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

COMMUNITY HOSPITAL OF STAUNTON

Staunton, IL · CCN 141306 · Rates published

16,023 distinct procedures filed
16 distinct payers
359,900 rate rows
2025-01-21 last MRF observed · ⚠ 19 mo old
Data quality

325,969 of 359,900 rate rows are consumer-grade (90.6%)

33,931 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
per-diem day rate — not a per-procedure price 13,926
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 12,333
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 4,590
template filing: same amount across many unrelated codes — excluded 2,904
exceeds 10× this hospital's gross charge — excluded from medians 166
below 25% of the Medicare reference for this DRG — likely a mislabeled per-diem; excluded from rankings 12

⚠ Possibly outdated The most recent machine-readable file we have for this hospital is 19 months old. CMS requires hospitals to refresh these files at least annually, so newer rates may exist that we haven't ingested yet. The prices below are exactly as last filed.

Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://stauntonhospital.org/wp-content/uploads/2026/04/370624255_anderson_healthcare_standardcharges.csv
Found on page https://stauntonhospital.org/visitor-patient-information/price-transparency/
Discovered viaCMS hospital list
Last fetch not_modified · 2026-08-12
Content fingerprint 65bb0e644ce58a50… · 35,936,850 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
'583-4
OTHER 		Neonate With Ecmo 4 $190,753.52 $190,753.52 $190,753.52 nat. median
$221,551
0.9× median
'588-4
OTHER 		Neonate Birth Weight < 1500 Grams With Major Procedure 4 $156,469.62 $156,469.62 $156,469.62 nat. median
$202,324
0.8× median
'583-3
OTHER 		Neonate With Ecmo 4 $151,080.42 $151,080.42 $151,080.42 nat. median
$195,630
0.8× median
'161-4
OTHER 		Implantable Heart Assist Systems 4 $149,603.53 $149,603.53 $149,603.53 nat. median
$182,608
0.8× median
'002-4
OTHER 		Heart And/or Lung Transplant 4 $144,371.88 $144,371.88 $144,371.88 nat. median
$205,014
0.7× median
'161-3
OTHER 		Implantable Heart Assist Systems 4 $114,611.68 $114,611.68 $114,611.68 nat. median
$114,612
1.0× median
'630-4
OTHER 		Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 4 $113,571.45 $113,571.45 $113,571.45 nat. median
$127,072
0.9× median
'583-2
OTHER 		Neonate With Ecmo 4 $111,407.32 $111,407.32 $111,407.32 nat. median
$119,004
0.9× median
'841-4
OTHER 		Extensive Third Degree Burns With Skin Graft 4 $105,500.94 $105,500.94 $105,500.94 nat. median
$138,284
0.8× median
'593-4
OTHER 		Neonate Birth Weight 750-999 Grams Without Major Procedure 4 $102,047.97 $102,047.97 $102,047.97 nat. median
$115,906
0.9× median
'588-3
OTHER 		Neonate Birth Weight < 1500 Grams With Major Procedure 4 $100,803.67 $100,803.67 $100,803.67 nat. median
$131,074
0.8× median
'588-2
OTHER 		Neonate Birth Weight < 1500 Grams With Major Procedure 4 $98,706.40 $98,706.40 $98,706.40 nat. median
$110,776
0.9× median
'591-4
OTHER 		Neonate Birth Weight 500-749 Grams Without Major Procedure 4 $98,544.17 $98,544.17 $98,544.17 nat. median
$119,104
0.8× median
'011-4
OTHER 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 4 $98,417.51 $98,417.51 $98,417.51 nat. median
$98,418
1.0× median
'609-4
OTHER 		Neonate Birth Weight 1500-2499 Grams With Major Procedure 4 $97,915.57 $97,915.57 $97,915.57 nat. median
$130,670
0.7× median
'583-1
OTHER 		Neonate With Ecmo 4 $96,276.06 $96,276.06 $96,276.06 nat. median
$105,798
0.9× median
'007-4
OTHER 		Allogeneic Bone Marrow Transplant 4 $94,647.89 $94,647.89 $94,647.89 nat. median
$131,941
0.7× median
'631-4
OTHER 		Neonate Birth Weight > 2499 Grams With Other Major Procedure 4 $94,003.26 $94,003.26 $94,003.26 nat. median
$112,354
0.8× median
'004-4
OTHER 		Tracheostomy With Mv >96 Hours With Extensive Procedure 4 $93,749.17 $93,749.17 $93,749.17 nat. median
$101,809
0.9× median
C9076
HCPCS 		Lisocabtagene Car Pos T 4 $92,877.03 $92,877.03 $92,877.03 nat. median
$27,935
outlier · 3.3×
Q2056
HCPCS 		Ciltacabtagene Car-pos T 4 $92,877.03 $92,877.03 $92,877.03 nat. median
$631,793
outlier · 0.1×
J3393
HCPCS 		Inj, Betibeglogene Autotemce 4 $92,877.03 $92,877.03 $92,877.03 nat. median
$2,997,086
outlier · 0.0×
C9081
HCPCS 		Idecabtagene Car Pos T 4 $92,877.03 $92,877.03 $92,877.03 nat. median
$27,427
outlier · 3.4×
J3394
HCPCS 		Inj, Lovotibeglogene Autotem 4 $92,877.03 $92,877.03 $92,877.03 nat. median
$3,286,000
outlier · 0.0×
Q2040
HCPCS 		Tisagenlecleucel Car-pos T 4 $92,877.03 $92,877.03 $92,877.03 nat. median
$10,345
outlier · 9.0×
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 4 $92,877.03 $92,877.03 $92,877.03 nat. median
$624,417
outlier · 0.1×
Q2053
HCPCS 		Brexucabtagene Car Pos T 4 $92,877.03 $92,877.03 $92,877.03 nat. median
$577,541
outlier · 0.2×
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 4 $92,877.03 $92,877.03 $92,877.03 nat. median
$588,565
outlier · 0.2×
C9098
HCPCS 		Ciltacabtagene Car Pos T 4 $92,877.03 $92,877.03 $92,877.03 nat. median
$30,221
outlier · 3.1×
C9073
HCPCS 		Brexucabtagene Autoleucel Ca 4 $92,877.03 $92,877.03 $92,877.03 nat. median
$27,071
outlier · 3.4×
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 4 $92,877.03 $92,877.03 $92,877.03 nat. median
$691,418
outlier · 0.1×
Q2055
HCPCS 		Idecabtagene Vicleucel Car 4 $92,877.03 $92,877.03 $92,877.03 nat. median
$610,161
outlier · 0.2×
'001-4
OTHER 		Liver Transplant And/or Intestinal Transplant 4 $92,291.43 $92,291.43 $92,291.43 nat. median
$107,546
0.9× median
'161-2
OTHER 		Implantable Heart Assist Systems 4 $92,023.26 $92,023.26 $92,023.26 nat. median
$86,952
1.1× median
'009-4
OTHER 		Extracorporeal Membrane Oxygenation (ecmo) 4 $91,782.85 $91,782.85 $91,782.85 nat. median
$89,522
1.0× median
'002-3
OTHER 		Heart And/or Lung Transplant 4 $89,277.46 $89,277.46 $89,277.46 nat. median
$89,928
1.0× median
'161-1
OTHER 		Implantable Heart Assist Systems 4 $87,421.77 $87,421.77 $87,421.77 nat. median
$70,718
1.2× median
'603-4
OTHER 		Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 4 $82,029.45 $82,029.45 $82,029.45 nat. median
$102,933
0.8× median
'006-4
OTHER 		Pancreas Transplant 4 $81,504.05 $81,504.05 $81,504.05 nat. median
$56,683
1.4× median
C9031
HCPCS 		Lutetium Lu 177 Dotatate, Tx 4 $74,517.38 $74,517.38 $74,517.38 nat. median
$524
outlier · 142.3×
A9543
HCPCS 		Y90 Ibritumomab, Rx 4 $74,517.38 $74,517.38 $74,517.38 nat. median
$63,643
1.2× median
A9513
HCPCS 		Lutetium Lu 177 Dotatat Ther 4 $74,517.38 $74,517.38 $74,517.38 nat. median
$470
outlier · 158.6×
A9607
HCPCS 		Lutetium Lu 177 Vipivotide 4 $74,517.38 $74,517.38 $74,517.38 nat. median
$421
outlier · 177.1×
'602-4
OTHER 		Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 4 $73,148.18 $73,148.18 $73,148.18 nat. median
$66,108
1.1× median
J0202
HCPCS 		Alemtuzumab 12 Mg/1.2 Ml Vial 14 $35,820.80 $90,547.02 $66,666.49 nat. median
$3,876
outlier · 17.2×
'002-2
OTHER 		Heart And/or Lung Transplant 4 $66,253.56 $66,253.56 $66,253.56 nat. median
$76,713
0.9× median
'593-3
OTHER 		Neonate Birth Weight 750-999 Grams Without Major Procedure 4 $65,623.40 $65,623.40 $65,623.40 nat. median
$82,229
0.8× median
'588-1
OTHER 		Neonate Birth Weight < 1500 Grams With Major Procedure 4 $64,972.13 $64,972.13 $64,972.13 nat. median
$98,245
0.7× median
'004-3
OTHER 		Tracheostomy With Mv >96 Hours With Extensive Procedure 4 $64,155.11 $64,155.11 $64,155.11 nat. median
$62,886
1.0× median
'160-4
OTHER 		Major Cardiothoracic Repair Of Heart Anomaly 4 $63,303.69 $63,303.69 $63,303.69 nat. median
$82,416
0.8× median

Other procedures at this hospital

Browse this hospital's 16,023 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
             
'583-4 OTHER Neonate With Ecmo 8 4 — — $190,753.52 $190,753.52 $190,753.52 2025-01-21
'588-4 OTHER Neonate Birth Weight < 1500 Grams With Major Procedure 8 4 — — $156,469.62 $156,469.62 $156,469.62 2025-01-21
'583-3 OTHER Neonate With Ecmo 8 4 — — $151,080.42 $151,080.42 $151,080.42 2025-01-21
'161-4 OTHER Implantable Heart Assist Systems 8 4 — — $149,603.53 $149,603.53 $149,603.53 2025-01-21
'002-4 OTHER Heart And/or Lung Transplant 8 4 — — $144,371.88 $144,371.88 $144,371.88 2025-01-21
'161-3 OTHER Implantable Heart Assist Systems 8 4 — — $114,611.68 $114,611.68 $114,611.68 2025-01-21
'630-4 OTHER Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 8 4 — — $113,571.45 $113,571.45 $113,571.45 2025-01-21
'583-2 OTHER Neonate With Ecmo 8 4 — — $111,407.32 $111,407.32 $111,407.32 2025-01-21
'841-4 OTHER Extensive Third Degree Burns With Skin Graft 8 4 — — $105,500.94 $105,500.94 $105,500.94 2025-01-21
'593-4 OTHER Neonate Birth Weight 750-999 Grams Without Major Procedure 8 4 — — $102,047.97 $102,047.97 $102,047.97 2025-01-21
'588-3 OTHER Neonate Birth Weight < 1500 Grams With Major Procedure 8 4 — — $100,803.67 $100,803.67 $100,803.67 2025-01-21
'588-2 OTHER Neonate Birth Weight < 1500 Grams With Major Procedure 8 4 — — $98,706.40 $98,706.40 $98,706.40 2025-01-21
'591-4 OTHER Neonate Birth Weight 500-749 Grams Without Major Procedure 8 4 — — $98,544.17 $98,544.17 $98,544.17 2025-01-21
'011-4 OTHER Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 8 4 — — $98,417.51 $98,417.51 $98,417.51 2025-01-21
'609-4 OTHER Neonate Birth Weight 1500-2499 Grams With Major Procedure 8 4 — — $97,915.57 $97,915.57 $97,915.57 2025-01-21
'583-1 OTHER Neonate With Ecmo 8 4 — — $96,276.06 $96,276.06 $96,276.06 2025-01-21
'007-4 OTHER Allogeneic Bone Marrow Transplant 8 4 — — $94,647.89 $94,647.89 $94,647.89 2025-01-21
'631-4 OTHER Neonate Birth Weight > 2499 Grams With Other Major Procedure 8 4 — — $94,003.26 $94,003.26 $94,003.26 2025-01-21
'004-4 OTHER Tracheostomy With Mv >96 Hours With Extensive Procedure 8 4 — — $93,749.17 $93,749.17 $93,749.17 2025-01-21
C9098 HCPCS Ciltacabtagene Car Pos T 8 4 — — $92,877.03 $92,877.03 $92,877.03 2025-01-21
C9081 HCPCS Idecabtagene Car Pos T 8 4 — — $92,877.03 $92,877.03 $92,877.03 2025-01-21
Q2054 HCPCS Lisocabtagene Mara Car Pos T 8 4 — — $92,877.03 $92,877.03 $92,877.03 2025-01-21
Q2055 HCPCS Idecabtagene Vicleucel Car 8 4 — — $92,877.03 $92,877.03 $92,877.03 2025-01-21
C9076 HCPCS Lisocabtagene Car Pos T 8 4 — — $92,877.03 $92,877.03 $92,877.03 2025-01-21
Q2040 HCPCS Tisagenlecleucel Car-pos T 8 4 — — $92,877.03 $92,877.03 $92,877.03 2025-01-21
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 8 4 — — $92,877.03 $92,877.03 $92,877.03 2025-01-21
Q2042 HCPCS Tisagenlecleucel Car-pos T 8 4 — — $92,877.03 $92,877.03 $92,877.03 2025-01-21
J3393 HCPCS Inj, Betibeglogene Autotemce 8 4 — — $92,877.03 $92,877.03 $92,877.03 2025-01-21
Q2056 HCPCS Ciltacabtagene Car-pos T 8 4 — — $92,877.03 $92,877.03 $92,877.03 2025-01-21
J3394 HCPCS Inj, Lovotibeglogene Autotem 8 4 — — $92,877.03 $92,877.03 $92,877.03 2025-01-21
C9073 HCPCS Brexucabtagene Autoleucel Ca 8 4 — — $92,877.03 $92,877.03 $92,877.03 2025-01-21
Q2053 HCPCS Brexucabtagene Car Pos T 8 4 — — $92,877.03 $92,877.03 $92,877.03 2025-01-21
'001-4 OTHER Liver Transplant And/or Intestinal Transplant 8 4 — — $92,291.43 $92,291.43 $92,291.43 2025-01-21
'161-2 OTHER Implantable Heart Assist Systems 8 4 — — $92,023.26 $92,023.26 $92,023.26 2025-01-21
'009-4 OTHER Extracorporeal Membrane Oxygenation (ecmo) 8 4 — — $91,782.85 $91,782.85 $91,782.85 2025-01-21
'002-3 OTHER Heart And/or Lung Transplant 8 4 — — $89,277.46 $89,277.46 $89,277.46 2025-01-21
'161-1 OTHER Implantable Heart Assist Systems 8 4 — — $87,421.77 $87,421.77 $87,421.77 2025-01-21
'603-4 OTHER Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 8 4 — — $82,029.45 $82,029.45 $82,029.45 2025-01-21
'006-4 OTHER Pancreas Transplant 8 4 — — $81,504.05 $81,504.05 $81,504.05 2025-01-21
A9607 HCPCS Lutetium Lu 177 Vipivotide 8 4 — — $74,517.38 $74,517.38 $74,517.38 2025-01-21
A9513 HCPCS Lutetium Lu 177 Dotatat Ther 8 4 — — $74,517.38 $74,517.38 $74,517.38 2025-01-21
C9031 HCPCS Lutetium Lu 177 Dotatate, Tx 8 4 — — $74,517.38 $74,517.38 $74,517.38 2025-01-21
A9543 HCPCS Y90 Ibritumomab, Rx 8 4 — — $74,517.38 $74,517.38 $74,517.38 2025-01-21
'602-4 OTHER Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 8 4 — — $73,148.18 $73,148.18 $73,148.18 2025-01-21
J0202 HCPCS Alemtuzumab 12 Mg/1.2 Ml Vial 58 14 $99,502.22 $49,751.11 50% off $35,820.80 $90,547.02 $66,666.49 2025-01-21
'002-2 OTHER Heart And/or Lung Transplant 8 4 — — $66,253.56 $66,253.56 $66,253.56 2025-01-21
'593-3 OTHER Neonate Birth Weight 750-999 Grams Without Major Procedure 8 4 — — $65,623.40 $65,623.40 $65,623.40 2025-01-21
'588-1 OTHER Neonate Birth Weight < 1500 Grams With Major Procedure 8 4 — — $64,972.13 $64,972.13 $64,972.13 2025-01-21
'004-3 OTHER Tracheostomy With Mv >96 Hours With Extensive Procedure 8 4 — — $64,155.11 $64,155.11 $64,155.11 2025-01-21
'160-4 OTHER Major Cardiothoracic Repair Of Heart Anomaly 8 4 — — $63,303.69 $63,303.69 $63,303.69 2025-01-21
'005-4 OTHER Tracheostomy With Mv >96 Hours Without Extensive Procedure 8 4 — — $61,782.63 $61,782.63 $61,782.63 2025-01-21
33981 HCPCS Replace Vad Pump Ext 8 4 — — $61,110.38 $61,110.38 $61,110.38 2025-01-21
33979 HCPCS Insert Intracorporeal Device 8 4 — — $61,110.38 $61,110.38 $61,110.38 2025-01-21
33991 HCPCS Insj Perq Vad L Hrt Artl&ven 8 4 — — $61,110.38 $61,110.38 $61,110.38 2025-01-21
0452T OTHER Insj/rplcmt Dev Vasc Seal 8 4 — — $61,110.38 $61,110.38 $61,110.38 2025-01-21
33982 HCPCS Replace Vad Intra Without Bp 8 4 — — $61,110.38 $61,110.38 $61,110.38 2025-01-21
33990 HCPCS Insj Perq Vad L Hrt Arterial 8 4 — — $61,110.38 $61,110.38 $61,110.38 2025-01-21
33976 HCPCS Implant Ventricular Device 8 4 — — $61,110.38 $61,110.38 $61,110.38 2025-01-21
0454T OTHER Insj/rplcmt Subq Electrode 8 4 — — $61,110.38 $61,110.38 $61,110.38 2025-01-21
33983 HCPCS Replace Vad Intra W/bp 8 4 — — $61,110.38 $61,110.38 $61,110.38 2025-01-21
33975 HCPCS Implant Ventricular Device 8 4 — — $61,110.38 $61,110.38 $61,110.38 2025-01-21
33995 HCPCS Insj Perq Vad R Hrt Venous 8 4 — — $61,110.38 $61,110.38 $61,110.38 2025-01-21
0451T OTHER Insj/rplcmt Aortic Ventr Sys 8 4 — — $61,110.38 $61,110.38 $61,110.38 2025-01-21
0459T OTHER Relocaj Rplcmt Aortic Ventr 8 4 — — $61,110.38 $61,110.38 $61,110.38 2025-01-21
0453T OTHER Insj/rplcmt Mech-elec Ntrfce 8 4 — — $61,110.38 $61,110.38 $61,110.38 2025-01-21
'162-4 OTHER Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 8 4 — — $59,662.68 $59,662.68 $59,662.68 2025-01-21
'591-3 OTHER Neonate Birth Weight 500-749 Grams Without Major Procedure 8 4 — — $57,731.94 $57,731.94 $57,731.94 2025-01-21
'602-3 OTHER Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 8 4 — — $57,679.16 $57,679.16 $57,679.16 2025-01-21
'006-3 OTHER Pancreas Transplant 8 4 — — $57,309.36 $57,309.36 $57,309.36 2025-01-21
'303-4 OTHER Dorsal And Lumbar Fusion Procedure For Curvature Of Back 8 4 — — $57,039.23 $57,039.23 $57,039.23 2025-01-21
'002-1 OTHER Heart And/or Lung Transplant 8 4 — — $56,796.86 $56,796.86 $56,796.86 2025-01-21
'607-4 OTHER Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 8 4 — — $56,184.29 $56,184.29 $56,184.29 2025-01-21
'007-3 OTHER Allogeneic Bone Marrow Transplant 8 4 — — $55,778.52 $55,778.52 $55,778.52 2025-01-21
'630-3 OTHER Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 8 4 — — $54,875.11 $54,875.11 $54,875.11 2025-01-21
'440-4 OTHER Kidney Transplant 8 4 — — $54,225.79 $54,225.79 $54,225.79 2025-01-21
'001-3 OTHER Liver Transplant And/or Intestinal Transplant 8 4 — — $53,356.39 $53,356.39 $53,356.39 2025-01-21
'842-4 OTHER Burns With Skin Graft Except Extensive Third Degree Burns 8 4 — — $53,317.30 $53,317.30 $53,317.30 2025-01-21
'593-2 OTHER Neonate Birth Weight 750-999 Grams Without Major Procedure 8 4 — — $52,012.81 $52,012.81 $52,012.81 2025-01-21
J3357 HCPCS Ustekinumab 90 Mg/ml Syringe 66 16 $95,013.73 $47,506.87 50% off $14,636.76 $86,462.49 $51,307.41 2025-01-21
'163-4 OTHER Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis 8 4 — — $50,769.30 $50,769.30 $50,769.30 2025-01-21
'178-4 OTHER External Heart Assist Systems 8 4 — — $50,430.37 $50,430.37 $50,430.37 2025-01-21
'006-2 OTHER Pancreas Transplant 8 4 — — $49,750.17 $49,750.17 $49,750.17 2025-01-21
69930 HCPCS Implant Cochlear Device 8 4 — — $49,271.80 $49,271.80 $49,271.80 2025-01-21
S2235 HCPCS Implant Auditory Brain Imp 8 4 — — $49,271.80 $49,271.80 $49,271.80 2025-01-21
'609-3 OTHER Neonate Birth Weight 1500-2499 Grams With Major Procedure 8 4 — — $48,781.87 $48,781.87 $48,781.87 2025-01-21
'011-3 OTHER Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 8 4 — — $48,443.73 $48,443.73 $48,443.73 2025-01-21
'008-4 OTHER Autologous Bone Marrow Transplant 8 4 — — $47,878.46 $47,878.46 $47,878.46 2025-01-21
'165-4 OTHER Coronary Bypass With Ami Or Complex Principal Diagnosis 8 4 — — $46,427.37 $46,427.37 $46,427.37 2025-01-21
0571T OTHER Insj/rplcmt Icds Ss Eltrd 8 4 — — $45,905.74 $45,905.74 $45,905.74 2025-01-21
0614T OTHER Rmvl&rplcmt Ss Impl Dfb Pg 8 4 — — $45,905.74 $45,905.74 $45,905.74 2025-01-21
33230 HCPCS Insrt Pulse Gen W/dual Leads 8 4 — — $45,905.74 $45,905.74 $45,905.74 2025-01-21
33249 HCPCS Insj/rplcmt Defib W/lead(s) 8 4 — — $45,905.74 $45,905.74 $45,905.74 2025-01-21
0414T OTHER Rmvl & Rpl Car Modulj Pls Gn 8 4 — — $45,905.74 $45,905.74 $45,905.74 2025-01-21
33231 HCPCS Insrt Pulse Gen W/mult Leads 8 4 — — $45,905.74 $45,905.74 $45,905.74 2025-01-21
C9741 HCPCS Impl Pressure Sensor W/angio 8 4 — — $45,905.74 $45,905.74 $45,905.74 2025-01-21
33289 HCPCS Tcat Impl Wrls P-art Prs Snr 8 4 — — $45,905.74 $45,905.74 $45,905.74 2025-01-21
33270 HCPCS Ins/rep Subq Defibrillator 8 4 — — $45,905.74 $45,905.74 $45,905.74 2025-01-21
0409T OTHER Insj/rplc Car Modulj Pls Gn 8 4 — — $45,905.74 $45,905.74 $45,905.74 2025-01-21
33264 HCPCS Rmvl & Rplcmt Dfb Gen Mlt Ld 8 4 — — $45,905.74 $45,905.74 $45,905.74 2025-01-21
33262 HCPCS Rmvl& Replc Pulse Gen 1 Lead 8 4 — — $45,905.74 $45,905.74 $45,905.74 2025-01-21
33240 HCPCS Insrt Pulse Gen W/singl Lead 8 4 — — $45,905.74 $45,905.74 $45,905.74 2025-01-21
33263 HCPCS Rmvl & Rplcmt Dfb Gen 2 Lead 8 4 — — $45,905.74 $45,905.74 $45,905.74 2025-01-21
G0448 HCPCS Place Perm Pacing Cardiovert 8 4 — — $45,905.74 $45,905.74 $45,905.74 2025-01-21
0520T OTHER Rmv&rplcmt Pg Wcs Lv Battery 8 4 — — $45,905.74 $45,905.74 $45,905.74 2025-01-21
'167-4 OTHER Other Cardiothoracic And Thoracic Vascular Procedures 8 4 — — $45,667.43 $45,667.43 $45,667.43 2025-01-21
'005-3 OTHER Tracheostomy With Mv >96 Hours Without Extensive Procedure 8 4 — — $45,495.81 $45,495.81 $45,495.81 2025-01-21
'001-2 OTHER Liver Transplant And/or Intestinal Transplant 8 4 — — $44,719.06 $44,719.06 $44,719.06 2025-01-21
J9381 HCPCS Inj Teplizumab Mzwv 5 Mcg 8 4 — — $44,475.48 $44,475.48 $44,475.48 2025-01-21
J9029 HCPCS Instill Adstiladrin, Tx Dose 8 4 — — $44,475.48 $44,475.48 $44,475.48 2025-01-21
J9298 HCPCS Inj Nivol Relatlimab 3mg/1mg 8 4 — — $44,475.48 $44,475.48 $44,475.48 2025-01-21
J9269 HCPCS Inj. Tagraxofusp-erzs 10 Mcg 8 4 — — $44,475.48 $44,475.48 $44,475.48 2025-01-21
J7180 HCPCS Factor Xiii Anti-hem Factor 8 4 — — $44,475.48 $44,475.48 $44,475.48 2025-01-21
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 8 4 — — $44,475.48 $44,475.48 $44,475.48 2025-01-21
J9210 HCPCS Inj., Emapalumab-lzsg, 1 Mg 8 4 — — $44,475.48 $44,475.48 $44,475.48 2025-01-21
J7175 HCPCS Inj, Factor X, (human), 1iu 8 4 — — $44,475.48 $44,475.48 $44,475.48 2025-01-21
J2840 HCPCS Inj Sebelipase Alfa 1 Mg 8 4 — — $44,475.48 $44,475.48 $44,475.48 2025-01-21
J2350 HCPCS Injection, Ocrelizumab, 1 Mg 8 4 — — $44,475.48 $44,475.48 $44,475.48 2025-01-21
J2326 HCPCS Inj, Nusinersen, 0.1mg 8 4 — — $44,475.48 $44,475.48 $44,475.48 2025-01-21
J1413 HCPCS Inj Delandistrogene Mox Rokl 8 4 — — $44,475.48 $44,475.48 $44,475.48 2025-01-21
J1747 HCPCS Inj, Spesolimab-sbzo, 1 Mg 8 4 — — $44,475.48 $44,475.48 $44,475.48 2025-01-21
J9226 HCPCS Supprelin La Implant 8 4 — — $44,475.48 $44,475.48 $44,475.48 2025-01-21
J0217 HCPCS Inj Velmanase Alfa-tycv 1 Mg 8 4 — — $44,475.48 $44,475.48 $44,475.48 2025-01-21
J1300 HCPCS Eculizumab Injection 8 4 — — $44,475.48 $44,475.48 $44,475.48 2025-01-21
C9146 HCPCS Inj, Elahere, 1 Mg 8 4 — — $44,475.48 $44,475.48 $44,475.48 2025-01-21
C9149 HCPCS Inj, Teplizumab-mzwv, 5 Mcg 8 4 — — $44,475.48 $44,475.48 $44,475.48 2025-01-21
J1411 HCPCS Inj, Hemgenix, Per Tx Dose 8 4 — — $44,475.48 $44,475.48 $44,475.48 2025-01-21
C9052 HCPCS Injection, Ravulizumab-cwv 8 4 — — $44,475.48 $44,475.48 $44,475.48 2025-01-21
J1412 HCPCS Inj Roctavian Ml 2x10^13vc G 8 4 — — $44,475.48 $44,475.48 $44,475.48 2025-01-21
C9085 HCPCS Inj Avalglucosid Alfa-ngpt 8 4 — — $44,475.48 $44,475.48 $44,475.48 2025-01-21
J9350 HCPCS Inj Mosunetuzumab-axgb, 1 Mg 8 4 — — $44,475.48 $44,475.48 $44,475.48 2025-01-21
J7170 HCPCS Inj., Emicizumab-kxwh 0.5 Mg 8 4 — — $44,475.48 $44,475.48 $44,475.48 2025-01-21
J9376 HCPCS Inj Pozelimab-bbfg, 1 Mg 8 4 — — $44,475.48 $44,475.48 $44,475.48 2025-01-21
J9600 HCPCS Porfimer Sodium Injection 8 4 — — $44,475.48 $44,475.48 $44,475.48 2025-01-21
Q9995 HCPCS Inj. Emicizumab-kxwh, 0.5 Mg 8 4 — — $44,475.48 $44,475.48 $44,475.48 2025-01-21
J0221 HCPCS Lumizyme Injection 8 4 — — $44,475.48 $44,475.48 $44,475.48 2025-01-21
J0219 HCPCS Inj Aval Alfa-nqpt 4mg 8 4 — — $44,475.48 $44,475.48 $44,475.48 2025-01-21
J0223 HCPCS Inj Givosiran 0.5 Mg 8 4 — — $44,475.48 $44,475.48 $44,475.48 2025-01-21
'004-2 OTHER Tracheostomy With Mv >96 Hours With Extensive Procedure 8 4 — — $44,106.88 $44,106.88 $44,106.88 2025-01-21
'602-2 OTHER Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 8 4 — — $44,011.11 $44,011.11 $44,011.11 2025-01-21
'304-4 OTHER Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back 8 4 — — $43,780.47 $43,780.47 $43,780.47 2025-01-21
'607-3 OTHER Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 8 4 — — $43,708.15 $43,708.15 $43,708.15 2025-01-21
'007-2 OTHER Allogeneic Bone Marrow Transplant 8 4 — — $43,630.35 $43,630.35 $43,630.35 2025-01-21
'303-3 OTHER Dorsal And Lumbar Fusion Procedure For Curvature Of Back 8 4 — — $43,188.22 $43,188.22 $43,188.22 2025-01-21
'183-4 OTHER Percutaneous Structural Cardiac Procedures 8 4 — — $43,034.59 $43,034.59 $43,034.59 2025-01-21
'611-4 OTHER Neonate Birth Weight 1500-1999 Grams With Major Anomaly 8 4 — — $42,695.67 $42,695.67 $42,695.67 2025-01-21
'009-3 OTHER Extracorporeal Membrane Oxygenation (ecmo) 8 4 — — $42,302.01 $42,302.01 $42,302.01 2025-01-21
'863-4 OTHER Neonatal Aftercare 8 4 — — $41,857.15 $41,857.15 $41,857.15 2025-01-21
'166-4 OTHER Coronary Bypass Without Ami Or Complex Principal Diagnosis 8 4 — — $41,850.11 $41,850.11 $41,850.11 2025-01-21
'910-4 OTHER Craniotomy For Multiple Significant Trauma 8 4 — — $41,343.48 $41,343.48 $41,343.48 2025-01-21
'179-4 OTHER Defibrillator Implants 8 4 — — $41,087.04 $41,087.04 $41,087.04 2025-01-21
'680-4 OTHER Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 8 4 — — $40,916.60 $40,916.60 $40,916.60 2025-01-21
'162-3 OTHER Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 8 4 — — $40,863.83 $40,863.83 $40,863.83 2025-01-21
'612-4 OTHER Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other… 8 4 — — $40,827.86 $40,827.86 $40,827.86 2025-01-21
'613-4 OTHER Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection 8 4 — — $40,056.97 $40,056.97 $40,056.97 2025-01-21
'603-3 OTHER Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 8 4 — — $39,918.20 $39,918.20 $39,918.20 2025-01-21
'001-1 OTHER Liver Transplant And/or Intestinal Transplant 8 4 — — $39,704.75 $39,704.75 $39,704.75 2025-01-21
'169-4 OTHER Major Abdominal Vascular Procedures 8 4 — — $39,170.37 $39,170.37 $39,170.37 2025-01-21
'006-1 OTHER Pancreas Transplant 8 4 — — $39,105.87 $39,105.87 $39,105.87 2025-01-21
0268T OTHER Implt/rpl Crtd Sns Dev Gen 8 4 — — $39,082.13 $39,082.13 $39,082.13 2025-01-21
0816T OTHER Opn Insj/rplcmt Ins Ptn Subq 8 4 — — $39,082.13 $39,082.13 $39,082.13 2025-01-21
0431T OTHER Rmvl/rplc Nstim Apnea Pls Gn 8 4 — — $39,082.13 $39,082.13 $39,082.13 2025-01-21
64582 HCPCS Opn Mpltj Hpglsl Nstm Ary Pg 8 4 — — $39,082.13 $39,082.13 $39,082.13 2025-01-21
0424T OTHER Insj/rplc Nstim Apnea Compl 8 4 — — $39,082.13 $39,082.13 $39,082.13 2025-01-21
0817T OTHER Opn Insj/rplcmt Ins Ptn Subf 8 4 — — $39,082.13 $39,082.13 $39,082.13 2025-01-21
0266T OTHER Implt/rpl Crtd Sns Dev Total 8 4 — — $39,082.13 $39,082.13 $39,082.13 2025-01-21
0316T OTHER Replc Vagus Nerve Pls Gen 8 4 — — $39,082.13 $39,082.13 $39,082.13 2025-01-21
0466T OTHER Insj Ch Wal Respir Eltrd/ra 8 4 — — $39,082.13 $39,082.13 $39,082.13 2025-01-21
61863 HCPCS Implant Neuroelectrode 8 4 — — $39,082.13 $39,082.13 $39,082.13 2025-01-21
61885 HCPCS Insrt/redo Neurostim 1 Array 8 4 — — $39,082.13 $39,082.13 $39,082.13 2025-01-21
61870 HCPCS Implant Neuroelectrodes 8 4 — — $39,082.13 $39,082.13 $39,082.13 2025-01-21
33276 HCPCS Insj Phrnc Nrv Stim Sys 8 4 — — $39,082.13 $39,082.13 $39,082.13 2025-01-21
61850 HCPCS Implant Neuroelectrodes 8 4 — — $39,082.13 $39,082.13 $39,082.13 2025-01-21
33287 HCPCS Rmv&rplcmt Phrnc Nrv Stim Pg 8 4 — — $39,082.13 $39,082.13 $39,082.13 2025-01-21
0427T OTHER Insj/rplc Nstim Apnea Pls Gn 8 4 — — $39,082.13 $39,082.13 $39,082.13 2025-01-21
64590 HCPCS Ins/rpl Prph Sac/gstr Npg/r 8 4 — — $39,082.13 $39,082.13 $39,082.13 2025-01-21
64575 HCPCS Opn Impltj Nea Perph Nerve 8 4 — — $39,082.13 $39,082.13 $39,082.13 2025-01-21
63655 HCPCS Implant Neuroelectrodes 8 4 — — $39,082.13 $39,082.13 $39,082.13 2025-01-21
63685 HCPCS Ins/rplc Spi Npg/rcvr Pocket 8 4 — — $39,082.13 $39,082.13 $39,082.13 2025-01-21
0312T OTHER Laps Impltj Nstim Vagus 8 4 — — $39,082.13 $39,082.13 $39,082.13 2025-01-21
63664 HCPCS Revise Spine Eltrd Plate 8 4 — — $39,082.13 $39,082.13 $39,082.13 2025-01-21
64553 HCPCS Implant Neuroelectrodes 8 4 — — $39,082.13 $39,082.13 $39,082.13 2025-01-21
61889 HCPCS Ins Sk-mnt Crnl Nstm Pg/rcvr 8 4 — — $39,082.13 $39,082.13 $39,082.13 2025-01-21
61886 HCPCS Implant Neurostim Arrays 8 4 — — $39,082.13 $39,082.13 $39,082.13 2025-01-21
61867 HCPCS Implant Neuroelectrode 8 4 — — $39,082.13 $39,082.13 $39,082.13 2025-01-21
61864 HCPCS Implant Neuroelectrde Addl 8 4 — — $39,082.13 $39,082.13 $39,082.13 2025-01-21
61868 HCPCS Implant Neuroelectrde Addl 8 4 — — $39,082.13 $39,082.13 $39,082.13 2025-01-21
64568 HCPCS Opn Impltj Crnl Nrv Nea&pg 8 4 — — $39,082.13 $39,082.13 $39,082.13 2025-01-21
61860 HCPCS Implant Neuroelectrodes 8 4 — — $39,082.13 $39,082.13 $39,082.13 2025-01-21
64569 HCPCS Revise/repl Vagus N Eltrd 8 4 — — $39,082.13 $39,082.13 $39,082.13 2025-01-21
64580 HCPCS Opn Impltj Nea Neuromuscular 8 4 — — $39,082.13 $39,082.13 $39,082.13 2025-01-21
'911-4 OTHER Extensive Abdominal Or Thoracic Procedures For Multiple Significant Trauma 8 4 — — $39,058.96 $39,058.96 $39,058.96 2025-01-21
'312-4 OTHER Skin Graft, Except Hand, For Musculoskeletal And Connective Tissue Diagnoses 8 4 — — $38,888.52 $38,888.52 $38,888.52 2025-01-21
'007-1 OTHER Allogeneic Bone Marrow Transplant 8 4 — — $38,849.43 $38,849.43 $38,849.43 2025-01-21
'841-3 OTHER Extensive Third Degree Burns With Skin Graft 8 4 — — $38,717.69 $38,717.69 $38,717.69 2025-01-21
'091-4 OTHER Other Major Head And Neck Procedures 8 4 — — $38,684.85 $38,684.85 $38,684.85 2025-01-21
'912-4 OTHER Musculoskeletal And Other Procedures For Multiple Significant Trauma 8 4 — — $37,949.14 $37,949.14 $37,949.14 2025-01-21
'178-3 OTHER External Heart Assist Systems 8 4 — — $37,308.43 $37,308.43 $37,308.43 2025-01-21
'850-4 OTHER Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal… 8 4 — — $37,156.75 $37,156.75 $37,156.75 2025-01-21
'023-4 OTHER Spinal Procedures 8 4 — — $37,061.37 $37,061.37 $37,061.37 2025-01-21
'021-4 OTHER Open Craniotomy Except Trauma 8 4 — — $36,553.56 $36,553.56 $36,553.56 2025-01-21
'441-4 OTHER Major Bladder Procedures 8 4 — — $36,546.92 $36,546.92 $36,546.92 2025-01-21
0746T OTHER Car Ablt Rad Arr Cnv Loc Map 8 4 — — $36,198.71 $36,198.71 $36,198.71 2025-01-21
93656 HCPCS Compre Ep Eval Abltj Atr Fib 8 4 — — $36,198.71 $36,198.71 $36,198.71 2025-01-21
93655 HCPCS Icar Cath Abltj Dscrt Arrhyt 8 4 — — $36,198.71 $36,198.71 $36,198.71 2025-01-21
93657 HCPCS Tx L/r Atrial Fib Addl 8 4 — — $36,198.71 $36,198.71 $36,198.71 2025-01-21
93650 HCPCS Ablate Heart Dysrhythm Focus 8 4 — — $36,198.71 $36,198.71 $36,198.71 2025-01-21
93609 HCPCS Map Tachycardia Add-on 8 4 — — $36,198.71 $36,198.71 $36,198.71 2025-01-21
93653 HCPCS Compre Ep Eval Tx Svt 8 4 — — $36,198.71 $36,198.71 $36,198.71 2025-01-21
93654 HCPCS Compre Ep Eval Tx Vt 8 4 — — $36,198.71 $36,198.71 $36,198.71 2025-01-21
0745T OTHER Car Ablt Rad Arr N-invas Loc 8 4 — — $36,198.71 $36,198.71 $36,198.71 2025-01-21
0747T OTHER Car Ablt Rad Arrhyt Dlvr Rad 8 4 — — $36,198.71 $36,198.71 $36,198.71 2025-01-21
33534 HCPCS Cabg Arterial Two 8 4 — — $36,131.04 $36,131.04 $36,131.04 2025-01-21
33533 HCPCS Cabg Arterial Single 8 4 — — $36,131.04 $36,131.04 $36,131.04 2025-01-21
33510 HCPCS Cabg Vein Single 8 4 — — $36,131.04 $36,131.04 $36,131.04 2025-01-21
33511 HCPCS Cabg Vein Two 8 4 — — $36,131.04 $36,131.04 $36,131.04 2025-01-21
33535 HCPCS Cabg Arterial Three 8 4 — — $36,131.04 $36,131.04 $36,131.04 2025-01-21
33530 HCPCS Coronary Artery Bypass/reop 8 4 — — $36,131.04 $36,131.04 $36,131.04 2025-01-21
33506 HCPCS Repair Artery Translocation 8 4 — — $36,131.04 $36,131.04 $36,131.04 2025-01-21
33507 HCPCS Repair Art Intramural 8 4 — — $36,131.04 $36,131.04 $36,131.04 2025-01-21
33504 HCPCS Coronary Artery Graft 8 4 — — $36,131.04 $36,131.04 $36,131.04 2025-01-21
33508 HCPCS Endoscopic Vein Harvest 8 4 — — $36,131.04 $36,131.04 $36,131.04 2025-01-21
33512 HCPCS Cabg Vein Three 8 4 — — $36,131.04 $36,131.04 $36,131.04 2025-01-21
33503 HCPCS Coronary Artery Graft 8 4 — — $36,131.04 $36,131.04 $36,131.04 2025-01-21
33523 HCPCS Cabg Art-vein Six Or More 8 4 — — $36,131.04 $36,131.04 $36,131.04 2025-01-21
33536 HCPCS Cabg Arterial Four Or More 8 4 — — $36,131.04 $36,131.04 $36,131.04 2025-01-21
33509 HCPCS Ndsc Hrv Uxtr Art 1 Sgm Cab 8 4 — — $36,131.04 $36,131.04 $36,131.04 2025-01-21
33502 HCPCS Coronary Artery Correction 8 4 — — $36,131.04 $36,131.04 $36,131.04 2025-01-21
33513 HCPCS Cabg Vein Four 8 4 — — $36,131.04 $36,131.04 $36,131.04 2025-01-21
33519 HCPCS Cabg Artery-vein Three 8 4 — — $36,131.04 $36,131.04 $36,131.04 2025-01-21
35600 HCPCS Open Hrv Uxtr Art 1 Sgm Cab 8 4 — — $36,131.04 $36,131.04 $36,131.04 2025-01-21
33521 HCPCS Cabg Artery-vein Four 8 4 — — $36,131.04 $36,131.04 $36,131.04 2025-01-21
33572 HCPCS Open Coronary Endarterectomy 8 4 — — $36,131.04 $36,131.04 $36,131.04 2025-01-21
33518 HCPCS Cabg Artery-vein Two 8 4 — — $36,131.04 $36,131.04 $36,131.04 2025-01-21
33516 HCPCS Cabg Vein Six Or More 8 4 — — $36,131.04 $36,131.04 $36,131.04 2025-01-21
33522 HCPCS Cabg Artery-vein Five 8 4 — — $36,131.04 $36,131.04 $36,131.04 2025-01-21
33517 HCPCS Cabg Artery-vein Single 8 4 — — $36,131.04 $36,131.04 $36,131.04 2025-01-21
33514 HCPCS Cabg Vein Five 8 4 — — $36,131.04 $36,131.04 $36,131.04 2025-01-21
33505 HCPCS Repair Artery W/tunnel 8 4 — — $36,131.04 $36,131.04 $36,131.04 2025-01-21
'631-3 OTHER Neonate Birth Weight > 2499 Grams With Other Major Procedure 8 4 — — $36,099.71 $36,099.71 $36,099.71 2025-01-21
'260-4 OTHER Major Pancreas, Liver And Shunt Procedures 8 4 — — $36,088.76 $36,088.76 $36,088.76 2025-01-21
'440-3 OTHER Kidney Transplant 8 4 — — $35,743.19 $35,743.19 $35,743.19 2025-01-21
'740-4 OTHER Mental Illness Diagnosis With O.r. Procedure 8 4 — — $35,626.31 $35,626.31 $35,626.31 2025-01-21
'608-4 OTHER Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 8 4 — — $35,573.53 $35,573.53 $35,573.53 2025-01-21
'681-4 OTHER Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 8 4 — — $34,890.21 $34,890.21 $34,890.21 2025-01-21
'630-2 OTHER Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 8 4 — — $34,816.32 $34,816.32 $34,816.32 2025-01-21
'178-2 OTHER External Heart Assist Systems 8 4 — — $34,759.64 $34,759.64 $34,759.64 2025-01-21
'220-4 OTHER Major Stomach, Esophageal And Duodenal Procedures 8 4 — — $34,623.21 $34,623.21 $34,623.21 2025-01-21
'089-4 OTHER Major Cranial Or Facial Bone Procedures 8 4 — — $34,389.44 $34,389.44 $34,389.44 2025-01-21
'165-3 OTHER Coronary Bypass With Ami Or Complex Principal Diagnosis 8 4 — — $34,289.76 $34,289.76 $34,289.76 2025-01-21
'950-4 OTHER Extensive O.r. Procedure Unrelated To Principal Diagnosis 8 4 — — $34,050.52 $34,050.52 $34,050.52 2025-01-21
0254T OTHER Evasc Rpr Iliac Art Bifur 8 4 — — $33,999.49 $33,999.49 $33,999.49 2025-01-21
0338T OTHER Trnscth Renal Symp Denrv Unl 8 4 — — $33,999.49 $33,999.49 $33,999.49 2025-01-21
0234T OTHER Trluml Perip Athrc Renal Art 8 4 — — $33,999.49 $33,999.49 $33,999.49 2025-01-21
34847 HCPCS Visc & Infraren Abd 3 Prosth 8 4 — — $33,999.49 $33,999.49 $33,999.49 2025-01-21
34846 HCPCS Visc & Infraren Abd 2 Prosth 8 4 — — $33,999.49 $33,999.49 $33,999.49 2025-01-21
34848 HCPCS Visc & Infraren Abd 4+ Prost 8 4 — — $33,999.49 $33,999.49 $33,999.49 2025-01-21
34843 HCPCS Endovasc Visc Aorta 3 Graft 8 4 — — $33,999.49 $33,999.49 $33,999.49 2025-01-21
34844 HCPCS Endovasc Visc Aorta 4 Graft 8 4 — — $33,999.49 $33,999.49 $33,999.49 2025-01-21
34845 HCPCS Visc & Infraren Abd 1 Prosth 8 4 — — $33,999.49 $33,999.49 $33,999.49 2025-01-21
34813 HCPCS Femoral Endovas Graft Add-on 8 4 — — $33,999.49 $33,999.49 $33,999.49 2025-01-21
34820 HCPCS Opn Iliac Art Expos 8 4 — — $33,999.49 $33,999.49 $33,999.49 2025-01-21
34841 HCPCS Endovasc Visc Aorta 1 Graft 8 4 — — $33,999.49 $33,999.49 $33,999.49 2025-01-21
34808 HCPCS Endovas Iliac A Device Addon 8 4 — — $33,999.49 $33,999.49 $33,999.49 2025-01-21
34842 HCPCS Endovasc Visc Aorta 2 Graft 8 4 — — $33,999.49 $33,999.49 $33,999.49 2025-01-21
35840 HCPCS Explore Abdominal Vessels 8 4 — — $33,999.49 $33,999.49 $33,999.49 2025-01-21
34718 HCPCS Evasc Rpr N/a A-iliac Ndgft 8 4 — — $33,999.49 $33,999.49 $33,999.49 2025-01-21
34711 HCPCS Dlyd Plmt Xtn Prosth Ea Addl 8 4 — — $33,999.49 $33,999.49 $33,999.49 2025-01-21
34709 HCPCS Plmt Xtn Prosth Evasc Rpr 8 4 — — $33,999.49 $33,999.49 $33,999.49 2025-01-21
34713 HCPCS Perq Access & Clsr Fem Art 8 4 — — $33,999.49 $33,999.49 $33,999.49 2025-01-21
34710 HCPCS Dlyd Plmt Xtn Prosth 1st Vsl 8 4 — — $33,999.49 $33,999.49 $33,999.49 2025-01-21
34712 HCPCS Tcat Dlvr Enhncd Fixj Dev 8 4 — — $33,999.49 $33,999.49 $33,999.49 2025-01-21
34706 HCPCS Evasc Rpr A-biiliac Rpt 8 4 — — $33,999.49 $33,999.49 $33,999.49 2025-01-21
33894 HCPCS Evasc St Rpr Thrc/aa Acrs Br 8 4 — — $33,999.49 $33,999.49 $33,999.49 2025-01-21
33883 HCPCS Insert Endovasc Prosth Taa 8 4 — — $33,999.49 $33,999.49 $33,999.49 2025-01-21
33881 HCPCS Endovasc Taa Repr Without Subcl 8 4 — — $33,999.49 $33,999.49 $33,999.49 2025-01-21
33884 HCPCS Endovasc Prosth Taa Add-on 8 4 — — $33,999.49 $33,999.49 $33,999.49 2025-01-21
33880 HCPCS Endovasc Taa Repr Incl Subcl 8 4 — — $33,999.49 $33,999.49 $33,999.49 2025-01-21
33886 HCPCS Endovasc Prosth Delayed 8 4 — — $33,999.49 $33,999.49 $33,999.49 2025-01-21
34704 HCPCS Evasc Rpr A-unilac Ndgft Rpt 8 4 — — $33,999.49 $33,999.49 $33,999.49 2025-01-21
34707 HCPCS Evasc Rpr Ilio-iliac Ndgft 8 4 — — $33,999.49 $33,999.49 $33,999.49 2025-01-21
33895 HCPCS Evasc St Rpr Thrc/aa X Crsg 8 4 — — $33,999.49 $33,999.49 $33,999.49 2025-01-21
34705 HCPCS Evac Rpr A-biiliac Ndgft 8 4 — — $33,999.49 $33,999.49 $33,999.49 2025-01-21
34703 HCPCS Evasc Rpr A-unilac Ndgft 8 4 — — $33,999.49 $33,999.49 $33,999.49 2025-01-21
34051 HCPCS Removal Of Artery Clot 8 4 — — $33,999.49 $33,999.49 $33,999.49 2025-01-21
34708 HCPCS Evasc Rpr Ilio-iliac Rpt 8 4 — — $33,999.49 $33,999.49 $33,999.49 2025-01-21
34717 HCPCS Evasc Rpr A-iliac Ndgft 8 4 — — $33,999.49 $33,999.49 $33,999.49 2025-01-21
34701 HCPCS Evasc Rpr A-ao Ndgft 8 4 — — $33,999.49 $33,999.49 $33,999.49 2025-01-21
34702 HCPCS Evasc Rpr A-ao Ndgft Rpt 8 4 — — $33,999.49 $33,999.49 $33,999.49 2025-01-21
0339T OTHER Trnscth Renal Symp Denrv Bil 8 4 — — $33,999.49 $33,999.49 $33,999.49 2025-01-21
'160-3 OTHER Major Cardiothoracic Repair Of Heart Anomaly 8 4 — — $33,981.71 $33,981.71 $33,981.71 2025-01-21
'608-3 OTHER Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 8 4 — — $33,879.29 $33,879.29 $33,879.29 2025-01-21
'607-2 OTHER Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 8 4 — — $33,844.50 $33,844.50 $33,844.50 2025-01-21
'163-3 OTHER Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis 8 4 — — $33,798.37 $33,798.37 $33,798.37 2025-01-21
'020-4 OTHER Open Craniotomy For Trauma 8 4 — — $33,723.32 $33,723.32 $33,723.32 2025-01-21
'120-4 OTHER Major Respiratory And Chest Procedures 8 4 — — $33,567.73 $33,567.73 $33,567.73 2025-01-21
'621-4 OTHER Neonate Birth Weight 2000-2499 Grams With Major Anomaly 8 4 — — $33,495.41 $33,495.41 $33,495.41 2025-01-21
'690-4 OTHER Acute Leukemia 8 4 — — $33,397.29 $33,397.29 $33,397.29 2025-01-21
'759-4 OTHER Eating Disorders 8 4 — — $33,337.48 $33,337.48 $33,337.48 2025-01-21
'005-2 OTHER Tracheostomy With Mv >96 Hours Without Extensive Procedure 8 4 — — $33,301.91 $33,301.91 $33,301.91 2025-01-21
'361-4 OTHER Skin Graft For Skin And Subcutaneous Tissue Diagnoses 8 4 — — $32,933.66 $32,933.66 $32,933.66 2025-01-21
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