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

Mercy Hospital, Inc

Moundridge, KS · CCN 170075 · Rates published

11,482 distinct procedures filed
23 distinct payers
247,196 rate rows
2026-05-08 last MRF observed
Data quality

187,156 of 247,196 rate rows are consumer-grade (75.7%)

60,040 rows are marked excluded from the consumer medians — these stay visible in the raw drill-down with the same reason shown here, so nothing is silently hidden.

Excluded — reasonRows
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 58,301
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 1,060
per-diem day rate — not a per-procedure price 530
placeholder amount (≤ $0.02) — excluded from medians 76
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 47
exceeds 10× this hospital's gross charge — excluded from medians 14
template filing: same amount across many unrelated codes — excluded 12
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://mrfs.hyvehealthcare.com/GreatPlainsHealthAlliance/480663711_mercy-hospital-ks_standardcharges.csv
Found on page www.mercyh.org/pricing/
Discovered viaCMS hospital list
Last fetch not_modified · 2026-10-11
Content fingerprint 6e8ecc3e4c988def… · 89,556,055 bytes · first seen 2026-05-09

Top 50 most expensive offerings

Outliers are flagged where this hospital's filed rate is ≥2× or ≤0.5× the national median for the same code.

Code Description Payers Min $ Max $ Avg median vs national
J3394
HCPCS 		Injection, Lovotibeglogene Autotemcel, Per Treatment 10 $4,929,000.00 $4,929,000.00 $4,929,000.00 nat. median
$3,248,446
1.5× median
J1413
HCPCS 		Inj Delandistrogene Mox Rokl 10 $4,000,000.00 $4,988,182.14 $4,494,091.07 nat. median
$3,325,455
1.4× median
J3393
HCPCS 		Injection, Betibeglogene Autotemcel, Per Treatment 10 $4,452,000.00 $4,452,000.00 $4,452,000.00 nat. median
$2,968,000
1.5× median
J1411
HCPCS 		Inj, Hemgenix, Per Tx Dose 1 $4,375,000.00 $4,375,000.00 $4,375,000.00 nat. median
$3,685,267
1.2× median
J3392
HCPCS 		Injection, Exagamglogene Autotemcel, Per Treatment 10 $3,498,000.00 $3,498,000.00 $3,498,000.00 nat. median
$2,332,000
1.5× median
J3399
HCPCS 		Inj Onase Abepar-xioi Treat 4 $107,435.26 $3,582,921.35 $1,506,656.73 nat. median
$2,455,111
0.6× median
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 10 $560,974.84 $793,789.28 $578,324.58 nat. median
$621,313
0.9× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 10 $498,550.50 $775,089.11 $541,635.66 nat. median
$579,571
0.9× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 10 $498,550.50 $789,881.39 $541,260.45 nat. median
$574,037
0.9× median
33276
CPT 		Insj Phrnc Nrv Stim Sys 10 $67,500.75 $67,500.75 $67,500.75 nat. median
$44,163
1.5× median
J9029
HCPCS 		Instill Adstiladrin, Tx Dose 10 $61,528.12 $95,032.16 $63,431.05 nat. median
$66,211
1.0× median
Q2043
HCPCS 		Sipuleucel-t Auto Cd54+ 10 $54,267.59 $82,522.84 $61,540.57 nat. median
$63,499
1.0× median
J9226
HCPCS 		Supprelin La Implant 10 $44,193.58 $68,025.32 $50,116.43 nat. median
$57,036
0.9× median
915T
OTHER 		Insertion Of Permanent Cardiac Contractility Modulation-defibrillation System Co… 10 $48,092.37 $48,092.37 $48,092.37 nat. median
$48,103
1.0× median
61886
CPT 		Implant Neurostim Arrays 10 $45,710.39 $45,710.39 $45,710.39 nat. median
$23,007
2.0× median
674T
OTHER 		Laps Insj Nw/rpcmt Prm Isdss 10 $45,710.39 $45,710.39 $45,710.39 nat. median
$35,986
1.3× median
268T
OTHER 		Implt/rpl Crtd Sns Dev Gen 10 $45,710.39 $45,710.39 $45,710.39 nat. median
$7,159
outlier · 6.4×
33287
CPT 		Rmv&rplcmt Phrnc Nrv Stim Pg 10 $45,710.39 $45,710.39 $45,710.39 nat. median
$27,599
1.7× median
A9543
HCPCS 		Y90 Ibritumomab, Rx 10 $22,162.11 $65,477.00 $43,819.56 nat. median
$65,477
0.7× median
C9760
HCPCS 		Non-blind Interatrial Shunt 10 $41,250.75 $41,250.75 $41,250.75 nat. median
$28,845
1.4× median
923T
OTHER 		Removal And Replacement Of Permanent Cardiac Contractility Modulation-defibrilla… 10 $33,669.29 $33,669.29 $33,669.29 nat. median
$34,088
1.0× median
916T
OTHER 		Insertion Of Permanent Cardiac Contractility Modulation-defibrillation System Co… 10 $33,669.29 $33,669.29 $33,669.29 nat. median
$34,088
1.0× median
614T
OTHER 		Rmvl&rplcmt Ss Impl Dfb Pg 10 $33,669.29 $33,669.29 $33,669.29 nat. median
$34,088
1.0× median
409T
OTHER 		Insj/rplc Car Modulj Pls Gn 10 $33,669.29 $33,669.29 $33,669.29 nat. median
$34,088
1.0× median
515T
OTHER 		Insj Wcs Lv Compl Sys 10 $33,669.29 $33,669.29 $33,669.29 nat. median
$34,088
1.0× median
414T
OTHER 		Rmvl & Rpl Car Modulj Pls Gn 10 $33,669.29 $33,669.29 $33,669.29 nat. median
$34,088
1.0× median
63655
CPT 		Implant Neuroelectrodes 10 $32,166.59 $33,438.09 $32,802.34 nat. median
$18,350
1.8× median
680T
OTHER 		Insj/rplcmt Pg Only Isdss 10 $32,166.59 $32,166.59 $32,166.59 nat. median
$29,730
1.1× median
64580
CPT 		Opn Impltj Nea Neuromuscular 10 $32,166.59 $32,166.59 $32,166.59 nat. median
$17,811
1.8× median
816T
OTHER 		Opn Insj/rplcmt Ins Ptn Subq 10 $32,166.59 $32,166.59 $32,166.59 nat. median
$29,730
1.1× median
817T
OTHER 		Opn Insj/rplcmt Ins Ptn Subf 10 $32,166.59 $32,166.59 $32,166.59 nat. median
$29,730
1.1× median
J9266
HCPCS 		Pegaspargase Injection 10 $27,571.34 $40,605.80 $31,266.46 nat. median
$31,084
1.0× median
54416
CPT 		Remv/repl Penis Contain Pros 10 $30,192.84 $30,192.84 $30,192.84 nat. median
$19,496
1.5× median
54405
CPT 		Insert Multi-comp Penis Pros 10 $30,192.84 $30,192.84 $30,192.84 nat. median
$17,094
1.8× median
54401
CPT 		Insert Self-contd Prosthesis 10 $30,192.84 $30,192.84 $30,192.84 nat. median
$18,598
1.6× median
54411
CPT 		Remov/replc Penis Pros Comp 10 $30,192.84 $30,192.84 $30,192.84 nat. median
$13,959
outlier · 2.2×
54410
CPT 		Remove/replace Penis Prosth 10 $30,192.84 $30,192.84 $30,192.84 nat. median
$12,124
outlier · 2.5×
J9600
HCPCS 		Porfimer Sodium Injection 10 $22,811.49 $35,805.21 $29,308.35 nat. median
$26,416
1.1× median
525T
OTHER 		Insj/rplcmt Compl Iims 10 $28,606.74 $28,606.74 $28,606.74 nat. median
$29,518
1.0× median
795T
OTHER 		Tcat Ins 2chmbr Ldls Pm Cmpl 10 $28,606.74 $28,606.74 $28,606.74 nat. median
$29,518
1.0× median
796T
OTHER 		Tcat Ins 2chmbr Ldls Pm Ra 10 $28,606.74 $28,606.74 $28,606.74 nat. median
$29,518
1.0× median
825T
OTHER 		Tcat Rmv&rpl1chmb Ldls Pm Ra 10 $28,606.74 $28,606.74 $28,606.74 nat. median
$29,518
1.0× median
823T
OTHER 		Tcat Ins 1chmbr Ldls Pm Ra 10 $28,606.74 $28,606.74 $28,606.74 nat. median
$29,518
1.0× median
801T
OTHER 		Tcat Rmv&rpl 2chmbr Ldls Pm 10 $28,606.74 $28,606.74 $28,606.74 nat. median
$29,518
1.0× median
802T
OTHER 		Tcat Rmv&rpl2chmb Ldls Pm Ra 10 $28,606.74 $28,606.74 $28,606.74 nat. median
$29,518
1.0× median
61891
CPT 		Rev/rplcmt Sk-mnt Crnl Nstm 10 $24,105.76 $32,166.59 $28,136.17 nat. median
$20,209
1.4× median
C8003
HCPCS 		Implantation Of Medial Knee Extraarticular Implantable Shock Absorber Spanning T… 10 $27,585.08 $27,585.08 $27,585.08 nat. median
$18,782
1.5× median
C9775
HCPCS 		Revasc Lith-sten-ath Tib/per 10 $26,935.08 $26,935.08 $26,935.08 nat. median
$23,462
1.1× median
C9774
HCPCS 		Revasc Lithotr-ather Tib/per 10 $26,935.08 $26,935.08 $26,935.08 nat. median
$20,557
1.3× median
632T
OTHER 		Perq Tcat US Abltj Nrv P-art 10 $26,935.08 $26,935.08 $26,935.08 nat. median
$28,093
1.0× median

Other procedures at this hospital

Browse this hospital's 11,482 published procedures. Use the slice to choose what to show, then sort or filter any column.

Slice
Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
Code Type Description Rate rows Payers Gross Cash Min $ Max $ Avg median Last observed
             
797T OTHER Tcat Ins 2chmbr Ldls Pm Rv 23 11 — — $17,177.60 $28,606.74 $22,892.17 2026-03-06
803T OTHER Tcat Rmv&rpl2chmb Ldls Pm Rv 23 11 — — $17,177.60 $28,606.74 $22,892.17 2026-03-06
37231 CPT Tib/per Revasc Stent & Ather 23 11 — — $6,668.81 $26,935.08 $16,801.94 2026-03-06
36837 CPT Prq Av Fstl Crt Uxtr Sep Acs 23 11 — — $5,528.29 $26,935.08 $16,231.68 2026-03-06
37230 CPT Tib/per Revasc W/stent 23 11 — — $5,048.69 $26,935.08 $15,991.89 2026-03-06
37229 CPT Tib/per Revasc W/ather 23 11 — — $5,042.42 $26,935.08 $15,988.75 2026-03-06
36836 CPT Prq Av Fstl Crtj Uxtr 1 Acs 23 11 — — $4,644.50 $26,935.08 $15,789.79 2026-03-06
36906 CPT Thrmbc/nfs Dialysis Circuit 23 11 — — $4,425.18 $26,935.08 $15,680.13 2026-03-06
37242 CPT Vasc Embolize/occlude Artery 23 11 — — $4,005.95 $26,935.08 $15,470.51 2026-03-06
37184 CPT Prim Art M-thrmbc 1st Vsl 23 11 — — $2,340.10 $26,935.08 $14,637.59 2026-03-06
37243 CPT Vasc Embolize/occlude Organ 23 11 — — $4,859.16 $17,010.86 $10,935.01 2026-03-06
37244 CPT Vasc Embolize/occlude Bleed 23 11 — — $3,717.21 $17,010.86 $10,364.03 2026-03-06
36903 CPT Intro Cath Dialysis Circuit 23 11 — — $3,645.83 $17,010.86 $10,328.34 2026-03-06
27447 CPT Total Knee Arthroplasty 23 11 — — $1,156.50 $19,300.23 $10,228.36 2026-03-06
27130 CPT Total Hip Arthroplasty 23 11 — — $1,112.84 $19,300.23 $10,206.53 2026-03-06
23473 CPT Revis Reconst Shoulder Joint 23 11 — — $1,088.62 $19,300.23 $10,194.42 2026-03-06
27828 CPT Treat Lower Leg Fracture 23 11 — — $1,077.80 $19,300.23 $10,189.01 2026-03-06
23470 CPT Reconstruct Shoulder Joint 23 11 — — $1,062.16 $19,300.23 $10,181.19 2026-03-06
28420 CPT Treat/graft Heel Fracture 23 11 — — $1,060.40 $19,300.23 $10,180.32 2026-03-06
24370 CPT Revise Reconst Elbow Joint 23 11 — — $1,028.37 $19,300.23 $10,164.30 2026-03-06
29889 CPT Knee Arthroscopy/surgery 23 11 — — $1,022.38 $19,300.23 $10,161.31 2026-03-06
27429 CPT Reconstruction Knee 23 11 — — $1,002.75 $19,300.23 $10,151.49 2026-03-06
25391 CPT Lengthen Radius Or Ulna 23 11 — — $966.01 $19,300.23 $10,133.12 2026-03-06
37241 CPT Vasc Embolize/occlude Venous 23 11 — — $2,623.40 $17,010.86 $9,817.13 2026-03-06
37228 CPT Tib/per Revasc W/tla 23 11 — — $2,342.58 $17,010.86 $9,676.72 2026-03-06
37187 CPT Venous Mech Thrombectomy 23 11 — — $2,275.48 $17,010.86 $9,643.17 2026-03-06
50593 CPT Perc Cryo Ablate Renal Tum 23 11 — — $3,456.69 $15,616.83 $9,536.76 2026-03-06
37238 CPT Open/perq Place Stent Same 23 11 — — $1,955.92 $17,010.86 $9,483.39 2026-03-06
47383 CPT Perq Abltj Lvr Cryoablation 23 11 — — $3,341.47 $15,616.83 $9,479.15 2026-03-06
37221 CPT Iliac Revasc W/stent 23 11 — — $1,745.67 $17,010.86 $9,378.26 2026-03-06
37236 CPT Open/perq Place Stent 1st 23 11 — — $1,558.58 $17,010.86 $9,284.72 2026-03-06
36905 CPT Thrmbc/nfs Dialysis Circuit 23 11 — — $1,491.08 $17,010.86 $9,250.97 2026-03-06
92987 CPT Revision Of Mitral Valve 23 11 — — $1,200.14 $17,010.86 $9,105.50 2026-03-06
27134 CPT Revise Hip Joint Replacement 23 11 — — $1,685.70 $16,456.59 $9,071.15 2026-03-06
19296 CPT Place Po Breast Cath For Rad 23 11 — — $3,705.34 $14,353.58 $9,029.46 2026-03-06
92990 CPT Revision Of Pulmonary Valve 23 11 — — $946.89 $17,010.86 $8,978.88 2026-03-06
27132 CPT Total Hip Arthroplasty 23 11 — — $1,411.66 $16,456.59 $8,934.12 2026-03-06
28415 CPT Treat Heel Fracture 23 11 — — $1,022.51 $16,768.63 $8,895.57 2026-03-06
27138 CPT Revise Hip Joint Replacement 23 11 — — $1,327.86 $16,456.59 $8,892.23 2026-03-06
27137 CPT Revise Hip Joint Replacement 23 11 — — $1,273.92 $16,456.59 $8,865.25 2026-03-06
23474 CPT Revis Reconst Shoulder Joint 23 11 — — $1,176.58 $16,551.09 $8,863.83 2026-03-06
55866 CPT Laps Surg Prst8ect Rpbic Rad 23 11 — — $1,379.27 $15,616.83 $8,498.05 2026-03-06
50543 CPT Laparo Partial Nephrectomy 23 11 — — $1,262.59 $15,616.83 $8,439.71 2026-03-06
50947 CPT Laparo New Ureter/bladder 23 11 — — $1,220.60 $15,616.83 $8,418.72 2026-03-06
58554 CPT Laparo-vag Hyst W/t/o Compl 23 11 — — $1,157.44 $15,616.83 $8,387.14 2026-03-06
50948 CPT Laparo New Ureter/bladder 23 11 — — $1,107.53 $15,616.83 $8,362.18 2026-03-06
50544 CPT Laparoscopy Pyeloplasty 23 11 — — $1,095.67 $15,616.83 $8,356.25 2026-03-06
47370 CPT Laparo Ablate Liver Tumor Rf 23 11 — — $1,012.52 $15,616.83 $8,314.67 2026-03-06
58546 CPT Laparo-myomectomy Complex 23 11 — — $1,006.28 $15,616.83 $8,311.56 2026-03-06
58553 CPT Laparo-vag Hyst Complex 23 11 — — $1,006.28 $15,616.83 $8,311.56 2026-03-06
58573 CPT Tlh W/t/o Uterus Over 250 G 23 11 — — $1,002.67 $15,616.83 $8,309.75 2026-03-06
43282 CPT Lap Paraesoph Her Rpr W/mesh 23 11 — — $998.57 $15,616.83 $8,307.70 2026-03-06
50542 CPT Laparo Ablate Renal Mass 23 11 — — $993.92 $15,616.83 $8,305.38 2026-03-06
47371 CPT Laparo Ablate Liver Cryosurg 23 11 — — $984.58 $15,616.83 $8,300.70 2026-03-06
43280 CPT Laparoscopy Fundoplasty 23 11 — — $892.49 $15,616.83 $8,254.66 2026-03-06
58572 CPT Tlh Uterus Over 250 G 23 11 — — $886.78 $15,616.83 $8,251.81 2026-03-06
43281 CPT Lap Paraesophag Hern Repair 23 11 — — $886.74 $15,616.83 $8,251.78 2026-03-06
38120 CPT Laparoscopy Splenectomy 23 11 — — $886.30 $15,616.83 $8,251.57 2026-03-06
58552 CPT Laparo-vag Hyst Incl T/o 23 11 — — $857.62 $15,616.83 $8,237.23 2026-03-06
38572 CPT Laparoscopy Lymphadenectomy 23 11 — — $817.15 $15,616.83 $8,216.99 2026-03-06
58544 CPT Lsh W/t/o Uterus Above 250 G 23 11 — — $810.37 $15,616.83 $8,213.60 2026-03-06
57425 CPT Laparoscopy Surg Colpopexy 23 11 — — $806.74 $15,616.83 $8,211.78 2026-03-06
50541 CPT Laparo Ablate Renal Cyst 23 11 — — $795.12 $15,616.83 $8,205.98 2026-03-06
58571 CPT Tlh W/t/o 250 G Or Less 23 11 — — $783.11 $15,616.83 $8,199.97 2026-03-06
38573 CPT Laps Pelvic Lymphadec 23 11 — — $782.35 $15,616.83 $8,199.59 2026-03-06
27536 CPT Treat Knee Fracture 23 11 — — $982.98 $14,554.30 $7,768.64 2026-03-06
A0431 HCPCS Rotary Wing Air Transport 23 11 — — $5,992.16 $9,511.72 $7,751.94 2026-03-06
81552 CPT Onc Uveal Mlnma Mrna 15 Gene 23 11 — — $6,609.60 $8,553.60 $7,581.60 2026-03-06
50081 CPT Perq Nl/pl Lithotrp Cplx>2cm 23 11 — — $1,025.84 $13,870.73 $7,448.28 2026-03-06
33285 CPT Insj Subq Car Rhythm Mntr 23 11 — — $2,397.99 $12,413.97 $7,405.98 2026-03-06
54344 CPT Rrp Hypspad Comp Moblj&urtp 23 11 — — $842.53 $13,870.73 $7,356.63 2026-03-06
54112 CPT Treat Penis Lesion Graft 23 11 — — $776.00 $13,870.73 $7,323.36 2026-03-06
81529 CPT Onc Cutan Mlnma Mrna 31 Gene 23 11 — — $6,114.05 $7,912.30 $7,013.18 2026-03-06
22514 CPT Perq Vertebral Augmentation 23 11 — — $3,235.37 $10,715.60 $6,975.48 2026-03-06
J3394 HCPCS Injection, Lovotibeglogene Autotemcel, Per Treatment 19 10 — — $4,929,000.00 $4,929,000.00 $4,929,000.00 2026-03-06
J1413 HCPCS Inj Delandistrogene Mox Rokl 19 10 — — $4,000,000.00 $4,988,182.14 $4,494,091.07 2026-03-06
J3393 HCPCS Injection, Betibeglogene Autotemcel, Per Treatment 19 10 — — $4,452,000.00 $4,452,000.00 $4,452,000.00 2026-03-06
J3392 HCPCS Injection, Exagamglogene Autotemcel, Per Treatment 19 10 — — $3,498,000.00 $3,498,000.00 $3,498,000.00 2026-03-06
Q2042 HCPCS Tisagenlecleucel Car-pos T 19 10 — — $560,974.84 $793,789.28 $578,324.58 2026-03-06
Q2054 HCPCS Lisocabtagene Mara Car Pos T 19 10 — — $498,550.50 $775,089.11 $541,635.66 2026-03-06
Q2055 HCPCS Idecabtagene Vicleucel Car 19 10 — — $498,550.50 $789,881.39 $541,260.45 2026-03-06
33276 CPT Insj Phrnc Nrv Stim Sys 19 10 — — $67,500.75 $67,500.75 $67,500.75 2026-03-06
J9029 HCPCS Instill Adstiladrin, Tx Dose 19 10 — — $61,528.12 $95,032.16 $63,431.05 2026-03-06
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 19 10 — — $54,267.59 $82,522.84 $61,540.57 2026-03-06
J9226 HCPCS Supprelin La Implant 19 10 — — $44,193.58 $68,025.32 $50,116.43 2026-03-06
915T OTHER Insertion Of Permanent Cardiac Contractility Modulation-defibrillation System Co… 19 10 — — $48,092.37 $48,092.37 $48,092.37 2026-03-06
674T OTHER Laps Insj Nw/rpcmt Prm Isdss 19 10 — — $45,710.39 $45,710.39 $45,710.39 2026-03-06
61886 CPT Implant Neurostim Arrays 19 10 — — $45,710.39 $45,710.39 $45,710.39 2026-03-06
33287 CPT Rmv&rplcmt Phrnc Nrv Stim Pg 19 10 — — $45,710.39 $45,710.39 $45,710.39 2026-03-06
268T OTHER Implt/rpl Crtd Sns Dev Gen 19 10 — — $45,710.39 $45,710.39 $45,710.39 2026-03-06
A9543 HCPCS Y90 Ibritumomab, Rx 19 10 — — $22,162.11 $65,477.00 $43,819.56 2026-03-06
C9760 HCPCS Non-blind Interatrial Shunt 19 10 — — $41,250.75 $41,250.75 $41,250.75 2026-03-06
515T OTHER Insj Wcs Lv Compl Sys 19 10 — — $33,669.29 $33,669.29 $33,669.29 2026-03-06
409T OTHER Insj/rplc Car Modulj Pls Gn 19 10 — — $33,669.29 $33,669.29 $33,669.29 2026-03-06
414T OTHER Rmvl & Rpl Car Modulj Pls Gn 19 10 — — $33,669.29 $33,669.29 $33,669.29 2026-03-06
923T OTHER Removal And Replacement Of Permanent Cardiac Contractility Modulation-defibrilla… 19 10 — — $33,669.29 $33,669.29 $33,669.29 2026-03-06
614T OTHER Rmvl&rplcmt Ss Impl Dfb Pg 19 10 — — $33,669.29 $33,669.29 $33,669.29 2026-03-06
916T OTHER Insertion Of Permanent Cardiac Contractility Modulation-defibrillation System Co… 19 10 — — $33,669.29 $33,669.29 $33,669.29 2026-03-06
63655 CPT Implant Neuroelectrodes 19 10 — — $32,166.59 $33,438.09 $32,802.34 2026-03-06
64580 CPT Opn Impltj Nea Neuromuscular 19 10 — — $32,166.59 $32,166.59 $32,166.59 2026-03-06
817T OTHER Opn Insj/rplcmt Ins Ptn Subf 19 10 — — $32,166.59 $32,166.59 $32,166.59 2026-03-06
816T OTHER Opn Insj/rplcmt Ins Ptn Subq 19 10 — — $32,166.59 $32,166.59 $32,166.59 2026-03-06
680T OTHER Insj/rplcmt Pg Only Isdss 19 10 — — $32,166.59 $32,166.59 $32,166.59 2026-03-06
J9266 HCPCS Pegaspargase Injection 19 10 — — $27,571.34 $40,605.80 $31,266.46 2026-03-06
54410 CPT Remove/replace Penis Prosth 19 10 — — $30,192.84 $30,192.84 $30,192.84 2026-03-06
54411 CPT Remov/replc Penis Pros Comp 19 10 — — $30,192.84 $30,192.84 $30,192.84 2026-03-06
54401 CPT Insert Self-contd Prosthesis 19 10 — — $30,192.84 $30,192.84 $30,192.84 2026-03-06
54416 CPT Remv/repl Penis Contain Pros 19 10 — — $30,192.84 $30,192.84 $30,192.84 2026-03-06
54405 CPT Insert Multi-comp Penis Pros 19 10 — — $30,192.84 $30,192.84 $30,192.84 2026-03-06
J9600 HCPCS Porfimer Sodium Injection 19 10 — — $22,811.49 $35,805.21 $29,308.35 2026-03-06
825T OTHER Tcat Rmv&rpl1chmb Ldls Pm Ra 19 10 — — $28,606.74 $28,606.74 $28,606.74 2026-03-06
801T OTHER Tcat Rmv&rpl 2chmbr Ldls Pm 19 10 — — $28,606.74 $28,606.74 $28,606.74 2026-03-06
823T OTHER Tcat Ins 1chmbr Ldls Pm Ra 19 10 — — $28,606.74 $28,606.74 $28,606.74 2026-03-06
802T OTHER Tcat Rmv&rpl2chmb Ldls Pm Ra 19 10 — — $28,606.74 $28,606.74 $28,606.74 2026-03-06
525T OTHER Insj/rplcmt Compl Iims 19 10 — — $28,606.74 $28,606.74 $28,606.74 2026-03-06
796T OTHER Tcat Ins 2chmbr Ldls Pm Ra 19 10 — — $28,606.74 $28,606.74 $28,606.74 2026-03-06
795T OTHER Tcat Ins 2chmbr Ldls Pm Cmpl 19 10 — — $28,606.74 $28,606.74 $28,606.74 2026-03-06
61891 CPT Rev/rplcmt Sk-mnt Crnl Nstm 19 10 — — $24,105.76 $32,166.59 $28,136.17 2026-03-06
C8003 HCPCS Implantation Of Medial Knee Extraarticular Implantable Shock Absorber Spanning T… 19 10 — — $27,585.08 $27,585.08 $27,585.08 2026-03-06
632T OTHER Perq Tcat US Abltj Nrv P-art 19 10 — — $26,935.08 $26,935.08 $26,935.08 2026-03-06
C9797 HCPCS Vasc Emb/occ W/prs Cath 19 10 — — $26,935.08 $26,935.08 $26,935.08 2026-03-06
C9774 HCPCS Revasc Lithotr-ather Tib/per 19 10 — — $26,935.08 $26,935.08 $26,935.08 2026-03-06
C9773 HCPCS Revasc Lithotr-stent Tib/per 19 10 — — $26,935.08 $26,935.08 $26,935.08 2026-03-06
793T OTHER Prq Tcat Thrm Ablt Nrv P-art 19 10 — — $26,935.08 $26,935.08 $26,935.08 2026-03-06
C9775 HCPCS Revasc Lith-sten-ath Tib/per 19 10 — — $26,935.08 $26,935.08 $26,935.08 2026-03-06
645T OTHER Tcat Impltj C Sins Rdctj Dev 19 10 — — $26,935.08 $26,935.08 $26,935.08 2026-03-06
686T OTHER Histotripsy Mal Hepatcel Tis 19 10 — — $26,250.75 $26,250.75 $26,250.75 2026-03-06
888T OTHER Histotripsy (ie, Non-thermal Ablation Via Acoustic Energy Delivery) Of Malignant… 19 10 — — $26,250.75 $26,250.75 $26,250.75 2026-03-06
53444 CPT Insert Tandem Cuff 19 10 — — $20,745.41 $30,192.84 $25,469.12 2026-03-06
53445 CPT Insert Uro/ves Nck Sphincter 19 10 — — $20,433.84 $30,192.84 $25,313.34 2026-03-06
308T OTHER Insj Ocular Telescope Prosth 19 10 — — $24,624.66 $24,624.66 $24,624.66 2026-03-06
66683 CPT Implantation Of Iris Prosthesis, Including Suture Fixation And Repair Or Removal… 19 10 — — $24,624.66 $24,624.66 $24,624.66 2026-03-06
61889 CPT Ins Sk-mnt Crnl Nstm Pg/rcvr 19 10 — — $24,105.76 $24,105.76 $24,105.76 2026-03-06
67027 CPT Implant Eye Drug System 19 10 — — $23,047.25 $23,047.25 $23,047.25 2026-03-06
C9602 HCPCS Perc D-e Cor Stent Ather S 19 10 — — $14,007.67 $26,935.08 $20,471.38 2026-03-06
C9607 HCPCS Perc D-e Cor Revasc Chro Sin 19 10 — — $14,007.67 $26,935.08 $20,471.38 2026-03-06
54417 CPT Remv/replc Penis Pros Compl 19 10 — — $19,488.63 $19,488.63 $19,488.63 2026-03-06
54400 CPT Insert Semi-rigid Prosthesis 19 10 — — $19,488.63 $19,488.63 $19,488.63 2026-03-06
Q0488 HCPCS Pwr Pack Base Elec Vad, Rep 19 10 — — $19,033.34 $19,622.00 $19,327.67 2026-03-06
29907 CPT Subtalar Arthro W/fusion 19 10 — — $19,300.23 $19,300.23 $19,300.23 2026-03-06
629T OTHER Perq Njx Algc CT Lmbr 1st 19 10 — — $19,300.23 $19,300.23 $19,300.23 2026-03-06
C9757 HCPCS Spine Device Implant Surgery 19 10 — — $19,300.23 $19,300.23 $19,300.23 2026-03-06
737T OTHER Xenograft Impltj Artclr Surf 19 10 — — $19,300.23 $19,300.23 $19,300.23 2026-03-06
C9604 HCPCS Perc D-e Cor Revasc T Cabg S 19 10 — — $17,010.86 $21,547.37 $19,279.12 2026-03-06
C7537 HCPCS Insrt Atril Pm W/l Vent Lead 19 10 — — $18,752.82 $18,752.82 $18,752.82 2026-03-06
C7539 HCPCS Insrt A & V Pm W/l Vent Lead 19 10 — — $18,752.82 $18,752.82 $18,752.82 2026-03-06
C7540 HCPCS Rmv&rplc Pm Dul W/l Vnt Lead 19 10 — — $18,752.82 $18,752.82 $18,752.82 2026-03-06
C7538 HCPCS Insrt Vent Pm W/l Vent Lead 19 10 — — $18,752.82 $18,752.82 $18,752.82 2026-03-06
61715 CPT Magnetic Resonance Image Guided High Intensity Focused Ultrasound (MRgFUS), Ster… 19 10 — — $18,705.47 $18,705.47 $18,705.47 2026-03-06
33288 CPT Rmv&rplcmt Phrnc Nrv Stim Ld 19 10 — — $18,705.47 $18,705.47 $18,705.47 2026-03-06
64575 CPT Opn Impltj Nea Perph Nerve 19 10 — — $18,705.47 $18,705.47 $18,705.47 2026-03-06
43647 CPT Lap Impl Electrode Antrum 19 10 — — $18,705.47 $18,705.47 $18,705.47 2026-03-06
675T OTHER Laps Insj Nw/rpcmt Isdss 1ld 19 10 — — $18,705.47 $18,705.47 $18,705.47 2026-03-06
C9606 HCPCS Perc D-e Cor Revasc W Ami S 19 10 — — $12,237.75 $23,261.01 $17,749.38 2026-03-06
C9772 HCPCS Revasc Lithotrip Tibi/perone 19 10 — — $17,010.86 $17,010.86 $17,010.86 2026-03-06
234T OTHER Trluml Perip Athrc Renal Art 19 10 — — $17,010.86 $17,010.86 $17,010.86 2026-03-06
236T OTHER Trluml Perip Athrc Abd Aorta 19 10 — — $17,010.86 $17,010.86 $17,010.86 2026-03-06
C9767 HCPCS Revasc Lithotrip-stent-ather 19 10 — — $5,753.21 $26,935.08 $16,344.15 2026-03-06
C9765 HCPCS Revasc Intra Lithotrip-stent 19 10 — — $5,753.21 $26,935.08 $16,344.15 2026-03-06
C9766 HCPCS Revasc Intra Lithotrip-ather 19 10 — — $5,753.21 $26,935.08 $16,344.15 2026-03-06
J1412 HCPCS Inj Roctavian Ml 2x10^13vc G 19 10 — — $14,160.16 $18,011.72 $16,085.94 2026-03-06
53440 CPT Male Sling Procedure 19 10 — — $12,176.36 $19,488.63 $15,832.50 2026-03-06
519T OTHER Rmv&rplcmt Pg Wcs Lv Both 19 10 — — $15,698.00 $15,698.00 $15,698.00 2026-03-06
516T OTHER Insj Wcs Lv Eltrd Only 19 10 — — $15,698.00 $15,698.00 $15,698.00 2026-03-06
520T OTHER Rmv&rplcmt Pg Wcs Lv Battery 19 10 — — $15,698.00 $15,698.00 $15,698.00 2026-03-06
517T OTHER Insj Wcs Lv Both Compnt Pg 19 10 — — $15,698.00 $15,698.00 $15,698.00 2026-03-06
43648 CPT Lap Revise/remv Eltrd Antrum 19 10 — — $15,616.83 $15,616.83 $15,616.83 2026-03-06
679T OTHER Laps Rmvl Lead Isdss 19 10 — — $15,616.83 $15,616.83 $15,616.83 2026-03-06
677T OTHER Laps Repos Lead Isdss 1st Ld 19 10 — — $15,616.83 $15,616.83 $15,616.83 2026-03-06
23491 CPT Reinforce Shoulder Bones 19 10 — — $11,705.16 $19,300.23 $15,502.69 2026-03-06
24498 CPT Reinforce Humerus 19 10 — — $11,430.30 $19,300.23 $15,365.26 2026-03-06
238T OTHER Trluml Perip Athrc Iliac Art 19 10 — — $2,789.96 $26,935.08 $14,862.52 2026-03-06
24365 CPT Reconstruct Head Of Radius 19 10 — — $9,655.18 $19,300.23 $14,477.70 2026-03-06
S2115 HCPCS Periacetabular Osteotomy 19 10 — — $13,897.23 $14,327.04 $14,112.14 2026-03-06
421T OTHER Waterjet Prostate Abltj Cmpl 19 10 — — $13,870.73 $13,870.73 $13,870.73 2026-03-06
54316 CPT Reconstruction Of Urethra 19 10 — — $13,870.73 $13,870.73 $13,870.73 2026-03-06
237T OTHER Trluml Perip Athrc Brchiocph 19 10 — — $9,511.09 $17,010.86 $13,260.98 2026-03-06
C9601 HCPCS Perc Drug-el Cor Stent Bran 19 10 — — $6,341.32 $19,823.93 $13,082.62 2026-03-06
C9600 HCPCS Perc Drug-el Cor Stent Sing 19 10 — — $5,489.51 $20,000.88 $12,745.19 2026-03-06
C1772 HCPCS Infusion Pump, Programmable 19 10 — — $12,456.66 $12,841.92 $12,649.29 2026-03-06
917T OTHER Insertion Of Permanent Cardiac Contractility Modulation-defibrillation System Co… 19 10 — — $12,413.97 $12,413.97 $12,413.97 2026-03-06
410T OTHER Insj/rplc Car Modulj Atr Elt 19 10 — — $12,413.97 $12,413.97 $12,413.97 2026-03-06
526T OTHER Insj/rplcmt Iims Eltrd Only 19 10 — — $12,413.97 $12,413.97 $12,413.97 2026-03-06
918T OTHER Insertion Of Permanent Cardiac Contractility Modulation-defibrillation System Co… 19 10 — — $12,413.97 $12,413.97 $12,413.97 2026-03-06
411T OTHER Insj/rplc Car Modulj Vnt Elt 19 10 — — $12,413.97 $12,413.97 $12,413.97 2026-03-06
527T OTHER Insj/rplcmt Iims Implt Mntr 19 10 — — $12,413.97 $12,413.97 $12,413.97 2026-03-06
C9780 HCPCS Insert Cv Cath Inf & Sup App 19 10 — — $12,375.75 $12,375.75 $12,375.75 2026-03-06
C9605 HCPCS Perc D-e Cor Revasc T Cabg B 19 10 — — $11,795.94 $11,795.94 $11,795.94 2026-03-06
C9608 HCPCS Perc D-e Cor Revasc Chro Add 19 10 — — $11,795.94 $11,795.94 $11,795.94 2026-03-06
C9603 HCPCS Perc D-e Cor Stent Ather Br 19 10 — — $11,795.94 $11,795.94 $11,795.94 2026-03-06
27415 CPT Osteochondral Knee Allograft 19 10 — — $3,966.27 $19,300.23 $11,633.25 2026-03-06
C1815 HCPCS Pros, Urinary Sph, Imp 19 10 — — $11,426.55 $11,779.95 $11,603.25 2026-03-06
C9764 HCPCS Revasc Intravasc Lithotripsy 19 10 — — $5,753.21 $17,010.86 $11,382.03 2026-03-06
58580 CPT Transcrv Abltj Utrn Fibrd Rf 19 10 — — $11,092.22 $11,092.22 $11,092.22 2026-03-06
G0276 HCPCS Pild/placebo Control Clin Tr 19 10 — — $10,715.60 $10,715.60 $10,715.60 2026-03-06
221T OTHER Plmt Post Facet Implt Lumb 19 10 — — $10,715.60 $10,715.60 $10,715.60 2026-03-06
28446 CPT Osteochondral Talus Autogrft 19 10 — — $10,715.60 $10,715.60 $10,715.60 2026-03-06
29905 CPT Subtalar Arthro W/exc 19 10 — — $10,715.60 $10,715.60 $10,715.60 2026-03-06
594T OTHER Osteot Hum Xtrnl Lngth Dev 19 10 — — $10,715.60 $10,715.60 $10,715.60 2026-03-06
274T OTHER Perq Lamot/lam Crv/thrc 19 10 — — $10,715.60 $10,715.60 $10,715.60 2026-03-06
29868 CPT Meniscal Trnspl Knee W/scpe 19 10 — — $10,715.60 $10,715.60 $10,715.60 2026-03-06
335T OTHER Insj Sinus Tarsi Implant 19 10 — — $10,715.60 $10,715.60 $10,715.60 2026-03-06
201T OTHER Perq Sacral Augmt Bilat Inj 19 10 — — $10,715.60 $10,715.60 $10,715.60 2026-03-06
200T OTHER Perq Sacral Augmt Unilat Inj 19 10 — — $10,715.60 $10,715.60 $10,715.60 2026-03-06
511T OTHER Rmvl&rinsj Sinus Tarsi Implt 19 10 — — $10,715.60 $10,715.60 $10,715.60 2026-03-06
G0413 HCPCS Pelvic Ring Fracture Uni/bil 19 10 — — $10,715.60 $10,715.60 $10,715.60 2026-03-06
C1813 HCPCS Prosthesis, Penile, Inflatab 19 10 — — $10,534.14 $10,859.94 $10,697.04 2026-03-06
58673 CPT Laparoscopy Salpingostomy 19 10 — — $4,506.06 $15,616.83 $10,061.44 2026-03-06
53449 CPT Repair Uro Sphincter 19 10 — — $5,965.97 $13,870.73 $9,918.35 2026-03-06
64596 CPT Ins/rplcmt Prq Eltrd Ra Pn 1 19 10 — — $1,008.72 $18,705.47 $9,857.09 2026-03-06
C7507 HCPCS Perq Thor&lumb Vert Aug 19 10 — — $9,851.47 $9,851.47 $9,851.47 2026-03-06
C7508 HCPCS Perq Lumb&thor Vert Aug 19 10 — — $9,851.47 $9,851.47 $9,851.47 2026-03-06
587T OTHER Perq Impltj/rplcmt Isdns Ptn 19 10 — — $9,844.35 $9,844.35 $9,844.35 2026-03-06
27416 CPT Osteochondral Knee Autograft 19 10 — — $8,946.43 $10,715.60 $9,831.01 2026-03-06
22513 CPT Perq Vertebral Augmentation 19 10 — — $8,821.63 $10,715.60 $9,768.61 2026-03-06
269T OTHER Rev/remvl Crtd Sns Dev Total 19 10 — — $9,606.11 $9,606.11 $9,606.11 2026-03-06
C2621 HCPCS Pmkr, Other Than Sing/dual 19 10 — — $9,388.40 $9,678.76 $9,533.58 2026-03-06
29828 CPT Sho Arthrs Srg Bicp Tenodsis 19 10 — — $8,347.19 $10,715.60 $9,531.40 2026-03-06
600T OTHER Ire Abltj 1+tum Organ Perq 19 10 — — $3,256.28 $15,616.83 $9,436.56 2026-03-06
C8002 HCPCS Preparation Of Skin Cell Suspension Autograft, Automated, Including All Enzymati… 19 10 — — $9,375.75 $9,375.75 $9,375.75 2026-03-06
886T OTHER Sigmoidoscopy, Flexible, With Initial Transendoscopic Mechanical Dilation (eg, N… 19 10 — — $8,929.22 $8,929.22 $8,929.22 2026-03-06
21267 CPT Revise Eye Sockets 19 10 — — $8,873.49 $8,873.49 $8,873.49 2026-03-06
21275 CPT Revision Orbitofacial Bones 19 10 — — $8,873.49 $8,873.49 $8,873.49 2026-03-06
21261 CPT Revise Eye Sockets 19 10 — — $8,873.49 $8,873.49 $8,873.49 2026-03-06
D7485 HCPCS Surg Reduct Osseoustuberosit 19 10 — — $8,873.49 $8,873.49 $8,873.49 2026-03-06
D7770 HCPCS Open Reduc Compd Alveolus Fx 19 10 — — $8,873.49 $8,873.49 $8,873.49 2026-03-06
D7950 HCPCS Mandible Graft 19 10 — — $8,873.49 $8,873.49 $8,873.49 2026-03-06
21263 CPT Revise Eye Sockets 19 10 — — $8,873.49 $8,873.49 $8,873.49 2026-03-06
21260 CPT Revise Eye Sockets 19 10 — — $8,873.49 $8,873.49 $8,873.49 2026-03-06
D7350 HCPCS Vestibuloplasty Exten Graft 19 10 — — $8,873.49 $8,873.49 $8,873.49 2026-03-06
D4260 HCPCS Osseous Surgery 4 Or More 19 10 — — $8,873.49 $8,873.49 $8,873.49 2026-03-06
D7340 HCPCS Vestibuloplasty Ridge Extens 19 10 — — $8,873.49 $8,873.49 $8,873.49 2026-03-06
315U OTHER Onc Cutan Sq Cll Ca Mrna 40 19 10 — — $8,245.00 $9,350.00 $8,797.50 2026-03-06
43659 CPT Unlisted Laps Px Stomach 19 10 — — $8,751.54 $8,751.54 $8,751.54 2026-03-06
60659 CPT Unlisted Laps Px Endoc Sys 19 10 — — $8,751.54 $8,751.54 $8,751.54 2026-03-06
58578 CPT Unlisted Laps Px Uterus 19 10 — — $8,751.54 $8,751.54 $8,751.54 2026-03-06
59898 CPT Unlstd Laps Px Mat Care&dlvr 19 10 — — $8,751.54 $8,751.54 $8,751.54 2026-03-06
55559 CPT Unlstd Laps Px Sprmatic Cord 19 10 — — $8,751.54 $8,751.54 $8,751.54 2026-03-06
47379 CPT Unlisted Laps Px Liver 19 10 — — $8,751.54 $8,751.54 $8,751.54 2026-03-06
54699 CPT Unlisted Laps Px Testis 19 10 — — $8,751.54 $8,751.54 $8,751.54 2026-03-06
50949 CPT Unlisted Laps Px Ureter 19 10 — — $8,751.54 $8,751.54 $8,751.54 2026-03-06
60699 CPT Unlisted Px Endocrine System 19 10 — — $8,751.54 $8,751.54 $8,751.54 2026-03-06
38129 CPT Unlisted Laps Px Spleen 19 10 — — $8,751.54 $8,751.54 $8,751.54 2026-03-06
50549 CPT Unlisted Laps Px Renal 19 10 — — $8,751.54 $8,751.54 $8,751.54 2026-03-06
49329 CPT Unlstd Laps Px Abd Pertm&omn 19 10 — — $8,751.54 $8,751.54 $8,751.54 2026-03-06
51999 CPT Unlisted Laps Px Bladder 19 10 — — $8,751.54 $8,751.54 $8,751.54 2026-03-06
211U OTHER Onc Pan-tum Dna&rna Gnrj Seq 19 10 — — $8,201.35 $9,300.50 $8,750.92 2026-03-06
48160 CPT Pancreas Removal/transplant 19 10 — — $8,649.57 $8,826.09 $8,737.83 2026-03-06
913T OTHER Percutaneous Transcatheter Therapeutic Drug Delivery By Intracoronary Drug-deliv… 19 10 — — $8,552.28 $8,552.28 $8,552.28 2026-03-06
339T OTHER Trnscth Renal Symp Denrv Bil 19 10 — — $8,552.28 $8,552.28 $8,552.28 2026-03-06
338T OTHER Trnscth Renal Symp Denrv Unl 19 10 — — $8,552.28 $8,552.28 $8,552.28 2026-03-06
644T OTHER Tcat Rmvl/dblk Icar Mas Perq 19 10 — — $8,552.28 $8,552.28 $8,552.28 2026-03-06
C1874 HCPCS Stent, Coated/cov W/del Sys 19 10 — — $1,878.39 $15,199.09 $8,538.74 2026-03-06
27745 CPT Reinforce Tibia 19 10 — — $6,277.59 $10,715.60 $8,496.59 2026-03-06
601T OTHER Ire Abltj 1+tumors Open 19 10 — — $1,312.57 $15,616.83 $8,464.70 2026-03-06
63650 CPT Implant Neuroelectrodes 19 10 — — $6,916.58 $9,844.35 $8,380.47 2026-03-06
64561 CPT Implant Neuroelectrodes 19 10 — — $6,664.44 $9,844.35 $8,254.40 2026-03-06
C7533 HCPCS Ptca With Plcmt Brachytx Dev 19 10 — — $8,197.67 $8,197.67 $8,197.67 2026-03-06
C1877 HCPCS Stent, Non-coat/cov Without Del 19 10 — — $8,197.67 $8,197.67 $8,197.67 2026-03-06
744T OTHER Insj Bioprostc Vlv Fem Vn 19 10 — — $8,108.55 $8,108.55 $8,108.55 2026-03-06
C1876 HCPCS Stent, Non-coa/non-cov W/del 19 10 — — $1,569.44 $14,634.90 $8,102.17 2026-03-06
47579 CPT Unlisted Laps Px Biliary Trc 19 10 — — $7,215.59 $8,751.54 $7,983.56 2026-03-06
C1786 HCPCS Pmkr, Single, Rate-resp 19 10 — — $7,706.85 $7,945.21 $7,826.03 2026-03-06
449T OTHER Insj Aqueous Drain Dev 1st 19 10 — — $7,739.57 $7,739.57 $7,739.57 2026-03-06
65781 CPT Ocular Reconst Transplant 19 10 — — $7,739.57 $7,739.57 $7,739.57 2026-03-06
671T OTHER Insj Ant Sgm Aq DRG Dev 1+ 19 10 — — $7,739.57 $7,739.57 $7,739.57 2026-03-06
54660 CPT Revision Of Testis 19 10 — — $7,625.43 $7,625.43 $7,625.43 2026-03-06
53431 CPT Reconstruct Urethra/bladder 19 10 — — $7,625.43 $7,625.43 $7,625.43 2026-03-06
54352 CPT Revj Prior Hypspad Repair 19 10 — — $7,625.43 $7,625.43 $7,625.43 2026-03-06
714T OTHER Tprnl Lsr Ablt B9 Prst8 Hypr 19 10 — — $7,625.43 $7,625.43 $7,625.43 2026-03-06
54408 CPT Repair Multi-comp Penis Pros 19 10 — — $7,625.43 $7,625.43 $7,625.43 2026-03-06
867T OTHER Transperineal Laser Ablation Of Benign Prostatic Hyperplasia, Including Imaging … 19 10 — — $7,625.43 $7,625.43 $7,625.43 2026-03-06
655T OTHER Tprnl Focal Abltj Mal Prst8 19 10 — — $7,625.43 $7,625.43 $7,625.43 2026-03-06
23490 CPT Reinforce Clavicle 19 10 — — $4,453.21 $10,715.60 $7,584.40 2026-03-06
26555 CPT Positional Change Of Finger 19 10 — — $4,453.21 $10,715.60 $7,584.40 2026-03-06
23397 CPT Muscle Transfers 19 10 — — $4,453.21 $10,715.60 $7,584.40 2026-03-06
57335 CPT Repair Vagina 19 10 — — $7,404.68 $7,404.68 $7,404.68 2026-03-06
55970 CPT Sex Transformation M To F 19 10 — — $7,404.68 $7,404.68 $7,404.68 2026-03-06
Q0224 HCPCS Injection, Pemivibart, For The Pre-exposure Prophylaxis Only, For Certain Adults… 19 10 — — $7,021.83 $7,962.90 $7,239.00 2026-03-06
24935 CPT Revision Of Amputation 19 10 — — $3,738.26 $10,715.60 $7,226.93 2026-03-06
265T OTHER IM B1 Mrw Cel Ther Hrvst Onl 19 10 — — $7,027.76 $7,027.76 $7,027.76 2026-03-06
342T OTHER Thxp Apheresis W/hdl Delip 19 10 — — $7,027.76 $7,027.76 $7,027.76 2026-03-06
263T OTHER IM B1 Mrw Cel Ther Cmpl 19 10 — — $7,027.76 $7,027.76 $7,027.76 2026-03-06
264T OTHER IM B1 Mrw Cel Ther Xcl Hrvst 19 10 — — $7,027.76 $7,027.76 $7,027.76 2026-03-06
267U OTHER Rare Do Id Opt Gen Mapg&seq 19 10 — — $6,537.15 $7,413.26 $6,975.20 2026-03-06
44979 CPT Unlisted Laps Px Appendix 19 10 — — $4,871.94 $8,751.54 $6,811.74 2026-03-06
51992 CPT Laparo Sling Operation 19 10 — — $4,810.16 $8,751.54 $6,780.85 2026-03-06
J3101 HCPCS 50242-0120-01 - Tenecteplase 50. Mg Powder-inj [mrks] 12 9 $9,098.33 $7,733.58 $6,785.37 $9,098.33 $7,928.09 2026-05-08
J3399 HCPCS Inj Onase Abepar-xioi Treat 4 4 — — $107,435.26 $3,582,921.35 $1,506,656.73 2026-03-06
A9604 HCPCS Sm 153 Lexidronam 4 4 — — $225.89 $17,260.00 $11,607.28 2026-03-06
J3110 HCPCS Teriparatide Injection 3 3 — — $84.26 $14,537.00 $14,100.89 2026-03-06
A9508 HCPCS I131 Iodobenguate, Dx 3 3 — — $225.89 $10,338.00 $10,027.86 2026-03-06
63685 CPT Ins/rplc Spi Npg/rcvr Pocket 2 2 — — $1,035.17 $45,710.39 $23,372.78 2026-03-06
62361 CPT Implant Spine Infusion Pump 2 2 — — $1,215.33 $26,511.18 $13,863.25 2026-03-06
62360 CPT Insert Spine Infusion Device 2 2 — — $1,215.33 $26,511.18 $13,863.25 2026-03-06
25491 CPT Reinforce Ulna 2 2 — — $955.51 $19,300.23 $10,127.87 2026-03-06
64553 CPT Implant Neuroelectrodes 2 2 — — $849.46 $18,705.47 $9,777.47 2026-03-06
63664 CPT Revise Spine Eltrd Plate 2 2 — — $779.47 $18,705.47 $9,742.47 2026-03-06
784T OTHER Ins/rplmt Eltrd Ra Spi Nstim 2 2 — — $779.47 $18,705.47 $9,742.47 2026-03-06
J1411 HCPCS Inj, Hemgenix, Per Tx Dose 1 1 — — $4,375,000.00 $4,375,000.00 $4,375,000.00 2026-03-06
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