Hospital

STAFFORD HOSPITAL, LLC

Stafford, VA · CCN 490140 · Rates published

13,970 distinct procedures filed

12 distinct payers

228,601 rate rows

2026-05-06 last MRF observed

Data quality

222,240 of 228,601 rate rows are consumer-grade (97.2%)

6,361 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
template filing: same amount across many unrelated codes — excluded	4,972
exceeds 10× this hospital's gross charge — excluded from medians	743
per-diem day rate — not a per-procedure price	646

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

Source MRF file	https://www.marywashingtonhealthcare.com/documents/134316364_stafford-hospital_standardcharges.csv
Found on page	https://www.marywashingtonhealthcare.com/patients-visitors/cost-estimates/
Discovered via	Discovered by HANK
Last fetch	not_modified · 2026-05-15
Content fingerprint	83d02fb1d8e10f6f… · 6,506,116 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
583-4 OTHER	Neonate With Ecmo	7	$552,172.00	$590,825.00	$552,172.00	nat. median $309,400 1.8× median
589-1 OTHER	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational…	7	$505,693.00	$541,091.00	$505,693.00	nat. median $86,371 outlier · 5.9×
589-2 OTHER	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational…	7	$487,801.00	$521,947.00	$487,801.00	nat. median $49,980 outlier · 9.8×
583-3 OTHER	Neonate With Ecmo	7	$485,003.00	$518,953.00	$485,003.00	nat. median $259,487 1.9× median
18 OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	5	$307,518.00	$494,833.00	$424,612.00	nat. median $386,529 1.1× median
588-4 OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	7	$390,096.00	$417,403.00	$390,096.00	nat. median $267,493 1.5× median
161-4 OTHER	Implantable Heart Assist Systems	7	$377,813.00	$404,260.00	$377,813.00	nat. median $202,242 1.9× median
630-4 OTHER	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure	7	$341,938.00	$365,873.00	$341,938.00	nat. median $210,669 1.6× median
583-2 OTHER	Neonate With Ecmo	7	$333,714.00	$357,074.00	$333,714.00	nat. median $191,347 1.7× median
609-4 OTHER	Neonate Birth Weight 1500-2499 Grams With Major Procedure	7	$326,416.00	$349,265.00	$326,416.00	nat. median $169,856 1.9× median
841-4 OTHER	Extensive Third Degree Burns With Skin Graft	7	$320,170.00	$342,582.00	$320,170.00	nat. median $151,691 outlier · 2.1×
1 OTHER	Heart Transplant Or Implant Of Heart Assist System With Mcc	6	$229,690.00	$369,600.00	$314,303.00	nat. median $239,422 1.3× median
011-4 OTHER	Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies	7	$304,162.00	$325,453.00	$304,162.00	nat. median $105,647 outlier · 2.9×
160-4 OTHER	Major Cardiothoracic Repair Of Heart Anomaly	7	$303,465.00	$324,707.00	$303,465.00	nat. median $106,926 outlier · 2.8×
591-4 OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure	7	$288,453.00	$308,645.00	$288,453.00	nat. median $156,696 1.8× median
631-4 OTHER	Neonate Birth Weight > 2499 Grams With Other Major Procedure	7	$272,740.00	$291,832.00	$272,740.00	nat. median $203,379 1.3× median
593-4 OTHER	Neonate Birth Weight 750-999 Grams Without Major Procedure	7	$251,808.00	$269,434.00	$251,808.00	nat. median $151,250 1.7× median
3 OTHER	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…	5	$174,758.00	$281,207.00	$245,716.00	nat. median $181,005 1.4× median
927 OTHER	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	5	$164,000.00	$335,125.00	$237,610.00	nat. median $146,562 1.6× median
009-4 OTHER	Extracorporeal Membrane Oxygenation (ecmo)	7	$228,525.00	$244,522.00	$228,525.00	nat. median $150,954 1.5× median
589-3 OTHER	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational…	7	$226,706.00	$242,576.00	$226,706.00	nat. median $87,000 outlier · 2.6×
603-4 OTHER	Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition	7	$225,266.00	$241,034.00	$225,266.00	nat. median $107,050 outlier · 2.1×
004-4 OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	7	$219,311.00	$234,662.00	$219,311.00	nat. median $110,000 2.0× median
583-1 OTHER	Neonate With Ecmo	7	$208,882.00	$223,504.00	$208,882.00	nat. median $171,226 1.2× median
792-4 OTHER	Extensive O.r. Procedures For Other Complications Of Treatment	7	$187,791.00	$200,936.00	$187,791.00	nat. median $43,650 outlier · 4.3×
161-3 OTHER	Implantable Heart Assist Systems	7	$183,215.00	$196,040.00	$183,215.00	nat. median $152,491 1.2× median
161-2 OTHER	Implantable Heart Assist Systems	7	$178,872.00	$191,393.00	$178,872.00	nat. median $109,992 1.6× median
593-3 OTHER	Neonate Birth Weight 750-999 Grams Without Major Procedure	7	$173,619.00	$185,772.00	$173,619.00	nat. median $112,711 1.5× median
680-4 OTHER	Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms	7	$172,870.00	$184,971.00	$172,870.00	nat. median $61,090 outlier · 2.8×
011-3 OTHER	Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies	7	$172,840.00	$184,939.00	$172,840.00	nat. median $171,094 1.0× median
681-4 OTHER	Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms	7	$170,645.00	$182,591.00	$170,645.00	nat. median $52,952 outlier · 3.2×
161-1 OTHER	Implantable Heart Assist Systems	7	$169,889.00	$181,781.00	$169,889.00	nat. median $101,352 1.7× median
602-4 OTHER	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	7	$169,884.00	$181,776.00	$169,884.00	nat. median $125,000 1.4× median
591-3 OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure	7	$169,377.00	$181,233.00	$169,377.00	nat. median $99,157 1.7× median
4 OTHER	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…	5	$115,219.00	$186,896.00	$166,935.00	nat. median $134,983 1.2× median
005-4 OTHER	Tracheostomy With Mv >96 Hours Without Extensive Procedure	7	$159,852.00	$171,042.00	$159,852.00	nat. median $88,000 1.8× median
842-4 OTHER	Burns With Skin Graft Except Extensive Third Degree Burns	7	$157,794.00	$168,840.00	$157,794.00	nat. median $83,517 1.9× median
609-3 OTHER	Neonate Birth Weight 1500-2499 Grams With Major Procedure	7	$157,695.00	$168,733.00	$157,695.00	nat. median $83,785 1.9× median
602-3 OTHER	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	7	$153,668.00	$164,425.00	$153,668.00	nat. median $99,067 1.6× median
J7330 OTHER	Cultured Chondrocytes Implnt	1	$144,921.00	$144,921.00	$144,921.00	nat. median $65,518 outlier · 2.2×
588-3 OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	7	$143,836.00	$153,904.00	$143,836.00	nat. median $165,000 0.9× median
7 OTHER	Lung Transplant	5	$106,566.00	$171,477.00	$141,370.00	nat. median $169,933 0.8× median
630-3 OTHER	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure	7	$141,046.00	$150,919.00	$141,046.00	nat. median $95,000 1.5× median
591-2 OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure	7	$139,860.00	$149,650.00	$139,860.00	nat. median $80,000 1.7× median
588-2 OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	7	$137,827.00	$147,475.00	$137,827.00	nat. median $153,523 0.9× median
588-1 OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	7	$137,827.00	$147,475.00	$137,827.00	nat. median $75,325 1.8× median
607-4 OTHER	Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…	7	$133,248.00	$142,575.00	$133,248.00	nat. median $100,015 1.3× median
14 OTHER	Allogeneic Bone Marrow Transplant	5	$106,835.00	$171,910.00	$132,087.00	nat. median $100,915 1.3× median
613-4 OTHER	Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection	7	$126,247.00	$135,085.00	$126,247.00	nat. median $68,200 1.9× median
612-4 OTHER	Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other…	7	$124,630.00	$133,354.00	$124,630.00	nat. median $76,321 1.6× median

Other procedures at this hospital

Browse this hospital's 13,970 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

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
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
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
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
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
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
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
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
009-1	OTHER	Extracorporeal Membrane Oxygenation (ecmo)	8	7	—	—	$68,572.00	$73,372.00	$68,572.00	2026-05-06
009-2	OTHER	Extracorporeal Membrane Oxygenation (ecmo)	8	7	—	—	$68,572.00	$73,372.00	$68,572.00	2026-05-06
009-3	OTHER	Extracorporeal Membrane Oxygenation (ecmo)	8	7	—	—	$110,666.00	$118,413.00	$110,666.00	2026-05-06
009-4	OTHER	Extracorporeal Membrane Oxygenation (ecmo)	8	7	—	—	$228,525.00	$244,522.00	$228,525.00	2026-05-06
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
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
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
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
020-4	OTHER	Open Craniotomy For Trauma	8	7	—	—	$100,663.00	$107,709.00	$100,663.00	2026-05-06
021-3	OTHER	Open Craniotomy Except Trauma	8	7	—	—	$54,058.00	$57,842.00	$54,058.00	2026-05-06
021-4	OTHER	Open Craniotomy Except Trauma	8	7	—	—	$79,289.00	$84,839.00	$79,289.00	2026-05-06
022-4	OTHER	Ventricular Shunt Procedures	8	7	—	—	$74,412.00	$79,621.00	$74,412.00	2026-05-06
023-4	OTHER	Spinal Procedures	8	7	—	—	$81,924.00	$87,658.00	$81,924.00	2026-05-06
024-4	OTHER	Open Extracranial Vascular Procedures	8	7	—	—	$54,292.00	$58,092.00	$54,292.00	2026-05-06
026-4	OTHER	Other Nervous System And Related Procedures	8	7	—	—	$71,948.00	$76,985.00	$71,948.00	2026-05-06
027-4	OTHER	Other Open Craniotomy	8	7	—	—	$80,169.00	$85,781.00	$80,169.00	2026-05-06
029-4	OTHER	Other Percutaneous Intracranial Procedures	8	7	—	—	$63,860.00	$68,330.00	$63,860.00	2026-05-06
030-4	OTHER	Percutaneous Intracranial And Extracranial Vascular Procedures	8	7	—	—	$58,788.00	$62,903.00	$58,788.00	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
049-4	OTHER	Bacterial And Tuberculous Infections Of Nervous System	8	7	—	—	$61,029.00	$65,301.00	$61,029.00	2026-05-06
073-4	OTHER	Orbit And Eye Procedures	8	7	—	—	$57,572.00	$61,602.00	$57,572.00	2026-05-06
089-4	OTHER	Major Cranial Or Facial Bone Procedures	8	7	—	—	$75,688.00	$80,986.00	$75,688.00	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
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
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
10	OTHER	Pancreas Transplant	9	5	—	—	$55,477.00	$104,616.00	$67,615.00	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
120-4	OTHER	Major Respiratory And Chest Procedures	8	7	—	—	$81,503.00	$87,208.00	$81,503.00	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
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
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
14	OTHER	Allogeneic Bone Marrow Transplant	9	5	—	—	$106,835.00	$171,910.00	$132,087.00	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
160-3	OTHER	Major Cardiothoracic Repair Of Heart Anomaly	8	7	—	—	$75,523.00	$80,809.00	$75,523.00	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
161-1	OTHER	Implantable Heart Assist Systems	8	7	—	—	$169,889.00	$181,781.00	$169,889.00	2026-05-06
161-2	OTHER	Implantable Heart Assist Systems	8	7	—	—	$178,872.00	$191,393.00	$178,872.00	2026-05-06
161-3	OTHER	Implantable Heart Assist Systems	8	7	—	—	$183,215.00	$196,040.00	$183,215.00	2026-05-06
161-4	OTHER	Implantable Heart Assist Systems	8	7	—	—	$377,813.00	$404,260.00	$377,813.00	2026-05-06
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
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
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
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
163	OTHER	Major Chest Procedures With Mcc	9	5	—	—	$37,584.00	$60,478.00	$54,324.00	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
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
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
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
167-3	OTHER	Other Cardiothoracic And Thoracic Vascular Procedures	8	7	—	—	$64,587.00	$69,108.00	$64,587.00	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
169-4	OTHER	Major Abdominal Vascular Procedures	8	7	—	—	$85,509.00	$91,494.00	$85,509.00	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
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
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
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
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
178-1	OTHER	External Heart Assist Systems	8	7	—	—	$60,141.00	$64,351.00	$60,141.00	2026-05-06
178-2	OTHER	External Heart Assist Systems	8	7	—	—	$74,935.00	$80,181.00	$74,935.00	2026-05-06
178-3	OTHER	External Heart Assist Systems	8	7	—	—	$77,045.00	$82,438.00	$77,045.00	2026-05-06
178-4	OTHER	External Heart Assist Systems	8	7	—	—	$81,223.00	$86,909.00	$81,223.00	2026-05-06
179-2	OTHER	Defibrillator Implants	8	7	—	—	$51,186.00	$54,769.00	$51,186.00	2026-05-06
179-3	OTHER	Defibrillator Implants	8	7	—	—	$56,915.00	$60,899.00	$56,915.00	2026-05-06
179-4	OTHER	Defibrillator Implants	8	7	—	—	$72,732.00	$77,823.00	$72,732.00	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
180-4	OTHER	Other Circulatory System Procedures	8	7	—	—	$58,856.00	$62,976.00	$58,856.00	2026-05-06
181-4	OTHER	Lower Extremity Arterial Procedures	8	7	—	—	$68,421.00	$73,211.00	$68,421.00	2026-05-06
182-4	OTHER	Other Peripheral Vascular And Related Procedures	8	7	—	—	$50,472.00	$54,005.00	$50,472.00	2026-05-06
183-3	OTHER	Percutaneous Structural Cardiac Procedures	8	7	—	—	$55,926.00	$59,841.00	$55,926.00	2026-05-06
183-4	OTHER	Percutaneous Structural Cardiac Procedures	8	7	—	—	$86,948.00	$93,034.00	$86,948.00	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
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
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
200-4	OTHER	Cardiac Structural And Valvular Disorders	8	7	—	—	$58,638.00	$62,742.00	$58,638.00	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
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
212	OTHER	Concomitant Aortic And Mitral Valve Procedures	9	5	—	—	$88,831.00	$142,939.00	$124,132.00	2026-05-06
215	OTHER	Other Heart Assist System Implant	10	6	—	—	$86,393.00	$191,833.00	$118,476.50	2026-05-06
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
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
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
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
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
220-4	OTHER	Major Stomach, Esophageal And Duodenal Procedures	8	7	—	—	$65,079.00	$69,634.00	$65,079.00	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
222-4	OTHER	Other Stomach, Esophageal And Duodenal Procedures	8	7	—	—	$54,292.00	$58,092.00	$54,292.00	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
224-4	OTHER	Peritoneal Adhesiolysis	8	7	—	—	$60,672.00	$64,919.00	$60,672.00	2026-05-06
228	OTHER	Other Cardiothoracic Procedures With Mcc	10	6	—	—	$40,634.00	$84,027.00	$58,441.50	2026-05-06
229-4	OTHER	Other Digestive System And Abdominal Procedures	8	7	—	—	$69,987.00	$74,886.00	$69,987.00	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
230-4	OTHER	Major Small Bowel Procedures	8	7	—	—	$81,014.00	$86,685.00	$81,014.00	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
231-4	OTHER	Major Large Bowel Procedures	8	7	—	—	$61,711.00	$66,031.00	$61,711.00	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
232-4	OTHER	Gastric Fundoplication	8	7	—	—	$70,974.00	$75,943.00	$70,974.00	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
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
235	OTHER	Coronary Bypass Without Cardiac Catheterization With Mcc	11	7	—	—	$47,981.00	$84,779.00	$68,638.00	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
245	OTHER	Aicd Generator Procedures	9	5	—	—	$39,848.00	$64,121.00	$52,224.00	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
260-4	OTHER	Major Pancreas, Liver And Shunt Procedures	8	7	—	—	$65,758.00	$70,362.00	$65,758.00	2026-05-06
261-4	OTHER	Major Biliary Tract Procedures	8	7	—	—	$71,529.00	$76,536.00	$71,529.00	2026-05-06
263-4	OTHER	Cholecystectomy	8	7	—	—	$65,926.00	$70,541.00	$65,926.00	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
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
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
270	OTHER	Other Major Cardiovascular Procedures With Mcc	11	7	—	—	$41,857.00	$75,538.00	$58,281.00	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
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
277	OTHER	Cardiac Defibrillator Implant Without Mcc	10	6	—	—	$37,938.00	$66,262.00	$55,041.50	2026-05-06
28	OTHER	Spinal Procedures With Mcc	9	5	—	—	$49,574.00	$79,770.00	$69,451.00	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
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
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
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
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
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
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
305-4	OTHER	Amputation Of Lower Limb Except Toes	8	7	—	—	$53,346.00	$57,080.00	$53,346.00	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
309-4	OTHER	Other Significant Hip And Femur Surgery	8	7	—	—	$53,273.00	$57,002.00	$53,273.00	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
313-4	OTHER	Knee And Lower Leg Procedures Except Foot	8	7	—	—	$56,929.00	$60,914.00	$56,929.00	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
320-4	OTHER	Other Musculoskeletal System And Connective Tissue Procedures	8	7	—	—	$56,416.00	$60,366.00	$56,416.00	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
326	OTHER	Stomach, Esophageal And Duodenal Procedures With Mcc	9	5	—	—	$41,416.00	$66,643.00	$58,535.00	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
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
363-4	OTHER	Breast Procedures Except Mastectomy	8	7	—	—	$53,376.00	$57,112.00	$53,376.00	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
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
401-4	OTHER	Adrenal Procedures	8	7	—	—	$81,170.00	$86,852.00	$81,170.00	2026-05-06
403-4	OTHER	Procedures For Obesity	8	7	—	—	$56,571.00	$60,531.00	$56,571.00	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
405	OTHER	Pancreas, Liver And Shunt Procedures With Mcc	9	5	—	—	$44,267.00	$71,231.00	$63,447.00	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
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
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
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
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
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
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
440-1	OTHER	Kidney Transplant	8	7	—	—	$57,905.00	$61,958.00	$57,905.00	2026-05-06
440-2	OTHER	Kidney Transplant	8	7	—	—	$95,587.00	$102,278.00	$95,587.00	2026-05-06
440-3	OTHER	Kidney Transplant	8	7	—	—	$118,080.00	$126,346.00	$118,080.00	2026-05-06
440-4	OTHER	Kidney Transplant	8	7	—	—	$120,871.00	$129,332.00	$120,871.00	2026-05-06
441-4	OTHER	Major Bladder Procedures	8	7	—	—	$88,072.00	$94,237.00	$88,072.00	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
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
447-4	OTHER	Other Kidney, Urinary Tract And Related Procedures	8	7	—	—	$70,769.00	$75,723.00	$70,769.00	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
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
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
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
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
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
466	OTHER	Revision Of Hip Or Knee Replacement With Mcc	11	7	—	—	$41,543.00	$89,745.00	$60,189.00	2026-05-06
471	OTHER	Cervical Spinal Fusion With Mcc	11	7	—	—	$39,608.00	$63,734.00	$57,385.00	2026-05-06
483-4	OTHER	Penis, Testes And Scrotal Procedures	8	7	—	—	$52,394.00	$56,062.00	$52,394.00	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
5	OTHER	Liver Transplant With Mcc Or Intestinal Transplant	9	5	—	—	$86,837.00	$139,731.00	$119,284.00	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
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
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
514-4	OTHER	Female Reproductive System Reconstructive Procedures	8	7	—	—	$57,283.00	$61,293.00	$57,283.00	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
519-4	OTHER	Uterine And Adnexa Procedures For Leiomyoma	8	7	—	—	$51,128.00	$54,707.00	$51,128.00	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
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
583-1	OTHER	Neonate With Ecmo	8	7	—	—	$208,882.00	$223,504.00	$208,882.00	2026-05-06
583-2	OTHER	Neonate With Ecmo	8	7	—	—	$333,714.00	$357,074.00	$333,714.00	2026-05-06
583-3	OTHER	Neonate With Ecmo	8	7	—	—	$485,003.00	$518,953.00	$485,003.00	2026-05-06
583-4	OTHER	Neonate With Ecmo	8	7	—	—	$552,172.00	$590,825.00	$552,172.00	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
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
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
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
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
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
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
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
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
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
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
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
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
6	OTHER	Liver Transplant Without Mcc	9	5	—	—	$39,542.00	$63,627.00	$55,745.00	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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
650	OTHER	Kidney Transplant With Hemodialysis With Mcc	9	5	—	—	$37,569.00	$60,453.00	$51,834.00	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
653	OTHER	Major Bladder Procedures With Mcc	9	5	—	—	$45,456.00	$73,145.00	$62,392.00	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
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
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
690-3	OTHER	Acute Leukemia	8	7	—	—	$56,837.00	$60,816.00	$56,837.00	2026-05-06
690-4	OTHER	Acute Leukemia	8	7	—	—	$109,336.00	$116,989.00	$109,336.00	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
695-4	OTHER	Chemotherapy For Acute Leukemia	8	7	—	—	$65,980.00	$70,599.00	$65,980.00	2026-05-06
7	OTHER	Lung Transplant	9	5	—	—	$106,566.00	$171,477.00	$141,370.00	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
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
790	OTHER	Extreme Immaturity Or Respiratory Distress Syndrome, Neonate	4	3	—	—	$48,480.00	$63,230.00	$51,146.50	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
799	OTHER	Splenic Procedures With Mcc	9	5	—	—	$38,772.00	$62,993.00	$56,174.00	2026-05-06
8	OTHER	Simultaneous Pancreas And Kidney Transplant	9	5	—	—	$44,368.00	$71,394.00	$60,641.00	2026-05-06
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
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
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
834	OTHER	Acute Leukemia With Mcc	9	5	—	—	$45,071.00	$72,524.00	$64,528.00	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
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
841-3	OTHER	Extensive Third Degree Burns With Skin Graft	8	7	—	—	$106,982.00	$114,471.00	$106,982.00	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
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
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
850	OTHER	Acute Leukemia With Other Procedures	9	5	—	—	$75,116.00	$120,871.00	$106,160.00	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
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
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
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
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
863-3	OTHER	Neonatal Aftercare	8	7	—	—	$63,866.00	$68,336.00	$63,866.00	2026-05-06
863-4	OTHER	Neonatal Aftercare	8	7	—	—	$108,047.00	$115,610.00	$108,047.00	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
890-4	OTHER	HIV With Multiple Major HIV Related Conditions	8	7	—	—	$100,566.00	$107,606.00	$100,566.00	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
910-4	OTHER	Craniotomy For Multiple Significant Trauma	8	7	—	—	$106,606.00	$114,068.00	$106,606.00	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
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
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
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
930-4	OTHER	Multiple Significant Trauma Without O.r. Procedure	8	7	—	—	$52,530.00	$56,207.00	$52,530.00	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
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
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
955	OTHER	Craniotomy For Multiple Significant Trauma	9	5	—	—	$55,680.00	$89,596.00	$70,190.00	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
969	OTHER	HIV With Extensive O.r. Procedures With Mcc	9	5	—	—	$51,570.00	$87,378.00	$74,717.00	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
A9543	OTHER	Y90 Ibritumomab, Rx	15	7	—	—	$49,911.00	$140,775.00	$53,405.00	2026-05-06
A9699	OTHER	Radiopharm Rx Agent Noc	1	1	—	—	$98,421.00	$98,421.00	$98,421.00	2026-05-06
J7330	OTHER	Cultured Chondrocytes Implnt	1	1	—	—	$144,921.00	$144,921.00	$144,921.00	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
Q2043	OTHER	Sipuleucel-t Auto Cd54+	17	8	—	—	$33,151.00	$124,146.00	$53,427.00	2026-05-06
Q2053	OTHER	Brexucabtagene Car Pos T	17	8	—	—	$1.00	$1,051,520.00	$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
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

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