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Hospital facility prices. What the hospital charges for the facility side of care — the surgeon’s and anesthesiologist’s fees are billed separately and are not included. How we scope prices →

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Hospital

CLAY COUNTY MEDICAL CENTER

Clay Center, KS · CCN 171371 · Rates published

3,106 distinct procedures filed
5 distinct payers
21,632 rate rows
2026-04-24 last MRF observed
Data quality

21,632 of 21,632 rate rows are consumer-grade (100.0%)

Every filed rate row passes our consumer-grade checks — none are excluded from the medians.

Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://apps.para-hcfs.com/PTT/FinalLinks/Reports.aspx?dbName=dbClayCounty&type=CDMWithoutLabel
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-05-15
Content fingerprint 1ff7fbf3ed343813… · 9,139,426 bytes · first seen 2026-05-07

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
64582
HCPCS 		Insertion Of Hypoglossal Nerve Neurostimulator Electrode And Generator And Breat… 5 $456.27 $36,890.40 $36,502.08 nat. median
$28,316
1.3× median
C1767
HCPCS 		Generator, Neurostimulator (implantable), Non-rechargeable 5 $31,186.62 $31,857.30 $31,857.30 nat. median
$22,481
1.4× median
J2350
HCPCS 		Injection, Ocrelizumab, 1 Mg 5 $26,401.58 $26,969.36 $26,969.36 nat. median
$683
outlier · 39.5×
9262706_1
CDM 		Dressing, PuraPly Am 8 X 16 5 $23,956.80 $24,472.00 $24,472.00 nat. median
$24,472
1.0× median
C1721
HCPCS 		Cardioverter-defibrillator, Dual Chamber (implantable) 5 $22,148.55 $24,463.26 $23,286.56 nat. median
$22,213
1.0× median
23474
HCPCS 		Revision Of Total Shoulder Repair, Total Shoulder 5 $75.00 $22,462.19 $21,989.30 nat. median
$8,467
outlier · 2.6×
27447
HCPCS 		Replacement Of Knee Joint, Both Sides Of Knee 5 $75.00 $19,467.23 $19,057.39 nat. median
$12,649
1.5× median
23472
HCPCS 		Prosthetic Repair Of Shoulder Joint, Total Shoulder 5 $75.00 $19,467.23 $19,057.39 nat. median
$16,400
1.2× median
27446
HCPCS 		Replacement Of Knee Joint On Side Of Knee 5 $75.00 $17,969.75 $17,591.44 nat. median
$12,483
1.4× median
10057808_1
CDM 		EpiFix 7cm X 7cm 5 $15,989.49 $16,333.35 $16,333.35 nat. median
$16,333
1.0× median
J9217
HCPCS 		Leuprolide Acetate (for Depot Suspension), 7.5 Mg 5 $15,838.37 $16,178.98 $16,178.98 nat. median
$1,521
outlier · 10.6×
9402063_1
CDM 		Dressing, PuraPly Am Xt 6 X 9 5 $15,229.68 $15,557.20 $15,557.20 nat. median
$15,557
1.0× median
J2356
HCPCS 		Injection, Tezepelumab-ekko, 1 Mg 5 $14,965.15 $15,286.99 $15,286.99 nat. median
$66
outlier · 232.2×
J0517
HCPCS 		Injection, Benralizumab, 1 Mg 5 $12,133.34 $12,394.28 $12,394.28 nat. median
$914
outlier · 13.6×
27487
HCPCS 		Revision Of Thigh And Lower Leg Bone Components Of Total Knee Joint Prosthesis 5 $75.00 $11,116.48 $10,882.45 nat. median
$11,516
0.9× median
J2323
HCPCS 		Injection, Natalizumab, 1 Mg 5 $10,632.01 $10,860.65 $10,860.65 nat. median
$197
outlier · 55.1×
9262705_1
CDM 		Dressing, PuraPly Am 6 X 9 5 $10,164.53 $10,383.12 $10,383.12 nat. median
$10,383
1.0× median
10057807_1
CDM 		EpiFix 5cm X 6cm 5 $9,789.78 $10,000.32 $10,000.32 nat. median
$10,000
1.0× median
J2182
HCPCS 		Injection, Mepolizumab, 1 Mg 5 $9,494.69 $9,698.87 $9,698.87 nat. median
$3,087
outlier · 3.1×
27486
HCPCS 		Revision Of Component Of Total Knee Joint Prosthesis 5 $75.00 $9,528.41 $9,327.82 nat. median
$8,742
1.1× median
J3101
HCPCS 		Injection, Tenecteplase, 1 Mg 5 $9,007.70 $9,201.42 $9,201.42 nat. median
$5,957
1.5× median
23430
HCPCS 		Anchoring Of Biceps Tendon 5 $75.00 $9,098.87 $8,907.32 nat. median
$6,990
1.3× median
29827
HCPCS 		Repair Of Shoulder Rotator Cuff Using An Endoscope 5 $75.00 $9,062.66 $8,871.87 nat. median
$7,155
1.2× median
27488
HCPCS 		Removal Of Total Knee Joint Prosthesis 5 $75.00 $8,469.70 $8,291.39 nat. median
$5,263
1.6× median
27445
HCPCS 		Knee Joint Replacement Using Hinged Prosthesis 5 $75.00 $8,469.70 $8,291.39 nat. median
$6,477
1.3× median
C1764
HCPCS 		Event Recorder, Cardiac (implantable) 5 $7,948.52 $8,119.46 $8,119.46 nat. median
$7,664
1.1× median
23410
HCPCS 		Repair Of Acute Torn Shoulder Rotator Cuff 5 $75.00 $7,640.69 $7,479.83 nat. median
$6,989
1.1× median
9402062_1
CDM 		Dressing, PuraPly Am Xt 5 X 5 5 $7,272.60 $7,429.00 $7,429.00 nat. median
$7,429
1.0× median
Q5108
HCPCS 		Injection, Pegfilgrastim-jmdb (fulphila), Biosimilar, 0.5 Mg 5 $4,659.30 $9,519.00 $7,039.05 nat. median
$1,257
outlier · 5.6×
12656390_1
CDM 		MariGen Fenestrated – 7 X 10 Cm 5 $6,829.08 $6,975.95 $6,975.95 nat. median
$6,976
1.0× median
J2406
HCPCS 		Injection, Oritavancin (kimyrsa), 10 Mg 5 $6,736.87 $6,881.75 $6,881.75 nat. median
$63
outlier · 109.4×
9262139_1
CDM 		Monitor, Carelink Type 25000 5 $6,545.34 $6,686.10 $6,686.10 nat. median
$6,686
1.0× median
12664900_1
CDM 		MariGen – 7 X 10 Cm 5 $6,208.26 $6,341.77 $6,341.77 nat. median
$6,342
1.0× median
27443
HCPCS 		Knee Replacement With Repair Of End Of Thigh Or Lower Leg Bone And Removal Of Kn… 5 $75.00 $6,352.27 $6,218.54 nat. median
$11,616
0.5× median
27442
HCPCS 		Repair Of End Of Thigh Or Lower Leg Bone At Knee Joint With Prosthesis 5 $75.00 $6,352.27 $6,218.54 nat. median
$11,338
0.5× median
27441
HCPCS 		Repair Of Lower Part Of Knee Joint With Prosthesis And Removal Of Joint Lining 5 $75.00 $6,352.27 $6,218.54 nat. median
$11,731
0.5× median
C1785
HCPCS 		Pacemaker, Dual Chamber, Rate-responsive (implantable) 5 $5,980.64 $6,467.60 $6,118.00 nat. median
$6,506
0.9× median
Q5115
HCPCS 		Injection, Rituximab-abbs, Biosimilar, (truxima), 10 Mg 5 $5,661.89 $5,783.65 $5,783.65 nat. median
$884
outlier · 6.5×
10057810_1
CDM 		EpiCord 3cm X 5cm 5 $5,492.95 $5,611.08 $5,611.08 nat. median
$5,611
1.0× median
10057806_1
CDM 		EpiFix 4cm X 4cm 5 $5,220.88 $5,333.16 $5,333.16 nat. median
$5,333
1.0× median
24358
HCPCS 		Incision Of Elbow Tendon With Removal Of Tissue 5 $75.00 $5,077.67 $4,970.78 nat. median
$3,493
1.4× median
29884
HCPCS 		Removal Of Scar Tissue From Knee Using An Endoscope 5 $75.00 $5,076.52 $4,969.65 nat. median
$3,900
1.3× median
28820
HCPCS 		Amputation Of Toe At Joint Between Forefoot And Toes 5 $75.00 $4,900.36 $4,797.19 nat. median
$3,382
1.4× median
29822
HCPCS 		Limited Removal Of Abnormal Shoulder Joint Tissue Using Endoscope 5 $75.00 $4,750.67 $4,650.66 nat. median
$3,851
1.2× median
C1778
HCPCS 		Lead, Neurostimulator (implantable) 5 $3,336.84 $5,899.50 $4,591.95 nat. median
$4,308
1.1× median
9262703_1
CDM 		Dressing, PuraPly Am 5 X 5 5 $4,449.12 $4,544.80 $4,544.80 nat. median
$4,545
1.0× median
J1306
HCPCS 		Injection, Inclisiran, 1 Mg 5 $4,417.09 $4,512.08 $4,512.08 nat. median
$57
outlier · 79.8×
J2357
HCPCS 		Injection, Omalizumab, 5 Mg 5 $2,861.87 $8,404.88 $4,463.51 nat. median
$1,302
outlier · 3.4×
28825
HCPCS 		Amputation Of Toe At Toe Joint 5 $75.00 $4,518.10 $4,422.98 nat. median
$3,319
1.3× median
29880
HCPCS 		Removal Of Both Knee Cartilages Using An Endoscope 5 $75.00 $4,376.47 $4,284.33 nat. median
$3,917
1.1× median

Other procedures at this hospital

Browse this hospital's 3,106 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
             
64582 HCPCS Insertion Of Hypoglossal Nerve Neurostimulator Electrode And Generator And Breat… 6 5 $38,832.00 $38,832.00 $456.27 $36,890.40 $36,502.08 2026-04-24
C1767 HCPCS Generator, Neurostimulator (implantable), Non-rechargeable 5 5 $33,534.00 $33,534.00 $31,186.62 $31,857.30 $31,857.30 2026-04-24
J2350 HCPCS Injection, Ocrelizumab, 1 Mg 5 5 $28,388.80 $28,388.80 $26,401.58 $26,969.36 $26,969.36 2026-04-24
9262706_1 CDM Dressing, PuraPly Am 8 X 16 5 5 $25,760.00 $25,760.00 $23,956.80 $24,472.00 $24,472.00 2026-04-24
C1721 HCPCS Cardioverter-defibrillator, Dual Chamber (implantable) 10 5 $24,783.22 $24,783.22 $22,148.55 $24,463.26 $23,286.56 2026-04-24
23474 HCPCS Revision Of Total Shoulder Repair, Total Shoulder 8 5 $23,644.41 $23,644.41 $75.00 $22,462.19 $21,989.30 2026-04-24
23472 HCPCS Prosthetic Repair Of Shoulder Joint, Total Shoulder 8 5 $20,491.82 $20,491.82 $75.00 $19,467.23 $19,057.39 2026-04-24
27447 HCPCS Replacement Of Knee Joint, Both Sides Of Knee 8 5 $20,491.82 $20,491.82 $75.00 $19,467.23 $19,057.39 2026-04-24
27446 HCPCS Replacement Of Knee Joint On Side Of Knee 8 5 $18,915.53 $18,915.53 $75.00 $17,969.75 $17,591.44 2026-04-24
10057808_1 CDM EpiFix 7cm X 7cm 5 5 $17,193.00 $17,193.00 $15,989.49 $16,333.35 $16,333.35 2026-04-24
J9217 HCPCS Leuprolide Acetate (for Depot Suspension), 7.5 Mg 5 5 $17,030.50 $17,030.50 $15,838.37 $16,178.98 $16,178.98 2026-04-24
9402063_1 CDM Dressing, PuraPly Am Xt 6 X 9 5 5 $16,376.00 $16,376.00 $15,229.68 $15,557.20 $15,557.20 2026-04-24
J2356 HCPCS Injection, Tezepelumab-ekko, 1 Mg 5 5 $16,091.56 $16,091.56 $14,965.15 $15,286.99 $15,286.99 2026-04-24
J0517 HCPCS Injection, Benralizumab, 1 Mg 5 5 $13,046.61 $13,046.61 $12,133.34 $12,394.28 $12,394.28 2026-04-24
27487 HCPCS Revision Of Thigh And Lower Leg Bone Components Of Total Knee Joint Prosthesis 8 5 $11,701.56 $11,701.56 $75.00 $11,116.48 $10,882.45 2026-04-24
J2323 HCPCS Injection, Natalizumab, 1 Mg 5 5 $11,432.26 $11,432.26 $10,632.01 $10,860.65 $10,860.65 2026-04-24
9262705_1 CDM Dressing, PuraPly Am 6 X 9 5 5 $10,929.60 $10,929.60 $10,164.53 $10,383.12 $10,383.12 2026-04-24
10057807_1 CDM EpiFix 5cm X 6cm 5 5 $10,526.65 $10,526.65 $9,789.78 $10,000.32 $10,000.32 2026-04-24
J2182 HCPCS Injection, Mepolizumab, 1 Mg 5 5 $10,209.34 $10,209.34 $9,494.69 $9,698.87 $9,698.87 2026-04-24
27486 HCPCS Revision Of Component Of Total Knee Joint Prosthesis 8 5 $10,029.91 $10,029.91 $75.00 $9,528.41 $9,327.82 2026-04-24
J3101 HCPCS Injection, Tenecteplase, 1 Mg 5 5 $9,685.70 $9,685.70 $9,007.70 $9,201.42 $9,201.42 2026-04-24
23430 HCPCS Anchoring Of Biceps Tendon 8 5 $9,577.76 $9,577.76 $75.00 $9,098.87 $8,907.32 2026-04-24
29827 HCPCS Repair Of Shoulder Rotator Cuff Using An Endoscope 8 5 $9,539.64 $9,539.64 $75.00 $9,062.66 $8,871.87 2026-04-24
27488 HCPCS Removal Of Total Knee Joint Prosthesis 8 5 $8,915.47 $8,915.47 $75.00 $8,469.70 $8,291.39 2026-04-24
27445 HCPCS Knee Joint Replacement Using Hinged Prosthesis 8 5 $8,915.47 $8,915.47 $75.00 $8,469.70 $8,291.39 2026-04-24
C1764 HCPCS Event Recorder, Cardiac (implantable) 5 5 $8,546.80 $8,546.80 $7,948.52 $8,119.46 $8,119.46 2026-04-24
23410 HCPCS Repair Of Acute Torn Shoulder Rotator Cuff 8 5 $8,042.83 $8,042.83 $75.00 $7,640.69 $7,479.83 2026-04-24
9402062_1 CDM Dressing, PuraPly Am Xt 5 X 5 5 5 $7,820.00 $7,820.00 $7,272.60 $7,429.00 $7,429.00 2026-04-24
Q5108 HCPCS Injection, Pegfilgrastim-jmdb (fulphila), Biosimilar, 0.5 Mg 10 5 $7,515.00 $7,515.00 $4,659.30 $9,519.00 $7,039.05 2026-04-24
12656390_1 CDM MariGen Fenestrated – 7 X 10 Cm 5 5 $7,343.10 $7,343.10 $6,829.08 $6,975.95 $6,975.95 2026-04-24
J2406 HCPCS Injection, Oritavancin (kimyrsa), 10 Mg 5 5 $7,243.95 $7,243.95 $6,736.87 $6,881.75 $6,881.75 2026-04-24
9262139_1 CDM Monitor, Carelink Type 25000 5 5 $7,038.00 $7,038.00 $6,545.34 $6,686.10 $6,686.10 2026-04-24
12664900_1 CDM MariGen – 7 X 10 Cm 5 5 $6,675.55 $6,675.55 $6,208.26 $6,341.77 $6,341.77 2026-04-24
27441 HCPCS Repair Of Lower Part Of Knee Joint With Prosthesis And Removal Of Joint Lining 8 5 $6,686.60 $6,686.60 $75.00 $6,352.27 $6,218.54 2026-04-24
27442 HCPCS Repair Of End Of Thigh Or Lower Leg Bone At Knee Joint With Prosthesis 8 5 $6,686.60 $6,686.60 $75.00 $6,352.27 $6,218.54 2026-04-24
27443 HCPCS Knee Replacement With Repair Of End Of Thigh Or Lower Leg Bone And Removal Of Kn… 8 5 $6,686.60 $6,686.60 $75.00 $6,352.27 $6,218.54 2026-04-24
C1785 HCPCS Pacemaker, Dual Chamber, Rate-responsive (implantable) 15 5 $6,440.00 $6,440.00 $5,980.64 $6,467.60 $6,118.00 2026-04-24
Q5115 HCPCS Injection, Rituximab-abbs, Biosimilar, (truxima), 10 Mg 5 5 $6,088.05 $6,088.05 $5,661.89 $5,783.65 $5,783.65 2026-04-24
10057810_1 CDM EpiCord 3cm X 5cm 5 5 $5,906.40 $5,906.40 $5,492.95 $5,611.08 $5,611.08 2026-04-24
10057806_1 CDM EpiFix 4cm X 4cm 5 5 $5,613.85 $5,613.85 $5,220.88 $5,333.16 $5,333.16 2026-04-24
24358 HCPCS Incision Of Elbow Tendon With Removal Of Tissue 8 5 $5,344.92 $5,344.92 $75.00 $5,077.67 $4,970.78 2026-04-24
29884 HCPCS Removal Of Scar Tissue From Knee Using An Endoscope 8 5 $5,343.71 $5,343.71 $75.00 $5,076.52 $4,969.65 2026-04-24
28820 HCPCS Amputation Of Toe At Joint Between Forefoot And Toes 8 5 $5,158.27 $5,158.27 $75.00 $4,900.36 $4,797.19 2026-04-24
29822 HCPCS Limited Removal Of Abnormal Shoulder Joint Tissue Using Endoscope 8 5 $5,000.71 $5,000.71 $75.00 $4,750.67 $4,650.66 2026-04-24
C1778 HCPCS Lead, Neurostimulator (implantable) 10 5 $4,899.00 $4,899.00 $3,336.84 $5,899.50 $4,591.95 2026-04-24
9262703_1 CDM Dressing, PuraPly Am 5 X 5 5 5 $4,784.00 $4,784.00 $4,449.12 $4,544.80 $4,544.80 2026-04-24
J1306 HCPCS Injection, Inclisiran, 1 Mg 5 5 $4,749.55 $4,749.55 $4,417.09 $4,512.08 $4,512.08 2026-04-24
J2357 HCPCS Injection, Omalizumab, 5 Mg 15 5 $4,698.43 $4,698.43 $2,861.87 $8,404.88 $4,463.51 2026-04-24
28825 HCPCS Amputation Of Toe At Toe Joint 8 5 $4,755.89 $4,755.89 $75.00 $4,518.10 $4,422.98 2026-04-24
29880 HCPCS Removal Of Both Knee Cartilages Using An Endoscope 8 5 $4,606.81 $4,606.81 $75.00 $4,376.47 $4,284.33 2026-04-24
10180 HCPCS Complex Drainage Of Wound Infection After Surgery 18 5 $4,541.36 $4,541.36 $75.00 $4,638.38 $4,223.46 2026-04-24
27440 HCPCS Repair Of Lower Part Of Knee Joint 8 5 $4,532.88 $4,532.88 $75.00 $4,306.24 $4,215.58 2026-04-24
10057805_1 CDM EpiFix 3cm X 4cm 5 5 $4,377.40 $4,377.40 $4,070.98 $4,158.53 $4,158.53 2026-04-24
29881 HCPCS Removal Of Knee Cartilage Using An Endoscope 8 5 $4,314.00 $4,314.00 $75.00 $4,098.30 $4,012.02 2026-04-24
9595394_1 CDM Dressing, NuShield 6 X 6 5 5 $4,094.00 $4,094.00 $3,807.42 $3,889.30 $3,889.30 2026-04-24
25447 HCPCS Replacement Of Joint Between Wrist And Fingers Using Tissue 8 5 $4,176.55 $4,176.55 $75.00 $3,967.72 $3,884.19 2026-04-24
26910 HCPCS Amputation Of Finger Or Thumb 5 5 $4,063.76 $4,063.76 $3,779.30 $3,860.57 $3,860.57 2026-04-24
2100077_1 CDM Operating Room Services - General Classification 5 5 $4,000.00 $4,000.00 $3,720.00 $3,800.00 $3,800.00 2026-04-24
26951 HCPCS Amputation Of Finger Or Thumb With Direct Closure 5 5 $3,774.75 $3,774.75 $3,510.52 $3,586.01 $3,586.01 2026-04-24
10289541_1 CDM Lens Glaukos Istent Inject 5 5 $3,523.60 $3,523.60 $3,276.95 $3,347.42 $3,347.42 2026-04-24
2100063_1 CDM Operating Room Services - General Classification 5 5 $3,500.00 $3,500.00 $3,255.00 $3,325.00 $3,325.00 2026-04-24
15120 HCPCS Partial Thickness Self Skin Graft To Face, Scalp, Eyelids, Mouth, Neck, Ears, Ar… 10 5 $3,538.50 $3,538.50 $1,288.00 $5,407.45 $3,304.65 2026-04-24
C8911 HCPCS Magnetic Resonance Angiography Without Contrast Followed By With Contrast, Chest… 5 5 $3,465.00 $3,465.00 $3,222.45 $3,291.75 $3,291.75 2026-04-24
9595393_1 CDM Dressing, NuShield 4 X 4 5 5 $3,422.40 $3,422.40 $3,182.83 $3,251.28 $3,251.28 2026-04-24
15115 HCPCS Outer Layer Self Skin Graft Of Face, Scalp, Eyelids, Mouth, Neck, Ears, Around E… 5 5 $3,407.25 $3,407.25 $3,168.74 $3,236.89 $3,236.89 2026-04-24
15273 HCPCS Skin Substitute Graft To Wound 100.0 Sq Cm Or More Of Trunk, Arms, Or Legs, 100.… 15 5 $3,407.25 $3,407.25 $374.00 $5,940.11 $3,236.89 2026-04-24
15110 HCPCS Outer Layer Self Skin Graft Of Trunk, Arms, Or Legs, 100.0 Sq Cm Or 1% Body Area… 5 5 $3,407.25 $3,407.25 $3,168.74 $3,236.89 $3,236.89 2026-04-24
9235950_1 CDM Specialty Services - Treatment Room 5 5 $3,367.00 $3,367.00 $3,131.31 $3,198.65 $3,198.65 2026-04-24
J3111 HCPCS Injection, Romosozumab-aqqg, 1 Mg 5 5 $3,299.59 $3,299.59 $3,068.62 $3,134.61 $3,134.61 2026-04-24
J2997 HCPCS Injection, Alteplase Recombinant, 1 Mg 10 5 $3,293.10 $3,293.10 $232.42 $6,019.47 $3,065.08 2026-04-24
9608203_1 CDM Dressing, PuraPly Am Xt Ef 4.91 X 4.91 5 5 $3,128.00 $3,128.00 $2,909.04 $2,971.60 $2,971.60 2026-04-24
24105 HCPCS Removal Of Fluid-filled Sac Of Elbow 8 5 $3,137.87 $3,137.87 $75.00 $2,980.98 $2,918.22 2026-04-24
2100049_1 CDM Operating Room Services - General Classification 5 5 $3,000.00 $3,000.00 $2,790.00 $2,850.00 $2,850.00 2026-04-24
64718 HCPCS Release And/or Relocation Of Elbow Nerve 8 5 $2,975.46 $2,975.46 $75.00 $2,826.69 $2,767.18 2026-04-24
J1602 HCPCS Injection, Golimumab, 1 Mg, For Intravenous Use 5 5 $2,878.85 $2,878.85 $2,677.33 $2,734.91 $2,734.91 2026-04-24
73723 HCPCS MRI Scan Of Leg Joint Before And After Contrast 18 5 $2,937.90 $2,937.90 $75.00 $2,892.75 $2,732.25 2026-04-24
12664899_1 CDM MariGen – 7 X 7 Cm 5 5 $2,821.50 $2,821.50 $2,624.00 $2,680.43 $2,680.43 2026-04-24
J0349 HCPCS Injection, Rezafungin, 1 Mg 5 5 $2,808.00 $2,808.00 $2,611.44 $2,667.60 $2,667.60 2026-04-24
27562 HCPCS Closed Treatment Of Dislocated Kneecap Under Anesthesia 8 5 $2,836.05 $2,836.05 $75.00 $2,694.25 $2,637.53 2026-04-24
70548 HCPCS MRI Scan Of Blood Vessels Of Neck With Contrast 8 5 $2,797.20 $2,797.20 $70.05 $2,657.34 $2,601.40 2026-04-24
25111 HCPCS Removal Of First Cyst Of Wrist 8 5 $2,796.08 $2,796.08 $75.00 $2,656.28 $2,600.35 2026-04-24
11223393_1 CDM Jada Vacuum Induced Hemorrhage Control System 5 5 $2,668.00 $2,668.00 $2,481.24 $2,534.60 $2,534.60 2026-04-24
73720 HCPCS MRI Scan Of Leg Before And After Contrast 18 5 $2,704.80 $2,704.80 $75.00 $2,803.73 $2,515.46 2026-04-24
37618 HCPCS Tying Of Major Arm Or Leg Artery 5 5 $2,611.09 $2,611.09 $2,428.31 $2,480.54 $2,480.54 2026-04-24
C1787 HCPCS Patient Programmer, Neurostimulator 5 5 $2,576.00 $2,576.00 $2,395.68 $2,447.20 $2,447.20 2026-04-24
73220 HCPCS MRI Scan Of Arm Before And After Contrast 18 5 $2,625.00 $2,625.00 $75.00 $2,693.25 $2,441.25 2026-04-24
57200 HCPCS Suture Of Nonobstetrical Injury Of Vagina 5 5 $2,521.31 $2,521.31 $2,344.82 $2,395.24 $2,395.24 2026-04-24
59300 HCPCS Episiotomy Or Repair Of Vagina 5 5 $2,521.31 $2,521.31 $2,344.82 $2,395.24 $2,395.24 2026-04-24
2100035_1 CDM Operating Room Services - General Classification 5 5 $2,500.00 $2,500.00 $2,325.00 $2,375.00 $2,375.00 2026-04-24
J0875 HCPCS Injection, Dalbavancin, 5 Mg 5 5 $2,487.35 $2,487.35 $2,313.24 $2,362.98 $2,362.98 2026-04-24
10057804_1 CDM EpiFix 2cm X 4cm 5 5 $2,484.00 $2,484.00 $2,310.12 $2,359.80 $2,359.80 2026-04-24
12664898_1 CDM MariGen – 5 X 7 Cm 5 5 $2,473.10 $2,473.10 $2,299.98 $2,349.45 $2,349.45 2026-04-24
J1568 HCPCS Injection, Immune Globulin, (octagam), Intravenous, Non-lyophilized (e.g., Liqui… 5 5 $2,467.55 $2,467.55 $2,294.82 $2,344.17 $2,344.17 2026-04-24
73722 HCPCS MRI Scan Of Leg Joint With Contrast 18 5 $2,520.00 $2,520.00 $75.00 $2,693.25 $2,343.60 2026-04-24
26160 HCPCS Removal Of Growth Of Tendon Finger Or Hand 8 5 $2,489.45 $2,489.45 $75.00 $2,364.98 $2,315.19 2026-04-24
73222 HCPCS MRI Scan Of Arm Joint With Contrast 18 5 $2,481.15 $2,481.15 $75.00 $2,756.09 $2,307.47 2026-04-24
12656388_1 CDM MariGen Fenestrated – 3 X 7 Cm 5 5 $2,400.50 $2,400.50 $2,232.47 $2,280.48 $2,280.48 2026-04-24
10057809_1 CDM EpiCord 2cm X 3cm 5 5 $2,382.80 $2,382.80 $2,216.00 $2,263.66 $2,263.66 2026-04-24
38505 HCPCS Needle Biopsy Or Removal Of Surface Lymph Nodes 8 5 $2,430.36 $2,430.36 $64.45 $2,308.84 $2,260.23 2026-04-24
J0897 HCPCS Injection, Denosumab, 1 Mg 5 5 $2,348.09 $2,348.09 $2,183.73 $2,230.69 $2,230.69 2026-04-24
71552 HCPCS MRI Scan Of Chest Before And After Contrast 5 5 $2,346.50 $2,346.50 $2,182.25 $2,229.18 $2,229.18 2026-04-24
35226 HCPCS Repair Of Blood Vessel Of Leg 8 5 $2,312.36 $2,312.36 $75.00 $2,196.74 $2,150.49 2026-04-24
59510 HCPCS Cesarean Delivery With Care Before And After Delivery 3 3 $4,368.00 $4,368.00 $75.00 $2,126.19 $2,091.88 2026-04-24
73721 HCPCS MRI Scan Of Leg Joint Without Contrast 18 5 $2,238.60 $2,238.60 $63.30 $2,544.62 $2,081.90 2026-04-24
12664897_1 CDM MariGen – 3 X 7 Cm 5 5 $2,182.25 $2,182.25 $2,029.49 $2,073.14 $2,073.14 2026-04-24
70336 HCPCS MRI Scan Of Jaw Joint 5 5 $2,157.75 $2,157.75 $2,006.71 $2,049.86 $2,049.86 2026-04-24
9902244_10 CDM 49205 Exc Abd Tum Over 10 Cm 1 1 $3,405.70 $3,405.70 $2,043.42 $2,043.42 $2,043.42 2026-04-24
9902244_12 CDM 49205 Exc Abd Tum Over 10 Cm 1 1 $3,405.70 $3,405.70 $2,043.42 $2,043.42 $2,043.42 2026-04-24
73221 HCPCS MRI Scan Of Arm Joint Without Contrast 18 5 $2,187.15 $2,187.15 $63.98 $2,697.99 $2,034.05 2026-04-24
27818 HCPCS Closed Treatment Of 3 Broken Lower Leg Bones At Ankle With Manipulation 8 5 $2,171.40 $2,171.40 $75.00 $2,062.83 $2,019.40 2026-04-24
9387392_1 CDM Dressing, Affinity 2.5 X 2.5 5 5 $2,116.00 $2,116.00 $1,967.88 $2,010.20 $2,010.20 2026-04-24
9608202_1 CDM Dressing, Affinity 1.5 X 1.5 5 5 $2,116.00 $2,116.00 $1,967.88 $2,010.20 $2,010.20 2026-04-24
73718 HCPCS MRI Scan Of Leg Without Contrast 18 5 $2,157.75 $2,157.75 $62.99 $2,149.61 $2,006.71 2026-04-24
73218 HCPCS MRI Scan Of Arm Without Contrast 18 5 $2,157.75 $2,157.75 $63.30 $2,544.62 $2,006.71 2026-04-24
10057803_1 CDM EpiFix 2cm X 3cm 5 5 $2,105.00 $2,105.00 $1,957.65 $1,999.75 $1,999.75 2026-04-24
9219008_1 CDM Labor Room/delivery - General Classification 5 5 $2,100.00 $2,100.00 $1,953.00 $1,995.00 $1,995.00 2026-04-24
8314318_1 CDM Labor Room/delivery - General Classification 5 5 $2,100.00 $2,100.00 $1,953.00 $1,995.00 $1,995.00 2026-04-24
2100021_1 CDM Operating Room Services - General Classification 5 5 $2,000.00 $2,000.00 $1,860.00 $1,900.00 $1,900.00 2026-04-24
26418 HCPCS Repair Of Tendon On Top Side Of Finger 8 5 $2,038.05 $2,038.05 $75.00 $1,936.15 $1,895.39 2026-04-24
78452 HCPCS Nuclear Medicine Studies Of Heart Muscle At Rest And With Stress And Spect 5 5 $1,985.97 $1,985.97 $1,846.95 $1,886.67 $1,886.67 2026-04-24
59400 HCPCS Vaginal Delivery With Care Before And After Delivery 4 4 $3,937.50 $3,937.50 $75.00 $2,592.94 $1,885.20 2026-04-24
J7325 HCPCS Hyaluronan Or Derivative, Synvisc Or Synvisc-one, For Intra-articular Injection,… 5 5 $1,972.25 $1,972.25 $1,834.19 $1,873.64 $1,873.64 2026-04-24
10057802_1 CDM EpiFix 2cm X 2cm 5 5 $1,957.80 $1,957.80 $1,820.75 $1,859.91 $1,859.91 2026-04-24
19083 HCPCS Biopsy Of Breast And Placement Of Locating Device Using Ultrasound, First Growth 8 5 $1,968.29 $1,968.29 $75.00 $1,869.88 $1,830.51 2026-04-24
73201 HCPCS CT Scan Of Arm With Contrast 13 5 $1,913.10 $1,913.10 $54.10 $1,931.16 $1,817.45 2026-04-24
64721 HCPCS Release And/or Relocation Of Hand Nerve 9 5 $1,948.90 $1,948.90 $75.00 $1,851.46 $1,812.48 2026-04-24
28495 HCPCS Closed Treatment Of Broken Great Toe With Manipulation 8 5 $1,940.41 $1,940.41 $75.00 $1,843.39 $1,804.58 2026-04-24
10593515_10 CDM Sleep Lab Director Fee 1 1 $3,000.00 $3,000.00 $1,800.00 $1,800.00 $1,800.00 2026-04-24
73701 HCPCS CT Scan Of Leg With Contrast Material 18 5 $1,913.10 $1,913.10 $54.10 $2,194.50 $1,779.18 2026-04-24
11422 HCPCS Removal Of Noncancer Skin Growth Of Scalp, Neck, Hands, Feet, Or Genitals, 1.1-2… 8 5 $1,895.70 $1,895.70 $75.00 $1,800.92 $1,763.00 2026-04-24
23605 HCPCS Closed Treatment Of Broken Top Of Upper Arm Bone With Manipulation 5 5 $1,843.80 $1,843.80 $1,714.73 $1,751.61 $1,751.61 2026-04-24
64635 HCPCS Destruction Of Lower Or Sacral Spinal Facet Joint Nerves Using Imaging Guidance,… 10 5 $1,874.08 $1,874.08 $761.67 $2,782.69 $1,751.08 2026-04-24
73700 HCPCS CT Scan Of Leg Without Contrast 18 5 $1,877.40 $1,877.40 $46.75 $2,169.81 $1,745.98 2026-04-24
64633 HCPCS Destruction Of Upper Or Middle Spinal Facet Joint Nerves Using Imaging Guidance,… 10 5 $1,865.15 $1,865.15 $745.07 $2,782.69 $1,742.60 2026-04-24
9235951_1 CDM Specialty Services - Treatment Room 5 5 $1,831.00 $1,831.00 $1,702.83 $1,739.45 $1,739.45 2026-04-24
93306 HCPCS Ultrasound Of Heart With Color-depicted Blood Flow, Rate, Direction And Valve Fu… 5 5 $1,777.32 $1,777.32 $1,652.91 $1,688.45 $1,688.45 2026-04-24
44150 HCPCS Removal Of Large Bowel With Attachment Of Small Bowel To Rectum Or Creation Of O… 3 3 $3,518.05 $3,518.05 $75.00 $1,681.78 $1,674.40 2026-04-24
26055 HCPCS Incision Of Tendon Covering Of Finger 8 5 $1,785.28 $1,785.28 $75.00 $1,696.02 $1,660.31 2026-04-24
44207 HCPCS Partial Removal Of Large Bowel And Reattachment To Rectum Using An Endoscope 3 3 $3,504.40 $3,504.40 $75.00 $1,941.19 $1,645.89 2026-04-24
73200 HCPCS CT Scan Of Arm Without Contrast 18 5 $1,766.10 $1,766.10 $46.75 $1,777.55 $1,642.47 2026-04-24
25535 HCPCS Closed Treatment Of Broken Midpart Of Forearm Bone On Small Finger Side With Man… 8 5 $1,745.28 $1,745.28 $75.00 $1,658.02 $1,623.11 2026-04-24
15274 HCPCS Skin Substitute Graft To Wound 100.0 Sq Cm Or More Of Trunk, Arms, Or Legs, Each… 15 5 $1,704.15 $1,704.15 $84.96 $2,970.56 $1,618.94 2026-04-24
2100105_1 CDM Operating Room Services - General Classification 5 5 $1,680.00 $1,680.00 $1,562.40 $1,596.00 $1,596.00 2026-04-24
24530 HCPCS Closed Treatment Of Upper Arm Bone Broken At Elbow 8 5 $1,693.65 $1,693.65 $75.00 $1,608.97 $1,575.09 2026-04-24
9262707_1 CDM Dressing, PuraPly Am 2 X 4 5 5 $1,656.00 $1,656.00 $1,540.08 $1,573.20 $1,573.20 2026-04-24
78451 HCPCS Nuclear Medicine Study Of Heart Muscle At Rest And With Stress And Spect 5 5 $1,653.75 $1,653.75 $1,537.99 $1,571.06 $1,571.06 2026-04-24
10527195_1 CDM Tyrx Absorbable Antibacterial Envelope Size Large 5 5 $1,646.80 $1,646.80 $1,531.52 $1,564.46 $1,564.46 2026-04-24
10289547_1 CDM Lens Extended Depth, Alcon Clareon Panoptix 5 5 $1,646.80 $1,646.80 $1,531.52 $1,564.46 $1,564.46 2026-04-24
10289546_1 CDM Lens Astigmatism Correcting, Alcon Clareon Vivity Toric Mc-noncov 5 5 $1,646.80 $1,646.80 $1,531.52 $1,564.46 $1,564.46 2026-04-24
10289545_1 CDM Lens Astigmatism Correcting, Alcon Clareon Panoptix Toric Mc-noncov 5 5 $1,646.80 $1,646.80 $1,531.52 $1,564.46 $1,564.46 2026-04-24
10289548_1 CDM Lens Extended Depth, Alcon Clareon Vivity 5 5 $1,646.80 $1,646.80 $1,531.52 $1,564.46 $1,564.46 2026-04-24
43644 HCPCS Bypass Of Stomach Using An Endoscope 3 3 $3,289.15 $3,289.15 $75.00 $1,816.32 $1,564.05 2026-04-24
43282 HCPCS Repair Of Hernia Of Muscle At Esophagus And Stomach With Implantation Of Mesh Us… 3 3 $3,707.05 $3,707.05 $75.00 $2,070.14 $1,563.49 2026-04-24
Q0138 HCPCS Injection, Ferumoxytol, For Treatment Of Iron Deficiency Anemia, 1 Mg (non-esrd … 5 5 $1,643.84 $1,643.84 $1,528.77 $1,561.65 $1,561.65 2026-04-24
20525 HCPCS Complicated Removal Of Foreign Body In Deep Muscle Or Tendon 8 5 $1,652.70 $1,652.70 $75.00 $1,570.07 $1,537.01 2026-04-24
28010 HCPCS Repair Of Toe Tendon 10 5 $1,635.90 $1,635.90 $395.48 $2,704.22 $1,525.64 2026-04-24
25600 HCPCS Closed Treatment Of Broken Forearm (radius) Bone At The Wrist Area On The Thumb … 8 5 $1,632.75 $1,632.75 $75.00 $1,551.11 $1,518.46 2026-04-24
28001 HCPCS Drainage Of Fluid Filled Sac In Foot 10 5 $1,615.43 $1,615.43 $324.20 $2,738.14 $1,505.83 2026-04-24
44227 HCPCS Closure Of Opening From Large Or Small Bowel To Skin Using An Endoscope 3 3 $3,395.20 $3,395.20 $75.00 $1,744.56 $1,503.64 2026-04-24
44143 HCPCS Partial Removal Of Large Bowel With Creation Of Opening From Large Bowel To Skin 3 3 $2,974.15 $2,974.15 $75.00 $1,574.22 $1,499.89 2026-04-24
8307335_1 CDM Room & Board - Private (one Bed) - Hospice 5 5 $1,575.00 $1,575.00 $1,464.75 $1,496.25 $1,496.25 2026-04-24
8775068_1 CDM Room & Board - Semi-private (two Beds) - General Classification 5 5 $1,575.00 $1,575.00 $1,464.75 $1,496.25 $1,496.25 2026-04-24
27570 HCPCS Manipulation Of Knee Joint Under Anesthesia 8 5 $1,597.42 $1,597.42 $75.00 $1,517.55 $1,485.60 2026-04-24
64625 HCPCS Destruction Of Nerves Supplying Joint Between Spine And Pelvis Using Imaging Gui… 5 5 $1,557.70 $1,557.70 $1,448.66 $1,479.82 $1,479.82 2026-04-24
64624 HCPCS Destruction Of Nerve Branches Of Knee Using Imaging Guidance 5 5 $1,557.70 $1,557.70 $1,448.66 $1,479.82 $1,479.82 2026-04-24
23473 HCPCS Revision Of Total Shoulder Repair 3 3 $2,862.91 $2,862.91 $75.00 $2,068.98 $1,461.25 2026-04-24
20225 HCPCS Deep Biopsy Of Bone Using Needle Or Trocar 10 5 $1,551.38 $1,551.38 $205.07 $2,738.14 $1,444.98 2026-04-24
44626 HCPCS Closure Of Surgically Created Large Or Small Bowel Opening With Bowel Removal An… 3 3 $3,040.30 $3,040.30 $75.00 $1,651.40 $1,444.98 2026-04-24
2100007_1 CDM Operating Room Services - General Classification 5 5 $1,500.00 $1,500.00 $1,395.00 $1,425.00 $1,425.00 2026-04-24
41850 HCPCS Destruction Of Growth Of Structure Supporting Teeth 8 5 $1,512.00 $1,512.00 $75.00 $1,436.40 $1,406.16 2026-04-24
C1713 HCPCS Anchor/screw For Opposing Bone-to-bone Or Soft Tissue-to-bone (implantable) 30 5 $1,487.35 $1,487.35 $767.34 $1,900.10 $1,397.72 2026-04-24
28192 HCPCS Removal Of Foreign Body Of Foot Tissue, Deep 8 5 $1,495.61 $1,495.61 $75.00 $1,420.83 $1,390.92 2026-04-24
43281 HCPCS Repair Of Hernia Of Muscle At Esophagus And Stomach Using An Endoscope 3 3 $3,296.50 $3,296.50 $75.00 $1,841.15 $1,390.59 2026-04-24
44204 HCPCS Partial Removal Of Large Bowel Using An Endoscope 3 3 $2,978.35 $2,978.35 $75.00 $1,638.93 $1,390.44 2026-04-24
9262701_1 CDM Dressing, NuShield 2 X 3 5 5 $1,462.80 $1,462.80 $1,360.40 $1,389.66 $1,389.66 2026-04-24
49618 HCPCS Repair Of Recurrent Entrapped Hernia Of Abdomen, More Than 10 Cm In Length 1 1 $2,314.80 $2,314.80 $1,388.88 $1,388.88 $1,388.88 2026-04-24
44141 HCPCS Partial Removal Of Large Bowel With Creation Of Opening To Skin 3 3 $3,084.40 $3,084.40 $75.00 $1,643.08 $1,376.52 2026-04-24
V2788 HCPCS Presbyopia Correcting Function Of Intraocular Lens 5 5 $1,444.40 $1,444.40 $1,343.29 $1,372.18 $1,372.18 2026-04-24
24605 HCPCS Repair Of Dislocated Elbow Under Anesthesia 8 5 $1,471.84 $1,471.84 $75.00 $1,398.25 $1,368.81 2026-04-24
23655 HCPCS Closed Treatment Of Dislocated Shoulder With Manipulation Under Anesthesia 8 5 $1,471.84 $1,471.84 $75.00 $1,398.25 $1,368.81 2026-04-24
12656389_1 CDM MariGen Fenestrated – 3 X 3.5 Cm 5 5 $1,434.85 $1,434.85 $1,334.41 $1,363.11 $1,363.11 2026-04-24
15734 HCPCS Creation Of Muscle Graft To Trunk 3 3 $2,814.55 $2,814.55 $75.00 $1,645.12 $1,356.75 2026-04-24
27552 HCPCS Closed Treatment Of Dislocated Knee Under Anesthesia 5 5 $1,420.12 $1,420.12 $1,320.71 $1,349.11 $1,349.11 2026-04-24
15100 HCPCS Partial Thickness Self Skin Graft To Trunk, Arms, Or Legs, 100.0 Sq Cm Or 1% Bod… 13 5 $1,422.25 $1,422.25 $75.00 $4,425.91 $1,341.64 2026-04-24
9902262_12 CDM 49655 Lap Inc Hern Repair Comp 1 1 $2,210.80 $2,210.80 $1,326.48 $1,326.48 $1,326.48 2026-04-24
9902262_10 CDM 49655 Lap Inc Hern Repair Comp 1 1 $2,210.80 $2,210.80 $1,326.48 $1,326.48 $1,326.48 2026-04-24
99291 HCPCS Critical Care, First 30-74 Minutes 8 5 $1,422.75 $1,422.75 $75.00 $1,351.61 $1,323.16 2026-04-24
27252 HCPCS Closed Treatment Of Dislocated Hip Under Anesthesia 5 5 $1,386.52 $1,386.52 $1,289.46 $1,317.19 $1,317.19 2026-04-24
9262702_1 CDM Dressing, PuraPly Am 2 X 2 5 5 $1,380.00 $1,380.00 $1,283.40 $1,311.00 $1,311.00 2026-04-24
10057801_1 CDM EpiFix 18mm Disc 5 5 $1,369.00 $1,369.00 $1,273.17 $1,300.55 $1,300.55 2026-04-24
Q5103 HCPCS Injection, Infliximab-dyyb, Biosimilar, (inflectra), 10 Mg 5 5 $1,362.65 $1,362.65 $1,267.26 $1,294.52 $1,294.52 2026-04-24
10139557_1 CDM PeritX Peritoneal Catheter Kit (50-9000c) 5 5 $1,356.10 $1,356.10 $1,261.17 $1,288.30 $1,288.30 2026-04-24
30420 HCPCS Reshaping Of Bony Cartilage Dividing Nasal Passages 3 3 $2,512.10 $2,512.10 $75.00 $1,509.33 $1,266.43 2026-04-24
36556 HCPCS Insertion Of Non-tunneled Central Venous Tube For Infusion (5 Years Or Older) 18 5 $1,359.49 $1,359.49 $75.00 $1,348.62 $1,264.33 2026-04-24
9560797_1 CDM Specialty Services - Treatment Room 5 5 $1,307.67 $1,307.67 $1,216.13 $1,242.29 $1,242.29 2026-04-24
9260780_1 CDM Pleurx Pleural Catheter Kit (50-7000b) 5 5 $1,306.40 $1,306.40 $1,214.95 $1,241.08 $1,241.08 2026-04-24
20680 HCPCS Removal Of Deep Implant From Bone 13 5 $1,283.10 $1,283.10 $75.00 $3,210.11 $1,218.95 2026-04-24
12664896_1 CDM MariGen – 3 X 3.5 Cm 5 5 $1,277.15 $1,277.15 $1,187.75 $1,213.29 $1,213.29 2026-04-24
44140 HCPCS Partial Removal Of Large Bowel With Connection 3 3 $2,566.75 $2,566.75 $75.00 $1,389.63 $1,210.40 2026-04-24
44205 HCPCS Partial Removal Of Small And Large Bowel With Attachment Of Small And Large Bowe… 3 3 $2,640.25 $2,640.25 $75.00 $1,453.35 $1,209.23 2026-04-24
9902260_10 CDM 49653 Lap Vent/abd Hern Proc Comp 1 1 $1,996.60 $1,996.60 $1,197.96 $1,197.96 $1,197.96 2026-04-24
9902260_12 CDM 49653 Lap Vent/abd Hern Proc Comp 1 1 $1,996.60 $1,996.60 $1,197.96 $1,197.96 $1,197.96 2026-04-24
10597539_1 CDM Arthrex Proximal Tenodesis Implant 5 5 $1,242.00 $1,242.00 $1,155.06 $1,179.90 $1,179.90 2026-04-24
51102 HCPCS Aspiration Of Bladder With Insertion Of Bladder Tube To Skin 5 5 $1,230.34 $1,230.34 $1,144.22 $1,168.82 $1,168.82 2026-04-24
94002 HCPCS Initial Hospital Inpatient Or Observation Ventilation Assistance And Management 5 5 $1,220.10 $1,220.10 $1,134.69 $1,159.10 $1,159.10 2026-04-24
49596 HCPCS Initial Repair Of Entrapped Hernia Of Abdomen, More Than 10 Cm In Length 1 1 $1,912.85 $1,912.85 $1,147.71 $1,147.71 $1,147.71 2026-04-24
12354365_1 CDM Sp Catheter Pal-p 19/36 5 5 $1,201.10 $1,201.10 $1,117.02 $1,141.05 $1,141.05 2026-04-24
62323 HCPCS Injection Of Substance Into Lower Spine Canal Using Imaging Guidance 15 5 $1,198.89 $1,198.89 $559.04 $1,324.45 $1,138.95 2026-04-24
25605 HCPCS Closed Treatment Of Broken Or Growth Plate Separate Of Forearm Bone At Wrist Wit… 8 5 $1,223.51 $1,223.51 $75.00 $1,162.33 $1,137.86 2026-04-24
27810 HCPCS Closed Treatment Of 2 Broken Lower Leg Bones At Ankle With Manipulation 8 5 $1,223.51 $1,223.51 $75.00 $1,162.33 $1,137.86 2026-04-24
9261112_1 CDM Het Bipolar Forceps Disposable (4/bx) Ref 180-1022 5 5 $1,196.95 $1,196.95 $1,113.16 $1,137.10 $1,137.10 2026-04-24
C1789 HCPCS Prosthesis, Breast (implantable) 5 5 $1,190.15 $1,190.15 $1,106.84 $1,130.64 $1,130.64 2026-04-24
59515 HCPCS Cesarean Delivery With Care After Delivery 3 3 $3,570.00 $3,570.00 $75.00 $1,255.70 $1,130.28 2026-04-24
9236062_1 CDM Specialty Services - Treatment Room 5 5 $1,188.86 $1,188.86 $1,105.64 $1,129.42 $1,129.42 2026-04-24
9902263_12 CDM 49656 Lap Inc Hernia Repair Recur 1 1 $1,882.15 $1,882.15 $1,129.29 $1,129.29 $1,129.29 2026-04-24
9902263_10 CDM 49656 Lap Inc Hernia Repair Recur 1 1 $1,882.15 $1,882.15 $1,129.29 $1,129.29 $1,129.29 2026-04-24
44160 HCPCS Partial Removal Of Small And Large Bowel With Attachment Of Small And Large Bowe… 3 3 $2,405.05 $2,405.05 $75.00 $1,233.80 $1,120.72 2026-04-24
62321 HCPCS Injection Of Substance Into Middle Or Upper Spine Canal Using Imaging Guidance 10 5 $1,176.54 $1,176.54 $891.79 $1,324.45 $1,103.76 2026-04-24
44120 HCPCS Partial Removal Of Small Bowel With Reconnection 3 3 $2,311.60 $2,311.60 $75.00 $1,129.07 $1,102.86 2026-04-24
71550 HCPCS MRI Scan Of Chest Without Contrast 10 5 $1,178.07 $1,178.07 $629.75 $1,595.03 $1,102.37 2026-04-24
44188 HCPCS Creation Of Large Bowel Opening Using An Endoscope 3 3 $2,472.25 $2,472.25 $75.00 $1,234.79 $1,102.02 2026-04-24
11044 HCPCS Removal Of Bone, 20.0 Sq Cm Or Less 10 5 $1,176.75 $1,176.75 $425.75 $1,800.92 $1,098.95 2026-04-24
12046 HCPCS Intermediate Repair Of Wound Of Neck, Hands, Feet, Or Genitals, 20.1-30.0 Cm 5 5 $1,153.95 $1,153.95 $1,073.17 $1,096.25 $1,096.25 2026-04-24
L8607 HCPCS Injectable Bulking Agent For Vocal Cord Medialization, 0.1 Ml, Includes Shipping… 5 5 $1,150.00 $1,150.00 $1,069.50 $1,092.50 $1,092.50 2026-04-24
9902261_12 CDM 49654 Lap Inc Hernia Repair 1 1 $1,819.15 $1,819.15 $1,091.49 $1,091.49 $1,091.49 2026-04-24
9902261_10 CDM 49654 Lap Inc Hernia Repair 1 1 $1,819.15 $1,819.15 $1,091.49 $1,091.49 $1,091.49 2026-04-24
9235952_1 CDM Specialty Services - Treatment Room 5 5 $1,147.00 $1,147.00 $1,066.71 $1,089.65 $1,089.65 2026-04-24
23470 HCPCS Partial Replacement Of Shoulder Joint 3 3 $2,245.37 $2,245.37 $75.00 $1,384.91 $1,082.95 2026-04-24
19307 HCPCS Removal Of Breast And Underarm Lymph Nodes 3 3 $2,259.10 $2,259.10 $75.00 $1,144.35 $1,080.09 2026-04-24
12036 HCPCS Intermediate Repair Of Wound Of Scalp, Underarms, Trunk, Arms, Or Legs, 20.1-30.… 8 5 $1,153.95 $1,153.95 $75.00 $1,096.25 $1,073.17 2026-04-24
99285 HCPCS Emergency Department Visit With High Level Of Medical Decision Making 9 5 $1,150.00 $1,150.00 $158.11 $1,092.50 $1,069.50 2026-04-24
65235 HCPCS Removal Of Foreign Body In Eye Or Lens 5 5 $1,117.99 $1,117.99 $1,039.73 $1,062.09 $1,062.09 2026-04-24
64505 HCPCS Injection Of Anesthetic Agent, Trigeminal Nerve Bundle 5 5 $1,114.60 $1,114.60 $1,036.58 $1,058.87 $1,058.87 2026-04-24
9902251_10 CDM 49561 Rpr Ventral Hern Init, Block 1 1 $1,764.55 $1,764.55 $1,058.73 $1,058.73 $1,058.73 2026-04-24
9902251_12 CDM 49561 Rpr Ventral Hern Init, Block 1 1 $1,764.55 $1,764.55 $1,058.73 $1,058.73 $1,058.73 2026-04-24
12045 HCPCS Intermediate Repair Of Wound Of Neck, Hands, Feet, Or Genitals, 12.6-20.0 Cm 8 5 $1,129.80 $1,129.80 $75.00 $1,073.31 $1,050.71 2026-04-24
45400 HCPCS Repair Of Rectal Prolapse Using An Endoscope 3 3 $2,345.20 $2,345.20 $75.00 $1,202.58 $1,033.61 2026-04-24
41252 HCPCS Repair Of Lacerated Tongue Or Floor Of Mouth, More Than 2.6 Cm 5 5 $1,080.97 $1,080.97 $1,005.30 $1,026.92 $1,026.92 2026-04-24
87507 HCPCS Detection Test By Nucleic Acid For Digestive Tract Pathogen, Multiple Types Or S… 5 5 $1,072.05 $1,072.05 $997.01 $1,018.45 $1,018.45 2026-04-24
24201 HCPCS Removal Of Foreign Body, Upper Arm Or Elbow Area 5 5 $1,070.74 $1,070.74 $995.79 $1,017.20 $1,017.20 2026-04-24
43775 HCPCS Partial Removal Of Stomach For Weight Loss Using An Endoscope 3 3 $2,900.65 $2,900.65 $75.00 $1,544.91 $1,005.90 2026-04-24
J7307 HCPCS Etonogestrel (contraceptive) Implant System, Including Implant And Supplies 3 3 $1,821.95 $1,821.95 $75.00 $1,121.78 $1,001.19 2026-04-24
210091_1 CDM Operating Room Services - General Classification 5 5 $1,050.00 $1,050.00 $976.50 $997.50 $997.50 2026-04-24
8223045_1 CDM Room & Board - Semi-private (two Beds) - General Classification 5 5 $1,050.00 $1,050.00 $976.50 $997.50 $997.50 2026-04-24
9079152_1 CDM Room & Board - Private (one Bed) - Hospice 5 5 $1,050.00 $1,050.00 $976.50 $997.50 $997.50 2026-04-24
8078891_1 CDM Room & Board - Semi-private (two Beds) - General Classification 5 5 $1,050.00 $1,050.00 $976.50 $997.50 $997.50 2026-04-24
27786 HCPCS Closed Treatment Of Broken Outside Lower Leg Bone At Ankle 8 5 $1,071.00 $1,071.00 $75.00 $1,017.45 $996.03 2026-04-24
49617 HCPCS Repair Of Recurrent Sliding Hernia Of Abdomen, More Than 10 Cm In Length 1 1 $1,656.39 $1,656.39 $993.83 $993.83 $993.83 2026-04-24
15277 HCPCS Skin Substitute Graft To Wound 100.0 Sq Cm Or More Of Face, Scalp, Eyelids, Mout… 15 5 $1,043.70 $1,043.70 $423.80 $3,236.89 $991.52 2026-04-24
15275 HCPCS Application Of Skin Substitute Graft To Wound Of Face, Scalp, Eyelids, Mouth, Ne… 15 5 $1,043.70 $1,043.70 $181.63 $5,296.73 $991.52 2026-04-24
15271 HCPCS Application Of Skin Substitute Graft To Wound Of Trunk, Arms, Or Legs, 25.0 Sq C… 15 5 $1,043.70 $1,043.70 $157.22 $3,562.07 $991.52 2026-04-24
44005 HCPCS Release Of Intestinal Scar Tissue 3 3 $2,039.65 $2,039.65 $75.00 $1,076.18 $985.68 2026-04-24
12006 HCPCS Simple Repair Of Surface Wound Of Scalp, Neck, Underarms, Trunk, Arms, Or Legs, … 5 5 $1,033.72 $1,033.72 $961.36 $982.03 $982.03 2026-04-24
26605 HCPCS Closed Treatment Of Broken Hand Bone With Manipulation 8 5 $1,053.45 $1,053.45 $75.00 $1,000.78 $979.71 2026-04-24
9263210_1 CDM Endo Gia Articulating Reload W/tri-staple Technology 5 5 $1,027.35 $1,027.35 $955.44 $975.98 $975.98 2026-04-24
43280 HCPCS Strengthening Of Muscle Between Esophagus And Stomach By Wrapping Part Of Stomac… 3 3 $2,180.35 $2,180.35 $75.00 $1,150.90 $972.66 2026-04-24
J7296 HCPCS Levonorgestrel-releasing Intrauterine Contraceptive System, (kyleena), 19.5 Mg 3 3 $1,821.95 $1,821.95 $75.00 $1,144.21 $972.58 2026-04-24
J7298 HCPCS Levonorgestrel-releasing Intrauterine Contraceptive System (mirena), 52 Mg 3 3 $1,821.95 $1,821.95 $75.00 $1,144.21 $972.58 2026-04-24
90375 HCPCS Rabies Immune Globulin For Injection 5 5 $1,022.60 $1,022.60 $951.02 $971.47 $971.47 2026-04-24
23570 HCPCS Closed Treatment Of Broken Shoulder Blade 8 5 $1,043.62 $1,043.62 $75.00 $991.44 $970.57 2026-04-24
9263211_1 CDM Endo Gia Ultra Universal Stapler (3/box) 5 5 $1,020.00 $1,020.00 $948.60 $969.00 $969.00 2026-04-24
25660 HCPCS Closed Treatment Of Dislocated Wrist Bones With Manipulation 5 5 $1,016.92 $1,016.92 $945.74 $966.07 $966.07 2026-04-24
49616 HCPCS Repair Of Recurrent Entrapped Hernia Of Abdomen, 3-10 Cm In Length 1 1 $1,605.36 $1,605.36 $963.22 $963.22 $963.22 2026-04-24
45540 HCPCS Suture Of Rectum To Sacrum Through Abdomen 3 3 $2,031.75 $2,031.75 $75.00 $1,070.58 $963.00 2026-04-24
9902259_12 CDM 49652 Lap Vent/abd Hernia Repair 1 1 $1,598.65 $1,598.65 $959.19 $959.19 $959.19 2026-04-24
9902259_10 CDM 49652 Lap Vent/abd Hernia Repair 1 1 $1,598.65 $1,598.65 $959.19 $959.19 $959.19 2026-04-24
64483 HCPCS Injection Of Anesthetic And/or Steroid Drug Into Sacral Spine Nerve Root Using I… 10 5 $1,022.62 $1,022.62 $660.11 $1,268.66 $958.13 2026-04-24
64479 HCPCS Injection Of Anesthetic And/or Steroid Drug Into Upper Or Middle Spine Nerve Roo… 10 5 $1,022.62 $1,022.62 $660.11 $1,268.66 $958.13 2026-04-24
81420 HCPCS Test For Detecting Genes Associated With Fetal Disease, Aneuploidy Genomic Seque… 5 5 $1,001.70 $1,001.70 $931.58 $951.62 $951.62 2026-04-24
94003 HCPCS Follow-up Inpatient Or Observation Ventilation Assistance And Management 5 5 $997.76 $997.76 $927.92 $947.87 $947.87 2026-04-24
47564 HCPCS Removal Of Gallbladder With Exploration Of Common Bile Duct Using An Endoscope 3 3 $2,009.20 $2,009.20 $75.00 $1,003.22 $947.36 2026-04-24
32651 HCPCS Partial Removal Of Chest Cavity Lining And Lung Lining Using An Endoscope 3 3 $2,042.25 $2,042.25 $75.00 $979.49 $942.77 2026-04-24
P9036 HCPCS Platelets, Pheresis, Irradiated, Each Unit 5 5 $992.25 $992.25 $922.79 $942.64 $942.64 2026-04-24
44310 HCPCS Creation Of Opening From Small Bowel To Skin 3 3 $1,869.55 $1,869.55 $75.00 $1,057.77 $941.68 2026-04-24
59410 HCPCS Vaginal Delivery With Post Delivery Care 3 3 $2,940.00 $2,940.00 $75.00 $1,053.35 $932.85 2026-04-24
47600 HCPCS Removal Of Gallbladder 3 3 $1,904.20 $1,904.20 $75.00 $963.22 $922.93 2026-04-24
9902252_10 CDM 49565 Rerepair Ventrl Hern, Reduce 1 1 $1,528.30 $1,528.30 $916.98 $916.98 $916.98 2026-04-24
9902252_12 CDM 49565 Rerepair Ventrl Hern, Reduce 1 1 $1,528.30 $1,528.30 $916.98 $916.98 $916.98 2026-04-24
20670 HCPCS Removal Of Surface Implant From Bone 5 5 $960.75 $960.75 $893.50 $912.71 $912.71 2026-04-24
10304593_1 CDM Olympus Thunderbeat Laparoscopic Handpiece TB-0535fcs (5/bx) 5 5 $956.80 $956.80 $889.82 $908.96 $908.96 2026-04-24
J7300 HCPCS Intrauterine Copper Contraceptive 3 3 $1,707.50 $1,707.50 $75.00 $1,061.40 $902.19 2026-04-24
32555 HCPCS Aspiration Of Fluid From Chest Cavity Using Imaging Guidance 18 5 $969.15 $969.15 $75.00 $960.02 $901.31 2026-04-24
36573 HCPCS Insertion Of Tube For Infusion With Imaging Guidance And Review By Radiologist, … 10 5 $954.84 $954.84 $588.09 $1,213.45 $894.33 2026-04-24
64636 HCPCS Destruction Of Lower Or Sacral Spinal Facet Joint Nerves Using Imaging Guidance,… 10 5 $950.00 $950.00 $318.34 $1,479.82 $886.92 2026-04-24
P9035 HCPCS Platelets, Pheresis, Leukocytes Reduced, Each Unit 5 5 $929.25 $929.25 $864.20 $882.79 $882.79 2026-04-24
20103 HCPCS Exploration Of Wound Of Arm Or Leg 5 5 $925.84 $925.84 $861.03 $879.55 $879.55 2026-04-24
13152 HCPCS Complicated Repair Of Wound Of Eyelids, Nose, Ears, Or Lip, 2.6-7.5 Cm 8 5 $941.85 $941.85 $75.00 $894.76 $875.92 2026-04-24
20220 HCPCS Biopsy Of Bone Using Needle Or Trocar 10 5 $939.23 $939.23 $138.66 $1,642.88 $874.97 2026-04-24
64493 HCPCS Injection Of Lower Or Sacral Spine Facet Joint Using Imaging Guidance, Single Le… 10 5 $933.89 $933.89 $495.09 $1,268.66 $873.84 2026-04-24
64490 HCPCS Injection Of Upper Or Middle Spine Facet Joint Using Imaging Guidance, Single Le… 10 5 $933.89 $933.89 $495.09 $1,268.66 $873.84 2026-04-24
49595 HCPCS Initial Repair Of Sliding Hernia Of Abdomen, More Than 10 Cm In Length 1 1 $1,441.96 $1,441.96 $865.18 $865.18 $865.18 2026-04-24
19303 HCPCS Simple Complete Removal Of Breast 3 3 $1,726.75 $1,726.75 $75.00 $896.47 $859.83 2026-04-24
10121 HCPCS Removal Of Foreign Body From Tissue, Accessed Beneath The Skin, Complex 8 5 $922.42 $922.42 $75.00 $876.30 $857.85 2026-04-24
32556 HCPCS Drainage Of Fluid From Chest Cavity With Insertion Of Indwelling Tube 8 5 $920.51 $920.51 $75.00 $874.48 $856.07 2026-04-24
9902250_10 CDM 49560 Rpr Ventral Hern Init, Reduc 1 1 $1,414.90 $1,414.90 $848.94 $848.94 $848.94 2026-04-24
9902250_12 CDM 49560 Rpr Ventral Hern Init, Reduc 1 1 $1,414.90 $1,414.90 $848.94 $848.94 $848.94 2026-04-24
C1788 HCPCS Port, Indwelling (implantable) 10 5 $903.08 $903.08 $574.69 $1,128.79 $846.04 2026-04-24
24650 HCPCS Closed Treatment Of Broken Forearm Bone On Thumb Side At Elbow 8 5 $908.25 $908.25 $75.00 $862.84 $844.67 2026-04-24
44050 HCPCS Repair Of Twisted Or Herniated Small Bowel 3 3 $1,791.30 $1,791.30 $75.00 $937.01 $842.82 2026-04-24
49594 HCPCS Initial Repair Of Entrapped Hernia Of Abdomen, 3-10 Cm In Length 1 1 $1,395.08 $1,395.08 $837.05 $837.05 $837.05 2026-04-24
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