acute Liver Disorders 1 1 — — $81,633.50 $81,633.50 $81,633.50 2026-05-09
9113 OTHER Extensive Abdominal Or Thoracic Procedures For Multiple Significant Trauma 1 1 — — $80,412.49 $80,412.49 $80,412.49 2026-05-09
3264 OTHER Elective Knee Joint Replacement 1 1 — — $79,609.09 $79,609.09 $79,609.09 2026-05-09
1301 OTHER Respiratory System Diagnosis With Ventilator Support > 96 Hours 1 1 — — $79,437.39 $79,437.39 $79,437.39 2026-05-09
8904 OTHER HIV With Multiple Major HIV Related Conditions 1 1 — — $79,121.54 $79,121.54 $79,121.54 2026-05-09
1673 OTHER Other Cardiothoracic And Thoracic Vascular Procedures 1 1 — — $78,835.36 $78,835.36 $78,835.36 2026-05-09
3174 OTHER Tendon, Muscle And Other Soft Tissue Procedures 1 1 — — $78,364.77 $78,364.77 $78,364.77 2026-05-09
429 OTHER Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 2 2 — — $55,859.52 $100,808.41 $78,333.96 2026-05-09
4013 OTHER Adrenal Procedures 1 1 — — $78,303.29 $78,303.29 $78,303.29 2026-05-09
5474 OTHER Antepartum With O.r. Procedure 1 1 — — $77,864.49 $77,864.49 $77,864.49 2026-05-09
2284 OTHER Inguinal, Femoral And Umbilical Hernia Procedures 1 1 — — $77,754.26 $77,754.26 $77,754.26 2026-05-09
3164 OTHER Hand And Wrist Procedures 1 1 — — $77,752.14 $77,752.14 $77,752.14 2026-05-09
6364 OTHER Neonate Birth Weight > 2499 Grams With Congenital Or Perinatal Infection 1 1 — — $77,260.35 $77,260.35 $77,260.35 2026-05-09
1703 OTHER Permanent Cardiac Pacemaker Implant With Ami, Heart Failure Or Shock 1 1 — — $76,880.91 $76,880.91 $76,880.91 2026-05-09
7504 OTHER Schizophrenia 1 1 — — $76,677.41 $76,677.41 $76,677.41 2026-05-09
4473 OTHER Other Kidney, Urinary Tract And Related Procedures 1 1 — — $76,056.30 $76,056.30 $76,056.30 2026-05-09
6031 OTHER Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 1 1 — — $75,992.71 $75,992.71 $75,992.71 2026-05-09
6312 OTHER Neonate Birth Weight > 2499 Grams With Other Major Procedure 1 1 — — $75,979.99 $75,979.99 $75,979.99 2026-05-09
1744 OTHER Percutaneous Cardiac Intervention With Ami 1 1 — — $75,587.83 $75,587.83 $75,587.83 2026-05-09
1693 OTHER Major Abdominal Vascular Procedures 1 1 — — $75,456.40 $75,456.40 $75,456.40 2026-05-09
850 OTHER Acute Leukemia With Other Procedures 2 2 — — $53,688.90 $96,891.15 $75,290.02 2026-05-09
6132 OTHER Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection 1 1 — — $74,854.38 $74,854.38 $74,854.38 2026-05-09
1692 OTHER Major Abdominal Vascular Procedures 1 1 — — $74,667.84 $74,667.84 $74,667.84 2026-05-09
9304 OTHER Multiple Significant Trauma Without O.r. Procedure 1 1 — — $74,470.69 $74,470.69 $74,470.69 2026-05-09
2414 OTHER Peptic Ulcer And Gastritis 1 1 — — $74,301.11 $74,301.11 $74,301.11 2026-05-09
6614 OTHER Coagulation And Platelet Disorders 1 1 — — $74,279.91 $74,279.91 $74,279.91 2026-05-09
1631 OTHER Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis 1 1 — — $74,135.77 $74,135.77 $74,135.77 2026-05-09
4264 OTHER Non-hypovolemic Sodium Disorders 1 1 — — $74,036.13 $74,036.13 $74,036.13 2026-05-09
6213 OTHER Neonate Birth Weight 2000-2499 Grams With Major Anomaly 1 1 — — $73,987.38 $73,987.38 $73,987.38 2026-05-09
1763 OTHER Insertion, Revision And Replacements Of Pacemaker And Other Cardiac Devices 1 1 — — $73,923.79 $73,923.79 $73,923.79 2026-05-09
5134 OTHER Uterine And Adnexa Procedures For Non-malignancy Except Leiomyoma 1 1 — — $73,872.91 $73,872.91 $73,872.91 2026-05-09
2613 OTHER Major Biliary Tract Procedures 1 1 — — $73,665.17 $73,665.17 $73,665.17 2026-05-09
1651 OTHER Coronary Bypass With Ami Or Complex Principal Diagnosis 1 1 — — $73,510.42 $73,510.42 $73,510.42 2026-05-09
1691 OTHER Major Abdominal Vascular Procedures 1 1 — — $73,296.32 $73,296.32 $73,296.32 2026-05-09
456 OTHER Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 2 2 — — $52,101.08 $94,025.64 $73,063.36 2026-05-09
1974 OTHER Peripheral And Other Vascular Disorders 1 1 — — $72,916.88 $72,916.88 $72,916.88 2026-05-09
4464 OTHER Urethral And Transurethral Procedures 1 1 — — $72,880.84 $72,880.84 $72,880.84 2026-05-09
3253 OTHER Non-elective Or Complex Knee Joint Replacement 1 1 — — $72,654.03 $72,654.03 $72,654.03 2026-05-09
6803 OTHER Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 1 1 — — $72,581.95 $72,581.95 $72,581.95 2026-05-09
1934 OTHER Acute And Subacute Endocarditis 1 1 — — $71,850.62 $71,850.62 $71,850.62 2026-05-09
4824 OTHER Transurethral Prostatectomy 1 1 — — $71,606.84 $71,606.84 $71,606.84 2026-05-09
7944 OTHER Non-extensive O.r. Procedures For Other Complications Of Treatment 1 1 — — $71,536.89 $71,536.89 $71,536.89 2026-05-09
9503 OTHER Extensive O.r. Procedure Unrelated To Principal Diagnosis 2 1 — — $71,466.94 $71,466.94 $71,466.94 2026-05-09
9102 OTHER Craniotomy For Multiple Significant Trauma 1 1 — — $71,036.62 $71,036.62 $71,036.62 2026-05-09
3213 OTHER Spinal Fusion And Other Back And Neck Procedures Except For Disc Procedures 1 1 — — $70,867.03 $70,867.03 $70,867.03 2026-05-09
3041 OTHER Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back 1 1 — — $70,854.32 $70,854.32 $70,854.32 2026-05-09
2603 OTHER Major Pancreas, Liver And Shunt Procedures 1 1 — — $70,368.88 $70,368.88 $70,368.88 2026-05-09
2264 OTHER Anal And Perineal Procedures 1 1 — — $70,288.33 $70,288.33 $70,288.33 2026-05-09
2474 OTHER Intestinal Obstruction 1 1 — — $70,125.10 $70,125.10 $70,125.10 2026-05-09
3223 OTHER Shoulder And Elbow Joint Replacement 1 1 — — $69,938.56 $69,938.56 $69,938.56 2026-05-09
3133 OTHER Knee And Lower Leg Procedures Except Foot 2 1 — — $69,444.65 $69,444.65 $69,444.65 2026-05-09
1994 OTHER Hypertension 1 1 — — $69,423.45 $69,423.45 $69,423.45 2026-05-09
9101 OTHER Craniotomy For Multiple Significant Trauma 1 1 — — $69,412.85 $69,412.85 $69,412.85 2026-05-09
6311 OTHER Neonate Birth Weight > 2499 Grams With Other Major Procedure 1 1 — — $69,073.68 $69,073.68 $69,073.68 2026-05-09
2824 OTHER Disorders Of Pancreas Except Malignancy 1 1 — — $68,999.49 $68,999.49 $68,999.49 2026-05-09
1213 OTHER Other Respiratory And Chest Procedures 2 1 — — $68,284.13 $69,629.07 $68,956.60 2026-05-09
2404 OTHER Digestive Malignancy 1 1 — — $68,933.78 $68,933.78 $68,933.78 2026-05-09
1662 OTHER Coronary Bypass Without Ami Or Complex Principal Diagnosis 1 1 — — $68,931.66 $68,931.66 $68,931.66 2026-05-09
8502 OTHER Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal… 1 1 — — $68,910.46 $68,910.46 $68,910.46 2026-05-09
6252 OTHER Neonate Birth Weight 2000-2499 Grams With Other Significant Condition 1 1 — — $68,870.18 $68,870.18 $68,870.18 2026-05-09
20 OTHER Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 2 2 — — $48,786.56 $88,044.00 $68,415.28 2026-05-09
8513 OTHER Gender Related Procedures 1 1 — — $68,096.46 $68,096.46 $68,096.46 2026-05-09
5394 OTHER Cesarean Section With Sterilization 1 1 — — $68,015.90 $68,015.90 $68,015.90 2026-05-09
6604 OTHER Major Hematologic Or Immunologic Diagnoses Except Sickle Cell Crisis And Coagula… 1 1 — — $67,933.23 $67,933.23 $67,933.23 2026-05-09
404 OTHER Spinal Disorders And Injuries 1 1 — — $67,782.72 $67,782.72 $67,782.72 2026-05-09
2334 OTHER Appendectomy With Complex Principal Diagnosis 1 1 — — $67,744.57 $67,744.57 $67,744.57 2026-05-09
1804 OTHER Other Circulatory System Procedures 1 1 — — $67,683.09 $67,683.09 $67,683.09 2026-05-09
C1882 HCPCS Icd Bi-v Momentum X4 1s4 Df1 7 4 $107,214.00 $96,492.60 $43,207.24 $81,482.64 $67,544.82 2026-05-09
212 OTHER Concomitant Aortic And Mitral Valve Procedures 3 3 — — $52,939.89 $121,670.30 $67,419.42 2026-05-09
3613 OTHER Skin Graft For Skin And Subcutaneous Tissue Diagnoses 1 1 — — $66,972.96 $66,972.96 $66,972.96 2026-05-09
219 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 2 2 — — $47,605.46 $85,912.50 $66,758.98 2026-05-09
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