Hospital

ODESSA REGIONAL MEDICAL CENTER

Odessa, TX · CCN 450661 · Rates published

10,905 distinct procedures filed

72 distinct payers

542,857 rate rows

2026-05-18 last MRF observed

Data quality

520,119 of 542,857 rate rows are consumer-grade (95.8%)

22,738 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	14,196
per-diem day rate — not a per-procedure price	7,541
template filing: same amount across many unrelated codes — excluded	584
placeholder amount (≤ $0.02) — excluded from medians	336
exceeds 10× this hospital's gross charge — excluded from medians	81

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

Source MRF file	https://www.odessaregional.com/wp-content/uploads/2026/04/621795574_OdessaTexasHospitalCompany_standardcharges_TX.csv
Found on page	https://www.odessaregional.com/price-transparency/
Discovered via	CMS hospital list
Last fetch	success · 2026-06-22
Content fingerprint	2651d8c5c0fa6ae9… · 2,669,311 bytes · first seen 2026-06-22

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
583-4 OTHER	Neonate With Ecmo	12	$296,286.44	$625,493.59	$387,566.60	nat. median $309,400 1.3× median
18 OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	30	$3,500.00	$2,288,048.80	$384,607.39	nat. median $386,529 1.0× median
583-3 OTHER	Neonate With Ecmo	12	$250,884.47	$529,645.00	$328,177.17	nat. median $259,487 1.3× median
7 OTHER	Lung Transplant	25	$3,500.00	$1,730,277.76	$259,110.07	nat. median $169,933 1.5× median
002-4 OTHER	Heart And/or Lung Transplant	12	$198,000.00	$418,000.00	$259,000.00	nat. median $216,800 1.2× median
007-4 OTHER	Allogeneic Bone Marrow Transplant	12	$198,000.00	$418,000.00	$259,000.00	nat. median $172,311 1.5× median
588-4 OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	12	$187,544.45	$395,927.18	$245,323.29	nat. median $267,493 0.9× median
161-4 OTHER	Implantable Heart Assist Systems	12	$182,118.53	$384,472.45	$238,225.76	nat. median $202,242 1.2× median
009-4 OTHER	Extracorporeal Membrane Oxygenation (ecmo)	12	$170,616.39	$360,190.16	$223,180.03	nat. median $150,954 1.5× median
1 OTHER	Heart Transplant Or Implant Of Heart Assist System With Mcc	27	$3,500.00	$677,273.62	$210,390.32	nat. median $239,422 0.9× median
630-4 OTHER	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure	12	$139,545.58	$294,596.22	$182,536.90	nat. median $210,669 0.9× median
609-4 OTHER	Neonate Birth Weight 1500-2499 Grams With Major Procedure	12	$138,308.95	$291,985.56	$180,919.29	nat. median $169,856 1.1× median
927 OTHER	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	27	$3,500.00	$372,534.00	$177,575.81	nat. median $146,562 1.2× median
583-2 OTHER	Neonate With Ecmo	12	$125,010.00	$263,910.01	$163,523.18	nat. median $191,347 0.9× median
3 OTHER	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…	31	$3,500.00	$516,079.53	$160,633.25	nat. median $181,005 0.9× median
011-4 OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	12	$118,705.18	$250,599.82	$155,275.96	nat. median $105,647 1.5× median
200-4 OTHER	Cardiac Structural And Valvular Disorders	12	$110,309.80	$232,876.24	$144,294.13	nat. median $19,067 outlier · 7.6×
583-1 OTHER	Neonate With Ecmo	12	$110,073.79	$232,378.01	$143,985.41	nat. median $171,226 0.8× median
007-3 OTHER	Allogeneic Bone Marrow Transplant	12	$101,704.55	$214,709.61	$133,037.77	nat. median $104,111 1.3× median
588-3 OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	12	$100,630.21	$212,441.56	$131,632.45	nat. median $165,000 0.8× median
588-2 OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	12	$100,170.28	$211,470.59	$131,030.82	nat. median $153,523 0.9× median
841-4 OTHER	Extensive Third Degree Burns With Skin Graft	12	$99,481.75	$210,017.04	$130,130.17	nat. median $151,691 0.9× median
631-4 OTHER	Neonate Birth Weight > 2499 Grams With Other Major Procedure	12	$98,488.17	$207,919.47	$128,830.49	nat. median $203,379 0.6× median
850-4 OTHER	Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal…	12	$95,893.60	$202,442.04	$125,436.58	nat. median $54,797 outlier · 2.3×
591-4 OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure	12	$95,034.59	$200,628.59	$124,312.93	nat. median $156,696 0.8× median
161-3 OTHER	Implantable Heart Assist Systems	12	$94,922.64	$200,392.23	$124,166.48	nat. median $152,491 0.8× median
588-1 OTHER	Female Reproductive System Reconstructive Procedures	12	$94,420.96	$199,333.14	$123,510.25	nat. median $75,325 1.6× median
001-4 OTHER	Liver Transplant And/or Intestinal Transplant	12	$86,453.53	$182,513.01	$113,088.20	nat. median $124,561 0.9× median
008-4 OTHER	Autologous Bone Marrow Transplant Or T-cell Immunotherapy	12	$86,107.12	$181,781.70	$112,635.07	nat. median $81,385 1.4× median
4 OTHER	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…	31	$3,500.00	$759,369.02	$112,628.63	nat. median $134,983 0.8× median
681-4 OTHER	Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms	12	$84,577.15	$178,551.75	$110,633.74	nat. median $52,952 outlier · 2.1×
160-4 OTHER	Major Cardiothoracic Repair Of Heart Anomaly	12	$84,529.94	$178,452.10	$110,571.99	nat. median $106,926 1.0× median
009-3 OTHER	Extracorporeal Membrane Oxygenation (ecmo)	12	$83,823.47	$176,960.66	$109,647.87	nat. median $87,912 1.2× median
246-4 OTHER	Gastrointestinal Vascular Insufficiency	12	$81,970.49	$173,048.80	$107,224.01	nat. median $14,775 outlier · 7.3×
603-4 OTHER	Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition	12	$81,547.62	$172,156.08	$106,670.88	nat. median $107,050 1.0× median
006-4 OTHER	Pancreas Transplant	12	$79,139.52	$167,072.32	$103,520.89	nat. median $92,449 1.1× median
589-1 OTHER	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational…	12	$79,133.27	$167,059.13	$103,512.71	nat. median $86,371 1.2× median
593-4 OTHER	Neonate Birth Weight 750-999 Grams Without Major Procedure	12	$78,896.49	$166,559.25	$103,202.98	nat. median $151,250 0.7× median
004-4 OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	12	$99,911.26	$105,966.48	$100,920.46	nat. median $110,000 0.9× median
589-2 OTHER	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational…	12	$76,696.31	$161,914.43	$100,324.97	nat. median $49,980 outlier · 2.0×
14 OTHER	Allogeneic Bone Marrow Transplant	27	$3,500.00	$170,584.15	$99,171.35	nat. median $100,915 1.0× median
162-4 OTHER	Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis	12	$73,738.17	$155,669.47	$96,455.49	nat. median $80,850 1.2× median
602-4 OTHER	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	12	$72,528.07	$153,114.82	$94,872.58	nat. median $125,000 0.8× median
589-3 OTHER	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational…	12	$71,939.41	$151,872.09	$94,102.56	nat. median $87,000 1.1× median
621-4 OTHER	Neonate Birth Weight 2000-2499 Grams With Major Anomaly	12	$68,873.61	$145,399.84	$90,092.24	nat. median $80,035 1.1× median
007-2 OTHER	Allogeneic Bone Marrow Transplant	12	$68,334.10	$144,260.87	$89,386.52	nat. median $74,284 1.2× median
161-2 OTHER	Implantable Heart Assist Systems	12	$68,234.62	$144,050.87	$89,256.40	nat. median $109,992 0.8× median
011-3 OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	12	$67,454.41	$142,403.76	$88,235.82	nat. median $171,094 0.5× median
2 OTHER	Heart Transplant Or Implant Of Heart Assist System Without Mcc	27	$3,500.00	$602,309.54	$87,559.23	nat. median $111,558 0.8× median
863-4 OTHER	Neonatal Aftercare	12	$66,408.16	$140,195.01	$86,867.24	nat. median $108,047 0.8× median

Other procedures at this hospital

Browse this hospital's 10,905 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

583-4	OTHER	Neonate With Ecmo	12	12	—	—	$296,286.44	$625,493.59	$387,566.60	2026-05-07
18	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	30	30	—	—	$3,500.00	$2,288,048.80	$384,607.39	2026-05-07
583-3	OTHER	Neonate With Ecmo	12	12	—	—	$250,884.47	$529,645.00	$328,177.17	2026-05-07
7	OTHER	Lung Transplant	25	25	—	—	$3,500.00	$1,730,277.76	$259,110.07	2026-05-07
007-4	OTHER	Allogeneic Bone Marrow Transplant	12	12	—	—	$198,000.00	$418,000.00	$259,000.00	2026-05-07
002-4	OTHER	Heart And/or Lung Transplant	12	12	—	—	$198,000.00	$418,000.00	$259,000.00	2026-05-07
588-4	OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	12	12	—	—	$187,544.45	$395,927.18	$245,323.29	2026-05-07
161-4	OTHER	Implantable Heart Assist Systems	12	12	—	—	$182,118.53	$384,472.45	$238,225.76	2026-05-07
009-4	OTHER	Extracorporeal Membrane Oxygenation (ecmo)	12	12	—	—	$170,616.39	$360,190.16	$223,180.03	2026-05-07
1	OTHER	Heart Transplant Or Implant Of Heart Assist System With Mcc	27	27	—	—	$3,500.00	$677,273.62	$210,390.32	2026-05-07
630-4	OTHER	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure	12	12	—	—	$139,545.58	$294,596.22	$182,536.90	2026-05-07
609-4	OTHER	Neonate Birth Weight 1500-2499 Grams With Major Procedure	12	12	—	—	$138,308.95	$291,985.56	$180,919.29	2026-05-07
927	OTHER	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	27	27	—	—	$3,500.00	$372,534.00	$177,575.81	2026-05-07
583-2	OTHER	Neonate With Ecmo	12	12	—	—	$125,010.00	$263,910.01	$163,523.18	2026-05-07
3	OTHER	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…	31	31	—	—	$3,500.00	$516,079.53	$160,633.25	2026-05-07
011-4	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	12	12	—	—	$118,705.18	$250,599.82	$155,275.96	2026-05-07
200-4	OTHER	Cardiac Structural And Valvular Disorders	12	12	—	—	$110,309.80	$232,876.24	$144,294.13	2026-05-07
583-1	OTHER	Neonate With Ecmo	12	12	—	—	$110,073.79	$232,378.01	$143,985.41	2026-05-07
007-3	OTHER	Allogeneic Bone Marrow Transplant	12	12	—	—	$101,704.55	$214,709.61	$133,037.77	2026-05-07
588-3	OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	12	12	—	—	$100,630.21	$212,441.56	$131,632.45	2026-05-07
588-2	OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	12	12	—	—	$100,170.28	$211,470.59	$131,030.82	2026-05-07
841-4	OTHER	Extensive Third Degree Burns With Skin Graft	12	12	—	—	$99,481.75	$210,017.04	$130,130.17	2026-05-07
631-4	OTHER	Neonate Birth Weight > 2499 Grams With Other Major Procedure	12	12	—	—	$98,488.17	$207,919.47	$128,830.49	2026-05-07
850-4	OTHER	Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal…	12	12	—	—	$95,893.60	$202,442.04	$125,436.58	2026-05-07
591-4	OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure	12	12	—	—	$95,034.59	$200,628.59	$124,312.93	2026-05-07
161-3	OTHER	Implantable Heart Assist Systems	12	12	—	—	$94,922.64	$200,392.23	$124,166.48	2026-05-07
588-1	OTHER	Female Reproductive System Reconstructive Procedures	12	12	—	—	$94,420.96	$199,333.14	$123,510.25	2026-05-07
001-4	OTHER	Liver Transplant And/or Intestinal Transplant	12	12	—	—	$86,453.53	$182,513.01	$113,088.20	2026-05-07
008-4	OTHER	Autologous Bone Marrow Transplant Or T-cell Immunotherapy	12	12	—	—	$86,107.12	$181,781.70	$112,635.07	2026-05-07
4	OTHER	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…	31	31	—	—	$3,500.00	$759,369.02	$112,628.63	2026-05-07
681-4	OTHER	Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms	12	12	—	—	$84,577.15	$178,551.75	$110,633.74	2026-05-07
160-4	OTHER	Major Cardiothoracic Repair Of Heart Anomaly	12	12	—	—	$84,529.94	$178,452.10	$110,571.99	2026-05-07
009-3	OTHER	Extracorporeal Membrane Oxygenation (ecmo)	12	12	—	—	$83,823.47	$176,960.66	$109,647.87	2026-05-07
246-4	OTHER	Gastrointestinal Vascular Insufficiency	12	12	—	—	$81,970.49	$173,048.80	$107,224.01	2026-05-07
603-4	OTHER	Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition	12	12	—	—	$81,547.62	$172,156.08	$106,670.88	2026-05-07
006-4	OTHER	Pancreas Transplant	12	12	—	—	$79,139.52	$167,072.32	$103,520.89	2026-05-07
589-1	OTHER	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …	12	12	—	—	$79,133.27	$167,059.13	$103,512.71	2026-05-07
593-4	OTHER	Neonate Birth Weight 750-999 Grams Without Major Procedure	12	12	—	—	$78,896.49	$166,559.25	$103,202.98	2026-05-07
004-4	OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	12	12	—	—	$99,911.26	$105,966.48	$100,920.46	2026-05-07
589-2	OTHER	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …	12	12	—	—	$76,696.31	$161,914.43	$100,324.97	2026-05-07
14	OTHER	Allogeneic Bone Marrow Transplant	27	27	—	—	$3,500.00	$170,584.15	$99,171.35	2026-05-07
162-4	OTHER	Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis	12	12	—	—	$73,738.17	$155,669.47	$96,455.49	2026-05-07
602-4	OTHER	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	12	12	—	—	$72,528.07	$153,114.82	$94,872.58	2026-05-07
589-3	OTHER	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …	12	12	—	—	$71,939.41	$151,872.09	$94,102.56	2026-05-07
621-4	OTHER	Neonate Birth Weight 2000-2499 Grams With Major Anomaly	12	12	—	—	$68,873.61	$145,399.84	$90,092.24	2026-05-07
007-2	OTHER	Allogeneic Bone Marrow Transplant	12	12	—	—	$68,334.10	$144,260.87	$89,386.52	2026-05-07
161-2	OTHER	Implantable Heart Assist Systems	12	12	—	—	$68,234.62	$144,050.87	$89,256.40	2026-05-07
011-3	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	12	12	—	—	$67,454.41	$142,403.76	$88,235.82	2026-05-07
2	OTHER	Heart Transplant Or Implant Of Heart Assist System Without Mcc	27	27	—	—	$3,500.00	$602,309.54	$87,559.23	2026-05-07
863-4	OTHER	Neonatal Aftercare	12	12	—	—	$66,408.16	$140,195.01	$86,867.24	2026-05-07
630-3	OTHER	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure	12	12	—	—	$65,770.34	$138,848.50	$86,032.92	2026-05-07
161-1	OTHER	Implantable Heart Assist Systems	12	12	—	—	$64,714.34	$136,619.16	$84,651.58	2026-05-07
440-4	OTHER	Kidney Transplant	12	12	—	—	$64,554.40	$136,281.50	$84,442.36	2026-05-07
004-3	OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	12	12	—	—	$64,237.64	$135,612.79	$84,028.02	2026-05-07
212	OTHER	Hip & Femur Procedures Except Major Joint Age 0-17	29	29	—	—	$3,500.00	$142,552.22	$82,880.24	2026-05-07
680-4	OTHER	Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms	12	12	—	—	$62,580.10	$132,113.54	$81,859.83	2026-05-07
591-3	OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure	12	12	—	—	$62,580.10	$132,113.54	$81,859.83	2026-05-07
608-4	OTHER	Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition	12	12	—	—	$62,402.60	$131,738.82	$81,627.65	2026-05-07
5	OTHER	Liver Transplant With Mcc Or Intestinal Transplant	25	25	—	—	$3,500.00	$378,849.96	$81,076.20	2026-05-07
215	OTHER	Other Heart Assist System Implant	31	31	—	—	$3,500.00	$268,102.88	$80,673.32	2026-05-07
441-4	OTHER	Major Bladder Procedures	12	12	—	—	$61,091.86	$128,971.71	$79,913.09	2026-05-07
002-3	OTHER	Heart And/or Lung Transplant	12	12	—	—	$59,442.90	$125,490.56	$77,756.11	2026-05-07
008-3	OTHER	Autologous Bone Marrow Transplant Or T-cell Immunotherapy	12	12	—	—	$58,201.98	$122,870.85	$76,132.90	2026-05-07
178-4	OTHER	External Heart Assist Systems	12	12	—	—	$57,219.32	$120,796.34	$74,847.49	2026-05-07
593-3	OTHER	Neonate Birth Weight 750-999 Grams Without Major Procedure	12	12	—	—	$56,349.39	$118,959.83	$73,709.56	2026-05-07
216	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	33	33	—	—	$3,500.00	$243,046.92	$73,705.48	2026-05-07
611-4	OTHER	Neonate Birth Weight 1500-1999 Grams With Major Anomaly	12	12	—	—	$56,284.64	$118,823.13	$73,624.86	2026-05-07
167-4	OTHER	Other Cardiothoracic And Thoracic Vascular Procedures	12	12	—	—	$56,035.75	$118,297.70	$73,299.29	2026-05-07
690-4	OTHER	Acute Leukemia	12	12	—	—	$55,532.52	$117,235.31	$72,641.01	2026-05-07
043-4	OTHER	Multiple Sclerosis, Other Demyelinating Disease And Inflammatory Neuropathies	12	12	—	—	$55,192.35	$116,517.19	$72,196.05	2026-05-07
009-2	OTHER	Extracorporeal Membrane Oxygenation (ecmo)	12	12	—	—	$55,130.33	$116,386.25	$72,114.92	2026-05-07
009-1	OTHER	Extracorporeal Membrane Oxygenation (ecmo)	12	12	—	—	$53,465.38	$112,871.35	$69,937.03	2026-05-07
969	OTHER	HIV With Extensive O.r. Procedures With Mcc	31	31	—	—	$3,500.00	$592,708.51	$68,510.65	2026-05-07
633-4	OTHER	Neonate Birth Weight > 2499 Grams With Major Anomaly	12	12	—	—	$52,341.49	$110,498.70	$68,466.89	2026-05-07
303-4	OTHER	Dorsal And Lumbar Fusion Procedure For Curvature Of Back	12	12	—	—	$52,022.38	$109,825.03	$68,049.48	2026-05-07
453	OTHER	Combined Anterior And Posterior Spinal Fusion With Mcc	29	29	—	—	$3,500.00	$218,924.50	$67,876.29	2026-05-07
591-2	OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure	12	12	—	—	$51,669.73	$109,080.55	$67,588.18	2026-05-07
607-4	OTHER	Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…	12	12	—	—	$51,164.16	$108,013.23	$66,926.85	2026-05-07
006-3	OTHER	Pancreas Transplant	12	12	—	—	$51,143.09	$107,968.75	$66,899.29	2026-05-07
231	OTHER	Coronary Bypass With Ptca With Mcc	33	33	—	—	$3,500.00	$250,048.24	$65,015.95	2026-05-07
456	OTHER	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	31	31	—	—	$3,500.00	$260,402.15	$64,981.27	2026-05-07
005-4	OTHER	Tracheostomy With Mv >96 Hours Without Extensive Procedure	12	12	—	—	$64,259.48	$68,154.00	$64,908.57	2026-05-07
220-4	OTHER	Major Stomach, Esophageal And Duodenal Procedures	12	12	—	—	$48,754.90	$102,927.00	$63,775.35	2026-05-07
613-4	OTHER	Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection	12	12	—	—	$48,489.24	$102,366.17	$63,427.85	2026-05-07
447-4	OTHER	Other Kidney, Urinary Tract And Related Procedures	12	12	—	—	$48,375.72	$102,126.51	$63,279.35	2026-05-07
20	OTHER	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc	31	31	—	—	$3,500.00	$309,746.98	$62,715.25	2026-05-07
002-2	OTHER	Heart And/or Lung Transplant	12	12	—	—	$47,752.33	$100,810.48	$62,463.91	2026-05-07
023-4	OTHER	Spinal Procedures	12	12	—	—	$47,659.10	$100,613.67	$62,341.96	2026-05-07
910-4	OTHER	Craniotomy For Multiple Significant Trauma	12	12	—	—	$47,486.68	$100,249.65	$62,116.41	2026-05-07
10	OTHER	Pancreas Transplant	25	25	—	—	$3,500.00	$291,126.68	$61,328.24	2026-05-07
011-2	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	12	12	—	—	$46,876.56	$98,961.63	$61,318.32	2026-05-07
602-3	OTHER	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	12	12	—	—	$46,874.61	$98,957.51	$61,315.77	2026-05-07
19	OTHER	Simultaneous Pancreas And Kidney Transplant With Hemodialysis	26	26	—	—	$3,500.00	$104,887.72	$60,991.03	2026-05-07
005-3	OTHER	Tracheostomy With Mv >96 Hours Without Extensive Procedure	12	12	—	—	$46,290.23	$97,723.82	$60,551.36	2026-05-07
006-2	OTHER	Pancreas Transplant	12	12	—	—	$46,258.25	$97,656.29	$60,509.53	2026-05-07
950-4	OTHER	Extensive O.r. Procedure Unrelated To Principal Diagnosis	12	12	—	—	$46,076.85	$97,273.34	$60,272.24	2026-05-07
233	OTHER	Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc	33	33	—	—	$3,500.00	$172,335.30	$60,162.62	2026-05-07
006-1	OTHER	Pancreas Transplant	12	12	—	—	$45,661.00	$96,395.44	$59,728.28	2026-05-07
219	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	33	33	—	—	$3,500.00	$241,945.65	$59,580.21	2026-05-07
275	OTHER	Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc	29	29	—	—	$3,500.00	$119,217.27	$58,928.99	2026-05-07
007-1	OTHER	Allogeneic Bone Marrow Transplant	12	12	—	—	$44,870.65	$94,726.93	$58,694.43	2026-05-07
001-3	OTHER	Liver Transplant And/or Intestinal Transplant	12	12	—	—	$44,542.97	$94,035.16	$58,265.81	2026-05-07
609-3	OTHER	Neonate Birth Weight 1500-2499 Grams With Major Procedure	12	12	—	—	$44,490.30	$93,923.97	$58,196.91	2026-05-07
026-4	OTHER	Other Nervous System And Related Procedures	12	12	—	—	$44,463.38	$93,867.15	$58,161.71	2026-05-07
593-2	OTHER	Neonate Birth Weight 750-999 Grams Without Major Procedure	12	12	—	—	$44,271.45	$93,461.96	$57,910.64	2026-05-07
303-3	OTHER	Dorsal And Lumbar Fusion Procedure For Curvature Of Back	12	12	—	—	$44,008.92	$92,907.71	$57,567.21	2026-05-07
957	OTHER	Other O.r. Procedures For Multiple Significant Trauma With Mcc	31	31	—	—	$3,500.00	$143,572.59	$57,562.85	2026-05-07
182-4	OTHER	Other Peripheral Vascular And Related Procedures	12	12	—	—	$43,973.42	$92,832.78	$57,520.79	2026-05-07
163-4	OTHER	Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis	12	12	—	—	$43,947.29	$92,777.61	$57,486.60	2026-05-07
792-4	OTHER	Extensive O.r. Procedures For Other Complications Of Treatment	12	12	—	—	$43,227.93	$91,258.97	$56,545.63	2026-05-07
304-4	OTHER	Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back	12	12	—	—	$43,217.40	$91,236.73	$56,531.86	2026-05-07
205-4	OTHER	Cardiomyopathy	12	12	—	—	$43,095.30	$90,978.97	$56,372.14	2026-05-07
695-4	OTHER	Chemotherapy For Acute Leukemia	12	12	—	—	$43,039.90	$90,862.02	$56,299.67	2026-05-07
841-3	OTHER	Extensive Third Degree Burns With Skin Graft	12	12	—	—	$42,995.83	$90,768.97	$56,242.02	2026-05-07
005-2	OTHER	Tracheostomy With Mv >96 Hours Without Extensive Procedure	12	12	—	—	$42,273.36	$89,243.75	$55,296.96	2026-05-07
651-4	OTHER	Other Procedures Of Blood And Blood-forming Organs	12	12	—	—	$42,131.75	$88,944.80	$55,111.73	2026-05-07
004-2	OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	12	12	—	—	$42,000.28	$88,667.27	$54,939.77	2026-05-07
614-4	OTHER	Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition	12	12	—	—	$41,559.08	$87,735.84	$54,362.63	2026-05-07
162-3	OTHER	Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis	12	12	—	—	$41,488.47	$87,586.78	$54,270.28	2026-05-07
021-4	OTHER	Open Craniotomy Except Trauma	12	12	—	—	$41,390.17	$87,379.24	$54,141.68	2026-05-07
230-4	OTHER	Major Small Bowel Procedures	12	12	—	—	$41,240.76	$87,063.82	$53,946.24	2026-05-07
4810000237	OTHER	L Ventric Pacing Lead Add-on	50	47	$121,999.32	$109,799.39	$535.80	$121,999.32	$53,923.70	2026-05-07
870	OTHER	Septicemia Or Severe Sepsis With Mv >96 Hours	31	31	—	—	$3,500.00	$164,279.21	$53,815.26	2026-05-07
022-4	OTHER	Ventricular Shunt Procedures	12	12	—	—	$41,078.09	$86,720.41	$53,733.46	2026-05-07
268	OTHER	Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc	32	32	—	—	$3,500.00	$432,603.33	$53,573.27	2026-05-07
442-4	OTHER	Kidney And Urinary Tract Procedures For Malignancy	12	12	—	—	$40,852.99	$86,245.21	$53,439.01	2026-05-07
952-4	OTHER	Non-extensive O.r. Procedure Unrelated To Principal Diagnosis	12	12	—	—	$40,602.17	$85,715.69	$53,110.92	2026-05-07
955	OTHER	Craniotomy For Multiple Significant Trauma	31	31	—	—	$3,500.00	$162,701.74	$52,868.95	2026-05-07
911-4	OTHER	Extensive Abdominal Or Thoracic Procedures For Multiple Significant Trauma	12	12	—	—	$40,231.17	$84,932.48	$52,625.63	2026-05-07
7914561S	OTHER	Implant Interstim Nuero Stimul	43	42	$105,066.00	$94,559.40	$2,000.00	$105,066.00	$52,533.00	2026-05-07
207	OTHER	Respiratory System Diagnosis With Ventilator Support >96 Hours	31	31	—	—	$3,500.00	$446,384.20	$52,476.75	2026-05-07
928	OTHER	Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc	27	27	—	—	$3,500.00	$89,037.78	$51,779.63	2026-05-07
440-3	OTHER	Kidney Transplant	12	12	—	—	$39,510.27	$83,410.56	$51,682.62	2026-05-07
315-4	OTHER	Shoulder, Upper Arm And Forearm Procedures Except Joint Replacement	12	12	—	—	$39,507.53	$83,404.79	$51,679.04	2026-05-07
169-4	OTHER	Major Abdominal Vascular Procedures	12	12	—	—	$39,373.34	$83,121.49	$51,503.51	2026-05-07
120-4	OTHER	Major Respiratory And Chest Procedures	12	12	—	—	$39,213.40	$82,783.85	$51,294.30	2026-05-07
459	OTHER	Spinal Fusion Except Cervical With Mcc	30	30	—	—	$3,500.00	$141,579.10	$51,165.08	2026-05-07
483-4	OTHER	Penis, Testes And Scrotal Procedures	12	12	—	—	$39,064.38	$82,469.25	$51,099.36	2026-05-07
6	OTHER	Liver Transplant Without Mcc	25	25	—	—	$3,500.00	$490,405.16	$50,812.82	2026-05-07
089-4	OTHER	Major Cranial Or Facial Bone Procedures	12	12	—	—	$38,645.41	$81,584.76	$50,551.32	2026-05-07
912-4	OTHER	Musculoskeletal And Other Procedures For Multiple Significant Trauma	12	12	—	—	$38,594.31	$81,476.87	$50,484.47	2026-05-07
217	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	33	33	—	—	$3,500.00	$129,622.44	$50,134.84	2026-05-07
165-4	OTHER	Coronary Bypass With Ami Or Complex Principal Diagnosis	12	12	—	—	$38,009.94	$80,243.21	$49,720.07	2026-05-07
8	OTHER	Simultaneous Pancreas And Kidney Transplant	25	25	—	—	$3,500.00	$473,552.32	$49,049.53	2026-05-07
591-1	OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure	12	12	—	—	$37,254.31	$78,648.00	$48,731.65	2026-05-07
260-4	OTHER	Major Pancreas, Liver And Shunt Procedures	12	12	—	—	$37,051.07	$78,218.92	$48,465.79	2026-05-07
002-1	OTHER	Heart And/or Lung Transplant	12	12	—	—	$36,987.48	$78,084.68	$48,382.61	2026-05-07
276	OTHER	Non-maligant Breast Disorders	29	29	—	—	$3,500.00	$82,886.49	$48,204.73	2026-05-07
573	OTHER	Skin Graft For Skin Ulcer Or Cellulitis With Mcc	31	31	—	—	$3,500.00	$82,426.85	$47,922.59	2026-05-07
178-3	OTHER	External Heart Assist Systems	12	12	—	—	$36,617.28	$77,303.14	$47,898.36	2026-05-07
121-4	OTHER	Other Respiratory And Chest Procedures	12	12	—	—	$36,596.21	$77,258.67	$47,870.80	2026-05-07
461	OTHER	Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc	31	31	—	—	$3,500.00	$299,185.13	$47,763.91	2026-05-07
631-3	OTHER	Neonate Birth Weight > 2499 Grams With Other Major Procedure	12	12	—	—	$36,462.40	$76,976.18	$47,695.77	2026-05-07
454	OTHER	Combined Anterior And Posterior Spinal Fusion With Cc	29	29	—	—	$3,500.00	$81,894.91	$47,613.32	2026-05-07
232	OTHER	Coronary Bypass With Ptca Without Mcc	33	33	—	—	$3,500.00	$155,398.09	$47,557.23	2026-05-07
28	OTHER	Spinal Procedures With Mcc	31	31	—	—	$3,500.00	$81,427.71	$47,341.69	2026-05-07
625-4	OTHER	Neonate Birth Weight 2000-2499 Grams With Other Significant Condition	12	12	—	—	$36,167.88	$76,354.41	$47,310.51	2026-05-07
612-4	OTHER	Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other…	12	12	—	—	$36,063.72	$76,134.52	$47,174.26	2026-05-07
4810000246	OTHER	Insj/rplcmt Defib W/lead(s)	73	67	$195,954.55	$176,359.10	$1,060.28	$195,954.55	$47,127.61	2026-05-07
16	OTHER	Autologous Bone Marrow Transplant With Cc/mcc	25	25	—	—	$3,500.00	$141,557.60	$47,035.22	2026-05-07
17	OTHER	Autologous Bone Marrow Transplant Without Cc/mcc	27	27	—	—	$3,500.00	$80,874.12	$47,035.22	2026-05-07
160-3	OTHER	Major Cardiothoracic Repair Of Heart Anomaly	12	12	—	—	$35,721.61	$75,412.28	$46,726.75	2026-05-07
266	OTHER	Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc	31	31	—	—	$3,500.00	$149,906.89	$46,702.46	2026-05-07
224-4	OTHER	Peritoneal Adhesiolysis	12	12	—	—	$35,664.65	$75,292.04	$46,652.25	2026-05-07
218	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	33	33	—	—	$3,500.00	$79,774.67	$46,380.62	2026-05-07
790	OTHER	Extreme Immaturity Or Respiratory Distress Syndrome, Neonate	29	29	—	—	$2,203.77	$68,180.93	$46,347.38	2026-05-07
602-2	OTHER	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	12	12	—	—	$35,416.15	$74,767.43	$46,327.18	2026-05-07
361-4	OTHER	Skin Graft For Skin And Subcutaneous Tissue Diagnoses	12	12	—	—	$35,317.06	$74,558.24	$46,197.57	2026-05-07
091-4	OTHER	Other Major Head And Neck Procedures	12	12	—	—	$35,127.09	$74,157.19	$45,949.07	2026-05-07
235	OTHER	Coronary Bypass Without Cardiac Catheterization With Mcc	33	33	—	—	$3,500.00	$96,330.35	$45,900.08	2026-05-07
21	OTHER	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc	31	31	—	—	$3,500.00	$295,555.84	$45,769.53	2026-05-07
020-4	OTHER	Open Craniotomy For Trauma	12	12	—	—	$34,768.58	$73,400.34	$45,480.11	2026-05-07
820	OTHER	Lymphoma And Leukemia With Major O.r. Procedures With Mcc	31	31	—	—	$3,500.00	$127,714.66	$45,459.16	2026-05-07
005-1	OTHER	Tracheostomy With Mv >96 Hours Without Extensive Procedure	12	12	—	—	$34,532.18	$72,901.27	$45,170.88	2026-05-07
004-1	OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	12	12	—	—	$34,465.86	$72,761.26	$45,084.13	2026-05-07
457	OTHER	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	31	31	—	—	$3,500.00	$77,109.72	$44,847.49	2026-05-07
001-2	OTHER	Liver Transplant And/or Intestinal Transplant	12	12	—	—	$34,213.08	$72,227.62	$44,753.47	2026-05-07
181-4	OTHER	Lower Extremity Arterial Procedures	12	12	—	—	$34,199.04	$72,197.96	$44,735.10	2026-05-07
227-4	OTHER	Hernia Procedures Except Inguinal, Femoral And Umbilical	12	12	—	—	$34,094.49	$71,977.26	$44,598.35	2026-05-07
23	OTHER	Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…	31	31	—	—	$3,500.00	$229,530.84	$44,578.04	2026-05-07
660-4	OTHER	Major Hematologic Or Immunologic Diagnoses Except Sickle Cell Crisis And Coagula…	12	12	—	—	$33,982.53	$71,740.90	$44,451.90	2026-05-07
623-4	OTHER	Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection	12	12	—	—	$33,975.50	$71,726.06	$44,442.70	2026-05-07
842-4	OTHER	Burns With Skin Graft Except Extensive Third Degree Burns	12	12	—	—	$33,937.28	$71,645.37	$44,392.70	2026-05-07
8136871S	OTHER	26mmx12mmx16cm 16fr Excluder A	43	42	$88,152.00	$79,336.80	$2,000.00	$88,152.00	$44,076.00	2026-05-07
653	OTHER	Major Bladder Procedures With Mcc	31	31	—	—	$3,500.00	$346,102.22	$44,064.59	2026-05-07
834	OTHER	Acute Leukemia Without Major O.r. Procedures With Mcc	31	31	—	—	$3,500.00	$74,416.87	$43,265.62	2026-05-07
183-4	OTHER	Percutaneous Structural Cardiac Procedures	12	12	—	—	$33,072.03	$69,818.73	$43,260.88	2026-05-07
001-1	OTHER	Liver Transplant And/or Intestinal Transplant	12	12	—	—	$32,928.48	$69,515.68	$43,073.11	2026-05-07
261-4	OTHER	Major Biliary Tract Procedures	12	12	—	—	$32,547.35	$68,711.07	$42,574.57	2026-05-07
405	OTHER	Pancreas, Liver And Shunt Procedures With Mcc	31	31	—	—	$3,500.00	$125,924.47	$42,537.80	2026-05-07
607-3	OTHER	Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…	12	12	—	—	$32,431.09	$68,465.64	$42,422.49	2026-05-07
463	OTHER	Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …	31	31	—	—	$3,500.00	$101,324.06	$42,333.33	2026-05-07
11	OTHER	Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc	31	31	—	—	$3,500.00	$180,115.88	$42,295.67	2026-05-07
576	OTHER	Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc	31	31	—	—	$3,500.00	$72,740.95	$42,291.25	2026-05-07
183-3	OTHER	Percutaneous Structural Cardiac Procedures	12	12	—	—	$32,259.84	$68,104.11	$42,198.49	2026-05-07
951-4	OTHER	Moderately Extensive O.r. Procedure Unrelated To Principal Diagnosis	12	12	—	—	$32,133.45	$67,837.28	$42,033.15	2026-05-07
303-2	OTHER	Dorsal And Lumbar Fusion Procedure For Curvature Of Back	12	12	—	—	$31,930.60	$67,409.04	$41,767.81	2026-05-07
234	OTHER	Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc	33	33	—	—	$3,500.00	$121,077.15	$41,736.90	2026-05-07
220	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	33	33	—	—	$3,500.00	$88,868.49	$41,563.45	2026-05-07
050-4	OTHER	Non-bacterial Infections Of Nervous System Except Viral Meningitis	12	12	—	—	$31,607.98	$66,727.95	$41,345.79	2026-05-07
178-2	OTHER	External Heart Assist Systems	12	12	—	—	$31,427.36	$66,346.65	$41,109.53	2026-05-07
710-4	OTHER	Infectious And Parasitic Diseases Including HIV With O.r. Procedure	12	12	—	—	$31,373.92	$66,233.83	$41,039.62	2026-05-07
837	OTHER	Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot…	31	31	—	—	$3,500.00	$374,649.90	$40,747.67	2026-05-07
570	OTHER	Skin Debridement With Mcc	31	31	—	—	$3,500.00	$449,415.11	$40,733.09	2026-05-07
603-3	OTHER	Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition	12	12	—	—	$31,098.50	$65,652.40	$40,679.35	2026-05-07
4810000878	OTHER	Rmvl & Rplcmt Dfb Gen Mlt Ld	73	67	$106,325.36	$95,692.82	$469.70	$106,325.36	$40,641.99	2026-05-07
162-2	OTHER	Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis	12	12	—	—	$30,979.92	$65,402.06	$40,524.24	2026-05-07
270	OTHER	Other Major Cardiovascular Procedures With Mcc	32	32	—	—	$3,500.00	$78,227.13	$40,373.15	2026-05-07
466	OTHER	Revision Of Hip Or Knee Replacement With Mcc	32	32	—	—	$3,500.00	$68,923.20	$40,071.63	2026-05-07
223-4	OTHER	Other Small And Large Bowel Procedures	12	12	—	—	$30,622.58	$64,647.67	$40,056.82	2026-05-07
326	OTHER	Stomach, Esophageal And Duodenal Procedures With Mcc	31	31	—	—	$3,500.00	$304,865.89	$39,956.49	2026-05-07
691-4	OTHER	Lymphoma, Myeloma And Non-acute Leukemia	12	12	—	—	$30,434.16	$64,249.90	$39,810.35	2026-05-07
277	OTHER	Cellulitis Age >17 W Cc	29	29	—	—	$3,500.00	$186,329.60	$39,711.41	2026-05-07
239	OTHER	Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc	32	32	—	—	$3,500.00	$156,738.40	$39,645.72	2026-05-07
008-2	OTHER	Autologous Bone Marrow Transplant Or T-cell Immunotherapy	12	12	—	—	$30,297.24	$63,960.83	$39,631.24	2026-05-07
694-4	OTHER	Lymphatic And Other Malignancies And Neoplasms Of Uncertain Behavior	12	12	—	—	$30,125.99	$63,599.31	$39,407.22	2026-05-07
278	OTHER	Cellulitis Age >17 Without Cc	29	29	—	—	$3,500.00	$67,764.04	$39,397.70	2026-05-07
853	OTHER	Infectious And Parasitic Diseases With O.r. Procedures With Mcc	31	31	—	—	$3,500.00	$67,738.64	$39,382.93	2026-05-07
723-4	OTHER	Viral Illness	12	12	—	—	$30,085.02	$63,512.82	$39,353.64	2026-05-07
228	OTHER	Other Cardiothoracic Procedures With Mcc	32	32	—	—	$3,500.00	$79,966.83	$39,271.52	2026-05-07
130-4	OTHER	Respiratory System Diagnosis With Ventilator Support > 96 Hours	12	12	—	—	$38,584.56	$40,923.02	$38,974.30	2026-05-07
092-4	OTHER	Facial Bone Procedures Except Major Cranial Or Facial Bone Procedures	12	12	—	—	$29,761.63	$62,830.10	$38,930.61	2026-05-07
245	OTHER	Aicd Generator Procedures	31	31	—	—	$3,500.00	$77,888.41	$38,537.76	2026-05-07
163-3	OTHER	Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis	12	12	—	—	$29,432.77	$62,135.85	$38,500.44	2026-05-07
8122264S	OTHER	Catheter Thrmb Mech Asp 25mm 1	50	47	$81,000.00	$72,900.00	$2,000.00	$81,000.00	$38,475.00	2026-05-07
166-4	OTHER	Coronary Bypass Without Ami Or Complex Principal Diagnosis	12	12	—	—	$29,374.65	$62,013.14	$38,424.41	2026-05-07
471	OTHER	Cervical Spinal Fusion With Mcc	31	31	—	—	$3,500.00	$311,469.55	$38,320.01	2026-05-07
661-4	OTHER	Coagulation And Platelet Disorders	12	12	—	—	$29,107.82	$61,449.85	$38,075.38	2026-05-07
163	OTHER	Major Chest Procedures With Mcc	31	31	—	—	$3,500.00	$368,003.46	$37,834.27	2026-05-07
826	OTHER	Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. …	31	31	—	—	$3,500.00	$119,963.66	$37,735.30	2026-05-07
178-1	OTHER	External Heart Assist Systems	12	12	—	—	$28,809.00	$60,819.00	$37,684.50	2026-05-07
799	OTHER	Splenectomy With Mcc	31	31	—	—	$3,500.00	$81,223.66	$37,563.39	2026-05-07
981	OTHER	Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc	31	31	—	—	$3,500.00	$70,667.91	$37,556.76	2026-05-07
092-3	OTHER	Facial Bone Procedures Except Major Cranial Or Facial Bone Procedures	12	12	—	—	$28,706.01	$60,601.58	$37,549.78	2026-05-07
176-4	OTHER	Insertion, Revision And Replacements Of Pacemaker And Other Cardiac Devices	12	12	—	—	$28,536.71	$60,244.17	$37,328.32	2026-05-07
267	OTHER	Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc	31	31	—	—	$3,500.00	$133,371.04	$37,212.89	2026-05-07
823	OTHER	Lymphoma And Non-acute Leukemia With Other Procedures With Mcc	31	31	—	—	$3,500.00	$136,344.24	$37,007.56	2026-05-07
513-4	OTHER	Uterine And Adnexa Procedures For Non-malignancy Except Leiomyoma	12	12	—	—	$28,132.18	$59,390.15	$36,799.16	2026-05-07
179-4	OTHER	Defibrillator Implants	12	12	—	—	$28,115.01	$59,353.91	$36,776.71	2026-05-07
312-4	OTHER	Skin Graft, Except Hand, For Musculoskeletal And Connective Tissue Diagnoses	12	12	—	—	$28,076.78	$59,273.19	$36,726.69	2026-05-07
841-2	OTHER	Extensive Third Degree Burns With Skin Graft	12	12	—	—	$27,940.25	$58,984.96	$36,548.10	2026-05-07
650	OTHER	Kidney Transplant With Hemodialysis With Mcc	24	24	—	—	$3,500.00	$189,318.00	$36,494.23	2026-05-07
455	OTHER	Combined Anterior And Posterior Spinal Fusion Without Cc/mcc	29	29	—	—	$3,500.00	$116,926.68	$36,462.08	2026-05-07
221	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	33	33	—	—	$3,500.00	$103,887.50	$36,366.11	2026-05-07
329	OTHER	Major Small And Large Bowel Procedures With Mcc	31	31	—	—	$3,500.00	$129,654.39	$36,360.95	2026-05-07
171-4	OTHER	Permanent Cardiac Pacemaker Implant Without Ami, Heart Failure Or Shock	12	12	—	—	$27,792.40	$58,672.84	$36,354.71	2026-05-07
841-1	OTHER	Chemotherapy For Acute Leukemia	12	12	—	—	$27,722.96	$58,526.25	$36,263.87	2026-05-07
634-4	OTHER	Neonate Birth Weight > 2499 Grams With Respiratory Distress Syndrome Or Other Ma…	12	12	—	—	$27,720.32	$58,520.67	$36,260.42	2026-05-07
264-4	OTHER	Other Hepatobiliary, Pancreas And Abdominal Procedures	12	12	—	—	$27,577.06	$58,218.25	$36,073.03	2026-05-07
162-1	OTHER	Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis	12	12	—	—	$27,488.12	$58,030.48	$35,956.68	2026-05-07
856	OTHER	Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc	31	31	—	—	$3,500.00	$61,521.30	$35,768.20	2026-05-07
510-4	OTHER	Pelvic Evisceration, Radical Hysterectomy And Other Radical Gynecological Proced…	12	12	—	—	$27,192.42	$57,406.22	$35,569.88	2026-05-07
474	OTHER	Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc	31	31	—	—	$3,500.00	$61,179.82	$35,569.66	2026-05-07
740-4	OTHER	Mental Illness Diagnosis With O.r. Procedure	12	12	—	—	$27,165.50	$57,349.39	$35,534.68	2026-05-07
25	OTHER	Craniotomy And Endovascular Intracranial Procedures With Mcc	31	31	—	—	$3,500.00	$73,292.11	$35,478.12	2026-05-07
401-3	OTHER	Adrenal Procedures	12	12	—	—	$27,063.69	$57,134.46	$35,401.49	2026-05-07
304-3	OTHER	Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back	12	12	—	—	$27,060.96	$57,128.69	$35,397.92	2026-05-07
901	OTHER	Wound Debridements For Injuries With Mcc	31	31	—	—	$3,500.00	$71,539.00	$35,169.59	2026-05-07
310-4	OTHER	Vertebral And Intervertebral Spinal Procedures Including Disc Procedures	12	12	—	—	$26,774.23	$56,523.38	$35,022.86	2026-05-07
233-4	OTHER	Appendectomy With Complex Principal Diagnosis	12	12	—	—	$26,755.90	$56,484.67	$34,998.88	2026-05-07
511-4	OTHER	Uterine And Adnexa Procedures For Ovarian And Adnexal Malignancy	12	12	—	—	$26,717.28	$56,403.14	$34,948.36	2026-05-07
319	OTHER	Other Endovascular Cardiac Valve Procedures With Mcc	30	30	—	—	$3,500.00	$99,274.64	$34,911.53	2026-05-07
011-1	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	12	12	—	—	$26,658.37	$56,278.79	$34,871.31	2026-05-07
480-4	OTHER	Major Male Pelvic Procedures	12	12	—	—	$26,506.23	$55,957.60	$34,672.29	2026-05-07
711-4	OTHER	Post-operative, Post-trauma, Other Device Infections With O.r. Procedure	12	12	—	—	$26,347.85	$55,623.24	$34,465.11	2026-05-07
933	OTHER	Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft	27	27	—	—	$3,500.00	$110,486.12	$34,425.29	2026-05-07
030-4	OTHER	Percutaneous Intracranial And Extracranial Vascular Procedures	12	12	—	—	$26,279.19	$55,478.30	$34,375.31	2026-05-07
4810000875	OTHER	Insrt Pulse Gen W/mult Leads	73	67	$85,907.21	$77,316.49	$466.63	$85,907.21	$34,362.88	2026-05-07
458	OTHER	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	31	31	—	—	$3,500.00	$85,742.89	$34,359.61	2026-05-07
346-4	OTHER	Connective Tissue Disorders	12	12	—	—	$26,192.59	$55,295.46	$34,262.03	2026-05-07
404-4	OTHER	Thyroid, Parathyroid And Thyroglossal Procedures	12	12	—	—	$26,110.67	$55,122.52	$34,154.86	2026-05-07
876	OTHER	O.r. Procedures With Principal Diagnosis Of Mental Illness	29	29	—	—	$3,500.00	$69,040.34	$33,963.88	2026-05-07
356	OTHER	Other Digestive System O.r. Procedures With Mcc	31	31	—	—	$3,500.00	$264,271.64	$33,953.09	2026-05-07
323	OTHER	Urinary Stones W Cc, &/or Esw Lithotripsy	29	29	—	—	$3,500.00	$58,319.35	$33,927.23	2026-05-07
443-4	OTHER	Kidney And Urinary Tract Procedures For Non-malignancy	12	12	—	—	$25,913.28	$54,705.81	$33,896.67	2026-05-07
180-4	OTHER	Other Circulatory System Procedures	12	12	—	—	$25,900.40	$54,678.62	$33,879.82	2026-05-07
029-4	OTHER	Other Percutaneous Intracranial Procedures	12	12	—	—	$25,880.90	$54,637.45	$33,854.31	2026-05-07
073-4	OTHER	Orbit And Eye Procedures	12	12	—	—	$25,829.01	$54,527.91	$33,786.43	2026-05-07
140	OTHER	Major Head And Neck Procedures With Mcc	30	30	—	—	$3,500.00	$147,696.34	$33,704.41	2026-05-07
8122269S	OTHER	System Thrmb Mech Asp Flowtrie	52	49	$72,000.00	$64,800.00	$2,000.00	$72,000.00	$33,624.00	2026-05-07
468-4	OTHER	Other Kidney And Urinary Tract Diagnoses, Signs And Symptoms	12	12	—	—	$25,698.72	$54,252.85	$33,616.00	2026-05-07
313-4	OTHER	Knee And Lower Leg Procedures Except Foot	12	12	—	—	$25,626.56	$54,100.51	$33,521.60	2026-05-07
31	OTHER	Ventricular Shunt Procedures With Mcc	31	31	—	—	$3,500.00	$98,599.86	$33,398.75	2026-05-07
673	OTHER	Other Kidney And Urinary Tract Procedures With Mcc	31	31	—	—	$3,500.00	$139,756.90	$33,391.35	2026-05-07
793	OTHER	Full Term Neonate With Major Problems	29	29	—	—	$2,968.43	$48,928.35	$33,250.39	2026-05-07
440-2	OTHER	Kidney Transplant	12	12	—	—	$25,412.39	$53,648.38	$33,241.46	2026-05-07
815-4	OTHER	Other Injury, Poisoning And Toxic Effect Diagnoses	12	12	—	—	$25,398.34	$53,618.72	$33,223.08	2026-05-07
008-1	OTHER	Autologous Bone Marrow Transplant Or T-cell Immunotherapy	12	12	—	—	$25,375.72	$53,570.96	$33,193.49	2026-05-07
269	OTHER	Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc	32	32	—	—	$3,500.00	$167,214.62	$33,188.51	2026-05-07
091-3	OTHER	Other Major Head And Neck Procedures	12	12	—	—	$25,203.29	$53,206.95	$32,967.94	2026-05-07
175-4	OTHER	Percutaneous Cardiac Intervention Without Ami	12	12	—	—	$25,163.12	$53,122.14	$32,915.39	2026-05-07
692-4	OTHER	Radiotherapy	12	12	—	—	$25,145.55	$53,085.06	$32,892.42	2026-05-07
098-4	OTHER	Other Ear, Nose, Mouth And Throat Procedures	12	12	—	—	$25,112.79	$53,015.88	$32,849.55	2026-05-07
236	OTHER	Coronary Bypass Without Cardiac Catheterization Without Mcc	33	33	—	—	$3,500.00	$79,745.18	$32,819.30	2026-05-07
958	OTHER	Other O.r. Procedures For Multiple Significant Trauma With Cc	31	31	—	—	$3,500.00	$58,512.19	$32,802.32	2026-05-07
12	OTHER	Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc	31	31	—	—	$3,500.00	$136,091.66	$32,757.31	2026-05-07
231-4	OTHER	Major Large Bowel Procedures	12	12	—	—	$25,017.21	$52,814.11	$32,724.54	2026-05-07
165-3	OTHER	Coronary Bypass With Ami Or Complex Principal Diagnosis	12	12	—	—	$24,990.69	$52,758.12	$32,689.84	2026-05-07
810-4	OTHER	Hemorrhage Or Hematoma Due To Complication	12	12	—	—	$24,980.94	$52,737.53	$32,677.08	2026-05-07
603-2	OTHER	Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition	12	12	—	—	$24,910.33	$52,588.48	$32,584.72	2026-05-07

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