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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

HEALDSBURG HOSPITAL

Healdsburg, CA · CCN 051321 · Rates published

13,143 distinct procedures filed
17 distinct payers
74,698 rate rows
2026-04-01 last MRF observed
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://pricetransparency.providence.org/norcal/live/852390012_healdsburg-hospital_standardcharges.json
Found on page https://www.providence.org/billing-support/pricing-transparency
Discovered viaCMS hospital list
Last fetch not_modified · 2026-08-12
Content fingerprint d8ec69442065dca8… · 157,202,460 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
J3391
HCPCS 		Inj, Atidarsagene Autotemcel 2 $4,335,000.00 $4,505,000.00 $4,335,000.00 nat. median
$4,505,000
1.0× median
C9172
HCPCS 		Inj, Beqvez, Per Tx Dose 1 $3,570,000.00 $3,570,000.00 $3,570,000.00 nat. median
$3,675,000
1.0× median
J1414
HCPCS 		Inj, Beqvez, Per Tx Dose 1 $3,570,000.00 $3,570,000.00 $3,570,000.00 nat. median
$3,508,750
1.0× median
J1411
HCPCS 		Inj, Hemgenix, Per Tx Dose 2 $3,570,000.00 $3,691,450.00 $3,570,000.00 nat. median
$3,685,267
1.0× median
J1413
HCPCS 		Inj Delandistrogene Mox Rokl 2 $3,264,000.00 $3,321,376.38 $3,264,000.00 nat. median
$3,325,455
1.0× median
J3394
HCPCS 		Inj, Lovotibeglogene Autotem 2 $3,162,000.00 $3,245,381.39 $3,162,000.00 nat. median
$3,248,446
1.0× median
J3393
HCPCS 		Inj, Betibeglogene Autotemce 2 $2,856,000.00 $2,938,320.00 $2,856,000.00 nat. median
$2,968,000
1.0× median
J3399
HCPCS 		Inj Onase Abepar-xioi Treat 2 $2,439,539.81 $2,587,087.26 $2,439,539.81 nat. median
$2,455,111
1.0× median
J3392
HCPCS 		Inj, Exagamglogene Autotem 2 $2,244,000.00 $2,332,000.00 $2,244,000.00 nat. median
$2,332,000
1.0× median
Q2057
HCPCS 		Afamitresgene Autoleucel 2 $741,540.00 $770,620.00 $741,540.00 nat. median
$813,967
0.9× median
Q2056
HCPCS 		Ciltacabtagene Car-pos T 2 $566,416.65 $588,494.81 $566,416.65 nat. median
$599,737
0.9× median
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 2 $721.00 $614,180.81 $552,054.73 nat. median
$621,313
0.9× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 2 $541,977.41 $562,260.84 $541,977.41 nat. median
$579,571
0.9× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 2 $538,878.68 $559,781.08 $538,878.68 nat. median
$574,037
0.9× median
Q2058
HCPCS 		Obecbtge Autol Up To 400 Mil 2 $278,250.00 $535,500.00 $535,500.00 nat. median
$286,598
1.9× median
C9301
HCPCS 		Obecabtagene Car Pos T 1 $535,500.00 $535,500.00 $535,500.00 nat. median
$377,029
1.4× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 2 $513,651.60 $531,849.12 $513,651.60 nat. median
$562,501
0.9× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 2 $471,240.00 $489,290.60 $471,240.00 nat. median
$513,770
0.9× median
535
MS_DRG 		Fractures Of Hip And Pelvis With Mcc 1 $262,439.82 $262,439.82 $262,439.82 nat. median
$9,602
outlier · 27.3×
463
MS_DRG 		Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective… 1 $181,925.44 $181,925.44 $181,925.44 nat. median
$38,795
outlier · 4.7×
26
MS_DRG 		Craniotomy And Endovascular Intracranial Procedures With Cc 1 $138,636.51 $138,636.51 $138,636.51 nat. median
$22,161
outlier · 6.3×
A9543
HCPCS 		Y90 Ibritumomab, Rx 2 $56,824.55 $188,576.15 $122,700.35 nat. median
$65,477
1.9× median
562
MS_DRG 		Fracture, Sprain, Strain And Dislocation Except Femur, Hip, Pelvis And Thigh Wit… 1 $114,127.34 $114,127.34 $114,127.34 nat. median
$10,412
outlier · 11.0×
J7330
HCPCS 		Cultured Chondrocytes Implnt 3 $67,138.44 $177,298.62 $93,991.56 nat. median
$92,809
1.0× median
561
MS_DRG 		Aftercare, Musculoskeletal System And Connective Tissue Without Cc/Mcc 1 $89,805.12 $89,805.12 $89,805.12 nat. median
$5,841
outlier · 15.4×
A9545
HCPCS 		I-131 Tositumomab, Rx, Per Dose 1 $71,937.48 $71,937.48 $71,937.48 nat. median
$41,848
1.7× median
863
MS_DRG 		Postoperative And Post-traumatic Infections Without Mcc 1 $67,353.84 $67,353.84 $67,353.84 nat. median
$7,491
outlier · 9.0×
Q2043
HCPCS 		Sipuleucel-t Auto Cd54+ 4 $56,269.19 $111,073.00 $66,147.00 nat. median
$63,499
1.0× median
J9029
HCPCS 		Inj, Adstiladrin, Per Tx Dos 4 $61,200.00 $203,588.58 $64,282.30 nat. median
$66,211
1.0× median
682
MS_DRG 		Renal Failure With Mcc 1 $62,769.00 $62,769.00 $62,769.00 nat. median
$11,096
outlier · 5.7×
80
MS_DRG 		Nontraumatic Stupor And Coma With Mcc 1 $59,994.91 $59,994.91 $59,994.91 nat. median
$12,822
outlier · 4.7×
58
MS_DRG 		Multiple Sclerosis And Cerebellar Ataxia With Mcc 1 $58,066.30 $58,066.30 $58,066.30 nat. median
$12,201
outlier · 4.8×
922
MS_DRG 		Other Injury, Poisoning And Toxic Effect Diagnoses With Mcc 1 $58,066.30 $58,066.30 $58,066.30 nat. median
$12,029
outlier · 4.8×
815
MS_DRG 		Reticuloendothelial And Immunity Disorders With Cc 1 $58,066.30 $58,066.30 $58,066.30 nat. median
$7,481
outlier · 7.8×
344
MS_DRG 		Minor Small And Large Bowel Procedures With Mcc 1 $58,049.91 $58,049.91 $58,049.91 nat. median
$18,257
outlier · 3.2×
559
MS_DRG 		Aftercare, Musculoskeletal System And Connective Tissue With Mcc 1 $57,999.14 $57,999.14 $57,999.14 nat. median
$13,403
outlier · 4.3×
327
MS_DRG 		Stomach, Esophageal And Duodenal Procedures With Cc 1 $55,568.85 $55,568.85 $55,568.85 nat. median
$18,223
outlier · 3.0×
189
MS_DRG 		Pulmonary Edema And Respiratory Failure 1 $55,125.08 $55,125.08 $55,125.08 nat. median
$9,470
outlier · 5.8×
42
MS_DRG 		Peripheral, Cranial Nerve And Other Nervous System Procedures Without Cc/Mcc 1 $54,209.08 $54,209.08 $54,209.08 nat. median
$12,708
outlier · 4.3×
J9226
HCPCS 		Supprelin La Implant 4 $41,173.43 $90,523.60 $51,185.25 nat. median
$57,036
0.9× median
438
MS_DRG 		Disorders Of Pancreas Except Malignancy With Mcc 1 $50,515.38 $50,515.38 $50,515.38 nat. median
$11,966
outlier · 4.2×
81
MS_DRG 		Nontraumatic Stupor And Coma Without Mcc 1 $50,351.86 $50,351.86 $50,351.86 nat. median
$6,471
outlier · 7.8×
853
MS_DRG 		Infectious And Parasitic Diseases With O.r. Procedures With Mcc 1 $49,056.37 $49,056.37 $49,056.37 nat. median
$34,733
1.4× median
56
MS_DRG 		Degenerative Nervous System Disorders With Mcc 2 $36,643.59 $59,786.91 $48,215.25 nat. median
$14,194
outlier · 3.4×
466
MS_DRG 		Revision Of Hip Or Knee Replacement With Mcc 1 $45,000.00 $45,000.00 $45,000.00 nat. median
$36,541
1.2× median
917
MS_DRG 		Poisoning And Toxic Effects Of Drugs With Mcc 1 $42,651.60 $42,651.60 $42,651.60 nat. median
$10,747
outlier · 4.0×
40
MS_DRG 		Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 1 $42,585.42 $42,585.42 $42,585.42 nat. median
$27,156
1.6× median
193
MS_DRG 		Simple Pneumonia And Pleurisy With Mcc 2 $37,451.70 $45,092.95 $41,272.32 nat. median
$9,802
outlier · 4.2×
137
MS_DRG 		Mouth Procedures With Cc/Mcc 1 $41,160.68 $41,160.68 $41,160.68 nat. median
$10,613
outlier · 3.9×
57
MS_DRG 		Degenerative Nervous System Disorders Without Mcc 1 $38,748.30 $38,748.30 $38,748.30 nat. median
$8,924
outlier · 4.3×

Other procedures at this hospital

Browse this hospital's 13,143 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
             
J3391 HCPCS Inj, Atidarsagene Autotemcel 6 2 — — $4,335,000.00 $4,505,000.00 $4,335,000.00 2026-04-01
C9172 HCPCS Inj, Beqvez, Per Tx Dose 4 1 — — $3,570,000.00 $3,570,000.00 $3,570,000.00 2026-04-01
J1411 HCPCS Inj, Hemgenix, Per Tx Dose 6 2 — — $3,570,000.00 $3,691,450.00 $3,570,000.00 2026-04-01
J1414 HCPCS Inj, Beqvez, Per Tx Dose 4 1 — — $3,570,000.00 $3,570,000.00 $3,570,000.00 2026-04-01
J1413 HCPCS Inj Delandistrogene Mox Rokl 6 2 — — $3,264,000.00 $3,321,376.38 $3,264,000.00 2026-04-01
J3394 HCPCS Inj, Lovotibeglogene Autotem 6 2 — — $3,162,000.00 $3,245,381.39 $3,162,000.00 2026-04-01
J3393 HCPCS Inj, Betibeglogene Autotemce 6 2 — — $2,856,000.00 $2,938,320.00 $2,856,000.00 2026-04-01
J3399 HCPCS Inj Onase Abepar-xioi Treat 6 2 — — $2,439,539.81 $2,587,087.26 $2,439,539.81 2026-04-01
J3392 HCPCS Inj, Exagamglogene Autotem 6 2 — — $2,244,000.00 $2,332,000.00 $2,244,000.00 2026-04-01
Q2057 HCPCS Afamitresgene Autoleucel 6 2 — — $741,540.00 $770,620.00 $741,540.00 2026-04-01
Q2056 HCPCS Ciltacabtagene Car-pos T 6 2 — — $566,416.65 $588,494.81 $566,416.65 2026-04-01
Q2042 HCPCS Tisagenlecleucel Car-pos T 10 2 — — $721.00 $614,180.81 $552,054.73 2026-04-01
Q2054 HCPCS Lisocabtagene Mara Car Pos T 6 2 — — $541,977.41 $562,260.84 $541,977.41 2026-04-01
Q2055 HCPCS Idecabtagene Vicleucel Car 6 2 — — $538,878.68 $559,781.08 $538,878.68 2026-04-01
Q2058 HCPCS Obecbtge Autol Up To 400 Mil 6 2 — — $278,250.00 $535,500.00 $535,500.00 2026-04-01
C9301 HCPCS Obecabtagene Car Pos T 4 1 — — $535,500.00 $535,500.00 $535,500.00 2026-04-01
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 6 2 — — $513,651.60 $531,849.12 $513,651.60 2026-04-01
Q2053 HCPCS Brexucabtagene Car Pos T 6 2 — — $471,240.00 $489,290.60 $471,240.00 2026-04-01
535 MS_DRG Fractures Of Hip And Pelvis With Mcc 2 1 — — $262,439.82 $262,439.82 $262,439.82 2026-04-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 2 1 — — $181,925.44 $181,925.44 $181,925.44 2026-04-01
26 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Cc 2 1 — — $138,636.51 $138,636.51 $138,636.51 2026-04-01
A9543 HCPCS Y90 Ibritumomab, Rx 4 2 — — $56,824.55 $188,576.15 $122,700.35 2026-04-01
562 MS_DRG Fracture, Sprain, Strain And Dislocation Except Femur, Hip, Pelvis And Thigh Wit… 2 1 — — $114,127.34 $114,127.34 $114,127.34 2026-04-01
J7330 HCPCS Cultured Chondrocytes Implnt 8 3 — — $67,138.44 $177,298.62 $93,991.56 2026-04-01
561 MS_DRG Aftercare, Musculoskeletal System And Connective Tissue Without Cc/Mcc 2 1 — — $89,805.12 $89,805.12 $89,805.12 2026-04-01
A9545 HCPCS I-131 Tositumomab, Rx, Per Dose 2 1 — — $71,937.48 $71,937.48 $71,937.48 2026-04-01
863 MS_DRG Postoperative And Post-traumatic Infections Without Mcc 2 1 — — $67,353.84 $67,353.84 $67,353.84 2026-04-01
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 10 4 — — $56,269.19 $111,073.00 $66,147.00 2026-04-01
J9029 HCPCS Inj, Adstiladrin, Per Tx Dos 10 4 — — $61,200.00 $203,588.58 $64,282.30 2026-04-01
682 MS_DRG Renal Failure With Mcc 2 1 — — $62,769.00 $62,769.00 $62,769.00 2026-04-01
80 MS_DRG Nontraumatic Stupor And Coma With Mcc 2 1 — — $59,994.91 $59,994.91 $59,994.91 2026-04-01
922 MS_DRG Other Injury, Poisoning And Toxic Effect Diagnoses With Mcc 2 1 — — $58,066.30 $58,066.30 $58,066.30 2026-04-01
815 MS_DRG Reticuloendothelial And Immunity Disorders With Cc 2 1 — — $58,066.30 $58,066.30 $58,066.30 2026-04-01
58 MS_DRG Multiple Sclerosis And Cerebellar Ataxia With Mcc 2 1 — — $58,066.30 $58,066.30 $58,066.30 2026-04-01
344 MS_DRG Minor Small And Large Bowel Procedures With Mcc 2 1 — — $58,049.91 $58,049.91 $58,049.91 2026-04-01
559 MS_DRG Aftercare, Musculoskeletal System And Connective Tissue With Mcc 2 1 — — $57,999.14 $57,999.14 $57,999.14 2026-04-01
327 MS_DRG Stomach, Esophageal And Duodenal Procedures With Cc 2 1 — — $55,568.85 $55,568.85 $55,568.85 2026-04-01
189 MS_DRG Pulmonary Edema And Respiratory Failure 2 1 — — $55,125.08 $55,125.08 $55,125.08 2026-04-01
42 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures Without Cc/Mcc 2 1 — — $54,209.08 $54,209.08 $54,209.08 2026-04-01
J9226 HCPCS Supprelin La Implant 10 4 — — $41,173.43 $90,523.60 $51,185.25 2026-04-01
438 MS_DRG Disorders Of Pancreas Except Malignancy With Mcc 2 1 — — $50,515.38 $50,515.38 $50,515.38 2026-04-01
81 MS_DRG Nontraumatic Stupor And Coma Without Mcc 2 1 — — $50,351.86 $50,351.86 $50,351.86 2026-04-01
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 2 1 — — $49,056.37 $49,056.37 $49,056.37 2026-04-01
56 MS_DRG Degenerative Nervous System Disorders With Mcc 4 2 — — $36,643.59 $59,786.91 $48,215.25 2026-04-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 2 1 — — $45,000.00 $45,000.00 $45,000.00 2026-04-01
917 MS_DRG Poisoning And Toxic Effects Of Drugs With Mcc 2 1 — — $42,651.60 $42,651.60 $42,651.60 2026-04-01
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 2 1 — — $42,585.42 $42,585.42 $42,585.42 2026-04-01
193 MS_DRG Simple Pneumonia And Pleurisy With Mcc 4 2 — — $37,451.70 $45,092.95 $41,272.32 2026-04-01
137 MS_DRG Mouth Procedures With Cc/Mcc 2 1 — — $41,160.68 $41,160.68 $41,160.68 2026-04-01
57 MS_DRG Degenerative Nervous System Disorders Without Mcc 2 1 — — $38,748.30 $38,748.30 $38,748.30 2026-04-01
629 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Cc 2 1 — — $38,683.67 $38,683.67 $38,683.67 2026-04-01
92 MS_DRG Other Disorders Of Nervous System With Cc 4 2 — — $17,362.43 $58,066.30 $37,714.37 2026-04-01
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 2 1 — — $35,639.90 $35,639.90 $35,639.90 2026-04-01
813 MS_DRG Coagulation Disorders 2 1 — — $33,808.29 $33,808.29 $33,808.29 2026-04-01
197 MS_DRG Interstitial Lung Disease With Cc 2 1 — — $33,676.92 $33,676.92 $33,676.92 2026-04-01
91 MS_DRG Other Disorders Of Nervous System With Mcc 4 2 — — $8,448.48 $58,066.30 $33,257.39 2026-04-01
282 MS_DRG Acute Myocardial Infarction, Discharged Alive Without Cc/Mcc 2 1 — — $32,724.45 $32,724.45 $32,724.45 2026-04-01
389 MS_DRG Gastrointestinal Obstruction With Cc 4 2 — — $22,685.51 $40,393.06 $31,539.28 2026-04-01
896 MS_DRG Alcohol, Drug Abuse Or Dependence Without Rehabilitation Therapy With Mcc 2 1 — — $30,718.46 $30,718.46 $30,718.46 2026-04-01
59 MS_DRG Multiple Sclerosis And Cerebellar Ataxia With Cc 4 2 — — $2,969.87 $58,066.30 $30,518.08 2026-04-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 2 1 — — $28,579.90 $28,579.90 $28,579.90 2026-04-01
5061 OTHER Hyperbaric Oxygen 8 4 — — $24,725.46 $31,901.65 $27,718.14 2026-04-01
J9266 HCPCS Pegaspargase Injection 10 4 — — $4,248.53 $54,141.06 $27,351.45 2026-04-01
140 MS_DRG Major Head And Neck Procedures With Mcc 2 1 — — $27,204.53 $27,204.53 $27,204.53 2026-04-01
69 MS_DRG Transient Ischemia Without Thrombolytic 2 1 — — $26,926.87 $26,926.87 $26,926.87 2026-04-01
383 MS_DRG Uncomplicated Peptic Ulcer With Mcc 2 1 — — $26,193.16 $26,193.16 $26,193.16 2026-04-01
862 MS_DRG Postoperative And Post-traumatic Infections With Mcc 2 1 — — $24,322.22 $24,322.22 $24,322.22 2026-04-01
J7310 HCPCS Ganciclovir Long Act Implant 4 2 — — $15,709.31 $31,872.00 $23,790.65 2026-04-01
J9600 HCPCS Porfimer Sodium Injection 8 3 — — $8,899.53 $46,459.42 $23,789.46 2026-04-01
353 MS_DRG Hernia Procedures Except Inguinal And Femoral With Mcc 2 1 — — $23,546.41 $23,546.41 $23,546.41 2026-04-01
280 MS_DRG Acute Myocardial Infarction, Discharged Alive With Mcc 4 2 — — $15,228.37 $31,711.18 $23,469.78 2026-04-01
871 MS_DRG Septicemia Or Severe Sepsis Without Mv >96 Hours With Mcc 12 5 — — $4,012.00 $92,812.32 $23,219.16 2026-04-01
5115 OTHER Level 5 Musculoskeletal Procedures 20 6 — — $4,056.19 $41,488.28 $20,799.01 2026-04-01
607 MS_DRG Minor Skin Disorders Without Mcc 2 1 — — $20,580.34 $20,580.34 $20,580.34 2026-04-01
710 MS_DRG Penis Procedures Without Cc/Mcc 2 1 — — $20,580.34 $20,580.34 $20,580.34 2026-04-01
315 MS_DRG Other Circulatory System Diagnoses With Cc 2 1 — — $20,386.08 $20,386.08 $20,386.08 2026-04-01
897 MS_DRG Alcohol, Drug Abuse Or Dependence Without Rehabilitation Therapy Without Mcc 4 2 — — $342.06 $40,052.87 $20,197.47 2026-04-01
244 MS_DRG Permanent Cardiac Pacemaker Implant Without Cc/Mcc 2 1 — — $20,175.60 $20,175.60 $20,175.60 2026-04-01
699 MS_DRG Other Kidney And Urinary Tract Diagnoses With Cc 2 1 — — $19,658.81 $19,658.81 $19,658.81 2026-04-01
5116 OTHER Level 6 Musculoskeletal Procedures 4 2 — — $19,318.65 $19,876.01 $19,597.33 2026-04-01
65 MS_DRG Intracranial Hemorrhage Or Cerebral Infarction With Cc Or Tpa In 24 Hours 6 3 — — $17,199.28 $31,422.00 $19,000.00 2026-04-01
53 MS_DRG Spinal Disorders And Injuries Without Cc/Mcc 2 1 — — $18,523.38 $18,523.38 $18,523.38 2026-04-01
603 MS_DRG Cellulitis Without Mcc 4 2 — — $17,816.40 $18,709.40 $18,262.90 2026-04-01
64 MS_DRG Intracranial Hemorrhage Or Cerebral Infarction With Mcc 8 4 — — $5,553.30 $57,858.30 $18,232.97 2026-04-01
208 MS_DRG Respiratory System Diagnosis With Ventilator Support <=96 Hours 2 1 — — $17,604.95 $17,604.95 $17,604.95 2026-04-01
1003T OTHER Arthrp 1st Crp/mtcrpl Prostc 2 1 — — $17,298.12 $17,298.12 $17,298.12 2026-04-01
C9734 HCPCS U/s Trtmt, Not Leiomyomata 2 1 — — $17,298.12 $17,298.12 $17,298.12 2026-04-01
93581 HCPCS Transcath Closure Of Vsd 4 2 — — $9,048.95 $24,699.02 $16,873.99 2026-04-01
93580 HCPCS Transcath Closure Of Asd 4 2 — — $9,048.95 $24,699.02 $16,873.99 2026-04-01
93582 HCPCS Perq Transcath Closure Pda 4 2 — — $9,048.95 $24,699.02 $16,873.99 2026-04-01
A9572 HCPCS Indium In-111 Pentetreotide 4 2 — — $2,000.94 $30,563.93 $16,282.44 2026-04-01
C9767 HCPCS Revasc Lithotrip-stent-ather 4 2 — — $6,970.59 $24,699.02 $15,834.81 2026-04-01
C9766 HCPCS Revasc Intra Lithotrip-ather 4 2 — — $6,970.59 $24,699.02 $15,834.81 2026-04-01
22862 HCPCS Revise Lumbar Artif Disc 4 2 — — $7,887.95 $23,624.08 $15,756.01 2026-04-01
22861 HCPCS Revise Cerv Artific Disc 4 2 — — $7,887.95 $23,624.08 $15,756.01 2026-04-01
C9765 HCPCS Revasc Intra Lithotrip-stent 4 2 — — $6,323.17 $24,699.02 $15,511.09 2026-04-01
854 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Cc 2 1 — — $15,096.58 $15,096.58 $15,096.58 2026-04-01
872 MS_DRG Septicemia Or Severe Sepsis Without Mv >96 Hours Without Mcc 2 1 — — $15,016.28 $15,016.28 $15,016.28 2026-04-01
560 MS_DRG Aftercare, Musculoskeletal System And Connective Tissue With Cc 2 1 — — $14,967.52 $14,967.52 $14,967.52 2026-04-01
554 MS_DRG Bone Diseases And Arthropathies Without Mcc 2 1 — — $14,967.52 $14,967.52 $14,967.52 2026-04-01
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 2 1 — — $14,967.52 $14,967.52 $14,967.52 2026-04-01
380 MS_DRG Complicated Peptic Ulcer With Mcc 2 1 — — $14,967.52 $14,967.52 $14,967.52 2026-04-01
S3865 HCPCS Comp Genet Test Hyp Cardiomy 2 1 — — $14,862.02 $14,862.02 $14,862.02 2026-04-01
0094U OTHER Genome Rapid Sequence Alys 4 2 — — $7,582.20 $21,391.95 $14,487.08 2026-04-01
351 MS_DRG Inguinal And Femoral Hernia Procedures With Cc 2 1 — — $14,360.81 $14,360.81 $14,360.81 2026-04-01
951 MS_DRG Other Factors Influencing Health Status 2 1 — — $13,404.87 $13,404.87 $13,404.87 2026-04-01
0036U OTHER Xome Tum & Nml Spec Seq Alys 6 3 — — $4,780.00 $13,608.18 $13,275.74 2026-04-01
5114 OTHER Level 4 Musculoskeletal Procedures 18 6 — — $2,263.13 $28,480.23 $13,190.74 2026-04-01
82 MS_DRG Traumatic Stupor And Coma >1 Hour With Mcc 2 1 — — $13,096.58 $13,096.58 $13,096.58 2026-04-01
0267U OTHER Rare Do Id Opt Gen Mapg&seq 4 2 — — $6,739.33 $19,013.92 $12,876.62 2026-04-01
177 MS_DRG Respiratory Infections And Inflammations With Mcc 4 2 — — $6,558.44 $18,913.25 $12,735.85 2026-04-01
81280 HCPCS Long Qt Synd Gene Full Seq 2 1 — — $12,724.29 $12,724.29 $12,724.29 2026-04-01
69714 HCPCS Implant Temple Bone W/Stimul 8 3 — — $9,383.00 $17,298.12 $12,669.20 2026-04-01
5241 OTHER Level 1 Blood Product Exchange And Related Services 4 2 — — $1,273.83 $24,018.20 $12,646.02 2026-04-01
0202T OTHER Post Vert Arthrplst 1 Lumbar 4 2 — — $7,887.95 $17,298.12 $12,593.03 2026-04-01
602 MS_DRG Cellulitis With Mcc 2 1 — — $12,566.87 $12,566.87 $12,566.87 2026-04-01
J1412 HCPCS Inj Roctavian Ml 2x10^13vc G 10 4 — — $11,901.49 $38,438.01 $12,553.71 2026-04-01
644 MS_DRG Endocrine Disorders With Cc 2 1 — — $12,257.30 $12,257.30 $12,257.30 2026-04-01
66 MS_DRG Intracranial Hemorrhage Or Cerebral Infarction Without Cc/Mcc 4 2 — — $6,723.84 $17,602.12 $12,162.98 2026-04-01
A9571 HCPCS Indium In-111 Auto Platelet 2 1 — — $12,134.73 $12,134.73 $12,134.73 2026-04-01
C9781 HCPCS Arthro/shoul Surg; W/spacer 4 2 — — $6,970.59 $17,298.12 $12,134.35 2026-04-01
194 MS_DRG Simple Pneumonia And Pleurisy With Cc 2 1 — — $12,124.44 $12,124.44 $12,124.44 2026-04-01
139 MS_DRG Salivary Gland Procedures 2 1 — — $12,113.31 $12,113.31 $12,113.31 2026-04-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 2 1 — — $12,105.36 $12,105.36 $12,105.36 2026-04-01
J9219 HCPCS Leuprolide Acetate Implant 4 2 — — $8,000.90 $16,072.19 $12,036.55 2026-04-01
38572 HCPCS Laparoscopy Lymphadenectomy 8 3 — — $9,383.00 $15,700.40 $11,980.02 2026-04-01
38571 HCPCS Laparoscopy Lymphadenectomy 8 3 — — $9,383.00 $15,700.40 $11,980.02 2026-04-01
81529 HCPCS Onc Cutan Mlnma Mrna 31 Gene 6 3 — — $7,193.00 $20,477.75 $11,389.87 2026-04-01
147 MS_DRG Ear, Nose, Mouth And Throat Malignancy With Cc 2 1 — — $11,225.64 $11,225.64 $11,225.64 2026-04-01
948 MS_DRG Signs And Symptoms Without Mcc 2 1 — — $11,225.64 $11,225.64 $11,225.64 2026-04-01
281 MS_DRG Acute Myocardial Infarction, Discharged Alive With Cc 2 1 — — $11,225.64 $11,225.64 $11,225.64 2026-04-01
A9604 HCPCS Sm 153 Lexidronam 4 2 — — $3,159.80 $19,090.55 $11,125.17 2026-04-01
81542 HCPCS Onc Prostate Mrna 22 Cnt Gen 6 3 — — $3,873.00 $12,168.19 $11,026.04 2026-04-01
81541 HCPCS Onc Prostate Mrna 46 Genes 6 3 — — $3,873.00 $12,934.79 $11,026.04 2026-04-01
81521 HCPCS Onc Breast Mrna 70 Genes 6 3 — — $3,873.00 $12,934.79 $11,026.04 2026-04-01
C9764 HCPCS Revasc Intravasc Lithotripsy 4 2 — — $6,323.17 $15,553.99 $10,938.58 2026-04-01
0211U OTHER Onc Pan-tum Dna&rna Gnrj Seq 4 2 — — $8,455.00 $13,388.22 $10,921.61 2026-04-01
81518 HCPCS Onc Brst Mrna 11 Genes 6 3 — — $3,873.00 $11,026.04 $10,756.67 2026-04-01
47383 HCPCS Perq Abltj Lvr Cryoablation 8 3 — — $6,972.00 $15,700.40 $10,741.52 2026-04-01
C9792 HCPCS Blind/nonblind Trans Atrial 4 2 — — $8,501.05 $12,858.76 $10,679.90 2026-04-01
0265U OTHER Rar Do Whl Gn&mtcdrl DNA Als 4 2 — — $5,475.80 $15,449.08 $10,462.44 2026-04-01
0212U OTHER Rare Ds Gen DNA Alys Proband 4 2 — — $5,475.20 $15,447.38 $10,461.29 2026-04-01
19325 HCPCS Enlarge Breast With Implant 8 3 — — $9,383.00 $15,700.40 $10,325.19 2026-04-01
19296 HCPCS Place Po Breast Cath For Rad 8 3 — — $9,383.00 $15,700.40 $10,325.19 2026-04-01
0026U OTHER Onc Thyr Dna&mrna 112 Genes 6 3 — — $3,600.00 $11,310.48 $10,248.84 2026-04-01
391 MS_DRG Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders With Mcc 2 1 — — $10,178.03 $10,178.03 $10,178.03 2026-04-01
690 MS_DRG Kidney And Urinary Tract Infections Without Mcc 2 1 — — $10,000.00 $10,000.00 $10,000.00 2026-04-01
425 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures Without Cc/Mcc 2 1 — — $10,000.00 $10,000.00 $10,000.00 2026-04-01
0335U OTHER Rare Ds Whl Gen Seq Fetal 4 2 — — $5,224.60 $14,740.35 $9,982.48 2026-04-01
0214U OTHER Rare Ds Xom DNA Alys Proband 4 2 — — $5,224.60 $14,740.35 $9,982.48 2026-04-01
81211 HCPCS Brca1&2 Seq & Com Dup/del 2 1 — — $9,968.93 $9,968.93 $9,968.93 2026-04-01
0080U OTHER Onc Lng 5 Clin Rsk Factr Alg 6 3 — — $3,520.00 $10,021.09 $9,931.10 2026-04-01
C9785 HCPCS Endo Outlet Restrict W/tube 4 2 — — $5,330.31 $14,322.04 $9,826.17 2026-04-01
27458 HCPCS Osteot Femur Imed Lngth Dev 2 1 — — $9,776.62 $9,776.62 $9,776.62 2026-04-01
62330 HCPCS Dcmprn Prq Rmv Lig Flv 1lmbr 2 1 — — $9,776.62 $9,776.62 $9,776.62 2026-04-01
27713 HCPCS Osteot Tibia Imed Lngth Dev 2 1 — — $9,776.62 $9,776.62 $9,776.62 2026-04-01
A9515 HCPCS Choline C-11 4 2 — — $2,516.43 $16,965.72 $9,741.08 2026-04-01
0037U OTHER Trgt Gen Seq DNA 324 Genes 6 3 — — $3,500.00 $9,964.15 $9,720.73 2026-04-01
69717 HCPCS Temple Bone Implant Revision 8 3 — — $9,383.00 $15,700.40 $9,707.31 2026-04-01
37184 HCPCS Prim Art M-thrmbc 1st Vsl 8 3 — — $3,572.00 $24,699.02 $9,684.70 2026-04-01
20808 HCPCS Replantation Hand Complete 6 2 — — $9,383.00 $23,624.08 $9,638.00 2026-04-01
20805 HCPCS Replant Forearm Complete 6 2 — — $9,383.00 $23,624.08 $9,638.00 2026-04-01
92990 HCPCS Revision Of Pulmonary Valve 6 2 — — $9,383.00 $15,553.99 $9,638.00 2026-04-01
92987 HCPCS Revision Of Mitral Valve 6 2 — — $9,383.00 $15,553.99 $9,638.00 2026-04-01
19297 HCPCS Place Breast Cath For Rad 6 2 — — $9,383.00 $15,700.40 $9,638.00 2026-04-01
81436 HCPCS Hereditary Colon Ca Dsordrs 2 1 — — $9,620.95 $9,620.95 $9,620.95 2026-04-01
81519 HCPCS Oncology Breast Mrna 6 3 — — $3,873.00 $9,775.50 $9,620.95 2026-04-01
81416 HCPCS Exome Sequence Analysis 6 3 — — $3,430.00 $12,000.00 $9,620.95 2026-04-01
C9032 HCPCS Voretigne Neparvovec-rzyl 2 1 — — $9,613.91 $9,613.91 $9,613.91 2026-04-01
37187 HCPCS Venous Mech Thrombectomy 8 3 — — $3,572.00 $15,700.40 $9,611.49 2026-04-01
5691 OTHER Level 1 Drug Administration 16 5 — — $1,386.45 $13,255.95 $9,554.75 2026-04-01
C9761 HCPCS Cysto, Litho, Vacuum Kidney 4 2 — — $6,323.17 $12,754.58 $9,538.88 2026-04-01
50590 HCPCS Fragmenting Of Kidney Stone 8 3 — — $4,749.36 $15,700.40 $9,510.50 2026-04-01
50947 HCPCS Laparo New Ureter/Bladder 8 3 — — $7,887.95 $14,322.04 $9,510.50 2026-04-01
33207 HCPCS Insert Heart Pm Ventricular 8 3 — — $8,501.05 $14,082.43 $9,510.50 2026-04-01
50948 HCPCS Laparo New Ureter/Bladder 8 3 — — $7,887.95 $14,322.04 $9,510.50 2026-04-01
58552 HCPCS Laparo-vag Hyst Incl T/o 8 3 — — $8,501.05 $14,322.04 $9,510.50 2026-04-01
0394T OTHER Hdr Elctrnc Skn Surf Brchytx 4 1 — — $9,383.00 $9,638.00 $9,510.50 2026-04-01
55873 HCPCS Cryoablate Prostate 8 3 — — $7,887.95 $12,754.58 $9,510.50 2026-04-01
36905 HCPCS Thrmbc/nfs Dialysis Circuit 8 3 — — $8,501.05 $15,553.99 $9,510.50 2026-04-01
58554 HCPCS Laparo-vag Hyst W/t/o Compl 8 3 — — $8,501.05 $14,322.04 $9,510.50 2026-04-01
33212 HCPCS Insert Pulse Gen Sngl Lead 8 3 — — $5,330.31 $11,149.80 $9,510.50 2026-04-01
53850 HCPCS Prostatic Microwave Thermotx 8 3 — — $4,749.36 $15,700.40 $9,510.50 2026-04-01
58553 HCPCS Laparo-vag Hyst Complex 8 3 — — $8,501.05 $14,322.04 $9,510.50 2026-04-01
33211 HCPCS Insert Card Electrodes Dual 8 3 — — $6,323.17 $11,149.80 $9,510.50 2026-04-01
33369 HCPCS Replace Aortic Valve W/byp 4 1 — — $9,383.00 $9,638.00 $9,510.50 2026-04-01
33213 HCPCS Insert Pulse Gen Dual Leads 8 3 — — $5,330.31 $14,082.43 $9,510.50 2026-04-01
33271 HCPCS Insj Subq Impltbl Dfb Elctrd 8 3 — — $5,330.31 $11,149.80 $9,510.50 2026-04-01
33217 HCPCS Insert 2 Electrode Pm-defib 8 3 — — $6,323.17 $11,149.80 $9,510.50 2026-04-01
33214 HCPCS Upgrade Of Pacemaker System 8 3 — — $8,501.05 $14,082.43 $9,510.50 2026-04-01
58546 HCPCS Laparo-myomectomy Complex 8 3 — — $8,501.05 $14,322.04 $9,510.50 2026-04-01
33208 HCPCS Insrt Heart Pm Atrial & Vent 8 3 — — $8,501.05 $14,082.43 $9,510.50 2026-04-01
47135 HCPCS Transplantation Of Liver 4 1 — — $9,383.00 $9,638.00 $9,510.50 2026-04-01
44207 HCPCS L Colectomy/coloproctostomy 4 1 — — $9,383.00 $9,638.00 $9,510.50 2026-04-01
44208 HCPCS L Colectomy/coloproctostomy 4 1 — — $9,383.00 $9,638.00 $9,510.50 2026-04-01
29868 HCPCS Meniscal Trnspl Knee W/scpe 8 3 — — $5,330.31 $9,776.62 $9,510.50 2026-04-01
44206 HCPCS Lap Part Colectomy W/stoma 4 1 — — $9,383.00 $9,638.00 $9,510.50 2026-04-01
29867 HCPCS Allgrft Implnt Knee W/scope 8 3 — — $5,330.31 $17,298.12 $9,510.50 2026-04-01
29866 HCPCS Autgrft Implnt Knee W/scope 8 3 — — $5,330.31 $9,776.62 $9,510.50 2026-04-01
43280 HCPCS Laparoscopy Fundoplasty 8 3 — — $6,970.59 $14,322.04 $9,510.50 2026-04-01
33367 HCPCS Replace Aortic Valve W/byp 4 1 — — $9,383.00 $9,638.00 $9,510.50 2026-04-01
29862 HCPCS Hip Arthr0 W/debridement 8 3 — — $6,323.17 $9,776.62 $9,510.50 2026-04-01
19298 HCPCS Place Breast Rad Tube/caths 8 3 — — $7,887.95 $18,567.68 $9,510.50 2026-04-01
33206 HCPCS Insert Heart Pm Atrial 8 3 — — $8,501.05 $14,082.43 $9,510.50 2026-04-01
23470 HCPCS Reconstruct Shoulder Joint 8 3 — — $6,970.59 $17,298.12 $9,510.50 2026-04-01
33249 HCPCS Insj/rplcmt Defib W/lead(s) 8 3 — — $8,501.05 $42,291.60 $9,510.50 2026-04-01
38573 HCPCS Laps Pelvic Lymphadec 8 3 — — $7,887.95 $14,322.04 $9,510.50 2026-04-01
27446 HCPCS Revision Of Knee Joint 8 3 — — $6,970.59 $17,298.12 $9,510.50 2026-04-01
33210 HCPCS Insert Electrd/pm Cath Sngl 8 3 — — $6,323.17 $11,149.80 $9,510.50 2026-04-01
39503 HCPCS Repair Of Diaphragm Hernia 4 1 — — $9,383.00 $9,638.00 $9,510.50 2026-04-01
27412 HCPCS Autochondrocyte Implant Knee 8 3 — — $5,330.31 $9,776.62 $9,510.50 2026-04-01
36906 HCPCS Thrmbc/nfs Dialysis Circuit 8 3 — — $8,501.05 $24,699.02 $9,510.50 2026-04-01
63741 HCPCS Install Spinal Shunt 8 3 — — $5,198.77 $11,824.09 $9,510.50 2026-04-01
27415 HCPCS Osteochondral Knee Allograft 8 3 — — $5,330.31 $17,298.12 $9,510.50 2026-04-01
33240 HCPCS Insrt Pulse Gen W/singl Lead 8 3 — — $8,501.05 $29,969.75 $9,510.50 2026-04-01
33368 HCPCS Replace Aortic Valve W/byp 4 1 — — $9,383.00 $9,638.00 $9,510.50 2026-04-01
63655 HCPCS Implant Neuroelectrodes 8 3 — — $7,887.95 $26,138.63 $9,510.50 2026-04-01
47556 HCPCS Biliary Endoscopy Thru Skin 8 3 — — $5,330.31 $14,322.04 $9,510.50 2026-04-01
33216 HCPCS Insert 1 Electrode Pm-defib 8 3 — — $6,323.17 $11,149.80 $9,510.50 2026-04-01
93650 HCPCS Ablate Heart Dysrhythm Focus 4 2 — — $8,501.05 $10,508.83 $9,504.94 2026-04-01
93619 HCPCS Electrophysiology Evaluation 4 2 — — $8,501.05 $10,508.83 $9,504.94 2026-04-01
93620 HCPCS Electrophysiology Evaluation 4 2 — — $8,501.05 $10,508.83 $9,504.94 2026-04-01
93600 HCPCS Bundle Of His Recording 4 2 — — $8,501.05 $10,508.83 $9,504.94 2026-04-01
0108U OTHER Gi Barrett Esoph 9 Prtn Bmrk 4 2 — — $4,950.00 $13,965.62 $9,457.81 2026-04-01
355 MS_DRG Hernia Procedures Except Inguinal And Femoral Without Cc/Mcc 2 1 — — $9,415.95 $9,415.95 $9,415.95 2026-04-01
20822 HCPCS Replantation Digit Complete 6 2 — — $2,166.52 $9,638.00 $9,383.00 2026-04-01
20816 HCPCS Replantation Digit Complete 6 2 — — $2,166.52 $9,638.00 $9,383.00 2026-04-01
20824 HCPCS Replantation Thumb Complete 6 2 — — $2,166.52 $9,638.00 $9,383.00 2026-04-01
92986 HCPCS Revision Of Aortic Valve 6 2 — — $7,668.49 $9,638.00 $9,383.00 2026-04-01
20827 HCPCS Replantation Thumb Complete 6 2 — — $2,166.52 $9,638.00 $9,383.00 2026-04-01
19294 HCPCS Prep Tum Cav Iort Prtl Mast 6 2 — — $3,982.87 $9,638.00 $9,383.00 2026-04-01
0395T OTHER Hdr Elctr Ntrst/ntrcv Brchtx 6 2 — — $938.39 $9,638.00 $9,383.00 2026-04-01
0100T OTHER Prosth Retina Receive&Gen 6 2 — — $8,501.05 $9,638.00 $9,383.00 2026-04-01
52647 HCPCS Laser Surgery Of Prostate 6 2 — — $6,970.59 $9,638.00 $9,383.00 2026-04-01
178 MS_DRG Respiratory Infections And Inflammations With Cc 2 1 — — $9,361.48 $9,361.48 $9,361.48 2026-04-01
G0419 HCPCS Sat Biopsy Prostate: >60 2 1 — — $9,341.58 $9,341.58 $9,341.58 2026-04-01
C9459 HCPCS Flutemetamol F18 2 1 — — $9,331.15 $9,331.15 $9,331.15 2026-04-01
482 MS_DRG Hip And Femur Procedures Except Major Joint Without Cc/Mcc 2 1 — — $9,215.55 $9,215.55 $9,215.55 2026-04-01
49521 HCPCS Rerepair Ing Hernia Blocked 8 3 — — $6,323.17 $9,638.00 $9,052.73 2026-04-01
69729 HCPCS Impl Oi Implt Sk Tc Esp>=100 8 3 — — $2,335.00 $17,298.12 $9,049.70 2026-04-01
69730 HCPCS Rplc Oi Implt Sk Tc Esp>=100 8 3 — — $2,335.00 $17,298.12 $9,049.70 2026-04-01
37182 HCPCS Insert Hepatic Shunt (tips) 8 3 — — $2,335.00 $24,699.02 $9,049.70 2026-04-01
93583 HCPCS Perq Transcath Septal Reduxn 2 1 — — $9,048.95 $9,048.95 $9,048.95 2026-04-01
C7558 HCPCS Cor Angio/vent W/drug Admin 2 1 — — $9,048.95 $9,048.95 $9,048.95 2026-04-01
C7557 HCPCS Cor Angio/vent W/ffr 2 1 — — $9,048.95 $9,048.95 $9,048.95 2026-04-01
34834 HCPCS Xpose Endoprosth Brachial 2 1 — — $9,048.95 $9,048.95 $9,048.95 2026-04-01
34833 HCPCS Xpose For Endoprosth Iliac 2 1 — — $9,048.95 $9,048.95 $9,048.95 2026-04-01
C9016 HCPCS Inj, Triptorelin Ext Rel 2 1 — — $9,048.38 $9,048.38 $9,048.38 2026-04-01
50593 HCPCS Perc Cryo Ablate Renal Tum 8 3 — — $3,572.00 $15,700.40 $8,995.52 2026-04-01
64561 HCPCS Implant Neuroelectrodes 8 3 — — $5,330.31 $9,638.00 $8,984.81 2026-04-01
64555 HCPCS Implant Neuroelectrodes 8 3 — — $3,982.87 $9,638.00 $8,984.81 2026-04-01
64581 HCPCS Implant Neuroelectrodes 8 3 — — $5,330.31 $9,638.00 $8,984.81 2026-04-01
35876 HCPCS Removal Of Clot In Graft 8 3 — — $7,497.28 $9,638.00 $8,942.02 2026-04-01
35875 HCPCS Removal Of Clot In Graft 8 3 — — $7,497.28 $9,638.00 $8,942.02 2026-04-01
30465 HCPCS Repair Nasal Stenosis 8 3 — — $7,976.05 $9,638.00 $8,942.02 2026-04-01
30462 HCPCS Revision Of Nose 8 3 — — $7,976.05 $9,638.00 $8,942.02 2026-04-01
36831 HCPCS Open Thrombect Av Fistula 8 3 — — $7,497.28 $9,638.00 $8,942.02 2026-04-01
22865 HCPCS Remove Lumb Artif Disc 4 2 — — $7,887.95 $9,776.62 $8,832.28 2026-04-01
22864 HCPCS Remove Cerv Artif Disc 4 2 — — $7,887.95 $9,776.62 $8,832.28 2026-04-01
G0414 HCPCS Pelvic Ring Fx Treat Int Fix 4 2 — — $7,887.95 $9,776.62 $8,832.28 2026-04-01
81520 HCPCS Onc Breast Mrna 58 Genes 6 3 — — $2,510.21 $10,349.91 $8,822.61 2026-04-01
44370 HCPCS Small Bowel Endoscopy/Stent 8 3 — — $6,970.59 $9,638.00 $8,781.30 2026-04-01
44379 HCPCS S Bowel Endoscope W/Stent 8 3 — — $6,970.59 $9,638.00 $8,781.30 2026-04-01
51992 HCPCS Laparo Sling Operation 8 3 — — $6,970.59 $9,638.00 $8,764.20 2026-04-01
58545 HCPCS Laparoscopic Myomectomy 8 3 — — $7,887.95 $9,638.00 $8,764.20 2026-04-01
54690 HCPCS Laparoscopy Orchiectomy 8 3 — — $7,887.95 $9,638.00 $8,764.20 2026-04-01
43652 HCPCS Laparoscopy Vagus Nerve 8 3 — — $6,970.59 $9,638.00 $8,764.20 2026-04-01
43653 HCPCS Laparoscopy Gastrostomy 8 3 — — $7,887.95 $9,638.00 $8,764.20 2026-04-01
43651 HCPCS Laparoscopy Vagus Nerve 8 3 — — $6,970.59 $9,638.00 $8,764.20 2026-04-01
54692 HCPCS Laparoscopy Orchiopexy 8 3 — — $7,887.95 $9,638.00 $8,764.20 2026-04-01
55550 HCPCS Laparo Ligate Spermatic Vein 8 3 — — $7,887.95 $9,638.00 $8,764.20 2026-04-01
38570 HCPCS Laparoscopy Lymph Node Biop 8 3 — — $7,887.95 $9,638.00 $8,764.20 2026-04-01
58550 HCPCS Laparo-asst Vag Hysterectomy 8 3 — — $7,887.95 $9,638.00 $8,764.20 2026-04-01
81554 HCPCS Pulm Ds Ipf Mrna 190 Gen Alg 6 3 — — $5,409.60 $15,657.95 $8,709.07 2026-04-01
A9542 HCPCS In111 Ibritumomab, Dx 2 1 — — $8,701.62 $8,701.62 $8,701.62 2026-04-01
21127 HCPCS Augmentation Lower Jaw Bone 8 3 — — $7,887.95 $9,638.00 $8,679.52 2026-04-01
36904 HCPCS Thrmbc/nfs Dialysis Circuit 8 3 — — $6,970.59 $9,638.00 $8,525.74 2026-04-01
81552 HCPCS Onc Uveal Mlnma Mrna 15 Gene 6 3 — — $7,776.00 $21,938.72 $8,507.77 2026-04-01
93641 HCPCS Electrophysiology Evaluation 2 1 — — $8,501.05 $8,501.05 $8,501.05 2026-04-01
50250 HCPCS Cryoablate Renal Mass Open 2 1 — — $8,501.05 $8,501.05 $8,501.05 2026-04-01
93609 HCPCS Map Tachycardia Add-on 2 1 — — $8,501.05 $8,501.05 $8,501.05 2026-04-01
93621 HCPCS Electrophysiology Evaluation 2 1 — — $8,501.05 $8,501.05 $8,501.05 2026-04-01
93622 HCPCS Electrophysiology Evaluation 2 1 — — $8,501.05 $8,501.05 $8,501.05 2026-04-01
93640 HCPCS Evaluation Heart Device 2 1 — — $8,501.05 $8,501.05 $8,501.05 2026-04-01
57283 HCPCS Colpopexy Intraperitoneal 4 2 — — $6,970.59 $9,991.14 $8,480.86 2026-04-01
49419 HCPCS Insert Tun Ip Cath W/port 8 3 — — $5,198.77 $9,638.00 $8,440.14 2026-04-01
36566 HCPCS Insert Tunneled Cv Cath 8 3 — — $5,330.31 $9,638.00 $8,440.14 2026-04-01
439 MS_DRG Disorders Of Pancreas Except Malignancy With Cc 8 4 — — $6,465.71 $14,967.52 $8,382.74 2026-04-01
G0413 HCPCS Pelvic Ring Fracture Uni/bil 4 2 — — $6,970.59 $9,776.62 $8,373.60 2026-04-01
22206 HCPCS Incis Spine 3 Column Thorac 4 2 — — $6,970.59 $9,776.62 $8,373.60 2026-04-01
G0412 HCPCS Open Tx Iliac Spine Uni/bil 4 2 — — $6,970.59 $9,776.62 $8,373.60 2026-04-01
22010 HCPCS I&d P-spine C/t/cerv-thor 4 2 — — $6,970.59 $9,776.62 $8,373.60 2026-04-01
22207 HCPCS Incis Spine 3 Column Lumbar 4 2 — — $6,970.59 $9,776.62 $8,373.60 2026-04-01
22015 HCPCS I&d Abscess P-spine L/s/ls 4 2 — — $6,970.59 $9,776.62 $8,373.60 2026-04-01
81540 HCPCS Oncology Tum Unknown Origin 6 3 — — $3,750.00 $10,580.01 $8,313.81 2026-04-01
55875 HCPCS Transperi Needle Place Pros 8 3 — — $5,330.31 $9,638.00 $8,303.59 2026-04-01
52648 HCPCS Laser Surgery Of Prostate 8 3 — — $6,970.59 $9,638.00 $8,303.59 2026-04-01
55874 HCPCS Tprnl Plmt Biodegrdabl Matrl 8 3 — — $3,982.87 $9,638.00 $8,303.59 2026-04-01
A9544 HCPCS I-131 Tositumomab, Dx, Per Dose 2 1 — — $8,300.48 $8,300.48 $8,300.48 2026-04-01
0261U OTHER Onc Clrct Ca Img Alys W/ai 4 2 — — $2,513.25 $13,965.62 $8,239.44 2026-04-01
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