|
583-4
|
OTHER
|
Neonate With Ecmo
|
8
|
7
|
—
|
—
|
$552,172.00
|
$590,825.00
|
$552,172.00
|
2026-05-06
|
|
589-1
|
OTHER
|
Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …
|
8
|
7
|
—
|
—
|
$505,693.00
|
$541,091.00
|
$505,693.00
|
2026-05-06
|
|
589-2
|
OTHER
|
Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …
|
8
|
7
|
—
|
—
|
$487,801.00
|
$521,947.00
|
$487,801.00
|
2026-05-06
|
|
583-3
|
OTHER
|
Neonate With Ecmo
|
8
|
7
|
—
|
—
|
$485,003.00
|
$518,953.00
|
$485,003.00
|
2026-05-06
|
|
18
|
OTHER
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
9
|
5
|
—
|
—
|
$307,518.00
|
$494,833.00
|
$424,612.00
|
2026-05-06
|
|
588-4
|
OTHER
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
8
|
7
|
—
|
—
|
$390,096.00
|
$417,403.00
|
$390,096.00
|
2026-05-06
|
|
161-4
|
OTHER
|
Implantable Heart Assist Systems
|
8
|
7
|
—
|
—
|
$377,813.00
|
$404,260.00
|
$377,813.00
|
2026-05-06
|
|
630-4
|
OTHER
|
Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure
|
8
|
7
|
—
|
—
|
$341,938.00
|
$365,873.00
|
$341,938.00
|
2026-05-06
|
|
583-2
|
OTHER
|
Neonate With Ecmo
|
8
|
7
|
—
|
—
|
$333,714.00
|
$357,074.00
|
$333,714.00
|
2026-05-06
|
|
609-4
|
OTHER
|
Neonate Birth Weight 1500-2499 Grams With Major Procedure
|
8
|
7
|
—
|
—
|
$326,416.00
|
$349,265.00
|
$326,416.00
|
2026-05-06
|
|
841-4
|
OTHER
|
Extensive Third Degree Burns With Skin Graft
|
8
|
7
|
—
|
—
|
$320,170.00
|
$342,582.00
|
$320,170.00
|
2026-05-06
|
|
1
|
OTHER
|
Heart Transplant Or Implant Of Heart Assist System With Mcc
|
10
|
6
|
—
|
—
|
$229,690.00
|
$369,600.00
|
$314,303.00
|
2026-05-06
|
|
011-4
|
OTHER
|
Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies
|
8
|
7
|
—
|
—
|
$304,162.00
|
$325,453.00
|
$304,162.00
|
2026-05-06
|
|
160-4
|
OTHER
|
Major Cardiothoracic Repair Of Heart Anomaly
|
8
|
7
|
—
|
—
|
$303,465.00
|
$324,707.00
|
$303,465.00
|
2026-05-06
|
|
591-4
|
OTHER
|
Neonate Birth Weight 500-749 Grams Without Major Procedure
|
8
|
7
|
—
|
—
|
$288,453.00
|
$308,645.00
|
$288,453.00
|
2026-05-06
|
|
631-4
|
OTHER
|
Neonate Birth Weight > 2499 Grams With Other Major Procedure
|
8
|
7
|
—
|
—
|
$272,740.00
|
$291,832.00
|
$272,740.00
|
2026-05-06
|
|
593-4
|
OTHER
|
Neonate Birth Weight 750-999 Grams Without Major Procedure
|
8
|
7
|
—
|
—
|
$251,808.00
|
$269,434.00
|
$251,808.00
|
2026-05-06
|
|
3
|
OTHER
|
Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…
|
9
|
5
|
—
|
—
|
$174,758.00
|
$281,207.00
|
$245,716.00
|
2026-05-06
|
|
927
|
OTHER
|
Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft
|
9
|
5
|
—
|
—
|
$164,000.00
|
$335,125.00
|
$237,610.00
|
2026-05-06
|
|
009-4
|
OTHER
|
Extracorporeal Membrane Oxygenation (ecmo)
|
8
|
7
|
—
|
—
|
$228,525.00
|
$244,522.00
|
$228,525.00
|
2026-05-06
|
|
589-3
|
OTHER
|
Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …
|
8
|
7
|
—
|
—
|
$226,706.00
|
$242,576.00
|
$226,706.00
|
2026-05-06
|
|
603-4
|
OTHER
|
Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition
|
8
|
7
|
—
|
—
|
$225,266.00
|
$241,034.00
|
$225,266.00
|
2026-05-06
|
|
004-4
|
OTHER
|
Tracheostomy With Mv >96 Hours With Extensive Procedure
|
8
|
7
|
—
|
—
|
$219,311.00
|
$234,662.00
|
$219,311.00
|
2026-05-06
|
|
583-1
|
OTHER
|
Neonate With Ecmo
|
8
|
7
|
—
|
—
|
$208,882.00
|
$223,504.00
|
$208,882.00
|
2026-05-06
|
|
792-4
|
OTHER
|
Extensive O.r. Procedures For Other Complications Of Treatment
|
8
|
7
|
—
|
—
|
$187,791.00
|
$200,936.00
|
$187,791.00
|
2026-05-06
|
|
161-3
|
OTHER
|
Implantable Heart Assist Systems
|
8
|
7
|
—
|
—
|
$183,215.00
|
$196,040.00
|
$183,215.00
|
2026-05-06
|
|
161-2
|
OTHER
|
Implantable Heart Assist Systems
|
8
|
7
|
—
|
—
|
$178,872.00
|
$191,393.00
|
$178,872.00
|
2026-05-06
|
|
593-3
|
OTHER
|
Neonate Birth Weight 750-999 Grams Without Major Procedure
|
8
|
7
|
—
|
—
|
$173,619.00
|
$185,772.00
|
$173,619.00
|
2026-05-06
|
|
680-4
|
OTHER
|
Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms
|
8
|
7
|
—
|
—
|
$172,870.00
|
$184,971.00
|
$172,870.00
|
2026-05-06
|
|
011-3
|
OTHER
|
Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies
|
8
|
7
|
—
|
—
|
$172,840.00
|
$184,939.00
|
$172,840.00
|
2026-05-06
|
|
681-4
|
OTHER
|
Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms
|
8
|
7
|
—
|
—
|
$170,645.00
|
$182,591.00
|
$170,645.00
|
2026-05-06
|
|
161-1
|
OTHER
|
Implantable Heart Assist Systems
|
8
|
7
|
—
|
—
|
$169,889.00
|
$181,781.00
|
$169,889.00
|
2026-05-06
|
|
602-4
|
OTHER
|
Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…
|
8
|
7
|
—
|
—
|
$169,884.00
|
$181,776.00
|
$169,884.00
|
2026-05-06
|
|
591-3
|
OTHER
|
Neonate Birth Weight 500-749 Grams Without Major Procedure
|
8
|
7
|
—
|
—
|
$169,377.00
|
$181,233.00
|
$169,377.00
|
2026-05-06
|
|
4
|
OTHER
|
Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…
|
9
|
5
|
—
|
—
|
$115,219.00
|
$186,896.00
|
$166,935.00
|
2026-05-06
|
|
005-4
|
OTHER
|
Tracheostomy With Mv >96 Hours Without Extensive Procedure
|
8
|
7
|
—
|
—
|
$159,852.00
|
$171,042.00
|
$159,852.00
|
2026-05-06
|
|
842-4
|
OTHER
|
Burns With Skin Graft Except Extensive Third Degree Burns
|
8
|
7
|
—
|
—
|
$157,794.00
|
$168,840.00
|
$157,794.00
|
2026-05-06
|
|
609-3
|
OTHER
|
Neonate Birth Weight 1500-2499 Grams With Major Procedure
|
8
|
7
|
—
|
—
|
$157,695.00
|
$168,733.00
|
$157,695.00
|
2026-05-06
|
|
602-3
|
OTHER
|
Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…
|
8
|
7
|
—
|
—
|
$153,668.00
|
$164,425.00
|
$153,668.00
|
2026-05-06
|
|
J7330
|
OTHER
|
Cultured Chondrocytes Implnt
|
1
|
1
|
—
|
—
|
$144,921.00
|
$144,921.00
|
$144,921.00
|
2026-05-06
|
|
588-3
|
OTHER
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
8
|
7
|
—
|
—
|
$143,836.00
|
$153,904.00
|
$143,836.00
|
2026-05-06
|
|
7
|
OTHER
|
Lung Transplant
|
9
|
5
|
—
|
—
|
$106,566.00
|
$171,477.00
|
$141,370.00
|
2026-05-06
|
|
630-3
|
OTHER
|
Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure
|
8
|
7
|
—
|
—
|
$141,046.00
|
$150,919.00
|
$141,046.00
|
2026-05-06
|
|
591-2
|
OTHER
|
Neonate Birth Weight 500-749 Grams Without Major Procedure
|
8
|
7
|
—
|
—
|
$139,860.00
|
$149,650.00
|
$139,860.00
|
2026-05-06
|
|
588-1
|
OTHER
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
8
|
7
|
—
|
—
|
$137,827.00
|
$147,475.00
|
$137,827.00
|
2026-05-06
|
|
588-2
|
OTHER
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
8
|
7
|
—
|
—
|
$137,827.00
|
$147,475.00
|
$137,827.00
|
2026-05-06
|
|
607-4
|
OTHER
|
Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…
|
8
|
7
|
—
|
—
|
$133,248.00
|
$142,575.00
|
$133,248.00
|
2026-05-06
|
|
14
|
OTHER
|
Allogeneic Bone Marrow Transplant
|
9
|
5
|
—
|
—
|
$106,835.00
|
$171,910.00
|
$132,087.00
|
2026-05-06
|
|
613-4
|
OTHER
|
Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection
|
8
|
7
|
—
|
—
|
$126,247.00
|
$135,085.00
|
$126,247.00
|
2026-05-06
|
|
612-4
|
OTHER
|
Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other…
|
8
|
7
|
—
|
—
|
$124,630.00
|
$133,354.00
|
$124,630.00
|
2026-05-06
|
|
212
|
OTHER
|
Concomitant Aortic And Mitral Valve Procedures
|
9
|
5
|
—
|
—
|
$88,831.00
|
$142,939.00
|
$124,132.00
|
2026-05-06
|
|
440-4
|
OTHER
|
Kidney Transplant
|
8
|
7
|
—
|
—
|
$120,871.00
|
$129,332.00
|
$120,871.00
|
2026-05-06
|
|
426
|
OTHER
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
9
|
5
|
—
|
—
|
$85,475.00
|
$137,540.00
|
$120,800.00
|
2026-05-06
|
|
011-2
|
OTHER
|
Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies
|
8
|
7
|
—
|
—
|
$120,114.00
|
$128,522.00
|
$120,114.00
|
2026-05-06
|
|
5
|
OTHER
|
Liver Transplant With Mcc Or Intestinal Transplant
|
9
|
5
|
—
|
—
|
$86,837.00
|
$139,731.00
|
$119,284.00
|
2026-05-06
|
|
215
|
OTHER
|
Other Heart Assist System Implant
|
10
|
6
|
—
|
—
|
$86,393.00
|
$191,833.00
|
$118,476.50
|
2026-05-06
|
|
440-3
|
OTHER
|
Kidney Transplant
|
8
|
7
|
—
|
—
|
$118,080.00
|
$126,346.00
|
$118,080.00
|
2026-05-06
|
|
593-2
|
OTHER
|
Neonate Birth Weight 750-999 Grams Without Major Procedure
|
8
|
7
|
—
|
—
|
$117,659.00
|
$125,895.00
|
$117,659.00
|
2026-05-06
|
|
2
|
OTHER
|
Heart Transplant Or Implant Of Heart Assist System Without Mcc
|
10
|
6
|
—
|
—
|
$76,686.00
|
$177,026.00
|
$117,251.50
|
2026-05-06
|
|
004-3
|
OTHER
|
Tracheostomy With Mv >96 Hours With Extensive Procedure
|
8
|
7
|
—
|
—
|
$117,142.00
|
$125,342.00
|
$117,142.00
|
2026-05-06
|
|
850-4
|
OTHER
|
Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal…
|
8
|
7
|
—
|
—
|
$117,109.00
|
$125,307.00
|
$117,109.00
|
2026-05-06
|
|
631-3
|
OTHER
|
Neonate Birth Weight > 2499 Grams With Other Major Procedure
|
8
|
7
|
—
|
—
|
$116,868.00
|
$125,049.00
|
$116,868.00
|
2026-05-06
|
|
602-2
|
OTHER
|
Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…
|
8
|
7
|
—
|
—
|
$115,976.00
|
$124,094.00
|
$115,976.00
|
2026-05-06
|
|
303-4
|
OTHER
|
Dorsal And Lumbar Fusion Procedure For Curvature Of Back
|
8
|
7
|
—
|
—
|
$115,463.00
|
$123,546.00
|
$115,463.00
|
2026-05-06
|
|
216
|
OTHER
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
11
|
7
|
—
|
—
|
$78,697.00
|
$126,877.00
|
$113,280.00
|
2026-05-06
|
|
603-3
|
OTHER
|
Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition
|
8
|
7
|
—
|
—
|
$112,507.00
|
$120,383.00
|
$112,507.00
|
2026-05-06
|
|
009-3
|
OTHER
|
Extracorporeal Membrane Oxygenation (ecmo)
|
8
|
7
|
—
|
—
|
$110,666.00
|
$118,413.00
|
$110,666.00
|
2026-05-06
|
|
690-4
|
OTHER
|
Acute Leukemia
|
8
|
7
|
—
|
—
|
$109,336.00
|
$116,989.00
|
$109,336.00
|
2026-05-06
|
|
162-4
|
OTHER
|
Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis
|
8
|
7
|
—
|
—
|
$109,199.00
|
$116,843.00
|
$109,199.00
|
2026-05-06
|
|
863-4
|
OTHER
|
Neonatal Aftercare
|
8
|
7
|
—
|
—
|
$108,047.00
|
$115,610.00
|
$108,047.00
|
2026-05-06
|
|
841-3
|
OTHER
|
Extensive Third Degree Burns With Skin Graft
|
8
|
7
|
—
|
—
|
$106,982.00
|
$114,471.00
|
$106,982.00
|
2026-05-06
|
|
611-4
|
OTHER
|
Neonate Birth Weight 1500-1999 Grams With Major Anomaly
|
8
|
7
|
—
|
—
|
$106,957.00
|
$114,444.00
|
$106,957.00
|
2026-05-06
|
|
910-4
|
OTHER
|
Craniotomy For Multiple Significant Trauma
|
8
|
7
|
—
|
—
|
$106,606.00
|
$114,068.00
|
$106,606.00
|
2026-05-06
|
|
850
|
OTHER
|
Acute Leukemia With Other Procedures
|
9
|
5
|
—
|
—
|
$75,116.00
|
$120,871.00
|
$106,160.00
|
2026-05-06
|
|
630-2
|
OTHER
|
Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure
|
8
|
7
|
—
|
—
|
$105,204.00
|
$112,568.00
|
$105,204.00
|
2026-05-06
|
|
312-4
|
OTHER
|
Skin Graft, Except Hand, For Musculoskeletal And Connective Tissue Diagnoses
|
8
|
7
|
—
|
—
|
$103,669.00
|
$110,926.00
|
$103,669.00
|
2026-05-06
|
|
304-4
|
OTHER
|
Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back
|
8
|
7
|
—
|
—
|
$101,443.00
|
$108,544.00
|
$101,443.00
|
2026-05-06
|
|
004-2
|
OTHER
|
Tracheostomy With Mv >96 Hours With Extensive Procedure
|
8
|
7
|
—
|
—
|
$100,971.00
|
$108,038.00
|
$100,971.00
|
2026-05-06
|
|
625-4
|
OTHER
|
Neonate Birth Weight 2000-2499 Grams With Other Significant Condition
|
8
|
7
|
—
|
—
|
$100,944.00
|
$108,010.00
|
$100,944.00
|
2026-05-06
|
|
591-1
|
OTHER
|
Neonate Birth Weight 500-749 Grams Without Major Procedure
|
8
|
7
|
—
|
—
|
$100,838.00
|
$107,897.00
|
$100,838.00
|
2026-05-06
|
|
020-4
|
OTHER
|
Open Craniotomy For Trauma
|
8
|
7
|
—
|
—
|
$100,663.00
|
$107,709.00
|
$100,663.00
|
2026-05-06
|
|
890-4
|
OTHER
|
HIV With Multiple Major HIV Related Conditions
|
8
|
7
|
—
|
—
|
$100,566.00
|
$107,606.00
|
$100,566.00
|
2026-05-06
|
|
607-3
|
OTHER
|
Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…
|
8
|
7
|
—
|
—
|
$99,232.00
|
$106,179.00
|
$99,232.00
|
2026-05-06
|
|
A9699
|
OTHER
|
Radiopharm Rx Agent Noc
|
1
|
1
|
—
|
—
|
$98,421.00
|
$98,421.00
|
$98,421.00
|
2026-05-06
|
|
456
|
OTHER
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
11
|
7
|
—
|
—
|
$69,059.00
|
$124,514.00
|
$98,388.00
|
2026-05-06
|
|
633-4
|
OTHER
|
Neonate Birth Weight > 2499 Grams With Major Anomaly
|
8
|
7
|
—
|
—
|
$96,981.00
|
$103,770.00
|
$96,981.00
|
2026-05-06
|
|
429
|
OTHER
|
Combined Anterior And Posterior Cervical Spinal Fusion With Mcc
|
9
|
5
|
—
|
—
|
$68,011.00
|
$109,437.00
|
$96,119.00
|
2026-05-06
|
|
163-4
|
OTHER
|
Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis
|
8
|
7
|
—
|
—
|
$96,111.00
|
$102,839.00
|
$96,111.00
|
2026-05-06
|
|
440-2
|
OTHER
|
Kidney Transplant
|
8
|
7
|
—
|
—
|
$95,587.00
|
$102,278.00
|
$95,587.00
|
2026-05-06
|
|
608-4
|
OTHER
|
Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition
|
8
|
7
|
—
|
—
|
$95,512.00
|
$102,198.00
|
$95,512.00
|
2026-05-06
|
|
20
|
OTHER
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc
|
9
|
5
|
—
|
—
|
$65,731.00
|
$107,464.00
|
$95,235.00
|
2026-05-06
|
|
231
|
OTHER
|
Coronary Bypass With Ptca With Mcc
|
11
|
7
|
—
|
—
|
$69,099.00
|
$111,188.00
|
$93,799.00
|
2026-05-06
|
|
361-4
|
OTHER
|
Skin Graft For Skin And Subcutaneous Tissue Diagnoses
|
8
|
7
|
—
|
—
|
$93,037.00
|
$99,549.00
|
$93,037.00
|
2026-05-06
|
|
19
|
OTHER
|
Simultaneous Pancreas And Kidney Transplant With Hemodialysis
|
9
|
5
|
—
|
—
|
$64,640.00
|
$104,014.00
|
$92,125.00
|
2026-05-06
|
|
621-4
|
OTHER
|
Neonate Birth Weight 2000-2499 Grams With Major Anomaly
|
8
|
7
|
—
|
—
|
$91,966.00
|
$98,404.00
|
$91,966.00
|
2026-05-06
|
|
950-4
|
OTHER
|
Extensive O.r. Procedure Unrelated To Principal Diagnosis
|
8
|
7
|
—
|
—
|
$91,756.00
|
$98,179.00
|
$91,756.00
|
2026-05-06
|
|
005-3
|
OTHER
|
Tracheostomy With Mv >96 Hours Without Extensive Procedure
|
8
|
7
|
—
|
—
|
$91,670.00
|
$98,087.00
|
$91,670.00
|
2026-05-06
|
|
177-4
|
OTHER
|
Cardiac Pacemaker And Defibrillator Revision Except Device Replacement
|
8
|
7
|
—
|
—
|
$90,314.00
|
$96,636.00
|
$90,314.00
|
2026-05-06
|
|
233
|
OTHER
|
Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc
|
11
|
7
|
—
|
—
|
$63,736.00
|
$102,559.00
|
$89,890.00
|
2026-05-06
|
|
651-4
|
OTHER
|
Other Procedures Of Blood And Blood-forming Organs
|
8
|
7
|
—
|
—
|
$89,713.00
|
$95,993.00
|
$89,713.00
|
2026-05-06
|
|
219
|
OTHER
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
9
|
5
|
—
|
—
|
$63,093.00
|
$101,525.00
|
$88,872.00
|
2026-05-06
|
|
441-4
|
OTHER
|
Major Bladder Procedures
|
8
|
7
|
—
|
—
|
$88,072.00
|
$94,237.00
|
$88,072.00
|
2026-05-06
|
|
183-4
|
OTHER
|
Percutaneous Structural Cardiac Procedures
|
8
|
7
|
—
|
—
|
$86,948.00
|
$93,034.00
|
$86,948.00
|
2026-05-06
|
|
162-3
|
OTHER
|
Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis
|
8
|
7
|
—
|
—
|
$86,619.00
|
$92,683.00
|
$86,619.00
|
2026-05-06
|
|
169-4
|
OTHER
|
Major Abdominal Vascular Procedures
|
8
|
7
|
—
|
—
|
$85,509.00
|
$91,494.00
|
$85,509.00
|
2026-05-06
|
|
911-4
|
OTHER
|
Extensive Abdominal Or Thoracic Procedures For Multiple Significant Trauma
|
8
|
7
|
—
|
—
|
$84,636.00
|
$90,560.00
|
$84,636.00
|
2026-05-06
|
|
167-4
|
OTHER
|
Other Cardiothoracic And Thoracic Vascular Procedures
|
8
|
7
|
—
|
—
|
$83,956.00
|
$89,833.00
|
$83,956.00
|
2026-05-06
|
|
614-4
|
OTHER
|
Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition
|
8
|
7
|
—
|
—
|
$83,608.00
|
$89,461.00
|
$83,608.00
|
2026-05-06
|
|
957
|
OTHER
|
Other O.r. Procedures For Multiple Significant Trauma With Mcc
|
9
|
5
|
—
|
—
|
$60,865.00
|
$97,939.00
|
$83,355.00
|
2026-05-06
|
|
130-4
|
OTHER
|
Respiratory System Diagnosis With Ventilator Support > 96 Hours
|
8
|
7
|
—
|
—
|
$82,828.00
|
$88,626.00
|
$82,828.00
|
2026-05-06
|
|
023-4
|
OTHER
|
Spinal Procedures
|
8
|
7
|
—
|
—
|
$81,924.00
|
$87,658.00
|
$81,924.00
|
2026-05-06
|
|
427
|
OTHER
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
9
|
5
|
—
|
—
|
$57,888.00
|
$93,149.00
|
$81,813.00
|
2026-05-06
|
|
275
|
OTHER
|
Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc
|
10
|
6
|
—
|
—
|
$57,626.00
|
$92,986.00
|
$81,605.00
|
2026-05-06
|
|
612-3
|
OTHER
|
Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other…
|
8
|
7
|
—
|
—
|
$81,573.00
|
$87,283.00
|
$81,573.00
|
2026-05-06
|
|
120-4
|
OTHER
|
Major Respiratory And Chest Procedures
|
8
|
7
|
—
|
—
|
$81,503.00
|
$87,208.00
|
$81,503.00
|
2026-05-06
|
|
178-4
|
OTHER
|
External Heart Assist Systems
|
8
|
7
|
—
|
—
|
$81,223.00
|
$86,909.00
|
$81,223.00
|
2026-05-06
|
|
401-4
|
OTHER
|
Adrenal Procedures
|
8
|
7
|
—
|
—
|
$81,170.00
|
$86,852.00
|
$81,170.00
|
2026-05-06
|
|
230-4
|
OTHER
|
Major Small Bowel Procedures
|
8
|
7
|
—
|
—
|
$81,014.00
|
$86,685.00
|
$81,014.00
|
2026-05-06
|
|
091-4
|
OTHER
|
Other Major Head And Neck Procedures
|
8
|
7
|
—
|
—
|
$80,889.00
|
$86,551.00
|
$80,889.00
|
2026-05-06
|
|
870
|
OTHER
|
Septicemia Or Severe Sepsis With Mv >96 Hours
|
9
|
5
|
—
|
—
|
$56,729.00
|
$91,283.00
|
$80,270.00
|
2026-05-06
|
|
027-4
|
OTHER
|
Other Open Craniotomy
|
8
|
7
|
—
|
—
|
$80,169.00
|
$85,781.00
|
$80,169.00
|
2026-05-06
|
|
912-4
|
OTHER
|
Musculoskeletal And Other Procedures For Multiple Significant Trauma
|
8
|
7
|
—
|
—
|
$79,710.00
|
$85,289.00
|
$79,710.00
|
2026-05-06
|
|
021-4
|
OTHER
|
Open Craniotomy Except Trauma
|
8
|
7
|
—
|
—
|
$79,289.00
|
$84,839.00
|
$79,289.00
|
2026-05-06
|
|
928
|
OTHER
|
Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc
|
9
|
5
|
—
|
—
|
$54,462.00
|
$87,977.00
|
$78,906.00
|
2026-05-06
|
|
268
|
OTHER
|
Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc
|
11
|
7
|
—
|
—
|
$54,369.00
|
$100,185.00
|
$78,773.00
|
2026-05-06
|
|
004-1
|
OTHER
|
Tracheostomy With Mv >96 Hours With Extensive Procedure
|
8
|
7
|
—
|
—
|
$78,126.00
|
$83,595.00
|
$78,126.00
|
2026-05-06
|
|
092-4
|
OTHER
|
Facial Bone Procedures Except Major Cranial Or Facial Bone Procedures
|
8
|
7
|
—
|
—
|
$77,451.00
|
$82,873.00
|
$77,451.00
|
2026-05-06
|
|
447
|
OTHER
|
Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall…
|
9
|
5
|
—
|
—
|
$54,671.00
|
$87,973.00
|
$77,266.00
|
2026-05-06
|
|
005-2
|
OTHER
|
Tracheostomy With Mv >96 Hours Without Extensive Procedure
|
8
|
7
|
—
|
—
|
$77,256.00
|
$82,664.00
|
$77,256.00
|
2026-05-06
|
|
178-3
|
OTHER
|
External Heart Assist Systems
|
8
|
7
|
—
|
—
|
$77,045.00
|
$82,438.00
|
$77,045.00
|
2026-05-06
|
|
207
|
OTHER
|
Respiratory System Diagnosis With Ventilator Support >96 Hours
|
9
|
5
|
—
|
—
|
$52,743.00
|
$87,828.00
|
$76,416.00
|
2026-05-06
|
|
089-4
|
OTHER
|
Major Cranial Or Facial Bone Procedures
|
8
|
7
|
—
|
—
|
$75,688.00
|
$80,986.00
|
$75,688.00
|
2026-05-06
|
|
160-3
|
OTHER
|
Major Cardiothoracic Repair Of Heart Anomaly
|
8
|
7
|
—
|
—
|
$75,523.00
|
$80,809.00
|
$75,523.00
|
2026-05-06
|
|
165-4
|
OTHER
|
Coronary Bypass With Ami Or Complex Principal Diagnosis
|
8
|
7
|
—
|
—
|
$75,026.00
|
$80,278.00
|
$75,026.00
|
2026-05-06
|
|
178-2
|
OTHER
|
External Heart Assist Systems
|
8
|
7
|
—
|
—
|
$74,935.00
|
$80,181.00
|
$74,935.00
|
2026-05-06
|
|
969
|
OTHER
|
HIV With Extensive O.r. Procedures With Mcc
|
9
|
5
|
—
|
—
|
$51,570.00
|
$87,378.00
|
$74,717.00
|
2026-05-06
|
|
022-4
|
OTHER
|
Ventricular Shunt Procedures
|
8
|
7
|
—
|
—
|
$74,412.00
|
$79,621.00
|
$74,412.00
|
2026-05-06
|
|
404-4
|
OTHER
|
Thyroid, Parathyroid And Thyroglossal Procedures
|
8
|
7
|
—
|
—
|
$74,339.00
|
$79,543.00
|
$74,339.00
|
2026-05-06
|
|
217
|
OTHER
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
11
|
7
|
—
|
—
|
$52,659.00
|
$84,734.00
|
$74,296.00
|
2026-05-06
|
|
405-4
|
OTHER
|
Other Procedures For Endocrine, Nutritional And Metabolic Disorders
|
8
|
7
|
—
|
—
|
$74,149.00
|
$79,339.00
|
$74,149.00
|
2026-05-06
|
|
121-4
|
OTHER
|
Other Respiratory And Chest Procedures
|
8
|
7
|
—
|
—
|
$73,533.00
|
$78,681.00
|
$73,533.00
|
2026-05-06
|
|
611-3
|
OTHER
|
Neonate Birth Weight 1500-1999 Grams With Major Anomaly
|
8
|
7
|
—
|
—
|
$73,511.00
|
$78,657.00
|
$73,511.00
|
2026-05-06
|
|
607-2
|
OTHER
|
Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…
|
8
|
7
|
—
|
—
|
$72,976.00
|
$78,084.00
|
$72,976.00
|
2026-05-06
|
|
608-3
|
OTHER
|
Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition
|
8
|
7
|
—
|
—
|
$72,950.00
|
$78,057.00
|
$72,950.00
|
2026-05-06
|
|
179-4
|
OTHER
|
Defibrillator Implants
|
8
|
7
|
—
|
—
|
$72,732.00
|
$77,823.00
|
$72,732.00
|
2026-05-06
|
|
276
|
OTHER
|
Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator
|
10
|
6
|
—
|
—
|
$50,511.00
|
$84,298.00
|
$72,029.00
|
2026-05-06
|
|
026-4
|
OTHER
|
Other Nervous System And Related Procedures
|
8
|
7
|
—
|
—
|
$71,948.00
|
$76,985.00
|
$71,948.00
|
2026-05-06
|
|
573
|
OTHER
|
Skin Graft For Skin Ulcer Or Cellulitis With Mcc
|
9
|
5
|
—
|
—
|
$50,215.00
|
$80,803.00
|
$71,664.00
|
2026-05-06
|
|
261-4
|
OTHER
|
Major Biliary Tract Procedures
|
8
|
7
|
—
|
—
|
$71,529.00
|
$76,536.00
|
$71,529.00
|
2026-05-06
|
|
266
|
OTHER
|
Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc
|
10
|
6
|
—
|
—
|
$48,850.00
|
$103,940.00
|
$71,381.50
|
2026-05-06
|
|
317
|
OTHER
|
Concomitant Left Atrial Appendage Closure And Cardiac Ablation
|
9
|
5
|
—
|
—
|
$50,445.00
|
$81,173.00
|
$71,294.00
|
2026-05-06
|
|
16
|
OTHER
|
Autologous Bone Marrow Transplant With Cc/mcc
|
9
|
5
|
—
|
—
|
$49,218.00
|
$79,198.00
|
$71,190.00
|
2026-05-06
|
|
17
|
OTHER
|
Autologous Bone Marrow Transplant Without Cc/mcc
|
9
|
5
|
—
|
—
|
$49,218.00
|
$79,198.00
|
$71,190.00
|
2026-05-06
|
|
232-4
|
OTHER
|
Gastric Fundoplication
|
8
|
7
|
—
|
—
|
$70,974.00
|
$75,943.00
|
$70,974.00
|
2026-05-06
|
|
447-4
|
OTHER
|
Other Kidney, Urinary Tract And Related Procedures
|
8
|
7
|
—
|
—
|
$70,769.00
|
$75,723.00
|
$70,769.00
|
2026-05-06
|
|
623-4
|
OTHER
|
Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection
|
8
|
7
|
—
|
—
|
$70,396.00
|
$75,324.00
|
$70,396.00
|
2026-05-06
|
|
955
|
OTHER
|
Craniotomy For Multiple Significant Trauma
|
9
|
5
|
—
|
—
|
$55,680.00
|
$89,596.00
|
$70,190.00
|
2026-05-06
|
|
229-4
|
OTHER
|
Other Digestive System And Abdominal Procedures
|
8
|
7
|
—
|
—
|
$69,987.00
|
$74,886.00
|
$69,987.00
|
2026-05-06
|
|
841-1
|
OTHER
|
Extensive Third Degree Burns With Skin Graft
|
8
|
7
|
—
|
—
|
$69,520.00
|
$74,387.00
|
$69,520.00
|
2026-05-06
|
|
841-2
|
OTHER
|
Extensive Third Degree Burns With Skin Graft
|
8
|
7
|
—
|
—
|
$69,520.00
|
$74,387.00
|
$69,520.00
|
2026-05-06
|
|
28
|
OTHER
|
Spinal Procedures With Mcc
|
9
|
5
|
—
|
—
|
$49,574.00
|
$79,770.00
|
$69,451.00
|
2026-05-06
|
|
232
|
OTHER
|
Coronary Bypass With Ptca Without Mcc
|
11
|
7
|
—
|
—
|
$49,812.00
|
$93,799.00
|
$69,432.00
|
2026-05-06
|
|
457
|
OTHER
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
10
|
6
|
—
|
—
|
$46,800.00
|
$85,511.00
|
$68,912.00
|
2026-05-06
|
|
820
|
OTHER
|
Lymphoma And Leukemia With Major O.r. Procedures With Mcc
|
9
|
5
|
—
|
—
|
$47,476.00
|
$76,878.00
|
$68,786.00
|
2026-05-06
|
|
235
|
OTHER
|
Coronary Bypass Without Cardiac Catheterization With Mcc
|
11
|
7
|
—
|
—
|
$47,981.00
|
$84,779.00
|
$68,638.00
|
2026-05-06
|
|
009-2
|
OTHER
|
Extracorporeal Membrane Oxygenation (ecmo)
|
8
|
7
|
—
|
—
|
$68,572.00
|
$73,372.00
|
$68,572.00
|
2026-05-06
|
|
009-1
|
OTHER
|
Extracorporeal Membrane Oxygenation (ecmo)
|
8
|
7
|
—
|
—
|
$68,572.00
|
$73,372.00
|
$68,572.00
|
2026-05-06
|
|
181-4
|
OTHER
|
Lower Extremity Arterial Procedures
|
8
|
7
|
—
|
—
|
$68,421.00
|
$73,211.00
|
$68,421.00
|
2026-05-06
|
|
011-1
|
OTHER
|
Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies
|
8
|
7
|
—
|
—
|
$68,307.00
|
$73,088.00
|
$68,307.00
|
2026-05-06
|
|
613-3
|
OTHER
|
Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection
|
8
|
7
|
—
|
—
|
$67,852.00
|
$72,602.00
|
$67,852.00
|
2026-05-06
|
|
10
|
OTHER
|
Pancreas Transplant
|
9
|
5
|
—
|
—
|
$55,477.00
|
$104,616.00
|
$67,615.00
|
2026-05-06
|
|
951-4
|
OTHER
|
Moderately Extensive O.r. Procedure Unrelated To Principal Diagnosis
|
8
|
7
|
—
|
—
|
$67,563.00
|
$72,293.00
|
$67,563.00
|
2026-05-06
|
|
176-4
|
OTHER
|
Insertion, Revision And Replacements Of Pacemaker And Other Cardiac Devices
|
8
|
7
|
—
|
—
|
$66,551.00
|
$71,209.00
|
$66,551.00
|
2026-05-06
|
|
710-4
|
OTHER
|
Infectious And Parasitic Diseases Including HIV With O.r. Procedure
|
8
|
7
|
—
|
—
|
$66,480.00
|
$71,133.00
|
$66,480.00
|
2026-05-06
|
|
461
|
OTHER
|
Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc
|
10
|
6
|
—
|
—
|
$48,850.00
|
$86,690.00
|
$66,199.50
|
2026-05-06
|
|
695-4
|
OTHER
|
Chemotherapy For Acute Leukemia
|
8
|
7
|
—
|
—
|
$65,980.00
|
$70,599.00
|
$65,980.00
|
2026-05-06
|
|
263-4
|
OTHER
|
Cholecystectomy
|
8
|
7
|
—
|
—
|
$65,926.00
|
$70,541.00
|
$65,926.00
|
2026-05-06
|
|
260-4
|
OTHER
|
Major Pancreas, Liver And Shunt Procedures
|
8
|
7
|
—
|
—
|
$65,758.00
|
$70,362.00
|
$65,758.00
|
2026-05-06
|
|
218
|
OTHER
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
9
|
5
|
—
|
—
|
$48,513.00
|
$78,064.00
|
$65,654.00
|
2026-05-06
|
|
603-2
|
OTHER
|
Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition
|
8
|
7
|
—
|
—
|
$65,442.00
|
$70,023.00
|
$65,442.00
|
2026-05-06
|
|
23
|
OTHER
|
Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…
|
9
|
5
|
—
|
—
|
$46,520.00
|
$74,857.00
|
$65,333.00
|
2026-05-06
|
|
220-4
|
OTHER
|
Major Stomach, Esophageal And Duodenal Procedures
|
8
|
7
|
—
|
—
|
$65,079.00
|
$69,634.00
|
$65,079.00
|
2026-05-06
|
|
163-3
|
OTHER
|
Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis
|
8
|
7
|
—
|
—
|
$64,985.00
|
$69,534.00
|
$64,985.00
|
2026-05-06
|
|
177-3
|
OTHER
|
Cardiac Pacemaker And Defibrillator Revision Except Device Replacement
|
8
|
7
|
—
|
—
|
$64,587.00
|
$69,108.00
|
$64,587.00
|
2026-05-06
|
|
167-3
|
OTHER
|
Other Cardiothoracic And Thoracic Vascular Procedures
|
8
|
7
|
—
|
—
|
$64,587.00
|
$69,108.00
|
$64,587.00
|
2026-05-06
|
|
511-4
|
OTHER
|
Uterine And Adnexa Procedures For Ovarian And Adnexal Malignancy
|
8
|
7
|
—
|
—
|
$64,576.00
|
$69,097.00
|
$64,576.00
|
2026-05-06
|
|
510-4
|
OTHER
|
Pelvic Evisceration, Radical Hysterectomy And Other Radical Gynecological Proced…
|
8
|
7
|
—
|
—
|
$64,561.00
|
$69,081.00
|
$64,561.00
|
2026-05-06
|
|
834
|
OTHER
|
Acute Leukemia With Mcc
|
9
|
5
|
—
|
—
|
$45,071.00
|
$72,524.00
|
$64,528.00
|
2026-05-06
|
|
863-3
|
OTHER
|
Neonatal Aftercare
|
8
|
7
|
—
|
—
|
$63,866.00
|
$68,336.00
|
$63,866.00
|
2026-05-06
|
|
029-4
|
OTHER
|
Other Percutaneous Intracranial Procedures
|
8
|
7
|
—
|
—
|
$63,860.00
|
$68,330.00
|
$63,860.00
|
2026-05-06
|
|
463
|
OTHER
|
Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …
|
9
|
5
|
—
|
—
|
$44,041.00
|
$72,008.00
|
$63,809.00
|
2026-05-06
|
|
576
|
OTHER
|
Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc
|
9
|
5
|
—
|
—
|
$43,994.00
|
$72,255.00
|
$63,741.00
|
2026-05-06
|
|
405
|
OTHER
|
Pancreas, Liver And Shunt Procedures With Mcc
|
9
|
5
|
—
|
—
|
$44,267.00
|
$71,231.00
|
$63,447.00
|
2026-05-06
|
|
428
|
OTHER
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
9
|
5
|
—
|
—
|
$44,894.00
|
$72,239.00
|
$63,447.00
|
2026-05-06
|
|
609-1
|
OTHER
|
Neonate Birth Weight 1500-2499 Grams With Major Procedure
|
8
|
7
|
—
|
—
|
$63,290.00
|
$67,721.00
|
$63,290.00
|
2026-05-06
|
|
609-2
|
OTHER
|
Neonate Birth Weight 1500-2499 Grams With Major Procedure
|
8
|
7
|
—
|
—
|
$63,290.00
|
$67,721.00
|
$63,290.00
|
2026-05-06
|
|
589-4
|
OTHER
|
Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …
|
8
|
7
|
—
|
—
|
$63,164.00
|
$67,585.00
|
$63,164.00
|
2026-05-06
|
|
21
|
OTHER
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc
|
9
|
5
|
—
|
—
|
$43,550.00
|
$78,082.00
|
$63,098.00
|
2026-05-06
|
|
430
|
OTHER
|
Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc
|
9
|
5
|
—
|
—
|
$44,607.00
|
$71,779.00
|
$63,043.00
|
2026-05-06
|
|
442-4
|
OTHER
|
Kidney And Urinary Tract Procedures For Malignancy
|
8
|
7
|
—
|
—
|
$62,624.00
|
$67,008.00
|
$62,624.00
|
2026-05-06
|
|
653
|
OTHER
|
Major Bladder Procedures With Mcc
|
9
|
5
|
—
|
—
|
$45,456.00
|
$73,145.00
|
$62,392.00
|
2026-05-06
|
|
303-3
|
OTHER
|
Dorsal And Lumbar Fusion Procedure For Curvature Of Back
|
8
|
7
|
—
|
—
|
$61,714.00
|
$66,034.00
|
$61,714.00
|
2026-05-06
|
|
231-4
|
OTHER
|
Major Large Bowel Procedures
|
8
|
7
|
—
|
—
|
$61,711.00
|
$66,031.00
|
$61,711.00
|
2026-05-06
|
|
049-4
|
OTHER
|
Bacterial And Tuberculous Infections Of Nervous System
|
8
|
7
|
—
|
—
|
$61,029.00
|
$65,301.00
|
$61,029.00
|
2026-05-06
|
|
325-4
|
OTHER
|
Non-elective Or Complex Knee Joint Replacement
|
8
|
7
|
—
|
—
|
$60,816.00
|
$65,073.00
|
$60,816.00
|
2026-05-06
|
|
224-4
|
OTHER
|
Peritoneal Adhesiolysis
|
8
|
7
|
—
|
—
|
$60,672.00
|
$64,919.00
|
$60,672.00
|
2026-05-06
|
|
8
|
OTHER
|
Simultaneous Pancreas And Kidney Transplant
|
9
|
5
|
—
|
—
|
$44,368.00
|
$71,394.00
|
$60,641.00
|
2026-05-06
|
|
220
|
OTHER
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
9
|
5
|
—
|
—
|
$43,190.00
|
$69,498.00
|
$60,444.00
|
2026-05-06
|
|
952-4
|
OTHER
|
Non-extensive O.r. Procedure Unrelated To Principal Diagnosis
|
8
|
7
|
—
|
—
|
$60,258.00
|
$64,477.00
|
$60,258.00
|
2026-05-06
|
|
466
|
OTHER
|
Revision Of Hip Or Knee Replacement With Mcc
|
11
|
7
|
—
|
—
|
$41,543.00
|
$89,745.00
|
$60,189.00
|
2026-05-06
|
|
178-1
|
OTHER
|
External Heart Assist Systems
|
8
|
7
|
—
|
—
|
$60,141.00
|
$64,351.00
|
$60,141.00
|
2026-05-06
|
|
660-4
|
OTHER
|
Major Hematologic Or Immunologic Diagnoses Except Sickle Cell Crisis And Coagula…
|
8
|
7
|
—
|
—
|
$59,974.00
|
$64,173.00
|
$59,974.00
|
2026-05-06
|
|
234
|
OTHER
|
Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc
|
11
|
7
|
—
|
—
|
$43,383.00
|
$93,359.00
|
$59,906.00
|
2026-05-06
|
|
518-4
|
OTHER
|
Other Female Reproductive System And Related Procedures
|
8
|
7
|
—
|
—
|
$59,867.00
|
$64,058.00
|
$59,867.00
|
2026-05-06
|
|
170-4
|
OTHER
|
Permanent Cardiac Pacemaker Implant With Ami, Heart Failure Or Shock
|
8
|
7
|
—
|
—
|
$59,603.00
|
$63,775.00
|
$59,603.00
|
2026-05-06
|
|
11
|
OTHER
|
Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc
|
9
|
5
|
—
|
—
|
$44,000.00
|
$70,801.00
|
$59,426.00
|
2026-05-06
|
|
450
|
OTHER
|
Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically …
|
9
|
5
|
—
|
—
|
$41,995.00
|
$67,574.00
|
$59,350.00
|
2026-05-06
|
|
303-2
|
OTHER
|
Dorsal And Lumbar Fusion Procedure For Curvature Of Back
|
8
|
7
|
—
|
—
|
$59,172.00
|
$63,314.00
|
$59,172.00
|
2026-05-06
|
|
180-4
|
OTHER
|
Other Circulatory System Procedures
|
8
|
7
|
—
|
—
|
$58,856.00
|
$62,976.00
|
$58,856.00
|
2026-05-06
|
|
030-4
|
OTHER
|
Percutaneous Intracranial And Extracranial Vascular Procedures
|
8
|
7
|
—
|
—
|
$58,788.00
|
$62,903.00
|
$58,788.00
|
2026-05-06
|
|
200-4
|
OTHER
|
Cardiac Structural And Valvular Disorders
|
8
|
7
|
—
|
—
|
$58,638.00
|
$62,742.00
|
$58,638.00
|
2026-05-06
|
|
634-4
|
OTHER
|
Neonate Birth Weight > 2499 Grams With Respiratory Distress Syndrome Or Other Ma…
|
8
|
7
|
—
|
—
|
$58,626.00
|
$62,730.00
|
$58,626.00
|
2026-05-06
|
|
326
|
OTHER
|
Stomach, Esophageal And Duodenal Procedures With Mcc
|
9
|
5
|
—
|
—
|
$41,416.00
|
$66,643.00
|
$58,535.00
|
2026-05-06
|
|
228
|
OTHER
|
Other Cardiothoracic Procedures With Mcc
|
10
|
6
|
—
|
—
|
$40,634.00
|
$84,027.00
|
$58,441.50
|
2026-05-06
|
|
270
|
OTHER
|
Other Major Cardiovascular Procedures With Mcc
|
11
|
7
|
—
|
—
|
$41,857.00
|
$75,538.00
|
$58,281.00
|
2026-05-06
|
|
440-1
|
OTHER
|
Kidney Transplant
|
8
|
7
|
—
|
—
|
$57,905.00
|
$61,958.00
|
$57,905.00
|
2026-05-06
|
|
130-3
|
OTHER
|
Respiratory System Diagnosis With Ventilator Support > 96 Hours
|
8
|
7
|
—
|
—
|
$57,823.00
|
$61,871.00
|
$57,823.00
|
2026-05-06
|
|
623-3
|
OTHER
|
Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection
|
8
|
7
|
—
|
—
|
$57,729.00
|
$61,770.00
|
$57,729.00
|
2026-05-06
|
|
853
|
OTHER
|
Infectious And Parasitic Diseases With O.r. Procedures With Mcc
|
9
|
5
|
—
|
—
|
$40,786.00
|
$65,630.00
|
$57,617.00
|
2026-05-06
|
|
073-4
|
OTHER
|
Orbit And Eye Procedures
|
8
|
7
|
—
|
—
|
$57,572.00
|
$61,602.00
|
$57,572.00
|
2026-05-06
|
|
631-2
|
OTHER
|
Neonate Birth Weight > 2499 Grams With Other Major Procedure
|
8
|
7
|
—
|
—
|
$57,532.00
|
$61,559.00
|
$57,532.00
|
2026-05-06
|
|
711-4
|
OTHER
|
Post-operative, Post-trauma, Other Device Infections With O.r. Procedure
|
8
|
7
|
—
|
—
|
$57,420.00
|
$61,439.00
|
$57,420.00
|
2026-05-06
|
|
471
|
OTHER
|
Cervical Spinal Fusion With Mcc
|
11
|
7
|
—
|
—
|
$39,608.00
|
$63,734.00
|
$57,385.00
|
2026-05-06
|
|
514-4
|
OTHER
|
Female Reproductive System Reconstructive Procedures
|
8
|
7
|
—
|
—
|
$57,283.00
|
$61,293.00
|
$57,283.00
|
2026-05-06
|
|
313-4
|
OTHER
|
Knee And Lower Leg Procedures Except Foot
|
8
|
7
|
—
|
—
|
$56,929.00
|
$60,914.00
|
$56,929.00
|
2026-05-06
|
|
179-3
|
OTHER
|
Defibrillator Implants
|
8
|
7
|
—
|
—
|
$56,915.00
|
$60,899.00
|
$56,915.00
|
2026-05-06
|
|
690-3
|
OTHER
|
Acute Leukemia
|
8
|
7
|
—
|
—
|
$56,837.00
|
$60,816.00
|
$56,837.00
|
2026-05-06
|
|
223-4
|
OTHER
|
Other Small And Large Bowel Procedures
|
8
|
7
|
—
|
—
|
$56,815.00
|
$60,792.00
|
$56,815.00
|
2026-05-06
|
|
042-4
|
OTHER
|
Degenerative Nervous System Disorders Except Multiple Sclerosis
|
8
|
7
|
—
|
—
|
$56,773.00
|
$60,747.00
|
$56,773.00
|
2026-05-06
|
|
403-4
|
OTHER
|
Procedures For Obesity
|
8
|
7
|
—
|
—
|
$56,571.00
|
$60,531.00
|
$56,571.00
|
2026-05-06
|
|
320-4
|
OTHER
|
Other Musculoskeletal System And Connective Tissue Procedures
|
8
|
7
|
—
|
—
|
$56,416.00
|
$60,366.00
|
$56,416.00
|
2026-05-06
|
|
910-3
|
OTHER
|
Craniotomy For Multiple Significant Trauma
|
8
|
7
|
—
|
—
|
$56,292.00
|
$60,232.00
|
$56,292.00
|
2026-05-06
|
|
621-3
|
OTHER
|
Neonate Birth Weight 2000-2499 Grams With Major Anomaly
|
8
|
7
|
—
|
—
|
$56,268.00
|
$60,206.00
|
$56,268.00
|
2026-05-06
|
|
799
|
OTHER
|
Splenic Procedures With Mcc
|
9
|
5
|
—
|
—
|
$38,772.00
|
$62,993.00
|
$56,174.00
|
2026-05-06
|
|
183-3
|
OTHER
|
Percutaneous Structural Cardiac Procedures
|
8
|
7
|
—
|
—
|
$55,926.00
|
$59,841.00
|
$55,926.00
|
2026-05-06
|
|
267
|
OTHER
|
Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc
|
10
|
6
|
—
|
—
|
$38,363.00
|
$79,267.00
|
$55,913.00
|
2026-05-06
|
|
162-2
|
OTHER
|
Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis
|
8
|
7
|
—
|
—
|
$55,892.00
|
$59,804.00
|
$55,892.00
|
2026-05-06
|
|
6
|
OTHER
|
Liver Transplant Without Mcc
|
9
|
5
|
—
|
—
|
$39,542.00
|
$63,627.00
|
$55,745.00
|
2026-05-06
|
|
303-1
|
OTHER
|
Dorsal And Lumbar Fusion Procedure For Curvature Of Back
|
8
|
7
|
—
|
—
|
$55,734.00
|
$59,635.00
|
$55,734.00
|
2026-05-06
|
|
166-4
|
OTHER
|
Coronary Bypass Without Ami Or Complex Principal Diagnosis
|
8
|
7
|
—
|
—
|
$55,420.00
|
$59,300.00
|
$55,420.00
|
2026-05-06
|
|
239
|
OTHER
|
Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc
|
9
|
5
|
—
|
—
|
$41,071.00
|
$66,089.00
|
$55,398.00
|
2026-05-06
|
|
512-4
|
OTHER
|
Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy
|
8
|
7
|
—
|
—
|
$55,230.00
|
$59,096.00
|
$55,230.00
|
2026-05-06
|
|
277
|
OTHER
|
Cardiac Defibrillator Implant Without Mcc
|
10
|
6
|
—
|
—
|
$37,938.00
|
$66,262.00
|
$55,041.50
|
2026-05-06
|
|
861-4
|
OTHER
|
Signs, Symptoms And Other Factors Influencing Health Status
|
8
|
7
|
—
|
—
|
$54,982.00
|
$58,830.00
|
$54,982.00
|
2026-05-06
|
|
837
|
OTHER
|
Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot…
|
9
|
5
|
—
|
—
|
$40,829.00
|
$65,699.00
|
$54,820.00
|
2026-05-06
|
|
981
|
OTHER
|
Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc
|
9
|
5
|
—
|
—
|
$38,770.00
|
$62,386.00
|
$54,633.00
|
2026-05-06
|
|
850-3
|
OTHER
|
Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal…
|
8
|
7
|
—
|
—
|
$54,350.00
|
$58,154.00
|
$54,350.00
|
2026-05-06
|
|
163
|
OTHER
|
Major Chest Procedures With Mcc
|
9
|
5
|
—
|
—
|
$37,584.00
|
$60,478.00
|
$54,324.00
|
2026-05-06
|
|
024-4
|
OTHER
|
Open Extracranial Vascular Procedures
|
8
|
7
|
—
|
—
|
$54,292.00
|
$58,092.00
|
$54,292.00
|
2026-05-06
|
|
222-4
|
OTHER
|
Other Stomach, Esophageal And Duodenal Procedures
|
8
|
7
|
—
|
—
|
$54,292.00
|
$58,092.00
|
$54,292.00
|
2026-05-06
|
|
021-3
|
OTHER
|
Open Craniotomy Except Trauma
|
8
|
7
|
—
|
—
|
$54,058.00
|
$57,842.00
|
$54,058.00
|
2026-05-06
|
|
614-3
|
OTHER
|
Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition
|
8
|
7
|
—
|
—
|
$53,825.00
|
$57,593.00
|
$53,825.00
|
2026-05-06
|
|
221
|
OTHER
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
9
|
5
|
—
|
—
|
$37,449.00
|
$60,260.00
|
$53,575.00
|
2026-05-06
|
|
Q2043
|
OTHER
|
Sipuleucel-t Auto Cd54+
|
17
|
8
|
—
|
—
|
$33,151.00
|
$124,146.00
|
$53,427.00
|
2026-05-06
|
|
A9543
|
OTHER
|
Y90 Ibritumomab, Rx
|
15
|
7
|
—
|
—
|
$49,911.00
|
$140,775.00
|
$53,405.00
|
2026-05-06
|
|
363-4
|
OTHER
|
Breast Procedures Except Mastectomy
|
8
|
7
|
—
|
—
|
$53,376.00
|
$57,112.00
|
$53,376.00
|
2026-05-06
|
|
305-4
|
OTHER
|
Amputation Of Lower Limb Except Toes
|
8
|
7
|
—
|
—
|
$53,346.00
|
$57,080.00
|
$53,346.00
|
2026-05-06
|
|
309-4
|
OTHER
|
Other Significant Hip And Femur Surgery
|
8
|
7
|
—
|
—
|
$53,273.00
|
$57,002.00
|
$53,273.00
|
2026-05-06
|
|
Q2053
|
OTHER
|
Brexucabtagene Car Pos T
|
17
|
8
|
—
|
—
|
$1.00
|
$1,051,520.00
|
$52,975.00
|
2026-05-06
|
|
Q2055
|
OTHER
|
Idecabtagene Vicleucel Car
|
15
|
7
|
—
|
—
|
$1.00
|
$1,042,084.00
|
$52,975.00
|
2026-05-06
|
|
Q2056
|
OTHER
|
Ciltacabtagene Car-pos T
|
17
|
8
|
—
|
—
|
$1.00
|
$1,153,200.00
|
$52,975.00
|
2026-05-06
|
|
Q2041
|
OTHER
|
Axicabtagene Ciloleucel Car+
|
17
|
8
|
—
|
—
|
$1.00
|
$1,051,520.00
|
$52,975.00
|
2026-05-06
|
|
Q2042
|
OTHER
|
Tisagenlecleucel Car-pos T
|
15
|
7
|
—
|
—
|
$1.00
|
$1,098,806.00
|
$52,975.00
|
2026-05-06
|
|
Q2054
|
OTHER
|
Lisocabtagene Mara Car Pos T
|
17
|
8
|
—
|
—
|
$1.00
|
$1,063,333.00
|
$52,975.00
|
2026-05-06
|
|
162-1
|
OTHER
|
Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis
|
8
|
7
|
—
|
—
|
$52,879.00
|
$56,581.00
|
$52,879.00
|
2026-05-06
|
|
930-4
|
OTHER
|
Multiple Significant Trauma Without O.r. Procedure
|
8
|
7
|
—
|
—
|
$52,530.00
|
$56,207.00
|
$52,530.00
|
2026-05-06
|
|
005-1
|
OTHER
|
Tracheostomy With Mv >96 Hours Without Extensive Procedure
|
8
|
7
|
—
|
—
|
$52,524.00
|
$56,200.00
|
$52,524.00
|
2026-05-06
|
|
483-4
|
OTHER
|
Penis, Testes And Scrotal Procedures
|
8
|
7
|
—
|
—
|
$52,394.00
|
$56,062.00
|
$52,394.00
|
2026-05-06
|
|
842-3
|
OTHER
|
Burns With Skin Graft Except Extensive Third Degree Burns
|
8
|
7
|
—
|
—
|
$52,377.00
|
$56,043.00
|
$52,377.00
|
2026-05-06
|
|
691-4
|
OTHER
|
Lymphoma, Myeloma And Non-acute Leukemia
|
8
|
7
|
—
|
—
|
$52,262.00
|
$55,920.00
|
$52,262.00
|
2026-05-06
|
|
245
|
OTHER
|
Aicd Generator Procedures
|
9
|
5
|
—
|
—
|
$39,848.00
|
$64,121.00
|
$52,224.00
|
2026-05-06
|
|
458
|
OTHER
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
11
|
7
|
—
|
—
|
$35,210.00
|
$124,514.00
|
$52,220.00
|
2026-05-06
|
|
304-3
|
OTHER
|
Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back
|
8
|
7
|
—
|
—
|
$52,183.00
|
$55,836.00
|
$52,183.00
|
2026-05-06
|
|
329
|
OTHER
|
Major Small And Large Bowel Procedures With Mcc
|
9
|
5
|
—
|
—
|
$37,444.00
|
$60,252.00
|
$52,056.00
|
2026-05-06
|
|
823
|
OTHER
|
Lymphoma And Non-acute Leukemia With Other Procedures With Mcc
|
9
|
5
|
—
|
—
|
$38,158.00
|
$61,400.00
|
$51,884.00
|
2026-05-06
|
|
650
|
OTHER
|
Kidney Transplant With Hemodialysis With Mcc
|
9
|
5
|
—
|
—
|
$37,569.00
|
$60,453.00
|
$51,834.00
|
2026-05-06
|
|
607-1
|
OTHER
|
Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…
|
8
|
7
|
—
|
—
|
$51,721.00
|
$55,341.00
|
$51,721.00
|
2026-05-06
|
|
608-2
|
OTHER
|
Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition
|
8
|
7
|
—
|
—
|
$51,376.00
|
$54,972.00
|
$51,376.00
|
2026-05-06
|
|
308-4
|
OTHER
|
Hip And Femur Fracture Repair
|
8
|
7
|
—
|
—
|
$51,355.00
|
$54,950.00
|
$51,355.00
|
2026-05-06
|
|
179-2
|
OTHER
|
Defibrillator Implants
|
8
|
7
|
—
|
—
|
$51,186.00
|
$54,769.00
|
$51,186.00
|
2026-05-06
|
|
790
|
OTHER
|
Extreme Immaturity Or Respiratory Distress Syndrome, Neonate
|
4
|
3
|
—
|
—
|
$48,480.00
|
$63,230.00
|
$51,146.50
|
2026-05-06
|
|
519-4
|
OTHER
|
Uterine And Adnexa Procedures For Leiomyoma
|
8
|
7
|
—
|
—
|
$51,128.00
|
$54,707.00
|
$51,128.00
|
2026-05-06
|
|
856
|
OTHER
|
Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc
|
9
|
5
|
—
|
—
|
$36,789.00
|
$59,197.00
|
$51,037.00
|
2026-05-06
|
|
484-4
|
OTHER
|
Other Male Reproductive System And Related Procedures
|
8
|
7
|
—
|
—
|
$50,911.00
|
$54,474.00
|
$50,911.00
|
2026-05-06
|
|
25
|
OTHER
|
Craniotomy And Endovascular Intracranial Procedures With Mcc
|
9
|
5
|
—
|
—
|
$36,468.00
|
$58,682.00
|
$50,894.00
|
2026-05-06
|
|
826
|
OTHER
|
Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. …
|
9
|
5
|
—
|
—
|
$38,941.00
|
$62,660.00
|
$50,581.00
|
2026-05-06
|
|
182-4
|
OTHER
|
Other Peripheral Vascular And Related Procedures
|
8
|
7
|
—
|
—
|
$50,472.00
|
$54,005.00
|
$50,472.00
|
2026-05-06
|
|
421-4
|
OTHER
|
Malnutrition, Failure To Thrive And Other Nutritional Disorders
|
8
|
7
|
—
|
—
|
$50,420.00
|
$53,949.00
|
$50,420.00
|
2026-05-06
|
|
625-3
|
OTHER
|
Neonate Birth Weight 2000-2499 Grams With Other Significant Condition
|
8
|
7
|
—
|
—
|
$50,415.00
|
$53,944.00
|
$50,415.00
|
2026-05-06
|
|
364-4
|
OTHER
|
Other Skin, Subcutaneous Tissue And Related Procedures
|
8
|
7
|
—
|
—
|
$50,311.00
|
$53,833.00
|
$50,311.00
|
2026-05-06
|