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

Rehabilitation Hospital Of The Northwest

Post Falls, ID · CCN 133027 · Rates published

1,052 distinct procedures filed
18 distinct payers
29,968 rate rows
2026-08-10 last MRF observed
Data quality

8,522 of 29,968 rate rows are consumer-grade (28.4%)

21,446 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 20,436
per-diem day rate — not a per-procedure price 1,010
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://ernesthealth.com/wp-content/uploads/2025/01/pricing/Rehabilitation%20Hospital%20of%20the%20Northwest/461337794_Rehabilitation-Hospital-of-the-Northwest_Standard-Charges.json
Found on page https://rhn.ernesthealth.com/price-transparency/
Discovered viaDiscovered by HANK
Last fetch success · 2026-09-21
Content fingerprint cb8b169b569e685a… · 5,968,149 bytes · first seen 2026-09-21

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
D0407
HCPCS 		Traumatic Spinal Cord Injury M <24.50 And A >=61.50- Tier Tier 3 11 $64,949.05 $64,949.05 $64,949.05 nat. median
$69,540
0.9× median
B0505
HCPCS 		Non-traumatic Spinal Cord Injury M <39.50- Tier Tier 1 11 $53,677.24 $53,677.24 $53,677.24 nat. median
$60,224
0.9× median
C0106
HCPCS 		Stroke M <41.50 And A <84.50- Tier Tier 2 11 $44,855.90 $44,855.90 $44,855.90 nat. median
$48,486
0.9× median
B0704
HCPCS 		Fracture Of Lower Extremity M <41.50- Tier Tier 1 11 $44,390.79 $44,390.79 $44,390.79 nat. median
$44,391
1.0× median
B0604
HCPCS 		Neurological M <43.50- Tier Tier 1 11 $44,318.47 $44,318.47 $44,318.47 nat. median
$47,224
0.9× median
B1004
HCPCS 		Amputation Lower Extremity M <47.50- Tier Tier 1 11 $40,949.74 $45,733.74 $43,341.74 nat. median
$45,558
1.0× median
C0105
HCPCS 		Stroke M <41.50 And A >=84.50- Tier Tier 2 11 $43,210.39 $43,210.39 $43,210.39 nat. median
$43,210
1.0× median
D0106
HCPCS 		Stroke M <41.50 And A <84.50- Tier Tier 3 11 $40,170.86 $44,098.59 $42,134.72 nat. median
$43,929
1.0× median
A0106
HCPCS 		Stroke M <41.50 And A <84.50- Tier None 11 $38,945.84 $41,828.74 $40,387.29 nat. median
$41,668
1.0× median
B2005
HCPCS 		Miscellaneous M <46.50 And A <77.50- Tier Tier 1 11 $39,527.86 $39,527.86 $39,527.86 nat. median
$42,636
0.9× median
C1705
HCPCS 		Major Multiple Trauma Without Brain Or Spinal Cord Injury M <36.50- Tier Tier 2 11 $36,269.46 $36,269.46 $36,269.46 nat. median
$39,029
0.9× median
D0105
HCPCS 		Stroke M <41.50 And A >=84.50- Tier Tier 3 11 $31,818.62 $39,148.65 $35,483.64 nat. median
$38,998
0.9× median
D0205
HCPCS 		Traumatic Brain Injury M <35.50- Tier Tier 3 11 $35,125.20 $35,125.20 $35,125.20 nat. median
$38,154
0.9× median
C0604
HCPCS 		Neurological M <43.50- Tier Tier 2 11 $33,180.12 $35,901.58 $34,540.85 nat. median
$35,764
1.0× median
C2005
HCPCS 		Miscellaneous M <46.50 And A <77.50- Tier Tier 2 11 $34,324.49 $34,324.49 $34,324.49 nat. median
$34,324
1.0× median
C0305
HCPCS 		Non-traumatic Brain Injury M <42.50 And A <78.50- Tier Tier 2 11 $33,948.90 $33,948.90 $33,948.90 nat. median
$36,207
0.9× median
C1004
HCPCS 		Amputation Lower Extremity M <47.50- Tier Tier 2 11 $33,867.04 $33,867.04 $33,867.04 nat. median
$37,855
0.9× median
D1705
HCPCS 		Major Multiple Trauma Without Brain Or Spinal Cord Injury M <36.50- Tier Tier 3 11 $33,589.43 $33,589.43 $33,589.43 nat. median
$33,589
1.0× median
A1705
HCPCS 		Major Multiple Trauma Without Brain Or Spinal Cord Injury M <36.50- Tier None 11 $30,473.39 $36,542.40 $33,507.89 nat. median
$33,508
1.0× median
A0205
HCPCS 		Traumatic Brain Injury M <35.50- Tier None 11 $33,069.79 $33,069.79 $33,069.79 nat. median
$35,847
0.9× median
D1903
HCPCS 		Guillain-barré M >=38.50 And M <51.50- Tier Tier 3 11 $32,060.77 $32,060.77 $32,060.77 nat. median
$32,685
1.0× median
C0704
HCPCS 		Fracture Of Lower Extremity M <41.50- Tier Tier 2 11 $32,037.64 $32,037.64 $32,037.64 nat. median
$34,816
0.9× median
D1704
HCPCS 		Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=36.50 And M <41.50… 11 $31,247.71 $31,247.71 $31,247.71 nat. median
$28,915
1.1× median
D1004
HCPCS 		Amputation Lower Extremity M <47.50- Tier Tier 3 11 $30,936.08 $30,936.08 $30,936.08 nat. median
$34,358
0.9× median
D0304
HCPCS 		Non-traumatic Brain Injury M <42.50 And A >=78.50- Tier Tier 3 11 $30,932.29 $30,932.29 $30,932.29 nat. median
$30,932
1.0× median
C1704
HCPCS 		Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=36.50 And M <41.50… 11 $30,905.83 $30,905.83 $30,905.83 nat. median
$33,526
0.9× median
D1504
HCPCS 		Pulmonary M <45.50- Tier Tier 3 11 $30,895.15 $30,895.15 $30,895.15 nat. median
$34,002
0.9× median
C0304
HCPCS 		Non-traumatic Brain Injury M <42.50 And A >=78.50- Tier Tier 2 11 $30,783.04 $30,783.04 $30,783.04 nat. median
$33,053
0.9× median
D2005
HCPCS 		Miscellaneous M <46.50 And A <77.50- Tier Tier 3 11 $29,494.63 $31,921.12 $30,707.88 nat. median
$31,799
1.0× median
C0904
HCPCS 		Other Orthopedic M <44.5- Tier Tier 2 11 $30,525.00 $30,525.00 $30,525.00 nat. median
$32,826
0.9× median
C0204
HCPCS 		Traumatic Brain Injury M >=35.50 And M <49.50- Tier Tier 2 11 $30,192.22 $30,192.22 $30,192.22 nat. median
$32,552
0.9× median
C1404
HCPCS 		Cardiac M <45.50- Tier Tier 2 11 $30,081.89 $30,081.89 $30,081.89 nat. median
$33,337
0.9× median
B0602
HCPCS 		Neurological M >=52.50 And M <64.50- Tier Tier 1 11 $29,991.13 $29,991.13 $29,991.13 nat. median
$31,400
1.0× median
C2004
HCPCS 		Miscellaneous M <46.50 And A >=77.50- Tier Tier 2 11 $29,953.76 $29,953.76 $29,953.76 nat. median
$32,666
0.9× median
A1004
HCPCS 		Amputation Lower Extremity M <47.50- Tier None 11 $27,716.84 $32,025.61 $29,871.22 nat. median
$31,429
1.0× median
D0305
HCPCS 		Non-traumatic Brain Injury M <42.50 And A <78.50- Tier Tier 3 11 $27,881.97 $31,185.22 $29,533.60 nat. median
$33,755
0.9× median
D1404
HCPCS 		Cardiac M <45.50- Tier Tier 3 11 $27,969.54 $30,943.90 $29,456.72 nat. median
$30,825
1.0× median
A0305
HCPCS 		Non-traumatic Brain Injury M <42.50 And A <78.50- Tier None 11 $29,393.19 $29,393.19 $29,393.19 nat. median
$31,600
0.9× median
D1103
HCPCS 		Amputation Non-lower Extremity M <52.50- Tier Tier 3 11 $28,690.26 $28,690.26 $28,690.26 nat. median
$30,380
0.9× median
D0805
HCPCS 		Replacement Of Lower-extremity Joint M <42.50- Tier Tier 3 11 $26,835.95 $30,462.07 $28,649.01 nat. median
$30,345
0.9× median
D0904
HCPCS 		Other Orthopedic M <44.5- Tier Tier 3 11 $28,451.80 $28,451.80 $28,451.80 nat. median
$31,008
0.9× median
D0704
HCPCS 		Fracture Of Lower Extremity M <41.50- Tier Tier 3 11 $22,428.45 $33,709.13 $28,068.79 nat. median
$31,214
0.9× median
A0704
HCPCS 		Fracture Of Lower Extremity M <41.50- Tier None 11 $28,038.94 $28,038.94 $28,038.94 nat. median
$30,471
0.9× median
D2004
HCPCS 		Miscellaneous M <46.50 And A >=77.50- Tier Tier 3 11 $27,981.99 $27,981.99 $27,981.99 nat. median
$30,380
0.9× median
A0604
HCPCS 		Neurological M <43.50- Tier None 11 $27,935.72 $27,935.72 $27,935.72 nat. median
$30,256
0.9× median
A0104
HCPCS 		Stroke M >=41.50 And M <50.50- Tier None 11 $27,465.92 $27,465.92 $27,465.92 nat. median
$29,682
0.9× median
C0503
HCPCS 		Non-traumatic Spinal Cord Injury M >=48.50 And M <53.50- Tier Tier 2 11 $27,365.93 $27,365.93 $27,365.93 nat. median
$27,366
1.0× median
D0604
HCPCS 		Neurological M <43.50- Tier Tier 3 11 $23,530.48 $30,975.23 $27,252.85 nat. median
$30,918
0.9× median
D0504
HCPCS 		Non-traumatic Spinal Cord Injury M >=39.50 And M <48.50- Tier Tier 3 11 $26,037.16 $28,391.30 $27,214.23 nat. median
$30,303
0.9× median
C0603
HCPCS 		Neurological M >=43.50 And M <52.50- Tier Tier 2 11 $26,456.90 $27,824.53 $27,140.72 nat. median
$28,279
1.0× median

Other procedures at this hospital

Browse this hospital's 1,052 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
             
D0407 HCPCS Traumatic Spinal Cord Injury M <24.50 And A >=61.50- Tier Tier 3 21 11 — — $64,949.05 $64,949.05 $64,949.05 2026-08-10
B0505 HCPCS Non-traumatic Spinal Cord Injury M <39.50- Tier Tier 1 21 11 — — $53,677.24 $53,677.24 $53,677.24 2026-08-10
C0106 HCPCS Stroke M <41.50 And A <84.50- Tier Tier 2 21 11 — — $44,855.90 $44,855.90 $44,855.90 2026-08-10
B0704 HCPCS Fracture Of Lower Extremity M <41.50- Tier Tier 1 21 11 — — $44,390.79 $44,390.79 $44,390.79 2026-08-10
B0604 HCPCS Neurological M <43.50- Tier Tier 1 21 11 — — $44,318.47 $44,318.47 $44,318.47 2026-08-10
B1004 HCPCS Amputation Lower Extremity M <47.50- Tier Tier 1 21 11 — — $40,949.74 $45,733.74 $43,341.74 2026-08-10
C0105 HCPCS Stroke M <41.50 And A >=84.50- Tier Tier 2 21 11 — — $43,210.39 $43,210.39 $43,210.39 2026-08-10
D0106 HCPCS Stroke M <41.50 And A <84.50- Tier Tier 3 21 11 — — $40,170.86 $44,098.59 $42,134.72 2026-08-10
A0106 HCPCS Stroke M <41.50 And A <84.50- Tier None 21 11 — — $38,945.84 $41,828.74 $40,387.29 2026-08-10
B2005 HCPCS Miscellaneous M <46.50 And A <77.50- Tier Tier 1 21 11 — — $39,527.86 $39,527.86 $39,527.86 2026-08-10
C1705 HCPCS Major Multiple Trauma Without Brain Or Spinal Cord Injury M <36.50- Tier Tier 2 21 11 — — $36,269.46 $36,269.46 $36,269.46 2026-08-10
D0105 HCPCS Stroke M <41.50 And A >=84.50- Tier Tier 3 21 11 — — $31,818.62 $39,148.65 $35,483.64 2026-08-10
D0205 HCPCS Traumatic Brain Injury M <35.50- Tier Tier 3 21 11 — — $35,125.20 $35,125.20 $35,125.20 2026-08-10
C0604 HCPCS Neurological M <43.50- Tier Tier 2 21 11 — — $33,180.12 $35,901.58 $34,540.85 2026-08-10
C2005 HCPCS Miscellaneous M <46.50 And A <77.50- Tier Tier 2 21 11 — — $34,324.49 $34,324.49 $34,324.49 2026-08-10
C0305 HCPCS Non-traumatic Brain Injury M <42.50 And A <78.50- Tier Tier 2 21 11 — — $33,948.90 $33,948.90 $33,948.90 2026-08-10
C1004 HCPCS Amputation Lower Extremity M <47.50- Tier Tier 2 21 11 — — $33,867.04 $33,867.04 $33,867.04 2026-08-10
D1705 HCPCS Major Multiple Trauma Without Brain Or Spinal Cord Injury M <36.50- Tier Tier 3 21 11 — — $33,589.43 $33,589.43 $33,589.43 2026-08-10
A1705 HCPCS Major Multiple Trauma Without Brain Or Spinal Cord Injury M <36.50- Tier None 21 11 — — $30,473.39 $36,542.40 $33,507.89 2026-08-10
A0205 HCPCS Traumatic Brain Injury M <35.50- Tier None 21 11 — — $33,069.79 $33,069.79 $33,069.79 2026-08-10
D1903 HCPCS Guillain-barré M >=38.50 And M <51.50- Tier Tier 3 21 11 — — $32,060.77 $32,060.77 $32,060.77 2026-08-10
C0704 HCPCS Fracture Of Lower Extremity M <41.50- Tier Tier 2 21 11 — — $32,037.64 $32,037.64 $32,037.64 2026-08-10
D1704 HCPCS Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=36.50 And M <41.50… 21 11 — — $31,247.71 $31,247.71 $31,247.71 2026-08-10
D1004 HCPCS Amputation Lower Extremity M <47.50- Tier Tier 3 21 11 — — $30,936.08 $30,936.08 $30,936.08 2026-08-10
D0304 HCPCS Non-traumatic Brain Injury M <42.50 And A >=78.50- Tier Tier 3 21 11 — — $30,932.29 $30,932.29 $30,932.29 2026-08-10
C1704 HCPCS Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=36.50 And M <41.50… 21 11 — — $30,905.83 $30,905.83 $30,905.83 2026-08-10
D1504 HCPCS Pulmonary M <45.50- Tier Tier 3 21 11 — — $30,895.15 $30,895.15 $30,895.15 2026-08-10
C0304 HCPCS Non-traumatic Brain Injury M <42.50 And A >=78.50- Tier Tier 2 21 11 — — $30,783.04 $30,783.04 $30,783.04 2026-08-10
D2005 HCPCS Miscellaneous M <46.50 And A <77.50- Tier Tier 3 21 11 — — $29,494.63 $31,921.12 $30,707.88 2026-08-10
C0904 HCPCS Other Orthopedic M <44.5- Tier Tier 2 21 11 — — $30,525.00 $30,525.00 $30,525.00 2026-08-10
C0204 HCPCS Traumatic Brain Injury M >=35.50 And M <49.50- Tier Tier 2 21 11 — — $30,192.22 $30,192.22 $30,192.22 2026-08-10
C1404 HCPCS Cardiac M <45.50- Tier Tier 2 21 11 — — $30,081.89 $30,081.89 $30,081.89 2026-08-10
B0602 HCPCS Neurological M >=52.50 And M <64.50- Tier Tier 1 21 11 — — $29,991.13 $29,991.13 $29,991.13 2026-08-10
C2004 HCPCS Miscellaneous M <46.50 And A >=77.50- Tier Tier 2 21 11 — — $29,953.76 $29,953.76 $29,953.76 2026-08-10
A1004 HCPCS Amputation Lower Extremity M <47.50- Tier None 21 11 — — $27,716.84 $32,025.61 $29,871.22 2026-08-10
D0305 HCPCS Non-traumatic Brain Injury M <42.50 And A <78.50- Tier Tier 3 21 11 — — $27,881.97 $31,185.22 $29,533.60 2026-08-10
D1404 HCPCS Cardiac M <45.50- Tier Tier 3 21 11 — — $27,969.54 $30,943.90 $29,456.72 2026-08-10
A0305 HCPCS Non-traumatic Brain Injury M <42.50 And A <78.50- Tier None 21 11 — — $29,393.19 $29,393.19 $29,393.19 2026-08-10
D1103 HCPCS Amputation Non-lower Extremity M <52.50- Tier Tier 3 21 11 — — $28,690.26 $28,690.26 $28,690.26 2026-08-10
D0805 HCPCS Replacement Of Lower-extremity Joint M <42.50- Tier Tier 3 21 11 — — $26,835.95 $30,462.07 $28,649.01 2026-08-10
D0904 HCPCS Other Orthopedic M <44.5- Tier Tier 3 21 11 — — $28,451.80 $28,451.80 $28,451.80 2026-08-10
D0704 HCPCS Fracture Of Lower Extremity M <41.50- Tier Tier 3 21 11 — — $22,428.45 $33,709.13 $28,068.79 2026-08-10
A0704 HCPCS Fracture Of Lower Extremity M <41.50- Tier None 21 11 — — $28,038.94 $28,038.94 $28,038.94 2026-08-10
D2004 HCPCS Miscellaneous M <46.50 And A >=77.50- Tier Tier 3 21 11 — — $27,981.99 $27,981.99 $27,981.99 2026-08-10
A0604 HCPCS Neurological M <43.50- Tier None 21 11 — — $27,935.72 $27,935.72 $27,935.72 2026-08-10
A0104 HCPCS Stroke M >=41.50 And M <50.50- Tier None 21 11 — — $27,465.92 $27,465.92 $27,465.92 2026-08-10
C0503 HCPCS Non-traumatic Spinal Cord Injury M >=48.50 And M <53.50- Tier Tier 2 21 11 — — $27,365.93 $27,365.93 $27,365.93 2026-08-10
D0604 HCPCS Neurological M <43.50- Tier Tier 3 21 11 — — $23,530.48 $30,975.23 $27,252.85 2026-08-10
D0504 HCPCS Non-traumatic Spinal Cord Injury M >=39.50 And M <48.50- Tier Tier 3 21 11 — — $26,037.16 $28,391.30 $27,214.23 2026-08-10
C0603 HCPCS Neurological M >=43.50 And M <52.50- Tier Tier 2 21 11 — — $26,456.90 $27,824.53 $27,140.72 2026-08-10
A0204 HCPCS Traumatic Brain Injury M >=35.50 And M <49.50- Tier None 21 11 — — $25,818.03 $28,049.02 $26,933.53 2026-08-10
A0504 HCPCS Non-traumatic Spinal Cord Injury M >=39.50 And M <48.50- Tier None 21 11 — — $26,163.27 $26,163.27 $26,163.27 2026-08-10
A0904 HCPCS Other Orthopedic M <44.5- Tier None 21 11 — — $26,031.58 $26,031.58 $26,031.58 2026-08-10
C2003 HCPCS Miscellaneous M >=46.50 And M <55.50- Tier Tier 2 21 11 — — $25,052.82 $26,887.97 $25,970.40 2026-08-10
A1704 HCPCS Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=36.50 And M <41.50… 21 11 — — $25,967.52 $25,967.52 $25,967.52 2026-08-10
A2004 HCPCS Miscellaneous M <46.50 And A >=77.50- Tier None 21 11 — — $25,469.24 $25,469.24 $25,469.24 2026-08-10
D1703 HCPCS Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=41.50 And M <50.50… 21 11 — — $25,289.50 $25,289.50 $25,289.50 2026-08-10
D1003 HCPCS Amputation Lower Extremity M >=47.50 And M <55.50- Tier Tier 3 21 11 — — $24,164.81 $25,930.10 $25,047.46 2026-08-10
A0805 HCPCS Replacement Of Lower-extremity Joint M <42.50- Tier None 21 11 — — $25,029.68 $25,029.68 $25,029.68 2026-08-10
D2003 HCPCS Miscellaneous M >=46.50 And M <55.50- Tier Tier 3 21 11 — — $25,005.13 $25,005.13 $25,005.13 2026-08-10
D1503 HCPCS Pulmonary M >=45.50 And M <56.50- Tier Tier 3 21 11 — — $24,947.82 $24,947.82 $24,947.82 2026-08-10
D0703 HCPCS Fracture Of Lower Extremity M >=41.50 And M <52.50- Tier Tier 3 21 11 — — $24,842.83 $24,842.83 $24,842.83 2026-08-10
D0104 HCPCS Stroke M >=41.50 And M <50.50- Tier Tier 3 21 11 — — $20,863.25 $28,820.17 $24,841.71 2026-08-10
D0603 HCPCS Neurological M >=43.50 And M <52.50- Tier Tier 3 21 11 — — $24,698.68 $24,698.68 $24,698.68 2026-08-10
C1403 HCPCS Cardiac M >=45.50 And M <55.50- Tier Tier 2 21 11 — — $24,550.98 $24,550.98 $24,550.98 2026-08-10
D0303 HCPCS Non-traumatic Brain Injury M >=42.50 And M <52.50- Tier Tier 3 21 11 — — $24,389.04 $24,389.04 $24,389.04 2026-08-10
D0204 HCPCS Traumatic Brain Injury M >=35.50 And M <49.50- Tier Tier 3 21 11 — — $20,122.75 $27,421.43 $23,772.09 2026-08-10
B0601 HCPCS Neurological M >=64.50- Tier Tier 1 21 11 — — $23,645.18 $23,645.18 $23,645.18 2026-08-10
D1702 HCPCS Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=50.50 And M <57.50… 21 11 — — $23,143.58 $23,143.58 $23,143.58 2026-08-10
C0902 HCPCS Other Orthopedic M >=51.50 And M <63.50- Tier Tier 2 21 11 — — $23,060.38 $23,060.38 $23,060.38 2026-08-10
A0703 HCPCS Fracture Of Lower Extremity M >=41.50 And M <52.50- Tier None 21 11 — — $22,952.92 $22,952.92 $22,952.92 2026-08-10
A1703 HCPCS Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=41.50 And M <50.50… 21 11 — — $22,944.02 $22,944.02 $22,944.02 2026-08-10
A0804 HCPCS Replacement Of Lower-extremity Joint M >=42.50 And M <51.50- Tier None 21 11 — — $22,915.24 $22,915.24 $22,915.24 2026-08-10
A2003 HCPCS Miscellaneous M >=46.50 And M <55.50- Tier None 21 11 — — $22,892.02 $22,892.02 $22,892.02 2026-08-10
A1803 HCPCS Major Multiple Trauma With Brain Or Spinal Cord Injury M >=45.50 And M <55.50- T… 21 11 — — $22,839.03 $22,839.03 $22,839.03 2026-08-10
D0804 HCPCS Replacement Of Lower-extremity Joint M >=42.50 And M <51.50- Tier Tier 3 21 11 — — $22,376.34 $22,376.34 $22,376.34 2026-08-10
D0702 HCPCS Fracture Of Lower Extremity M >=52.50 And M <61.50- Tier Tier 3 21 11 — — $22,282.47 $22,282.47 $22,282.47 2026-08-10
A0603 HCPCS Neurological M >=43.50 And M <52.50- Tier None 21 11 — — $22,274.91 $22,274.91 $22,274.91 2026-08-10
D0203 HCPCS Traumatic Brain Injury M >=49.50 And M <61.50- Tier Tier 3 21 11 — — $22,109.41 $22,109.41 $22,109.41 2026-08-10
A0402 HCPCS Traumatic Spinal Cord Injury M >=47.50 And M <56.50- Tier None 21 11 — — $21,712.56 $21,712.56 $21,712.56 2026-08-10
A1003 HCPCS Amputation Lower Extremity M >=47.50 And M <55.50- Tier None 21 11 — — $21,650.28 $21,650.28 $21,650.28 2026-08-10
A1403 HCPCS Cardiac M >=45.50 And M <55.50- Tier None 21 11 — — $21,004.29 $21,004.29 $21,004.29 2026-08-10
D0602 HCPCS Neurological M >=52.50 And M <64.50- Tier Tier 3 21 11 — — $20,961.58 $20,961.58 $20,961.58 2026-08-10
C2002 HCPCS Miscellaneous M >=55.50 And M <66.50- Tier Tier 2 21 11 — — $20,920.65 $20,920.65 $20,920.65 2026-08-10
A1902 HCPCS Guillain-barré M >=51.50 And M <66.50- Tier None 21 11 — — $20,881.50 $20,881.50 $20,881.50 2026-08-10
D0505 HCPCS Non-traumatic Spinal Cord Injury M <39.50- Tier Tier 3 21 11 — — $13,731.57 $27,696.17 $20,713.87 2026-08-10
A1502 HCPCS Pulmonary M >=56.50 And M <68.50- Tier None 21 11 — — $20,534.48 $20,534.48 $20,534.48 2026-08-10
A1805 HCPCS Major Multiple Trauma With Brain Or Spinal Cord Injury M >=30.50 And M <40.50- T… 21 11 — — $20,428.08 $20,428.08 $20,428.08 2026-08-10
D0302 HCPCS Non-traumatic Brain Injury M >=52.50 And M <65.50- Tier Tier 3 21 11 — — $20,269.33 $20,269.33 $20,269.33 2026-08-10
A1002 HCPCS Amputation Lower Extremity M >=55.50 And M <64.50- Tier None 21 11 — — $20,229.35 $20,229.35 $20,229.35 2026-08-10
A0103 HCPCS Stroke M >=50.50 And M <63.50- Tier None 21 11 — — $18,413.88 $21,520.37 $19,967.12 2026-08-10
A0203 HCPCS Traumatic Brain Injury M >=49.50 And M <61.50- Tier None 21 11 — — $17,171.61 $22,758.50 $19,965.06 2026-08-10
D0902 HCPCS Other Orthopedic M >=51.50 And M <63.50- Tier Tier 3 21 11 — — $19,883.16 $19,883.16 $19,883.16 2026-08-10
A0902 HCPCS Other Orthopedic M >=51.50 And M <63.50- Tier None 21 11 — — $19,873.30 $19,873.30 $19,873.30 2026-08-10
D2002 HCPCS Miscellaneous M >=55.50 And M <66.50- Tier Tier 3 21 11 — — $19,543.26 $19,543.26 $19,543.26 2026-08-10
A1702 HCPCS Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=50.50 And M <57.50… 21 11 — — $19,308.36 $19,308.36 $19,308.36 2026-08-10
D0103 HCPCS Stroke M >=50.50 And M <63.50- Tier Tier 3 21 11 — — $13,811.48 $24,594.90 $19,203.19 2026-08-10
D0903 HCPCS Other Orthopedic M >=44.50 And M <51.50- Tier Tier 3 21 11 — — $14,527.50 $23,744.83 $19,136.17 2026-08-10
A0302 HCPCS Non-traumatic Brain Injury M >=52.50 And M <65.50- Tier None 21 11 — — $19,103.71 $19,103.71 $19,103.71 2026-08-10
A0602 HCPCS Neurological M >=52.50 And M <64.50- Tier None 21 11 — — $18,904.40 $18,904.40 $18,904.40 2026-08-10
A1402 HCPCS Cardiac M >=55.50 And M <68.50- Tier None 21 11 — — $18,868.99 $18,868.99 $18,868.99 2026-08-10
A0702 HCPCS Fracture Of Lower Extremity M >=52.50 And M <61.50- Tier None 21 11 — — $18,664.15 $18,664.15 $18,664.15 2026-08-10
D1402 HCPCS Cardiac M >=55.50 And M <68.50- Tier Tier 3 21 11 — — $18,655.26 $18,655.26 $18,655.26 2026-08-10
A2002 HCPCS Miscellaneous M >=55.50 And M <66.50- Tier None 21 11 — — $17,788.60 $19,494.02 $18,641.31 2026-08-10
D0802 HCPCS Replacement Of Lower-extremity Joint M >=57.50 And M <63.50- Tier Tier 3 21 11 — — $17,943.43 $17,943.43 $17,943.43 2026-08-10
D0202 HCPCS Traumatic Brain Injury M >=61.50 And M <73.50- Tier Tier 3 21 11 — — $17,753.01 $17,753.01 $17,753.01 2026-08-10
D0102 HCPCS Stroke M >=63.50 And M <72.50- Tier Tier 3 21 11 — — $17,519.89 $17,519.89 $17,519.89 2026-08-10
A0105 HCPCS Stroke M <41.50 And A >=84.50- Tier None 21 11 — — $17,425.68 $17,425.68 $17,425.68 2026-08-10
D2001 HCPCS Miscellaneous M >=66.50- Tier Tier 3 21 11 — — $17,152.57 $17,152.57 $17,152.57 2026-08-10
A0802 HCPCS Replacement Of Lower-extremity Joint M >=57.50 And M <63.50- Tier None 21 11 — — $16,735.10 $16,735.10 $16,735.10 2026-08-10
D1002 HCPCS Amputation Lower Extremity M >=55.50 And M <64.50- Tier Tier 3 21 11 — — $16,710.15 $16,710.15 $16,710.15 2026-08-10
A0102 HCPCS Stroke M >=63.50 And M <72.50- Tier None 21 11 — — $16,697.73 $16,697.73 $16,697.73 2026-08-10
A1804 HCPCS Major Multiple Trauma With Brain Or Spinal Cord Injury M >=40.50 And M <45.50- T… 21 11 — — $16,550.98 $16,550.98 $16,550.98 2026-08-10
D0701 HCPCS Fracture Of Lower Extremity M >=61.50- Tier Tier 3 21 11 — — $16,356.05 $16,356.05 $16,356.05 2026-08-10
A0601 HCPCS Neurological M >=64.50- Tier None 21 11 — — $16,235.34 $16,235.34 $16,235.34 2026-08-10
D0301 HCPCS Non-traumatic Brain Injury M >=65.50- Tier Tier 3 21 11 — — $15,678.03 $15,678.03 $15,678.03 2026-08-10
A2005 HCPCS Miscellaneous M <46.50 And A <77.50- Tier None 21 11 — — $2,684.66 $26,846.63 $14,765.65 2026-08-10
A1404 HCPCS Cardiac M <45.50- Tier None 21 11 — — $2,757.45 $25,736.17 $14,246.81 2026-08-10
A0903 HCPCS Other Orthopedic M >=44.50 And M <51.50- Tier None 21 11 — — $4,177.89 $21,725.02 $12,951.45 2026-08-10
A0303 HCPCS Non-traumatic Brain Injury M >=42.50 And M <52.50- Tier None 21 11 — — $2,462.86 $22,986.73 $12,724.80 2026-08-10
D1403 HCPCS Cardiac M >=45.50 And M <55.50- Tier Tier 3 21 11 — — $4,769.23 $4,769.23 $4,769.23 2026-08-10
0545 RC Ambulance - Air Ambulance 1 1 — — $2,300.00 $2,300.00 $2,300.00 2026-08-10
0158 RC Room & Board - Ward - Rehabilitation 17 9 — — $1,350.00 $1,350.00 $1,350.00 2026-08-10
0148 RC Room & Board - Deluxe Private - Rehabilitation 18 10 — — $1,350.00 $1,350.00 $1,350.00 2026-08-10
0138 RC Room & Board - Three And Four Beds - Rehabilitation 18 10 — — $1,350.00 $1,350.00 $1,350.00 2026-08-10
0128 RC Room & Board - Semi-private (Two Beds) - Rehabilitation 18 10 — — $1,337.50 $1,337.50 $1,337.50 2026-08-10
0274 RC Medical/Surgical Supplies And Devices - Prosthetic/Orthotic Devices 2 1 — — $1,250.00 $1,250.00 $1,250.00 2026-08-10
0636 RC Pharmacy - Drugs Requiring Detailed Coding 3 2 — — $1,250.00 $1,250.00 $1,250.00 2026-08-10
0278 RC Medical/Surgical Supplies And Devices - Other Implants 2 1 — — $1,250.00 $1,250.00 $1,250.00 2026-08-10
0275 RC Medical/Surgical Supplies And Devices - Pacemaker 2 1 — — $1,250.00 $1,250.00 $1,250.00 2026-08-10
0118 RC Room & Board - Private (One Bed) - Rehabilitation 18 10 — — $805.00 $1,177.50 $1,177.50 2026-08-10
0802 RC Inpatient Renal Dialysis - Peritoneal Dialysis (non-capd) 19 3 — — $580.00 $612.00 $612.00 2026-08-10
0800 RC Inpatient Renal Dialysis - General Classification 19 3 — — $600.00 $627.00 $612.00 2026-08-10
0801 RC Inpatient Renal Dialysis - Hemodialysis 19 3 — — $580.00 $612.00 $612.00 2026-08-10
0809 RC Inpatient Renal Dialysis - Other 19 3 — — $600.00 $627.00 $612.00 2026-08-10
0808 RC Inpatient Renal Dialysis - Other 18 2 — — $600.00 $612.00 $612.00 2026-08-10
0807 RC Inpatient Renal Dialysis - Observation/Hourly 18 2 — — $600.00 $612.00 $612.00 2026-08-10
0806 RC Inpatient Renal Dialysis - Continuation 18 2 — — $600.00 $612.00 $612.00 2026-08-10
0805 RC Inpatient Renal Dialysis - Treatment 18 2 — — $600.00 $612.00 $612.00 2026-08-10
0804 RC Inpatient Renal Dialysis - Continuous Cycling Peritoneal Dialysis (ccpd) 19 3 — — $600.00 $627.00 $612.00 2026-08-10
0803 RC Inpatient Renal Dialysis - Continuous Ambulatory Peritoneal Dialysis (capd) 19 3 — — $600.00 $627.00 $612.00 2026-08-10
0549 RC Ambulance - Other 1 1 — — $350.00 $350.00 $350.00 2026-08-10
0548 RC Ambulance - EKG Transmission 1 1 — — $350.00 $350.00 $350.00 2026-08-10
0547 RC Ambulance - Pharmacy 1 1 — — $350.00 $350.00 $350.00 2026-08-10
0546 RC Ambulance - Neonatal Ambulance 1 1 — — $350.00 $350.00 $350.00 2026-08-10
0543 RC Ambulance - Heart Mobile 1 1 — — $350.00 $350.00 $350.00 2026-08-10
0542 RC Ambulance - Medical Transport 1 1 — — $350.00 $350.00 $350.00 2026-08-10
0540 RC Ambulance - General Classification 1 1 — — $350.00 $350.00 $350.00 2026-08-10
0424 RC Physical Therapy - Evaluation Or Re-evaluation 42 11 — — $150.00 $150.00 $150.00 2026-08-10
92524 HCPCS Behavral Qualit Analys Voice 42 11 — — $150.00 $150.00 $150.00 2026-08-10
92522 HCPCS Evaluate Speech Production 42 11 — — $150.00 $150.00 $150.00 2026-08-10
92523 HCPCS Speech Sound Lang Comprehen 42 11 — — $150.00 $150.00 $150.00 2026-08-10
92521 HCPCS Evaluation Of Speech Fluency 1 1 — — $150.00 $150.00 $150.00 2026-08-10
0421 RC Physical Therapy - Visit Charge 41 10 — — $150.00 $150.00 $150.00 2026-08-10
0410 RC Respiratory Services - General Classification 41 10 — — $150.00 $150.00 $150.00 2026-08-10
0444 RC Speech Therapy - Language Pathology - Evaluation Or Reevaluation 40 10 — — $150.00 $150.00 $150.00 2026-08-10
97168 HCPCS Ot Re-eval Est Plan Care 42 11 — — $150.00 $150.00 $150.00 2026-08-10
97167 HCPCS Ot Eval High Complex 60 Min 42 11 — — $150.00 $150.00 $150.00 2026-08-10
97166 HCPCS Ot Eval Mod Complex 45 Min 42 11 — — $150.00 $150.00 $150.00 2026-08-10
97165 HCPCS Ot Eval Low Complex 30 Min 42 11 — — $150.00 $150.00 $150.00 2026-08-10
97164 HCPCS Pt Re-eval Est Plan Care 42 11 — — $150.00 $150.00 $150.00 2026-08-10
97163 HCPCS Pt Eval High Complex 45 Min 42 11 — — $150.00 $150.00 $150.00 2026-08-10
97162 HCPCS Pt Eval Mod Complex 30 Min 42 11 — — $150.00 $150.00 $150.00 2026-08-10
97161 HCPCS Pt Eval Low Complex 20 Min 42 11 — — $150.00 $150.00 $150.00 2026-08-10
96105 HCPCS Assessment Of Aphasia 42 11 — — $150.00 $150.00 $150.00 2026-08-10
0434 RC Occupational Therapy - Evaluation Or Reevaluation 42 11 — — $150.00 $150.00 $150.00 2026-08-10
0420 RC Physical Therapy - General Classification 42 11 — — $90.00 $120.00 $120.00 2026-08-10
0440 RC Speech Therapy - Language Pathology - General Classification 42 11 — — $90.00 $120.00 $120.00 2026-08-10
0430 RC Occupational Therapy - General Classification 42 11 — — $90.00 $120.00 $120.00 2026-08-10
92597 HCPCS Oral Speech Device Eval 1 1 — — $90.00 $90.00 $90.00 2026-08-10
92526 HCPCS Oral Function Therapy 42 11 — — $90.00 $90.00 $90.00 2026-08-10
92507 HCPCS Speech/hearing Therapy 42 11 — — $90.00 $90.00 $90.00 2026-08-10
92605 HCPCS Ex For Nonspeech Device Rx 1 1 — — $90.00 $90.00 $90.00 2026-08-10
92607 HCPCS Ex For Speech Device Rx 1hr 42 11 — — $90.00 $90.00 $90.00 2026-08-10
92606 HCPCS Non-speech Device Service 1 1 — — $90.00 $90.00 $90.00 2026-08-10
97537 HCPCS Community/work Reintegration 42 11 — — $90.00 $90.00 $90.00 2026-08-10
97535 HCPCS Self Care Mngment Training 42 11 — — $90.00 $90.00 $90.00 2026-08-10
97530 HCPCS Therapeutic Activities 42 11 — — $90.00 $90.00 $90.00 2026-08-10
97140 HCPCS Manual Therapy 1/> Regions 42 11 — — $90.00 $90.00 $90.00 2026-08-10
97129 HCPCS Ther Ivntj 1st 15 Min 42 11 — — $90.00 $90.00 $90.00 2026-08-10
97124 HCPCS Massage Therapy 42 11 — — $90.00 $90.00 $90.00 2026-08-10
97116 HCPCS Gait Training Therapy 42 11 — — $90.00 $90.00 $90.00 2026-08-10
97113 HCPCS Aquatic Therapy/exercises 42 11 — — $90.00 $90.00 $90.00 2026-08-10
97112 HCPCS Neuromuscular Reeducation 42 11 — — $90.00 $90.00 $90.00 2026-08-10
97110 HCPCS Therapeutic Exercises 42 11 — — $90.00 $90.00 $90.00 2026-08-10
97032 HCPCS Appl Modality 1+estim Ea 15 42 11 — — $90.00 $90.00 $90.00 2026-08-10
94003 HCPCS Vent Mgmt Inpat Subq Day 0 0 — — — — — 2026-08-10
94002 HCPCS Vent Mgmt Inpat Init Day 0 0 — — — — — 2026-08-10
76700 HCPCS US Exam Abdom Complete 0 0 — — — — — 2026-08-10
93971 HCPCS Extremity Study 0 0 — — — — — 2026-08-10
93970 HCPCS Extremity Study 0 0 — — — — — 2026-08-10
74177 HCPCS CT Abd & Pelv W/contrast 0 0 — — — — — 2026-08-10
93926 HCPCS Lower Extremity Study 0 0 — — — — — 2026-08-10
92612 HCPCS Endoscopy Swallow (fees) Vid 0 0 — — — — — 2026-08-10
92610 HCPCS Evaluate Swallowing Function 0 0 — — — — — 2026-08-10
A1604 HCPCS Pain Syndrome M <43.50- Tier None 0 0 — — — — — 2026-08-10
92609 HCPCS Use Of Speech Device Service 0 0 — — — — — 2026-08-10
74018 HCPCS X-ray Exam Abdomen 1 View 0 0 — — — — — 2026-08-10
73610 HCPCS X-ray Exam Of Ankle 0 0 — — — — — 2026-08-10
A1602 HCPCS Pain Syndrome M >=58.50 And M <65.50- Tier None 0 0 — — — — — 2026-08-10
A1504 HCPCS Pulmonary M <45.50- Tier None 0 0 — — — — — 2026-08-10
73560 HCPCS X-ray Exam Of Knee 1 Or 2 0 0 — — — — — 2026-08-10
A1503 HCPCS Pulmonary M >=45.50 And M <56.50- Tier None 0 0 — — — — — 2026-08-10
A1501 HCPCS Pulmonary M >=68.50- Tier None 0 0 — — — — — 2026-08-10
73100 HCPCS X-ray Exam Of Wrist 0 0 — — — — — 2026-08-10
A1401 HCPCS Cardiac M >=68.50- Tier None 0 0 — — — — — 2026-08-10
A1305 HCPCS Rheumatoid Other Arthritis M <51.50 And A <64.50- Tier None 0 0 — — — — — 2026-08-10
A1303 HCPCS Rheumatoid Other Arthritis M >=44.50 And M <51.50 And A >=64.50- Tier None 0 0 — — — — — 2026-08-10
A1302 HCPCS Rheumatoid Other Arthritis M >=51.50 And M <62.50- Tier None 0 0 — — — — — 2026-08-10
A1301 HCPCS Rheumatoid Other Arthritis M >=62.50- Tier None 0 0 — — — — — 2026-08-10
73030 HCPCS X-ray Exam Of Shoulder 0 0 — — — — — 2026-08-10
729 MS_DRG Other Male Reproductive System Diagnoses With Cc/mcc 0 0 — — — — — 2026-08-10
A1203 HCPCS Osteoarthritis M <49.50 And A >=74.50- Tier None 0 0 — — — — — 2026-08-10
A1201 HCPCS Osteoarthritis M >=61.50- Tier None 0 0 — — — — — 2026-08-10
72170 HCPCS X-ray Exam Of Pelvis 0 0 — — — — — 2026-08-10
A1103 HCPCS Amputation Non-lower Extremity M <52.50- Tier None 0 0 — — — — — 2026-08-10
A1102 HCPCS Amputation Non-lower Extremity M >=52.50 And M <58.50- Tier None 0 0 — — — — — 2026-08-10
91 MS_DRG Other Disorders Of Nervous System With Mcc 0 0 — — — — — 2026-08-10
A1101 HCPCS Amputation Non-lower Extremity M >=58.50- Tier None 0 0 — — — — — 2026-08-10
A1202 HCPCS Osteoarthritis M >=49.50 And M <61.50- Tier None 0 0 — — — — — 2026-08-10
90999 HCPCS Unlisted Dialysis Procedure 0 0 — — — — — 2026-08-10
A1204 HCPCS Osteoarthritis M <49.50 And A <74.50- Tier None 0 0 — — — — — 2026-08-10
72158 HCPCS MRI Lumbar Spine Without & With Contrast 0 0 — — — — — 2026-08-10
90993 HCPCS Dialysis Training Incompl 0 0 — — — — — 2026-08-10
A1001 HCPCS Amputation Lower Extremity M >=64.50- Tier None 0 0 — — — — — 2026-08-10
A1304 HCPCS Rheumatoid Other Arthritis M <44.50 And A >=64.50- Tier None 0 0 — — — — — 2026-08-10
90937 HCPCS Hemodialysis Repeated Eval 0 0 — — — — — 2026-08-10
90935 HCPCS Hemodialysis One Evaluation 0 0 — — — — — 2026-08-10
A0901 HCPCS Other Orthopedic M >=63.50- Tier None 0 0 — — — — — 2026-08-10
90676 HCPCS Rabies Vaccine Id 0 0 — — — — — 2026-08-10
71046 HCPCS X-ray Exam Chest 2 Views 0 0 — — — — — 2026-08-10
71045 HCPCS X-ray Exam Chest 1 View 0 0 — — — — — 2026-08-10
A0803 HCPCS Replacement Of Lower-extremity Joint M >=51.50 And M <57.50- Tier None 0 0 — — — — — 2026-08-10
90675 HCPCS Rabies Vaccine IM 0 0 — — — — — 2026-08-10
A0801 HCPCS Replacement Of Lower-extremity Joint M >=63.50- Tier None 0 0 — — — — — 2026-08-10
A1601 HCPCS Pain Syndrome M >=65.50- Tier None 0 0 — — — — — 2026-08-10
90396 HCPCS Varicella-zoster Ig IM 0 0 — — — — — 2026-08-10
A1603 HCPCS Pain Syndrome M >=43.50 And M <58.50- Tier None 0 0 — — — — — 2026-08-10
90378 HCPCS Rsv Mab IM 50mg 0 0 — — — — — 2026-08-10
A1701 HCPCS Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=57.50- Tier None 0 0 — — — — — 2026-08-10
A0701 HCPCS Fracture Of Lower Extremity M >=61.50- Tier None 0 0 — — — — — 2026-08-10
90377 HCPCS Rabies Ig Ht&sol Human Im/sc 0 0 — — — — — 2026-08-10
70470 HCPCS CT Head/brain Without & With Contrast 0 0 — — — — — 2026-08-10
90376 HCPCS Rabies Ig Heat Treated 0 0 — — — — — 2026-08-10
A1801 HCPCS Major Multiple Trauma With Brain Or Spinal Cord Injury M >=67.50- Tier None 0 0 — — — — — 2026-08-10
A1802 HCPCS Major Multiple Trauma With Brain Or Spinal Cord Injury M >=55.50 And M <67.50- T… 0 0 — — — — — 2026-08-10
90375 HCPCS Rabies Ig Im/sc 0 0 — — — — — 2026-08-10
A0505 HCPCS Non-traumatic Spinal Cord Injury M <39.50- Tier None 0 0 — — — — — 2026-08-10
A0503 HCPCS Non-traumatic Spinal Cord Injury M >=48.50 And M <53.50- Tier None 0 0 — — — — — 2026-08-10
A1806 HCPCS Major Multiple Trauma With Brain Or Spinal Cord Injury M <30.50- Tier None 0 0 — — — — — 2026-08-10
A1901 HCPCS Guillain-barré M >=66.50- Tier None 0 0 — — — — — 2026-08-10
A0502 HCPCS Non-traumatic Spinal Cord Injury M >=53.50 And M <60.50- Tier None 0 0 — — — — — 2026-08-10
A1903 HCPCS Guillain-barré M >=38.50 And M <51.50- Tier None 0 0 — — — — — 2026-08-10
A1904 HCPCS Guillain-barré M <38.50- Tier None 0 0 — — — — — 2026-08-10
90371 HCPCS Hep B Ig IM 0 0 — — — — — 2026-08-10
87635 HCPCS Sars-cov-2 Covid-19 Amp Prb 0 0 — — — — — 2026-08-10
640 MS_DRG Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes With M… 0 0 — — — — — 2026-08-10
29130 HCPCS Application Of Finger Splint 0 0 — — — — — 2026-08-10
29126 HCPCS Apply Forearm Splint 0 0 — — — — — 2026-08-10
A0501 HCPCS Non-traumatic Spinal Cord Injury M >=60.50- Tier None 0 0 — — — — — 2026-08-10
A0407 HCPCS Traumatic Spinal Cord Injury M <24.50 And A >=61.50- Tier None 0 0 — — — — — 2026-08-10
87633 HCPCS Resp Virus 12-25 Targets 0 0 — — — — — 2026-08-10
A0406 HCPCS Traumatic Spinal Cord Injury M >=24.50 And M <31.50 And A >=61.50- Tier None 0 0 — — — — — 2026-08-10
A0405 HCPCS Traumatic Spinal Cord Injury M >=31.50 And M <41.50- Tier None 0 0 — — — — — 2026-08-10
87493 HCPCS C Diff Amplified Probe 0 0 — — — — — 2026-08-10
29125 HCPCS Apply Forearm Splint 0 0 — — — — — 2026-08-10
A0404 HCPCS Traumatic Spinal Cord Injury M <31.50 And A <61.50- Tier None 0 0 — — — — — 2026-08-10
A0403 HCPCS Traumatic Spinal Cord Injury M >=41.50 And M <47.50- Tier None 0 0 — — — — — 2026-08-10
87340 HCPCS Hepatitis B Surface Ag Ia 0 0 — — — — — 2026-08-10
A0401 HCPCS Traumatic Spinal Cord Injury M >=56.50- Tier None 0 0 — — — — — 2026-08-10
87086 HCPCS Urine Culture/colony Count 0 0 — — — — — 2026-08-10
20561 HCPCS Ndl Insj Without Njx 3+ Musc 0 0 — — — — — 2026-08-10
A0304 HCPCS Non-traumatic Brain Injury M <42.50 And A >=78.50- Tier None 0 0 — — — — — 2026-08-10
87070 HCPCS Culture Othr Specimn Aerobic 0 0 — — — — — 2026-08-10
87040 HCPCS Blood Culture For Bacteria 0 0 — — — — — 2026-08-10
A0301 HCPCS Non-traumatic Brain Injury M >=65.50- Tier None 0 0 — — — — — 2026-08-10
86905 HCPCS Blood Typing Rbc Antigens 0 0 — — — — — 2026-08-10
86140 HCPCS C-reactive Protein 0 0 — — — — — 2026-08-10
20560 HCPCS Ndl Insj Without Njx 1 Or 2 Musc 0 0 — — — — — 2026-08-10
193 MS_DRG Simple Pneumonia And Pleurisy With Mcc 0 0 — — — — — 2026-08-10
A0202 HCPCS Traumatic Brain Injury M >=61.50 And M <73.50- Tier None 0 0 — — — — — 2026-08-10
A0201 HCPCS Traumatic Brain Injury M >=73.50- Tier None 0 0 — — — — — 2026-08-10
860 APR_DRG Rehabilitation 0 0 — — — — — 2026-08-10
85610 HCPCS Prothrombin Time 0 0 — — — — — 2026-08-10
11721 HCPCS Debride Nail 6 Or More 0 0 — — — — — 2026-08-10
85027 HCPCS Complete Cbc Automated 0 0 — — — — — 2026-08-10
A0101 HCPCS Stroke M >=72.50- Tier None 0 0 — — — — — 2026-08-10
85025 HCPCS Complete Cbc W/auto Diff Wbc 0 0 — — — — — 2026-08-10
0831 RC Peritoneal Dialysis - Outpatient Or Home - Peritoneal/Composite Or Other Rate 0 0 — — — — — 2026-08-10
99499 HCPCS Unlisted E&m Service 0 0 — — — — — 2026-08-10
99232 HCPCS Sbsq Hosp Ip/obs Moderate 35 0 0 — — — — — 2026-08-10
84481 HCPCS Free Assay (ft-3) 0 0 — — — — — 2026-08-10
99231 HCPCS Sbsq Hosp Ip/obs Sf/low 25 0 0 — — — — — 2026-08-10
99223 HCPCS 1st Hosp Ip/obs High 75 0 0 — — — — — 2026-08-10
84443 HCPCS Assay Thyroid Stim Hormone 0 0 — — — — — 2026-08-10
99199 HCPCS Unlisted Special Svc Px/rprt 0 0 — — — — — 2026-08-10
97763 HCPCS Orthc/prostc Mgmt Sbsq Enc 0 0 — — — — — 2026-08-10
84145 HCPCS Procalcitonin (pct) 0 0 — — — — — 2026-08-10
97761 HCPCS Prosthetic Traing 1st Enc 0 0 — — — — — 2026-08-10
97760 HCPCS Orthotic Mgmt&traing 1st Enc 0 0 — — — — — 2026-08-10
See an error in this hospital's data? Submit a correction