|
01808086_1
|
CDM
|
Collagen 10x15 Mesh
|
8
|
8
|
$9,700.20
|
$9,700.20
|
$2,425.05
|
$8,730.18
|
$7,954.16
|
2026-05-04
|
|
01808567_1
|
CDM
|
Arthrodesis Toe
|
8
|
8
|
$7,814.15
|
$7,814.15
|
$1,953.54
|
$7,032.74
|
$6,407.60
|
2026-05-04
|
|
01808598_1
|
CDM
|
Wright Special Heel
|
8
|
8
|
$7,807.80
|
$7,807.80
|
$1,951.95
|
$7,027.02
|
$6,402.40
|
2026-05-04
|
|
01808647_1
|
CDM
|
Synthes Distal Radius
|
8
|
8
|
$8,259.90
|
$8,259.90
|
$2,064.98
|
$7,433.91
|
$6,773.12
|
2026-05-04
|
|
01808662_1
|
CDM
|
Distal Femoral
|
8
|
8
|
$7,964.50
|
$7,964.50
|
$1,991.13
|
$7,168.05
|
$6,530.89
|
2026-05-04
|
|
01808804_1
|
CDM
|
Synthes External Fixator Kit Large
|
8
|
8
|
$20,840.25
|
$20,840.25
|
$5,210.06
|
$18,756.23
|
$17,089.01
|
2026-05-04
|
|
01808805_1
|
CDM
|
Large External Fixator Trauma Kit
|
8
|
8
|
$13,520.80
|
$13,520.80
|
$3,380.20
|
$12,168.72
|
$11,087.06
|
2026-05-04
|
|
01809391_1
|
CDM
|
Esophy Endo Gastric
|
8
|
8
|
$10,418.85
|
$10,418.85
|
$2,604.71
|
$9,376.97
|
$8,543.45
|
2026-05-04
|
|
01809394_1
|
CDM
|
Lap Band With Access Port Lg
|
8
|
8
|
$9,569.65
|
$9,569.65
|
$2,392.41
|
$8,612.69
|
$7,847.11
|
2026-05-04
|
|
01809395_1
|
CDM
|
Lap Band With Access Port Std
|
8
|
8
|
$9,569.65
|
$9,569.65
|
$2,392.41
|
$8,612.69
|
$7,847.11
|
2026-05-04
|
|
01809414_1
|
CDM
|
Linx System 14 Bead
|
8
|
8
|
$13,942.50
|
$13,942.50
|
$3,485.63
|
$12,548.25
|
$11,432.85
|
2026-05-04
|
|
03108598_1
|
CDM
|
Special Acl Graft
|
8
|
8
|
$8,112.00
|
$8,112.00
|
$2,028.00
|
$7,300.80
|
$6,651.84
|
2026-05-04
|
|
03717108_1
|
CDM
|
Dynabunion Plate Standard Left
|
8
|
8
|
$8,016.95
|
$8,016.95
|
$2,004.24
|
$7,215.26
|
$6,573.90
|
2026-05-04
|
|
04603037_1
|
CDM
|
Nf-humira Subcutaneous Kit
|
8
|
8
|
$7,994.22
|
$7,994.22
|
$1,998.56
|
$7,194.80
|
$6,555.26
|
2026-05-04
|
|
04604802_1
|
CDM
|
***nf-humira Subcut Solution 40mg/0.4
|
8
|
8
|
$10,002.54
|
$10,002.54
|
$2,500.64
|
$9,002.29
|
$8,202.08
|
2026-05-04
|
|
15734
|
HCPCS
|
Creation Of Muscle Graft To Trunk
|
12
|
12
|
$11,869.95
|
$11,869.95
|
$1,796.74
|
$12,226.05
|
$6,825.22
|
2026-05-04
|
|
15830
|
HCPCS
|
Removal Of Extra Skin And Tissue Of Abdomen
|
21
|
12
|
$19,564.38
|
$19,564.38
|
$241.69
|
$20,151.31
|
$6,783.99
|
2026-05-04
|
|
15832
|
HCPCS
|
Removal Of Extra Skin And Tissue Of Thigh
|
12
|
12
|
$8,586.15
|
$8,586.15
|
$1,100.53
|
$8,843.73
|
$7,255.30
|
2026-05-04
|
|
15876
|
HCPCS
|
Suction Assisted Removal Of Fat Of Head And Neck
|
11
|
11
|
$10,982.91
|
$10,982.91
|
$3,620.48
|
$11,312.40
|
$9,335.47
|
2026-05-04
|
|
15877
|
HCPCS
|
Suction Assisted Removal Of Fat Of Body
|
11
|
11
|
$10,982.91
|
$10,982.91
|
$3,620.48
|
$11,312.40
|
$9,335.47
|
2026-05-04
|
|
15879
|
HCPCS
|
Suction Assisted Removal Of Fat Of Leg
|
11
|
11
|
$10,982.91
|
$10,982.91
|
$3,620.48
|
$11,312.40
|
$9,335.47
|
2026-05-04
|
|
18043282_1
|
CDM
|
Operating Room Services - General Classification
|
8
|
8
|
$14,243.20
|
$14,243.20
|
$3,560.80
|
$12,818.88
|
$11,679.42
|
2026-05-04
|
|
18044238_1
|
CDM
|
Operating Room Services - General Classification
|
8
|
8
|
$7,195.20
|
$7,195.20
|
$1,798.80
|
$6,475.68
|
$5,900.07
|
2026-05-04
|
|
19302
|
HCPCS
|
Partial Removal Of Breast And Underarm Lymph Nodes
|
21
|
12
|
$21,561.48
|
$21,561.48
|
$649.69
|
$22,208.32
|
$6,783.99
|
2026-05-04
|
|
19303
|
HCPCS
|
Simple Complete Removal Of Breast
|
21
|
12
|
$21,728.13
|
$21,728.13
|
$683.66
|
$22,379.97
|
$6,783.99
|
2026-05-04
|
|
19307
|
HCPCS
|
Removal Of Breast And Underarm Lymph Nodes
|
21
|
12
|
$24,955.08
|
$24,955.08
|
$848.89
|
$25,703.73
|
$6,783.99
|
2026-05-04
|
|
19380
|
HCPCS
|
Surgical Change To Reconstructed Breast
|
12
|
12
|
$19,564.38
|
$19,564.38
|
$970.37
|
$20,151.31
|
$11,217.74
|
2026-05-04
|
|
20692
|
HCPCS
|
Placement Of Multiple Direction External Bone Stabilizing Device To Arm Or Leg
|
21
|
12
|
$38,600.46
|
$38,600.46
|
$667.48
|
$39,758.47
|
$13,116.80
|
2026-05-04
|
|
20693
|
HCPCS
|
Revision Of External Bone Stabilizing Device Under Anesthesia
|
21
|
12
|
$21,431.19
|
$21,431.19
|
$350.00
|
$22,074.13
|
$7,413.38
|
2026-05-04
|
|
21600
|
HCPCS
|
Partial Removal Of Rib
|
21
|
12
|
$21,431.19
|
$21,431.19
|
$446.73
|
$22,074.13
|
$7,413.38
|
2026-05-04
|
|
22513
|
HCPCS
|
Treatment Of Broken Middle Spine Bone With Placement Of Stabilizing Device Using…
|
12
|
12
|
$25,204.65
|
$25,204.65
|
$1,157.02
|
$25,960.79
|
$9,141.74
|
2026-05-04
|
|
22514
|
HCPCS
|
Treatment Of Broken Lower Spine Bone With Placement Of Stabilizing Device
|
12
|
12
|
$25,204.65
|
$25,204.65
|
$1,077.96
|
$25,960.79
|
$9,141.74
|
2026-05-04
|
|
23130
|
HCPCS
|
Partial Removal Or Repair Of Shoulder Bone Near Collar Bone
|
12
|
12
|
$9,733.83
|
$9,733.83
|
$747.41
|
$10,025.84
|
$5,564.97
|
2026-05-04
|
|
23184
|
HCPCS
|
Partial Removal Of Infected Top Of Upper Arm Bone
|
12
|
12
|
$21,431.19
|
$21,431.19
|
$891.32
|
$22,074.13
|
$12,279.17
|
2026-05-04
|
|
23405
|
HCPCS
|
Incision Of Shoulder Tendon
|
12
|
12
|
$21,431.19
|
$21,431.19
|
$749.54
|
$22,074.13
|
$13,260.55
|
2026-05-04
|
|
23410
|
HCPCS
|
Repair Of Acute Torn Shoulder Rotator Cuff
|
21
|
12
|
$21,431.19
|
$21,431.19
|
$450.00
|
$22,074.13
|
$6,685.61
|
2026-05-04
|
|
23412
|
HCPCS
|
Repair Of Chronic Torn Shoulder Rotator Cuff
|
21
|
12
|
$21,431.19
|
$21,431.19
|
$715.94
|
$22,074.13
|
$7,413.38
|
2026-05-04
|
|
23415
|
HCPCS
|
Release Of Collar Bone And Shoulder Ligament
|
12
|
12
|
$26,482.20
|
$26,482.20
|
$842.04
|
$27,276.67
|
$15,227.26
|
2026-05-04
|
|
23420
|
HCPCS
|
Repair Of Complete Tear Of Shoulder Rotator Cuff With Release Of Pressure On Col…
|
12
|
12
|
$21,431.19
|
$21,431.19
|
$1,170.99
|
$22,074.13
|
$12,279.17
|
2026-05-04
|
|
23430
|
HCPCS
|
Anchoring Of Biceps Tendon
|
21
|
12
|
$23,944.41
|
$23,944.41
|
$630.95
|
$24,662.74
|
$7,413.38
|
2026-05-04
|
|
23450
|
HCPCS
|
Reattachment Of Shoulder Joint Capsule Without Bone Transfer
|
12
|
12
|
$21,431.19
|
$21,431.19
|
$1,137.46
|
$22,074.13
|
$13,260.55
|
2026-05-04
|
|
23455
|
HCPCS
|
Reattachment Of Shoulder Joint Capsule And Cartilage Without Bone Transfer With …
|
21
|
12
|
$21,431.19
|
$21,431.19
|
$514.00
|
$22,074.13
|
$7,413.38
|
2026-05-04
|
|
23470
|
HCPCS
|
Partial Replacement Of Shoulder Joint
|
12
|
12
|
$47,288.82
|
$47,288.82
|
$1,440.38
|
$48,707.48
|
$27,359.38
|
2026-05-04
|
|
23472
|
HCPCS
|
Prosthetic Repair Of Shoulder Joint, Total Shoulder
|
21
|
12
|
$55,170.15
|
$55,170.15
|
$1,175.60
|
$56,825.25
|
$17,913.60
|
2026-05-04
|
|
23485
|
HCPCS
|
Incision Or Partial Removal Of Collar Bone With Bone Graft
|
12
|
12
|
$38,600.46
|
$38,600.46
|
$1,143.57
|
$39,758.47
|
$23,884.04
|
2026-05-04
|
|
23515
|
HCPCS
|
Treatment Of Broken Collar Bone
|
21
|
12
|
$21,431.19
|
$21,431.19
|
$225.00
|
$22,074.13
|
$7,413.38
|
2026-05-04
|
|
23552
|
HCPCS
|
Treatment Of Dislocated Joint Between Collar Bone And Shoulder With Tissue Graft
|
12
|
12
|
$21,431.19
|
$21,431.19
|
$790.37
|
$22,074.13
|
$12,279.17
|
2026-05-04
|
|
23615
|
HCPCS
|
Treatment Of Broken Top Of Upper Arm Bone
|
21
|
12
|
$47,288.82
|
$47,288.82
|
$646.20
|
$48,707.48
|
$13,116.80
|
2026-05-04
|
|
23616
|
HCPCS
|
Treatment Of Broken Upper Arm Bone With Replacement
|
12
|
12
|
$55,170.15
|
$55,170.15
|
$1,481.82
|
$56,825.25
|
$31,024.86
|
2026-05-04
|
|
23630
|
HCPCS
|
Treatment Of Upper Arm Bone, Broken At Shoulder Joint
|
12
|
12
|
$21,431.19
|
$21,431.19
|
$938.39
|
$22,074.13
|
$12,279.17
|
2026-05-04
|
|
23660
|
HCPCS
|
Treatment Of Dislocated Shoulder
|
12
|
12
|
$21,431.19
|
$21,431.19
|
$706.08
|
$22,074.13
|
$12,279.17
|
2026-05-04
|
|
23670
|
HCPCS
|
Treatment Of Dislocated Shoulder And Upper Arm Bone, Broken At Shoulder Joint
|
12
|
12
|
$21,431.19
|
$21,431.19
|
$1,047.20
|
$22,074.13
|
$12,279.17
|
2026-05-04
|
|
24301
|
HCPCS
|
Relocation Of Muscle Or Tendon Of Upper Arm Or Elbow
|
12
|
12
|
$21,431.19
|
$21,431.19
|
$904.44
|
$22,074.13
|
$12,279.17
|
2026-05-04
|
|
24343
|
HCPCS
|
Repair Of Ligament Of Thumb Side Of Elbow
|
12
|
12
|
$13,362.30
|
$13,362.30
|
$862.37
|
$13,763.17
|
$7,683.33
|
2026-05-04
|
|
24346
|
HCPCS
|
Repair Of Ligament Of Small Finger Side Of Elbow With Tendon Graft
|
12
|
12
|
$38,600.46
|
$38,600.46
|
$1,326.16
|
$39,758.47
|
$23,884.04
|
2026-05-04
|
|
24366
|
HCPCS
|
Joint Repair (arthroplasty) Forearm Bone On The Thumb Side (radius) At The Elbow…
|
12
|
12
|
$38,600.46
|
$38,600.46
|
$823.13
|
$39,758.47
|
$21,998.58
|
2026-05-04
|
|
24435
|
HCPCS
|
Repair Of Nonhealed Broken Upper Arm Bone With Self Bone Graft
|
12
|
12
|
$38,600.46
|
$38,600.46
|
$1,297.93
|
$39,758.47
|
$21,998.58
|
2026-05-04
|
|
24498
|
HCPCS
|
Stabilization Of Upper Arm Bone With Device
|
12
|
12
|
$38,600.46
|
$38,600.46
|
$1,042.77
|
$39,758.47
|
$21,998.58
|
2026-05-04
|
|
24515
|
HCPCS
|
Treatment Of Broken Middle Part Of Upper Arm Bone With Placement Of Stabilizing …
|
21
|
12
|
$47,288.82
|
$47,288.82
|
$743.25
|
$48,707.48
|
$13,116.80
|
2026-05-04
|
|
24516
|
HCPCS
|
Treatment Of Broken Middle Part Of Upper Arm Bone With Placement Of Stabilizing …
|
21
|
12
|
$38,600.46
|
$38,600.46
|
$720.32
|
$39,758.47
|
$13,116.80
|
2026-05-04
|
|
24545
|
HCPCS
|
Treatment Of Upper Arm Bone Broken At Elbow
|
12
|
12
|
$38,600.46
|
$38,600.46
|
$1,116.36
|
$39,758.47
|
$21,998.58
|
2026-05-04
|
|
24575
|
HCPCS
|
Treatment Of Broken Outer Part Of Upper Arm Bone At Elbow
|
21
|
12
|
$38,600.46
|
$38,600.46
|
$450.00
|
$39,758.47
|
$13,116.80
|
2026-05-04
|
|
24579
|
HCPCS
|
Treatment Of Broken Elbow
|
21
|
12
|
$38,600.46
|
$38,600.46
|
$705.96
|
$39,758.47
|
$13,116.80
|
2026-05-04
|
|
24582
|
HCPCS
|
Placement Of Stabilizing Device For Broken Elbow With Manipulation
|
12
|
12
|
$21,431.19
|
$21,431.19
|
$983.56
|
$22,074.13
|
$12,279.17
|
2026-05-04
|
|
24635
|
HCPCS
|
Treatment Of Broken And Dislocated Forearm Bones At Elbow
|
12
|
12
|
$21,431.19
|
$21,431.19
|
$814.57
|
$22,074.13
|
$12,279.17
|
2026-05-04
|
|
24665
|
HCPCS
|
Treatment Of Broken Forearm Bone On Thumb Side At Elbow
|
21
|
12
|
$23,944.41
|
$23,944.41
|
$556.83
|
$24,662.74
|
$7,413.38
|
2026-05-04
|
|
25400
|
HCPCS
|
Repair Non-healed Fracture Of Forearm Bone
|
12
|
12
|
$21,431.19
|
$21,431.19
|
$968.02
|
$22,074.13
|
$12,279.17
|
2026-05-04
|
|
25420
|
HCPCS
|
Treatment Of Both Nonhealed Broken Forearm Bones With Self Bone Graft
|
12
|
12
|
$21,431.19
|
$21,431.19
|
$1,400.27
|
$22,074.13
|
$12,279.17
|
2026-05-04
|
|
25447
|
HCPCS
|
Replacement Of Joint Between Wrist And Fingers Using Tissue
|
12
|
12
|
$10,441.38
|
$10,441.38
|
$1,002.82
|
$10,754.62
|
$6,305.83
|
2026-05-04
|
|
25525
|
HCPCS
|
Treatment Of Broken Midpart Of Forearm Bone On Thumb Side And Closed Treatment O…
|
12
|
12
|
$17,859.33
|
$17,859.33
|
$950.44
|
$18,395.11
|
$10,850.42
|
2026-05-04
|
|
25526
|
HCPCS
|
Treatment Of Broken Midpart Of Forearm Bone On Thumb Side And Dislocated Wrist J…
|
12
|
12
|
$21,431.19
|
$21,431.19
|
$1,150.15
|
$22,074.13
|
$12,279.17
|
2026-05-04
|
|
25545
|
HCPCS
|
Treatment Of Broken Midpart Of Forearm Bone On Small Finger Side
|
21
|
12
|
$23,944.41
|
$23,944.41
|
$300.00
|
$24,662.74
|
$7,413.38
|
2026-05-04
|
|
25574
|
HCPCS
|
Treatment Of Broken Midpart Of Both Forearm Bones With Placement Of Stabilizing …
|
12
|
12
|
$21,431.19
|
$21,431.19
|
$814.16
|
$22,074.13
|
$13,260.55
|
2026-05-04
|
|
25575
|
HCPCS
|
Treatment Of Broken Midpart Of Both Forearm Bones With Placement Of Stabilizing …
|
21
|
12
|
$21,431.19
|
$21,431.19
|
$710.65
|
$22,074.13
|
$7,413.38
|
2026-05-04
|
|
25607
|
HCPCS
|
Treatment Of Broken Forearm Bone On Thumb Side Of Wrist, Above Wrist, With Place…
|
12
|
12
|
$21,431.19
|
$21,431.19
|
$891.32
|
$22,074.13
|
$13,260.55
|
2026-05-04
|
|
25608
|
HCPCS
|
Treatment Of 2 Broken Lower Forearm Bone Pieces On Thumb Side Inside Wrist Joint…
|
21
|
12
|
$21,431.19
|
$21,431.19
|
$606.27
|
$22,074.13
|
$7,413.38
|
2026-05-04
|
|
25609
|
HCPCS
|
Treatment Of 3 Or More Broken Lower Forearm Bone Pieces On Thumb Side Inside Wri…
|
21
|
12
|
$21,431.19
|
$21,431.19
|
$773.39
|
$22,074.13
|
$7,413.38
|
2026-05-04
|
|
25652
|
HCPCS
|
Treatment Of Broken Base Of Forearm Bone On Small Finger Side At Wrist
|
12
|
12
|
$21,431.19
|
$21,431.19
|
$753.24
|
$22,074.13
|
$12,279.17
|
2026-05-04
|
|
26123
|
HCPCS
|
Removal Of Connective Tissue Of Palm And Release Of Finger, First Digit
|
12
|
12
|
$9,733.83
|
$9,733.83
|
$1,010.05
|
$10,025.84
|
$6,022.81
|
2026-05-04
|
|
26525
|
HCPCS
|
Repair Of Joint Capsule Of Finger
|
12
|
12
|
$12,065.46
|
$12,065.46
|
$845.41
|
$12,427.42
|
$6,937.64
|
2026-05-04
|
|
26530
|
HCPCS
|
Repair Of Joint Connecting Hand And Finger Bones With Implant
|
12
|
12
|
$21,431.19
|
$21,431.19
|
$655.11
|
$22,074.13
|
$12,279.17
|
2026-05-04
|
|
26535
|
HCPCS
|
Replacement Of Finger Joint
|
12
|
12
|
$14,568.24
|
$14,568.24
|
$529.87
|
$15,005.29
|
$8,376.74
|
2026-05-04
|
|
26540
|
HCPCS
|
Repair Of Ligament Of Finger Or Hand And Finger Joint
|
12
|
12
|
$10,441.38
|
$10,441.38
|
$861.08
|
$10,754.62
|
$6,003.79
|
2026-05-04
|
|
26546
|
HCPCS
|
Repair Of Nonhealed Hand Or Finger Bone
|
12
|
12
|
$21,431.19
|
$21,431.19
|
$1,265.13
|
$22,074.13
|
$12,279.17
|
2026-05-04
|
|
26841
|
HCPCS
|
Fusion Of Thumb At Wrist
|
12
|
12
|
$21,431.19
|
$21,431.19
|
$949.14
|
$22,074.13
|
$12,279.17
|
2026-05-04
|
|
26860
|
HCPCS
|
Fusion Of Finger Joint, Initial Joint
|
12
|
12
|
$9,733.83
|
$9,733.83
|
$753.64
|
$10,025.84
|
$5,564.97
|
2026-05-04
|
|
27130
|
HCPCS
|
Replacement Of Thigh Bone And Hip Joint With Prosthesis
|
21
|
12
|
$47,288.82
|
$47,288.82
|
$1,047.30
|
$48,707.48
|
$13,116.80
|
2026-05-04
|
|
27235
|
HCPCS
|
Placement Of Stabilizing Device For Upper End Of Broken Thigh Bone
|
21
|
12
|
$21,431.19
|
$21,431.19
|
$350.00
|
$22,074.13
|
$7,413.38
|
2026-05-04
|
|
27350
|
HCPCS
|
Removal Of Kneecap
|
12
|
12
|
$21,431.19
|
$21,431.19
|
$789.92
|
$22,074.13
|
$12,279.17
|
2026-05-04
|
|
27380
|
HCPCS
|
Primary Suture Of Tendon Below Knee
|
21
|
12
|
$21,431.19
|
$21,431.19
|
$510.73
|
$22,074.13
|
$7,413.38
|
2026-05-04
|
|
27385
|
HCPCS
|
Primary Suture Of Ruptured Muscle Of Thigh
|
12
|
12
|
$21,431.19
|
$21,431.19
|
$737.25
|
$22,074.13
|
$13,260.55
|
2026-05-04
|
|
27393
|
HCPCS
|
Lengthening Of Hamstring Tendon
|
12
|
12
|
$21,431.19
|
$21,431.19
|
$607.39
|
$22,074.13
|
$12,279.17
|
2026-05-04
|
|
27394
|
HCPCS
|
Lengthening Of Multiple Hamstring Tendons In Leg
|
12
|
12
|
$21,431.19
|
$21,431.19
|
$789.86
|
$22,074.13
|
$12,279.17
|
2026-05-04
|
|
27415
|
HCPCS
|
Implantation Of Donor Cartilage Cells Into Knee Joint
|
12
|
12
|
$38,600.46
|
$38,600.46
|
$1,644.33
|
$39,758.47
|
$23,884.04
|
2026-05-04
|
|
27420
|
HCPCS
|
Repair Of Dislocating Kneecap
|
12
|
12
|
$34,751.07
|
$34,751.07
|
$895.65
|
$35,793.60
|
$19,981.87
|
2026-05-04
|
|
27425
|
HCPCS
|
Release Of Ligaments Of Knee Joint
|
12
|
12
|
$11,332.20
|
$11,332.20
|
$548.42
|
$11,672.17
|
$6,516.01
|
2026-05-04
|
|
27427
|
HCPCS
|
Reconstruction Of Ligaments Outside Knee Joint
|
12
|
12
|
$46,940.76
|
$46,940.76
|
$857.69
|
$48,348.98
|
$26,990.94
|
2026-05-04
|
|
27428
|
HCPCS
|
Reconstruction Ligaments Inside Knee Joint
|
12
|
12
|
$38,600.46
|
$38,600.46
|
$1,341.05
|
$39,758.47
|
$23,884.04
|
2026-05-04
|
|
27430
|
HCPCS
|
Repair Of Muscle Group Above Knee Joint
|
12
|
12
|
$21,431.19
|
$21,431.19
|
$894.84
|
$22,074.13
|
$12,279.17
|
2026-05-04
|
|
27438
|
HCPCS
|
Repair Of Kneecap With Prosthesis
|
12
|
12
|
$38,600.46
|
$38,600.46
|
$1,011.42
|
$39,758.47
|
$21,998.58
|
2026-05-04
|
|
27446
|
HCPCS
|
Replacement Of Knee Joint On Side Of Knee
|
12
|
12
|
$47,288.82
|
$47,288.82
|
$1,382.88
|
$48,707.48
|
$27,359.38
|
2026-05-04
|
|
27447
|
HCPCS
|
Replacement Of Knee Joint, Both Sides Of Knee
|
21
|
12
|
$47,288.82
|
$47,288.82
|
$1,045.81
|
$48,707.48
|
$13,116.80
|
2026-05-04
|
|
27509
|
HCPCS
|
Treatment Of Broken Thigh Bone At Far End With Placement Of Stabilizing Device
|
12
|
12
|
$21,431.19
|
$21,431.19
|
$820.75
|
$22,074.13
|
$12,279.17
|
2026-05-04
|
|
27566
|
HCPCS
|
Treatment Of Dislocated Kneecap
|
12
|
12
|
$21,431.19
|
$21,431.19
|
$1,073.29
|
$22,074.13
|
$12,279.17
|
2026-05-04
|
|
27652
|
HCPCS
|
Repair Of Ruptured Achilles Tendon With Graft
|
12
|
12
|
$21,431.19
|
$21,431.19
|
$807.43
|
$22,074.13
|
$12,279.17
|
2026-05-04
|
|
27654
|
HCPCS
|
Secondary Repair Of Ruptured Achilles Tendon
|
12
|
12
|
$21,431.19
|
$21,431.19
|
$866.53
|
$22,074.13
|
$12,279.17
|
2026-05-04
|
|
27658
|
HCPCS
|
Primary Repair Of Tendon On Back Of Leg
|
12
|
12
|
$11,886.69
|
$11,886.69
|
$448.54
|
$12,243.29
|
$6,834.85
|
2026-05-04
|
|
27665
|
HCPCS
|
Secondary Repair Of Tendon On Front Of Leg
|
12
|
12
|
$21,431.19
|
$21,431.19
|
$511.51
|
$22,074.13
|
$12,279.17
|
2026-05-04
|
|
27687
|
HCPCS
|
Lengthening Of Calf Muscle
|
12
|
12
|
$9,733.83
|
$9,733.83
|
$551.37
|
$10,025.84
|
$5,564.97
|
2026-05-04
|
|
27696
|
HCPCS
|
Primary Repair Of Disruption Of Both Ankle Ligaments
|
16
|
12
|
$21,431.19
|
$21,431.19
|
$669.74
|
$22,074.13
|
$7,413.38
|
2026-05-04
|
|
27712
|
HCPCS
|
Insertion Of Rod In Shin Bone
|
12
|
12
|
$21,431.19
|
$21,431.19
|
$1,321.81
|
$22,074.13
|
$18,109.35
|
2026-05-04
|
|
27720
|
HCPCS
|
Repair Of Nonhealed Broken Shin Bone
|
12
|
12
|
$21,431.19
|
$21,431.19
|
$1,052.80
|
$22,074.13
|
$12,279.17
|
2026-05-04
|
|
27759
|
HCPCS
|
Treatment Of Broken Part Of Shin Bone With Rod
|
21
|
12
|
$38,600.46
|
$38,600.46
|
$828.76
|
$39,758.47
|
$13,116.80
|
2026-05-04
|
|
27766
|
HCPCS
|
Treatment Of Inside Portion Of Broken Shin Bone At Ankle
|
21
|
12
|
$35,614.62
|
$35,614.62
|
$526.61
|
$36,683.06
|
$7,413.38
|
2026-05-04
|
|
27792
|
HCPCS
|
Treatment Of Broken Outer Lower Leg Bone At Ankle
|
21
|
12
|
$23,944.41
|
$23,944.41
|
$350.00
|
$24,662.74
|
$7,413.38
|
2026-05-04
|
|
27814
|
HCPCS
|
Treatment Of Both Broken Lower Leg Bones At Ankle
|
21
|
12
|
$21,431.19
|
$21,431.19
|
$648.11
|
$22,074.13
|
$7,413.38
|
2026-05-04
|
|
27822
|
HCPCS
|
Treatment Of 3 Broken Lower Leg Bones At Ankle
|
21
|
12
|
$26,154.96
|
$26,154.96
|
$750.41
|
$26,939.61
|
$7,413.38
|
2026-05-04
|
|
27823
|
HCPCS
|
Treatment Of 3 Broken Lower Leg Bones At Ankle With Fixation Of Posterior Lip
|
21
|
12
|
$26,157.99
|
$26,157.99
|
$837.38
|
$26,942.73
|
$7,413.38
|
2026-05-04
|
|
27827
|
HCPCS
|
Treatment Of Broken Shin Bone At Lower Weight Bearing Joint
|
21
|
12
|
$38,600.46
|
$38,600.46
|
$953.99
|
$39,758.47
|
$13,116.80
|
2026-05-04
|
|
27828
|
HCPCS
|
Treatment Of Broken Lower Weight Bearing Joint Of Both Lower Leg Bones
|
21
|
12
|
$38,600.46
|
$38,600.46
|
$1,077.80
|
$39,758.47
|
$13,116.80
|
2026-05-04
|
|
27829
|
HCPCS
|
Treatment Of Ligament Tear At Ankle Joint
|
21
|
12
|
$21,431.19
|
$21,431.19
|
$491.76
|
$22,074.13
|
$6,439.78
|
2026-05-04
|
|
27846
|
HCPCS
|
Treatment Of Dislocated Ankle
|
12
|
12
|
$21,431.19
|
$21,431.19
|
$873.45
|
$22,074.13
|
$12,279.17
|
2026-05-04
|
|
28118
|
HCPCS
|
Removal Of Heel Bone
|
12
|
12
|
$19,619.25
|
$19,619.25
|
$731.04
|
$20,207.83
|
$11,281.07
|
2026-05-04
|
|
28126
|
HCPCS
|
Removal Of Toe Bone At Foot
|
12
|
12
|
$9,733.83
|
$9,733.83
|
$472.75
|
$10,025.84
|
$5,564.97
|
2026-05-04
|
|
28160
|
HCPCS
|
Partial Removal Of Toe At Joint
|
12
|
12
|
$9,733.83
|
$9,733.83
|
$500.04
|
$10,025.84
|
$5,564.97
|
2026-05-04
|
|
28238
|
HCPCS
|
Reconstruction Of Ankle Tendon With Removal Of Extra Ankle Joint Bone
|
12
|
12
|
$21,431.19
|
$21,431.19
|
$817.24
|
$22,074.13
|
$12,279.17
|
2026-05-04
|
|
28270
|
HCPCS
|
Incision Of Joint Capsule Of Foot And Toe
|
12
|
12
|
$24,949.02
|
$24,949.02
|
$591.94
|
$25,697.49
|
$14,345.69
|
2026-05-04
|
|
28286
|
HCPCS
|
Correction Of Fifth Toe Joint Deformity
|
12
|
12
|
$9,733.83
|
$9,733.83
|
$539.21
|
$10,025.84
|
$6,022.81
|
2026-05-04
|
|
28289
|
HCPCS
|
Correction Of Rigid Deformity Of First Joint Of Big Toe
|
12
|
12
|
$9,968.70
|
$9,968.70
|
$835.33
|
$10,267.76
|
$5,732.01
|
2026-05-04
|
|
28291
|
HCPCS
|
Correction Of Rigid Deformity Of First Joint Of Big Toe Using Implant
|
12
|
12
|
$21,431.19
|
$21,431.19
|
$863.75
|
$22,074.13
|
$12,279.17
|
2026-05-04
|
|
28297
|
HCPCS
|
Correction Of Bunion With Forefoot And Midfoot Bone Fusion
|
12
|
12
|
$38,600.46
|
$38,600.46
|
$1,261.69
|
$39,758.47
|
$23,884.04
|
2026-05-04
|
|
28298
|
HCPCS
|
Correction Of Bunion With Alignment Correction Of Big Toe
|
21
|
12
|
$21,431.19
|
$21,431.19
|
$446.56
|
$22,074.13
|
$7,413.38
|
2026-05-04
|
|
28299
|
HCPCS
|
Correction Of Bunion With 2 Areas Of Realignment
|
12
|
12
|
$23,944.41
|
$23,944.41
|
$1,226.47
|
$24,662.74
|
$14,265.83
|
2026-05-04
|
|
28300
|
HCPCS
|
Incision Or Partial Removal Of Heel Bone
|
12
|
12
|
$45,553.02
|
$45,553.02
|
$786.78
|
$46,919.61
|
$26,192.99
|
2026-05-04
|
|
28304
|
HCPCS
|
Incision Or Partial Removal Of Foot Bone
|
12
|
12
|
$42,110.94
|
$42,110.94
|
$1,002.09
|
$43,374.27
|
$24,213.79
|
2026-05-04
|
|
28306
|
HCPCS
|
Incision Or Partial Removal Of Big Toe Bone To Straighten Toe
|
12
|
12
|
$21,431.19
|
$21,431.19
|
$733.94
|
$22,074.13
|
$12,279.17
|
2026-05-04
|
|
28309
|
HCPCS
|
Incision Or Partial Removal Of Multiple Foot Bones To Straighten Toes
|
12
|
12
|
$21,431.19
|
$21,431.19
|
$1,080.56
|
$22,074.13
|
$12,279.17
|
2026-05-04
|
|
28415
|
HCPCS
|
Treatment Of Broken Heel Bone
|
12
|
12
|
$47,910.36
|
$47,910.36
|
$1,365.30
|
$49,347.67
|
$27,548.46
|
2026-05-04
|
|
28465
|
HCPCS
|
Treatment Of Broken Hind Portion Of Foot
|
12
|
12
|
$21,431.19
|
$21,431.19
|
$774.83
|
$22,074.13
|
$12,279.17
|
2026-05-04
|
|
28485
|
HCPCS
|
Treatment Of Broken Midportion Of Foot
|
21
|
12
|
$23,944.41
|
$23,944.41
|
$391.95
|
$24,662.74
|
$7,413.38
|
2026-05-04
|
|
28615
|
HCPCS
|
Treatment Of Dislocated Midfoot Bone
|
12
|
12
|
$21,431.19
|
$21,431.19
|
$1,001.38
|
$22,074.13
|
$12,279.17
|
2026-05-04
|
|
28725
|
HCPCS
|
Fusion Of Foot Below Ankle
|
12
|
12
|
$38,600.46
|
$38,600.46
|
$940.01
|
$39,758.47
|
$23,884.04
|
2026-05-04
|
|
28730
|
HCPCS
|
Fusion Of Multiple Foot Joints
|
21
|
12
|
$38,600.46
|
$38,600.46
|
$400.00
|
$39,758.47
|
$13,116.80
|
2026-05-04
|
|
28750
|
HCPCS
|
Fusion Of Big Toe At Joint With Foot
|
21
|
12
|
$25,618.65
|
$25,618.65
|
$495.10
|
$26,387.21
|
$7,413.38
|
2026-05-04
|
|
28755
|
HCPCS
|
Fusion Of Big Toe Between Toe Joints
|
21
|
12
|
$21,431.19
|
$21,431.19
|
$373.56
|
$22,074.13
|
$7,413.38
|
2026-05-04
|
|
29806
|
HCPCS
|
Repair Of Shoulder Joint Capsule Using An Endoscope
|
12
|
12
|
$21,734.19
|
$21,734.19
|
$1,273.45
|
$22,386.22
|
$13,381.74
|
2026-05-04
|
|
29807
|
HCPCS
|
Repair Of Shoulder Socket Using An Endoscope
|
21
|
12
|
$27,994.17
|
$27,994.17
|
$861.22
|
$28,834.00
|
$7,413.38
|
2026-05-04
|
|
29820
|
HCPCS
|
Partial Removal Of Shoulder Joint Lining Using An Endoscope
|
21
|
12
|
$21,431.19
|
$21,431.19
|
$415.65
|
$22,074.13
|
$7,413.38
|
2026-05-04
|
|
29821
|
HCPCS
|
Removal Of Entire Shoulder Joint Lining Using An Endoscope
|
12
|
12
|
$9,733.83
|
$9,733.83
|
$717.34
|
$10,025.84
|
$6,022.81
|
2026-05-04
|
|
29825
|
HCPCS
|
Removal Of Shoulder Scar Tissue Using An Endoscope
|
12
|
12
|
$9,735.39
|
$9,735.39
|
$708.43
|
$10,027.45
|
$6,023.43
|
2026-05-04
|
|
29827
|
HCPCS
|
Repair Of Shoulder Rotator Cuff Using An Endoscope
|
21
|
12
|
$23,849.10
|
$23,849.10
|
$883.71
|
$24,564.57
|
$7,413.38
|
2026-05-04
|
|
29828
|
HCPCS
|
Release Of Tendon Connecting Biceps Muscle And Shoulder Using An Endoscope
|
12
|
12
|
$23,849.10
|
$23,849.10
|
$1,102.83
|
$24,564.57
|
$14,227.71
|
2026-05-04
|
|
29834
|
HCPCS
|
Removal Of Loose Or Foreign Body In Elbow Joint Using An Endoscope
|
12
|
12
|
$9,733.83
|
$9,733.83
|
$594.55
|
$10,025.84
|
$6,022.81
|
2026-05-04
|
|
29837
|
HCPCS
|
Removal Of Elbow Joint Tissue Using An Endoscope
|
12
|
12
|
$9,733.83
|
$9,733.83
|
$639.47
|
$10,025.84
|
$6,022.81
|
2026-05-04
|
|
29855
|
HCPCS
|
Treatment Of Broken Upper Portion Of Lower Leg Bone On Side Using An Endoscope
|
12
|
12
|
$21,431.19
|
$21,431.19
|
$939.99
|
$22,074.13
|
$12,279.17
|
2026-05-04
|
|
29867
|
HCPCS
|
Repair Of Knee Cartilage And Bone With Donor Cartilage Graft Using An Endoscope
|
21
|
12
|
$38,600.46
|
$38,600.46
|
$270.99
|
$39,758.47
|
$13,116.80
|
2026-05-04
|
|
29871
|
HCPCS
|
Exam, Washing, And Drainage Of Infected Knee Joint Using An Endoscope
|
12
|
12
|
$9,733.83
|
$9,733.83
|
$620.35
|
$10,025.84
|
$6,022.81
|
2026-05-04
|
|
29873
|
HCPCS
|
Release Of Ligaments At Outer Side Of Knee Joint Using An Endoscope
|
12
|
12
|
$9,733.83
|
$9,733.83
|
$648.23
|
$10,025.84
|
$6,022.81
|
2026-05-04
|
|
29875
|
HCPCS
|
Partial Removal Of Knee Joint Lining Using An Endoscope
|
12
|
12
|
$9,733.83
|
$9,733.83
|
$598.52
|
$10,025.84
|
$6,022.81
|
2026-05-04
|
|
29877
|
HCPCS
|
Removal Or Shaving Of Knee Joint Cartilage Using An Endoscope
|
12
|
12
|
$11,517.03
|
$11,517.03
|
$748.38
|
$11,862.54
|
$6,736.09
|
2026-05-04
|
|
29883
|
HCPCS
|
Repair Of Inside And Outside Knee Joint Cartilage Using An Endoscope
|
12
|
12
|
$11,517.03
|
$11,517.03
|
$1,010.73
|
$11,862.54
|
$6,736.09
|
2026-05-04
|
|
29888
|
HCPCS
|
Repair Of Anterior Cruciate Ligament Of Knee Using An Endoscope
|
21
|
12
|
$25,230.81
|
$25,230.81
|
$806.03
|
$25,987.73
|
$7,413.38
|
2026-05-04
|
|
29893
|
HCPCS
|
Repair Of Fibrous Tissue Of Arch Of Foot Using An Endoscope
|
12
|
12
|
$9,733.83
|
$9,733.83
|
$812.68
|
$10,025.84
|
$5,564.97
|
2026-05-04
|
|
29894
|
HCPCS
|
Removal Of Loose Or Foreign Body In Ankle Using An Endoscope
|
12
|
12
|
$12,944.16
|
$12,944.16
|
$611.70
|
$13,332.48
|
$7,442.90
|
2026-05-04
|
|
29895
|
HCPCS
|
Partial Removal Of Ankle Joint Lining Using An Endoscope
|
12
|
12
|
$12,556.32
|
$12,556.32
|
$569.91
|
$12,933.01
|
$7,219.89
|
2026-05-04
|
|
29897
|
HCPCS
|
Removal Of Limited Dead Or Infected Tissue Using An Endoscope
|
12
|
12
|
$12,880.53
|
$12,880.53
|
$598.01
|
$13,266.95
|
$7,406.31
|
2026-05-04
|
|
29898
|
HCPCS
|
Removal Of Extensive Dead Or Infected Tissue Using An Endoscope
|
12
|
12
|
$14,950.50
|
$14,950.50
|
$682.32
|
$15,399.02
|
$8,596.54
|
2026-05-04
|
|
29907
|
HCPCS
|
Fusion Of Foot Joint Using An Endoscope
|
12
|
12
|
$38,600.46
|
$38,600.46
|
$1,053.69
|
$39,758.47
|
$32,617.39
|
2026-05-04
|
|
29999
|
HCPCS
|
Other Procedure On Joint Using An Endoscope
|
11
|
11
|
$10,368.66
|
$10,368.66
|
$252.01
|
$10,679.72
|
$8,294.93
|
2026-05-04
|
|
30115
|
HCPCS
|
Extensive Removal Of Nasal Polyp
|
12
|
12
|
$9,729.21
|
$9,729.21
|
$576.21
|
$10,021.09
|
$5,585.32
|
2026-05-04
|
|
30465
|
HCPCS
|
Repair Of Nasal Passage
|
12
|
12
|
$17,746.98
|
$17,746.98
|
$1,265.49
|
$18,279.39
|
$10,980.94
|
2026-05-04
|
|
30520
|
HCPCS
|
Reshaping Of Nasal Cartilage
|
12
|
12
|
$10,317.90
|
$10,317.90
|
$830.34
|
$10,627.44
|
$6,255.42
|
2026-05-04
|
|
30930
|
HCPCS
|
Therapeutic Fracture Of Nasal Passages
|
12
|
12
|
$9,729.21
|
$9,729.21
|
$142.35
|
$10,021.09
|
$5,585.32
|
2026-05-04
|
|
31240
|
HCPCS
|
Removal Of Nasal Breathing Passages Using An Endoscope
|
12
|
12
|
$13,898.61
|
$13,898.61
|
$191.40
|
$14,315.57
|
$7,991.70
|
2026-05-04
|
|
31254
|
HCPCS
|
Partial Removal Of Nasal Sinus Using An Endoscope
|
12
|
12
|
$22,369.65
|
$22,369.65
|
$538.69
|
$23,040.74
|
$13,490.73
|
2026-05-04
|
|
31255
|
HCPCS
|
Removal Of Nasal Sinus Using An Endoscope
|
12
|
12
|
$22,369.65
|
$22,369.65
|
$392.48
|
$23,040.74
|
$13,490.73
|
2026-05-04
|
|
31256
|
HCPCS
|
Incision Of Nasal Sinus Using An Endoscope
|
12
|
12
|
$12,060.24
|
$12,060.24
|
$217.54
|
$12,422.05
|
$7,243.66
|
2026-05-04
|
|
31276
|
HCPCS
|
Exploration Of Nasal Sinus Using An Endoscope
|
12
|
12
|
$22,140.21
|
$22,140.21
|
$457.69
|
$22,804.42
|
$13,398.95
|
2026-05-04
|
|
31288
|
HCPCS
|
Removal Of Sphenoid Nasal Sinus Tissue Using An Endoscope
|
12
|
12
|
$20,767.41
|
$20,767.41
|
$283.52
|
$21,390.43
|
$12,849.83
|
2026-05-04
|
|
31530
|
HCPCS
|
Removal Of Foreign Body In Voice Box Using An Endoscope
|
12
|
12
|
$12,471.48
|
$12,471.48
|
$239.90
|
$12,845.62
|
$7,171.10
|
2026-05-04
|
|
31600
|
HCPCS
|
Incision Of Windpipe For Insertion Of Breathing Tube (older Than 2 Years)
|
12
|
12
|
$9,729.21
|
$9,729.21
|
$366.66
|
$10,021.09
|
$8,221.18
|
2026-05-04
|
|
33285
|
HCPCS
|
Insertion Of Heart Rhythm Monitor Under Skin
|
12
|
12
|
$24,827.94
|
$24,827.94
|
$5,546.84
|
$25,572.78
|
$15,362.29
|
2026-05-04
|
|
34201
|
HCPCS
|
Removal Of Blood Clot In Artery Of Groin And Leg
|
21
|
12
|
$16,217.10
|
$16,217.10
|
$801.29
|
$16,703.61
|
$5,685.01
|
2026-05-04
|
|
35201
|
HCPCS
|
Repair Of Blood Vessel Of Neck
|
12
|
12
|
$16,217.10
|
$16,217.10
|
$1,109.03
|
$16,703.61
|
$9,329.35
|
2026-05-04
|
|
36261
|
HCPCS
|
Revision Of Implanted Arterial Infusion Pump
|
12
|
12
|
$10,917.90
|
$10,917.90
|
$492.02
|
$11,245.44
|
$6,276.11
|
2026-05-04
|
|
36563
|
HCPCS
|
Insertion Of Central Venous Tube With Pump
|
12
|
12
|
$16,217.10
|
$16,217.10
|
$1,408.01
|
$16,703.61
|
$10,034.33
|
2026-05-04
|
|
37766
|
HCPCS
|
Removal Of Varicose Veins Of Arm Or Leg, More Than 20 Incisions
|
12
|
12
|
$9,442.50
|
$9,442.50
|
$605.38
|
$9,725.78
|
$5,842.55
|
2026-05-04
|
|
38531
|
HCPCS
|
Biopsy Or Removal Of Lymph Nodes Of Groin
|
12
|
12
|
$11,487.84
|
$11,487.84
|
$534.21
|
$11,832.48
|
$6,595.26
|
2026-05-04
|
|
38542
|
HCPCS
|
Removal Of Deep Lymph Nodes Of Neck
|
21
|
12
|
$17,503.08
|
$17,503.08
|
$350.00
|
$18,028.17
|
$6,176.47
|
2026-05-04
|
|
38570
|
HCPCS
|
Biopsy And Removal Of Lymph Nodes Of Abdominal Cavity Using An Endoscope
|
12
|
12
|
$17,503.08
|
$17,503.08
|
$621.89
|
$18,028.17
|
$10,089.47
|
2026-05-04
|
|
38572
|
HCPCS
|
Removal Of Lymph Nodes Of Both Sides Of Pelvis And Abdominal Lymph Node Biopsy U…
|
12
|
12
|
$31,233.66
|
$31,233.66
|
$1,098.04
|
$32,170.67
|
$17,923.51
|
2026-05-04
|
|
38760
|
HCPCS
|
Removal Of Lymph Nodes Of Groin
|
21
|
12
|
$19,564.38
|
$19,564.38
|
$690.95
|
$20,151.31
|
$6,783.99
|
2026-05-04
|
|
38900
|
HCPCS
|
Imaging Of Lymph Nodes During Surgery
|
12
|
12
|
$14,292.51
|
$14,292.51
|
$111.06
|
$14,721.29
|
$8,218.19
|
2026-05-04
|
|
40520
|
HCPCS
|
V-shaped Removal Of Lip Tissue
|
12
|
12
|
$9,729.21
|
$9,729.21
|
$614.48
|
$10,021.09
|
$5,585.32
|
2026-05-04
|
|
41008
|
HCPCS
|
Drainage Of Abscess, Cyst, Or Blood Accumulation Under Jaw Bone From Inside Mout…
|
12
|
12
|
$9,729.21
|
$9,729.21
|
$476.67
|
$10,021.09
|
$8,221.18
|
2026-05-04
|
|
42120
|
HCPCS
|
Partial Removal Of Roof Of Mouth
|
12
|
12
|
$17,746.98
|
$17,746.98
|
$1,229.04
|
$18,279.39
|
$14,996.19
|
2026-05-04
|
|
42415
|
HCPCS
|
Removal Of Growth Of Saliva Gland With Release Of Facial Nerve
|
21
|
12
|
$19,338.27
|
$19,338.27
|
$846.05
|
$19,918.42
|
$6,048.05
|
2026-05-04
|
|
42815
|
HCPCS
|
Removal Of Congenital Cyst Or Abnormal Drainage Tract Of Neck And/or Throat
|
21
|
12
|
$17,746.98
|
$17,746.98
|
$439.72
|
$18,279.39
|
$6,048.05
|
2026-05-04
|
|
42820
|
HCPCS
|
Removal Of Tonsils And Adenoid Glands (younger Than 12 Years)
|
21
|
12
|
$19,158.03
|
$19,158.03
|
$240.15
|
$19,732.77
|
$6,048.05
|
2026-05-04
|
|
42825
|
HCPCS
|
Removal Of Tonsils (younger Than 12 Years)
|
21
|
12
|
$19,158.03
|
$19,158.03
|
$224.20
|
$19,732.77
|
$6,048.05
|
2026-05-04
|
|
42835
|
HCPCS
|
Secondary Removal Of Adenoids (younger Than 12 Years)
|
12
|
12
|
$9,729.21
|
$9,729.21
|
$239.21
|
$10,021.09
|
$6,019.95
|
2026-05-04
|
|
43130
|
HCPCS
|
Removal Of Defect In Wall Of Esophagus Through Neck
|
21
|
12
|
$17,746.98
|
$17,746.98
|
$650.00
|
$18,279.39
|
$6,048.05
|
2026-05-04
|
|
43257
|
HCPCS
|
Heat Delivery To Muscle At Esophagus And/or Stomach To Treat Gastric Reflux Usin…
|
12
|
12
|
$11,413.59
|
$11,413.59
|
$282.51
|
$11,756.00
|
$9,644.49
|
2026-05-04
|
|
43280
|
HCPCS
|
Strengthening Of Muscle Between Esophagus And Stomach By Wrapping Part Of Stomac…
|
21
|
12
|
$33,926.01
|
$33,926.01
|
$892.49
|
$34,943.79
|
$10,860.10
|
2026-05-04
|
|
43281
|
HCPCS
|
Repair Of Hernia Of Muscle At Esophagus And Stomach Using An Endoscope
|
21
|
12
|
$33,926.01
|
$33,926.01
|
$886.74
|
$34,943.79
|
$10,860.10
|
2026-05-04
|
|
43284
|
HCPCS
|
Insertion Of Magnetic Band Around Base Of Esophagus To Tighten Opening Into Stom…
|
21
|
12
|
$31,233.66
|
$31,233.66
|
$440.94
|
$32,170.67
|
$10,860.10
|
2026-05-04
|
|
43659
|
HCPCS
|
Other Procedure On Stomach Using An Endoscope
|
11
|
11
|
$17,503.08
|
$17,503.08
|
$6,176.47
|
$18,028.17
|
$14,877.62
|
2026-05-04
|
|
43770
|
HCPCS
|
Insertion Of Adjustable Stomach Reduction Device Using An Endoscope
|
12
|
12
|
$31,233.66
|
$31,233.66
|
$1,346.94
|
$32,170.67
|
$17,923.51
|
2026-05-04
|
|
43773
|
HCPCS
|
Replacement Of Stomach Reduction Device Using An Endoscope
|
12
|
12
|
$32,868.66
|
$32,868.66
|
$1,527.22
|
$33,854.72
|
$18,899.48
|
2026-05-04
|
|
44950
|
HCPCS
|
Removal Of Appendix
|
21
|
12
|
$18,719.25
|
$18,719.25
|
$520.42
|
$19,280.83
|
$6,614.04
|
2026-05-04
|
|
44970
|
HCPCS
|
Removal Of Appendix Using An Endoscope
|
21
|
12
|
$17,503.08
|
$17,503.08
|
$463.01
|
$18,028.17
|
$6,176.47
|
2026-05-04
|
|
45347
|
HCPCS
|
Insertion Of Stent Into Lower Large Bowel Using A Flexible Endoscope
|
12
|
12
|
$17,858.43
|
$17,858.43
|
$187.40
|
$18,394.18
|
$7,617.74
|
2026-05-04
|
|
46707
|
HCPCS
|
Repair Of Abnormal Anal Drainage Tract With Implanted Plug
|
12
|
12
|
$8,227.17
|
$8,227.17
|
$607.84
|
$8,473.99
|
$6,951.95
|
2026-05-04
|
|
47379
|
HCPCS
|
Other Procedure On Liver Using An Endoscope
|
11
|
11
|
$17,503.08
|
$17,503.08
|
$6,176.47
|
$18,028.17
|
$14,877.62
|
2026-05-04
|
|
47531
|
HCPCS
|
Injection Of Bile Duct For X-ray Through Already Existing Skin Access Using Imag…
|
12
|
12
|
$10,587.18
|
$10,587.18
|
$536.74
|
$10,904.80
|
$6,063.84
|
2026-05-04
|
|
47532
|
HCPCS
|
Injection Of Bile Duct For X-ray Through New Skin Access Using Imaging Guidance …
|
12
|
12
|
$10,587.18
|
$10,587.18
|
$602.47
|
$10,904.80
|
$6,063.84
|
2026-05-04
|
|
47553
|
HCPCS
|
Biopsy Of Bile Duct Using An Endoscope
|
12
|
12
|
$18,719.25
|
$18,719.25
|
$337.82
|
$19,280.83
|
$15,817.76
|
2026-05-04
|
|
47562
|
HCPCS
|
Removal Of Gallbladder Using An Endoscope
|
21
|
12
|
$19,552.56
|
$19,552.56
|
$560.89
|
$20,139.14
|
$6,176.47
|
2026-05-04
|
|
47563
|
HCPCS
|
Removal Of Gallbladder With X-ray Study Of Bile Ducts Using An Endoscope
|
21
|
12
|
$19,552.56
|
$19,552.56
|
$435.00
|
$20,139.14
|
$6,176.47
|
2026-05-04
|
|
47564
|
HCPCS
|
Removal Of Gallbladder With Exploration Of Common Bile Duct Using An Endoscope
|
21
|
12
|
$31,233.66
|
$31,233.66
|
$734.93
|
$32,170.67
|
$10,860.10
|
2026-05-04
|
|
49320
|
HCPCS
|
Diagnostic Exam Of Abdomen Using An Endoscope
|
21
|
12
|
$17,503.08
|
$17,503.08
|
$245.63
|
$18,028.17
|
$6,176.47
|
2026-05-04
|
|
49321
|
HCPCS
|
Biopsy Of Abdomen Using An Endoscope
|
21
|
12
|
$17,503.08
|
$17,503.08
|
$257.85
|
$18,028.17
|
$6,176.47
|
2026-05-04
|
|
49322
|
HCPCS
|
Aspiration Of Abdominal Cavity Or Cyst Using An Endoscope
|
12
|
12
|
$17,503.08
|
$17,503.08
|
$449.47
|
$18,028.17
|
$10,830.03
|
2026-05-04
|
|
49324
|
HCPCS
|
Insertion Of Abdominal Cavity Tube Using An Endoscope
|
12
|
12
|
$17,503.08
|
$17,503.08
|
$462.91
|
$18,028.17
|
$10,830.03
|
2026-05-04
|
|
49329
|
HCPCS
|
Other Procedure On Abdomen Using An Endoscope
|
12
|
12
|
$17,503.08
|
$17,503.08
|
$257.50
|
$18,028.17
|
$14,790.10
|
2026-05-04
|
|
49402
|
HCPCS
|
Removal Of Foreign Body In Abdominal Cavity
|
12
|
12
|
$10,587.18
|
$10,587.18
|
$1,020.00
|
$10,904.80
|
$6,398.09
|
2026-05-04
|
|
49418
|
HCPCS
|
Insertion Of Abdominal Tube Using Imaging Guidance With Review By Radiologist
|
12
|
12
|
$11,344.32
|
$11,344.32
|
$1,242.94
|
$11,684.65
|
$6,700.95
|
2026-05-04
|
|
49500
|
HCPCS
|
Repair Of Groin Hernia (6 Months To Younger Than 5 Years)
|
21
|
12
|
$18,719.25
|
$18,719.25
|
$308.16
|
$19,280.83
|
$6,614.04
|
2026-05-04
|
|
49521
|
HCPCS
|
Repair Of Trapped Or Strangulated Groin Hernia
|
21
|
12
|
$18,719.25
|
$18,719.25
|
$465.00
|
$19,280.83
|
$6,614.04
|
2026-05-04
|
|
49592
|
HCPCS
|
Initial Repair Of Entrapped Hernia Of Abdomen, Less Than 3 Cm In Length
|
12
|
12
|
$17,503.08
|
$17,503.08
|
$558.83
|
$18,028.17
|
$10,830.03
|
2026-05-04
|
|
49593
|
HCPCS
|
Initial Repair Of Sliding Hernia Of Abdomen, 3-10 Cm In Length
|
12
|
12
|
$18,719.25
|
$18,719.25
|
$673.77
|
$19,280.83
|
$11,582.53
|
2026-05-04
|
|
49594
|
HCPCS
|
Initial Repair Of Entrapped Hernia Of Abdomen, 3-10 Cm In Length
|
12
|
12
|
$17,503.08
|
$17,503.08
|
$876.53
|
$18,028.17
|
$10,830.03
|
2026-05-04
|
|
49615
|
HCPCS
|
Repair Of Recurrent Sliding Hernia Of Abdomen, 3-10 Cm In Length
|
12
|
12
|
$18,719.25
|
$18,719.25
|
$751.84
|
$19,280.83
|
$10,794.72
|
2026-05-04
|
|
49650
|
HCPCS
|
Repair Of Groin Hernia Using An Endoscope
|
21
|
12
|
$21,585.72
|
$21,585.72
|
$344.18
|
$22,233.29
|
$6,176.47
|
2026-05-04
|
|
49651
|
HCPCS
|
Repair Of Recurrent Groin Hernia Using An Endoscope
|
21
|
12
|
$28,427.46
|
$28,427.46
|
$445.50
|
$29,280.28
|
$6,176.47
|
2026-05-04
|
|
49659
|
HCPCS
|
Other Repair Of Hernia Using An Endoscope
|
18
|
11
|
$17,503.08
|
$17,503.08
|
$19.43
|
$18,028.17
|
$6,176.47
|
2026-05-04
|
|
51715
|
HCPCS
|
Injection Of Implant Material Beneath Lining Of Bladder And/or Urethra Using An …
|
12
|
12
|
$10,346.91
|
$10,346.91
|
$459.18
|
$10,657.32
|
$6,402.15
|
2026-05-04
|
|
51860
|
HCPCS
|
Suture Of Simple Wound, Injury, Or Rupture Of Bladder
|
21
|
12
|
$27,741.45
|
$27,741.45
|
$624.53
|
$28,573.69
|
$9,671.50
|
2026-05-04
|
|
52240
|
HCPCS
|
Destruction And/or Removal Of Large Growth Of Bladder Using An Endoscope
|
12
|
12
|
$15,250.86
|
$15,250.86
|
$472.29
|
$15,708.39
|
$9,436.48
|
2026-05-04
|
|
52325
|
HCPCS
|
Fragmenting Of Stone In Ureter Using An Endoscope
|
12
|
12
|
$15,250.86
|
$15,250.86
|
$385.61
|
$15,708.39
|
$9,436.48
|
2026-05-04
|
|
52341
|
HCPCS
|
Dilation Of Bladder And Urethra Using An Endoscope
|
12
|
12
|
$10,346.91
|
$10,346.91
|
$341.65
|
$10,657.32
|
$6,402.15
|
2026-05-04
|
|
52342
|
HCPCS
|
Repair Of Stricture At Junction Of Kidney And Ureter Using An Endoscope
|
12
|
12
|
$10,346.91
|
$10,346.91
|
$372.03
|
$10,657.32
|
$6,402.15
|
2026-05-04
|
|
52345
|
HCPCS
|
Repair Of Stricture Of Upper Attachment Of Ureter To Kidney Using An Endoscope
|
12
|
12
|
$10,346.91
|
$10,346.91
|
$474.92
|
$10,657.32
|
$6,402.15
|
2026-05-04
|
|
52351
|
HCPCS
|
Diagnostic Exam Of Bladder, Urethra, And Ureter Or Kidney Using An Endoscope
|
12
|
12
|
$10,892.85
|
$10,892.85
|
$364.34
|
$11,219.64
|
$6,620.53
|
2026-05-04
|
|
52352
|
HCPCS
|
Removal Or Manipulation Of Stone In Ureter Or Kidney Using An Endoscope
|
12
|
12
|
$11,835.18
|
$11,835.18
|
$426.51
|
$12,190.24
|
$6,997.45
|
2026-05-04
|
|
52353
|
HCPCS
|
Crushing Of Stone Of Ureter Using An Endoscope
|
12
|
12
|
$15,250.86
|
$15,250.86
|
$472.29
|
$15,708.39
|
$9,436.48
|
2026-05-04
|
|
52354
|
HCPCS
|
Biopsy And/or Destruction Of Growth Of Ureter Or Kidney Using An Endoscope
|
12
|
12
|
$15,250.86
|
$15,250.86
|
$502.46
|
$15,708.39
|
$9,436.48
|
2026-05-04
|
|
52500
|
HCPCS
|
Removal Of Bladder Neck Through Urethra
|
12
|
12
|
$10,346.91
|
$10,346.91
|
$596.28
|
$10,657.32
|
$5,939.43
|
2026-05-04
|
|
52601
|
HCPCS
|
Removal Of Prostate Gland Using An Electrocautery Knife Through Urethra With Con…
|
12
|
12
|
$15,250.86
|
$15,250.86
|
$884.18
|
$15,708.39
|
$9,436.48
|
2026-05-04
|
|
52630
|
HCPCS
|
Complete Removal Of Remaining Or Regrown Prostate Tissue With Control Of Bleedin…
|
12
|
12
|
$17,041.89
|
$17,041.89
|
$491.22
|
$17,553.15
|
$9,799.08
|
2026-05-04
|
|
52700
|
HCPCS
|
Drainage Of Prostate Abscess
|
12
|
12
|
$10,346.91
|
$10,346.91
|
$536.57
|
$10,657.32
|
$8,743.14
|
2026-05-04
|
|
53447
|
HCPCS
|
Removal And Replacement Of Inflatable Urethra Or Bladder Neck Sphincter
|
12
|
12
|
$60,385.68
|
$60,385.68
|
$979.62
|
$62,197.25
|
$34,849.43
|
2026-05-04
|
|
53450
|
HCPCS
|
Repair Of Urethra And Urinary Opening
|
12
|
12
|
$10,346.91
|
$10,346.91
|
$497.39
|
$10,657.32
|
$5,939.43
|
2026-05-04
|
|
53510
|
HCPCS
|
Suture Of Urethra Wound Or Injury
|
12
|
12
|
$15,250.86
|
$15,250.86
|
$768.52
|
$15,708.39
|
$12,886.97
|
2026-05-04
|
|
54522
|
HCPCS
|
Partial Removal Of Testicle
|
12
|
12
|
$10,346.91
|
$10,346.91
|
$714.41
|
$10,657.32
|
$5,939.43
|
2026-05-04
|
|
54600
|
HCPCS
|
Repair Of Twisted Testicle
|
12
|
12
|
$10,346.91
|
$10,346.91
|
$550.12
|
$10,657.32
|
$5,939.43
|
2026-05-04
|
|
54861
|
HCPCS
|
Removal Of Both Sperm Reservoirs
|
12
|
12
|
$10,346.91
|
$10,346.91
|
$690.91
|
$10,657.32
|
$5,939.43
|
2026-05-04
|
|
55720
|
HCPCS
|
Simple Incision And Drainage Of Abscess Of Prostate
|
12
|
12
|
$10,346.91
|
$10,346.91
|
$549.90
|
$10,657.32
|
$8,743.14
|
2026-05-04
|
|
57220
|
HCPCS
|
Plastic Repair Of Muscles At Urinary Opening Through Vagina
|
12
|
12
|
$14,809.35
|
$14,809.35
|
$424.39
|
$15,253.63
|
$12,513.90
|
2026-05-04
|
|
57282
|
HCPCS
|
Repair Of Pelvic Ligaments Through Vagina
|
21
|
12
|
$22,184.43
|
$22,184.43
|
$412.41
|
$22,849.96
|
$7,576.05
|
2026-05-04
|
|
57285
|
HCPCS
|
Repair Of Vaginal Wall Defect Through Vagina
|
12
|
12
|
$22,184.43
|
$22,184.43
|
$847.28
|
$22,849.96
|
$12,661.80
|
2026-05-04
|
|
57295
|
HCPCS
|
Revision Of Prosthetic Vaginal Graft
|
12
|
12
|
$9,538.59
|
$9,538.59
|
$613.62
|
$9,824.75
|
$5,902.00
|
2026-05-04
|
|
57426
|
HCPCS
|
Revision Or Removal Of Prosthetic Vaginal Graft Using An Endoscope
|
21
|
12
|
$22,184.43
|
$22,184.43
|
$518.80
|
$22,849.96
|
$7,576.05
|
2026-05-04
|
|
58543
|
HCPCS
|
Partial Removal Of Uterus With Retention Of Cervix Using An Endoscope, More Than…
|
12
|
12
|
$31,233.66
|
$31,233.66
|
$1,028.34
|
$32,170.67
|
$26,392.44
|
2026-05-04
|
|
58545
|
HCPCS
|
Removal Of Growth Of Uterus Using An Endoscope, 250.0 G Or Less
|
21
|
12
|
$51,831.18
|
$51,831.18
|
$550.00
|
$53,386.12
|
$6,176.47
|
2026-05-04
|
|
58550
|
HCPCS
|
Removal Of Uterus Through Vagina Using An Endoscope, 250.0 G Or Less
|
21
|
12
|
$23,582.49
|
$23,582.49
|
$716.19
|
$24,289.96
|
$6,176.47
|
2026-05-04
|
|
58552
|
HCPCS
|
Removal Of Uterus, Tubes, And/or Ovaries Through Vagina Using An Endoscope, 250.…
|
21
|
12
|
$33,926.01
|
$33,926.01
|
$797.42
|
$34,943.79
|
$10,860.10
|
2026-05-04
|
|
58554
|
HCPCS
|
Removal Of Uterus, Tubes, And/or Ovaries Through Vagina Using An Endoscope, More…
|
21
|
12
|
$31,233.66
|
$31,233.66
|
$1,055.62
|
$32,170.67
|
$10,860.10
|
2026-05-04
|
|
58571
|
HCPCS
|
Removal Of Uterus, Tubes, And/or Ovaries Through Abdomen Using An Endoscope, 250…
|
21
|
12
|
$31,864.65
|
$31,864.65
|
$748.39
|
$32,820.59
|
$10,860.10
|
2026-05-04
|
|
58578
|
HCPCS
|
Other Procedure On Uterus Using An Endoscope
|
11
|
11
|
$17,503.08
|
$17,503.08
|
$6,176.47
|
$18,028.17
|
$14,877.62
|
2026-05-04
|
|
58660
|
HCPCS
|
Removal Of Scar Tissue Of Ovaries Or Fallopian Tubes Using An Endoscope
|
21
|
12
|
$17,503.08
|
$17,503.08
|
$565.33
|
$18,028.17
|
$6,176.47
|
2026-05-04
|
|
58661
|
HCPCS
|
Removal Of Ovaries And/or Tubes Using An Endoscope
|
21
|
12
|
$18,749.64
|
$18,749.64
|
$530.94
|
$19,312.13
|
$6,176.47
|
2026-05-04
|
|
58662
|
HCPCS
|
Destruction Or Removal Of Ovary Or Growth Of Pelvis Using An Endoscope
|
21
|
12
|
$17,503.08
|
$17,503.08
|
$585.39
|
$18,028.17
|
$6,176.47
|
2026-05-04
|
|
58670
|
HCPCS
|
Destruction Of Fallopian Tubes Using An Endoscope
|
21
|
12
|
$17,503.08
|
$17,503.08
|
$286.80
|
$18,028.17
|
$6,176.47
|
2026-05-04
|
|
58671
|
HCPCS
|
Blockage Of Uterine Tubes By Device Using An Endoscope
|
21
|
12
|
$17,503.08
|
$17,503.08
|
$303.41
|
$18,028.17
|
$6,176.47
|
2026-05-04
|
|
58673
|
HCPCS
|
Repair Of Uterine Tube Using An Endoscope
|
21
|
12
|
$31,233.66
|
$31,233.66
|
$176.61
|
$32,170.67
|
$10,860.10
|
2026-05-04
|
|
59150
|
HCPCS
|
Removal Of Ovarian Or Tubal Pregnancy Using An Endoscope
|
21
|
12
|
$17,503.08
|
$17,503.08
|
$620.07
|
$18,028.17
|
$6,176.47
|
2026-05-04
|
|
59151
|
HCPCS
|
Removal Of Ovarian Or Tubal Pregnancy With Removal Of Ovary And/or Tube Using An…
|
21
|
12
|
$18,352.71
|
$18,352.71
|
$603.51
|
$18,903.29
|
$6,176.47
|
2026-05-04
|
|
59870
|
HCPCS
|
Removal Of Abnormal Pregnancy Contents With Scraping Of Uterine Wall
|
12
|
12
|
$28,957.71
|
$28,957.71
|
$638.76
|
$29,826.44
|
$16,650.68
|
2026-05-04
|
|
60200
|
HCPCS
|
Incision Of Cyst Or Growth Of Thyroid
|
21
|
12
|
$17,503.08
|
$17,503.08
|
$548.98
|
$18,028.17
|
$6,176.47
|
2026-05-04
|
|
60210
|
HCPCS
|
Partial Removal Of Thyroid Lobe On Side Of Neck
|
21
|
12
|
$17,503.08
|
$17,503.08
|
$583.93
|
$18,028.17
|
$6,176.47
|
2026-05-04
|
|
60212
|
HCPCS
|
Partial Removal Of Thyroid Lobes On Both Sides Of Neck And Connecting Tissue
|
21
|
12
|
$17,503.08
|
$17,503.08
|
$853.73
|
$18,028.17
|
$6,176.47
|
2026-05-04
|
|
60220
|
HCPCS
|
Removal Of Thyroid Lobe On Side Of Neck
|
21
|
12
|
$18,031.53
|
$18,031.53
|
$579.99
|
$18,572.48
|
$6,176.47
|
2026-05-04
|
|
60225
|
HCPCS
|
Removal Of Thyroid Lobe On Side Of Neck And Partial Removal Of Thyroid Lobe On O…
|
21
|
12
|
$17,503.08
|
$17,503.08
|
$767.69
|
$18,028.17
|
$6,176.47
|
2026-05-04
|
|
60240
|
HCPCS
|
Removal Of Thyroid
|
21
|
12
|
$19,271.25
|
$19,271.25
|
$700.00
|
$19,849.39
|
$6,176.47
|
2026-05-04
|
|
60260
|
HCPCS
|
Removal Of Remaining Thyroid Tissue From Prior Operation
|
12
|
12
|
$17,746.98
|
$17,746.98
|
$1,313.02
|
$18,279.39
|
$10,980.94
|
2026-05-04
|
|
60280
|
HCPCS
|
Removal Of Cyst Of Thyroid Or Drainage Of Thyroid Gland Duct
|
21
|
12
|
$17,503.08
|
$17,503.08
|
$365.72
|
$18,028.17
|
$6,176.47
|
2026-05-04
|
|
60500
|
HCPCS
|
Removal Or Exploration Of Parathyroid Glands
|
21
|
12
|
$19,338.27
|
$19,338.27
|
$800.22
|
$19,918.42
|
$6,048.05
|
2026-05-04
|
|
66850
|
HCPCS
|
Aspiration Of Lens Material By Fragmenting And Aspiration
|
12
|
12
|
$16,531.68
|
$16,531.68
|
$949.40
|
$17,027.63
|
$9,505.72
|
2026-05-04
|
|
67900
|
HCPCS
|
Repair Of Brow Paralysis
|
12
|
12
|
$6,998.88
|
$6,998.88
|
$789.25
|
$7,208.85
|
$5,914.06
|
2026-05-04
|
|
67915
|
HCPCS
|
Repair Of Turning-outward Defect Of Upper Or Lower Eyelid Using Heat
|
12
|
12
|
$6,998.88
|
$6,998.88
|
$386.82
|
$7,208.85
|
$5,914.06
|
2026-05-04
|
|
69421
|
HCPCS
|
Incision, Aspiration, And Inflation Of Eardrum Under Anesthesia
|
12
|
12
|
$9,729.21
|
$9,729.21
|
$184.33
|
$10,021.09
|
$5,585.32
|
2026-05-04
|
|
69424
|
HCPCS
|
Removal Of Implanted Eardrum Tube Under Anesthesia
|
12
|
12
|
$9,729.21
|
$9,729.21
|
$158.46
|
$10,021.09
|
$5,585.32
|
2026-05-04
|
|
92019
|
HCPCS
|
Limited Exam Of Visual System Under General Anesthesia
|
12
|
12
|
$6,998.88
|
$6,998.88
|
$82.50
|
$7,208.85
|
$5,914.06
|
2026-05-04
|
|
C1762
|
HCPCS
|
Connective Tissue, Human (includes Fascia Lata)
|
8
|
8
|
$7,186.75
|
$7,186.75
|
$5,749.40
|
$7,402.35
|
$6,288.41
|
2026-05-04
|
|
C1776
|
HCPCS
|
Joint Device (implantable)
|
1,120
|
8
|
$6,682.27
|
$6,682.27
|
$109.32
|
$37,156.59
|
$5,898.16
|
2026-05-04
|
|
C1874
|
HCPCS
|
Stent, Coated/covered, With Delivery System
|
8
|
8
|
$6,717.75
|
$6,717.75
|
$5,374.20
|
$15,199.09
|
$6,717.75
|
2026-05-04
|
|
C9781
|
HCPCS
|
Arthroscopy, Shoulder, Surgical; With Implantation Of Subacromial Spacer (e.g., …
|
11
|
11
|
$23,595.80
|
$23,595.80
|
$13,116.80
|
$24,303.67
|
$20,056.43
|
2026-05-04
|
|
G0330
|
HCPCS
|
Facility Services For Dental Rehabilitation Procedure(s) Performed On A Patient …
|
11
|
11
|
$9,729.21
|
$9,729.21
|
$3,387.27
|
$10,021.09
|
$8,269.83
|
2026-05-04
|
|
J3101
|
HCPCS
|
Injection, Tenecteplase, 1 Mg
|
12
|
12
|
$16,860.00
|
$16,860.00
|
$143.65
|
$17,365.80
|
$6,848.47
|
2026-05-04
|