|
00620
|
HCPCS
|
Anesthesia For Other Procedure On Middle Spine
|
8
|
8
|
$192,700.00
|
$192,700.00
|
$105,985.00
|
$196,554.00
|
$147,415.50
|
2026-08-14
|
|
J3101
|
HCPCS
|
Injection, Tenecteplase, 1 Mg
|
10
|
10
|
$85,127.09
|
$85,127.09
|
$217.42
|
$86,829.63
|
$59,588.96
|
2026-08-14
|
|
33262
|
HCPCS
|
Removal And Replacement Of Single Lead Defibrillator
|
10
|
10
|
$96,677.00
|
$96,677.00
|
$301.74
|
$82,175.45
|
$57,764.51
|
2026-08-14
|
|
37275
|
HCPCS
|
Revascularization, Endovascular, Open Or Percutaneous, Femoral And Popliteal Vas…
|
18
|
10
|
$80,154.00
|
$80,154.00
|
$26,066.60
|
$81,757.08
|
$53,022.06
|
2026-08-14
|
|
0238T
|
OTHER
|
Catheter Removal Of Plaque From Groin Artery, Accessed Through The Skin Or Open …
|
10
|
10
|
$72,883.00
|
$72,883.00
|
$26,066.60
|
$74,340.66
|
$51,018.10
|
2026-08-14
|
|
37288
|
HCPCS
|
Revascularization, Endovascular, Open Or Percutaneous, Tibial And Peroneal Vascu…
|
10
|
10
|
$72,308.00
|
$72,308.00
|
$26,066.60
|
$73,754.16
|
$50,615.60
|
2026-08-14
|
|
C9767
|
HCPCS
|
Revascularization, Endovascular, Open Or Percutaneous, Lower Extremity Artery(ie…
|
8
|
8
|
$75,522.00
|
$75,522.00
|
$26,066.60
|
$64,193.70
|
$48,900.50
|
2026-08-14
|
|
C9765
|
HCPCS
|
Revascularization, Endovascular, Open Or Percutaneous, Lower Extremity Artery(ie…
|
8
|
8
|
$75,519.00
|
$75,519.00
|
$26,066.60
|
$64,191.15
|
$48,898.56
|
2026-08-14
|
|
C9775
|
HCPCS
|
Revascularization, Endovascular, Open Or Percutaneous, Tibial/peroneal Artery(ie…
|
8
|
8
|
$75,519.00
|
$75,519.00
|
$26,066.60
|
$64,191.15
|
$48,898.56
|
2026-08-14
|
|
C9773
|
HCPCS
|
Revascularization, Endovascular, Open Or Percutaneous, Tibial/peroneal Artery(i…
|
8
|
8
|
$75,519.00
|
$75,519.00
|
$26,066.60
|
$64,191.15
|
$48,898.56
|
2026-08-14
|
|
C9766
|
HCPCS
|
Revascularization, Endovascular, Open Or Percutaneous, Lower Extremity Artery(ie…
|
8
|
8
|
$75,519.00
|
$75,519.00
|
$26,066.60
|
$64,191.15
|
$48,898.56
|
2026-08-14
|
|
C9774
|
HCPCS
|
Revascularization, Endovascular, Open Or Percutaneous, Tibial/peroneal Artery(ie…
|
8
|
8
|
$75,519.00
|
$75,519.00
|
$26,066.60
|
$64,191.15
|
$48,898.56
|
2026-08-14
|
|
37231
|
HCPCS
|
Removal Of Plaque And Insertion Of Stents In Artery Of Leg, Initial Vessel
|
10
|
8
|
$69,159.00
|
$69,159.00
|
$1,862.35
|
$70,542.18
|
$48,411.30
|
2026-08-14
|
|
31620043_1
|
CDM
|
Implant Cardiac Defibrillator
|
6
|
6
|
$63,999.00
|
$63,999.00
|
$35,199.45
|
$54,399.15
|
$44,799.30
|
2026-08-14
|
|
C1882
|
HCPCS
|
Cardioverter-defibrillator, Other Than Single Or Dual Chamber (implantable)
|
64
|
8
|
$56,924.50
|
$56,924.50
|
$12,846.90
|
$78,099.36
|
$41,813.20
|
2026-08-14
|
|
37284
|
HCPCS
|
Revascularization, Endovascular, Open Or Percutaneous, Tibial And Peroneal Vascu…
|
18
|
10
|
$40,665.00
|
$40,665.00
|
$22,365.75
|
$81,758.10
|
$41,071.65
|
2026-08-14
|
|
C1721
|
HCPCS
|
Cardioverter-defibrillator, Dual Chamber (implantable)
|
8
|
8
|
$48,826.00
|
$48,826.00
|
$26,854.30
|
$49,802.52
|
$37,351.89
|
2026-08-14
|
|
37296
|
HCPCS
|
Revascularization, Endovascular, Open Or Percutaneous, Inframalleolar Vascular T…
|
10
|
10
|
$50,482.00
|
$50,482.00
|
$16,415.20
|
$51,491.64
|
$35,337.40
|
2026-08-14
|
|
0525T
|
OTHER
|
Insertion Or Replacement Of Complete Monitoring System For Deficient Blood Flow …
|
10
|
10
|
$46,759.00
|
$46,759.00
|
$25,717.45
|
$47,694.18
|
$34,652.82
|
2026-08-14
|
|
C1722
|
HCPCS
|
Cardioverter-defibrillator, Single Chamber (implantable)
|
32
|
8
|
$43,716.50
|
$43,716.50
|
$18,603.75
|
$51,876.18
|
$32,931.21
|
2026-08-14
|
|
C1787
|
HCPCS
|
Patient Programmer, Neurostimulator
|
8
|
8
|
$41,574.00
|
$41,574.00
|
$22,865.70
|
$42,405.48
|
$31,804.11
|
2026-08-14
|
|
C1820
|
HCPCS
|
Generator, Neurostimulator (implantable), With Rechargeable Battery And Charging…
|
8
|
8
|
$41,361.00
|
$41,361.00
|
$22,748.55
|
$42,188.22
|
$31,641.17
|
2026-08-14
|
|
C9772
|
HCPCS
|
Revascularization, Endovascular, Open Or Percutaneous, Tibial/peroneal Artery(ie…
|
8
|
8
|
$48,057.00
|
$48,057.00
|
$16,415.20
|
$40,848.45
|
$31,116.91
|
2026-08-14
|
|
J1162
|
HCPCS
|
Injection, Digoxin Immune Fab (ovine), Per Vial
|
10
|
10
|
$51,825.72
|
$51,825.72
|
$5,383.32
|
$44,051.86
|
$30,965.87
|
2026-08-14
|
|
C9764
|
HCPCS
|
Revascularization, Endovascular, Open Or Percutaneous, Lower Extremity Artery(ie…
|
8
|
8
|
$47,694.00
|
$47,694.00
|
$16,415.20
|
$40,539.90
|
$30,881.86
|
2026-08-14
|
|
37230
|
HCPCS
|
Insertion Of Stent In Artery Of Leg, Initial Vessel
|
10
|
8
|
$40,665.00
|
$40,665.00
|
$1,692.35
|
$41,478.30
|
$28,465.50
|
2026-08-14
|
|
37271
|
HCPCS
|
Revascularization, Endovascular, Open Or Percutaneous, Femoral And Popliteal Vas…
|
28
|
10
|
$40,665.00
|
$40,665.00
|
$45.00
|
$81,757.08
|
$28,465.50
|
2026-08-14
|
|
G0390
|
HCPCS
|
Trauma Response Team Associated With Hospital Critical Care Service
|
26
|
10
|
$33,260.00
|
$33,260.00
|
$1,895.33
|
$50,886.78
|
$26,690.88
|
2026-08-14
|
|
37267
|
HCPCS
|
Revascularization, Endovascular, Open Or Percutaneous, Femoral And Popliteal Vas…
|
28
|
10
|
$40,665.00
|
$40,665.00
|
$75.00
|
$51,491.64
|
$26,330.59
|
2026-08-14
|
|
61623
|
HCPCS
|
Balloon Occlusion Of Head Or Neck Artery With Review By Radiologist
|
10
|
10
|
$39,431.00
|
$39,431.00
|
$300.07
|
$33,516.35
|
$23,560.03
|
2026-08-14
|
|
C1767
|
HCPCS
|
Generator, Neurostimulator (implantable), Non-rechargeable
|
8
|
8
|
$26,339.00
|
$26,339.00
|
$14,486.45
|
$26,865.78
|
$20,149.33
|
2026-08-14
|
|
J0401
|
HCPCS
|
Injection, Aripiprazole (abilify Maintena), 1 Mg
|
10
|
10
|
$30,225.63
|
$30,225.63
|
$7.46
|
$25,691.79
|
$18,059.81
|
2026-08-14
|
|
J0630
|
HCPCS
|
Injection, Calcitonin Salmon, Up To 400 Units
|
8
|
8
|
$22,919.17
|
$22,919.17
|
$12,605.54
|
$23,377.56
|
$17,533.17
|
2026-08-14
|
|
Q4116
|
HCPCS
|
Alloderm, Per Square Centimeter
|
10
|
10
|
$28,612.00
|
$28,612.00
|
$36.98
|
$24,320.20
|
$17,095.67
|
2026-08-14
|
|
C2621
|
HCPCS
|
Pacemaker, Other Than Single Or Dual Chamber (implantable)
|
24
|
8
|
$23,358.00
|
$23,358.00
|
$8,456.25
|
$30,424.56
|
$16,961.95
|
2026-08-14
|
|
J3111
|
HCPCS
|
Injection, Romosozumab-aqqg, 1 Mg
|
10
|
10
|
$27,360.22
|
$27,360.22
|
$12.73
|
$23,256.19
|
$16,347.73
|
2026-08-14
|
|
Q4130
|
HCPCS
|
Strattice Tm, Per Square Centimeter
|
8
|
8
|
$23,662.00
|
$23,662.00
|
$147.49
|
$20,112.70
|
$15,321.15
|
2026-08-14
|
|
37280
|
HCPCS
|
Revascularization, Endovascular, Open Or Percutaneous, Tibial And Peroneal Vascu…
|
28
|
10
|
$19,667.00
|
$19,667.00
|
$50.00
|
$51,491.64
|
$15,045.26
|
2026-08-14
|
|
31610098_1
|
CDM
|
Interbody Lordotic
|
6
|
6
|
$20,910.00
|
$20,910.00
|
$11,500.50
|
$17,773.50
|
$14,637.00
|
2026-08-14
|
|
47383
|
HCPCS
|
Destruction Of Growth Of Liver Through Skin Using Freezing
|
10
|
10
|
$20,300.00
|
$20,300.00
|
$416.98
|
$18,893.75
|
$14,155.00
|
2026-08-14
|
|
37285
|
HCPCS
|
Revascularization, Endovascular, Open Or Percutaneous, Tibial And Peroneal Vascu…
|
10
|
10
|
$19,667.00
|
$19,667.00
|
$147.06
|
$20,060.34
|
$13,766.90
|
2026-08-14
|
|
37254
|
HCPCS
|
Revascularization, Endovascular, Open Or Percutaneous, Iliac Vascular Territory,…
|
10
|
10
|
$19,667.00
|
$19,667.00
|
$8,093.09
|
$20,060.34
|
$13,766.90
|
2026-08-14
|
|
37233
|
HCPCS
|
Removal Of Plaque In Artery Of Leg, Each Additional Vessel
|
10
|
8
|
$19,667.00
|
$19,667.00
|
$842.35
|
$20,060.34
|
$13,766.90
|
2026-08-14
|
|
37223
|
HCPCS
|
Insertion Of Stent In Groin Artery, Additional Vessel
|
10
|
8
|
$19,667.00
|
$19,667.00
|
$503.20
|
$20,060.34
|
$13,766.90
|
2026-08-14
|
|
37293
|
HCPCS
|
Revascularization, Endovascular, Open Or Percutaneous, Tibial And Peroneal Vascu…
|
10
|
10
|
$19,667.00
|
$19,667.00
|
$290.41
|
$20,060.34
|
$13,766.90
|
2026-08-14
|
|
C1764
|
HCPCS
|
Event Recorder, Cardiac (implantable)
|
8
|
8
|
$17,611.00
|
$17,611.00
|
$9,686.05
|
$17,963.22
|
$13,472.42
|
2026-08-14
|
|
J7168
|
HCPCS
|
Prothrombin Complex Concentrate (human), Kcentra, Per I.u. Of Factor Ix Activity
|
10
|
10
|
$22,060.50
|
$22,060.50
|
$2.01
|
$18,751.43
|
$13,181.15
|
2026-08-14
|
|
47556
|
HCPCS
|
Dilation Of Bile Ducts With Stent Insertion Using An Endoscope
|
10
|
10
|
$18,310.00
|
$18,310.00
|
$344.01
|
$18,893.75
|
$12,817.00
|
2026-08-14
|
|
32994
|
HCPCS
|
Destruction Of Growth Of Lung Using Extreme Cold
|
10
|
10
|
$18,310.00
|
$18,310.00
|
$8,260.18
|
$18,893.75
|
$12,817.00
|
2026-08-14
|
|
37263
|
HCPCS
|
Revascularization, Endovascular, Open Or Percutaneous, Femoral And Popliteal Vas…
|
28
|
10
|
$19,667.00
|
$19,667.00
|
$45.00
|
$25,092.00
|
$12,734.38
|
2026-08-14
|
|
75705
|
HCPCS
|
Review By Radiologist Of Spinal Artery Image
|
10
|
10
|
$20,126.00
|
$20,126.00
|
$303.17
|
$17,107.10
|
$12,025.28
|
2026-08-14
|
|
36226
|
HCPCS
|
Insertion Of Tube Into Brain Artery For Diagnosis Or Treatment With Review By Ra…
|
10
|
10
|
$20,126.00
|
$20,126.00
|
$281.46
|
$17,107.10
|
$12,025.28
|
2026-08-14
|
|
J1459
|
HCPCS
|
Injection, Immune Globulin (privigen), Intravenous, Non-lyophilized (e.g., Liqui…
|
10
|
10
|
$19,852.27
|
$19,852.27
|
$51.22
|
$16,874.43
|
$11,861.74
|
2026-08-14
|
|
50592
|
HCPCS
|
Destruction Of Growth Of Kidney Using Radiofrequency
|
8
|
8
|
$18,310.00
|
$18,310.00
|
$8,596.41
|
$15,563.50
|
$11,855.73
|
2026-08-14
|
|
20982
|
HCPCS
|
Destruction Of Growths And Adjacent Soft Tissue
|
10
|
10
|
$16,863.00
|
$16,863.00
|
$3,678.13
|
$31,165.13
|
$11,804.10
|
2026-08-14
|
|
37239
|
HCPCS
|
Insertion Of Stent In Vein With Review By Radiologist, Each Additional Vein
|
10
|
10
|
$19,667.00
|
$19,667.00
|
$127.33
|
$16,716.95
|
$11,751.03
|
2026-08-14
|
|
J0897
|
HCPCS
|
Injection, Denosumab, 1 Mg
|
10
|
10
|
$19,523.92
|
$19,523.92
|
$30.10
|
$16,595.33
|
$11,665.55
|
2026-08-14
|
|
34712
|
HCPCS
|
Delivery Of Fixation Device To Graft With Review By Radiologist
|
10
|
10
|
$19,211.00
|
$19,211.00
|
$577.72
|
$16,329.35
|
$11,478.58
|
2026-08-14
|
|
47539
|
HCPCS
|
Placement Of Stent Of Biliary Duct Through New Skin Access Using Imaging With Re…
|
10
|
10
|
$18,654.00
|
$18,654.00
|
$4,570.73
|
$15,855.90
|
$11,388.67
|
2026-08-14
|
|
47540
|
HCPCS
|
Placement Of Stent And Drainage Tube Of Biliary Duct Using Imaging Guidance With…
|
10
|
10
|
$18,654.00
|
$18,654.00
|
$4,746.45
|
$15,855.90
|
$11,388.67
|
2026-08-14
|
|
47538
|
HCPCS
|
Placement Of Stent Of Biliary Duct Through Existing Skin Access Using Imaging Gu…
|
10
|
10
|
$18,654.00
|
$18,654.00
|
$4,189.49
|
$15,855.90
|
$11,388.67
|
2026-08-14
|
|
32998
|
HCPCS
|
Destruction Of Growth Of Lung Using Radiofrequency
|
10
|
10
|
$18,310.00
|
$18,310.00
|
$2,589.81
|
$15,563.50
|
$11,277.73
|
2026-08-14
|
|
47382
|
HCPCS
|
Destruction Of Growth Of Liver Through Skin Using Radiofrequency
|
10
|
10
|
$18,310.00
|
$18,310.00
|
$794.63
|
$15,563.50
|
$11,277.73
|
2026-08-14
|
|
C1786
|
HCPCS
|
Pacemaker, Single Chamber, Rate-responsive (implantable)
|
24
|
8
|
$15,245.00
|
$15,245.00
|
$7,042.75
|
$15,826.32
|
$11,159.00
|
2026-08-14
|
|
C1762
|
HCPCS
|
Connective Tissue, Human (includes Fascia Lata)
|
96
|
8
|
$13,903.50
|
$13,903.50
|
$1,353.00
|
$47,419.80
|
$10,353.52
|
2026-08-14
|
|
55875
|
HCPCS
|
Insertion Of Needle Or Tube Into Prostate For Radiation Therapy
|
10
|
10
|
$17,144.00
|
$17,144.00
|
$1,030.21
|
$14,572.40
|
$10,294.06
|
2026-08-14
|
|
C1785
|
HCPCS
|
Pacemaker, Dual Chamber, Rate-responsive (implantable)
|
72
|
8
|
$11,513.00
|
$11,513.00
|
$5,412.00
|
$34,065.96
|
$9,778.10
|
2026-08-14
|
|
33272
|
HCPCS
|
Removal Of Defibrillator Electrode
|
10
|
10
|
$16,322.00
|
$16,322.00
|
$316.08
|
$13,873.70
|
$9,752.40
|
2026-08-14
|
|
31610070_1
|
CDM
|
Spinal System 13x16mm
|
6
|
6
|
$13,912.00
|
$13,912.00
|
$7,651.60
|
$11,825.20
|
$9,738.40
|
2026-08-14
|
|
20000024_1
|
CDM
|
Intensive Care Unit - Trauma
|
1
|
1
|
$35,817.00
|
$35,817.00
|
$9,491.51
|
$9,491.51
|
$9,491.51
|
2026-08-14
|
|
0201T
|
OTHER
|
Injections Of Both Sides Of Sacrum For Enlargement, 2 Or More Needles, Accessed …
|
10
|
10
|
$11,486.00
|
$11,486.00
|
$6,317.30
|
$12,897.38
|
$9,361.09
|
2026-08-14
|
|
0200T
|
OTHER
|
Injections Of One Side Of Sacrum For Enlargement, 1 Or More Needles, Accessed Th…
|
10
|
10
|
$11,486.00
|
$11,486.00
|
$6,317.30
|
$12,897.38
|
$9,361.09
|
2026-08-14
|
|
J7300
|
HCPCS
|
Intrauterine Copper Contraceptive (paragard)
|
16
|
8
|
$11,859.24
|
$11,859.24
|
$5,220.94
|
$14,510.37
|
$9,211.24
|
2026-08-14
|
|
J7307
|
HCPCS
|
Etonogestrel (contraceptive) Implant System, Including Implant And Supplies
|
8
|
8
|
$12,007.23
|
$12,007.23
|
$6,603.98
|
$12,247.38
|
$9,185.53
|
2026-08-14
|
|
C1771
|
HCPCS
|
Repair Device, Urinary, Incontinence, With Sling Graft
|
8
|
8
|
$11,880.00
|
$11,880.00
|
$6,534.00
|
$12,117.60
|
$9,088.20
|
2026-08-14
|
|
37269
|
HCPCS
|
Revascularization, Endovascular, Open Or Percutaneous, Femoral And Popliteal Vas…
|
20
|
10
|
$26,209.00
|
$26,209.00
|
$50.00
|
$51,491.64
|
$9,030.40
|
2026-08-14
|
|
37282
|
HCPCS
|
Revascularization, Endovascular, Open Or Percutaneous, Tibial And Peroneal Vascu…
|
20
|
10
|
$25,919.00
|
$25,919.00
|
$45.00
|
$51,229.50
|
$8,893.12
|
2026-08-14
|
|
75842
|
HCPCS
|
Review By Radiologist Of Both Adrenal Gland Veins Image
|
8
|
8
|
$11,490.00
|
$11,490.00
|
$6,319.50
|
$11,719.80
|
$8,789.85
|
2026-08-14
|
|
36299
|
HCPCS
|
Other Blood Vessel Injection Procedure
|
8
|
8
|
$11,490.00
|
$11,490.00
|
$6,319.50
|
$11,719.80
|
$8,789.85
|
2026-08-14
|
|
37258
|
HCPCS
|
Revascularization, Endovascular, Open Or Percutaneous, Iliac Vascular Territory,…
|
20
|
10
|
$25,817.00
|
$25,817.00
|
$50.00
|
$51,491.64
|
$8,697.20
|
2026-08-14
|
|
J9217
|
HCPCS
|
Leuprolide Acetate (for Depot Suspension), 7.5 Mg
|
10
|
10
|
$14,149.43
|
$14,149.43
|
$160.34
|
$12,027.02
|
$8,454.28
|
2026-08-14
|
|
34813
|
HCPCS
|
Insertion Of Graft In Upper Thigh Artery
|
10
|
10
|
$14,133.00
|
$14,133.00
|
$200.29
|
$12,013.05
|
$8,444.47
|
2026-08-14
|
|
34709
|
HCPCS
|
Repair Of Abdominal Or Groin Artery With Prosthesis With Review By Radiologist
|
10
|
10
|
$14,133.00
|
$14,133.00
|
$274.28
|
$12,013.05
|
$8,444.47
|
2026-08-14
|
|
80511402_1
|
CDM
|
Level 3 Musculoskel Proc
|
6
|
6
|
$11,963.00
|
$11,963.00
|
$6,579.65
|
$10,168.55
|
$8,374.10
|
2026-08-14
|
|
37268
|
HCPCS
|
Revascularization, Endovascular, Open Or Percutaneous, Femoral And Popliteal Vas…
|
10
|
10
|
$11,870.00
|
$11,870.00
|
$162.19
|
$12,107.40
|
$8,309.00
|
2026-08-14
|
|
75893
|
HCPCS
|
Review By Radiologist Of Imaging Guidance For Removal Of Blood Sample
|
8
|
8
|
$11,490.00
|
$11,490.00
|
$6,319.50
|
$9,890.50
|
$8,264.95
|
2026-08-14
|
|
49419
|
HCPCS
|
Insertion Of Abdominal Cavity Tube For Drug Delivery
|
10
|
10
|
$12,675.00
|
$12,675.00
|
$212.35
|
$10,773.75
|
$8,207.07
|
2026-08-14
|
|
C1714
|
HCPCS
|
Catheter, Transluminal Atherectomy, Directional
|
8
|
8
|
$10,554.00
|
$10,554.00
|
$5,804.70
|
$10,765.08
|
$8,073.81
|
2026-08-14
|
|
93457
|
HCPCS
|
Insertion Of Tube In Right Heart Chambers, Coronary Artery, And Bypass Graft For…
|
10
|
10
|
$13,398.00
|
$13,398.00
|
$1,601.85
|
$11,388.30
|
$8,005.30
|
2026-08-14
|
|
C1777
|
HCPCS
|
Lead, Cardioverter-defibrillator, Endocardial Single Coil (implantable)
|
32
|
8
|
$11,182.00
|
$11,182.00
|
$3,298.35
|
$14,806.32
|
$7,989.40
|
2026-08-14
|
|
J1451
|
HCPCS
|
Injection, Fomepizole, 15 Mg
|
10
|
10
|
$12,910.58
|
$12,910.58
|
$6.18
|
$10,973.99
|
$7,714.07
|
2026-08-14
|
|
75605
|
HCPCS
|
Review By Radiologist Of Chest Aorta Serial Images
|
10
|
10
|
$11,490.00
|
$11,490.00
|
$177.21
|
$9,890.50
|
$7,690.45
|
2026-08-14
|
|
L8699
|
HCPCS
|
Prosthetic Implant, Not Otherwise Specified
|
24
|
8
|
$10,660.00
|
$10,660.00
|
$2,277.55
|
$12,755.10
|
$7,462.00
|
2026-08-14
|
|
75831
|
HCPCS
|
Review By Radiologist Of Kidney Image
|
8
|
8
|
$11,490.00
|
$11,490.00
|
$4,489.77
|
$9,766.50
|
$7,439.77
|
2026-08-14
|
|
75840
|
HCPCS
|
Review By Radiologist Of Adrenal Gland Vein Image
|
8
|
8
|
$11,490.00
|
$11,490.00
|
$4,489.77
|
$9,766.50
|
$7,439.77
|
2026-08-14
|
|
22899
|
HCPCS
|
Other Procedure On Spine
|
8
|
8
|
$11,486.00
|
$11,486.00
|
$350.75
|
$9,763.10
|
$7,437.18
|
2026-08-14
|
|
72285
|
HCPCS
|
Review By Radiologist Of Disc Of Upper Or Middle Spine Image
|
10
|
10
|
$12,312.00
|
$12,312.00
|
$144.11
|
$10,465.20
|
$7,356.42
|
2026-08-14
|
|
C1778
|
HCPCS
|
Lead, Neurostimulator (implantable)
|
8
|
8
|
$9,594.00
|
$9,594.00
|
$5,276.70
|
$9,785.88
|
$7,339.41
|
2026-08-14
|
|
36566
|
HCPCS
|
Insertion Of 2 Central Venous Tubes In 2 Veins With Port
|
10
|
10
|
$10,463.00
|
$10,463.00
|
$217.80
|
$9,890.50
|
$7,324.10
|
2026-08-14
|
|
36260
|
HCPCS
|
Insertion Of Implantable Arterial Infusion Pump
|
10
|
10
|
$10,463.00
|
$10,463.00
|
$854.44
|
$9,890.50
|
$7,324.10
|
2026-08-14
|
|
36563
|
HCPCS
|
Insertion Of Central Venous Tube With Pump
|
10
|
10
|
$10,463.00
|
$10,463.00
|
$318.69
|
$9,890.50
|
$7,324.10
|
2026-08-14
|
|
J1745
|
HCPCS
|
Injection, Infliximab, Excludes Biosimilar, 10 Mg
|
10
|
10
|
$12,241.45
|
$12,241.45
|
$31.48
|
$10,405.23
|
$7,314.26
|
2026-08-14
|
|
C1776
|
HCPCS
|
Joint Device (implantable)
|
128
|
8
|
$9,594.00
|
$9,594.00
|
$879.45
|
$22,345.14
|
$7,143.53
|
2026-08-14
|
|
C1889
|
HCPCS
|
Implantable/insertable Device, Not Otherwise Classified
|
24
|
8
|
$10,455.00
|
$10,455.00
|
$2,462.90
|
$11,500.50
|
$7,034.07
|
2026-08-14
|
|
C1763
|
HCPCS
|
Connective Tissue, Non-human (includes Synthetic)
|
32
|
8
|
$9,481.50
|
$9,481.50
|
$2,190.65
|
$12,812.22
|
$6,918.77
|
2026-08-14
|
|
47541
|
HCPCS
|
Placement Of Access Device Into Biliary Tract Using Imaging Guidance With Review…
|
10
|
10
|
$9,862.00
|
$9,862.00
|
$1,081.53
|
$11,506.78
|
$6,903.40
|
2026-08-14
|
|
31610090_1
|
CDM
|
Vasc Covered Straight
|
6
|
6
|
$9,830.00
|
$9,830.00
|
$5,406.50
|
$8,355.50
|
$6,881.00
|
2026-08-14
|
|
75731
|
HCPCS
|
Review By Radiologist Of Adrenal Gland Artery Image
|
10
|
10
|
$11,490.00
|
$11,490.00
|
$221.47
|
$9,766.50
|
$6,865.27
|
2026-08-14
|
|
36254
|
HCPCS
|
Insertion Of Tube Into Second Or Third Order Branches Of Arteries Of Both Kidney…
|
10
|
10
|
$11,490.00
|
$11,490.00
|
$341.19
|
$9,766.50
|
$6,865.27
|
2026-08-14
|
|
75743
|
HCPCS
|
Review By Radiologist Of Arteries Of Both Lungs Image
|
10
|
10
|
$11,490.00
|
$11,490.00
|
$215.83
|
$9,766.50
|
$6,865.27
|
2026-08-14
|
|
75733
|
HCPCS
|
Review By Radiologist Of Both Adrenal Glands Arteries Image
|
10
|
10
|
$11,490.00
|
$11,490.00
|
$236.66
|
$9,766.50
|
$6,865.27
|
2026-08-14
|
|
36252
|
HCPCS
|
Insertion Of Tube Into First Order Main And Accessory Arteries Of Both Kidneys F…
|
10
|
10
|
$11,490.00
|
$11,490.00
|
$296.72
|
$9,766.50
|
$6,865.27
|
2026-08-14
|
|
36222
|
HCPCS
|
Insertion Of Tube Into Extracranial Artery For Diagnosis Or Treatment With Revie…
|
10
|
10
|
$11,490.00
|
$11,490.00
|
$237.90
|
$9,766.50
|
$6,865.27
|
2026-08-14
|
|
36221
|
HCPCS
|
Insertion Of Tube Into Chest Aorta For Diagnosis Or Treatment With Review By Rad…
|
10
|
10
|
$11,490.00
|
$11,490.00
|
$173.86
|
$9,766.50
|
$6,865.27
|
2026-08-14
|
|
22511
|
HCPCS
|
Stabilization Of Lower Spine Bone
|
10
|
10
|
$11,486.00
|
$11,486.00
|
$370.07
|
$9,763.10
|
$6,862.89
|
2026-08-14
|
|
20555
|
HCPCS
|
Insertion Of Needles Or Tubes Into Muscle Or Tissue For Radiation Treatment
|
10
|
10
|
$11,486.00
|
$11,486.00
|
$246.09
|
$9,763.10
|
$6,862.89
|
2026-08-14
|
|
22510
|
HCPCS
|
Stabilization Of Upper Spine Bone
|
10
|
10
|
$11,486.00
|
$11,486.00
|
$393.89
|
$9,763.10
|
$6,862.89
|
2026-08-14
|
|
C1821
|
HCPCS
|
Interspinous Process Distraction Device (implantable)
|
184
|
8
|
$8,713.00
|
$8,713.00
|
$705.10
|
$40,774.50
|
$6,857.44
|
2026-08-14
|
|
80511352_1
|
CDM
|
Level 2 Vasc Procedure
|
6
|
6
|
$9,788.00
|
$9,788.00
|
$5,383.40
|
$8,319.80
|
$6,851.60
|
2026-08-14
|
|
C1768
|
HCPCS
|
Graft, Vascular
|
120
|
8
|
$9,898.00
|
$9,898.00
|
$24.20
|
$46,627.26
|
$6,822.71
|
2026-08-14
|
|
C1781
|
HCPCS
|
Mesh (implantable)
|
136
|
8
|
$9,808.00
|
$9,808.00
|
$205.70
|
$41,100.90
|
$6,797.34
|
2026-08-14
|
|
58820
|
HCPCS
|
Drainage Of Abscess Of Ovaries Through Vagina
|
10
|
10
|
$11,249.00
|
$11,249.00
|
$229.54
|
$9,561.65
|
$6,721.28
|
2026-08-14
|
|
80511430_1
|
CDM
|
Level 3 Extraocular Repair
|
6
|
6
|
$9,572.00
|
$9,572.00
|
$5,264.60
|
$8,136.20
|
$6,700.40
|
2026-08-14
|
|
37619
|
HCPCS
|
Tying Of Inferior Vena Cava
|
10
|
10
|
$9,539.00
|
$9,539.00
|
$1,904.32
|
$9,890.50
|
$6,677.30
|
2026-08-14
|
|
49421
|
HCPCS
|
Insertion Of Abdominal Cavity Tube For Drainage Or Dialysis
|
10
|
10
|
$10,777.00
|
$10,777.00
|
$261.73
|
$9,160.45
|
$6,657.54
|
2026-08-14
|
|
37215
|
HCPCS
|
Insertion Of Stent And Blood Clot Protection Device In Neck Artery With Review B…
|
10
|
10
|
$11,055.00
|
$11,055.00
|
$860.75
|
$9,396.75
|
$6,605.36
|
2026-08-14
|
|
C9362
|
HCPCS
|
Porous Purified Collagen Matrix Bone Void Filler (integra Mozaik Osteoconductive…
|
16
|
8
|
$8,533.50
|
$8,533.50
|
$3,588.20
|
$10,753.86
|
$6,589.24
|
2026-08-14
|
|
L3904
|
HCPCS
|
Wrist Hand Finger Orthosis, External Powered, Electric, Custom Fabricated
|
10
|
10
|
$10,893.00
|
$10,893.00
|
$2,940.35
|
$9,259.05
|
$6,508.57
|
2026-08-14
|
|
47532
|
HCPCS
|
Injection Of Bile Duct For X-ray Through New Skin Access Using Imaging Guidance …
|
10
|
10
|
$9,862.00
|
$9,862.00
|
$749.07
|
$8,382.70
|
$6,362.45
|
2026-08-14
|
|
47533
|
HCPCS
|
Placement Of External Drainage Tube Of Biliary Duct Using Imaging Guidance With …
|
10
|
10
|
$9,862.00
|
$9,862.00
|
$1,225.61
|
$8,382.70
|
$6,362.45
|
2026-08-14
|
|
37197
|
HCPCS
|
Retrieval Of Foreign Body In Blood Vessel With Review By Radiologist
|
10
|
10
|
$10,463.00
|
$10,463.00
|
$253.54
|
$8,893.55
|
$6,251.65
|
2026-08-14
|
|
36582
|
HCPCS
|
Replacement Of Tunneled Central Venous Tube With Port
|
10
|
10
|
$10,463.00
|
$10,463.00
|
$330.28
|
$8,893.55
|
$6,251.65
|
2026-08-14
|
|
37192
|
HCPCS
|
Repositioning Of Vena Cava Filter With Review By Radiologist
|
10
|
10
|
$10,463.00
|
$10,463.00
|
$303.47
|
$8,893.55
|
$6,251.65
|
2026-08-14
|
|
36560
|
HCPCS
|
Insertion Of Central Venous Tube With Port (younger Than 5 Years)
|
10
|
10
|
$10,463.00
|
$10,463.00
|
$262.47
|
$8,893.55
|
$6,251.65
|
2026-08-14
|
|
31626
|
HCPCS
|
Placement Of Radiation Therapy Markers Into Lung Airways Using An Endoscope
|
10
|
10
|
$8,920.00
|
$8,920.00
|
$375.28
|
$12,544.13
|
$6,244.00
|
2026-08-14
|
|
C1713
|
HCPCS
|
Anchor/screw For Opposing Bone-to-bone Or Soft Tissue-to-bone (implantable)
|
232
|
8
|
$8,699.00
|
$8,699.00
|
$24.20
|
$47,047.50
|
$6,212.11
|
2026-08-14
|
|
36557
|
HCPCS
|
Insertion Of Tunneled Central Venous Tube For Infusion (younger Than 5 Years)
|
10
|
10
|
$8,580.00
|
$8,580.00
|
$138.50
|
$9,890.50
|
$6,006.00
|
2026-08-14
|
|
Q4100
|
HCPCS
|
Skin Substitute, Not Otherwise Specified
|
16
|
8
|
$8,053.00
|
$8,053.00
|
$3,911.60
|
$9,173.88
|
$5,945.65
|
2026-08-14
|
|
36478
|
HCPCS
|
Laser Destruction Of Incompetent Vein Of Arm Or Leg Using Imaging Guidance
|
10
|
10
|
$9,539.00
|
$9,539.00
|
$2,624.85
|
$8,108.15
|
$5,882.43
|
2026-08-14
|
|
41019
|
HCPCS
|
Insertion Of Needles, Tubes, Or Devices Into Head And/or Neck For Radiation Ther…
|
10
|
10
|
$8,291.00
|
$8,291.00
|
$521.75
|
$10,522.10
|
$5,803.70
|
2026-08-14
|
|
50695
|
HCPCS
|
Placement Of Stent Of Ureter And Separate Tube In Kidney Through New Skin Access…
|
10
|
10
|
$8,952.00
|
$8,952.00
|
$1,301.93
|
$7,609.20
|
$5,796.42
|
2026-08-14
|
|
55920
|
HCPCS
|
Insertion Of Needles Or Tubes Into Pelvic Or Genital Organs For Radiation Therap…
|
10
|
10
|
$8,188.00
|
$8,188.00
|
$344.01
|
$8,891.51
|
$5,731.60
|
2026-08-14
|
|
43278
|
HCPCS
|
Destruction Of Polyp Or Growth Of Gallbladder And/or Bile Duct Using A Flexible …
|
10
|
10
|
$8,623.00
|
$8,623.00
|
$391.29
|
$7,329.55
|
$5,583.40
|
2026-08-14
|
|
47555
|
HCPCS
|
Dilation Of Bile Ducts Using An Endoscope
|
10
|
10
|
$7,975.00
|
$7,975.00
|
$230.83
|
$11,506.78
|
$5,582.50
|
2026-08-14
|
|
47552
|
HCPCS
|
Diagnostic Exam Of Bile Duct Using An Endoscope
|
10
|
10
|
$7,975.00
|
$7,975.00
|
$166.05
|
$11,506.78
|
$5,582.50
|
2026-08-14
|
|
36570
|
HCPCS
|
Insertion Of Central Venous Tube With Port For Infusion (younger Than 5 Years)
|
10
|
10
|
$8,580.00
|
$8,580.00
|
$338.42
|
$7,293.00
|
$5,555.55
|
2026-08-14
|
|
36595
|
HCPCS
|
Mechanical Removal Of Obstructive Material From Central Venous Tube
|
10
|
10
|
$8,580.00
|
$8,580.00
|
$728.03
|
$7,293.00
|
$5,555.55
|
2026-08-14
|
|
36585
|
HCPCS
|
Replacement Of Peripherally Inserted Central Venous Tube (picc) With Port
|
10
|
10
|
$8,580.00
|
$8,580.00
|
$417.87
|
$7,293.00
|
$5,555.55
|
2026-08-14
|
|
36578
|
HCPCS
|
Replacement Of Central Venous Tube, Tube Only
|
10
|
10
|
$8,580.00
|
$8,580.00
|
$147.24
|
$7,293.00
|
$5,555.55
|
2026-08-14
|
|
90375
|
HCPCS
|
Rabies Immune Globulin For Injection
|
16
|
10
|
$7,092.66
|
$7,092.66
|
$281.19
|
$18,072.14
|
$5,425.89
|
2026-08-14
|
|
37264
|
HCPCS
|
Revascularization, Endovascular, Open Or Percutaneous, Femoral And Popliteal Vas…
|
10
|
10
|
$7,698.00
|
$7,698.00
|
$130.55
|
$7,851.96
|
$5,388.60
|
2026-08-14
|
|
80511404_1
|
CDM
|
Level 3 Urology Procedure
|
6
|
6
|
$7,669.00
|
$7,669.00
|
$4,217.95
|
$6,518.65
|
$5,368.30
|
2026-08-14
|
|
50020
|
HCPCS
|
Drainage Of Abscess Of Kidney
|
10
|
10
|
$8,952.00
|
$8,952.00
|
$846.97
|
$7,609.20
|
$5,348.82
|
2026-08-14
|
|
50382
|
HCPCS
|
Removal And Replacement Of Stent In Ureter With Review By Radiologist
|
10
|
10
|
$8,952.00
|
$8,952.00
|
$1,362.99
|
$7,609.20
|
$5,348.82
|
2026-08-14
|
|
46706
|
HCPCS
|
Repair Of Abnormal Anal Drainage Tract With Tissue Glue
|
10
|
10
|
$8,513.00
|
$8,513.00
|
$108.51
|
$7,236.05
|
$5,212.22
|
2026-08-14
|
|
43263
|
HCPCS
|
Pressure Measurement Of Pancreatic Or Bile Duct Sphincter Using A Flexible Endos…
|
10
|
10
|
$8,623.00
|
$8,623.00
|
$266.94
|
$7,329.55
|
$5,152.24
|
2026-08-14
|
|
47999
|
HCPCS
|
Other Procedure On Bile Duct
|
9
|
8
|
$7,975.00
|
$7,975.00
|
$459.00
|
$6,778.75
|
$5,143.88
|
2026-08-14
|
|
C1877
|
HCPCS
|
Stent, Non-coated/non-covered, Without Delivery System
|
48
|
8
|
$6,636.50
|
$6,636.50
|
$2,345.20
|
$36,958.68
|
$5,022.77
|
2026-08-14
|
|
C9359
|
HCPCS
|
Porous Purified Collagen Matrix Bone Void Filler (integra Mozaik Osteoconductive…
|
80
|
8
|
$6,637.00
|
$6,637.00
|
$1,055.45
|
$16,309.80
|
$4,921.02
|
2026-08-14
|
|
J7298
|
HCPCS
|
Levonorgestrel-releasing Intrauterine Contraceptive System (mirena), 52 Mg
|
8
|
8
|
$6,426.02
|
$6,426.02
|
$3,534.31
|
$6,554.54
|
$4,915.90
|
2026-08-14
|
|
44799
|
HCPCS
|
Other Procedure On Small Bowel
|
10
|
9
|
$8,188.00
|
$8,188.00
|
$65.00
|
$6,959.80
|
$4,892.33
|
2026-08-14
|
|
49999
|
HCPCS
|
Other Procedure On Abdomen
|
10
|
9
|
$8,188.00
|
$8,188.00
|
$70.00
|
$6,959.80
|
$4,892.33
|
2026-08-14
|
|
47544
|
HCPCS
|
Removal Of Biliary Duct Or Gallbladder Stone Using Imaging Guidance With Review …
|
10
|
10
|
$7,975.00
|
$7,975.00
|
$134.63
|
$6,778.75
|
$4,765.07
|
2026-08-14
|
|
20999
|
HCPCS
|
Other Procedure On Muscle Or Bone
|
9
|
8
|
$7,309.00
|
$7,309.00
|
$350.75
|
$6,212.65
|
$4,750.85
|
2026-08-14
|
|
21000004_1
|
CDM
|
Nursery - Newborn - Level IV
|
1
|
1
|
$17,884.00
|
$17,884.00
|
$4,739.26
|
$4,739.26
|
$4,739.26
|
2026-08-14
|
|
J1561
|
HCPCS
|
Injection, Immune Globulin, (gamunex-c/gammaked), Non-lyophilized (e.g., Liquid)…
|
16
|
10
|
$6,157.62
|
$6,157.62
|
$49.01
|
$12,683.30
|
$4,710.57
|
2026-08-14
|
|
22526
|
HCPCS
|
Treatment Of Spine Disc Using Fluoroscopic Guidance, Single Level
|
8
|
8
|
$6,142.00
|
$6,142.00
|
$3,378.10
|
$6,264.84
|
$4,698.63
|
2026-08-14
|
|
58345
|
HCPCS
|
Insertion Of Tube Into Fallopian Tube
|
10
|
10
|
$6,132.00
|
$6,132.00
|
$3,372.60
|
$6,254.64
|
$4,692.99
|
2026-08-14
|
|
C1888
|
HCPCS
|
Catheter, Ablation, Non-cardiac, Endovascular (implantable)
|
8
|
8
|
$6,075.00
|
$6,075.00
|
$3,341.25
|
$6,196.50
|
$4,647.38
|
2026-08-14
|
|
37265
|
HCPCS
|
Revascularization, Endovascular, Open Or Percutaneous, Femoral And Popliteal Vas…
|
20
|
10
|
$12,992.50
|
$12,992.50
|
$50.00
|
$25,092.00
|
$4,635.17
|
2026-08-14
|
|
C1874
|
HCPCS
|
Stent, Coated/covered, With Delivery System
|
56
|
8
|
$5,740.00
|
$5,740.00
|
$528.00
|
$10,550.88
|
$4,629.10
|
2026-08-14
|
|
80511396_1
|
CDM
|
Level 4 GYN Procedure
|
6
|
6
|
$6,304.00
|
$6,304.00
|
$3,467.20
|
$5,358.40
|
$4,412.80
|
2026-08-14
|
|
C2618
|
HCPCS
|
Probe/needle, Cryoablation
|
32
|
8
|
$6,156.50
|
$6,156.50
|
$2,345.20
|
$12,686.76
|
$4,400.81
|
2026-08-14
|
|
A4913
|
HCPCS
|
Miscellaneous Dialysis Supplies, Not Otherwise Specified
|
8
|
8
|
$5,731.00
|
$5,731.00
|
$3,152.05
|
$5,845.62
|
$4,384.22
|
2026-08-14
|
|
90380
|
HCPCS
|
Respiratory Syncytial Virus Antibody, 0.5 Ml Dosage For Injection Into Muscle
|
8
|
8
|
$5,673.98
|
$5,673.98
|
$3,120.69
|
$5,787.46
|
$4,340.59
|
2026-08-14
|
|
C1788
|
HCPCS
|
Port, Indwelling (implantable)
|
8
|
8
|
$5,666.00
|
$5,666.00
|
$3,116.30
|
$5,779.32
|
$4,334.49
|
2026-08-14
|
|
C2623
|
HCPCS
|
Catheter, Transluminal Angioplasty, Drug-coated, Non-laser
|
32
|
8
|
$5,535.00
|
$5,535.00
|
$616.00
|
$10,350.96
|
$4,334.22
|
2026-08-14
|
|
58800
|
HCPCS
|
Drainage Of Cysts Of Ovaries Through Vagina
|
10
|
10
|
$6,132.00
|
$6,132.00
|
$229.54
|
$5,753.78
|
$4,292.40
|
2026-08-14
|
|
80511403_1
|
CDM
|
Level 2 Musculoskel Proc
|
6
|
6
|
$6,105.00
|
$6,105.00
|
$3,357.75
|
$5,189.25
|
$4,273.50
|
2026-08-14
|
|
80511406_1
|
CDM
|
Level 2 Exc/bx/i&d
|
6
|
6
|
$6,098.00
|
$6,098.00
|
$3,353.90
|
$5,183.30
|
$4,268.60
|
2026-08-14
|
|
33223
|
HCPCS
|
Relocation Of Defibrillator Skin Pocket
|
10
|
10
|
$7,093.00
|
$7,093.00
|
$369.32
|
$6,029.05
|
$4,238.07
|
2026-08-14
|
|
33222
|
HCPCS
|
Relocation Of Pacemaker Skin Pocket
|
10
|
10
|
$7,093.00
|
$7,093.00
|
$441.11
|
$6,029.05
|
$4,238.07
|
2026-08-14
|
|
80511405_1
|
CDM
|
Level 3 Airway Endoscopy
|
6
|
6
|
$5,986.00
|
$5,986.00
|
$3,292.30
|
$5,088.10
|
$4,190.20
|
2026-08-14
|
|
C1876
|
HCPCS
|
Stent, Non-coated/non-covered, With Delivery System
|
56
|
8
|
$4,797.00
|
$4,797.00
|
$323.95
|
$32,448.24
|
$4,170.73
|
2026-08-14
|
|
64680
|
HCPCS
|
Injection Of Agent To Destroy Abdominal Nerve Bundle
|
10
|
10
|
$6,891.00
|
$6,891.00
|
$118.02
|
$5,857.35
|
$4,117.38
|
2026-08-14
|
|
C1779
|
HCPCS
|
Lead, Pacemaker, Transvenous Vdd Single Pass
|
40
|
8
|
$5,997.00
|
$5,997.00
|
$1,302.95
|
$11,312.82
|
$4,109.45
|
2026-08-14
|
|
A4264
|
HCPCS
|
Permanent Implantable Contraceptive Intratubal Occlusion Device(s) And Delivery …
|
16
|
8
|
$5,373.00
|
$5,373.00
|
$2,902.35
|
$5,578.38
|
$4,108.91
|
2026-08-14
|
|
49657
|
HCPCS
|
Laparoscopy, Surgical, Repair, Recurrent Incisional Hernia (includes Mesh Insert…
|
2
|
2
|
$4,430.00
|
$4,430.00
|
$3,765.50
|
$4,430.00
|
$4,097.75
|
2026-08-14
|
|
47535
|
HCPCS
|
Conversion Of External Biliary Drainage Tube To Internal-external Biliary Draina…
|
10
|
10
|
$5,826.00
|
$5,826.00
|
$1,014.52
|
$6,363.91
|
$4,078.20
|
2026-08-14
|
|
J1670
|
HCPCS
|
Injection, Tetanus Immune Globulin, Human, Up To 250 Units
|
10
|
10
|
$6,799.97
|
$6,799.97
|
$595.02
|
$5,779.97
|
$4,062.98
|
2026-08-14
|
|
C1884
|
HCPCS
|
Embolization Protective System
|
24
|
8
|
$5,101.00
|
$5,101.00
|
$2,228.05
|
$6,398.46
|
$4,012.44
|
2026-08-14
|
|
J0248
|
HCPCS
|
Injection, Remdesivir, 1 Mg
|
10
|
10
|
$6,710.64
|
$6,710.64
|
$7.51
|
$5,704.05
|
$4,009.61
|
2026-08-14
|
|
58999
|
HCPCS
|
Other Procedure On Female Genital System (nonobstetrical)
|
1
|
1
|
$4,600.00
|
$4,600.00
|
$3,910.00
|
$3,910.00
|
$3,910.00
|
2026-08-14
|
|
25000019_1
|
CDM
|
Room & Board - Private (one Bed) - Obstetrics (ob)
|
1
|
1
|
$14,461.00
|
$14,461.00
|
$3,832.17
|
$3,832.17
|
$3,832.17
|
2026-08-14
|
|
22527
|
HCPCS
|
Treatment Of Spine Disc Using Fluoroscopic Guidance, Each Additional Bone Level
|
8
|
8
|
$5,009.00
|
$5,009.00
|
$2,754.95
|
$5,109.18
|
$3,831.89
|
2026-08-14
|
|
49204
|
HCPCS
|
Excision Or Destruction, Open, Intra-abdominal Tumors, Cysts Or Endometriomas, 1…
|
2
|
2
|
$4,125.00
|
$4,125.00
|
$3,506.25
|
$4,125.00
|
$3,815.62
|
2026-08-14
|
|
21300009_1
|
CDM
|
Nursery - Newborn - Level Iii
|
1
|
1
|
$14,307.00
|
$14,307.00
|
$3,791.36
|
$3,791.36
|
$3,791.36
|
2026-08-14
|
|
36906
|
HCPCS
|
Removal And/or Dissolving Of Blood Clot In Hemodialysis Circuit And Balloon Dila…
|
20
|
10
|
$34,269.00
|
$34,269.00
|
$50.00
|
$56,943.20
|
$3,786.97
|
2026-08-14
|
|
49442
|
HCPCS
|
Insertion Of Large Bowel Tube Using Fluoroscopic Guidance With Contrast
|
10
|
10
|
$6,332.00
|
$6,332.00
|
$891.29
|
$5,382.20
|
$3,783.37
|
2026-08-14
|
|
88020
|
HCPCS
|
Autopsy With Microscopic Examination Of Tissue
|
2
|
2
|
$4,045.00
|
$4,045.00
|
$3,438.25
|
$4,045.00
|
$3,741.62
|
2026-08-14
|
|
50387
|
HCPCS
|
Removal And Replacement Of Stent In Kidney And Ureter Using Fluoroscopic Guidanc…
|
10
|
10
|
$5,826.00
|
$5,826.00
|
$662.69
|
$4,952.10
|
$3,736.64
|
2026-08-14
|
|
A9572
|
HCPCS
|
Indium In-111 Pentetreotide, Diagnostic, Per Study Dose, Up To 6 Millicuries
|
14
|
8
|
$4,562.00
|
$4,562.00
|
$2,000.94
|
$15,394.35
|
$3,718.03
|
2026-08-14
|
|
61608
|
HCPCS
|
Removal Of Growth Or Tissue Of Middle Skull Base Within Brain Membrane
|
10
|
10
|
$10,169.00
|
$10,169.00
|
$2,081.53
|
$8,643.65
|
$3,717.36
|
2026-08-14
|
|
25000027_1
|
CDM
|
Room & Board - Semi-private (two Beds) - Obstetrics (ob)
|
1
|
1
|
$13,907.00
|
$13,907.00
|
$3,685.36
|
$3,685.36
|
$3,685.36
|
2026-08-14
|
|
Z7506
|
HCPCS
|
Use Of Oper Room Or Cyst Room-first Hour
|
464
|
8
|
$4,878.00
|
$4,878.00
|
$28.05
|
$17,047.26
|
$3,586.07
|
2026-08-14
|
|
33285
|
HCPCS
|
Insertion Of Heart Rhythm Monitor Under Skin
|
20
|
10
|
$14,651.00
|
$14,651.00
|
$65.00
|
$24,673.80
|
$3,585.49
|
2026-08-14
|
|
81519
|
HCPCS
|
Test For Detecting Genes Associated With Breast Cancer
|
10
|
10
|
$4,375.00
|
$4,375.00
|
$2,406.25
|
$4,841.25
|
$3,565.62
|
2026-08-14
|
|
50384
|
HCPCS
|
Removal Of Stent In Ureter Through Skin With Review By Radiologist
|
10
|
10
|
$5,374.00
|
$5,374.00
|
$1,317.57
|
$4,567.90
|
$3,479.66
|
2026-08-14
|
|
20000022_1
|
CDM
|
Intensive Care Unit - General Classification
|
1
|
1
|
$13,049.00
|
$13,049.00
|
$3,457.99
|
$3,457.99
|
$3,457.99
|
2026-08-14
|
|
34832
|
HCPCS
|
Repair Of Aneurysm Of Aorta Or Upper Thigh Artery With Prothesis
|
10
|
10
|
$5,749.00
|
$5,749.00
|
$1,638.66
|
$4,886.65
|
$3,435.03
|
2026-08-14
|
|
34831
|
HCPCS
|
Repair Of Aneurysm Of Aorta Or Groin Artery With Prosthesis
|
10
|
10
|
$5,749.00
|
$5,749.00
|
$1,678.80
|
$4,886.65
|
$3,435.03
|
2026-08-14
|
|
50593
|
HCPCS
|
Destruction Of Growth Of Kidney By Freezing
|
21
|
10
|
$4,000.00
|
$4,000.00
|
$60.00
|
$18,893.75
|
$3,400.00
|
2026-08-14
|
|
C1757
|
HCPCS
|
Catheter, Thrombectomy/embolectomy
|
48
|
8
|
$4,677.50
|
$4,677.50
|
$287.65
|
$10,210.20
|
$3,381.07
|
2026-08-14
|
|
80511344_1
|
CDM
|
Level 3 Clsd Tx Fx
|
6
|
6
|
$4,776.00
|
$4,776.00
|
$2,626.80
|
$4,059.60
|
$3,343.20
|
2026-08-14
|
|
47361
|
HCPCS
|
Control Of Bleeding Of Liver With Exploration, Removal Of Tissue, Suture Or Caut…
|
10
|
10
|
$5,719.00
|
$5,719.00
|
$292.63
|
$4,861.15
|
$3,263.96
|
2026-08-14
|
|
C1880
|
HCPCS
|
Vena Cava Filter
|
24
|
8
|
$4,264.00
|
$4,264.00
|
$2,231.35
|
$4,892.94
|
$3,261.96
|
2026-08-14
|
|
L3901
|
HCPCS
|
Wrist Hand Finger Orthosis, Dynamic Flexor Hinge, Reciprocal Wrist Extension/ Fl…
|
10
|
10
|
$5,440.00
|
$5,440.00
|
$1,169.72
|
$4,624.00
|
$3,250.40
|
2026-08-14
|
|
J9220
|
HCPCS
|
Injection, Indigotindisulfonate Sodium, 1 Mg
|
8
|
8
|
$5,011.45
|
$5,011.45
|
$9.30
|
$4,259.73
|
$3,244.91
|
2026-08-14
|
|
J0883
|
HCPCS
|
Injection, Argatroban, 1 Mg (for Non-esrd Use)
|
10
|
10
|
$5,400.12
|
$5,400.12
|
$0.86
|
$4,590.10
|
$3,226.57
|
2026-08-14
|
|
L3967
|
HCPCS
|
Shoulder Elbow Wrist Hand Orthosis, Abduction Positioning (airplane Design), Tho…
|
10
|
10
|
$5,373.00
|
$5,373.00
|
$1,627.79
|
$4,567.05
|
$3,210.37
|
2026-08-14
|
|
L3973
|
HCPCS
|
Shoulder Elbow Wrist Hand Orthosis, Abduction Positioning (airplane Design), Tho…
|
10
|
10
|
$5,373.00
|
$5,373.00
|
$1,627.79
|
$4,567.05
|
$3,210.37
|
2026-08-14
|
|
L3978
|
HCPCS
|
Shoulder Elbow Wrist Hand Finger Orthosis, Abduction Positioning (airplane Desig…
|
10
|
10
|
$5,373.00
|
$5,373.00
|
$1,627.79
|
$4,567.05
|
$3,210.37
|
2026-08-14
|
|
95811
|
HCPCS
|
Sleep Study In Sleep Lab With Continuous Airway Pressure (6 Years Or Older)
|
10
|
10
|
$5,343.00
|
$5,343.00
|
$513.11
|
$4,541.55
|
$3,192.44
|
2026-08-14
|
|
C1789
|
HCPCS
|
Prosthesis, Breast (implantable)
|
16
|
8
|
$5,341.50
|
$5,341.50
|
$586.30
|
$9,809.34
|
$3,188.34
|
2026-08-14
|
|
90675
|
HCPCS
|
Rabies Vaccine For Injection Into Muscle
|
10
|
10
|
$5,313.77
|
$5,313.77
|
$331.98
|
$4,516.71
|
$3,174.98
|
2026-08-14
|
|
43195
|
HCPCS
|
Balloon Dilation Of Esophagus Using A Rigid Endoscope, Less Than 3.0 Cm
|
10
|
10
|
$4,519.00
|
$4,519.00
|
$156.74
|
$6,852.84
|
$3,163.30
|
2026-08-14
|
|
20000206_1
|
CDM
|
Intensive Care Unit - Intermediate ICU
|
1
|
1
|
$11,929.00
|
$11,929.00
|
$3,161.19
|
$3,161.19
|
$3,161.19
|
2026-08-14
|
|
23000005_1
|
CDM
|
Nursery - Newborn - Level Ii
|
1
|
1
|
$11,789.00
|
$11,789.00
|
$3,124.09
|
$3,124.09
|
$3,124.09
|
2026-08-14
|
|
22300009_1
|
CDM
|
Nursery - Newborn - Level Ii
|
1
|
1
|
$11,789.00
|
$11,789.00
|
$3,124.09
|
$3,124.09
|
$3,124.09
|
2026-08-14
|
|
21000005_1
|
CDM
|
Nursery - Newborn - Level Ii
|
1
|
1
|
$11,789.00
|
$11,789.00
|
$3,124.09
|
$3,124.09
|
$3,124.09
|
2026-08-14
|
|
95810
|
HCPCS
|
Sleep Study In Sleep Lab (6 Years Or Older)
|
10
|
10
|
$5,203.00
|
$5,203.00
|
$499.27
|
$4,422.55
|
$3,108.80
|
2026-08-14
|
|
48105
|
HCPCS
|
Removal Of Pancreatic Tissue
|
10
|
10
|
$8,632.00
|
$8,632.00
|
$25.00
|
$7,337.20
|
$3,048.30
|
2026-08-14
|
|
L3971
|
HCPCS
|
Shoulder Elbow Wrist Hand Orthosis, Shoulder Cap Design, Includes One Or More No…
|
10
|
10
|
$5,100.00
|
$5,100.00
|
$1,545.15
|
$4,335.00
|
$3,047.25
|
2026-08-14
|
|
L3977
|
HCPCS
|
Shoulder Elbow Wrist Hand Finger Orthosis, Shoulder Cap Design, Includes One Or …
|
10
|
10
|
$5,100.00
|
$5,100.00
|
$1,545.15
|
$4,335.00
|
$3,047.25
|
2026-08-14
|
|
36903
|
HCPCS
|
Insertion Of Needle And/or Tube Into Hemodialysis Circuit And Insertion Of Stent…
|
20
|
10
|
$22,573.50
|
$22,573.50
|
$45.00
|
$37,567.45
|
$2,991.24
|
2026-08-14
|
|
49203
|
HCPCS
|
Excision Or Destruction, Open, Intra-abdominal Tumors, Cysts Or Endometriomas, 1…
|
2
|
2
|
$3,233.00
|
$3,233.00
|
$2,748.05
|
$3,233.00
|
$2,990.53
|
2026-08-14
|
|
80511349_1
|
CDM
|
Level 4 ENT Procedure
|
6
|
6
|
$4,264.00
|
$4,264.00
|
$2,345.20
|
$3,624.40
|
$2,984.80
|
2026-08-14
|
|
36228
|
HCPCS
|
Insertion Of Tube Into Neck Or Brain Artery For Diagnosis Or Treatment With Revi…
|
10
|
10
|
$4,983.00
|
$4,983.00
|
$181.31
|
$4,235.55
|
$2,977.35
|
2026-08-14
|
|
43265
|
HCPCS
|
Destruction Of Stone Of Bile Or Pancreatic Duct Using A Flexible Endoscope
|
20
|
10
|
$5,002.00
|
$5,002.00
|
$55.00
|
$10,790.61
|
$2,958.25
|
2026-08-14
|
|
59618
|
HCPCS
|
Cesarean Delivery And Care Before And After Delivery Following Attempted Vaginal…
|
10
|
10
|
$5,839.00
|
$5,839.00
|
$60.00
|
$4,963.15
|
$2,930.66
|
2026-08-14
|
|
37259
|
HCPCS
|
Revascularization, Endovascular, Open Or Percutaneous, Iliac Vascular Territory,…
|
10
|
10
|
$4,182.00
|
$4,182.00
|
$172.71
|
$4,265.64
|
$2,927.40
|
2026-08-14
|
|
43196
|
HCPCS
|
Insertion Of Wire And Dilation Of Esophagus Using An Endoscope
|
10
|
10
|
$4,519.00
|
$4,519.00
|
$170.89
|
$3,841.15
|
$2,926.06
|
2026-08-14
|
|
49441
|
HCPCS
|
Insertion Of Small Bowel Tube Using Fluoroscopic Guidance With Contrast
|
10
|
10
|
$4,519.00
|
$4,519.00
|
$1,093.82
|
$3,841.15
|
$2,926.06
|
2026-08-14
|
|
49446
|
HCPCS
|
Conversion Of Stomach Tube To Stomach-to-small Bowel Tube Using Fluoroscopic Gui…
|
10
|
10
|
$4,519.00
|
$4,519.00
|
$912.51
|
$3,841.15
|
$2,926.06
|
2026-08-14
|
|
43215
|
HCPCS
|
Removal Of Foreign Bodies In Esophagus Using A Flexible Endoscope
|
10
|
10
|
$4,519.00
|
$4,519.00
|
$223.38
|
$3,841.15
|
$2,926.06
|
2026-08-14
|
|
43194
|
HCPCS
|
Removal Of Foreign Bodies From Esophagus Using A Rigid Endoscope
|
10
|
10
|
$4,519.00
|
$4,519.00
|
$140.36
|
$3,841.15
|
$2,926.06
|
2026-08-14
|
|
43226
|
HCPCS
|
Dilation Of Esophagus With Insertion Of Guide Wire Using A Flexible Endoscope
|
10
|
10
|
$4,519.00
|
$4,519.00
|
$178.70
|
$3,841.15
|
$2,926.06
|
2026-08-14
|
|
J0881
|
HCPCS
|
Injection, Darbepoetin Alfa, 1 Microgram (non-esrd Use)
|
10
|
10
|
$4,886.46
|
$4,886.46
|
$2.92
|
$4,153.49
|
$2,919.66
|
2026-08-14
|
|
59510
|
HCPCS
|
Cesarean Delivery With Care Before And After Delivery
|
10
|
10
|
$5,334.00
|
$5,334.00
|
$60.00
|
$4,533.90
|
$2,904.70
|
2026-08-14
|
|
61512
|
HCPCS
|
Removal Of Skull Bone For Removal Of Growth Of Upper Brain Membrane
|
10
|
10
|
$7,864.00
|
$7,864.00
|
$45.00
|
$6,684.40
|
$2,860.87
|
2026-08-14
|
|
75860
|
HCPCS
|
Review By Radiologist Of Head Or Neck Vein System Image
|
8
|
8
|
$3,687.00
|
$3,687.00
|
$2,027.85
|
$5,612.21
|
$2,820.56
|
2026-08-14
|
|
75887
|
HCPCS
|
Review By Radiologist Of The Vein That Transports Blood To The Liver Image
|
8
|
8
|
$3,687.00
|
$3,687.00
|
$2,027.85
|
$5,612.21
|
$2,820.56
|
2026-08-14
|
|
72909401_1
|
CDM
|
Hemodialysis Acute
|
6
|
6
|
$3,951.00
|
$3,951.00
|
$2,173.05
|
$3,358.35
|
$2,765.70
|
2026-08-14
|
|
32553
|
HCPCS
|
Insertion Of Device In Chest Cavity For Radiation Therapy Guidance
|
10
|
10
|
$4,621.00
|
$4,621.00
|
$519.36
|
$3,927.85
|
$2,761.05
|
2026-08-14
|
|
49411
|
HCPCS
|
Insertion Of Device In Abdominal Cavity Through Skin For Radiation Therapy Guida…
|
10
|
10
|
$4,621.00
|
$4,621.00
|
$453.09
|
$3,927.85
|
$2,761.05
|
2026-08-14
|
|
C9250
|
HCPCS
|
Human Plasma Fibrin Sealant, Vapor-heated, Solvent-detergent (artiss), 2 Ml
|
8
|
8
|
$4,264.00
|
$4,264.00
|
$145.67
|
$3,624.40
|
$2,760.94
|
2026-08-14
|
|
59610
|
HCPCS
|
Vaginal Delivery And Care Before And After Delivery After Previous Cesarean Deli…
|
10
|
10
|
$4,209.00
|
$4,209.00
|
$70.00
|
$3,577.65
|
$2,732.33
|
2026-08-14
|
|
L3976
|
HCPCS
|
Shoulder Elbow Wrist Hand Finger Orthosis, Abduction Positioning (airplane Desig…
|
10
|
10
|
$4,550.00
|
$4,550.00
|
$1,378.72
|
$3,867.50
|
$2,718.62
|
2026-08-14
|
|
L3975
|
HCPCS
|
Shoulder Elbow Wrist Hand Finger Orthosis, Shoulder Cap Design, Without Joints, …
|
10
|
10
|
$4,550.00
|
$4,550.00
|
$1,378.72
|
$3,867.50
|
$2,718.62
|
2026-08-14
|
|
L3961
|
HCPCS
|
Shoulder Elbow Wrist Hand Orthosis, Shoulder Cap Design, Without Joints, May Inc…
|
10
|
10
|
$4,550.00
|
$4,550.00
|
$1,378.72
|
$3,867.50
|
$2,718.62
|
2026-08-14
|
|
37241
|
HCPCS
|
Occlusion Of Vein With Review By Radiologist
|
20
|
10
|
$20,328.50
|
$20,328.50
|
$80.00
|
$33,516.35
|
$2,711.85
|
2026-08-14
|
|
22000053_1
|
CDM
|
Room & Board - Semi-private (two Beds) - Medical/surgical/gyn
|
1
|
1
|
$10,014.00
|
$10,014.00
|
$2,653.71
|
$2,653.71
|
$2,653.71
|
2026-08-14
|
|
L3900
|
HCPCS
|
Wrist Hand Finger Orthosis, Dynamic Flexor Hinge, Reciprocal Wrist Extension/ Fl…
|
10
|
10
|
$4,420.00
|
$4,420.00
|
$878.66
|
$3,757.00
|
$2,640.95
|
2026-08-14
|
|
37184
|
HCPCS
|
Primary Removal And Dissolving Of Blood Clot From Artery Or Artery Graft Using F…
|
21
|
10
|
$14,231.00
|
$14,231.00
|
$65.00
|
$32,583.25
|
$2,635.14
|
2026-08-14
|
|
80511350_1
|
CDM
|
Level 1 Vasc Procedure
|
6
|
6
|
$3,757.00
|
$3,757.00
|
$2,066.35
|
$3,193.45
|
$2,629.90
|
2026-08-14
|
|
59400
|
HCPCS
|
Vaginal Delivery With Care Before And After Delivery
|
10
|
10
|
$4,889.00
|
$4,889.00
|
$1,390.14
|
$4,155.65
|
$2,626.88
|
2026-08-14
|
|
23000029_1
|
CDM
|
Room & Board - Private (one Bed) - Pediatric
|
1
|
1
|
$9,880.00
|
$9,880.00
|
$2,618.20
|
$2,618.20
|
$2,618.20
|
2026-08-14
|
|
25100017_1
|
CDM
|
Room & Board - Private (one Bed) - Obstetrics (ob)
|
1
|
1
|
$9,880.00
|
$9,880.00
|
$2,618.20
|
$2,618.20
|
$2,618.20
|
2026-08-14
|
|
22500017_1
|
CDM
|
Room & Board - Private (one Bed) - Medical/surgical/gyn
|
1
|
1
|
$9,880.00
|
$9,880.00
|
$2,618.20
|
$2,618.20
|
$2,618.20
|
2026-08-14
|
|
27000017_1
|
CDM
|
Room & Board - Private (one Bed) - Rehabilitation
|
1
|
1
|
$9,880.00
|
$9,880.00
|
$2,618.20
|
$2,618.20
|
$2,618.20
|
2026-08-14
|
|
22100028_1
|
CDM
|
Room & Board - Private (one Bed) - Medical/surgical/gyn
|
1
|
1
|
$9,880.00
|
$9,880.00
|
$2,618.20
|
$2,618.20
|
$2,618.20
|
2026-08-14
|
|
22000012_1
|
CDM
|
Room & Board - Private (one Bed) - Medical/surgical/gyn
|
1
|
1
|
$9,880.00
|
$9,880.00
|
$2,618.20
|
$2,618.20
|
$2,618.20
|
2026-08-14
|
|
22000020_1
|
CDM
|
Room & Board - Private (one Bed) - Medical/surgical/gyn
|
1
|
1
|
$9,880.00
|
$9,880.00
|
$2,618.20
|
$2,618.20
|
$2,618.20
|
2026-08-14
|
|
25200023_1
|
CDM
|
Room & Board - Private (one Bed) - Obstetrics (ob)
|
1
|
1
|
$9,880.00
|
$9,880.00
|
$2,618.20
|
$2,618.20
|
$2,618.20
|
2026-08-14
|
|
25200015_1
|
CDM
|
Room & Board - Private (one Bed) - Obstetrics (ob)
|
1
|
1
|
$9,880.00
|
$9,880.00
|
$2,618.20
|
$2,618.20
|
$2,618.20
|
2026-08-14
|
|
23000011_1
|
CDM
|
Room & Board - Private (one Bed) - Pediatric
|
1
|
1
|
$9,880.00
|
$9,880.00
|
$2,618.20
|
$2,618.20
|
$2,618.20
|
2026-08-14
|
|
J2356
|
HCPCS
|
Injection, Tezepelumab-ekko, 1 Mg
|
10
|
10
|
$4,381.46
|
$4,381.46
|
$17.92
|
$3,724.24
|
$2,617.92
|
2026-08-14
|
|
78803
|
HCPCS
|
Nuclear Medicine Study, Spect Imaging, 1 Area Or Single Acquisition, Single Day …
|
36
|
10
|
$2,823.00
|
$2,823.00
|
$51.33
|
$6,158.76
|
$2,611.28
|
2026-08-14
|
|
75756
|
HCPCS
|
Review By Radiologist Of Breast Artery Of Breast Image
|
10
|
10
|
$3,687.00
|
$3,687.00
|
$217.70
|
$5,612.21
|
$2,580.90
|
2026-08-14
|
|
47120
|
HCPCS
|
Partial Removal Of Liver Lobe
|
10
|
10
|
$7,157.00
|
$7,157.00
|
$70.00
|
$6,083.45
|
$2,580.40
|
2026-08-14
|
|
J1442
|
HCPCS
|
Injection, Filgrastim (g-csf), Excludes Biosimilars, 1 Microgram
|
16
|
10
|
$3,330.93
|
$3,330.93
|
$1.01
|
$4,746.03
|
$2,548.16
|
2026-08-14
|
|
61510
|
HCPCS
|
Removal Of Skull Bone For Removal Of Growth Of Upper Brain
|
10
|
10
|
$6,779.00
|
$6,779.00
|
$45.00
|
$5,762.15
|
$2,536.19
|
2026-08-14
|
|
Q9957
|
HCPCS
|
Injection, Perflutren Lipid Microspheres, Per Ml
|
16
|
8
|
$3,425.01
|
$3,425.01
|
$1,619.45
|
$3,983.69
|
$2,528.86
|
2026-08-14
|
|
25100033_1
|
CDM
|
Room & Board - Semi-private (two Beds) - Obstetrics (ob)
|
1
|
1
|
$9,502.00
|
$9,502.00
|
$2,518.03
|
$2,518.03
|
$2,518.03
|
2026-08-14
|
|
22000038_1
|
CDM
|
Room & Board - Semi-private (two Beds) - Medical/surgical/gyn
|
1
|
1
|
$9,502.00
|
$9,502.00
|
$2,518.03
|
$2,518.03
|
$2,518.03
|
2026-08-14
|
|
23000037_1
|
CDM
|
Room & Board - Semi-private (two Beds) - Pediatric
|
1
|
1
|
$9,502.00
|
$9,502.00
|
$2,518.03
|
$2,518.03
|
$2,518.03
|
2026-08-14
|
|
25200031_1
|
CDM
|
Room & Board - Semi-private (two Beds) - Obstetrics (ob)
|
1
|
1
|
$9,502.00
|
$9,502.00
|
$2,518.03
|
$2,518.03
|
$2,518.03
|
2026-08-14
|
|
22500030_1
|
CDM
|
Room & Board - Semi-private (two Beds) - Medical/surgical/gyn
|
1
|
1
|
$9,502.00
|
$9,502.00
|
$2,518.03
|
$2,518.03
|
$2,518.03
|
2026-08-14
|
|
25100035_1
|
CDM
|
Room & Board - Semi-private (two Beds) - Obstetrics (ob)
|
1
|
1
|
$9,502.00
|
$9,502.00
|
$2,518.03
|
$2,518.03
|
$2,518.03
|
2026-08-14
|
|
27000033_1
|
CDM
|
Room & Board - Semi-private (two Beds) - Rehabilitation
|
1
|
1
|
$9,502.00
|
$9,502.00
|
$2,518.03
|
$2,518.03
|
$2,518.03
|
2026-08-14
|
|
22000069_1
|
CDM
|
Room & Board - Semi-private (two Beds) - Medical/surgical/gyn
|
1
|
1
|
$9,502.00
|
$9,502.00
|
$2,518.03
|
$2,518.03
|
$2,518.03
|
2026-08-14
|
|
A9562
|
HCPCS
|
Technetium Tc-99m Mertiatide, Diagnostic, Per Study Dose, Up To 15 Millicuries
|
8
|
8
|
$3,267.00
|
$3,267.00
|
$1,796.85
|
$3,332.34
|
$2,499.26
|
2026-08-14
|
|
49653
|
HCPCS
|
Laparoscopy, Surgical, Repair, Ventral, Umbilical, Spigelian Or Epigastric Herni…
|
2
|
2
|
$2,698.00
|
$2,698.00
|
$2,293.30
|
$2,698.00
|
$2,495.65
|
2026-08-14
|
|
44158
|
HCPCS
|
Removal Of Large Bowel And Rectum With Attachment Of Small Bowel To Anus And Cre…
|
10
|
10
|
$6,565.00
|
$6,565.00
|
$60.00
|
$5,580.25
|
$2,485.70
|
2026-08-14
|
|
38129
|
HCPCS
|
Other Procedure On Spleen Using An Endoscope
|
1
|
1
|
$2,910.00
|
$2,910.00
|
$2,473.50
|
$2,473.50
|
$2,473.50
|
2026-08-14
|
|
22512
|
HCPCS
|
Stabilization Of Spine Bone, Each Additional Bone
|
10
|
10
|
$4,122.00
|
$4,122.00
|
$178.55
|
$3,503.70
|
$2,462.89
|
2026-08-14
|
|
61343
|
HCPCS
|
Removal Of Skull Base Bone And Upper Spine Bone To Release Spinal Cord
|
10
|
10
|
$6,292.00
|
$6,292.00
|
$30.00
|
$5,348.20
|
$2,460.02
|
2026-08-14
|
|
36568
|
HCPCS
|
Insertion Of Tube For Infusion (younger Than 5 Years)
|
10
|
10
|
$3,790.00
|
$3,790.00
|
$68.56
|
$3,221.50
|
$2,454.03
|
2026-08-14
|
|
36596
|
HCPCS
|
Mechanical Removal Of Tissue Or Obstructive Material From Central Venous Tube
|
10
|
10
|
$3,790.00
|
$3,790.00
|
$167.29
|
$3,221.50
|
$2,454.03
|
2026-08-14
|
|
36576
|
HCPCS
|
Repair Of Central Venous Tube For Infusion With Port Or Pump
|
10
|
10
|
$3,790.00
|
$3,790.00
|
$115.04
|
$3,221.50
|
$2,454.03
|
2026-08-14
|