Price Transparency Hospital negotiated rates

Hospital facility prices. What the hospital charges for the facility side of care — the surgeon’s and anesthesiologist’s fees are billed separately and are not included. How we scope prices →

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Hospital

ARKANSAS CHILDREN'S NORTHWEST, INC

Springdale, AR · CCN 043301 · Rates published

13,243 distinct procedures filed
30 distinct payers
481,938 rate rows
2026-05-09 last MRF observed
Data quality

391,783 of 481,938 rate rows are consumer-grade (81.3%)

90,155 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 — reasonRows
exceeds 10× this hospital's gross charge — excluded from medians 40,571
per-diem day rate — not a per-procedure price 26,450
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 23,046
placeholder amount (≤ $0.02) — excluded from medians 88
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://apim.services.craneware.com/api-pricing-transparency/api/public/eb18b2f68dd86a27732870abb762237f/charges/mrf
Discovered viaDiscovered by HANK (automated)
Last fetch not_modified · 2026-05-17
Content fingerprint b1ffdddd241fd471… · 81,156,288 bytes · first seen 2026-05-09

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
67979-0002-01
OTHER 		Supprelin La 30 $43,185.34 $86,927.59 $65,056.46 nat. median
$46,424
1.4× median
0571T
OTHER 		Insj/rplcmt Icds Ss Eltrd 30 $29,296.07 $29,296.07 $29,296.07 nat. median
$31,782
0.9× median
L5856
OTHER 		Elec Knee-shin Swing/stance 30 $28,851.23 $28,851.23 $28,851.23 nat. median
$29,277
1.0× median
L6880
OTHER 		Elec Hand Ind Art Digits 30 $28,715.00 $28,715.00 $28,715.00 nat. median
$29,218
1.0× median
33289
OTHER 		Tcat Impl Wrls P-art Prs Snr 7 $947.50 $26,770.94 $26,770.94 nat. median
$26,244
1.0× median
L5858
OTHER 		Stance Phase Only 30 $22,336.47 $22,336.47 $22,336.47 nat. median
$22,682
1.0× median
33902
OTHER 		Perq P-art Revsc 1 Abnor Uni 26 $17,109.41 $24,982.37 $21,045.89 nat. median
$16,887
1.2× median
93654
OTHER 		Compre Ep Eval Tx Vt 30 $2,011.32 $34,150.19 $18,080.76 nat. median
$22,049
0.8× median
61624
OTHER 		Tcat Perm Occls/embolj Cns 25 $17,109.41 $17,109.41 $17,109.41 nat. median
$9,514
1.8× median
33231
OTHER 		Insrt Pulse Gen W/mult Leads 8 $1,375.77 $46,650.45 $15,711.62 nat. median
$30,055
0.5× median
33264
OTHER 		Rmvl & Rplcmt Dfb Gen Mlt Ld 8 $1,375.77 $46,650.45 $15,711.62 nat. median
$29,348
0.5× median
33270
OTHER 		Ins/rep Subq Defibrillator 8 $1,125.63 $46,650.45 $15,518.25 nat. median
$29,560
0.5× median
33249
OTHER 		Insj/rplcmt Defib W/lead(s) 8 $1,125.63 $46,650.45 $15,518.25 nat. median
$30,055
0.5× median
93581
OTHER 		Transcath Closure Of Vsd 30 $5,033.04 $24,982.37 $15,007.70 nat. median
$15,359
1.0× median
93580
OTHER 		Transcath Closure Of Asd 30 $3,763.77 $24,982.37 $14,373.07 nat. median
$15,964
0.9× median
33229
OTHER 		Remv&replc Pm Gen Mult Leads 30 $1,375.77 $27,155.79 $14,265.78 nat. median
$17,630
0.8× median
33221
OTHER 		Insert Pulse Gen Mult Leads 30 $1,375.77 $27,155.79 $14,265.78 nat. median
$17,878
0.8× median
93582
OTHER 		Perq Transcath Closure Pda 30 $3,451.14 $24,982.37 $14,216.75 nat. median
$15,359
0.9× median
93591
OTHER 		Perq Transcath Cls Aortic 30 $3,412.25 $24,982.37 $14,197.31 nat. median
$16,515
0.9× median
93653
OTHER 		Compre Ep Eval Tx Svt 8 $1,507.59 $34,150.19 $13,363.07 nat. median
$22,805
0.6× median
33903
OTHER 		Perq P-art Revsc 1 Abnor Bi 26 $10,774.50 $15,438.47 $13,106.49 nat. median
$10,910
1.2× median
92997
OTHER 		Pul Art Balloon Repr Percut 30 $10,774.50 $15,438.47 $13,106.49 nat. median
$10,359
1.3× median
33214
OTHER 		Upgrade Of Pacemaker System 26 $9,755.13 $15,021.74 $12,388.43 nat. median
$10,059
1.2× median
81416
OTHER 		Test For Detecting Exome; Sequence Analysis; Each Comparator Exome 30 $2,084.78 $12,000.00 $12,000.00 nat. median
$12,000
1.0× median
33230
OTHER 		Insrt Pulse Gen W/dual Leads 8 $1,375.77 $33,186.01 $11,443.85 nat. median
$1,403
outlier · 8.2×
33262
OTHER 		Rmvl& Replc Pulse Gen 1 Lead 8 $1,375.77 $33,186.01 $11,443.85 nat. median
$21,449
0.5× median
33263
OTHER 		Rmvl & Rplcmt Dfb Gen 2 Lead 8 $1,375.77 $33,186.01 $11,443.85 nat. median
$21,459
0.5× median
33901
OTHER 		Perq P-art Revsc 1 Nm Nt Bi 26 $10,774.50 $10,774.50 $10,774.50 nat. median
$10,794
1.0× median
33900
OTHER 		Perq P-art Revsc 1 Nm Nt Uni 26 $10,774.50 $10,774.50 $10,774.50 nat. median
$10,930
1.0× median
L6925
OTHER 		Wrist Disart Myoelectronic C 30 $10,417.12 $10,417.12 $10,417.12 nat. median
$10,783
1.0× median
L5857
OTHER 		Elec Knee-shin Swing Only 30 $10,237.55 $10,237.55 $10,237.55 nat. median
$10,400
1.0× median
27428
OTHER 		Reconstruction Ligaments Inside Knee Joint 30 $1,125.63 $18,976.59 $10,051.11 nat. median
$7,100
1.4× median
25365
OTHER 		Incision Or Partial Removal Of Both Forearm Bones 30 $1,125.63 $18,976.59 $10,051.11 nat. median
$4,380
outlier · 2.3×
24575
OTHER 		Treatment Of Broken Outer Part Of Upper Arm Bone At Elbow 30 $1,125.63 $18,976.59 $10,051.11 nat. median
$8,029
1.3× median
24545
OTHER 		Treatment Of Upper Arm Bone Broken At Elbow 30 $1,125.63 $18,976.59 $10,051.11 nat. median
$8,150
1.2× median
24579
OTHER 		Treatment Of Broken Elbow 30 $1,125.63 $18,976.59 $10,051.11 nat. median
$9,646
1.0× median
24435
OTHER 		Repair Of Nonhealed Broken Upper Arm Bone With Self Bone Graft 30 $1,125.63 $18,976.59 $10,051.11 nat. median
$9,279
1.1× median
24515
OTHER 		Treatment Of Broken Middle Part Of Upper Arm Bone With Placement Of Stabilizing… 30 $1,125.63 $18,976.59 $10,051.11 nat. median
$9,733
1.0× median
27827
OTHER 		Treatment Of Broken Shin Bone At Lower Weight Bearing Joint 30 $1,125.63 $18,976.59 $10,051.11 nat. median
$10,197
1.0× median
27828
OTHER 		Treatment Of Broken Lower Weight Bearing Joint Of Both Lower Leg Bones 30 $1,125.63 $18,976.59 $10,051.11 nat. median
$9,684
1.0× median
27759
OTHER 		Treatment Of Broken Part Of Shin Bone With Rod 30 $1,125.63 $18,976.59 $10,051.11 nat. median
$10,483
1.0× median
27758
OTHER 		Treatment Broken Middle Part Of Shin Bone With Plate Or Screws 30 $1,125.63 $18,976.59 $10,051.11 nat. median
$10,032
1.0× median
33274
OTHER 		Tcat Insj/rpl Perm Ldls Pm 8 $947.50 $24,982.37 $9,721.23 nat. median
$17,695
0.5× median
37184
OTHER 		Prim Art M-thrmbc 1st Vsl 30 $1,375.77 $17,109.41 $9,242.59 nat. median
$9,495
1.0× median
37182
OTHER 		Insert Hepatic Shunt (tips) 29 $1,375.77 $17,109.41 $9,242.59 nat. median
$9,542
1.0× median
37242
OTHER 		Vasc Embolize/occlude Artery 30 $1,125.63 $17,109.41 $9,117.52 nat. median
$15,256
0.6× median
92990
OTHER 		Revision Of Pulmonary Valve 30 $2,449.29 $15,438.47 $8,943.88 nat. median
$9,628
0.9× median
20982
OTHER 		Ablate Bone Tumor(s) Perq 30 $1,125.63 $16,364.78 $8,745.20 nat. median
$9,877
0.9× median
L5987
OTHER 		Shank Ft W Vert Load Pylon 30 $8,645.73 $8,645.73 $8,645.73 nat. median
$8,780
1.0× median
37221
OTHER 		Iliac Revasc W/stent 30 $1,375.77 $15,438.47 $8,407.12 nat. median
$9,467
0.9× median

Other procedures at this hospital

Browse this hospital's 13,243 published procedures. Use the slice to choose what to show, then sort or filter any column.

Slice
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
             
00019-4816-04 OTHER Md-gastroview 23 23 $36.56 $32.90 $4,272.00 $4,272.00 $4,272.00 2026-05-09
00264-7622-00 OTHER Dextrose-sodium Chloride 23 23 $45.00 $40.50 $4,272.00 $4,272.00 $4,272.00 2026-05-09
0212U OTHER Rare Ds Gen DNA Alys Proband 30 29 $3,125.00 $2,812.50 $5,475.20 $5,475.20 $5,475.20 2026-05-09
0214U OTHER Rare Ds Xom DNA Alys Proband 30 29 $1,876.25 $1,688.63 $5,224.60 $5,224.60 $5,224.60 2026-05-09
0571T OTHER Insj/rplcmt Icds Ss Eltrd 31 30 $52,748.59 $47,473.73 $29,296.07 $29,296.07 $29,296.07 2026-05-09
10006070031 OTHER Melatonin 23 23 $54.60 $49.14 $4,272.00 $4,272.00 $4,272.00 2026-05-09
10006070033 OTHER Vitamin D3 23 23 $14.09 $12.68 $4,272.00 $4,272.00 $4,272.00 2026-05-09
10006070047 OTHER Vitamin C-250 23 23 $7.96 $7.16 $4,272.00 $4,272.00 $4,272.00 2026-05-09
10006073038 OTHER Magnesium Oxide 23 23 $13.78 $12.40 $4,272.00 $4,272.00 $4,272.00 2026-05-09
10006073048 OTHER Poly Vitamin With Iron 23 23 $19.20 $17.28 $4,272.00 $4,272.00 $4,272.00 2026-05-09
1001092020062201YN10010ACH CAM ORAL [51] OTHER Famotidine 40 Mg/5 Ml (8 Mg/ml) Oral Susr 23 23 $14.34 $12.91 $4,272.00 $4,272.00 $4,272.00 2026-05-09
1001092020062201YN10010ORAL LIQUID [43] OTHER Famotidine 40 Mg/5 Ml (8 Mg/ml) Oral Susr 23 23 $29.55 $26.60 $4,272.00 $4,272.00 $4,272.00 2026-05-09
10019005561 OTHER Brevibloc 23 23 $517.60 $465.84 $4,272.00 $4,272.00 $4,272.00 2026-05-09
10019007587 OTHER Brevibloc 23 23 $1,955.04 $1,759.54 $4,272.00 $4,272.00 $4,272.00 2026-05-09
10019055303 OTHER Transderm Scop 23 23 $675.65 $608.09 $4,272.00 $4,272.00 $4,272.00 2026-05-09
10019055390 OTHER Transderm Scop 23 23 $31.06 $27.95 $4,272.00 $4,272.00 $4,272.00 2026-05-09
10019066810 OTHER Brevibloc Novaplus Double Strength 23 23 $1,955.04 $1,759.54 $4,272.00 $4,272.00 $4,272.00 2026-05-09
10019067210 OTHER Brevibloc Novaplus 23 23 $1,816.00 $1,634.40 $4,272.00 $4,272.00 $4,272.00 2026-05-09
10019092501 OTHER Ifosfamide 23 23 $236.09 $212.48 $4,272.00 $4,272.00 $4,272.00 2026-05-09
10019092582 OTHER Ifosfamide 23 23 $236.09 $212.48 $4,272.00 $4,272.00 $4,272.00 2026-05-09
10019092602 OTHER Ifosfamide 23 23 $507.96 $457.16 $4,272.00 $4,272.00 $4,272.00 2026-05-09
10019092616 OTHER Ifosfamide 23 23 $507.96 $457.16 $4,272.00 $4,272.00 $4,272.00 2026-05-09
10019093901 OTHER cycloPHOSphamide Novaplus 23 23 $586.91 $528.22 $4,272.00 $4,272.00 $4,272.00 2026-05-09
10019093950 OTHER cycloPHOSphamide Novaplus 23 23 $586.91 $528.22 $4,272.00 $4,272.00 $4,272.00 2026-05-09
10019095301 OTHER Mesna 23 23 $114.25 $102.83 $4,272.00 $4,272.00 $4,272.00 2026-05-09
10019095362 OTHER Mesna 23 23 $114.25 $102.83 $4,272.00 $4,272.00 $4,272.00 2026-05-09
10019095601 OTHER cycloPHOSphamide 23 23 $1,897.82 $1,708.04 $4,272.00 $4,272.00 $4,272.00 2026-05-09
10019095616 OTHER cycloPHOSphamide 23 23 $1,897.82 $1,708.04 $4,272.00 $4,272.00 $4,272.00 2026-05-09
1005260687036395YN10052ACH CAM ORAL [51] OTHER Flucytosine 500 Mg Oral Cap 23 23 $193.50 $174.15 $4,272.00 $4,272.00 $4,272.00 2026-05-09
1005260687036395YN10052ORAL SOLIDS [42] OTHER Flucytosine 500 Mg Oral Cap 23 23 $413.32 $371.99 $4,272.00 $4,272.00 $4,272.00 2026-05-09
1005981298866001YN10059ACH CAM OUTPATIENT INJECTION [78] OTHER Fluorescein 500 Mg/5 Ml (10 %) IV Soln 23 23 $110.48 $99.43 $4,272.00 $4,272.00 $4,272.00 2026-05-09
1005981298866001YN10059INJ [19] OTHER Fluorescein 500 Mg/5 Ml (10 %) IV Soln 23 23 $287.35 $258.62 $4,272.00 $4,272.00 $4,272.00 2026-05-09
100679854010011YN1006ACH CAM ORAL [51] OTHER Beta Carotene 7,500 Mcg (25,000 Unit) Oral Cap 23 23 $12.40 $11.16 $4,272.00 $4,272.00 $4,272.00 2026-05-09
100679854010011YN1006ORAL SOLIDS [42] OTHER Beta Carotene 7,500 Mcg (25,000 Unit) Oral Cap 23 23 $16.72 $15.05 $4,272.00 $4,272.00 $4,272.00 2026-05-09
101 OTHER Seizures Without Comorbity 24 24 — — $2,372.80 $4,272.00 $4,272.00 2026-05-09
10100017 OTHER Hc Base Dly Care- Lev C- Med/surg(brn) 23 23 $2,131.00 $1,917.90 $4,272.00 $4,272.00 $4,272.00 2026-05-09
10100018 OTHER Hc Base Dly Care- Lev D- Med/surg(brn) 23 23 $3,084.00 $2,775.60 $4,272.00 $4,272.00 $4,272.00 2026-05-09
10100019 OTHER Hc Base Dly Care- Lev E- Med/surg(brn) 23 23 $3,894.00 $3,504.60 $4,272.00 $4,272.00 $4,272.00 2026-05-09
10100020 OTHER Hc Base Dly Care- Lev F- Med/surg(brn) 23 23 $4,793.00 $4,313.70 $4,272.00 $4,272.00 $4,272.00 2026-05-09
11133027434001017YY111330ACH CAM ORAL [51] OTHER Copper Gluconate 2 Mg Oral Cap 23 23 $10.50 $9.45 $4,272.00 $4,272.00 $4,272.00 2026-05-09
11133027434001017YY111330ORAL SOLIDS [42] OTHER Copper Gluconate 2 Mg Oral Cap 23 23 $12.55 $11.30 $4,272.00 $4,272.00 $4,272.00 2026-05-09
1114300713053606YN11143ACH CAM SUPPOSITORY [79] OTHER Promethazine 12.5 Mg Rect Supp 23 23 $23.21 $20.89 $4,272.00 $4,272.00 $4,272.00 2026-05-09
1114300713053606YN11143SUPPOSITORY [44] OTHER Promethazine 12.5 Mg Rect Supp 23 23 $50.12 $45.11 $4,272.00 $4,272.00 $4,272.00 2026-05-09
1114400713052606YN11144ACH CAM SUPPOSITORY [79] OTHER Promethazine 25 Mg Rect Supp 23 23 $23.21 $20.89 $4,272.00 $4,272.00 $4,272.00 2026-05-09
1114400713052606YN11144SUPPOSITORY [44] OTHER Promethazine 25 Mg Rect Supp 23 23 $50.12 $45.11 $4,272.00 $4,272.00 $4,272.00 2026-05-09
113 OTHER Orbital Procedures With Cc/mcc 24 24 — — $4,272.00 $4,272.00 $4,272.00 2026-05-09
113006126 OTHER GoodSense Tussin Mucus + Chest Congestion 23 23 $10.96 $9.86 $4,272.00 $4,272.00 $4,272.00 2026-05-09
113030410 OTHER Good Sense Nasal Spray 23 23 $7.51 $6.76 $4,272.00 $4,272.00 $4,272.00 2026-05-09
113030602 OTHER Good Sense ClearLax 23 23 $20.37 $18.33 $4,272.00 $4,272.00 $4,272.00 2026-05-09
113095828 OTHER Good Sense Children's Cough Dm 23 23 $30.05 $27.05 $4,272.00 $4,272.00 $4,272.00 2026-05-09
1139596295012751YN11395ACH CAM SUPPOSITORY [79] OTHER Sodium Phosphates 19-7 Gram/118 Ml Rect Enem 23 23 $6.57 $5.91 $4,272.00 $4,272.00 $4,272.00 2026-05-09
114 OTHER Orbital Procedures Without Cc/mcc 24 24 — — $4,272.00 $4,272.00 $4,272.00 2026-05-09
115148801 OTHER Mixed Amphetamine Salt 23 23 $1,344.51 $1,210.06 $4,272.00 $4,272.00 $4,272.00 2026-05-09
115167801 OTHER Alendronate Sodium 23 23 $298.20 $268.38 $4,272.00 $4,272.00 $4,272.00 2026-05-09
115168201 OTHER Dexmethylphenidate HCl 23 23 $786.00 $707.40 $4,272.00 $4,272.00 $4,272.00 2026-05-09
115168301 OTHER Dexmethylphenidate HCl 23 23 $1,993.85 $1,794.47 $4,272.00 $4,272.00 $4,272.00 2026-05-09
115703301 OTHER Fludrocortisone Acetate 23 23 $80.30 $72.27 $4,272.00 $4,272.00 $4,272.00 2026-05-09
1157339822100106YN11573ACH CAM OUTPATIENT INJECTION [78] OTHER Tranexamic Acid 1,000 Mg/10 Ml (100 Mg/ml) IV Soln 23 23 $36.61 $32.95 $4,272.00 $4,272.00 $4,272.00 2026-05-09
116400530 OTHER Lactulose 23 23 $7.33 $6.60 $4,272.00 $4,272.00 $4,272.00 2026-05-09
116401016 OTHER Amantadine HCl 23 23 $77.87 $70.08 $4,272.00 $4,272.00 $4,272.00 2026-05-09
117 OTHER Intraocular Procedures Without Cc/mcc 24 24 — — $4,272.00 $4,272.00 $4,272.00 2026-05-09
12090001907 OTHER Lantiseptic Skin Protectant 23 23 $16.72 $15.05 $4,272.00 $4,272.00 $4,272.00 2026-05-09
121057716 OTHER Lactulose 23 23 $40.03 $36.03 $4,272.00 $4,272.00 $4,272.00 2026-05-09
121059500 OTHER Citric Acid/Sodium Citrate 23 23 $10.60 $9.54 $4,272.00 $4,272.00 $4,272.00 2026-05-09
121064616 OTHER Amantadine HCl 23 23 $78.35 $70.52 $4,272.00 $4,272.00 $4,272.00 2026-05-09
121079916 OTHER levETIRAcetam 23 23 $313.43 $282.09 $4,272.00 $4,272.00 $4,272.00 2026-05-09
121086505 OTHER diphenhydrAMINE HCl 23 23 $8.18 $7.36 $4,272.00 $4,272.00 $4,272.00 2026-05-09
121086720 OTHER Vancomycin HCl 23 23 $1,372.81 $1,235.53 $4,272.00 $4,272.00 $4,272.00 2026-05-09
121086800 OTHER Nystatin 23 23 $7.77 $6.99 $4,272.00 $4,272.00 $4,272.00 2026-05-09
121086805 OTHER Nystatin 23 23 $12.26 $11.03 $4,272.00 $4,272.00 $4,272.00 2026-05-09
121086816 OTHER Nystatin 23 23 $311.08 $279.97 $4,272.00 $4,272.00 $4,272.00 2026-05-09
121088516 OTHER prednisoLONE 23 23 $696.70 $627.03 $4,272.00 $4,272.00 $4,272.00 2026-05-09
121090494 OTHER Morphine Sulfate 23 23 $7.13 $6.42 $4,272.00 $4,272.00 $4,272.00 2026-05-09
121093516 OTHER Docusate Sodium 23 23 $18.75 $16.88 $4,272.00 $4,272.00 $4,272.00 2026-05-09
121099205 OTHER Lacosamide 23 23 $54.75 $49.28 $4,272.00 $4,272.00 $4,272.00 2026-05-09
121099295 OTHER Lacosamide 23 23 $54.75 $49.28 $4,272.00 $4,272.00 $4,272.00 2026-05-09
121148800 OTHER guaiFENesin 23 23 $11.38 $10.24 $4,272.00 $4,272.00 $4,272.00 2026-05-09
121148810 OTHER guaiFENesin 23 23 $6.14 $5.53 $4,272.00 $4,272.00 $4,272.00 2026-05-09
121157610 OTHER Metoclopramide 23 23 $10.36 $9.32 $4,272.00 $4,272.00 $4,272.00 2026-05-09
121168000 OTHER Potassium Chloride 23 23 $19.96 $17.96 $4,272.00 $4,272.00 $4,272.00 2026-05-09
121168015 OTHER Potassium Chloride 23 23 $46.31 $41.68 $4,272.00 $4,272.00 $4,272.00 2026-05-09
121168016 OTHER Potassium Chloride 23 23 $89.70 $80.73 $4,272.00 $4,272.00 $4,272.00 2026-05-09
121168040 OTHER Potassium Chloride 23 23 $20.71 $18.64 $4,272.00 $4,272.00 $4,272.00 2026-05-09
121231615 OTHER HYDROcodone Bitartrate-acetaminophen 23 23 $21.02 $18.92 $4,272.00 $4,272.00 $4,272.00 2026-05-09
121467555 OTHER Valproic Acid 23 23 $6.06 $5.45 $4,272.00 $4,272.00 $4,272.00 2026-05-09
121479905 OTHER levETIRAcetam 23 23 $12.37 $11.13 $4,272.00 $4,272.00 $4,272.00 2026-05-09
12180192024072904YN121801ACH CAM ORAL [51] OTHER Dexamethasone 1 Mg/ml Oral Drop 23 23 $24.22 $21.80 $4,272.00 $4,272.00 $4,272.00 2026-05-09
12180192024072904YN121801ORAL LIQUID [43] OTHER Dexamethasone 1 Mg/ml Oral Drop 23 23 $55.54 $49.99 $4,272.00 $4,272.00 $4,272.00 2026-05-09
12180192024072908YN121801ACH CAM ORAL [51] OTHER Dexamethasone 1 Mg/ml Oral Drop 23 23 $42.94 $38.65 $4,272.00 $4,272.00 $4,272.00 2026-05-09
12214944206043993YN122149INJ [19] OTHER Immun Glob G(igg)-pro-iga 0-50 10 % IV Soln 23 23 $25,733.75 $23,160.38 $4,272.00 $4,272.00 $4,272.00 2026-05-09
19318 OTHER Breast Reduction 93 30 $8,643.48 $7,779.13 $1,125.63 $9,827.99 $4,884.56 2026-05-09
20900 OTHER Harvest Of Graft From Small Bone 31 30 $9,620.04 $8,658.04 $1,125.63 $9,620.04 $5,372.84 2026-05-09
20982 OTHER Ablate Bone Tumor(s) Perq 31 30 $4,578.68 $4,120.81 $1,125.63 $16,364.78 $8,745.20 2026-05-09
20983 OTHER Ablate Bone Tumor(s) Perq 31 30 $10,899.50 $9,809.55 $1,125.63 $9,620.04 $5,372.84 2026-05-09
21048 OTHER Removal Of Growth Or Cyst Of Upper Jaw Bone Through Mouth 31 30 $9,453.02 $8,507.72 $1,125.63 $7,765.79 $4,445.71 2026-05-09
21235 OTHER Obtaining Ear Cartilage For Grafting 121 30 $7,486.06 $6,737.45 $947.50 $7,765.79 $4,445.71 2026-05-09
23156 OTHER Removal Of Cyst Or Growth Of Top Of Upper Arm Bone With Donor Bone Graft 31 30 $4,555.39 $4,099.85 $1,125.63 $9,620.04 $5,372.84 2026-05-09
23515 OTHER Treatment Of Broken Collar Bone 31 30 $13,157.36 $11,841.62 $1,125.63 $9,620.04 $5,372.84 2026-05-09
24116 OTHER Removal Of Cyst Or Growth Of Upper Arm Bone And Donor Bone Graft 31 30 $10,203.53 $9,183.18 $1,125.63 $9,620.04 $5,372.84 2026-05-09
24341 OTHER Repair Of Tendon Or Muscle Of Upper Arm Or Elbow 62 30 $10,774.11 $9,696.70 $1,125.63 $9,620.04 $5,372.84 2026-05-09
24435 OTHER Repair Of Nonhealed Broken Upper Arm Bone With Self Bone Graft 31 30 $8,759.56 $7,883.60 $1,125.63 $18,976.59 $10,051.11 2026-05-09
24515 OTHER Treatment Of Broken Middle Part Of Upper Arm Bone With Placement Of Stabilizing … 31 30 $12,372.89 $11,135.60 $1,125.63 $18,976.59 $10,051.11 2026-05-09
24538 OTHER Placement Of Stabilizing Device To Upper Arm Broken At Elbow 100 30 $6,095.71 $5,486.14 $1,125.63 $9,620.04 $5,372.84 2026-05-09
24545 OTHER Treatment Of Upper Arm Bone Broken At Elbow 31 30 $15,673.53 $14,106.18 $1,125.63 $18,976.59 $10,051.11 2026-05-09
24575 OTHER Treatment Of Broken Outer Part Of Upper Arm Bone At Elbow 93 30 $11,181.80 $10,063.62 $1,125.63 $18,976.59 $10,051.11 2026-05-09
24579 OTHER Treatment Of Broken Elbow 93 30 $7,719.34 $6,947.41 $1,125.63 $18,976.59 $10,051.11 2026-05-09
24582 OTHER Placement Of Stabilizing Device For Broken Elbow With Manipulation 62 30 $7,987.86 $7,189.08 $1,125.63 $9,620.04 $5,372.84 2026-05-09
24635 OTHER Treatment Of Broken And Dislocated Forearm Bones At Elbow 62 30 $13,305.68 $11,975.11 $1,125.63 $9,620.04 $5,372.84 2026-05-09
24665 OTHER Treatment Of Broken Forearm Bone On Thumb Side At Elbow 62 30 $10,499.91 $9,449.92 $1,125.63 $9,620.04 $5,372.84 2026-05-09
24685 OTHER Treatment Of Broken Forearm Bone On Small Finger Side At Elbow 31 30 $8,444.63 $7,600.17 $1,125.63 $9,620.04 $5,372.84 2026-05-09
25360 OTHER Incision Or Partial Removal Of Forearm Bone On Small Finger Side 31 30 $16,115.83 $14,504.25 $1,125.63 $9,620.04 $5,372.84 2026-05-09
25365 OTHER Incision Or Partial Removal Of Both Forearm Bones 31 30 $31,616.01 $28,454.41 $1,125.63 $18,976.59 $10,051.11 2026-05-09
25405 OTHER Repair Non-healed Fracture Of Forearm Bone With Patient-derived Bone Graft 31 30 $15,321.13 $13,789.02 $1,125.63 $9,620.04 $5,372.84 2026-05-09
25515 OTHER Treatment Of Broken Midpart Of Forearm Bone On Thumb Side 62 30 $6,275.49 $5,647.93 $1,125.63 $9,620.04 $5,372.84 2026-05-09
25545 OTHER Treatment Of Broken Midpart Of Forearm Bone On Small Finger Side 91 30 $0.01 $10,886.58 $1,125.63 $9,620.04 $5,372.84 2026-05-09
25574 OTHER Treatment Of Broken Midpart Of Both Forearm Bones With Placement Of Stabilizing … 31 30 $6,267.83 $5,641.05 $1,125.63 $9,620.04 $5,372.84 2026-05-09
25575 OTHER Treatment Of Broken Midpart Of Both Forearm Bones With Placement Of Stabilizing … 62 30 $8,534.70 $7,681.23 $1,125.63 $9,620.04 $5,372.84 2026-05-09
25607 OTHER Treatment Of Broken Forearm Bone On Thumb Side Of Wrist; Above Wrist; With Place… 31 30 $18,677.46 $16,809.71 $1,125.63 $9,620.04 $5,372.84 2026-05-09
25608 OTHER Treatment Of 2 Broken Lower Forearm Bone Pieces On Thumb Side Inside Wrist Joint… 31 30 $18,237.96 $16,414.16 $1,125.63 $9,620.04 $5,372.84 2026-05-09
25652 OTHER Treatment Of Broken Base Of Forearm Bone On Small Finger Side At Wrist 30 29 $0.01 — $1,125.63 $9,620.04 $5,372.84 2026-05-09
27393 OTHER Lengthening Of Hamstring Tendon 31 30 $14,385.78 $12,947.20 $1,125.63 $9,620.04 $5,372.84 2026-05-09
27405 OTHER Primary Repair Of Torn Ligament Or Joint Capsule At Outside Part Of Knee 30 29 $0.01 — $1,125.63 $9,620.04 $5,372.84 2026-05-09
27415 OTHER Implantation Of Donor Cartilage Cells Into Knee Joint 8 8 $19,248.12 $17,323.31 $1,125.63 $25,174.75 $6,861.55 2026-05-09
27418 OTHER Repair Of Upper End Of Shin Bone At Knee Joint 31 30 $0.01 — $1,125.63 $9,620.04 $5,372.84 2026-05-09
27422 OTHER Repair Of Dislocating Kneecap With Realignment 31 30 $9,620.04 $8,658.04 $1,125.63 $9,620.04 $5,372.84 2026-05-09
27427 OTHER Reconstruction Of Ligaments Outside Knee Joint 124 30 $13,971.18 $12,574.07 $1,125.63 $9,620.04 $5,372.84 2026-05-09
27428 OTHER Reconstruction Ligaments Inside Knee Joint 31 30 $18,351.34 $16,516.21 $1,125.63 $18,976.59 $10,051.11 2026-05-09
27437 OTHER Repair Of Kneecap 31 30 $5,670.21 $5,103.19 $1,125.63 $9,620.04 $5,372.84 2026-05-09
27475 OTHER Removal Of Growth Plate At Lower End Of Thigh Bone 31 30 $7,521.59 $6,769.43 $1,125.63 $9,620.04 $5,372.84 2026-05-09
27477 OTHER Removal Of Growth Plate Of Both Lower Leg Bones 31 30 $13,883.54 $12,495.19 $1,125.63 $9,620.04 $5,372.84 2026-05-09
27485 OTHER Removal Of Growth Plate Of Leg Or Thigh Bones 124 30 $9,043.10 $8,138.79 $1,125.63 $9,620.04 $5,372.84 2026-05-09
27509 OTHER Treatment Of Broken Thigh Bone At Far End With Placement Of Stabilizing Device 31 30 $6,668.92 $6,002.03 $1,125.63 $9,620.04 $5,372.84 2026-05-09
27524 OTHER Treatment Of Broken Kneecap With Placement Of Stabilizing Device And/or Removal … 31 30 $4,580.47 $4,122.42 $1,125.63 $9,620.04 $5,372.84 2026-05-09
27690 OTHER Transfer Of Tendon And Muscle Rerouting At Lower Leg Or Ankle 31 30 $1,396.79 $1,257.11 $1,125.63 $9,620.04 $5,372.84 2026-05-09
27691 OTHER Transfer Of Deep Tendon Of Foot With Muscle Rerouting 62 30 $8,340.99 $7,506.89 $1,125.63 $9,620.04 $5,372.84 2026-05-09
27695 OTHER Primary Repair Of Disrupted Ankle Ligament 62 30 $8,336.89 $7,503.20 $1,125.63 $9,620.04 $5,372.84 2026-05-09
27705 OTHER Incision Or Partial Removal Of Shin Bone 62 30 $8,805.04 $7,924.54 $1,125.63 $9,620.04 $5,372.84 2026-05-09
27756 OTHER Placement Of Stabilizing Device For Broken Middle Part Of Shin Bone 31 30 $11,411.80 $10,270.62 $1,125.63 $9,620.04 $5,372.84 2026-05-09
27758 OTHER Treatment Broken Middle Part Of Shin Bone With Plate Or Screws 31 30 $12,812.09 $11,530.88 $1,125.63 $18,976.59 $10,051.11 2026-05-09
27759 OTHER Treatment Of Broken Part Of Shin Bone With Rod 62 30 $18,158.00 $16,342.19 $1,125.63 $18,976.59 $10,051.11 2026-05-09
27766 OTHER Treatment Of Inside Portion Of Broken Shin Bone At Ankle 62 30 $4,465.13 $8,037.23 $947.50 $9,620.04 $5,372.84 2026-05-09
27784 OTHER Treatment Of Broken Upper Or Middle Part Of Outer Lower Leg Bone 31 30 $9,620.04 $8,658.04 $1,125.63 $9,620.04 $5,372.84 2026-05-09
27792 OTHER Treatment Of Broken Outer Lower Leg Bone At Ankle 93 30 $11,341.42 $12,725.14 $1,125.63 $9,620.04 $5,372.84 2026-05-09
27814 OTHER Treatment Of Both Broken Lower Leg Bones At Ankle 93 30 $8,504.51 $7,654.06 $1,125.63 $9,620.04 $5,372.84 2026-05-09
27827 OTHER Treatment Of Broken Shin Bone At Lower Weight Bearing Joint 62 30 $6,170.75 $5,553.68 $1,125.63 $18,976.59 $10,051.11 2026-05-09
27828 OTHER Treatment Of Broken Lower Weight Bearing Joint Of Both Lower Leg Bones 62 30 $14,385.55 $12,946.99 $1,125.63 $18,976.59 $10,051.11 2026-05-09
27829 OTHER Treatment Of Ligament Tear At Ankle Joint 93 30 $6,466.72 $5,820.05 $1,125.63 $9,620.04 $5,372.84 2026-05-09
28238 OTHER Reconstruction Of Ankle Tendon With Removal Of Extra Ankle Joint Bone 35 30 $10,550.59 $9,495.53 $1,125.63 $9,620.04 $5,372.84 2026-05-09
28300 OTHER Incision Or Partial Removal Of Heel Bone 62 30 $4,810.03 $8,658.04 $1,125.63 $9,620.04 $5,372.84 2026-05-09
28304 OTHER Incision Or Partial Removal Of Foot Bone 31 30 $10,196.64 $9,176.98 $1,125.63 $9,620.04 $5,372.84 2026-05-09
28305 OTHER Incision Or Partial Removal Of Foot Bone With Bone Graft 61 30 $5,837.87 $10,508.16 $1,125.63 $9,620.04 $5,372.84 2026-05-09
28306 OTHER Incision Or Partial Removal Of Big Toe Bone To Straighten Toe 62 30 $9,443.61 $8,499.25 $947.50 $9,620.04 $5,328.30 2026-05-09
28485 OTHER Treatment Of Broken Midportion Of Foot 89 30 $11,573.26 $10,415.93 $1,125.63 $9,620.04 $5,372.84 2026-05-09
28750 OTHER Fusion Of Big Toe At Joint With Foot 31 30 $1.00 $0.90 $1,125.63 $9,620.04 $5,372.84 2026-05-09
28755 OTHER Fusion Of Big Toe Between Toe Joints 31 30 $14,643.53 $13,179.18 $1,125.63 $9,620.04 $5,372.84 2026-05-09
29806 OTHER Repair Of Shoulder Joint Capsule Using An Endoscope 31 30 $16,690.37 $15,021.33 $1,125.63 $9,620.04 $5,372.84 2026-05-09
29887 OTHER Repair Of Knee Joint With Bone Graft And Internal Stabilizing Device Using An En… 31 30 $25,173.48 $22,656.13 $1,125.63 $9,620.04 $5,372.84 2026-05-09
29888 OTHER Repair Of Anterior Cruciate Ligament Of Knee Using An Endoscope 90 30 $9,670.61 $9,644.73 $1,125.63 $15,702.32 $5,372.84 2026-05-09
30460 OTHER Revision Of Congenital Nasal Defect To Lengthen Tip Of Nose 31 30 $10,806.67 $9,726.00 $1,375.77 $8,645.35 $4,570.78 2026-05-09
30462 OTHER Revision Of Congenital Nasal Defect With Lengthening Of Tip Of Nose 31 30 $7,237.77 $6,513.99 $947.50 $7,765.79 $4,356.65 2026-05-09
30600 OTHER Repair Of Abnormal Drainage Tract Between Mouth And Nasal Cavity 31 30 $15,410.21 $13,869.19 $1,375.77 $7,765.79 $4,570.78 2026-05-09
31254 OTHER Partial Removal Of Nasal Sinus Using An Endoscope 31 30 $5,778.92 $5,201.03 $1,125.63 $8,998.22 $5,061.93 2026-05-09
31255 OTHER Removal Of Nasal Sinus Using An Endoscope 62 30 $4,449.28 $8,008.69 $1,125.63 $8,998.22 $5,061.93 2026-05-09
31257 OTHER Exam Of Nose And Sinus With Removal Of Nasal Sinus Using An Endoscope 62 30 $8,102.06 $7,291.86 $1,125.63 $8,998.22 $5,061.93 2026-05-09
31259 OTHER Removal Of Tissue From Sphenoid Sinus Using An Endoscope 30 30 $0.01 — $1,125.63 $8,998.22 $5,061.93 2026-05-09
31267 OTHER Removal Of Nasal Sinus Tissue Using An Endoscope 124 30 $3,602.96 $7,291.86 $1,125.63 $8,998.22 $5,061.93 2026-05-09
31276 OTHER Exploration Of Nasal Sinus Using An Endoscope 93 30 $0.01 $8,098.40 $1,125.63 $8,998.22 $5,061.93 2026-05-09
31292 OTHER Decompression Of Medial Or Inferior Wall Of Eye Socket Using An Endoscope 31 30 $4,499.11 $4,049.20 $1,125.63 $8,998.22 $5,061.93 2026-05-09
31561 OTHER Removal Of Voice Box Cartilage Using An Endoscope With Operating Microscope Or T… 31 30 $8,998.22 $8,098.40 $947.50 $8,998.22 $4,972.86 2026-05-09
33206 OTHER Insert Heart Pm Atrial 31 30 $17,159.77 $15,443.79 $1,375.77 $9,755.13 $5,565.45 2026-05-09
33207 OTHER Insert Heart Pm Ventricular 31 30 $17,159.77 $15,443.79 $1,212.80 $9,755.13 $5,483.97 2026-05-09
33208 OTHER Insrt Heart Pm Atrial & Vent 31 30 $17,326.37 $15,593.73 $1,125.63 $9,755.13 $5,440.38 2026-05-09
33210 OTHER Insert Electrd/pm Cath Sngl 31 30 $12,915.96 $11,624.36 $1,212.80 $11,871.59 $6,542.19 2026-05-09
33212 OTHER Insert Pulse Gen Sngl Lead 31 30 $4,935.43 $4,441.89 $1,125.63 $11,871.59 $6,498.61 2026-05-09
33213 OTHER Insert Pulse Gen Dual Leads 31 30 $16,523.91 $14,871.52 $1,375.77 $15,021.74 $8,198.75 2026-05-09
33214 OTHER Upgrade Of Pacemaker System 27 26 $4,935.43 $4,441.89 $9,755.13 $15,021.74 $12,388.43 2026-05-09
33216 OTHER Insert 1 Electrode Pm-defib 31 30 $4,935.43 $4,441.89 $1,125.63 $11,871.59 $6,498.61 2026-05-09
33221 OTHER Insert Pulse Gen Mult Leads 31 30 $29,871.37 $26,884.23 $1,375.77 $27,155.79 $14,265.78 2026-05-09
33227 OTHER Remove&replace Pm Gen Singl 31 30 $12,667.57 $11,400.81 $1,375.77 $11,871.59 $6,623.68 2026-05-09
33228 OTHER Remv&replc Pm Gen Dual Lead 31 30 $17,326.37 $15,593.73 $1,375.77 $15,021.74 $8,198.75 2026-05-09
33229 OTHER Remv&replc Pm Gen Mult Leads 31 30 $4,885.57 $4,397.01 $1,375.77 $27,155.79 $14,265.78 2026-05-09
33230 OTHER Insrt Pulse Gen W/dual Leads 8 8 $4,791.61 $4,312.45 $1,375.77 $33,186.01 $11,443.85 2026-05-09
33231 OTHER Insrt Pulse Gen W/mult Leads 8 8 $4,983.33 $4,485.00 $1,375.77 $46,650.45 $15,711.62 2026-05-09
33233 OTHER Removal Of Pm Generator 31 30 $4,983.35 $4,485.02 $947.50 $11,871.59 $6,409.55 2026-05-09
33249 OTHER Insj/rplcmt Defib W/lead(s) 8 8 $53,368.12 $48,031.31 $1,125.63 $46,650.45 $15,518.25 2026-05-09
33262 OTHER Rmvl& Replc Pulse Gen 1 Lead 8 8 $7,549.15 $6,794.24 $1,375.77 $33,186.01 $11,443.85 2026-05-09
33263 OTHER Rmvl & Rplcmt Dfb Gen 2 Lead 8 8 $37,964.78 $34,168.30 $1,375.77 $33,186.01 $11,443.85 2026-05-09
33264 OTHER Rmvl & Rplcmt Dfb Gen Mlt Ld 8 8 $5,081.04 $4,572.94 $1,375.77 $46,650.45 $15,711.62 2026-05-09
33270 OTHER Ins/rep Subq Defibrillator 8 8 $53,368.12 $48,031.31 $1,125.63 $46,650.45 $15,518.25 2026-05-09
33274 OTHER Tcat Insj/rpl Perm Ldls Pm 8 8 $7,260.32 $6,534.29 $947.50 $24,982.37 $9,721.23 2026-05-09
33285 OTHER Insj Subq Car Rhythm Mntr 31 30 $12,915.96 $11,624.36 $1,125.63 $11,871.59 $6,498.61 2026-05-09
33289 OTHER Tcat Impl Wrls P-art Prs Snr 11 7 $47,737.51 $42,963.76 $947.50 $26,770.94 $26,770.94 2026-05-09
33900 OTHER Perq P-art Revsc 1 Nm Nt Uni 27 26 $11,280.22 $10,152.20 $10,774.50 $10,774.50 $10,774.50 2026-05-09
33901 OTHER Perq P-art Revsc 1 Nm Nt Bi 27 26 $11,280.22 $10,152.20 $10,774.50 $10,774.50 $10,774.50 2026-05-09
33902 OTHER Perq P-art Revsc 1 Abnor Uni 27 26 $11,501.41 $10,351.27 $17,109.41 $24,982.37 $21,045.89 2026-05-09
33903 OTHER Perq P-art Revsc 1 Abnor Bi 27 26 $11,501.41 $10,351.27 $10,774.50 $15,438.47 $13,106.49 2026-05-09
36902 OTHER Intro Cath Dialysis Circuit 31 30 $2,163.48 $1,947.13 $1,125.63 $7,585.06 $4,355.35 2026-05-09
37182 OTHER Insert Hepatic Shunt (tips) 30 29 $11,340.03 $10,206.03 $1,375.77 $17,109.41 $9,242.59 2026-05-09
37183 OTHER Revision Tips 31 30 $8,593.88 $7,734.49 $1,375.77 $7,585.06 $4,480.41 2026-05-09
37184 OTHER Prim Art M-thrmbc 1st Vsl 31 30 $5,373.77 $4,836.39 $1,375.77 $17,109.41 $9,242.59 2026-05-09
37187 OTHER Venous Mech Thrombectomy 31 30 $8,132.20 $7,318.98 $1,375.77 $15,438.47 $8,407.12 2026-05-09
37191 OTHER Ins Endovas Vena Cava Filtr 31 30 $10,059.96 $9,053.96 $1,375.77 $7,475.04 $4,425.40 2026-05-09
37220 OTHER Iliac Revasc 31 30 $6,054.96 $5,449.46 $1,375.77 $7,585.06 $4,480.41 2026-05-09
37221 OTHER Iliac Revasc W/stent 31 30 $8,927.71 $8,034.94 $1,375.77 $15,438.47 $8,407.12 2026-05-09
37236 OTHER Open/perq Place Stent 1st 31 30 $14,745.12 $13,270.61 $1,375.77 $15,438.47 $8,407.12 2026-05-09
37238 OTHER Open/perq Place Stent Same 31 30 $16,746.06 $15,071.45 $1,375.77 $15,438.47 $8,407.12 2026-05-09
37241 OTHER Vasc Embolize/occlude Venous 31 30 $16,585.04 $14,926.54 $1,125.63 $15,438.47 $8,282.05 2026-05-09
37242 OTHER Vasc Embolize/occlude Artery 31 30 $14,889.68 $13,400.71 $1,125.63 $17,109.41 $9,117.52 2026-05-09
37243 OTHER Vasc Embolize/occlude Organ 31 30 $7,567.83 $6,811.05 $1,125.63 $15,438.47 $8,282.05 2026-05-09
37244 OTHER Vasc Embolize/occlude Bleed 31 30 $16,266.09 $14,639.48 $1,125.63 $15,438.47 $8,282.05 2026-05-09
37246 OTHER Trluml Balo Angiop 1st Art 31 30 $8,372.16 $7,534.94 $1,375.77 $7,585.06 $4,480.41 2026-05-09
37248 OTHER Trluml Balo Angiop 1st Vein 31 30 $8,291.65 $7,462.49 $1,375.77 $7,585.06 $4,480.41 2026-05-09
40700 OTHER Primary Plastic Repair Of Deformity Present At Birth On 1 Side Of Nose And/or Li… 4 4 $0.01 — $5,525.14 $7,765.79 $5,525.14 2026-05-09
42200 OTHER Repair Of Defect Of Soft And/or Hard Tissue Of Roof Of Mouth For Cleft Palate 62 30 $8,608.90 $7,748.01 $1,125.63 $7,765.79 $4,489.30 2026-05-09
42210 OTHER Repair Of Cleft Palate With Bone Graft 36 30 $136.08 $122.47 $947.50 $7,765.79 $5,264.18 2026-05-09
42215 OTHER Revision Of Prior Cleft Palate Repair 31 30 $6,172.21 $5,554.99 $1,125.63 $7,765.79 $4,445.71 2026-05-09
42220 OTHER Repair Of Cleft Palate With Palate Lengthening 31 30 $8,260.08 $7,434.07 $1,212.80 $7,765.79 $4,489.30 2026-05-09
42410 OTHER Removal Of Growth Of Saliva Gland Or Saliva Gland; Lateral Lobe 31 30 $10,031.74 $9,028.57 $1,125.63 $8,025.39 $4,445.71 2026-05-09
42415 OTHER Removal Of Growth Of Saliva Gland With Release Of Facial Nerve 31 30 $14,367.97 $12,931.17 $1,125.63 $7,765.79 $4,445.71 2026-05-09
42815 OTHER Removal Of Congenital Cyst Or Abnormal Drainage Tract Of Neck And/or Throat 31 30 $5,775.76 $5,198.18 $1,125.63 $7,765.79 $4,445.71 2026-05-09
42820 OTHER Removal Of Tonsils And Adenoid Glands (younger Than 12 Years) 63 30 $2,169.82 $1,952.84 $1,375.77 $7,765.79 $4,696.76 2026-05-09
42825 OTHER Removal Of Tonsils (younger Than 12 Years) 31 30 $3,514.74 $3,163.27 $1,375.77 $7,765.79 $4,570.78 2026-05-09
42870 OTHER Removal Or Destruction Of Growth Of Tongue Lymph Node 31 30 $12,521.48 $11,269.33 $1,125.63 $7,765.79 $4,445.71 2026-05-09
43265 OTHER Ercp Lithotripsy Calculi 31 30 $5,591.33 $5,032.20 $5,666.13 $5,666.13 $5,666.13 2026-05-09
43653 OTHER Creation Of Surgical Opening From Stomach To Skin Using An Endoscope 93 30 $7,580.33 $6,822.30 $1,125.63 $7,580.33 $4,352.98 2026-05-09
43659 OTHER Other Procedure On Stomach Using An Endoscope 27 26 $5,758.28 $5,182.45 $5,642.45 $7,580.33 $6,611.39 2026-05-09
44180 OTHER Release Of Small Bowel Scar Tissue Using An Endoscope 31 30 $7,580.33 $6,822.30 $1,125.63 $7,580.33 $4,352.98 2026-05-09
44238 OTHER Other Procedure On Bowel Using An Endoscope 30 30 $13,632.08 $12,268.87 $1,125.63 $7,580.33 $4,352.98 2026-05-09
44970 OTHER Removal Of Appendix Using An Endoscope 35 30 $7,580.33 $6,822.30 $1,375.77 $7,580.33 $4,478.05 2026-05-09
47539 OTHER Perq Plmt Bile Duct Stent 31 30 $4,592.97 $4,133.67 $1,125.63 $7,580.33 $4,352.98 2026-05-09
47562 OTHER Removal Of Gallbladder Using An Endoscope 62 30 $7,670.68 $6,903.61 $1,125.63 $7,580.33 $4,352.98 2026-05-09
47579 OTHER Other Procedure On Bile Duct Using An Endoscope 27 26 $1,477.32 $1,329.59 $5,642.45 $7,580.33 $6,611.39 2026-05-09
49320 OTHER Diagnostic Exam Of Abdomen Using An Endoscope 35 30 $6,955.12 $6,259.61 $267.53 $7,580.33 $4,352.98 2026-05-09
49322 OTHER Aspiration Of Abdominal Cavity Or Cyst Using An Endoscope 31 30 $4,034.45 $3,631.01 $1,125.63 $7,580.33 $4,352.98 2026-05-09
49491 OTHER Repair Of Groin Hernia In Preterm Infant Younger Than 37 Weeks Gestation Perform… 31 30 $4,164.63 $3,748.17 $1,375.77 $7,580.33 $4,478.05 2026-05-09
49592 OTHER Repair Of Anterior Abdominal Hernia(s) (ie; Epigastric; Incisional; Ventral; Umb… 31 30 $8,450.36 $7,605.32 $1,375.77 $7,580.33 $4,478.05 2026-05-09
49650 OTHER Repair Of Groin Hernia Using An Endoscope 155 30 $5,642.12 $5,571.98 $1,125.63 $7,580.33 $4,352.98 2026-05-09
49651 OTHER Repair Of Recurrent Groin Hernia Using An Endoscope 62 30 $3,814.24 $3,432.81 $1,125.63 $7,580.33 $4,352.98 2026-05-09
50590 OTHER Shock Wave Crushing Of Kidney Stones 31 30 $8,386.72 $7,548.05 $3,289.96 $8,386.72 $5,838.34 2026-05-09
51500 OTHER Repair Of Congenital Defect Of Bladder 62 30 $4,594.86 $4,135.37 $1,125.63 $7,580.33 $4,352.98 2026-05-09
54344 OTHER Repair Of Complication Of Urinary Outlet Of Penis At Underside Of Penis With Mob… 31 30 $7,792.20 $7,012.98 $1,125.63 $8,835.30 $4,980.47 2026-05-09
54660 OTHER Insertion Of Testicular Implant 31 30 $9,654.34 $8,688.91 $5,004.31 $5,004.31 $5,004.31 2026-05-09
54690 OTHER Removal Of Testicles Using An Endoscope 31 30 $3,372.70 $3,035.43 $1,125.63 $7,580.33 $4,352.98 2026-05-09
54692 OTHER Removal Of Congenital Malpositioned Testicle Using An Endoscope 62 30 $5,178.40 $4,660.56 $1,125.63 $7,580.33 $4,352.98 2026-05-09
58661 OTHER Removal Of Ovaries And/or Tubes Using An Endoscope 31 30 $8,617.49 $7,755.74 $1,125.63 $7,580.33 $4,352.98 2026-05-09
58662 OTHER Destruction Or Removal Of Ovary Or Growth Of Pelvis Using An Endoscope 93 30 $4,590.45 $8,532.30 $1,125.63 $7,580.33 $4,352.98 2026-05-09
60240 OTHER Removal Of Thyroid 31 30 $10,955.43 $9,859.89 $1,212.80 $9,859.89 $4,396.56 2026-05-09
60280 OTHER Removal Of Cyst Of Thyroid Or Drainage Of Thyroid Gland Duct 31 30 $9,883.15 $8,894.84 $1,212.80 $7,580.33 $4,396.56 2026-05-09
61623 OTHER Endovasc Tempory Vessel Occl 31 30 $16,219.66 $14,597.69 $1,375.77 $15,438.47 $8,407.12 2026-05-09
61624 OTHER Tcat Perm Occls/embolj Cns 26 25 $2,451.94 $2,206.75 $17,109.41 $17,109.41 $17,109.41 2026-05-09
61626 OTHER Tcat Perm Occls/embol Noncns 31 30 $16,266.09 $14,639.48 $1,125.63 $15,438.47 $8,282.05 2026-05-09
64910 OTHER Repair Of Nerve With Graft 31 30 $11,957.46 $10,761.71 $1,212.80 $8,985.96 $5,099.38 2026-05-09
67979-0002-01 OTHER Supprelin La 31 30 $187,277.56 $168,549.80 $43,185.34 $86,927.59 $65,056.46 2026-05-09
69631 OTHER Repair Of Eardrum And Ear Canal With Opening To Ear Bones 154 30 $0.01 $5,810.32 $1,125.63 $7,765.79 $4,445.71 2026-05-09
69633 OTHER Repair Of Eardrum; Ear Canal; And Bones With Insertion Of Prosthesis 62 30 $6,347.80 $5,713.02 $1,125.63 $7,765.79 $4,445.71 2026-05-09
69635 OTHER Repair Of Eardrum And Ear Canal With Incision Of Middle Ear Bone 31 30 $7,580.38 $6,822.34 $1,125.63 $7,765.79 $4,445.71 2026-05-09
69641 OTHER Complex Repair Of Eardrum And Ear Canal With Removal Of Mastoid Bone 61 30 $3,882.90 $6,989.21 $1,125.63 $7,765.79 $4,445.71 2026-05-09
69642 OTHER Repair Of Eardrum; Ear Canal; And Bones With Removal Of Middle Ear Bone 62 30 $8,512.08 $7,660.88 $1,125.63 $7,765.79 $4,445.71 2026-05-09
75605 OTHER Contrast Exam Thoracic Aorta 30 29 $4,105.98 $3,695.38 $5,193.48 $5,193.48 $5,193.48 2026-05-09
75705 OTHER Artery X-rays Spine 30 29 $2,003.66 $1,803.29 $5,193.48 $5,193.48 $5,193.48 2026-05-09
75726 OTHER Artery X-rays Abdomen 30 29 $6,026.51 $5,423.86 $5,193.48 $5,193.48 $5,193.48 2026-05-09
75736 OTHER Artery X-rays Pelvis 30 29 $6,026.51 $5,423.86 $5,193.48 $5,193.48 $5,193.48 2026-05-09
75893 OTHER Venous Sampling By Catheter 30 29 $6,026.51 $5,423.86 $5,193.48 $5,193.48 $5,193.48 2026-05-09
81415 OTHER Test For Detecting Exome; Sequence Analysis 57 30 $519.02 $467.12 $415.22 $4,780.00 $4,780.00 2026-05-09
81416 OTHER Test For Detecting Exome; Sequence Analysis; Each Comparator Exome 57 30 $2,605.98 $2,345.38 $2,084.78 $12,000.00 $12,000.00 2026-05-09
81425 OTHER Test For Detecting Genes Associated With Disease; Genome Sequence Analysis 61 30 $5,500.00 $4,950.00 $3,125.00 $5,031.20 $5,031.20 2026-05-09
81455 OTHER So/hl 51/>gsap Dna/dna&rna 42 29 $6,983.75 $6,285.38 $2,455.16 $6,983.75 $4,951.68 2026-05-09
81529 OTHER Onc Cutan Mlnma Mrna 31 Gene 30 29 $1,605.72 $1,445.15 $1,605.72 $7,193.00 $4,399.36 2026-05-09
92920 OTHER Prq Trluml C Angiop 1art&/br 31 30 $9,209.38 $8,288.44 $1,212.80 $7,585.06 $4,398.93 2026-05-09
92928 OTHER Prq Tcat Plmt Ntrac St 1 Les 31 30 $18,420.66 $16,578.59 $1,212.80 $15,438.47 $8,325.64 2026-05-09
92986 OTHER Revision Of Aortic Valve 31 30 $8,372.16 $7,534.94 $3,121.33 $7,585.06 $5,353.19 2026-05-09
92990 OTHER Revision Of Pulmonary Valve 31 30 $15,034.24 $13,530.82 $2,449.29 $15,438.47 $8,943.88 2026-05-09
92997 OTHER Pul Art Balloon Repr Percut 31 30 $15,034.24 $13,530.82 $10,774.50 $15,438.47 $13,106.49 2026-05-09
93580 OTHER Transcath Closure Of Asd 31 30 $24,136.99 $21,723.29 $3,763.77 $24,982.37 $14,373.07 2026-05-09
93581 OTHER Transcath Closure Of Vsd 31 30 $5,209.15 $4,688.24 $5,033.04 $24,982.37 $15,007.70 2026-05-09
93582 OTHER Perq Transcath Closure Pda 31 30 $24,136.99 $21,723.29 $3,451.14 $24,982.37 $14,216.75 2026-05-09
93591 OTHER Perq Transcath Cls Aortic 31 30 $28,579.83 $25,721.85 $3,412.25 $24,982.37 $14,197.31 2026-05-09
93619 OTHER Comprehensive Ep Evaluation 31 30 $11,201.86 $10,081.67 $1,451.57 $9,791.84 $5,621.70 2026-05-09
93620 OTHER Comp Ep Evl R At Ven Pac&rec 31 30 $11,201.86 $10,081.67 $2,001.88 $9,791.84 $5,896.86 2026-05-09
93650 OTHER Icar Cath Abltj Av Node Func 31 30 $11,201.86 $10,081.67 $1,650.20 $9,791.84 $5,721.02 2026-05-09
93653 OTHER Compre Ep Eval Tx Svt 8 8 $39,067.82 $35,161.04 $1,507.59 $34,150.19 $13,363.07 2026-05-09
93654 OTHER Compre Ep Eval Tx Vt 31 30 $39,067.82 $35,161.04 $2,011.32 $34,150.19 $18,080.76 2026-05-09
L2005 OTHER Kafo Sng/dbl Mechanical Act 31 30 $8,052.03 $7,246.83 $4,915.21 $4,915.21 $4,915.21 2026-05-09
L5200 OTHER Kne Sing Axis Fric Shin Sach 31 30 $8,091.18 $7,282.06 $4,913.09 $4,913.09 $4,913.09 2026-05-09
L5230 OTHER Fem Focal Defic Constant Fri 31 30 $6,001.47 $5,401.32 $6,209.65 $6,209.65 $6,209.65 2026-05-09
L5312 OTHER Knee Disart, Sach Ft, Endo 31 30 $6,987.94 $6,289.15 $4,823.95 $4,823.95 $4,823.95 2026-05-09
L5321 OTHER Ak Open End Sach 31 30 $6,308.21 $5,677.39 $5,364.98 $5,364.98 $5,364.98 2026-05-09
L5700 OTHER Replace Socket Below Knee 31 30 $6,350.33 $5,715.30 $4,470.21 $4,470.21 $4,470.21 2026-05-09
L5701 OTHER Replace Socket Above Knee 31 30 $7,626.21 $6,863.59 $5,550.13 $5,550.13 $5,550.13 2026-05-09
L5828 OTHER Endo Knee-shin Fluid Swg/sta 31 30 $4,494.93 $4,045.44 $4,478.35 $4,478.35 $4,478.35 2026-05-09
L5856 OTHER Elec Knee-shin Swing/stance 31 30 $39,796.43 $35,816.79 $28,851.23 $28,851.23 $28,851.23 2026-05-09
L5857 OTHER Elec Knee-shin Swing Only 31 30 $12,403.85 $11,163.47 $10,237.55 $10,237.55 $10,237.55 2026-05-09
L5858 OTHER Stance Phase Only 31 30 $27,063.01 $24,356.71 $22,336.47 $22,336.47 $22,336.47 2026-05-09
L5980 OTHER Flex Foot System 31 30 $7,430.73 $6,687.66 $5,166.71 $5,166.71 $5,166.71 2026-05-09
L5987 OTHER Shank Ft W Vert Load Pylon 31 30 $15,831.48 $14,248.33 $8,645.73 $8,645.73 $8,645.73 2026-05-09
L6250 OTHER Elbow Inter Loc Elbow Forarm 31 30 $7,322.57 $6,590.31 $4,383.37 $4,383.37 $4,383.37 2026-05-09
L6300 OTHER Shlder Disart Int Lock Elbow 31 30 $8,817.86 $7,936.07 $6,081.45 $6,081.45 $6,081.45 2026-05-09
L6880 OTHER Elec Hand Ind Art Digits 31 30 $42,732.68 $38,459.41 $28,715.00 $28,715.00 $28,715.00 2026-05-09
L6881 OTHER Term Dev Auto Grasp Feature 31 30 $8,997.13 $8,097.42 $4,913.43 $4,913.43 $4,913.43 2026-05-09
L6925 OTHER Wrist Disart Myoelectronic C 31 30 $18,871.18 $16,984.06 $10,417.12 $10,417.12 $10,417.12 2026-05-09
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