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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

Northern Colorado Rehabilitation Hospital, Inc

Johnstown, CO · CCN 063033 · Rates published

2,225 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 not_modified · 2026-05-17
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
LOCAL 		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
$64,290
1.1× median
D0407
LOCAL 		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
$67,662
1.0× median
D1806
LOCAL 		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
$48,581
1.1× median
B0106
LOCAL 		Stroke M <41.50 And A <84.50- Tier Tier 1 13 $51,557.95 $51,557.95 $51,557.95 nat. median
$53,762
1.0× median
C0505
LOCAL 		Non-traumatic Spinal Cord Injury M <39.50- Tier Tier 2 13 $48,202.44 $48,202.44 $48,202.44 nat. median
$43,704
1.1× median
D0406
LOCAL 		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
$49,763
0.9× median
C0106
LOCAL 		Stroke M <41.50 And A <84.50- Tier Tier 2 13 $44,930.14 $44,930.14 $44,930.14 nat. median
$46,986
1.0× median
D0106
LOCAL 		Stroke M <41.50 And A <84.50- Tier Tier 3 13 $39,234.46 $50,221.23 $44,727.85 nat. median
$42,703
1.0× median
B0604
LOCAL 		Neurological M <43.50- Tier Tier 1 13 $44,178.34 $44,178.34 $44,178.34 nat. median
$46,423
1.0× median
C0305
LOCAL 		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
$35,561
1.1× median
B2005
LOCAL 		Miscellaneous M <46.50 And A <77.50- Tier Tier 1 13 $39,402.88 $39,402.88 $39,402.88 nat. median
$40,995
1.0× median
D0505
LOCAL 		Non-traumatic Spinal Cord Injury M <39.50- Tier Tier 3 13 $39,326.60 $39,326.60 $39,326.60 nat. median
$41,099
1.0× median
C2005
LOCAL 		Miscellaneous M <46.50 And A <77.50- Tier Tier 2 13 $31,473.34 $46,533.64 $39,003.49 nat. median
$32,921
1.2× median
A1304
LOCAL 		Rheumatoid Other Arthritis M <44.50 And A >=64.50- Tier None 13 $38,957.59 $38,957.59 $38,957.59 nat. median
$29,767
1.3× median
A0106
LOCAL 		Stroke M <41.50 And A <84.50- Tier None 13 $38,939.88 $38,939.88 $38,939.88 nat. median
$39,573
1.0× median
B2004
LOCAL 		Miscellaneous M <46.50 And A >=77.50- Tier Tier 1 13 $37,382.35 $37,382.35 $37,382.35 nat. median
$39,191
1.0× median
C0205
LOCAL 		Traumatic Brain Injury M <35.50- Tier Tier 2 13 $37,299.34 $37,299.34 $37,299.34 nat. median
$40,508
0.9× median
D0105
LOCAL 		Stroke M <41.50 And A >=84.50- Tier Tier 3 13 $35,029.96 $38,100.24 $36,565.10 nat. median
$37,662
1.0× median
B0204
LOCAL 		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
$38,420
1.0× median
A0505
LOCAL 		Non-traumatic Spinal Cord Injury M <39.50- Tier None 13 $36,239.93 $36,239.93 $36,239.93 nat. median
$37,907
1.0× median
C1705
LOCAL 		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
$37,992
1.0× median
B0603
LOCAL 		Neurological M >=43.50 And M <52.50- Tier Tier 1 13 $35,227.01 $35,227.01 $35,227.01 nat. median
$36,931
1.0× median
D0205
LOCAL 		Traumatic Brain Injury M <35.50- Tier Tier 3 13 $35,014.14 $35,014.14 $35,014.14 nat. median
$36,592
1.0× median
C1805
LOCAL 		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
$36,594
1.0× median
A0105
LOCAL 		Stroke M <41.50 And A >=84.50- Tier None 13 $33,238.10 $34,237.15 $33,737.62 nat. median
$35,375
1.0× median
A0405
LOCAL 		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
$35,438
1.0× median
D1705
LOCAL 		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
$34,992
1.0× median
C0604
LOCAL 		Neurological M <43.50- Tier Tier 2 13 $33,075.21 $33,075.21 $33,075.21 nat. median
$34,756
1.0× median
A0205
LOCAL 		Traumatic Brain Injury M <35.50- Tier None 13 $32,965.23 $32,965.23 $32,965.23 nat. median
$33,234
1.0× median
D1805
LOCAL 		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
$34,208
0.9× median
B0903
LOCAL 		Other Orthopedic M >=44.50 And M <51.50- Tier Tier 1 13 $32,143.02 $32,143.02 $32,143.02 nat. median
$33,505
1.0× median
C0704
LOCAL 		Fracture Of Lower Extremity M <41.50- Tier Tier 2 13 $31,936.34 $31,936.34 $31,936.34 nat. median
$33,146
1.0× median
B2003
LOCAL 		Miscellaneous M >=46.50 And M <55.50- Tier Tier 1 13 $31,265.79 $31,265.79 $31,265.79 nat. median
$32,854
1.0× median
D1004
LOCAL 		Amputation Lower Extremity M <47.50- Tier Tier 3 13 $30,838.27 $30,838.27 $30,838.27 nat. median
$32,228
1.0× median
D1504
LOCAL 		Pulmonary M <45.50- Tier Tier 3 13 $30,797.47 $30,797.47 $30,797.47 nat. median
$32,186
1.0× median
D0305
LOCAL 		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
$32,319
1.0× median
D2005
LOCAL 		Miscellaneous M <46.50 And A <77.50- Tier Tier 3 13 $29,401.37 $31,801.87 $30,601.62 nat. median
$30,727
1.0× median
A1705
LOCAL 		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
$31,920
1.0× median
D0604
LOCAL 		Neurological M <43.50- Tier Tier 3 13 $29,546.60 $31,050.85 $30,298.72 nat. median
$32,269
0.9× median
D0704
LOCAL 		Fracture Of Lower Extremity M <41.50- Tier Tier 3 13 $30,252.87 $30,252.87 $30,252.87 nat. median
$31,616
1.0× median
D1305
LOCAL 		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
$30,172
1.0× median
C1404
LOCAL 		Cardiac M <45.50- Tier Tier 2 13 $29,986.77 $29,986.77 $29,986.77 nat. median
$30,962
1.0× median
C2004
LOCAL 		Miscellaneous M <46.50 And A >=77.50- Tier Tier 2 13 $29,859.05 $29,859.05 $29,859.05 nat. median
$31,232
1.0× median
C0904
LOCAL 		Other Orthopedic M <44.5- Tier Tier 2 13 $29,317.81 $29,317.81 $29,317.81 nat. median
$31,818
0.9× median
A0305
LOCAL 		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
$30,648
1.0× median
A1504
LOCAL 		Pulmonary M <45.50- Tier None 13 $28,808.87 $28,808.87 $28,808.87 nat. median
$30,273
1.0× median
D1503
LOCAL 		Pulmonary M >=45.50 And M <56.50- Tier Tier 3 13 $28,781.12 $28,781.12 $28,781.12 nat. median
$26,132
1.1× median
C0603
LOCAL 		Neurological M >=43.50 And M <52.50- Tier Tier 2 13 $25,256.46 $31,848.98 $28,552.72 nat. median
$27,713
1.0× median
A2005
LOCAL 		Miscellaneous M <46.50 And A <77.50- Tier None 13 $26,748.00 $30,269.44 $28,508.72 nat. median
$27,843
1.0× median
D0504
LOCAL 		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
$29,577
1.0× median

Other procedures at this hospital

Browse this hospital's 2,225 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 LOCAL 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 LOCAL 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 LOCAL 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 LOCAL 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 LOCAL 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 LOCAL 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 LOCAL 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 LOCAL 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 LOCAL Neurological M <43.50- Tier Tier 1 23 13 — — $44,178.34 $44,178.34 $44,178.34 2026-03-17
C0305 LOCAL 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 LOCAL 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 LOCAL 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 LOCAL 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 LOCAL 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 LOCAL 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 LOCAL 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 LOCAL Traumatic Brain Injury M <35.50- Tier Tier 2 23 13 — — $37,299.34 $37,299.34 $37,299.34 2026-03-17
D0105 LOCAL 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 LOCAL 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 LOCAL 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 LOCAL 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 LOCAL 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 LOCAL Traumatic Brain Injury M <35.50- Tier Tier 3 24 13 — — $35,014.14 $35,014.14 $35,014.14 2026-03-17
C1805 LOCAL 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 LOCAL 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 LOCAL 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 LOCAL 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 LOCAL Neurological M <43.50- Tier Tier 2 23 13 — — $33,075.21 $33,075.21 $33,075.21 2026-03-17
A0205 LOCAL Traumatic Brain Injury M <35.50- Tier None 24 13 — — $32,965.23 $32,965.23 $32,965.23 2026-03-17
D1805 LOCAL 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 LOCAL 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 LOCAL 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 LOCAL 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 LOCAL Amputation Lower Extremity M <47.50- Tier Tier 3 23 13 — — $30,838.27 $30,838.27 $30,838.27 2026-03-17
D1504 LOCAL Pulmonary M <45.50- Tier Tier 3 23 13 — — $30,797.47 $30,797.47 $30,797.47 2026-03-17
D0305 LOCAL 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 LOCAL 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 LOCAL 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 LOCAL Neurological M <43.50- Tier Tier 3 24 13 — — $29,546.60 $31,050.85 $30,298.72 2026-03-17
D0704 LOCAL 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 LOCAL 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 LOCAL Cardiac M <45.50- Tier Tier 2 23 13 — — $29,986.77 $29,986.77 $29,986.77 2026-03-17
C2004 LOCAL 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 LOCAL Other Orthopedic M <44.5- Tier Tier 2 23 13 — — $29,317.81 $29,317.81 $29,317.81 2026-03-17
A0305 LOCAL 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 LOCAL Pulmonary M <45.50- Tier None 23 13 — — $28,808.87 $28,808.87 $28,808.87 2026-03-17
D1503 LOCAL 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 LOCAL 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 LOCAL 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 LOCAL 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 LOCAL 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 LOCAL Cardiac M <45.50- Tier Tier 3 24 13 — — $27,530.75 $28,642.92 $28,086.83 2026-03-17
B0502 LOCAL 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 LOCAL Fracture Of Lower Extremity M <41.50- Tier None 23 13 — — $27,950.29 $27,950.29 $27,950.29 2026-03-17
D2004 LOCAL 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 LOCAL 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 LOCAL Neurological M <43.50- Tier None 24 13 — — $27,290.45 $27,847.40 $27,568.92 2026-03-17
D0204 LOCAL 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 LOCAL 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 LOCAL 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 LOCAL 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 LOCAL 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 LOCAL 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 LOCAL Other Orthopedic M <44.5- Tier None 23 13 — — $25,949.27 $25,949.27 $25,949.27 2026-03-17
A0104 LOCAL 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 LOCAL 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 LOCAL 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 LOCAL Cardiac M <45.50- Tier None 23 13 — — $25,316.72 $25,316.72 $25,316.72 2026-03-17
A0204 LOCAL 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 LOCAL 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 LOCAL 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 LOCAL 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 LOCAL 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 LOCAL 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 LOCAL 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 LOCAL 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 LOCAL 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 LOCAL 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 LOCAL 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 LOCAL 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 LOCAL 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 LOCAL 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 LOCAL 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 LOCAL 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 LOCAL 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 LOCAL 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 LOCAL 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 LOCAL 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 LOCAL 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 LOCAL 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 LOCAL 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 LOCAL 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 LOCAL 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 LOCAL Other Orthopedic M <44.5- Tier Tier 3 24 13 — — $15,638.66 $28,361.84 $22,000.25 2026-03-17
D1502 LOCAL 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 LOCAL 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 LOCAL 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 LOCAL 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 LOCAL 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 LOCAL 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 LOCAL 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 LOCAL 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 LOCAL 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 LOCAL 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 LOCAL 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 LOCAL 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 LOCAL 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 LOCAL 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 LOCAL 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 LOCAL Amputation Lower Extremity M <47.50- Tier Tier 2 24 13 — — $6,218.94 $33,759.96 $19,989.45 2026-03-17
D0803 LOCAL 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 LOCAL 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 LOCAL 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 LOCAL 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 LOCAL 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 LOCAL 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 LOCAL 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 LOCAL 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 LOCAL 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 LOCAL 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 LOCAL 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 LOCAL 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 LOCAL 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 LOCAL 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 LOCAL Neurological M >=64.50- Tier Tier 2 23 13 — — $17,647.21 $17,647.21 $17,647.21 2026-03-17
A0802 LOCAL 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 LOCAL 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 LOCAL 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 LOCAL 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 LOCAL Non-traumatic Brain Injury M >=65.50- Tier None 23 13 — — $14,729.07 $14,729.07 $14,729.07 2026-03-17
A0701 LOCAL Fracture Of Lower Extremity M >=61.50- Tier None 23 13 — — $14,656.32 $14,656.32 $14,656.32 2026-03-17
A2001 LOCAL Miscellaneous M >=66.50- Tier None 23 13 — — $14,221.72 $14,221.72 $14,221.72 2026-03-17
D2001 LOCAL Miscellaneous M >=66.50- Tier Tier 3 24 13 — — $13,797.94 $13,797.94 $13,797.94 2026-03-17
A2003 LOCAL 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 LOCAL 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 LOCAL 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
0820 RC Hemodialysis - Outpatient Or Home - General Classification 4 2 — — $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
0834 RC Peritoneal Dialysis - Outpatient Or Home - Maintenance 100% 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
0839 RC Peritoneal Dialysis - Outpatient Or Home - Other 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
0831 RC Peritoneal Dialysis - Outpatient Or Home - Peritoneal/Composite Or Other Rate 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
0825 RC Hemodialysis - Outpatient Or Home - Support Services 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
0829 RC Hemodialysis - Outpatient Or Home - Other Op Hemodialysis 4 2 — — $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
0823 RC Hemodialysis - Outpatient Or Home - Home Equipment 3 1 — — $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
0807 RC Inpatient Renal Dialysis - Observation/Hourly 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
0808 RC Inpatient Renal Dialysis - Other 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
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
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
0803 RC Inpatient Renal Dialysis - Continuous Ambulatory Peritoneal Dialysis (capd) 9 4 — — $450.00 $600.00 $500.00 2026-03-17
0809 RC Inpatient Renal Dialysis - Other 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
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
0422 RC Physical Therapy - 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
0449 RC Speech Therapy - Language Pathology - Other 11 4 — — $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
0443 RC Speech Therapy - Language Pathology - Group Rate 14 5 — — $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
0423 RC Physical Therapy - Group Rate 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
97168 HCPCS Ot Re-eval Est Plan Care 35 15 — — $40.00 $150.00 $95.00 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
92524 HCPCS Behavral Qualit Analys Voice 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
92522 HCPCS Evaluate Speech Production 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
0424 RC Physical Therapy - Evaluation Or Re-evaluation 46 17 — — $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
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
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
36589 HCPCS Removal Tunneled Cv Cath 0 0 — — — — — 2026-03-17
36573 HCPCS Insj Picc Rs&i 5 Yr+ 0 0 — — — — — 2026-03-17
24615 HCPCS Treat Elbow Dislocation 0 0 — — — — — 2026-03-17
36569 HCPCS Insj Picc 5 Yr+ Without Imaging 0 0 — — — — — 2026-03-17
36561 HCPCS Insert Tunneled Cv Cath 0 0 — — — — — 2026-03-17
24516 HCPCS Treat Humerus Fracture 0 0 — — — — — 2026-03-17
15853 HCPCS Removal Sutr/stapl Xreq Anes 0 0 — — — — — 2026-03-17
36558 HCPCS Insert Tunneled Cv Cath 0 0 — — — — — 2026-03-17
36556 HCPCS Insert Non-tunnel Cv Cath 0 0 — — — — — 2026-03-17
24430 HCPCS Repair Of Humerus 0 0 — — — — — 2026-03-17
36514 HCPCS Apheresis Plasma 0 0 — — — — — 2026-03-17
36460 HCPCS Intrauterine Transfusion Ftl 0 0 — — — — — 2026-03-17
24344 HCPCS Reconstruct Elbow Lat Ligmnt 0 0 — — — — — 2026-03-17
15772 HCPCS Grfg Autol Fat Lipo Ea Addl 0 0 — — — — — 2026-03-17
10060 HCPCS I&d Abscess Simple/single 0 0 — — — — — 2026-03-17
59025 HCPCS Fetal Non-stress Test 0 0 — — — — — 2026-03-17
59012 HCPCS Fetal Cord Puncture Prenatal 0 0 — — — — — 2026-03-17
36430 HCPCS Transfusion Bld/bld Compnt 0 0 — — — — — 2026-03-17
59820 HCPCS Care Of Miscarriage 0 0 — — — — — 2026-03-17
59897 HCPCS Unlisted Fetal Invas Px W/us 0 0 — — — — — 2026-03-17
60220 HCPCS Partial Removal Of Thyroid 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
58662 HCPCS Laparoscopy Excise Lesions 0 0 — — — — — 2026-03-17
58661 HCPCS Laparoscopy Remove Adnexa 0 0 — — — — — 2026-03-17
36415 HCPCS Routine Venipuncture 0 0 — — — — — 2026-03-17
23650 HCPCS Cltx Sho Dslc W/mnpj Wo Anes 0 0 — — — — — 2026-03-17
58571 HCPCS Tlh W/t/o 250 G Or Less 0 0 — — — — — 2026-03-17
58570 HCPCS Tlh Uterus 250 G Or Less 0 0 — — — — — 2026-03-17
36248 HCPCS Ins Cath Abd/l-ext Art Addl 0 0 — — — — — 2026-03-17
58563 HCPCS Hysteroscopy Ablation 0 0 — — — — — 2026-03-17
58561 HCPCS Hysteroscopy Remove Myoma 0 0 — — — — — 2026-03-17
36247 HCPCS Ins Cath Abd/l-ext Art 3rd 0 0 — — — — — 2026-03-17
23515 HCPCS Optx Clavicular Fx W/int Fix 0 0 — — — — — 2026-03-17
15771 HCPCS Grfg Autol Fat Lipo 50 Cc/< 0 0 — — — — — 2026-03-17
58558 HCPCS Hysteroscopy Biopsy 0 0 — — — — — 2026-03-17
58554 HCPCS Laparo-vag Hyst W/t/o Compl 0 0 — — — — — 2026-03-17
36225 HCPCS Place Cath Subclavian Art 0 0 — — — — — 2026-03-17
58552 HCPCS Laparo-vag Hyst Incl T/o 0 0 — — — — — 2026-03-17
58550 HCPCS Laparo-asst Vag Hysterectomy 0 0 — — — — — 2026-03-17
36200 HCPCS Place Catheter In Aorta 0 0 — — — — — 2026-03-17
23412 HCPCS Repair Rotator Cuff Chronic 0 0 — — — — — 2026-03-17
58301 HCPCS Remove Intrauterine Device 0 0 — — — — — 2026-03-17
58120 HCPCS Dilation And Curettage 0 0 — — — — — 2026-03-17
36012 HCPCS Place Catheter In Vein 0 0 — — — — — 2026-03-17
57522 HCPCS Conization Of Cervix 0 0 — — — — — 2026-03-17
57461 HCPCS Conz Of Cervix W/scope Leep 0 0 — — — — — 2026-03-17
33228 HCPCS Remv&replc Pm Gen Dual Lead 0 0 — — — — — 2026-03-17
22552 HCPCS Arthrd Ant Ntrbd Cervical Ea 0 0 — — — — — 2026-03-17
14020 HCPCS Tis Trnfr S/a/l 10 Sq Cm/< 0 0 — — — — — 2026-03-17
10005 HCPCS Fna Bx W/us Gdn 1st Les 0 0 — — — — — 2026-03-17
00410 HCPCS Anesth Correct Heart Rhythm 0 0 — — — — — 2026-03-17
57288 HCPCS Repair Bladder Defect 0 0 — — — — — 2026-03-17
57260 HCPCS Cmbn Ant Pst Colprhy 0 0 — — — — — 2026-03-17
33227 HCPCS Remove&replace Pm Gen Singl 0 0 — — — — — 2026-03-17
55880 HCPCS Abltj Mal Prst8 Tiss Hifu 0 0 — — — — — 2026-03-17
55700 HCPCS Biopsy Of Prostate 0 0 — — — — — 2026-03-17
33207 HCPCS Insert Heart Pm Ventricular 0 0 — — — — — 2026-03-17
22548 HCPCS Arthrd Ant Toral/xoral C1-c2 0 0 — — — — — 2026-03-17
55040 HCPCS Removal Of Hydrocele 0 0 — — — — — 2026-03-17
54161 HCPCS Circum 28 Days Or Older 0 0 — — — — — 2026-03-17
32555 HCPCS Aspirate Pleura With Imaging 0 0 — — — — — 2026-03-17
53445 HCPCS Insert Uro/ves Nck Sphincter 0 0 — — — — — 2026-03-17
52601 HCPCS Prostatectomy (turp) 0 0 — — — — — 2026-03-17
32408 HCPCS Core Ndl Bx Lng/med Perq 0 0 — — — — — 2026-03-17
22515 HCPCS Perq Vertebral Augmentation 0 0 — — — — — 2026-03-17
14000 HCPCS Tis Trnfr Trunk 10 Sq Cm/< 0 0 — — — — — 2026-03-17
52356 HCPCS Cysto/uretero W/lithotripsy 0 0 — — — — — 2026-03-17
52332 HCPCS Cystoscopy And Treatment 0 0 — — — — — 2026-03-17
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