Price Transparencybeta 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 →

Export CSV
Hospital

Vibra Rehabilitation Hospital Of Rancho Mirage

Rancho Mirage, CA · CCN 053041 · Rates published

2,205 distinct procedures filed
21 distinct payers
31,735 rate rows
2026-03-17 last MRF observed
Data quality

7,577 of 31,735 rate rows are consumer-grade (23.9%)

24,158 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
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 23,857
per-diem day rate — not a per-procedure price 301
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://ernesthealth.com/pricing/2026/811012327_rehabilitation-hospital-of-southern-ca_standard-charges.json
Found on page https://rhsc.ernesthealth.com/price-transparency/
Discovered viaCMS hospital list
Last fetch not_modified · 2026-09-21
Content fingerprint 2b4266747ebf039d… · 11,930,035 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
D0406
HCPCS 		Traumatic Spinal Cord Injury M >=24.50 And M <31.50 And A >=61.50- Tier Tier 3 12 $103,236.11 $103,236.11 $103,236.11 nat. median
$52,411
2.0× median
A2005
HCPCS 		Miscellaneous M <46.50 And A <77.50- Tier None 12 $35,359.63 $166,359.50 $100,859.57 nat. median
$273
outlier · 370.0×
C0505
HCPCS 		Non-traumatic Spinal Cord Injury M <39.50- Tier Tier 2 12 $76,912.44 $92,831.32 $84,871.88 nat. median
$46,281
1.8× median
D2005
HCPCS 		Miscellaneous M <46.50 And A <77.50- Tier Tier 3 12 $28,576.73 $136,769.64 $82,673.18 nat. median
$31,799
outlier · 2.6×
C2005
HCPCS 		Miscellaneous M <46.50 And A <77.50- Tier Tier 2 12 $64,150.41 $64,150.41 $64,150.41 nat. median
$34,324
1.9× median
D0505
HCPCS 		Non-traumatic Spinal Cord Injury M <39.50- Tier Tier 3 3 $5,507.60 $130,143.94 $64,111.74 nat. median
$43,056
1.5× median
A0505
HCPCS 		Non-traumatic Spinal Cord Injury M <39.50- Tier None 12 $63,046.66 $63,116.17 $63,081.42 nat. median
$39,679
1.6× median
C0704
HCPCS 		Fracture Of Lower Extremity M <41.50- Tier Tier 2 12 $59,510.27 $59,510.27 $59,510.27 nat. median
$34,816
1.7× median
C0903
HCPCS 		Other Orthopedic M >=44.50 And M <51.50- Tier Tier 2 12 $59,422.07 $59,422.07 $59,422.07 nat. median
$27,259
outlier · 2.2×
D0106
HCPCS 		Stroke M <41.50 And A <84.50- Tier Tier 3 12 $50,357.94 $68,098.25 $59,228.10 nat. median
$43,929
1.3× median
B0604
HCPCS 		Neurological M <43.50- Tier Tier 1 12 $54,446.21 $63,351.61 $58,898.91 nat. median
$47,224
1.2× median
A0603
HCPCS 		Neurological M >=43.50 And M <52.50- Tier None 12 $27,153.64 $90,205.64 $58,679.64 nat. median
$23,924
outlier · 2.5×
C1705
HCPCS 		Major Multiple Trauma Without Brain Or Spinal Cord Injury M <36.50- Tier Tier 2 12 $57,202.14 $57,202.14 $57,202.14 nat. median
$39,029
1.5× median
D0604
HCPCS 		Neurological M <43.50- Tier Tier 3 12 $56,802.36 $56,802.36 $56,802.36 nat. median
$30,918
1.8× median
B0302
HCPCS 		Non-traumatic Brain Injury M >=52.50 And M <65.50- Tier Tier 1 12 $56,469.78 $56,469.78 $56,469.78 nat. median
$29,773
1.9× median
A0704
HCPCS 		Fracture Of Lower Extremity M <41.50- Tier None 12 $44,011.71 $68,795.57 $56,403.64 nat. median
$30,471
1.9× median
C0106
HCPCS 		Stroke M <41.50 And A <84.50- Tier Tier 2 12 $55,106.46 $55,106.46 $55,106.46 nat. median
$48,486
1.1× median
C1304
HCPCS 		Rheumatoid Other Arthritis M <44.50 And A >=64.50- Tier Tier 2 12 $54,336.96 $54,336.96 $54,336.96 nat. median
$35,311
1.5× median
C2004
HCPCS 		Miscellaneous M <46.50 And A >=77.50- Tier Tier 2 12 $53,982.93 $53,982.93 $53,982.93 nat. median
$32,666
1.7× median
A0105
HCPCS 		Stroke M <41.50 And A >=84.50- Tier None 12 $53,749.29 $53,749.29 $53,749.29 nat. median
$36,992
1.5× median
C2003
HCPCS 		Miscellaneous M >=46.50 And M <55.50- Tier Tier 2 12 $53,223.42 $53,223.42 $53,223.42 nat. median
$26,785
2.0× median
D1004
HCPCS 		Amputation Lower Extremity M <47.50- Tier Tier 3 12 $52,127.36 $52,127.36 $52,127.36 nat. median
$34,358
1.5× median
D0105
HCPCS 		Stroke M <41.50 And A >=84.50- Tier Tier 3 12 $52,097.49 $52,097.49 $52,097.49 nat. median
$38,998
1.3× median
C0305
HCPCS 		Non-traumatic Brain Injury M <42.50 And A <78.50- Tier Tier 2 12 $41,706.97 $60,424.00 $51,065.49 nat. median
$36,207
1.4× median
C0804
HCPCS 		Replacement Of Lower-extremity Joint M >=42.50 And M <51.50- Tier Tier 2 12 $51,027.40 $51,027.40 $51,027.40 nat. median
$27,257
1.9× median
D0205
HCPCS 		Traumatic Brain Injury M <35.50- Tier Tier 3 12 $50,826.20 $50,826.20 $50,826.20 nat. median
$38,154
1.3× median
C0703
HCPCS 		Fracture Of Lower Extremity M >=41.50 And M <52.50- Tier Tier 2 12 $50,537.63 $50,537.63 $50,537.63 nat. median
$28,633
1.8× median
C0205
HCPCS 		Traumatic Brain Injury M <35.50- Tier Tier 2 12 $50,299.05 $50,299.05 $50,299.05 nat. median
$41,763
1.2× median
A1703
HCPCS 		Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=41.50 And M <50.50… 12 $48,158.93 $48,158.93 $48,158.93 nat. median
$24,903
1.9× median
C0904
HCPCS 		Other Orthopedic M <44.5- Tier Tier 2 12 $48,022.26 $48,022.26 $48,022.26 nat. median
$32,826
1.5× median
A1004
HCPCS 		Amputation Lower Extremity M <47.50- Tier None 12 $47,098.12 $47,098.12 $47,098.12 nat. median
$31,429
1.5× median
D1304
HCPCS 		Rheumatoid Other Arthritis M <44.50 And A >=64.50- Tier Tier 3 12 $47,015.26 $47,015.26 $47,015.26 nat. median
$32,354
1.5× median
C0204
HCPCS 		Traumatic Brain Injury M >=35.50 And M <49.50- Tier Tier 2 12 $37,091.81 $56,747.28 $46,919.54 nat. median
$32,552
1.4× median
D0703
HCPCS 		Fracture Of Lower Extremity M >=41.50 And M <52.50- Tier Tier 3 12 $42,508.25 $50,671.22 $46,589.74 nat. median
$125
outlier · 372.6×
A0904
HCPCS 		Other Orthopedic M <44.5- Tier None 12 $38,787.97 $53,857.53 $46,322.75 nat. median
$28,288
1.6× median
B0703
HCPCS 		Fracture Of Lower Extremity M >=41.50 And M <52.50- Tier Tier 1 12 $46,153.25 $46,153.25 $46,153.25 nat. median
$35,812
1.3× median
D1705
HCPCS 		Major Multiple Trauma Without Brain Or Spinal Cord Injury M <36.50- Tier Tier 3 12 $44,261.01 $44,261.01 $44,261.01 nat. median
$33,589
1.3× median
A0805
HCPCS 		Replacement Of Lower-extremity Joint M <42.50- Tier None 12 $44,217.83 $44,217.83 $44,217.83 nat. median
$27,974
1.6× median
A0504
HCPCS 		Non-traumatic Spinal Cord Injury M >=39.50 And M <48.50- Tier None 12 $44,122.43 $44,122.43 $44,122.43 nat. median
$27,926
1.6× median
A1704
HCPCS 		Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=36.50 And M <41.50… 12 $43,449.90 $43,449.90 $43,449.90 nat. median
$28,656
1.5× median
D0503
HCPCS 		Non-traumatic Spinal Cord Injury M >=48.50 And M <53.50- Tier Tier 3 12 $43,389.83 $43,389.83 $43,389.83 nat. median
$25,360
1.7× median
D0504
HCPCS 		Non-traumatic Spinal Cord Injury M >=39.50 And M <48.50- Tier Tier 3 12 $43,121.00 $43,121.00 $43,121.00 nat. median
$30,303
1.4× median
D0704
HCPCS 		Fracture Of Lower Extremity M <41.50- Tier Tier 3 12 $38,112.68 $47,264.59 $42,688.64 nat. median
$31,214
1.4× median
A1403
HCPCS 		Cardiac M >=45.50 And M <55.50- Tier None 12 $42,571.55 $42,571.55 $42,571.55 nat. median
$22,719
1.9× median
D0805
HCPCS 		Replacement Of Lower-extremity Joint M <42.50- Tier Tier 3 12 $37,930.56 $45,254.65 $41,592.61 nat. median
$30,345
1.4× median
A0104
HCPCS 		Stroke M >=41.50 And M <50.50- Tier None 12 $41,316.71 $41,316.71 $41,316.71 nat. median
$29,682
1.4× median
D0104
HCPCS 		Stroke M >=41.50 And M <50.50- Tier Tier 3 12 $35,517.87 $46,604.46 $41,061.17 nat. median
$31,294
1.3× median
C0604
HCPCS 		Neurological M <43.50- Tier Tier 2 12 $41,023.04 $41,023.04 $41,023.04 nat. median
$35,764
1.1× median
A0204
HCPCS 		Traumatic Brain Injury M >=35.50 And M <49.50- Tier None 12 $40,738.71 $40,738.71 $40,738.71 nat. median
$27,941
1.5× median
D0904
HCPCS 		Other Orthopedic M <44.5- Tier Tier 3 12 $34,953.66 $44,648.86 $39,801.26 nat. median
$31,008
1.3× median

Other procedures at this hospital

Browse this hospital's 2,205 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
             
D0406 HCPCS Traumatic Spinal Cord Injury M >=24.50 And M <31.50 And A >=61.50- Tier Tier 3 28 12 — — $103,236.11 $103,236.11 $103,236.11 2026-03-17
A2005 HCPCS Miscellaneous M <46.50 And A <77.50- Tier None 28 12 — — $35,359.63 $166,359.50 $100,859.57 2026-03-17
C0505 HCPCS Non-traumatic Spinal Cord Injury M <39.50- Tier Tier 2 28 12 — — $76,912.44 $92,831.32 $84,871.88 2026-03-17
D2005 HCPCS Miscellaneous M <46.50 And A <77.50- Tier Tier 3 28 12 — — $28,576.73 $136,769.64 $82,673.18 2026-03-17
C2005 HCPCS Miscellaneous M <46.50 And A <77.50- Tier Tier 2 28 12 — — $64,150.41 $64,150.41 $64,150.41 2026-03-17
D0505 HCPCS Non-traumatic Spinal Cord Injury M <39.50- Tier Tier 3 4 3 — — $5,507.60 $130,143.94 $64,111.74 2026-03-17
A0505 HCPCS Non-traumatic Spinal Cord Injury M <39.50- Tier None 28 12 — — $63,046.66 $63,116.17 $63,081.42 2026-03-17
C0704 HCPCS Fracture Of Lower Extremity M <41.50- Tier Tier 2 28 12 — — $59,510.27 $59,510.27 $59,510.27 2026-03-17
C0903 HCPCS Other Orthopedic M >=44.50 And M <51.50- Tier Tier 2 28 12 — — $59,422.07 $59,422.07 $59,422.07 2026-03-17
D0106 HCPCS Stroke M <41.50 And A <84.50- Tier Tier 3 28 12 — — $50,357.94 $68,098.25 $59,228.10 2026-03-17
B0604 HCPCS Neurological M <43.50- Tier Tier 1 28 12 — — $54,446.21 $63,351.61 $58,898.91 2026-03-17
A0603 HCPCS Neurological M >=43.50 And M <52.50- Tier None 28 12 — — $27,153.64 $90,205.64 $58,679.64 2026-03-17
C1705 HCPCS Major Multiple Trauma Without Brain Or Spinal Cord Injury M <36.50- Tier Tier 2 28 12 — — $57,202.14 $57,202.14 $57,202.14 2026-03-17
D0604 HCPCS Neurological M <43.50- Tier Tier 3 28 12 — — $56,802.36 $56,802.36 $56,802.36 2026-03-17
B0302 HCPCS Non-traumatic Brain Injury M >=52.50 And M <65.50- Tier Tier 1 28 12 — — $56,469.78 $56,469.78 $56,469.78 2026-03-17
A0704 HCPCS Fracture Of Lower Extremity M <41.50- Tier None 28 12 — — $44,011.71 $68,795.57 $56,403.64 2026-03-17
C0106 HCPCS Stroke M <41.50 And A <84.50- Tier Tier 2 28 12 — — $55,106.46 $55,106.46 $55,106.46 2026-03-17
C1304 HCPCS Rheumatoid Other Arthritis M <44.50 And A >=64.50- Tier Tier 2 28 12 — — $54,336.96 $54,336.96 $54,336.96 2026-03-17
C2004 HCPCS Miscellaneous M <46.50 And A >=77.50- Tier Tier 2 28 12 — — $53,982.93 $53,982.93 $53,982.93 2026-03-17
A0105 HCPCS Stroke M <41.50 And A >=84.50- Tier None 28 12 — — $53,749.29 $53,749.29 $53,749.29 2026-03-17
C2003 HCPCS Miscellaneous M >=46.50 And M <55.50- Tier Tier 2 28 12 — — $53,223.42 $53,223.42 $53,223.42 2026-03-17
D1004 HCPCS Amputation Lower Extremity M <47.50- Tier Tier 3 28 12 — — $52,127.36 $52,127.36 $52,127.36 2026-03-17
D0105 HCPCS Stroke M <41.50 And A >=84.50- Tier Tier 3 28 12 — — $52,097.49 $52,097.49 $52,097.49 2026-03-17
C0305 HCPCS Non-traumatic Brain Injury M <42.50 And A <78.50- Tier Tier 2 28 12 — — $41,706.97 $60,424.00 $51,065.49 2026-03-17
C0804 HCPCS Replacement Of Lower-extremity Joint M >=42.50 And M <51.50- Tier Tier 2 28 12 — — $51,027.40 $51,027.40 $51,027.40 2026-03-17
D0205 HCPCS Traumatic Brain Injury M <35.50- Tier Tier 3 28 12 — — $50,826.20 $50,826.20 $50,826.20 2026-03-17
C0703 HCPCS Fracture Of Lower Extremity M >=41.50 And M <52.50- Tier Tier 2 28 12 — — $50,537.63 $50,537.63 $50,537.63 2026-03-17
C0205 HCPCS Traumatic Brain Injury M <35.50- Tier Tier 2 28 12 — — $50,299.05 $50,299.05 $50,299.05 2026-03-17
A1703 HCPCS Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=41.50 And M <50.50… 28 12 — — $48,158.93 $48,158.93 $48,158.93 2026-03-17
C0904 HCPCS Other Orthopedic M <44.5- Tier Tier 2 28 12 — — $48,022.26 $48,022.26 $48,022.26 2026-03-17
A1004 HCPCS Amputation Lower Extremity M <47.50- Tier None 28 12 — — $47,098.12 $47,098.12 $47,098.12 2026-03-17
D1304 HCPCS Rheumatoid Other Arthritis M <44.50 And A >=64.50- Tier Tier 3 28 12 — — $47,015.26 $47,015.26 $47,015.26 2026-03-17
C0204 HCPCS Traumatic Brain Injury M >=35.50 And M <49.50- Tier Tier 2 28 12 — — $37,091.81 $56,747.28 $46,919.54 2026-03-17
D0703 HCPCS Fracture Of Lower Extremity M >=41.50 And M <52.50- Tier Tier 3 28 12 — — $42,508.25 $50,671.22 $46,589.74 2026-03-17
A0904 HCPCS Other Orthopedic M <44.5- Tier None 28 12 — — $38,787.97 $53,857.53 $46,322.75 2026-03-17
B0703 HCPCS Fracture Of Lower Extremity M >=41.50 And M <52.50- Tier Tier 1 28 12 — — $46,153.25 $46,153.25 $46,153.25 2026-03-17
D1705 HCPCS Major Multiple Trauma Without Brain Or Spinal Cord Injury M <36.50- Tier Tier 3 28 12 — — $44,261.01 $44,261.01 $44,261.01 2026-03-17
A0805 HCPCS Replacement Of Lower-extremity Joint M <42.50- Tier None 28 12 — — $44,217.83 $44,217.83 $44,217.83 2026-03-17
A0504 HCPCS Non-traumatic Spinal Cord Injury M >=39.50 And M <48.50- Tier None 28 12 — — $44,122.43 $44,122.43 $44,122.43 2026-03-17
A1704 HCPCS Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=36.50 And M <41.50… 28 12 — — $43,449.90 $43,449.90 $43,449.90 2026-03-17
D0503 HCPCS Non-traumatic Spinal Cord Injury M >=48.50 And M <53.50- Tier Tier 3 28 12 — — $43,389.83 $43,389.83 $43,389.83 2026-03-17
D0504 HCPCS Non-traumatic Spinal Cord Injury M >=39.50 And M <48.50- Tier Tier 3 28 12 — — $43,121.00 $43,121.00 $43,121.00 2026-03-17
D0704 HCPCS Fracture Of Lower Extremity M <41.50- Tier Tier 3 28 12 — — $38,112.68 $47,264.59 $42,688.64 2026-03-17
A1403 HCPCS Cardiac M >=45.50 And M <55.50- Tier None 28 12 — — $42,571.55 $42,571.55 $42,571.55 2026-03-17
D0805 HCPCS Replacement Of Lower-extremity Joint M <42.50- Tier Tier 3 28 12 — — $37,930.56 $45,254.65 $41,592.61 2026-03-17
A0104 HCPCS Stroke M >=41.50 And M <50.50- Tier None 28 12 — — $41,316.71 $41,316.71 $41,316.71 2026-03-17
D0104 HCPCS Stroke M >=41.50 And M <50.50- Tier Tier 3 28 12 — — $35,517.87 $46,604.46 $41,061.17 2026-03-17
C0604 HCPCS Neurological M <43.50- Tier Tier 2 28 12 — — $41,023.04 $41,023.04 $41,023.04 2026-03-17
A0204 HCPCS Traumatic Brain Injury M >=35.50 And M <49.50- Tier None 28 12 — — $40,738.71 $40,738.71 $40,738.71 2026-03-17
D0904 HCPCS Other Orthopedic M <44.5- Tier Tier 3 28 12 — — $34,953.66 $44,648.86 $39,801.26 2026-03-17
D1703 HCPCS Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=41.50 And M <50.50… 28 12 — — $39,707.35 $39,707.35 $39,707.35 2026-03-17
A0106 HCPCS Stroke M <41.50 And A <84.50- Tier None 28 12 — — $5,374.20 $74,039.48 $39,706.84 2026-03-17
A2004 HCPCS Miscellaneous M <46.50 And A >=77.50- Tier None 28 12 — — $38,894.96 $38,894.96 $38,894.96 2026-03-17
A0804 HCPCS Replacement Of Lower-extremity Joint M >=42.50 And M <51.50- Tier None 28 12 — — $36,269.21 $41,279.90 $38,774.56 2026-03-17
D0903 HCPCS Other Orthopedic M >=44.50 And M <51.50- Tier Tier 3 28 12 — — $38,023.72 $38,023.72 $38,023.72 2026-03-17
A1705 HCPCS Major Multiple Trauma Without Brain Or Spinal Cord Injury M <36.50- Tier None 28 12 — — $37,863.26 $37,863.26 $37,863.26 2026-03-17
C0603 HCPCS Neurological M >=43.50 And M <52.50- Tier Tier 2 28 12 — — $36,629.83 $37,537.14 $37,083.49 2026-03-17
C0502 HCPCS Non-traumatic Spinal Cord Injury M >=53.50 And M <60.50- Tier Tier 2 28 12 — — $36,800.21 $36,800.21 $36,800.21 2026-03-17
D2004 HCPCS Miscellaneous M <46.50 And A >=77.50- Tier Tier 3 28 12 — — $36,709.32 $36,709.32 $36,709.32 2026-03-17
D0204 HCPCS Traumatic Brain Injury M >=35.50 And M <49.50- Tier Tier 3 28 12 — — $36,523.57 $36,523.57 $36,523.57 2026-03-17
B0203 HCPCS Traumatic Brain Injury M >=49.50 And M <61.50- Tier Tier 1 28 12 — — $36,309.13 $36,309.13 $36,309.13 2026-03-17
A0604 HCPCS Neurological M <43.50- Tier None 28 12 — — $36,283.07 $36,283.07 $36,283.07 2026-03-17
D2003 HCPCS Miscellaneous M >=46.50 And M <55.50- Tier Tier 3 28 12 — — $36,241.80 $36,241.80 $36,241.80 2026-03-17
C0805 HCPCS Replacement Of Lower-extremity Joint M <42.50- Tier Tier 2 28 12 — — $36,160.47 $36,160.47 $36,160.47 2026-03-17
D0203 HCPCS Traumatic Brain Injury M >=49.50 And M <61.50- Tier Tier 3 28 12 — — $35,797.25 $35,797.25 $35,797.25 2026-03-17
A0703 HCPCS Fracture Of Lower Extremity M >=41.50 And M <52.50- Tier None 28 12 — — $35,198.36 $35,198.36 $35,198.36 2026-03-17
D0304 HCPCS Non-traumatic Brain Injury M <42.50 And A >=78.50- Tier Tier 3 28 12 — — $34,973.09 $34,973.09 $34,973.09 2026-03-17
A1502 HCPCS Pulmonary M >=56.50 And M <68.50- Tier None 28 12 — — $34,742.63 $34,742.63 $34,742.63 2026-03-17
D1403 HCPCS Cardiac M >=45.50 And M <55.50- Tier Tier 3 28 12 — — $34,589.23 $34,589.23 $34,589.23 2026-03-17
D2002 HCPCS Miscellaneous M >=55.50 And M <66.50- Tier Tier 3 28 12 — — $24,009.33 $44,293.74 $34,151.54 2026-03-17
D0401 HCPCS Traumatic Spinal Cord Injury M >=56.50- Tier Tier 3 28 12 — — $33,262.45 $33,262.45 $33,262.45 2026-03-17
D1702 HCPCS Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=50.50 And M <57.50… 28 12 — — $32,995.90 $32,995.90 $32,995.90 2026-03-17
A0304 HCPCS Non-traumatic Brain Injury M <42.50 And A >=78.50- Tier None 28 12 — — $32,743.37 $32,743.37 $32,743.37 2026-03-17
D0603 HCPCS Neurological M >=43.50 And M <52.50- Tier Tier 3 28 12 — — $30,342.88 $34,753.12 $32,548.00 2026-03-17
A0702 HCPCS Fracture Of Lower Extremity M >=52.50 And M <61.50- Tier None 28 12 — — $32,467.80 $32,467.80 $32,467.80 2026-03-17
A1404 HCPCS Cardiac M <45.50- Tier None 28 12 — — $32,172.62 $32,172.62 $32,172.62 2026-03-17
A1303 HCPCS Rheumatoid Other Arthritis M >=44.50 And M <51.50 And A >=64.50- Tier None 28 12 — — $31,012.06 $31,012.06 $31,012.06 2026-03-17
D1503 HCPCS Pulmonary M >=45.50 And M <56.50- Tier Tier 3 28 12 — — $30,774.57 $30,774.57 $30,774.57 2026-03-17
D0804 HCPCS Replacement Of Lower-extremity Joint M >=42.50 And M <51.50- Tier Tier 3 28 12 — — $27,652.48 $33,854.11 $30,753.29 2026-03-17
A0903 HCPCS Other Orthopedic M >=44.50 And M <51.50- Tier None 28 12 — — $26,663.56 $33,998.54 $30,331.05 2026-03-17
C0203 HCPCS Traumatic Brain Injury M >=49.50 And M <61.50- Tier Tier 2 28 12 — — $29,978.18 $29,978.18 $29,978.18 2026-03-17
D0303 HCPCS Non-traumatic Brain Injury M >=42.50 And M <52.50- Tier Tier 3 28 12 — — $29,523.11 $29,523.11 $29,523.11 2026-03-17
A0502 HCPCS Non-traumatic Spinal Cord Injury M >=53.50 And M <60.50- Tier None 28 12 — — $28,815.91 $28,815.91 $28,815.91 2026-03-17
D0902 HCPCS Other Orthopedic M >=51.50 And M <63.50- Tier Tier 3 28 12 — — $24,628.84 $32,438.30 $28,533.57 2026-03-17
D0103 HCPCS Stroke M >=50.50 And M <63.50- Tier Tier 3 28 12 — — $27,807.82 $27,807.82 $27,807.82 2026-03-17
A0103 HCPCS Stroke M >=50.50 And M <63.50- Tier None 28 12 — — $27,718.29 $27,718.29 $27,718.29 2026-03-17
A0503 HCPCS Non-traumatic Spinal Cord Injury M >=48.50 And M <53.50- Tier None 28 12 — — $27,097.17 $27,097.17 $27,097.17 2026-03-17
A0601 HCPCS Neurological M >=64.50- Tier None 28 12 — — $25,756.00 $25,756.00 $25,756.00 2026-03-17
D0602 HCPCS Neurological M >=52.50 And M <64.50- Tier Tier 3 28 12 — — $25,751.76 $25,751.76 $25,751.76 2026-03-17
A0203 HCPCS Traumatic Brain Injury M >=49.50 And M <61.50- Tier None 28 12 — — $25,572.49 $25,572.49 $25,572.49 2026-03-17
B0704 HCPCS Fracture Of Lower Extremity M <41.50- Tier Tier 1 28 12 — — $25,029.43 $25,029.43 $25,029.43 2026-03-17
D0302 HCPCS Non-traumatic Brain Injury M >=52.50 And M <65.50- Tier Tier 3 28 12 — — $24,901.32 $24,901.32 $24,901.32 2026-03-17
D0702 HCPCS Fracture Of Lower Extremity M >=52.50 And M <61.50- Tier Tier 3 28 12 — — $24,818.24 $24,818.24 $24,818.24 2026-03-17
D0803 HCPCS Replacement Of Lower-extremity Joint M >=51.50 And M <57.50- Tier Tier 3 28 12 — — $24,573.97 $24,573.97 $24,573.97 2026-03-17
D0102 HCPCS Stroke M >=63.50 And M <72.50- Tier Tier 3 28 12 — — $21,523.57 $27,090.91 $24,307.24 2026-03-17
A0801 HCPCS Replacement Of Lower-extremity Joint M >=63.50- Tier None 28 12 — — $23,827.91 $23,827.91 $23,827.91 2026-03-17
A1702 HCPCS Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=50.50 And M <57.50… 28 12 — — $23,720.74 $23,720.74 $23,720.74 2026-03-17
D0802 HCPCS Replacement Of Lower-extremity Joint M >=57.50 And M <63.50- Tier Tier 3 28 12 — — $23,565.65 $23,565.65 $23,565.65 2026-03-17
A0302 HCPCS Non-traumatic Brain Injury M >=52.50 And M <65.50- Tier None 28 12 — — $23,469.33 $23,469.33 $23,469.33 2026-03-17
A0202 HCPCS Traumatic Brain Injury M >=61.50 And M <73.50- Tier None 28 12 — — $23,300.51 $23,300.51 $23,300.51 2026-03-17
A0602 HCPCS Neurological M >=52.50 And M <64.50- Tier None 28 12 — — $23,224.47 $23,224.47 $23,224.47 2026-03-17
A0803 HCPCS Replacement Of Lower-extremity Joint M >=51.50 And M <57.50- Tier None 28 12 — — $22,885.60 $22,885.60 $22,885.60 2026-03-17
A0902 HCPCS Other Orthopedic M >=51.50 And M <63.50- Tier None 28 12 — — $22,349.97 $22,349.97 $22,349.97 2026-03-17
A2002 HCPCS Miscellaneous M >=55.50 And M <66.50- Tier None 28 12 — — $22,040.59 $22,040.59 $22,040.59 2026-03-17
D0601 HCPCS Neurological M >=64.50- Tier Tier 3 28 12 — — $21,777.18 $21,777.18 $21,777.18 2026-03-17
A0802 HCPCS Replacement Of Lower-extremity Joint M >=57.50 And M <63.50- Tier None 28 12 — — $20,559.44 $20,559.44 $20,559.44 2026-03-17
A0102 HCPCS Stroke M >=63.50 And M <72.50- Tier None 28 12 — — $20,513.52 $20,513.52 $20,513.52 2026-03-17
A2001 HCPCS Miscellaneous M >=66.50- Tier None 28 12 — — $17,527.12 $17,527.12 $17,527.12 2026-03-17
B1403 HCPCS Cardiac M >=45.50 And M <55.50- Tier Tier 1 28 12 — — $9,571.38 $9,571.38 $9,571.38 2026-03-17
D1002 HCPCS Amputation Lower Extremity M >=55.50 And M <64.50- Tier Tier 3 28 12 — — $7,390.41 $7,390.41 $7,390.41 2026-03-17
A2003 HCPCS Miscellaneous M >=46.50 And M <55.50- Tier None 28 12 — — $5,451.95 $5,451.95 $5,451.95 2026-03-17
A0501 HCPCS Non-traumatic Spinal Cord Injury M >=60.50- Tier None 28 12 — — $4,717.59 $4,717.59 $4,717.59 2026-03-17
A0205 HCPCS Traumatic Brain Injury M <35.50- Tier None 28 12 — — $3,385.58 $3,385.58 $3,385.58 2026-03-17
0128 RC Room & Board - Semi-private (Two Beds) - Rehabilitation 15 8 — — $2,319.00 $2,319.00 $2,319.00 2026-03-17
0148 RC Room & Board - Deluxe Private - Rehabilitation 10 6 — — $2,319.00 $2,319.00 $2,319.00 2026-03-17
0158 RC Room & Board - Ward - Rehabilitation 10 6 — — $2,319.00 $2,319.00 $2,319.00 2026-03-17
0138 RC Room & Board - Three And Four Beds - Rehabilitation 10 6 — — $2,319.00 $2,319.00 $2,319.00 2026-03-17
0118 RC Room & Board - Private (One Bed) - Rehabilitation 4 2 — — $1.00 $1,294.65 $647.88 2026-03-17
0800 RC Inpatient Renal Dialysis - General Classification 11 5 — — $438.00 $690.00 $600.00 2026-03-17
0809 RC Inpatient Renal Dialysis - Other 11 5 — — $438.00 $690.00 $600.00 2026-03-17
0802 RC Inpatient Renal Dialysis - Peritoneal Dialysis (non-capd) 15 6 — — $377.00 $690.00 $500.00 2026-03-17
0804 RC Inpatient Renal Dialysis - Continuous Cycling Peritoneal Dialysis (ccpd) 15 6 — — $377.00 $690.00 $500.00 2026-03-17
0803 RC Inpatient Renal Dialysis - Continuous Ambulatory Peritoneal Dialysis (capd) 15 6 — — $377.00 $690.00 $500.00 2026-03-17
0801 RC Inpatient Renal Dialysis - Hemodialysis 15 6 — — $438.00 $690.00 $500.00 2026-03-17
0808 RC Inpatient Renal Dialysis - Other 4 2 — — $438.00 $500.00 $438.00 2026-03-17
0807 RC Inpatient Renal Dialysis - Observation/Hourly 4 2 — — $438.00 $500.00 $438.00 2026-03-17
0806 RC Inpatient Renal Dialysis - Continuation 4 2 — — $438.00 $500.00 $438.00 2026-03-17
0805 RC Inpatient Renal Dialysis - Treatment 4 2 — — $438.00 $500.00 $438.00 2026-03-17
0559 RC Skilled Nursing - Other 3 1 — — $220.00 $220.00 $220.00 2026-03-17
97024 HCPCS Diathermy Eg Microwave 1 1 — — $185.00 $185.00 $185.00 2026-03-17
97034 HCPCS App Mdlty 1+cntrst Bth Ea 15 1 1 — — $185.00 $185.00 $185.00 2026-03-17
S9152 HCPCS Speech Therapy, Re-eval 5 2 — — $185.00 $185.00 $185.00 2026-03-17
S9129 HCPCS Occupational Therapy, In The 1 1 — — $185.00 $185.00 $185.00 2026-03-17
S9150 HCPCS Evaluation By Ocularist 5 2 — — $185.00 $185.00 $185.00 2026-03-17
S9125 HCPCS Respite Care, In The Home, P 1 1 — — $185.00 $185.00 $185.00 2026-03-17
S9122 HCPCS Home Health Aide Or Certifie 1 1 — — $185.00 $185.00 $185.00 2026-03-17
S9126 HCPCS Hospice Care, In The Home, P 1 1 — — $185.00 $185.00 $185.00 2026-03-17
S8940 HCPCS Hippotherapy Per Session 1 1 — — $185.00 $185.00 $185.00 2026-03-17
S8948 HCPCS Low-level Laser Trmt 15 Min 1 1 — — $185.00 $185.00 $185.00 2026-03-17
S9127 HCPCS Social Work Visit, In The Ho 1 1 — — $185.00 $185.00 $185.00 2026-03-17
S9128 HCPCS Speech Therapy, In The Home, 1 1 — — $185.00 $185.00 $185.00 2026-03-17
97799 HCPCS Unlisted Physcl Med/rehab Px 1 1 — — $185.00 $185.00 $185.00 2026-03-17
97755 HCPCS Assistive Technology Assess 1 1 — — $185.00 $185.00 $185.00 2026-03-17
97546 HCPCS Work Hardening Add-on 1 1 — — $185.00 $185.00 $185.00 2026-03-17
97545 HCPCS Work Hardening 1 1 — — $185.00 $185.00 $185.00 2026-03-17
97171 HCPCS Athletic Trn Eval High Cmplx 1 1 — — $185.00 $185.00 $185.00 2026-03-17
97170 HCPCS Athletic Trn Eval Mod Cmplx 1 1 — — $185.00 $185.00 $185.00 2026-03-17
97172 HCPCS Athletic Trn Re-eval Plan Cr 1 1 — — $185.00 $185.00 $185.00 2026-03-17
97169 HCPCS Athletic Trn Eval Low Cmplx 1 1 — — $185.00 $185.00 $185.00 2026-03-17
97157 HCPCS Mult Fam Adapt Bhv Tx Gdn 1 1 — — $185.00 $185.00 $185.00 2026-03-17
97153 HCPCS Adaptive Behavior Tx By Tech 1 1 — — $185.00 $185.00 $185.00 2026-03-17
97152 HCPCS Bhv Id Suprt Assmt By 1 Tech 1 1 — — $185.00 $185.00 $185.00 2026-03-17
97154 HCPCS Grp Adapt Bhv Tx By Tech 1 1 — — $185.00 $185.00 $185.00 2026-03-17
97158 HCPCS Grp Adapt Bhv Tx By Phy/qhp 1 1 — — $185.00 $185.00 $185.00 2026-03-17
97150 HCPCS Group Therapeutic Procedures 1 1 — — $185.00 $185.00 $185.00 2026-03-17
97139 HCPCS Unlisted Therapeutic Px 1 1 — — $185.00 $185.00 $185.00 2026-03-17
97155 HCPCS Adapt Behavior Tx Phys/qhp 1 1 — — $185.00 $185.00 $185.00 2026-03-17
97156 HCPCS Fam Adapt Bhv Tx Gdn Phy/qhp 1 1 — — $185.00 $185.00 $185.00 2026-03-17
97151 HCPCS Bhv Id Assmt By Phys/qhp 1 1 — — $185.00 $185.00 $185.00 2026-03-17
97039 HCPCS Unlisted Modality 1 1 — — $185.00 $185.00 $185.00 2026-03-17
97036 HCPCS App Mdlty 1+hubbrd Tnk Ea 15 1 1 — — $185.00 $185.00 $185.00 2026-03-17
97026 HCPCS Infrared Therapy 1 1 — — $185.00 $185.00 $185.00 2026-03-17
S8950 HCPCS Complex Lymphedema Therapy, 1 1 — — $185.00 $185.00 $185.00 2026-03-17
S9131 HCPCS Pt In The Home Per Diem 1 1 — — $185.00 $185.00 $185.00 2026-03-17
S9124 HCPCS Nursing Care, In The Home; B 1 1 — — $185.00 $185.00 $185.00 2026-03-17
S9123 HCPCS Nursing Care In Home Rn 1 1 — — $185.00 $185.00 $185.00 2026-03-17
S8990 HCPCS Pt Or Manip For Maint 1 1 — — $185.00 $185.00 $185.00 2026-03-17
97016 HCPCS Vasopneumatic Device Therapy 1 1 — — $185.00 $185.00 $185.00 2026-03-17
97028 HCPCS Ultraviolet Therapy 1 1 — — $185.00 $185.00 $185.00 2026-03-17
97010 HCPCS Hot Or Cold Packs Therapy 1 1 — — $185.00 $185.00 $185.00 2026-03-17
97037 HCPCS Appl Modality 1+lllt Po Pain 1 1 — — $185.00 $185.00 $185.00 2026-03-17
97022 HCPCS Whirlpool Therapy 1 1 — — $185.00 $185.00 $185.00 2026-03-17
0423 RC Physical Therapy - Group Rate 18 8 — — $163.00 $185.00 $174.00 2026-03-17
0449 RC Speech Therapy - Language Pathology - Other 17 8 — — $163.00 $185.00 $174.00 2026-03-17
0439 RC Occupational Therapy - Other 17 8 — — $163.00 $185.00 $174.00 2026-03-17
0422 RC Physical Therapy - Hourly Charge 18 8 — — $163.00 $185.00 $174.00 2026-03-17
0432 RC Occupational Therapy - Hourly Charge 18 8 — — $163.00 $185.00 $174.00 2026-03-17
0433 RC Occupational Therapy - Group Rate 18 8 — — $163.00 $185.00 $174.00 2026-03-17
0429 RC Physical Therapy - Other 17 8 — — $163.00 $185.00 $174.00 2026-03-17
0443 RC Speech Therapy - Language Pathology - Group Rate 22 9 — — $163.00 $185.00 $174.00 2026-03-17
0442 RC Speech Therapy - Language Pathology - Hourly Charge 22 9 — — $163.00 $185.00 $174.00 2026-03-17
97763 HCPCS Orthc/prostc Mgmt Sbsq Enc 26 12 — — $150.00 $185.00 $167.50 2026-03-17
97761 HCPCS Prosthetic Traing 1st Enc 26 12 — — $150.00 $185.00 $167.50 2026-03-17
97760 HCPCS Orthotic Mgmt&traing 1st Enc 26 12 — — $150.00 $185.00 $167.50 2026-03-17
97542 HCPCS Wheelchair Mngment Training 30 13 — — $150.00 $185.00 $167.50 2026-03-17
97750 HCPCS Physical Performance Test 30 13 — — $150.00 $185.00 $167.50 2026-03-17
97533 HCPCS Sensory Integration 26 12 — — $150.00 $185.00 $167.50 2026-03-17
97130 HCPCS Ther Ivntj Ea Addl 15 Min 26 12 — — $150.00 $185.00 $167.50 2026-03-17
97033 HCPCS App Mdlty 1+iontphrsis Ea 15 26 12 — — $150.00 $185.00 $167.50 2026-03-17
97035 HCPCS App Mdlty 1+ultrasound Ea 15 26 12 — — $150.00 $185.00 $167.50 2026-03-17
97018 HCPCS Paraffin Bath Therapy 26 12 — — $150.00 $185.00 $167.50 2026-03-17
97012 HCPCS Mechanical Traction Therapy 26 12 — — $150.00 $185.00 $167.50 2026-03-17
97014 HCPCS Electric Stimulation Therapy 26 12 — — $150.00 $185.00 $167.50 2026-03-17
0435 RC Occupational Therapy - Treatment 15 7 — — $163.00 $163.00 $163.00 2026-03-17
0428 RC Physical Therapy - Other 15 7 — — $163.00 $163.00 $163.00 2026-03-17
0437 RC Occupational Therapy - Observation/Hourly 15 7 — — $163.00 $163.00 $163.00 2026-03-17
0427 RC Physical Therapy - Observation/Hourly 15 7 — — $163.00 $163.00 $163.00 2026-03-17
0436 RC Occupational Therapy - Continuation 15 7 — — $163.00 $163.00 $163.00 2026-03-17
0438 RC Occupational Therapy - Other 15 7 — — $163.00 $163.00 $163.00 2026-03-17
0448 RC Speech-language Pathology - Other 15 7 — — $163.00 $163.00 $163.00 2026-03-17
0426 RC Physical Therapy - Continuation 15 7 — — $163.00 $163.00 $163.00 2026-03-17
0425 RC Physical Therapy - Treatment 15 7 — — $163.00 $163.00 $163.00 2026-03-17
0446 RC Speech-language Pathology - Continuation 15 7 — — $163.00 $163.00 $163.00 2026-03-17
0447 RC Speech-language Pathology - Observation/Hourly 15 7 — — $163.00 $163.00 $163.00 2026-03-17
0445 RC Speech-language Pathology - Treatment 15 7 — — $163.00 $163.00 $163.00 2026-03-17
0434 RC Occupational Therapy - Evaluation Or Reevaluation 46 18 — — $131.00 $185.00 $158.00 2026-03-17
0424 RC Physical Therapy - Evaluation Or Re-evaluation 42 17 — — $131.00 $185.00 $158.00 2026-03-17
97167 HCPCS Ot Eval High Complex 60 Min 31 14 — — $131.00 $185.00 $158.00 2026-03-17
97166 HCPCS Ot Eval Mod Complex 45 Min 40 17 — — $131.00 $185.00 $158.00 2026-03-17
97168 HCPCS Ot Re-eval Est Plan Care 31 14 — — $131.00 $185.00 $158.00 2026-03-17
97164 HCPCS Pt Re-eval Est Plan Care 36 16 — — $131.00 $185.00 $158.00 2026-03-17
97165 HCPCS Ot Eval Low Complex 30 Min 40 17 — — $131.00 $185.00 $158.00 2026-03-17
97161 HCPCS Pt Eval Low Complex 20 Min 36 16 — — $131.00 $185.00 $158.00 2026-03-17
97162 HCPCS Pt Eval Mod Complex 30 Min 36 16 — — $131.00 $185.00 $158.00 2026-03-17
97163 HCPCS Pt Eval High Complex 45 Min 36 16 — — $131.00 $185.00 $158.00 2026-03-17
0444 RC Speech Therapy - Language Pathology - Evaluation Or Reevaluation 43 17 — — $131.00 $185.00 $158.00 2026-03-17
0301 RC Laboratory - Chemistry 38 14 — — $150.00 $150.00 $150.00 2026-03-17
0300 RC Laboratory - General Classification 38 14 — — $150.00 $150.00 $150.00 2026-03-17
92612 HCPCS Endoscopy Swallow (fees) Vid 25 11 — — $150.00 $150.00 $150.00 2026-03-17
99232 HCPCS Sbsq Hosp Ip/obs Moderate 35 25 11 — — $150.00 $150.00 $150.00 2026-03-17
20561 HCPCS Ndl Insj Without Njx 3+ Musc 26 11 — — $150.00 $150.00 $150.00 2026-03-17
99499 HCPCS Unlisted E&m Service 25 11 — — $150.00 $150.00 $150.00 2026-03-17
20560 HCPCS Ndl Insj Without Njx 1 Or 2 Musc 26 11 — — $150.00 $150.00 $150.00 2026-03-17
99199 HCPCS Unlisted Special Svc Px/rprt 34 14 — — $150.00 $150.00 $150.00 2026-03-17
29130 HCPCS Application Of Finger Splint 26 11 — — $150.00 $150.00 $150.00 2026-03-17
97550 HCPCS Caregiver Traing 1st 30 Min 25 11 — — $150.00 $150.00 $150.00 2026-03-17
29126 HCPCS Apply Forearm Splint 26 11 — — $150.00 $150.00 $150.00 2026-03-17
99223 HCPCS 1st Hosp Ip/obs High 75 25 11 — — $150.00 $150.00 $150.00 2026-03-17
29125 HCPCS Apply Forearm Splint 35 14 — — $150.00 $150.00 $150.00 2026-03-17
99231 HCPCS Sbsq Hosp Ip/obs Sf/low 25 25 11 — — $150.00 $150.00 $150.00 2026-03-17
11721 HCPCS Debride Nail 6 Or More 26 11 — — $150.00 $150.00 $150.00 2026-03-17
96125 HCPCS Cognitive Test By Hc Pro 25 11 — — $150.00 $150.00 $150.00 2026-03-17
95992 HCPCS Canalith Repositioning Proc 25 11 — — $150.00 $150.00 $150.00 2026-03-17
93926 HCPCS Lower Extremity Study 34 14 — — $150.00 $150.00 $150.00 2026-03-17
92609 HCPCS Use Of Speech Device Service 25 11 — — $150.00 $150.00 $150.00 2026-03-17
94003 HCPCS Vent Mgmt Inpat Subq Day 34 14 — — $150.00 $150.00 $150.00 2026-03-17
71045 HCPCS X-ray Exam Chest 1 View 35 14 — — $150.00 $150.00 $150.00 2026-03-17
93971 HCPCS Extremity Study 34 14 — — $150.00 $150.00 $150.00 2026-03-17
94002 HCPCS Vent Mgmt Inpat Init Day 34 14 — — $150.00 $150.00 $150.00 2026-03-17
87635 HCPCS Sars-cov-2 Covid-19 Amp Prb 34 14 — — $150.00 $150.00 $150.00 2026-03-17
87340 HCPCS Hepatitis B Surface Ag Ia 34 14 — — $150.00 $150.00 $150.00 2026-03-17
87633 HCPCS Resp Virus 12-25 Targets 25 11 — — $150.00 $150.00 $150.00 2026-03-17
87070 HCPCS Culture Othr Specimn Aerobic 34 14 — — $150.00 $150.00 $150.00 2026-03-17
85610 HCPCS Prothrombin Time 34 14 — — $150.00 $150.00 $150.00 2026-03-17
70470 HCPCS CT Head/brain Without & With Contrast 26 11 — — $150.00 $150.00 $150.00 2026-03-17
86140 HCPCS C-reactive Protein 34 14 — — $150.00 $150.00 $150.00 2026-03-17
87086 HCPCS Urine Culture/colony Count 34 14 — — $150.00 $150.00 $150.00 2026-03-17
84443 HCPCS Assay Thyroid Stim Hormone 34 14 — — $150.00 $150.00 $150.00 2026-03-17
84100 HCPCS Assay Of Phosphorus 34 14 — — $150.00 $150.00 $150.00 2026-03-17
84481 HCPCS Free Assay (ft-3) 34 14 — — $150.00 $150.00 $150.00 2026-03-17
82962 HCPCS Glucose Blood Test 25 11 — — $150.00 $150.00 $150.00 2026-03-17
82805 HCPCS Blood Gases W/o2 Saturation 34 14 — — $150.00 $150.00 $150.00 2026-03-17
83036 HCPCS Hemoglobin Glycosylated A1c 34 14 — — $150.00 $150.00 $150.00 2026-03-17
85025 HCPCS Complete Cbc W/auto Diff Wbc 34 14 — — $150.00 $150.00 $150.00 2026-03-17
80053 HCPCS Comprehen Metabolic Panel 34 14 — — $150.00 $150.00 $150.00 2026-03-17
80202 HCPCS Assay Of Vancomycin 34 14 — — $150.00 $150.00 $150.00 2026-03-17
76700 HCPCS US Exam Abdom Complete 34 14 — — $150.00 $150.00 $150.00 2026-03-17
74177 HCPCS CT Abd & Pelv W/contrast 34 14 — — $150.00 $150.00 $150.00 2026-03-17
80048 HCPCS Metabolic Panel Total Ca 34 14 — — $150.00 $150.00 $150.00 2026-03-17
81001 HCPCS Urinalysis Auto W/scope 34 14 — — $150.00 $150.00 $150.00 2026-03-17
73560 HCPCS X-ray Exam Of Knee 1 Or 2 34 14 — — $150.00 $150.00 $150.00 2026-03-17
80069 HCPCS Renal Function Panel 34 14 — — $150.00 $150.00 $150.00 2026-03-17
82728 HCPCS Assay Of Ferritin 34 14 — — $150.00 $150.00 $150.00 2026-03-17
82803 HCPCS Blood Gases Any Combination 34 14 — — $150.00 $150.00 $150.00 2026-03-17
82945 HCPCS Glucose Other Fluid 34 14 — — $150.00 $150.00 $150.00 2026-03-17
82948 HCPCS Reagent Strip/blood Glucose 34 14 — — $150.00 $150.00 $150.00 2026-03-17
83735 HCPCS Assay Of Magnesium 34 14 — — $150.00 $150.00 $150.00 2026-03-17
83880 HCPCS Assay Of Natriuretic Peptide 34 14 — — $150.00 $150.00 $150.00 2026-03-17
84134 HCPCS Assay Of Prealbumin 34 14 — — $150.00 $150.00 $150.00 2026-03-17
84145 HCPCS Procalcitonin (pct) 34 14 — — $150.00 $150.00 $150.00 2026-03-17
73100 HCPCS X-ray Exam Of Wrist 34 14 — — $150.00 $150.00 $150.00 2026-03-17
73610 HCPCS X-ray Exam Of Ankle 34 14 — — $150.00 $150.00 $150.00 2026-03-17
86905 HCPCS Blood Typing Rbc Antigens 34 14 — — $150.00 $150.00 $150.00 2026-03-17
87040 HCPCS Blood Culture For Bacteria 34 14 — — $150.00 $150.00 $150.00 2026-03-17
72170 HCPCS X-ray Exam Of Pelvis 34 14 — — $150.00 $150.00 $150.00 2026-03-17
87493 HCPCS C Diff Amplified Probe 25 11 — — $150.00 $150.00 $150.00 2026-03-17
72158 HCPCS MRI Lumbar Spine Without & With Contrast 26 11 — — $150.00 $150.00 $150.00 2026-03-17
90935 HCPCS Hemodialysis One Evaluation 34 14 — — $150.00 $150.00 $150.00 2026-03-17
73030 HCPCS X-ray Exam Of Shoulder 34 14 — — $150.00 $150.00 $150.00 2026-03-17
74018 HCPCS X-ray Exam Abdomen 1 View 34 14 — — $150.00 $150.00 $150.00 2026-03-17
82330 HCPCS Assay Of Calcium 34 14 — — $150.00 $150.00 $150.00 2026-03-17
71046 HCPCS X-ray Exam Chest 2 Views 35 14 — — $150.00 $150.00 $150.00 2026-03-17
85027 HCPCS Complete Cbc Automated 34 14 — — $150.00 $150.00 $150.00 2026-03-17
93970 HCPCS Extremity Study 34 14 — — $150.00 $150.00 $150.00 2026-03-17
92610 HCPCS Evaluate Swallowing Function 34 14 — — $150.00 $150.00 $150.00 2026-03-17
0431 RC Occupational Therapy - Visit Charge 22 9 — — $99.00 $185.00 $142.00 2026-03-17
0421 RC Physical Therapy - Visit Charge 41 16 — — $99.00 $185.00 $142.00 2026-03-17
0410 RC Respiratory Services - General Classification 41 16 — — $99.00 $185.00 $142.00 2026-03-17
0412 RC Respiratory Services - Inhalation Services 22 9 — — $99.00 $185.00 $142.00 2026-03-17
0419 RC Respiratory Services - Other 19 8 — — $99.00 $185.00 $142.00 2026-03-17
0441 RC Speech Therapy - Language Pathology - Visit Charge 26 10 — — $99.00 $185.00 $142.00 2026-03-17
92521 HCPCS Evaluation Of Speech Fluency 5 2 — — $131.00 $150.00 $141.00 2026-03-17
96105 HCPCS Assessment Of Aphasia 26 12 — — $131.00 $150.00 $140.50 2026-03-17
92524 HCPCS Behavral Qualit Analys Voice 26 12 — — $131.00 $150.00 $140.50 2026-03-17
92523 HCPCS Speech Sound Lang Comprehen 35 15 — — $131.00 $150.00 $140.50 2026-03-17
92522 HCPCS Evaluate Speech Production 26 12 — — $131.00 $150.00 $140.50 2026-03-17
0430 RC Occupational Therapy - General Classification 46 18 — — $90.00 $185.00 $137.50 2026-03-17
0420 RC Physical Therapy - General Classification 45 18 — — $90.00 $185.00 $137.50 2026-03-17
97530 HCPCS Therapeutic Activities 36 16 — — $90.00 $185.00 $137.50 2026-03-17
97535 HCPCS Self Care Mngment Training 36 16 — — $90.00 $185.00 $137.50 2026-03-17
See an error in this hospital's data? Submit a correction