|
0024
|
RC
|
Replacement Of Lower Extremity D0803
|
8
|
8
|
—
|
—
|
$4,040.85
|
$4,087.89
|
$4,040.85
|
2026-07-15
|
|
15100
|
CPT
|
Skin Splt Grft Trnk/arm/leg 100 Sq Cm/1 Ba (15100
|
48
|
38
|
$7,333.00
|
$4,399.80
40% off
|
$2,175.67
|
$6,966.35
|
$4,586.79
|
2026-07-15
|
|
15120
|
CPT
|
Skn Splt A-grft Fac/nck/hf/g 100 Sq Cm/1 Ba (1512
|
42
|
38
|
$9,116.00
|
$5,469.60
40% off
|
$3,736.76
|
$8,660.20
|
$5,702.06
|
2026-07-15
|
|
15220
|
CPT
|
Skin Full Graft Sclp/arm/leg < 20 Sq Cm (15220)
|
42
|
38
|
$6,205.00
|
$3,723.00
40% off
|
$2,175.67
|
$5,894.75
|
$4,074.76
|
2026-07-15
|
|
15240
|
CPT
|
Skin Full Grft Face/genit/hf < 20 Sq Cm (15240)
|
42
|
38
|
$6,568.00
|
$3,940.80
40% off
|
$2,175.67
|
$6,239.60
|
$4,154.41
|
2026-07-15
|
|
15271
|
CPT
|
Skin Sub Graft Trnk/arm/leg (15271)
|
45
|
37
|
$6,292.00
|
$3,775.20
40% off
|
$779.33
|
$5,977.40
|
$3,624.19
|
2026-07-15
|
|
25
|
MS_DRG
|
Craniotomy And Endovascular Intracranial Procedures With Mcc
|
4
|
4
|
—
|
—
|
$4,108.15
|
$4,237.88
|
$4,178.16
|
2026-07-15
|
|
27
|
MS_DRG
|
Craniotomy And Endovascular Intracranial Procedures Without Cc/mcc
|
4
|
4
|
—
|
—
|
$4,108.15
|
$4,237.88
|
$4,178.16
|
2026-07-15
|
|
28
|
MS_DRG
|
Spinal Procedures With Mcc
|
4
|
4
|
—
|
—
|
$4,108.15
|
$4,237.88
|
$4,178.16
|
2026-07-15
|
|
30
|
MS_DRG
|
Spinal Procedures Without Cc/mcc
|
4
|
4
|
—
|
—
|
$4,108.15
|
$4,237.88
|
$4,178.16
|
2026-07-15
|
|
32555
|
CPT
|
Thoracntsis-ndl/cth W Img Nmh
|
16
|
15
|
$4,561.00
|
$2,736.60
40% off
|
$2,280.50
|
$4,104.90
|
$3,603.19
|
2026-07-15
|
|
36558
|
CPT
|
Insert Tunnel Cv Cath Nmh
|
16
|
15
|
$6,610.00
|
$3,966.00
40% off
|
$3,305.00
|
$5,949.00
|
$5,221.90
|
2026-07-15
|
|
36561
|
CPT
|
Ir Cva Port Place Nmh
|
16
|
15
|
$13,133.00
|
$7,879.80
40% off
|
$6,566.50
|
$11,819.70
|
$10,375.07
|
2026-07-15
|
|
36569
|
CPT
|
Ins Pic Age 5 Yrs/>
|
32
|
15
|
$4,717.50
|
$2,830.50
40% off
|
$2,319.50
|
$4,316.40
|
$3,711.20
|
2026-07-15
|
|
36573
|
CPT
|
Insj Picc W/imaging 5 Yr Nmh
|
16
|
15
|
$5,756.00
|
$3,453.60
40% off
|
$2,878.00
|
$5,180.40
|
$4,547.24
|
2026-07-15
|
|
36581
|
CPT
|
Cath Exchange Central Tunneled Nmh
|
16
|
15
|
$8,903.00
|
$5,341.80
40% off
|
$4,451.50
|
$8,012.70
|
$7,033.37
|
2026-07-15
|
|
36904
|
CPT
|
Thrmbc/nfs Dialysis Circuit S I Nmh
|
16
|
15
|
$6,134.00
|
$3,680.40
40% off
|
$3,067.00
|
$5,520.60
|
$4,845.86
|
2026-07-15
|
|
37191
|
CPT
|
Ins Endvas Venacavafiltr Nmh
|
16
|
15
|
$12,827.00
|
$7,696.20
40% off
|
$6,413.50
|
$11,544.30
|
$10,133.33
|
2026-07-15
|
|
37193
|
CPT
|
Rem Endvas Venacava Filter Nmh
|
16
|
15
|
$10,164.00
|
$6,098.40
40% off
|
$5,082.00
|
$9,147.60
|
$8,029.56
|
2026-07-15
|
|
40
|
MS_DRG
|
Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc
|
4
|
4
|
—
|
—
|
$4,108.15
|
$4,237.88
|
$4,178.16
|
2026-07-15
|
|
42
|
MS_DRG
|
Peripheral, Cranial Nerve And Other Nervous System Procedures Without Cc/mcc
|
4
|
4
|
—
|
—
|
$4,108.15
|
$4,237.88
|
$4,178.16
|
2026-07-15
|
|
43239
|
CPT
|
Upper Gi Endoscopy Biopsy
|
16
|
15
|
$4,597.00
|
$2,758.20
40% off
|
$2,298.50
|
$4,137.30
|
$3,631.63
|
2026-07-15
|
|
43246
|
CPT
|
Upper Gi Endoscopy/G Tube Placement Nmh
|
16
|
15
|
$4,736.00
|
$2,841.60
40% off
|
$2,368.00
|
$4,262.40
|
$3,741.44
|
2026-07-15
|
|
45330
|
CPT
|
Sigmoidoscopy Dx Tc Nmh
|
16
|
15
|
$4,433.00
|
$2,659.80
40% off
|
$2,216.50
|
$3,989.70
|
$3,502.07
|
2026-07-15
|
|
45380
|
CPT
|
Colonoscopy W/bx Nmh
|
16
|
15
|
$5,849.00
|
$3,509.40
40% off
|
$2,924.50
|
$5,264.10
|
$4,620.71
|
2026-07-15
|
|
45384
|
CPT
|
Colonoscopy With Removal Tumor Nmh
|
16
|
15
|
$4,504.00
|
$2,702.40
40% off
|
$2,252.00
|
$4,053.60
|
$3,558.16
|
2026-07-15
|
|
47000
|
CPT
|
Needle Biopsy Liver Nmh
|
16
|
15
|
$4,967.00
|
$2,980.20
40% off
|
$2,483.50
|
$4,470.30
|
$3,923.93
|
2026-07-15
|
|
49406
|
CPT
|
Img-guide Fluid Collect Drn Cath Peri/retroperiton
|
16
|
15
|
$4,471.00
|
$2,682.60
40% off
|
$2,235.50
|
$4,023.90
|
$3,532.09
|
2026-07-15
|
|
49440
|
CPT
|
Percutaneous Placement Gastic Tube Under Fluoro Gu
|
16
|
15
|
$5,946.00
|
$3,567.60
40% off
|
$2,973.00
|
$5,351.40
|
$4,697.34
|
2026-07-15
|
|
49446
|
CPT
|
Change G-tube To G-j Perc Nmh
|
16
|
15
|
$5,017.00
|
$3,010.20
40% off
|
$2,508.50
|
$4,515.30
|
$3,963.43
|
2026-07-15
|
|
50435
|
CPT
|
Exchange Nephrostomy Cath Nmh
|
16
|
15
|
$11,383.00
|
$6,829.80
40% off
|
$5,691.50
|
$10,244.70
|
$8,992.57
|
2026-07-15
|
|
52
|
MS_DRG
|
Spinal Disorders And Injuries With Cc/mcc
|
4
|
4
|
—
|
—
|
$4,108.15
|
$4,237.88
|
$4,178.16
|
2026-07-15
|
|
53
|
MS_DRG
|
Spinal Disorders And Injuries Without Cc/mcc
|
4
|
4
|
—
|
—
|
$4,108.15
|
$4,237.88
|
$4,178.16
|
2026-07-15
|
|
54
|
MS_DRG
|
Nervous System Neoplasms With Mcc
|
4
|
4
|
—
|
—
|
$4,108.15
|
$4,237.88
|
$4,178.16
|
2026-07-15
|
|
55
|
MS_DRG
|
Nervous System Neoplasms Without Mcc
|
4
|
4
|
—
|
—
|
$4,108.15
|
$4,237.88
|
$4,178.16
|
2026-07-15
|
|
63650
|
CPT
|
Implant Neuroelectrodes Epidural (63650)
|
42
|
38
|
$21,222.00
|
$12,733.20
40% off
|
$6,720.15
|
$20,160.90
|
$13,313.19
|
2026-07-15
|
|
63685
|
CPT
|
Revise/Remove Imp Spinal Neurostim Gen W/detach El
|
42
|
38
|
$28,068.00
|
$16,840.80
40% off
|
$13,051.62
|
$57,677.86
|
$25,120.86
|
2026-07-15
|
|
63688
|
CPT
|
Revj/rmvl Implnt Spinal Neurostim Gen W/detach Cnn
|
41
|
37
|
$14,324.00
|
$8,594.40
40% off
|
$3,686.55
|
$13,607.80
|
$7,620.37
|
2026-07-15
|
|
64555
|
CPT
|
Implant Neuroelectrodes Peripheral Nrv (64555)
|
42
|
38
|
$18,494.00
|
$11,096.40
40% off
|
$6,720.15
|
$17,964.86
|
$12,832.08
|
2026-07-15
|
|
64590
|
CPT
|
Insert/rplcmt Periphl/sacral/gast Neurostim Gen With
|
42
|
38
|
$20,526.00
|
$12,315.60
40% off
|
$9,544.59
|
$57,677.86
|
$18,370.77
|
2026-07-15
|
|
64596
|
CPT
|
Insert/replace Perq Electrode Array Pn W/intgd Neu
|
41
|
37
|
$23,553.00
|
$14,131.80
40% off
|
$10,952.15
|
$22,375.35
|
$12,832.08
|
2026-07-15
|
|
64597
|
CPT
|
Insert/replace Perq Electrode Array Pn W/intgd Neu
|
33
|
31
|
$11,776.00
|
$7,065.60
40% off
|
$5,475.84
|
$12,832.08
|
$7,654.40
|
2026-07-15
|
|
64598
|
CPT
|
Revise/remove Neurostim Electrode Array Pn W/intgr
|
41
|
37
|
$7,353.00
|
$4,411.80
40% off
|
$3,419.14
|
$7,003.11
|
$4,117.68
|
2026-07-15
|
|
64620
|
CPT
|
Destr W Neurolytic Intercostal Nrv (64620)
|
42
|
38
|
$7,125.00
|
$4,275.00
40% off
|
$932.65
|
$6,768.75
|
$3,864.83
|
2026-07-15
|
|
64624
|
CPT
|
Destruction Neurolytic Agt Genicular Nerve W/img (
|
82
|
37
|
$8,568.50
|
$5,141.10
40% off
|
$2,059.10
|
$9,767.90
|
$4,618.44
|
2026-07-15
|
|
64625
|
CPT
|
Radiofrequency Abltj Nrv Nrvtg Si Jt W/img Gdn (64
|
82
|
37
|
$6,868.00
|
$4,120.80
40% off
|
$2,059.10
|
$7,829.90
|
$4,120.75
|
2026-07-15
|
|
70487
|
CPT
|
CT Maxillofacial With Contrast
|
16
|
15
|
$4,389.00
|
$2,633.40
40% off
|
$2,194.50
|
$3,950.10
|
$3,467.31
|
2026-07-15
|
|
70488
|
CPT
|
CT Maxillofacial With Without Contrast
|
16
|
15
|
$4,750.00
|
$2,850.00
40% off
|
$2,375.00
|
$4,275.00
|
$3,752.50
|
2026-07-15
|
|
70491
|
CPT
|
CT Neck/Larynx Infusion Nmh
|
32
|
15
|
$4,492.00
|
$2,695.20
40% off
|
$2,170.00
|
$4,179.60
|
$3,477.50
|
2026-07-15
|
|
70496
|
CPT
|
CT Angiograph Head With And/or Without Contrast Nm
|
32
|
15
|
$5,048.50
|
$3,029.10
40% off
|
$2,437.00
|
$4,700.70
|
$3,908.22
|
2026-07-15
|
|
70498
|
CPT
|
CT Angiography Neck
|
32
|
15
|
$5,198.00
|
$3,118.80
40% off
|
$2,478.00
|
$4,896.00
|
$3,989.58
|
2026-07-15
|
|
70542
|
CPT
|
MRI Face/Neck W/Contrast
|
47
|
37
|
$7,476.00
|
$4,485.60
40% off
|
$367.88
|
$7,102.20
|
$3,977.23
|
2026-07-15
|
|
70543
|
CPT
|
MRI Face/Neck W Without Contrast
|
63
|
37
|
$8,384.00
|
$5,030.40
40% off
|
$367.88
|
$7,964.80
|
$4,695.04
|
2026-07-15
|
|
70546
|
CPT
|
MRA Head W Without Contrast
|
64
|
38
|
$6,947.00
|
$4,168.20
40% off
|
$367.88
|
$7,342.20
|
$4,340.06
|
2026-07-15
|
|
70549
|
CPT
|
MRA Neck W Without Contrast
|
64
|
38
|
$6,082.00
|
$3,649.20
40% off
|
$367.88
|
$5,777.90
|
$3,454.57
|
2026-07-15
|
|
70553
|
CPT
|
MRI Brain IAC/Cranial Nerve W Without Cont
|
63
|
37
|
$6,998.00
|
$4,198.80
40% off
|
$367.88
|
$6,923.70
|
$4,092.68
|
2026-07-15
|
|
70555
|
CPT
|
MRI Brain Functional Md/phd Nmh
|
16
|
15
|
$5,946.00
|
$3,567.60
40% off
|
$2,973.00
|
$5,351.40
|
$4,697.34
|
2026-07-15
|
|
71260
|
CPT
|
CT Lung Infusion Nmh
|
32
|
15
|
$4,526.00
|
$2,715.60
40% off
|
$2,259.00
|
$4,080.60
|
$3,575.46
|
2026-07-15
|
|
71270
|
CPT
|
CT Lung W Without Infusion Nmh
|
32
|
15
|
$5,240.00
|
$3,144.00
40% off
|
$2,440.00
|
$5,040.00
|
$3,928.40
|
2026-07-15
|
|
71275
|
CPT
|
CT Angiograph Chest With And/or Without Nmh
|
32
|
15
|
$5,279.00
|
$3,167.40
40% off
|
$2,502.00
|
$4,998.60
|
$4,028.22
|
2026-07-15
|
|
71552
|
CPT
|
MRI Brachial Plexus W Without Contrast Lt
|
157
|
37
|
$6,308.00
|
$3,784.80
40% off
|
$367.88
|
$5,992.60
|
$3,469.40
|
2026-07-15
|
|
72126
|
CPT
|
CT Cervical Spine Inf Nmh
|
32
|
15
|
$4,835.50
|
$2,901.30
40% off
|
$2,337.50
|
$4,496.40
|
$3,743.50
|
2026-07-15
|
|
72127
|
CPT
|
CT C-spine With Without Contrast
|
16
|
15
|
$5,608.00
|
$3,364.80
40% off
|
$2,804.00
|
$5,047.20
|
$4,430.32
|
2026-07-15
|
|
72130
|
CPT
|
CT T-spine With Without Contrast
|
16
|
15
|
$5,457.00
|
$3,274.20
40% off
|
$2,728.50
|
$4,911.30
|
$4,311.03
|
2026-07-15
|
|
72133
|
CPT
|
CT L-spine With Without Contrast
|
16
|
15
|
$6,279.00
|
$3,767.40
40% off
|
$3,139.50
|
$5,651.10
|
$4,960.41
|
2026-07-15
|
|
72156
|
CPT
|
MRI Spine Cervical W Without Contrast
|
63
|
37
|
$7,724.00
|
$4,634.40
40% off
|
$367.88
|
$7,337.80
|
$4,415.55
|
2026-07-15
|
|
72157
|
CPT
|
MRI Spine Thoracic W Without Contrast
|
63
|
37
|
$7,712.00
|
$4,627.20
40% off
|
$367.88
|
$7,326.40
|
$4,318.72
|
2026-07-15
|
|
72158
|
CPT
|
MRI Spine Lumbar W Without Contrast
|
63
|
37
|
$7,642.00
|
$4,585.20
40% off
|
$367.88
|
$7,259.90
|
$4,279.52
|
2026-07-15
|
|
72191
|
CPT
|
CT Angiograph Pelvis Nmh
|
16
|
15
|
$4,832.00
|
$2,899.20
40% off
|
$2,416.00
|
$4,348.80
|
$3,817.28
|
2026-07-15
|
|
72196
|
CPT
|
MRI Pelvis With Contrast
|
32
|
15
|
$6,330.00
|
$3,798.00
40% off
|
$3,150.00
|
$5,724.00
|
$5,000.40
|
2026-07-15
|
|
72197
|
CPT
|
MRI Pelvis Msk W Wo Contrast
|
63
|
37
|
$6,676.00
|
$4,005.60
40% off
|
$367.88
|
$6,342.20
|
$3,845.38
|
2026-07-15
|
|
73220
|
CPT
|
MRI Forearm W Without Contrast Right
|
94
|
37
|
$6,477.00
|
$3,886.20
40% off
|
$367.88
|
$6,153.15
|
$3,445.76
|
2026-07-15
|
|
73223
|
CPT
|
MRI Elbow W Without Contrast Left
|
94
|
37
|
$7,385.00
|
$4,431.00
40% off
|
$367.88
|
$7,015.75
|
$3,928.82
|
2026-07-15
|
|
73702
|
CPT
|
CT Lower Extremity With Without Contrast Bil
|
126
|
37
|
$5,300.00
|
$3,180.00
40% off
|
$184.95
|
$7,515.45
|
$3,829.44
|
2026-07-15
|
|
73723
|
CPT
|
MRI Ankle/Hindfoot W Without Contrast Left
|
110
|
37
|
$6,382.00
|
$3,829.20
40% off
|
$367.88
|
$6,062.90
|
$3,510.10
|
2026-07-15
|
|
73725
|
CPT
|
MRA Lower Ext W Without Contrast Lt-73725
|
150
|
32
|
$7,542.00
|
$4,525.20
40% off
|
$1,002.74
|
$7,164.90
|
$4,012.34
|
2026-07-15
|
|
74160
|
CPT
|
CT Abdomen With Contrast
|
32
|
15
|
$4,552.50
|
$2,731.50
40% off
|
$2,266.00
|
$4,115.70
|
$3,596.27
|
2026-07-15
|
|
74170
|
CPT
|
CT Abdomen With Without Contrast
|
32
|
15
|
$5,254.00
|
$3,152.40
40% off
|
$2,613.50
|
$4,752.90
|
$4,150.39
|
2026-07-15
|
|
74174
|
CPT
|
CT Angiography Abdomen/pelvis Nmh (74174
|
32
|
15
|
$7,869.00
|
$4,721.40
40% off
|
$3,871.50
|
$7,195.50
|
$6,194.40
|
2026-07-15
|
|
74176
|
CPT
|
CT Abdomen/Pelvis Without Contrast
|
32
|
15
|
$7,439.00
|
$4,463.40
40% off
|
$3,430.00
|
$7,216.20
|
$5,522.30
|
2026-07-15
|
|
74177
|
CPT
|
CT Abdomen/Pelvis With Contrast
|
32
|
15
|
$8,597.50
|
$5,158.50
40% off
|
$4,276.50
|
$7,777.80
|
$6,791.58
|
2026-07-15
|
|
74178
|
CPT
|
CT Abdomen/Pelvis With Without Contrast
|
32
|
15
|
$9,908.00
|
$5,944.80
40% off
|
$4,832.50
|
$9,135.90
|
$7,732.00
|
2026-07-15
|
|
74183
|
CPT
|
MRI Pelvis Enterography W Without Contrast
|
63
|
37
|
$6,824.00
|
$4,094.40
40% off
|
$367.88
|
$6,482.80
|
$3,821.44
|
2026-07-15
|
|
75
|
MS_DRG
|
Viral Meningitis With Cc/mcc
|
4
|
4
|
—
|
—
|
$4,108.15
|
$4,237.88
|
$4,178.16
|
2026-07-15
|
|
75574
|
CPT
|
CT Angio Hrt W/3d Image Nmh
|
16
|
15
|
$5,202.00
|
$3,121.20
40% off
|
$2,601.00
|
$4,681.80
|
$4,109.58
|
2026-07-15
|
|
75825
|
CPT
|
Ivc-gram Nmh
|
16
|
15
|
$5,605.00
|
$3,363.00
40% off
|
$2,802.50
|
$5,044.50
|
$4,427.95
|
2026-07-15
|
|
76
|
MS_DRG
|
Viral Meningitis Without Cc/mcc
|
4
|
4
|
—
|
—
|
$4,108.15
|
$4,237.88
|
$4,178.16
|
2026-07-15
|
|
77
|
MS_DRG
|
Hypertensive Encephalopathy With Mcc
|
4
|
4
|
—
|
—
|
$3,807.56
|
$3,927.80
|
$3,872.45
|
2026-07-15
|
|
77285
|
CPT
|
Stimulator Assist Intermed Nmh
|
16
|
15
|
$5,447.00
|
$3,268.20
40% off
|
$2,723.50
|
$4,902.30
|
$4,303.13
|
2026-07-15
|
|
77290
|
CPT
|
Stimulator Assist Complex Nmh
|
16
|
15
|
$6,211.00
|
$3,726.60
40% off
|
$3,105.50
|
$5,589.90
|
$4,906.69
|
2026-07-15
|
|
77295
|
CPT
|
Therapeutic Radiology 3d Nmh
|
16
|
15
|
$7,417.00
|
$4,450.20
40% off
|
$3,708.50
|
$6,675.30
|
$5,859.43
|
2026-07-15
|
|
77301
|
CPT
|
Imrt Planning Nmh
|
16
|
15
|
$27,170.00
|
$16,302.00
40% off
|
$13,585.00
|
$24,453.00
|
$21,464.30
|
2026-07-15
|
|
77307
|
CPT
|
Pln Iso Complex W/calc Nmh (77307)
|
16
|
15
|
$6,949.00
|
$4,169.40
40% off
|
$3,474.50
|
$6,254.10
|
$5,489.71
|
2026-07-15
|
|
77371
|
CPT
|
Gk Delivery Complex Nmh
|
16
|
15
|
$53,098.00
|
$31,858.80
40% off
|
$26,549.00
|
$47,788.20
|
$41,947.42
|
2026-07-15
|
|
77386
|
CPT
|
Imrt Treatment Complex Nmh
|
16
|
15
|
$4,650.00
|
$2,790.00
40% off
|
$2,325.00
|
$4,185.00
|
$3,673.50
|
2026-07-15
|
|
78
|
MS_DRG
|
Hypertensive Encephalopathy With Cc
|
4
|
4
|
—
|
—
|
$3,807.56
|
$3,927.80
|
$3,872.45
|
2026-07-15
|
|
80
|
MS_DRG
|
Nontraumatic Stupor And Coma With Mcc
|
4
|
4
|
—
|
—
|
$4,108.15
|
$4,237.88
|
$4,178.16
|
2026-07-15
|
|
82
|
MS_DRG
|
Traumatic Stupor And Coma >1 Hour With Mcc
|
4
|
4
|
—
|
—
|
$4,108.15
|
$4,237.88
|
$4,178.16
|
2026-07-15
|
|
83
|
MS_DRG
|
Traumatic Stupor And Coma >1 Hour With Cc
|
4
|
4
|
—
|
—
|
$4,108.15
|
$4,237.88
|
$4,178.16
|
2026-07-15
|
|
84
|
MS_DRG
|
Traumatic Stupor And Coma >1 Hour Without Cc/mcc
|
4
|
4
|
—
|
—
|
$4,108.15
|
$4,237.88
|
$4,178.16
|
2026-07-15
|
|
85
|
MS_DRG
|
Traumatic Stupor And Coma <1 Hour With Mcc
|
4
|
4
|
—
|
—
|
$4,108.15
|
$4,237.88
|
$4,178.16
|
2026-07-15
|
|
86
|
MS_DRG
|
Traumatic Stupor And Coma <1 Hour With Cc
|
4
|
4
|
—
|
—
|
$4,108.15
|
$4,237.88
|
$4,178.16
|
2026-07-15
|
|
86834
|
CPT
|
Ref Post Luminex Hla Class I Sa Fp Ol Titers Nmh
|
16
|
15
|
$4,578.00
|
$2,746.80
40% off
|
$2,289.00
|
$4,120.20
|
$3,616.62
|
2026-07-15
|
|
87
|
MS_DRG
|
Traumatic Stupor And Coma <1 Hour Without Cc/mcc
|
4
|
4
|
—
|
—
|
$4,108.15
|
$4,237.88
|
$4,178.16
|
2026-07-15
|
|
88
|
MS_DRG
|
Concussion With Mcc
|
4
|
4
|
—
|
—
|
$4,108.15
|
$4,237.88
|
$4,178.16
|
2026-07-15
|
|
90
|
MS_DRG
|
Concussion Without Cc/mcc
|
4
|
4
|
—
|
—
|
$4,108.15
|
$4,237.88
|
$4,178.16
|
2026-07-15
|
|
92
|
MS_DRG
|
Other Disorders Of Nervous System With Cc
|
4
|
4
|
—
|
—
|
$4,108.15
|
$4,237.88
|
$4,178.16
|
2026-07-15
|
|
933
|
MS_DRG
|
Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft
|
4
|
4
|
—
|
—
|
$3,907.76
|
$4,031.16
|
$3,974.36
|
2026-07-15
|
|
93306
|
CPT
|
Echo 2 D M-mode C Doppler Nmh
|
16
|
15
|
$4,683.00
|
$2,809.80
40% off
|
$2,341.50
|
$4,214.70
|
$3,699.57
|
2026-07-15
|
|
93350
|
CPT
|
Echo 2d Nmh
|
16
|
15
|
$4,468.00
|
$2,680.80
40% off
|
$2,234.00
|
$4,021.20
|
$3,529.72
|
2026-07-15
|
|
93351
|
CPT
|
Stress Echo-pharm Agent Nmh
|
16
|
15
|
$6,415.00
|
$3,849.00
40% off
|
$3,207.50
|
$5,773.50
|
$5,067.85
|
2026-07-15
|
|
939
|
MS_DRG
|
O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc
|
4
|
4
|
—
|
—
|
$2,499.38
|
$347,039.26
|
$120,115.32
|
2026-07-15
|
|
94
|
MS_DRG
|
Bacterial And Tuberculous Infections Of Nervous System With Mcc
|
4
|
4
|
—
|
—
|
$4,108.15
|
$4,237.88
|
$4,178.16
|
2026-07-15
|
|
955
|
MS_DRG
|
Craniotomy For Multiple Significant Trauma
|
4
|
4
|
—
|
—
|
$4,108.15
|
$4,237.88
|
$4,178.16
|
2026-07-15
|
|
957
|
MS_DRG
|
Other O.r. Procedures For Multiple Significant Trauma With Mcc
|
4
|
4
|
—
|
—
|
$4,108.15
|
$4,237.88
|
$4,178.16
|
2026-07-15
|
|
95810
|
CPT
|
Sleep Disorder Study
|
16
|
15
|
$5,700.00
|
$3,420.00
40% off
|
$2,850.00
|
$5,130.00
|
$4,503.00
|
2026-07-15
|
|
95811
|
CPT
|
Polysomnogram With Cpap Nmh
|
16
|
15
|
$7,113.00
|
$4,267.80
40% off
|
$3,556.50
|
$6,401.70
|
$5,619.27
|
2026-07-15
|
|
959
|
MS_DRG
|
Other O.r. Procedures For Multiple Significant Trauma Without Cc/mcc
|
4
|
4
|
—
|
—
|
$4,108.15
|
$4,237.88
|
$4,178.16
|
2026-07-15
|
|
96000
|
CPT
|
Comprehensive Computer Based Motion Analysis-4 Cha
|
182
|
38
|
$7,929.00
|
$4,757.40
40% off
|
$278.20
|
$8,340.05
|
$4,522.52
|
2026-07-15
|
|
96001
|
CPT
|
Dynamic Plantar Pressure Meas During Walk-3 Charge
|
182
|
38
|
$7,245.00
|
$4,347.00
40% off
|
$278.20
|
$7,213.35
|
$4,055.35
|
2026-07-15
|
|
963
|
MS_DRG
|
Other Multiple Significant Trauma With Mcc
|
4
|
4
|
—
|
—
|
$4,108.15
|
$4,237.88
|
$4,178.16
|
2026-07-15
|
|
965
|
MS_DRG
|
Other Multiple Significant Trauma Without Cc/mcc
|
4
|
4
|
—
|
—
|
$4,108.15
|
$4,237.88
|
$4,178.16
|
2026-07-15
|
|
97
|
MS_DRG
|
Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc
|
4
|
4
|
—
|
—
|
$4,108.15
|
$4,237.88
|
$4,178.16
|
2026-07-15
|
|
99285
|
CPT
|
Ed Visit Level 5 Nmh
|
16
|
15
|
$5,049.00
|
$3,029.40
40% off
|
$2,524.50
|
$4,544.10
|
$3,988.71
|
2026-07-15
|
|
C1778
|
HCPCS
|
Sprint Pns Dual Lead C1778
|
70
|
33
|
$14,629.00
|
$8,777.40
40% off
|
$1,553.58
|
$17,004.05
|
$8,953.08
|
2026-07-15
|
|
C8930
|
HCPCS
|
Stress Tte Complete W Contrast Nmh
|
16
|
15
|
$6,800.00
|
$4,080.00
40% off
|
$3,400.00
|
$6,120.00
|
$5,372.00
|
2026-07-15
|
|
E0770
|
HCPCS
|
E0770 Fes Complete System Nos
|
35
|
27
|
$8,161.00
|
$4,896.60
40% off
|
$3,794.87
|
$7,752.95
|
$5,304.65
|
2026-07-15
|
|
J1568
|
HCPCS
|
68982-0850-04 - Immune Globulin Intravenous 10 So
|
86
|
20
|
$10,552.00
|
$6,331.20
40% off
|
$396.00
|
$14,209.20
|
$4,731.24
|
2026-07-15
|
|
J1569
|
HCPCS
|
00944-2700-05 - Immune Globulin Intravenous 10 So
|
66
|
20
|
$14,358.00
|
$8,614.80
40% off
|
$862.00
|
$20,550.15
|
$9,332.70
|
2026-07-15
|
|
J3262
|
HCPCS
|
50242-0137-01 - Tocilizumab 20 mg/mL Soln
|
22
|
20
|
$28,348.70
|
$17,009.22
40% off
|
$1,500.00
|
$25,513.83
|
$18,866.06
|
2026-07-15
|
|
J7327
|
HCPCS
|
59676-0820-01 - Hyaluronan 88 Mg/4 Ml Soln
|
42
|
38
|
$15,939.80
|
$9,563.88
40% off
|
$564.77
|
$15,142.81
|
$8,631.40
|
2026-07-15
|
|
L0112
|
HCPCS
|
Cranial Cervical Orthosis Congenital Torticolous
|
48
|
40
|
$7,752.00
|
$4,651.20
40% off
|
$806.21
|
$7,364.40
|
$4,263.60
|
2026-07-15
|
|
L0457
|
HCPCS
|
Tlso Flex Trnk Sj-ss Pre Ots (l0457)
|
16
|
16
|
$5,099.00
|
$3,059.40
40% off
|
$2,549.50
|
$4,589.10
|
$4,028.21
|
2026-07-15
|
|
L0480
|
HCPCS
|
Thoracic-lumbar-sacral Orthosis Triplaner Control
|
48
|
40
|
$8,369.00
|
$5,021.40
40% off
|
$934.06
|
$7,950.55
|
$4,602.95
|
2026-07-15
|
|
L0482
|
HCPCS
|
Thoracic-lumbar-sacral Orthosis Triplaner Control
|
48
|
40
|
$9,346.00
|
$5,607.60
40% off
|
$1,136.49
|
$8,878.70
|
$5,140.30
|
2026-07-15
|
|
L0484
|
HCPCS
|
Thoracic-lumbar-sacral Orthosis 2-piece Rigid She
|
48
|
40
|
$10,095.00
|
$6,057.00
40% off
|
$1,291.68
|
$9,590.25
|
$5,552.25
|
2026-07-15
|
|
L0486
|
HCPCS
|
Thoracic-lumbar-sacral Orthosis 2-piece Rigid She
|
48
|
40
|
$11,339.00
|
$6,803.40
40% off
|
$1,549.44
|
$10,772.05
|
$6,236.45
|
2026-07-15
|
|
L0640
|
HCPCS
|
L0640 Lumbar-sacral Orthosis Sac - T9 Custom Fab
|
17
|
17
|
$5,626.00
|
$3,375.60
40% off
|
$969.00
|
$5,063.40
|
$4,388.28
|
2026-07-15
|
|
L0650
|
HCPCS
|
Lso Sc R Ant/pos Pnl Pre Ots (l0650)
|
48
|
40
|
$6,450.00
|
$3,870.00
40% off
|
$536.44
|
$6,127.50
|
$3,579.75
|
2026-07-15
|
|
L0651
|
HCPCS
|
Lso Sag-co Shell Pnl Pre Ots (l0651)
|
48
|
40
|
$6,644.00
|
$3,986.40
40% off
|
$576.64
|
$6,311.80
|
$3,687.42
|
2026-07-15
|
|
L0720
|
HCPCS
|
Ctlso Ant/post/lat Control Prefab Customized
|
48
|
40
|
$6,451.00
|
$3,870.60
40% off
|
$536.65
|
$6,128.45
|
$3,580.31
|
2026-07-15
|
|
L0810
|
HCPCS
|
Cervical Halo Procedure Incorporated Into Jacket
|
48
|
40
|
$7,053.00
|
$4,231.80
40% off
|
$661.38
|
$6,700.35
|
$3,879.15
|
2026-07-15
|
|
L0830
|
HCPCS
|
Cervical Halo Procedure Incorporated Into Milwauk
|
48
|
40
|
$8,488.00
|
$5,092.80
40% off
|
$958.71
|
$8,063.60
|
$4,668.40
|
2026-07-15
|
|
L1680
|
HCPCS
|
Hip Orthosis Dynamic Abduction/Pelvic/Adj Hip Co
|
48
|
40
|
$6,311.00
|
$3,786.60
40% off
|
$507.64
|
$5,995.45
|
$3,471.05
|
2026-07-15
|
|
L1681
|
HCPCS
|
Hip Orthosis Bilat Hip Abduction Adjust Flexion Ex
|
48
|
40
|
$10,382.00
|
$6,229.20
40% off
|
$1,351.15
|
$9,862.90
|
$5,762.01
|
2026-07-15
|
|
L1690
|
HCPCS
|
Hip Orthosis Adduction Control
|
48
|
40
|
$10,402.00
|
$6,241.20
40% off
|
$1,355.29
|
$9,881.90
|
$5,721.10
|
2026-07-15
|
|
L1844
|
HCPCS
|
Knee Orthosis Single Upright Thigh/Calf Adjustab
|
48
|
40
|
$8,439.00
|
$5,063.40
40% off
|
$948.56
|
$8,017.05
|
$4,641.45
|
2026-07-15
|
|
L1846
|
HCPCS
|
Knee Orthosis Double Upright Medial/Lateral/Rota
|
48
|
40
|
$6,484.00
|
$3,890.40
40% off
|
$543.48
|
$6,159.80
|
$3,566.20
|
2026-07-15
|
|
L1860
|
HCPCS
|
Knee Orthosis Supracondylar Model Molded To Pati
|
48
|
40
|
$6,907.00
|
$4,144.20
40% off
|
$631.13
|
$6,561.65
|
$3,798.85
|
2026-07-15
|
|
L2005
|
HCPCS
|
Knee-ankle-foot Orthosis Single Or Double Upright
|
48
|
40
|
$22,699.00
|
$13,619.40
40% off
|
$3,796.00
|
$21,564.05
|
$12,484.45
|
2026-07-15
|
|
L2006
|
HCPCS
|
L2006 Kafo Microprocessor Swing And/or Stance
|
40
|
34
|
$107,464.00
|
$64,478.40
40% off
|
$21,466.54
|
$102,090.80
|
$65,284.38
|
2026-07-15
|
|
L2034
|
HCPCS
|
L2034 Knee-ankle-foot Orthosis Full Plastic Sing
|
48
|
40
|
$10,925.00
|
$6,555.00
40% off
|
$1,463.66
|
$10,378.75
|
$6,008.75
|
2026-07-15
|
|
L2036
|
HCPCS
|
Knee-ankle-foot Orthosis Double Upright Free Kne
|
48
|
40
|
$10,270.00
|
$6,162.00
40% off
|
$1,327.94
|
$9,756.50
|
$5,648.50
|
2026-07-15
|
|
L2037
|
HCPCS
|
Knee-ankle-foot Orthosis Single Upright Full Pla
|
48
|
40
|
$8,920.00
|
$5,352.00
40% off
|
$1,048.22
|
$8,474.00
|
$4,906.00
|
2026-07-15
|
|
L2627
|
HCPCS
|
Lower Extremity Addition Pelvic Control Reciproc
|
48
|
40
|
$11,494.00
|
$6,896.40
40% off
|
$1,581.56
|
$10,919.30
|
$6,321.70
|
2026-07-15
|
|
L2628
|
HCPCS
|
Lower Extremity Addition Pelvic Control Reciproc
|
48
|
40
|
$8,425.00
|
$5,055.00
40% off
|
$945.66
|
$8,003.75
|
$4,633.75
|
2026-07-15
|
|
L3904
|
HCPCS
|
Wrist-hand-finger Orthosis Electric External Pow
|
48
|
40
|
$10,811.00
|
$6,486.60
40% off
|
$1,440.04
|
$10,270.45
|
$5,946.05
|
2026-07-15
|
|
L4631
|
HCPCS
|
Afo Walk Boot Type Cus Fab
|
48
|
40
|
$6,599.00
|
$3,959.40
40% off
|
$567.31
|
$6,269.05
|
$3,629.45
|
2026-07-15
|
|
L5020
|
HCPCS
|
Partial Foot Molded Socket Tibial Tubercle Heigh
|
48
|
40
|
$9,098.00
|
$5,458.80
40% off
|
$1,085.11
|
$8,643.10
|
$5,003.90
|
2026-07-15
|
|
L5050
|
HCPCS
|
Ankle Symes Molded Socket Sach Foot
|
48
|
40
|
$10,236.00
|
$6,141.60
40% off
|
$1,320.90
|
$9,724.20
|
$5,629.80
|
2026-07-15
|
|
L5060
|
HCPCS
|
Ankle Symes Metal Frame Molded Leather Socket
|
48
|
40
|
$9,357.00
|
$5,614.20
40% off
|
$1,138.77
|
$8,889.15
|
$5,146.35
|
2026-07-15
|
|
L5100
|
HCPCS
|
Below Knee Molded Socket Shin Sach Foot (exo)
|
48
|
40
|
$9,891.00
|
$5,934.60
40% off
|
$1,249.42
|
$9,396.45
|
$5,440.05
|
2026-07-15
|
|
L5105
|
HCPCS
|
Below Knee Plastic Socket Joints And Thigh Lacer
|
48
|
40
|
$13,831.00
|
$8,298.60
40% off
|
$2,065.78
|
$13,139.45
|
$7,607.05
|
2026-07-15
|
|
L5150
|
HCPCS
|
Knee Disartic (or Through Knee) Molded Socket Ex
|
48
|
40
|
$14,006.00
|
$8,403.60
40% off
|
$2,102.04
|
$13,305.70
|
$7,703.30
|
2026-07-15
|
|
L5160
|
HCPCS
|
Knee Disarticulation Molded Socket Bent Knee Con
|
48
|
40
|
$13,017.00
|
$7,810.20
40% off
|
$1,897.12
|
$12,366.15
|
$7,159.35
|
2026-07-15
|
|
L5200
|
HCPCS
|
Above Knee Molded Socket Single Axis Constant Fr
|
48
|
40
|
$13,058.00
|
$7,834.80
40% off
|
$1,905.62
|
$12,405.10
|
$7,181.90
|
2026-07-15
|
|
L5210
|
HCPCS
|
Above Knee Short Prosthesis No Knee Joint (""stub
|
48
|
40
|
$10,367.00
|
$6,220.20
40% off
|
$1,348.04
|
$9,848.65
|
$5,701.85
|
2026-07-15
|
|
L5220
|
HCPCS
|
Above Knee Short Prosthesis No Knee Joint (""stub
|
48
|
40
|
$8,872.00
|
$5,323.20
40% off
|
$1,038.28
|
$8,428.40
|
$4,879.60
|
2026-07-15
|
|
L5230
|
HCPCS
|
Above Knee For Proximal Femoral Focal Deficiency
|
48
|
40
|
$17,127.00
|
$10,276.20
40% off
|
$2,748.71
|
$16,270.65
|
$9,419.85
|
2026-07-15
|
|
L5250
|
HCPCS
|
Hip Disartic Canadian Type Molded Socket Hip Jt
|
48
|
40
|
$15,490.00
|
$9,294.00
40% off
|
$2,409.53
|
$14,715.50
|
$8,519.50
|
2026-07-15
|
|
L5270
|
HCPCS
|
Hip Disartic Tilt Table Type Molded Socket Lock
|
48
|
40
|
$17,258.00
|
$10,354.80
40% off
|
$2,775.86
|
$16,395.10
|
$9,491.90
|
2026-07-15
|
|
L5280
|
HCPCS
|
Hemipelvectomy Canadian Type Molded Socket Hip
|
48
|
40
|
$16,781.00
|
$10,068.60
40% off
|
$2,677.02
|
$15,941.95
|
$9,229.55
|
2026-07-15
|
|
L5301
|
HCPCS
|
Below Knee Molded Socket Shin Sach Foot Endosk
|
48
|
40
|
$9,624.00
|
$5,774.40
40% off
|
$1,194.09
|
$9,142.80
|
$5,293.20
|
2026-07-15
|
|
L5312
|
HCPCS
|
Knee Disart Sach Ft Endo (l5312)
|
48
|
40
|
$14,040.00
|
$8,424.00
40% off
|
$2,109.09
|
$13,338.00
|
$7,722.00
|
2026-07-15
|
|
L5321
|
HCPCS
|
Above Knee Molded Socket Open End Sach Foot En
|
48
|
40
|
$12,838.00
|
$7,702.80
40% off
|
$1,860.03
|
$12,196.10
|
$7,060.90
|
2026-07-15
|
|
L5331
|
HCPCS
|
Hip Disart Canadian Type Molded Socket Endo Sys
|
48
|
40
|
$18,799.00
|
$11,279.40
40% off
|
$3,095.15
|
$17,859.05
|
$10,339.45
|
2026-07-15
|
|
L5341
|
HCPCS
|
Hemipel Canadian Type Molded Socket Endo System
|
48
|
40
|
$15,514.00
|
$9,308.40
40% off
|
$2,414.50
|
$14,738.30
|
$8,532.70
|
2026-07-15
|
|
L5530
|
HCPCS
|
Prep Bk ""ptb"" Type Socket Non-align Sys Pylon
|
48
|
40
|
$7,454.00
|
$4,472.40
40% off
|
$744.47
|
$7,081.30
|
$4,099.70
|
2026-07-15
|
|
L5540
|
HCPCS
|
Prep Bk ""ptb"" Type Socket Non-alignable Sys Pyl
|
48
|
40
|
$7,431.00
|
$4,458.60
40% off
|
$739.70
|
$7,059.45
|
$4,087.05
|
2026-07-15
|
|
L5560
|
HCPCS
|
Prep Ak Or Knee Disartic Ischial Level Socket N
|
48
|
40
|
$6,467.00
|
$3,880.20
40% off
|
$539.96
|
$6,143.65
|
$3,556.85
|
2026-07-15
|
|
L5580
|
HCPCS
|
L5580 Prep Ak Or Knee Disartic Ischial Level Soc
|
48
|
40
|
$10,195.00
|
$6,117.00
40% off
|
$1,312.40
|
$9,685.25
|
$5,607.25
|
2026-07-15
|
|
L5585
|
HCPCS
|
Prep Ak Or Knee Disartic Ischial Level Socket N
|
48
|
40
|
$9,125.00
|
$5,475.00
40% off
|
$1,090.70
|
$8,668.75
|
$5,018.75
|
2026-07-15
|
|
L5590
|
HCPCS
|
Prep Ak Or Knee Disartic Ischial Level Socket N
|
48
|
40
|
$10,533.00
|
$6,319.80
40% off
|
$1,382.44
|
$10,006.35
|
$5,793.15
|
2026-07-15
|
|
L5595
|
HCPCS
|
Prep Hip Disartic - Hemipel Pylon No Cover Sac
|
48
|
40
|
$16,464.00
|
$9,878.40
40% off
|
$2,611.34
|
$15,640.80
|
$9,055.20
|
2026-07-15
|
|
L5600
|
HCPCS
|
Prep Hip Disartic Or Hemipel Pylon No Cover Sa
|
48
|
40
|
$18,734.00
|
$11,240.40
40% off
|
$3,081.68
|
$17,797.30
|
$10,303.70
|
2026-07-15
|
|
L5610
|
HCPCS
|
Addition To Le Endo Sys Ak Hydracadence System
|
48
|
40
|
$7,257.00
|
$4,354.20
40% off
|
$703.65
|
$6,894.15
|
$3,991.35
|
2026-07-15
|
|
L5613
|
HCPCS
|
Addition To Le Endo Sys Ak Or Knee Disartic 4-b
|
48
|
40
|
$9,200.00
|
$5,520.00
40% off
|
$1,106.24
|
$8,740.00
|
$5,060.00
|
2026-07-15
|
|
L5615
|
HCPCS
|
Ak 4 Bar Fluid Swing/stance
|
44
|
40
|
$18,377.00
|
$11,026.20
40% off
|
$3,007.71
|
$17,458.15
|
$10,107.35
|
2026-07-15
|
|
L5643
|
HCPCS
|
Addition To Le Hip Disartic Flexible Inner Socke
|
48
|
40
|
$7,196.00
|
$4,317.60
40% off
|
$691.01
|
$6,836.20
|
$3,957.80
|
2026-07-15
|
|
L5649
|
HCPCS
|
Addition To Le Ischial Containment/narrow M-l Soc
|
48
|
40
|
$9,258.00
|
$5,554.80
40% off
|
$1,118.26
|
$8,795.10
|
$5,091.90
|
2026-07-15
|
|
L5700
|
HCPCS
|
Replacement Socket Bk Molded To Patient Model
|
48
|
40
|
$11,586.00
|
$6,951.60
40% off
|
$1,600.62
|
$11,006.70
|
$6,372.30
|
2026-07-15
|
|
L5701
|
HCPCS
|
Replacement Socket AK/knee Disartic Incl Attach
|
48
|
40
|
$13,670.00
|
$8,202.00
40% off
|
$2,032.42
|
$12,986.50
|
$7,518.50
|
2026-07-15
|
|
L5702
|
HCPCS
|
Replacement Socket Hip Disartic Incl Hip Joint
|
48
|
40
|
$13,933.00
|
$8,359.80
40% off
|
$2,086.92
|
$13,236.35
|
$7,663.15
|
2026-07-15
|
|
L5703
|
HCPCS
|
L5703 Ankle Symes Molded To Patient Model Without So
|
48
|
40
|
$6,700.00
|
$4,020.00
40% off
|
$588.24
|
$6,365.00
|
$3,685.00
|
2026-07-15
|
|
L5728
|
HCPCS
|
Addition Exo Knee-shin Sys Single Axis Fluid Sw
|
48
|
40
|
$7,003.00
|
$4,201.80
40% off
|
$651.02
|
$6,652.85
|
$3,851.65
|
2026-07-15
|
|
L5781
|
HCPCS
|
Addition Vacuum Pump Residual Limb Volume Manage
|
48
|
40
|
$15,111.00
|
$9,066.60
40% off
|
$2,331.00
|
$14,355.45
|
$8,311.05
|
2026-07-15
|
|
L5782
|
HCPCS
|
Addition Vacuum Pump Residual Limb Volume Manage
|
48
|
40
|
$15,151.00
|
$9,090.60
40% off
|
$2,339.29
|
$14,393.45
|
$8,333.05
|
2026-07-15
|
|
L5814
|
HCPCS
|
Addition Endo Knee-shin Sys Polycentric Hydraul
|
48
|
40
|
$14,452.00
|
$8,671.20
40% off
|
$2,194.45
|
$13,729.40
|
$7,948.60
|
2026-07-15
|
|
L5822
|
HCPCS
|
Addition Endo Knee-shin Sys Single Axis Pneumat
|
48
|
40
|
$6,295.00
|
$3,777.00
40% off
|
$504.32
|
$5,980.25
|
$3,462.25
|
2026-07-15
|
|
L5826
|
HCPCS
|
Addition Endo Knee-shin Sys Single Axis Hydraul
|
48
|
40
|
$9,074.00
|
$5,444.40
40% off
|
$1,080.13
|
$8,620.30
|
$4,990.70
|
2026-07-15
|
|
L5827
|
HCPCS
|
Addition Endo Knee-shin System Electromechanical S
|
48
|
40
|
$20,889.00
|
$12,533.40
40% off
|
$3,528.20
|
$19,844.55
|
$11,593.40
|
2026-07-15
|
|
L5828
|
HCPCS
|
Addition Endo Knee-shin Sys Single Axis Fluid S
|
48
|
40
|
$10,587.00
|
$6,352.20
40% off
|
$1,393.63
|
$10,057.65
|
$5,822.85
|
2026-07-15
|
|
L5840
|
HCPCS
|
Addition Endo Knee-shin Sys 4-bar Linkage Or Mul
|
48
|
40
|
$14,010.00
|
$8,406.00
40% off
|
$2,102.87
|
$13,309.50
|
$7,705.50
|
2026-07-15
|
|
L5845
|
HCPCS
|
Addition Endo Knee-shin Sys Stance Flexion Featu
|
48
|
40
|
$6,441.00
|
$3,864.60
40% off
|
$534.58
|
$6,118.95
|
$3,542.55
|
2026-07-15
|
|
L5856
|
HCPCS
|
Addition To Le Pros Endo Knee-shin Sys Microproc
|
48
|
40
|
$86,237.00
|
$51,742.20
40% off
|
$17,068.31
|
$81,925.15
|
$47,430.35
|
2026-07-15
|
|
L5857
|
HCPCS
|
Addition To Le Pros Endo Knee-shin Sys Microproc
|
48
|
40
|
$24,746.00
|
$14,847.60
40% off
|
$4,327.37
|
$23,508.70
|
$13,610.30
|
2026-07-15
|
|
L5858
|
HCPCS
|
L5858 Add To Le Pros Endo Knee-shin Sys Micropro
|
48
|
40
|
$51,834.00
|
$31,100.40
40% off
|
$9,940.00
|
$49,242.30
|
$28,508.70
|
2026-07-15
|
|
L5859
|
HCPCS
|
Addition To Le Pros Endo Knee-shin Sys Powered
|
48
|
40
|
$43,371.00
|
$26,022.60
40% off
|
$8,186.47
|
$41,202.45
|
$23,854.05
|
2026-07-15
|
|
L5930
|
HCPCS
|
Addition Endo Sys High Activity Knee Control Fra
|
48
|
40
|
$12,094.00
|
$7,256.40
40% off
|
$1,705.88
|
$11,489.30
|
$6,651.70
|
2026-07-15
|
|
L5961
|
HCPCS
|
Endo Poly Hip Pneu/hyd/rot
|
48
|
40
|
$24,548.00
|
$14,728.80
40% off
|
$4,286.35
|
$23,320.60
|
$13,501.40
|
2026-07-15
|
|
L5968
|
HCPCS
|
All Le Prosthesis Ankle Multiaxial Shock Absorbi
|
48
|
40
|
$10,559.00
|
$6,335.40
40% off
|
$1,387.82
|
$10,031.05
|
$5,807.45
|
2026-07-15
|
|
L5969
|
HCPCS
|
Ak/ft Power Asst Incl Motors (l5969)
|
40
|
34
|
$48,742.00
|
$29,245.20
40% off
|
$9,299.34
|
$46,304.90
|
$29,610.76
|
2026-07-15
|
|
L5973
|
HCPCS
|
Ank-foot Sys Dors-plant Flex
|
48
|
40
|
$52,801.00
|
$31,680.60
40% off
|
$10,140.37
|
$50,160.95
|
$29,040.55
|
2026-07-15
|
|
L5979
|
HCPCS
|
All Le Prostheses Multi-axial Ankle/foot Dynamic
|
48
|
40
|
$9,419.00
|
$5,651.40
40% off
|
$1,151.62
|
$8,948.05
|
$5,180.45
|
2026-07-15
|
|
L5980
|
HCPCS
|
All Le Prostheses Flex-foot System
|
48
|
40
|
$14,346.00
|
$8,607.60
40% off
|
$2,172.49
|
$13,628.70
|
$7,890.30
|
2026-07-15
|
|
L5981
|
HCPCS
|
All Le Prostheses Flex-walk System Or Equal
|
48
|
40
|
$12,888.00
|
$7,732.80
40% off
|
$1,870.39
|
$12,243.60
|
$7,088.40
|
2026-07-15
|
|
L5987
|
HCPCS
|
All Le Prosthesis Shank Foot System With Vertical
|
44
|
40
|
$27,982.00
|
$16,789.20
40% off
|
$4,997.87
|
$26,582.90
|
$14,410.73
|
2026-07-15
|
|
L5988
|
HCPCS
|
All Le Prosthesis Combination Vertical Shock And
|
44
|
40
|
$7,771.00
|
$4,662.60
40% off
|
$810.15
|
$7,382.45
|
$4,002.07
|
2026-07-15
|
|
L5990
|
HCPCS
|
Addtion To Le Prosthesis User Adj Heel Height
|
44
|
40
|
$6,583.00
|
$3,949.80
40% off
|
$564.00
|
$6,253.85
|
$3,561.40
|
2026-07-15
|
|
L5991
|
HCPCS
|
Addition Le Ext Osseointegrated Connector
|
48
|
40
|
$34,748.00
|
$20,848.80
40% off
|
$6,399.79
|
$33,010.60
|
$19,285.14
|
2026-07-15
|
|
L5999
|
HCPCS
|
L5999 - Lower Extremity Prosthesis Not Otherwise
|
40
|
34
|
$8,953.48
|
$5,372.09
40% off
|
$1,055.16
|
$8,505.81
|
$5,439.24
|
2026-07-15
|
|
L6000
|
HCPCS
|
Partial Hand Robin-aids Thumb Remaining (or Equ
|
44
|
40
|
$6,514.00
|
$3,908.40
40% off
|
$549.70
|
$6,188.30
|
$3,524.07
|
2026-07-15
|
|
L6020
|
HCPCS
|
Partial Hand Robin-aids No Fingers Remaining (or
|
44
|
40
|
$6,631.00
|
$3,978.60
40% off
|
$573.94
|
$6,299.45
|
$3,587.37
|
2026-07-15
|
|
L6026
|
HCPCS
|
Part Hand Myo Exclu Term Dev (l6026)
|
44
|
40
|
$14,710.00
|
$8,826.00
40% off
|
$2,247.91
|
$13,974.50
|
$8,090.50
|
2026-07-15
|
|
L6028
|
HCPCS
|
Partial Hand Molded Socket Flexible Or Non-flexibl
|
36
|
34
|
$9,064.00
|
$5,438.40
40% off
|
$1,078.06
|
$8,610.80
|
$5,334.16
|
2026-07-15
|
|
L6031
|
HCPCS
|
Replacement Socket Partial Hand
|
36
|
34
|
$10,300.00
|
$6,180.00
40% off
|
$1,334.16
|
$9,785.00
|
$6,061.55
|
2026-07-15
|
|
L6034
|
HCPCS
|
Partial Hand Transmetacarpal Incl Flex Or Non-fl
|
40
|
34
|
$9,064.00
|
$5,438.40
40% off
|
$1,078.06
|
$8,610.80
|
$5,506.38
|
2026-07-15
|
|
L6035
|
HCPCS
|
Single Prosthetic Digit Mechanical Initial Or Re
|
40
|
34
|
$13,022.00
|
$7,813.20
40% off
|
$1,898.16
|
$12,370.90
|
$7,910.86
|
2026-07-15
|
|
L6036
|
HCPCS
|
Prosthetic Thumb Mechanical Initial Or Replaceme
|
40
|
34
|
$15,013.00
|
$9,007.80
40% off
|
$2,310.69
|
$14,262.35
|
$9,120.40
|
2026-07-15
|
|
L6038
|
HCPCS
|
Addition To Single Prosthetic Digit Or Thumb Mult
|
40
|
34
|
$7,507.00
|
$4,504.20
40% off
|
$755.45
|
$7,131.65
|
$4,560.51
|
2026-07-15
|
|
L6039
|
HCPCS
|
Passive Prosthetic Digit Or Thumb Custom Made Pe
|
40
|
34
|
$6,946.00
|
$4,167.60
40% off
|
$639.21
|
$6,598.70
|
$4,219.69
|
2026-07-15
|
|
L6050
|
HCPCS
|
Wrist Disartic Molded Socket Flexible Elbow Hing
|
48
|
40
|
$9,099.00
|
$5,459.40
40% off
|
$1,085.31
|
$8,644.05
|
$5,004.45
|
2026-07-15
|
|
L6055
|
HCPCS
|
Wrist Disarticulation Molded Socket Flexible Elb
|
48
|
40
|
$11,505.00
|
$6,903.00
40% off
|
$1,583.84
|
$10,929.75
|
$6,327.75
|
2026-07-15
|
|
L6100
|
HCPCS
|
Be Molded Socket Flexible Elbow Hinges Triceps
|
44
|
40
|
$9,121.00
|
$5,472.60
40% off
|
$1,089.87
|
$8,664.95
|
$4,934.46
|
2026-07-15
|
|
L6110
|
HCPCS
|
Be Molded Socket (Muenster Or Northwestern Suspen
|
44
|
40
|
$9,651.00
|
$5,790.60
40% off
|
$1,199.69
|
$9,168.45
|
$5,221.19
|
2026-07-15
|
|
L6120
|
HCPCS
|
Be Molded Socket (Muenster Or Northwestern Suspen
|
48
|
40
|
$8,481.00
|
$5,088.60
40% off
|
$957.26
|
$8,056.95
|
$4,664.55
|
2026-07-15
|
|
L6130
|
HCPCS
|
L6130 Be Molded Socket (Muenster Or Northwestern
|
48
|
40
|
$8,940.00
|
$5,364.00
40% off
|
$1,052.37
|
$8,493.00
|
$4,917.00
|
2026-07-15
|
|
L6200
|
HCPCS
|
Elbow Disartic Molded Socket Outside Locking Hin
|
44
|
40
|
$9,125.00
|
$5,475.00
40% off
|
$1,090.70
|
$8,668.75
|
$4,936.62
|
2026-07-15
|
|
L6205
|
HCPCS
|
Elbow Disartic Molded Socket With Expandable Inte
|
48
|
40
|
$12,630.00
|
$7,578.00
40% off
|
$1,816.94
|
$11,998.50
|
$6,946.50
|
2026-07-15
|
|
L6250
|
HCPCS
|
Ae Molded Double Wall Socket Internal Locking El
|
44
|
40
|
$11,669.00
|
$7,001.40
40% off
|
$1,617.82
|
$11,085.55
|
$6,312.93
|
2026-07-15
|
|
L6300
|
HCPCS
|
Shoulder Disartic Molded Socket Shoulder Bulkhea
|
44
|
40
|
$16,107.00
|
$9,664.20
40% off
|
$2,537.37
|
$15,301.65
|
$8,713.89
|
2026-07-15
|
|
L6310
|
HCPCS
|
Shoulder Disartic Passive Restoration (complete P
|
48
|
40
|
$11,256.00
|
$6,753.60
40% off
|
$1,532.24
|
$10,693.20
|
$6,190.80
|
2026-07-15
|
|
L6320
|
HCPCS
|
Shoulder Disartic Passive Restoration (shoulder C
|
48
|
40
|
$7,608.00
|
$4,564.80
40% off
|
$776.38
|
$7,227.60
|
$4,184.40
|
2026-07-15
|
|
L6350
|
HCPCS
|
Interscapular Thoracic Molded Socket Shoulder Bu
|
48
|
40
|
$13,810.00
|
$8,286.00
40% off
|
$2,061.43
|
$13,119.50
|
$7,595.50
|
2026-07-15
|
|
L6360
|
HCPCS
|
Interscapular Thoracic Passive Restoration (compl
|
48
|
40
|
$11,817.00
|
$7,090.20
40% off
|
$1,648.48
|
$11,226.15
|
$6,499.35
|
2026-07-15
|
|
L6370
|
HCPCS
|
Intrascapular Thoracic Passive Restoration (shoul
|
48
|
40
|
$6,852.00
|
$4,111.20
40% off
|
$619.73
|
$6,509.40
|
$3,768.60
|
2026-07-15
|
|
L6400
|
HCPCS
|
Be Molded Socket Endo Sys Incl Soft Prosthetic
|
48
|
40
|
$9,968.00
|
$5,980.80
40% off
|
$1,265.37
|
$9,469.60
|
$5,482.40
|
2026-07-15
|
|
L6450
|
HCPCS
|
Elbow Disartic Molded Socket Endo Sys Incl Soft
|
48
|
40
|
$10,021.00
|
$6,012.60
40% off
|
$1,276.35
|
$9,519.95
|
$5,511.55
|
2026-07-15
|
|
L6500
|
HCPCS
|
Ae Molded Socket Endo Sys Incl Soft Prosthetic
|
48
|
40
|
$12,671.00
|
$7,602.60
40% off
|
$1,825.43
|
$12,037.45
|
$6,969.05
|
2026-07-15
|
|
L6550
|
HCPCS
|
Shoulder Disartic Molded Socket Endo Sys Incl S
|
48
|
40
|
$12,979.00
|
$7,787.40
40% off
|
$1,889.25
|
$12,330.05
|
$7,138.45
|
2026-07-15
|
|
L6570
|
HCPCS
|
L6570 Shoulder Disartic Molded Socket Endo Sys
|
48
|
40
|
$14,223.00
|
$8,533.80
40% off
|
$2,147.01
|
$13,511.85
|
$7,822.65
|
2026-07-15
|
|
L6580
|
HCPCS
|
Prep Wrist Disartic Or Be Plastic Molded To Pati
|
48
|
40
|
$7,326.00
|
$4,395.60
40% off
|
$717.95
|
$6,959.70
|
$4,029.30
|
2026-07-15
|
|
L6584
|
HCPCS
|
Prep Elbow Disartic Or Ae Plastic Molded To Pati
|
48
|
40
|
$7,073.00
|
$4,243.80
40% off
|
$665.53
|
$6,719.35
|
$3,890.15
|
2026-07-15
|
|
L6586
|
HCPCS
|
Prep Elbow Disartic Or Ae Direct Formed
|
48
|
40
|
$7,073.00
|
$4,243.80
40% off
|
$665.53
|
$6,719.35
|
$3,890.15
|
2026-07-15
|
|
L6588
|
HCPCS
|
Prep Shoulder Disartic Or Interscapular Thoracic
|
48
|
40
|
$10,039.00
|
$6,023.40
40% off
|
$1,280.08
|
$9,537.05
|
$5,521.45
|
2026-07-15
|
|
L6590
|
HCPCS
|
Prep Shoulder Disartic Or Interscapular Thoracic
|
48
|
40
|
$8,691.00
|
$5,214.60
40% off
|
$1,000.78
|
$8,256.45
|
$4,780.05
|
2026-07-15
|
|
L6621
|
HCPCS
|
L6621 Upper Extremity Additionsflexion/extension
|
44
|
40
|
$8,462.00
|
$5,077.20
40% off
|
$953.33
|
$8,038.90
|
$4,577.94
|
2026-07-15
|
|
L6624
|
HCPCS
|
Upper Extremity Addition Flexion/extension And Ro
|
44
|
40
|
$11,160.00
|
$6,696.00
40% off
|
$1,512.35
|
$10,602.00
|
$6,037.56
|
2026-07-15
|
|
L6638
|
HCPCS
|
Ue Addition Electric Lock Feature With Manually Po
|
44
|
40
|
$9,163.00
|
$5,497.80
40% off
|
$1,098.57
|
$8,704.85
|
$4,957.18
|
2026-07-15
|
|
L6646
|
HCPCS
|
Ue Addition Shoulder Jt Multipositional Lock Fl
|
44
|
40
|
$11,672.00
|
$7,003.20
40% off
|
$1,618.44
|
$11,088.40
|
$6,314.55
|
2026-07-15
|
|
L6648
|
HCPCS
|
Ue Addition Shoulder Lock Mechanism External Pow
|
44
|
40
|
$11,918.00
|
$7,150.80
40% off
|
$1,669.41
|
$11,322.10
|
$6,447.64
|
2026-07-15
|
|
L6693
|
HCPCS
|
Ue Addition External Locking Elbow Forearm Count
|
44
|
40
|
$10,934.00
|
$6,560.40
40% off
|
$1,465.52
|
$10,387.30
|
$5,915.30
|
2026-07-15
|
|
L6700
|
HCPCS
|
Addition Ue Pattern Recognition System
|
48
|
40
|
$56,084.00
|
$33,650.40
40% off
|
$10,820.60
|
$53,279.80
|
$31,126.62
|
2026-07-15
|
|
L6715
|
HCPCS
|
Term Device Multi Art Digit
|
44
|
40
|
$10,249.00
|
$6,149.40
40% off
|
$1,323.59
|
$9,736.55
|
$5,544.71
|
2026-07-15
|
|
L6721
|
HCPCS
|
Hook/hand Hvy Dty Vol Open
|
44
|
40
|
$6,706.00
|
$4,023.60
40% off
|
$589.48
|
$6,370.70
|
$3,627.95
|
2026-07-15
|
|
L6722
|
HCPCS
|
Hook/hand Hvy Dty Vol Clos
|
48
|
40
|
$7,509.00
|
$4,505.40
40% off
|
$755.86
|
$7,133.55
|
$4,129.95
|
2026-07-15
|
|
L6880
|
HCPCS
|
L6880 Elec Hand Ind Art Digits
|
48
|
40
|
$86,957.00
|
$52,174.20
40% off
|
$17,217.49
|
$82,609.15
|
$47,826.35
|
2026-07-15
|
|
L6881
|
HCPCS
|
Automatic Grasp Feature Addition To Upper-limb Pr
|
44
|
40
|
$15,904.00
|
$9,542.40
40% off
|
$2,495.31
|
$15,108.80
|
$8,604.07
|
2026-07-15
|
|
L6882
|
HCPCS
|
Microproc Control Feature Addtion To Upper-limb P
|
44
|
40
|
$11,140.00
|
$6,684.00
40% off
|
$1,508.21
|
$10,583.00
|
$6,026.74
|
2026-07-15
|
|
L6883
|
HCPCS
|
L6883 Replacement Socketbelow Elbow/wrist Disarti
|
44
|
40
|
$10,705.00
|
$6,423.00
40% off
|
$1,418.08
|
$10,169.75
|
$5,791.41
|
2026-07-15
|
|
L6884
|
HCPCS
|
L6884 Replacement Socketabove Elbow/elbow Disarti
|
44
|
40
|
$7,219.00
|
$4,331.40
40% off
|
$695.78
|
$6,858.05
|
$3,905.48
|
2026-07-15
|
|
L6885
|
HCPCS
|
L6885 Replacement Socketshoulder Disarticulation/
|
48
|
40
|
$11,217.00
|
$6,730.20
40% off
|
$1,524.16
|
$10,656.15
|
$6,169.35
|
2026-07-15
|
|
L6920
|
HCPCS
|
Wrist Disartic Ext Power Self-susp Inner Socket
|
48
|
40
|
$24,580.00
|
$14,748.00
40% off
|
$4,292.98
|
$23,351.00
|
$13,519.00
|
2026-07-15
|
|
L6925
|
HCPCS
|
Wrist Disartic Ext Power Self-susp Inner Socket
|
48
|
40
|
$26,256.00
|
$15,753.60
40% off
|
$4,640.24
|
$24,943.20
|
$14,440.80
|
2026-07-15
|
|
L6930
|
HCPCS
|
Be Ext Power Self-susp Inner Socket Remov Shell
|
48
|
40
|
$23,676.00
|
$14,205.60
40% off
|
$4,105.67
|
$22,492.20
|
$13,021.80
|
2026-07-15
|
|
L6935
|
HCPCS
|
Be Ext Power Self-susp Inner Socket Remov Shell
|
44
|
40
|
$32,960.00
|
$19,776.00
40% off
|
$6,029.31
|
$31,312.00
|
$17,831.36
|
2026-07-15
|
|
L6940
|
HCPCS
|
Elbow Disartic External Power Switch Control
|
48
|
40
|
$30,570.00
|
$18,342.00
40% off
|
$5,534.10
|
$29,041.50
|
$16,813.50
|
2026-07-15
|
|
L6945
|
HCPCS
|
Elbow Disartic External Power Myo Control
|
48
|
40
|
$34,106.00
|
$20,463.60
40% off
|
$6,266.76
|
$32,400.70
|
$18,758.30
|
2026-07-15
|
|
L6950
|
HCPCS
|
Above Elbow External Power Switch Control
|
48
|
40
|
$37,736.00
|
$22,641.60
40% off
|
$7,018.90
|
$35,849.20
|
$20,754.80
|
2026-07-15
|
|
L6955
|
HCPCS
|
Above Elbow External Power Myo Control
|
44
|
40
|
$35,386.00
|
$21,231.60
40% off
|
$6,531.98
|
$33,616.70
|
$19,143.82
|
2026-07-15
|
|
L6960
|
HCPCS
|
Shoulder Disarticulation External Power Switch C
|
44
|
40
|
$45,574.00
|
$27,344.40
40% off
|
$8,642.93
|
$43,295.30
|
$24,655.53
|
2026-07-15
|
|
L6965
|
HCPCS
|
Shoulder Disarticulation External Power Myo Cont
|
44
|
40
|
$54,529.00
|
$32,717.40
40% off
|
$10,498.41
|
$51,802.55
|
$29,500.19
|
2026-07-15
|
|
L6970
|
HCPCS
|
Intrerscapular-thoracic Ext Power Molded Inner S
|
48
|
40
|
$47,199.00
|
$28,319.40
40% off
|
$8,979.63
|
$44,839.05
|
$25,959.45
|
2026-07-15
|
|
L6975
|
HCPCS
|
Interscapular-thoracic Ext Power Molded Inner So
|
48
|
40
|
$52,029.00
|
$31,217.40
40% off
|
$9,980.41
|
$49,427.55
|
$28,615.95
|
2026-07-15
|
|
L7007
|
HCPCS
|
Electric Hand Switch Or Myo Adult
|
44
|
40
|
$13,857.00
|
$8,314.20
40% off
|
$2,071.17
|
$13,164.15
|
$7,496.64
|
2026-07-15
|
|
L7008
|
HCPCS
|
Electric Hand Switch Or Myo Pediatric
|
48
|
40
|
$20,347.00
|
$12,208.20
40% off
|
$3,415.90
|
$19,329.65
|
$11,190.85
|
2026-07-15
|
|
L7009
|
HCPCS
|
Electric Hook Switch Or Myo Adult
|
48
|
40
|
$13,558.00
|
$8,134.80
40% off
|
$2,009.22
|
$12,880.10
|
$7,456.90
|
2026-07-15
|
|
L7040
|
HCPCS
|
Prehensile Actuator Hosmer Or Equal Switch Contr
|
48
|
40
|
$8,927.00
|
$5,356.20
40% off
|
$1,049.67
|
$8,480.65
|
$4,909.85
|
2026-07-15
|
|
L7170
|
HCPCS
|
Electronic Elbow Hosmer Or Equal Switch Controll
|
48
|
40
|
$17,824.00
|
$10,694.40
40% off
|
$2,893.13
|
$16,932.80
|
$9,803.20
|
2026-07-15
|
|
L7180
|
HCPCS
|
Electronic Elbow Microproc Sequential Control Of
|
48
|
40
|
$115,320.00
|
$69,192.00
40% off
|
$23,094.30
|
$109,554.00
|
$63,426.00
|
2026-07-15
|
|
L7181
|
HCPCS
|
Electronic Elbow Microproc Simultaneous Control O
|
44
|
40
|
$127,351.00
|
$76,410.60
40% off
|
$25,587.13
|
$120,983.45
|
$68,896.89
|
2026-07-15
|
|
L7185
|
HCPCS
|
Electronic Elbow Adolescent Variety Village Or E
|
48
|
40
|
$18,743.00
|
$11,245.80
40% off
|
$3,083.55
|
$17,805.85
|
$10,308.65
|
2026-07-15
|
|
L7186
|
HCPCS
|
Electronic Elbow Child Variety Village Or Equal
|
48
|
40
|
$38,960.00
|
$23,376.00
40% off
|
$7,272.51
|
$37,012.00
|
$21,428.00
|
2026-07-15
|
|
L7190
|
HCPCS
|
Electronic Elbow Adolescent Variety Village Or E
|
48
|
40
|
$24,864.00
|
$14,918.40
40% off
|
$4,351.82
|
$23,620.80
|
$13,675.20
|
2026-07-15
|
|
L7191
|
HCPCS
|
Electronic Elbow Child Variety Village Or Equal
|
48
|
40
|
$33,138.00
|
$19,882.80
40% off
|
$6,066.19
|
$31,481.10
|
$18,225.90
|
2026-07-15
|
|
L7259
|
HCPCS
|
Electronic Wrist Rotator Any
|
44
|
40
|
$13,701.00
|
$8,220.60
40% off
|
$2,038.85
|
$13,015.95
|
$7,535.55
|
2026-07-15
|
|
L7499
|
HCPCS
|
L7499 - Ue Prosthesis Not Otherwise Specified
|
36
|
34
|
$15,616.52
|
$9,369.91
40% off
|
$2,435.74
|
$14,835.69
|
$9,190.33
|
2026-07-15
|
|
L8701
|
HCPCS
|
Powered Ue Orthosis Elbow Wrist Hand Custom
|
48
|
40
|
$55,720.00
|
$33,432.00
40% off
|
$10,745.18
|
$52,934.00
|
$34,410.61
|
2026-07-15
|
|
L8702
|
HCPCS
|
Powered Ue Orthosis Elbow Wrist Hand Finger Cust
|
48
|
40
|
$106,169.00
|
$63,701.40
40% off
|
$21,198.22
|
$100,860.55
|
$67,700.88
|
2026-07-15
|
|
Q4278
|
HCPCS
|
Graft EpiEffect 7cm X 7cm
|
114
|
34
|
$8,978.00
|
$5,386.80
40% off
|
$787.34
|
$37,553.70
|
$5,099.51
|
2026-07-15
|