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 →

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Hospital

Northern Colorado Rehabilitation Hospital, Inc

Johnstown, CO · CCN 063033 · Rates published

2,222 distinct procedures filed
20 distinct payers
27,414 rate rows
2026-03-17 last MRF observed
Data quality

5,011 of 27,414 rate rows are consumer-grade (18.3%)

22,403 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 22,204
per-diem day rate — not a per-procedure price 199
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://ernesthealth.com/pricing/2026/562479701_northern-colorado-rehabilitation-hospital_standard-charges.json
Found on page https://ncrh.ernesthealth.com/price-transparency/
Discovered viaCMS hospital list
Last fetch success · 2026-08-14
Content fingerprint 3d2c36ea175a49ec… · 10,591,502 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
B1806
HCPCS 		Major Multiple Trauma With Brain Or Spinal Cord Injury M <30.50- Tier Tier 1 13 $70,376.36 $70,376.36 $70,376.36 nat. median
$71,463
1.0× median
D0407
HCPCS 		Traumatic Spinal Cord Injury M <24.50 And A >=61.50- Tier Tier 3 13 $64,743.69 $64,743.69 $64,743.69 nat. median
$69,540
0.9× median
D1806
HCPCS 		Major Multiple Trauma With Brain Or Spinal Cord Injury M <30.50- Tier Tier 3 13 $50,505.35 $55,072.82 $52,789.08 nat. median
$53,782
1.0× median
B0106
HCPCS 		Stroke M <41.50 And A <84.50- Tier Tier 1 13 $51,557.95 $51,557.95 $51,557.95 nat. median
$54,601
0.9× median
C0505
HCPCS 		Non-traumatic Spinal Cord Injury M <39.50- Tier Tier 2 13 $48,202.44 $48,202.44 $48,202.44 nat. median
$46,281
1.0× median
D0406
HCPCS 		Traumatic Spinal Cord Injury M >=24.50 And M <31.50 And A >=61.50- Tier Tier 3 13 $45,353.17 $45,353.17 $45,353.17 nat. median
$52,411
0.9× median
C0106
HCPCS 		Stroke M <41.50 And A <84.50- Tier Tier 2 13 $44,930.14 $44,930.14 $44,930.14 nat. median
$48,486
0.9× median
D0106
HCPCS 		Stroke M <41.50 And A <84.50- Tier Tier 3 13 $39,234.46 $50,221.23 $44,727.85 nat. median
$43,929
1.0× median
B0604
HCPCS 		Neurological M <43.50- Tier Tier 1 13 $44,178.34 $44,178.34 $44,178.34 nat. median
$47,224
0.9× median
C0305
HCPCS 		Non-traumatic Brain Injury M <42.50 And A <78.50- Tier Tier 2 13 $39,889.45 $39,889.45 $39,889.45 nat. median
$36,207
1.1× median
B2005
HCPCS 		Miscellaneous M <46.50 And A <77.50- Tier Tier 1 13 $39,402.88 $39,402.88 $39,402.88 nat. median
$42,636
0.9× median
D0505
HCPCS 		Non-traumatic Spinal Cord Injury M <39.50- Tier Tier 3 13 $39,326.60 $39,326.60 $39,326.60 nat. median
$43,056
0.9× median
C2005
HCPCS 		Miscellaneous M <46.50 And A <77.50- Tier Tier 2 13 $31,473.34 $46,533.64 $39,003.49 nat. median
$34,324
1.1× median
A1304
HCPCS 		Rheumatoid Other Arthritis M <44.50 And A >=64.50- Tier None 13 $38,957.59 $38,957.59 $38,957.59 nat. median
$29,389
1.3× median
A0106
HCPCS 		Stroke M <41.50 And A <84.50- Tier None 13 $38,939.88 $38,939.88 $38,939.88 nat. median
$41,668
0.9× median
B2004
HCPCS 		Miscellaneous M <46.50 And A >=77.50- Tier Tier 1 13 $37,382.35 $37,382.35 $37,382.35 nat. median
$40,733
0.9× median
C0205
HCPCS 		Traumatic Brain Injury M <35.50- Tier Tier 2 13 $37,299.34 $37,299.34 $37,299.34 nat. median
$41,763
0.9× median
D0105
HCPCS 		Stroke M <41.50 And A >=84.50- Tier Tier 3 13 $35,029.96 $38,100.24 $36,565.10 nat. median
$38,998
0.9× median
B0204
HCPCS 		Traumatic Brain Injury M >=35.50 And M <49.50- Tier Tier 1 13 $36,539.73 $36,539.73 $36,539.73 nat. median
$40,941
0.9× median
A0505
HCPCS 		Non-traumatic Spinal Cord Injury M <39.50- Tier None 13 $36,239.93 $36,239.93 $36,239.93 nat. median
$39,679
0.9× median
C1705
HCPCS 		Major Multiple Trauma Without Brain Or Spinal Cord Injury M <36.50- Tier Tier 2 13 $36,154.78 $36,154.78 $36,154.78 nat. median
$39,029
0.9× median
B0603
HCPCS 		Neurological M >=43.50 And M <52.50- Tier Tier 1 13 $35,227.01 $35,227.01 $35,227.01 nat. median
$37,339
0.9× median
D0205
HCPCS 		Traumatic Brain Injury M <35.50- Tier Tier 3 13 $35,014.14 $35,014.14 $35,014.14 nat. median
$38,154
0.9× median
C1805
HCPCS 		Major Multiple Trauma With Brain Or Spinal Cord Injury M >=30.50 And M <40.50- T… 13 $34,918.31 $34,918.31 $34,918.31 nat. median
$40,352
0.9× median
A0105
HCPCS 		Stroke M <41.50 And A >=84.50- Tier None 13 $33,238.10 $34,237.15 $33,737.62 nat. median
$36,992
0.9× median
A0405
HCPCS 		Traumatic Spinal Cord Injury M >=31.50 And M <41.50- Tier None 13 $33,724.48 $33,724.48 $33,724.48 nat. median
$35,266
1.0× median
D1705
HCPCS 		Major Multiple Trauma Without Brain Or Spinal Cord Injury M <36.50- Tier Tier 3 13 $33,483.22 $33,483.22 $33,483.22 nat. median
$33,589
1.0× median
C0604
HCPCS 		Neurological M <43.50- Tier Tier 2 13 $33,075.21 $33,075.21 $33,075.21 nat. median
$35,764
0.9× median
A0205
HCPCS 		Traumatic Brain Injury M <35.50- Tier None 13 $32,965.23 $32,965.23 $32,965.23 nat. median
$35,847
0.9× median
D1805
HCPCS 		Major Multiple Trauma With Brain Or Spinal Cord Injury M >=30.50 And M <40.50- T… 13 $31,902.60 $32,553.67 $32,228.13 nat. median
$37,121
0.9× median
B0903
HCPCS 		Other Orthopedic M >=44.50 And M <51.50- Tier Tier 1 13 $32,143.02 $32,143.02 $32,143.02 nat. median
$35,989
0.9× median
C0704
HCPCS 		Fracture Of Lower Extremity M <41.50- Tier Tier 2 13 $31,936.34 $31,936.34 $31,936.34 nat. median
$34,816
0.9× median
B2003
HCPCS 		Miscellaneous M >=46.50 And M <55.50- Tier Tier 1 13 $31,265.79 $31,265.79 $31,265.79 nat. median
$33,399
0.9× median
D1004
HCPCS 		Amputation Lower Extremity M <47.50- Tier Tier 3 13 $30,838.27 $30,838.27 $30,838.27 nat. median
$34,358
0.9× median
D1504
HCPCS 		Pulmonary M <45.50- Tier Tier 3 13 $30,797.47 $30,797.47 $30,797.47 nat. median
$34,002
0.9× median
D0305
HCPCS 		Non-traumatic Brain Injury M <42.50 And A <78.50- Tier Tier 3 13 $30,464.89 $31,086.62 $30,775.76 nat. median
$33,755
0.9× median
D2005
HCPCS 		Miscellaneous M <46.50 And A <77.50- Tier Tier 3 13 $29,401.37 $31,801.87 $30,601.62 nat. median
$31,799
1.0× median
A1705
HCPCS 		Major Multiple Trauma Without Brain Or Spinal Cord Injury M <36.50- Tier None 13 $30,377.04 $30,377.04 $30,377.04 nat. median
$33,508
0.9× median
D0604
HCPCS 		Neurological M <43.50- Tier Tier 3 13 $29,546.60 $31,050.85 $30,298.72 nat. median
$30,918
1.0× median
D0704
HCPCS 		Fracture Of Lower Extremity M <41.50- Tier Tier 3 13 $30,252.87 $30,252.87 $30,252.87 nat. median
$31,214
1.0× median
D1305
HCPCS 		Rheumatoid Other Arthritis M <51.50 And A <64.50- Tier Tier 3 13 $30,015.82 $30,015.82 $30,015.82 nat. median
$33,325
0.9× median
C1404
HCPCS 		Cardiac M <45.50- Tier Tier 2 13 $29,986.77 $29,986.77 $29,986.77 nat. median
$33,337
0.9× median
C2004
HCPCS 		Miscellaneous M <46.50 And A >=77.50- Tier Tier 2 13 $29,859.05 $29,859.05 $29,859.05 nat. median
$32,666
0.9× median
C0904
HCPCS 		Other Orthopedic M <44.5- Tier Tier 2 13 $29,317.81 $29,317.81 $29,317.81 nat. median
$32,826
0.9× median
A0305
HCPCS 		Non-traumatic Brain Injury M <42.50 And A <78.50- Tier None 13 $29,300.26 $29,300.26 $29,300.26 nat. median
$31,600
0.9× median
A1504
HCPCS 		Pulmonary M <45.50- Tier None 13 $28,808.87 $28,808.87 $28,808.87 nat. median
$32,504
0.9× median
D1503
HCPCS 		Pulmonary M >=45.50 And M <56.50- Tier Tier 3 13 $28,781.12 $28,781.12 $28,781.12 nat. median
$27,114
1.1× median
C0603
HCPCS 		Neurological M >=43.50 And M <52.50- Tier Tier 2 13 $25,256.46 $31,848.98 $28,552.72 nat. median
$28,279
1.0× median
A2005
HCPCS 		Miscellaneous M <46.50 And A <77.50- Tier None 13 $26,748.00 $30,269.44 $28,508.72 nat. median
$273
outlier · 104.6×
D0504
HCPCS 		Non-traumatic Spinal Cord Injury M >=39.50 And M <48.50- Tier Tier 3 13 $28,301.53 $28,301.53 $28,301.53 nat. median
$30,303
0.9× median

Other procedures at this hospital

Browse this hospital's 2,222 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
             
B1806 HCPCS Major Multiple Trauma With Brain Or Spinal Cord Injury M <30.50- Tier Tier 1 23 13 — — $70,376.36 $70,376.36 $70,376.36 2026-03-17
D0407 HCPCS Traumatic Spinal Cord Injury M <24.50 And A >=61.50- Tier Tier 3 24 13 — — $64,743.69 $64,743.69 $64,743.69 2026-03-17
D1806 HCPCS Major Multiple Trauma With Brain Or Spinal Cord Injury M <30.50- Tier Tier 3 24 13 — — $50,505.35 $55,072.82 $52,789.08 2026-03-17
B0106 HCPCS Stroke M <41.50 And A <84.50- Tier Tier 1 23 13 — — $51,557.95 $51,557.95 $51,557.95 2026-03-17
C0505 HCPCS Non-traumatic Spinal Cord Injury M <39.50- Tier Tier 2 23 13 — — $48,202.44 $48,202.44 $48,202.44 2026-03-17
D0406 HCPCS Traumatic Spinal Cord Injury M >=24.50 And M <31.50 And A >=61.50- Tier Tier 3 23 13 — — $45,353.17 $45,353.17 $45,353.17 2026-03-17
C0106 HCPCS Stroke M <41.50 And A <84.50- Tier Tier 2 23 13 — — $44,930.14 $44,930.14 $44,930.14 2026-03-17
D0106 HCPCS Stroke M <41.50 And A <84.50- Tier Tier 3 24 13 — — $39,234.46 $50,221.23 $44,727.85 2026-03-17
B0604 HCPCS Neurological M <43.50- Tier Tier 1 23 13 — — $44,178.34 $44,178.34 $44,178.34 2026-03-17
C0305 HCPCS Non-traumatic Brain Injury M <42.50 And A <78.50- Tier Tier 2 23 13 — — $39,889.45 $39,889.45 $39,889.45 2026-03-17
B2005 HCPCS Miscellaneous M <46.50 And A <77.50- Tier Tier 1 23 13 — — $39,402.88 $39,402.88 $39,402.88 2026-03-17
D0505 HCPCS Non-traumatic Spinal Cord Injury M <39.50- Tier Tier 3 24 13 — — $39,326.60 $39,326.60 $39,326.60 2026-03-17
C2005 HCPCS Miscellaneous M <46.50 And A <77.50- Tier Tier 2 24 13 — — $31,473.34 $46,533.64 $39,003.49 2026-03-17
A1304 HCPCS Rheumatoid Other Arthritis M <44.50 And A >=64.50- Tier None 24 13 — — $38,957.59 $38,957.59 $38,957.59 2026-03-17
A0106 HCPCS Stroke M <41.50 And A <84.50- Tier None 24 13 — — $38,939.88 $38,939.88 $38,939.88 2026-03-17
B2004 HCPCS Miscellaneous M <46.50 And A >=77.50- Tier Tier 1 23 13 — — $37,382.35 $37,382.35 $37,382.35 2026-03-17
C0205 HCPCS Traumatic Brain Injury M <35.50- Tier Tier 2 23 13 — — $37,299.34 $37,299.34 $37,299.34 2026-03-17
D0105 HCPCS Stroke M <41.50 And A >=84.50- Tier Tier 3 24 13 — — $35,029.96 $38,100.24 $36,565.10 2026-03-17
B0204 HCPCS Traumatic Brain Injury M >=35.50 And M <49.50- Tier Tier 1 23 13 — — $36,539.73 $36,539.73 $36,539.73 2026-03-17
A0505 HCPCS Non-traumatic Spinal Cord Injury M <39.50- Tier None 24 13 — — $36,239.93 $36,239.93 $36,239.93 2026-03-17
C1705 HCPCS Major Multiple Trauma Without Brain Or Spinal Cord Injury M <36.50- Tier Tier 2 23 13 — — $36,154.78 $36,154.78 $36,154.78 2026-03-17
B0603 HCPCS Neurological M >=43.50 And M <52.50- Tier Tier 1 23 13 — — $35,227.01 $35,227.01 $35,227.01 2026-03-17
D0205 HCPCS Traumatic Brain Injury M <35.50- Tier Tier 3 24 13 — — $35,014.14 $35,014.14 $35,014.14 2026-03-17
C1805 HCPCS Major Multiple Trauma With Brain Or Spinal Cord Injury M >=30.50 And M <40.50- T… 23 13 — — $34,918.31 $34,918.31 $34,918.31 2026-03-17
A0105 HCPCS Stroke M <41.50 And A >=84.50- Tier None 24 13 — — $33,238.10 $34,237.15 $33,737.62 2026-03-17
A0405 HCPCS Traumatic Spinal Cord Injury M >=31.50 And M <41.50- Tier None 23 13 — — $33,724.48 $33,724.48 $33,724.48 2026-03-17
D1705 HCPCS Major Multiple Trauma Without Brain Or Spinal Cord Injury M <36.50- Tier Tier 3 23 13 — — $33,483.22 $33,483.22 $33,483.22 2026-03-17
C0604 HCPCS Neurological M <43.50- Tier Tier 2 23 13 — — $33,075.21 $33,075.21 $33,075.21 2026-03-17
A0205 HCPCS Traumatic Brain Injury M <35.50- Tier None 24 13 — — $32,965.23 $32,965.23 $32,965.23 2026-03-17
D1805 HCPCS Major Multiple Trauma With Brain Or Spinal Cord Injury M >=30.50 And M <40.50- T… 23 13 — — $31,902.60 $32,553.67 $32,228.13 2026-03-17
B0903 HCPCS Other Orthopedic M >=44.50 And M <51.50- Tier Tier 1 23 13 — — $32,143.02 $32,143.02 $32,143.02 2026-03-17
C0704 HCPCS Fracture Of Lower Extremity M <41.50- Tier Tier 2 23 13 — — $31,936.34 $31,936.34 $31,936.34 2026-03-17
B2003 HCPCS Miscellaneous M >=46.50 And M <55.50- Tier Tier 1 23 13 — — $31,265.79 $31,265.79 $31,265.79 2026-03-17
D1004 HCPCS Amputation Lower Extremity M <47.50- Tier Tier 3 23 13 — — $30,838.27 $30,838.27 $30,838.27 2026-03-17
D1504 HCPCS Pulmonary M <45.50- Tier Tier 3 23 13 — — $30,797.47 $30,797.47 $30,797.47 2026-03-17
D0305 HCPCS Non-traumatic Brain Injury M <42.50 And A <78.50- Tier Tier 3 24 13 — — $30,464.89 $31,086.62 $30,775.76 2026-03-17
D2005 HCPCS Miscellaneous M <46.50 And A <77.50- Tier Tier 3 24 13 — — $29,401.37 $31,801.87 $30,601.62 2026-03-17
A1705 HCPCS Major Multiple Trauma Without Brain Or Spinal Cord Injury M <36.50- Tier None 23 13 — — $30,377.04 $30,377.04 $30,377.04 2026-03-17
D0604 HCPCS Neurological M <43.50- Tier Tier 3 24 13 — — $29,546.60 $31,050.85 $30,298.72 2026-03-17
D0704 HCPCS Fracture Of Lower Extremity M <41.50- Tier Tier 3 23 13 — — $30,252.87 $30,252.87 $30,252.87 2026-03-17
D1305 HCPCS Rheumatoid Other Arthritis M <51.50 And A <64.50- Tier Tier 3 23 13 — — $30,015.82 $30,015.82 $30,015.82 2026-03-17
C1404 HCPCS Cardiac M <45.50- Tier Tier 2 23 13 — — $29,986.77 $29,986.77 $29,986.77 2026-03-17
C2004 HCPCS Miscellaneous M <46.50 And A >=77.50- Tier Tier 2 23 13 — — $29,859.05 $29,859.05 $29,859.05 2026-03-17
C0904 HCPCS Other Orthopedic M <44.5- Tier Tier 2 23 13 — — $29,317.81 $29,317.81 $29,317.81 2026-03-17
A0305 HCPCS Non-traumatic Brain Injury M <42.50 And A <78.50- Tier None 24 13 — — $29,300.26 $29,300.26 $29,300.26 2026-03-17
A1504 HCPCS Pulmonary M <45.50- Tier None 23 13 — — $28,808.87 $28,808.87 $28,808.87 2026-03-17
D1503 HCPCS Pulmonary M >=45.50 And M <56.50- Tier Tier 3 23 13 — — $28,781.12 $28,781.12 $28,781.12 2026-03-17
C0603 HCPCS Neurological M >=43.50 And M <52.50- Tier Tier 2 23 13 — — $25,256.46 $31,848.98 $28,552.72 2026-03-17
A2005 HCPCS Miscellaneous M <46.50 And A <77.50- Tier None 23 13 — — $26,748.00 $30,269.44 $28,508.72 2026-03-17
D0504 HCPCS Non-traumatic Spinal Cord Injury M >=39.50 And M <48.50- Tier Tier 3 23 13 — — $28,301.53 $28,301.53 $28,301.53 2026-03-17
B0103 HCPCS Stroke M >=50.50 And M <63.50- Tier Tier 1 23 13 — — $27,836.33 $28,404.42 $28,120.38 2026-03-17
D1404 HCPCS Cardiac M <45.50- Tier Tier 3 24 13 — — $27,530.75 $28,642.92 $28,086.83 2026-03-17
B0502 HCPCS Non-traumatic Spinal Cord Injury M >=53.50 And M <60.50- Tier Tier 1 23 13 — — $27,978.38 $27,978.38 $27,978.38 2026-03-17
A0704 HCPCS Fracture Of Lower Extremity M <41.50- Tier None 23 13 — — $27,950.29 $27,950.29 $27,950.29 2026-03-17
D2004 HCPCS Miscellaneous M <46.50 And A >=77.50- Tier Tier 3 23 13 — — $27,893.52 $27,893.52 $27,893.52 2026-03-17
D0304 HCPCS Non-traumatic Brain Injury M <42.50 And A >=78.50- Tier Tier 3 23 13 — — $27,624.23 $27,624.23 $27,624.23 2026-03-17
A0604 HCPCS Neurological M <43.50- Tier None 24 13 — — $27,290.45 $27,847.40 $27,568.92 2026-03-17
D0204 HCPCS Traumatic Brain Injury M >=35.50 And M <49.50- Tier Tier 3 24 13 — — $27,334.73 $27,358.87 $27,346.80 2026-03-17
C1703 HCPCS Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=41.50 And M <50.50… 23 13 — — $27,219.42 $27,219.42 $27,219.42 2026-03-17
D0603 HCPCS Neurological M >=43.50 And M <52.50- Tier Tier 3 23 13 — — $24,620.59 $29,224.59 $26,922.59 2026-03-17
D1804 HCPCS Major Multiple Trauma With Brain Or Spinal Cord Injury M >=40.50 And M <45.50- T… 23 13 — — $26,850.44 $26,850.44 $26,850.44 2026-03-17
D0104 HCPCS Stroke M >=41.50 And M <50.50- Tier Tier 3 24 13 — — $24,931.58 $28,729.05 $26,830.31 2026-03-17
D0805 HCPCS Replacement Of Lower-extremity Joint M <42.50- Tier Tier 3 23 13 — — $26,751.10 $26,751.10 $26,751.10 2026-03-17
A0904 HCPCS Other Orthopedic M <44.5- Tier None 23 13 — — $25,949.27 $25,949.27 $25,949.27 2026-03-17
A0104 HCPCS Stroke M >=41.50 And M <50.50- Tier None 24 13 — — $24,025.24 $27,379.07 $25,702.15 2026-03-17
A1704 HCPCS Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=36.50 And M <41.50… 23 13 — — $25,593.90 $25,593.90 $25,593.90 2026-03-17
A2004 HCPCS Miscellaneous M <46.50 And A >=77.50- Tier None 23 13 — — $25,388.71 $25,388.71 $25,388.71 2026-03-17
A1404 HCPCS Cardiac M <45.50- Tier None 23 13 — — $25,316.72 $25,316.72 $25,316.72 2026-03-17
A0204 HCPCS Traumatic Brain Injury M >=35.50 And M <49.50- Tier None 23 13 — — $24,955.18 $24,955.18 $24,955.18 2026-03-17
A0805 HCPCS Replacement Of Lower-extremity Joint M <42.50- Tier None 23 13 — — $24,950.54 $24,950.54 $24,950.54 2026-03-17
C0303 HCPCS Non-traumatic Brain Injury M >=42.50 And M <52.50- Tier Tier 2 23 13 — — $24,919.02 $24,919.02 $24,919.02 2026-03-17
D0703 HCPCS Fracture Of Lower Extremity M >=41.50 And M <52.50- Tier Tier 3 23 13 — — $24,764.28 $24,764.28 $24,764.28 2026-03-17
D1803 HCPCS Major Multiple Trauma With Brain Or Spinal Cord Injury M >=45.50 And M <55.50- T… 23 13 — — $24,554.95 $24,554.95 $24,554.95 2026-03-17
C0903 HCPCS Other Orthopedic M >=44.50 And M <51.50- Tier Tier 2 23 13 — — $24,345.71 $24,345.71 $24,345.71 2026-03-17
A0403 HCPCS Traumatic Spinal Cord Injury M >=41.50 And M <47.50- Tier None 23 13 — — $24,306.12 $24,306.12 $24,306.12 2026-03-17
D1703 HCPCS Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=41.50 And M <50.50… 23 13 — — $24,159.78 $24,159.78 $24,159.78 2026-03-17
D1003 HCPCS Amputation Lower Extremity M >=47.50 And M <55.50- Tier Tier 3 24 13 — — $24,088.41 $24,088.41 $24,088.41 2026-03-17
C1403 HCPCS Cardiac M >=45.50 And M <55.50- Tier Tier 2 23 13 — — $23,863.66 $23,863.66 $23,863.66 2026-03-17
D0503 HCPCS Non-traumatic Spinal Cord Injury M >=48.50 And M <53.50- Tier Tier 3 23 13 — — $23,808.12 $23,808.12 $23,808.12 2026-03-17
D0903 HCPCS Other Orthopedic M >=44.50 And M <51.50- Tier Tier 3 23 13 — — $23,669.75 $23,669.75 $23,669.75 2026-03-17
A0406 HCPCS Traumatic Spinal Cord Injury M >=24.50 And M <31.50 And A >=61.50- Tier None 24 13 — — $4,303.24 $43,032.37 $23,667.81 2026-03-17
A0804 HCPCS Replacement Of Lower-extremity Joint M >=42.50 And M <51.50- Tier None 23 13 — — $20,803.06 $26,140.15 $23,471.60 2026-03-17
D2003 HCPCS Miscellaneous M >=46.50 And M <55.50- Tier Tier 3 23 13 — — $23,329.16 $23,329.16 $23,329.16 2026-03-17
A0303 HCPCS Non-traumatic Brain Injury M >=42.50 And M <52.50- Tier None 23 13 — — $22,914.05 $22,914.05 $22,914.05 2026-03-17
A1803 HCPCS Major Multiple Trauma With Brain Or Spinal Cord Injury M >=45.50 And M <55.50- T… 23 13 — — $22,766.82 $22,766.82 $22,766.82 2026-03-17
A0703 HCPCS Fracture Of Lower Extremity M >=41.50 And M <52.50- Tier None 24 13 — — $22,422.74 $22,880.35 $22,651.54 2026-03-17
A1703 HCPCS Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=41.50 And M <50.50… 23 13 — — $22,241.87 $22,871.48 $22,556.67 2026-03-17
D0303 HCPCS Non-traumatic Brain Injury M >=42.50 And M <52.50- Tier Tier 3 24 13 — — $20,570.78 $24,311.92 $22,441.35 2026-03-17
D1403 HCPCS Cardiac M >=45.50 And M <55.50- Tier Tier 3 24 13 — — $22,064.54 $22,754.40 $22,409.47 2026-03-17
D0804 HCPCS Replacement Of Lower-extremity Joint M >=42.50 And M <51.50- Tier Tier 3 23 13 — — $22,305.59 $22,305.59 $22,305.59 2026-03-17
A0603 HCPCS Neurological M >=43.50 And M <52.50- Tier None 23 13 — — $22,204.48 $22,204.48 $22,204.48 2026-03-17
A1303 HCPCS Rheumatoid Other Arthritis M >=44.50 And M <51.50 And A >=64.50- Tier None 23 13 — — $22,087.40 $22,087.40 $22,087.40 2026-03-17
D0203 HCPCS Traumatic Brain Injury M >=49.50 And M <61.50- Tier Tier 3 24 13 — — $22,039.50 $22,039.50 $22,039.50 2026-03-17
D0904 HCPCS Other Orthopedic M <44.5- Tier Tier 3 24 13 — — $15,638.66 $28,361.84 $22,000.25 2026-03-17
D1502 HCPCS Pulmonary M >=56.50 And M <68.50- Tier Tier 3 23 13 — — $21,881.62 $21,881.62 $21,881.62 2026-03-17
A0504 HCPCS Non-traumatic Spinal Cord Injury M >=39.50 And M <48.50- Tier None 23 13 — — $17,329.46 $26,080.55 $21,705.01 2026-03-17
A0903 HCPCS Other Orthopedic M >=44.50 And M <51.50- Tier None 23 13 — — $21,656.33 $21,656.33 $21,656.33 2026-03-17
D0103 HCPCS Stroke M >=50.50 And M <63.50- Tier Tier 3 24 13 — — $20,651.72 $22,511.37 $21,581.54 2026-03-17
C0902 HCPCS Other Orthopedic M >=51.50 And M <63.50- Tier Tier 2 23 13 — — $21,266.06 $21,266.06 $21,266.06 2026-03-17
D1702 HCPCS Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=50.50 And M <57.50… 23 13 — — $21,214.61 $21,214.61 $21,214.61 2026-03-17
A0103 HCPCS Stroke M >=50.50 And M <63.50- Tier None 24 13 — — $20,756.09 $21,452.32 $21,104.21 2026-03-17
C0302 HCPCS Non-traumatic Brain Injury M >=52.50 And M <65.50- Tier Tier 2 23 13 — — $21,074.60 $21,074.60 $21,074.60 2026-03-17
D0602 HCPCS Neurological M >=52.50 And M <64.50- Tier Tier 3 23 13 — — $20,895.30 $20,895.30 $20,895.30 2026-03-17
A0503 HCPCS Non-traumatic Spinal Cord Injury M >=48.50 And M <53.50- Tier None 23 13 — — $20,873.17 $20,873.17 $20,873.17 2026-03-17
A0203 HCPCS Traumatic Brain Injury M >=49.50 And M <61.50- Tier None 23 13 — — $20,334.84 $20,749.84 $20,542.34 2026-03-17
D0302 HCPCS Non-traumatic Brain Injury M >=52.50 And M <65.50- Tier Tier 3 23 13 — — $20,205.24 $20,205.24 $20,205.24 2026-03-17
D0702 HCPCS Fracture Of Lower Extremity M >=52.50 And M <61.50- Tier Tier 3 23 13 — — $20,137.83 $20,137.83 $20,137.83 2026-03-17
C1802 HCPCS Major Multiple Trauma With Brain Or Spinal Cord Injury M >=55.50 And M <67.50- T… 23 13 — — $20,033.01 $20,033.01 $20,033.01 2026-03-17
C1402 HCPCS Cardiac M >=55.50 And M <68.50- Tier Tier 2 23 13 — — $20,001.24 $20,001.24 $20,001.24 2026-03-17
C1004 HCPCS Amputation Lower Extremity M <47.50- Tier Tier 2 24 13 — — $6,218.94 $33,759.96 $19,989.45 2026-03-17
D0803 HCPCS Replacement Of Lower-extremity Joint M >=51.50 And M <57.50- Tier Tier 3 23 13 — — $19,908.99 $19,908.99 $19,908.99 2026-03-17
D0902 HCPCS Other Orthopedic M >=51.50 And M <63.50- Tier Tier 3 23 13 — — $19,820.29 $19,820.29 $19,820.29 2026-03-17
D2002 HCPCS Miscellaneous M >=55.50 And M <66.50- Tier Tier 3 23 13 — — $19,481.47 $19,481.47 $19,481.47 2026-03-17
C0802 HCPCS Replacement Of Lower-extremity Joint M >=57.50 And M <63.50- Tier Tier 2 23 13 — — $19,471.75 $19,471.75 $19,471.75 2026-03-17
D0102 HCPCS Stroke M >=63.50 And M <72.50- Tier Tier 3 24 13 — — $18,064.42 $20,465.89 $19,265.15 2026-03-17
A0302 HCPCS Non-traumatic Brain Injury M >=52.50 And M <65.50- Tier None 23 13 — — $19,037.09 $19,043.30 $19,040.19 2026-03-17
A1702 HCPCS Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=50.50 And M <57.50… 23 13 — — $18,955.26 $18,955.26 $18,955.26 2026-03-17
A0702 HCPCS Fracture Of Lower Extremity M >=52.50 And M <61.50- Tier None 23 13 — — $18,605.14 $18,605.14 $18,605.14 2026-03-17
A0803 HCPCS Replacement Of Lower-extremity Joint M >=51.50 And M <57.50- Tier None 23 13 — — $18,569.66 $18,569.66 $18,569.66 2026-03-17
A0602 HCPCS Neurological M >=52.50 And M <64.50- Tier None 23 13 — — $17,609.38 $18,844.62 $18,227.00 2026-03-17
A0902 HCPCS Other Orthopedic M >=51.50 And M <63.50- Tier None 23 13 — — $18,135.04 $18,135.04 $18,135.04 2026-03-17
D0802 HCPCS Replacement Of Lower-extremity Joint M >=57.50 And M <63.50- Tier Tier 3 23 13 — — $17,886.69 $17,886.69 $17,886.69 2026-03-17
A2002 HCPCS Miscellaneous M >=55.50 And M <66.50- Tier None 23 13 — — $17,732.36 $17,732.36 $17,732.36 2026-03-17
A1802 HCPCS Major Multiple Trauma With Brain Or Spinal Cord Injury M >=55.50 And M <67.50- T… 23 13 — — $17,719.94 $17,719.94 $17,719.94 2026-03-17
C0601 HCPCS Neurological M >=64.50- Tier Tier 2 23 13 — — $17,647.21 $17,647.21 $17,647.21 2026-03-17
A0802 HCPCS Replacement Of Lower-extremity Joint M >=57.50 And M <63.50- Tier None 23 13 — — $16,682.18 $16,682.18 $16,682.18 2026-03-17
D0501 HCPCS Non-traumatic Spinal Cord Injury M >=60.50- Tier Tier 3 23 13 — — $16,556.23 $16,556.23 $16,556.23 2026-03-17
D0801 HCPCS Replacement Of Lower-extremity Joint M >=63.50- Tier Tier 3 23 13 — — $15,269.23 $15,269.23 $15,269.23 2026-03-17
A0501 HCPCS Non-traumatic Spinal Cord Injury M >=60.50- Tier None 23 13 — — $15,255.93 $15,255.93 $15,255.93 2026-03-17
A0301 HCPCS Non-traumatic Brain Injury M >=65.50- Tier None 23 13 — — $14,729.07 $14,729.07 $14,729.07 2026-03-17
A0701 HCPCS Fracture Of Lower Extremity M >=61.50- Tier None 23 13 — — $14,656.32 $14,656.32 $14,656.32 2026-03-17
A2001 HCPCS Miscellaneous M >=66.50- Tier None 23 13 — — $14,221.72 $14,221.72 $14,221.72 2026-03-17
D2001 HCPCS Miscellaneous M >=66.50- Tier Tier 3 24 13 — — $13,797.94 $13,797.94 $13,797.94 2026-03-17
A2003 HCPCS Miscellaneous M >=46.50 And M <55.50- Tier None 24 13 — — $4,243.13 $21,234.13 $12,738.63 2026-03-17
B1403 HCPCS Cardiac M >=45.50 And M <55.50- Tier Tier 1 24 13 — — $9,667.47 $9,667.47 $9,667.47 2026-03-17
B0904 HCPCS Other Orthopedic M <44.5- Tier Tier 1 23 13 — — $7,821.64 $7,821.64 $7,821.64 2026-03-17
0158 RC Room & Board - Ward - Rehabilitation 17 8 — — $1,308.50 $1,308.50 $1,308.50 2026-03-17
0148 RC Room & Board - Deluxe Private - Rehabilitation 17 8 — — $1,308.50 $1,308.50 $1,308.50 2026-03-17
0138 RC Room & Board - Three And Four Beds - Rehabilitation 17 8 — — $1,250.00 $1,250.00 $1,250.00 2026-03-17
0128 RC Room & Board - Semi-private (Two Beds) - Rehabilitation 17 8 — — $1,200.00 $1,200.00 $1,200.00 2026-03-17
0118 RC Room & Board - Private (One Bed) - Rehabilitation 17 8 — — $1,171.50 $1,171.50 $1,171.50 2026-03-17
0839 RC Peritoneal Dialysis - Outpatient Or Home - Other 3 1 — — $600.00 $600.00 $600.00 2026-03-17
0835 RC Peritoneal Dialysis - Outpatient Or Home - Support Services 3 1 — — $600.00 $600.00 $600.00 2026-03-17
0832 RC Peritoneal Dialysis - Outpatient Or Home - Home Supplies 3 1 — — $600.00 $600.00 $600.00 2026-03-17
0829 RC Hemodialysis - Outpatient Or Home - Other Op Hemodialysis 4 2 — — $600.00 $600.00 $600.00 2026-03-17
0833 RC Peritoneal Dialysis - Outpatient Or Home - Home Equipment 3 1 — — $600.00 $600.00 $600.00 2026-03-17
0822 RC Hemodialysis - Outpatient Or Home - Home Supplies 3 1 — — $600.00 $600.00 $600.00 2026-03-17
0823 RC Hemodialysis - Outpatient Or Home - Home Equipment 3 1 — — $600.00 $600.00 $600.00 2026-03-17
0830 RC Peritoneal Dialysis - Outpatient Or Home - General Classification 3 1 — — $600.00 $600.00 $600.00 2026-03-17
0821 RC Hemodialysis - Outpatient Or Home - Hemodialysis Composite Or Other Rate 4 2 — — $600.00 $600.00 $600.00 2026-03-17
0820 RC Hemodialysis - Outpatient Or Home - General Classification 4 2 — — $600.00 $600.00 $600.00 2026-03-17
0825 RC Hemodialysis - Outpatient Or Home - Support Services 3 1 — — $600.00 $600.00 $600.00 2026-03-17
0831 RC Peritoneal Dialysis - Outpatient Or Home - Peritoneal/Composite Or Other Rate 4 2 — — $600.00 $600.00 $600.00 2026-03-17
0824 RC Hemodialysis - Outpatient Or Home - Maintenance 100% 3 1 — — $600.00 $600.00 $600.00 2026-03-17
0834 RC Peritoneal Dialysis - Outpatient Or Home - Maintenance 100% 3 1 — — $600.00 $600.00 $600.00 2026-03-17
0808 RC Inpatient Renal Dialysis - Other 8 3 — — $450.00 $600.00 $525.00 2026-03-17
0807 RC Inpatient Renal Dialysis - Observation/Hourly 8 3 — — $450.00 $600.00 $525.00 2026-03-17
0805 RC Inpatient Renal Dialysis - Treatment 8 3 — — $450.00 $600.00 $525.00 2026-03-17
0806 RC Inpatient Renal Dialysis - Continuation 8 3 — — $450.00 $600.00 $525.00 2026-03-17
0809 RC Inpatient Renal Dialysis - Other 9 4 — — $450.00 $600.00 $500.00 2026-03-17
0803 RC Inpatient Renal Dialysis - Continuous Ambulatory Peritoneal Dialysis (capd) 9 4 — — $450.00 $600.00 $500.00 2026-03-17
0802 RC Inpatient Renal Dialysis - Peritoneal Dialysis (non-capd) 9 4 — — $450.00 $600.00 $500.00 2026-03-17
0804 RC Inpatient Renal Dialysis - Continuous Cycling Peritoneal Dialysis (ccpd) 9 4 — — $450.00 $600.00 $500.00 2026-03-17
0800 RC Inpatient Renal Dialysis - General Classification 9 4 — — $450.00 $600.00 $500.00 2026-03-17
0801 RC Inpatient Renal Dialysis - Hemodialysis 9 4 — — $450.00 $600.00 $500.00 2026-03-17
97162 HCPCS Pt Eval Mod Complex 30 Min 40 17 — — $40.00 $179.40 $109.70 2026-03-17
97113 HCPCS Aquatic Therapy/exercises 35 15 — — $40.00 $179.40 $109.70 2026-03-17
97166 HCPCS Ot Eval Mod Complex 45 Min 40 17 — — $40.00 $179.40 $109.70 2026-03-17
97161 HCPCS Pt Eval Low Complex 20 Min 40 17 — — $40.00 $179.40 $109.70 2026-03-17
96125 HCPCS Cognitive Test By Hc Pro 28 13 — — $102.07 $111.74 $106.91 2026-03-17
0443 RC Speech Therapy - Language Pathology - Group Rate 14 5 — — $106.00 $106.00 $106.00 2026-03-17
0449 RC Speech Therapy - Language Pathology - Other 11 4 — — $106.00 $106.00 $106.00 2026-03-17
0442 RC Speech Therapy - Language Pathology - Hourly Charge 14 5 — — $106.00 $106.00 $106.00 2026-03-17
0433 RC Occupational Therapy - Group Rate 14 5 — — $106.00 $106.00 $106.00 2026-03-17
0429 RC Physical Therapy - Other 11 4 — — $106.00 $106.00 $106.00 2026-03-17
0439 RC Occupational Therapy - Other 11 4 — — $106.00 $106.00 $106.00 2026-03-17
0423 RC Physical Therapy - Group Rate 14 5 — — $106.00 $106.00 $106.00 2026-03-17
0432 RC Occupational Therapy - Hourly Charge 14 5 — — $106.00 $106.00 $106.00 2026-03-17
0422 RC Physical Therapy - Hourly Charge 14 5 — — $106.00 $106.00 $106.00 2026-03-17
0441 RC Speech Therapy - Language Pathology - Visit Charge 16 5 — — $100.00 $130.00 $100.00 2026-03-17
0431 RC Occupational Therapy - Visit Charge 16 5 — — $100.00 $130.00 $100.00 2026-03-17
0421 RC Physical Therapy - Visit Charge 39 15 — — $100.00 $130.00 $100.00 2026-03-17
92523 HCPCS Speech Sound Lang Comprehen 40 17 — — $40.00 $150.00 $95.00 2026-03-17
96105 HCPCS Assessment Of Aphasia 35 15 — — $40.00 $150.00 $95.00 2026-03-17
92522 HCPCS Evaluate Speech Production 35 15 — — $40.00 $150.00 $95.00 2026-03-17
92521 HCPCS Evaluation Of Speech Fluency 10 4 — — $40.00 $150.00 $95.00 2026-03-17
92524 HCPCS Behavral Qualit Analys Voice 35 15 — — $40.00 $150.00 $95.00 2026-03-17
97165 HCPCS Ot Eval Low Complex 30 Min 40 17 — — $40.00 $150.00 $95.00 2026-03-17
0444 RC Speech Therapy - Language Pathology - Evaluation Or Reevaluation 44 15 — — $40.00 $150.00 $95.00 2026-03-17
0434 RC Occupational Therapy - Evaluation Or Reevaluation 46 17 — — $40.00 $150.00 $95.00 2026-03-17
0424 RC Physical Therapy - Evaluation Or Re-evaluation 46 17 — — $40.00 $150.00 $95.00 2026-03-17
97164 HCPCS Pt Re-eval Est Plan Care 40 17 — — $40.00 $150.00 $95.00 2026-03-17
97163 HCPCS Pt Eval High Complex 45 Min 40 17 — — $40.00 $150.00 $95.00 2026-03-17
97167 HCPCS Ot Eval High Complex 60 Min 35 15 — — $40.00 $150.00 $95.00 2026-03-17
97168 HCPCS Ot Re-eval Est Plan Care 35 15 — — $40.00 $150.00 $95.00 2026-03-17
97535 HCPCS Self Care Mngment Training 40 17 — — $32.99 $120.00 $76.50 2026-03-17
97530 HCPCS Therapeutic Activities 40 17 — — $40.00 $107.64 $73.82 2026-03-17
0440 RC Speech Therapy - Language Pathology - General Classification 44 17 — — $40.00 $106.00 $73.00 2026-03-17
0430 RC Occupational Therapy - General Classification 44 17 — — $40.00 $106.00 $73.00 2026-03-17
0420 RC Physical Therapy - General Classification 44 17 — — $40.00 $106.00 $73.00 2026-03-17
92605 HCPCS Ex For Nonspeech Device Rx 10 4 — — $40.00 $90.00 $65.00 2026-03-17
92606 HCPCS Non-speech Device Service 10 4 — — $40.00 $90.00 $65.00 2026-03-17
97537 HCPCS Community/work Reintegration 35 15 — — $40.00 $90.00 $65.00 2026-03-17
97032 HCPCS Appl Modality 1+estim Ea 15 34 14 — — $40.00 $90.00 $65.00 2026-03-17
92607 HCPCS Ex For Speech Device Rx 1hr 35 15 — — $40.00 $90.00 $65.00 2026-03-17
92526 HCPCS Oral Function Therapy 40 17 — — $40.00 $90.00 $65.00 2026-03-17
92507 HCPCS Speech/hearing Therapy 40 17 — — $40.00 $90.00 $65.00 2026-03-17
92597 HCPCS Oral Speech Device Eval 10 4 — — $40.00 $90.00 $65.00 2026-03-17
92610 HCPCS Evaluate Swallowing Function 36 16 — — $63.32 $63.32 $63.32 2026-03-17
97533 HCPCS Sensory Integration 31 14 — — $62.92 $62.92 $62.92 2026-03-17
97112 HCPCS Neuromuscular Reeducation 40 17 — — $29.63 $90.00 $59.81 2026-03-17
97110 HCPCS Therapeutic Exercises 40 17 — — $29.59 $90.00 $59.80 2026-03-17
97140 HCPCS Manual Therapy 1/> Regions 35 15 — — $27.91 $90.00 $58.95 2026-03-17
97130 HCPCS Ther Ivntj Ea Addl 15 Min 28 13 — — $54.66 $63.09 $58.88 2026-03-17
97124 HCPCS Massage Therapy 35 15 — — $26.07 $90.00 $58.03 2026-03-17
97116 HCPCS Gait Training Therapy 40 17 — — $25.35 $90.00 $57.67 2026-03-17
97129 HCPCS Ther Ivntj 1st 15 Min 35 15 — — $18.79 $90.00 $54.40 2026-03-17
0270 RC Medical/Surgical Supplies And Devices - General Classification 11 4 — — $21.50 $21.50 $21.50 2026-03-17
0250 RC Pharmacy - General Classification 11 4 — — $2.64 $2.64 $2.64 2026-03-17
0257 RC Pharmacy - Nonprescription 11 4 — — $1.64 $1.64 $1.64 2026-03-17
36600 HCPCS Withdrawal Of Arterial Blood 0 0 — — — — — 2026-03-17
36597 HCPCS Reposition Venous Catheter 0 0 — — — — — 2026-03-17
25608 HCPCS Treat Fx Rad Intra-articul 0 0 — — — — — 2026-03-17
36590 HCPCS Removal Tunneled Cv Cath 0 0 — — — — — 2026-03-17
36589 HCPCS Removal Tunneled Cv Cath 0 0 — — — — — 2026-03-17
25607 HCPCS Treat Fx Rad Extra-articul 0 0 — — — — — 2026-03-17
19083 HCPCS Bx Breast 1st Lesion US Imag 0 0 — — — — — 2026-03-17
36573 HCPCS Insj Picc Rs&i 5 Yr+ 0 0 — — — — — 2026-03-17
36569 HCPCS Insj Picc 5 Yr+ Without Imaging 0 0 — — — — — 2026-03-17
24685 HCPCS Treat Ulnar Fracture 0 0 — — — — — 2026-03-17
36561 HCPCS Insert Tunneled Cv Cath 0 0 — — — — — 2026-03-17
36558 HCPCS Insert Tunneled Cv Cath 0 0 — — — — — 2026-03-17
24615 HCPCS Treat Elbow Dislocation 0 0 — — — — — 2026-03-17
19081 HCPCS Bx Breast 1st Lesion Strtctc 0 0 — — — — — 2026-03-17
11406 HCPCS Exc Tr-ext B9+marg >4.0 Cm 0 0 — — — — — 2026-03-17
60220 HCPCS Partial Removal Of Thyroid 0 0 — — — — — 2026-03-17
59897 HCPCS Unlisted Fetal Invas Px W/us 0 0 — — — — — 2026-03-17
36556 HCPCS Insert Non-tunnel Cv Cath 0 0 — — — — — 2026-03-17
61782 HCPCS Scan Proc Cranial Extra 0 0 — — — — — 2026-03-17
62270 HCPCS Dx Lmbr Spi Pnxr 0 0 — — — — — 2026-03-17
62328 HCPCS Dx Lmbr Spi Pnxr W/fluor/ct 0 0 — — — — — 2026-03-17
64450 HCPCS Njx Aa&/strd Other Pn/branch 0 0 — — — — — 2026-03-17
64718 HCPCS Revise Ulnar Nerve At Elbow 0 0 — — — — — 2026-03-17
64721 HCPCS Carpal Tunnel Surgery 0 0 — — — — — 2026-03-17
65426 HCPCS Removal Of Eye Lesion 0 0 — — — — — 2026-03-17
65730 HCPCS Corneal Transplant 0 0 — — — — — 2026-03-17
65755 HCPCS Corneal Transplant 0 0 — — — — — 2026-03-17
65756 HCPCS Corneal Trnspl Endothelial 0 0 — — — — — 2026-03-17
65820 HCPCS Relieve Inner Eye Pressure 0 0 — — — — — 2026-03-17
66170 HCPCS Glaucoma Surgery 0 0 — — — — — 2026-03-17
66180 HCPCS Aqueous Shunt Eye W/graft 0 0 — — — — — 2026-03-17
66250 HCPCS Follow-up Surgery Of Eye 0 0 — — — — — 2026-03-17
66500 HCPCS Incision Of Iris 0 0 — — — — — 2026-03-17
66625 HCPCS Removal Of Iris 0 0 — — — — — 2026-03-17
59820 HCPCS Care Of Miscarriage 0 0 — — — — — 2026-03-17
59025 HCPCS Fetal Non-stress Test 0 0 — — — — — 2026-03-17
36514 HCPCS Apheresis Plasma 0 0 — — — — — 2026-03-17
24516 HCPCS Treat Humerus Fracture 0 0 — — — — — 2026-03-17
59012 HCPCS Fetal Cord Puncture Prenatal 0 0 — — — — — 2026-03-17
58662 HCPCS Laparoscopy Excise Lesions 0 0 — — — — — 2026-03-17
36460 HCPCS Intrauterine Transfusion Ftl 0 0 — — — — — 2026-03-17
58661 HCPCS Laparoscopy Remove Adnexa 0 0 — — — — — 2026-03-17
58571 HCPCS Tlh W/t/o 250 G Or Less 0 0 — — — — — 2026-03-17
36430 HCPCS Transfusion Bld/bld Compnt 0 0 — — — — — 2026-03-17
24430 HCPCS Repair Of Humerus 0 0 — — — — — 2026-03-17
16020 HCPCS Dress/debrid P-thick Burn S 0 0 — — — — — 2026-03-17
58570 HCPCS Tlh Uterus 250 G Or Less 0 0 — — — — — 2026-03-17
58563 HCPCS Hysteroscopy Ablation 0 0 — — — — — 2026-03-17
36415 HCPCS Routine Venipuncture 0 0 — — — — — 2026-03-17
58561 HCPCS Hysteroscopy Remove Myoma 0 0 — — — — — 2026-03-17
58558 HCPCS Hysteroscopy Biopsy 0 0 — — — — — 2026-03-17
36248 HCPCS Ins Cath Abd/l-ext Art Addl 0 0 — — — — — 2026-03-17
24344 HCPCS Reconstruct Elbow Lat Ligmnt 0 0 — — — — — 2026-03-17
58554 HCPCS Laparo-vag Hyst W/t/o Compl 0 0 — — — — — 2026-03-17
58552 HCPCS Laparo-vag Hyst Incl T/o 0 0 — — — — — 2026-03-17
36247 HCPCS Ins Cath Abd/l-ext Art 3rd 0 0 — — — — — 2026-03-17
58550 HCPCS Laparo-asst Vag Hysterectomy 0 0 — — — — — 2026-03-17
58301 HCPCS Remove Intrauterine Device 0 0 — — — — — 2026-03-17
36225 HCPCS Place Cath Subclavian Art 0 0 — — — — — 2026-03-17
23650 HCPCS Cltx Sho Dslc W/mnpj Wo Anes 0 0 — — — — — 2026-03-17
15853 HCPCS Removal Sutr/stapl Xreq Anes 0 0 — — — — — 2026-03-17
11045 HCPCS Dbrdmt Subq Tiss Each Addl 0 0 — — — — — 2026-03-17
00410 HCPCS Anesth Correct Heart Rhythm 0 0 — — — — — 2026-03-17
58120 HCPCS Dilation And Curettage 0 0 — — — — — 2026-03-17
57522 HCPCS Conization Of Cervix 0 0 — — — — — 2026-03-17
36200 HCPCS Place Catheter In Aorta 0 0 — — — — — 2026-03-17
57461 HCPCS Conz Of Cervix W/scope Leep 0 0 — — — — — 2026-03-17
57288 HCPCS Repair Bladder Defect 0 0 — — — — — 2026-03-17
36012 HCPCS Place Catheter In Vein 0 0 — — — — — 2026-03-17
23515 HCPCS Optx Clavicular Fx W/int Fix 0 0 — — — — — 2026-03-17
57260 HCPCS Cmbn Ant Pst Colprhy 0 0 — — — — — 2026-03-17
55880 HCPCS Abltj Mal Prst8 Tiss Hifu 0 0 — — — — — 2026-03-17
33228 HCPCS Remv&replc Pm Gen Dual Lead 0 0 — — — — — 2026-03-17
55700 HCPCS Biopsy Of Prostate 0 0 — — — — — 2026-03-17
55040 HCPCS Removal Of Hydrocele 0 0 — — — — — 2026-03-17
33227 HCPCS Remove&replace Pm Gen Singl 0 0 — — — — — 2026-03-17
23412 HCPCS Repair Rotator Cuff Chronic 0 0 — — — — — 2026-03-17
15772 HCPCS Grfg Autol Fat Lipo Ea Addl 0 0 — — — — — 2026-03-17
54161 HCPCS Circum 28 Days Or Older 0 0 — — — — — 2026-03-17
53445 HCPCS Insert Uro/ves Nck Sphincter 0 0 — — — — — 2026-03-17
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