Hospital

Siskin Hospital For Physical Rehabilitation

Chattanooga, TN · CCN 443025 · Rates published

4,431 distinct procedures filed

8 distinct payers

101,048 rate rows

2026-04-14 last MRF observed

Data quality

13,016 of 101,048 rate rows are consumer-grade (12.9%)

88,032 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	87,904
percent-of-charges filed in the dollar field — excluded from medians	72
per-diem day rate — not a per-procedure price	56

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

Source MRF file	https://siskin.pt.panaceainc.com/MRFDownload/siskin/siskin
Found on page	https://www.siskinrehab.org/price-transparency
Discovered via	CMS hospital list
Last fetch	not_modified · 2026-05-17
Content fingerprint	c45b0ea931fbb78c… · 29,313,631 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
B0407 OTHER	Traumatic Spinal Cord Injury M <24.50 And A >=61.50	4	$77,299.75	$77,299.75	$77,299.75	nat. median $86,320 0.9× median
B1904 OTHER	Guillain-barr? M <38.50	4	$72,367.90	$72,367.90	$72,367.90	nat. median $80,609 0.9× median
C0407 OTHER	Traumatic Spinal Cord Injury M <24.50 And A >=61.50	4	$63,182.92	$63,182.92	$63,182.92	nat. median $71,021 0.9× median
D0407 OTHER	Traumatic Spinal Cord Injury M <24.50 And A >=61.50	4	$61,520.21	$61,520.21	$61,520.21	nat. median $68,708 0.9× median
B1806 OTHER	Major Multiple Trauma With Brain Or Spinal Cord Injury M <30.50	4	$61,254.18	$61,254.18	$61,254.18	nat. median $68,402 0.9× median
B0406 OTHER	Traumatic Spinal Cord Injury M >=24.50 And M <31.50 And A >=61.50	4	$56,446.82	$56,446.82	$56,446.82	nat. median $62,870 0.9× median
A0407 OTHER	Traumatic Spinal Cord Injury M <24.50 And A >=61.50	4	$55,669.19	$55,669.19	$55,669.19	nat. median $62,810 0.9× median
B0404 OTHER	Traumatic Spinal Cord Injury M <31.50 And A <61.50	4	$54,170.19	$54,170.19	$54,170.19	nat. median $60,491 0.9× median
B0505 OTHER	Non-traumatic Spinal Cord Injury M <39.50	4	$53,278.30	$53,278.30	$53,278.30	nat. median $59,495 0.9× median
C1904 OTHER	Guillain-barr? M <38.50	4	$51,144.91	$51,144.91	$51,144.91	nat. median $57,113 0.9× median
C1806 OTHER	Major Multiple Trauma With Brain Or Spinal Cord Injury M <30.50	4	$50,111.48	$50,111.48	$50,111.48	nat. median $55,837 0.9× median
B0106 OTHER	Stroke M <41.50 And A <84.50	4	$48,303.81	$48,303.81	$48,303.81	nat. median $54,065 0.9× median
B1903 OTHER	Guillain-barr? M >=38.50 And M <51.50	4	$47,062.32	$47,062.32	$47,062.32	nat. median $52,554 0.9× median
B0205 OTHER	Traumatic Brain Injury M <35.50	4	$46,467.16	$46,467.16	$46,467.16	nat. median $51,964 0.9× median
C0406 OTHER	Traumatic Spinal Cord Injury M >=24.50 And M <31.50 And A >=61.50	4	$46,138.03	$46,138.03	$46,138.03	nat. median $51,880 0.9× median
D1806 OTHER	Major Multiple Trauma With Brain Or Spinal Cord Injury M <30.50	4	$46,098.81	$46,098.81	$46,098.81	nat. median $51,478 0.9× median
D0406 OTHER	Traumatic Spinal Cord Injury M >=24.50 And M <31.50 And A >=61.50	4	$44,923.82	$44,923.82	$44,923.82	nat. median $50,515 0.9× median
A1904 OTHER	Guillain-barr? M <38.50	4	$44,475.32	$44,475.32	$44,475.32	nat. median $50,010 0.9× median
D1904 OTHER	Guillain-barr? M <38.50	4	$44,461.68	$44,461.68	$44,461.68	nat. median $49,901 0.9× median
C0404 OTHER	Traumatic Spinal Cord Injury M <31.50 And A <61.50	4	$44,277.50	$44,277.50	$44,277.50	nat. median $49,743 0.9× median
B1705 OTHER	Major Multiple Trauma Without Brain Or Spinal Cord Injury M <36.50	4	$43,583.43	$43,583.43	$43,583.43	nat. median $48,669 0.9× median
B2102 OTHER	Burns M <52.50	4	$43,402.66	$43,402.66	$43,402.66	nat. median $48,467 0.9× median
A1806 OTHER	Major Multiple Trauma With Brain Or Spinal Cord Injury M <30.50	4	$43,267.94	$43,267.94	$43,267.94	nat. median $48,628 0.9× median
D0404 OTHER	Traumatic Spinal Cord Injury M <31.50 And A <61.50	4	$43,112.75	$43,112.75	$43,112.75	nat. median $48,434 0.9× median
B0405 OTHER	Traumatic Spinal Cord Injury M >=31.50 And M <41.50	4	$42,908.11	$42,908.11	$42,908.11	nat. median $47,915 0.9× median
C0106 OTHER	Stroke M <41.50 And A <84.50	4	$42,894.47	$42,894.47	$42,894.47	nat. median $47,971 0.9× median
B0105 OTHER	Stroke M <41.50 And A >=84.50	4	$42,882.53	$42,882.53	$42,882.53	nat. median $47,979 0.9× median
B1805 OTHER	Major Multiple Trauma With Brain Or Spinal Cord Injury M >=30.50 And M <40.50	4	$42,278.84	$42,278.84	$42,278.84	nat. median $47,212 0.9× median
B0604 OTHER	Neurological M <43.50	4	$41,777.47	$41,777.47	$41,777.47	nat. median $46,755 0.9× median
C0505 OTHER	Non-traumatic Spinal Cord Injury M <39.50	4	$40,943.56	$40,943.56	$40,943.56	nat. median $45,787 0.9× median
A0406 OTHER	Traumatic Spinal Cord Injury M >=24.50 And M <31.50 And A >=61.50	4	$40,651.94	$40,651.94	$40,651.94	nat. median $45,990 0.9× median
B0305 OTHER	Non-traumatic Brain Injury M <42.50 And A <78.50	4	$40,414.90	$40,414.90	$40,414.90	nat. median $45,142 0.9× median
B1004 OTHER	Amputation Lower Extremity M <47.50	4	$40,304.05	$40,304.05	$40,304.05	nat. median $45,008 0.9× median
B1504 OTHER	Pulmonary M <45.50	4	$39,947.64	$39,947.64	$39,947.64	nat. median $44,609 0.9× median
B0704 OTHER	Fracture Of Lower Extremity M <41.50	4	$39,120.55	$39,120.55	$39,120.55	nat. median $43,748 0.9× median
B1304 OTHER	Rheumatoid Other Arthritis M <44.50 And A >=64.50	4	$39,072.80	$39,072.80	$39,072.80	nat. median $43,632 0.9× median
A0404 OTHER	Traumatic Spinal Cord Injury M <31.50 And A <61.50	4	$39,013.11	$39,013.11	$39,013.11	nat. median $43,915 0.9× median
B1305 OTHER	Rheumatoid Other Arthritis M <51.50 And A <64.50	4	$38,996.06	$38,996.06	$38,996.06	nat. median $43,434 0.9× median
D0106 OTHER	Stroke M <41.50 And A <84.50	4	$38,863.04	$38,863.04	$38,863.04	nat. median $43,510 0.9× median
B0904 OTHER	Other Orthopedic M <44.5	4	$38,339.50	$38,339.50	$38,339.50	nat. median $42,813 0.9× median
D0505 OTHER	Non-traumatic Spinal Cord Injury M <39.50	4	$38,090.52	$38,090.52	$38,090.52	nat. median $42,599 0.9× median
C0105 OTHER	Stroke M <41.50 And A >=84.50	4	$38,080.29	$38,080.29	$38,080.29	nat. median $42,585 0.9× median
B2005 OTHER	Miscellaneous M <46.50 And A <77.50	4	$37,718.75	$37,718.75	$37,718.75	nat. median $42,136 0.9× median
B0504 OTHER	Non-traumatic Spinal Cord Injury M >=39.50 And M <48.50	4	$37,498.76	$37,498.76	$37,498.76	nat. median $41,890 0.9× median
B1704 OTHER	Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=36.50 And M <41.50	4	$37,437.37	$37,437.37	$37,437.37	nat. median $41,893 0.9× median
A5104 OTHER	Expired, Not Orthopedic, Length Of Stay Is 16 Days Or More	4	$37,314.59	$37,314.59	$37,314.59	nat. median $42,119 0.9× median
C0205 OTHER	Traumatic Brain Injury M <35.50	4	$36,946.23	$36,946.23	$36,946.23	nat. median $41,316 0.9× median
B0304 OTHER	Non-traumatic Brain Injury M <42.50 And A >=78.50	4	$36,895.07	$36,895.07	$36,895.07	nat. median $41,216 0.9× median
A0106 OTHER	Stroke M <41.50 And A <84.50	4	$36,862.67	$36,862.67	$36,862.67	nat. median $41,450 0.9× median
B1404 OTHER	Cardiac M <45.50	4	$36,610.28	$36,610.28	$36,610.28	nat. median $40,898 0.9× median

Other procedures at this hospital

Browse this hospital's 4,431 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

B0407	OTHER	Traumatic Spinal Cord Injury M <24.50 And A >=61.50	10	4	—	—	$77,299.75	$77,299.75	$77,299.75	2026-04-14
B1904	OTHER	Guillain-barr? M <38.50	10	4	—	—	$72,367.90	$72,367.90	$72,367.90	2026-04-14
C0407	OTHER	Traumatic Spinal Cord Injury M <24.50 And A >=61.50	10	4	—	—	$63,182.92	$63,182.92	$63,182.92	2026-04-14
D0407	OTHER	Traumatic Spinal Cord Injury M <24.50 And A >=61.50	10	4	—	—	$61,520.21	$61,520.21	$61,520.21	2026-04-14
B1806	OTHER	Major Multiple Trauma With Brain Or Spinal Cord Injury M <30.50	10	4	—	—	$61,254.18	$61,254.18	$61,254.18	2026-04-14
B0406	OTHER	Traumatic Spinal Cord Injury M >=24.50 And M <31.50 And A >=61.50	10	4	—	—	$56,446.82	$56,446.82	$56,446.82	2026-04-14
A0407	OTHER	Traumatic Spinal Cord Injury M <24.50 And A >=61.50	10	4	—	—	$55,669.19	$55,669.19	$55,669.19	2026-04-14
B0404	OTHER	Traumatic Spinal Cord Injury M <31.50 And A <61.50	10	4	—	—	$54,170.19	$54,170.19	$54,170.19	2026-04-14
B0505	OTHER	Non-traumatic Spinal Cord Injury M <39.50	10	4	—	—	$53,278.30	$53,278.30	$53,278.30	2026-04-14
C1904	OTHER	Guillain-barr? M <38.50	10	4	—	—	$51,144.91	$51,144.91	$51,144.91	2026-04-14
C1806	OTHER	Major Multiple Trauma With Brain Or Spinal Cord Injury M <30.50	10	4	—	—	$50,111.48	$50,111.48	$50,111.48	2026-04-14
B0106	OTHER	Stroke M <41.50 And A <84.50	10	4	—	—	$48,303.81	$48,303.81	$48,303.81	2026-04-14
B1903	OTHER	Guillain-barr? M >=38.50 And M <51.50	10	4	—	—	$47,062.32	$47,062.32	$47,062.32	2026-04-14
B0205	OTHER	Traumatic Brain Injury M <35.50	10	4	—	—	$46,467.16	$46,467.16	$46,467.16	2026-04-14
C0406	OTHER	Traumatic Spinal Cord Injury M >=24.50 And M <31.50 And A >=61.50	10	4	—	—	$46,138.03	$46,138.03	$46,138.03	2026-04-14
D1806	OTHER	Major Multiple Trauma With Brain Or Spinal Cord Injury M <30.50	10	4	—	—	$46,098.81	$46,098.81	$46,098.81	2026-04-14
D0406	OTHER	Traumatic Spinal Cord Injury M >=24.50 And M <31.50 And A >=61.50	10	4	—	—	$44,923.82	$44,923.82	$44,923.82	2026-04-14
A1904	OTHER	Guillain-barr? M <38.50	10	4	—	—	$44,475.32	$44,475.32	$44,475.32	2026-04-14
D1904	OTHER	Guillain-barr? M <38.50	10	4	—	—	$44,461.68	$44,461.68	$44,461.68	2026-04-14
C0404	OTHER	Traumatic Spinal Cord Injury M <31.50 And A <61.50	10	4	—	—	$44,277.50	$44,277.50	$44,277.50	2026-04-14
B1705	OTHER	Major Multiple Trauma Without Brain Or Spinal Cord Injury M <36.50	10	4	—	—	$43,583.43	$43,583.43	$43,583.43	2026-04-14
B2102	OTHER	Burns M <52.50	10	4	—	—	$43,402.66	$43,402.66	$43,402.66	2026-04-14
A1806	OTHER	Major Multiple Trauma With Brain Or Spinal Cord Injury M <30.50	10	4	—	—	$43,267.94	$43,267.94	$43,267.94	2026-04-14
D0404	OTHER	Traumatic Spinal Cord Injury M <31.50 And A <61.50	10	4	—	—	$43,112.75	$43,112.75	$43,112.75	2026-04-14
B0405	OTHER	Traumatic Spinal Cord Injury M >=31.50 And M <41.50	10	4	—	—	$42,908.11	$42,908.11	$42,908.11	2026-04-14
C0106	OTHER	Stroke M <41.50 And A <84.50	10	4	—	—	$42,894.47	$42,894.47	$42,894.47	2026-04-14
B0105	OTHER	Stroke M <41.50 And A >=84.50	10	4	—	—	$42,882.53	$42,882.53	$42,882.53	2026-04-14
B1805	OTHER	Major Multiple Trauma With Brain Or Spinal Cord Injury M >=30.50 And M <40.50	10	4	—	—	$42,278.84	$42,278.84	$42,278.84	2026-04-14
B0604	OTHER	Neurological M <43.50	10	4	—	—	$41,777.47	$41,777.47	$41,777.47	2026-04-14
C0505	OTHER	Non-traumatic Spinal Cord Injury M <39.50	10	4	—	—	$40,943.56	$40,943.56	$40,943.56	2026-04-14
A0406	OTHER	Traumatic Spinal Cord Injury M >=24.50 And M <31.50 And A >=61.50	10	4	—	—	$40,651.94	$40,651.94	$40,651.94	2026-04-14
B0305	OTHER	Non-traumatic Brain Injury M <42.50 And A <78.50	10	4	—	—	$40,414.90	$40,414.90	$40,414.90	2026-04-14
B1004	OTHER	Amputation Lower Extremity M <47.50	10	4	—	—	$40,304.05	$40,304.05	$40,304.05	2026-04-14
B1504	OTHER	Pulmonary M <45.50	10	4	—	—	$39,947.64	$39,947.64	$39,947.64	2026-04-14
B0704	OTHER	Fracture Of Lower Extremity M <41.50	10	4	—	—	$39,120.55	$39,120.55	$39,120.55	2026-04-14
B1304	OTHER	Rheumatoid Other Arthritis M <44.50 And A >=64.50	10	4	—	—	$39,072.80	$39,072.80	$39,072.80	2026-04-14
A0404	OTHER	Traumatic Spinal Cord Injury M <31.50 And A <61.50	10	4	—	—	$39,013.11	$39,013.11	$39,013.11	2026-04-14
B1305	OTHER	Rheumatoid Other Arthritis M <51.50 And A <64.50	10	4	—	—	$38,996.06	$38,996.06	$38,996.06	2026-04-14
D0106	OTHER	Stroke M <41.50 And A <84.50	10	4	—	—	$38,863.04	$38,863.04	$38,863.04	2026-04-14
B0904	OTHER	Other Orthopedic M <44.5	10	4	—	—	$38,339.50	$38,339.50	$38,339.50	2026-04-14
D0505	OTHER	Non-traumatic Spinal Cord Injury M <39.50	10	4	—	—	$38,090.52	$38,090.52	$38,090.52	2026-04-14
C0105	OTHER	Stroke M <41.50 And A >=84.50	10	4	—	—	$38,080.29	$38,080.29	$38,080.29	2026-04-14
B2005	OTHER	Miscellaneous M <46.50 And A <77.50	10	4	—	—	$37,718.75	$37,718.75	$37,718.75	2026-04-14
B0504	OTHER	Non-traumatic Spinal Cord Injury M >=39.50 And M <48.50	10	4	—	—	$37,498.76	$37,498.76	$37,498.76	2026-04-14
B1704	OTHER	Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=36.50 And M <41.50	10	4	—	—	$37,437.37	$37,437.37	$37,437.37	2026-04-14
A5104	OTHER	Expired, Not Orthopedic, Length Of Stay Is 16 Days Or More	10	4	—	—	$37,314.59	$37,314.59	$37,314.59	2026-04-14
C0205	OTHER	Traumatic Brain Injury M <35.50	10	4	—	—	$36,946.23	$36,946.23	$36,946.23	2026-04-14
B0304	OTHER	Non-traumatic Brain Injury M <42.50 And A >=78.50	10	4	—	—	$36,895.07	$36,895.07	$36,895.07	2026-04-14
A0106	OTHER	Stroke M <41.50 And A <84.50	10	4	—	—	$36,862.67	$36,862.67	$36,862.67	2026-04-14
B1404	OTHER	Cardiac M <45.50	10	4	—	—	$36,610.28	$36,610.28	$36,610.28	2026-04-14
B1204	OTHER	Osteoarthritis M <49.50 And A <74.50	10	4	—	—	$36,605.17	$36,605.17	$36,605.17	2026-04-14
C2102	OTHER	Burns M <52.50	10	4	—	—	$36,489.20	$36,489.20	$36,489.20	2026-04-14
B0204	OTHER	Traumatic Brain Injury M >=35.50 And M <49.50	10	4	—	—	$36,219.76	$36,219.76	$36,219.76	2026-04-14
B2004	OTHER	Miscellaneous M <46.50 And A >=77.50	10	4	—	—	$36,035.58	$36,035.58	$36,035.58	2026-04-14
B0805	OTHER	Replacement Of Lower-extremity Joint M <42.50	10	4	—	—	$35,658.70	$35,658.70	$35,658.70	2026-04-14
B1203	OTHER	Osteoarthritis M <49.50 And A >=74.50	10	4	—	—	$35,556.38	$35,556.38	$35,556.38	2026-04-14
B1804	OTHER	Major Multiple Trauma With Brain Or Spinal Cord Injury M >=40.50 And M <45.50	10	4	—	—	$35,240.89	$35,240.89	$35,240.89	2026-04-14
A0505	OTHER	Non-traumatic Spinal Cord Injury M <39.50	10	4	—	—	$35,102.76	$35,102.76	$35,102.76	2026-04-14
C0405	OTHER	Traumatic Spinal Cord Injury M >=31.50 And M <41.50	10	4	—	—	$35,072.06	$35,072.06	$35,072.06	2026-04-14
A5102	OTHER	Expired, Orthopedic, Length Of Stay Is 14 Days Or More	10	4	—	—	$34,933.93	$34,933.93	$34,933.93	2026-04-14
C1805	OTHER	Major Multiple Trauma With Brain Or Spinal Cord Injury M >=30.50 And M <40.50	10	4	—	—	$34,587.75	$34,587.75	$34,587.75	2026-04-14
C1705	OTHER	Major Multiple Trauma Without Brain Or Spinal Cord Injury M <36.50	10	4	—	—	$34,528.06	$34,528.06	$34,528.06	2026-04-14
D0105	OTHER	Stroke M <41.50 And A >=84.50	10	4	—	—	$34,500.77	$34,500.77	$34,500.77	2026-04-14
B0104	OTHER	Stroke M >=41.50 And M <50.50	10	4	—	—	$34,408.68	$34,408.68	$34,408.68	2026-04-14
B1604	OTHER	Pain Syndrome M <43.50	10	4	—	—	$34,190.40	$34,190.40	$34,190.40	2026-04-14
D0405	OTHER	Traumatic Spinal Cord Injury M >=31.50 And M <41.50	10	4	—	—	$34,149.47	$34,149.47	$34,149.47	2026-04-14
D0205	OTHER	Traumatic Brain Injury M <35.50	10	4	—	—	$33,753.83	$33,753.83	$33,753.83	2026-04-14
C1004	OTHER	Amputation Lower Extremity M <47.50	10	4	—	—	$33,489.51	$33,489.51	$33,489.51	2026-04-14
B0403	OTHER	Traumatic Spinal Cord Injury M >=41.50 And M <47.50	10	4	—	—	$33,431.52	$33,431.52	$33,431.52	2026-04-14
B1902	OTHER	Guillain-barr? M >=51.50 And M <66.50	10	4	—	—	$33,262.69	$33,262.69	$33,262.69	2026-04-14
C1903	OTHER	Guillain-barr? M >=38.50 And M <51.50	10	4	—	—	$33,260.99	$33,260.99	$33,260.99	2026-04-14
B0603	OTHER	Neurological M >=43.50 And M <52.50	10	4	—	—	$33,032.47	$33,032.47	$33,032.47	2026-04-14
B1103	OTHER	Amputation Non-lower Extremity M <52.50	10	4	—	—	$32,988.13	$32,988.13	$32,988.13	2026-04-14
A0105	OTHER	Stroke M <41.50 And A >=84.50	10	4	—	—	$32,725.51	$32,725.51	$32,725.51	2026-04-14
B1703	OTHER	Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=41.50 And M <50.50	10	4	—	—	$32,534.51	$32,534.51	$32,534.51	2026-04-14
C1504	OTHER	Pulmonary M <45.50	10	4	—	—	$32,120.12	$32,120.12	$32,120.12	2026-04-14
D1705	OTHER	Major Multiple Trauma Without Brain Or Spinal Cord Injury M <36.50	10	4	—	—	$32,058.72	$32,058.72	$32,058.72	2026-04-14
C0305	OTHER	Non-traumatic Brain Injury M <42.50 And A <78.50	10	4	—	—	$32,031.44	$32,031.44	$32,031.44	2026-04-14
B1503	OTHER	Pulmonary M >=45.50 And M <56.50	10	4	—	—	$31,855.79	$31,855.79	$31,855.79	2026-04-14
B0903	OTHER	Other Orthopedic M >=44.50 And M <51.50	10	4	—	—	$31,838.73	$31,838.73	$31,838.73	2026-04-14
D1805	OTHER	Major Multiple Trauma With Brain Or Spinal Cord Injury M >=30.50 And M <40.50	10	4	—	—	$31,818.27	$31,818.27	$31,818.27	2026-04-14
A0205	OTHER	Traumatic Brain Injury M <35.50	10	4	—	—	$31,712.54	$31,712.54	$31,712.54	2026-04-14
B0703	OTHER	Fracture Of Lower Extremity M >=41.50 And M <52.50	10	4	—	—	$31,681.84	$31,681.84	$31,681.84	2026-04-14
C0604	OTHER	Neurological M <43.50	10	4	—	—	$31,639.21	$31,639.21	$31,639.21	2026-04-14
B0503	OTHER	Non-traumatic Spinal Cord Injury M >=48.50 And M <53.50	10	4	—	—	$31,381.70	$31,381.70	$31,381.70	2026-04-14
C0704	OTHER	Fracture Of Lower Extremity M <41.50	10	4	—	—	$31,279.38	$31,279.38	$31,279.38	2026-04-14
C1304	OTHER	Rheumatoid Other Arthritis M <44.50 And A >=64.50	10	4	—	—	$31,238.45	$31,238.45	$31,238.45	2026-04-14
C1103	OTHER	Amputation Non-lower Extremity M <52.50	10	4	—	—	$31,229.93	$31,229.93	$31,229.93	2026-04-14
C1305	OTHER	Rheumatoid Other Arthritis M <51.50 And A <64.50	10	4	—	—	$31,175.36	$31,175.36	$31,175.36	2026-04-14
B0303	OTHER	Non-traumatic Brain Injury M >=42.50 And M <52.50	10	4	—	—	$31,142.95	$31,142.95	$31,142.95	2026-04-14
A0405	OTHER	Traumatic Spinal Cord Injury M >=31.50 And M <41.50	10	4	—	—	$30,902.50	$30,902.50	$30,902.50	2026-04-14
C1604	OTHER	Pain Syndrome M <43.50	10	4	—	—	$30,641.58	$30,641.58	$30,641.58	2026-04-14
C0104	OTHER	Stroke M >=41.50 And M <50.50	10	4	—	—	$30,556.32	$30,556.32	$30,556.32	2026-04-14
D1004	OTHER	Amputation Lower Extremity M <47.50	10	4	—	—	$30,396.01	$30,396.01	$30,396.01	2026-04-14
B1003	OTHER	Amputation Lower Extremity M >=47.50 And M <55.50	10	4	—	—	$30,300.52	$30,300.52	$30,300.52	2026-04-14
B1303	OTHER	Rheumatoid Other Arthritis M >=44.50 And M <51.50 And A >=64.50	10	4	—	—	$30,273.23	$30,273.23	$30,273.23	2026-04-14
C2005	OTHER	Miscellaneous M <46.50 And A <77.50	10	4	—	—	$30,249.35	$30,249.35	$30,249.35	2026-04-14
B1803	OTHER	Major Multiple Trauma With Brain Or Spinal Cord Injury M >=45.50 And M <55.50	10	4	—	—	$30,174.32	$30,174.32	$30,174.32	2026-04-14
D1504	OTHER	Pulmonary M <45.50	10	4	—	—	$30,080.53	$30,080.53	$30,080.53	2026-04-14
C0805	OTHER	Replacement Of Lower-extremity Joint M <42.50	10	4	—	—	$30,032.78	$30,032.78	$30,032.78	2026-04-14
A1805	OTHER	Major Multiple Trauma With Brain Or Spinal Cord Injury M >=30.50 And M <40.50	10	4	—	—	$29,863.95	$29,863.95	$29,863.95	2026-04-14
D0305	OTHER	Non-traumatic Brain Injury M <42.50 And A <78.50	10	4	—	—	$29,862.24	$29,862.24	$29,862.24	2026-04-14
D0604	OTHER	Neurological M <43.50	10	4	—	—	$29,800.85	$29,800.85	$29,800.85	2026-04-14
D0704	OTHER	Fracture Of Lower Extremity M <41.50	10	4	—	—	$29,707.06	$29,707.06	$29,707.06	2026-04-14
C1704	OTHER	Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=36.50 And M <41.50	10	4	—	—	$29,659.31	$29,659.31	$29,659.31	2026-04-14
B2003	OTHER	Miscellaneous M >=46.50 And M <55.50	10	4	—	—	$29,546.75	$29,546.75	$29,546.75	2026-04-14
A1705	OTHER	Major Multiple Trauma Without Brain Or Spinal Cord Injury M <36.50	10	4	—	—	$29,512.65	$29,512.65	$29,512.65	2026-04-14
C1404	OTHER	Cardiac M <45.50	10	4	—	—	$29,492.18	$29,492.18	$29,492.18	2026-04-14
B0203	OTHER	Traumatic Brain Injury M >=49.50 And M <61.50	10	4	—	—	$29,388.16	$29,388.16	$29,388.16	2026-04-14
B1403	OTHER	Cardiac M >=45.50 And M <55.50	10	4	—	—	$29,343.82	$29,343.82	$29,343.82	2026-04-14
C0304	OTHER	Non-traumatic Brain Injury M <42.50 And A >=78.50	10	4	—	—	$29,241.50	$29,241.50	$29,241.50	2026-04-14
C1204	OTHER	Osteoarthritis M <49.50 And A <74.50	10	4	—	—	$29,053.91	$29,053.91	$29,053.91	2026-04-14
C0904	OTHER	Other Orthopedic M <44.5	10	4	—	—	$29,040.27	$29,040.27	$29,040.27	2026-04-14
B0402	OTHER	Traumatic Spinal Cord Injury M >=47.50 And M <56.50	10	4	—	—	$28,965.23	$28,965.23	$28,965.23	2026-04-14
A1903	OTHER	Guillain-barr? M >=38.50 And M <51.50	10	4	—	—	$28,922.60	$28,922.60	$28,922.60	2026-04-14
D1903	OTHER	Guillain-barr? M >=38.50 And M <51.50	10	4	—	—	$28,915.78	$28,915.78	$28,915.78	2026-04-14
C2004	OTHER	Miscellaneous M <46.50 And A >=77.50	10	4	—	—	$28,898.72	$28,898.72	$28,898.72	2026-04-14
C1804	OTHER	Major Multiple Trauma With Brain Or Spinal Cord Injury M >=40.50 And M <45.50	10	4	—	—	$28,830.51	$28,830.51	$28,830.51	2026-04-14
C0504	OTHER	Non-traumatic Spinal Cord Injury M >=39.50 And M <48.50	10	4	—	—	$28,816.87	$28,816.87	$28,816.87	2026-04-14
C0204	OTHER	Traumatic Brain Injury M >=35.50 And M <49.50	10	4	—	—	$28,798.11	$28,798.11	$28,798.11	2026-04-14
A1504	OTHER	Pulmonary M <45.50	10	4	—	—	$28,755.48	$28,755.48	$28,755.48	2026-04-14
B0804	OTHER	Replacement Of Lower-extremity Joint M >=42.50 And M <51.50	10	4	—	—	$28,629.28	$28,629.28	$28,629.28	2026-04-14
D1304	OTHER	Rheumatoid Other Arthritis M <44.50 And A >=64.50	10	4	—	—	$28,622.46	$28,622.46	$28,622.46	2026-04-14
D1305	OTHER	Rheumatoid Other Arthritis M <51.50 And A <64.50	10	4	—	—	$28,564.48	$28,564.48	$28,564.48	2026-04-14
A1004	OTHER	Amputation Lower Extremity M <47.50	10	4	—	—	$28,223.41	$28,223.41	$28,223.41	2026-04-14
C1203	OTHER	Osteoarthritis M <49.50 And A >=74.50	10	4	—	—	$28,220.00	$28,220.00	$28,220.00	2026-04-14
D2005	OTHER	Miscellaneous M <46.50 And A <77.50	10	4	—	—	$28,131.32	$28,131.32	$28,131.32	2026-04-14
D1604	OTHER	Pain Syndrome M <43.50	10	4	—	—	$28,029.00	$28,029.00	$28,029.00	2026-04-14
A0305	OTHER	Non-traumatic Brain Injury M <42.50 And A <78.50	10	4	—	—	$27,955.67	$27,955.67	$27,955.67	2026-04-14
B0602	OTHER	Neurological M >=52.50 And M <64.50	10	4	—	—	$27,778.31	$27,778.31	$27,778.31	2026-04-14
B1702	OTHER	Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=50.50 And M <57.50	10	4	—	—	$27,728.86	$27,728.86	$27,728.86	2026-04-14
B0502	OTHER	Non-traumatic Spinal Cord Injury M >=53.50 And M <60.50	10	4	—	—	$27,713.51	$27,713.51	$27,713.51	2026-04-14
D0104	OTHER	Stroke M >=41.50 And M <50.50	10	4	—	—	$27,684.52	$27,684.52	$27,684.52	2026-04-14
D1704	OTHER	Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=36.50 And M <41.50	10	4	—	—	$27,537.86	$27,537.86	$27,537.86	2026-04-14
D2102	OTHER	Burns M <52.50	10	4	—	—	$27,517.40	$27,517.40	$27,517.40	2026-04-14
D0904	OTHER	Other Orthopedic M <44.5	10	4	—	—	$27,432.13	$27,432.13	$27,432.13	2026-04-14
B2101	OTHER	Burns M >=52.50	10	4	—	—	$27,389.50	$27,389.50	$27,389.50	2026-04-14
C0403	OTHER	Traumatic Spinal Cord Injury M >=41.50 And M <47.50	10	4	—	—	$27,326.40	$27,326.40	$27,326.40	2026-04-14
B1502	OTHER	Pulmonary M >=56.50 And M <68.50	10	4	—	—	$27,322.99	$27,322.99	$27,322.99	2026-04-14
D1404	OTHER	Cardiac M <45.50	10	4	—	—	$27,270.12	$27,270.12	$27,270.12	2026-04-14
D0304	OTHER	Non-traumatic Brain Injury M <42.50 And A >=78.50	10	4	—	—	$27,259.89	$27,259.89	$27,259.89	2026-04-14
A0704	OTHER	Fracture Of Lower Extremity M <41.50	10	4	—	—	$27,145.63	$27,145.63	$27,145.63	2026-04-14
B0103	OTHER	Stroke M >=50.50 And M <63.50	10	4	—	—	$26,940.99	$26,940.99	$26,940.99	2026-04-14
D1103	OTHER	Amputation Non-lower Extremity M <52.50	10	4	—	—	$26,876.19	$26,876.19	$26,876.19	2026-04-14
D2004	OTHER	Miscellaneous M <46.50 And A >=77.50	10	4	—	—	$26,876.19	$26,876.19	$26,876.19	2026-04-14
D0805	OTHER	Replacement Of Lower-extremity Joint M <42.50	10	4	—	—	$26,845.49	$26,845.49	$26,845.49	2026-04-14
B0902	OTHER	Other Orthopedic M >=51.50 And M <63.50	10	4	—	—	$26,830.14	$26,830.14	$26,830.14	2026-04-14
D0504	OTHER	Non-traumatic Spinal Cord Injury M >=39.50 And M <48.50	10	4	—	—	$26,807.97	$26,807.97	$26,807.97	2026-04-14
A0604	OTHER	Neurological M <43.50	10	4	—	—	$26,767.05	$26,767.05	$26,767.05	2026-04-14
D0403	OTHER	Traumatic Spinal Cord Injury M >=41.50 And M <47.50	10	4	—	—	$26,606.74	$26,606.74	$26,606.74	2026-04-14
B1202	OTHER	Osteoarthritis M >=49.50 And M <61.50	10	4	—	—	$26,562.41	$26,562.41	$26,562.41	2026-04-14
D1804	OTHER	Major Multiple Trauma With Brain Or Spinal Cord Injury M >=40.50 And M <45.50	10	4	—	—	$26,521.48	$26,521.48	$26,521.48	2026-04-14
A2102	OTHER	Burns M <52.50	10	4	—	—	$26,388.46	$26,388.46	$26,388.46	2026-04-14
B0302	OTHER	Non-traumatic Brain Injury M >=52.50 And M <65.50	10	4	—	—	$26,339.01	$26,339.01	$26,339.01	2026-04-14
B1102	OTHER	Amputation Non-lower Extremity M >=52.50 And M <58.50	10	4	—	—	$26,337.30	$26,337.30	$26,337.30	2026-04-14
D0204	OTHER	Traumatic Brain Injury M >=35.50 And M <49.50	10	4	—	—	$26,310.01	$26,310.01	$26,310.01	2026-04-14
A0104	OTHER	Stroke M >=41.50 And M <50.50	10	4	—	—	$26,258.85	$26,258.85	$26,258.85	2026-04-14
B1302	OTHER	Rheumatoid Other Arthritis M >=51.50 And M <62.50	10	4	—	—	$26,194.05	$26,194.05	$26,194.05	2026-04-14
B1603	OTHER	Pain Syndrome M >=43.50 And M <58.50	10	4	—	—	$26,120.72	$26,120.72	$26,120.72	2026-04-14
A1304	OTHER	Rheumatoid Other Arthritis M <44.50 And A >=64.50	10	4	—	—	$25,999.64	$25,999.64	$25,999.64	2026-04-14
D1204	OTHER	Osteoarthritis M <49.50 And A <74.50	10	4	—	—	$25,963.83	$25,963.83	$25,963.83	2026-04-14
A1305	OTHER	Rheumatoid Other Arthritis M <51.50 And A <64.50	10	4	—	—	$25,948.48	$25,948.48	$25,948.48	2026-04-14
B0702	OTHER	Fracture Of Lower Extremity M >=52.50 And M <61.50	10	4	—	—	$25,861.51	$25,861.51	$25,861.51	2026-04-14
C1703	OTHER	Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=41.50 And M <50.50	10	4	—	—	$25,774.54	$25,774.54	$25,774.54	2026-04-14
A2005	OTHER	Miscellaneous M <46.50 And A <77.50	10	4	—	—	$25,752.37	$25,752.37	$25,752.37	2026-04-14
C1503	OTHER	Pulmonary M >=45.50 And M <56.50	10	4	—	—	$25,614.23	$25,614.23	$25,614.23	2026-04-14
A0304	OTHER	Non-traumatic Brain Injury M <42.50 And A >=78.50	10	4	—	—	$25,520.44	$25,520.44	$25,520.44	2026-04-14
B1002	OTHER	Amputation Lower Extremity M >=55.50 And M <64.50	10	4	—	—	$25,459.05	$25,459.05	$25,459.05	2026-04-14
A1604	OTHER	Pain Syndrome M <43.50	10	4	—	—	$25,406.18	$25,406.18	$25,406.18	2026-04-14
A1704	OTHER	Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=36.50 And M <41.50	10	4	—	—	$25,351.61	$25,351.61	$25,351.61	2026-04-14
C0703	OTHER	Fracture Of Lower Extremity M >=41.50 And M <52.50	10	4	—	—	$25,331.15	$25,331.15	$25,331.15	2026-04-14
D1203	OTHER	Osteoarthritis M <49.50 And A >=74.50	10	4	—	—	$25,218.60	$25,218.60	$25,218.60	2026-04-14
B0803	OTHER	Replacement Of Lower-extremity Joint M >=51.50 And M <57.50	10	4	—	—	$25,201.54	$25,201.54	$25,201.54	2026-04-14
C1003	OTHER	Amputation Lower Extremity M >=47.50 And M <55.50	10	4	—	—	$25,177.67	$25,177.67	$25,177.67	2026-04-14
B2002	OTHER	Miscellaneous M >=55.50 And M <66.50	10	4	—	—	$25,162.32	$25,162.32	$25,162.32	2026-04-14
A0805	OTHER	Replacement Of Lower-extremity Joint M <42.50	10	4	—	—	$25,152.09	$25,152.09	$25,152.09	2026-04-14
A1404	OTHER	Cardiac M <45.50	10	4	—	—	$25,077.05	$25,077.05	$25,077.05	2026-04-14
A0904	OTHER	Other Orthopedic M <44.5	10	4	—	—	$25,025.89	$25,025.89	$25,025.89	2026-04-14
C0603	OTHER	Neurological M >=43.50 And M <52.50	10	4	—	—	$25,017.37	$25,017.37	$25,017.37	2026-04-14
C1102	OTHER	Amputation Non-lower Extremity M >=52.50 And M <58.50	10	4	—	—	$24,933.80	$24,933.80	$24,933.80	2026-04-14
A1804	OTHER	Major Multiple Trauma With Brain Or Spinal Cord Injury M >=40.50 And M <45.50	10	4	—	—	$24,892.88	$24,892.88	$24,892.88	2026-04-14
A0204	OTHER	Traumatic Brain Injury M >=35.50 And M <49.50	10	4	—	—	$24,718.93	$24,718.93	$24,718.93	2026-04-14
A0504	OTHER	Non-traumatic Spinal Cord Injury M >=39.50 And M <48.50	10	4	—	—	$24,705.29	$24,705.29	$24,705.29	2026-04-14
C1803	OTHER	Major Multiple Trauma With Brain Or Spinal Cord Injury M >=45.50 And M <55.50	10	4	—	—	$24,684.82	$24,684.82	$24,684.82	2026-04-14
C0303	OTHER	Non-traumatic Brain Injury M >=42.50 And M <52.50	10	4	—	—	$24,683.12	$24,683.12	$24,683.12	2026-04-14
A2004	OTHER	Miscellaneous M <46.50 And A >=77.50	10	4	—	—	$24,602.97	$24,602.97	$24,602.97	2026-04-14
B1402	OTHER	Cardiac M >=55.50 And M <68.50	10	4	—	—	$24,277.25	$24,277.25	$24,277.25	2026-04-14
B1802	OTHER	Major Multiple Trauma With Brain Or Spinal Cord Injury M >=55.50 And M <67.50	10	4	—	—	$24,255.08	$24,255.08	$24,255.08	2026-04-14
C1303	OTHER	Rheumatoid Other Arthritis M >=44.50 And M <51.50 And A >=64.50	10	4	—	—	$24,202.21	$24,202.21	$24,202.21	2026-04-14
C0503	OTHER	Non-traumatic Spinal Cord Injury M >=48.50 And M <53.50	10	4	—	—	$24,116.94	$24,116.94	$24,116.94	2026-04-14
C0903	OTHER	Other Orthopedic M >=44.50 And M <51.50	10	4	—	—	$24,115.24	$24,115.24	$24,115.24	2026-04-14
C0804	OTHER	Replacement Of Lower-extremity Joint M >=42.50 And M <51.50	10	4	—	—	$24,113.53	$24,113.53	$24,113.53	2026-04-14
A0403	OTHER	Traumatic Spinal Cord Injury M >=41.50 And M <47.50	10	4	—	—	$24,076.02	$24,076.02	$24,076.02	2026-04-14
D0703	OTHER	Fracture Of Lower Extremity M >=41.50 And M <52.50	10	4	—	—	$24,058.96	$24,058.96	$24,058.96	2026-04-14
A1204	OTHER	Osteoarthritis M <49.50 And A <74.50	10	4	—	—	$24,045.32	$24,045.32	$24,045.32	2026-04-14
D1503	OTHER	Pulmonary M >=45.50 And M <56.50	10	4	—	—	$23,987.34	$23,987.34	$23,987.34	2026-04-14
D1703	OTHER	Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=41.50 And M <50.50	10	4	—	—	$23,931.06	$23,931.06	$23,931.06	2026-04-14
C0103	OTHER	Stroke M >=50.50 And M <63.50	10	4	—	—	$23,924.24	$23,924.24	$23,924.24	2026-04-14
C2003	OTHER	Miscellaneous M >=46.50 And M <55.50	10	4	—	—	$23,695.72	$23,695.72	$23,695.72	2026-04-14
C0402	OTHER	Traumatic Spinal Cord Injury M >=47.50 And M <56.50	10	4	—	—	$23,675.26	$23,675.26	$23,675.26	2026-04-14
C1403	OTHER	Cardiac M >=45.50 And M <55.50	10	4	—	—	$23,637.74	$23,637.74	$23,637.74	2026-04-14
B0202	OTHER	Traumatic Brain Injury M >=61.50 And M <73.50	10	4	—	—	$23,637.74	$23,637.74	$23,637.74	2026-04-14
D0603	OTHER	Neurological M >=43.50 And M <52.50	10	4	—	—	$23,562.71	$23,562.71	$23,562.71	2026-04-14
A1103	OTHER	Amputation Non-lower Extremity M <52.50	10	4	—	—	$23,514.96	$23,514.96	$23,514.96	2026-04-14
C1902	OTHER	Guillain-barr? M >=51.50 And M <66.50	10	4	—	—	$23,508.14	$23,508.14	$23,508.14	2026-04-14
C1603	OTHER	Pain Syndrome M >=43.50 And M <58.50	10	4	—	—	$23,409.23	$23,409.23	$23,409.23	2026-04-14
C0203	OTHER	Traumatic Brain Injury M >=49.50 And M <61.50	10	4	—	—	$23,366.59	$23,366.59	$23,366.59	2026-04-14
A1203	OTHER	Osteoarthritis M <49.50 And A >=74.50	10	4	—	—	$23,356.36	$23,356.36	$23,356.36	2026-04-14
B0401	OTHER	Traumatic Spinal Cord Injury M >=56.50	10	4	—	—	$23,103.97	$23,103.97	$23,103.97	2026-04-14
B1101	OTHER	Amputation Non-lower Extremity M >=58.50	10	4	—	—	$23,063.04	$23,063.04	$23,063.04	2026-04-14
D0402	OTHER	Traumatic Spinal Cord Injury M >=47.50 And M <56.50	10	4	—	—	$23,052.81	$23,052.81	$23,052.81	2026-04-14
C2101	OTHER	Burns M >=52.50	10	4	—	—	$23,027.23	$23,027.23	$23,027.23	2026-04-14
D0303	OTHER	Non-traumatic Brain Injury M >=42.50 And M <52.50	10	4	—	—	$23,011.88	$23,011.88	$23,011.88	2026-04-14
A1503	OTHER	Pulmonary M >=45.50 And M <56.50	10	4	—	—	$22,930.03	$22,930.03	$22,930.03	2026-04-14
B0802	OTHER	Replacement Of Lower-extremity Joint M >=57.50 And M <63.50	10	4	—	—	$22,899.33	$22,899.33	$22,899.33	2026-04-14
B1901	OTHER	Guillain-barr? M >=66.50	10	4	—	—	$22,863.52	$22,863.52	$22,863.52	2026-04-14
D1003	OTHER	Amputation Lower Extremity M >=47.50 And M <55.50	10	4	—	—	$22,851.58	$22,851.58	$22,851.58	2026-04-14
D0903	OTHER	Other Orthopedic M >=44.50 And M <51.50	10	4	—	—	$22,779.96	$22,779.96	$22,779.96	2026-04-14
D1803	OTHER	Major Multiple Trauma With Brain Or Spinal Cord Injury M >=45.50 And M <55.50	10	4	—	—	$22,708.33	$22,708.33	$22,708.33	2026-04-14
B1201	OTHER	Osteoarthritis M >=61.50	10	4	—	—	$22,590.66	$22,590.66	$22,590.66	2026-04-14
B1701	OTHER	Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=57.50	10	4	—	—	$22,495.16	$22,495.16	$22,495.16	2026-04-14
D0503	OTHER	Non-traumatic Spinal Cord Injury M >=48.50 And M <53.50	10	4	—	—	$22,435.48	$22,435.48	$22,435.48	2026-04-14
B1501	OTHER	Pulmonary M >=68.50	10	4	—	—	$22,345.09	$22,345.09	$22,345.09	2026-04-14
B0601	OTHER	Neurological M >=64.50	10	4	—	—	$22,331.45	$22,331.45	$22,331.45	2026-04-14
B0501	OTHER	Non-traumatic Spinal Cord Injury M >=60.50	10	4	—	—	$22,322.92	$22,322.92	$22,322.92	2026-04-14
D1303	OTHER	Rheumatoid Other Arthritis M >=44.50 And M <51.50 And A >=64.50	10	4	—	—	$22,176.26	$22,176.26	$22,176.26	2026-04-14
D2003	OTHER	Miscellaneous M >=46.50 And M <55.50	10	4	—	—	$22,036.43	$22,036.43	$22,036.43	2026-04-14
A1703	OTHER	Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=41.50 And M <50.50	10	4	—	—	$22,031.31	$22,031.31	$22,031.31	2026-04-14
A0703	OTHER	Fracture Of Lower Extremity M >=41.50 And M <52.50	10	4	—	—	$21,985.27	$21,985.27	$21,985.27	2026-04-14
C1502	OTHER	Pulmonary M >=56.50 And M <68.50	10	4	—	—	$21,969.92	$21,969.92	$21,969.92	2026-04-14
C1702	OTHER	Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=50.50 And M <57.50	10	4	—	—	$21,966.51	$21,966.51	$21,966.51	2026-04-14
D1403	OTHER	Cardiac M >=45.50 And M <55.50	10	4	—	—	$21,855.66	$21,855.66	$21,855.66	2026-04-14
C1101	OTHER	Amputation Non-lower Extremity M >=58.50	10	4	—	—	$21,835.20	$21,835.20	$21,835.20	2026-04-14
D0103	OTHER	Stroke M >=50.50 And M <63.50	10	4	—	—	$21,674.89	$21,674.89	$21,674.89	2026-04-14
B1602	OTHER	Pain Syndrome M >=58.50 And M <65.50	10	4	—	—	$21,569.16	$21,569.16	$21,569.16	2026-04-14
D0804	OTHER	Replacement Of Lower-extremity Joint M >=42.50 And M <51.50	10	4	—	—	$21,553.82	$21,553.82	$21,553.82	2026-04-14
A0303	OTHER	Non-traumatic Brain Injury M >=42.50 And M <52.50	10	4	—	—	$21,543.58	$21,543.58	$21,543.58	2026-04-14
D1102	OTHER	Amputation Non-lower Extremity M >=52.50 And M <58.50	10	4	—	—	$21,456.61	$21,456.61	$21,456.61	2026-04-14
D1603	OTHER	Pain Syndrome M >=43.50 And M <58.50	10	4	—	—	$21,413.98	$21,413.98	$21,413.98	2026-04-14
B1301	OTHER	Rheumatoid Other Arthritis M >=62.50	10	4	—	—	$21,362.82	$21,362.82	$21,362.82	2026-04-14
D0203	OTHER	Traumatic Brain Injury M >=49.50 And M <61.50	10	4	—	—	$21,347.47	$21,347.47	$21,347.47	2026-04-14
A1803	OTHER	Major Multiple Trauma With Brain Or Spinal Cord Injury M >=45.50 And M <55.50	10	4	—	—	$21,313.36	$21,313.36	$21,313.36	2026-04-14
C0502	OTHER	Non-traumatic Spinal Cord Injury M >=53.50 And M <60.50	10	4	—	—	$21,298.01	$21,298.01	$21,298.01	2026-04-14
C0803	OTHER	Replacement Of Lower-extremity Joint M >=51.50 And M <57.50	10	4	—	—	$21,226.39	$21,226.39	$21,226.39	2026-04-14
A1003	OTHER	Amputation Lower Extremity M >=47.50 And M <55.50	10	4	—	—	$21,217.86	$21,217.86	$21,217.86	2026-04-14
A0603	OTHER	Neurological M >=43.50 And M <52.50	10	4	—	—	$21,165.00	$21,165.00	$21,165.00	2026-04-14
C1002	OTHER	Amputation Lower Extremity M >=55.50 And M <64.50	10	4	—	—	$21,154.76	$21,154.76	$21,154.76	2026-04-14
B0901	OTHER	Other Orthopedic M >=63.50	10	4	—	—	$21,120.66	$21,120.66	$21,120.66	2026-04-14
C1202	OTHER	Osteoarthritis M >=49.50 And M <61.50	10	4	—	—	$21,081.44	$21,081.44	$21,081.44	2026-04-14
C0602	OTHER	Neurological M >=52.50 And M <64.50	10	4	—	—	$21,038.80	$21,038.80	$21,038.80	2026-04-14
B0102	OTHER	Stroke M >=63.50 And M <72.50	10	4	—	—	$20,985.94	$20,985.94	$20,985.94	2026-04-14
B1001	OTHER	Amputation Lower Extremity M >=64.50	10	4	—	—	$20,956.95	$20,956.95	$20,956.95	2026-04-14
C1302	OTHER	Rheumatoid Other Arthritis M >=51.50 And M <62.50	10	4	—	—	$20,941.60	$20,941.60	$20,941.60	2026-04-14
B0701	OTHER	Fracture Of Lower Extremity M >=61.50	10	4	—	—	$20,922.84	$20,922.84	$20,922.84	2026-04-14
C0302	OTHER	Non-traumatic Brain Injury M >=52.50 And M <65.50	10	4	—	—	$20,875.09	$20,875.09	$20,875.09	2026-04-14
A0402	OTHER	Traumatic Spinal Cord Injury M >=47.50 And M <56.50	10	4	—	—	$20,859.74	$20,859.74	$20,859.74	2026-04-14
A0903	OTHER	Other Orthopedic M >=44.50 And M <51.50	10	4	—	—	$20,783.00	$20,783.00	$20,783.00	2026-04-14
C0702	OTHER	Fracture Of Lower Extremity M >=52.50 And M <61.50	10	4	—	—	$20,677.27	$20,677.27	$20,677.27	2026-04-14
A0503	OTHER	Non-traumatic Spinal Cord Injury M >=48.50 And M <53.50	10	4	—	—	$20,675.56	$20,675.56	$20,675.56	2026-04-14
D1502	OTHER	Pulmonary M >=56.50 And M <68.50	10	4	—	—	$20,574.95	$20,574.95	$20,574.95	2026-04-14
A0103	OTHER	Stroke M >=50.50 And M <63.50	10	4	—	—	$20,559.60	$20,559.60	$20,559.60	2026-04-14
A1902	OTHER	Guillain-barr? M >=51.50 And M <66.50	10	4	—	—	$20,441.93	$20,441.93	$20,441.93	2026-04-14
D1902	OTHER	Guillain-barr? M >=51.50 And M <66.50	10	4	—	—	$20,436.82	$20,436.82	$20,436.82	2026-04-14
D1702	OTHER	Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=50.50 And M <57.50	10	4	—	—	$20,395.89	$20,395.89	$20,395.89	2026-04-14
B0301	OTHER	Non-traumatic Brain Injury M >=65.50	10	4	—	—	$20,360.08	$20,360.08	$20,360.08	2026-04-14
C0902	OTHER	Other Orthopedic M >=51.50 And M <63.50	10	4	—	—	$20,322.56	$20,322.56	$20,322.56	2026-04-14
B2001	OTHER	Miscellaneous M >=66.50	10	4	—	—	$20,266.28	$20,266.28	$20,266.28	2026-04-14
A0804	OTHER	Replacement Of Lower-extremity Joint M >=42.50 And M <51.50	10	4	—	—	$20,194.66	$20,194.66	$20,194.66	2026-04-14
C2002	OTHER	Miscellaneous M >=55.50 And M <66.50	10	4	—	—	$20,179.31	$20,179.31	$20,179.31	2026-04-14
A2003	OTHER	Miscellaneous M >=46.50 And M <55.50	10	4	—	—	$20,174.19	$20,174.19	$20,174.19	2026-04-14
A1303	OTHER	Rheumatoid Other Arthritis M >=44.50 And M <51.50 And A >=64.50	10	4	—	—	$20,143.50	$20,143.50	$20,143.50	2026-04-14
A1403	OTHER	Cardiac M >=45.50 And M <55.50	10	4	—	—	$20,099.16	$20,099.16	$20,099.16	2026-04-14
B0801	OTHER	Replacement Of Lower-extremity Joint M >=63.50	10	4	—	—	$20,090.63	$20,090.63	$20,090.63	2026-04-14
A0203	OTHER	Traumatic Brain Injury M >=49.50 And M <61.50	10	4	—	—	$20,056.52	$20,056.52	$20,056.52	2026-04-14
C1802	OTHER	Major Multiple Trauma With Brain Or Spinal Cord Injury M >=55.50 And M <67.50	10	4	—	—	$19,843.36	$19,843.36	$19,843.36	2026-04-14
D0602	OTHER	Neurological M >=52.50 And M <64.50	10	4	—	—	$19,814.37	$19,814.37	$19,814.37	2026-04-14
D0502	OTHER	Non-traumatic Spinal Cord Injury M >=53.50 And M <60.50	10	4	—	—	$19,812.66	$19,812.66	$19,812.66	2026-04-14
A1502	OTHER	Pulmonary M >=56.50 And M <68.50	10	4	—	—	$19,669.41	$19,669.41	$19,669.41	2026-04-14
D0702	OTHER	Fracture Of Lower Extremity M >=52.50 And M <61.50	10	4	—	—	$19,637.01	$19,637.01	$19,637.01	2026-04-14
C1402	OTHER	Cardiac M >=55.50 And M <68.50	10	4	—	—	$19,556.86	$19,556.86	$19,556.86	2026-04-14
D0302	OTHER	Non-traumatic Brain Injury M >=52.50 And M <65.50	10	4	—	—	$19,461.36	$19,461.36	$19,461.36	2026-04-14
A1603	OTHER	Pain Syndrome M >=43.50 And M <58.50	10	4	—	—	$19,410.20	$19,410.20	$19,410.20	2026-04-14
C1602	OTHER	Pain Syndrome M >=58.50 And M <65.50	10	4	—	—	$19,330.05	$19,330.05	$19,330.05	2026-04-14
C0802	OTHER	Replacement Of Lower-extremity Joint M >=57.50 And M <63.50	10	4	—	—	$19,287.42	$19,287.42	$19,287.42	2026-04-14
D1002	OTHER	Amputation Lower Extremity M >=55.50 And M <64.50	10	4	—	—	$19,200.44	$19,200.44	$19,200.44	2026-04-14
D0902	OTHER	Other Orthopedic M >=51.50 And M <63.50	10	4	—	—	$19,197.03	$19,197.03	$19,197.03	2026-04-14
D1302	OTHER	Rheumatoid Other Arthritis M >=51.50 And M <62.50	10	4	—	—	$19,188.51	$19,188.51	$19,188.51	2026-04-14
B1801	OTHER	Major Multiple Trauma With Brain Or Spinal Cord Injury M >=67.50	10	4	—	—	$19,081.07	$19,081.07	$19,081.07	2026-04-14
B1401	OTHER	Cardiac M >=68.50	10	4	—	—	$19,057.19	$19,057.19	$19,057.19	2026-04-14
D0803	OTHER	Replacement Of Lower-extremity Joint M >=51.50 And M <57.50	10	4	—	—	$18,973.63	$18,973.63	$18,973.63	2026-04-14
C0401	OTHER	Traumatic Spinal Cord Injury M >=56.50	10	4	—	—	$18,884.95	$18,884.95	$18,884.95	2026-04-14
D1202	OTHER	Osteoarthritis M >=49.50 And M <61.50	10	4	—	—	$18,838.91	$18,838.91	$18,838.91	2026-04-14
C0202	OTHER	Traumatic Brain Injury M >=61.50 And M <73.50	10	4	—	—	$18,794.57	$18,794.57	$18,794.57	2026-04-14
D1101	OTHER	Amputation Non-lower Extremity M >=58.50	10	4	—	—	$18,791.16	$18,791.16	$18,791.16	2026-04-14
A1702	OTHER	Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=50.50 And M <57.50	10	4	—	—	$18,775.81	$18,775.81	$18,775.81	2026-04-14
A1102	OTHER	Amputation Non-lower Extremity M >=52.50 And M <58.50	10	4	—	—	$18,774.11	$18,774.11	$18,774.11	2026-04-14
D2002	OTHER	Miscellaneous M >=55.50 And M <66.50	10	4	—	—	$18,765.58	$18,765.58	$18,765.58	2026-04-14
C0102	OTHER	Stroke M >=63.50 And M <72.50	10	4	—	—	$18,635.97	$18,635.97	$18,635.97	2026-04-14
D0401	OTHER	Traumatic Spinal Cord Injury M >=56.50	10	4	—	—	$18,388.70	$18,388.70	$18,388.70	2026-04-14
A0502	OTHER	Non-traumatic Spinal Cord Injury M >=53.50 And M <60.50	10	4	—	—	$18,259.09	$18,259.09	$18,259.09	2026-04-14

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