Hospital

THOMAS MEMORIAL HOSPITAL

South Charleston, WV · CCN 510029 · Rates published

6,414 distinct procedures filed

21 distinct payers

252,965 rate rows

2026-05-14 last MRF observed

Data quality

200,267 of 252,965 rate rows are consumer-grade (79.2%)

52,698 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	51,514
per-diem day rate — not a per-procedure price	1,046
exceeds 10× this hospital's gross charge — excluded from medians	106
placeholder amount (≤ $0.02) — excluded from medians	32

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

Source MRF file	https://wvumedicine.org/wp-content/uploads/2026/03/550404900_Herbert-J-Thomas-Memorial-Hospital-Association_standardcharges.csv
Found on page	https://wvumedicine.org/billing-and-insurance/costs-and-charges/
Discovered via	CMS hospital list
Last fetch	not_modified · 2026-05-18
Content fingerprint	3d678084d666a6b8… · 42,241,386 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	12	$213,180.96	$860,461.26	$312,559.80	nat. median $424,868 0.7× median
001 OTHER	Heart Transplant Or Implant Of Heart Assist Systemwithcomorbity	11	$138,345.87	$632,887.80	$201,077.10	nat. median $263,894 0.8× median
J9029 OTHER	Instill Adstiladrin, Tx Dose	21	$64,274.79	$297,470.16	$180,872.48	nat. median $66,509 outlier · 2.7×
927 OTHER	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	12	$105,401.23	$615,607.44	$154,783.69	nat. median $146,562 1.1× median
003 OTHER	Ecmo Or Trach With Mv >96 Hrs Or Pdx Exc Face; Mouth & Neck With Maj O.r.	12	$98,662.12	$497,935.61	$153,145.43	nat. median $218,232 0.7× median
454 OTHER	Combined Anterior/posterior Spinal Fusion With Complication	1	$142,846.19	$142,846.19	$142,846.19	nat. median $34,066 outlier · 4.2×
J9226 OTHER	Supprelin La Implant	21	$43,185.34	$199,866.07	$121,525.71	nat. median $45,345 outlier · 2.7×
0620T OTHER	Evasc Ven Artlz Tibl/prnl Vn	18	$42,251.87	$195,545.88	$118,898.88	nat. median $34,721 outlier · 3.4×
455 OTHER	Combined Anterior/posterior Spinal Fusion Without Complication/comorbity	1	$107,563.79	$107,563.79	$107,563.79	nat. median $38,868 outlier · 2.8×
004 OTHER	Trach With Mv >96 Hrs Or Pdx Exc Face; Mouth & Neck Without Maj O.r.	12	$63,751.69	$343,318.50	$100,110.74	nat. median $150,232 0.7× median
007 OTHER	Lung Transplant	12	$63,931.38	$286,481.77	$93,629.02	nat. median $141,082 0.7× median
014 OTHER	Allogeneic Bone Marrow Transplant	12	$59,328.89	$267,669.32	$86,923.62	nat. median $105,808 0.8× median
0408T OTHER	Insj/rplc Cardiac Modulj Sys	18	$29,962.43	$138,669.12	$84,315.77	nat. median $31,782 outlier · 2.7×
0571T OTHER	Insj/rplcmt Icds Ss Eltrd	18	$29,962.43	$138,669.12	$84,315.77	nat. median $31,782 outlier · 2.7×
0915T OTHER	Insj Perm Ccm-d Sys Pg&eltrd	18	$29,962.43	$138,669.12	$84,315.77	nat. median $32,479 outlier · 2.6×
209 OTHER	Complex Aortic Arch Procedures	11	$55,877.63	$86,082.89	$82,287.33	nat. median $23,389 outlier · 3.5×
002 OTHER	Heart Transplant Or Implant Of Heart Assist System Without Mcc	11	$55,941.81	$285,960.96	$81,596.67	nat. median $117,167 0.7× median
426 OTHER	Non-hypovolemic Sodium Disorders	11	$54,408.47	$83,819.91	$80,136.62	nat. median $80,273 1.0× median
212 OTHER	Concomitant Aortic And Mitral Valve Procedures	12	$53,682.28	$251,549.70	$79,073.59	nat. median $90,581 0.9× median
005 OTHER	Liver Transplant With Mcc Or Intestinal Transplant	12	$50,899.95	$241,724.25	$74,643.48	nat. median $104,489 0.7× median
215 OTHER	Other Heart Assist System Implant	12	$49,154.82	$238,566.65	$72,100.99	nat. median $92,359 0.8× median
216 OTHER	Cardiac Valve & Oth Maj Cardiothoracic Proc With Card Cath With Comorbity	12	$48,294.85	$226,667.28	$70,848.09	nat. median $90,130 0.8× median
429 OTHER	Combined Anterior And Posterior Cervical Spinal Fusion With Mcc	11	$44,477.78	$68,520.05	$65,599.36	nat. median $62,997 1.0× median
850 OTHER	Acute Leukemia With Other Procedures	11	$42,749.44	$65,858.18	$63,069.29	nat. median $407 outlier · 154.9×
231 OTHER	Coronary Bypass With Ptca With Comorbity	12	$41,615.97	$189,530.50	$61,117.61	nat. median $74,989 0.8× median
456 OTHER	Spinal Fus Exc Cerv With Spinal Curv/malig/infec Or Ext Fus With Comorbity	12	$41,039.86	$196,868.64	$60,927.00	nat. median $76,493 0.8× median
0923T OTHER	Rmvl&rplcmt Perm Ccm-d Pg	18	$21,232.75	$98,267.29	$59,750.02	nat. median $23,016 outlier · 2.6×
0614T OTHER	Rmvl&rplcmt Ss Impl Dfb Pg	18	$21,232.75	$98,267.29	$59,750.02	nat. median $23,016 outlier · 2.6×
0409T OTHER	Insj/rplc Car Modulj Pls Gn	18	$21,232.75	$98,267.29	$59,750.02	nat. median $23,016 outlier · 2.6×
0916T OTHER	Insj Perm Ccm-d Sys Pg Only	18	$21,232.75	$98,267.29	$59,750.02	nat. median $23,016 outlier · 2.6×
0414T OTHER	Rmvl & Rpl Car Modulj Pls Gn	18	$21,232.75	$98,267.29	$59,750.02	nat. median $22,811 outlier · 2.6×
020 OTHER	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc	12	$38,845.98	$197,405.80	$57,081.98	nat. median $82,426 0.7× median
219 OTHER	Cardiac Valve & Oth Maj Cardiothoracic Proc Without Card Cath With Comorbity	12	$37,905.54	$180,095.08	$55,711.85	nat. median $72,612 0.8× median
233 OTHER	Coronary Bypass With Cardiac Cath With Comorbity	12	$37,742.14	$182,159.66	$55,473.79	nat. median $68,249 0.8× median
957 OTHER	Other O.r. Procedures For Multiple Significant Trauma With Comorbity	12	$37,023.35	$168,915.04	$55,291.83	nat. median $68,309 0.8× median
427 OTHER	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	11	$35,636.13	$54,662.25	$52,154.80	nat. median $51,811 1.0× median
010 OTHER	Pancreas Transplant	12	$35,424.35	$112,421.63	$52,097.00	nat. median $67,882 0.8× median
928 OTHER	Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc	12	$35,409.54	$161,609.59	$52,075.43	nat. median $46,003 1.1× median
019 OTHER	Simultaneous Pancreas And Kidney Transplant With Hemodialysis	12	$35,221.45	$186,688.19	$51,801.40	nat. median $67,495 0.8× median
275 OTHER	Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc	12	$35,200.72	$164,321.11	$51,771.18	nat. median $29,655 1.7× median
0802T OTHER	Tcat Rmv&rpl2chmb Ldls Pm Ra	18	$18,386.36	$85,093.91	$51,740.14	nat. median $19,502 outlier · 2.7×
0803T OTHER	Tcat Rmv&rpl2chmb Ldls Pm Rv	18	$18,386.36	$85,093.91	$51,740.14	nat. median $19,512 outlier · 2.7×
0795T OTHER	Tcat Ins 2chmbr Ldls Pm Cmpl	18	$18,386.36	$85,093.91	$51,740.14	nat. median $19,584 outlier · 2.6×
0825T OTHER	Tcat Rmv&rpl1chmb Ldls Pm Ra	18	$18,386.36	$85,093.91	$51,740.14	nat. median $19,502 outlier · 2.7×
0797T OTHER	Tcat Ins 2chmbr Ldls Pm Rv	18	$18,386.36	$85,093.91	$51,740.14	nat. median $19,788 outlier · 2.6×
0801T OTHER	Tcat Rmv&rpl 2chmbr Ldls Pm	18	$18,386.36	$85,093.91	$51,740.14	nat. median $19,502 outlier · 2.7×
33274 OTHER	Insertion Of Permanent Leadless Pacemaker Using Imaging Guidance	21	$361.84	$85,093.91	$51,740.14	nat. median $17,695 outlier · 2.9×
0823T OTHER	Tcat Ins 1chmbr Ldls Pm Ra	18	$18,386.36	$85,093.91	$51,740.14	nat. median $19,503 outlier · 2.7×
33229 OTHER	Removal And Replacement Of Multiple Lead Permanent Pacemaker	21	$205.80	$85,093.91	$51,740.14	nat. median $17,630 outlier · 2.9×
870 OTHER	Septicemia Or Severe Sepsis With Mv >96 Hours	12	$34,121.55	$162,665.24	$50,198.94	nat. median $54,564 0.9× median

Other procedures at this hospital

Browse this hospital's 6,414 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

001	OTHER	Heart Transplant Or Implant Of Heart Assist Systemwithcomorbity	11	11	—	—	$138,345.87	$632,887.80	$201,077.10	2026-05-14
002	OTHER	Heart Transplant Or Implant Of Heart Assist System Without Mcc	11	11	—	—	$55,941.81	$285,960.96	$81,596.67	2026-05-14
003	OTHER	Ecmo Or Trach With Mv >96 Hrs Or Pdx Exc Face; Mouth & Neck With Maj O.r.	12	12	—	—	$98,662.12	$497,935.61	$153,145.43	2026-05-14
004	OTHER	Trach With Mv >96 Hrs Or Pdx Exc Face; Mouth & Neck Without Maj O.r.	12	12	—	—	$63,751.69	$343,318.50	$100,110.74	2026-05-14
005	OTHER	Liver Transplant With Mcc Or Intestinal Transplant	12	12	—	—	$50,899.95	$241,724.25	$74,643.48	2026-05-14
006	OTHER	Liver Transplant Without Mcc	12	12	—	—	$22,891.52	$112,965.80	$33,837.85	2026-05-14
007	OTHER	Lung Transplant	12	12	—	—	$63,931.38	$286,481.77	$93,629.02	2026-05-14
008	OTHER	Simultaneous Pancreas And Kidney Transplant	12	12	—	—	$27,668.28	$122,887.00	$40,797.15	2026-05-14
010	OTHER	Pancreas Transplant	12	12	—	—	$35,424.35	$112,421.63	$52,097.00	2026-05-14
011	OTHER	Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc	12	12	—	—	$26,925.31	$120,425.39	$39,904.72	2026-05-14
012	OTHER	Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc	12	12	—	—	$20,813.17	$93,534.44	$30,809.90	2026-05-14
013	OTHER	Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy Without Cc/mcc	12	12	—	—	$14,226.61	$62,724.52	$21,315.42	2026-05-14
014	OTHER	Allogeneic Bone Marrow Transplant	12	12	—	—	$59,328.89	$267,669.32	$86,923.62	2026-05-14
016	OTHER	Autologous Bone Marrow Transplant With Cc/mcc	12	12	—	—	$29,273.21	$144,263.84	$43,135.36	2026-05-14
017	OTHER	Autologous Bone Marrow Transplant Without Cc/mcc	12	12	—	—	$26,817.69	$144,263.84	$39,557.92	2026-05-14
018	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	12	12	—	—	$213,180.96	$860,461.26	$312,559.80	2026-05-14
019	OTHER	Simultaneous Pancreas And Kidney Transplant With Hemodialysis	12	12	—	—	$35,221.45	$186,688.19	$51,801.40	2026-05-14
020	OTHER	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc	12	12	—	—	$38,845.98	$197,405.80	$57,081.98	2026-05-14
021	OTHER	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc	12	12	—	—	$26,133.96	$143,432.40	$38,746.28	2026-05-14
022	OTHER	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/…	12	12	—	—	$15,685.90	$81,198.33	$23,429.28	2026-05-14
023	OTHER	Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…	12	12	—	—	$28,288.83	$132,394.82	$41,701.21	2026-05-14
0238T	OTHER	Trluml Perip Athrc Iliac Art	19	18	$19,806.00	$9,903.00 50% off	$17,498.57	$80,985.13	$49,241.85	2026-05-14
024	OTHER	Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…	12	12	—	—	$19,311.92	$88,487.42	$28,622.71	2026-05-14
025	OTHER	Craniotomy & Endovascular Intracranial Procedures With Comorbity	12	12	—	—	$22,445.74	$103,135.68	$33,188.42	2026-05-14
026	OTHER	Craniotomy & Endovascular Intracranial Procedures With Complication	12	12	—	—	$15,349.22	$68,969.65	$22,849.45	2026-05-14
028	OTHER	Spinal Procedures With Comorbity	12	12	—	—	$27,718.15	$140,739.57	$43,700.68	2026-05-14
029	OTHER	Spinal Procedures With Complication Or Spinal Neurostimulators	12	12	—	—	$15,603.95	$80,065.61	$25,024.40	2026-05-14
031	OTHER	Ventricular Shunt Procedures With Mcc	12	12	—	—	$16,511.81	$96,143.19	$32,712.26	2026-05-14
034	OTHER	Carotid Artery Stent Procedure With Comorbity	12	12	—	—	$17,514.95	$91,117.20	$28,326.40	2026-05-14
037	OTHER	Extracranial Procedures With Comorbity	12	12	—	—	$16,252.14	$78,837.14	$24,164.92	2026-05-14
040	OTHER	Periph/cranial Nerve & Other Nerv Syst Proc With Comorbity	12	12	—	—	$15,081.16	$89,928.43	$28,258.07	2026-05-14
0408T	OTHER	Insj/rplc Cardiac Modulj Sys	19	18	$22,536.00	$11,268.00 50% off	$29,962.43	$138,669.12	$84,315.77	2026-05-14
0409T	OTHER	Insj/rplc Car Modulj Pls Gn	19	18	$16,978.00	$8,489.00 50% off	$21,232.75	$98,267.29	$59,750.02	2026-05-14
0410T	OTHER	Insj/rplc Car Modulj Atr Elt	19	18	$6,456.00	$3,228.00 50% off	$7,899.32	$36,558.84	$22,229.08	2026-05-14
0411T	OTHER	Insj/rplc Car Modulj Vnt Elt	19	18	$6,456.00	$3,228.00 50% off	$7,899.32	$36,558.84	$22,229.08	2026-05-14
0414T	OTHER	Rmvl & Rpl Car Modulj Pls Gn	19	18	$16,978.00	$8,489.00 50% off	$21,232.75	$98,267.29	$59,750.02	2026-05-14
0571T	OTHER	Insj/rplcmt Icds Ss Eltrd	19	18	$22,536.00	$11,268.00 50% off	$29,962.43	$138,669.12	$84,315.77	2026-05-14
0572T	OTHER	Insertion Ss Dfb Electrode	19	18	$6,456.00	$3,228.00 50% off	$7,899.32	$36,558.84	$22,229.08	2026-05-14
0614T	OTHER	Rmvl&rplcmt Ss Impl Dfb Pg	19	18	$16,978.00	$8,489.00 50% off	$21,232.75	$98,267.29	$59,750.02	2026-05-14
0620T	OTHER	Evasc Ven Artlz Tibl/prnl Vn	19	18	$71,780.00	$35,890.00 50% off	$42,251.87	$195,545.88	$118,898.88	2026-05-14
0627T	OTHER	Perq Njx Algc Fluor Lmbr 1st	19	18	$16,390.00	$8,195.00 50% off	$12,255.24	$56,718.48	$34,486.86	2026-05-14
077	OTHER	Hypertensive Encephalopathy With Comorbity	1	1	—	—	$35,287.07	$35,287.07	$35,287.07	2026-05-14
0795T	OTHER	Tcat Ins 2chmbr Ldls Pm Cmpl	19	18	$17,073.00	$8,536.50 50% off	$18,386.36	$85,093.91	$51,740.14	2026-05-14
0797T	OTHER	Tcat Ins 2chmbr Ldls Pm Rv	19	18	$17,073.00	$8,536.50 50% off	$18,386.36	$85,093.91	$51,740.14	2026-05-14
0801T	OTHER	Tcat Rmv&rpl 2chmbr Ldls Pm	19	18	$17,073.00	$8,536.50 50% off	$18,386.36	$85,093.91	$51,740.14	2026-05-14
0802T	OTHER	Tcat Rmv&rpl2chmb Ldls Pm Ra	19	18	$17,073.00	$8,536.50 50% off	$18,386.36	$85,093.91	$51,740.14	2026-05-14
0803T	OTHER	Tcat Rmv&rpl2chmb Ldls Pm Rv	19	18	$17,073.00	$8,536.50 50% off	$18,386.36	$85,093.91	$51,740.14	2026-05-14
0823T	OTHER	Tcat Ins 1chmbr Ldls Pm Ra	19	18	$17,073.00	$8,536.50 50% off	$18,386.36	$85,093.91	$51,740.14	2026-05-14
0825T	OTHER	Tcat Rmv&rpl1chmb Ldls Pm Ra	19	18	$17,073.00	$8,536.50 50% off	$18,386.36	$85,093.91	$51,740.14	2026-05-14
0913T	OTHER	Prq Tcat Ther Rx Ntrac Balo1	19	18	$9,275.00	$4,637.50 50% off	$11,019.58	$50,999.72	$31,009.65	2026-05-14
0915T	OTHER	Insj Perm Ccm-d Sys Pg&eltrd	19	18	$22,537.00	$11,268.50 50% off	$29,962.43	$138,669.12	$84,315.77	2026-05-14
0916T	OTHER	Insj Perm Ccm-d Sys Pg Only	19	18	$16,977.00	$8,488.50 50% off	$21,232.75	$98,267.29	$59,750.02	2026-05-14
0917T	OTHER	Insj Perm Ccm-d Sys 1 Lead	19	18	$6,457.00	$3,228.50 50% off	$7,899.32	$36,558.84	$22,229.08	2026-05-14
0918T	OTHER	Insj Perm Ccm-d Sys Dual Ld	19	18	$6,457.00	$3,228.50 50% off	$7,899.32	$36,558.84	$22,229.08	2026-05-14
0923T	OTHER	Rmvl&rplcmt Perm Ccm-d Pg	19	18	$16,977.00	$8,488.50 50% off	$21,232.75	$98,267.29	$59,750.02	2026-05-14
094	OTHER	Bacterial & Tuberculous Infections Of Nervous System With Comorbity	12	12	—	—	$17,374.26	$84,608.16	$25,799.74	2026-05-14
097	OTHER	Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc	12	12	—	—	$16,542.42	$84,939.80	$26,464.30	2026-05-14
140	OTHER	Major Head And Neck Procedures With Mcc	12	12	—	—	$21,056.55	$88,237.53	$31,164.48	2026-05-14
143	OTHER	Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc	12	12	—	—	$18,495.88	$77,669.39	$27,433.84	2026-05-14
163	OTHER	Major Chest Procedures With Comorbity	12	12	—	—	$21,639.08	$110,086.13	$32,721.60	2026-05-14
166	OTHER	Other Resp System O.r. Procedures With Comorbity	12	12	—	—	$17,166.92	$94,769.92	$27,369.81	2026-05-14
173	OTHER	Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary…	12	12	—	—	$14,693.62	$71,816.62	$21,999.05	2026-05-14
19325	OTHER	Insertion Of Breast Implant	23	21	$16,208.00	$8,104.00 50% off	$7,801.96	$36,108.25	$21,955.10	2026-05-14
19342	OTHER	Placement Of Implant On Separate Day Of Breast Reconstruction	23	21	$31,376.67	$15,688.34 50% off	$7,801.96	$36,108.25	$21,955.10	2026-05-14
19357	OTHER	Reconstruction Of Breast Using Tissue Expander	83	21	$23,733.75	$11,866.88 50% off	$205.80	$60,881.22	$37,017.96	2026-05-14
207	OTHER	Respiratory System Diagnosis With Ventilator Support >96 Hours	12	12	—	—	$31,766.25	$161,336.34	$46,767.47	2026-05-14
209	OTHER	Complex Aortic Arch Procedures	11	11	—	—	$55,877.63	$86,082.89	$82,287.33	2026-05-14
212	OTHER	Concomitant Aortic And Mitral Valve Procedures	12	12	—	—	$53,682.28	$251,549.70	$79,073.59	2026-05-14
213	OTHER	Endovascular Abdominal Aorta With Iliac Branch Procedures	11	11	—	—	$28,173.31	$43,402.57	$41,731.64	2026-05-14
215	OTHER	Other Heart Assist System Implant	12	12	—	—	$49,154.82	$238,566.65	$72,100.99	2026-05-14
216	OTHER	Cardiac Valve & Oth Maj Cardiothoracic Proc With Card Cath With Comorbity	12	12	—	—	$48,294.85	$226,667.28	$70,848.09	2026-05-14
217	OTHER	Cardiac Valve & Oth Maj Cardiothoracic Proc With Card Cath With Complication	12	12	—	—	$32,460.35	$148,661.58	$47,778.73	2026-05-14
218	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	12	12	—	—	$28,986.88	$133,046.43	$47,778.73	2026-05-14
219	OTHER	Cardiac Valve & Oth Maj Cardiothoracic Proc Without Card Cath With Comorbity	12	12	—	—	$37,905.54	$180,095.08	$55,711.85	2026-05-14
220	OTHER	Cardiac Valve & Oth Maj Cardiothoracic Proc Without Card Cath With Complication	12	12	—	—	$26,326.49	$122,487.63	$39,028.12	2026-05-14
221	OTHER	Cardiac Valve & Oth Maj Cardiothoracic Proc Without Card Cath Without Complicati…	12	12	—	—	$24,882.01	$108,568.05	$36,737.81	2026-05-14
22612	OTHER	Fusion Of Spine In Lower Back	79	21	$9,855.50	$4,927.75 50% off	$1,229.64	$77,460.56	$47,098.79	2026-05-14
22630	OTHER	Fusion Of Lower Spine Bone And Partial Removal Of Spine Bone Or Disc Through Bac…	14	14	$50,027.00	$25,013.50 50% off	$1,232.47	$119,872.19	$27,066.50	2026-05-14
22633	OTHER	Fusion Of Spine In Lower Back With Partial Removal Of Spine Bone And Disc	14	14	$26,458.33	$13,229.17 50% off	$205.80	$119,872.19	$27,066.50	2026-05-14
228	OTHER	Other Cardiothoracic Procedures With Mcc	12	12	—	—	$24,423.88	$117,678.84	$36,070.35	2026-05-14
229	OTHER	Other Cardiothoracic Procedures Without Comorbity	12	12	—	—	$15,548.17	$74,259.56	$23,250.00	2026-05-14
231	OTHER	Coronary Bypass With Ptca With Comorbity	12	12	—	—	$41,615.97	$189,530.50	$61,117.61	2026-05-14
232	OTHER	Coronary Bypass With Ptca Without Mcc	12	12	—	—	$29,588.17	$138,929.55	$44,091.24	2026-05-14
233	OTHER	Coronary Bypass With Cardiac Cath With Comorbity	12	12	—	—	$37,742.14	$182,159.66	$55,473.79	2026-05-14
234	OTHER	Coronary Bypass With Cardiac Cath Without Comorbity	12	12	—	—	$26,967.77	$121,396.95	$39,966.87	2026-05-14
23470	OTHER	Partial Replacement Of Shoulder Joint	23	21	$35,983.00	$17,991.50 50% off	$12,255.24	$56,718.48	$34,486.86	2026-05-14
23472	OTHER	Prosthetic Repair Of Shoulder Joint; Total Shoulder	106	21	$38,017.00	$19,008.50 50% off	$205.80	$77,460.56	$47,098.79	2026-05-14
23473	OTHER	Revision Of Total Shoulder Repair	46	21	$52,763.50	$26,381.75 50% off	$12,255.24	$56,718.48	$34,486.86	2026-05-14
23474	OTHER	Revision Of Total Shoulder Repair; Total Shoulder	46	21	$39,542.50	$19,771.25 50% off	$12,255.24	$56,718.48	$34,486.86	2026-05-14
235	OTHER	Coronary Bypass Without Cardiac Cath With Comorbity	12	12	—	—	$28,971.58	$137,341.41	$42,695.91	2026-05-14
236	OTHER	Coronary Bypass Without Cardiac Cath Without Comorbity	12	12	—	—	$20,678.89	$94,382.23	$30,760.74	2026-05-14
23615	OTHER	Treatment Of Broken Top Of Upper Arm Bone	23	21	$30,974.00	$15,487.00 50% off	$12,255.24	$56,718.48	$34,486.86	2026-05-14
239	OTHER	Amputation For Circ Sys Disorders Exc Upper Limb & Toe With Comorbity	12	12	—	—	$24,297.01	$112,262.81	$35,885.52	2026-05-14
240	OTHER	Amputation For Circ Sys Disorders Exc Upper Limb & Toe With Complication	12	12	—	—	$14,072.09	$65,608.87	$20,988.78	2026-05-14
242	OTHER	Permanent Cardiac Pacemaker Implant With Comorbity	12	12	—	—	$15,761.93	$80,693.86	$23,450.72	2026-05-14
24435	OTHER	Repair Of Nonhealed Broken Upper Arm Bone With Self Bone Graft	23	21	$54,915.00	$27,457.50 50% off	$12,255.24	$56,718.48	$34,486.86	2026-05-14
245	OTHER	Aicd Generator Procedures	12	12	—	—	$22,523.25	$105,830.85	$33,460.65	2026-05-14
24516	OTHER	Treatment Of Broken Middle Part Of Upper Arm Bone With Placement Of Stabilizing …	46	21	$35,278.00	$17,639.00 50% off	$12,255.24	$56,718.48	$34,486.86	2026-05-14
24575	OTHER	Treatment Of Broken Outer Part Of Upper Arm Bone At Elbow	23	21	$22,635.00	$11,317.50 50% off	$12,255.24	$56,718.48	$34,486.86	2026-05-14
24666	OTHER	Treatment Of Broken Forearm Bone On Thumb Side At Elbow With Prosthesis	46	21	$22,078.67	$11,039.33 50% off	$12,255.24	$56,718.48	$34,486.86	2026-05-14
252	OTHER	Other Vascular Procedures With Comorbity	12	12	—	—	$17,220.73	$78,328.00	$25,576.05	2026-05-14
258	OTHER	Cardiac Pacemaker Device Replacement With Mcc	12	12	—	—	$15,511.64	$63,259.35	$23,171.65	2026-05-14
25810	OTHER	Fusion Of Wrist Joint With Graft From Hip Or Other Bone	23	21	$67,558.00	$33,779.00 50% off	$12,255.24	$56,718.48	$34,486.86	2026-05-14
260	OTHER	Cardiac Pacemaker Revision Except Device Replacement With Comorbity	12	12	—	—	$16,058.13	$77,426.50	$23,996.52	2026-05-14
263	OTHER	Vein Ligation And Stripping	12	12	—	—	$15,093.50	$65,982.55	$22,476.88	2026-05-14
264	OTHER	Other Circulatory System O.r. Procedures	12	12	—	—	$13,475.24	$76,277.43	$24,513.75	2026-05-14
265	OTHER	Aicd Lead Procedures	12	12	—	—	$17,862.00	$82,538.91	$26,637.18	2026-05-14
266	OTHER	Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc	12	12	—	—	$30,254.13	$145,877.67	$44,777.71	2026-05-14
267	OTHER	Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc	12	12	—	—	$22,604.70	$113,977.07	$34,728.26	2026-05-14
268	OTHER	Aortic And Heart Assist Procedures Except Pulsation Balloon With Comorbity	12	12	—	—	$33,096.20	$160,091.52	$49,955.12	2026-05-14
269	OTHER	Aortic And Heart Assist Procedures Except Pulsation Balloon Without Comorbity	12	12	—	—	$20,848.71	$97,124.10	$30,861.67	2026-05-14
270	OTHER	Other Major Cardiovascular Procedures With Comorbity	12	12	—	—	$26,047.56	$118,103.90	$38,435.93	2026-05-14
271	OTHER	Other Major Cardiovascular Procedures With Complication	12	12	—	—	$17,556.42	$80,719.55	$26,065.12	2026-05-14
27279	OTHER	Fusion Of Pelvic Joint Using Imaging Guidance	83	21	$16,710.00	$8,355.00 50% off	$205.80	$77,460.56	$47,098.79	2026-05-14
273	OTHER	Percutaneous Intracardiac Procedures With Comorbity	12	12	—	—	$20,366.40	$91,014.44	$30,158.99	2026-05-14
274	OTHER	Percutaneous Intracardiac Procedures Without Comorbity	12	12	—	—	$16,250.17	$75,688.88	$24,162.03	2026-05-14
27446	OTHER	Replacement Of Knee Joint On Side Of Knee	46	21	$29,792.00	$14,896.00 50% off	$12,255.24	$56,718.48	$34,486.86	2026-05-14
27447	OTHER	Replacement Of Knee Joint; Both Sides Of Knee	83	21	$25,685.67	$12,842.83 50% off	$205.80	$56,718.48	$34,486.86	2026-05-14
27486	OTHER	Revision Of Component Of Total Knee Joint Prosthesis	46	21	$30,220.00	$15,110.00 50% off	$12,255.24	$56,718.48	$34,486.86	2026-05-14
27487	OTHER	Revision Of Thigh And Lower Leg Bone Components Of Total Knee Joint Prosthesis	83	21	$44,288.50	$22,144.25 50% off	$205.80	$77,460.56	$23,549.38	2026-05-14
275	OTHER	Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc	12	12	—	—	$35,200.72	$164,321.11	$51,771.18	2026-05-14
276	OTHER	Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator	12	12	—	—	$25,941.92	$145,039.22	$43,688.46	2026-05-14
277	OTHER	Cardiac Defibrillator Implant Without Mcc	12	12	—	—	$22,800.20	$111,692.95	$33,704.82	2026-05-14
27759	OTHER	Treatment Of Broken Part Of Shin Bone With Rod	23	21	$14,731.34	$7,365.67 50% off	$12,255.24	$56,718.48	$34,486.86	2026-05-14
278	OTHER	Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures …	12	12	—	—	$27,478.72	$104,172.64	$40,714.83	2026-05-14
27827	OTHER	Treatment Of Broken Shin Bone At Lower Weight Bearing Joint	83	21	$18,302.00	$9,151.00 50% off	$205.80	$56,718.48	$34,486.86	2026-05-14
27828	OTHER	Treatment Of Broken Lower Weight Bearing Joint Of Both Lower Leg Bones	23	21	$8,815.75	$4,407.88 50% off	$12,255.24	$56,718.48	$34,486.86	2026-05-14
279	OTHER	Hepatic Coma And Other Major Acute Liver Disorders	12	12	—	—	$17,803.75	$74,750.01	$26,425.47	2026-05-14
28297	OTHER	Correction Of Bunion With Midfoot And Hindfoot Bone Fusion	23	21	$23,691.50	$11,845.75 50% off	$12,255.24	$56,718.48	$34,486.86	2026-05-14
28715	OTHER	Fusion Of 3 Bones Of Ankle	23	21	$60,295.00	$30,147.50 50% off	$12,255.24	$56,718.48	$34,486.86	2026-05-14
28730	OTHER	Fusion Of Multiple Foot Joints	46	21	$42,758.67	$21,379.33 50% off	$12,255.24	$56,718.48	$34,486.86	2026-05-14
28735	OTHER	Fusion Of Multiple Foot Joints With Bone Incision To Correct A Foot Deformity	46	21	$49,092.83	$24,546.42 50% off	$12,255.24	$56,718.48	$34,486.86	2026-05-14
317	OTHER	Concomitant Left Atrial Appendage Closure And Cardiac Ablation	11	11	—	—	$33,009.31	$50,670.42	$48,346.08	2026-05-14
319	OTHER	Other Endovascular Cardiac Valve Procedures With Mcc	12	12	—	—	$22,032.04	$101,872.17	$32,585.68	2026-05-14
323	OTHER	Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc	12	12	—	—	$21,363.12	$96,689.70	$31,762.38	2026-05-14
324	OTHER	Non-elective Or Complex Hip Joint Replacement	12	12	—	—	$15,555.57	$69,331.65	$23,150.08	2026-05-14
325	OTHER	Coronary Intravascular Lithotripsy Without Intraluminal Device	12	12	—	—	$15,848.81	$61,757.63	$23,690.12	2026-05-14
326	OTHER	Stomach; Esophageal & Duodenal Proc With Comorbity	12	12	—	—	$24,621.35	$118,620.04	$36,358.04	2026-05-14
329	OTHER	Major Small & Large Bowel Procedures With Comorbity	12	12	—	—	$21,706.71	$105,489.86	$33,546.57	2026-05-14
332	OTHER	Rectal Resection With Mcc	12	12	—	—	$17,874.35	$84,722.60	$26,655.24	2026-05-14
33208	OTHER	Insertion Of Pacemaker And Upper And Lower Heart Chamber Electrode	60	21	$10,725.00	$5,362.50 50% off	$205.80	$46,174.60	$28,075.81	2026-05-14
33228	OTHER	Removal And Replacement Of Dual Lead Permanent Pacemaker	60	21	$11,237.00	$5,618.50 50% off	$205.80	$46,174.60	$28,075.81	2026-05-14
33229	OTHER	Removal And Replacement Of Multiple Lead Permanent Pacemaker	60	21	$17,072.00	$8,536.00 50% off	$205.80	$85,093.91	$51,740.14	2026-05-14
33230	OTHER	Insrt Pulse Gen W/dual Leads	14	14	$16,978.00	$8,489.00 50% off	$205.80	$98,267.29	$22,188.22	2026-05-14
33231	OTHER	Insrt Pulse Gen W/mult Leads	14	14	$22,536.00	$11,268.00 50% off	$205.80	$138,669.12	$31,310.74	2026-05-14
33240	OTHER	Insrt Pulse Gen W/singl Lead	14	14	$16,978.00	$8,489.00 50% off	$205.80	$98,267.29	$22,188.22	2026-05-14
33249	OTHER	Insj/rplcmt Defib W/lead(s)	14	14	$22,535.00	$11,267.50 50% off	$205.80	$138,669.12	$31,310.74	2026-05-14
33262	OTHER	Rmvl& Replc Pulse Gen 1 Lead	14	14	$16,977.00	$8,488.50 50% off	$205.80	$98,267.29	$22,188.22	2026-05-14
33263	OTHER	Rmvl & Rplcmt Dfb Gen 2 Lead	14	14	$16,977.00	$8,488.50 50% off	$205.80	$98,267.29	$22,188.22	2026-05-14
33264	OTHER	Rmvl & Rplcmt Dfb Gen Mlt Ld	14	14	$22,535.00	$11,267.50 50% off	$205.80	$138,669.12	$31,310.74	2026-05-14
33270	OTHER	Ins/rep Subq Defibrillator	14	14	$22,536.00	$11,268.00 50% off	$205.80	$138,669.12	$31,310.74	2026-05-14
33274	OTHER	Insertion Of Permanent Leadless Pacemaker Using Imaging Guidance	60	21	$15,881.00	$7,940.50 50% off	$361.84	$85,093.91	$51,740.14	2026-05-14
335	OTHER	Peritoneal Adhesiolysis With Comorbity	12	12	—	—	$17,628.50	$83,494.12	$26,295.35	2026-05-14
353	OTHER	Hernia Procedures Except Inguinal & Femoral With Comorbity	12	12	—	—	$14,326.33	$68,297.03	$21,359.19	2026-05-14
356	OTHER	Other Digestive System O.r. Procedures With Comorbity	12	12	—	—	$21,685.98	$99,929.04	$32,081.50	2026-05-14
359	OTHER	Percutaneous Coronary Atherectomy With Intraluminal Device With Mcc	11	11	—	—	$16,975.37	$26,304.56	$25,097.92	2026-05-14
37236	OTHER	Insertion Of Stent In Artery (except Lower Extremity; Chest; Heart; Neck And Bra…	60	21	$37,040.00	$18,520.00 50% off	$205.80	$50,999.72	$31,009.65	2026-05-14
37238	OTHER	Insertion Of Stent In Vein With Review By Radiologist; Initial Vein	83	21	$37,040.00	$18,520.00 50% off	$205.80	$50,999.72	$31,009.65	2026-05-14
37258	OTHER	Revsc Evasc Ivt Stent Sf 1st	23	21	$37,412.00	$18,706.00 50% off	$11,019.58	$50,999.72	$31,009.65	2026-05-14
37260	OTHER	Revsc Evasc Ivt St Cplx 1st	23	21	$37,412.00	$18,706.00 50% off	$11,019.58	$50,999.72	$31,009.65	2026-05-14
37267	OTHER	Revsc Evsc Fpvt Stent Sf 1st	23	21	$37,040.00	$18,520.00 50% off	$11,019.58	$50,999.72	$31,009.65	2026-05-14
37269	OTHER	Revsc Evasc Fpvt St Cplx 1st	23	21	$37,040.00	$18,520.00 50% off	$11,019.58	$50,999.72	$31,009.65	2026-05-14
37271	OTHER	Revsc Evsc Fpvt Athrc Sf 1st	23	21	$37,039.00	$18,519.50 50% off	$17,498.57	$80,985.13	$49,241.85	2026-05-14
37273	OTHER	Revsc Evsc Fpvt Athrc Cplx 1	23	21	$37,039.00	$18,519.50 50% off	$17,498.57	$80,985.13	$49,241.85	2026-05-14
37275	OTHER	Rvsc Evsc Fpvt St Athrc Sf 1	23	21	$59,220.00	$29,610.00 50% off	$17,498.57	$80,985.13	$49,241.85	2026-05-14
37277	OTHER	Rvsc Evsc Fpvt St Athr Cpx 1	23	21	$59,220.00	$29,610.00 50% off	$17,498.57	$80,985.13	$49,241.85	2026-05-14
37280	OTHER	Revsc Evsc Tpvt Angio Sf 1st	23	21	$37,042.00	$18,521.00 50% off	$11,019.58	$50,999.72	$31,009.65	2026-05-14
37282	OTHER	Rvsc Evsc Tpvt Angio Cplx 1	23	21	$37,042.00	$18,521.00 50% off	$11,019.58	$50,999.72	$31,009.65	2026-05-14
37284	OTHER	Revsc Evasc Tpvt St Sf 1st	23	21	$19,030.00	$9,515.00 50% off	$17,498.57	$80,985.13	$49,241.85	2026-05-14
37286	OTHER	Revsc Evasc Tpvt St Cplx 1st	23	21	$19,030.00	$9,515.00 50% off	$17,498.57	$80,985.13	$49,241.85	2026-05-14
37288	OTHER	Revsc Evsc Tpvt Athrc Sf 1st	23	21	$59,220.00	$29,610.00 50% off	$17,498.57	$80,985.13	$49,241.85	2026-05-14
37290	OTHER	Revsc Evsc Tpvt Athrc Cplx 1	23	21	$59,220.00	$29,610.00 50% off	$17,498.57	$80,985.13	$49,241.85	2026-05-14
37292	OTHER	Rvsc Evsc Tpvt St Athrc Sf 1	23	21	$19,030.00	$9,515.00 50% off	$17,498.57	$80,985.13	$49,241.85	2026-05-14
37294	OTHER	Rvsc Evsc Tpvt St Athr Cpx 1	23	21	$19,030.00	$9,515.00 50% off	$17,498.57	$80,985.13	$49,241.85	2026-05-14
37296	OTHER	Revsc Evasc Imvt Angio Sf 1	23	21	$15,930.00	$7,965.00 50% off	$11,019.58	$50,999.72	$31,009.65	2026-05-14
37298	OTHER	Revsc Evsc Imvt Angio Cplx 1	23	21	$15,930.00	$7,965.00 50% off	$11,019.58	$50,999.72	$31,009.65	2026-05-14
402	OTHER	Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical	11	11	—	—	$19,848.04	$30,670.01	$29,263.12	2026-05-14
405	OTHER	Pancreas; Liver & Shunt Procedures With Comorbity	12	12	—	—	$27,006.27	$128,573.95	$39,832.67	2026-05-14
406	OTHER	Pancreas, Liver And Shunt Procedures With Cc	12	12	—	—	$14,317.45	$67,435.23	$21,346.26	2026-05-14
408	OTHER	Biliary Tract Proc Except Only Cholecyst With Or Without C.d.e. With Comorbity	12	12	—	—	$17,602.33	$86,931.98	$26,257.06	2026-05-14
411	OTHER	Cholecystectomy With C.d.e. With Mcc	12	12	—	—	$16,307.43	$67,274.08	$24,348.00	2026-05-14
414	OTHER	Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc	12	12	—	—	$17,587.52	$82,331.05	$26,235.37	2026-05-14
420	OTHER	Hepatobiliary Diagnostic Procedures With Comorbity	12	12	—	—	$16,819.86	$74,754.68	$25,111.62	2026-05-14
423	OTHER	Other Hepatobiliary Or Pancreas O.r. Procedures With Comorbity	12	12	—	—	$20,502.16	$91,339.07	$30,502.04	2026-05-14
426	OTHER	Non-hypovolemic Sodium Disorders	11	11	—	—	$54,408.47	$83,819.91	$80,136.62	2026-05-14
427	OTHER	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	11	11	—	—	$35,636.13	$54,662.25	$52,154.80	2026-05-14
428	OTHER	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	11	11	—	—	$27,754.18	$42,684.50	$40,726.49	2026-05-14
429	OTHER	Combined Anterior And Posterior Cervical Spinal Fusion With Mcc	11	11	—	—	$44,477.78	$68,520.05	$65,599.36	2026-05-14
430	OTHER	Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc	11	11	—	—	$28,470.50	$43,773.05	$41,765.11	2026-05-14
43889	OTHER	Gstr Rstcv Px Trnsorl Esg	23	21	$21,044.00	$10,522.00 50% off	$10,146.78	$46,960.31	$28,553.54	2026-05-14
447	OTHER	Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall…	11	11	—	—	$32,985.12	$50,815.53	$48,775.52	2026-05-14
448	OTHER	Multiple Level Spinal Fusion Except Cervical Without Mcc	11	11	—	—	$20,935.60	$32,322.70	$30,840.00	2026-05-14
450	OTHER	Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically …	11	11	—	—	$26,310.69	$40,533.35	$39,005.00	2026-05-14
451	OTHER	Single Level Spinal Fusion Except Cervical Without Mcc	11	11	—	—	$15,947.55	$24,742.63	$23,607.65	2026-05-14
454	OTHER	Combined Anterior/posterior Spinal Fusion With Complication	1	1	—	—	$142,846.19	$142,846.19	$142,846.19	2026-05-14
455	OTHER	Combined Anterior/posterior Spinal Fusion Without Complication/comorbity	1	1	—	—	$107,563.79	$107,563.79	$107,563.79	2026-05-14
456	OTHER	Spinal Fus Exc Cerv With Spinal Curv/malig/infec Or Ext Fus With Comorbity	12	12	—	—	$41,039.86	$196,868.64	$60,927.00	2026-05-14
457	OTHER	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	12	12	—	—	$29,438.10	$141,888.63	$43,375.59	2026-05-14
458	OTHER	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	12	12	—	—	$20,598.92	$105,821.50	$30,497.76	2026-05-14
461	OTHER	Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc	12	12	—	—	$27,265.45	$159,246.07	$40,402.66	2026-05-14
463	OTHER	Wnd Debrid & Skn Grft Exc Hand; For Musculo-conn Tiss Dis With Comorbity	12	12	—	—	$27,167.70	$132,275.71	$41,479.71	2026-05-14
464	OTHER	Wnd Debrid & Skn Grft Exc Hand; For Musculo-conn Tiss Dis With Complication	12	12	—	—	$15,342.31	$70,097.70	$22,889.00	2026-05-14
466	OTHER	Revision Of Hip Or Knee Replacement With Comorbity	12	12	—	—	$25,697.55	$121,133.04	$37,925.98	2026-05-14
467	OTHER	Revision Of Hip Or Knee Replacement With Complication	12	12	—	—	$17,409.80	$81,422.54	$25,851.51	2026-05-14
469	OTHER	Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Com…	12	12	—	—	$14,974.03	$77,767.48	$22,302.83	2026-05-14
471	OTHER	Cervical Spinal Fusion With Comorbity	12	12	—	—	$23,837.89	$114,883.24	$35,216.62	2026-05-14
472	OTHER	Cervical Spinal Fusion With Complication	12	12	—	—	$14,544.04	$69,023.37	$21,676.38	2026-05-14
474	OTHER	Amputation For Musculoskeletal Sys & Conn Tissue Dis With Comorbity	12	12	—	—	$21,192.80	$100,491.89	$31,362.98	2026-05-14
477	OTHER	Biopsies Of Musculoskeletal System & Connective Tissue With Comorbity	12	12	—	—	$16,408.64	$78,683.00	$25,333.67	2026-05-14
480	OTHER	Hip & Femur Procedures Except Major Joint With Comorbity	12	12	—	—	$14,377.18	$68,871.56	$21,433.28	2026-05-14
485	OTHER	Knee Procedures With Pdx Of Infection With Comorbity	12	12	—	—	$15,931.26	$76,931.37	$23,810.81	2026-05-14
492	OTHER	Lower Extrem & Humer Proc Except Hip; Foot; Femur With Comorbity	12	12	—	—	$17,800.30	$80,857.35	$26,894.39	2026-05-14
495	OTHER	Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit…	12	12	—	—	$17,899.03	$83,638.93	$26,691.38	2026-05-14
498	OTHER	Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur With Cc…	12	12	—	—	$14,893.07	$60,979.91	$22,184.87	2026-05-14
500	OTHER	Soft Tissue Procedures With Comorbity	12	12	—	—	$15,623.70	$75,735.59	$23,249.35	2026-05-14
50080	OTHER	Removal Or Crushing Kidney Stone Or Insertion Of Kidney Stent Using An Endoscope…	23	21	$19,781.00	$9,890.50 50% off	$9,036.26	$41,820.71	$25,428.49	2026-05-14
50081	OTHER	Removal Or Crushing Kidney Stone Or Insertion Of Kidney Stent Using An Endoscope…	83	21	$17,155.42	$8,577.71 50% off	$205.80	$41,820.71	$25,428.49	2026-05-14
50543	OTHER	Partial Removal Of Kidney Using An Endoscope	46	21	$30,839.50	$15,419.75 50% off	$10,146.78	$46,960.31	$28,553.54	2026-05-14
510	OTHER	Shoulder; Elbow Or Forearm Proc; Exc Major Joint Proc With Comorbity	12	12	—	—	$14,911.33	$63,539.61	$22,317.76	2026-05-14
515	OTHER	Other Musculoskelet Sys & Conn Tiss O.r. Proc With Comorbity	12	12	—	—	$15,732.80	$73,836.83	$23,520.28	2026-05-14
518	OTHER	Back & Neck Proc Exc Spinal Fusion With Comorbity Or Disc Device/neurostim	12	12	—	—	$18,449.97	$85,287.79	$27,497.88	2026-05-14
521	OTHER	Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc	12	12	—	—	$14,169.35	$69,929.54	$21,130.47	2026-05-14
570	OTHER	Skin Debridement With Comorbity	12	12	—	—	$12,341.28	$68,247.98	$21,640.43	2026-05-14
573	OTHER	Skin Graft For Skin Ulcer Or Cellulitis With Mcc	12	12	—	—	$32,342.36	$145,223.73	$47,834.63	2026-05-14
574	OTHER	Skin Graft For Skin Ulcer Or Cellulitis With Complication	12	12	—	—	$14,987.36	$79,542.46	$25,454.51	2026-05-14
576	OTHER	Skin Graft Exc For Skin Ulcer Or Cellulitis With Comorbity	12	12	—	—	$24,195.80	$132,728.80	$35,909.08	2026-05-14
579	OTHER	Other Skin; Subcut Tiss & Breast Proc With Comorbity	12	12	—	—	$15,987.54	$78,057.08	$23,779.43	2026-05-14
58571	OTHER	Removal Of Uterus; Tubes; And/or Ovaries Through Abdomen Using An Endoscope; 250…	60	21	$20,649.34	$10,324.67 50% off	$205.80	$46,960.31	$28,553.54	2026-05-14
616	OTHER	Amputat Of Lower Limb For Endocrine; Nutrit; & Metabol Dis With Comorbity	12	12	—	—	$17,068.18	$92,432.08	$25,569.57	2026-05-14
619	OTHER	O.r. Procedures For Obesity With Mcc	12	12	—	—	$14,254.26	$60,454.42	$21,355.89	2026-05-14
622	OTHER	Skin Grafts & Wound Debrid For Endoc; Nutrit & Metab Dis With Comorbity	12	12	—	—	$14,186.62	$89,346.89	$26,085.98	2026-05-14
625	OTHER	Thyroid, Parathyroid And Thyroglossal Procedures With Mcc	12	12	—	—	$14,909.36	$68,224.63	$22,314.87	2026-05-14
628	OTHER	Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc	12	12	—	—	$13,935.84	$93,758.65	$27,291.42	2026-05-14
63685	OTHER	Ins/rplc Spi Npg/rcvr Pocket	35	21	$27,686.00	$13,843.00 50% off	$205.80	$136,322.58	$31,222.73	2026-05-14
650	OTHER	Kidney Transplant With Hemodialysis With Mcc	12	12	—	—	$23,209.45	$105,039.11	$34,301.03	2026-05-14
651	OTHER	Kidney Transplant With Hemodialysis Without Mcc	12	12	—	—	$18,294.46	$80,770.93	$27,140.38	2026-05-14
652	OTHER	Kidney Transplant	12	12	—	—	$15,943.10	$70,167.76	$23,714.67	2026-05-14
653	OTHER	Major Bladder Procedures With Mcc	12	12	—	—	$25,653.12	$126,434.63	$38,042.39	2026-05-14
654	OTHER	Major Bladder Procedures With Complication	12	12	—	—	$13,819.33	$63,934.31	$20,719.21	2026-05-14
656	OTHER	Kidney & Ureter Procedures For Neoplasm With Comorbity	12	12	—	—	$15,717.50	$73,278.65	$23,385.99	2026-05-14
662	OTHER	Minor Bladder Procedures With Comorbity	12	12	—	—	$15,113.74	$69,987.93	$22,614.06	2026-05-14
665	OTHER	Prostatectomy With Mcc	12	12	—	—	$15,408.46	$72,145.93	$23,045.48	2026-05-14
668	OTHER	Transurethral Procedures With Comorbity	12	12	—	—	$14,415.19	$65,814.39	$21,591.48	2026-05-14
673	OTHER	Other Kidney & Urinary Tract Procedures With Comorbity	12	12	—	—	$20,528.81	$86,366.79	$30,706.33	2026-05-14
736	OTHER	Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc	12	12	—	—	$17,646.27	$90,785.56	$26,196.04	2026-05-14
739	OTHER	Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc…	12	12	—	—	$17,687.24	$84,458.69	$26,381.34	2026-05-14
790	OTHER	Extreme Immaturity Or Respiratory Distress Syndrome; Neonate	12	12	—	—	$5,257.10	$140,132.34	$43,234.62	2026-05-14
791	OTHER	Prematurity With Major Problems	12	12	—	—	$2,688.53	$95,701.78	$29,680.71	2026-05-14
793	OTHER	Full Term Neonate With Major Problems	12	12	—	—	$2,074.90	$98,308.20	$30,476.17	2026-05-14
799	OTHER	Splenic Procedures With Mcc	12	12	—	—	$20,876.85	$115,714.68	$33,060.38	2026-05-14
802	OTHER	Other O.r. Proc Of The Blood & Blood Forming Organs With Comorbity	12	12	—	—	$19,668.35	$79,180.46	$29,281.43	2026-05-14
820	OTHER	Lymphoma And Leukemia With Major O.r. Procedures With Mcc	12	12	—	—	$28,952.82	$141,220.68	$42,872.75	2026-05-14
823	OTHER	Lymphoma & Non-acute Leukemia With Other Proc With Comorbity	12	12	—	—	$22,633.83	$105,141.87	$33,622.52	2026-05-14
826	OTHER	Myeloprolif Disord Or Poorly Diff Neopl With Maj O.r. Proc With Comorbity	12	12	—	—	$23,092.94	$102,500.42	$34,294.63	2026-05-14
829	OTHER	Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce…	12	12	—	—	$15,600.00	$73,657.00	$23,214.82	2026-05-14
834	OTHER	Acute Leukemia Without Major O.r. Procedure With Comorbity	12	12	—	—	$27,102.04	$130,764.64	$39,972.19	2026-05-14
837	OTHER	Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot…	12	12	—	—	$9,820.10	$111,090.39	$35,041.14	2026-05-14
840	OTHER	Lymphoma & Non-acute Leukemia With Comorbity	12	12	—	—	$15,969.76	$72,989.05	$23,753.52	2026-05-14
850	OTHER	Acute Leukemia With Other Procedures	11	11	—	—	$42,749.44	$65,858.18	$63,069.29	2026-05-14
853	OTHER	Infectious & Parasitic Diseases With O.r. Procedure With Comorbity	12	12	—	—	$24,380.44	$116,758.65	$36,007.07	2026-05-14
856	OTHER	Postoperative Or Post-traumatic Infections With O.r. Proc With Comorbity	12	12	—	—	$18,920.93	$103,425.28	$33,202.79	2026-05-14
870	OTHER	Septicemia Or Severe Sepsis With Mv >96 Hours	12	12	—	—	$34,121.55	$162,665.24	$50,198.94	2026-05-14
876	OTHER	O.r. Procedures With Principal Diagnosis Of Mental Illness	12	12	—	—	$19,079.89	$87,149.18	$28,420.00	2026-05-14
901	OTHER	Wound Debridements For Injuries With Comorbity	12	12	—	—	$20,717.40	$101,075.77	$30,817.11	2026-05-14
904	OTHER	Skin Grafts For Injuries With Cc/mcc	12	12	—	—	$18,133.03	$76,048.55	$27,033.92	2026-05-14
907	OTHER	Other O.r. Procedures For Injuries With Comorbity	12	12	—	—	$16,191.92	$86,868.92	$28,100.55	2026-05-14
927	OTHER	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	12	12	—	—	$105,401.23	$615,607.44	$154,783.69	2026-05-14
928	OTHER	Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc	12	12	—	—	$35,409.54	$161,609.59	$52,075.43	2026-05-14
929	OTHER	Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/mcc	12	12	—	—	$15,900.16	$75,098.00	$23,765.28	2026-05-14
92928	OTHER	Insertion Of Stents With Balloon Dilation Of Coronary Artery Or Branch; Single A…	129	21	$42,459.00	$21,229.50 50% off	$450.63	$50,999.72	$31,009.65	2026-05-14
92930	OTHER	Prq Tcat Plmt Ntrac St 2+les	23	21	$19,030.00	$9,515.00 50% off	$17,498.57	$80,985.13	$49,241.85	2026-05-14
92937	OTHER	Removal Of Plaque; Insertion Of Stent And/or Balloon Dilation Of Single Coronary…	83	21	$30,894.00	$15,447.00 50% off	$450.38	$50,999.72	$31,009.65	2026-05-14
933	OTHER	Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft	12	12	—	—	$19,224.54	$70,812.36	$28,631.76	2026-05-14
93653	OTHER	Compre Ep Eval Tx Svt	14	14	$36,898.00	$18,449.00 50% off	$636.95	$115,471.33	$26,072.80	2026-05-14
93654	OTHER	Compre Ep Eval Tx Vt	14	14	$35,699.00	$17,849.50 50% off	$767.69	$115,471.33	$26,072.80	2026-05-14
93656	OTHER	Compre Ep Eval Abltj Atr Fib	14	14	$37,813.00	$18,906.50 50% off	$721.62	$115,471.33	$26,072.80	2026-05-14
939	OTHER	O.r. Proc With Diagnoses Of Other Contact With Health Services With Comorbity	12	12	—	—	$17,912.85	$75,093.33	$26,711.61	2026-05-14
955	OTHER	Craniotomy For Multiple Significant Trauma	12	12	—	—	$33,229.49	$142,236.62	$48,899.30	2026-05-14
956	OTHER	Limb Reattachment; Hip & Femur Proc For Multiple Significant Trauma	12	12	—	—	$18,576.84	$90,575.36	$27,683.60	2026-05-14
957	OTHER	Other O.r. Procedures For Multiple Significant Trauma With Comorbity	12	12	—	—	$37,023.35	$168,915.04	$55,291.83	2026-05-14
958	OTHER	Other O.r. Procedures For Multiple Significant Trauma With Complication	12	12	—	—	$20,639.40	$94,466.30	$30,794.81	2026-05-14
959	OTHER	Other O.r. Procedures For Multiple Significant Trauma Without Cc/mcc	12	12	—	—	$14,534.17	$59,144.20	$21,661.99	2026-05-14
969	OTHER	HIV With Extensive O.r. Procedures With Mcc	12	12	—	—	$30,219.08	$160,509.57	$44,726.40	2026-05-14
974	OTHER	HIV With Major Related Condition With Comorbity	12	12	—	—	$14,247.35	$68,114.86	$21,244.11	2026-05-14
981	OTHER	Extensive O.r. Procedure Unrelated To Principal Diagnosis With Comorbity	12	12	—	—	$23,162.06	$110,712.04	$34,232.01	2026-05-14
987	OTHER	Non-extensive O.r. Proc Unrelated To Principal Diagnosis With Comorbity	12	12	—	—	$16,020.12	$78,862.83	$25,145.24	2026-05-14
C9600	OTHER	Percutaneous Transcatheter Placement Of Drug Eluting Intracoronary Stent(s); Wit…	138	21	$42,459.00	$21,229.50 50% off	$11,019.58	$50,999.72	$31,009.65	2026-05-14
C9602	OTHER	Perc D-e Cor Stent Ather S	46	21	$19,028.00	$9,514.00 50% off	$17,498.57	$80,985.13	$49,241.85	2026-05-14
C9604	OTHER	Percutaneous Transluminal Revascularization Of Or Through Coronary Artery Bypass…	115	21	$45,858.00	$22,929.00 50% off	$11,019.58	$50,999.72	$31,009.65	2026-05-14
C9607	OTHER	Perc D-e Cor Revasc Chro Sin	46	21	$67,144.00	$33,572.00 50% off	$17,498.57	$80,985.13	$49,241.85	2026-05-14
C9740	OTHER	Cystourethroscopy; With Insertion Of Transprostatic Implant; 4 Or More Implants	23	21	$6,181.00	$3,090.50 50% off	$9,036.26	$41,820.71	$25,428.49	2026-05-14
C9764	OTHER	Revascularization; Endovascular; Open Or Percutaneous; Lower Extremity Artery (i…	92	21	$15,921.50	$7,960.75 50% off	$11,019.58	$50,999.72	$31,009.65	2026-05-14
C9765	OTHER	Revascularization; Endovascular; Open Or Percutaneous; Lower Extremity Artery(ie…	92	21	$47,489.50	$23,744.75 50% off	$17,498.57	$80,985.13	$49,241.85	2026-05-14
C9772	OTHER	Revasc Lithotrip Tibi/perone	23	21	$16,497.00	$8,248.50 50% off	$11,019.58	$50,999.72	$31,009.65	2026-05-14
C9773	OTHER	Revasc Lithotr-stent Tib/per	46	21	$19,009.50	$9,504.75 50% off	$17,498.57	$80,985.13	$49,241.85	2026-05-14
C9774	OTHER	Revasc Lithotr-ather Tib/per	23	21	$19,030.00	$9,515.00 50% off	$17,498.57	$80,985.13	$49,241.85	2026-05-14
C9781	OTHER	Arthroscopy; Shoulder; Surgical; With Implantation Of Subacromial Spacer (e.g.; …	67	21	$9,507.66	$4,753.83 50% off	$12,255.24	$56,718.48	$34,486.86	2026-05-14
C9797	OTHER	Vasc Emb/occ W/prs Cath	23	21	$19,806.00	$9,903.00 50% off	$17,498.57	$80,985.13	$49,241.85	2026-05-14
J9029	OTHER	Instill Adstiladrin, Tx Dose	23	21	$161,490.00	$80,745.00 50% off	$64,274.79	$297,470.16	$180,872.48	2026-05-14
J9226	OTHER	Supprelin La Implant	23	21	$150,543.00	$75,271.50 50% off	$43,185.34	$199,866.07	$121,525.71	2026-05-14

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