Hospital

UINTAH BASIN MEDICAL CENTER

Roosevelt, UT · CCN 460019 · Rates published

6,671 distinct procedures filed

14 distinct payers

198,598 rate rows

2026-05-14 last MRF observed

Data quality

96,791 of 198,598 rate rows are consumer-grade (48.7%)

101,807 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	100,981
per-diem day rate — not a per-procedure price	777
exceeds 10× this hospital's gross charge — excluded from medians	49

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

Source MRF file	https://apim.services.craneware.com/api-pricing-transparency/api/public/6e8a5a2ffad6b97f31198aa99dbc26b1/charges/mrf
Found on page	https://s46669.pcdn.co/wp-content/uploads/sites/227/2026/05/cms-hpt.txt
Discovered via	CMS hospital list
Last fetch	not_modified · 2026-05-19
Content fingerprint	b17bc34426d79b4a… · 31,980,277 bytes · first seen 2026-05-14

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
018 OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	6	$368,827.47	$368,827.47	$368,827.47	nat. median $424,868 0.9× median
001 OTHER	Heart Transplant Or Implant Of Heart Assist System With Mcc	4	$239,354.18	$239,354.18	$239,354.18	nat. median $263,894 0.9× median
927 OTHER	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	6	$182,356.18	$182,356.18	$182,356.18	nat. median $146,562 1.2× median
003 OTHER	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…	6	$181,285.98	$181,285.98	$181,285.98	nat. median $218,232 0.8× median
004 OTHER	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…	6	$118,305.83	$118,305.83	$118,305.83	nat. median $150,232 0.8× median
007 OTHER	Lung Transplant	3	$110,608.60	$110,608.60	$110,608.60	nat. median $141,082 0.8× median
014 OTHER	Allogeneic Bone Marrow Transplant	4	$102,645.77	$102,645.77	$102,645.77	nat. median $105,808 1.0× median
63685 OTHER	Insertion Of Spinal Neurostimulator Generator Or Receiver	14	$33,298.59	$74,921.82	$74,921.82	nat. median $25,009 outlier · 3.0×
64582 OTHER	Insertion Of Hypoglossal Nerve Neurostimulator Electrode And Generator And Breat…	14	$33,298.59	$116,545.06	$74,921.82	nat. median $28,637 outlier · 2.6×
002 OTHER	Heart Transplant Or Implant Of Heart Assist System Without Mcc	13	$50,824.36	$96,785.73	$50,824.36	nat. median $117,167 outlier · 0.4×
209 OTHER	Complex Aortic Arch Procedures	14	$50,768.85	$96,674.69	$50,768.85	nat. median $23,389 outlier · 2.2×
426 OTHER	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	14	$49,497.94	$94,132.88	$49,497.94	nat. median $80,273 0.6× median
212 OTHER	Concomitant Aortic And Mitral Valve Procedures	14	$48,869.74	$92,876.48	$48,869.74	nat. median $90,581 0.5× median
005 OTHER	Liver Transplant With Mcc Or Intestinal Transplant	12	$46,462.87	$88,062.74	$46,462.87	nat. median $104,489 outlier · 0.4×
215 OTHER	Other Heart Assist System Implant	14	$44,953.23	$85,043.46	$44,953.23	nat. median $92,359 outlier · 0.5×
216 OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	14	$44,209.32	$83,555.63	$44,209.32	nat. median $90,130 outlier · 0.5×
23472 OTHER	Prosthetic Repair Of Shoulder Joint; Total Shoulder	14	$18,920.76	$66,222.66	$42,571.71	nat. median $17,032 outlier · 2.5×
429 OTHER	Combined Anterior And Posterior Cervical Spinal Fusion With Mcc	14	$40,907.32	$76,951.65	$40,907.32	nat. median $62,997 0.6× median
850 OTHER	Acute Leukemia With Other Procedures	14	$39,412.21	$73,961.42	$39,412.21	nat. median $407 outlier · 96.8×
231 OTHER	Coronary Bypass With Ptca With Mcc	14	$38,431.69	$72,000.39	$38,431.69	nat. median $74,989 0.5× median
456 OTHER	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	14	$38,318.53	$71,774.06	$38,318.53	nat. median $76,493 0.5× median
020 OTHER	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc	14	$36,035.50	$67,208.00	$36,035.50	nat. median $82,426 outlier · 0.4×
219 OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	14	$35,221.96	$65,580.93	$35,221.96	nat. median $72,612 outlier · 0.5×
233 OTHER	Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc	14	$35,080.61	$65,298.21	$35,080.61	nat. median $68,249 0.5× median
957 OTHER	Other O.r. Procedures For Multiple Significant Trauma With Mcc	14	$34,972.56	$65,082.12	$34,972.56	nat. median $68,309 0.5× median
427 OTHER	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	14	$33,258.79	$61,654.59	$33,258.79	nat. median $51,811 0.6× median
010 OTHER	Pancreas Transplant	12	$33,075.59	$61,288.18	$33,075.59	nat. median $67,882 outlier · 0.5×
928 OTHER	Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc	14	$33,062.78	$61,262.56	$33,062.78	nat. median $46,003 0.7× median
019 OTHER	Simultaneous Pancreas And Kidney Transplant With Hemodialysis	14	$32,900.07	$60,937.13	$32,900.07	nat. median $67,495 outlier · 0.5×
275 OTHER	Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc	14	$32,882.13	$60,901.26	$32,882.13	nat. median $29,655 1.1× median
870 OTHER	Septicemia Or Severe Sepsis With Mv >96 Hours	14	$31,948.60	$59,034.20	$31,948.60	nat. median $54,564 0.6× median
C1767 OTHER	Generator, Neuro Non-recharg	1	$31,857.30	$31,857.30	$31,857.30	nat. median $23,715 1.3× median
268 OTHER	Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc	14	$31,803.82	$58,744.64	$31,803.82	nat. median $67,670 outlier · 0.5×
C1822 OTHER	Generator; Neurostimulator (implantable); High Frequency; With Rechargeable Batt…	1	$31,471.36	$31,471.36	$31,471.36	nat. median $4,495 outlier · 7.0×
955 OTHER	Craniotomy For Multiple Significant Trauma	14	$31,176.90	$57,490.81	$31,176.90	nat. median $62,467 outlier · 0.5×
28737 OTHER	Fusion Of Upper Part Of Foot And Lengthening Of Tendon	14	$13,854.24	$48,489.84	$31,172.04	nat. median $7,601 outlier · 4.1×
28725 OTHER	Fusion Of Foot Below Ankle	14	$13,854.24	$48,489.84	$31,172.04	nat. median $10,662 outlier · 2.9×
27447 OTHER	Replacement Of Knee Joint; Both Sides Of Knee	14	$13,854.24	$48,489.84	$31,172.04	nat. median $12,698 outlier · 2.5×
28297 OTHER	Correction Of Bunion With Midfoot And Hindfoot Bone Fusion	14	$13,854.24	$48,489.84	$31,172.04	nat. median $6,879 outlier · 4.5×
28730 OTHER	Fusion Of Multiple Foot Joints	14	$13,854.24	$48,489.84	$31,172.04	nat. median $11,523 outlier · 2.7×
317 OTHER	Concomitant Left Atrial Appendage Closure And Cardiac Ablation	14	$30,986.44	$57,109.89	$30,986.44	nat. median $48,503 0.6× median
447 OTHER	Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall…	14	$30,965.51	$57,068.03	$30,965.51	nat. median $54,322 0.6× median
217 OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	14	$30,511.56	$56,160.13	$30,511.56	nat. median $60,727 0.5× median
218 OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	14	$30,511.56	$56,160.13	$30,511.56	nat. median $56,507 0.5× median
573 OTHER	Skin Graft For Skin Ulcer Or Cellulitis With Mcc	14	$30,409.49	$55,955.98	$30,409.49	nat. median $54,881 0.6× median
207 OTHER	Respiratory System Diagnosis With Ventilator Support >96 Hours	14	$29,911.12	$54,959.25	$29,911.12	nat. median $66,849 outlier · 0.4×
266 OTHER	Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc	14	$28,603.06	$52,343.11	$28,603.06	nat. median $58,866 outlier · 0.5×
969 OTHER	HIV With Extensive O.r. Procedures With Mcc	14	$28,572.74	$52,282.48	$28,572.74	nat. median $64,729 outlier · 0.4×
232 OTHER	Coronary Bypass With Ptca Without Mcc	14	$28,322.06	$51,781.12	$28,322.06	nat. median $56,351 0.5× median
028 OTHER	Spinal Procedures With Mcc	14	$28,090.17	$51,317.34	$28,090.17	nat. median $61,887 outlier · 0.5×

Other procedures at this hospital

Browse this hospital's 6,671 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

018	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	6	6	—	—	$368,827.47	$368,827.47	$368,827.47	2026-05-14
001	OTHER	Heart Transplant Or Implant Of Heart Assist System With Mcc	4	4	—	—	$239,354.18	$239,354.18	$239,354.18	2026-05-14
927	OTHER	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	6	6	—	—	$182,356.18	$182,356.18	$182,356.18	2026-05-14
003	OTHER	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…	6	6	—	—	$181,285.98	$181,285.98	$181,285.98	2026-05-14
004	OTHER	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…	6	6	—	—	$118,305.83	$118,305.83	$118,305.83	2026-05-14
007	OTHER	Lung Transplant	3	3	—	—	$110,608.60	$110,608.60	$110,608.60	2026-05-14
014	OTHER	Allogeneic Bone Marrow Transplant	4	4	—	—	$102,645.77	$102,645.77	$102,645.77	2026-05-14
63685	OTHER	Insertion Of Spinal Neurostimulator Generator Or Receiver	20	14	$5,725.00	$5,152.50	$33,298.59	$74,921.82	$74,921.82	2026-05-14
64582	OTHER	Insertion Of Hypoglossal Nerve Neurostimulator Electrode And Generator And Breat…	21	14	$13,600.00	$12,240.00	$33,298.59	$116,545.06	$74,921.82	2026-05-14
002	OTHER	Heart Transplant Or Implant Of Heart Assist System Without Mcc	18	13	—	—	$50,824.36	$96,785.73	$50,824.36	2026-05-14
209	OTHER	Complex Aortic Arch Procedures	21	14	—	—	$50,768.85	$96,674.69	$50,768.85	2026-05-14
426	OTHER	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	21	14	—	—	$49,497.94	$94,132.88	$49,497.94	2026-05-14
212	OTHER	Concomitant Aortic And Mitral Valve Procedures	21	14	—	—	$48,869.74	$92,876.48	$48,869.74	2026-05-14
005	OTHER	Liver Transplant With Mcc Or Intestinal Transplant	17	12	—	—	$46,462.87	$88,062.74	$46,462.87	2026-05-14
215	OTHER	Other Heart Assist System Implant	21	14	—	—	$44,953.23	$85,043.46	$44,953.23	2026-05-14
216	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	21	14	—	—	$44,209.32	$83,555.63	$44,209.32	2026-05-14
23472	OTHER	Prosthetic Repair Of Shoulder Joint; Total Shoulder	22	14	$15,750.00	$14,175.00	$18,920.76	$66,222.66	$42,571.71	2026-05-14
429	OTHER	Combined Anterior And Posterior Cervical Spinal Fusion With Mcc	21	14	—	—	$40,907.32	$76,951.65	$40,907.32	2026-05-14
850	OTHER	Acute Leukemia With Other Procedures	21	14	—	—	$39,412.21	$73,961.42	$39,412.21	2026-05-14
231	OTHER	Coronary Bypass With Ptca With Mcc	21	14	—	—	$38,431.69	$72,000.39	$38,431.69	2026-05-14
456	OTHER	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	21	14	—	—	$38,318.53	$71,774.06	$38,318.53	2026-05-14
020	OTHER	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc	21	14	—	—	$36,035.50	$67,208.00	$36,035.50	2026-05-14
219	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	21	14	—	—	$35,221.96	$65,580.93	$35,221.96	2026-05-14
233	OTHER	Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc	21	14	—	—	$35,080.61	$65,298.21	$35,080.61	2026-05-14
957	OTHER	Other O.r. Procedures For Multiple Significant Trauma With Mcc	21	14	—	—	$34,972.56	$65,082.12	$34,972.56	2026-05-14
427	OTHER	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	21	14	—	—	$33,258.79	$61,654.59	$33,258.79	2026-05-14
010	OTHER	Pancreas Transplant	17	12	—	—	$33,075.59	$61,288.18	$33,075.59	2026-05-14
928	OTHER	Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc	21	14	—	—	$33,062.78	$61,262.56	$33,062.78	2026-05-14
019	OTHER	Simultaneous Pancreas And Kidney Transplant With Hemodialysis	21	14	—	—	$32,900.07	$60,937.13	$32,900.07	2026-05-14
275	OTHER	Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc	21	14	—	—	$32,882.13	$60,901.26	$32,882.13	2026-05-14
870	OTHER	Septicemia Or Severe Sepsis With Mv >96 Hours	21	14	—	—	$31,948.60	$59,034.20	$31,948.60	2026-05-14
C1767	OTHER	Generator, Neuro Non-recharg	1	1	$36,359.00	$32,723.10	$31,857.30	$31,857.30	$31,857.30	2026-05-14
268	OTHER	Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc	21	14	—	—	$31,803.82	$58,744.64	$31,803.82	2026-05-14
C1822	OTHER	Generator; Neurostimulator (implantable); High Frequency; With Rechargeable Batt…	1	1	$34,208.00	$30,787.20	$31,471.36	$31,471.36	$31,471.36	2026-05-14
955	OTHER	Craniotomy For Multiple Significant Trauma	21	14	—	—	$31,176.90	$57,490.81	$31,176.90	2026-05-14
27447	OTHER	Replacement Of Knee Joint; Both Sides Of Knee	44	14	$14,137.50	$12,723.75	$13,854.24	$48,489.84	$31,172.04	2026-05-14
28737	OTHER	Fusion Of Upper Part Of Foot And Lengthening Of Tendon	22	14	$8,412.50	$7,571.25	$13,854.24	$48,489.84	$31,172.04	2026-05-14
28297	OTHER	Correction Of Bunion With Midfoot And Hindfoot Bone Fusion	44	14	$5,845.83	$5,261.24	$13,854.24	$48,489.84	$31,172.04	2026-05-14
28725	OTHER	Fusion Of Foot Below Ankle	22	14	$8,475.00	$7,627.50	$13,854.24	$48,489.84	$31,172.04	2026-05-14
28730	OTHER	Fusion Of Multiple Foot Joints	22	14	$14,675.00	$13,207.50	$13,854.24	$48,489.84	$31,172.04	2026-05-14
317	OTHER	Concomitant Left Atrial Appendage Closure And Cardiac Ablation	21	14	—	—	$30,986.44	$57,109.89	$30,986.44	2026-05-14
447	OTHER	Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall…	21	14	—	—	$30,965.51	$57,068.03	$30,965.51	2026-05-14
217	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	21	14	—	—	$30,511.56	$56,160.13	$30,511.56	2026-05-14
218	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	21	14	—	—	$30,511.56	$56,160.13	$30,511.56	2026-05-14
573	OTHER	Skin Graft For Skin Ulcer Or Cellulitis With Mcc	21	14	—	—	$30,409.49	$55,955.98	$30,409.49	2026-05-14
207	OTHER	Respiratory System Diagnosis With Ventilator Support >96 Hours	21	14	—	—	$29,911.12	$54,959.25	$29,911.12	2026-05-14
266	OTHER	Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc	21	14	—	—	$28,603.06	$52,343.11	$28,603.06	2026-05-14
969	OTHER	HIV With Extensive O.r. Procedures With Mcc	21	14	—	—	$28,572.74	$52,282.48	$28,572.74	2026-05-14
232	OTHER	Coronary Bypass With Ptca Without Mcc	21	14	—	—	$28,322.06	$51,781.12	$28,322.06	2026-05-14
028	OTHER	Spinal Procedures With Mcc	21	14	—	—	$28,090.17	$51,317.34	$28,090.17	2026-05-14
276	OTHER	Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator	21	14	—	—	$28,082.90	$51,302.81	$28,082.90	2026-05-14
457	OTHER	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	21	14	—	—	$27,897.14	$50,931.28	$27,897.14	2026-05-14
790	OTHER	Extreme Immaturity Or Respiratory Distress Syndrome; Neonate	21	14	—	—	$27,813.44	$50,763.87	$27,813.44	2026-05-14
016	OTHER	Autologous Bone Marrow Transplant With Cc/mcc	19	13	—	—	$27,754.51	$50,646.01	$27,754.51	2026-05-14
235	OTHER	Coronary Bypass Without Cardiac Catheterization With Mcc	21	14	—	—	$27,493.58	$50,124.15	$27,493.58	2026-05-14
820	OTHER	Lymphoma And Leukemia With Major O.r. Procedures With Mcc	21	14	—	—	$27,477.35	$50,091.69	$27,477.35	2026-05-14
430	OTHER	Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc	21	14	—	—	$27,060.11	$49,257.22	$27,060.11	2026-05-14
023	OTHER	Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…	21	14	—	—	$26,902.96	$48,942.91	$26,902.96	2026-05-14
213	OTHER	Endovascular Abdominal Aorta With Iliac Branch Procedures	21	14	—	—	$26,803.02	$48,743.04	$26,803.02	2026-05-14
463	OTHER	Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …	21	14	—	—	$26,771.42	$48,679.84	$26,771.42	2026-05-14
428	OTHER	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	21	14	—	—	$26,440.46	$48,017.91	$26,440.46	2026-05-14
008	OTHER	Simultaneous Pancreas And Kidney Transplant	17	12	—	—	$26,366.15	$47,869.30	$26,366.15	2026-05-14
278	OTHER	Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures …	21	14	—	—	$26,202.15	$47,541.30	$26,202.15	2026-05-14
461	OTHER	Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc	21	14	—	—	$26,017.67	$47,172.34	$26,017.67	2026-05-14
834	OTHER	Acute Leukemia With Mcc	21	14	—	—	$25,876.31	$46,889.63	$25,876.31	2026-05-14
405	OTHER	Pancreas, Liver And Shunt Procedures With Mcc	21	14	—	—	$25,793.47	$46,723.95	$25,793.47	2026-05-14
234	OTHER	Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc	21	14	—	—	$25,760.16	$46,657.32	$25,760.16	2026-05-14
011	OTHER	Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc	21	14	—	—	$25,723.44	$46,583.87	$25,723.44	2026-05-14
017	OTHER	Autologous Bone Marrow Transplant Without Cc/mcc	19	13	—	—	$25,630.33	$46,397.67	$25,630.33	2026-05-14
220	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	21	14	—	—	$25,205.42	$45,547.84	$25,205.42	2026-05-14
450	OTHER	Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically …	21	14	—	—	$25,191.76	$45,520.51	$25,191.76	2026-05-14
021	OTHER	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc	21	14	—	—	$25,038.87	$45,214.74	$25,038.87	2026-05-14
270	OTHER	Other Major Cardiovascular Procedures With Mcc	21	14	—	—	$24,964.13	$45,065.27	$24,964.13	2026-05-14
466	OTHER	Revision Of Hip Or Knee Replacement With Mcc	21	14	—	—	$24,661.35	$44,459.69	$24,661.35	2026-05-14
653	OTHER	Major Bladder Procedures With Mcc	21	14	—	—	$24,622.92	$44,382.84	$24,622.92	2026-05-14
221	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	21	14	—	—	$23,955.86	$43,048.72	$23,955.86	2026-05-14
326	OTHER	Stomach, Esophageal And Duodenal Procedures With Mcc	21	14	—	—	$23,730.38	$42,597.75	$23,730.38	2026-05-14
228	OTHER	Other Cardiothoracic Procedures With Mcc	21	14	—	—	$23,559.56	$42,256.11	$23,559.56	2026-05-14
853	OTHER	Infectious & Parasitic Diseases With O.r. Procedure With Comorbity	21	14	—	—	$23,521.97	$42,180.95	$23,521.97	2026-05-14
239	OTHER	Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc	21	14	—	—	$23,449.80	$42,036.60	$23,449.80	2026-05-14
576	OTHER	Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc	21	14	—	—	$23,362.25	$41,861.50	$23,362.25	2026-05-14
471	OTHER	Cervical Spinal Fusion With Mcc	21	14	—	—	$23,052.63	$41,242.27	$23,052.63	2026-05-14
837	OTHER	Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot…	21	14	—	—	$22,948.44	$41,033.88	$22,948.44	2026-05-14
267	OTHER	Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc	21	14	—	—	$22,762.67	$40,662.34	$22,762.67	2026-05-14
650	OTHER	Kidney Transplant With Hemodialysis With Mcc	21	14	—	—	$22,509.00	$40,155.00	$22,509.00	2026-05-14
981	OTHER	Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc	21	14	—	—	$22,468.01	$40,073.02	$22,468.01	2026-05-14
826	OTHER	Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. …	21	14	—	—	$22,408.22	$39,953.43	$22,408.22	2026-05-14
006	OTHER	Liver Transplant Without Mcc	17	12	—	—	$22,233.99	$39,604.97	$22,233.99	2026-05-14
277	OTHER	Cardiac Defibrillator Implant Without Mcc	21	14	—	—	$22,154.97	$39,446.94	$22,154.97	2026-05-14
329	OTHER	Major Small & Large Bowel Procedures With Comorbity	21	14	—	—	$22,061.02	$39,259.04	$22,061.02	2026-05-14
823	OTHER	Lymphoma And Non-acute Leukemia With Other Procedures With Mcc	21	14	—	—	$22,011.06	$39,159.11	$22,011.06	2026-05-14
245	OTHER	Aicd Generator Procedures	21	14	—	—	$21,915.40	$38,967.80	$21,915.40	2026-05-14
856	OTHER	Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc	21	14	—	—	$21,856.90	$38,850.79	$21,856.90	2026-05-14
025	OTHER	Craniotomy And Endovascular Intracranial Procedures With Mcc	21	14	—	—	$21,848.35	$38,833.70	$21,848.35	2026-05-14
799	OTHER	Splenic Procedures With Mcc	21	14	—	—	$21,772.33	$38,681.66	$21,772.33	2026-05-14
163	OTHER	Major Chest Procedures With Mcc	21	14	—	—	$21,571.19	$38,279.38	$21,571.19	2026-05-14
031	OTHER	Ventricular Shunt Procedures With Mcc	21	14	—	—	$21,565.63	$38,268.27	$21,565.63	2026-05-14
319	OTHER	Other Endovascular Cardiac Valve Procedures With Mcc	21	14	—	—	$21,490.47	$38,117.95	$21,490.47	2026-05-14
356	OTHER	Other Digestive System O.r. Procedures With Mcc	21	14	—	—	$21,191.12	$37,519.23	$21,191.12	2026-05-14
323	OTHER	Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc	21	14	—	—	$20,911.83	$36,960.65	$20,911.83	2026-05-14
474	OTHER	Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc	21	14	—	—	$20,764.49	$36,665.99	$20,764.49	2026-05-14
140	OTHER	Major Head And Neck Procedures With Mcc	21	14	—	—	$20,646.62	$36,430.25	$20,646.62	2026-05-14
448	OTHER	Multiple Level Spinal Fusion Except Cervical Without Mcc	21	14	—	—	$20,541.99	$36,220.99	$20,541.99	2026-05-14
269	OTHER	Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc	21	14	—	—	$20,466.83	$36,070.67	$20,466.83	2026-05-14
012	OTHER	Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc	21	14	—	—	$20,436.08	$36,009.17	$20,436.08	2026-05-14
958	OTHER	Other O.r. Procedures For Multiple Significant Trauma With Cc	21	14	—	—	$20,427.12	$35,991.23	$20,427.12	2026-05-14
673	OTHER	Other Kidney And Urinary Tract Procedures With Mcc	21	14	—	—	$20,374.59	$35,886.18	$20,374.59	2026-05-14
901	OTHER	Wound Debridements For Injuries With Mcc	21	14	—	—	$20,353.24	$35,843.47	$20,353.24	2026-05-14
236	OTHER	Coronary Bypass Without Cardiac Catheterization Without Mcc	21	14	—	—	$20,319.92	$35,776.85	$20,319.92	2026-05-14
458	OTHER	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	21	14	—	—	$20,250.74	$35,638.48	$20,250.74	2026-05-14
793	OTHER	Full Term Neonate With Major Problems	21	14	—	—	$20,237.93	$35,612.86	$20,237.93	2026-05-14
423	OTHER	Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc	21	14	—	—	$20,167.04	$35,471.08	$20,167.04	2026-05-14
33210	OTHER	Insert Electrd/pm Cath Sngl	21	14	$16,081.00	$14,472.90	$8,929.99	$31,254.96	$20,092.47	2026-05-14
273	OTHER	Percutaneous And Other Intracardiac Procedures With Mcc	21	14	—	—	$20,049.60	$35,236.21	$20,049.60	2026-05-14
791	OTHER	Prematurity With Major Problems	21	14	—	—	$19,765.61	$34,668.22	$19,765.61	2026-05-14
402	OTHER	Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical	21	14	—	—	$19,601.19	$34,339.39	$19,601.19	2026-05-14
802	OTHER	Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc	21	14	—	—	$19,445.74	$34,028.49	$19,445.74	2026-05-14
024	OTHER	Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…	21	14	—	—	$19,137.42	$33,411.83	$19,137.42	2026-05-14
933	OTHER	Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft	21	14	—	—	$19,061.83	$33,260.65	$19,061.83	2026-05-14
034	OTHER	Carotid Artery Stent Procedures With Mcc	21	14	—	—	$18,961.47	$33,059.93	$18,961.47	2026-05-14
876	OTHER	O.r. Procedures With Principal Diagnosis Of Mental Illness	19	13	—	—	$18,936.69	$33,010.39	$18,936.69	2026-05-14
040	OTHER	Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc	21	14	—	—	$18,920.90	$32,978.79	$18,920.90	2026-05-14
907	OTHER	Other O.r. Procedures For Injuries With Mcc	21	14	—	—	$18,827.37	$32,791.74	$18,827.37	2026-05-14
956	OTHER	Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma	21	14	—	—	$18,501.53	$32,140.05	$18,501.53	2026-05-14
143	OTHER	Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc	21	14	—	—	$18,431.49	$31,999.99	$18,431.49	2026-05-14
166	OTHER	Other Respiratory System O.r. Procedures With Mcc	21	14	—	—	$18,393.49	$31,923.97	$18,393.49	2026-05-14
518	OTHER	Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost…	21	14	—	—	$18,391.78	$31,920.55	$18,391.78	2026-05-14
628	OTHER	Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc	21	14	—	—	$18,346.94	$31,830.87	$18,346.94	2026-05-14
651	OTHER	Kidney Transplant With Hemodialysis Without Mcc	21	14	—	—	$18,257.25	$31,651.50	$18,257.25	2026-05-14
904	OTHER	Skin Grafts For Injuries With Cc/mcc	21	14	—	—	$18,117.61	$31,372.22	$18,117.61	2026-05-14
492	OTHER	Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc	21	14	—	—	$18,111.21	$31,359.42	$18,111.21	2026-05-14
939	OTHER	O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc	21	14	—	—	$17,927.15	$30,991.29	$17,927.15	2026-05-14
495	OTHER	Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit…	21	14	—	—	$17,915.18	$30,967.36	$17,915.18	2026-05-14
332	OTHER	Rectal Resection With Mcc	21	14	—	—	$17,893.83	$30,924.66	$17,893.83	2026-05-14
265	OTHER	Aicd Lead Procedures	21	14	—	—	$17,883.15	$30,903.31	$17,883.15	2026-05-14
097	OTHER	Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc	21	14	—	—	$17,855.82	$30,848.64	$17,855.82	2026-05-14
279	OTHER	Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures …	21	14	—	—	$17,832.76	$30,802.52	$17,832.76	2026-05-14
739	OTHER	Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc…	21	14	—	—	$17,731.98	$30,600.96	$17,731.98	2026-05-14
736	OTHER	Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc	21	14	—	—	$17,696.53	$30,530.06	$17,696.53	2026-05-14
335	OTHER	Peritoneal Adhesiolysis With Mcc	21	14	—	—	$17,681.15	$30,499.31	$17,681.15	2026-05-14
408	OTHER	Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With…	21	14	—	—	$17,658.52	$30,454.04	$17,658.52	2026-05-14
414	OTHER	Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc	21	14	—	—	$17,645.71	$30,428.42	$17,645.71	2026-05-14
622	OTHER	Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor…	21	14	—	—	$17,631.19	$30,399.38	$17,631.19	2026-05-14
271	OTHER	Other Major Cardiovascular Procedures With Cc	21	14	—	—	$17,618.81	$30,374.61	$17,618.81	2026-05-14
20900	OTHER	Removal Of Bone For Graft	19	13	$860.00	$774.00	$7,830.19	$17,617.93	$17,617.93	2026-05-14
27654	OTHER	Secondary Repair Of Ruptured Achilles Tendon	22	14	$4,175.00	$3,757.50	$7,830.19	$27,405.67	$17,617.93	2026-05-14
27659	OTHER	Secondary Repair Of Tendon On Back Of Leg	22	14	$6,800.00	$6,120.00	$6,120.00	$27,405.67	$17,617.93	2026-05-14
27814	OTHER	Treatment Of Both Broken Lower Leg Bones At Ankle	22	14	$13,600.00	$12,240.00	$7,830.19	$27,405.67	$17,617.93	2026-05-14
25652	OTHER	Treatment Of Broken Base Of Forearm Bone On Small Finger Side At Wrist	22	14	$6,262.50	$5,636.25	$5,636.25	$27,405.67	$17,617.93	2026-05-14
27822	OTHER	Treatment Of 3 Broken Lower Leg Bones At Ankle	22	14	$13,600.00	$12,240.00	$7,830.19	$27,405.67	$17,617.93	2026-05-14
28485	OTHER	Treatment Of Broken Midportion Of Foot	22	14	$5,000.00	$4,500.00	$7,830.19	$27,405.66	$17,617.92	2026-05-14
24341	OTHER	Repair Of Tendon Or Muscle Of Upper Arm Or Elbow	22	14	$11,450.00	$10,305.00	$7,830.19	$27,405.66	$17,617.92	2026-05-14
27698	OTHER	Secondary Repair Of Disrupted Collateral Ligament Of Ankle	22	14	$7,337.50	$6,603.75	$6,120.00	$27,405.66	$17,617.92	2026-05-14
28755	OTHER	Fusion Of Big Toe Between Toe Joints	22	14	$9,300.00	$8,370.00	$7,830.19	$27,405.66	$17,617.92	2026-05-14
28238	OTHER	Reconstruction Of Ankle Tendon With Removal Of Extra Ankle Joint Bone	22	14	$9,300.00	$8,370.00	$7,830.19	$27,405.66	$17,617.92	2026-05-14
28740	OTHER	Fusion Of Foot In Midfoot Region	22	14	$11,450.00	$10,305.00	$7,830.19	$27,405.66	$17,617.92	2026-05-14
28298	OTHER	Correction Of Bunion With Alignment Correction Of Big Toe	22	14	$3,458.33	$3,112.50	$7,830.19	$27,405.66	$17,617.92	2026-05-14
23515	OTHER	Treatment Of Broken Collar Bone	22	14	$11,450.00	$10,305.00	$7,830.19	$27,405.66	$17,617.92	2026-05-14
27676	OTHER	Repair Of Dislocated Lower Leg Tendons By Incision Or Partial Removal Of Lower L…	22	14	$7,337.50	$6,603.75	$7,830.19	$27,405.66	$17,617.92	2026-05-14
28750	OTHER	Fusion Of Big Toe At Joint With Foot	66	14	$4,175.00	$3,757.50	$3,757.50	$27,405.67	$17,617.92	2026-05-14
27784	OTHER	Treatment Of Broken Upper Or Middle Part Of Outer Lower Leg Bone	21	14	$5,725.00	$5,152.50	$7,830.19	$27,405.66	$17,617.92	2026-05-14
29827	OTHER	Repair Of Shoulder Rotator Cuff Using An Endoscope	22	14	$6,683.33	$6,015.00	$7,830.19	$27,405.66	$17,617.92	2026-05-14
22514	OTHER	Treatment Of Broken Lower Spine Bone With Placement Of Stabilizing Device	43	14	$12,067.50	$10,860.75	$7,830.19	$27,405.66	$17,617.92	2026-05-14
22513	OTHER	Treatment Of Broken Middle Spine Bone With Placement Of Stabilizing Device Using…	21	14	$5,948.75	$5,353.88	$7,830.19	$27,405.66	$17,617.92	2026-05-14
27524	OTHER	Treatment Of Broken Kneecap With Placement Of Stabilizing Device And/or Removal …	22	14	$11,450.00	$10,305.00	$7,830.19	$27,405.66	$17,617.92	2026-05-14
25608	OTHER	Treatment Of 2 Broken Lower Forearm Bone Pieces On Thumb Side Inside Wrist Joint…	44	14	$8,318.75	$7,486.88	$5,636.25	$27,405.67	$17,617.92	2026-05-14
27829	OTHER	Treatment Of Ligament Tear At Ankle Joint	21	14	$5,725.00	$5,152.50	$7,830.19	$27,405.66	$17,617.92	2026-05-14
27792	OTHER	Treatment Of Broken Outer Lower Leg Bone At Ankle	21	14	$10,375.00	$9,337.50	$7,830.19	$27,405.66	$17,617.92	2026-05-14
28299	OTHER	Correction Of Bunion With 2 Areas Of Realignment	22	14	$10,375.00	$9,337.50	$7,830.19	$27,405.66	$17,617.92	2026-05-14
467	OTHER	Revision Of Hip Or Knee Replacement With Cc	21	14	—	—	$17,491.97	$30,120.94	$17,491.97	2026-05-14
094	OTHER	Bacterial And Tuberculous Infections Of Nervous System With Mcc	21	14	—	—	$17,461.22	$30,059.45	$17,461.22	2026-05-14
252	OTHER	Other Vascular Procedures With Mcc	21	14	—	—	$17,328.42	$29,793.83	$17,328.42	2026-05-14
616	OTHER	Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With…	21	14	—	—	$17,324.57	$29,786.14	$17,324.57	2026-05-14
C1776	OTHER	Joint Device (implantable)	1	1	$13,610.61	$12,249.55	$17,303.26	$17,303.26	$17,303.26	2026-05-14
574	OTHER	Skin Graft For Skin Ulcer Or Cellulitis With Cc	21	14	—	—	$17,256.24	$29,649.48	$17,256.24	2026-05-14
477	OTHER	Biopsies Of Musculoskeletal System And Connective Tissue With Mcc	21	14	—	—	$17,184.50	$29,506.00	$17,184.50	2026-05-14
31267	OTHER	Removal Of Nasal Sinus Tissue Using An Endoscope	22	14	$3,131.25	$2,818.13	$2,818.13	$26,654.98	$17,135.35	2026-05-14
31255	OTHER	Removal Of Nasal Sinus Using An Endoscope	21	14	$2,290.00	$2,061.00	$7,615.71	$17,135.35	$17,135.35	2026-05-14
31253	OTHER	Complete Exam Of Nose And Sinuses Using An Endoscope	22	14	$3,131.25	$2,818.13	$2,818.13	$26,654.98	$17,135.35	2026-05-14
31288	OTHER	Removal Of Sphenoid Nasal Sinus Tissue Using An Endoscope	22	14	$3,131.25	$2,818.13	$2,818.13	$26,654.98	$17,135.35	2026-05-14
31276	OTHER	Exploration Of Nasal Sinus Using An Endoscope	21	14	$2,290.00	$2,061.00	$7,615.71	$17,135.35	$17,135.35	2026-05-14
31257	OTHER	Exam Of Nose And Sinus With Removal Of Nasal Sinus Using An Endoscope	21	14	$2,290.00	$2,061.00	$7,615.71	$17,135.35	$17,135.35	2026-05-14
31254	OTHER	Partial Removal Of Nasal Sinus Using An Endoscope	21	14	$1,860.00	$1,674.00	$7,615.71	$17,135.35	$17,135.35	2026-05-14
359	OTHER	Percutaneous Coronary Atherectomy With Intraluminal Device With Mcc	21	14	—	—	$17,116.17	$29,369.33	$17,116.17	2026-05-14
987	OTHER	Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc	21	14	—	—	$17,072.60	$29,282.20	$17,072.60	2026-05-14
029	OTHER	Spinal Procedures With Cc Or Spinal Neurostimulators	21	14	—	—	$17,000.87	$29,138.74	$17,000.87	2026-05-14
420	OTHER	Hepatobiliary Diagnostic Procedures With Mcc	21	14	—	—	$16,981.64	$29,100.28	$16,981.64	2026-05-14
264	OTHER	Other Circulatory System O.r. Procedures	21	14	—	—	$16,697.65	$28,532.31	$16,697.65	2026-05-14
411	OTHER	Cholecystectomy With C.d.e. With Mcc	21	14	—	—	$16,538.36	$28,213.72	$16,538.36	2026-05-14
037	OTHER	Extracranial Procedures With Mcc	21	14	—	—	$16,490.53	$28,118.07	$16,490.53	2026-05-14
274	OTHER	Percutaneous And Other Intracardiac Procedures Without Mcc	21	14	—	—	$16,488.83	$28,114.66	$16,488.83	2026-05-14
260	OTHER	Cardiac Pacemaker Revision Except Device Replacement With Mcc	21	14	—	—	$16,322.70	$27,782.40	$16,322.70	2026-05-14
579	OTHER	Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc	21	14	—	—	$16,261.64	$27,660.27	$16,261.64	2026-05-14
840	OTHER	Lymphoma And Non-acute Leukemia With Mcc	21	14	—	—	$16,246.26	$27,629.52	$16,246.26	2026-05-14
451	OTHER	Single Level Spinal Fusion Except Cervical Without Mcc	21	14	—	—	$16,227.04	$27,591.08	$16,227.04	2026-05-14
652	OTHER	Kidney Transplant	17	12	—	—	$16,223.20	$27,583.40	$16,223.20	2026-05-14
485	OTHER	Knee Procedures With Principal Diagnosis Of Infection With Mcc	21	14	—	—	$16,212.95	$27,562.90	$16,212.95	2026-05-14
929	OTHER	Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/mcc	21	14	—	—	$16,186.05	$27,509.09	$16,186.05	2026-05-14
325	OTHER	Coronary Intravascular Lithotripsy Without Intraluminal Device	21	14	—	—	$16,141.63	$27,420.26	$16,141.63	2026-05-14
242	OTHER	Permanent Cardiac Pacemaker Implant With Mcc	21	14	—	—	$16,066.47	$27,269.94	$16,066.47	2026-05-14
515	OTHER	Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc	21	14	—	—	$16,041.27	$27,219.54	$16,041.27	2026-05-14
656	OTHER	Kidney And Ureter Procedures For Neoplasm With Mcc	21	14	—	—	$16,028.03	$27,193.07	$16,028.03	2026-05-14
022	OTHER	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/…	21	14	—	—	$16,000.70	$27,138.41	$16,000.70	2026-05-14
500	OTHER	Soft Tissue Procedures With Mcc	21	14	—	—	$15,946.90	$27,030.80	$15,946.90	2026-05-14
829	OTHER	Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce…	21	14	—	—	$15,926.39	$26,989.78	$15,926.39	2026-05-14
324	OTHER	Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc	21	14	—	—	$15,887.96	$26,912.92	$15,887.96	2026-05-14
229	OTHER	Other Cardiothoracic Procedures Without Mcc	21	14	—	—	$15,881.56	$26,900.12	$15,881.56	2026-05-14
258	OTHER	Cardiac Pacemaker Device Replacement With Mcc	21	14	—	—	$15,849.95	$26,836.91	$15,849.95	2026-05-14
665	OTHER	Prostatectomy With Mcc	21	14	—	—	$15,760.70	$26,658.40	$15,760.70	2026-05-14
464	OTHER	Wnd Debrid & Skn Grft Exc Hand; For Musculo-conn Tiss Dis With Complication	21	14	—	—	$15,732.94	$26,602.88	$15,732.94	2026-05-14
44950	OTHER	Removal Of Appendix	21	14	$8,225.00	$7,402.50	$6,985.91	$24,450.68	$15,718.30	2026-05-14
49593	OTHER	Repair Of Anterior Abdominal Hernia(s) (ie; Epigastric; Incisional; Ventral; Umb…	21	14	$9,300.00	$8,370.00	$6,985.91	$24,450.68	$15,718.30	2026-05-14
026	OTHER	Craniotomy And Endovascular Intracranial Procedures With Cc	21	14	—	—	$15,709.45	$26,555.90	$15,709.45	2026-05-14
64628	OTHER	Heat Destruction Of Intraosseous Basivertebral Nerve In Bones Of Spine In Lower …	44	14	$15,671.38	$14,104.24	$4,928.13	$48,489.84	$15,586.02	2026-05-14
662	OTHER	Minor Bladder Procedures With Mcc	21	14	—	—	$15,505.75	$26,148.50	$15,505.75	2026-05-14
263	OTHER	Vein Ligation And Stripping	21	14	—	—	$15,488.24	$26,113.48	$15,488.24	2026-05-14
63650	OTHER	Insertion Of Spinal Neurostimulator Electrode Array Through Skin	21	14	$12,169.00	$10,952.10	$6,877.11	$24,069.88	$15,473.50	2026-05-14
469	OTHER	Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc…	21	14	—	—	$15,384.89	$25,906.77	$15,384.89	2026-05-14
510	OTHER	Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Mcc	21	14	—	—	$15,330.66	$25,798.32	$15,330.66	2026-05-14
625	OTHER	Thyroid, Parathyroid And Thyroglossal Procedures With Mcc	21	14	—	—	$15,328.94	$25,794.89	$15,328.94	2026-05-14
498	OTHER	Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur With Cc…	21	14	—	—	$15,314.85	$25,766.70	$15,314.85	2026-05-14
173	OTHER	Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary…	21	14	—	—	$15,142.33	$25,421.66	$15,142.33	2026-05-14
472	OTHER	Cervical Spinal Fusion With Cc	21	14	—	—	$15,012.92	$25,162.85	$15,012.92	2026-05-14
959	OTHER	Other O.r. Procedures For Multiple Significant Trauma Without Cc/mcc	21	14	—	—	$15,004.38	$25,145.76	$15,004.38	2026-05-14
570	OTHER	Skin Debridement With Mcc	21	14	—	—	$14,991.57	$25,120.14	$14,991.57	2026-05-14
668	OTHER	Transurethral Procedures With Mcc	21	14	—	—	$14,901.47	$24,939.93	$14,901.47	2026-05-14
480	OTHER	Hip And Femur Procedures Except Major Joint With Mcc	21	14	—	—	$14,868.58	$24,874.16	$14,868.58	2026-05-14
353	OTHER	Hernia Procedures Except Inguinal And Femoral With Mcc	21	14	—	—	$14,824.60	$24,786.21	$14,824.60	2026-05-14
406	OTHER	Pancreas, Liver And Shunt Procedures With Cc	21	14	—	—	$14,816.91	$24,770.82	$14,816.91	2026-05-14
619	OTHER	O.r. Procedures For Obesity With Mcc	21	14	—	—	$14,762.25	$24,661.49	$14,762.25	2026-05-14
974	OTHER	HIV With Major Related Condition With Mcc	21	14	—	—	$14,756.27	$24,649.54	$14,756.27	2026-05-14
013	OTHER	Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy Without Cc/mcc	21	14	—	—	$14,738.33	$24,613.67	$14,738.33	2026-05-14
521	OTHER	Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc	21	14	—	—	$14,688.80	$24,514.59	$14,688.80	2026-05-14
58662	OTHER	Destruction Or Removal Of Ovary Or Growth Of Pelvis Using An Endoscope	21	14	$9,300.00	$8,370.00	$6,523.74	$22,833.09	$14,678.42	2026-05-14
43653	OTHER	Creation Of Surgical Opening From Stomach To Skin Using An Endoscope	21	14	$12,525.00	$11,272.50	$6,523.74	$22,833.09	$14,678.42	2026-05-14
49614	OTHER	Repair Of Anterior Abdominal Hernia(s) (ie; Epigastric; Incisional; Ventral; Umb…	21	14	$7,150.00	$6,435.00	$6,523.74	$22,833.09	$14,678.42	2026-05-14
59151	OTHER	Removal Of Ovarian Or Tubal Pregnancy With Removal Of Ovary And/or Tube Using An…	21	14	$11,450.00	$10,305.00	$6,523.74	$22,833.09	$14,678.42	2026-05-14
44970	OTHER	Removal Of Appendix Using An Endoscope	65	14	$7,150.00	$6,435.00	$6,435.00	$22,833.09	$14,678.42	2026-05-14
58671	OTHER	Blockage Of Uterine Tubes By Device Using An Endoscope	43	14	$3,037.50	$2,733.75	$2,880.00	$22,833.09	$14,678.42	2026-05-14
60240	OTHER	Removal Of Thyroid	21	14	$18,975.00	$17,077.50	$6,523.74	$22,833.09	$14,678.42	2026-05-14
49592	OTHER	Repair Of Anterior Abdominal Hernia(s) (ie; Epigastric; Incisional; Ventral; Umb…	21	14	$7,150.00	$6,435.00	$6,435.00	$22,833.09	$14,678.42	2026-05-14
47562	OTHER	Removal Of Gallbladder Using An Endoscope	21	14	$11,450.00	$10,305.00	$6,435.00	$22,833.09	$14,678.42	2026-05-14
47563	OTHER	Removal Of Gallbladder With X-ray Study Of Bile Ducts Using An Endoscope	21	14	$9,300.00	$8,370.00	$6,523.74	$22,833.09	$14,678.42	2026-05-14
49320	OTHER	Diagnostic Exam Of Abdomen Using An Endoscope	21	14	$6,075.00	$5,467.50	$6,523.74	$22,833.09	$14,678.42	2026-05-14
60220	OTHER	Removal Of Thyroid Lobe On Side Of Neck	21	14	$11,450.00	$10,305.00	$6,523.74	$22,833.09	$14,678.42	2026-05-14
58661	OTHER	Removal Of Ovaries And/or Tubes Using An Endoscope	65	14	$7,337.50	$6,603.75	$6,523.74	$22,833.09	$14,678.42	2026-05-14
58550	OTHER	Removal Of Uterus Through Vagina Using An Endoscope; 250.0 G Or Less	21	14	$16,825.00	$15,142.50	$6,523.74	$22,833.09	$14,678.42	2026-05-14
58660	OTHER	Removal Of Scar Tissue Of Ovaries Or Fallopian Tubes Using An Endoscope	21	14	$5,187.50	$4,668.75	$6,523.74	$22,833.09	$14,678.42	2026-05-14
240	OTHER	Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc	21	14	—	—	$14,604.67	$24,346.34	$14,604.67	2026-05-14
800	OTHER	Splenic Procedures With Cc	21	14	—	—	$14,429.15	$23,995.30	$14,429.15	2026-05-14
654	OTHER	Major Bladder Procedures With Cc	21	14	—	—	$14,386.01	$23,909.02	$14,386.01	2026-05-14
60500	OTHER	Removal Or Exploration Of Parathyroid Glands	21	14	$11,450.00	$10,305.00	$6,388.09	$22,358.32	$14,373.20	2026-05-14
30465	OTHER	Repair Of Nasal Passage	21	14	$5,608.34	$5,047.51	$6,388.09	$22,358.32	$14,373.20	2026-05-14
42825	OTHER	Removal Of Tonsils (younger Than 12 Years)	21	14	$3,200.00	$2,880.00	$6,388.09	$22,358.32	$14,373.20	2026-05-14
69706	OTHER	Dilation Of Canal Between Middle Ear And Throat (eustachian Tube) On Both Sides …	21	14	$2,500.00	$2,250.00	$6,388.09	$22,358.32	$14,373.20	2026-05-14
42420	OTHER	Removal Of Growth Of Saliva Gland Or Saliva Gland With Release Of Facial Nerve	22	14	$13,600.00	$12,240.00	$6,388.09	$22,358.32	$14,373.20	2026-05-14
30540	OTHER	Repair Of Nasal Passage Through Nose	22	14	$9,300.00	$8,370.00	$6,388.09	$22,358.32	$14,373.20	2026-05-14
69631	OTHER	Repair Of Eardrum And Ear Canal With Opening To Ear Bones	22	14	$8,412.50	$7,571.25	$6,388.09	$22,358.32	$14,373.20	2026-05-14
42820	OTHER	Removal Of Tonsils And Adenoid Glands (younger Than 12 Years)	21	14	$4,100.00	$3,690.00	$5,467.50	$22,358.31	$14,373.20	2026-05-14
503	OTHER	Foot Procedures With Comorbity	21	14	—	—	$14,351.00	$23,838.99	$14,351.00	2026-05-14
483	OTHER	Major Joint Or Limb Reattachment Procedures Of Upper Extremities	21	14	—	—	$14,269.00	$23,675.01	$14,269.00	2026-05-14
061	OTHER	Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A…	21	14	—	—	$14,205.80	$23,548.59	$14,205.80	2026-05-14
208	OTHER	Respiratory System Diagnosis With Ventilator Support <=96 Hours	21	14	—	—	$14,169.92	$23,476.85	$14,169.92	2026-05-14
468	OTHER	Revision Of Hip Or Knee Replacement Without Cc/mcc	21	14	—	—	$14,166.93	$23,470.86	$14,166.93	2026-05-14
963	OTHER	Other Multiple Significant Trauma With Mcc	21	14	—	—	$14,106.30	$23,349.59	$14,106.30	2026-05-14
321	OTHER	Percutaneous Cardiovascular Procedures With Intraluminal Device With Mcc Or 4+ A…	21	14	—	—	$14,050.77	$23,238.55	$14,050.77	2026-05-14
849	OTHER	Radiotherapy	21	14	—	—	$14,002.52	$23,142.04	$14,002.52	2026-05-14
288	OTHER	Acute And Subacute Endocarditis With Mcc	21	14	—	—	$13,988.43	$23,113.86	$13,988.43	2026-05-14
255	OTHER	Upper Limb & Toe Amputation For Circ System Disorders With Comorbity	21	14	—	—	$13,950.84	$23,038.69	$13,950.84	2026-05-14
462	OTHER	Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without Mcc	21	14	—	—	$13,791.13	$22,719.26	$13,791.13	2026-05-14
577	OTHER	Skin Graft Except For Skin Ulcer Or Cellulitis With Cc	21	14	—	—	$13,751.41	$22,639.82	$13,751.41	2026-05-14
970	OTHER	HIV With Extensive O.r. Procedures Without Mcc	21	14	—	—	$13,694.61	$22,526.22	$13,694.61	2026-05-14
253	OTHER	Other Vascular Procedures With Cc	21	14	—	—	$13,516.10	$22,169.21	$13,516.10	2026-05-14
846	OTHER	Chemotherapy Without Acute Leukemia As Secondary Diagnosis With Mcc	21	14	—	—	$13,502.86	$22,142.73	$13,502.86	2026-05-14
344	OTHER	Minor Small And Large Bowel Procedures With Mcc	21	14	—	—	$13,461.44	$22,059.88	$13,461.44	2026-05-14
095	OTHER	Bacterial And Tuberculous Infections Of Nervous System With Cc	21	14	—	—	$13,446.07	$22,029.13	$13,446.07	2026-05-14
096	OTHER	Bacterial And Tuberculous Infections Of Nervous System Without Cc/mcc	21	14	—	—	$13,446.07	$22,029.13	$13,446.07	2026-05-14
749	OTHER	Other Female Reproductive System O.r. Procedures With Cc/mcc	21	14	—	—	$13,396.52	$21,930.05	$13,396.52	2026-05-14
272	OTHER	Other Major Cardiovascular Procedures Without Cc/mcc	21	14	—	—	$13,334.18	$21,805.36	$13,334.18	2026-05-14
659	OTHER	Kidney And Ureter Procedures For Non-neoplasm With Mcc	21	14	—	—	$13,282.50	$21,702.01	$13,282.50	2026-05-14
493	OTHER	Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Cc	21	14	—	—	$13,262.00	$21,661.01	$13,262.00	2026-05-14
164	OTHER	Major Chest Procedures With Cc	21	14	—	—	$13,210.33	$21,557.66	$13,210.33	2026-05-14
027	OTHER	Craniotomy And Endovascular Intracranial Procedures Without Cc/mcc	21	14	—	—	$13,205.64	$21,548.27	$13,205.64	2026-05-14
350	OTHER	Inguinal And Femoral Hernia Procedures With Mcc	21	14	—	—	$13,073.25	$21,283.50	$13,073.25	2026-05-14
545	OTHER	Connective Tissue Disorders With Mcc	21	14	—	—	$13,029.69	$21,196.38	$13,029.69	2026-05-14
52353	OTHER	Crushing Of Stone Of Ureter Using An Endoscope	22	14	$3,575.00	$3,217.50	$5,785.92	$20,250.72	$13,018.32	2026-05-14
52601	OTHER	Removal Of Prostate Gland Using An Electrocautery Knife Through Urethra With Con…	21	14	$10,375.00	$9,337.50	$5,785.92	$20,250.72	$13,018.32	2026-05-14
52356	OTHER	Crushing Of Stone Of Ureter With Insertion Of Stent Using An Endoscope	88	14	$8,225.00	$7,402.50	$5,467.50	$20,250.72	$13,018.32	2026-05-14
478	OTHER	Biopsies Of Musculoskeletal System And Connective Tissue With Cc	21	14	—	—	$12,933.60	$21,004.20	$12,933.60	2026-05-14
982	OTHER	Extensive O.r. Procedures Unrelated To Principal Diagnosis With Cc	21	14	—	—	$12,930.62	$20,998.24	$12,930.62	2026-05-14
66991	OTHER	Extracapsular Removal Of Cataract With Insertion Of Artificial Lens And Insertio…	22	14	$3,200.00	$2,880.00	$5,742.23	$20,097.80	$12,920.01	2026-05-14
783	OTHER	Cesarean Section With Sterilization With Comorbity	21	14	—	—	$12,916.09	$20,969.19	$12,916.09	2026-05-14
792	OTHER	Prematurity Without Major Problems	21	14	—	—	$1,300.00	$20,918.78	$12,890.89	2026-05-14
327	OTHER	Stomach, Esophageal And Duodenal Procedures With Cc	21	14	—	—	$12,869.55	$20,876.10	$12,869.55	2026-05-14
473	OTHER	Cervical Spinal Fusion Without Cc/mcc	21	14	—	—	$12,857.17	$20,851.33	$12,857.17	2026-05-14
318	OTHER	Percutaneous Coronary Atherectomy Without Intraluminal Device	21	14	—	—	$12,775.59	$20,688.19	$12,775.59	2026-05-14
360	OTHER	Percutaneous Coronary Atherectomy With Intraluminal Device Without Mcc	21	14	—	—	$12,741.85	$20,620.71	$12,741.85	2026-05-14
320	OTHER	Other Endovascular Cardiac Valve Procedures Without Mcc	21	14	—	—	$12,703.42	$20,543.85	$12,703.42	2026-05-14
330	OTHER	Major Small And Large Bowel Procedures With Cc	21	14	—	—	$12,672.07	$20,481.13	$12,672.07	2026-05-14
397	OTHER	Appendix Procedures With Mcc	21	14	—	—	$12,663.49	$20,463.97	$12,663.49	2026-05-14

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