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

AUDUBON COUNTY MEMORIAL HOSPITAL

Audubon, IA · CCN 161330 · Rates published

Your selected procedure

You selected 27447 (HCPCS)

Replacement of knee joint, both sides of knee

This hospital’s price: $2,450 across 10 payers · range $1,046-$24,838

Source: https://apps.para-hcfs.com/PTT/FinalLinks/Reports.aspx?dbName=dbACMHAUDUBONIA&type=CDMWithoutLabel&fileType=CSV · observed 2026-04-01

This is the facility’s filed rate for this code. The comparison board’s estimate also adds the surgeon and anesthesia fees, so it is usually higher.

2,785 distinct procedures filed
14 distinct payers
54,908 rate rows
2026-04-01 last MRF observed
Data quality

53,974 of 54,908 rate rows are consumer-grade (98.3%)

934 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
percent-of-charges filed in the dollar field — excluded from medians 364
template filing: same amount across many unrelated codes — excluded 244
exceeds 10× this hospital's gross charge — excluded from medians 214
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 80
per-diem day rate — not a per-procedure price 32
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://apps.para-hcfs.com/PTT/FinalLinks/Reports.aspx?dbName=dbACMHAUDUBONIA&type=CDMWithoutLabel&fileType=CSV
Found on page https://www.acmhhosp.org/price-transparency/
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-08-17
Content fingerprint a252a3a0e042bc8c… · 9,973,909 bytes · first seen 2026-05-08

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
J2350
HCPCS 		Injection, Ocrelizumab, 1 Mg 8 $33,448.44 $48,778.97 $43,668.79 nat. median
$331
outlier · 132.0×
54410
HCPCS 		Removal And Replacement Of Multicomponent Inflatable Penile Implant During Same… 10 $21,168.00 $39,181.21 $29,106.00 nat. median
$17,815
1.6× median
J2329
HCPCS 		Injection, Ublituximab-xiiy, 1mg 8 $18,008.28 $26,262.08 $23,510.81 nat. median
$168
outlier · 139.7×
J9042
HCPCS 		Injection, Brentuximab Vedotin, 1 Mg 8 $17,140.68 $24,996.83 $22,378.11 nat. median
$885
outlier · 25.3×
54405
HCPCS 		Insertion Of Multicomponent Inflatable Penile Implant 10 $15,192.00 $39,181.21 $20,889.00 nat. median
$18,432
1.1× median
J9022
HCPCS 		Injection, Atezolizumab, 10 Mg 8 $15,809.44 $23,055.43 $20,640.10 nat. median
$5,498
outlier · 3.8×
J3380
HCPCS 		Injection, Vedolizumab, Intravenous, 1 Mg 8 $15,173.14 $22,127.49 $19,809.37 nat. median
$150
outlier · 132.3×
J9144
HCPCS 		Injection, Daratumumab, 10 Mg And Hyaluronidase-fihj 8 $14,854.78 $21,663.22 $19,393.74 nat. median
$202
outlier · 96.0×
J1932
HCPCS 		Injection, Lanreotide, (cipla), 1 Mg 8 $14,416.19 $21,023.61 $18,821.14 nat. median
$104
outlier · 180.2×
J3101
HCPCS 		Injection, Tenecteplase, 1 Mg 8 $13,451.64 $19,616.98 $17,561.87 nat. median
$3,475
outlier · 5.1×
33285
HCPCS 		Insertion Of Heart Rhythm Monitor Under Skin 10 $67.38 $23,462.25 $16,088.40 nat. median
$8,877
1.8× median
J9301
HCPCS 		Injection, Obinutuzumab, 10 Mg 8 $12,104.14 $17,651.87 $15,802.62 nat. median
$272
outlier · 58.1×
J0896
HCPCS 		Injection, Luspatercept-aamt, 0.25 Mg 8 $6,542.71 $28,594.86 $14,574.68 nat. median
$4,503
outlier · 3.2×
J9217
HCPCS 		Leuprolide Acetate (for Depot Suspension), 7.5 Mg 8 $3,487.10 $30,438.95 $14,573.99 nat. median
$1,518
outlier · 9.6×
J9311
HCPCS 		Injection, Rituximab 10 Mg And Hyaluronidase 8 $10,664.14 $15,551.88 $13,922.63 nat. median
$1,789
outlier · 7.8×
J2506
HCPCS 		Injection, Pegfilgrastim, Excludes Biosimilar, 0.5 Mg 8 $10,407.23 $15,177.20 $13,587.21 nat. median
$1,555
outlier · 8.7×
58290
HCPCS 		Removal Of Uterus Through Vagina, More Than 250.0 G 10 $10,920.24 $15,925.35 $13,464.82 nat. median
$7,325
1.8× median
64590
HCPCS 		Insertion Or Replacement Of Peripheral, Sacral, Or Gastric Neurostimulator Gener… 10 $9,576.00 $52,083.33 $13,167.00 nat. median
$17,900
0.7× median
J9306
HCPCS 		Injection, Pertuzumab, 1 Mg 8 $9,587.85 $13,982.28 $12,517.47 nat. median
$67
outlier · 187.7×
22514
HCPCS 		Treatment Of Broken Lower Spine Bone With Placement Of Stabilizing Device 10 $385.34 $16,695.00 $12,481.50 nat. median
$8,313
1.5× median
49652
HCPCS 		Laparoscopy, Surgical, Repair, Ventral, Umbilical, Spigelian Or Epigastric Herni… 10 $1,356.00 $17,745.00 $12,168.00 nat. median
$5,168
outlier · 2.4×
58552
HCPCS 		Removal Of Uterus, Tubes, And/or Ovaries Through Vagina Using An Endoscope, 250.… 10 $8,784.00 $13,279.34 $12,005.56 nat. median
$9,808
1.2× median
28800
HCPCS 		Amputation Of Midfoot Bone 10 $8,640.00 $13,337.14 $11,880.00 nat. median
$3,383
outlier · 3.5×
28810
HCPCS 		Amputation Of Toe And Midfoot Bone 10 $8,640.00 $13,337.14 $11,880.00 nat. median
$3,382
outlier · 3.5×
28289
HCPCS 		Correction Of Rigid Deformity Of First Joint Of Big Toe 10 $8,604.72 $13,337.14 $11,831.49 nat. median
$3,531
outlier · 3.4×
64561
HCPCS 		Insertion Of Sacral Nerve Neurostimulator Electrode Array 10 $9,576.00 $13,965.00 $11,730.03 nat. median
$6,632
1.8× median
64581
HCPCS 		Insertion Of Sacral Nerve Neurostimulator Electrode 10 $9,576.00 $13,965.00 $11,730.03 nat. median
$6,805
1.7× median
29827
HCPCS 		Repair Of Shoulder Rotator Cuff Using An Endoscope 10 $883.71 $16,637.25 $11,408.40 nat. median
$7,177
1.6× median
47605
HCPCS 		Removal Of Gallbladder With X-ray Study Of Bile Ducts 10 $75.00 $16,288.65 $11,169.36 nat. median
$2,720
outlier · 4.1×
J9271
HCPCS 		Injection, Pembrolizumab, 1 Mg 8 $8,292.28 $12,092.90 $10,826.03 nat. median
$254
outlier · 42.6×
50590
HCPCS 		Shock Wave Crushing Of Kidney Stones 10 $5,994.60 $12,600.00 $10,500.00 nat. median
$4,399
outlier · 2.4×
27829
HCPCS 		Treatment Of Ligament Tear At Ankle Joint 10 $7,920.00 $11,550.00 $10,337.34 nat. median
$6,818
1.5× median
58670
HCPCS 		Destruction Of Fallopian Tubes Using An Endoscope 10 $6,896.44 $11,865.00 $9,887.50 nat. median
$5,654
1.7× median
19307
HCPCS 		Removal Of Breast And Underarm Lymph Nodes 10 $1,002.27 $14,070.00 $9,648.00 nat. median
$6,808
1.4× median
J1449
HCPCS 		Injection, Eflapegrastim-xnst, 0.1 Mg 8 $7,300.08 $10,645.95 $9,530.66 nat. median
$29
outlier · 324.3×
29807
HCPCS 		Repair Of Shoulder Socket Using An Endoscope 10 $860.92 $13,873.68 $9,207.36 nat. median
$7,107
1.3× median
29806
HCPCS 		Repair Of Shoulder Joint Capsule Using An Endoscope 10 $879.92 $13,873.68 $9,207.36 nat. median
$7,179
1.3× median
47563
HCPCS 		Removal Of Gallbladder With X-ray Study Of Bile Ducts Using An Endoscope 10 $607.09 $13,650.00 $8,929.74 nat. median
$6,018
1.5× median
58662
HCPCS 		Destruction Or Removal Of Ovary Or Growth Of Pelvis Using An Endoscope 10 $6,896.44 $10,710.00 $8,925.00 nat. median
$6,034
1.5× median
49653
HCPCS 		Laparoscopy, Surgical, Repair, Ventral, Umbilical, Spigelian Or Epigastric Herni… 10 $1,699.00 $11,865.00 $8,886.61 nat. median
$5,374
1.7× median
49656
HCPCS 		Laparoscopy, Surgical, Repair, Recurrent Incisional Hernia (includes Mesh Insert… 10 $1,672.00 $11,865.00 $8,886.61 nat. median
$6,058
1.5× median
49655
HCPCS 		Laparoscopy, Surgical, Repair, Incisional Hernia (includes Mesh Insertion, When… 10 $1,886.00 $11,865.00 $8,886.61 nat. median
$6,424
1.4× median
52601
HCPCS 		Removal Of Prostate Gland Using An Electrocautery Knife Through Urethra With Con… 10 $6,480.00 $9,561.78 $8,750.15 nat. median
$5,323
1.6× median
57265
HCPCS 		Repair Of Bulging Of Rectum And Bladder Into Vaginal Wall 10 $3,778.26 $10,447.50 $8,706.25 nat. median
$5,071
1.7× median
28238
HCPCS 		Reconstruction Of Ankle Tendon With Removal Of Extra Ankle Joint Bone 10 $425.82 $13,337.14 $8,604.72 nat. median
$6,796
1.3× median
27766
HCPCS 		Treatment Of Inside Portion Of Broken Shin Bone At Ankle 10 $6,192.00 $10,774.68 $8,514.00 nat. median
$7,019
1.2× median
28415
HCPCS 		Treatment Of Broken Heel Bone 10 $6,192.00 $10,774.68 $8,514.00 nat. median
$7,358
1.2× median
63042
HCPCS 		Partial Removal Of Spine Bone With Re-exploration, Release Of Lower Spinal Cord… 10 $6,588.00 $9,607.50 $8,446.19 nat. median
$7,513
1.1× median
52356
HCPCS 		Crushing Of Stone Of Ureter With Insertion Of Stent Using An Endoscope 10 $6,842.16 $9,978.15 $8,436.74 nat. median
$5,594
1.5× median
Q5120
HCPCS 		Injection, Pegfilgrastim-bmez (ziextenzo), Biosimilar, 0.5 Mg 8 $6,369.44 $9,288.76 $8,315.66 nat. median
$357
outlier · 23.3×

Other procedures at this hospital

Browse this hospital's 2,785 published procedures. Use the slice to choose what to show, then sort or filter any column.

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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
             
J2350 HCPCS Injection, Ocrelizumab, 1 Mg 16 8 $46,456.16 $46,456.16 $33,448.44 $48,778.97 $43,668.79 2026-04-01
54410 HCPCS Removal And Replacement Of Multicomponent Inflatable Penile Implant During Same … 20 10 $29,400.00 $29,400.00 $21,168.00 $39,181.21 $29,106.00 2026-04-01
J2329 HCPCS Injection, Ublituximab-xiiy, 1mg 16 8 $25,011.50 $25,011.50 $18,008.28 $26,262.08 $23,510.81 2026-04-01
J9042 HCPCS Injection, Brentuximab Vedotin, 1 Mg 16 8 $23,806.50 $23,806.50 $17,140.68 $24,996.83 $22,378.11 2026-04-01
54405 HCPCS Insertion Of Multicomponent Inflatable Penile Implant 20 10 $21,100.00 $21,100.00 $15,192.00 $39,181.21 $20,889.00 2026-04-01
J9022 HCPCS Injection, Atezolizumab, 10 Mg 16 8 $21,957.55 $21,957.55 $15,809.44 $23,055.43 $20,640.10 2026-04-01
J3380 HCPCS Injection, Vedolizumab, Intravenous, 1 Mg 16 8 $21,073.80 $21,073.80 $15,173.14 $22,127.49 $19,809.37 2026-04-01
J9144 HCPCS Injection, Daratumumab, 10 Mg And Hyaluronidase-fihj 16 8 $20,631.64 $20,631.64 $14,854.78 $21,663.22 $19,393.74 2026-04-01
J1932 HCPCS Injection, Lanreotide, (cipla), 1 Mg 16 8 $20,022.49 $20,022.49 $14,416.19 $21,023.61 $18,821.14 2026-04-01
J3101 HCPCS Injection, Tenecteplase, 1 Mg 16 8 $18,682.84 $18,682.84 $13,451.64 $19,616.98 $17,561.87 2026-04-01
33285 HCPCS Insertion Of Heart Rhythm Monitor Under Skin 36 10 $22,345.00 $22,345.00 $67.38 $23,462.25 $16,088.40 2026-04-01
J9301 HCPCS Injection, Obinutuzumab, 10 Mg 16 8 $16,811.30 $16,811.30 $12,104.14 $17,651.87 $15,802.62 2026-04-01
J0896 HCPCS Injection, Luspatercept-aamt, 0.25 Mg 32 8 $18,160.15 $18,160.15 $6,542.71 $28,594.86 $14,574.68 2026-04-01
J9217 HCPCS Leuprolide Acetate (for Depot Suspension), 7.5 Mg 64 8 $16,916.09 $16,916.09 $3,487.10 $30,438.95 $14,573.99 2026-04-01
J9311 HCPCS Injection, Rituximab 10 Mg And Hyaluronidase 16 8 $14,811.31 $14,811.31 $10,664.14 $15,551.88 $13,922.63 2026-04-01
J2506 HCPCS Injection, Pegfilgrastim, Excludes Biosimilar, 0.5 Mg 16 8 $14,454.48 $14,454.48 $10,407.23 $15,177.20 $13,587.21 2026-04-01
58290 HCPCS Removal Of Uterus Through Vagina, More Than 250.0 G 20 10 $15,167.00 $15,167.00 $10,920.24 $15,925.35 $13,464.82 2026-04-01
64590 HCPCS Insertion Or Replacement Of Peripheral, Sacral, Or Gastric Neurostimulator Gener… 20 10 $13,300.00 $13,300.00 $9,576.00 $52,083.33 $13,167.00 2026-04-01
J9306 HCPCS Injection, Pertuzumab, 1 Mg 16 8 $13,316.46 $13,316.46 $9,587.85 $13,982.28 $12,517.47 2026-04-01
22514 HCPCS Treatment Of Broken Lower Spine Bone With Placement Of Stabilizing Device 36 10 $15,900.00 $15,900.00 $385.34 $16,695.00 $12,481.50 2026-04-01
49652 HCPCS Laparoscopy, Surgical, Repair, Ventral, Umbilical, Spigelian Or Epigastric Herni… 30 10 $16,900.00 $16,900.00 $1,356.00 $17,745.00 $12,168.00 2026-04-01
58552 HCPCS Removal Of Uterus, Tubes, And/or Ovaries Through Vagina Using An Endoscope, 250.… 20 10 $12,200.00 $12,200.00 $8,784.00 $13,279.34 $12,005.56 2026-04-01
28800 HCPCS Amputation Of Midfoot Bone 20 10 $12,000.00 $12,000.00 $8,640.00 $13,337.14 $11,880.00 2026-04-01
28810 HCPCS Amputation Of Toe And Midfoot Bone 20 10 $12,000.00 $12,000.00 $8,640.00 $13,337.14 $11,880.00 2026-04-01
28289 HCPCS Correction Of Rigid Deformity Of First Joint Of Big Toe 20 10 $11,951.00 $11,951.00 $8,604.72 $13,337.14 $11,831.49 2026-04-01
64561 HCPCS Insertion Of Sacral Nerve Neurostimulator Electrode Array 20 10 $13,300.00 $13,300.00 $9,576.00 $13,965.00 $11,730.03 2026-04-01
64581 HCPCS Insertion Of Sacral Nerve Neurostimulator Electrode 20 10 $13,300.00 $13,300.00 $9,576.00 $13,965.00 $11,730.03 2026-04-01
29827 HCPCS Repair Of Shoulder Rotator Cuff Using An Endoscope 36 10 $15,845.00 $15,845.00 $883.71 $16,637.25 $11,408.40 2026-04-01
47605 HCPCS Removal Of Gallbladder With X-ray Study Of Bile Ducts 36 10 $15,513.00 $15,513.00 $75.00 $16,288.65 $11,169.36 2026-04-01
J9271 HCPCS Injection, Pembrolizumab, 1 Mg 16 8 $11,517.05 $11,517.05 $8,292.28 $12,092.90 $10,826.03 2026-04-01
50590 HCPCS Shock Wave Crushing Of Kidney Stones 20 10 $12,000.00 $12,000.00 $5,994.60 $12,600.00 $10,500.00 2026-04-01
27829 HCPCS Treatment Of Ligament Tear At Ankle Joint 20 10 $11,000.00 $11,000.00 $7,920.00 $11,550.00 $10,337.34 2026-04-01
58670 HCPCS Destruction Of Fallopian Tubes Using An Endoscope 20 10 $11,300.00 $11,300.00 $6,896.44 $11,865.00 $9,887.50 2026-04-01
19307 HCPCS Removal Of Breast And Underarm Lymph Nodes 36 10 $13,400.00 $13,400.00 $1,002.27 $14,070.00 $9,648.00 2026-04-01
J1449 HCPCS Injection, Eflapegrastim-xnst, 0.1 Mg 16 8 $10,139.00 $10,139.00 $7,300.08 $10,645.95 $9,530.66 2026-04-01
29807 HCPCS Repair Of Shoulder Socket Using An Endoscope 36 10 $12,788.00 $12,788.00 $860.92 $13,873.68 $9,207.36 2026-04-01
29806 HCPCS Repair Of Shoulder Joint Capsule Using An Endoscope 36 10 $12,788.00 $12,788.00 $879.92 $13,873.68 $9,207.36 2026-04-01
47563 HCPCS Removal Of Gallbladder With X-ray Study Of Bile Ducts Using An Endoscope 36 10 $13,000.00 $13,000.00 $607.09 $13,650.00 $8,929.74 2026-04-01
58662 HCPCS Destruction Or Removal Of Ovary Or Growth Of Pelvis Using An Endoscope 20 10 $10,200.00 $10,200.00 $6,896.44 $10,710.00 $8,925.00 2026-04-01
49656 HCPCS Laparoscopy, Surgical, Repair, Recurrent Incisional Hernia (includes Mesh Insert… 30 10 $11,300.00 $11,300.00 $1,672.00 $11,865.00 $8,886.61 2026-04-01
49653 HCPCS Laparoscopy, Surgical, Repair, Ventral, Umbilical, Spigelian Or Epigastric Herni… 30 10 $11,300.00 $11,300.00 $1,699.00 $11,865.00 $8,886.61 2026-04-01
49655 HCPCS Laparoscopy, Surgical, Repair, Incisional Hernia (includes Mesh Insertion, When … 30 10 $11,300.00 $11,300.00 $1,886.00 $11,865.00 $8,886.61 2026-04-01
52601 HCPCS Removal Of Prostate Gland Using An Electrocautery Knife Through Urethra With Con… 20 10 $9,000.00 $9,000.00 $6,480.00 $9,561.78 $8,750.15 2026-04-01
57265 HCPCS Repair Of Bulging Of Rectum And Bladder Into Vaginal Wall 20 10 $9,950.00 $9,950.00 $3,778.26 $10,447.50 $8,706.25 2026-04-01
28238 HCPCS Reconstruction Of Ankle Tendon With Removal Of Extra Ankle Joint Bone 36 10 $11,951.00 $11,951.00 $425.82 $13,337.14 $8,604.72 2026-04-01
27766 HCPCS Treatment Of Inside Portion Of Broken Shin Bone At Ankle 20 10 $8,600.00 $8,600.00 $6,192.00 $10,774.68 $8,514.00 2026-04-01
28415 HCPCS Treatment Of Broken Heel Bone 20 10 $8,600.00 $8,600.00 $6,192.00 $10,774.68 $8,514.00 2026-04-01
63042 HCPCS Partial Removal Of Spine Bone With Re-exploration, Release Of Lower Spinal Cord … 20 10 $9,150.00 $9,150.00 $6,588.00 $9,607.50 $8,446.19 2026-04-01
52356 HCPCS Crushing Of Stone Of Ureter With Insertion Of Stent Using An Endoscope 20 10 $9,503.00 $9,503.00 $6,842.16 $9,978.15 $8,436.74 2026-04-01
Q5120 HCPCS Injection, Pegfilgrastim-bmez (ziextenzo), Biosimilar, 0.5 Mg 16 8 $8,846.44 $8,846.44 $6,369.44 $9,288.76 $8,315.66 2026-04-01
Q5122 HCPCS Injection, Pegfilgrastim-apgf (nyvepria), Biosimilar, 0.5 Mg 16 8 $8,845.25 $8,845.25 $6,368.58 $9,287.51 $8,314.54 2026-04-01
C9778 HCPCS Colpopexy, Vaginal; Minimally Invasive Extra-peritoneal Approach (sacrospinous) 20 10 $9,500.00 $9,500.00 $3,849.16 $9,975.00 $8,312.50 2026-04-01
63047 HCPCS Partial Removal Of Spine Bone With Release Of Lower Spinal Cord And/or Nerves, 1… 52 10 $10,600.00 $10,600.00 $933.05 $11,550.00 $8,288.69 2026-04-01
25447 HCPCS Replacement Of Joint Between Wrist And Fingers Using Tissue 36 10 $12,600.00 $12,600.00 $675.77 $13,230.00 $8,247.15 2026-04-01
27698 HCPCS Secondary Repair Of Disrupted Collateral Ligament Of Ankle 20 10 $8,300.00 $8,300.00 $5,976.00 $14,204.05 $8,217.00 2026-04-01
27659 HCPCS Secondary Repair Of Tendon On Back Of Leg 20 10 $8,300.00 $8,300.00 $5,976.00 $14,204.05 $8,217.00 2026-04-01
49650 HCPCS Repair Of Groin Hernia Using An Endoscope 36 10 $12,400.00 $12,400.00 $377.54 $13,020.00 $8,172.65 2026-04-01
25310 HCPCS Relocation Of Tendon Of Forearm And/or Wrist 20 10 $9,300.00 $9,300.00 $3,986.71 $9,765.00 $8,137.50 2026-04-01
47562 HCPCS Removal Of Gallbladder Using An Endoscope 36 10 $11,300.00 $11,300.00 $561.02 $11,865.00 $8,136.00 2026-04-01
58291 HCPCS Removal Of Uterus, Tubes, And/or Ovaries Through Vagina, More Than 250.0 G 20 10 $8,100.00 $8,100.00 $5,832.00 $13,279.34 $8,019.00 2026-04-01
49651 HCPCS Repair Of Recurrent Groin Hernia Using An Endoscope 36 10 $11,300.00 $11,300.00 $489.35 $11,865.00 $7,956.86 2026-04-01
27536 HCPCS Treatment Of Broken Shin Bone On Both Sides Of Upper End 36 10 $11,000.00 $11,000.00 $984.01 $11,550.00 $7,920.00 2026-04-01
25609 HCPCS Treatment Of 3 Or More Broken Lower Forearm Bone Pieces On Thumb Side Inside Wri… 36 10 $10,953.00 $10,953.00 $878.21 $11,500.65 $7,886.16 2026-04-01
25607 HCPCS Treatment Of Broken Forearm Bone On Thumb Side Of Wrist, Above Wrist, With Place… 36 10 $10,953.00 $10,953.00 $632.06 $11,500.65 $7,886.16 2026-04-01
25608 HCPCS Treatment Of 2 Broken Lower Forearm Bone Pieces On Thumb Side Inside Wrist Joint… 36 10 $10,953.00 $10,953.00 $699.37 $11,500.65 $7,886.16 2026-04-01
19303 HCPCS Simple Complete Removal Of Breast 36 10 $11,100.00 $11,100.00 $814.66 $11,655.00 $7,803.68 2026-04-01
58661 HCPCS Removal Of Ovaries And/or Tubes Using An Endoscope 20 10 $8,900.00 $8,900.00 $6,408.00 $9,345.00 $7,803.40 2026-04-01
49320 HCPCS Diagnostic Exam Of Abdomen Using An Endoscope 20 10 $8,900.00 $8,900.00 $6,408.00 $9,345.00 $7,787.50 2026-04-01
J9173 HCPCS Injection, Durvalumab, 10 Mg 16 8 $8,226.88 $8,226.88 $5,923.35 $8,638.22 $7,733.26 2026-04-01
J2802 HCPCS Injection, Romiplostim, 1 Microgram 32 8 $9,305.42 $9,305.42 $4,469.98 $13,022.68 $7,724.28 2026-04-01
44970 HCPCS Removal Of Appendix Using An Endoscope 36 10 $10,700.00 $10,700.00 $514.00 $11,235.00 $7,704.00 2026-04-01
63267 HCPCS Removal Of Growth Of Lower Spine Bone Outside Spine Membrane 36 10 $10,600.00 $10,600.00 $1,147.98 $11,130.00 $7,632.00 2026-04-01
58262 HCPCS Removal Of Uterus, Tubes, And/or Ovaries Through Vagina, 250.0 G Or Less 20 10 $8,100.00 $8,100.00 $5,832.00 $8,505.00 $7,628.86 2026-04-01
26531 HCPCS Repair Of Joint Between Hand And Finger Bones With Prosthesis 36 10 $10,500.00 $10,500.00 $534.93 $11,025.00 $7,560.00 2026-04-01
J9305 HCPCS Injection, Pemetrexed, Not Otherwise Specified, 10 Mg 16 8 $7,900.35 $7,900.35 $5,688.25 $8,295.37 $7,426.33 2026-04-01
64595 HCPCS Removal Or Revision Of A Peripheral, Sacral, Or Gastric Neurostimulator Pulse Ge… 20 10 $7,500.00 $7,500.00 $5,400.00 $9,956.97 $7,425.00 2026-04-01
28297 HCPCS Correction Of Bunion With Forefoot And Midfoot Bone Fusion 20 10 $7,400.00 $7,400.00 $5,328.00 $13,337.14 $7,326.00 2026-04-01
49615 HCPCS Repair Of Recurrent Sliding Hernia Of Abdomen, 3-10 Cm In Length 16 8 $7,775.00 $7,775.00 $5,598.00 $8,163.75 $7,308.50 2026-04-01
49616 HCPCS Repair Of Recurrent Entrapped Hernia Of Abdomen, 3-10 Cm In Length 16 8 $7,775.00 $7,775.00 $5,598.00 $8,163.75 $7,308.50 2026-04-01
49618 HCPCS Repair Of Recurrent Entrapped Hernia Of Abdomen, More Than 10 Cm In Length 16 8 $7,775.00 $7,775.00 $5,598.00 $8,163.75 $7,308.50 2026-04-01
49617 HCPCS Repair Of Recurrent Sliding Hernia Of Abdomen, More Than 10 Cm In Length 16 8 $7,775.00 $7,775.00 $5,598.00 $8,163.75 $7,308.50 2026-04-01
49613 HCPCS Repair Of Recurrent Sliding Hernia Of Abdomen, Less Than 3 Cm In Length 16 8 $7,775.00 $7,775.00 $5,598.00 $8,163.75 $7,308.50 2026-04-01
49614 HCPCS Repair Of Recurrent Entrapped Hernia Of Abdomen, Less Than 3 Cm In Length 16 8 $7,775.00 $7,775.00 $5,598.00 $8,163.75 $7,308.50 2026-04-01
49595 HCPCS Initial Repair Of Sliding Hernia Of Abdomen, More Than 10 Cm In Length 16 8 $7,700.00 $7,700.00 $5,544.00 $8,085.00 $7,238.00 2026-04-01
49591 HCPCS Initial Repair Of Sliding Hernia Of Abdomen, Less Than 3 Cm In Length 16 8 $7,700.00 $7,700.00 $5,544.00 $8,085.00 $7,238.00 2026-04-01
49593 HCPCS Initial Repair Of Sliding Hernia Of Abdomen, 3-10 Cm In Length 16 8 $7,700.00 $7,700.00 $5,544.00 $8,085.00 $7,238.00 2026-04-01
49596 HCPCS Initial Repair Of Entrapped Hernia Of Abdomen, More Than 10 Cm In Length 16 8 $7,700.00 $7,700.00 $5,544.00 $8,085.00 $7,238.00 2026-04-01
90375 HCPCS Rabies Immune Globulin For Injection 16 8 $7,671.29 $7,671.29 $5,523.33 $8,054.85 $7,211.01 2026-04-01
25448 HCPCS Replacement Of Joint Between Wrist And Fingers Using Tendon Or Stitches 26 8 $9,874.00 $9,874.00 $744.41 $10,367.70 $7,109.28 2026-04-01
27886 HCPCS Re-amputation Of Lower Leg 36 10 $13,300.00 $13,300.00 $537.63 $13,965.00 $7,041.74 2026-04-01
52630 HCPCS Complete Removal Of Remaining Or Regrown Prostate Tissue With Control Of Bleedin… 20 10 $7,050.00 $7,050.00 $5,076.00 $9,561.78 $6,979.50 2026-04-01
51860 HCPCS Suture Of Simple Wound, Injury, Or Rupture Of Bladder 20 10 $7,001.00 $7,001.00 $5,040.72 $8,320.77 $6,930.99 2026-04-01
19302 HCPCS Partial Removal Of Breast And Underarm Lymph Nodes 36 10 $9,581.00 $9,581.00 $771.69 $10,060.05 $6,898.32 2026-04-01
J9299 HCPCS Injection, Nivolumab, 1 Mg 32 8 $8,874.59 $8,874.59 $1,834.12 $15,961.88 $6,810.03 2026-04-01
23420 HCPCS Repair Of Complete Tear Of Shoulder Rotator Cuff With Release Of Pressure On Col… 36 10 $9,300.00 $9,300.00 $819.00 $11,055.06 $6,696.00 2026-04-01
57250 HCPCS Repair Of Herniated Rectum Into Vaginal Wall 20 10 $7,600.00 $7,600.00 $3,778.26 $7,980.00 $6,650.00 2026-04-01
19301 HCPCS Partial Removal Of Breast 36 10 $9,200.00 $9,200.00 $562.94 $9,660.00 $6,624.00 2026-04-01
63035 HCPCS Partial Removal Of Spine Bone With Release Of Upper Or Lower Spinal Cord Or Nerv… 36 10 $9,150.00 $9,150.00 $179.30 $9,607.50 $6,588.00 2026-04-01
63030 HCPCS Partial Removal Of Spine Bone With Release Of Lower Spinal Cord Or Nerves And/or… 36 10 $9,150.00 $9,150.00 $788.59 $9,607.50 $6,588.00 2026-04-01
49565 HCPCS Repair Recurrent Incisional Or Ventral Hernia; Reducible 30 10 $7,750.00 $7,750.00 $1,462.00 $9,789.05 $6,587.50 2026-04-01
49572 HCPCS Repair Epigastric Hernia (eg, Preperitoneal Fat); Incarcerated Or Strangulated 30 10 $7,700.00 $7,700.00 $991.00 $9,789.05 $6,545.00 2026-04-01
J1950 HCPCS Injection, Leuprolide Acetate (for Depot Suspension), Per 3.75 Mg 32 8 $8,119.04 $8,119.04 $2,927.88 $12,780.16 $6,516.69 2026-04-01
49585 HCPCS Repair Umbilical Hernia, Age 5 Years Or Older; Reducible 30 10 $7,648.00 $7,648.00 $854.00 $8,567.57 $6,500.80 2026-04-01
J9047 HCPCS Injection, Carfilzomib, 1 Mg 16 8 $6,914.02 $6,914.02 $4,978.09 $7,259.72 $6,499.18 2026-04-01
49000 HCPCS Exploration Of Abdominal Cavity 20 10 $6,550.00 $6,550.00 $4,716.00 $7,454.65 $6,484.50 2026-04-01
52353 HCPCS Crushing Of Stone Of Ureter Using An Endoscope 20 10 $7,050.00 $7,050.00 $5,076.00 $7,402.50 $6,474.18 2026-04-01
63709 HCPCS Repair Of Cerebrospinal Fluid Leak With Partial Removal Of Vertebra 20 10 $6,500.00 $6,500.00 $4,680.00 $17,647.48 $6,435.00 2026-04-01
47379 HCPCS Other Procedure On Liver Using An Endoscope 26 10 $8,900.00 $8,900.00 $2,945.19 $9,345.00 $6,408.00 2026-04-01
58555 HCPCS Diagnostic Exam Of Uterus Using An Endoscope 20 10 $7,300.00 $7,300.00 $5,256.00 $7,665.00 $6,387.50 2026-04-01
58563 HCPCS Exam Of Uterus With Destruction Of Lining Of Uterus Using An Endoscope 20 10 $7,256.00 $7,256.00 $5,224.32 $7,618.80 $6,349.00 2026-04-01
57288 HCPCS Creation Of Sling Around Urethra In Female To Control Leakage 20 10 $6,300.00 $6,300.00 $4,536.00 $7,152.40 $6,237.00 2026-04-01
55040 HCPCS Removal Of Fluid Collection In Testicle And Sperm Reservoir 20 10 $7,100.00 $7,100.00 $3,269.91 $7,455.00 $6,212.50 2026-04-01
27814 HCPCS Treatment Of Both Broken Lower Leg Bones At Ankle 36 10 $8,600.00 $8,600.00 $647.81 $10,774.68 $6,192.00 2026-04-01
52260 HCPCS Dilation Of Bladder Using An Endoscope Under General Or Spinal Anesthesia 20 10 $7,050.00 $7,050.00 $2,669.39 $7,402.50 $6,168.75 2026-04-01
52344 HCPCS Repair Of Stricture Of Ureter Using An Endoscope 20 10 $7,050.00 $7,050.00 $2,669.39 $7,402.50 $6,168.75 2026-04-01
58558 HCPCS Biopsy Of Lining Of Uterus And/or Removal Of Polyp Using An Endoscope 20 10 $6,900.00 $6,900.00 $4,968.00 $7,245.00 $6,134.89 2026-04-01
51102 HCPCS Aspiration Of Bladder With Insertion Of Bladder Tube To Skin 20 10 $7,001.00 $7,001.00 $2,669.39 $7,351.05 $6,125.88 2026-04-01
27650 HCPCS Repair Of Ruptured Achilles Tendon 20 10 $6,150.00 $6,150.00 $4,428.00 $7,382.01 $6,088.50 2026-04-01
23430 HCPCS Anchoring Of Biceps Tendon 36 10 $8,300.00 $8,300.00 $630.95 $11,055.06 $5,976.00 2026-04-01
23180 HCPCS Partial Removal Of Infected Collar Bone 36 10 $8,300.00 $8,300.00 $592.03 $11,055.06 $5,976.00 2026-04-01
23130 HCPCS Partial Removal Or Repair Of Shoulder Bone Near Collar Bone 36 10 $8,300.00 $8,300.00 $534.65 $11,055.06 $5,976.00 2026-04-01
23120 HCPCS Partial Removal Of Collar Bone 36 10 $8,267.00 $8,267.00 $511.66 $11,055.06 $5,952.24 2026-04-01
Rx42367054032_1 CDM Ryanodex 250 Mg Vial 12 6 $7,471.31 $7,471.31 $5,379.34 $7,321.88 $5,902.34 2026-04-01
30520 HCPCS Reshaping Of Nasal Cartilage 36 10 $8,200.00 $8,200.00 $563.03 $8,610.00 $5,855.00 2026-04-01
49329 HCPCS Other Procedure On Abdomen Using An Endoscope 26 10 $6,500.00 $6,500.00 $1,150.00 $7,454.65 $5,850.00 2026-04-01
49594 HCPCS Initial Repair Of Entrapped Hernia Of Abdomen, 3-10 Cm In Length 26 8 $7,700.00 $7,700.00 $601.94 $8,085.00 $5,544.00 2026-04-01
49592 HCPCS Initial Repair Of Entrapped Hernia Of Abdomen, Less Than 3 Cm In Length 26 8 $7,700.00 $7,700.00 $385.80 $8,085.00 $5,544.00 2026-04-01
28285 HCPCS Correction Of Toe Joint Deformity 20 10 $6,300.00 $6,300.00 $4,536.00 $6,615.00 $5,531.01 2026-04-01
28041 HCPCS Removal Of Growth Of Muscle Of Foot Or Toe, 1.5 Cm Or More 20 10 $6,300.00 $6,300.00 $4,536.00 $6,615.00 $5,531.01 2026-04-01
28039 HCPCS Removal (1.5 Centimeters Or Greater) Tissue Growth Beneath The Skin Of Foot Or T… 20 10 $6,300.00 $6,300.00 $4,536.00 $6,615.00 $5,531.01 2026-04-01
26230 HCPCS Partial Removal Of Hand Bone 36 10 $7,668.00 $7,668.00 $428.34 $8,051.40 $5,520.96 2026-04-01
28119 HCPCS Removal Of Heel Bone Spur 20 10 $6,200.00 $6,200.00 $4,464.00 $6,510.00 $5,486.01 2026-04-01
29893 HCPCS Repair Of Fibrous Tissue Of Arch Of Foot Using An Endoscope 20 10 $6,158.00 $6,158.00 $4,433.76 $6,465.90 $5,467.11 2026-04-01
64585 HCPCS Revision Of Peripheral Neurostimulator Electrodes 20 10 $5,500.00 $5,500.00 $3,960.00 $9,956.97 $5,445.00 2026-04-01
29999 HCPCS Other Procedure On Joint Using An Endoscope 26 10 $6,600.00 $6,600.00 $1,050.00 $6,930.00 $5,349.07 2026-04-01
78816 HCPCS Nuclear Medicine Study Whole Body With CT Scan 20 10 $6,600.00 $6,600.00 $3,625.12 $6,930.00 $5,346.00 2026-04-01
78815 HCPCS Nuclear Medicine Study From Skull Base To Mid-thigh With CT Scan 20 10 $6,600.00 $6,600.00 $3,625.12 $6,930.00 $5,346.00 2026-04-01
58562 HCPCS Removal Of Foreign Body In Uterus Using An Endoscope 36 10 $7,300.00 $7,300.00 $177.79 $7,665.00 $5,256.00 2026-04-01
J2426 HCPCS Injection, Paliperidone Palmitate Extended Release (invega Sustenna), 1 Mg 48 8 $5,367.85 $5,367.85 $2,901.05 $8,446.82 $5,045.78 2026-04-01
J0897 HCPCS Injection, Denosumab, 1 Mg 32 8 $6,004.82 $6,004.82 $3,048.28 $8,164.72 $5,022.03 2026-04-01
55250 HCPCS Removal Of Sperm Duct 20 10 $5,690.00 $5,690.00 $2,759.43 $5,974.50 $4,978.75 2026-04-01
54520 HCPCS Simple Removal Of Testicle 20 10 $5,690.00 $5,690.00 $2,759.43 $5,974.50 $4,978.75 2026-04-01
29828 HCPCS Release Of Tendon Connecting Biceps Muscle And Shoulder Using An Endoscope 36 10 $6,850.00 $6,850.00 $763.78 $13,873.68 $4,932.00 2026-04-01
J9312 HCPCS Injection, Rituximab, 10 Mg 32 8 $6,355.76 $6,355.76 $1,532.10 $11,112.78 $4,927.25 2026-04-01
29826 HCPCS Shaving Of Part Of Shoulder Bone And Repair Of Ligament Using An Endoscope 36 10 $6,900.00 $6,900.00 $133.37 $7,245.00 $4,911.97 2026-04-01
29881 HCPCS Removal Of Knee Cartilage Using An Endoscope 36 10 $6,900.00 $6,900.00 $467.10 $7,245.00 $4,911.97 2026-04-01
29880 HCPCS Removal Of Both Knee Cartilages Using An Endoscope 36 10 $6,900.00 $6,900.00 $482.80 $7,245.00 $4,911.97 2026-04-01
29824 HCPCS Partial Removal Of Collar Bone At Shoulder Using An Endoscope 36 10 $6,832.00 $6,832.00 $579.07 $7,173.60 $4,887.49 2026-04-01
29820 HCPCS Partial Removal Of Shoulder Joint Lining Using An Endoscope 36 10 $6,832.00 $6,832.00 $455.64 $7,173.60 $4,887.49 2026-04-01
29819 HCPCS Removal Of Loose Or Foreign Body In Shoulder Joint Using An Endoscope 36 10 $6,832.00 $6,832.00 $498.98 $7,173.60 $4,887.49 2026-04-01
58120 HCPCS Dilation And Scraping Of Uterus 20 10 $4,800.00 $4,800.00 $3,456.00 $6,059.78 $4,752.00 2026-04-01
29883 HCPCS Repair Of Inside And Outside Knee Joint Cartilage Using An Endoscope 36 10 $6,600.00 $6,600.00 $710.02 $6,930.00 $4,752.00 2026-04-01
29848 HCPCS Release Of Wrist Ligament Using An Endoscope 36 10 $6,600.00 $6,600.00 $441.12 $6,930.00 $4,752.00 2026-04-01
28820 HCPCS Amputation Of Toe At Joint Between Forefoot And Toes 36 10 $6,400.00 $6,400.00 $150.36 $6,720.00 $4,608.00 2026-04-01
J9034 HCPCS Injection, Bendamustine Hcl (bendeka), 1 Mg 16 8 $4,840.41 $4,840.41 $3,485.10 $5,082.43 $4,549.99 2026-04-01
24140 HCPCS Partial Removal Of Infected Upper Arm Bone 36 10 $6,200.00 $6,200.00 $593.62 $11,055.06 $4,464.00 2026-04-01
Q5108 HCPCS Injection, Pegfilgrastim-jmdb (fulphila), Biosimilar, 0.5 Mg 16 8 $4,710.88 $4,710.88 $3,391.83 $4,946.42 $4,428.23 2026-04-01
66982 HCPCS Complex Removal Of Cataract With Insertion Of Prosthetic Lens 20 10 $4,600.00 $4,600.00 $3,312.00 $4,830.00 $4,409.01 2026-04-01
66825 HCPCS Repositioning Of Lens Prosthesis 20 10 $4,600.00 $4,600.00 $3,312.00 $4,830.00 $4,409.01 2026-04-01
29879 HCPCS Repair Of Knee Joint With Drilling And Or Scraping Of Joint Using An Endoscope 36 10 $6,109.00 $6,109.00 $563.69 $6,414.45 $4,398.48 2026-04-01
J3145 HCPCS Injection, Testosterone Undecanoate, 1 Mg 16 8 $4,677.08 $4,677.08 $3,367.50 $4,910.93 $4,396.45 2026-04-01
Q5118 HCPCS Injection, Bevacizumab-bvzr, Biosimilar, (zirabev), 10 Mg 32 8 $5,507.25 $5,507.25 $1,646.57 $9,163.98 $4,342.56 2026-04-01
66984 HCPCS Removal Of Cataract With Insertion Of Prosthetic Lens 20 10 $4,400.00 $4,400.00 $3,168.00 $4,747.70 $4,311.01 2026-04-01
57282 HCPCS Repair Of Pelvic Ligaments Through Vagina 20 10 $4,843.00 $4,843.00 $3,486.96 $5,085.15 $4,299.38 2026-04-01
38510 HCPCS Biopsy Or Removal Of Deep Lymph Nodes Of Neck 36 10 $5,900.00 $5,900.00 $342.64 $6,195.00 $4,248.00 2026-04-01
46945 HCPCS Tying Of Single Internal Hemorrhoid Group 20 10 $4,800.00 $4,800.00 $3,456.00 $5,040.00 $4,240.98 2026-04-01
31256 HCPCS Incision Of Nasal Sinus Using An Endoscope 36 10 $6,700.00 $6,700.00 $140.83 $7,035.00 $4,221.17 2026-04-01
31254 HCPCS Partial Removal Of Nasal Sinus Using An Endoscope 36 10 $6,700.00 $6,700.00 $189.69 $7,035.00 $4,221.17 2026-04-01
25120 HCPCS Removal Of Cyst Or Growth Of Lower Forearm Bone 36 10 $6,200.00 $6,200.00 $431.48 $6,510.00 $4,189.14 2026-04-01
24359 HCPCS Incision And Repair Of Elbow Tendon With Removal Of Tissue Or Bone 36 10 $8,267.00 $8,267.00 $559.24 $8,680.35 $4,189.14 2026-04-01
24357 HCPCS Incision Of Elbow Tendon 36 10 $6,175.00 $6,175.00 $356.09 $6,483.75 $4,189.14 2026-04-01
46260 HCPCS Removal Of Multiple Hemorrhoid Groups 36 10 $5,800.00 $5,800.00 $434.31 $6,090.00 $4,176.00 2026-04-01
J3032 HCPCS Injection, Eptinezumab-jjmr, 1 Mg 16 8 $4,262.34 $4,262.34 $3,068.88 $4,475.46 $4,006.60 2026-04-01
90691 HCPCS Typhoid Vaccine For Injection Into Muscle 20 10 $4,573.18 $4,573.18 $80.12 $4,801.84 $4,001.53 2026-04-01
20694 HCPCS Removal Of External Bone Stabilizing Device Under Anesthesia 36 10 $5,550.00 $5,550.00 $298.59 $5,827.50 $3,996.00 2026-04-01
24343 HCPCS Repair Of Ligament Of Thumb Side Of Elbow 36 10 $5,539.00 $5,539.00 $613.74 $5,815.95 $3,987.39 2026-04-01
29822 HCPCS Limited Removal Of Abnormal Shoulder Joint Tissue Using Endoscope 36 10 $5,500.00 $5,500.00 $467.23 $5,775.00 $3,960.00 2026-04-01
26841 HCPCS Fusion Of Thumb At Wrist 36 10 $5,500.00 $5,500.00 $683.30 $6,713.48 $3,960.00 2026-04-01
26480 HCPCS Transfer Of Tendon To Back Of Hand 36 10 $5,500.00 $5,500.00 $607.44 $6,713.48 $3,960.00 2026-04-01
25820 HCPCS Fusion Of Part Of Wrist Joint 36 10 $5,500.00 $5,500.00 $559.01 $6,713.48 $3,960.00 2026-04-01
45384 HCPCS Removal Of Polyps Or Growths Of Large Bowel Using A Flexible Endoscope With Elec… 20 10 $4,450.00 $4,450.00 $2,582.18 $4,672.50 $3,893.75 2026-04-01
11644 HCPCS Removal Of Cancer Skin Growth Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 3.1-… 20 10 $4,450.00 $4,450.00 $2,701.29 $4,672.50 $3,893.75 2026-04-01
44640 HCPCS Closure Of Abnormal Drainage Tract From Small Bowel To Skin 36 10 $5,400.00 $5,400.00 $75.00 $8,912.77 $3,888.00 2026-04-01
40816 HCPCS Complex Removal Of Tissue And Muscle Growth Of Mouth 20 10 $3,900.00 $3,900.00 $2,808.00 $6,156.62 $3,861.00 2026-04-01
40814 HCPCS Removal Of Growth Of Mouth With Complicated Repair 20 10 $3,900.00 $3,900.00 $2,808.00 $6,156.62 $3,861.00 2026-04-01
J0875 HCPCS Injection, Dalbavancin, 5 Mg 16 8 $4,017.04 $4,017.04 $2,892.27 $4,217.89 $3,776.02 2026-04-01
26433 HCPCS Repair Of Tendon On Upper Side Of End Of Finger 20 10 $4,300.00 $4,300.00 $3,096.00 $4,515.00 $3,762.50 2026-04-01
Q5119 HCPCS Injection, Rituximab-pvvr, Biosimilar, (ruxience), 10 Mg 32 8 $4,852.40 $4,852.40 $1,171.30 $8,481.90 $3,762.15 2026-04-01
45990 HCPCS Diagnostic Exam Of Anus And Rectum Under Anesthesia 36 10 $5,146.00 $5,146.00 $90.02 $5,403.30 $3,705.12 2026-04-01
45005 HCPCS Drainage Of Superficial Rectal Abscess 36 10 $5,146.00 $5,146.00 $155.69 $5,403.30 $3,705.12 2026-04-01
J9330 HCPCS Injection, Temsirolimus, 1 Mg 16 8 $3,917.12 $3,917.12 $2,820.33 $4,112.98 $3,682.10 2026-04-01
55700 HCPCS Biopsy Of Prostate Gland 20 10 $4,175.00 $4,175.00 $2,924.63 $4,383.75 $3,653.12 2026-04-01
42831 HCPCS Primary Removal Of Adenoids (12 Years Or Older) 36 10 $5,100.00 $5,100.00 $195.54 $5,355.00 $3,639.34 2026-04-01
42820 HCPCS Removal Of Tonsils And Adenoid Glands (younger Than 12 Years) 36 10 $5,100.00 $5,100.00 $240.15 $5,355.00 $3,639.34 2026-04-01
64718 HCPCS Release And/or Relocation Of Elbow Nerve 36 10 $5,700.00 $5,700.00 $521.63 $5,985.00 $3,628.15 2026-04-01
42825 HCPCS Removal Of Tonsils (younger Than 12 Years) 36 10 $5,050.00 $5,050.00 $224.20 $5,302.50 $3,621.34 2026-04-01
22513 HCPCS Treatment Of Broken Middle Spine Bone With Placement Of Stabilizing Device Using… 20 10 $3,650.00 $3,650.00 $2,628.00 $8,657.39 $3,613.50 2026-04-01
25076 HCPCS Removal Of Growth Of Muscle Of Forearm Or Wrist, Less Than 3.0 Cm 36 10 $5,016.00 $5,016.00 $445.42 $5,266.80 $3,611.52 2026-04-01
25073 HCPCS Removal Of Growth Of Muscle Of Forearm Or Wrist, 3.0 Cm Or More 36 10 $5,016.00 $5,016.00 $459.14 $5,266.80 $3,611.52 2026-04-01
25020 HCPCS Incision Of Tissue Of Forearm And/or Wrist Muscle Compartment On One Side Of The… 36 10 $5,016.00 $5,016.00 $657.50 $5,266.80 $3,611.52 2026-04-01
J2315 HCPCS Injection, Naltrexone, Depot Form, 1 Mg 16 8 $3,817.27 $3,817.27 $2,748.43 $4,008.13 $3,588.23 2026-04-01
67917 HCPCS Extensive Repair Of Turning-outward Eyelid Defect 20 10 $4,000.00 $4,000.00 $2,880.00 $4,200.00 $3,571.70 2026-04-01
73720 HCPCS MRI Scan Of Leg Before And After Contrast 20 10 $4,400.00 $4,400.00 $1,013.16 $4,620.00 $3,564.00 2026-04-01
72197 HCPCS MRI Scan Of Pelvis Before And After Contrast 20 10 $4,400.00 $4,400.00 $1,013.16 $4,620.00 $3,564.00 2026-04-01
74183 HCPCS MRI Scan Of Abdomen Before And After Contrast 20 10 $4,400.00 $4,400.00 $1,013.16 $4,620.00 $3,564.00 2026-04-01
27630 HCPCS Removal Of Growth Of Leg And/or Ankle Tendon Lining Or Capsule 36 10 $4,900.00 $4,900.00 $318.46 $7,382.01 $3,528.00 2026-04-01
36561 HCPCS Insertion Of Central Venous Tube With Port (5 Years Or Older) 36 10 $4,900.00 $4,900.00 $274.05 $5,200.68 $3,528.00 2026-04-01
25000 HCPCS Incision Or The Tendon Covering On The Top Side Of The Wrist 36 10 $4,850.00 $4,850.00 $309.83 $5,092.50 $3,492.00 2026-04-01
21554 HCPCS Removal Of Growth Of Muscle Of Neck Or Front Of Chest, 5.0 Cm Or More 36 10 $4,823.00 $4,823.00 $612.30 $5,064.15 $3,472.56 2026-04-01
69620 HCPCS Repair Of Defect Or Tear Of Eardrum 36 10 $4,800.00 $4,800.00 $415.14 $5,040.00 $3,456.00 2026-04-01
21933 HCPCS Removal Of Growth Of Muscle Of Back Or Lower Sides, 5.0 Cm Or More 36 10 $4,800.00 $4,800.00 $625.70 $5,040.00 $3,456.00 2026-04-01
21556 HCPCS Removal Of Growth Of Muscle Of Neck Or Front Of Chest, Less Than 5.0 Cm 36 10 $4,705.00 $4,705.00 $445.17 $4,940.25 $3,387.60 2026-04-01
20670 HCPCS Removal Of Surface Implant From Bone 36 10 $4,705.00 $4,705.00 $128.35 $4,969.50 $3,387.60 2026-04-01
53200 HCPCS Biopsy Of Urethra 20 10 $3,400.00 $3,400.00 $2,448.00 $7,152.40 $3,366.00 2026-04-01
72156 HCPCS MRI Scan Of Upper Spinal Canal Before And After Contrast 20 10 $4,100.00 $4,100.00 $1,013.16 $4,305.00 $3,321.00 2026-04-01
73723 HCPCS MRI Scan Of Leg Joint Before And After Contrast 20 10 $4,100.00 $4,100.00 $1,013.16 $4,305.00 $3,321.00 2026-04-01
73223 HCPCS MRI Scan Of Arm Joint Before And After Contrast 20 10 $4,100.00 $4,100.00 $1,013.16 $4,305.00 $3,321.00 2026-04-01
72158 HCPCS MRI Scan Of Lower Spinal Canal Before And After Contrast 20 10 $4,100.00 $4,100.00 $1,013.16 $4,305.00 $3,321.00 2026-04-01
42830 HCPCS Primary Removal Of Adenoids (younger Than 12 Years) 36 10 $4,600.00 $4,600.00 $179.54 $4,830.00 $3,312.00 2026-04-01
42821 HCPCS Removal Of Tonsils And Adenoid Glands (12 Years Or Older) 36 10 $4,600.00 $4,600.00 $250.59 $4,830.00 $3,312.00 2026-04-01
42826 HCPCS Removal Of Tonsils (12 Years Or Older) 36 10 $4,600.00 $4,600.00 $213.03 $4,830.00 $3,312.00 2026-04-01
21012 HCPCS Removal Of Growth Under Skin Of Face Or Scalp, 2.0 Cm Or More 36 10 $4,600.00 $4,600.00 $293.03 $4,830.00 $3,312.00 2026-04-01
30930 HCPCS Therapeutic Fracture Of Nasal Passages 36 10 $4,600.00 $4,600.00 $100.15 $6,395.61 $3,312.00 2026-04-01
30140 HCPCS Removal Of Nasal Air Passage Under Lining Tissue 36 10 $4,600.00 $4,600.00 $141.16 $6,395.61 $3,312.00 2026-04-01
46255 HCPCS Removal Of Single External And Internal Hemorrhoid Group 36 10 $4,500.00 $4,500.00 $318.90 $5,078.84 $3,240.00 2026-04-01
49321 HCPCS Biopsy Of Abdomen Using An Endoscope 36 10 $4,500.00 $4,500.00 $294.59 $7,454.65 $3,240.00 2026-04-01
J0129 HCPCS Injection, Abatacept, 10 Mg (code May Be Used For Medicare When Drug Administere… 16 8 $3,419.76 $3,419.76 $2,462.23 $3,590.75 $3,214.57 2026-04-01
J7327 HCPCS Hyaluronan Or Derivative, Monovisc, For Intra-articular Injection, Per Dose 16 8 $3,389.00 $3,389.00 $2,440.08 $3,558.45 $3,185.66 2026-04-01
J1439 HCPCS Injection, Ferric Carboxymaltose, 1 Mg 16 8 $3,327.34 $3,327.34 $2,395.68 $3,493.71 $3,127.70 2026-04-01
J9145 HCPCS Injection, Daratumumab, 10 Mg 32 8 $3,914.01 $3,914.01 $1,268.40 $6,369.66 $3,108.76 2026-04-01
J1561 HCPCS Injection, Immune Globulin, (gamunex-c/gammaked), Non-lyophilized (e.g., Liquid)… 48 8 $3,299.00 $3,299.00 $601.38 $13,811.70 $3,101.06 2026-04-01
26440 HCPCS Release Of Tendon Of Palm Or Finger 36 10 $4,300.00 $4,300.00 $585.68 $4,515.00 $3,096.00 2026-04-01
72157 HCPCS MRI Scan Of Middle Spinal Canal Before And After Contrast 20 10 $3,800.00 $3,800.00 $1,013.16 $3,990.00 $3,078.00 2026-04-01
26160 HCPCS Removal Of Growth Of Tendon Finger Or Hand 36 10 $4,269.00 $4,269.00 $280.85 $4,482.45 $3,073.68 2026-04-01
J9264 HCPCS Injection, Paclitaxel Protein-bound Particles, 1 Mg 16 8 $3,212.49 $3,212.49 $2,312.99 $3,373.11 $3,019.74 2026-04-01
J2357 HCPCS Injection, Omalizumab, 5 Mg 16 8 $3,200.27 $3,200.27 $2,304.19 $3,360.28 $3,008.25 2026-04-01
41010 HCPCS Incision Of Tissue Connecting Tongue And Floor Of Mouth 36 10 $4,600.00 $4,600.00 $94.12 $4,830.00 $3,006.08 2026-04-01
69424 HCPCS Removal Of Implanted Eardrum Tube Under Anesthesia 36 10 $4,800.00 $4,800.00 $51.53 $5,040.00 $3,006.08 2026-04-01
69436 HCPCS Incision Of Eardrum With Placement Of Eardrum Tube Under General Anesthesia 36 10 $4,400.00 $4,400.00 $133.05 $4,620.00 $3,006.08 2026-04-01
69540 HCPCS Removal Of Polyp Of Outer Ear 36 10 $4,533.00 $4,533.00 $110.37 $4,759.65 $3,006.08 2026-04-01
52235 HCPCS Destruction And/or Removal Of Growth Of Bladder And Urethra Using An Endoscope, … 20 10 $3,358.00 $3,358.00 $2,417.76 $3,525.90 $2,981.34 2026-04-01
52234 HCPCS Destruction And/or Removal Of Growth Of Bladder And Urethra Using An Endoscope, … 20 10 $3,358.00 $3,358.00 $2,417.76 $3,525.90 $2,981.34 2026-04-01
52005 HCPCS Insertion Of Tube Into Ureter Using An Endoscope Through Bladder Area 20 10 $3,358.00 $3,358.00 $2,417.76 $3,525.90 $2,981.34 2026-04-01
52204 HCPCS Biopsy Of Bladder Using An Endoscope 20 10 $3,358.00 $3,358.00 $2,417.76 $3,525.90 $2,981.34 2026-04-01
52310 HCPCS Simple Removal Of Foreign Body, Stone, Or Stent In Urethra Or Bladder Using An E… 20 10 $3,358.00 $3,358.00 $2,417.76 $3,525.90 $2,981.34 2026-04-01
52332 HCPCS Insertion Of Stent In Ureter Using An Endoscope 20 10 $3,358.00 $3,358.00 $2,417.76 $3,525.90 $2,981.34 2026-04-01
52287 HCPCS Exam With Injections Of Chemical For Destruction Of Bladder Using An Endoscope 20 10 $3,358.00 $3,358.00 $2,417.76 $3,525.90 $2,981.34 2026-04-01
52000 HCPCS Diagnostic Exam Of Bladder And Urethra Using An Endoscope 20 10 $3,358.00 $3,358.00 $2,417.76 $3,525.90 $2,981.34 2026-04-01
38531 HCPCS Biopsy Or Removal Of Lymph Nodes Of Groin 36 10 $4,100.00 $4,100.00 $386.23 $5,032.76 $2,952.00 2026-04-01
J7325 HCPCS Hyaluronan Or Derivative, Synvisc Or Synvisc-one, For Intra-articular Injection,… 16 8 $3,095.65 $3,095.65 $2,228.87 $3,250.43 $2,909.91 2026-04-01
26045 HCPCS Partial Release Of Connective Tissue Of Palm 36 10 $4,000.00 $4,000.00 $411.39 $4,200.00 $2,880.00 2026-04-01
J9355 HCPCS Injection, Trastuzumab, Excludes Biosimilar, 10 Mg 16 8 $3,055.42 $3,055.42 $2,199.90 $3,208.19 $2,872.10 2026-04-01
26418 HCPCS Repair Of Tendon On Top Side Of Finger 36 10 $3,982.00 $3,982.00 $571.93 $4,181.10 $2,867.04 2026-04-01
19281 HCPCS Placement Of Locating Device In Breast Using Imaging Guidance, First Growth 36 10 $4,200.00 $4,200.00 $78.35 $4,410.00 $2,859.31 2026-04-01
74178 HCPCS CT Scan Of Abdomen And Pelvis Before And After Contrast 20 10 $3,500.00 $3,500.00 $832.37 $3,675.00 $2,835.00 2026-04-01
95811 HCPCS Sleep Study In Sleep Lab With Continuous Airway Pressure (6 Years Or Older) 20 10 $3,000.00 $3,000.00 $2,160.00 $3,150.00 $2,800.32 2026-04-01
J3111 HCPCS Injection, Romosozumab-aqqg, 1 Mg 16 8 $2,971.53 $2,971.53 $2,139.50 $3,120.11 $2,793.24 2026-04-01
J3262 HCPCS Injection, Tocilizumab, 1 Mg 32 8 $3,599.36 $3,599.36 $870.56 $6,289.08 $2,791.04 2026-04-01
11443 HCPCS Removal Of Noncancer Skin Growth Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 2… 36 10 $4,000.00 $4,000.00 $147.06 $4,200.00 $2,790.64 2026-04-01
11044 HCPCS Removal Of Bone, 20.0 Sq Cm Or Less 36 10 $3,800.00 $3,800.00 $184.27 $4,090.88 $2,736.00 2026-04-01
19120 HCPCS Removal Of Growth And Tissue Of Breast, Duct, Or Nipple 36 10 $3,700.00 $3,700.00 $364.45 $3,885.00 $2,664.00 2026-04-01
15004 HCPCS Preparation Of Skin Graft Site Of Face, Scalp, Eyelids, Mouth, Neck, Ears, Aroun… 36 10 $3,700.00 $3,700.00 $211.31 $4,090.88 $2,664.00 2026-04-01
26115 HCPCS Removal (less Than 1.5 Centimeters) Tissue Beneath The Skin Growth Of Hand Or Fi… 36 10 $3,700.00 $3,700.00 $291.99 $3,885.00 $2,664.00 2026-04-01
25075 HCPCS Removal Of Growth Under Skin Of Forearm Or Wrist, Less Than 3.0 Cm 36 10 $3,700.00 $3,700.00 $277.50 $4,391.56 $2,664.00 2026-04-01
21930 HCPCS Removal Of Growth Under Skin Of Back Or Lower Sides, Less Than 3.0 Cm 36 10 $3,700.00 $3,700.00 $316.68 $4,029.18 $2,664.00 2026-04-01
21555 HCPCS Removal Of Growth Under Skin Of Neck Or Front Of Chest, Less Than 3.0 Cm 36 10 $3,700.00 $3,700.00 $269.08 $4,222.87 $2,664.00 2026-04-01
20680 HCPCS Removal Of Deep Implant From Bone 36 10 $3,700.00 $3,700.00 $359.09 $4,969.50 $2,664.00 2026-04-01
J1459 HCPCS Injection, Immune Globulin (privigen), Intravenous, Non-lyophilized (e.g., Liqui… 32 8 $3,191.23 $3,191.23 $1,535.15 $4,462.82 $2,649.49 2026-04-01
027211525_1 CDM Hb Acmh Avaflex 10g 20mm Balloon 12 6 $3,313.00 $3,313.00 $2,385.36 $3,246.74 $2,617.27 2026-04-01
J7307 HCPCS Etonogestrel (contraceptive) Implant System, Including Implant And Supplies 16 8 $2,744.42 $2,744.42 $1,975.98 $2,881.64 $2,579.76 2026-04-01
J7296 HCPCS Levonorgestrel-releasing Intrauterine Contraceptive System, (kyleena), 19.5 Mg 16 8 $2,744.42 $2,744.42 $1,975.98 $2,881.64 $2,579.76 2026-04-01
54161 HCPCS Removal Of Foreskin (older Than 28 Days) 20 10 $2,600.00 $2,600.00 $1,872.00 $3,601.97 $2,574.00 2026-04-01
72195 HCPCS MRI Scan Of Pelvis Without Contrast 20 10 $3,170.00 $3,170.00 $724.60 $3,328.50 $2,567.70 2026-04-01
70551 HCPCS MRI Scan Of Brain Without Contrast 20 10 $3,150.00 $3,150.00 $724.60 $3,307.50 $2,551.50 2026-04-01
Q0138 HCPCS Injection, Ferumoxytol, For Treatment Of Iron Deficiency Anemia, 1 Mg (non-esrd … 16 8 $2,699.65 $2,699.65 $1,943.75 $2,834.63 $2,537.68 2026-04-01
51725 HCPCS Simple Measurement Of Pressure Of Urine Flow In Bladder 20 10 $2,890.00 $2,890.00 $684.89 $3,034.50 $2,528.75 2026-04-01
69706 HCPCS Dilation Of Canal Between Middle Ear And Throat (eustachian Tube) On Both Sides … 36 10 $2,550.00 $2,550.00 $189.38 $7,596.75 $2,524.50 2026-04-01
19125 HCPCS Removal Of Growth Of Breast Identified By X-ray Marker, First Growth 36 10 $3,500.00 $3,500.00 $403.56 $3,675.00 $2,520.00 2026-04-01
45385 HCPCS Removal Of Polyps Or Growths Of Large Bowel Using An Endoscope With Mechanical S… 36 10 $3,500.00 $3,500.00 $208.30 $3,675.00 $2,520.00 2026-04-01
55706 HCPCS Needle Biopsy Of Prostate Gland Using Image Guidance 36 10 $3,500.00 $3,500.00 $594.00 $3,675.00 $2,520.00 2026-04-01
73218 HCPCS MRI Scan Of Arm Without Contrast 20 10 $3,100.00 $3,100.00 $724.60 $3,255.00 $2,511.00 2026-04-01
70544 HCPCS MRI Scan Of Blood Vessels Of Head Without Contrast 20 10 $3,100.00 $3,100.00 $652.99 $3,255.00 $2,511.00 2026-04-01
45379 HCPCS Removal Of Foreign Bodies In Large Bowel Using A Flexible Endoscope 36 10 $3,486.00 $3,486.00 $195.60 $3,660.30 $2,509.92 2026-04-01
J1745 HCPCS Injection, Infliximab, Excludes Biosimilar, 10 Mg 16 8 $2,641.60 $2,641.60 $1,901.95 $2,773.68 $2,483.11 2026-04-01
J1569 HCPCS Injection, Immune Globulin, (gammagard Liquid), Non-lyophilized, (e.g., Liquid),… 96 8 $2,960.55 $2,960.55 $292.95 $12,390.19 $2,458.03 2026-04-01
27447 HCPCS Replacement Of Knee Joint, Both Sides Of Knee 34 10 $2,500.00 $2,500.00 $1,045.50 $24,837.69 $2,450.00 2026-04-01
23655 HCPCS Closed Treatment Of Dislocated Shoulder With Manipulation Under Anesthesia 36 10 $3,400.00 $3,400.00 $378.77 $3,570.00 $2,447.73 2026-04-01
J7300 HCPCS Intrauterine Copper Contraceptive 16 8 $2,574.25 $2,574.25 $1,853.46 $2,702.96 $2,419.80 2026-04-01
26445 HCPCS Release Of Tendon Of Top Of Hand Or Finger 36 10 $3,300.00 $3,300.00 $551.44 $3,486.38 $2,376.00 2026-04-01
26111 HCPCS Removal (1.5 Centimeters Or Greater) Tissue Beneath The Skin Growth Of Hand Or F… 36 10 $3,300.00 $3,300.00 $356.71 $3,486.38 $2,376.00 2026-04-01
26055 HCPCS Incision Of Tendon Covering Of Finger 36 10 $3,300.00 $3,300.00 $261.70 $3,486.38 $2,376.00 2026-04-01
25112 HCPCS Removal Of Recurrent Cyst Of Wrist 36 10 $3,300.00 $3,300.00 $342.74 $3,486.38 $2,376.00 2026-04-01
027211531_1 CDM Hb Acmh Het Bipolar Forceps 12 6 $2,975.00 $2,975.00 $2,142.00 $2,915.50 $2,350.25 2026-04-01
73718 HCPCS MRI Scan Of Leg Without Contrast 20 10 $2,900.00 $2,900.00 $724.60 $3,045.00 $2,349.00 2026-04-01
72141 HCPCS MRI Scan Of Upper Spinal Canal Without Contrast 20 10 $2,900.00 $2,900.00 $724.60 $3,045.00 $2,349.00 2026-04-01
74181 HCPCS MRI Scan Of Abdomen Without Contrast 20 10 $2,900.00 $2,900.00 $724.60 $3,045.00 $2,349.00 2026-04-01
45380 HCPCS Biopsy Of Large Bowel Using A Flexible Endoscope 36 10 $3,250.00 $3,250.00 $165.17 $3,412.50 $2,340.00 2026-04-01
45378 HCPCS Diagnostic Exam Of Large Bowel Using A Flexible Endoscope 36 10 $3,250.00 $3,250.00 $152.60 $3,412.50 $2,340.00 2026-04-01
43249 HCPCS Balloon Dilation Of Esophagus, Stomach, And/or Upper Small Bowel Using A Flexibl… 36 10 $2,400.00 $2,400.00 $126.88 $2,955.75 $2,227.87 2026-04-01
95810 HCPCS Sleep Study In Sleep Lab (6 Years Or Older) 20 10 $2,250.00 $2,250.00 $1,620.00 $2,900.63 $2,227.50 2026-04-01
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