|
C1826
|
HCPCS
|
Generator, Neurostimulator (implantable), Includes Closed Feedback Loop Leads An…
|
18
|
18
|
$52,650.00
|
$47,385.00
|
$27,378.00
|
$53,176.50
|
$50,017.50
|
2026-03-10
|
|
C1820
|
HCPCS
|
Generator, Neurostimulator (implantable), With Rechargeable Battery And Charging…
|
54
|
18
|
$44,850.00
|
$40,365.00
|
$18,099.90
|
$55,146.00
|
$42,159.00
|
2026-03-10
|
|
950
|
MS_DRG
|
Aftercare Without Cc/mcc
|
15
|
15
|
$21,188.38
|
$19,069.54
|
$3,266.24
|
$20,340.84
|
$19,069.54
|
2026-03-10
|
|
J1932
|
HCPCS
|
Injection, Lanreotide, (cipla), 1 Mg
|
18
|
18
|
$18,894.52
|
$17,005.07
|
$9,825.15
|
$19,083.47
|
$17,949.79
|
2026-03-10
|
|
J3380
|
HCPCS
|
Injection, Vedolizumab, Intravenous, 1 Mg
|
18
|
18
|
$18,495.20
|
$16,645.68
|
$9,617.50
|
$18,680.15
|
$17,570.44
|
2026-03-10
|
|
200
|
MS_DRG
|
Pneumothorax With Cc
|
15
|
15
|
$17,850.70
|
$16,065.63
|
$4,257.18
|
$17,136.67
|
$16,065.63
|
2026-03-10
|
|
J0180
|
HCPCS
|
Injection, Agalsidase Beta, 1 Mg
|
18
|
18
|
$15,654.94
|
$14,089.45
|
$8,140.57
|
$15,811.49
|
$14,872.19
|
2026-03-10
|
|
949
|
MS_DRG
|
Aftercare With Cc/mcc
|
15
|
15
|
$16,033.81
|
$14,430.43
|
$6,241.31
|
$15,392.46
|
$14,430.43
|
2026-03-10
|
|
J7170
|
HCPCS
|
Injection, Emicizumab-kxwh, 0.5 Mg
|
72
|
18
|
$19,709.85
|
$17,738.86
|
$3,726.95
|
$36,194.44
|
$14,334.42
|
2026-03-10
|
|
J3101
|
HCPCS
|
Injection, Tenecteplase, 1 Mg
|
18
|
18
|
$15,077.80
|
$13,570.02
|
$7,840.46
|
$15,228.58
|
$14,323.91
|
2026-03-10
|
|
788
|
MS_DRG
|
Cesarean Section Without Sterilization Without Cc/mcc
|
15
|
15
|
$13,480.10
|
$12,132.09
|
$3,590.01
|
$12,940.90
|
$12,132.09
|
2026-03-10
|
|
292
|
MS_DRG
|
Heart Failure And Shock With Cc
|
15
|
15
|
$13,148.85
|
$11,833.97
|
$4,670.19
|
$12,622.90
|
$11,833.97
|
2026-03-10
|
|
28805
|
HCPCS
|
Amputation Of Foot Across Instep
|
18
|
18
|
$11,999.00
|
$10,799.10
|
$6,239.48
|
$12,118.99
|
$11,399.05
|
2026-03-10
|
|
58554
|
HCPCS
|
Removal Of Uterus, Tubes, And/or Ovaries Through Vagina Using An Endoscope, More…
|
18
|
18
|
$11,950.00
|
$10,755.00
|
$6,214.00
|
$12,069.50
|
$11,352.50
|
2026-03-10
|
|
J7192
|
HCPCS
|
Factor Viii (antihemophilic Factor, Recombinant) Per I.u., Not Otherwise Specifi…
|
18
|
18
|
$11,505.14
|
$10,354.63
|
$5,982.67
|
$11,620.19
|
$10,929.88
|
2026-03-10
|
|
552
|
MS_DRG
|
Medical Back Problems Without Mcc
|
15
|
15
|
$11,919.18
|
$10,727.26
|
$4,860.81
|
$11,442.41
|
$10,727.26
|
2026-03-10
|
|
179
|
MS_DRG
|
Respiratory Infections And Inflammations Without Cc/mcc
|
15
|
15
|
$10,357.88
|
$9,322.09
|
$2,922.84
|
$10,357.88
|
$9,839.99
|
2026-03-10
|
|
191
|
MS_DRG
|
Chronic Obstructive Pulmonary Disease With Cc
|
15
|
15
|
$10,432.60
|
$9,389.34
|
$3,240.54
|
$10,015.30
|
$9,389.34
|
2026-03-10
|
|
42820
|
HCPCS
|
Removal Of Tonsils And Adenoid Glands (younger Than 12 Years)
|
18
|
18
|
$9,694.00
|
$8,724.60
|
$5,040.88
|
$9,790.94
|
$9,209.30
|
2026-03-10
|
|
192
|
MS_DRG
|
Chronic Obstructive Pulmonary Disease Without Cc/mcc
|
15
|
15
|
$9,996.45
|
$8,996.81
|
$2,478.06
|
$9,596.59
|
$8,996.81
|
2026-03-10
|
|
194
|
MS_DRG
|
Simple Pneumonia And Pleurisy With Cc
|
15
|
15
|
$9,747.65
|
$8,772.89
|
$4,193.64
|
$9,357.74
|
$8,772.89
|
2026-03-10
|
|
J2356
|
HCPCS
|
Injection, Tezepelumab-ekko, 1 Mg
|
18
|
18
|
$8,632.20
|
$7,768.98
|
$4,488.74
|
$8,718.52
|
$8,200.59
|
2026-03-10
|
|
554
|
MS_DRG
|
Bone Diseases And Arthropathies Without Mcc
|
15
|
15
|
$8,926.90
|
$8,034.21
|
$5,083.20
|
$8,569.82
|
$8,034.21
|
2026-03-10
|
|
57135
|
HCPCS
|
Removal Of Cyst Or Growth Of Vaginal
|
18
|
18
|
$8,415.00
|
$7,573.50
|
$4,375.80
|
$8,499.15
|
$7,994.25
|
2026-03-10
|
|
4490377_1
|
CDM
|
Labor Room/delivery - General Classification
|
14
|
14
|
$7,922.00
|
$7,129.80
|
$4,119.44
|
$7,605.12
|
$7,248.63
|
2026-03-10
|
|
4474176_1
|
CDM
|
Operating Room Services - General Classification
|
14
|
14
|
$7,863.15
|
$7,076.84
|
$4,088.84
|
$7,548.62
|
$7,194.78
|
2026-03-10
|
|
44146
|
HCPCS
|
Partial Removal Of Large Bowel And Reattachment To Rectum And Creation Of Large …
|
18
|
18
|
$7,500.00
|
$6,750.00
|
$3,900.00
|
$7,575.00
|
$7,125.00
|
2026-03-10
|
|
190
|
MS_DRG
|
Chronic Obstructive Pulmonary Disease With Mcc
|
15
|
15
|
$7,487.60
|
$6,738.84
|
$5,083.20
|
$7,487.60
|
$7,113.22
|
2026-03-10
|
|
605
|
MS_DRG
|
Trauma To The Skin, Subcutaneous Tissue And Breast Without Mcc
|
15
|
15
|
$7,710.80
|
$6,939.72
|
$4,288.95
|
$7,402.37
|
$6,939.72
|
2026-03-10
|
|
Q4197
|
HCPCS
|
Puraply Xt, Per Square Centimeter
|
36
|
18
|
$10,650.00
|
$9,585.00
|
$2,652.00
|
$16,362.00
|
$6,787.50
|
2026-03-10
|
|
J1306
|
HCPCS
|
Injection, Inclisiran, 1 Mg
|
18
|
18
|
$7,089.36
|
$6,380.42
|
$3,686.47
|
$7,160.25
|
$6,734.89
|
2026-03-10
|
|
195
|
MS_DRG
|
Simple Pneumonia And Pleurisy Without Cc/mcc
|
15
|
15
|
$7,177.25
|
$6,459.53
|
$3,558.24
|
$6,890.16
|
$6,574.95
|
2026-03-10
|
|
L8689
|
HCPCS
|
External Recharging System For Battery (internal) For Use With Implantable Neuro…
|
18
|
18
|
$6,825.00
|
$6,142.50
|
$3,549.00
|
$6,893.25
|
$6,483.75
|
2026-03-10
|
|
807
|
MS_DRG
|
Vaginal Delivery Without Sterilization Or D&c Without Cc/mcc
|
15
|
15
|
$7,169.03
|
$6,452.12
|
$2,668.68
|
$6,882.26
|
$6,452.12
|
2026-03-10
|
|
J2182
|
HCPCS
|
Injection, Mepolizumab, 1 Mg
|
18
|
18
|
$6,641.98
|
$5,977.78
|
$3,453.83
|
$6,708.40
|
$6,309.88
|
2026-03-10
|
|
948
|
MS_DRG
|
Signs And Symptoms Without Mcc
|
15
|
15
|
$6,593.40
|
$5,934.06
|
$4,440.10
|
$7,116.48
|
$6,263.73
|
2026-03-10
|
|
805
|
MS_DRG
|
Vaginal Delivery Without Sterilization Or D&c With Mcc
|
15
|
15
|
$6,551.70
|
$5,896.53
|
$3,113.46
|
$6,551.70
|
$6,224.12
|
2026-03-10
|
|
27590
|
HCPCS
|
Amputation Of Thigh Through Thigh Bone
|
18
|
18
|
$6,500.00
|
$5,850.00
|
$3,380.00
|
$6,565.00
|
$6,175.00
|
2026-03-10
|
|
204
|
MS_DRG
|
Respiratory Signs And Symptoms
|
15
|
15
|
$6,587.30
|
$5,928.57
|
$3,113.46
|
$6,494.39
|
$6,169.67
|
2026-03-10
|
|
563
|
MS_DRG
|
Fracture, Sprain, Strain And Dislocation Except Femur, Hip, Pelvis And Thigh Wit…
|
15
|
15
|
$6,800.28
|
$6,120.25
|
$4,829.26
|
$6,528.27
|
$6,120.25
|
2026-03-10
|
|
27880
|
HCPCS
|
Amputation Of Both Lower Leg Bones
|
18
|
18
|
$6,400.00
|
$5,760.00
|
$3,328.00
|
$6,464.00
|
$6,080.00
|
2026-03-10
|
|
14001
|
HCPCS
|
Repair Of Wound Of Trunk By Transferring Skin, 10.1-30.0 Sq Cm
|
18
|
18
|
$6,000.00
|
$5,400.00
|
$3,120.00
|
$6,060.00
|
$5,700.00
|
2026-03-10
|
|
382
|
MS_DRG
|
Complicated Peptic Ulcer Without Cc/mcc
|
15
|
15
|
$5,853.00
|
$5,267.70
|
$3,685.32
|
$5,853.00
|
$5,560.35
|
2026-03-10
|
|
69610
|
HCPCS
|
Repair Of Eardrum
|
18
|
18
|
$5,688.00
|
$5,119.20
|
$2,957.76
|
$5,744.88
|
$5,403.60
|
2026-03-10
|
|
177
|
MS_DRG
|
Respiratory Infections And Inflammations With Mcc
|
15
|
15
|
$5,592.10
|
$5,032.89
|
$4,753.29
|
$6,290.46
|
$5,312.50
|
2026-03-10
|
|
58670
|
HCPCS
|
Destruction Of Fallopian Tubes Using An Endoscope
|
18
|
18
|
$5,565.00
|
$5,008.50
|
$2,893.80
|
$5,620.65
|
$5,286.75
|
2026-03-10
|
|
641
|
MS_DRG
|
Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes Withou…
|
15
|
15
|
$5,432.06
|
$4,888.85
|
$4,617.25
|
$5,432.06
|
$5,160.45
|
2026-03-10
|
|
872
|
MS_DRG
|
Septicemia Or Severe Sepsis Without Mv >96 Hours Without Mcc
|
15
|
15
|
$5,418.10
|
$4,876.29
|
$4,605.39
|
$5,418.10
|
$5,147.20
|
2026-03-10
|
|
866
|
MS_DRG
|
Viral Illness Without Mcc
|
15
|
15
|
$5,642.35
|
$5,078.12
|
$3,462.93
|
$5,416.66
|
$5,098.22
|
2026-03-10
|
|
58561
|
HCPCS
|
Removal Of Growth Of Muscle Of Uterus Using An Endoscope
|
18
|
18
|
$5,365.00
|
$4,828.50
|
$2,789.80
|
$5,418.65
|
$5,096.75
|
2026-03-10
|
|
42830
|
HCPCS
|
Primary Removal Of Adenoids (younger Than 12 Years)
|
18
|
18
|
$5,221.00
|
$4,698.90
|
$2,714.92
|
$5,273.21
|
$4,959.95
|
2026-03-10
|
|
44145
|
HCPCS
|
Partial Removal Of Large Bowel And Reattachment To Rectum
|
18
|
18
|
$5,000.00
|
$4,500.00
|
$2,600.00
|
$5,050.00
|
$4,750.00
|
2026-03-10
|
|
44120
|
HCPCS
|
Partial Removal Of Small Bowel With Reconnection
|
18
|
18
|
$5,000.00
|
$4,500.00
|
$2,600.00
|
$5,050.00
|
$4,750.00
|
2026-03-10
|
|
379
|
MS_DRG
|
Gastrointestinal Hemorrhage Without Cc/mcc
|
15
|
15
|
$4,935.50
|
$4,441.95
|
$2,922.84
|
$4,935.50
|
$4,688.73
|
2026-03-10
|
|
373
|
MS_DRG
|
Major Gastrointestinal Disorders And Peritoneal Infections Without Cc/mcc
|
15
|
15
|
$4,886.45
|
$4,397.81
|
$3,049.92
|
$4,886.45
|
$4,642.13
|
2026-03-10
|
|
28315
|
HCPCS
|
Removal Of Small Bone Underlying Long Bone Of Foot At Big Toe Joint
|
18
|
18
|
$4,720.00
|
$4,248.00
|
$2,454.40
|
$4,767.20
|
$4,484.00
|
2026-03-10
|
|
42821
|
HCPCS
|
Removal Of Tonsils And Adenoid Glands (12 Years Or Older)
|
18
|
18
|
$4,668.85
|
$4,201.97
|
$2,427.80
|
$4,715.54
|
$4,435.41
|
2026-03-10
|
|
6579135_1
|
CDM
|
C1713 Allograft Graftlink: D=10.0 L=68 Mm
|
6
|
6
|
$4,950.70
|
$4,455.63
|
$1,732.75
|
$4,752.67
|
$4,331.86
|
2026-03-10
|
|
58563
|
HCPCS
|
Exam Of Uterus With Destruction Of Lining Of Uterus Using An Endoscope
|
18
|
18
|
$4,495.00
|
$4,045.50
|
$2,337.40
|
$4,539.95
|
$4,270.25
|
2026-03-10
|
|
58600
|
HCPCS
|
Tying Or Incision Of Fallopian Tubes
|
18
|
18
|
$4,413.00
|
$3,971.70
|
$2,294.76
|
$4,457.13
|
$4,192.35
|
2026-03-10
|
|
28289
|
HCPCS
|
Correction Of Rigid Deformity Of First Joint Of Big Toe
|
18
|
18
|
$4,400.00
|
$3,960.00
|
$2,288.00
|
$4,444.00
|
$4,180.00
|
2026-03-10
|
|
C1778
|
HCPCS
|
Lead, Neurostimulator (implantable)
|
18
|
18
|
$4,377.80
|
$3,940.02
|
$2,276.46
|
$4,421.58
|
$4,158.91
|
2026-03-10
|
|
29827
|
HCPCS
|
Repair Of Shoulder Rotator Cuff Using An Endoscope
|
36
|
18
|
$7,040.83
|
$6,336.74
|
$1,047.10
|
$12,188.68
|
$4,154.57
|
2026-03-10
|
|
27827
|
HCPCS
|
Treatment Of Broken Shin Bone At Lower Weight Bearing Joint
|
35
|
18
|
$7,942.00
|
$7,147.80
|
$751.92
|
$8,021.42
|
$4,129.84
|
2026-03-10
|
|
30520
|
HCPCS
|
Reshaping Of Nasal Cartilage
|
18
|
18
|
$4,305.00
|
$3,874.50
|
$2,238.60
|
$4,348.05
|
$4,089.75
|
2026-03-10
|
|
27823
|
HCPCS
|
Treatment Of 3 Broken Lower Leg Bones At Ankle With Fixation Of Posterior Lip
|
36
|
18
|
$6,807.50
|
$6,126.75
|
$1,159.60
|
$11,498.85
|
$4,086.25
|
2026-03-10
|
|
390
|
MS_DRG
|
Gastrointestinal Obstruction Without Cc/mcc
|
15
|
15
|
$4,221.25
|
$3,799.13
|
$2,954.61
|
$4,221.25
|
$4,010.19
|
2026-03-10
|
|
36558
|
HCPCS
|
Insertion Of Tunneled Central Venous Tube For Infusion (5 Years Or Older)
|
18
|
18
|
$4,130.00
|
$3,717.00
|
$2,147.60
|
$4,171.30
|
$3,923.50
|
2026-03-10
|
|
4634657_1
|
CDM
|
Room & Board - Semi-private (two Beds) - General Classification
|
14
|
14
|
$4,117.00
|
$3,705.30
|
$3,499.45
|
$4,117.00
|
$3,911.15
|
2026-03-10
|
|
66984
|
HCPCS
|
Removal Of Cataract With Insertion Of Prosthetic Lens
|
18
|
18
|
$4,107.00
|
$3,696.30
|
$2,135.64
|
$4,148.07
|
$3,901.65
|
2026-03-10
|
|
44950
|
HCPCS
|
Removal Of Appendix
|
35
|
18
|
$7,502.00
|
$6,751.80
|
$330.23
|
$7,577.02
|
$3,901.04
|
2026-03-10
|
|
23430
|
HCPCS
|
Anchoring Of Biceps Tendon
|
36
|
18
|
$6,760.46
|
$6,084.41
|
$730.56
|
$12,237.16
|
$3,859.64
|
2026-03-10
|
|
J9312
|
HCPCS
|
Injection, Rituximab, 10 Mg
|
36
|
18
|
$5,847.75
|
$5,262.98
|
$1,737.68
|
$8,437.34
|
$3,859.55
|
2026-03-10
|
|
21552
|
HCPCS
|
Removal Of Growth Of Soft Tissue Under Skin Of Neck Or Front Of Chest, 3.0 Cm Or…
|
18
|
18
|
$4,049.00
|
$3,644.10
|
$2,105.48
|
$4,089.49
|
$3,846.55
|
2026-03-10
|
|
93
|
MS_DRG
|
Other Disorders Of Nervous System Without Cc/mcc
|
15
|
15
|
$4,002.60
|
$3,602.34
|
$3,402.21
|
$4,002.60
|
$3,802.47
|
2026-03-10
|
|
66982
|
HCPCS
|
Complex Removal Of Cataract With Insertion Of Prosthetic Lens
|
18
|
18
|
$3,994.00
|
$3,594.60
|
$2,076.88
|
$4,033.94
|
$3,794.30
|
2026-03-10
|
|
59400
|
HCPCS
|
Vaginal Delivery With Care Before And After Delivery
|
17
|
17
|
$3,911.00
|
$3,519.90
|
$330.23
|
$3,950.11
|
$3,715.45
|
2026-03-10
|
|
52500
|
HCPCS
|
Removal Of Bladder Neck Through Urethra
|
18
|
18
|
$3,900.00
|
$3,510.00
|
$2,028.00
|
$3,939.00
|
$3,705.00
|
2026-03-10
|
|
310
|
MS_DRG
|
Cardiac Arrhythmia And Conduction Disorders Without Cc/mcc
|
15
|
15
|
$3,860.53
|
$3,474.47
|
$2,255.67
|
$3,860.53
|
$3,667.50
|
2026-03-10
|
|
J3032
|
HCPCS
|
Injection, Eptinezumab-jjmr, 1 Mg
|
18
|
18
|
$3,833.58
|
$3,450.22
|
$1,993.46
|
$3,871.92
|
$3,641.90
|
2026-03-10
|
|
42826
|
HCPCS
|
Removal Of Tonsils (12 Years Or Older)
|
18
|
18
|
$3,781.28
|
$3,403.15
|
$1,966.27
|
$3,819.09
|
$3,592.22
|
2026-03-10
|
|
28288
|
HCPCS
|
Removal Of Foot Bone Spur
|
18
|
18
|
$3,760.00
|
$3,384.00
|
$1,955.20
|
$3,797.60
|
$3,572.00
|
2026-03-10
|
|
947
|
MS_DRG
|
Signs And Symptoms With Mcc
|
15
|
15
|
$3,751.05
|
$3,375.95
|
$3,188.39
|
$7,529.49
|
$3,563.50
|
2026-03-10
|
|
52260
|
HCPCS
|
Dilation Of Bladder Using An Endoscope Under General Or Spinal Anesthesia
|
18
|
18
|
$3,740.00
|
$3,366.00
|
$1,944.80
|
$3,777.40
|
$3,553.00
|
2026-03-10
|
|
58700
|
HCPCS
|
Removal Of Uterine Tubes
|
18
|
18
|
$3,680.00
|
$3,312.00
|
$1,913.60
|
$3,716.80
|
$3,496.00
|
2026-03-10
|
|
884
|
MS_DRG
|
Organic Disturbances And Intellectual Disability
|
15
|
15
|
$3,649.85
|
$3,284.87
|
$3,102.37
|
$5,305.59
|
$3,467.36
|
2026-03-10
|
|
690
|
MS_DRG
|
Kidney And Urinary Tract Infections Without Mcc
|
15
|
15
|
$3,581.00
|
$3,222.90
|
$3,043.85
|
$4,034.79
|
$3,401.95
|
2026-03-10
|
|
4634667_1
|
CDM
|
Nursery - Newborn - Level Iii
|
14
|
14
|
$3,551.00
|
$3,195.90
|
$3,018.35
|
$3,551.00
|
$3,373.45
|
2026-03-10
|
|
J0897
|
HCPCS
|
Injection, Denosumab, 1 Mg
|
36
|
18
|
$3,484.91
|
$3,136.42
|
$1,771.38
|
$3,598.95
|
$3,349.52
|
2026-03-10
|
|
4634656_1
|
CDM
|
Room & Board - Semi-private (two Beds) - General Classification
|
14
|
14
|
$3,500.00
|
$3,150.00
|
$2,975.00
|
$3,500.00
|
$3,325.00
|
2026-03-10
|
|
4634655_1
|
CDM
|
Nursery - Newborn - Level Ii
|
14
|
14
|
$3,491.00
|
$3,141.90
|
$2,967.35
|
$3,491.00
|
$3,316.45
|
2026-03-10
|
|
29866
|
HCPCS
|
Repair Of Knee Cartilage And Bone With Patient-derived Healthy Cartilage Transpl…
|
36
|
18
|
$5,450.34
|
$4,905.31
|
$988.36
|
$9,090.00
|
$3,299.85
|
2026-03-10
|
|
2120840_1
|
CDM
|
Room & Board - Semi-private (two Beds) - General Classification
|
14
|
14
|
$3,431.00
|
$3,087.90
|
$2,916.35
|
$3,431.00
|
$3,259.45
|
2026-03-10
|
|
2120838_1
|
CDM
|
Nursery - General Classification
|
14
|
14
|
$3,431.00
|
$3,087.90
|
$2,916.35
|
$3,431.00
|
$3,259.45
|
2026-03-10
|
|
20822
|
HCPCS
|
Reattachment Of Part Of Cutoff Finger
|
17
|
17
|
$3,350.00
|
$3,015.00
|
$330.23
|
$3,383.50
|
$3,182.50
|
2026-03-10
|
|
Q5130
|
HCPCS
|
Injection, Pegfilgrastim-pbbk (fylnetra), Biosimilar, 0.5 Mg
|
18
|
18
|
$3,293.98
|
$2,964.58
|
$1,712.87
|
$3,326.92
|
$3,129.28
|
2026-03-10
|
|
27829
|
HCPCS
|
Treatment Of Ligament Tear At Ankle Joint
|
36
|
18
|
$5,213.68
|
$4,692.32
|
$864.99
|
$8,851.55
|
$3,118.65
|
2026-03-10
|
|
30140
|
HCPCS
|
Removal Of Nasal Air Passage Under Lining Tissue
|
18
|
18
|
$3,265.00
|
$2,938.50
|
$1,697.80
|
$3,297.65
|
$3,101.75
|
2026-03-10
|
|
28285
|
HCPCS
|
Correction Of Toe Joint Deformity
|
18
|
18
|
$3,240.00
|
$2,916.00
|
$1,684.80
|
$3,272.40
|
$3,078.00
|
2026-03-10
|
|
4441941_1
|
CDM
|
Room & Board - Semi-private (two Beds) - General Classification
|
14
|
14
|
$3,238.00
|
$2,914.20
|
$2,752.30
|
$3,238.00
|
$3,076.10
|
2026-03-10
|
|
301
|
MS_DRG
|
Peripheral Vascular Disorders Without Cc/mcc
|
15
|
15
|
$3,158.80
|
$2,842.92
|
$2,684.98
|
$3,158.80
|
$3,000.86
|
2026-03-10
|
|
812
|
MS_DRG
|
Red Blood Cell Disorders Without Mcc
|
15
|
15
|
$3,140.50
|
$2,826.45
|
$2,669.43
|
$4,161.87
|
$2,983.48
|
2026-03-10
|
|
46270
|
HCPCS
|
Repair Of Abnormal Anal Drainage Tract
|
18
|
18
|
$3,131.00
|
$2,817.90
|
$1,628.12
|
$3,162.31
|
$2,974.45
|
2026-03-10
|
|
Q5108
|
HCPCS
|
Injection, Pegfilgrastim-jmdb (fulphila), Biosimilar, 0.5 Mg
|
18
|
18
|
$3,130.40
|
$2,817.36
|
$1,627.81
|
$3,161.70
|
$2,973.88
|
2026-03-10
|
|
29850
|
HCPCS
|
Treatment Of Broken Knee Joint Using An Endoscope
|
18
|
18
|
$3,100.00
|
$2,790.00
|
$1,612.00
|
$3,131.00
|
$2,945.00
|
2026-03-10
|
|
20525
|
HCPCS
|
Complicated Removal Of Foreign Body In Deep Muscle Or Tendon
|
18
|
18
|
$3,100.00
|
$2,790.00
|
$36.10
|
$3,131.00
|
$2,945.00
|
2026-03-10
|
|
52318
|
HCPCS
|
Crushing, Fragmenting, And Removal Of Bladder Stones, More Than 2.5 Cm
|
36
|
18
|
$5,010.00
|
$4,509.00
|
$624.00
|
$8,908.20
|
$2,899.20
|
2026-03-10
|
|
14041
|
HCPCS
|
Repair Of Wound Of Forehead, Cheeks, Chin, Mouth, Neck, Underarms, Genitals, Han…
|
18
|
18
|
$3,050.00
|
$2,745.00
|
$1,586.00
|
$3,080.50
|
$2,897.50
|
2026-03-10
|
|
22903
|
HCPCS
|
Removal Of Growth Of Soft Tissue Of Abdominal Wall, 3.0 Cm Or More
|
18
|
18
|
$3,049.00
|
$2,744.10
|
$1,585.48
|
$3,079.49
|
$2,896.55
|
2026-03-10
|
|
49616
|
HCPCS
|
Repair Of Recurrent Entrapped Hernia Of Abdomen, 3-10 Cm In Length
|
36
|
18
|
$5,023.00
|
$4,520.70
|
$560.56
|
$9,057.68
|
$2,876.07
|
2026-03-10
|
|
29882
|
HCPCS
|
Repair Of Inside Or Outside Knee Joint Cartilage Using An Endoscope
|
36
|
18
|
$4,519.99
|
$4,067.98
|
$1,070.66
|
$7,050.81
|
$2,854.84
|
2026-03-10
|
|
C1897
|
HCPCS
|
Lead, Neurostimulator Test Kit (implantable)
|
18
|
18
|
$3,003.00
|
$2,702.70
|
$1,561.56
|
$3,033.03
|
$2,852.85
|
2026-03-10
|
|
44204
|
HCPCS
|
Partial Removal Of Large Bowel Using An Endoscope
|
52
|
18
|
$2,870.61
|
$2,583.55
|
$1,273.43
|
$6,579.14
|
$2,813.20
|
2026-03-10
|
|
47350
|
HCPCS
|
Suture Of Simple Liver Wound To Control Bleeding
|
36
|
18
|
$4,520.50
|
$4,068.45
|
$908.96
|
$7,365.93
|
$2,778.92
|
2026-03-10
|
|
28124
|
HCPCS
|
Partial Removal Of Toe Bone
|
18
|
18
|
$2,915.00
|
$2,623.50
|
$1,515.80
|
$2,944.15
|
$2,769.25
|
2026-03-10
|
|
J2357
|
HCPCS
|
Injection, Omalizumab, 5 Mg
|
18
|
18
|
$2,910.18
|
$2,619.16
|
$1,513.29
|
$2,939.28
|
$2,764.67
|
2026-03-10
|
|
69424
|
HCPCS
|
Removal Of Implanted Eardrum Tube Under Anesthesia
|
18
|
18
|
$2,900.00
|
$2,610.00
|
$1,508.00
|
$2,929.00
|
$2,755.00
|
2026-03-10
|
|
49614
|
HCPCS
|
Repair Of Recurrent Entrapped Hernia Of Abdomen, Less Than 3 Cm In Length
|
36
|
18
|
$4,892.00
|
$4,402.80
|
$424.32
|
$9,057.68
|
$2,743.76
|
2026-03-10
|
|
29828
|
HCPCS
|
Release Of Tendon Connecting Biceps Muscle And Shoulder Using An Endoscope
|
52
|
18
|
$2,788.21
|
$2,509.39
|
$190.70
|
$12,188.68
|
$2,732.44
|
2026-03-10
|
|
49000
|
HCPCS
|
Exploration Of Abdominal Cavity
|
35
|
18
|
$5,150.00
|
$4,635.00
|
$330.23
|
$5,201.50
|
$2,678.00
|
2026-03-10
|
|
49405
|
HCPCS
|
Drainage Of Fluid Collection By Tube Through Skin Using Imaging Guidance
|
18
|
18
|
$2,800.00
|
$2,520.00
|
$1,456.00
|
$2,828.00
|
$2,660.00
|
2026-03-10
|
|
44205
|
HCPCS
|
Partial Removal Of Small And Large Bowel With Attachment Of Small And Large Bowe…
|
36
|
18
|
$4,192.24
|
$3,773.02
|
$972.65
|
$6,579.14
|
$2,638.23
|
2026-03-10
|
|
43246
|
HCPCS
|
Insertion Of Stomach Tube Using A Flexible Endoscope
|
18
|
18
|
$2,775.00
|
$2,497.50
|
$1,443.00
|
$2,802.75
|
$2,636.25
|
2026-03-10
|
|
42825
|
HCPCS
|
Removal Of Tonsils (younger Than 12 Years)
|
18
|
18
|
$2,754.00
|
$2,478.60
|
$1,432.08
|
$2,781.54
|
$2,616.30
|
2026-03-10
|
|
J7188
|
HCPCS
|
Injection, Factor Viii (antihemophilic Factor, Recombinant), (obizur), Per I.u.
|
18
|
18
|
$2,711.80
|
$2,440.62
|
$1,410.14
|
$2,738.92
|
$2,576.21
|
2026-03-10
|
|
28485
|
HCPCS
|
Treatment Of Broken Midportion Of Foot
|
36
|
18
|
$4,322.00
|
$3,889.80
|
$663.00
|
$7,442.69
|
$2,559.82
|
2026-03-10
|
|
64633
|
HCPCS
|
Destruction Of Upper Or Middle Spinal Facet Joint Nerves Using Imaging Guidance,…
|
34
|
18
|
$4,882.00
|
$4,393.80
|
$66.00
|
$4,930.82
|
$2,551.34
|
2026-03-10
|
|
A4264
|
HCPCS
|
Permanent Implantable Contraceptive Intratubal Occlusion Device(s) And Delivery …
|
36
|
18
|
$3,076.80
|
$2,769.12
|
$1,323.97
|
$3,643.58
|
$2,546.10
|
2026-03-10
|
|
27301
|
HCPCS
|
Drainage Of Deep Abscess Or Blood Accumulation Of Thigh Or Knee
|
35
|
18
|
$4,836.00
|
$4,352.40
|
$330.23
|
$4,884.36
|
$2,514.72
|
2026-03-10
|
|
44208
|
HCPCS
|
Partial Removal Of Large Bowel And Reattachment To Rectum And Creation Of Openin…
|
52
|
18
|
$2,524.00
|
$2,271.60
|
$1,312.48
|
$6,365.02
|
$2,473.52
|
2026-03-10
|
|
J3111
|
HCPCS
|
Injection, Romosozumab-aqqg, 1 Mg
|
18
|
18
|
$2,597.38
|
$2,337.64
|
$1,350.64
|
$2,623.35
|
$2,467.51
|
2026-03-10
|
|
27447
|
HCPCS
|
Replacement Of Knee Joint, Both Sides Of Knee
|
17
|
17
|
$2,550.00
|
$2,295.00
|
$330.23
|
$2,575.50
|
$2,422.50
|
2026-03-10
|
|
44180
|
HCPCS
|
Release Of Small Bowel Scar Tissue Using An Endoscope
|
36
|
18
|
$4,104.50
|
$3,694.05
|
$609.96
|
$7,106.36
|
$2,421.72
|
2026-03-10
|
|
44050
|
HCPCS
|
Repair Of Twisted Or Herniated Small Bowel
|
36
|
18
|
$3,636.50
|
$3,272.85
|
$1,085.76
|
$5,236.85
|
$2,402.54
|
2026-03-10
|
|
44140
|
HCPCS
|
Partial Removal Of Large Bowel With Connection
|
53
|
18
|
$2,510.00
|
$2,259.00
|
$330.23
|
$7,070.00
|
$2,384.50
|
2026-03-10
|
|
44160
|
HCPCS
|
Partial Removal Of Small And Large Bowel With Attachment Of Small And Large Bowe…
|
69
|
18
|
$2,773.00
|
$2,495.70
|
$66.00
|
$9,090.00
|
$2,373.50
|
2026-03-10
|
|
29880
|
HCPCS
|
Removal Of Both Knee Cartilages Using An Endoscope
|
36
|
18
|
$3,758.60
|
$3,382.74
|
$878.38
|
$5,886.28
|
$2,368.32
|
2026-03-10
|
|
11012
|
HCPCS
|
Removal Of Foreign Material From Skin, Tissue, Muscle, And Bone At Open Broken A…
|
92
|
18
|
$3,800.00
|
$3,420.00
|
$36.10
|
$4,343.00
|
$2,364.18
|
2026-03-10
|
|
74174
|
HCPCS
|
CT Scan Of Blood Vessels Of Abdomen And Pelvis With Contrast
|
36
|
18
|
$2,415.00
|
$2,173.50
|
$1,223.04
|
$2,502.78
|
$2,328.27
|
2026-03-10
|
|
58571
|
HCPCS
|
Removal Of Uterus, Tubes, And/or Ovaries Through Abdomen Using An Endoscope, 250…
|
55
|
18
|
$2,424.00
|
$2,181.60
|
$330.23
|
$13,736.00
|
$2,327.04
|
2026-03-10
|
|
C1787
|
HCPCS
|
Patient Programmer, Neurostimulator
|
54
|
18
|
$2,457.00
|
$2,211.30
|
$1,038.34
|
$3,545.10
|
$2,309.58
|
2026-03-10
|
|
J7298
|
HCPCS
|
Levonorgestrel-releasing Intrauterine Contraceptive System (mirena), 52 Mg
|
18
|
18
|
$2,429.26
|
$2,186.33
|
$1,263.22
|
$2,453.55
|
$2,307.80
|
2026-03-10
|
|
J7296
|
HCPCS
|
Levonorgestrel-releasing Intrauterine Contraceptive System, (kyleena), 19.5 Mg
|
18
|
18
|
$2,429.26
|
$2,186.33
|
$1,263.22
|
$2,453.55
|
$2,307.80
|
2026-03-10
|
|
C8929
|
HCPCS
|
Transthoracic Echocardiography With Contrast, Or Without Contrast Followed By Wi…
|
18
|
18
|
$2,399.00
|
$2,159.10
|
$1,247.48
|
$2,422.99
|
$2,279.05
|
2026-03-10
|
|
19083
|
HCPCS
|
Biopsy Of Breast And Placement Of Locating Device Using Ultrasound, First Growth
|
72
|
18
|
$2,424.64
|
$2,182.18
|
$1,117.48
|
$2,473.78
|
$2,278.92
|
2026-03-10
|
|
Q4159
|
HCPCS
|
Affinity, Per Square Centimeter
|
36
|
18
|
$3,375.00
|
$3,037.50
|
$1,053.00
|
$4,772.25
|
$2,251.12
|
2026-03-10
|
|
29881
|
HCPCS
|
Removal Of Knee Cartilage Using An Endoscope
|
36
|
18
|
$3,544.77
|
$3,190.30
|
$848.93
|
$5,511.57
|
$2,243.26
|
2026-03-10
|
|
26765
|
HCPCS
|
Treatment Of Broken End Of Finger Or Thumb
|
88
|
18
|
$2,862.74
|
$2,576.47
|
$36.10
|
$3,535.00
|
$2,242.50
|
2026-03-10
|
|
44143
|
HCPCS
|
Partial Removal Of Large Bowel With Creation Of Opening From Large Bowel To Skin
|
53
|
18
|
$2,399.00
|
$2,159.10
|
$330.23
|
$3,151.20
|
$2,231.07
|
2026-03-10
|
|
11772
|
HCPCS
|
Complicated Removal Of Cyst Of Tailbone
|
36
|
18
|
$3,514.50
|
$3,163.05
|
$828.88
|
$5,489.35
|
$2,218.07
|
2026-03-10
|
|
27818
|
HCPCS
|
Closed Treatment Of 3 Broken Lower Leg Bones At Ankle With Manipulation
|
54
|
18
|
$2,600.00
|
$2,340.00
|
$36.10
|
$2,723.97
|
$2,210.00
|
2026-03-10
|
|
J7168
|
HCPCS
|
Prothrombin Complex Concentrate (human), Kcentra, Per I.u. Of Factor Ix Activity
|
18
|
18
|
$2,309.32
|
$2,078.39
|
$1,200.85
|
$2,332.41
|
$2,193.85
|
2026-03-10
|
|
44206
|
HCPCS
|
Partial Removal Of Large Bowel With Creation Of Opening From Large Bowel To Skin…
|
52
|
18
|
$2,224.00
|
$2,001.60
|
$1,156.48
|
$6,365.02
|
$2,179.52
|
2026-03-10
|
|
26418
|
HCPCS
|
Repair Of Tendon On Top Side Of Finger
|
35
|
18
|
$4,165.00
|
$3,748.50
|
$426.92
|
$4,206.65
|
$2,165.80
|
2026-03-10
|
|
794
|
MS_DRG
|
Neonate With Other Significant Problems
|
15
|
15
|
$2,273.70
|
$2,046.33
|
$1,239.03
|
$2,273.70
|
$2,160.02
|
2026-03-10
|
|
52317
|
HCPCS
|
Crushing, Fragmenting, And Removal Of Bladder Stones, Less Than 2.5 Cm
|
17
|
17
|
$2,270.00
|
$2,043.00
|
$1,180.40
|
$2,292.70
|
$2,156.50
|
2026-03-10
|
|
15734
|
HCPCS
|
Creation Of Muscle Graft To Trunk
|
52
|
18
|
$2,200.00
|
$1,980.00
|
$450.00
|
$5,757.00
|
$2,156.00
|
2026-03-10
|
|
49321
|
HCPCS
|
Biopsy Of Abdomen Using An Endoscope
|
36
|
18
|
$3,811.00
|
$3,429.90
|
$323.44
|
$7,070.00
|
$2,134.11
|
2026-03-10
|
|
639
|
MS_DRG
|
Diabetes Without Cc/mcc
|
15
|
15
|
$2,241.25
|
$2,017.13
|
$1,905.06
|
$2,255.67
|
$2,129.19
|
2026-03-10
|
|
29877
|
HCPCS
|
Removal Or Shaving Of Knee Joint Cartilage Using An Endoscope
|
36
|
18
|
$3,500.07
|
$3,150.06
|
$609.51
|
$5,886.28
|
$2,107.21
|
2026-03-10
|
|
29876
|
HCPCS
|
Removal Of Joint Lining From Multiple Knee Joint Compartments Using An Endoscope
|
36
|
18
|
$3,314.50
|
$2,983.05
|
$769.60
|
$5,200.49
|
$2,086.14
|
2026-03-10
|
|
27427
|
HCPCS
|
Reconstruction Of Ligaments Outside Knee Joint
|
52
|
18
|
$2,117.00
|
$1,905.30
|
$604.70
|
$20,184.85
|
$2,074.66
|
2026-03-10
|
|
38100
|
HCPCS
|
Removal Of Spleen
|
17
|
17
|
$2,175.00
|
$1,957.50
|
$330.23
|
$2,196.75
|
$2,066.25
|
2026-03-10
|
|
49613
|
HCPCS
|
Repair Of Recurrent Sliding Hernia Of Abdomen, Less Than 3 Cm In Length
|
36
|
18
|
$3,681.50
|
$3,313.35
|
$288.08
|
$6,877.09
|
$2,050.11
|
2026-03-10
|
|
923
|
MS_DRG
|
Other Injury, Poisoning And Toxic Effect Diagnoses Without Mcc
|
15
|
15
|
$2,154.15
|
$1,938.74
|
$1,831.03
|
$3,081.69
|
$2,046.44
|
2026-03-10
|
|
38510
|
HCPCS
|
Biopsy Or Removal Of Deep Lymph Nodes Of Neck
|
36
|
18
|
$3,477.50
|
$3,129.75
|
$491.40
|
$6,070.10
|
$2,039.83
|
2026-03-10
|
|
14060
|
HCPCS
|
Repair Of Wound Of Eyelids, Nose, Ears, Or Lips By Transferring Skin, 10.0 Sq Cm…
|
34
|
18
|
$2,470.00
|
$2,223.00
|
$300.00
|
$2,494.70
|
$2,035.00
|
2026-03-10
|
|
59160
|
HCPCS
|
Scraping Of Lining Of Uterus After Delivery
|
18
|
18
|
$2,125.00
|
$1,912.50
|
$1,105.00
|
$2,146.25
|
$2,018.75
|
2026-03-10
|
|
29823
|
HCPCS
|
Removal Of Extensive Shoulder Joint Tissue Using An Endoscope
|
36
|
18
|
$3,336.31
|
$3,002.67
|
$582.20
|
$5,608.53
|
$2,009.18
|
2026-03-10
|
|
29824
|
HCPCS
|
Partial Removal Of Collar Bone At Shoulder Using An Endoscope
|
36
|
18
|
$3,249.09
|
$2,924.18
|
$663.61
|
$5,274.22
|
$2,002.18
|
2026-03-10
|
|
47600
|
HCPCS
|
Removal Of Gallbladder
|
53
|
18
|
$2,007.00
|
$1,806.30
|
$330.23
|
$6,479.15
|
$2,000.00
|
2026-03-10
|
|
93306
|
HCPCS
|
Ultrasound Of Heart With Color-depicted Blood Flow, Rate, Direction And Valve Fu…
|
36
|
18
|
$2,143.45
|
$1,929.11
|
$1,039.48
|
$2,310.79
|
$1,999.00
|
2026-03-10
|
|
46948
|
HCPCS
|
Tying Of Arteries To Multiple Internal Hemorrhoid Groups
|
18
|
18
|
$2,100.00
|
$1,890.00
|
$1,092.00
|
$2,121.00
|
$1,995.00
|
2026-03-10
|
|
J9217
|
HCPCS
|
Leuprolide Acetate (for Depot Suspension), 7.5 Mg
|
90
|
18
|
$2,080.21
|
$1,872.19
|
$540.49
|
$12,356.22
|
$1,976.20
|
2026-03-10
|
|
J1439
|
HCPCS
|
Injection, Ferric Carboxymaltose, 1 Mg
|
18
|
18
|
$2,076.44
|
$1,868.80
|
$1,079.75
|
$2,097.20
|
$1,972.62
|
2026-03-10
|
|
27822
|
HCPCS
|
Treatment Of 3 Broken Lower Leg Bones At Ankle
|
52
|
18
|
$2,008.50
|
$1,807.65
|
$300.00
|
$11,953.47
|
$1,968.33
|
2026-03-10
|
|
36556
|
HCPCS
|
Insertion Of Non-tunneled Central Venous Tube For Infusion (5 Years Or Older)
|
68
|
18
|
$3,700.00
|
$3,330.00
|
$72.46
|
$3,838.00
|
$1,959.62
|
2026-03-10
|
|
28010
|
HCPCS
|
Repair Of Toe Tendon
|
57
|
18
|
$2,710.00
|
$2,439.00
|
$36.10
|
$3,040.10
|
$1,956.50
|
2026-03-10
|
|
52315
|
HCPCS
|
Complicated Removal Of Foreign Body, Stone, Or Stent In Urethra Or Bladder Using…
|
18
|
18
|
$2,059.00
|
$1,853.10
|
$1,070.68
|
$2,079.59
|
$1,956.05
|
2026-03-10
|
|
44005
|
HCPCS
|
Release Of Intestinal Scar Tissue
|
17
|
17
|
$2,048.00
|
$1,843.20
|
$330.23
|
$2,068.48
|
$1,945.60
|
2026-03-10
|
|
833
|
MS_DRG
|
Other Antepartum Diagnoses Without O.r. Procedures Without Cc/mcc
|
15
|
15
|
$2,047.00
|
$1,842.30
|
$1,739.95
|
$2,047.00
|
$1,944.65
|
2026-03-10
|
|
28615
|
HCPCS
|
Treatment Of Dislocated Midfoot Bone
|
36
|
18
|
$2,857.50
|
$2,571.75
|
$969.80
|
$3,888.50
|
$1,942.83
|
2026-03-10
|
|
392
|
MS_DRG
|
Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders Without Mcc
|
15
|
15
|
$1,997.10
|
$1,797.39
|
$1,697.54
|
$3,494.70
|
$1,897.25
|
2026-03-10
|
|
57307
|
HCPCS
|
Closure Of Abnormal Drainage Tract From Rectum To Vagina With Creation Of Large …
|
17
|
17
|
$1,960.00
|
$1,764.00
|
$330.23
|
$1,979.60
|
$1,862.00
|
2026-03-10
|
|
31238
|
HCPCS
|
Control Of Bleeding Of Nose Using An Endoscope
|
36
|
18
|
$2,773.00
|
$2,495.70
|
$36.10
|
$3,884.46
|
$1,858.46
|
2026-03-10
|
|
69436
|
HCPCS
|
Incision Of Eardrum With Placement Of Eardrum Tube Under General Anesthesia
|
18
|
18
|
$1,950.00
|
$1,755.00
|
$1,014.00
|
$1,969.50
|
$1,852.50
|
2026-03-10
|
|
Q4101
|
HCPCS
|
Apligraf, Per Square Centimeter
|
18
|
18
|
$1,943.00
|
$1,748.70
|
$1,010.36
|
$1,962.43
|
$1,845.85
|
2026-03-10
|
|
59410
|
HCPCS
|
Vaginal Delivery With Post Delivery Care
|
17
|
17
|
$1,940.00
|
$1,746.00
|
$330.23
|
$1,959.40
|
$1,843.00
|
2026-03-10
|
|
58150
|
HCPCS
|
Removal Of Uterus And Cervix Through Abdomen
|
17
|
17
|
$1,925.00
|
$1,732.50
|
$330.23
|
$1,944.25
|
$1,828.75
|
2026-03-10
|
|
44625
|
HCPCS
|
Closure Of Surgically Created Large Or Small Bowel Opening With Bowel Removal An…
|
17
|
17
|
$1,925.00
|
$1,732.50
|
$330.23
|
$1,944.25
|
$1,828.75
|
2026-03-10
|
|
57456
|
HCPCS
|
Scraping Of Cervix Using An Endoscope
|
18
|
18
|
$1,924.00
|
$1,731.60
|
$36.10
|
$1,943.24
|
$1,827.80
|
2026-03-10
|
|
57452
|
HCPCS
|
Exam Of Cervix And Upper Part Of Vagina Using An Endoscope
|
18
|
18
|
$1,924.00
|
$1,731.60
|
$36.10
|
$1,943.24
|
$1,827.80
|
2026-03-10
|
|
43249
|
HCPCS
|
Balloon Dilation Of Esophagus, Stomach, And/or Upper Small Bowel Using A Flexibl…
|
53
|
18
|
$1,940.00
|
$1,746.00
|
$330.23
|
$2,161.40
|
$1,819.00
|
2026-03-10
|
|
694
|
MS_DRG
|
Urinary Stones Without Mcc
|
15
|
15
|
$1,897.85
|
$1,708.07
|
$1,613.17
|
$3,335.85
|
$1,802.96
|
2026-03-10
|
|
15260
|
HCPCS
|
Full Thickness Skin Graft To Nose, Ears, Eyelids, Or Lips, 20.0 Sq Cm Or Less
|
18
|
18
|
$1,888.00
|
$1,699.20
|
$981.76
|
$1,906.88
|
$1,793.60
|
2026-03-10
|
|
25400
|
HCPCS
|
Repair Non-healed Fracture Of Forearm Bone
|
52
|
18
|
$1,820.00
|
$1,638.00
|
$672.80
|
$5,154.03
|
$1,783.60
|
2026-03-10
|
|
Q4106
|
HCPCS
|
Dermagraft, Per Square Centimeter
|
18
|
18
|
$1,875.00
|
$1,687.50
|
$975.00
|
$1,893.75
|
$1,781.25
|
2026-03-10
|
|
51550
|
HCPCS
|
Simple Partial Removal Of Bladder
|
17
|
17
|
$1,845.00
|
$1,660.50
|
$330.23
|
$1,863.45
|
$1,752.75
|
2026-03-10
|
|
36584
|
HCPCS
|
Replacement Of Peripherally Inserted Central Venous Tube (picc) With Review By R…
|
18
|
18
|
$1,805.00
|
$1,624.50
|
$938.60
|
$1,823.05
|
$1,714.75
|
2026-03-10
|
|
49440
|
HCPCS
|
Insertion Of Stomach Tube Using Fluoroscopic Guidance With Contrast
|
18
|
18
|
$1,800.00
|
$1,620.00
|
$936.00
|
$1,818.00
|
$1,710.00
|
2026-03-10
|
|
15100
|
HCPCS
|
Partial Thickness Self Skin Graft To Trunk, Arms, Or Legs, 100.0 Sq Cm Or 1% Bod…
|
39
|
18
|
$1,707.00
|
$1,536.30
|
$36.10
|
$5,041.92
|
$1,707.00
|
2026-03-10
|
|
15736
|
HCPCS
|
Creation Of Muscle Graft To Arm
|
52
|
18
|
$1,823.10
|
$1,640.79
|
$66.00
|
$1,841.33
|
$1,702.74
|
2026-03-10
|
|
29826
|
HCPCS
|
Shaving Of Part Of Shoulder Bone And Repair Of Ligament Using An Endoscope
|
36
|
18
|
$3,098.75
|
$2,788.88
|
$187.46
|
$5,895.37
|
$1,699.67
|
2026-03-10
|
|
795
|
MS_DRG
|
Normal Newborn
|
15
|
15
|
$1,880.48
|
$1,692.43
|
$794.25
|
$1,805.26
|
$1,692.43
|
2026-03-10
|
|
59426
|
HCPCS
|
Predelivery Care, 7 Or More Visits
|
17
|
17
|
$1,768.00
|
$1,591.20
|
$330.23
|
$1,785.68
|
$1,679.60
|
2026-03-10
|
|
27562
|
HCPCS
|
Closed Treatment Of Dislocated Kneecap Under Anesthesia
|
35
|
18
|
$3,227.00
|
$2,904.30
|
$330.23
|
$3,259.27
|
$1,678.04
|
2026-03-10
|
|
69421
|
HCPCS
|
Incision, Aspiration, And Inflation Of Eardrum Under Anesthesia
|
18
|
18
|
$1,757.00
|
$1,581.30
|
$913.64
|
$1,774.57
|
$1,669.15
|
2026-03-10
|
|
15120
|
HCPCS
|
Partial Thickness Self Skin Graft To Face, Scalp, Eyelids, Mouth, Neck, Ears, Ar…
|
39
|
18
|
$1,666.00
|
$1,499.40
|
$36.10
|
$5,161.10
|
$1,666.00
|
2026-03-10
|
|
58611
|
HCPCS
|
Tying Or Incision Of Fallopian Tubes During Cesarean Delivery Or Other Abdominal…
|
35
|
18
|
$3,198.72
|
$2,878.85
|
$123.25
|
$3,230.71
|
$1,663.33
|
2026-03-10
|
|
15110
|
HCPCS
|
Outer Layer Self Skin Graft Of Trunk, Arms, Or Legs, 100.0 Sq Cm Or 1% Body Area…
|
39
|
18
|
$1,661.00
|
$1,494.90
|
$36.10
|
$3,277.45
|
$1,661.00
|
2026-03-10
|
|
25609
|
HCPCS
|
Treatment Of 3 Or More Broken Lower Forearm Bone Pieces On Thumb Side Inside Wri…
|
53
|
18
|
$1,709.45
|
$1,538.51
|
$863.02
|
$9,529.35
|
$1,659.66
|
2026-03-10
|
|
43250
|
HCPCS
|
Removal Of Polyps Or Growths Of Esophagus, Stomach, And/or Upper Small Bowel Usi…
|
18
|
18
|
$1,747.00
|
$1,572.30
|
$908.44
|
$1,764.47
|
$1,659.65
|
2026-03-10
|
|
57421
|
HCPCS
|
Biopsy Of Vagina And Cervix Using An Endoscope
|
53
|
18
|
$1,950.00
|
$1,755.00
|
$36.10
|
$2,170.49
|
$1,657.50
|
2026-03-10
|
|
15115
|
HCPCS
|
Outer Layer Self Skin Graft Of Face, Scalp, Eyelids, Mouth, Neck, Ears, Around E…
|
39
|
18
|
$1,657.00
|
$1,491.30
|
$36.10
|
$3,277.45
|
$1,657.00
|
2026-03-10
|
|
59514
|
HCPCS
|
Cesarean Delivery
|
55
|
18
|
$1,725.25
|
$1,552.73
|
$66.00
|
$4,938.90
|
$1,638.99
|
2026-03-10
|
|
75635
|
HCPCS
|
CT Scan Of Abdominal Aorta And Both Leg Arteries With Contrast
|
18
|
18
|
$1,725.00
|
$1,552.50
|
$897.00
|
$1,742.25
|
$1,638.75
|
2026-03-10
|
|
46200
|
HCPCS
|
Removal Of Chronic Tear Of Anus
|
36
|
18
|
$2,941.65
|
$2,647.49
|
$166.04
|
$5,619.64
|
$1,607.88
|
2026-03-10
|
|
70498
|
HCPCS
|
CT Scan Of Blood Vessels Of Neck With Contrast
|
36
|
18
|
$1,700.50
|
$1,530.45
|
$832.00
|
$1,819.01
|
$1,600.00
|
2026-03-10
|
|
26608
|
HCPCS
|
Treatment Of Broken Finger Bone With Stabilizing Device Accessed Through Skin
|
36
|
18
|
$2,520.00
|
$2,268.00
|
$569.40
|
$3,984.45
|
$1,578.68
|
2026-03-10
|
|
23550
|
HCPCS
|
Treatment Of Dislocated Joint Between Collar Bone And Shoulder
|
36
|
18
|
$2,526.00
|
$2,273.40
|
$553.80
|
$4,026.87
|
$1,574.44
|
2026-03-10
|
|
58550
|
HCPCS
|
Removal Of Uterus Through Vagina Using An Endoscope, 250.0 G Or Less
|
17
|
17
|
$1,650.00
|
$1,485.00
|
$330.23
|
$1,666.50
|
$1,567.50
|
2026-03-10
|
|
44960
|
HCPCS
|
Removal Of Ruptured Infected Appendix
|
17
|
17
|
$1,650.00
|
$1,485.00
|
$330.23
|
$1,666.50
|
$1,567.50
|
2026-03-10
|
|
14040
|
HCPCS
|
Repair Of Wound Of Forehead, Cheeks, Chin, Mouth, Neck, Underarms, Genitals, Han…
|
39
|
18
|
$1,560.00
|
$1,404.00
|
$330.23
|
$2,371.48
|
$1,560.00
|
2026-03-10
|
|
29806
|
HCPCS
|
Repair Of Shoulder Joint Capsule Using An Endoscope
|
52
|
18
|
$1,591.35
|
$1,432.22
|
$450.00
|
$11,107.98
|
$1,559.53
|
2026-03-10
|
|
44620
|
HCPCS
|
Closure Of Surgically Created Large Or Small Bowel Opening
|
17
|
17
|
$1,640.00
|
$1,476.00
|
$330.23
|
$1,656.40
|
$1,558.00
|
2026-03-10
|
|
74175
|
HCPCS
|
CT Scan Of Blood Vessels Of Abdomen With Contrast
|
18
|
18
|
$1,637.00
|
$1,473.30
|
$851.24
|
$1,653.37
|
$1,555.15
|
2026-03-10
|
|
24076
|
HCPCS
|
Removal Of Growth Of Muscle Of Upper Arm Or Elbow, Less Than 5.0 Cm
|
18
|
18
|
$1,636.00
|
$1,472.40
|
$850.72
|
$1,652.36
|
$1,554.20
|
2026-03-10
|
|
78452
|
HCPCS
|
Nuclear Medicine Studies Of Heart Muscle At Rest And With Stress And Spect
|
36
|
18
|
$1,768.36
|
$1,591.53
|
$802.78
|
$2,012.85
|
$1,543.80
|
2026-03-10
|
|
47562
|
HCPCS
|
Removal Of Gallbladder Using An Endoscope
|
52
|
18
|
$1,572.82
|
$1,415.54
|
$435.00
|
$10,536.32
|
$1,541.37
|
2026-03-10
|
|
29888
|
HCPCS
|
Repair Of Anterior Cruciate Ligament Of Knee Using An Endoscope
|
39
|
18
|
$1,539.85
|
$1,385.87
|
$330.23
|
$11,531.11
|
$1,539.85
|
2026-03-10
|
|
44386
|
HCPCS
|
Biopsy Of Small Bowel Pouch Using An Endoscope
|
18
|
18
|
$1,600.00
|
$1,440.00
|
$832.00
|
$1,616.00
|
$1,520.00
|
2026-03-10
|
|
70496
|
HCPCS
|
CT Scan Of Blood Vessels Of Head With Contrast
|
36
|
18
|
$1,599.00
|
$1,439.10
|
$831.48
|
$1,614.99
|
$1,519.05
|
2026-03-10
|
|
44110
|
HCPCS
|
Removal Of Growth Of Small Or Large Bowels
|
17
|
17
|
$1,595.00
|
$1,435.50
|
$330.23
|
$1,610.95
|
$1,515.25
|
2026-03-10
|
|
43255
|
HCPCS
|
Control Of Bleeding Of Esophagus, Stomach, And/or Upper Small Bowel Using A Flex…
|
18
|
18
|
$1,594.00
|
$1,434.60
|
$828.88
|
$1,609.94
|
$1,514.30
|
2026-03-10
|
|
27792
|
HCPCS
|
Treatment Of Broken Outer Lower Leg Bone At Ankle
|
39
|
18
|
$1,514.10
|
$1,362.69
|
$330.23
|
$12,237.16
|
$1,514.10
|
2026-03-10
|
|
4643160_1
|
CDM
|
Recovery Room - General Classification
|
14
|
14
|
$1,650.00
|
$1,485.00
|
$858.00
|
$1,584.00
|
$1,509.75
|
2026-03-10
|
|
29873
|
HCPCS
|
Release Of Ligaments At Outer Side Of Knee Joint Using An Endoscope
|
36
|
18
|
$2,489.77
|
$2,240.79
|
$455.80
|
$4,144.03
|
$1,509.43
|
2026-03-10
|
|
J0881
|
HCPCS
|
Injection, Darbepoetin Alfa, 1 Microgram (non-esrd Use)
|
36
|
18
|
$2,204.43
|
$1,983.98
|
$764.71
|
$2,967.64
|
$1,506.61
|
2026-03-10
|
|
28465
|
HCPCS
|
Treatment Of Broken Hind Portion Of Foot
|
36
|
18
|
$2,215.00
|
$1,993.50
|
$746.20
|
$3,024.95
|
$1,503.38
|
2026-03-10
|
|
36590
|
HCPCS
|
Removal Of Central Venous Tube With Port Or Pump
|
70
|
18
|
$2,300.00
|
$2,070.00
|
$158.71
|
$2,923.95
|
$1,500.20
|
2026-03-10
|
|
71275
|
HCPCS
|
CT Scan Of Blood Vessels Of Chest With Contrast
|
18
|
18
|
$1,579.00
|
$1,421.10
|
$821.08
|
$1,594.79
|
$1,500.05
|
2026-03-10
|
|
19303
|
HCPCS
|
Simple Complete Removal Of Breast
|
53
|
18
|
$1,544.62
|
$1,390.16
|
$779.81
|
$9,930.30
|
$1,499.63
|
2026-03-10
|
|
11462
|
HCPCS
|
Removal Of Skin And Tissue Of Groin For Inflamed Sweat Glands With Simple Or Int…
|
36
|
18
|
$2,615.50
|
$2,353.95
|
$285.48
|
$4,728.82
|
$1,494.57
|
2026-03-10
|
|
44188
|
HCPCS
|
Creation Of Large Bowel Opening Using An Endoscope
|
52
|
18
|
$1,556.45
|
$1,400.81
|
$66.00
|
$7,106.36
|
$1,486.41
|
2026-03-10
|
|
184
|
MS_DRG
|
Major Chest Trauma With Cc
|
15
|
15
|
$1,558.50
|
$1,402.65
|
$1,324.73
|
$4,098.33
|
$1,480.58
|
2026-03-10
|
|
66
|
MS_DRG
|
Intracranial Hemorrhage Or Cerebral Infarction Without Cc/mcc
|
15
|
15
|
$1,542.70
|
$1,388.43
|
$1,311.30
|
$3,081.69
|
$1,465.57
|
2026-03-10
|
|
23412
|
HCPCS
|
Repair Of Chronic Torn Shoulder Rotator Cuff
|
52
|
18
|
$1,487.05
|
$1,338.35
|
$450.00
|
$8,686.76
|
$1,457.31
|
2026-03-10
|
|
26440
|
HCPCS
|
Release Of Tendon Of Palm Or Finger
|
52
|
18
|
$1,542.94
|
$1,388.65
|
$66.00
|
$1,569.54
|
$1,455.51
|
2026-03-10
|
|
59409
|
HCPCS
|
Vaginal Delivery
|
53
|
18
|
$1,515.00
|
$1,363.50
|
$211.12
|
$4,009.70
|
$1,439.25
|
2026-03-10
|
|
44388
|
HCPCS
|
Diagnostic Exam Of Large Bowel Using An Endoscope Inserted Through Surgically Cr…
|
18
|
18
|
$1,490.00
|
$1,341.00
|
$774.80
|
$1,504.90
|
$1,415.50
|
2026-03-10
|
|
43236
|
HCPCS
|
Injection Of Esophagus, Stomach, And/or Upper Small Bowel Using A Flexible Endos…
|
36
|
18
|
$2,518.75
|
$2,266.88
|
$202.02
|
$4,695.49
|
$1,404.93
|
2026-03-10
|
|
64718
|
HCPCS
|
Release And/or Relocation Of Elbow Nerve
|
39
|
18
|
$1,390.50
|
$1,251.45
|
$330.23
|
$3,801.64
|
$1,390.50
|
2026-03-10
|
|
73220
|
HCPCS
|
MRI Scan Of Arm Before And After Contrast
|
36
|
18
|
$1,460.00
|
$1,314.00
|
$759.20
|
$1,474.60
|
$1,387.00
|
2026-03-10
|
|
70543
|
HCPCS
|
MRI Scan Of Bone Of Eye Socket, Face, And/or Neck Before And After Contrast
|
18
|
18
|
$1,460.00
|
$1,314.00
|
$759.20
|
$1,474.60
|
$1,387.00
|
2026-03-10
|
|
72157
|
HCPCS
|
MRI Scan Of Middle Spinal Canal Before And After Contrast
|
18
|
18
|
$1,460.00
|
$1,314.00
|
$759.20
|
$1,474.60
|
$1,387.00
|
2026-03-10
|
|
72158
|
HCPCS
|
MRI Scan Of Lower Spinal Canal Before And After Contrast
|
18
|
18
|
$1,460.00
|
$1,314.00
|
$759.20
|
$1,474.60
|
$1,387.00
|
2026-03-10
|
|
70553
|
HCPCS
|
MRI Scan Of Brain Before And After Contrast
|
18
|
18
|
$1,460.00
|
$1,314.00
|
$759.20
|
$1,474.60
|
$1,387.00
|
2026-03-10
|
|
71552
|
HCPCS
|
MRI Scan Of Chest Before And After Contrast
|
18
|
18
|
$1,460.00
|
$1,314.00
|
$759.20
|
$1,474.60
|
$1,387.00
|
2026-03-10
|
|
74183
|
HCPCS
|
MRI Scan Of Abdomen Before And After Contrast
|
18
|
18
|
$1,460.00
|
$1,314.00
|
$759.20
|
$1,474.60
|
$1,387.00
|
2026-03-10
|
|
72197
|
HCPCS
|
MRI Scan Of Pelvis Before And After Contrast
|
18
|
18
|
$1,460.00
|
$1,314.00
|
$759.20
|
$1,474.60
|
$1,387.00
|
2026-03-10
|
|
70546
|
HCPCS
|
MRI Scan Of Blood Vessels Of Head Before And After Contrast
|
18
|
18
|
$1,448.00
|
$1,303.20
|
$752.96
|
$1,462.48
|
$1,375.60
|
2026-03-10
|
|
27509
|
HCPCS
|
Treatment Of Broken Thigh Bone At Far End With Placement Of Stabilizing Device
|
36
|
18
|
$2,052.00
|
$1,846.80
|
$641.68
|
$2,898.70
|
$1,369.37
|
2026-03-10
|
|
73722
|
HCPCS
|
MRI Scan Of Leg Joint With Contrast
|
36
|
18
|
$1,428.00
|
$1,285.20
|
$728.00
|
$1,470.56
|
$1,368.64
|
2026-03-10
|
|
44800
|
HCPCS
|
Repair Of Congenital Bowel Defect
|
17
|
17
|
$1,440.00
|
$1,296.00
|
$330.23
|
$1,454.40
|
$1,368.00
|
2026-03-10
|
|
22902
|
HCPCS
|
Removal Of Growth Of Soft Tissue Of Abdominal Wall, Less Than 3.0 Cm
|
36
|
18
|
$2,112.50
|
$1,901.25
|
$569.40
|
$3,161.30
|
$1,366.78
|
2026-03-10
|
|
27238
|
HCPCS
|
Closed Treatment Of Broken Below Neck Of Thigh Bone
|
71
|
18
|
$2,100.00
|
$1,890.00
|
$36.10
|
$2,121.00
|
$1,365.00
|
2026-03-10
|
|
72156
|
HCPCS
|
MRI Scan Of Upper Spinal Canal Before And After Contrast
|
18
|
18
|
$1,435.70
|
$1,292.13
|
$746.56
|
$1,450.06
|
$1,363.92
|
2026-03-10
|
|
J7328
|
HCPCS
|
Hyaluronan Or Derivative, Gelsyn-3, For Intra-articular Injection, 0.1 Mg
|
18
|
18
|
$1,435.16
|
$1,291.64
|
$746.28
|
$1,449.51
|
$1,363.40
|
2026-03-10
|
|
6556728_1
|
CDM
|
C1718 Mesh, Ventralight St 6
|
6
|
6
|
$1,549.10
|
$1,394.19
|
$542.19
|
$1,487.14
|
$1,355.47
|
2026-03-10
|
|
27252
|
HCPCS
|
Closed Treatment Of Dislocated Hip Under Anesthesia
|
17
|
17
|
$1,425.00
|
$1,282.50
|
$330.23
|
$1,439.25
|
$1,353.75
|
2026-03-10
|
|
6385422_1
|
CDM
|
Bowel Grasper Fenestrated 20 Mm Jaw Monopolar 5 Mm 31 Cm
|
6
|
6
|
$1,546.20
|
$1,391.58
|
$541.17
|
$1,484.35
|
$1,352.92
|
2026-03-10
|
|
Q4196
|
HCPCS
|
Puraply Am, Per Square Centimeter
|
108
|
18
|
$1,665.00
|
$1,498.50
|
$335.40
|
$8,999.10
|
$1,350.00
|
2026-03-10
|
|
38571
|
HCPCS
|
Removal Of Lymph Nodes Of Both Sides Of Pelvis Using An Endoscope
|
52
|
18
|
$1,376.00
|
$1,238.40
|
$548.94
|
$9,191.00
|
$1,348.48
|
2026-03-10
|
|
21933
|
HCPCS
|
Removal Of Growth Of Muscle Of Back Or Lower Sides, 5.0 Cm Or More
|
52
|
18
|
$1,371.36
|
$1,234.22
|
$431.68
|
$4,623.80
|
$1,343.93
|
2026-03-10
|
|
J0585
|
HCPCS
|
Injection, Onabotulinumtoxina, 1 Unit
|
36
|
18
|
$1,953.00
|
$1,757.70
|
$677.04
|
$2,630.04
|
$1,334.55
|
2026-03-10
|
|
J7307
|
HCPCS
|
Etonogestrel (contraceptive) Implant System, Including Implant And Supplies
|
18
|
18
|
$1,402.00
|
$1,261.80
|
$729.04
|
$1,416.02
|
$1,331.90
|
2026-03-10
|
|
58720
|
HCPCS
|
Removal Of Uterine Tubes And Ovaries
|
17
|
17
|
$1,400.00
|
$1,260.00
|
$330.23
|
$1,414.00
|
$1,330.00
|
2026-03-10
|
|
58925
|
HCPCS
|
Removal Of Cysts Of Ovaries
|
17
|
17
|
$1,400.00
|
$1,260.00
|
$330.23
|
$1,414.00
|
$1,330.00
|
2026-03-10
|
|
10061
|
HCPCS
|
Complicated Or Multiple Drainage Of Skin Abscess
|
105
|
18
|
$1,976.00
|
$1,778.40
|
$36.10
|
$2,100.80
|
$1,330.00
|
2026-03-10
|
|
29851
|
HCPCS
|
Treatment Of Broken Knee Joint With Placement Of Stabilizing Device Using An End…
|
52
|
18
|
$1,354.00
|
$1,218.60
|
$300.00
|
$9,543.49
|
$1,326.92
|
2026-03-10
|
|
49594
|
HCPCS
|
Initial Repair Of Entrapped Hernia Of Abdomen, 3-10 Cm In Length
|
53
|
18
|
$1,358.57
|
$1,222.71
|
$685.88
|
$6,565.00
|
$1,319.00
|
2026-03-10
|
|
43233
|
HCPCS
|
Balloon Dilation Of Esophagus, Stomach, And/or Upper Small Bowel Using A Flexibl…
|
18
|
18
|
$1,375.00
|
$1,237.50
|
$715.00
|
$1,388.75
|
$1,306.25
|
2026-03-10
|
|
27310
|
HCPCS
|
Incision Of Knee Joint For Exploration, Fluid Drainage, Or Removal Of Foreign Bo…
|
17
|
17
|
$1,375.00
|
$1,237.50
|
$330.23
|
$1,388.75
|
$1,306.25
|
2026-03-10
|
|
58120
|
HCPCS
|
Dilation And Scraping Of Uterus
|
35
|
18
|
$2,500.00
|
$2,250.00
|
$330.23
|
$2,525.00
|
$1,300.00
|
2026-03-10
|
|
49505
|
HCPCS
|
Repair Of Groin Hernia (5 Years Or Older)
|
88
|
18
|
$1,297.00
|
$1,167.30
|
$410.79
|
$7,375.02
|
$1,297.00
|
2026-03-10
|
|
25605
|
HCPCS
|
Closed Treatment Of Broken Or Growth Plate Separate Of Forearm Bone At Wrist Wit…
|
89
|
18
|
$1,900.00
|
$1,710.00
|
$36.10
|
$2,018.99
|
$1,287.65
|
2026-03-10
|
|
10140
|
HCPCS
|
Drainage Of Blood Or Fluid Accumulation
|
105
|
18
|
$1,502.00
|
$1,351.80
|
$36.10
|
$1,627.12
|
$1,279.25
|
2026-03-10
|
|
27360
|
HCPCS
|
Partial Removal Of Thigh And/or Lower Leg Bones
|
52
|
18
|
$1,328.00
|
$1,195.20
|
$66.00
|
$5,302.50
|
$1,268.24
|
2026-03-10
|
|
72147
|
HCPCS
|
MRI Scan Of Middle Spinal Canal With Contrast
|
18
|
18
|
$1,325.00
|
$1,192.50
|
$689.00
|
$1,338.25
|
$1,258.75
|
2026-03-10
|
|
70552
|
HCPCS
|
MRI Scan Of Brain With Contrast
|
18
|
18
|
$1,325.00
|
$1,192.50
|
$689.00
|
$1,338.25
|
$1,258.75
|
2026-03-10
|
|
72149
|
HCPCS
|
MRI Scan Of Lower Spinal Canal With Contrast
|
18
|
18
|
$1,325.00
|
$1,192.50
|
$689.00
|
$1,338.25
|
$1,258.75
|
2026-03-10
|
|
72196
|
HCPCS
|
MRI Scan Of Pelvis With Contrast
|
18
|
18
|
$1,325.00
|
$1,192.50
|
$689.00
|
$1,338.25
|
$1,258.75
|
2026-03-10
|
|
74270
|
HCPCS
|
Single Contrast X-ray Of Large Intestine
|
18
|
18
|
$1,324.00
|
$1,191.60
|
$688.48
|
$1,337.24
|
$1,257.80
|
2026-03-10
|
|
74280
|
HCPCS
|
Double Contrast X-ray Of Large Intestine
|
18
|
18
|
$1,324.00
|
$1,191.60
|
$688.48
|
$1,337.24
|
$1,257.80
|
2026-03-10
|
|
58660
|
HCPCS
|
Removal Of Scar Tissue Of Ovaries Or Fallopian Tubes Using An Endoscope
|
53
|
18
|
$1,242.81
|
$1,118.53
|
$646.26
|
$6,565.00
|
$1,242.81
|
2026-03-10
|
|
72142
|
HCPCS
|
MRI Scan Of Upper Spinal Canal With Contrast
|
18
|
18
|
$1,300.00
|
$1,170.00
|
$676.00
|
$1,313.00
|
$1,235.00
|
2026-03-10
|
|
71550
|
HCPCS
|
MRI Scan Of Chest Without Contrast
|
18
|
18
|
$1,290.00
|
$1,161.00
|
$670.80
|
$1,302.90
|
$1,225.50
|
2026-03-10
|
|
73723
|
HCPCS
|
MRI Scan Of Leg Joint Before And After Contrast
|
54
|
18
|
$1,282.00
|
$1,153.80
|
$666.64
|
$1,346.33
|
$1,224.31
|
2026-03-10
|
|
J0248
|
HCPCS
|
Injection, Remdesivir, 1 Mg
|
18
|
18
|
$1,284.00
|
$1,155.60
|
$667.68
|
$1,296.84
|
$1,219.80
|
2026-03-10
|
|
70549
|
HCPCS
|
MRI Scan Of Blood Vessels Of Neck Before And After Contrast
|
36
|
18
|
$1,283.00
|
$1,154.70
|
$667.16
|
$1,295.83
|
$1,218.85
|
2026-03-10
|