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Hospital

CHEYENNE COUNTY HOSPITAL

St Francis, KS · CCN 171310 · Rates published

2,188 distinct procedures filed
24 distinct payers
94,381 rate rows
2026-03-02 last MRF observed
Data quality

94,095 of 94,381 rate rows are consumer-grade (99.7%)

286 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 110
exceeds 10× this hospital's gross charge — excluded from medians 105
per-diem day rate — not a per-procedure price 71
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://apps.para-hcfs.com/PTT/FinalLinks/Reports.aspx?dbName=dbCheyenneCounty&type=CDMWithoutLabel
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-05-15
Content fingerprint 4a6ba1968b447e3e… · 39,135,460 bytes · first seen 2026-05-04

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
J3380
HCPCS 		Injection, Vedolizumab, Intravenous, 1 Mg 24 $24.91 $13,097.93 $12,115.58 nat. median
$288
outlier · 42.1×
J3101
HCPCS 		Injection, Tenecteplase, 1 Mg 24 $161.92 $10,288.66 $9,517.01 nat. median
$5,949
1.6× median
36475
HCPCS 		Destruction Of First Incompetent Vein Of Arm Or Leg Using Radiofrequency And Ima… 24 $38.00 $11,816.79 $7,483.97 nat. median
$4,182
1.8× median
66991
HCPCS 		Extracapsular Removal Of Cataract With Insertion Of Artificial Lens And Insertio… 23 $5,192.60 $11,127.00 $7,047.10 nat. median
$5,756
1.2× median
28270
HCPCS 		Incision Of Joint Capsule Of Foot And Toe 24 $289.14 $14,821.20 $7,015.37 nat. median
$3,285
outlier · 2.1×
20205
HCPCS 		Deep Biopsy Of Muscle 24 $1,015.00 $10,888.02 $6,895.75 nat. median
$2,946
outlier · 2.3×
59514
HCPCS 		Cesarean Delivery 23 $395.00 $10,575.00 $6,697.50 nat. median
$2,550
outlier · 2.6×
C1764
HCPCS 		Event Recorder, Cardiac (implantable) 24 $3,600.00 $10,837.51 $5,700.00 nat. median
$7,664
0.7× median
44970
HCPCS 		Removal Of Appendix Using An Endoscope 24 $289.14 $12,558.00 $5,629.20 nat. median
$6,035
0.9× median
10180
HCPCS 		Complex Drainage Of Wound Infection After Surgery 24 $38.00 $8,970.32 $5,520.45 nat. median
$2,867
1.9× median
36478
HCPCS 		Laser Destruction Of Incompetent Vein Of Arm Or Leg Using Imaging Guidance 24 $38.00 $8,637.56 $5,470.45 nat. median
$4,061
1.3× median
58671
HCPCS 		Blockage Of Uterine Tubes By Device Using An Endoscope 24 $2,700.00 $8,539.20 $5,408.16 nat. median
$5,845
0.9× median
47562
HCPCS 		Removal Of Gallbladder Using An Endoscope 24 $289.14 $11,734.79 $5,151.11 nat. median
$5,956
0.9× median
J0840
HCPCS 		Injection, Crotalidae Polyvalent Immune Fab (ovine), Up To 1 Gram 24 $3,269.75 $5,449.59 $5,040.87 nat. median
$3,427
1.5× median
J2182
HCPCS 		Injection, Mepolizumab, 1 Mg 24 $37.68 $5,415.08 $5,008.95 nat. median
$3,098
1.6× median
4490377_1
CDM 		Labor Room/delivery - General Classification 19 $160.00 $6,125.00 $5,000.00 nat. median
$4,378
1.1× median
28820
HCPCS 		Amputation Of Toe At Joint Between Forefoot And Toes 24 $1,490.00 $7,660.80 $4,851.84 nat. median
$3,382
1.4× median
J2802
HCPCS 		Injection, Romiplostim, 1 Microgram 23 $1,486.65 $9,910.84 $4,707.67 nat. median
$2,983
1.6× median
Q5108
HCPCS 		Injection, Pegfilgrastim-jmdb (fulphila), Biosimilar, 0.5 Mg 24 $395.59 $5,081.18 $4,700.09 nat. median
$1,258
outlier · 3.7×
49593
HCPCS 		Initial Repair Of Sliding Hernia Of Abdomen, 3-10 Cm In Length 23 $392.50 $9,622.50 $4,618.80 nat. median
$5,868
0.8× median
28825
HCPCS 		Amputation Of Toe At Toe Joint 24 $1,490.00 $7,063.20 $4,473.36 nat. median
$3,319
1.3× median
Q5119
HCPCS 		Injection, Rituximab-pvvr, Biosimilar, (ruxience), 10 Mg 23 $2,810.57 $4,684.28 $4,450.07 nat. median
$934
outlier · 4.8×
58670
HCPCS 		Destruction Of Fallopian Tubes Using An Endoscope 24 $289.14 $9,885.00 $4,431.00 nat. median
$5,656
0.8× median
49591
HCPCS 		Initial Repair Of Sliding Hernia Of Abdomen, Less Than 3 Cm In Length 23 $234.25 $9,211.50 $4,421.52 nat. median
$3,788
1.2× median
66982
HCPCS 		Complex Removal Of Cataract With Insertion Of Prosthetic Lens 24 $1,490.00 $6,978.00 $4,419.40 nat. median
$2,968
1.5× median
66984
HCPCS 		Removal Of Cataract With Insertion Of Prosthetic Lens 24 $1,490.00 $6,745.50 $4,272.15 nat. median
$2,924
1.5× median
11446
HCPCS 		Removal Of Noncancer Skin Growth Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, M… 24 $1,490.00 $6,658.50 $4,217.05 nat. median
$2,849
1.5× median
J2506
HCPCS 		Injection, Pegfilgrastim, Excludes Biosimilar, 0.5 Mg 23 $2,637.88 $4,396.47 $4,176.65 nat. median
$2,076
outlier · 2.0×
49505
HCPCS 		Repair Of Groin Hernia (5 Years Or Older) 24 $289.14 $9,176.76 $4,028.24 nat. median
$3,829
1.1× median
J9217
HCPCS 		Leuprolide Acetate (for Depot Suspension), 7.5 Mg 24 $302.77 $29,207.29 $3,844.04 nat. median
$1,523
outlier · 2.5×
J0490
HCPCS 		Injection, Belimumab, 10 Mg 24 $57.66 $3,884.42 $3,593.09 nat. median
$1,079
outlier · 3.3×
Q4199
HCPCS 		Cygnus Matrix, Per Square Centimeter 23 $711.00 $14,220.00 $3,555.00 nat. median
$332
outlier · 10.7×
46946
HCPCS 		Tying Of Multiple Internal Hemorrhoid Groups 24 $289.14 $8,839.50 $3,467.00 nat. median
$2,789
1.2× median
36561
HCPCS 		Insertion Of Central Venous Tube With Port (5 Years Or Older) 24 $289.14 $7,231.50 $3,422.91 nat. median
$3,693
0.9× median
38525
HCPCS 		Biopsy Or Removal Of Deep Lymph Nodes Of Underarm 24 $289.14 $6,732.00 $3,231.36 nat. median
$3,950
0.8× median
59812
HCPCS 		Treatment Of Miscarriage 24 $550.00 $5,466.75 $3,192.32 nat. median
$3,255
1.0× median
20680
HCPCS 		Removal Of Deep Implant From Bone 24 $1,490.00 $5,018.40 $3,178.32 nat. median
$3,269
1.0× median
J3358
HCPCS 		Ustekinumab, For Intravenous Injection, 1 Mg 24 $14.79 $3,428.95 $3,171.78 nat. median
$214
outlier · 14.8×
6599415_1
CDM 		Tofidence 400 Mg/20 Ml Vial 19 $2,207.52 $3,605.62 $3,127.32 nat. median
$3,127
1.0× median
J3240
HCPCS 		Injection, Thyrotropin Alpha, 0.9 Mg, Provided In 1.1 Mg Vial 24 $2,012.88 $3,354.80 $3,103.19 nat. median
$2,976
1.0× median
59414
HCPCS 		Delivery Of Placenta 23 $1,490.00 $4,823.21 $3,054.70 nat. median
$2,876
1.1× median
21552
HCPCS 		Removal Of Growth Of Soft Tissue Under Skin Of Neck Or Front Of Chest, 3.0 Cm Or… 24 $289.14 $7,093.50 $3,049.00 nat. median
$3,062
1.0× median
36556
HCPCS 		Insertion Of Non-tunneled Central Venous Tube For Infusion (5 Years Or Older) 24 $550.00 $4,752.00 $3,009.60 nat. median
$2,458
1.2× median
56740
HCPCS 		Removal Of Cyst Of Female Genital Gland 23 $1,490.00 $4,721.78 $2,990.46 nat. median
$3,326
0.9× median
57200
HCPCS 		Suture Of Nonobstetrical Injury Of Vagina 23 $550.00 $4,721.78 $2,990.46 nat. median
$3,185
0.9× median
25447
HCPCS 		Replacement Of Joint Between Wrist And Fingers Using Tissue 24 $289.14 $6,202.80 $2,977.34 nat. median
$4,023
0.7× median
58600
HCPCS 		Tying Or Incision Of Fallopian Tubes 24 $289.14 $6,114.60 $2,935.01 nat. median
$3,265
0.9× median
46230
HCPCS 		Removal Of Multiple External Noncancer Growths Of Anus 24 $245.39 $6,055.50 $2,906.64 nat. median
$2,668
1.1× median
74174
HCPCS 		CT Scan Of Blood Vessels Of Abdomen And Pelvis With Contrast 24 $751.16 $4,339.50 $2,748.35 nat. median
$958
outlier · 2.9×
28285
HCPCS 		Correction Of Toe Joint Deformity 24 $1,490.00 $4,293.00 $2,718.90 nat. median
$3,551
0.8× median

Other procedures at this hospital

Browse this hospital's 2,188 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
             
49651 HCPCS Repair Of Recurrent Groin Hernia Using An Endoscope 47 24 $15,266.00 $12,976.10 $19.54 $22,899.00 $2,700.00 2026-03-02
J3380 HCPCS Injection, Vedolizumab, Intravenous, 1 Mg 24 24 $13,097.93 $11,133.24 $24.91 $13,097.93 $12,115.58 2026-03-02
J3101 HCPCS Injection, Tenecteplase, 1 Mg 24 24 $10,288.66 $8,745.36 $161.92 $10,288.66 $9,517.01 2026-03-02
49521 HCPCS Repair Of Trapped Or Strangulated Groin Hernia 47 24 $9,942.50 $8,451.13 $25.07 $14,913.75 $1,850.00 2026-03-02
28270 HCPCS Incision Of Joint Capsule Of Foot And Toe 44 24 $9,880.80 $8,398.68 $289.14 $14,821.20 $7,015.37 2026-03-02
J9217 HCPCS Leuprolide Acetate (for Depot Suspension), 7.5 Mg 93 24 $8,407.37 $7,146.26 $302.77 $29,207.29 $3,844.04 2026-03-02
44970 HCPCS Removal Of Appendix Using An Endoscope 44 24 $8,372.00 $7,116.20 $289.14 $12,558.00 $5,629.20 2026-03-02
36475 HCPCS Destruction Of First Incompetent Vein Of Arm Or Leg Using Radiofrequency And Ima… 24 24 $7,877.86 $6,696.18 $38.00 $11,816.79 $7,483.97 2026-03-02
47562 HCPCS Removal Of Gallbladder Using An Endoscope 44 24 $7,823.19 $6,649.71 $289.14 $11,734.79 $5,151.11 2026-03-02
66991 HCPCS Extracapsular Removal Of Cataract With Insertion Of Artificial Lens And Insertio… 23 23 $7,418.00 $6,305.30 $5,192.60 $11,127.00 $7,047.10 2026-03-02
20205 HCPCS Deep Biopsy Of Muscle 24 24 $7,258.68 $6,169.88 $1,015.00 $10,888.02 $6,895.75 2026-03-02
59514 HCPCS Cesarean Delivery 23 23 $7,050.00 $5,992.50 $395.00 $10,575.00 $6,697.50 2026-03-02
58670 HCPCS Destruction Of Fallopian Tubes Using An Endoscope 44 24 $6,590.00 $5,601.50 $289.14 $9,885.00 $4,431.00 2026-03-02
49593 HCPCS Initial Repair Of Sliding Hernia Of Abdomen, 3-10 Cm In Length 42 23 $6,415.00 $5,452.75 $392.50 $9,622.50 $4,618.80 2026-03-02
4490377_1 CDM Labor Room/delivery - General Classification 19 19 $6,250.00 $5,312.50 $160.00 $6,125.00 $5,000.00 2026-03-02
49591 HCPCS Initial Repair Of Sliding Hernia Of Abdomen, Less Than 3 Cm In Length 42 23 $6,141.00 $5,219.85 $234.25 $9,211.50 $4,421.52 2026-03-02
49505 HCPCS Repair Of Groin Hernia (5 Years Or Older) 44 24 $6,117.84 $5,200.16 $289.14 $9,176.76 $4,028.24 2026-03-02
C1764 HCPCS Event Recorder, Cardiac (implantable) 24 24 $6,000.00 $5,100.00 $3,600.00 $10,837.51 $5,700.00 2026-03-02
10180 HCPCS Complex Drainage Of Wound Infection After Surgery 48 24 $5,895.60 $5,011.27 $38.00 $8,970.32 $5,520.45 2026-03-02
46946 HCPCS Tying Of Multiple Internal Hemorrhoid Groups 45 24 $5,893.00 $5,009.05 $289.14 $8,839.50 $3,467.00 2026-03-02
36478 HCPCS Laser Destruction Of Incompetent Vein Of Arm Or Leg Using Imaging Guidance 24 24 $5,758.37 $4,894.61 $38.00 $8,637.56 $5,470.45 2026-03-02
58671 HCPCS Blockage Of Uterine Tubes By Device Using An Endoscope 24 24 $5,692.80 $4,838.88 $2,700.00 $8,539.20 $5,408.16 2026-03-02
J0840 HCPCS Injection, Crotalidae Polyvalent Immune Fab (ovine), Up To 1 Gram 24 24 $5,449.59 $4,632.15 $3,269.75 $5,449.59 $5,040.87 2026-03-02
J2182 HCPCS Injection, Mepolizumab, 1 Mg 24 24 $5,415.08 $4,602.82 $37.68 $5,415.08 $5,008.95 2026-03-02
28820 HCPCS Amputation Of Toe At Joint Between Forefoot And Toes 24 24 $5,107.20 $4,341.12 $1,490.00 $7,660.80 $4,851.84 2026-03-02
Q5108 HCPCS Injection, Pegfilgrastim-jmdb (fulphila), Biosimilar, 0.5 Mg 24 24 $5,081.18 $4,319.00 $395.59 $5,081.18 $4,700.09 2026-03-02
J2802 HCPCS Injection, Romiplostim, 1 Microgram 69 23 $4,955.44 $4,212.12 $1,486.65 $9,910.84 $4,707.67 2026-03-02
21552 HCPCS Removal Of Growth Of Soft Tissue Under Skin Of Neck Or Front Of Chest, 3.0 Cm Or… 45 24 $4,729.00 $4,019.65 $289.14 $7,093.50 $3,049.00 2026-03-02
28825 HCPCS Amputation Of Toe At Toe Joint 24 24 $4,708.80 $4,002.48 $1,490.00 $7,063.20 $4,473.36 2026-03-02
Q5119 HCPCS Injection, Rituximab-pvvr, Biosimilar, (ruxience), 10 Mg 23 23 $4,684.28 $3,981.64 $2,810.57 $4,684.28 $4,450.07 2026-03-02
66982 HCPCS Complex Removal Of Cataract With Insertion Of Prosthetic Lens 24 24 $4,652.00 $3,954.20 $1,490.00 $6,978.00 $4,419.40 2026-03-02
36571 HCPCS Insertion Of Central Venous Tube With Port For Infusion (5 Years Or Older) 47 24 $4,551.60 $3,868.86 $10.84 $6,827.40 $1,850.00 2026-03-02
66984 HCPCS Removal Of Cataract With Insertion Of Prosthetic Lens 24 24 $4,497.00 $3,822.45 $1,490.00 $6,745.50 $4,272.15 2026-03-02
38525 HCPCS Biopsy Or Removal Of Deep Lymph Nodes Of Underarm 45 24 $4,488.00 $3,814.80 $289.14 $6,732.00 $3,231.36 2026-03-02
Q4199 HCPCS Cygnus Matrix, Per Square Centimeter 184 23 $4,443.75 $3,777.19 $711.00 $14,220.00 $3,555.00 2026-03-02
11446 HCPCS Removal Of Noncancer Skin Growth Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, M… 24 24 $4,439.00 $3,773.15 $1,490.00 $6,658.50 $4,217.05 2026-03-02
J2506 HCPCS Injection, Pegfilgrastim, Excludes Biosimilar, 0.5 Mg 23 23 $4,396.47 $3,737.00 $2,637.88 $4,396.47 $4,176.65 2026-03-02
25447 HCPCS Replacement Of Joint Between Wrist And Fingers Using Tissue 45 24 $4,135.20 $3,514.92 $289.14 $6,202.80 $2,977.34 2026-03-02
58600 HCPCS Tying Or Incision Of Fallopian Tubes 45 24 $4,076.40 $3,464.94 $289.14 $6,114.60 $2,935.01 2026-03-02
46230 HCPCS Removal Of Multiple External Noncancer Growths Of Anus 45 24 $4,037.00 $3,431.45 $245.39 $6,055.50 $2,906.64 2026-03-02
25111 HCPCS Removal Of First Cyst Of Wrist 45 24 $3,921.50 $3,333.28 $289.14 $5,882.25 $2,307.00 2026-03-02
J0490 HCPCS Injection, Belimumab, 10 Mg 24 24 $3,884.42 $3,301.76 $57.66 $3,884.42 $3,593.09 2026-03-02
58605 HCPCS Tying Or Incision Of Fallopian Tubes During Same Hospitalization 47 24 $3,796.00 $3,226.60 $11.58 $5,694.00 $1,015.00 2026-03-02
36561 HCPCS Insertion Of Central Venous Tube With Port (5 Years Or Older) 68 24 $3,729.60 $3,170.16 $289.14 $7,231.50 $3,422.91 2026-03-02
21556 HCPCS Removal Of Growth Of Muscle Of Neck Or Front Of Chest, Less Than 5.0 Cm 45 24 $3,710.00 $3,153.50 $289.14 $5,565.00 $2,671.20 2026-03-02
6599415_1 CDM Tofidence 400 Mg/20 Ml Vial 19 19 $3,679.20 $3,127.32 $2,207.52 $3,605.62 $3,127.32 2026-03-02
26418 HCPCS Repair Of Tendon On Top Side Of Finger 45 24 $3,586.00 $3,048.10 $289.14 $5,379.00 $2,581.92 2026-03-02
59812 HCPCS Treatment Of Miscarriage 48 24 $3,484.92 $2,962.18 $550.00 $5,466.75 $3,192.32 2026-03-02
25105 HCPCS Incision Into Wrist Joint With Removal Of Joint Lining Tissue 45 24 $3,476.00 $2,954.60 $289.14 $5,214.00 $2,502.72 2026-03-02
J3358 HCPCS Ustekinumab, For Intravenous Injection, 1 Mg 24 24 $3,428.95 $2,914.61 $14.79 $3,428.95 $3,171.78 2026-03-02
J3240 HCPCS Injection, Thyrotropin Alpha, 0.9 Mg, Provided In 1.1 Mg Vial 24 24 $3,354.80 $2,851.58 $2,012.88 $3,354.80 $3,103.19 2026-03-02
20680 HCPCS Removal Of Deep Implant From Bone 24 24 $3,345.60 $2,843.76 $1,490.00 $5,018.40 $3,178.32 2026-03-02
Q4170 HCPCS Cygnus, Per Square Centimeter 207 23 $3,307.50 $2,811.38 $679.50 $7,357.50 $2,712.15 2026-03-02
95811 HCPCS Sleep Study In Sleep Lab With Continuous Airway Pressure (6 Years Or Older) 45 24 $3,300.00 $2,805.00 $289.14 $4,950.00 $2,310.00 2026-03-02
43246 HCPCS Insertion Of Stomach Tube Using A Flexible Endoscope 91 24 $3,277.26 $2,785.67 $176.66 $5,137.50 $2,466.00 2026-03-02
59414 HCPCS Delivery Of Placenta 23 23 $3,215.47 $2,733.15 $1,490.00 $4,823.21 $3,054.70 2026-03-02
36556 HCPCS Insertion Of Non-tunneled Central Venous Tube For Infusion (5 Years Or Older) 25 24 $3,168.00 $2,692.80 $550.00 $4,752.00 $3,009.60 2026-03-02
64719 HCPCS Release And/or Relocation Of Wrist Nerve 45 24 $3,160.80 $2,686.68 $289.14 $4,741.20 $2,275.78 2026-03-02
56740 HCPCS Removal Of Cyst Of Female Genital Gland 23 23 $3,147.85 $2,675.67 $1,490.00 $4,721.78 $2,990.46 2026-03-02
57200 HCPCS Suture Of Nonobstetrical Injury Of Vagina 23 23 $3,147.85 $2,675.67 $550.00 $4,721.78 $2,990.46 2026-03-02
56810 HCPCS Repair Of Skin In Area Between Anus And Genitals 43 23 $3,147.85 $2,675.67 $231.16 $4,721.78 $2,203.50 2026-03-02
19120 HCPCS Removal Of Growth And Tissue Of Breast, Duct, Or Nipple 45 24 $3,135.00 $2,664.75 $289.14 $4,702.50 $2,257.20 2026-03-02
10081 HCPCS Complicated Drainage Of Cyst Of Tailbone 45 24 $3,110.60 $2,644.01 $38.00 $4,665.90 $2,177.42 2026-03-02
95810 HCPCS Sleep Study In Sleep Lab (6 Years Or Older) 45 24 $2,900.00 $2,465.00 $289.14 $4,350.00 $2,030.00 2026-03-02
74174 HCPCS CT Scan Of Blood Vessels Of Abdomen And Pelvis With Contrast 24 24 $2,893.00 $2,459.05 $751.16 $4,339.50 $2,748.35 2026-03-02
11424 HCPCS Removal Of Noncancer Skin Growth Of Scalp, Neck, Hands, Feet, Or Genitals, 3.1-4… 83 24 $2,892.00 $2,458.20 $174.30 $4,548.75 $2,082.24 2026-03-02
J2315 HCPCS Injection, Naltrexone, Depot Form, 1 Mg 24 24 $2,890.49 $2,456.92 $4.18 $2,890.49 $2,673.70 2026-03-02
24071 HCPCS Removal Of Growth Under Skin Of Upper Arm Or Elbow, 3.0 Cm Or More 45 24 $2,870.44 $2,439.87 $289.14 $4,305.66 $1,710.00 2026-03-02
28285 HCPCS Correction Of Toe Joint Deformity 24 24 $2,862.00 $2,432.70 $1,490.00 $4,293.00 $2,718.90 2026-03-02
J0875 HCPCS Injection, Dalbavancin, 5 Mg 24 24 $2,846.03 $2,419.13 $19.23 $2,846.03 $2,632.58 2026-03-02
66830 HCPCS Removal Of Recurring Cataract In Lens Capsule With Sectioning Of Cornea And Scle… 24 24 $2,800.00 $2,380.00 $1,490.00 $4,200.00 $2,660.00 2026-03-02
58611 HCPCS Tying Or Incision Of Fallopian Tubes During Cesarean Delivery Or Other Abdominal… 24 24 $2,799.60 $2,379.66 $1,010.00 $4,199.40 $2,659.62 2026-03-02
23078 HCPCS Extensive Removal Of Growth Of Shoulder, 5.0 Cm Or More 43 23 $2,789.84 $2,371.36 $289.14 $4,184.76 $2,008.68 2026-03-02
46270 HCPCS Repair Of Abnormal Anal Drainage Tract 45 24 $2,748.00 $2,335.80 $289.14 $4,122.00 $1,978.56 2026-03-02
20525 HCPCS Complicated Removal Of Foreign Body In Deep Muscle Or Tendon 24 24 $2,719.20 $2,311.32 $1,490.00 $4,078.80 $2,583.24 2026-03-02
46255 HCPCS Removal Of Single External And Internal Hemorrhoid Group 24 24 $2,701.20 $2,296.02 $38.00 $4,051.80 $2,566.14 2026-03-02
36576 HCPCS Repair Of Central Venous Tube For Infusion With Port Or Pump 45 24 $2,642.40 $2,246.04 $281.55 $3,963.60 $1,902.53 2026-03-02
93306 HCPCS Ultrasound Of Heart With Color-depicted Blood Flow, Rate, Direction And Valve Fu… 24 24 $2,578.00 $2,191.30 $1,517.00 $3,867.00 $2,449.10 2026-03-02
45541 HCPCS Suture Of Rectum To Sacrum Through Perineum 23 23 $2,495.04 $2,120.78 $550.00 $3,742.56 $2,370.29 2026-03-02
11406 HCPCS Removal Of Noncancer Skin Growth Of Body, Arms, Or Legs, More Than 4.0 Cm 84 24 $2,468.40 $2,098.14 $38.00 $5,020.50 $1,777.25 2026-03-02
26160 HCPCS Removal Of Growth Of Tendon Finger Or Hand 24 24 $2,464.80 $2,095.08 $1,015.00 $3,697.20 $2,341.56 2026-03-02
27762 HCPCS Closed Treatment Of Inside Portion Of Shin Bone At Ankle With Manipulation 44 24 $2,447.76 $2,080.60 $265.84 $3,671.64 $1,576.72 2026-03-02
12034 HCPCS Intermediate Repair Of Wound Of Scalp, Underarms, Trunk, Arms, Or Legs, 7.6-12.5… 68 24 $2,446.00 $2,079.10 $201.60 $3,741.00 $1,795.68 2026-03-02
10121 HCPCS Removal Of Foreign Body From Tissue, Accessed Beneath The Skin, Complex 44 24 $2,434.82 $2,069.60 $289.14 $3,652.23 $1,603.18 2026-03-02
12017 HCPCS Simple Repair Of Surface Wound Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 20.… 45 24 $2,430.71 $2,066.10 $38.00 $3,646.07 $1,701.50 2026-03-02
45398 HCPCS Banding Of Hemorrhoids Using A Flexible Endoscope (colonoscope) 45 24 $2,419.00 $2,056.15 $231.70 $3,628.50 $1,441.00 2026-03-02
J1459 HCPCS Injection, Immune Globulin (privigen), Intravenous, Non-lyophilized (e.g., Liqui… 70 24 $2,416.68 $2,054.18 $52.38 $4,978.01 $2,235.43 2026-03-02
43249 HCPCS Balloon Dilation Of Esophagus, Stomach, And/or Upper Small Bowel Using A Flexibl… 44 24 $2,406.00 $2,045.10 $289.14 $3,609.00 $1,617.60 2026-03-02
67924 HCPCS Extensive Repair Of Turning-inward Eyelid Defect 23 23 $2,402.82 $2,042.40 $1,490.00 $3,604.23 $2,282.68 2026-03-02
45385 HCPCS Removal Of Polyps Or Growths Of Large Bowel Using An Endoscope With Mechanical S… 44 24 $2,386.19 $2,028.26 $289.14 $3,579.29 $1,571.16 2026-03-02
28190 HCPCS Removal Of Foreign Body Of Foot Tissue, Accessed Beneath The Skin 44 24 $2,367.00 $2,011.95 $245.00 $3,550.50 $1,680.57 2026-03-02
78452 HCPCS Nuclear Medicine Studies Of Heart Muscle At Rest And With Stress And Spect 24 24 $2,365.08 $2,010.32 $1,000.00 $3,547.62 $2,246.83 2026-03-02
12006 HCPCS Simple Repair Of Surface Wound Of Scalp, Neck, Underarms, Trunk, Arms, Or Legs, … 44 24 $2,362.17 $2,007.84 $289.14 $3,543.26 $1,588.26 2026-03-02
57415 HCPCS Removal Of Impacted Foreign Body In Vagina Under Anesthesia 24 24 $2,362.00 $2,007.70 $1,490.00 $3,543.00 $2,243.90 2026-03-02
10061 HCPCS Complicated Or Multiple Drainage Of Skin Abscess 92 24 $2,346.12 $1,994.20 $6.25 $3,574.50 $1,470.00 2026-03-02
45388 HCPCS Destruction Of Polyp Or Growth Of Large Bowel Using A Flexible Endoscope 44 24 $2,334.31 $1,984.16 $238.00 $3,501.47 $1,537.01 2026-03-02
11404 HCPCS Removal Of Noncancer Skin Growth Of Body, Arms, Or Legs, 3.1-4.0 Cm 84 24 $2,325.00 $1,976.25 $38.00 $3,588.60 $1,674.00 2026-03-02
21315 HCPCS Closed Treatment Of Broken Nose Bone With Manipulation 44 24 $2,323.20 $1,974.72 $149.72 $3,484.80 $1,649.47 2026-03-02
G0277 HCPCS Hyperbaric Oxygen Under Pressure, Full Body Chamber, Per 30 Minute Interval 23 23 $2,315.09 $1,967.83 $108.00 $3,472.64 $2,199.34 2026-03-02
59820 HCPCS Treatment Of Miscarriage During First Trimester 24 24 $2,294.40 $1,950.24 $1,490.00 $3,441.60 $2,179.68 2026-03-02
33285 HCPCS Insertion Of Heart Rhythm Monitor Under Skin 46 23 $2,275.00 $1,933.75 $1,330.00 $3,975.00 $1,908.00 2026-03-02
36590 HCPCS Removal Of Central Venous Tube With Port Or Pump 82 24 $2,265.60 $1,925.76 $193.32 $4,392.00 $1,631.23 2026-03-02
11426 HCPCS Removal Of Noncancer Skin Growth Of Scalp, Neck, Hands, Feet, Or Genitals, More … 84 24 $2,236.80 $1,901.28 $38.00 $4,752.75 $1,610.50 2026-03-02
27750 HCPCS Closed Treatment Of Broken Middle Part Of Shin Bone 44 24 $2,233.44 $1,898.42 $289.14 $3,350.16 $1,501.70 2026-03-02
27788 HCPCS Closed Treatment Of Broken Outside Lower Leg Bone At Ankle With Manipulation 44 24 $2,233.44 $1,898.42 $229.57 $3,350.16 $1,501.70 2026-03-02
27808 HCPCS Closed Treatment Of 2 Broken Lower Leg Bones At Ankle 44 24 $2,233.00 $1,898.05 $289.14 $3,349.50 $1,501.55 2026-03-02
C8929 HCPCS Transthoracic Echocardiography With Contrast, Or Without Contrast Followed By Wi… 46 24 $2,225.00 $1,891.25 $1,517.00 $3,867.00 $2,169.38 2026-03-02
28039 HCPCS Removal (1.5 Centimeters Or Greater) Tissue Growth Beneath The Skin Of Foot Or T… 47 24 $2,218.00 $1,885.30 $11.93 $3,327.00 $1,368.00 2026-03-02
J1950 HCPCS Injection, Leuprolide Acetate (for Depot Suspension), Per 3.75 Mg 24 24 $2,215.93 $1,883.54 $1,329.56 $2,215.93 $2,049.74 2026-03-02
J2357 HCPCS Injection, Omalizumab, 5 Mg 24 24 $2,198.07 $1,868.36 $47.68 $2,198.07 $2,033.22 2026-03-02
45380 HCPCS Biopsy Of Large Bowel Using A Flexible Endoscope 44 24 $2,188.42 $1,860.16 $289.14 $3,282.63 $1,440.95 2026-03-02
Q4186 HCPCS Epifix, Per Square Centimeter 207 23 $2,184.00 $1,856.40 $319.50 $15,627.00 $2,074.80 2026-03-02
12035 HCPCS Intermediate Repair Of Wound Of Scalp, Underarms, Trunk, Arms, Or Legs, 12.6-20.… 44 24 $2,167.20 $1,842.12 $289.14 $3,250.80 $1,538.71 2026-03-02
51102 HCPCS Aspiration Of Bladder With Insertion Of Bladder Tube To Skin 23 23 $2,151.58 $1,828.84 $1,506.11 $3,227.37 $2,044.00 2026-03-02
Q4187 HCPCS Epicord, Per Square Centimeter 69 23 $2,122.50 $1,804.13 $883.80 $5,302.50 $2,016.38 2026-03-02
45384 HCPCS Removal Of Polyps Or Growths Of Large Bowel Using A Flexible Endoscope With Elec… 44 24 $2,120.33 $1,802.28 $289.14 $3,180.50 $1,396.12 2026-03-02
45381 HCPCS Injection Beneath Lining Of Large Bowel Using A Flexible Endoscope 45 24 $2,120.33 $1,802.28 $198.45 $3,180.50 $1,308.00 2026-03-02
75635 HCPCS CT Scan Of Abdominal Aorta And Both Leg Arteries With Contrast 24 24 $2,103.00 $1,787.55 $358.87 $3,154.50 $1,997.85 2026-03-02
43247 HCPCS Removal Of Foreign Bodies Of Esophagus, Stomach, And/or Upper Small Bowel Using … 44 24 $2,101.00 $1,785.85 $175.00 $3,151.50 $1,383.35 2026-03-02
J0897 HCPCS Injection, Denosumab, 1 Mg 47 24 $2,077.36 $1,765.76 $24.57 $3,891.60 $2,077.36 2026-03-02
15851 HCPCS Removal Of Sutures Or Staples Under Anesthesia 45 23 $2,058.43 $1,749.67 $1.57 $3,087.65 $1,015.00 2026-03-02
45378 HCPCS Diagnostic Exam Of Large Bowel Using A Flexible Endoscope 44 24 $2,029.00 $1,724.65 $191.10 $3,043.50 $1,364.15 2026-03-02
15823 HCPCS Removal Of Excessive Skin And Fat Of Upper Eyelid 24 24 $2,025.60 $1,721.76 $1,015.00 $3,038.40 $1,924.32 2026-03-02
36573 HCPCS Insertion Of Tube For Infusion With Imaging Guidance And Review By Radiologist, … 46 23 $2,023.56 $1,720.03 $550.00 $3,324.00 $1,794.50 2026-03-02
74175 HCPCS CT Scan Of Blood Vessels Of Abdomen With Contrast 24 24 $2,022.00 $1,718.70 $358.87 $3,033.00 $1,920.90 2026-03-02
78700 HCPCS Nuclear Medicine Study Of Kidney 23 23 $2,012.00 $1,710.20 $805.59 $3,018.00 $1,911.40 2026-03-02
46320 HCPCS Removal Of External Hemorrhoid With Blood Clot 24 24 $2,010.00 $1,708.50 $1,407.00 $3,015.00 $1,909.50 2026-03-02
70498 HCPCS CT Scan Of Blood Vessels Of Neck With Contrast 46 24 $1,975.00 $1,678.75 $358.87 $3,000.00 $1,888.12 2026-03-02
78582 HCPCS Nuclear Medicine Study Of Lung Ventilation And Circulation 24 24 $1,972.00 $1,676.20 $686.32 $2,958.00 $1,873.40 2026-03-02
J1745 HCPCS Injection, Infliximab, Excludes Biosimilar, 10 Mg 24 24 $1,968.46 $1,673.19 $68.53 $1,968.46 $1,820.82 2026-03-02
64430 HCPCS Injection Of Anesthetic Agent And/or Steroid Into External Genitals And Anus Ner… 45 24 $1,952.40 $1,659.54 $227.50 $2,928.60 $1,405.73 2026-03-02
J3111 HCPCS Injection, Romosozumab-aqqg, 1 Mg 23 23 $1,950.01 $1,657.51 $1,170.01 $1,950.01 $1,852.51 2026-03-02
71275 HCPCS CT Scan Of Blood Vessels Of Chest With Contrast 90 24 $1,950.00 $1,657.50 $358.87 $3,000.00 $1,871.75 2026-03-02
70496 HCPCS CT Scan Of Blood Vessels Of Head With Contrast 24 24 $1,950.00 $1,657.50 $358.87 $2,925.00 $1,852.50 2026-03-02
31730 HCPCS Insertion Of Needle Wire Dilator Or Indwelling Tube For Oxygen Therapy 23 23 $1,940.60 $1,649.51 $550.00 $2,910.90 $1,843.57 2026-03-02
46221 HCPCS Removal Of External Hemorrhoids By Rubber Banding 46 24 $1,939.20 $1,648.32 $235.54 $2,908.80 $1,396.22 2026-03-02
64721 HCPCS Release And/or Relocation Of Hand Nerve 45 24 $1,930.00 $1,640.50 $289.14 $2,895.00 $1,389.60 2026-03-02
J7168 HCPCS Prothrombin Complex Concentrate (human), Kcentra, Per I.u. Of Factor Ix Activity 23 23 $1,929.60 $1,640.16 $1,157.76 $1,929.60 $1,833.12 2026-03-02
64708 HCPCS Release Of Arm Or Leg Nerve 45 24 $1,929.60 $1,640.16 $289.14 $2,894.40 $1,389.31 2026-03-02
10140 HCPCS Drainage Of Blood Or Fluid Accumulation 68 24 $1,904.78 $1,619.06 $38.00 $2,997.00 $1,438.56 2026-03-02
43245 HCPCS Dilation Of Stomach Outlet Using A Flexible Endoscope 45 24 $1,878.00 $1,596.30 $289.14 $2,817.00 $1,352.16 2026-03-02
73706 HCPCS CT Scan Of Blood Vessels Of Lower Leg With Contrast 46 23 $1,874.00 $1,592.90 $358.87 $2,811.00 $1,780.30 2026-03-02
73206 HCPCS CT Scan Of Blood Vessels Of Arm With Contrast 46 23 $1,874.00 $1,592.90 $358.87 $2,811.00 $1,780.30 2026-03-02
43239 HCPCS Biopsy Of Esophagus, Stomach, And/or Upper Small Bowel Using A Flexible Endoscop… 44 24 $1,851.24 $1,573.55 $142.80 $2,776.86 $1,218.93 2026-03-02
J0588 HCPCS Injection, Incobotulinumtoxin A, 1 Unit 24 24 $1,839.60 $1,563.66 $6.56 $1,839.60 $1,701.63 2026-03-02
28230 HCPCS Incision To Lengthen Foot Tendon 43 23 $1,834.75 $1,559.54 $289.14 $2,752.13 $1,321.02 2026-03-02
12007 HCPCS Simple Repair Of Surface Wound To Scalp, Neck, Underarms, Trunk, Arms, Or Legs, … 24 24 $1,828.00 $1,553.80 $550.00 $2,742.00 $1,736.60 2026-03-02
59160 HCPCS Scraping Of Lining Of Uterus After Delivery 24 24 $1,827.60 $1,553.46 $1,279.32 $2,741.40 $1,736.22 2026-03-02
67005 HCPCS Partial Removal Of Eye Fluid Between Lens And Retina 23 23 $1,824.00 $1,550.40 $1,276.80 $2,736.00 $1,732.80 2026-03-02
74280 HCPCS Double Contrast X-ray Of Large Intestine 24 24 $1,795.00 $1,525.75 $358.87 $2,692.50 $1,705.25 2026-03-02
26055 HCPCS Incision Of Tendon Covering Of Finger 45 24 $1,767.60 $1,502.46 $289.14 $2,651.40 $1,272.67 2026-03-02
46220 HCPCS Removal Of Single External Noncancer Growth Of Anus 45 24 $1,758.00 $1,494.30 $255.50 $2,637.00 $1,265.76 2026-03-02
78598 HCPCS Nuclear Medicine Study Of Lung Ventilation And Circulation And Blood Flow To Lun… 23 23 $1,757.00 $1,493.45 $1,055.73 $2,635.50 $1,669.15 2026-03-02
15116 HCPCS Outer Layer Self Skin Graft Of Face, Scalp, Eyelids, Mouth, Neck, Ears, Around E… 24 24 $1,747.89 $1,485.71 $38.00 $2,621.84 $1,660.50 2026-03-02
26080 HCPCS Incision Of Finger Joint For Exploration, Fluid Drainage, Or Removal Of Foreign … 24 24 $1,728.00 $1,468.80 $550.00 $2,592.00 $1,641.60 2026-03-02
26075 HCPCS Incision Of Lower Finger Joint For Exploration, Fluid Drainage, Or Removal Of Fo… 24 24 $1,728.00 $1,468.80 $550.00 $2,592.00 $1,641.60 2026-03-02
26070 HCPCS Incision Of Wrist Joint At Finger For Exploration, Fluid Drainage, Or Removal Of… 24 24 $1,728.00 $1,468.80 $550.00 $2,592.00 $1,641.60 2026-03-02
28024 HCPCS Incision Of Toe Joint For Exploration, Fluid Drainage, Or Removal Of Foreign Bod… 24 24 $1,728.00 $1,468.80 $38.00 $2,592.00 $1,641.60 2026-03-02
25500 HCPCS Closed Treatment Of Broken Midpart Of Forearm Bone On Thumb Side 44 24 $1,728.00 $1,468.80 $289.14 $2,592.00 $1,226.88 2026-03-02
24605 HCPCS Repair Of Dislocated Elbow Under Anesthesia 24 24 $1,715.00 $1,457.75 $550.00 $2,572.50 $1,629.25 2026-03-02
25605 HCPCS Closed Treatment Of Broken Or Growth Plate Separate Of Forearm Bone At Wrist Wit… 44 24 $1,704.00 $1,448.40 $289.14 $2,556.00 $1,209.84 2026-03-02
55040 HCPCS Removal Of Fluid Collection In Testicle And Sperm Reservoir 43 23 $1,700.00 $1,445.00 $289.14 $2,550.00 $1,224.00 2026-03-02
J2407 HCPCS Injection, Oritavancin (orbactiv), 10 Mg 24 24 $1,692.82 $1,438.90 $30.43 $1,692.82 $1,565.86 2026-03-02
32551 HCPCS Removal Of Fluid From Between Lung And Chest Cavity 46 23 $1,687.36 $1,434.26 $550.00 $2,531.04 $1,602.99 2026-03-02
43248 HCPCS Insertion Of Guide Wire With Dilation Of Esophagus Using A Flexible Endoscope 44 24 $1,675.00 $1,423.75 $171.50 $2,512.50 $1,126.25 2026-03-02
11443 HCPCS Removal Of Noncancer Skin Growth Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 2… 92 24 $1,672.80 $1,421.88 $38.00 $2,532.60 $1,371.51 2026-03-02
28010 HCPCS Repair Of Toe Tendon 24 24 $1,670.82 $1,420.20 $38.00 $2,506.23 $1,587.28 2026-03-02
49180 HCPCS Needle Biopsy Of Growth Of Abdominal Cavity 46 24 $1,664.00 $1,414.40 $87.50 $2,496.00 $1,118.90 2026-03-02
43235 HCPCS Diagnostic Exam Of Esophagus, Stomach, And/or Upper Small Bowel Using A Flexible… 47 24 $1,658.33 $1,409.58 $4.25 $2,487.50 $1,015.00 2026-03-02
6262903_1 CDM Tcc-ez Casting Systems-- 10 4 Casting/ Lg Boot 10 10 $1,651.50 — $825.75 $1,618.47 $1,585.45 2026-03-02
11422 HCPCS Removal Of Noncancer Skin Growth Of Scalp, Neck, Hands, Feet, Or Genitals, 1.1-2… 92 24 $1,626.00 $1,382.10 $4.66 $3,153.00 $1,154.46 2026-03-02
15115 HCPCS Outer Layer Self Skin Graft Of Face, Scalp, Eyelids, Mouth, Neck, Ears, Around E… 24 24 $1,621.72 $1,378.46 $38.00 $2,432.58 $1,540.63 2026-03-02
15004 HCPCS Preparation Of Skin Graft Site Of Face, Scalp, Eyelids, Mouth, Neck, Ears, Aroun… 24 24 $1,619.94 $1,376.95 $38.00 $2,429.91 $1,538.94 2026-03-02
15111 HCPCS Outer Layer Self Skin Graft To Trunk, Arms, Or Legs, Each Additional 100.0 Sq Cm… 24 24 $1,599.31 $1,359.41 $38.00 $2,398.97 $1,519.34 2026-03-02
15005 HCPCS Preparation Of Skin Graft Site Of Face, Scalp, Eyelids, Mouth, Neck, Ears, Aroun… 24 24 $1,589.24 $1,350.85 $38.00 $2,383.86 $1,509.78 2026-03-02
J1439 HCPCS Injection, Ferric Carboxymaltose, 1 Mg 24 24 $1,588.70 $1,350.40 $1.39 $1,588.70 $1,469.55 2026-03-02
94002 HCPCS Initial Hospital Inpatient Or Observation Ventilation Assistance And Management 23 23 $1,586.00 $1,348.10 $251.00 $2,379.00 $1,506.70 2026-03-02
11403 HCPCS Removal Of Noncancer Skin Growth Of Body, Arms, Or Legs, 2.1-3.0 Cm 107 24 $1,568.00 $1,332.80 $38.00 $2,352.60 $1,129.25 2026-03-02
J7307 HCPCS Etonogestrel (contraceptive) Implant System, Including Implant And Supplies 24 24 $1,558.00 $1,324.30 $934.80 $1,558.00 $1,441.15 2026-03-02
24075 HCPCS Removal Of Growth Under Skin Of Upper Arm Or Elbow, Less Than 3.0 Cm 24 24 $1,550.00 $1,317.50 $1,015.00 $2,325.00 $1,472.50 2026-03-02
43830 HCPCS Insertion Of Stomach Feeding Tube 46 23 $1,535.80 $1,776.50 $24.53 $3,135.00 $1,222.30 2026-03-02
Q0138 HCPCS Injection, Ferumoxytol, For Treatment Of Iron Deficiency Anemia, 1 Mg (non-esrd … 24 24 $1,512.16 $1,285.34 $1.37 $1,512.16 $1,398.74 2026-03-02
30300 HCPCS Removal Of Foreign Body In Nose 44 24 $1,506.00 $1,280.10 $217.00 $2,259.00 $991.60 2026-03-02
J2783 HCPCS Injection, Rasburicase, 0.5 Mg 24 24 $1,477.64 $1,255.99 $353.93 $1,477.64 $1,366.82 2026-03-02
A9567 HCPCS Technetium Tc-99m Pentetate, Diagnostic, Aerosol, Per Study Dose, Up To 75 Milli… 23 23 $1,461.25 $1,242.06 $1,022.88 $2,191.88 $1,388.19 2026-03-02
J7298 HCPCS Levonorgestrel-releasing Intrauterine Contraceptive System (mirena), 52 Mg 24 24 $1,457.00 $1,238.45 $874.20 $1,457.00 $1,372.88 2026-03-02
11442 HCPCS Removal Of Noncancer Skin Growth Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 1… 83 24 $1,456.80 $1,238.28 $163.80 $2,906.31 $1,048.90 2026-03-02
P9037 HCPCS Platelets, Pheresis, Leukocytes Reduced, Irradiated, Each Unit 23 23 $1,435.50 $1,220.18 $160.00 $2,153.25 $1,363.73 2026-03-02
32555 HCPCS Aspiration Of Fluid From Chest Cavity Using Imaging Guidance 49 24 $1,423.00 $1,209.55 $550.00 $2,134.50 $1,351.85 2026-03-02
59426 HCPCS Predelivery Care, 7 Or More Visits 20 20 $1,415.00 $1,202.75 $289.14 $2,122.50 $1,344.25 2026-03-02
78580 HCPCS Nuclear Medicine Study Of Lung Circulation 23 23 $1,415.00 $1,202.75 $805.59 $2,122.50 $1,344.25 2026-03-02
15110 HCPCS Outer Layer Self Skin Graft Of Trunk, Arms, Or Legs, 100.0 Sq Cm Or 1% Body Area… 24 24 $1,413.53 $1,201.50 $38.00 $2,120.30 $1,342.85 2026-03-02
64495 HCPCS Injection Of Lower Or Sacral Spine Facet Joint Using Imaging Guidance, Third And… 70 24 $1,404.00 $1,193.40 $1.81 $2,844.95 $1,295.62 2026-03-02
99291 HCPCS Critical Care, First 30-74 Minutes 45 24 $1,390.00 $1,181.50 $289.14 $2,505.00 $1,000.80 2026-03-02
J7296 HCPCS Levonorgestrel-releasing Intrauterine Contraceptive System, (kyleena), 19.5 Mg 47 24 $1,388.00 $1,179.80 $574.06 $1,388.00 $956.77 2026-03-02
99285 HCPCS Emergency Department Visit With High Level Of Medical Decision Making 48 24 $1,380.00 $1,173.00 $966.00 $2,110.00 $1,311.00 2026-03-02
11441 HCPCS Removal Of Noncancer Skin Growth Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 0… 44 24 $1,380.00 $1,173.00 $210.00 $2,070.00 $993.60 2026-03-02
58661 HCPCS Removal Of Ovaries And/or Tubes Using An Endoscope 45 24 $1,375.20 $1,168.92 $289.14 $6,188.00 $990.14 2026-03-02
40819 HCPCS Removal Of Tissue At Dental Edge And Cheek 43 23 $1,365.81 $1,160.94 $273.00 $2,048.72 $983.38 2026-03-02
26725 HCPCS Closed Treatment Of Broken Finger Or Thumb At Midportion Or Part Near Hand With … 44 24 $1,351.20 $1,148.52 $249.20 $2,026.80 $959.35 2026-03-02
12044 HCPCS Intermediate Repair Of Wound Of Neck, Hands, Feet, Or Genitals, 7.6-12.5 Cm 44 24 $1,342.15 $1,140.83 $289.14 $2,013.23 $878.50 2026-03-02
26775 HCPCS Closed Treatment Of Dislocated Finger Joint With Manipulation Under Anesthesia 24 24 $1,342.00 $1,140.70 $550.00 $2,013.00 $1,274.90 2026-03-02
24655 HCPCS Closed Treatment Of Broken Forearm Bone On Thumb Side At Elbow With Manipulation 44 24 $1,327.20 $1,128.12 $230.68 $1,990.80 $942.31 2026-03-02
64633 HCPCS Destruction Of Upper Or Middle Spinal Facet Joint Nerves Using Imaging Guidance,… 46 23 $1,312.23 $1,789.47 $7.75 $3,157.89 $996.44 2026-03-02
64635 HCPCS Destruction Of Lower Or Sacral Spinal Facet Joint Nerves Using Imaging Guidance,… 46 23 $1,309.39 $1,789.47 $7.64 $3,157.89 $993.61 2026-03-02
65855 HCPCS Laser Repair To Improve Eye Fluid Flow 23 23 $1,300.00 $1,105.00 $910.00 $1,950.00 $1,235.00 2026-03-02
27266 HCPCS Closed Treatment Of Dislocated Hip Prosthesis Under Anesthesia 24 24 $1,280.40 $1,088.34 $550.00 $1,920.60 $1,216.38 2026-03-02
12016 HCPCS Simple Repair Of Surface Wound Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 12.… 45 24 $1,278.40 $1,086.64 $38.00 $1,917.60 $894.88 2026-03-02
10120 HCPCS Removal Of Foreign Body From Tissue, Accessed Beneath The Skin, Simple 68 24 $1,278.00 $1,086.30 $186.90 $1,936.50 $929.52 2026-03-02
72191 HCPCS CT Scan Of Blood Vessels Of Pelvis With Contrast 23 23 $1,250.00 $1,062.50 $358.87 $1,875.00 $1,187.50 2026-03-02
27265 HCPCS Closed Treatment Of Dislocated Hip Prosthesis 24 24 $1,242.00 $1,055.70 $550.00 $1,863.00 $1,179.90 2026-03-02
27048 HCPCS Removal Of Growth Of Soft Tissue Of Pelvis And Hip, Less Than 5.0 Cm 45 24 $1,242.00 $1,055.70 $289.14 $1,863.00 $894.24 2026-03-02
67917 HCPCS Extensive Repair Of Turning-outward Eyelid Defect 46 23 $1,238.91 $2,042.40 $15.52 $3,604.23 $1,019.01 2026-03-02
12031 HCPCS Intermediate Repair Of Wound Of Scalp, Underarms, Trunk, Arms, Or Legs, 2.5 Cm O… 44 24 $1,238.40 $1,052.64 $289.14 $1,857.60 $879.26 2026-03-02
32554 HCPCS Aspiration Of Fluid From Chest Cavity 69 24 $1,225.00 $1,041.25 $89.60 $1,837.50 $882.00 2026-03-02
26040 HCPCS Release Of Tissue Of Palm 43 23 $1,220.00 $1,037.00 $271.87 $1,830.00 $878.40 2026-03-02
13132 HCPCS Complicated Repair Of Wound Of Forehead, Cheeks, Chin, Mouth, Neck, Underarms, G… 24 24 $1,198.80 $1,018.98 $550.00 $1,798.20 $1,138.86 2026-03-02
5416153_1 CDM Or G0120 Colon Ca Scrn:barium Hrisk 10 10 $1,196.50 — $598.25 $1,172.57 $1,148.64 2026-03-02
G0105 HCPCS Colorectal Cancer Screening; Colonoscopy On Individual At High Risk 44 24 $1,196.40 $1,016.94 $279.12 $1,794.60 $849.44 2026-03-02
G0121 HCPCS Colorectal Cancer Screening; Colonoscopy On Individual Not Meeting Criteria For … 44 24 $1,196.40 $1,016.94 $279.31 $1,794.60 $849.44 2026-03-02
17110 HCPCS Destruction Of Skin Growth, 1-14 Growths 69 24 $1,179.60 $1,002.66 $38.00 $2,353.31 $1,120.62 2026-03-02
10080 HCPCS Simple Drainage Of Cyst Of Tailbone 106 24 $1,167.60 $992.46 $38.00 $2,480.90 $1,118.10 2026-03-02
12053 HCPCS Intermediate Repair Of Wound Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 5.1-7… 68 24 $1,156.80 $983.28 $38.00 $2,307.81 $1,098.96 2026-03-02
J7301 HCPCS Levonorgestrel-releasing Intrauterine Contraceptive System (skyla), 13.5 Mg 24 24 $1,155.00 $981.75 $693.00 $1,155.00 $1,097.25 2026-03-02
90853 HCPCS Group Psychotherapy 61 21 $1,155.00 $981.75 $29.33 $1,800.00 $864.00 2026-03-02
12018 HCPCS Simple Repair Of Surface Wound Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, Mor… 21 21 $1,147.00 $974.95 $289.14 $1,720.50 $1,089.65 2026-03-02
62321 HCPCS Injection Of Substance Into Middle Or Upper Spine Canal Using Imaging Guidance 70 24 $1,142.40 $1,311.75 $3.71 $2,314.86 $1,054.22 2026-03-02
62323 HCPCS Injection Of Substance Into Lower Spine Canal Using Imaging Guidance 71 24 $1,142.40 $971.04 $3.43 $2,314.86 $1,028.16 2026-03-02
11772 HCPCS Complicated Removal Of Cyst Of Tailbone 21 21 $1,130.80 $961.18 $289.14 $4,175.00 $1,074.26 2026-03-02
81450 HCPCS Genomic Sequence Analysis Panel Of DNA Or Combined DNA And RNA Of 5-50 Genes Ass… 23 23 $1,127.52 $958.39 $789.26 $8,563.85 $1,093.69 2026-03-02
10160 HCPCS Aspiration Of Abscess, Blood, Or Cyst 68 24 $1,125.60 $956.76 $38.00 $2,245.58 $1,069.32 2026-03-02
94003 HCPCS Follow-up Inpatient Or Observation Ventilation Assistance And Management 23 23 $1,124.00 $955.40 $251.00 $1,686.00 $1,067.80 2026-03-02
45915 HCPCS Removal Of Impacted Stool Or Foreign Body In Rectum Under Anesthesia 23 23 $1,124.00 $955.40 $786.80 $1,686.00 $1,067.80 2026-03-02
2120839_1 CDM Room & Board - Private (one Bed) - General Classification 15 15 $1,105.00 $939.25 $773.50 $1,105.00 $1,082.90 2026-03-02
78708 HCPCS Nuclear Medicine Study Of Kidney, Blood, Flow, And Function With Drug Administra… 24 24 $1,100.00 $935.00 $770.00 $1,650.00 $1,045.00 2026-03-02
4634665_1 CDM Room & Board - Semi-private (two Beds) - General Classification 15 15 $1,095.00 $930.75 $766.50 $1,095.00 $1,073.10 2026-03-02
J0585 HCPCS Injection, Onabotulinumtoxina, 1 Unit 24 24 $1,081.80 $919.53 $7.88 $1,081.80 $1,000.66 2026-03-02
66821 HCPCS Removal Of Recurring Cataract In Lens Capsule Using A Laser 24 24 $1,081.20 $919.02 $756.84 $1,621.80 $1,027.14 2026-03-02
2120840_1 CDM Room & Board - Semi-private (two Beds) - General Classification 15 15 $1,070.00 $909.50 $749.00 $1,070.00 $1,048.60 2026-03-02
71555 HCPCS MRI Scan Of Blood Vessels Of Chest 24 24 $1,065.00 $905.25 $522.91 $1,597.50 $1,011.75 2026-03-02
73225 HCPCS MRI Scan Of Blood Vessels Of Arm 72 24 $1,065.00 $905.25 $545.73 $1,597.50 $1,011.75 2026-03-02
70549 HCPCS MRI Scan Of Blood Vessels Of Neck Before And After Contrast 24 24 $1,065.00 $905.25 $627.00 $1,597.50 $1,011.75 2026-03-02
73725 HCPCS MRI Scan Of Blood Vessels Of Leg 48 24 $1,065.00 $905.25 $526.26 $1,597.50 $1,011.75 2026-03-02
72159 HCPCS MRI Scan Of Blood Vessels Of Spinal Canal 24 24 $1,065.00 $905.25 $545.73 $1,597.50 $1,011.75 2026-03-02
72198 HCPCS MRI Scan Of Blood Vessels Of Pelvis 24 24 $1,065.00 $905.25 $532.30 $1,597.50 $1,011.75 2026-03-02
70546 HCPCS MRI Scan Of Blood Vessels Of Head Before And After Contrast 24 24 $1,065.00 $905.25 $627.00 $1,597.50 $1,011.75 2026-03-02
74185 HCPCS MRI Scan Of Blood Vessels Of Abdomen 24 24 $1,065.00 $905.25 $529.62 $1,597.50 $1,011.75 2026-03-02
5404228_1 CDM Nursery - General Classification 15 15 $1,055.00 $896.75 $738.50 $1,055.00 $1,033.90 2026-03-02
23500 HCPCS Closed Treatment Of Broken Collar Bone 24 24 $1,053.00 $895.05 $38.00 $1,579.50 $1,000.35 2026-03-02
70548 HCPCS MRI Scan Of Blood Vessels Of Neck With Contrast 24 24 $1,040.00 $884.00 $627.00 $1,560.00 $988.00 2026-03-02
70545 HCPCS MRI Scan Of Blood Vessels Of Head With Contrast 24 24 $1,040.00 $884.00 $627.00 $1,560.00 $988.00 2026-03-02
10005 HCPCS Fine Needle Aspiration Biopsy Using Ultrasound Guidance, First Growth 21 21 $1,037.00 $881.45 $637.27 $1,555.50 $985.15 2026-03-02
70544 HCPCS MRI Scan Of Blood Vessels Of Head Without Contrast 24 24 $1,035.00 $879.75 $478.61 $1,552.50 $983.25 2026-03-02
70547 HCPCS MRI Scan Of Blood Vessels Of Neck Without Contrast 24 24 $1,035.00 $879.75 $478.61 $1,552.50 $983.25 2026-03-02
J3304 HCPCS Injection, Triamcinolone Acetonide, Preservative-free, Extended-release, Microsp… 24 24 $1,026.00 $872.10 $23.23 $1,026.00 $949.05 2026-03-02
2120838_1 CDM Nursery - General Classification 15 15 $1,025.00 $871.25 $717.50 $1,025.00 $1,004.50 2026-03-02
4441947_1 CDM Room & Board - Private (one Bed) - General Classification 15 15 $1,015.00 $862.75 $710.50 $1,015.00 $994.70 2026-03-02
78709 HCPCS Nuclear Medicine Studies Of Kidney, Blood Flow, And Function 23 23 $1,005.00 $854.25 $703.50 $1,507.50 $954.75 2026-03-02
G0390 HCPCS Trauma Response Team Associated With Hospital Critical Care Service 24 24 $1,000.00 $850.00 $1.00 $1,500.00 $950.00 2026-03-02
64630 HCPCS Destruction Of External Genital Nerve 23 23 $986.95 $838.91 $675.00 $1,480.43 $937.60 2026-03-02
64494 HCPCS Injection Of Lower Or Sacral Spine Facet Joint Using Imaging Guidance, Second Le… 95 24 $985.20 $1,131.25 $1.79 $1,996.32 $958.23 2026-03-02
J7300 HCPCS Intrauterine Copper Contraceptive 47 24 $970.32 $824.77 $582.19 $1,263.07 $950.91 2026-03-02
93307 HCPCS Ultrasound Of Heart 24 24 $968.00 $822.80 $570.00 $1,680.00 $919.60 2026-03-02
93308 HCPCS Ultrasound Of Heart, Follow-up 24 24 $968.00 $822.80 $570.00 $1,806.00 $919.60 2026-03-02
4441941_1 CDM Room & Board - Semi-private (two Beds) - General Classification 15 15 $965.00 $820.25 $675.50 $965.00 $945.70 2026-03-02
12005 HCPCS Simple Repair Of Surface Wound Of Scalp, Neck, Underarms, Trunk, Arms, Or Legs, … 91 24 $961.20 $817.02 $38.00 $1,917.60 $913.14 2026-03-02
23655 HCPCS Closed Treatment Of Dislocated Shoulder With Manipulation Under Anesthesia 24 24 $961.20 $817.02 $550.00 $1,441.80 $913.14 2026-03-02
12015 HCPCS Simple Repair Of Surface Wound Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 7.6… 68 24 $961.00 $816.85 $38.00 $1,917.60 $912.95 2026-03-02
51720 HCPCS Instillation Of Anti-cancer Drug Into Bladder 24 24 $960.00 $816.00 $672.00 $1,440.00 $912.00 2026-03-02
45308 HCPCS Removal Of Polyp Or Growth Of Rectum And Large Bowel Using An Endoscope With Ele… 24 24 $960.00 $816.00 $672.00 $1,440.00 $912.00 2026-03-02
J3262 HCPCS Injection, Tocilizumab, 1 Mg 47 24 $951.34 $808.64 $6.53 $4,541.45 $951.34 2026-03-02
28222 HCPCS Removal Of Scar Tissue Of Multiple Foot Tendons 23 23 $950.00 $807.50 $665.00 $1,490.00 $902.50 2026-03-02
78707 HCPCS Nuclear Medicine Study Of Kidney, Blood Flow, And Function 23 23 $945.00 $803.25 $661.50 $1,417.50 $897.75 2026-03-02
J9202 HCPCS Goserelin Acetate Implant, Per 3.6 Mg 24 24 $940.33 $799.28 $564.20 $940.33 $869.80 2026-03-02
5404227_1 CDM Room & Board - Semi-private (two Beds) - General Classification 15 15 $940.00 $799.00 $658.00 $940.00 $921.20 2026-03-02
94660 HCPCS Therapy Procedure Using A Positive Pressure Ventilator 24 24 $939.75 $798.79 $251.00 $1,409.63 $892.76 2026-03-02
J0248 HCPCS Injection, Remdesivir, 1 Mg 23 23 $936.00 $795.60 $561.60 $936.00 $889.20 2026-03-02
25031 HCPCS Drainage Of Fluid Filled Sac In Wrist Joint 21 21 $934.00 $793.90 $289.14 $1,401.00 $887.30 2026-03-02
99284 HCPCS Emergency Department Visit With Moderate Level Of Medical Decision Making 48 24 $925.00 $786.25 $647.50 $1,704.00 $878.75 2026-03-02
P9035 HCPCS Platelets, Pheresis, Leukocytes Reduced, Each Unit 23 23 $923.00 $784.55 $160.00 $1,384.50 $876.85 2026-03-02
23491 HCPCS Stabilization Of Top Of Upper Arm Bone With Device 20 20 $918.66 $780.86 $289.14 $1,377.99 $872.73 2026-03-02
6531900_1 CDM Tcc-ez 3 Casting System Ca/5 No Boot 10 10 $913.50 — $456.75 $895.23 $876.97 2026-03-02
6531876_1 CDM Tcc-ez Casting System 3 Casting System Case/5 1 Regular Boot 10 10 $910.60 — $455.30 $892.39 $874.17 2026-03-02
11646 HCPCS Removal Of Cancer Skin Growth Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, More… 21 21 $906.00 $770.10 $289.14 $1,878.00 $860.70 2026-03-02
11771 HCPCS Extensive Removal Of Cyst Of Tailbone 60 24 $900.00 $765.00 $289.14 $5,468.40 $891.00 2026-03-02
P9016 HCPCS Red Blood Cells, Leukocytes Reduced, Each Unit 24 24 $890.00 $756.50 $160.00 $1,335.00 $845.50 2026-03-02
78472 HCPCS Nuclear Medicine Study Of Heart Pumping Function By Labeling Red Blood Cells Wit… 24 24 $890.00 $756.50 $502.32 $1,335.00 $845.50 2026-03-02
77049 HCPCS MRI Scan Of Both Breasts 24 24 $885.61 $752.77 $492.70 $1,328.42 $841.33 2026-03-02
77046 HCPCS MRI Scan Of 1 Breast Without Contrast 48 24 $885.61 $752.77 $478.61 $1,328.42 $841.33 2026-03-02
77047 HCPCS MRI Scan Of Both Breasts Without Contrast 24 24 $885.61 $752.77 $478.61 $1,328.42 $841.33 2026-03-02
77048 HCPCS MRI Scan Of 1 Breast 48 24 $885.61 $752.77 $497.39 $1,328.42 $841.33 2026-03-02
72156 HCPCS MRI Scan Of Upper Spinal Canal Before And After Contrast 24 24 $885.00 $752.25 $521.00 $1,327.50 $840.75 2026-03-02
73220 HCPCS MRI Scan Of Arm Before And After Contrast 96 24 $885.00 $752.25 $521.00 $1,327.50 $840.75 2026-03-02
71552 HCPCS MRI Scan Of Chest Before And After Contrast 24 24 $885.00 $752.25 $521.00 $1,327.50 $840.75 2026-03-02
72158 HCPCS MRI Scan Of Lower Spinal Canal Before And After Contrast 24 24 $885.00 $752.25 $521.00 $1,327.50 $840.75 2026-03-02
73723 HCPCS MRI Scan Of Leg Joint Before And After Contrast 48 24 $885.00 $752.25 $521.00 $1,327.50 $840.75 2026-03-02
93970 HCPCS Ultrasound Study Of Arm Or Leg Veins With Compression And Maneuvers 24 24 $885.00 $752.25 $476.00 $1,327.50 $840.75 2026-03-02
93978 HCPCS Complete Ultrasound Of Aorta, Vena Cava, Groin Vessels Or Bypass Grafts 24 24 $885.00 $752.25 $476.00 $1,327.50 $840.75 2026-03-02
72197 HCPCS MRI Scan Of Pelvis Before And After Contrast 24 24 $885.00 $752.25 $521.00 $1,327.50 $840.75 2026-03-02
93925 HCPCS Ultrasound Of Leg Arteries Or Artery Grafts 24 24 $885.00 $752.25 $476.00 $1,327.50 $840.75 2026-03-02
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