Hospital

FORT DUNCAN MEDICAL CENTER

Eagle Pass, TX · CCN 450092 · Rates published

10,814 distinct procedures filed

12 distinct payers

551,870 rate rows

2026-05-23 last MRF observed

Data quality

551,654 of 551,870 rate rows are consumer-grade (100.0%)

216 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
per-diem day rate — not a per-procedure price	152
placeholder amount (≤ $0.02) — excluded from medians	58
exceeds 10× this hospital's gross charge — excluded from medians	6

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

Source MRF file	https://uhsfilecdn.eskycity.net/ac/233044530_fort-duncan-regional-medical-center_standardcharges.csv
Found on page	https://fortduncanmedicalcenter.com/patients-visitors/pricing-guide/
Discovered via	Discovered by HANK
Last fetch	not_modified · 2026-05-18
Content fingerprint	730f608a2d865b6d… · 37,005,362 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
9138 OTHER	Inj, Hemgenix, Per Tx Dose	3	$3,785,684.00	$3,821,300.00	$3,799,040.00	nat. median $3,746,358 1.0× median
773 OTHER	Inj, Beqvez, Per Tx Dose	3	$3,785,684.00	$3,821,300.00	$3,799,040.00	nat. median $3,605,000 1.1× median
9141 OTHER	Inj Onase Abepar-xioi Treat	4	$2,452,489.31	$3,244,669.31	$2,468,352.13	nat. median $2,588,981 1.0× median
9194 OTHER	Tisagenlecleucel Car-pos T	4	$577,162.57	$763,592.18	$580,895.69	nat. median $566,531 1.0× median
9498 OTHER	Ciltacabtagene Car-pos T	4	$562,565.23	$744,279.76	$566,203.94	nat. median $587,650 1.0× median
9422 OTHER	Idecabtagene Vicleucel Car	4	$539,090.00	$713,221.78	$542,576.86	nat. median $558,082 1.0× median
9413 OTHER	Lisocabtagene Car Pos T	4	$527,022.28	$697,256.06	$530,431.09	nat. median $562,201 0.9× median
9035 OTHER	Axicabtagene Ciloleucel Car+	4	$499,503.30	$660,848.15	$502,734.11	nat. median $532,192 0.9× median
9391 OTHER	Brexucabtagene Car Pos T	4	$498,007.76	$658,869.54	$501,228.91	nat. median $489,450 1.0× median
583-4 OTHER	Neonate With Ecmo	4	$327,167.72	$343,526.10	$340,254.42	nat. median $309,400 1.1× median
18 OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	5	$263,864.73	$423,778.73	$333,607.43	nat. median $386,529 0.9× median
007-4 OTHER	Allogeneic Bone Marrow Transplant	4	$318,269.06	$334,182.51	$330,999.82	nat. median $172,311 1.9× median
583-3 OTHER	Neonate With Ecmo	4	$277,033.60	$290,885.28	$288,114.95	nat. median $259,487 1.1× median
002-4 OTHER	Heart And/or Lung Transplant	4	$266,498.48	$279,823.40	$277,158.42	nat. median $216,800 1.3× median
1 OTHER	Heart Transplant Or Implant Of Heart Assist System With Mcc	5	$197,084.83	$316,527.19	$249,176.78	nat. median $239,422 1.0× median
588-4 OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	4	$207,091.80	$217,446.39	$215,375.47	nat. median $267,493 0.8× median
161-4 OTHER	Implantable Heart Assist Systems	4	$201,100.34	$211,155.36	$209,144.35	nat. median $202,242 1.0× median
009-4 OTHER	Extracorporeal Membrane Oxygenation (ecmo)	4	$188,399.35	$197,819.32	$195,935.33	nat. median $150,954 1.3× median
3 OTHER	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…	5	$149,950.24	$240,826.89	$189,583.93	nat. median $181,005 1.0× median
927 OTHER	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	5	$1.57	$266,573.10	$165,981.05	nat. median $146,562 1.1× median
630-4 OTHER	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure	4	$154,090.10	$161,794.61	$160,253.70	nat. median $210,669 0.8× median
609-4 OTHER	Neonate Birth Weight 1500-2499 Grams With Major Procedure	4	$152,724.59	$160,360.82	$158,833.58	nat. median $169,856 0.9× median
1907 OTHER	New Technology - Level 52 ($145,001-$160,000)	4	$155,611.51	$205,875.67	$156,618.02	nat. median $153,199 1.0× median
1908 OTHER	New Technology - Level 52 ($145,001-$160,000)	4	$155,611.51	$205,875.67	$156,618.02	nat. median $152,962 1.0× median
583-2 OTHER	Neonate With Ecmo	4	$138,039.52	$144,941.49	$143,561.10	nat. median $191,347 0.8× median
1905 OTHER	New Technology - Level 51 ($130,001-$145,000)	4	$140,305.51	$185,625.67	$141,213.02	nat. median $137,903 1.0× median
1906 OTHER	New Technology - Level 51 ($130,001-$145,000)	4	$140,305.51	$185,625.67	$141,213.02	nat. median $138,020 1.0× median
011-4 OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	4	$131,077.56	$137,631.43	$136,320.65	nat. median $105,647 1.3× median
200-4 OTHER	Cardiac Structural And Valvular Disorders	4	$121,807.15	$127,897.51	$126,679.43	nat. median $19,067 outlier · 6.6×
583-1 OTHER	Neonate With Ecmo	4	$121,546.54	$127,623.87	$126,408.40	nat. median $171,226 0.7× median
1904 OTHER	New Technology - Level 50 ($115,001-$130,000)	4	$124,999.51	$165,375.67	$125,808.01	nat. median $120,174 1.0× median
1903 OTHER	New Technology - Level 50 ($115,001-$130,000)	4	$124,999.51	$165,375.67	$125,808.01	nat. median $119,935 1.0× median
4 OTHER	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…	5	$98,863.21	$158,778.81	$124,993.98	nat. median $134,983 0.9× median
007-3 OTHER	Allogeneic Bone Marrow Transplant	4	$112,304.99	$117,920.24	$116,797.19	nat. median $104,111 1.1× median
14 OTHER	Allogeneic Bone Marrow Transplant	5	$91,669.22	$147,224.93	$115,898.52	nat. median $100,915 1.1× median
7 OTHER	Lung Transplant	5	$91,438.33	$146,854.11	$115,606.60	nat. median $169,933 0.7× median
588-3 OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	4	$111,118.68	$116,674.61	$115,563.43	nat. median $165,000 0.7× median
588-2 OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	4	$110,610.81	$116,141.35	$115,035.24	nat. median $153,523 0.7× median
004-4 OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	4	$110,324.78	$115,841.02	$114,737.77	nat. median $110,000 1.0× median
841-4 OTHER	Extensive Third Degree Burns With Skin Graft	4	$109,850.52	$115,343.04	$114,244.54	nat. median $151,691 0.8× median
631-4 OTHER	Neonate Birth Weight > 2499 Grams With Other Major Procedure	4	$108,753.37	$114,191.04	$113,103.51	nat. median $203,379 0.6× median
1902 OTHER	New Technology - Level 49 ($100,001-$115,000)	4	$109,693.51	$145,125.67	$110,403.01	nat. median $105,172 1.0× median
1901 OTHER	New Technology - Level 49 ($100,001-$115,000)	4	$109,693.51	$145,125.67	$110,403.01	nat. median $105,693 1.0× median
850-4 OTHER	Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal…	4	$105,888.38	$111,182.80	$110,123.92	nat. median $54,797 outlier · 2.0×
591-4 OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure	4	$104,939.84	$110,186.83	$109,137.43	nat. median $156,696 0.7× median
161-3 OTHER	Implantable Heart Assist Systems	4	$104,816.21	$110,057.02	$109,008.86	nat. median $152,491 0.7× median
588-1 OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	4	$104,262.25	$109,475.37	$108,432.74	nat. median $75,325 1.4× median
001-4 OTHER	Liver Transplant And/or Intestinal Transplant	4	$95,464.39	$100,237.61	$99,282.96	nat. median $124,561 0.8× median
008-4 OTHER	Autologous Bone Marrow Transplant Or T-cell Immunotherapy	4	$95,081.88	$99,835.97	$98,885.15	nat. median $81,385 1.2× median
1585 OTHER	New Technology - Level 48 ($90,001-$100,000)	4	$96,938.51	$128,250.68	$97,565.51	nat. median $95,360 1.0× median

Other procedures at this hospital

Browse this hospital's 10,814 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

C1882	OTHER	Crtd Cobalt Xt Hf Dtpa2q1	384	10	$102,219.00	$40,887.60 60% off	$9,297.00	$122,659.25	$47,566.56	2026-05-23
C1722	OTHER	Aicd Inventra Dx	308	10	$84,168.50	$33,667.40 60% off	$10,395.38	$110,875.45	$36,201.20	2026-05-23
C1767	OTHER	Generator Aspire Sr 106	88	10	$117,983.00	$47,193.20 60% off	$11,047.21	$160,215.60	$52,582.18	2026-05-23
37229	OTHER	Tib/peroneal Atherc Ini Bil Cs	78	10	$92,976.00	$37,190.40 60% off	$546.64	$88,327.20	$39,979.68	2026-05-23
33263	OTHER	Remove Replace Icd Gen 2lead	26	10	$169,211.00	$67,684.40 60% off	$300.99	$160,750.45	$72,760.73	2026-05-23
33230	OTHER	Insert Icd Gen 2lead	26	10	$169,211.00	$67,684.40 60% off	$296.44	$160,750.45	$72,760.73	2026-05-23
33262	OTHER	Remove Replace Icd Gen 1lead	26	10	$169,211.00	$67,684.40 60% off	$289.49	$160,750.45	$72,760.73	2026-05-23
33240	OTHER	Insert Icd Gen 1lead	26	10	$169,211.00	$67,684.40 60% off	$283.08	$160,750.45	$72,760.73	2026-05-23
33264	OTHER	Remove Replace Icd Multi Lead	26	10	$169,211.00	$67,684.40 60% off	$314.62	$160,750.45	$72,760.73	2026-05-23
33231	OTHER	Insert Icd Gen Multi Lead	26	10	$169,211.00	$67,684.40 60% off	$311.68	$160,750.45	$72,760.73	2026-05-23
33249	OTHER	Insert Replce Icd W/leads Dr	26	10	$154,375.00	$61,750.00 60% off	$711.57	$146,656.25	$71,990.29	2026-05-23
63685	OTHER	Insrt/replace Neurostim/recvr	26	10	$118,463.00	$47,385.20 60% off	$277.20	$112,539.85	$59,231.50	2026-05-23
64590	OTHER	Insrt/replace Perph Neurostm	26	10	$118,463.00	$47,385.20 60% off	$123.76	$112,539.85	$50,939.09	2026-05-23
62362	OTHER	Imp/replc Progrmmable Pump	26	10	$106,907.00	$42,762.80 60% off	$294.84	$101,561.65	$45,970.01	2026-05-23
62361	OTHER	Imp/replc Non-progrm Pump	26	10	$106,907.00	$42,762.80 60% off	$329.32	$101,561.65	$45,970.01	2026-05-23
33208	OTHER	Insert New/replce Pacer Av	26	10	$106,794.00	$42,717.60 60% off	$404.43	$101,454.30	$43,785.54	2026-05-23
33228	OTHER	Remove Replace Pacer Gen 2lead	26	10	$93,053.00	$37,221.20 60% off	$274.79	$88,400.35	$38,151.73	2026-05-23
92933	OTHER	Stent W/athrec W/wo Ptca 1st	26	10	$87,782.00	$35,112.80 60% off	$515.90	$83,392.90	$37,746.26	2026-05-23
927	OTHER	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	22	5	—	—	$1.57	$266,573.10	$165,981.05	2026-05-23
928	OTHER	Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc	22	5	—	—	$1.69	$75,050.80	$46,730.19	2026-05-23
820	OTHER	Lymphoma And Leukemia With Major O.r. Procedures With Mcc	22	5	—	—	$24.00	$65,425.19	$40,736.82	2026-05-23
834	OTHER	Acute Leukemia With Mcc	22	5	—	—	$130.68	$62,110.27	$38,672.80	2026-05-23
215	OTHER	Other Heart Assist System Implant	16	6	—	—	$74,128.52	$130,369.00	$95,897.21	2026-05-23
216	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	16	6	—	—	$67,525.74	$130,369.00	$87,355.45	2026-05-23
233	OTHER	Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc	16	6	—	—	$54,688.92	$93,451.00	$70,748.95	2026-05-23
219	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	16	6	—	—	$54,136.88	$86,946.29	$70,034.80	2026-05-23
231	OTHER	Coronary Bypass With Ptca With Mcc	16	6	—	—	$51,173.00	$95,221.21	$67,403.58	2026-05-23
456	OTHER	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	16	6	—	—	$31,069.00	$95,168.40	$67,366.19	2026-05-23
217	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	16	6	—	—	$45,183.92	$130,369.00	$58,452.69	2026-05-23
218	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	16	6	—	—	$41,625.40	$130,369.00	$53,849.18	2026-05-23
235	OTHER	Coronary Bypass Without Cardiac Catheterization With Mcc	16	6	—	—	$41,169.92	$73,592.00	$53,259.93	2026-05-23
232	OTHER	Coronary Bypass With Ptca Without Mcc	16	6	—	—	$42,740.67	$68,643.46	$52,605.28	2026-05-23
461	OTHER	Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc	16	6	—	—	$15,839.00	$68,958.10	$48,812.89	2026-05-23
234	OTHER	Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc	16	6	—	—	$37,223.78	$93,451.00	$48,154.97	2026-05-23
220	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	16	6	—	—	$37,059.36	$80,414.00	$47,942.27	2026-05-23
457	OTHER	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	16	6	—	—	$31,069.00	$64,493.64	$45,652.66	2026-05-23
228	OTHER	Other Cardiothoracic Procedures With Mcc	16	6	—	—	$34,866.60	$55,997.34	$45,105.57	2026-05-23
221	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	16	6	—	—	$32,132.99	$80,414.00	$41,569.21	2026-05-23
466	OTHER	Revision Of Hip Or Knee Replacement With Mcc	16	6	—	—	$23,150.00	$57,248.02	$40,523.76	2026-05-23
236	OTHER	Coronary Bypass Without Cardiac Catheterization Without Mcc	16	6	—	—	$28,771.08	$73,592.00	$37,220.04	2026-05-23
18	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	14	5	—	—	$263,864.73	$423,778.73	$333,607.43	2026-05-23
1	OTHER	Heart Transplant Or Implant Of Heart Assist System With Mcc	14	5	—	—	$197,084.83	$316,527.19	$249,176.78	2026-05-23
3	OTHER	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…	14	5	—	—	$149,950.24	$240,826.89	$189,583.93	2026-05-23
4	OTHER	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…	14	5	—	—	$98,863.21	$158,778.81	$124,993.98	2026-05-23
14	OTHER	Allogeneic Bone Marrow Transplant	14	5	—	—	$91,669.22	$147,224.93	$115,898.52	2026-05-23
7	OTHER	Lung Transplant	14	5	—	—	$91,438.33	$146,854.11	$115,606.60	2026-05-23
2	OTHER	Heart Transplant Or Implant Of Heart Assist System Without Mcc	14	5	—	—	$77,101.41	$123,828.37	$97,480.27	2026-05-23
212	OTHER	Concomitant Aortic And Mitral Valve Procedures	14	5	—	—	$76,221.23	$122,414.75	$96,367.44	2026-05-23
5	OTHER	Liver Transplant With Mcc Or Intestinal Transplant	14	5	—	—	$74,510.54	$119,667.31	$94,204.59	2026-05-23
426	OTHER	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	14	5	—	—	$73,293.12	$117,712.07	$92,665.39	2026-05-23
850	OTHER	Acute Leukemia With Other Procedures	14	5	—	—	$64,452.80	$103,514.12	$81,488.47	2026-05-23
429	OTHER	Combined Anterior And Posterior Cervical Spinal Fusion With Mcc	14	5	—	—	$58,356.58	$93,723.32	$73,780.95	2026-05-23
20	OTHER	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc	14	5	—	—	$56,401.01	$90,582.58	$71,308.49	2026-05-23
10	OTHER	Pancreas Transplant	14	5	—	—	$55,784.60	$89,592.60	$70,529.16	2026-05-23
19	OTHER	Simultaneous Pancreas And Kidney Transplant With Hemodialysis	14	5	—	—	$55,464.85	$89,079.07	$70,124.90	2026-05-23
957	OTHER	Other O.r. Procedures For Multiple Significant Trauma With Mcc	14	5	—	—	$52,224.69	$83,875.22	$66,028.31	2026-05-23
427	OTHER	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	14	5	—	—	$49,695.38	$79,813.04	$62,830.48	2026-05-23
870	OTHER	Septicemia Or Severe Sepsis With Mv >96 Hours	14	5	—	—	$48,672.47	$78,170.19	$61,537.20	2026-05-23
955	OTHER	Craniotomy For Multiple Significant Trauma	14	5	—	—	$47,775.49	$76,729.61	$60,403.14	2026-05-23
447	OTHER	Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall…	14	5	—	—	$46,910.70	$75,340.71	$59,309.78	2026-05-23
268	OTHER	Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc	14	5	—	—	$46,651.12	$74,923.82	$58,981.59	2026-05-23
207	OTHER	Respiratory System Diagnosis With Ventilator Support >96 Hours	14	5	—	—	$45,248.99	$72,671.93	$57,208.85	2026-05-23
969	OTHER	HIV With Extensive O.r. Procedures With Mcc	14	5	—	—	$44,249.16	$71,066.16	$55,944.76	2026-05-23
317	OTHER	Concomitant Left Atrial Appendage Closure And Cardiac Ablation	14	5	—	—	$43,284.32	$69,516.58	$54,724.89	2026-05-23
573	OTHER	Skin Graft For Skin Ulcer Or Cellulitis With Mcc	14	5	—	—	$43,087.01	$69,199.69	$54,475.44	2026-05-23
28	OTHER	Spinal Procedures With Mcc	14	5	—	—	$42,536.37	$68,315.34	$53,779.26	2026-05-23
16	OTHER	Autologous Bone Marrow Transplant With Cc/mcc	14	5	—	—	$42,231.31	$67,825.41	$53,393.57	2026-05-23
17	OTHER	Autologous Bone Marrow Transplant Without Cc/mcc	14	5	—	—	$42,231.31	$67,825.41	$53,393.57	2026-05-23
266	OTHER	Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc	14	5	—	—	$41,915.76	$67,318.62	$52,994.62	2026-05-23
23	OTHER	Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…	14	5	—	—	$39,916.81	$64,108.21	$50,467.31	2026-05-23
653	OTHER	Major Bladder Procedures With Mcc	14	5	—	—	$39,003.74	$62,641.78	$49,312.91	2026-05-23
21	OTHER	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc	14	5	—	—	$38,672.80	$62,110.27	$48,894.50	2026-05-23
428	OTHER	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	14	5	—	—	$38,510.48	$61,849.57	$48,689.27	2026-05-23
8	OTHER	Simultaneous Pancreas And Kidney Transplant	14	5	—	—	$38,069.68	$61,141.64	$48,131.97	2026-05-23
405	OTHER	Pancreas, Liver And Shunt Procedures With Mcc	14	5	—	—	$37,982.93	$61,002.30	$48,022.28	2026-05-23
463	OTHER	Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …	14	5	—	—	$37,789.12	$60,691.04	$47,777.25	2026-05-23
11	OTHER	Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc	14	5	—	—	$37,753.43	$60,633.73	$47,732.13	2026-05-23
576	OTHER	Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc	14	5	—	—	$37,749.24	$60,626.99	$47,726.82	2026-05-23
326	OTHER	Stomach, Esophageal And Duodenal Procedures With Mcc	14	5	—	—	$35,536.18	$57,072.72	$44,928.83	2026-05-23
239	OTHER	Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc	14	5	—	—	$35,241.62	$56,599.65	$44,556.42	2026-05-23
837	OTHER	Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot…	14	5	—	—	$35,033.82	$56,265.91	$44,293.69	2026-05-23
853	OTHER	Infectious And Parasitic Diseases With O.r. Procedures With Mcc	14	5	—	—	$34,992.54	$56,199.61	$44,241.50	2026-05-23
245	OTHER	Aicd Generator Procedures	14	5	—	—	$34,191.42	$54,912.97	$43,228.63	2026-05-23
6	OTHER	Liver Transplant Without Mcc	14	5	—	—	$33,928.34	$54,490.46	$42,896.02	2026-05-23
981	OTHER	Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc	14	5	—	—	$33,261.56	$53,419.57	$42,053.00	2026-05-23
267	OTHER	Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc	14	5	—	—	$32,917.32	$52,866.71	$41,617.78	2026-05-23
823	OTHER	Lymphoma And Non-acute Leukemia With Other Procedures With Mcc	14	5	—	—	$32,741.01	$52,583.54	$41,394.86	2026-05-23
277	OTHER	Cardiac Defibrillator Implant Without Mcc	14	5	—	—	$32,547.90	$52,273.40	$41,150.71	2026-05-23
163	OTHER	Major Chest Procedures With Mcc	14	5	—	—	$32,249.14	$51,793.58	$40,772.98	2026-05-23
650	OTHER	Kidney Transplant With Hemodialysis With Mcc	14	5	—	—	$32,235.84	$51,772.23	$40,756.18	2026-05-23
329	OTHER	Major Small And Large Bowel Procedures With Mcc	14	5	—	—	$32,128.10	$51,599.18	$40,619.95	2026-05-23
474	OTHER	Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc	14	5	—	—	$31,378.05	$50,394.57	$39,671.66	2026-05-23
25	OTHER	Craniotomy And Endovascular Intracranial Procedures With Mcc	14	5	—	—	$31,291.29	$50,255.24	$39,561.97	2026-05-23
319	OTHER	Other Endovascular Cardiac Valve Procedures With Mcc	14	5	—	—	$30,735.06	$49,361.89	$38,858.71	2026-05-23
933	OTHER	Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft	14	5	—	—	$30,273.97	$48,621.38	$38,275.76	2026-05-23
356	OTHER	Other Digestive System O.r. Procedures With Mcc	14	5	—	—	$29,845.78	$47,933.67	$37,734.38	2026-05-23
323	OTHER	Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc	14	5	—	—	$29,801.70	$47,862.88	$37,678.65	2026-05-23
140	OTHER	Major Head And Neck Procedures With Mcc	14	5	—	—	$29,590.40	$47,523.52	$37,411.50	2026-05-23
31	OTHER	Ventricular Shunt Procedures With Mcc	14	5	—	—	$29,320.32	$47,089.77	$37,070.05	2026-05-23
673	OTHER	Other Kidney And Urinary Tract Procedures With Mcc	14	5	—	—	$29,313.33	$47,078.54	$37,061.20	2026-05-23
269	OTHER	Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc	14	5	—	—	$29,111.12	$46,753.79	$36,805.55	2026-05-23
958	OTHER	Other O.r. Procedures For Multiple Significant Trauma With Cc	14	5	—	—	$28,754.99	$46,181.82	$36,355.29	2026-05-23
12	OTHER	Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc	14	5	—	—	$28,712.31	$46,113.28	$36,301.33	2026-05-23
448	OTHER	Multiple Level Spinal Fusion Except Cervical Without Mcc	14	5	—	—	$28,570.98	$45,886.29	$36,122.64	2026-05-23
423	OTHER	Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc	14	5	—	—	$28,458.33	$45,705.37	$35,980.22	2026-05-23
907	OTHER	Other O.r. Procedures For Injuries With Mcc	14	5	—	—	$27,872.71	$44,764.84	$35,239.81	2026-05-23
9141	OTHER	Inj Onase Abepar-xioi Treat	8	4	—	—	$2,452,489.31	$3,244,669.31	$2,468,352.13	2026-05-23
9194	OTHER	Tisagenlecleucel Car-pos T	8	4	—	—	$577,162.57	$763,592.18	$580,895.69	2026-05-23
9498	OTHER	Ciltacabtagene Car-pos T	8	4	—	—	$562,565.23	$744,279.76	$566,203.94	2026-05-23
9422	OTHER	Idecabtagene Vicleucel Car	8	4	—	—	$539,090.00	$713,221.78	$542,576.86	2026-05-23
9413	OTHER	Lisocabtagene Car Pos T	8	4	—	—	$527,022.28	$697,256.06	$530,431.09	2026-05-23
9035	OTHER	Axicabtagene Ciloleucel Car+	8	4	—	—	$499,503.30	$660,848.15	$502,734.11	2026-05-23
9391	OTHER	Brexucabtagene Car Pos T	8	4	—	—	$498,007.76	$658,869.54	$501,228.91	2026-05-23
583-4	OTHER	Neonate With Ecmo	8	4	—	—	$327,167.72	$343,526.10	$340,254.42	2026-05-23
007-4	OTHER	Allogeneic Bone Marrow Transplant	8	4	—	—	$318,269.06	$334,182.51	$330,999.82	2026-05-23
583-3	OTHER	Neonate With Ecmo	8	4	—	—	$277,033.60	$290,885.28	$288,114.95	2026-05-23
002-4	OTHER	Heart And/or Lung Transplant	8	4	—	—	$266,498.48	$279,823.40	$277,158.42	2026-05-23
588-4	OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	8	4	—	—	$207,091.80	$217,446.39	$215,375.47	2026-05-23
161-4	OTHER	Implantable Heart Assist Systems	8	4	—	—	$201,100.34	$211,155.36	$209,144.35	2026-05-23
009-4	OTHER	Extracorporeal Membrane Oxygenation (ecmo)	8	4	—	—	$188,399.35	$197,819.32	$195,935.33	2026-05-23
630-4	OTHER	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure	8	4	—	—	$154,090.10	$161,794.61	$160,253.70	2026-05-23
609-4	OTHER	Neonate Birth Weight 1500-2499 Grams With Major Procedure	8	4	—	—	$152,724.59	$160,360.82	$158,833.58	2026-05-23
1908	OTHER	New Technology - Level 52 ($145,001-$160,000)	8	4	—	—	$155,611.51	$205,875.67	$156,618.02	2026-05-23
1907	OTHER	New Technology - Level 52 ($145,001-$160,000)	8	4	—	—	$155,611.51	$205,875.67	$156,618.02	2026-05-23
583-2	OTHER	Neonate With Ecmo	8	4	—	—	$138,039.52	$144,941.49	$143,561.10	2026-05-23
1906	OTHER	New Technology - Level 51 ($130,001-$145,000)	8	4	—	—	$140,305.51	$185,625.67	$141,213.02	2026-05-23
1905	OTHER	New Technology - Level 51 ($130,001-$145,000)	8	4	—	—	$140,305.51	$185,625.67	$141,213.02	2026-05-23
011-4	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	8	4	—	—	$131,077.56	$137,631.43	$136,320.65	2026-05-23
200-4	OTHER	Cardiac Structural And Valvular Disorders	8	4	—	—	$121,807.15	$127,897.51	$126,679.43	2026-05-23
583-1	OTHER	Neonate With Ecmo	8	4	—	—	$121,546.54	$127,623.87	$126,408.40	2026-05-23
1903	OTHER	New Technology - Level 50 ($115,001-$130,000)	8	4	—	—	$124,999.51	$165,375.67	$125,808.01	2026-05-23
1904	OTHER	New Technology - Level 50 ($115,001-$130,000)	8	4	—	—	$124,999.51	$165,375.67	$125,808.01	2026-05-23
007-3	OTHER	Allogeneic Bone Marrow Transplant	8	4	—	—	$112,304.99	$117,920.24	$116,797.19	2026-05-23
588-3	OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	8	4	—	—	$111,118.68	$116,674.61	$115,563.43	2026-05-23
588-2	OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	8	4	—	—	$110,610.81	$116,141.35	$115,035.24	2026-05-23
004-4	OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	8	4	—	—	$110,324.78	$115,841.02	$114,737.77	2026-05-23
841-4	OTHER	Extensive Third Degree Burns With Skin Graft	8	4	—	—	$109,850.52	$115,343.04	$114,244.54	2026-05-23
631-4	OTHER	Neonate Birth Weight > 2499 Grams With Other Major Procedure	8	4	—	—	$108,753.37	$114,191.04	$113,103.51	2026-05-23
1901	OTHER	New Technology - Level 49 ($100,001-$115,000)	8	4	—	—	$109,693.51	$145,125.67	$110,403.01	2026-05-23
1902	OTHER	New Technology - Level 49 ($100,001-$115,000)	8	4	—	—	$109,693.51	$145,125.67	$110,403.01	2026-05-23
850-4	OTHER	Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal…	8	4	—	—	$105,888.38	$111,182.80	$110,123.92	2026-05-23
591-4	OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure	8	4	—	—	$104,939.84	$110,186.83	$109,137.43	2026-05-23
161-3	OTHER	Implantable Heart Assist Systems	8	4	—	—	$104,816.21	$110,057.02	$109,008.86	2026-05-23
588-1	OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	8	4	—	—	$104,262.25	$109,475.37	$108,432.74	2026-05-23
001-4	OTHER	Liver Transplant And/or Intestinal Transplant	8	4	—	—	$95,464.39	$100,237.61	$99,282.96	2026-05-23
008-4	OTHER	Autologous Bone Marrow Transplant Or T-cell Immunotherapy	8	4	—	—	$95,081.88	$99,835.97	$98,885.15	2026-05-23
1585	OTHER	New Technology - Level 48 ($90,001-$100,000)	8	4	—	—	$96,938.51	$128,250.68	$97,565.51	2026-05-23
1599	OTHER	New Technology - Level 48 ($90,001-$100,000)	8	4	—	—	$96,938.51	$128,250.68	$97,565.51	2026-05-23
681-4	OTHER	Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms	8	4	—	—	$93,392.43	$98,062.05	$97,128.12	2026-05-23
160-4	OTHER	Major Cardiothoracic Repair Of Heart Anomaly	8	4	—	—	$93,340.31	$98,007.32	$97,073.92	2026-05-23
009-3	OTHER	Extracorporeal Membrane Oxygenation (ecmo)	8	4	—	—	$92,560.20	$97,188.21	$96,262.61	2026-05-23
246-4	OTHER	Gastrointestinal Vascular Insufficiency	8	4	—	—	$90,514.09	$95,039.79	$94,134.65	2026-05-23
603-4	OTHER	Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition	8	4	—	—	$90,047.14	$94,549.50	$93,649.03	2026-05-23
006-4	OTHER	Pancreas Transplant	8	4	—	—	$87,388.05	$91,757.46	$90,883.58	2026-05-23
589-1	OTHER	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …	8	4	—	—	$87,381.16	$91,750.22	$90,876.41	2026-05-23
593-4	OTHER	Neonate Birth Weight 750-999 Grams Without Major Procedure	8	4	—	—	$87,119.69	$91,475.67	$90,604.48	2026-05-23
589-2	OTHER	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …	8	4	—	—	$84,690.20	$88,924.71	$88,077.80	2026-05-23
1598	OTHER	New Technology - Level 47 ($80,001-$90,000)	8	4	—	—	$86,734.51	$114,750.68	$87,295.51	2026-05-23
1584	OTHER	New Technology - Level 47 ($80,001-$90,000)	8	4	—	—	$86,734.51	$114,750.68	$87,295.51	2026-05-23
162-4	OTHER	Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis	8	4	—	—	$81,423.74	$85,494.92	$84,680.68	2026-05-23
602-4	OTHER	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	8	4	—	—	$80,087.52	$84,091.89	$83,291.01	2026-05-23
589-3	OTHER	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …	8	4	—	—	$79,437.50	$83,409.37	$82,614.99	2026-05-23
621-4	OTHER	Neonate Birth Weight 2000-2499 Grams With Major Anomaly	8	4	—	—	$76,052.15	$79,854.75	$79,094.23	2026-05-23
007-2	OTHER	Allogeneic Bone Marrow Transplant	8	4	—	—	$75,456.40	$79,229.22	$78,474.66	2026-05-23
161-2	OTHER	Implantable Heart Assist Systems	8	4	—	—	$75,346.56	$79,113.89	$78,360.43	2026-05-23
011-3	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	8	4	—	—	$74,485.04	$78,209.29	$77,464.44	2026-05-23
1583	OTHER	New Technology - Level 46 ($70,001-$80,000)	8	4	—	—	$76,530.51	$101,250.68	$77,025.51	2026-05-23
1597	OTHER	New Technology - Level 46 ($70,001-$80,000)	8	4	—	—	$76,530.51	$101,250.68	$77,025.51	2026-05-23
863-4	OTHER	Neonatal Aftercare	8	4	—	—	$73,329.74	$76,996.22	$76,262.93	2026-05-23
630-3	OTHER	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure	8	4	—	—	$72,625.44	$76,256.72	$75,530.46	2026-05-23
161-1	OTHER	Implantable Heart Assist Systems	8	4	—	—	$71,459.37	$75,032.34	$74,317.74	2026-05-23
440-4	OTHER	Kidney Transplant	8	4	—	—	$71,282.76	$74,846.90	$74,134.07	2026-05-23
005-4	OTHER	Tracheostomy With Mv >96 Hours Without Extensive Procedure	8	4	—	—	$70,957.11	$74,504.96	$73,795.39	2026-05-23
004-3	OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	8	4	—	—	$70,932.98	$74,479.63	$73,770.30	2026-05-23
680-4	OTHER	Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms	8	4	—	—	$69,102.68	$72,557.81	$71,866.79	2026-05-23
591-3	OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure	8	4	—	—	$69,102.68	$72,557.81	$71,866.79	2026-05-23
608-4	OTHER	Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition	8	4	—	—	$68,906.68	$72,352.02	$71,662.95	2026-05-23
441-4	OTHER	Major Bladder Procedures	8	4	—	—	$67,459.33	$70,832.29	$70,157.70	2026-05-23
002-3	OTHER	Heart And/or Lung Transplant	8	4	—	—	$65,638.50	$68,920.42	$68,264.04	2026-05-23
008-3	OTHER	Autologous Bone Marrow Transplant Or T-cell Immunotherapy	8	4	—	—	$64,268.25	$67,481.66	$66,838.98	2026-05-23
1582	OTHER	New Technology - Level 45 ($60,001-$70,000)	8	4	—	—	$66,326.51	$87,750.68	$66,755.51	2026-05-23
1596	OTHER	New Technology - Level 45 ($60,001-$70,000)	8	4	—	—	$66,326.51	$87,750.68	$66,755.51	2026-05-23
178-4	OTHER	External Heart Assist Systems	8	4	—	—	$63,183.16	$66,342.32	$65,710.49	2026-05-23
593-3	OTHER	Neonate Birth Weight 750-999 Grams Without Major Procedure	8	4	—	—	$62,222.56	$65,333.69	$64,711.46	2026-05-23
611-4	OTHER	Neonate Birth Weight 1500-1999 Grams With Major Anomaly	8	4	—	—	$62,151.06	$65,258.61	$64,637.10	2026-05-23
167-4	OTHER	Other Cardiothoracic And Thoracic Vascular Procedures	8	4	—	—	$61,876.23	$64,970.04	$64,351.28	2026-05-23
690-4	OTHER	Acute Leukemia	8	4	—	—	$61,320.55	$64,386.58	$63,773.38	2026-05-23
043-4	OTHER	Multiple Sclerosis, Other Demyelinating Disease And Inflammatory Neuropathies	8	4	—	—	$60,944.93	$63,992.17	$63,382.72	2026-05-23
009-2	OTHER	Extracorporeal Membrane Oxygenation (ecmo)	8	4	—	—	$60,876.44	$63,920.26	$63,311.50	2026-05-23
009-1	OTHER	Extracorporeal Membrane Oxygenation (ecmo)	8	4	—	—	$59,037.95	$61,989.85	$61,399.47	2026-05-23
5244	OTHER	Level 4 Blood Product Exchange And Related Services	8	4	—	—	$60,348.83	$79,842.15	$60,739.18	2026-05-23
633-4	OTHER	Neonate Birth Weight > 2499 Grams With Major Anomaly	8	4	—	—	$57,796.93	$60,686.77	$60,108.80	2026-05-23
303-4	OTHER	Dorsal And Lumbar Fusion Procedure For Curvature Of Back	8	4	—	—	$57,444.56	$60,316.79	$59,742.35	2026-05-23
591-2	OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure	8	4	—	—	$57,055.16	$59,907.91	$59,337.36	2026-05-23
607-4	OTHER	Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…	8	4	—	—	$56,496.89	$59,321.73	$58,756.76	2026-05-23
006-3	OTHER	Pancreas Transplant	8	4	—	—	$56,473.63	$59,297.31	$58,732.57	2026-05-23
1643	OTHER	Y90 Ibritumomab, Rx	8	4	—	—	$57,983.77	$76,713.14	$58,358.82	2026-05-23
9273	OTHER	Sipuleucel-t Auto Cd54+	8	4	—	—	$56,669.44	$74,974.27	$57,035.99	2026-05-23
1595	OTHER	New Technology - Level 44 ($50,001-$60,000)	8	4	—	—	$56,122.51	$74,250.68	$56,485.51	2026-05-23
1581	OTHER	New Technology - Level 44 ($50,001-$60,000)	8	4	—	—	$56,122.51	$74,250.68	$56,485.51	2026-05-23
220-4	OTHER	Major Stomach, Esophageal And Duodenal Procedures	8	4	—	—	$53,836.51	$56,528.34	$55,989.97	2026-05-23
613-4	OTHER	Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection	8	4	—	—	$53,543.16	$56,220.32	$55,684.89	2026-05-23
447-4	OTHER	Other Kidney, Urinary Tract And Related Procedures	8	4	—	—	$53,417.81	$56,088.70	$55,554.52	2026-05-23
002-2	OTHER	Heart And/or Lung Transplant	8	4	—	—	$52,729.45	$55,365.93	$54,838.63	2026-05-23
023-4	OTHER	Spinal Procedures	8	4	—	—	$52,626.50	$55,257.83	$54,731.57	2026-05-23
910-4	OTHER	Craniotomy For Multiple Significant Trauma	8	4	—	—	$52,436.11	$55,057.91	$54,533.55	2026-05-23
011-2	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	8	4	—	—	$51,762.40	$54,350.52	$53,832.89	2026-05-23
602-3	OTHER	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	8	4	—	—	$51,760.24	$54,348.25	$53,830.65	2026-05-23
005-3	OTHER	Tracheostomy With Mv >96 Hours Without Extensive Procedure	8	4	—	—	$51,114.96	$53,670.71	$53,159.56	2026-05-23
006-2	OTHER	Pancreas Transplant	8	4	—	—	$51,079.64	$53,633.62	$53,122.82	2026-05-23
950-4	OTHER	Extensive O.r. Procedure Unrelated To Principal Diagnosis	8	4	—	—	$50,879.34	$53,423.30	$52,914.51	2026-05-23
006-1	OTHER	Pancreas Transplant	8	4	—	—	$50,420.14	$52,941.15	$52,436.95	2026-05-23
007-1	OTHER	Allogeneic Bone Marrow Transplant	8	4	—	—	$49,547.42	$52,024.79	$51,529.32	2026-05-23
001-3	OTHER	Liver Transplant And/or Intestinal Transplant	8	4	—	—	$49,185.58	$51,644.86	$51,153.01	2026-05-23
609-3	OTHER	Neonate Birth Weight 1500-2499 Grams With Major Procedure	8	4	—	—	$49,127.43	$51,583.80	$51,092.53	2026-05-23
026-4	OTHER	Other Nervous System And Related Procedures	8	4	—	—	$49,097.71	$51,552.59	$51,061.61	2026-05-23
593-2	OTHER	Neonate Birth Weight 750-999 Grams Without Major Procedure	8	4	—	—	$48,885.77	$51,330.06	$50,841.21	2026-05-23
303-3	OTHER	Dorsal And Lumbar Fusion Procedure For Curvature Of Back	8	4	—	—	$48,595.87	$51,025.67	$50,539.71	2026-05-23
182-4	OTHER	Other Peripheral Vascular Procedures	8	4	—	—	$48,556.67	$50,984.51	$50,498.94	2026-05-23
163-4	OTHER	Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis	8	4	—	—	$48,527.81	$50,954.20	$50,468.93	2026-05-23
792-4	OTHER	Extensive O.r. Procedures For Other Complications Of Treatment	8	4	—	—	$47,733.49	$50,120.16	$49,642.82	2026-05-23
304-4	OTHER	Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back	8	4	—	—	$47,721.86	$50,107.95	$49,630.73	2026-05-23
205-4	OTHER	Cardiomyopathy	8	4	—	—	$47,587.03	$49,966.38	$49,490.51	2026-05-23
695-4	OTHER	Chemotherapy For Acute Leukemia	8	4	—	—	$47,525.86	$49,902.15	$49,426.90	2026-05-23
841-3	OTHER	Extensive Third Degree Burns With Skin Graft	8	4	—	—	$47,477.19	$49,851.04	$49,376.27	2026-05-23
005-2	OTHER	Tracheostomy With Mv >96 Hours Without Extensive Procedure	8	4	—	—	$46,679.42	$49,013.39	$48,546.60	2026-05-23
651-4	OTHER	Other Procedures Of Blood And Blood-forming Organs	8	4	—	—	$46,523.05	$48,849.20	$48,383.97	2026-05-23
004-2	OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	8	4	—	—	$46,377.88	$48,696.78	$48,233.00	2026-05-23
614-4	OTHER	Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition	8	4	—	—	$45,890.69	$48,185.23	$47,726.32	2026-05-23
162-3	OTHER	Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis	8	4	—	—	$45,812.72	$48,103.36	$47,645.24	2026-05-23
021-4	OTHER	Open Craniotomy Except Trauma	8	4	—	—	$45,704.17	$47,989.38	$47,532.34	2026-05-23
230-4	OTHER	Major Small Bowel Procedures	8	4	—	—	$45,539.19	$47,816.15	$47,360.76	2026-05-23
022-4	OTHER	Ventricular Shunt Procedures	8	4	—	—	$45,359.56	$47,627.54	$47,173.94	2026-05-23
442-4	OTHER	Kidney And Urinary Tract Procedures For Malignancy	8	4	—	—	$45,111.01	$47,366.57	$46,915.46	2026-05-23
952-4	OTHER	Non-extensive O.r. Procedure Unrelated To Principal Diagnosis	8	4	—	—	$44,834.04	$47,075.74	$46,627.40	2026-05-23
1142	OTHER	Supprelin La Implant	8	4	—	—	$46,185.14	$61,103.42	$46,483.87	2026-05-23
1594	OTHER	New Technology - Level 43 ($40,001-$50,000)	8	4	—	—	$45,918.51	$60,750.68	$46,215.51	2026-05-23
1580	OTHER	New Technology - Level 43 ($40,001-$50,000)	8	4	—	—	$45,918.51	$60,750.68	$46,215.51	2026-05-23
911-4	OTHER	Extensive Abdominal Or Thoracic Procedures For Multiple Significant Trauma	8	4	—	—	$44,424.38	$46,645.60	$46,201.35	2026-05-23
440-3	OTHER	Kidney Transplant	8	4	—	—	$43,628.34	$45,809.75	$45,373.47	2026-05-23
315-4	OTHER	Shoulder, Upper Arm And Forearm Procedures Except Joint Replacement	8	4	—	—	$43,625.32	$45,806.59	$45,370.33	2026-05-23
169-4	OTHER	Major Abdominal Vascular Procedures	8	4	—	—	$43,477.14	$45,651.00	$45,216.22	2026-05-23
120-4	OTHER	Major Respiratory And Chest Procedures	8	4	—	—	$43,300.53	$45,465.55	$45,032.54	2026-05-23
483-4	OTHER	Penis, Testes And Scrotal Procedures	8	4	—	—	$43,135.98	$45,292.77	$44,861.41	2026-05-23
089-4	OTHER	Major Cranial Or Facial Bone Procedures	8	4	—	—	$42,673.34	$44,807.01	$44,380.28	2026-05-23
912-4	OTHER	Musculoskeletal And Other Procedures For Multiple Significant Trauma	8	4	—	—	$42,616.91	$44,747.75	$44,321.58	2026-05-23
130-4	OTHER	Respiratory System Diagnosis With Ventilator Support > 96 Hours	8	4	—	—	$42,606.14	$44,736.45	$44,310.38	2026-05-23
165-4	OTHER	Coronary Bypass With Ami Or Complex Principal Diagnosis	8	4	—	—	$41,971.63	$44,070.21	$43,650.49	2026-05-23
591-1	OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure	8	4	—	—	$41,137.24	$43,194.11	$42,782.74	2026-05-23
260-4	OTHER	Major Pancreas, Liver And Shunt Procedures	8	4	—	—	$40,912.82	$42,958.46	$42,549.33	2026-05-23
002-1	OTHER	Heart And/or Lung Transplant	8	4	—	—	$40,842.60	$42,884.73	$42,476.31	2026-05-23
178-3	OTHER	External Heart Assist Systems	8	4	—	—	$40,433.81	$42,455.50	$42,051.17	2026-05-23
121-4	OTHER	Other Respiratory And Chest Procedures	8	4	—	—	$40,410.55	$42,431.08	$42,026.98	2026-05-23
631-3	OTHER	Neonate Birth Weight > 2499 Grams With Other Major Procedure	8	4	—	—	$40,262.80	$42,275.94	$41,873.31	2026-05-23
625-4	OTHER	Neonate Birth Weight 2000-2499 Grams With Other Significant Condition	8	4	—	—	$39,937.58	$41,934.45	$41,535.07	2026-05-23
612-4	OTHER	Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other…	8	4	—	—	$39,822.56	$41,813.69	$41,415.46	2026-05-23
160-3	OTHER	Major Cardiothoracic Repair Of Heart Anomaly	8	4	—	—	$39,444.78	$41,417.02	$41,022.57	2026-05-23
224-4	OTHER	Peritoneal Adhesiolysis	8	4	—	—	$39,381.89	$41,350.99	$40,957.17	2026-05-23
602-2	OTHER	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	8	4	—	—	$39,107.50	$41,062.87	$40,671.79	2026-05-23
361-4	OTHER	Skin Graft For Skin And Subcutaneous Tissue Diagnoses	8	4	—	—	$38,998.09	$40,947.99	$40,558.01	2026-05-23
091-4	OTHER	Other Major Head And Neck Procedures	8	4	—	—	$38,788.31	$40,727.72	$40,339.83	2026-05-23
020-4	OTHER	Open Craniotomy For Trauma	8	4	—	—	$38,392.44	$40,312.06	$39,928.13	2026-05-23
005-1	OTHER	Tracheostomy With Mv >96 Hours Without Extensive Procedure	8	4	—	—	$38,131.39	$40,037.96	$39,656.65	2026-05-23
004-1	OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	8	4	—	—	$38,058.17	$39,961.07	$39,580.49	2026-05-23
001-2	OTHER	Liver Transplant And/or Intestinal Transplant	8	4	—	—	$37,779.03	$39,667.98	$39,290.19	2026-05-23
181-4	OTHER	Lower Extremity Arterial Procedures	8	4	—	—	$37,763.52	$39,651.70	$39,274.07	2026-05-23
227-4	OTHER	Hernia Procedures Except Inguinal, Femoral And Umbilical	8	4	—	—	$37,648.08	$39,530.48	$39,154.00	2026-05-23
660-4	OTHER	Major Hematologic Or Immunologic Diagnoses Except Sickle Cell Crisis And Coagula…	8	4	—	—	$37,524.45	$39,400.67	$39,025.43	2026-05-23
623-4	OTHER	Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection	8	4	—	—	$37,516.70	$39,392.53	$39,017.36	2026-05-23
842-4	OTHER	Burns With Skin Graft Except Extensive Third Degree Burns	8	4	—	—	$37,474.48	$39,348.21	$38,973.46	2026-05-23
183-4	OTHER	Percutaneous Structural Cardiac Procedures	8	4	—	—	$36,519.06	$38,345.01	$37,979.82	2026-05-23
001-1	OTHER	Liver Transplant And/or Intestinal Transplant	8	4	—	—	$36,360.54	$38,178.56	$37,814.96	2026-05-23
261-4	OTHER	Major Biliary Tract Procedures	8	4	—	—	$35,939.68	$37,736.67	$37,377.27	2026-05-23
607-3	OTHER	Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…	8	4	—	—	$35,811.32	$37,601.88	$37,243.77	2026-05-23
183-3	OTHER	Percutaneous Structural Cardiac Procedures	8	4	—	—	$35,622.21	$37,403.32	$37,047.10	2026-05-23
951-4	OTHER	Moderately Extensive O.r. Procedure Unrelated To Principal Diagnosis	8	4	—	—	$35,482.65	$37,256.78	$36,901.95	2026-05-23
303-2	OTHER	Dorsal And Lumbar Fusion Procedure For Curvature Of Back	8	4	—	—	$35,258.65	$37,021.58	$36,669.00	2026-05-23
050-4	OTHER	Non-bacterial Infections Of Nervous System Except Viral Meningitis	8	4	—	—	$34,902.41	$36,647.53	$36,298.51	2026-05-23
178-2	OTHER	External Heart Assist Systems	8	4	—	—	$34,702.97	$36,438.12	$36,091.09	2026-05-23
710-4	OTHER	Infectious And Parasitic Diseases Including HIV With O.r. Procedure	8	4	—	—	$34,643.95	$36,376.15	$36,029.71	2026-05-23
1593	OTHER	New Technology - Level 42 ($30,001-$40,000)	8	4	—	—	$35,714.51	$47,250.68	$35,945.51	2026-05-23
1579	OTHER	New Technology - Level 42 ($30,001-$40,000)	8	4	—	—	$35,714.51	$47,250.68	$35,945.51	2026-05-23
603-3	OTHER	Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition	8	4	—	—	$34,339.84	$36,056.83	$35,713.43	2026-05-23
162-2	OTHER	Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis	8	4	—	—	$34,208.88	$35,919.33	$35,577.24	2026-05-23
223-4	OTHER	Other Small And Large Bowel Procedures	8	4	—	—	$33,814.31	$35,505.02	$35,166.88	2026-05-23
691-4	OTHER	Lymphoma, Myeloma And Non-acute Leukemia	8	4	—	—	$33,606.25	$35,286.56	$34,950.50	2026-05-23
773	OTHER	Inj, Beqvez, Per Tx Dose	6	3	—	—	$3,785,684.00	$3,821,300.00	$3,799,040.00	2026-05-23
9138	OTHER	Inj, Hemgenix, Per Tx Dose	6	3	—	—	$3,785,684.00	$3,821,300.00	$3,799,040.00	2026-05-23
81416	OTHER	Test For Detecting Exome, Sequence Analysis, Each Comparator Exome	6	1	—	—	$35,040.00	$47,400.00	$42,720.00	2026-05-23
54401	OTHER	Insertion Of Inflatable Penile Implant	4	1	—	—	$39,189.93	$63,442.00	$51,315.96	2026-05-23
54417	OTHER	Removal And Replacement Of Infected Noninflatable Penile Implant	4	1	—	—	$39,189.93	$63,442.00	$51,315.96	2026-05-23
54410	OTHER	Removal And Replacement Of Multicomponent Inflatable Penile Implant During Same …	4	1	—	—	$39,189.93	$63,442.00	$51,315.96	2026-05-23
54416	OTHER	Removal And Replacement Of Noninflatable Penile Implant	4	1	—	—	$39,189.93	$63,442.00	$51,315.96	2026-05-23
54411	OTHER	Removal And Replacement Of Infected Components Of Inflatable Penile Implant	4	1	—	—	$39,189.93	$63,442.00	$51,315.96	2026-05-23
54400	OTHER	Insertion Of Non-inflatable Penile Implant	4	1	—	—	$39,189.93	$63,442.00	$51,315.96	2026-05-23
54405	OTHER	Insertion Of Multicomponent Inflatable Penile Implant	4	1	—	—	$39,189.93	$63,442.00	$51,315.96	2026-05-23
33902	OTHER	Placement Of Stent In Pulmonary Artery With Abnormal Anatomical Connections, On …	4	1	—	—	$38,306.05	$62,011.14	$50,158.60	2026-05-23
22867	OTHER	Placement Of Device To Stabilize Or Reduce Pressure In Lower Spine In 1 Disc Spa…	4	1	—	—	$35,559.76	$57,565.35	$46,562.56	2026-05-23
69730	OTHER	Replacement Of Cochlear Stimulating System Outside Mastoid Bone Of Skull With Ma…	4	1	—	—	$29,097.22	$47,103.57	$38,100.40	2026-05-23
69729	OTHER	Implantation Of Cochlear Stimulating System Outside Mastoid Bone Of Skull With M…	4	1	—	—	$29,097.22	$47,103.57	$38,100.40	2026-05-23

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