Hospital

NORTHWEST HILLS SURGICAL HOSPITAL

Austin, TX · CCN 450808 · Rates published

10,205 distinct procedures filed

15 distinct payers

282,563 rate rows

2026-05-06 last MRF observed

Data quality

281,330 of 282,563 rate rows are consumer-grade (99.6%)

1,233 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	1,128
placeholder amount (≤ $0.02) — excluded from medians	51
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians	38
exceeds 10× this hospital's gross charge — excluded from medians	16

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

Source MRF file	https://uhsfilecdn.eskycity.net/ac/232238976_northwest-texas-healthcare-system-surgery-center_standardcharges.csv
Found on page	https://www.nwths.com/patients-visitors/pricing-guide
Discovered via	Discovered by HANK
Last fetch	success · 2026-09-18
Content fingerprint	0614735646b63225… · 68,434,110 bytes · first seen 2026-05-05

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	6	$3,710,000.00	$3,895,500.00	$3,821,300.00	nat. median $3,765,001 1.0× median
773 OTHER	Inj, Beqvez, Per Tx Dose	6	$3,710,000.00	$3,895,500.00	$3,821,300.00	nat. median $3,677,100 1.0× median
9141 OTHER	Inj Onase Abepar-xioi Treat	8	$2,403,458.75	$4,806,917.50	$2,523,631.69	nat. median $2,508,045 1.0× median
9194 OTHER	Tisagenlecleucel Car-pos T	8	$565,623.84	$1,131,247.68	$593,905.03	nat. median $555,653 1.1× median
9498 OTHER	Ciltacabtagene Car-pos T	8	$551,318.34	$1,102,636.68	$578,884.26	nat. median $553,480 1.0× median
9422 OTHER	Idecabtagene Vicleucel Car	8	$528,312.43	$1,056,624.86	$554,728.05	nat. median $552,917 1.0× median
9413 OTHER	Lisocabtagene Car Pos T	8	$516,485.97	$1,032,971.94	$542,310.27	nat. median $542,562 1.0× median
9035 OTHER	Axicabtagene Ciloleucel Car+	8	$489,517.15	$979,034.30	$513,993.01	nat. median $513,929 1.0× median
9391 OTHER	Brexucabtagene Car Pos T	8	$488,051.51	$976,103.02	$512,454.09	nat. median $483,557 1.1× median
583-4 OTHER	Neonate With Ecmo	3	$343,526.10	$359,884.49	$343,526.10	—
007-4 OTHER	Allogeneic Bone Marrow Transplant	3	$334,182.51	$350,095.96	$334,182.51	—
18 OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	11	$295,002.94	$501,504.99	$333,004.02	nat. median $292,587 1.1× median
583-3 OTHER	Neonate With Ecmo	3	$290,885.28	$304,736.96	$290,885.28	—
002-4 OTHER	Heart And/or Lung Transplant	3	$279,823.40	$293,148.32	$279,823.40	—
1 OTHER	Heart Transplant Or Implant Of Heart Assist System With Mcc	11	$220,342.46	$374,582.19	$248,726.09	nat. median $14,313 outlier · 17.4×
588-4 OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	3	$217,446.39	$227,800.98	$217,446.39	—
161-4 OTHER	Implantable Heart Assist Systems	3	$211,155.36	$221,210.38	$211,155.36	—
009-4 OTHER	Extracorporeal Membrane Oxygenation (ecmo)	3	$197,819.32	$207,239.29	$197,819.32	—
3 OTHER	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…	11	$167,645.60	$284,997.52	$189,241.03	nat. median $10,971 outlier · 17.2×
927 OTHER	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	11	$1.54	$315,465.91	$188,351.71	nat. median $2 outlier · 116988.6×
630-4 OTHER	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure	3	$161,794.61	$169,499.11	$161,794.61	—
609-4 OTHER	Neonate Birth Weight 1500-2499 Grams With Major Procedure	3	$160,360.82	$167,997.05	$160,360.82	—
1908 OTHER	New Technology - Level 52 ($145,001-$160,000)	8	$152,500.50	$305,001.00	$160,125.52	nat. median $149,948 1.1× median
1907 OTHER	New Technology - Level 52 ($145,001-$160,000)	8	$152,500.50	$305,001.00	$160,125.52	nat. median $149,948 1.1× median
583-2 OTHER	Neonate With Ecmo	3	$144,941.49	$151,843.47	$144,941.49	—
1905 OTHER	New Technology - Level 51 ($130,001-$145,000)	8	$137,500.50	$275,001.00	$144,375.52	nat. median $135,199 1.1× median
1906 OTHER	New Technology - Level 51 ($130,001-$145,000)	8	$137,500.50	$275,001.00	$144,375.52	nat. median $135,199 1.1× median
011-4 OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	3	$137,631.43	$144,185.31	$137,631.43	—
1903 OTHER	New Technology - Level 50 ($115,001-$130,000)	8	$122,500.50	$245,001.00	$128,625.52	nat. median $3,015 outlier · 42.7×
1904 OTHER	New Technology - Level 50 ($115,001-$130,000)	8	$122,500.50	$245,001.00	$128,625.52	nat. median $3,015 outlier · 42.7×
200-4 OTHER	Cardiac Structural And Valvular Disorders	3	$127,897.51	$133,987.86	$127,897.51	—
583-1 OTHER	Neonate With Ecmo	3	$127,623.87	$133,701.19	$127,623.87	—
4 OTHER	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…	11	$110,529.89	$187,900.81	$124,767.90	nat. median $7,428 outlier · 16.8×
007-3 OTHER	Allogeneic Bone Marrow Transplant	3	$117,920.24	$123,535.49	$117,920.24	—
J2326 HCPCS	Nusinersen Per 0.1mg	10	$1,042.50	$429,348.00	$116,997.33	nat. median $1,667 outlier · 70.2×
588-3 OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	3	$116,674.61	$122,230.54	$116,674.61	—
588-2 OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	3	$116,141.35	$121,671.89	$116,141.35	—
004-4 OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	3	$115,841.02	$121,357.26	$115,841.02	—
14 OTHER	Allogeneic Bone Marrow Transplant	11	$102,486.94	$174,227.80	$115,688.89	nat. median $6,714 outlier · 17.2×
7 OTHER	Lung Transplant	11	$102,228.80	$173,788.96	$115,397.50	nat. median $31,763 outlier · 3.6×
841-4 OTHER	Extensive Third Degree Burns With Skin Graft	3	$115,343.04	$120,835.57	$115,343.04	—
631-4 OTHER	Neonate Birth Weight > 2499 Grams With Other Major Procedure	3	$114,191.04	$119,628.71	$114,191.04	—
1901 OTHER	New Technology - Level 49 ($100,001-$115,000)	8	$107,500.50	$215,001.00	$112,875.52	nat. median $3,015 outlier · 37.4×
1902 OTHER	New Technology - Level 49 ($100,001-$115,000)	8	$107,500.50	$215,001.00	$112,875.52	nat. median $3,015 outlier · 37.4×
850-4 OTHER	Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal…	3	$111,182.80	$116,477.21	$111,182.80	—
591-4 OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure	3	$110,186.83	$115,433.83	$110,186.83	—
161-3 OTHER	Implantable Heart Assist Systems	3	$110,057.02	$115,297.83	$110,057.02	—
588-1 OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	3	$109,475.37	$114,688.48	$109,475.37	—
001-4 OTHER	Liver Transplant And/or Intestinal Transplant	3	$100,237.61	$105,010.83	$100,237.61	—
008-4 OTHER	Autologous Bone Marrow Transplant Or T-cell Immunotherapy	3	$99,835.97	$104,590.06	$99,835.97	—

Other procedures at this hospital

Browse this hospital's 10,205 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

9138	OTHER	Inj, Hemgenix, Per Tx Dose	7	6	—	—	$3,710,000.00	$3,895,500.00	$3,821,300.00	2026-05-06
773	OTHER	Inj, Beqvez, Per Tx Dose	7	6	—	—	$3,710,000.00	$3,895,500.00	$3,821,300.00	2026-05-06
9141	OTHER	Inj Onase Abepar-xioi Treat	9	8	—	—	$2,403,458.75	$4,806,917.50	$2,523,631.69	2026-05-06
9194	OTHER	Tisagenlecleucel Car-pos T	9	8	—	—	$565,623.84	$1,131,247.68	$593,905.03	2026-05-06
9498	OTHER	Ciltacabtagene Car-pos T	9	8	—	—	$551,318.34	$1,102,636.68	$578,884.26	2026-05-06
9422	OTHER	Idecabtagene Vicleucel Car	9	8	—	—	$528,312.43	$1,056,624.86	$554,728.05	2026-05-06
9413	OTHER	Lisocabtagene Car Pos T	9	8	—	—	$516,485.97	$1,032,971.94	$542,310.27	2026-05-06
9035	OTHER	Axicabtagene Ciloleucel Car+	9	8	—	—	$489,517.15	$979,034.30	$513,993.01	2026-05-06
9391	OTHER	Brexucabtagene Car Pos T	9	8	—	—	$488,051.51	$976,103.02	$512,454.09	2026-05-06
583-4	OTHER	Neonate With Ecmo	3	3	—	—	$343,526.10	$359,884.49	$343,526.10	2026-05-06
007-4	OTHER	Allogeneic Bone Marrow Transplant	3	3	—	—	$334,182.51	$350,095.96	$334,182.51	2026-05-06
18	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	15	11	—	—	$295,002.94	$501,504.99	$333,004.02	2026-05-06
583-3	OTHER	Neonate With Ecmo	3	3	—	—	$290,885.28	$304,736.96	$290,885.28	2026-05-06
002-4	OTHER	Heart And/or Lung Transplant	3	3	—	—	$279,823.40	$293,148.32	$279,823.40	2026-05-06
1	OTHER	Heart Transplant Or Implant Of Heart Assist System With Mcc	15	11	—	—	$220,342.46	$374,582.19	$248,726.09	2026-05-06
588-4	OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	3	3	—	—	$217,446.39	$227,800.98	$217,446.39	2026-05-06
161-4	OTHER	Implantable Heart Assist Systems	3	3	—	—	$211,155.36	$221,210.38	$211,155.36	2026-05-06
009-4	OTHER	Extracorporeal Membrane Oxygenation (ecmo)	3	3	—	—	$197,819.32	$207,239.29	$197,819.32	2026-05-06
3	OTHER	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…	15	11	—	—	$167,645.60	$284,997.52	$189,241.03	2026-05-06
927	OTHER	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	24	11	—	—	$1.54	$315,465.91	$188,351.71	2026-05-06
630-4	OTHER	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure	3	3	—	—	$161,794.61	$169,499.11	$161,794.61	2026-05-06
609-4	OTHER	Neonate Birth Weight 1500-2499 Grams With Major Procedure	3	3	—	—	$160,360.82	$167,997.05	$160,360.82	2026-05-06
1907	OTHER	New Technology - Level 52 ($145,001-$160,000)	9	8	—	—	$152,500.50	$305,001.00	$160,125.52	2026-05-06
1908	OTHER	New Technology - Level 52 ($145,001-$160,000)	9	8	—	—	$152,500.50	$305,001.00	$160,125.52	2026-05-06
583-2	OTHER	Neonate With Ecmo	3	3	—	—	$144,941.49	$151,843.47	$144,941.49	2026-05-06
1906	OTHER	New Technology - Level 51 ($130,001-$145,000)	9	8	—	—	$137,500.50	$275,001.00	$144,375.52	2026-05-06
1905	OTHER	New Technology - Level 51 ($130,001-$145,000)	9	8	—	—	$137,500.50	$275,001.00	$144,375.52	2026-05-06
011-4	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	3	3	—	—	$137,631.43	$144,185.31	$137,631.43	2026-05-06
1903	OTHER	New Technology - Level 50 ($115,001-$130,000)	9	8	—	—	$122,500.50	$245,001.00	$128,625.52	2026-05-06
1904	OTHER	New Technology - Level 50 ($115,001-$130,000)	9	8	—	—	$122,500.50	$245,001.00	$128,625.52	2026-05-06
200-4	OTHER	Cardiac Structural And Valvular Disorders	3	3	—	—	$127,897.51	$133,987.86	$127,897.51	2026-05-06
583-1	OTHER	Neonate With Ecmo	3	3	—	—	$127,623.87	$133,701.19	$127,623.87	2026-05-06
4	OTHER	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…	15	11	—	—	$110,529.89	$187,900.81	$124,767.90	2026-05-06
007-3	OTHER	Allogeneic Bone Marrow Transplant	3	3	—	—	$117,920.24	$123,535.49	$117,920.24	2026-05-06
J2326	HCPCS	Nusinersen Per 0.1mg	12	10	$536,685.00	$214,674.00 60% off	$1,042.50	$429,348.00	$116,997.33	2026-05-06
588-3	OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	3	3	—	—	$116,674.61	$122,230.54	$116,674.61	2026-05-06
588-2	OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	3	3	—	—	$116,141.35	$121,671.89	$116,141.35	2026-05-06
004-4	OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	3	3	—	—	$115,841.02	$121,357.26	$115,841.02	2026-05-06
14	OTHER	Allogeneic Bone Marrow Transplant	15	11	—	—	$102,486.94	$174,227.80	$115,688.89	2026-05-06
7	OTHER	Lung Transplant	15	11	—	—	$102,228.80	$173,788.96	$115,397.50	2026-05-06
841-4	OTHER	Extensive Third Degree Burns With Skin Graft	3	3	—	—	$115,343.04	$120,835.57	$115,343.04	2026-05-06
631-4	OTHER	Neonate Birth Weight > 2499 Grams With Other Major Procedure	3	3	—	—	$114,191.04	$119,628.71	$114,191.04	2026-05-06
1901	OTHER	New Technology - Level 49 ($100,001-$115,000)	9	8	—	—	$107,500.50	$215,001.00	$112,875.52	2026-05-06
1902	OTHER	New Technology - Level 49 ($100,001-$115,000)	9	8	—	—	$107,500.50	$215,001.00	$112,875.52	2026-05-06
850-4	OTHER	Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal…	3	3	—	—	$111,182.80	$116,477.21	$111,182.80	2026-05-06
591-4	OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure	3	3	—	—	$110,186.83	$115,433.83	$110,186.83	2026-05-06
161-3	OTHER	Implantable Heart Assist Systems	3	3	—	—	$110,057.02	$115,297.83	$110,057.02	2026-05-06
588-1	OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	3	3	—	—	$109,475.37	$114,688.48	$109,475.37	2026-05-06
001-4	OTHER	Liver Transplant And/or Intestinal Transplant	3	3	—	—	$100,237.61	$105,010.83	$100,237.61	2026-05-06
008-4	OTHER	Autologous Bone Marrow Transplant Or T-cell Immunotherapy	3	3	—	—	$99,835.97	$104,590.06	$99,835.97	2026-05-06
1599	OTHER	New Technology - Level 48 ($90,001-$100,000)	9	8	—	—	$95,000.50	$190,001.00	$99,750.52	2026-05-06
1585	OTHER	New Technology - Level 48 ($90,001-$100,000)	9	8	—	—	$95,000.50	$190,001.00	$99,750.52	2026-05-06
681-4	OTHER	Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms	3	3	—	—	$98,062.05	$102,731.67	$98,062.05	2026-05-06
160-4	OTHER	Major Cardiothoracic Repair Of Heart Anomaly	3	3	—	—	$98,007.32	$102,674.34	$98,007.32	2026-05-06
2	OTHER	Heart Transplant Or Implant Of Heart Assist System Without Mcc	15	11	—	—	$86,200.01	$146,540.02	$97,303.95	2026-05-06
009-3	OTHER	Extracorporeal Membrane Oxygenation (ecmo)	3	3	—	—	$97,188.21	$101,816.22	$97,188.21	2026-05-06
212	OTHER	Concomitant Aortic And Mitral Valve Procedures	15	11	—	—	$85,215.96	$144,867.13	$96,193.14	2026-05-06
246-4	OTHER	Gastrointestinal Vascular Insufficiency	3	3	—	—	$95,039.79	$99,565.49	$95,039.79	2026-05-06
603-4	OTHER	Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition	3	3	—	—	$94,549.50	$99,051.86	$94,549.50	2026-05-06
5	OTHER	Liver Transplant With Mcc Or Intestinal Transplant	15	11	—	—	$83,303.39	$141,615.77	$94,034.20	2026-05-06
215	OTHER	Other Heart Assist System Implant	15	11	—	—	$82,876.29	$140,889.70	$93,552.08	2026-05-06
426	OTHER	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	15	11	—	—	$81,942.30	$139,301.92	$92,497.78	2026-05-06
006-4	OTHER	Pancreas Transplant	3	3	—	—	$91,757.46	$96,126.86	$91,757.46	2026-05-06
589-1	OTHER	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …	3	3	—	—	$91,750.22	$96,119.28	$91,750.22	2026-05-06
593-4	OTHER	Neonate Birth Weight 750-999 Grams Without Major Procedure	3	3	—	—	$91,475.67	$95,831.66	$91,475.67	2026-05-06
1584	OTHER	New Technology - Level 47 ($80,001-$90,000)	9	8	—	—	$85,000.50	$170,001.00	$89,250.52	2026-05-06
1598	OTHER	New Technology - Level 47 ($80,001-$90,000)	9	8	—	—	$85,000.50	$170,001.00	$89,250.52	2026-05-06
589-2	OTHER	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …	3	3	—	—	$88,924.71	$93,159.22	$88,924.71	2026-05-06
162-4	OTHER	Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis	3	3	—	—	$85,494.92	$89,566.11	$85,494.92	2026-05-06
216	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	15	11	—	—	$75,494.34	$128,340.37	$85,219.21	2026-05-06
602-4	OTHER	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	3	3	—	—	$84,091.89	$88,096.27	$84,091.89	2026-05-06
589-3	OTHER	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …	3	3	—	—	$83,409.37	$87,381.25	$83,409.37	2026-05-06
850	OTHER	Acute Leukemia With Other Procedures	15	11	—	—	$72,058.76	$122,499.89	$81,341.08	2026-05-06
621-4	OTHER	Neonate Birth Weight 2000-2499 Grams With Major Anomaly	3	3	—	—	$79,854.75	$83,657.36	$79,854.75	2026-05-06
007-2	OTHER	Allogeneic Bone Marrow Transplant	3	3	—	—	$79,229.22	$83,002.04	$79,229.22	2026-05-06
161-2	OTHER	Implantable Heart Assist Systems	3	3	—	—	$79,113.89	$82,881.22	$79,113.89	2026-05-06
1583	OTHER	New Technology - Level 46 ($70,001-$80,000)	9	8	—	—	$75,000.50	$150,001.00	$78,750.52	2026-05-06
1597	OTHER	New Technology - Level 46 ($70,001-$80,000)	9	8	—	—	$75,000.50	$150,001.00	$78,750.52	2026-05-06
011-3	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	3	3	—	—	$78,209.29	$81,933.54	$78,209.29	2026-05-06
863-4	OTHER	Neonatal Aftercare	3	3	—	—	$76,996.22	$80,662.71	$76,996.22	2026-05-06
630-3	OTHER	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure	3	3	—	—	$76,256.72	$79,887.99	$76,256.72	2026-05-06
161-1	OTHER	Implantable Heart Assist Systems	3	3	—	—	$75,032.34	$78,605.31	$75,032.34	2026-05-06
440-4	OTHER	Kidney Transplant	3	3	—	—	$74,846.90	$78,411.04	$74,846.90	2026-05-06
231	OTHER	Coronary Bypass With Ptca With Mcc	15	11	—	—	$66,285.86	$112,685.96	$74,824.54	2026-05-06
456	OTHER	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	15	11	—	—	$66,249.09	$112,623.46	$74,783.04	2026-05-06
005-4	OTHER	Tracheostomy With Mv >96 Hours Without Extensive Procedure	3	3	—	—	$74,504.96	$78,052.82	$74,504.96	2026-05-06
004-3	OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	3	3	—	—	$74,479.63	$78,026.28	$74,479.63	2026-05-06
429	OTHER	Combined Anterior And Posterior Cervical Spinal Fusion With Mcc	15	11	—	—	$65,243.14	$110,913.34	$73,647.50	2026-05-06
591-3	OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure	3	3	—	—	$72,557.81	$76,012.95	$72,557.81	2026-05-06
680-4	OTHER	Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms	3	3	—	—	$72,557.81	$76,012.95	$72,557.81	2026-05-06
608-4	OTHER	Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition	3	3	—	—	$72,352.02	$75,797.35	$72,352.02	2026-05-06
20	OTHER	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc	15	11	—	—	$63,056.79	$107,196.55	$71,179.51	2026-05-06
441-4	OTHER	Major Bladder Procedures	3	3	—	—	$70,832.29	$74,205.26	$70,832.29	2026-05-06
10	OTHER	Pancreas Transplant	15	11	—	—	$62,367.64	$106,024.99	$70,401.59	2026-05-06
19	OTHER	Simultaneous Pancreas And Kidney Transplant With Hemodialysis	15	11	—	—	$62,010.16	$105,417.27	$69,998.06	2026-05-06
233	OTHER	Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc	15	11	—	—	$61,142.66	$103,942.52	$69,018.81	2026-05-06
002-3	OTHER	Heart And/or Lung Transplant	3	3	—	—	$68,920.42	$72,202.35	$68,920.42	2026-05-06
219	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	15	11	—	—	$60,525.48	$102,893.31	$68,322.13	2026-05-06
1582	OTHER	New Technology - Level 45 ($60,001-$70,000)	9	8	—	—	$65,000.50	$130,001.00	$68,250.52	2026-05-06
1596	OTHER	New Technology - Level 45 ($60,001-$70,000)	9	8	—	—	$65,000.50	$130,001.00	$68,250.52	2026-05-06
008-3	OTHER	Autologous Bone Marrow Transplant Or T-cell Immunotherapy	3	3	—	—	$67,481.66	$70,695.07	$67,481.66	2026-05-06
178-4	OTHER	External Heart Assist Systems	3	3	—	—	$66,342.32	$69,501.48	$66,342.32	2026-05-06
957	OTHER	Other O.r. Procedures For Multiple Significant Trauma With Mcc	15	11	—	—	$58,387.63	$99,258.97	$65,908.89	2026-05-06
C2624	HCPCS	Implantable Sensor Cardiomems	16	9	$321,540.00	$128,616.00 60% off	$12,554.26	$257,232.00	$65,754.93	2026-05-06
593-3	OTHER	Neonate Birth Weight 750-999 Grams Without Major Procedure	3	3	—	—	$65,333.69	$68,444.82	$65,333.69	2026-05-06
611-4	OTHER	Neonate Birth Weight 1500-1999 Grams With Major Anomaly	3	3	—	—	$65,258.61	$68,366.16	$65,258.61	2026-05-06
167-4	OTHER	Other Cardiothoracic And Thoracic Vascular Procedures	3	3	—	—	$64,970.04	$68,063.86	$64,970.04	2026-05-06
690-4	OTHER	Acute Leukemia	3	3	—	—	$64,386.58	$67,452.61	$64,386.58	2026-05-06
043-4	OTHER	Multiple Sclerosis, Other Demyelinating Disease And Inflammatory Neuropathies	3	3	—	—	$63,992.17	$67,039.42	$63,992.17	2026-05-06
009-2	OTHER	Extracorporeal Membrane Oxygenation (ecmo)	3	3	—	—	$63,920.26	$66,964.08	$63,920.26	2026-05-06
427	OTHER	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	15	11	—	—	$55,559.85	$94,451.74	$62,716.84	2026-05-06
5244	OTHER	Level 4 Blood Product Exchange And Related Services	9	8	—	—	$59,142.33	$118,284.66	$62,099.45	2026-05-06
009-1	OTHER	Extracorporeal Membrane Oxygenation (ecmo)	3	3	—	—	$61,989.85	$64,941.74	$61,989.85	2026-05-06
870	OTHER	Septicemia Or Severe Sepsis With Mv >96 Hours	15	11	—	—	$54,416.22	$92,507.57	$61,425.89	2026-05-06
633-4	OTHER	Neonate Birth Weight > 2499 Grams With Major Anomaly	3	3	—	—	$60,686.77	$63,576.62	$60,686.77	2026-05-06
303-4	OTHER	Dorsal And Lumbar Fusion Procedure For Curvature Of Back	3	3	—	—	$60,316.79	$63,189.02	$60,316.79	2026-05-06
955	OTHER	Craniotomy For Multiple Significant Trauma	15	11	—	—	$53,413.39	$90,802.77	$60,293.89	2026-05-06
591-2	OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure	3	3	—	—	$59,907.91	$62,760.67	$59,907.91	2026-05-06
1643	OTHER	Y90 Ibritumomab, Rx	9	8	—	—	$56,824.55	$113,649.10	$59,665.78	2026-05-06
607-4	OTHER	Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…	3	3	—	—	$59,321.73	$62,146.58	$59,321.73	2026-05-06
006-3	OTHER	Pancreas Transplant	3	3	—	—	$59,297.31	$62,120.99	$59,297.31	2026-05-06
447	OTHER	Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall…	15	11	—	—	$52,446.55	$89,159.13	$59,202.50	2026-05-06
268	OTHER	Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc	15	11	—	—	$52,156.34	$88,665.78	$58,874.91	2026-05-06
9273	OTHER	Sipuleucel-t Auto Cd54+	9	8	—	—	$55,536.50	$111,073.00	$58,313.32	2026-05-06
1581	OTHER	New Technology - Level 44 ($50,001-$60,000)	9	8	—	—	$55,000.50	$110,001.00	$57,750.53	2026-05-06
1595	OTHER	New Technology - Level 44 ($50,001-$60,000)	9	8	—	—	$55,000.50	$110,001.00	$57,750.53	2026-05-06
207	OTHER	Respiratory System Diagnosis With Ventilator Support >96 Hours	15	11	—	—	$50,588.74	$86,000.86	$57,105.38	2026-05-06
217	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	15	11	—	—	$50,515.99	$85,877.18	$57,023.26	2026-05-06
220-4	OTHER	Major Stomach, Esophageal And Duodenal Procedures	3	3	—	—	$56,528.34	$59,220.16	$56,528.34	2026-05-06
613-4	OTHER	Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection	3	3	—	—	$56,220.32	$58,897.48	$56,220.32	2026-05-06
447-4	OTHER	Other Kidney, Urinary Tract And Related Procedures	3	3	—	—	$56,088.70	$58,759.59	$56,088.70	2026-05-06
969	OTHER	HIV With Extensive O.r. Procedures With Mcc	15	11	—	—	$49,470.92	$84,100.57	$55,843.57	2026-05-06
002-2	OTHER	Heart And/or Lung Transplant	3	3	—	—	$55,365.93	$58,002.40	$55,365.93	2026-05-06
023-4	OTHER	Spinal Procedures	3	3	—	—	$55,257.83	$57,889.15	$55,257.83	2026-05-06
910-4	OTHER	Craniotomy For Multiple Significant Trauma	3	3	—	—	$55,057.91	$57,679.72	$55,057.91	2026-05-06
317	OTHER	Concomitant Left Atrial Appendage Closure And Cardiac Ablation	15	11	—	—	$48,392.22	$82,266.78	$54,625.91	2026-05-06
573	OTHER	Skin Graft For Skin Ulcer Or Cellulitis With Mcc	15	11	—	—	$48,171.63	$81,891.77	$54,376.91	2026-05-06
011-2	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	3	3	—	—	$54,350.52	$56,938.64	$54,350.52	2026-05-06
602-3	OTHER	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	3	3	—	—	$54,348.25	$56,936.27	$54,348.25	2026-05-06
461	OTHER	Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc	15	11	—	—	$48,003.45	$81,605.87	$54,187.06	2026-05-06
232	OTHER	Coronary Bypass With Ptca Without Mcc	15	11	—	—	$47,784.42	$81,233.52	$53,939.82	2026-05-06
28	OTHER	Spinal Procedures With Mcc	15	11	—	—	$47,556.01	$80,845.22	$53,681.99	2026-05-06
005-3	OTHER	Tracheostomy With Mv >96 Hours Without Extensive Procedure	3	3	—	—	$53,670.71	$56,226.46	$53,670.71	2026-05-06
006-2	OTHER	Pancreas Transplant	3	3	—	—	$53,633.62	$56,187.60	$53,633.62	2026-05-06
950-4	OTHER	Extensive O.r. Procedure Unrelated To Principal Diagnosis	3	3	—	—	$53,423.30	$55,967.27	$53,423.30	2026-05-06
16	OTHER	Autologous Bone Marrow Transplant With Cc/mcc	15	11	—	—	$47,214.96	$80,265.43	$53,297.00	2026-05-06
17	OTHER	Autologous Bone Marrow Transplant Without Cc/mcc	15	11	—	—	$47,214.96	$80,265.43	$53,297.00	2026-05-06
928	OTHER	Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc	24	11	—	—	$1.66	$88,816.04	$53,028.40	2026-05-06
006-1	OTHER	Pancreas Transplant	3	3	—	—	$52,941.15	$55,462.16	$52,941.15	2026-05-06
266	OTHER	Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc	15	11	—	—	$46,862.17	$79,665.69	$52,898.76	2026-05-06
218	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	15	11	—	—	$46,537.54	$79,113.82	$52,532.32	2026-05-06
007-1	OTHER	Allogeneic Bone Marrow Transplant	3	3	—	—	$52,024.79	$54,502.16	$52,024.79	2026-05-06
235	OTHER	Coronary Bypass Without Cardiac Catheterization With Mcc	15	11	—	—	$46,028.31	$78,248.12	$51,957.49	2026-05-06
001-3	OTHER	Liver Transplant And/or Intestinal Transplant	3	3	—	—	$51,644.86	$54,104.14	$51,644.86	2026-05-06
609-3	OTHER	Neonate Birth Weight 1500-2499 Grams With Major Procedure	3	3	—	—	$51,583.80	$54,040.17	$51,583.80	2026-05-06
026-4	OTHER	Other Nervous System And Related Procedures	3	3	—	—	$51,552.59	$54,007.48	$51,552.59	2026-05-06
593-2	OTHER	Neonate Birth Weight 750-999 Grams Without Major Procedure	3	3	—	—	$51,330.06	$53,774.35	$51,330.06	2026-05-06
303-3	OTHER	Dorsal And Lumbar Fusion Procedure For Curvature Of Back	3	3	—	—	$51,025.67	$53,455.46	$51,025.67	2026-05-06
182-4	OTHER	Other Peripheral Vascular Procedures	3	3	—	—	$50,984.51	$53,412.34	$50,984.51	2026-05-06
163-4	OTHER	Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis	3	3	—	—	$50,954.20	$53,380.59	$50,954.20	2026-05-06
457	OTHER	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	15	11	—	—	$44,895.63	$76,322.57	$50,678.90	2026-05-06
23	OTHER	Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…	15	11	—	—	$44,627.32	$75,866.45	$50,376.03	2026-05-06
792-4	OTHER	Extensive O.r. Procedures For Other Complications Of Treatment	3	3	—	—	$50,120.16	$52,506.84	$50,120.16	2026-05-06
304-4	OTHER	Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back	3	3	—	—	$50,107.95	$52,494.04	$50,107.95	2026-05-06
205-4	OTHER	Cardiomyopathy	3	3	—	—	$49,966.38	$52,345.73	$49,966.38	2026-05-06
695-4	OTHER	Chemotherapy For Acute Leukemia	3	3	—	—	$49,902.15	$52,278.45	$49,902.15	2026-05-06
841-3	OTHER	Extensive Third Degree Burns With Skin Graft	3	3	—	—	$49,851.04	$52,224.90	$49,851.04	2026-05-06
653	OTHER	Major Bladder Procedures With Mcc	15	11	—	—	$43,606.50	$74,131.06	$49,223.72	2026-05-06
005-2	OTHER	Tracheostomy With Mv >96 Hours Without Extensive Procedure	3	3	—	—	$49,013.39	$51,347.36	$49,013.39	2026-05-06
651-4	OTHER	Other Procedures Of Blood And Blood-forming Organs	3	3	—	—	$48,849.20	$51,175.35	$48,849.20	2026-05-06
21	OTHER	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc	15	11	—	—	$43,236.51	$73,502.06	$48,806.06	2026-05-06
004-2	OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	3	3	—	—	$48,696.78	$51,015.67	$48,696.78	2026-05-06
428	OTHER	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	15	11	—	—	$43,055.03	$73,193.55	$48,601.20	2026-05-06
614-4	OTHER	Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition	3	3	—	—	$48,185.23	$50,479.76	$48,185.23	2026-05-06
162-3	OTHER	Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis	3	3	—	—	$48,103.36	$50,394.00	$48,103.36	2026-05-06
8	OTHER	Simultaneous Pancreas And Kidney Transplant	15	11	—	—	$42,562.22	$72,355.77	$48,044.91	2026-05-06
021-4	OTHER	Open Craniotomy Except Trauma	3	3	—	—	$47,989.38	$50,274.59	$47,989.38	2026-05-06
405	OTHER	Pancreas, Liver And Shunt Procedures With Mcc	15	11	—	—	$42,465.22	$72,190.88	$47,935.42	2026-05-06
230-4	OTHER	Major Small Bowel Procedures	3	3	—	—	$47,816.15	$50,093.11	$47,816.15	2026-05-06
463	OTHER	Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …	15	11	—	—	$42,248.54	$71,822.52	$47,690.83	2026-05-06
11	OTHER	Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc	15	11	—	—	$42,208.65	$71,754.70	$47,645.80	2026-05-06
576	OTHER	Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc	15	11	—	—	$42,203.96	$71,746.72	$47,640.50	2026-05-06
022-4	OTHER	Ventricular Shunt Procedures	3	3	—	—	$47,627.54	$49,895.52	$47,627.54	2026-05-06
1142	OTHER	Supprelin La Implant	9	8	—	—	$45,261.80	$90,523.59	$47,524.89	2026-05-06
442-4	OTHER	Kidney And Urinary Tract Procedures For Malignancy	3	3	—	—	$47,366.57	$49,622.12	$47,366.57	2026-05-06
1580	OTHER	New Technology - Level 43 ($40,001-$50,000)	9	8	—	—	$45,000.50	$90,001.00	$47,250.53	2026-05-06
1594	OTHER	New Technology - Level 43 ($40,001-$50,000)	9	8	—	—	$45,000.50	$90,001.00	$47,250.53	2026-05-06
790	OTHER	Extreme Immaturity Or Respiratory Distress Syndrome, Neonate	24	11	—	—	$0.12	$79,053.98	$47,199.88	2026-05-06
952-4	OTHER	Non-extensive O.r. Procedure Unrelated To Principal Diagnosis	3	3	—	—	$47,075.74	$49,317.44	$47,075.74	2026-05-06
234	OTHER	Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc	15	11	—	—	$41,616.50	$70,748.04	$46,977.37	2026-05-06
220	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	15	11	—	—	$41,432.67	$70,435.54	$46,769.86	2026-05-06
911-4	OTHER	Extensive Abdominal Or Thoracic Procedures For Multiple Significant Trauma	3	3	—	—	$46,645.60	$48,866.82	$46,645.60	2026-05-06
820	OTHER	Lymphoma And Leukemia With Major O.r. Procedures With Mcc	24	11	—	—	$23.52	$77,424.97	$46,227.26	2026-05-06
440-3	OTHER	Kidney Transplant	3	3	—	—	$45,809.75	$47,991.17	$45,809.75	2026-05-06
315-4	OTHER	Shoulder, Upper Arm And Forearm Procedures Except Joint Replacement	3	3	—	—	$45,806.59	$47,987.85	$45,806.59	2026-05-06
169-4	OTHER	Major Abdominal Vascular Procedures	3	3	—	—	$45,651.00	$47,824.85	$45,651.00	2026-05-06
120-4	OTHER	Major Respiratory And Chest Procedures	3	3	—	—	$45,465.55	$47,630.58	$45,465.55	2026-05-06
483-4	OTHER	Penis, Testes And Scrotal Procedures	3	3	—	—	$45,292.77	$47,449.57	$45,292.77	2026-05-06
466	OTHER	Revision Of Hip Or Knee Replacement With Mcc	15	11	—	—	$39,851.77	$67,748.01	$44,985.32	2026-05-06
326	OTHER	Stomach, Esophageal And Duodenal Procedures With Mcc	15	11	—	—	$39,729.74	$67,540.57	$44,847.57	2026-05-06
089-4	OTHER	Major Cranial Or Facial Bone Procedures	3	3	—	—	$44,807.01	$46,940.67	$44,807.01	2026-05-06
912-4	OTHER	Musculoskeletal And Other Procedures For Multiple Significant Trauma	3	3	—	—	$44,747.75	$46,878.60	$44,747.75	2026-05-06
130-4	OTHER	Respiratory System Diagnosis With Ventilator Support > 96 Hours	3	3	—	—	$44,736.45	$46,866.75	$44,736.45	2026-05-06
239	OTHER	Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc	15	11	—	—	$39,400.42	$66,980.72	$44,475.83	2026-05-06
837	OTHER	Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot…	15	11	—	—	$39,168.10	$66,585.77	$44,213.58	2026-05-06
853	OTHER	Infectious And Parasitic Diseases With O.r. Procedures With Mcc	15	11	—	—	$39,121.95	$66,507.31	$44,161.48	2026-05-06
165-4	OTHER	Coronary Bypass With Ami Or Complex Principal Diagnosis	3	3	—	—	$44,070.21	$46,168.79	$44,070.21	2026-05-06
228	OTHER	Other Cardiothoracic Procedures With Mcc	15	11	—	—	$38,981.15	$66,267.95	$44,002.54	2026-05-06
834	OTHER	Acute Leukemia With Mcc	24	11	—	—	$128.07	$73,502.06	$43,885.06	2026-05-06
C1882	HCPCS	Aicd Inventra Hf-t Qp Df-4	641	9	$161,162.00	$64,464.80 60% off	$12,580.51	$206,521.60	$43,583.00	2026-05-06
591-1	OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure	3	3	—	—	$43,194.11	$45,250.97	$43,194.11	2026-05-06
245	OTHER	Aicd Generator Procedures	15	11	—	—	$38,226.29	$64,984.69	$43,150.44	2026-05-06
260-4	OTHER	Major Pancreas, Liver And Shunt Procedures	3	3	—	—	$42,958.46	$45,004.10	$42,958.46	2026-05-06
471	OTHER	Cervical Spinal Fusion With Mcc	15	11	—	—	$37,995.53	$64,592.40	$42,889.96	2026-05-06
002-1	OTHER	Heart And/or Lung Transplant	3	3	—	—	$42,884.73	$44,926.86	$42,884.73	2026-05-06
6	OTHER	Liver Transplant Without Mcc	15	11	—	—	$37,932.17	$64,484.68	$42,818.44	2026-05-06
178-3	OTHER	External Heart Assist Systems	3	3	—	—	$42,455.50	$44,477.19	$42,455.50	2026-05-06
121-4	OTHER	Other Respiratory And Chest Procedures	3	3	—	—	$42,431.08	$44,451.61	$42,431.08	2026-05-06
631-3	OTHER	Neonate Birth Weight > 2499 Grams With Other Major Procedure	3	3	—	—	$42,275.94	$44,289.08	$42,275.94	2026-05-06
981	OTHER	Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc	15	11	—	—	$37,186.70	$63,217.38	$41,976.94	2026-05-06
625-4	OTHER	Neonate Birth Weight 2000-2499 Grams With Other Significant Condition	3	3	—	—	$41,934.45	$43,931.33	$41,934.45	2026-05-06
612-4	OTHER	Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other…	3	3	—	—	$41,813.69	$43,804.82	$41,813.69	2026-05-06
267	OTHER	Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc	15	11	—	—	$36,801.84	$62,563.12	$41,542.50	2026-05-06
160-3	OTHER	Major Cardiothoracic Repair Of Heart Anomaly	3	3	—	—	$41,417.02	$43,389.26	$41,417.02	2026-05-06
224-4	OTHER	Peritoneal Adhesiolysis	3	3	—	—	$41,350.99	$43,320.08	$41,350.99	2026-05-06
823	OTHER	Lymphoma And Non-acute Leukemia With Other Procedures With Mcc	15	11	—	—	$36,604.71	$62,228.01	$41,319.99	2026-05-06
277	OTHER	Cardiac Defibrillator Implant Without Mcc	15	11	—	—	$36,388.82	$61,860.99	$41,076.28	2026-05-06
602-2	OTHER	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	3	3	—	—	$41,062.87	$43,018.25	$41,062.87	2026-05-06
361-4	OTHER	Skin Graft For Skin And Subcutaneous Tissue Diagnoses	3	3	—	—	$40,947.99	$42,897.89	$40,947.99	2026-05-06
091-4	OTHER	Other Major Head And Neck Procedures	3	3	—	—	$40,727.72	$42,667.14	$40,727.72	2026-05-06
163	OTHER	Major Chest Procedures With Mcc	15	11	—	—	$36,054.80	$61,293.16	$40,699.24	2026-05-06
650	OTHER	Kidney Transplant With Hemodialysis With Mcc	15	11	—	—	$36,039.94	$61,267.90	$40,682.46	2026-05-06
221	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	15	11	—	—	$35,924.95	$61,072.42	$40,552.66	2026-05-06
329	OTHER	Major Small And Large Bowel Procedures With Mcc	15	11	—	—	$35,919.48	$61,063.11	$40,546.48	2026-05-06
C1721	HCPCS	Defib Ovatio Dr 6550 Ela	620	9	$147,891.00	$59,156.40 60% off	$6,904.38	$228,227.20	$40,450.66	2026-05-06
020-4	OTHER	Open Craniotomy For Trauma	3	3	—	—	$40,312.06	$42,231.68	$40,312.06	2026-05-06
005-1	OTHER	Tracheostomy With Mv >96 Hours Without Extensive Procedure	3	3	—	—	$40,037.96	$41,944.53	$40,037.96	2026-05-06
004-1	OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	3	3	—	—	$39,961.07	$41,863.98	$39,961.07	2026-05-06
001-2	OTHER	Liver Transplant And/or Intestinal Transplant	3	3	—	—	$39,667.98	$41,556.94	$39,667.98	2026-05-06
181-4	OTHER	Lower Extremity Arterial Procedures	3	3	—	—	$39,651.70	$41,539.88	$39,651.70	2026-05-06
474	OTHER	Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc	15	11	—	—	$35,080.92	$59,637.56	$39,599.90	2026-05-06
227-4	OTHER	Hernia Procedures Except Inguinal, Femoral And Umbilical	3	3	—	—	$39,530.48	$41,412.89	$39,530.48	2026-05-06
25	OTHER	Craniotomy And Endovascular Intracranial Procedures With Mcc	15	11	—	—	$34,983.92	$59,472.67	$39,490.41	2026-05-06
660-4	OTHER	Major Hematologic Or Immunologic Diagnoses Except Sickle Cell Crisis And Coagula…	3	3	—	—	$39,400.67	$41,276.90	$39,400.67	2026-05-06
623-4	OTHER	Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection	3	3	—	—	$39,392.53	$41,268.37	$39,392.53	2026-05-06
842-4	OTHER	Burns With Skin Graft Except Extensive Third Degree Burns	3	3	—	—	$39,348.21	$41,221.93	$39,348.21	2026-05-06
319	OTHER	Other Endovascular Cardiac Valve Procedures With Mcc	15	11	—	—	$34,362.04	$58,415.47	$38,788.42	2026-05-06
183-4	OTHER	Percutaneous Structural Cardiac Procedures	3	3	—	—	$38,345.01	$40,170.96	$38,345.01	2026-05-06
933	OTHER	Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft	15	11	—	—	$33,846.55	$57,539.14	$38,206.53	2026-05-06
001-1	OTHER	Liver Transplant And/or Intestinal Transplant	3	3	—	—	$38,178.56	$39,996.59	$38,178.56	2026-05-06
458	OTHER	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	15	11	—	—	$33,776.93	$57,420.78	$38,127.94	2026-05-06
826	OTHER	Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. …	24	11	—	—	$87.14	$63,504.62	$37,916.00	2026-05-06
799	OTHER	Splenic Procedures With Mcc	24	11	—	—	$7.69	$63,229.35	$37,751.65	2026-05-06
261-4	OTHER	Major Biliary Tract Procedures	3	3	—	—	$37,736.67	$39,533.65	$37,736.67	2026-05-06
356	OTHER	Other Digestive System O.r. Procedures With Mcc	15	11	—	—	$33,367.82	$56,725.30	$37,666.13	2026-05-06
323	OTHER	Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc	15	11	—	—	$33,318.54	$56,641.52	$37,610.50	2026-05-06
607-3	OTHER	Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…	3	3	—	—	$37,601.88	$39,392.45	$37,601.88	2026-05-06
183-3	OTHER	Percutaneous Structural Cardiac Procedures	3	3	—	—	$37,403.32	$39,184.43	$37,403.32	2026-05-06
140	OTHER	Major Head And Neck Procedures With Mcc	15	11	—	—	$33,082.31	$56,239.92	$37,343.84	2026-05-06
951-4	OTHER	Moderately Extensive O.r. Procedure Unrelated To Principal Diagnosis	3	3	—	—	$37,256.78	$39,030.91	$37,256.78	2026-05-06
303-2	OTHER	Dorsal And Lumbar Fusion Procedure For Curvature Of Back	3	3	—	—	$37,021.58	$38,784.51	$37,021.58	2026-05-06
31	OTHER	Ventricular Shunt Procedures With Mcc	15	11	—	—	$32,780.36	$55,726.62	$37,003.00	2026-05-06
673	OTHER	Other Kidney And Urinary Tract Procedures With Mcc	15	11	—	—	$32,772.54	$55,713.32	$36,994.17	2026-05-06
1593	OTHER	New Technology - Level 42 ($30,001-$40,000)	9	8	—	—	$35,000.50	$70,001.00	$36,750.53	2026-05-06
1579	OTHER	New Technology - Level 42 ($30,001-$40,000)	9	8	—	—	$35,000.50	$70,001.00	$36,750.53	2026-05-06
269	OTHER	Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc	15	11	—	—	$32,546.48	$55,329.01	$36,738.98	2026-05-06
856	OTHER	Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc	24	11	—	—	$24,228.42	$59,995.28	$36,703.00	2026-05-06
050-4	OTHER	Non-bacterial Infections Of Nervous System Except Viral Meningitis	3	3	—	—	$36,647.53	$38,392.65	$36,647.53	2026-05-06
178-2	OTHER	External Heart Assist Systems	3	3	—	—	$36,438.12	$38,173.26	$36,438.12	2026-05-06
710-4	OTHER	Infectious And Parasitic Diseases Including HIV With O.r. Procedure	3	3	—	—	$36,376.15	$38,108.35	$36,376.15	2026-05-06
236	OTHER	Coronary Bypass Without Cardiac Catheterization Without Mcc	15	11	—	—	$32,166.31	$54,682.73	$36,309.84	2026-05-06
958	OTHER	Other O.r. Procedures For Multiple Significant Trauma With Cc	15	11	—	—	$32,148.32	$54,652.14	$36,289.53	2026-05-06
12	OTHER	Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc	15	11	—	—	$32,100.60	$54,571.02	$36,235.67	2026-05-06
448	OTHER	Multiple Level Spinal Fusion Except Cervical Without Mcc	15	11	—	—	$31,942.59	$54,302.40	$36,057.31	2026-05-06
603-3	OTHER	Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition	3	3	—	—	$36,056.83	$37,773.82	$36,056.83	2026-05-06
162-2	OTHER	Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis	3	3	—	—	$35,919.33	$37,629.77	$35,919.33	2026-05-06
423	OTHER	Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc	15	11	—	—	$31,816.65	$54,088.30	$35,915.14	2026-05-06
223-4	OTHER	Other Small And Large Bowel Procedures	3	3	—	—	$35,505.02	$37,195.74	$35,505.02	2026-05-06
C1722	HCPCS	Aicd Inventra Dx	656	9	$129,128.00	$51,651.20 60% off	$11,238.78	$171,520.00	$35,454.85	2026-05-06
691-4	OTHER	Lymphoma, Myeloma And Non-acute Leukemia	3	3	—	—	$35,286.56	$36,966.88	$35,286.56	2026-05-06
901	OTHER	Wound Debridements For Injuries With Mcc	24	11	—	—	$5.09	$58,916.81	$35,176.81	2026-05-06
907	OTHER	Other O.r. Procedures For Injuries With Mcc	15	11	—	—	$31,161.92	$52,975.26	$35,176.07	2026-05-06
008-2	OTHER	Autologous Bone Marrow Transplant Or T-cell Immunotherapy	3	3	—	—	$35,127.81	$36,800.56	$35,127.81	2026-05-06
694-4	OTHER	Lymphatic And Other Malignancies And Neoplasms Of Uncertain Behavior	3	3	—	—	$34,929.25	$36,592.54	$34,929.25	2026-05-06
723-4	OTHER	Viral Illness	3	3	—	—	$34,881.76	$36,542.79	$34,881.76	2026-05-06
628	OTHER	Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc	15	11	—	—	$30,864.67	$52,469.94	$34,840.53	2026-05-06
273	OTHER	Percutaneous And Other Intracardiac Procedures With Mcc	15	11	—	—	$30,587.76	$51,999.19	$34,527.95	2026-05-06
092-4	OTHER	Facial Bone Procedures Except Major Cranial Or Facial Bone Procedures	3	3	—	—	$34,506.80	$36,149.98	$34,506.80	2026-05-06
34	OTHER	Carotid Artery Stent Procedures With Mcc	15	11	—	—	$30,418.79	$51,711.95	$34,337.22	2026-05-06
616	OTHER	Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With…	15	11	—	—	$30,233.40	$51,396.79	$34,127.95	2026-05-06
163-3	OTHER	Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis	3	3	—	—	$34,125.51	$35,750.54	$34,125.51	2026-05-06
904	OTHER	Skin Grafts For Injuries With Cc/mcc	15	11	—	—	$30,202.90	$51,344.93	$34,093.51	2026-05-06
166-4	OTHER	Coronary Bypass Without Ami Or Complex Principal Diagnosis	3	3	—	—	$34,058.12	$35,679.93	$34,058.12	2026-05-06
166	OTHER	Other Respiratory System O.r. Procedures With Mcc	15	11	—	—	$30,118.42	$51,201.31	$33,998.15	2026-05-06
956	OTHER	Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma	15	11	—	—	$29,900.17	$50,830.29	$33,751.79	2026-05-06
661-4	OTHER	Coagulation And Platelet Disorders	3	3	—	—	$33,748.75	$35,355.83	$33,748.75	2026-05-06
5232	OTHER	Level 2 Icd And Similar Procedures	9	8	—	—	$32,061.58	$64,123.16	$33,664.66	2026-05-06
24	OTHER	Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…	15	11	—	—	$29,738.25	$50,555.02	$33,569.01	2026-05-06
178-1	OTHER	External Heart Assist Systems	3	3	—	—	$33,402.28	$34,992.87	$33,402.28	2026-05-06
5166	OTHER	Cochlear Implant Procedure	9	8	—	—	$31,807.82	$63,615.64	$33,398.21	2026-05-06

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