|
9138
|
OTHER
|
Inj, Hemgenix, Per Tx Dose
|
2
|
1
|
—
|
—
|
$3,685,266.67
|
$3,685,266.67
|
$3,685,266.67
|
2026-05-23
|
|
9141
|
OTHER
|
Inj Onase Abepar-xioi Treat
|
2
|
1
|
—
|
—
|
$2,455,110.60
|
$2,455,110.60
|
$2,455,110.60
|
2026-05-23
|
|
5834
|
OTHER
|
Neonate With Ecmo
|
10
|
5
|
—
|
—
|
$749,005.49
|
$977,072.54
|
$977,072.54
|
2026-05-23
|
|
2067
|
OTHER
|
Afamitresgene Autoleucel
|
2
|
1
|
—
|
—
|
$775,243.72
|
$775,243.72
|
$775,243.72
|
2026-05-23
|
|
5884
|
OTHER
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
10
|
5
|
—
|
—
|
$494,937.73
|
$645,642.88
|
$645,642.88
|
2026-05-23
|
|
5833
|
OTHER
|
Neonate With Ecmo
|
10
|
5
|
—
|
—
|
$491,608.67
|
$641,300.14
|
$641,300.14
|
2026-05-23
|
|
9194
|
OTHER
|
Tisagenlecleucel Car-pos T
|
2
|
1
|
—
|
—
|
$591,726.20
|
$591,726.20
|
$591,726.20
|
2026-05-23
|
|
9498
|
OTHER
|
Ciltacabtagene Car-pos T
|
2
|
1
|
—
|
—
|
$565,868.94
|
$565,868.94
|
$565,868.94
|
2026-05-23
|
|
9413
|
OTHER
|
Lisocabtagene Car Pos T
|
2
|
1
|
—
|
—
|
$562,538.19
|
$562,538.19
|
$562,538.19
|
2026-05-23
|
|
9422
|
OTHER
|
Idecabtagene Vicleucel Car
|
2
|
1
|
—
|
—
|
$557,317.93
|
$557,317.93
|
$557,317.93
|
2026-05-23
|
|
9035
|
OTHER
|
Axicabtagene Ciloleucel Car+
|
2
|
1
|
—
|
—
|
$533,230.17
|
$533,230.17
|
$533,230.17
|
2026-05-23
|
|
5832
|
OTHER
|
Neonate With Ecmo
|
10
|
5
|
—
|
—
|
$381,671.59
|
$497,887.97
|
$497,887.97
|
2026-05-23
|
|
1614
|
OTHER
|
Implantable Heart Assist Systems
|
10
|
5
|
—
|
—
|
$378,604.50
|
$493,886.98
|
$493,886.98
|
2026-05-23
|
|
9391
|
OTHER
|
Brexucabtagene Car Pos T
|
2
|
1
|
—
|
—
|
$489,304.61
|
$489,304.61
|
$489,304.61
|
2026-05-23
|
|
6304
|
OTHER
|
Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure
|
10
|
5
|
—
|
—
|
$365,940.41
|
$477,366.76
|
$477,366.76
|
2026-05-23
|
|
8414
|
OTHER
|
Extensive Third Degree Burns With Skin Graft
|
10
|
5
|
—
|
—
|
$359,782.55
|
$469,333.88
|
$469,333.88
|
2026-05-23
|
|
6094
|
OTHER
|
Neonate Birth Weight 1500-2499 Grams With Major Procedure
|
10
|
5
|
—
|
—
|
$331,628.36
|
$432,606.93
|
$432,606.93
|
2026-05-23
|
|
5883
|
OTHER
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
10
|
5
|
—
|
—
|
$328,228.23
|
$428,171.48
|
$428,171.48
|
2026-05-23
|
|
6314
|
OTHER
|
Neonate Birth Weight > 2499 Grams With Other Major Procedure
|
10
|
5
|
—
|
—
|
$325,906.66
|
$425,143.01
|
$425,143.01
|
2026-05-23
|
|
5914
|
OTHER
|
Neonate Birth Weight 500-749 Grams Without Major Procedure
|
10
|
5
|
—
|
—
|
$321,023.85
|
$418,773.42
|
$418,773.42
|
2026-05-23
|
|
5934
|
OTHER
|
Neonate Birth Weight 750-999 Grams Without Major Procedure
|
10
|
5
|
—
|
—
|
$298,988.50
|
$390,028.46
|
$390,028.46
|
2026-05-23
|
|
5882
|
OTHER
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
10
|
5
|
—
|
—
|
$290,233.17
|
$378,607.18
|
$378,607.18
|
2026-05-23
|
|
5831
|
OTHER
|
Neonate With Ecmo
|
10
|
5
|
—
|
—
|
$282,372.46
|
$368,352.94
|
$368,352.94
|
2026-05-23
|
|
6034
|
OTHER
|
Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition
|
10
|
5
|
—
|
—
|
$277,913.27
|
$362,535.96
|
$362,535.96
|
2026-05-23
|
|
1613
|
OTHER
|
Implantable Heart Assist Systems
|
12
|
6
|
—
|
—
|
$75.03
|
$341,231.27
|
$341,231.27
|
2026-05-23
|
|
5881
|
OTHER
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
12
|
6
|
—
|
—
|
$13,593.88
|
$327,895.85
|
$327,895.85
|
2026-05-23
|
|
5913
|
OTHER
|
Neonate Birth Weight 500-749 Grams Without Major Procedure
|
10
|
5
|
—
|
—
|
$242,944.88
|
$316,919.93
|
$316,919.93
|
2026-05-23
|
|
18
|
OTHER
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
22
|
10
|
—
|
—
|
$1,731.71
|
$602,087.42
|
$310,872.98
|
2026-05-23
|
|
1
|
OTHER
|
Heart Transplant Or Implant Of Heart Assist System With Mcc
|
12
|
6
|
—
|
—
|
$201,744.06
|
$390,730.51
|
$308,262.90
|
2026-05-23
|
|
1604
|
OTHER
|
Major Cardiothoracic Repair Of Heart Anomaly
|
10
|
5
|
—
|
—
|
$227,856.10
|
$297,236.73
|
$297,236.73
|
2026-05-23
|
|
6024
|
OTHER
|
Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…
|
10
|
5
|
—
|
—
|
$226,685.57
|
$295,709.77
|
$295,709.77
|
2026-05-23
|
|
1612
|
OTHER
|
Implantable Heart Assist Systems
|
10
|
5
|
—
|
—
|
$213,274.56
|
$278,215.21
|
$278,215.21
|
2026-05-23
|
|
5933
|
OTHER
|
Neonate Birth Weight 750-999 Grams Without Major Procedure
|
10
|
5
|
—
|
—
|
$212,910.86
|
$277,740.76
|
$277,740.76
|
2026-05-23
|
|
5891
|
OTHER
|
Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …
|
10
|
5
|
—
|
—
|
$204,381.27
|
$266,613.97
|
$266,613.97
|
2026-05-23
|
|
1611
|
OTHER
|
Implantable Heart Assist Systems
|
10
|
5
|
—
|
—
|
$203,989.70
|
$266,103.17
|
$266,103.17
|
2026-05-23
|
|
112
|
OTHER
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
10
|
5
|
—
|
—
|
$202,653.34
|
$264,359.89
|
$264,359.89
|
2026-05-23
|
|
5892
|
OTHER
|
Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …
|
10
|
5
|
—
|
—
|
$198,886.72
|
$259,446.36
|
$259,446.36
|
2026-05-23
|
|
8514
|
OTHER
|
Gender Related Procedures
|
10
|
5
|
—
|
—
|
$195,075.51
|
$254,474.66
|
$254,474.66
|
2026-05-23
|
|
5893
|
OTHER
|
Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …
|
10
|
5
|
—
|
—
|
$195,035.09
|
$254,421.95
|
$254,421.95
|
2026-05-23
|
|
8424
|
OTHER
|
Burns With Skin Graft Except Extensive Third Degree Burns
|
10
|
5
|
—
|
—
|
$192,415.32
|
$251,004.47
|
$251,004.47
|
2026-05-23
|
|
5912
|
OTHER
|
Neonate Birth Weight 500-749 Grams Without Major Procedure
|
10
|
5
|
—
|
—
|
$188,608.29
|
$246,038.22
|
$246,038.22
|
2026-05-23
|
|
6303
|
OTHER
|
Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure
|
10
|
5
|
—
|
—
|
$184,202.06
|
$240,290.32
|
$240,290.32
|
2026-05-23
|
|
927
|
OTHER
|
Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft
|
14
|
7
|
—
|
—
|
$1.61
|
$297,684.90
|
$234,855.50
|
2026-05-23
|
|
6074
|
OTHER
|
Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…
|
10
|
5
|
—
|
—
|
$177,959.19
|
$232,146.55
|
$232,146.55
|
2026-05-23
|
|
5932
|
OTHER
|
Neonate Birth Weight 750-999 Grams Without Major Procedure
|
10
|
5
|
—
|
—
|
$177,662.38
|
$231,759.36
|
$231,759.36
|
2026-05-23
|
|
3034
|
OTHER
|
Dorsal And Lumbar Fusion Procedure For Curvature Of Back
|
10
|
5
|
—
|
—
|
$168,363.58
|
$219,629.14
|
$219,629.14
|
2026-05-23
|
|
6023
|
OTHER
|
Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…
|
10
|
5
|
—
|
—
|
$166,061.52
|
$216,626.12
|
$216,626.12
|
2026-05-23
|
|
1624
|
OTHER
|
Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis
|
10
|
5
|
—
|
—
|
$160,859.60
|
$209,840.25
|
$209,840.25
|
2026-05-23
|
|
4404
|
OTHER
|
Kidney Transplant
|
10
|
5
|
—
|
—
|
$155,601.94
|
$202,981.67
|
$202,981.67
|
2026-05-23
|
|
8634
|
OTHER
|
Neonatal Aftercare
|
10
|
5
|
—
|
—
|
$151,241.69
|
$197,293.76
|
$197,293.76
|
2026-05-23
|
|
6134
|
OTHER
|
Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection
|
10
|
5
|
—
|
—
|
$148,274.94
|
$193,423.65
|
$193,423.65
|
2026-05-23
|
|
6114
|
OTHER
|
Neonate Birth Weight 1500-1999 Grams With Major Anomaly
|
10
|
5
|
—
|
—
|
$147,665.98
|
$192,629.27
|
$192,629.27
|
2026-05-23
|
|
1674
|
OTHER
|
Other Cardiothoracic And Thoracic Vascular Procedures
|
10
|
5
|
—
|
—
|
$137,603.55
|
$179,502.89
|
$179,502.89
|
2026-05-23
|
|
1634
|
OTHER
|
Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis
|
10
|
5
|
—
|
—
|
$136,786.96
|
$178,437.65
|
$178,437.65
|
2026-05-23
|
|
6022
|
OTHER
|
Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…
|
10
|
5
|
—
|
—
|
$136,428.83
|
$177,970.48
|
$177,970.48
|
2026-05-23
|
|
6093
|
OTHER
|
Neonate Birth Weight 1500-2499 Grams With Major Procedure
|
10
|
5
|
—
|
—
|
$135,174.69
|
$176,334.45
|
$176,334.45
|
2026-05-23
|
|
6033
|
OTHER
|
Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition
|
10
|
5
|
—
|
—
|
$132,871.24
|
$173,329.62
|
$173,329.62
|
2026-05-23
|
|
6124
|
OTHER
|
Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other…
|
10
|
5
|
—
|
—
|
$132,291.54
|
$172,573.41
|
$172,573.41
|
2026-05-23
|
|
1784
|
OTHER
|
External Heart Assist Systems
|
10
|
5
|
—
|
—
|
$131,781.52
|
$171,908.10
|
$171,908.10
|
2026-05-23
|
|
1654
|
OTHER
|
Coronary Bypass With Ami Or Complex Principal Diagnosis
|
10
|
5
|
—
|
—
|
$128,851.00
|
$168,085.25
|
$168,085.25
|
2026-05-23
|
|
6073
|
OTHER
|
Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…
|
10
|
5
|
—
|
—
|
$128,766.00
|
$167,974.36
|
$167,974.36
|
2026-05-23
|
|
14
|
OTHER
|
Allogeneic Bone Marrow Transplant
|
22
|
10
|
—
|
—
|
$86,516.86
|
$360,823.58
|
$167,562.70
|
2026-05-23
|
|
6214
|
OTHER
|
Neonate Birth Weight 2000-2499 Grams With Major Anomaly
|
10
|
5
|
—
|
—
|
$127,783.58
|
$166,692.81
|
$166,692.81
|
2026-05-23
|
|
6334
|
OTHER
|
Neonate Birth Weight > 2499 Grams With Major Anomaly
|
10
|
5
|
—
|
—
|
$126,678.54
|
$165,251.29
|
$165,251.29
|
2026-05-23
|
|
8413
|
OTHER
|
Extensive Third Degree Burns With Skin Graft
|
10
|
5
|
—
|
—
|
$126,508.53
|
$165,029.52
|
$165,029.52
|
2026-05-23
|
|
6804
|
OTHER
|
Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms
|
10
|
5
|
—
|
—
|
$126,296.72
|
$164,753.21
|
$164,753.21
|
2026-05-23
|
|
3044
|
OTHER
|
Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back
|
10
|
5
|
—
|
—
|
$123,042.91
|
$160,508.63
|
$160,508.63
|
2026-05-23
|
|
5911
|
OTHER
|
Neonate Birth Weight 500-749 Grams Without Major Procedure
|
10
|
5
|
—
|
—
|
$120,602.90
|
$157,325.66
|
$157,325.66
|
2026-05-23
|
|
6084
|
OTHER
|
Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition
|
10
|
5
|
—
|
—
|
$119,106.28
|
$155,373.33
|
$155,373.33
|
2026-05-23
|
|
7594
|
OTHER
|
Eating Disorders
|
10
|
5
|
—
|
—
|
$118,455.52
|
$154,524.42
|
$154,524.42
|
2026-05-23
|
|
9104
|
OTHER
|
Craniotomy For Multiple Significant Trauma
|
12
|
6
|
—
|
—
|
$999.37
|
$154,220.84
|
$154,220.84
|
2026-05-23
|
|
1907
|
OTHER
|
New Technology - Level 52 ($145,001-$160,000)
|
2
|
1
|
—
|
—
|
$153,415.50
|
$153,415.50
|
$153,415.50
|
2026-05-23
|
|
1908
|
OTHER
|
New Technology - Level 52 ($145,001-$160,000)
|
2
|
1
|
—
|
—
|
$153,415.50
|
$153,415.50
|
$153,415.50
|
2026-05-23
|
|
3
|
OTHER
|
Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…
|
22
|
10
|
—
|
—
|
$295.59
|
$295,937.87
|
$152,800.21
|
2026-05-23
|
|
1834
|
OTHER
|
Percutaneous Structural Cardiac Procedures
|
10
|
5
|
—
|
—
|
$116,993.74
|
$152,617.54
|
$152,617.54
|
2026-05-23
|
|
6814
|
OTHER
|
Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms
|
10
|
5
|
—
|
—
|
$116,565.94
|
$152,059.47
|
$152,059.47
|
2026-05-23
|
|
3124
|
OTHER
|
Skin Graft, Except Hand, For Musculoskeletal And Connective Tissue Diagnoses
|
10
|
5
|
—
|
—
|
$116,290.03
|
$151,699.55
|
$151,699.55
|
2026-05-23
|
|
7404
|
OTHER
|
Mental Illness Diagnosis With O.r. Procedure
|
10
|
5
|
—
|
—
|
$116,157.65
|
$151,526.85
|
$151,526.85
|
2026-05-23
|
|
6904
|
OTHER
|
Acute Leukemia
|
10
|
5
|
—
|
—
|
$115,628.12
|
$150,836.09
|
$150,836.09
|
2026-05-23
|
|
1664
|
OTHER
|
Coronary Bypass Without Ami Or Complex Principal Diagnosis
|
12
|
6
|
—
|
—
|
$2,194.62
|
$149,905.37
|
$149,905.37
|
2026-05-23
|
|
3614
|
OTHER
|
Skin Graft For Skin And Subcutaneous Tissue Diagnoses
|
10
|
5
|
—
|
—
|
$113,192.29
|
$147,658.56
|
$147,658.56
|
2026-05-23
|
|
6302
|
OTHER
|
Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure
|
10
|
5
|
—
|
—
|
$113,158.84
|
$147,614.94
|
$147,614.94
|
2026-05-23
|
|
8504
|
OTHER
|
Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal…
|
10
|
5
|
—
|
—
|
$113,132.37
|
$147,580.40
|
$147,580.40
|
2026-05-23
|
|
9114
|
OTHER
|
Extensive Abdominal Or Thoracic Procedures For Multiple Significant Trauma
|
12
|
6
|
—
|
—
|
$20.87
|
$145,989.82
|
$145,989.82
|
2026-05-23
|
|
6144
|
OTHER
|
Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition
|
10
|
5
|
—
|
—
|
$111,331.97
|
$145,231.79
|
$145,231.79
|
2026-05-23
|
|
6313
|
OTHER
|
Neonate Birth Weight > 2499 Grams With Other Major Procedure
|
10
|
5
|
—
|
—
|
$110,537.68
|
$144,195.64
|
$144,195.64
|
2026-05-23
|
|
1794
|
OTHER
|
Defibrillator Implants
|
10
|
5
|
—
|
—
|
$109,969.13
|
$143,453.98
|
$143,453.98
|
2026-05-23
|
|
6254
|
OTHER
|
Neonate Birth Weight 2000-2499 Grams With Other Significant Condition
|
10
|
5
|
—
|
—
|
$109,311.40
|
$142,595.97
|
$142,595.97
|
2026-05-23
|
|
7
|
OTHER
|
Lung Transplant
|
12
|
6
|
—
|
—
|
$93,228.49
|
$180,561.53
|
$142,452.20
|
2026-05-23
|
|
1623
|
OTHER
|
Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis
|
10
|
5
|
—
|
—
|
$108,802.77
|
$141,932.47
|
$141,932.47
|
2026-05-23
|
|
1204
|
OTHER
|
Major Respiratory And Chest Procedures
|
10
|
5
|
—
|
—
|
$107,484.53
|
$140,212.83
|
$140,212.83
|
2026-05-23
|
|
2604
|
OTHER
|
Major Pancreas, Liver And Shunt Procedures
|
10
|
5
|
—
|
—
|
$106,755.73
|
$139,262.12
|
$139,262.12
|
2026-05-23
|
|
1905
|
OTHER
|
New Technology - Level 51 ($130,001-$145,000)
|
2
|
1
|
—
|
—
|
$138,325.50
|
$138,325.50
|
$138,325.50
|
2026-05-23
|
|
1906
|
OTHER
|
New Technology - Level 51 ($130,001-$145,000)
|
2
|
1
|
—
|
—
|
$138,325.50
|
$138,325.50
|
$138,325.50
|
2026-05-23
|
|
9124
|
OTHER
|
Musculoskeletal And Other Procedures For Multiple Significant Trauma
|
10
|
5
|
—
|
—
|
$105,741.26
|
$137,938.75
|
$137,938.75
|
2026-05-23
|
|
2324
|
OTHER
|
Gastric Fundoplication
|
10
|
5
|
—
|
—
|
$104,804.83
|
$136,717.19
|
$136,717.19
|
2026-05-23
|
|
44
|
OTHER
|
Bone Or Joint Manipulation Under Anesthesia
|
20
|
5
|
—
|
—
|
$1,716.28
|
$353,083.37
|
$136,352.80
|
2026-05-23
|
|
6954
|
OTHER
|
Chemotherapy For Acute Leukemia
|
10
|
5
|
—
|
—
|
$104,371.46
|
$136,151.85
|
$136,151.85
|
2026-05-23
|
|
2204
|
OTHER
|
Major Stomach, Esophageal And Duodenal Procedures
|
10
|
5
|
—
|
—
|
$103,825.21
|
$135,439.27
|
$135,439.27
|
2026-05-23
|
|
1694
|
OTHER
|
Major Abdominal Vascular Procedures
|
12
|
6
|
—
|
—
|
$10.14
|
$134,697.61
|
$134,697.61
|
2026-05-23
|
|
4403
|
OTHER
|
Kidney Transplant
|
10
|
5
|
—
|
—
|
$102,534.83
|
$133,755.98
|
$133,755.98
|
2026-05-23
|
|
1603
|
OTHER
|
Major Cardiothoracic Repair Of Heart Anomaly
|
10
|
5
|
—
|
—
|
$102,233.83
|
$133,363.34
|
$133,363.34
|
2026-05-23
|
|
1783
|
OTHER
|
External Heart Assist Systems
|
10
|
5
|
—
|
—
|
$101,474.38
|
$132,372.63
|
$132,372.63
|
2026-05-23
|
|
9504
|
OTHER
|
Extensive O.r. Procedure Unrelated To Principal Diagnosis
|
12
|
6
|
—
|
—
|
$653.74
|
$130,952.93
|
$130,952.93
|
2026-05-23
|
|
6072
|
OTHER
|
Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…
|
10
|
5
|
—
|
—
|
$99,838.41
|
$130,238.53
|
$130,238.53
|
2026-05-23
|
|
6083
|
OTHER
|
Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition
|
10
|
5
|
—
|
—
|
$98,528.53
|
$128,529.79
|
$128,529.79
|
2026-05-23
|
|
924
|
OTHER
|
Facial Bone Procedures Except Major Cranial Or Facial Bone Procedures
|
10
|
5
|
—
|
—
|
$98,304.18
|
$128,237.12
|
$128,237.12
|
2026-05-23
|
|
1782
|
OTHER
|
External Heart Assist Systems
|
10
|
5
|
—
|
—
|
$98,194.09
|
$128,093.52
|
$128,093.52
|
2026-05-23
|
|
6113
|
OTHER
|
Neonate Birth Weight 1500-1999 Grams With Major Anomaly
|
10
|
5
|
—
|
—
|
$98,153.68
|
$128,040.80
|
$128,040.80
|
2026-05-23
|
|
7584
|
OTHER
|
Behavioral Disorders
|
10
|
5
|
—
|
—
|
$97,809.48
|
$127,591.80
|
$127,591.80
|
2026-05-23
|
|
6133
|
OTHER
|
Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection
|
10
|
5
|
—
|
—
|
$97,111.34
|
$126,681.08
|
$126,681.08
|
2026-05-23
|
|
4414
|
OTHER
|
Major Bladder Procedures
|
10
|
5
|
—
|
—
|
$96,266.88
|
$125,579.49
|
$125,579.49
|
2026-05-23
|
|
6234
|
OTHER
|
Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection
|
10
|
5
|
—
|
—
|
$94,951.42
|
$123,863.48
|
$123,863.48
|
2026-05-23
|
|
2614
|
OTHER
|
Major Biliary Tract Procedures
|
10
|
5
|
—
|
—
|
$94,763.30
|
$123,618.08
|
$123,618.08
|
2026-05-23
|
|
1764
|
OTHER
|
Insertion, Revision And Replacements Of Pacemaker And Other Cardiac Devices
|
10
|
5
|
—
|
—
|
$94,186.39
|
$122,865.51
|
$122,865.51
|
2026-05-23
|
|
1633
|
OTHER
|
Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis
|
10
|
5
|
—
|
—
|
$93,343.33
|
$121,765.73
|
$121,765.73
|
2026-05-23
|
|
1304
|
OTHER
|
Respiratory System Diagnosis With Ventilator Support > 96 Hours
|
10
|
5
|
—
|
—
|
$93,191.44
|
$121,567.59
|
$121,567.59
|
2026-05-23
|
|
426
|
OTHER
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
12
|
6
|
—
|
—
|
$79,341.62
|
$153,665.95
|
$121,233.20
|
2026-05-23
|
|
5144
|
OTHER
|
Female Reproductive System Reconstructive Procedures
|
10
|
5
|
—
|
—
|
$92,621.50
|
$120,824.11
|
$120,824.11
|
2026-05-23
|
|
7924
|
OTHER
|
Extensive O.r. Procedures For Other Complications Of Treatment
|
10
|
5
|
—
|
—
|
$92,464.03
|
$120,618.70
|
$120,618.70
|
2026-05-23
|
|
5104
|
OTHER
|
Pelvic Evisceration, Radical Hysterectomy And Other Radical Gynecological Proced…
|
10
|
5
|
—
|
—
|
$92,319.11
|
$120,429.65
|
$120,429.65
|
2026-05-23
|
|
4402
|
OTHER
|
Kidney Transplant
|
10
|
5
|
—
|
—
|
$92,253.62
|
$120,344.21
|
$120,344.21
|
2026-05-23
|
|
1814
|
OTHER
|
Lower Extremity Arterial Procedures
|
10
|
5
|
—
|
—
|
$92,051.56
|
$120,080.63
|
$120,080.63
|
2026-05-23
|
|
1653
|
OTHER
|
Coronary Bypass With Ami Or Complex Principal Diagnosis
|
10
|
5
|
—
|
—
|
$91,763.11
|
$119,704.34
|
$119,704.34
|
2026-05-23
|
|
6514
|
OTHER
|
Other Procedures Of Blood And Blood-forming Organs
|
10
|
5
|
—
|
—
|
$91,682.28
|
$119,598.91
|
$119,598.91
|
2026-05-23
|
|
8412
|
OTHER
|
Extensive Third Degree Burns With Skin Graft
|
10
|
5
|
—
|
—
|
$91,211.28
|
$118,984.49
|
$118,984.49
|
2026-05-23
|
|
8411
|
OTHER
|
Extensive Third Degree Burns With Skin Graft
|
10
|
5
|
—
|
—
|
$91,211.28
|
$118,984.49
|
$118,984.49
|
2026-05-23
|
|
6123
|
OTHER
|
Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other…
|
10
|
5
|
—
|
—
|
$89,246.45
|
$116,421.39
|
$116,421.39
|
2026-05-23
|
|
3032
|
OTHER
|
Dorsal And Lumbar Fusion Procedure For Curvature Of Back
|
10
|
5
|
—
|
—
|
$89,235.30
|
$116,406.84
|
$116,406.84
|
2026-05-23
|
|
2644
|
OTHER
|
Other Hepatobiliary, Pancreas And Abdominal Procedures
|
10
|
5
|
—
|
—
|
$89,161.45
|
$116,310.50
|
$116,310.50
|
2026-05-23
|
|
3634
|
OTHER
|
Breast Procedures Except Mastectomy
|
10
|
5
|
—
|
—
|
$88,889.72
|
$115,956.03
|
$115,956.03
|
2026-05-23
|
|
5114
|
OTHER
|
Uterine And Adnexa Procedures For Ovarian And Adnexal Malignancy
|
12
|
6
|
—
|
—
|
$7,186.59
|
$115,779.70
|
$115,779.70
|
2026-05-23
|
|
1214
|
OTHER
|
Other Respiratory And Chest Procedures
|
12
|
6
|
—
|
—
|
$50.74
|
$115,656.09
|
$115,656.09
|
2026-05-23
|
|
4044
|
OTHER
|
Thyroid, Parathyroid And Thyroglossal Procedures
|
10
|
5
|
—
|
—
|
$88,602.66
|
$115,581.56
|
$115,581.56
|
2026-05-23
|
|
3214
|
OTHER
|
Spinal Fusion And Other Back And Neck Procedures Except For Disc Procedures
|
10
|
5
|
—
|
—
|
$88,545.52
|
$115,507.03
|
$115,507.03
|
2026-05-23
|
|
2304
|
OTHER
|
Major Small Bowel Procedures
|
10
|
5
|
—
|
—
|
$88,530.19
|
$115,487.03
|
$115,487.03
|
2026-05-23
|
|
5184
|
OTHER
|
Other Female Reproductive System And Related Procedures
|
12
|
6
|
—
|
—
|
$5,438.13
|
$113,683.77
|
$113,683.77
|
2026-05-23
|
|
8633
|
OTHER
|
Neonatal Aftercare
|
10
|
5
|
—
|
—
|
$87,075.38
|
$113,589.24
|
$113,589.24
|
2026-05-23
|
|
4401
|
OTHER
|
Kidney Transplant
|
10
|
5
|
—
|
—
|
$86,725.62
|
$113,132.97
|
$113,132.97
|
2026-05-23
|
|
6224
|
OTHER
|
Neonate Birth Weight 2000-2499 Grams With Respiratory Distress Syndrome Or Other…
|
10
|
5
|
—
|
—
|
$86,338.23
|
$112,627.62
|
$112,627.62
|
2026-05-23
|
|
1673
|
OTHER
|
Other Cardiothoracic And Thoracic Vascular Procedures
|
10
|
5
|
—
|
—
|
$86,183.55
|
$112,425.85
|
$112,425.85
|
2026-05-23
|
|
4054
|
OTHER
|
Other Procedures For Endocrine, Nutritional And Metabolic Disorders
|
10
|
5
|
—
|
—
|
$85,844.93
|
$111,984.12
|
$111,984.12
|
2026-05-23
|
|
1781
|
OTHER
|
External Heart Assist Systems
|
10
|
5
|
—
|
—
|
$85,840.75
|
$111,978.67
|
$111,978.67
|
2026-05-23
|
|
1824
|
OTHER
|
Other Peripheral Vascular And Related Procedures
|
12
|
6
|
—
|
—
|
$4.23
|
$111,520.58
|
$111,520.58
|
2026-05-23
|
|
1622
|
OTHER
|
Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis
|
10
|
5
|
—
|
—
|
$85,212.28
|
$111,158.84
|
$111,158.84
|
2026-05-23
|
|
3043
|
OTHER
|
Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back
|
10
|
5
|
—
|
—
|
$85,106.37
|
$111,020.68
|
$111,020.68
|
2026-05-23
|
|
4014
|
OTHER
|
Adrenal Procedures
|
12
|
6
|
—
|
—
|
$214.76
|
$110,713.47
|
$110,713.47
|
2026-05-23
|
|
9103
|
OTHER
|
Craniotomy For Multiple Significant Trauma
|
12
|
6
|
—
|
—
|
$26.77
|
$110,604.41
|
$110,604.41
|
2026-05-23
|
|
4034
|
OTHER
|
Procedures For Obesity
|
10
|
5
|
—
|
—
|
$84,718.98
|
$110,515.33
|
$110,515.33
|
2026-05-23
|
|
7104
|
OTHER
|
Infectious And Parasitic Diseases Including HIV With O.r. Procedure
|
10
|
5
|
—
|
—
|
$84,220.11
|
$109,864.56
|
$109,864.56
|
2026-05-23
|
|
1793
|
OTHER
|
Defibrillator Implants
|
10
|
5
|
—
|
—
|
$84,210.36
|
$109,851.83
|
$109,851.83
|
2026-05-23
|
|
215
|
OTHER
|
Other Heart Assist System Implant
|
12
|
6
|
—
|
—
|
$71,680.44
|
$138,828.06
|
$109,527.00
|
2026-05-23
|
|
1833
|
OTHER
|
Percutaneous Structural Cardiac Procedures
|
10
|
5
|
—
|
—
|
$83,875.92
|
$109,415.56
|
$109,415.56
|
2026-05-23
|
|
6092
|
OTHER
|
Neonate Birth Weight 1500-2499 Grams With Major Procedure
|
10
|
5
|
—
|
—
|
$82,699.81
|
$107,881.33
|
$107,881.33
|
2026-05-23
|
|
6344
|
OTHER
|
Neonate Birth Weight > 2499 Grams With Respiratory Distress Syndrome Or Other Ma…
|
10
|
5
|
—
|
—
|
$82,676.12
|
$107,850.43
|
$107,850.43
|
2026-05-23
|
|
216
|
OTHER
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
12
|
6
|
—
|
—
|
$70,426.38
|
$136,399.23
|
$107,610.80
|
2026-05-23
|
|
6143
|
OTHER
|
Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition
|
10
|
5
|
—
|
—
|
$82,107.57
|
$107,108.77
|
$107,108.77
|
2026-05-23
|
|
6032
|
OTHER
|
Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition
|
10
|
5
|
—
|
—
|
$82,100.60
|
$107,099.68
|
$107,099.68
|
2026-05-23
|
|
6504
|
OTHER
|
Splenic Procedures
|
10
|
5
|
—
|
—
|
$82,022.57
|
$106,997.88
|
$106,997.88
|
2026-05-23
|
|
3254
|
OTHER
|
Non-elective Or Complex Knee Joint Replacement
|
10
|
5
|
—
|
—
|
$81,697.88
|
$106,574.33
|
$106,574.33
|
2026-05-23
|
|
7114
|
OTHER
|
Post-operative, Post-trauma, Other Device Infections With O.r. Procedure
|
10
|
5
|
—
|
—
|
$81,605.91
|
$106,454.35
|
$106,454.35
|
2026-05-23
|
|
8423
|
OTHER
|
Burns With Skin Graft Except Extensive Third Degree Burns
|
10
|
5
|
—
|
—
|
$81,596.16
|
$106,441.63
|
$106,441.63
|
2026-05-23
|
|
4474
|
OTHER
|
Other Kidney, Urinary Tract And Related Procedures
|
10
|
5
|
—
|
—
|
$81,129.34
|
$105,832.67
|
$105,832.67
|
2026-05-23
|
|
5124
|
OTHER
|
Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy
|
10
|
5
|
—
|
—
|
$80,439.56
|
$104,932.85
|
$104,932.85
|
2026-05-23
|
|
4424
|
OTHER
|
Kidney And Urinary Tract Procedures For Malignancy
|
10
|
5
|
—
|
—
|
$80,394.96
|
$104,874.68
|
$104,874.68
|
2026-05-23
|
|
1704
|
OTHER
|
Permanent Cardiac Pacemaker Implant With Ami, Heart Failure Or Shock
|
12
|
6
|
—
|
—
|
$1.49
|
$104,605.65
|
$104,605.65
|
2026-05-23
|
|
1663
|
OTHER
|
Coronary Bypass Without Ami Or Complex Principal Diagnosis
|
10
|
5
|
—
|
—
|
$79,799.94
|
$104,098.48
|
$104,098.48
|
2026-05-23
|
|
6233
|
OTHER
|
Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection
|
10
|
5
|
—
|
—
|
$79,526.82
|
$103,742.19
|
$103,742.19
|
2026-05-23
|
|
9514
|
OTHER
|
Moderately Extensive O.r. Procedure Unrelated To Principal Diagnosis
|
12
|
6
|
—
|
—
|
$8.07
|
$103,725.83
|
$103,725.83
|
2026-05-23
|
|
6091
|
OTHER
|
Neonate Birth Weight 1500-2499 Grams With Major Procedure
|
10
|
5
|
—
|
—
|
$79,471.08
|
$103,669.48
|
$103,669.48
|
2026-05-23
|
|
7934
|
OTHER
|
Moderately Extensive O.r. Procedures For Other Complications Of Treatment
|
10
|
5
|
—
|
—
|
$79,284.35
|
$103,425.89
|
$103,425.89
|
2026-05-23
|
|
1754
|
OTHER
|
Percutaneous Cardiac Intervention Without Ami
|
10
|
5
|
—
|
—
|
$79,281.56
|
$103,422.25
|
$103,422.25
|
2026-05-23
|
|
3154
|
OTHER
|
Shoulder, Upper Arm And Forearm Procedures Except Joint Replacement
|
10
|
5
|
—
|
—
|
$79,001.47
|
$103,056.88
|
$103,056.88
|
2026-05-23
|
|
294
|
OTHER
|
Other Percutaneous Intracranial Procedures
|
10
|
5
|
—
|
—
|
$78,963.84
|
$103,007.79
|
$103,007.79
|
2026-05-23
|
|
2314
|
OTHER
|
Major Large Bowel Procedures
|
10
|
5
|
—
|
—
|
$78,655.88
|
$102,606.06
|
$102,606.06
|
2026-05-23
|
|
4804
|
OTHER
|
Major Male Pelvic Procedures
|
10
|
5
|
—
|
—
|
$78,403.66
|
$102,277.04
|
$102,277.04
|
2026-05-23
|
|
6082
|
OTHER
|
Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition
|
10
|
5
|
—
|
—
|
$78,339.56
|
$102,193.42
|
$102,193.42
|
2026-05-23
|
|
3104
|
OTHER
|
Vertebral And Intervertebral Spinal Procedures Including Disc Procedures
|
10
|
5
|
—
|
—
|
$78,301.93
|
$102,144.34
|
$102,144.34
|
2026-05-23
|
|
6312
|
OTHER
|
Neonate Birth Weight > 2499 Grams With Other Major Procedure
|
10
|
5
|
—
|
—
|
$78,136.11
|
$101,928.02
|
$101,928.02
|
2026-05-23
|
|
3204
|
OTHER
|
Other Musculoskeletal System And Connective Tissue Procedures
|
10
|
5
|
—
|
—
|
$77,503.46
|
$101,102.73
|
$101,102.73
|
2026-05-23
|
|
2294
|
OTHER
|
Other Digestive System And Abdominal Procedures
|
10
|
5
|
—
|
—
|
$77,437.97
|
$101,017.30
|
$101,017.30
|
2026-05-23
|
|
3134
|
OTHER
|
Knee And Lower Leg Procedures Except Foot
|
10
|
5
|
—
|
—
|
$77,170.41
|
$100,668.28
|
$100,668.28
|
2026-05-23
|
|
3094
|
OTHER
|
Other Significant Hip And Femur Surgery
|
10
|
5
|
—
|
—
|
$77,035.25
|
$100,491.95
|
$100,491.95
|
2026-05-23
|
|
2224
|
OTHER
|
Other Stomach, Esophageal And Duodenal Procedures
|
10
|
5
|
—
|
—
|
$76,482.03
|
$99,770.28
|
$99,770.28
|
2026-05-23
|
|
4
|
OTHER
|
Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…
|
22
|
10
|
—
|
—
|
$1,882.51
|
$193,126.75
|
$99,716.23
|
2026-05-23
|
|
5194
|
OTHER
|
Uterine And Adnexa Procedures For Leiomyoma
|
12
|
6
|
—
|
—
|
$18,064.46
|
$99,623.04
|
$99,623.04
|
2026-05-23
|
|
2234
|
OTHER
|
Other Small And Large Bowel Procedures
|
10
|
5
|
—
|
—
|
$75,994.30
|
$99,134.05
|
$99,134.05
|
2026-05-23
|
|
893
|
OTHER
|
Major Cranial Or Facial Bone Procedures
|
12
|
6
|
—
|
—
|
$32.14
|
$99,090.42
|
$99,090.42
|
2026-05-23
|
|
1621
|
OTHER
|
Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis
|
10
|
5
|
—
|
—
|
$75,634.78
|
$98,665.06
|
$98,665.06
|
2026-05-23
|
|
4444
|
OTHER
|
Renal Dialysis Access Device Procedures
|
10
|
5
|
—
|
—
|
$75,634.78
|
$98,665.06
|
$98,665.06
|
2026-05-23
|
|
1652
|
OTHER
|
Coronary Bypass With Ami Or Complex Principal Diagnosis
|
10
|
5
|
—
|
—
|
$75,395.10
|
$98,352.39
|
$98,352.39
|
2026-05-23
|
|
9524
|
OTHER
|
Non-extensive O.r. Procedure Unrelated To Principal Diagnosis
|
12
|
6
|
—
|
—
|
$172.20
|
$98,310.58
|
$98,310.58
|
2026-05-23
|
|
1303
|
OTHER
|
Respiratory System Diagnosis With Ventilator Support > 96 Hours
|
10
|
5
|
—
|
—
|
$75,059.27
|
$97,914.30
|
$97,914.30
|
2026-05-23
|
|
3054
|
OTHER
|
Amputation Of Lower Limb Except Toes
|
10
|
5
|
—
|
—
|
$74,995.17
|
$97,830.68
|
$97,830.68
|
2026-05-23
|
|
2274
|
OTHER
|
Hernia Procedures Except Inguinal, Femoral And Umbilical
|
10
|
5
|
—
|
—
|
$74,951.97
|
$97,774.33
|
$97,774.33
|
2026-05-23
|
|
4234
|
OTHER
|
Inborn Errors Of Metabolism
|
10
|
5
|
—
|
—
|
$74,942.21
|
$97,761.61
|
$97,761.61
|
2026-05-23
|
|
984
|
OTHER
|
Other Ear, Nose, Mouth, Throat, Craniofacial, And Neck Procedures
|
10
|
5
|
—
|
—
|
$74,869.75
|
$97,667.08
|
$97,667.08
|
2026-05-23
|
|
6914
|
OTHER
|
Lymphoma, Myeloma And Non-acute Leukemia
|
10
|
5
|
—
|
—
|
$74,625.89
|
$97,348.96
|
$97,348.96
|
2026-05-23
|
|
3031
|
OTHER
|
Dorsal And Lumbar Fusion Procedure For Curvature Of Back
|
10
|
5
|
—
|
—
|
$74,453.10
|
$97,123.56
|
$97,123.56
|
2026-05-23
|
|
6122
|
OTHER
|
Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other…
|
10
|
5
|
—
|
—
|
$74,324.90
|
$96,956.32
|
$96,956.32
|
2026-05-23
|
|
1632
|
OTHER
|
Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis
|
10
|
5
|
—
|
—
|
$74,255.22
|
$96,865.43
|
$96,865.43
|
2026-05-23
|
|
2244
|
OTHER
|
Peritoneal Adhesiolysis
|
10
|
5
|
—
|
—
|
$74,055.95
|
$96,605.48
|
$96,605.48
|
2026-05-23
|
|
6903
|
OTHER
|
Acute Leukemia
|
10
|
5
|
—
|
—
|
$73,998.82
|
$96,530.95
|
$96,530.95
|
2026-05-23
|
|
4844
|
OTHER
|
Other Male Reproductive System And Related Procedures
|
10
|
5
|
—
|
—
|
$73,388.47
|
$95,734.75
|
$95,734.75
|
2026-05-23
|
|
4434
|
OTHER
|
Kidney And Urinary Tract Procedures For Non-malignancy
|
10
|
5
|
—
|
—
|
$73,338.30
|
$95,669.31
|
$95,669.31
|
2026-05-23
|
|
1585
|
OTHER
|
New Technology - Level 48 ($90,001-$100,000)
|
2
|
1
|
—
|
—
|
$95,570.50
|
$95,570.50
|
$95,570.50
|
2026-05-23
|
|
1599
|
OTHER
|
New Technology - Level 48 ($90,001-$100,000)
|
2
|
1
|
—
|
—
|
$95,570.50
|
$95,570.50
|
$95,570.50
|
2026-05-23
|
|
1804
|
OTHER
|
Other Circulatory System Procedures
|
10
|
5
|
—
|
—
|
$72,557.94
|
$94,651.34
|
$94,651.34
|
2026-05-23
|
|
1744
|
OTHER
|
Percutaneous Cardiac Intervention With Ami
|
10
|
5
|
—
|
—
|
$72,284.82
|
$94,295.05
|
$94,295.05
|
2026-05-23
|
|
6213
|
OTHER
|
Neonate Birth Weight 2000-2499 Grams With Major Anomaly
|
10
|
5
|
—
|
—
|
$72,169.16
|
$94,144.17
|
$94,144.17
|
2026-05-23
|
|
3174
|
OTHER
|
Tendon, Muscle And Other Soft Tissue Procedures
|
10
|
5
|
—
|
—
|
$72,128.75
|
$94,091.46
|
$94,091.46
|
2026-05-23
|
|
1832
|
OTHER
|
Percutaneous Structural Cardiac Procedures
|
12
|
6
|
—
|
—
|
$748.85
|
$93,936.94
|
$93,936.94
|
2026-05-23
|
|
1792
|
OTHER
|
Defibrillator Implants
|
10
|
5
|
—
|
—
|
$71,728.81
|
$93,569.75
|
$93,569.75
|
2026-05-23
|
|
4834
|
OTHER
|
Penis, Testes And Scrotal Procedures
|
10
|
5
|
—
|
—
|
$71,714.88
|
$93,551.57
|
$93,551.57
|
2026-05-23
|
|
43
|
OTHER
|
Open Or Percutaneous Treatment Of Fractures
|
20
|
5
|
—
|
—
|
$9,209.83
|
$229,541.63
|
$93,450.61
|
2026-05-23
|
|
1714
|
OTHER
|
Permanent Cardiac Pacemaker Implant Without Ami, Heart Failure Or Shock
|
10
|
5
|
—
|
—
|
$71,445.93
|
$93,200.73
|
$93,200.73
|
2026-05-23
|
|
1693
|
OTHER
|
Major Abdominal Vascular Procedures
|
10
|
5
|
—
|
—
|
$71,372.08
|
$93,104.39
|
$93,104.39
|
2026-05-23
|
|
456
|
OTHER
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
12
|
6
|
—
|
—
|
$60,496.08
|
$117,166.59
|
$92,437.40
|
2026-05-23
|
|
1602
|
OTHER
|
Major Cardiothoracic Repair Of Heart Anomaly
|
10
|
5
|
—
|
—
|
$70,208.51
|
$91,586.52
|
$91,586.52
|
2026-05-23
|
|
1831
|
OTHER
|
Percutaneous Structural Cardiac Procedures
|
10
|
5
|
—
|
—
|
$69,444.87
|
$90,590.36
|
$90,590.36
|
2026-05-23
|
|
3123
|
OTHER
|
Skin Graft, Except Hand, For Musculoskeletal And Connective Tissue Diagnoses
|
10
|
5
|
—
|
—
|
$69,442.09
|
$90,586.73
|
$90,586.73
|
2026-05-23
|
|
3244
|
OTHER
|
Elective Hip Joint Replacement
|
10
|
5
|
—
|
—
|
$69,389.13
|
$90,517.65
|
$90,517.65
|
2026-05-23
|
|
1651
|
OTHER
|
Coronary Bypass With Ami Or Complex Principal Diagnosis
|
10
|
5
|
—
|
—
|
$69,008.71
|
$90,021.39
|
$90,021.39
|
2026-05-23
|
|
8513
|
OTHER
|
Gender Related Procedures
|
10
|
5
|
—
|
—
|
$68,654.76
|
$89,559.67
|
$89,559.67
|
2026-05-23
|
|
3164
|
OTHER
|
Hand And Wrist Procedures
|
10
|
5
|
—
|
—
|
$68,398.36
|
$89,225.19
|
$89,225.19
|
2026-05-23
|
|
2634
|
OTHER
|
Cholecystectomy
|
12
|
6
|
—
|
—
|
$162.84
|
$89,072.49
|
$89,072.49
|
2026-05-23
|
|
6803
|
OTHER
|
Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms
|
10
|
5
|
—
|
—
|
$67,824.24
|
$88,476.25
|
$88,476.25
|
2026-05-23
|
|
9123
|
OTHER
|
Musculoskeletal And Other Procedures For Multiple Significant Trauma
|
12
|
6
|
—
|
—
|
$3.55
|
$88,363.55
|
$88,363.55
|
2026-05-23
|
|
1631
|
OTHER
|
Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis
|
10
|
5
|
—
|
—
|
$67,199.95
|
$87,661.88
|
$87,661.88
|
2026-05-23
|
|
4454
|
OTHER
|
Other Bladder Procedures
|
10
|
5
|
—
|
—
|
$66,988.14
|
$87,385.57
|
$87,385.57
|
2026-05-23
|
|
1662
|
OTHER
|
Coronary Bypass Without Ami Or Complex Principal Diagnosis
|
12
|
6
|
—
|
—
|
$1.96
|
$87,172.89
|
$87,172.89
|
2026-05-23
|
|
3224
|
OTHER
|
Shoulder And Elbow Joint Replacement
|
10
|
5
|
—
|
—
|
$66,774.93
|
$87,107.45
|
$87,107.45
|
2026-05-23
|
|
3234
|
OTHER
|
Non-elective Or Complex Hip Joint Replacement
|
10
|
5
|
—
|
—
|
$66,769.36
|
$87,100.17
|
$87,100.17
|
2026-05-23
|
|
6364
|
OTHER
|
Neonate Birth Weight > 2499 Grams With Congenital Or Perinatal Infection
|
10
|
5
|
—
|
—
|
$66,655.09
|
$86,951.11
|
$86,951.11
|
2026-05-23
|
|
6924
|
OTHER
|
Radiotherapy
|
10
|
5
|
—
|
—
|
$66,441.89
|
$86,672.99
|
$86,672.99
|
2026-05-23
|
|
1774
|
OTHER
|
Cardiac Pacemaker And Defibrillator Revision Except Device Replacement
|
10
|
5
|
—
|
—
|
$66,402.87
|
$86,622.09
|
$86,622.09
|
2026-05-23
|
|
7504
|
OTHER
|
Schizophrenia
|
10
|
5
|
—
|
—
|
$65,821.78
|
$85,864.07
|
$85,864.07
|
2026-05-23
|
|
5134
|
OTHER
|
Uterine And Adnexa Procedures For Non-malignancy Except Leiomyoma
|
10
|
5
|
—
|
—
|
$65,813.42
|
$85,853.16
|
$85,853.16
|
2026-05-23
|
|
6394
|
OTHER
|
Neonate Birth Weight > 2499 Grams With Other Significant Condition
|
10
|
5
|
—
|
—
|
$65,739.57
|
$85,756.82
|
$85,756.82
|
2026-05-23
|
|
3644
|
OTHER
|
Other Skin, Subcutaneous Tissue And Related Procedures
|
10
|
5
|
—
|
—
|
$65,593.25
|
$85,565.95
|
$85,565.95
|
2026-05-23
|
|
1598
|
OTHER
|
New Technology - Level 47 ($80,001-$90,000)
|
2
|
1
|
—
|
—
|
$85,510.50
|
$85,510.50
|
$85,510.50
|
2026-05-23
|
|
1584
|
OTHER
|
New Technology - Level 47 ($80,001-$90,000)
|
2
|
1
|
—
|
—
|
$85,510.50
|
$85,510.50
|
$85,510.50
|
2026-05-23
|
|
4013
|
OTHER
|
Adrenal Procedures
|
12
|
6
|
—
|
—
|
$216.06
|
$85,266.01
|
$85,266.01
|
2026-05-23
|
|
1791
|
OTHER
|
Defibrillator Implants
|
10
|
5
|
—
|
—
|
$65,059.54
|
$84,869.73
|
$84,869.73
|
2026-05-23
|
|
1813
|
OTHER
|
Lower Extremity Arterial Procedures
|
10
|
5
|
—
|
—
|
$64,896.50
|
$84,657.04
|
$84,657.04
|
2026-05-23
|
|
6964
|
OTHER
|
Other Chemotherapy
|
10
|
5
|
—
|
—
|
$64,832.40
|
$84,573.42
|
$84,573.42
|
2026-05-23
|
|
1302
|
OTHER
|
Respiratory System Diagnosis With Ventilator Support > 96 Hours
|
10
|
5
|
—
|
—
|
$64,819.86
|
$84,557.06
|
$84,557.06
|
2026-05-23
|
|
219
|
OTHER
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
12
|
6
|
—
|
—
|
$55,276.08
|
$107,056.69
|
$84,461.30
|
2026-05-23
|
|
1203
|
OTHER
|
Major Respiratory And Chest Procedures
|
12
|
6
|
—
|
—
|
$11.54
|
$84,413.46
|
$84,413.46
|
2026-05-23
|
|
957
|
OTHER
|
Other O.r. Procedures For Multiple Significant Trauma With Mcc
|
12
|
6
|
—
|
—
|
$54,855.66
|
$106,242.44
|
$83,818.90
|
2026-05-23
|
|
9304
|
OTHER
|
Multiple Significant Trauma Without O.r. Procedure
|
12
|
6
|
—
|
—
|
$29.29
|
$83,290.05
|
$83,290.05
|
2026-05-23
|
|
3624
|
OTHER
|
Mastectomy Procedures
|
10
|
5
|
—
|
—
|
$63,685.55
|
$83,077.37
|
$83,077.37
|
2026-05-23
|
|
7944
|
OTHER
|
Non-extensive O.r. Procedures For Other Complications Of Treatment
|
10
|
5
|
—
|
—
|
$63,533.66
|
$82,879.23
|
$82,879.23
|
2026-05-23
|
|
6112
|
OTHER
|
Neonate Birth Weight 1500-1999 Grams With Major Anomaly
|
10
|
5
|
—
|
—
|
$63,465.38
|
$82,790.16
|
$82,790.16
|
2026-05-23
|
|
6301
|
OTHER
|
Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure
|
10
|
5
|
—
|
—
|
$63,465.38
|
$82,790.16
|
$82,790.16
|
2026-05-23
|
|
3042
|
OTHER
|
Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back
|
10
|
5
|
—
|
—
|
$63,443.09
|
$82,761.07
|
$82,761.07
|
2026-05-23
|
|
1924
|
OTHER
|
Cardiac Catheterization For Other Non-coronary Conditions
|
10
|
5
|
—
|
—
|
$63,434.72
|
$82,750.16
|
$82,750.16
|
2026-05-23
|
|
6071
|
OTHER
|
Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…
|
10
|
5
|
—
|
—
|
$63,422.18
|
$82,733.80
|
$82,733.80
|
2026-05-23
|
|
2284
|
OTHER
|
Inguinal, Femoral And Umbilical Hernia Procedures
|
10
|
5
|
—
|
—
|
$63,339.97
|
$82,626.55
|
$82,626.55
|
2026-05-23
|
|
2603
|
OTHER
|
Major Pancreas, Liver And Shunt Procedures
|
10
|
5
|
—
|
—
|
$63,126.76
|
$82,348.43
|
$82,348.43
|
2026-05-23
|
|
2203
|
OTHER
|
Major Stomach, Esophageal And Duodenal Procedures
|
10
|
5
|
—
|
—
|
$62,754.70
|
$81,863.08
|
$81,863.08
|
2026-05-23
|
|
6253
|
OTHER
|
Neonate Birth Weight 2000-2499 Grams With Other Significant Condition
|
10
|
5
|
—
|
—
|
$62,749.12
|
$81,855.80
|
$81,855.80
|
2026-05-23
|
|
3464
|
OTHER
|
Connective Tissue Disorders
|
10
|
5
|
—
|
—
|
$62,736.58
|
$81,839.44
|
$81,839.44
|
2026-05-23
|
|
2
|
OTHER
|
Heart Transplant Or Implant Of Heart Assist System Without Mcc
|
22
|
10
|
—
|
—
|
$1,136.73
|
$157,996.57
|
$81,577.63
|
2026-05-23
|
|
3084
|
OTHER
|
Hip And Femur Fracture Repair
|
10
|
5
|
—
|
—
|
$62,510.84
|
$81,544.96
|
$81,544.96
|
2026-05-23
|
|
6604
|
OTHER
|
Major Hematologic Or Immunologic Diagnoses Except Sickle Cell Crisis And Coagula…
|
10
|
5
|
—
|
—
|
$62,496.90
|
$81,526.78
|
$81,526.78
|
2026-05-23
|
|
209
|
OTHER
|
Complex Aortic Arch Procedures
|
22
|
10
|
—
|
—
|
$885.80
|
$157,815.31
|
$81,484.04
|
2026-05-23
|
|
7574
|
OTHER
|
Organic Mental Health Disturbances
|
10
|
5
|
—
|
—
|
$62,319.93
|
$81,295.92
|
$81,295.92
|
2026-05-23
|
|
8904
|
OTHER
|
HIV With Multiple Major HIV Related Conditions
|
10
|
5
|
—
|
—
|
$62,248.86
|
$81,203.21
|
$81,203.21
|
2026-05-23
|
|
4464
|
OTHER
|
Urethral And Transurethral Procedures
|
10
|
5
|
—
|
—
|
$62,053.77
|
$80,948.72
|
$80,948.72
|
2026-05-23
|
|
1763
|
OTHER
|
Insertion, Revision And Replacements Of Pacemaker And Other Cardiac Devices
|
10
|
5
|
—
|
—
|
$61,828.02
|
$80,654.23
|
$80,654.23
|
2026-05-23
|
|
9503
|
OTHER
|
Extensive O.r. Procedure Unrelated To Principal Diagnosis
|
12
|
6
|
—
|
—
|
$48.93
|
$80,654.23
|
$80,654.23
|
2026-05-23
|
|
954
|
OTHER
|
Cleft Lip And Palate Repair
|
10
|
5
|
—
|
—
|
$61,674.74
|
$80,454.28
|
$80,454.28
|
2026-05-23
|
|
1672
|
OTHER
|
Other Cardiothoracic And Thoracic Vascular Procedures
|
10
|
5
|
—
|
—
|
$61,667.77
|
$80,445.19
|
$80,445.19
|
2026-05-23
|
|
3613
|
OTHER
|
Skin Graft For Skin And Subcutaneous Tissue Diagnoses
|
10
|
5
|
—
|
—
|
$61,557.69
|
$80,301.58
|
$80,301.58
|
2026-05-23
|
|
4824
|
OTHER
|
Transurethral Prostatectomy
|
10
|
5
|
—
|
—
|
$61,397.43
|
$80,092.53
|
$80,092.53
|
2026-05-23
|
|
1703
|
OTHER
|
Permanent Cardiac Pacemaker Implant With Ami, Heart Failure Or Shock
|
10
|
5
|
—
|
—
|
$61,369.56
|
$80,056.18
|
$80,056.18
|
2026-05-23
|
|
3213
|
OTHER
|
Spinal Fusion And Other Back And Neck Procedures Except For Disc Procedures
|
10
|
5
|
—
|
—
|
$61,252.51
|
$79,903.48
|
$79,903.48
|
2026-05-23
|
|
3814
|
OTHER
|
Major Skin Disorders
|
10
|
5
|
—
|
—
|
$61,214.89
|
$79,854.40
|
$79,854.40
|
2026-05-23
|
|
3253
|
OTHER
|
Non-elective Or Complex Knee Joint Replacement
|
10
|
5
|
—
|
—
|
$61,111.77
|
$79,719.88
|
$79,719.88
|
2026-05-23
|
|
9113
|
OTHER
|
Extensive Abdominal Or Thoracic Procedures For Multiple Significant Trauma
|
12
|
6
|
—
|
—
|
$393.66
|
$79,459.94
|
$79,459.94
|
2026-05-23
|
|
2344
|
OTHER
|
Appendectomy Without Complex Principal Diagnosis
|
10
|
5
|
—
|
—
|
$60,629.62
|
$79,090.92
|
$79,090.92
|
2026-05-23
|
|
8444
|
OTHER
|
Partial Thickness Burns Without Skin Graft
|
10
|
5
|
—
|
—
|
$60,603.14
|
$79,056.38
|
$79,056.38
|
2026-05-23
|
|
3264
|
OTHER
|
Elective Knee Joint Replacement
|
10
|
5
|
—
|
—
|
$60,568.30
|
$79,010.94
|
$79,010.94
|
2026-05-23
|
|
928
|
OTHER
|
Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc
|
14
|
7
|
—
|
—
|
$1.70
|
$100,007.23
|
$78,899.70
|
2026-05-23
|
|
2264
|
OTHER
|
Anal And Perineal Procedures
|
10
|
5
|
—
|
—
|
$60,382.97
|
$78,769.17
|
$78,769.17
|
2026-05-23
|
|
1314
|
OTHER
|
Cystic Fibrosis - Pulmonary Disease
|
10
|
5
|
—
|
—
|
$60,297.97
|
$78,658.28
|
$78,658.28
|
2026-05-23
|
|
1661
|
OTHER
|
Coronary Bypass Without Ami Or Complex Principal Diagnosis
|
10
|
5
|
—
|
—
|
$60,143.29
|
$78,456.51
|
$78,456.51
|
2026-05-23
|
|
1671
|
OTHER
|
Other Cardiothoracic And Thoracic Vascular Procedures
|
10
|
5
|
—
|
—
|
$60,129.35
|
$78,438.33
|
$78,438.33
|
2026-05-23
|
|
275
|
OTHER
|
Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc
|
12
|
6
|
—
|
—
|
$51,331.75
|
$99,417.46
|
$78,434.40
|
2026-05-23
|
|
1301
|
OTHER
|
Respiratory System Diagnosis With Ventilator Support > 96 Hours
|
10
|
5
|
—
|
—
|
$59,938.44
|
$78,189.29
|
$78,189.29
|
2026-05-23
|
|
7604
|
OTHER
|
Other Mental Health Disorders
|
10
|
5
|
—
|
—
|
$59,852.05
|
$78,076.59
|
$78,076.59
|
2026-05-23
|
|
233
|
OTHER
|
Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc
|
32
|
10
|
—
|
—
|
$2,927.14
|
$106,595.19
|
$77,919.27
|
2026-05-23
|
|
4413
|
OTHER
|
Major Bladder Procedures
|
10
|
5
|
—
|
—
|
$59,668.11
|
$77,836.64
|
$77,836.64
|
2026-05-23
|
|
7524
|
OTHER
|
Disorders Of Personality And Impulse Control
|
10
|
5
|
—
|
—
|
$59,537.12
|
$77,665.76
|
$77,665.76
|
2026-05-23
|
|
6132
|
OTHER
|
Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection
|
10
|
5
|
—
|
—
|
$59,516.21
|
$77,638.49
|
$77,638.49
|
2026-05-23
|
|
120
|
OTHER
|
Car T-cell Immunotherapy
|
10
|
5
|
—
|
—
|
$64,943.68
|
$77,136.41
|
$77,136.41
|
2026-05-23
|
|
1753
|
OTHER
|
Percutaneous Cardiac Intervention Without Ami
|
10
|
5
|
—
|
—
|
$58,929.55
|
$76,873.20
|
$76,873.20
|
2026-05-23
|
|
3144
|
OTHER
|
Foot And Toe Procedures
|
10
|
5
|
—
|
—
|
$58,852.91
|
$76,773.22
|
$76,773.22
|
2026-05-23
|
|
1601
|
OTHER
|
Major Cardiothoracic Repair Of Heart Anomaly
|
10
|
5
|
—
|
—
|
$58,781.84
|
$76,680.51
|
$76,680.51
|
2026-05-23
|