Price Transparency 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

Select Specialty Hospital-tricities

Bristol, TN · CCN 442016 · Rates published

829 distinct procedures filed
36 distinct payers
72,123 rate rows
2026-05-24 last MRF observed
Data quality

48,082 of 72,123 rate rows are consumer-grade (66.7%)

24,041 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 — reasonRows
per-diem day rate — not a per-procedure price 24,041
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://resources.selectmedical.com/pricing-transparency/critical-illness-recovery/25-1813125_Select_Specialty_Hospital-TriCities_standardcharges.csv
Found on page https://www.selectspecialtyhospitals.com/patients-and-caregivers/admissions/price-transparency/
Discovered viaDiscovered by HANK
Last fetch success · 2026-05-18
Content fingerprint b1933c6f7b9d917d… · 166,652,075 bytes · first seen 2026-05-18

Top 50 most expensive offerings

Outliers are flagged where this hospital's filed rate is ≥2× or ≤0.5× the national median for the same code.

Code Description Payers Min $ Max $ Avg median vs national
10
OTHER 		Pancreas Transplant 28 $1,608.50 $1,608.50 $1,608.50 nat. median
$62,879
outlier · 0.0×
100
OTHER 		Seizures With Mcc 28 $1,608.50 $1,608.50 $1,608.50 nat. median
$17,793
outlier · 0.1×
101
OTHER 		Seizures Without Mcc 28 $1,608.50 $1,608.50 $1,608.50 nat. median
$7,470
outlier · 0.2×
102
OTHER 		Headaches With Mcc 28 $1,608.50 $1,608.50 $1,608.50 nat. median
$8,495
outlier · 0.2×
103
OTHER 		Headaches Without Mcc 28 $1,608.50 $1,608.50 $1,608.50 nat. median
$7,617
outlier · 0.2×
11
OTHER 		Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With 28 $1,608.50 $1,608.50 $1,608.50 nat. median
$49,519
outlier · 0.0×
113
OTHER 		Orbital Procedures With Cc/mcc 28 $1,608.50 $1,608.50 $1,608.50 nat. median
$18,223
outlier · 0.1×
114
OTHER 		Orbital Procedures Without Cc/mcc 28 $1,608.50 $1,608.50 $1,608.50 nat. median
$10,012
outlier · 0.2×
115
OTHER 		Extraocular Procedures Except Orbit 28 $1,608.50 $1,608.50 $1,608.50 nat. median
$14,295
outlier · 0.1×
116
OTHER 		Intraocular Procedures With Cc/mcc 28 $1,608.50 $1,608.50 $1,608.50 nat. median
$17,102
outlier · 0.1×
117
OTHER 		Intraocular Procedures Without Cc/mcc 28 $1,608.50 $1,608.50 $1,608.50 nat. median
$10,202
outlier · 0.2×
12
OTHER 		Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With 28 $1,608.50 $1,608.50 $1,608.50 nat. median
$39,504
outlier · 0.0×
121
OTHER 		Acute Major Eye Infections With Cc/mcc 28 $1,608.50 $1,608.50 $1,608.50 nat. median
$10,782
outlier · 0.1×
122
OTHER 		Acute Major Eye Infections Without Cc/mcc 28 $1,608.50 $1,608.50 $1,608.50 nat. median
$7,004
outlier · 0.2×
123
OTHER 		Neurological Eye Disorders 28 $1,608.50 $1,608.50 $1,608.50 nat. median
$6,551
outlier · 0.2×
124
OTHER 		Other Disorders Of The Eye With Mcc Or Thrombolytic Agent 28 $1,608.50 $1,608.50 $1,608.50 nat. median
$12,277
outlier · 0.1×
125
OTHER 		Other Disorders Of The Eye Without Mcc 28 $1,608.50 $1,608.50 $1,608.50 nat. median
$7,914
outlier · 0.2×
129
OTHER 		Major Head & Neck Procedures W Cc/mcc Or Major Device 28 $1,608.50 $1,608.50 $1,608.50 nat. median
$1,931
0.8× median
13
OTHER 		Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With 28 $1,608.50 $1,608.50 $1,608.50 nat. median
$27,161
outlier · 0.1×
130
OTHER 		Major Head & Neck Procedures Without Cc/mcc 28 $1,608.50 $1,608.50 $1,608.50 nat. median
$1,931
0.8× median
131
OTHER 		Cranial/facial Procedures W Cc/mcc 28 $1,608.50 $1,608.50 $1,608.50 nat. median
$2,024
0.8× median
132
OTHER 		Cranial/facial Procedures Without Cc/mcc 28 $1,608.50 $1,608.50 $1,608.50 nat. median
$2,024
0.8× median
133
OTHER 		Other Ear, Nose, Mouth & Throat O.r. Procedures W Cc/mcc 28 $1,608.50 $1,608.50 $1,608.50 nat. median
$2,024
0.8× median
134
OTHER 		Other Ear, Nose, Mouth & Throat O.r. Procedures Without Cc/mcc 28 $1,608.50 $1,608.50 $1,608.50 nat. median
$1,982
0.8× median
135
OTHER 		Sinus And Mastoid Procedures With Cc/mcc 28 $1,608.50 $1,608.50 $1,608.50 nat. median
$21,358
outlier · 0.1×
136
OTHER 		Sinus And Mastoid Procedures Without Cc/mcc 28 $1,608.50 $1,608.50 $1,608.50 nat. median
$10,177
outlier · 0.2×
137
OTHER 		Mouth Procedures With Cc/mcc 28 $1,608.50 $1,608.50 $1,608.50 nat. median
$14,173
outlier · 0.1×
138
OTHER 		Mouth Procedures Without Cc/mcc 28 $1,608.50 $1,608.50 $1,608.50 nat. median
$8,682
outlier · 0.2×
139
OTHER 		Salivary Gland Procedures 28 $1,608.50 $1,608.50 $1,608.50 nat. median
$12,273
outlier · 0.1×
14
OTHER 		Allogeneic Bone Marrow Transplant 28 $1,608.50 $1,608.50 $1,608.50 nat. median
$100,915
outlier · 0.0×
140
OTHER 		Major Head And Neck Procedures With Mcc 28 $1,608.50 $1,608.50 $1,608.50 nat. median
$37,242
outlier · 0.0×
141
OTHER 		Major Head And Neck Procedures With Cc 28 $1,608.50 $1,608.50 $1,608.50 nat. median
$20,468
outlier · 0.1×
142
OTHER 		Major Head And Neck Procedures Without Cc/mcc 28 $1,608.50 $1,608.50 $1,608.50 nat. median
$15,554
outlier · 0.1×
143
OTHER 		Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 28 $1,608.50 $1,608.50 $1,608.50 nat. median
$31,981
outlier · 0.1×
144
OTHER 		Other Ear, Nose, Mouth And Throat O.r. Procedures With Cc 28 $1,608.50 $1,608.50 $1,608.50 nat. median
$16,586
outlier · 0.1×
145
OTHER 		Other Ear, Nose, Mouth And Throat O.r. Procedures Without Cc/mcc 28 $1,608.50 $1,608.50 $1,608.50 nat. median
$11,588
outlier · 0.1×
146
OTHER 		Ear, Nose, Mouth And Throat Malignancy With Mcc 28 $1,608.50 $1,608.50 $1,608.50 nat. median
$20,031
outlier · 0.1×
147
OTHER 		Ear, Nose, Mouth And Throat Malignancy With Cc 28 $1,608.50 $1,608.50 $1,608.50 nat. median
$12,394
outlier · 0.1×
148
OTHER 		Ear, Nose, Mouth And Throat Malignancy Without Cc/mcc 28 $1,608.50 $1,608.50 $1,608.50 nat. median
$8,470
outlier · 0.2×
149
OTHER 		Dysequilibrium 28 $1,608.50 $1,608.50 $1,608.50 nat. median
$7,929
outlier · 0.2×
15
OTHER 		Autologous Bone Marrow Transplant 28 $1,608.50 $1,608.50 $1,608.50 nat. median
$1,931
0.8× median
150
OTHER 		Epistaxis With Mcc 28 $1,608.50 $1,608.50 $1,608.50 nat. median
$12,874
outlier · 0.1×
151
OTHER 		Epistaxis Without Mcc 28 $1,608.50 $1,608.50 $1,608.50 nat. median
$7,732
outlier · 0.2×
152
OTHER 		Otitis Media And Uri With Mcc 28 $1,608.50 $1,608.50 $1,608.50 nat. median
$11,127
outlier · 0.1×
153
OTHER 		Otitis Media And Uri Without Mcc 28 $1,608.50 $1,608.50 $1,608.50 nat. median
$7,429
outlier · 0.2×
154
OTHER 		Other Ear, Nose, Mouth And Throat Diagnoses With Mcc 28 $1,608.50 $1,608.50 $1,608.50 nat. median
$15,473
outlier · 0.1×
155
OTHER 		Other Ear, Nose, Mouth And Throat Diagnoses With Cc 28 $1,608.50 $1,608.50 $1,608.50 nat. median
$9,066
outlier · 0.2×
156
OTHER 		Other Ear, Nose, Mouth And Throat Diagnoses Without Cc/mcc 28 $1,608.50 $1,608.50 $1,608.50 nat. median
$7,257
outlier · 0.2×
157
OTHER 		Dental And Oral Diseases With Mcc 28 $1,608.50 $1,608.50 $1,608.50 nat. median
$16,192
outlier · 0.1×
1
OTHER 		Heart Transplant Or Implant Of Heart Assist System With Mcc 28 $1,608.50 $1,608.50 $1,608.50 nat. median
$239,422
outlier · 0.0×

Other procedures at this hospital

Browse this hospital's 829 published procedures. Use the slice to choose what to show, then sort or filter any column.

Slice
Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
Code Type Description Rate rows Payers Gross Cash Min $ Max $ Avg median Last observed
             
207 OTHER Respiratory System Diagnosis With Ventilator Support >96 Hours 58 28 — — $1,608.50 $64,418.49 $1,608.50 2026-05-24
10 OTHER Pancreas Transplant 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
100 OTHER Seizures With Mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
101 OTHER Seizures Without Mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
102 OTHER Headaches With Mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
103 OTHER Headaches Without Mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
11 OTHER Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
113 OTHER Orbital Procedures With Cc/mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
114 OTHER Orbital Procedures Without Cc/mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
115 OTHER Extraocular Procedures Except Orbit 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
116 OTHER Intraocular Procedures With Cc/mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
117 OTHER Intraocular Procedures Without Cc/mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
12 OTHER Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
121 OTHER Acute Major Eye Infections With Cc/mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
122 OTHER Acute Major Eye Infections Without Cc/mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
123 OTHER Neurological Eye Disorders 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
124 OTHER Other Disorders Of The Eye With Mcc Or Thrombolytic Agent 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
125 OTHER Other Disorders Of The Eye Without Mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
129 OTHER Major Head & Neck Procedures W Cc/mcc Or Major Device 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
13 OTHER Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
130 OTHER Major Head & Neck Procedures Without Cc/mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
131 OTHER Cranial/facial Procedures W Cc/mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
132 OTHER Cranial/facial Procedures Without Cc/mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
133 OTHER Other Ear, Nose, Mouth & Throat O.r. Procedures W Cc/mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
134 OTHER Other Ear, Nose, Mouth & Throat O.r. Procedures Without Cc/mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
135 OTHER Sinus And Mastoid Procedures With Cc/mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
136 OTHER Sinus And Mastoid Procedures Without Cc/mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
137 OTHER Mouth Procedures With Cc/mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
138 OTHER Mouth Procedures Without Cc/mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
139 OTHER Salivary Gland Procedures 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
14 OTHER Allogeneic Bone Marrow Transplant 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
140 OTHER Major Head And Neck Procedures With Mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
141 OTHER Major Head And Neck Procedures With Cc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
142 OTHER Major Head And Neck Procedures Without Cc/mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
143 OTHER Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
144 OTHER Other Ear, Nose, Mouth And Throat O.r. Procedures With Cc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
145 OTHER Other Ear, Nose, Mouth And Throat O.r. Procedures Without Cc/mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
146 OTHER Ear, Nose, Mouth And Throat Malignancy With Mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
147 OTHER Ear, Nose, Mouth And Throat Malignancy With Cc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
148 OTHER Ear, Nose, Mouth And Throat Malignancy Without Cc/mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
149 OTHER Dysequilibrium 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
15 OTHER Autologous Bone Marrow Transplant 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
150 OTHER Epistaxis With Mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
151 OTHER Epistaxis Without Mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
152 OTHER Otitis Media And Uri With Mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
153 OTHER Otitis Media And Uri Without Mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
154 OTHER Other Ear, Nose, Mouth And Throat Diagnoses With Mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
155 OTHER Other Ear, Nose, Mouth And Throat Diagnoses With Cc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
156 OTHER Other Ear, Nose, Mouth And Throat Diagnoses Without Cc/mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
157 OTHER Dental And Oral Diseases With Mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
158 OTHER Dental And Oral Diseases With Cc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
159 OTHER Dental And Oral Diseases Without Cc/mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
16 OTHER Autologous Bone Marrow Transplant With Cc/mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
163 OTHER Major Chest Procedures With Mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
164 OTHER Major Chest Procedures With Cc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
165 OTHER Major Chest Procedures Without Cc/mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
166 OTHER Other Respiratory System O.r. Procedures With Mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
167 OTHER Other Respiratory System O.r. Procedures With Cc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
168 OTHER Other Respiratory System O.r. Procedures Without Cc/mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
17 OTHER Autologous Bone Marrow Transplant Without Cc/mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
173 OTHER Ultrasound Accelerated And Other Thrombolysis With Principal Diagnos 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
175 OTHER Pulmonary Embolism With Mcc Or Acute Cor Pulmonale 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
176 OTHER Pulmonary Embolism Without Mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
177 OTHER Respiratory Infections And Inflammations With Mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
178 OTHER Respiratory Infections And Inflammations With Cc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
179 OTHER Respiratory Infections And Inflammations Without Cc/mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
18 OTHER Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
180 OTHER Respiratory Neoplasms With Mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
181 OTHER Respiratory Neoplasms With Cc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
182 OTHER Respiratory Neoplasms Without Cc/mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
183 OTHER Major Chest Trauma With Mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
184 OTHER Major Chest Trauma With Cc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
185 OTHER Major Chest Trauma Without Cc/mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
186 OTHER Pleural Effusion With Mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
187 OTHER Pleural Effusion With Cc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
188 OTHER Pleural Effusion Without Cc/mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
189 OTHER Pulmonary Edema And Respiratory Failure 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
19 OTHER Simultaneous Pancreas And Kidney Transplant With Hemodialysis 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
190 OTHER Chronic Obstructive Pulmonary Disease With Mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
191 OTHER Chronic Obstructive Pulmonary Disease With Cc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
192 OTHER Chronic Obstructive Pulmonary Disease Without Cc/mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
193 OTHER Simple Pneumonia And Pleurisy With Mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
194 OTHER Simple Pneumonia And Pleurisy With Cc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
195 OTHER Simple Pneumonia And Pleurisy Without Cc/mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
196 OTHER Interstitial Lung Disease With Mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
197 OTHER Interstitial Lung Disease With Cc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
198 OTHER Interstitial Lung Disease Without Cc/mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
199 OTHER Pneumothorax With Mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
2 OTHER Heart Transplant Or Implant Of Heart Assist System Without Mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
20 OTHER Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
200 OTHER Pneumothorax With Cc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
201 OTHER Pneumothorax Without Cc/mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
202 OTHER Bronchitis And Asthma With Cc/mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
203 OTHER Bronchitis And Asthma Without Cc/mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
204 OTHER Respiratory Signs And Symptoms 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
205 OTHER Other Respiratory System Diagnoses With Mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
206 OTHER Other Respiratory System Diagnoses Without Mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
208 OTHER Respiratory System Diagnosis With Ventilator Support <=96 Hours 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
209 OTHER Complex Aortic Arch Procedures 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
21 OTHER Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
212 OTHER Concomitant Aortic And Mitral Valve Procedures 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
213 OTHER Endovascular Abdominal Aorta With Iliac Branch Procedures 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
215 OTHER Other Heart Assist System Implant 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
216 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
217 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
218 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
219 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures Without Card 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
22 OTHER Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
220 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures Without Card 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
221 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures Without Card 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
222 OTHER Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
223 OTHER Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
224 OTHER Cardiac Defibrillator Implant With Cardiac Catheterization Without A 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
225 OTHER Cardiac Defibrillator Implant With Cardiac Catheterization Without A 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
226 OTHER Cardiac Defibrillator Implant Without Cardiac Catheterization With M 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
227 OTHER Cardiac Defibrillator Implant Without Cardiac Catheterization Withou 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
228 OTHER Other Cardiothoracic Procedures With Mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
229 OTHER Other Cardiothoracic Procedures Without Mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
23 OTHER Craniotomy With Major Device Implant Or Acute Complex Cns Principal 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
230 OTHER Other Cardiothoracic Procedures Without Cc/mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
231 OTHER Coronary Bypass With Ptca With Mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
232 OTHER Coronary Bypass With Ptca Without Mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
233 OTHER Coronary Bypass With Cardiac Catheterization Or Open Ablation With M 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
234 OTHER Coronary Bypass With Cardiac Catheterization Or Open Ablation Withou 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
235 OTHER Coronary Bypass Without Cardiac Catheterization With Mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
236 OTHER Coronary Bypass Without Cardiac Catheterization Without Mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
237 OTHER Major Cardiovasc Procedures W Mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
238 OTHER Major Cardiovasc Procedures Without Mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
239 OTHER Amputation For Circulatory System Disorders Except Upper Limb And To 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
24 OTHER Craniotomy With Major Device Implant Or Acute Complex Cns Principal 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
240 OTHER Amputation For Circulatory System Disorders Except Upper Limb And To 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
241 OTHER Amputation For Circulatory System Disorders Except Upper Limb And To 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
242 OTHER Permanent Cardiac Pacemaker Implant With Mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
243 OTHER Permanent Cardiac Pacemaker Implant With Cc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
244 OTHER Permanent Cardiac Pacemaker Implant Without Cc/mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
245 OTHER Aicd Generator Procedures 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
246 OTHER Percutaneous Cardiovascular Procedures With Drug-eluting Stent With 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
247 OTHER Percutaneous Cardiovascular Procedures With Drug-eluting Stent Witho 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
248 OTHER Percutaneous Cardiovascular Procedures With Non-drug-eluting Stent W 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
249 OTHER Percutaneous Cardiovascular Procedures With Non-drug-eluting Stent W 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
25 OTHER Craniotomy And Endovascular Intracranial Procedures With Mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
250 OTHER Percutaneous Cardiovascular Procedures Without Intraluminal Device W 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
251 OTHER Percutaneous Cardiovascular Procedures Without Intraluminal Device W 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
252 OTHER Other Vascular Procedures With Mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
253 OTHER Other Vascular Procedures With Cc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
254 OTHER Other Vascular Procedures Without Cc/mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
255 OTHER Upper Limb And Toe Amputation For Circulatory System Disorders With 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
256 OTHER Upper Limb And Toe Amputation For Circulatory System Disorders With 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
257 OTHER Upper Limb And Toe Amputation For Circulatory System Disorders Witho 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
258 OTHER Cardiac Pacemaker Device Replacement With Mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
259 OTHER Cardiac Pacemaker Device Replacement Without Mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
26 OTHER Craniotomy And Endovascular Intracranial Procedures With Cc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
260 OTHER Cardiac Pacemaker Revision Except Device Replacement With Mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
261 OTHER Cardiac Pacemaker Revision Except Device Replacement With Cc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
262 OTHER Cardiac Pacemaker Revision Except Device Replacement Without Cc/mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
263 OTHER Vein Ligation And Stripping 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
264 OTHER Other Circulatory System O.r. Procedures 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
265 OTHER Aicd Lead Procedures 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
266 OTHER Endovascular Cardiac Valve Replacement And Supplement Procedures Wit 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
267 OTHER Endovascular Cardiac Valve Replacement And Supplement Procedures Wit 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
268 OTHER Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
269 OTHER Aortic And Heart Assist Procedures Except Pulsation Balloon Without 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
27 OTHER Craniotomy And Endovascular Intracranial Procedures Without Cc/mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
270 OTHER Other Major Cardiovascular Procedures With Mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
271 OTHER Other Major Cardiovascular Procedures With Cc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
272 OTHER Other Major Cardiovascular Procedures Without Cc/mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
273 OTHER Percutaneous And Other Intracardiac Procedures With Mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
274 OTHER Percutaneous And Other Intracardiac Procedures Without Mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
275 OTHER Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
276 OTHER Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimula 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
277 OTHER Cardiac Defibrillator Implant Without Mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
278 OTHER Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
279 OTHER Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
28 OTHER Spinal Procedures With Mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
280 OTHER Acute Myocardial Infarction, Discharged Alive With Mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
281 OTHER Acute Myocardial Infarction, Discharged Alive With Cc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
282 OTHER Acute Myocardial Infarction, Discharged Alive Without Cc/mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
283 OTHER Acute Myocardial Infarction, Expired With Mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
284 OTHER Acute Myocardial Infarction, Expired With Cc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
285 OTHER Acute Myocardial Infarction, Expired Without Cc/mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
286 OTHER Circulatory Disorders Except Ami, With Cardiac Catheterization With 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
287 OTHER Circulatory Disorders Except Ami, With Cardiac Catheterization Witho 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
288 OTHER Acute And Subacute Endocarditis With Mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
289 OTHER Acute And Subacute Endocarditis With Cc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
29 OTHER Spinal Procedures With Cc Or Spinal Neurostimulators 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
290 OTHER Acute And Subacute Endocarditis Without Cc/mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
291 OTHER Heart Failure And Shock With Mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
292 OTHER Heart Failure And Shock With Cc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
293 OTHER Heart Failure And Shock Without Cc/mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
294 OTHER Deep Vein Thrombophlebitis With Cc/mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
295 OTHER Deep Vein Thrombophlebitis Without Cc/mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
296 OTHER Cardiac Arrest, Unexplained With Mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
297 OTHER Cardiac Arrest, Unexplained With Cc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
298 OTHER Cardiac Arrest, Unexplained Without Cc/mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
299 OTHER Peripheral Vascular Disorders With Mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
3 OTHER Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
30 OTHER Spinal Procedures Without Cc/mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
300 OTHER Peripheral Vascular Disorders With Cc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
301 OTHER Peripheral Vascular Disorders Without Cc/mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
302 OTHER Atherosclerosis With Mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
303 OTHER Atherosclerosis Without Mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
304 OTHER Hypertension With Mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
305 OTHER Hypertension Without Mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
306 OTHER Cardiac Congenital And Valvular Disorders With Mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
307 OTHER Cardiac Congenital And Valvular Disorders Without Mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
308 OTHER Cardiac Arrhythmia And Conduction Disorders With Mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
309 OTHER Cardiac Arrhythmia And Conduction Disorders With Cc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
31 OTHER Ventricular Shunt Procedures With Mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
310 OTHER Cardiac Arrhythmia And Conduction Disorders Without Cc/mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
311 OTHER Angina Pectoris 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
312 OTHER Syncope And Collapse 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
313 OTHER Chest Pain 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
314 OTHER Other Circulatory System Diagnoses With Mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
315 OTHER Other Circulatory System Diagnoses With Cc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
316 OTHER Other Circulatory System Diagnoses Without Cc/mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
317 OTHER Concomitant Left Atrial Appendage Closure And Cardiac Ablation 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
318 OTHER Percutaneous Coronary Atherectomy Without Intraluminal Device 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
319 OTHER Other Endovascular Cardiac Valve Procedures With Mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
32 OTHER Ventricular Shunt Procedures With Cc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
320 OTHER Other Endovascular Cardiac Valve Procedures Without Mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
321 OTHER Percutaneous Cardiovascular Procedures With Intraluminal Device With 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
322 OTHER Percutaneous Cardiovascular Procedures With Intraluminal Device With 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
323 OTHER Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
324 OTHER Coronary Intravascular Lithotripsy With Intraluminal Device Without 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
325 OTHER Coronary Intravascular Lithotripsy Without Intraluminal Device 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
326 OTHER Stomach, Esophageal And Duodenal Procedures With Mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
327 OTHER Stomach, Esophageal And Duodenal Procedures With Cc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
328 OTHER Stomach, Esophageal And Duodenal Procedures Without Cc/mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
329 OTHER Major Small And Large Bowel Procedures With Mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
33 OTHER Ventricular Shunt Procedures Without Cc/mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
330 OTHER Major Small And Large Bowel Procedures With Cc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
331 OTHER Major Small And Large Bowel Procedures Without Cc/mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
332 OTHER Rectal Resection With Mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
333 OTHER Rectal Resection With Cc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
334 OTHER Rectal Resection Without Cc/mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
335 OTHER Peritoneal Adhesiolysis With Mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
336 OTHER Peritoneal Adhesiolysis With Cc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
337 OTHER Peritoneal Adhesiolysis Without Cc/mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
338 OTHER Appendectomy With Complicated Principal Diagnosis With Mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
339 OTHER Appendectomy With Complicated Principal Diagnosis With Cc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
34 OTHER Carotid Artery Stent Procedures With Mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
340 OTHER Appendectomy With Complicated Principal Diagnosis Without Cc/mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
341 OTHER Appendectomy Without Complicated Principal Diagnosis With Mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
342 OTHER Appendectomy Without Complicated Principal Diagnosis With Cc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
343 OTHER Appendectomy Without Complicated Principal Diagnosis Without Cc/mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
344 OTHER Minor Small And Large Bowel Procedures With Mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
345 OTHER Minor Small And Large Bowel Procedures With Cc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
346 OTHER Minor Small And Large Bowel Procedures Without Cc/mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
347 OTHER Anal And Stomal Procedures With Mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
348 OTHER Anal And Stomal Procedures With Cc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
349 OTHER Anal And Stomal Procedures Without Cc/mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
35 OTHER Carotid Artery Stent Procedures With Cc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
350 OTHER Inguinal And Femoral Hernia Procedures With Mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
351 OTHER Inguinal And Femoral Hernia Procedures With Cc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
352 OTHER Inguinal And Femoral Hernia Procedures Without Cc/mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
353 OTHER Hernia Procedures Except Inguinal And Femoral With Mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
354 OTHER Hernia Procedures Except Inguinal And Femoral With Cc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
355 OTHER Hernia Procedures Except Inguinal And Femoral Without Cc/mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
356 OTHER Other Digestive System O.r. Procedures With Mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
357 OTHER Other Digestive System O.r. Procedures With Cc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
358 OTHER Other Digestive System O.r. Procedures Without Cc/mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
359 OTHER Percutaneous Coronary Atherectomy With Intraluminal Device With Mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
36 OTHER Carotid Artery Stent Procedures Without Cc/mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
360 OTHER Percutaneous Coronary Atherectomy With Intraluminal Device Without M 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
368 OTHER Major Esophageal Disorders With Mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
369 OTHER Major Esophageal Disorders With Cc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
37 OTHER Extracranial Procedures With Mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
370 OTHER Major Esophageal Disorders Without Cc/mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
371 OTHER Major Gastrointestinal Disorders And Peritoneal Infections With Mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
372 OTHER Major Gastrointestinal Disorders And Peritoneal Infections With Cc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
373 OTHER Major Gastrointestinal Disorders And Peritoneal Infections Without C 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
374 OTHER Digestive Malignancy With Mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
375 OTHER Digestive Malignancy With Cc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
376 OTHER Digestive Malignancy Without Cc/mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
377 OTHER Gastrointestinal Hemorrhage With Mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
378 OTHER Gastrointestinal Hemorrhage With Cc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
379 OTHER Gastrointestinal Hemorrhage Without Cc/mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
38 OTHER Extracranial Procedures With Cc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
380 OTHER Complicated Peptic Ulcer With Mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
381 OTHER Complicated Peptic Ulcer With Cc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
382 OTHER Complicated Peptic Ulcer Without Cc/mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
383 OTHER Uncomplicated Peptic Ulcer With Mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
384 OTHER Uncomplicated Peptic Ulcer Without Mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
385 OTHER Inflammatory Bowel Disease With Mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
386 OTHER Inflammatory Bowel Disease With Cc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
387 OTHER Inflammatory Bowel Disease Without Cc/mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
388 OTHER Gastrointestinal Obstruction With Mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
389 OTHER Gastrointestinal Obstruction With Cc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
39 OTHER Extracranial Procedures Without Cc/mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
390 OTHER Gastrointestinal Obstruction Without Cc/mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
391 OTHER Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders W 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
392 OTHER Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders W 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
393 OTHER Other Digestive System Diagnoses With Mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
394 OTHER Other Digestive System Diagnoses With Cc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
395 OTHER Other Digestive System Diagnoses Without Cc/mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
397 OTHER Appendix Procedures With Mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
398 OTHER Appendix Procedures With Cc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
399 OTHER Appendix Procedures Without Cc/mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
4 OTHER Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, M 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
1 OTHER Heart Transplant Or Implant Of Heart Assist System With Mcc 58 28 — — $1,608.50 $1,608.50 $1,608.50 2026-05-24
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