Price Transparencybeta Hospital negotiated rates

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

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Hospital

MAINEHEALTH BEHAVIORAL HEALTH AT SPRING HARBOR

Westbrook, ME · CCN 204005 · Rates published

Your selected procedure

You selected 59510 (CPT)

CESAREAN DELIVERY

This hospital’s price: $2,307 across 2 payers

Source: https://sthpiprd.blob.core.windows.net/machine-readable-files/8065/010238552-1598798787_mainehealth_standardcharges.csv · observed 2026-10-30

This is the facility’s filed rate for this code. The comparison board’s estimate also adds the surgeon and anesthesia fees, so it is usually higher.

9,963 distinct procedures filed
6 distinct payers
113,751 rate rows
2025-08-12 last MRF observed · ⚠ 15 mo old
Data quality

31,226 of 113,751 rate rows are consumer-grade (27.5%)

82,525 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
professional (physician) fee — not the facility price 82,423
per-diem day rate — not a per-procedure price 63
placeholder amount (≤ $0.02) — excluded from medians 35
exceeds 10× this hospital's gross charge — excluded from medians 4

⚠ Possibly outdated The most recent machine-readable file we have for this hospital is 15 months old. CMS requires hospitals to refresh these files at least annually, so newer rates may exist that we haven't ingested yet. The prices below are exactly as last filed.

Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://sthpiprd.blob.core.windows.net/machine-readable-files/8065/010238552-1598798787_mainehealth_standardcharges.csv
Found on page https://search.hospitalpriceindex.com/hpi2/machineReadable/springharborhospital/8065
Discovered viaDiscovered by HANK
Last fetch success · 2026-10-31
Content fingerprint 6048918a125854ad… · 18,024,670 bytes · first seen 2026-10-31

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
J3391
HCPCS 		Apc 2 $4,377,500.00 $4,377,500.00 $4,377,500.00 nat. median
$4,505,000
1.0× median
J1414
HCPCS 		Inj, Beqvez, Per Tx Dose 2 $3,710,000.00 $3,710,000.00 $3,710,000.00 nat. median
$3,710,000
1.0× median
J1411
HCPCS 		Apc 2 $3,685,266.67 $3,685,266.67 $3,685,266.67 nat. median
$3,705,478
1.0× median
J1413
HCPCS 		Apc 2 $3,324,571.90 $3,324,571.90 $3,324,571.90 nat. median
$3,324,572
1.0× median
J3394
HCPCS 		Apc 2 $3,261,355.00 $3,261,355.00 $3,261,355.00 nat. median
$3,286,000
1.0× median
J3393
HCPCS 		Apc 2 $2,950,686.67 $2,950,686.67 $2,950,686.67 nat. median
$2,994,107
1.0× median
J3399
HCPCS 		Inj Onase Abepar-xioi Treat 2 $2,452,115.60 $2,452,115.60 $2,452,115.60 nat. median
$2,467,989
1.0× median
J3392
HCPCS 		Apc 2 $2,332,000.00 $2,332,000.00 $2,332,000.00 nat. median
$2,401,965
1.0× median
Q2057
HCPCS 		Apc 2 $770,620.00 $770,620.00 $770,620.00 nat. median
$813,967
0.9× median
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 2 $578,324.58 $578,324.58 $578,324.58 nat. median
$739,658
0.8× median
Q2056
HCPCS 		Apc 2 $553,378.83 $553,378.83 $553,378.83 nat. median
$646,415
0.9× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 2 $541,635.66 $541,635.66 $541,635.66 nat. median
$640,950
0.8× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 2 $541,260.45 $541,260.45 $541,260.45 nat. median
$623,527
0.9× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 2 $533,076.48 $533,076.48 $533,076.48 nat. median
$608,239
0.9× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 2 $489,720.00 $489,720.00 $489,720.00 nat. median
$592,235
0.8× median
Q2058
HCPCS 		Apc 2 $270,375.00 $270,375.00 $270,375.00 nat. median
$319,951
0.8× median
Q0480
HCPCS 		Driver Pneumatic Vad, Rep 2 $106,120.90 $106,120.90 $106,120.90 nat. median
$111,503
1.0× median
K1007
HCPCS 		Bil Hkaf Pc S/d Micro Sensor 2 $93,216.70 $93,216.70 $93,216.70 nat. median
$96,983
1.0× median
L8702
HCPCS 		Ewhf S/d Uprt Micro Sensor 2 $67,452.66 $67,452.66 $67,452.66 nat. median
$70,178
1.0× median
J9029
HCPCS 		Fee Schedule 2 $63,431.05 $63,431.05 $63,431.05 nat. median
$68,400
0.9× median
38240
CPT 		Transplt Allo Hct/donor 2 $57,240.31 $57,240.31 $57,240.31 nat. median
$12,874
outlier · 4.4×
A9543
HCPCS 		Y90 Ibritumomab, Rx 2 $56,824.55 $56,824.55 $56,824.55 nat. median
$63,504
0.9× median
Q2043
HCPCS 		Sipuleucel-t Auto Cd54+ 2 $55,945.97 $55,945.97 $55,945.97 nat. median
$65,720
0.9× median
L7181
HCPCS 		Electronic Elbo Simultaneous 2 $47,211.27 $47,211.27 $47,211.27 nat. median
$50,516
0.9× median
J9226
HCPCS 		Supprelin La Implant 2 $45,560.39 $45,560.39 $45,560.39 nat. median
$55,159
0.8× median
L7180
HCPCS 		Electronic Elbow Sequential 2 $45,177.95 $45,177.95 $45,177.95 nat. median
$46,980
1.0× median
33276
CPT 		Fee Schedule 2 $43,553.28 $43,553.28 $43,553.28 nat. median
$43,331
1.0× median
0266T
CPT 		Implt/rpl Crtd Sns Dev Total 2 $43,553.28 $43,553.28 $43,553.28 nat. median
$42,722
1.0× median
L2006
HCPCS 		Kaf Sng/dbl Swg/stn Mcpr Cus 2 $39,823.40 $39,823.40 $39,823.40 nat. median
$39,921
1.0× median
L8701
HCPCS 		Ewh S/d Uprt Micro Sensor 2 $34,284.44 $34,284.44 $34,284.44 nat. median
$35,670
1.0× median
0620T
CPT 		Evasc Ven Artlz Tibl/prnl Vn 2 $33,874.88 $33,874.88 $33,874.88 nat. median
$32,709
1.0× median
33264
CPT 		Rmvl & Rplcmt Dfb Gen Mlt Ld 2 $31,030.48 $31,030.48 $31,030.48 nat. median
$31,574
1.0× median
33270
CPT 		Ins/rep Subq Defibrillator 2 $31,030.48 $31,030.48 $31,030.48 nat. median
$32,114
1.0× median
0408T
CPT 		Insj/rplc Cardiac Modulj Sys 2 $31,030.48 $31,030.48 $31,030.48 nat. median
$32,041
1.0× median
33231
CPT 		Insrt Pulse Gen W/mult Leads 2 $31,030.48 $31,030.48 $31,030.48 nat. median
$30,121
1.0× median
33249
CPT 		Insj/rplcmt Defib W/lead(s) 2 $31,030.48 $31,030.48 $31,030.48 nat. median
$31,620
1.0× median
0571T
CPT 		Insj/rplcmt Icds Ss Eltrd 2 $31,030.48 $31,030.48 $31,030.48 nat. median
$32,226
1.0× median
0915T
CPT 		Apc 2 $31,030.48 $31,030.48 $31,030.48 nat. median
$32,703
0.9× median
69930
CPT 		Implant Cochlear Device 2 $30,784.88 $30,784.88 $30,784.88 nat. median
$29,205
1.1× median
64568
CPT 		Opn Impltj Crnl Nrv Nea&pg 2 $29,493.56 $29,493.56 $29,493.56 nat. median
$27,744
1.1× median
63685
CPT 		Insrt/redo Spine N Generator 2 $29,493.56 $29,493.56 $29,493.56 nat. median
$21,151
1.4× median
61886
CPT 		Implant Neurostim Arrays 2 $29,493.56 $29,493.56 $29,493.56 nat. median
$27,188
1.1× median
33287
CPT 		Fee Schedule 2 $29,493.56 $29,493.56 $29,493.56 nat. median
$28,987
1.0× median
0674T
CPT 		Laps Insj Nw/rpcmt Prm Isdss 2 $29,493.56 $29,493.56 $29,493.56 nat. median
$29,098
1.0× median
64582
CPT 		Opn Mpltj Hpglsl Nstm Ary Pg 2 $29,493.56 $29,493.56 $29,493.56 nat. median
$28,183
1.0× median
0268T
CPT 		Implt/rpl Crtd Sns Dev Gen 2 $29,493.56 $29,493.56 $29,493.56 nat. median
$29,794
1.0× median
L6700
HCPCS 		Apc 2 $28,931.56 $28,931.56 $28,931.56 nat. median
$30,378
1.0× median
L5856
HCPCS 		Elec Knee-shin Swing/stance 2 $28,607.84 $28,607.84 $28,607.84 nat. median
$30,017
1.0× median
J9266
HCPCS 		Pegaspargase Injection 2 $28,424.06 $28,424.06 $28,424.06 nat. median
$33,314
0.9× median
L6880
HCPCS 		Elec Hand Ind Art Digits 2 $28,151.96 $28,151.96 $28,151.96 nat. median
$30,016
0.9× median

Other procedures at this hospital

Browse this hospital's 9,963 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
             
J3391 HCPCS Apc 2 2 — — $4,377,500.00 $4,377,500.00 $4,377,500.00 2025-08-12
J1414 HCPCS Inj, Beqvez, Per Tx Dose 2 2 — — $3,710,000.00 $3,710,000.00 $3,710,000.00 2025-08-12
J1411 HCPCS Apc 2 2 — — $3,685,266.67 $3,685,266.67 $3,685,266.67 2025-08-12
J1413 HCPCS Apc 2 2 — — $3,324,571.90 $3,324,571.90 $3,324,571.90 2025-08-12
J3394 HCPCS Apc 2 2 — — $3,261,355.00 $3,261,355.00 $3,261,355.00 2025-08-12
J3393 HCPCS Apc 2 2 — — $2,950,686.67 $2,950,686.67 $2,950,686.67 2025-08-12
J3399 HCPCS Inj Onase Abepar-xioi Treat 2 2 — — $2,452,115.60 $2,452,115.60 $2,452,115.60 2025-08-12
J3392 HCPCS Apc 2 2 — — $2,332,000.00 $2,332,000.00 $2,332,000.00 2025-08-12
Q2057 HCPCS Apc 2 2 — — $770,620.00 $770,620.00 $770,620.00 2025-08-12
Q2042 HCPCS Tisagenlecleucel Car-pos T 2 2 — — $578,324.58 $578,324.58 $578,324.58 2025-08-12
Q2056 HCPCS Apc 2 2 — — $553,378.83 $553,378.83 $553,378.83 2025-08-12
Q2054 HCPCS Lisocabtagene Mara Car Pos T 2 2 — — $541,635.66 $541,635.66 $541,635.66 2025-08-12
Q2055 HCPCS Idecabtagene Vicleucel Car 2 2 — — $541,260.45 $541,260.45 $541,260.45 2025-08-12
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 2 2 — — $533,076.48 $533,076.48 $533,076.48 2025-08-12
Q2053 HCPCS Brexucabtagene Car Pos T 2 2 — — $489,720.00 $489,720.00 $489,720.00 2025-08-12
Q2058 HCPCS Apc 2 2 — — $270,375.00 $270,375.00 $270,375.00 2025-08-12
Q0480 HCPCS Driver Pneumatic Vad, Rep 2 2 — — $106,120.90 $106,120.90 $106,120.90 2025-08-12
K1007 HCPCS Bil Hkaf Pc S/d Micro Sensor 2 2 — — $93,216.70 $93,216.70 $93,216.70 2025-08-12
L8702 HCPCS Ewhf S/d Uprt Micro Sensor 2 2 — — $67,452.66 $67,452.66 $67,452.66 2025-08-12
J9029 HCPCS Fee Schedule 2 2 — — $63,431.05 $63,431.05 $63,431.05 2025-08-12
38240 CPT Transplt Allo Hct/donor 2 2 — — $57,240.31 $57,240.31 $57,240.31 2025-08-12
A9543 HCPCS Y90 Ibritumomab, Rx 2 2 — — $56,824.55 $56,824.55 $56,824.55 2025-08-12
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 2 2 — — $55,945.97 $55,945.97 $55,945.97 2025-08-12
L7181 HCPCS Electronic Elbo Simultaneous 2 2 — — $47,211.27 $47,211.27 $47,211.27 2025-08-12
J9226 HCPCS Supprelin La Implant 2 2 — — $45,560.39 $45,560.39 $45,560.39 2025-08-12
L7180 HCPCS Electronic Elbow Sequential 2 2 — — $45,177.95 $45,177.95 $45,177.95 2025-08-12
33276 CPT Fee Schedule 2 2 — — $43,553.28 $43,553.28 $43,553.28 2025-08-12
0266T CPT Implt/rpl Crtd Sns Dev Total 2 2 — — $43,553.28 $43,553.28 $43,553.28 2025-08-12
L2006 HCPCS Kaf Sng/dbl Swg/stn Mcpr Cus 2 2 — — $39,823.40 $39,823.40 $39,823.40 2025-08-12
L8701 HCPCS Ewh S/d Uprt Micro Sensor 2 2 — — $34,284.44 $34,284.44 $34,284.44 2025-08-12
0620T CPT Evasc Ven Artlz Tibl/prnl Vn 2 2 — — $33,874.88 $33,874.88 $33,874.88 2025-08-12
33264 CPT Rmvl & Rplcmt Dfb Gen Mlt Ld 2 2 — — $31,030.48 $31,030.48 $31,030.48 2025-08-12
33270 CPT Ins/rep Subq Defibrillator 2 2 — — $31,030.48 $31,030.48 $31,030.48 2025-08-12
0408T CPT Insj/rplc Cardiac Modulj Sys 2 2 — — $31,030.48 $31,030.48 $31,030.48 2025-08-12
33231 CPT Insrt Pulse Gen W/mult Leads 2 2 — — $31,030.48 $31,030.48 $31,030.48 2025-08-12
33249 CPT Insj/rplcmt Defib W/lead(s) 2 2 — — $31,030.48 $31,030.48 $31,030.48 2025-08-12
0571T CPT Insj/rplcmt Icds Ss Eltrd 2 2 — — $31,030.48 $31,030.48 $31,030.48 2025-08-12
0915T CPT Apc 2 2 — — $31,030.48 $31,030.48 $31,030.48 2025-08-12
69930 CPT Implant Cochlear Device 2 2 — — $30,784.88 $30,784.88 $30,784.88 2025-08-12
64568 CPT Opn Impltj Crnl Nrv Nea&pg 2 2 — — $29,493.56 $29,493.56 $29,493.56 2025-08-12
63685 CPT Insrt/redo Spine N Generator 2 2 — — $29,493.56 $29,493.56 $29,493.56 2025-08-12
61886 CPT Implant Neurostim Arrays 2 2 — — $29,493.56 $29,493.56 $29,493.56 2025-08-12
33287 CPT Fee Schedule 2 2 — — $29,493.56 $29,493.56 $29,493.56 2025-08-12
0674T CPT Laps Insj Nw/rpcmt Prm Isdss 2 2 — — $29,493.56 $29,493.56 $29,493.56 2025-08-12
64582 CPT Opn Mpltj Hpglsl Nstm Ary Pg 2 2 — — $29,493.56 $29,493.56 $29,493.56 2025-08-12
0268T CPT Implt/rpl Crtd Sns Dev Gen 2 2 — — $29,493.56 $29,493.56 $29,493.56 2025-08-12
L6700 HCPCS Apc 2 2 — — $28,931.56 $28,931.56 $28,931.56 2025-08-12
L5856 HCPCS Elec Knee-shin Swing/stance 2 2 — — $28,607.84 $28,607.84 $28,607.84 2025-08-12
J9266 HCPCS Pegaspargase Injection 2 2 — — $28,424.06 $28,424.06 $28,424.06 2025-08-12
L6880 HCPCS Elec Hand Ind Art Digits 2 2 — — $28,151.96 $28,151.96 $28,151.96 2025-08-12
33289 CPT Tcat Impl Wrls P-art Prs Snr 2 2 — — $27,514.07 $27,514.07 $27,514.07 2025-08-12
C9760 HCPCS Non-blind Interatrial Shunt 2 2 — — $26,616.08 $26,616.08 $26,616.08 2025-08-12
J9600 HCPCS Porfimer Sodium Injection 2 2 — — $24,228.42 $24,228.42 $24,228.42 2025-08-12
93656 CPT Compre Ep Eval Abltj Atr Fib 2 2 — — $23,743.34 $23,743.34 $23,743.34 2025-08-12
93653 CPT Compre Ep Eval Tx Svt 2 2 — — $23,743.34 $23,743.34 $23,743.34 2025-08-12
93654 CPT Compre Ep Eval Tx Vt 2 2 — — $23,743.34 $23,743.34 $23,743.34 2025-08-12
L8614 HCPCS Cochlear Device 2 2 — — $22,979.97 $22,979.97 $22,979.97 2025-08-12
L6975 HCPCS Interscap-thor Myoelectronic 2 2 — — $22,626.12 $22,626.12 $22,626.12 2025-08-12
Q0483 HCPCS Monitor Elec Vad, Rep 2 2 — — $22,092.08 $22,092.08 $22,092.08 2025-08-12
L5858 HCPCS Stance Phase Only 2 2 — — $21,898.50 $21,898.50 $21,898.50 2025-08-12
0956T CPT Apc 2 2 — — $21,776.88 $21,776.88 $21,776.88 2025-08-12
0960T CPT Apc 2 2 — — $21,776.88 $21,776.88 $21,776.88 2025-08-12
0923T CPT Apc 2 2 — — $21,724.32 $21,724.32 $21,724.32 2025-08-12
0515T CPT Insj Wcs Lv Compl Sys 2 2 — — $21,724.32 $21,724.32 $21,724.32 2025-08-12
33230 CPT Insrt Pulse Gen W/dual Leads 2 2 — — $21,724.32 $21,724.32 $21,724.32 2025-08-12
33263 CPT Rmvl & Rplcmt Dfb Gen 2 Lead 2 2 — — $21,724.32 $21,724.32 $21,724.32 2025-08-12
33240 CPT Insrt Pulse Gen W/singl Lead 2 2 — — $21,724.32 $21,724.32 $21,724.32 2025-08-12
0614T CPT Rmvl&rplcmt Ss Impl Dfb Pg 2 2 — — $21,724.32 $21,724.32 $21,724.32 2025-08-12
0414T CPT Rmvl & Rpl Car Modulj Pls Gn 2 2 — — $21,724.32 $21,724.32 $21,724.32 2025-08-12
33262 CPT Rmvl& Replc Pulse Gen 1 Lead 2 2 — — $21,724.32 $21,724.32 $21,724.32 2025-08-12
0409T CPT Insj/rplc Car Modulj Pls Gn 2 2 — — $21,724.32 $21,724.32 $21,724.32 2025-08-12
0916T CPT Apc 2 2 — — $21,724.32 $21,724.32 $21,724.32 2025-08-12
64580 CPT Opn Impltj Nea Neuromuscular 2 2 — — $20,754.74 $20,754.74 $20,754.74 2025-08-12
61885 CPT Insrt/redo Neurostim 1 Array 2 2 — — $20,754.74 $20,754.74 $20,754.74 2025-08-12
0817T CPT Apc 2 2 — — $20,754.74 $20,754.74 $20,754.74 2025-08-12
64590 CPT Insrt/redo Pn/gastr Stimul 2 2 — — $20,754.74 $20,754.74 $20,754.74 2025-08-12
63655 CPT Implant Neuroelectrodes 2 2 — — $20,754.74 $20,754.74 $20,754.74 2025-08-12
0816T CPT Apc 2 2 — — $20,754.74 $20,754.74 $20,754.74 2025-08-12
61891 CPT Fee Schedule 2 2 — — $20,754.74 $20,754.74 $20,754.74 2025-08-12
0680T CPT Insj/rplcmt Pg Only Isdss 2 2 — — $20,754.74 $20,754.74 $20,754.74 2025-08-12
L5973 HCPCS Ank-foot Sys Dors-plant Flex 2 2 — — $20,672.48 $20,672.48 $20,672.48 2025-08-12
L6970 HCPCS Interscapular-thor Switch CT 2 2 — — $20,074.32 $20,074.32 $20,074.32 2025-08-12
54411 CPT Remov/replc Penis Pros Comp 2 2 — — $19,481.23 $19,481.23 $19,481.23 2025-08-12
54405 CPT Insert Multi-comp Penis Pros 2 2 — — $19,481.23 $19,481.23 $19,481.23 2025-08-12
53445 CPT Insert Uro/ves Nck Sphincter 2 2 — — $19,481.23 $19,481.23 $19,481.23 2025-08-12
53444 CPT Insert Tandem Cuff 2 2 — — $19,481.23 $19,481.23 $19,481.23 2025-08-12
54410 CPT Remove/replace Penis Prosth 2 2 — — $19,481.23 $19,481.23 $19,481.23 2025-08-12
54401 CPT Insert Self-contd Prosthesis 2 2 — — $19,481.23 $19,481.23 $19,481.23 2025-08-12
53447 CPT Remove/replace Ur Sphincter 2 2 — — $19,481.23 $19,481.23 $19,481.23 2025-08-12
54416 CPT Remv/repl Penis Contain Pros 2 2 — — $19,481.23 $19,481.23 $19,481.23 2025-08-12
Q0489 HCPCS Pwr Pck Base Combo Vad, Rep 2 2 — — $19,152.62 $19,152.62 $19,152.62 2025-08-12
L6965 HCPCS Shldr Disartic Myoelectronic 2 2 — — $18,753.97 $18,753.97 $18,753.97 2025-08-12
0823T CPT Apc 2 2 — — $18,457.83 $18,457.83 $18,457.83 2025-08-12
33221 CPT Insert Pulse Gen Mult Leads 2 2 — — $18,457.83 $18,457.83 $18,457.83 2025-08-12
0825T CPT Apc 2 2 — — $18,457.83 $18,457.83 $18,457.83 2025-08-12
0796T CPT Apc 2 2 — — $18,457.83 $18,457.83 $18,457.83 2025-08-12
0801T CPT Apc 2 2 — — $18,457.83 $18,457.83 $18,457.83 2025-08-12
0802T CPT Apc 2 2 — — $18,457.83 $18,457.83 $18,457.83 2025-08-12
0797T CPT Apc 2 2 — — $18,457.83 $18,457.83 $18,457.83 2025-08-12
33274 CPT Tcat Insj/rpl Perm Ldls Pm 2 2 — — $18,457.83 $18,457.83 $18,457.83 2025-08-12
33229 CPT Remv&replc Pm Gen Mult Leads 2 2 — — $18,457.83 $18,457.83 $18,457.83 2025-08-12
0525T CPT Insj/rplcmt Compl Iims 2 2 — — $18,457.83 $18,457.83 $18,457.83 2025-08-12
0803T CPT Apc 2 2 — — $18,457.83 $18,457.83 $18,457.83 2025-08-12
0795T CPT Apc 2 2 — — $18,457.83 $18,457.83 $18,457.83 2025-08-12
27702 CPT Reconstruct Ankle Joint 2 2 — — $17,798.63 $17,798.63 $17,798.63 2025-08-12
28705 CPT Fusion Of Foot Bones 2 2 — — $17,798.63 $17,798.63 $17,798.63 2025-08-12
27278 CPT Fee Schedule 2 2 — — $17,798.63 $17,798.63 $17,798.63 2025-08-12
C8003 HCPCS Apc 2 2 — — $17,798.63 $17,798.63 $17,798.63 2025-08-12
24371 CPT Revise Reconst Elbow Joint 2 2 — — $17,798.63 $17,798.63 $17,798.63 2025-08-12
24363 CPT Replace Elbow Joint 2 2 — — $17,798.63 $17,798.63 $17,798.63 2025-08-12
27279 CPT Arthrodesis Sacroiliac Joint 2 2 — — $17,798.63 $17,798.63 $17,798.63 2025-08-12
23472 CPT Reconstruct Shoulder Joint 2 2 — — $17,798.63 $17,798.63 $17,798.63 2025-08-12
22856 CPT Tot Disc Arthrp Ant 1ntrspc 2 2 — — $17,798.63 $17,798.63 $17,798.63 2025-08-12
24361 CPT Reconstruct Elbow Joint 2 2 — — $17,798.63 $17,798.63 $17,798.63 2025-08-12
25442 CPT Reconstruct Wrist Joint 2 2 — — $17,798.63 $17,798.63 $17,798.63 2025-08-12
22630 CPT Arthrd Pst Tq 1ntrspc Lum 2 2 — — $17,798.63 $17,798.63 $17,798.63 2025-08-12
22633 CPT Arthrd Cmbn 1ntrspc Lumbar 2 2 — — $17,798.63 $17,798.63 $17,798.63 2025-08-12
23616 CPT Treat Humerus Fracture 2 2 — — $17,798.63 $17,798.63 $17,798.63 2025-08-12
25446 CPT Wrist Replacement 2 2 — — $17,798.63 $17,798.63 $17,798.63 2025-08-12
20696 CPT Comp Multiplane Ext Fixation 2 2 — — $17,798.63 $17,798.63 $17,798.63 2025-08-12
22867 CPT Insj Stablj Dev W/dcmprn 2 2 — — $17,798.63 $17,798.63 $17,798.63 2025-08-12
22612 CPT Arthrd Pst Tq 1ntrspc Lumbar 2 2 — — $17,798.63 $17,798.63 $17,798.63 2025-08-12
21243 CPT Reconstruction Of Jaw Joint 2 2 — — $17,798.63 $17,798.63 $17,798.63 2025-08-12
C2616 HCPCS Brachytx, Non-str,yttrium-90 2 2 — — $17,485.10 $17,485.10 $17,485.10 2025-08-12
37229 CPT Tib/per Revasc W/ather 2 2 — — $17,379.23 $17,379.23 $17,379.23 2025-08-12
C9602 HCPCS Perc D-e Cor Stent Ather S 2 2 — — $17,379.23 $17,379.23 $17,379.23 2025-08-12
0645T CPT Tcat Impltj C Sins Rdctj Dev 2 2 — — $17,379.23 $17,379.23 $17,379.23 2025-08-12
93591 CPT Perq Transcath Cls Aortic 2 2 — — $17,379.23 $17,379.23 $17,379.23 2025-08-12
93580 CPT Transcath Closure Of Asd 2 2 — — $17,379.23 $17,379.23 $17,379.23 2025-08-12
93582 CPT Perq Transcath Closure Pda 2 2 — — $17,379.23 $17,379.23 $17,379.23 2025-08-12
0632T CPT Perq Tcat US Abltj Nrv P-art 2 2 — — $17,379.23 $17,379.23 $17,379.23 2025-08-12
C9775 HCPCS Revasc Lith-sten-ath Tib/per 2 2 — — $17,379.23 $17,379.23 $17,379.23 2025-08-12
C9773 HCPCS Revasc Lithotr-stent Tib/per 2 2 — — $17,379.23 $17,379.23 $17,379.23 2025-08-12
C9797 HCPCS Apc 2 2 — — $17,379.23 $17,379.23 $17,379.23 2025-08-12
C9774 HCPCS Revasc Lithotr-ather Tib/per 2 2 — — $17,379.23 $17,379.23 $17,379.23 2025-08-12
0981T CPT Apc 2 2 — — $17,379.23 $17,379.23 $17,379.23 2025-08-12
93581 CPT Transcath Closure Of Vsd 2 2 — — $17,379.23 $17,379.23 $17,379.23 2025-08-12
92933 CPT Prq Card Stent/ath/angio 2 2 — — $17,379.23 $17,379.23 $17,379.23 2025-08-12
37242 CPT Vasc Embolize/occlude Artery 2 2 — — $17,379.23 $17,379.23 $17,379.23 2025-08-12
C9607 HCPCS Perc D-e Cor Revasc Chro Sin 2 2 — — $17,379.23 $17,379.23 $17,379.23 2025-08-12
37230 CPT Tib/per Revasc W/stent 2 2 — — $17,379.23 $17,379.23 $17,379.23 2025-08-12
37231 CPT Tib/per Revasc Stent & Ather 2 2 — — $17,379.23 $17,379.23 $17,379.23 2025-08-12
37227 CPT Fem/popl Revasc Stnt & Ather 2 2 — — $17,379.23 $17,379.23 $17,379.23 2025-08-12
37225 CPT Fem/popl Revas W/ather 2 2 — — $17,379.23 $17,379.23 $17,379.23 2025-08-12
C9765 HCPCS Revasc Intra Lithotrip-stent 2 2 — — $17,379.23 $17,379.23 $17,379.23 2025-08-12
C9766 HCPCS Revasc Intra Lithotrip-ather 2 2 — — $17,379.23 $17,379.23 $17,379.23 2025-08-12
37184 CPT Prim Art M-thrmbc 1st Vsl 2 2 — — $17,379.23 $17,379.23 $17,379.23 2025-08-12
36906 CPT Thrmbc/nfs Dialysis Circuit 2 2 — — $17,379.23 $17,379.23 $17,379.23 2025-08-12
36836 CPT Fee Schedule 2 2 — — $17,379.23 $17,379.23 $17,379.23 2025-08-12
36837 CPT Fee Schedule 2 2 — — $17,379.23 $17,379.23 $17,379.23 2025-08-12
33902 CPT Fee Schedule 2 2 — — $17,379.23 $17,379.23 $17,379.23 2025-08-12
0793T CPT Apc 2 2 — — $17,379.23 $17,379.23 $17,379.23 2025-08-12
0238T CPT Trluml Perip Athrc Iliac Art 2 2 — — $17,379.23 $17,379.23 $17,379.23 2025-08-12
93590 CPT Perq Transcath Cls Mitral 2 2 — — $17,379.23 $17,379.23 $17,379.23 2025-08-12
C9767 HCPCS Revasc Lithotrip-stent-ather 2 2 — — $17,379.23 $17,379.23 $17,379.23 2025-08-12
Q0481 HCPCS Microprcsr Cu Elec Vad, Rep 2 2 — — $17,121.35 $17,121.35 $17,121.35 2025-08-12
62362 CPT Implant Spine Infusion Pump 2 2 — — $17,105.72 $17,105.72 $17,105.72 2025-08-12
62360 CPT Insert Spine Infusion Device 2 2 — — $17,105.72 $17,105.72 $17,105.72 2025-08-12
62361 CPT Implant Spine Infusion Pump 2 2 — — $17,105.72 $17,105.72 $17,105.72 2025-08-12
L5859 HCPCS Knee-shin Pro Flex/ext Cont 2 2 — — $17,095.98 $17,095.98 $17,095.98 2025-08-12
C8005 HCPCS Apc 2 2 — — $16,937.68 $16,937.68 $16,937.68 2025-08-12
0888T CPT Apc 2 2 — — $16,937.68 $16,937.68 $16,937.68 2025-08-12
C9758 HCPCS Blind Interatrial Shunt Ide 2 2 — — $16,937.68 $16,937.68 $16,937.68 2025-08-12
0686T CPT Histotripsy Mal Hepatcel Tis 2 2 — — $16,937.68 $16,937.68 $16,937.68 2025-08-12
C9782 HCPCS Blind Myocar Trpl Bon Marrow 2 2 — — $16,937.68 $16,937.68 $16,937.68 2025-08-12
19357 CPT Tiss Xpndr Plmt Brst Rcnstj 2 2 — — $16,838.82 $16,838.82 $16,838.82 2025-08-12
L6960 HCPCS Shldr Disartic Switch Contro 2 2 — — $15,983.88 $15,983.88 $15,983.88 2025-08-12
0308T CPT Insj Ocular Telescope Prosth 2 2 — — $15,888.49 $15,888.49 $15,888.49 2025-08-12
66683 CPT Apc 2 2 — — $15,888.49 $15,888.49 $15,888.49 2025-08-12
67027 CPT Implant Eye Drug System 2 2 — — $14,870.70 $14,870.70 $14,870.70 2025-08-12
L6955 HCPCS Above Elbow Myoelectronic CT 2 2 — — $14,500.89 $14,500.89 $14,500.89 2025-08-12
Q0479 HCPCS Power Module Combo Vad, Rep 2 2 — — $14,086.53 $14,086.53 $14,086.53 2025-08-12
65770 CPT Revise Cornea With Implant 2 2 — — $13,829.77 $13,829.77 $13,829.77 2025-08-12
L6945 HCPCS Elbow Disart Myoelectronic C 2 2 — — $12,966.63 $12,966.63 $12,966.63 2025-08-12
55882 CPT Apc 2 2 — — $12,574.58 $12,574.58 $12,574.58 2025-08-12
54417 CPT Remv/replc Penis Pros Compl 2 2 — — $12,574.58 $12,574.58 $12,574.58 2025-08-12
53451 CPT Tprnl Balo Cntnc Dev Bi 2 2 — — $12,574.58 $12,574.58 $12,574.58 2025-08-12
53440 CPT Male Sling Procedure 2 2 — — $12,574.58 $12,574.58 $12,574.58 2025-08-12
54400 CPT Insert Semi-rigid Prosthesis 2 2 — — $12,574.58 $12,574.58 $12,574.58 2025-08-12
69714 CPT Impltj Oi Implt Skl Perq Esp 2 2 — — $12,453.02 $12,453.02 $12,453.02 2025-08-12
27443 CPT Revision Of Knee Joint 2 2 — — $12,453.02 $12,453.02 $12,453.02 2025-08-12
69716 CPT Impltj Oi Implt Skl Tc Esp 2 2 — — $12,453.02 $12,453.02 $12,453.02 2025-08-12
29889 CPT Knee Arthroscopy/surgery 2 2 — — $12,453.02 $12,453.02 $12,453.02 2025-08-12
24366 CPT Reconstruct Head Of Radius 2 2 — — $12,453.02 $12,453.02 $12,453.02 2025-08-12
24410 CPT Revision Of Humerus 2 2 — — $12,453.02 $12,453.02 $12,453.02 2025-08-12
24575 CPT Treat Humerus Fracture 2 2 — — $12,453.02 $12,453.02 $12,453.02 2025-08-12
27438 CPT Revise Kneecap With Implant 2 2 — — $12,453.02 $12,453.02 $12,453.02 2025-08-12
23473 CPT Revis Reconst Shoulder Joint 2 2 — — $12,453.02 $12,453.02 $12,453.02 2025-08-12
23802 CPT Fusion Of Shoulder Joint 2 2 — — $12,453.02 $12,453.02 $12,453.02 2025-08-12
29856 CPT Tibial Arthroscopy/surgery 2 2 — — $12,453.02 $12,453.02 $12,453.02 2025-08-12
23680 CPT Treat Dislocation/fracture 2 2 — — $12,453.02 $12,453.02 $12,453.02 2025-08-12
23491 CPT Reinforce Shoulder Bones 2 2 — — $12,453.02 $12,453.02 $12,453.02 2025-08-12
C9781 HCPCS Arthro/shoul Surg; W/spacer 2 2 — — $12,453.02 $12,453.02 $12,453.02 2025-08-12
24370 CPT Revise Reconst Elbow Joint 2 2 — — $12,453.02 $12,453.02 $12,453.02 2025-08-12
69729 CPT Fee Schedule 2 2 — — $12,453.02 $12,453.02 $12,453.02 2025-08-12
24430 CPT Repair Of Humerus 2 2 — — $12,453.02 $12,453.02 $12,453.02 2025-08-12
24516 CPT Treat Humerus Fracture 2 2 — — $12,453.02 $12,453.02 $12,453.02 2025-08-12
24579 CPT Treat Humerus Fracture 2 2 — — $12,453.02 $12,453.02 $12,453.02 2025-08-12
23470 CPT Reconstruct Shoulder Joint 2 2 — — $12,453.02 $12,453.02 $12,453.02 2025-08-12
69719 CPT Revj/rplcmt Oi Implt Tc Esp 2 2 — — $12,453.02 $12,453.02 $12,453.02 2025-08-12
25810 CPT Fusion/graft Of Wrist Joint 2 2 — — $12,453.02 $12,453.02 $12,453.02 2025-08-12
69730 CPT Fee Schedule 2 2 — — $12,453.02 $12,453.02 $12,453.02 2025-08-12
24666 CPT Treat Radius Fracture 2 2 — — $12,453.02 $12,453.02 $12,453.02 2025-08-12
27429 CPT Reconstruction Knee 2 2 — — $12,453.02 $12,453.02 $12,453.02 2025-08-12
24346 CPT Reconstruct Elbow Med Ligmnt 2 2 — — $12,453.02 $12,453.02 $12,453.02 2025-08-12
C9757 HCPCS Spine/lumbar Disk Surgery 2 2 — — $12,453.02 $12,453.02 $12,453.02 2025-08-12
25491 CPT Reinforce Ulna 2 2 — — $12,453.02 $12,453.02 $12,453.02 2025-08-12
C9734 HCPCS U/s Trtmt, Not Leiomyomata 2 2 — — $12,453.02 $12,453.02 $12,453.02 2025-08-12
23615 CPT Treat Humerus Fracture 2 2 — — $12,453.02 $12,453.02 $12,453.02 2025-08-12
24362 CPT Reconstruct Elbow Joint 2 2 — — $12,453.02 $12,453.02 $12,453.02 2025-08-12
24545 CPT Treat Humerus Fracture 2 2 — — $12,453.02 $12,453.02 $12,453.02 2025-08-12
25444 CPT Reconstruct Wrist Joint 2 2 — — $12,453.02 $12,453.02 $12,453.02 2025-08-12
22869 CPT Insj Stablj Dev Without Dcmprn 2 2 — — $12,453.02 $12,453.02 $12,453.02 2025-08-12
0627T CPT Perq Njx Algc Fluor Lmbr 1st 2 2 — — $12,453.02 $12,453.02 $12,453.02 2025-08-12
27130 CPT Total Hip Arthroplasty 2 2 — — $12,453.02 $12,453.02 $12,453.02 2025-08-12
25441 CPT Reconstruct Wrist Joint 2 2 — — $12,453.02 $12,453.02 $12,453.02 2025-08-12
24546 CPT Treat Humerus Fracture 2 2 — — $12,453.02 $12,453.02 $12,453.02 2025-08-12
20692 CPT Apply Bone Fixation Device 2 2 — — $12,453.02 $12,453.02 $12,453.02 2025-08-12
20982 CPT Ablate Bone Tumor(s) Perq 2 2 — — $12,453.02 $12,453.02 $12,453.02 2025-08-12
22551 CPT Arthrd Ant Ntrbdy Cervical 2 2 — — $12,453.02 $12,453.02 $12,453.02 2025-08-12
25365 CPT Revise Radius & Ulna 2 2 — — $12,453.02 $12,453.02 $12,453.02 2025-08-12
25391 CPT Lengthen Radius Or Ulna 2 2 — — $12,453.02 $12,453.02 $12,453.02 2025-08-12
24802 CPT Fusion/graft Of Elbow Joint 2 2 — — $12,453.02 $12,453.02 $12,453.02 2025-08-12
24435 CPT Repair Humerus With Graft 2 2 — — $12,453.02 $12,453.02 $12,453.02 2025-08-12
22554 CPT Arthrd Ant Ntrbd Min Dsc Crv 2 2 — — $12,453.02 $12,453.02 $12,453.02 2025-08-12
24586 CPT Treat Elbow Fracture 2 2 — — $12,453.02 $12,453.02 $12,453.02 2025-08-12
0737T CPT Xenograft Impltj Artclr Surf 2 2 — — $12,453.02 $12,453.02 $12,453.02 2025-08-12
0629T CPT Perq Njx Algc CT Lmbr 1st 2 2 — — $12,453.02 $12,453.02 $12,453.02 2025-08-12
29907 CPT Subtalar Arthro W/fusion 2 2 — — $12,453.02 $12,453.02 $12,453.02 2025-08-12
29867 CPT Allgrft Implnt Knee W/scope 2 2 — — $12,453.02 $12,453.02 $12,453.02 2025-08-12
23485 CPT Revision Of Collar Bone 2 2 — — $12,453.02 $12,453.02 $12,453.02 2025-08-12
28735 CPT Fusion Of Foot Bones 2 2 — — $12,453.02 $12,453.02 $12,453.02 2025-08-12
28737 CPT Revision Of Foot Bones 2 2 — — $12,453.02 $12,453.02 $12,453.02 2025-08-12
28715 CPT Fusion Of Foot Bones 2 2 — — $12,453.02 $12,453.02 $12,453.02 2025-08-12
28420 CPT Treat/graft Heel Fracture 2 2 — — $12,453.02 $12,453.02 $12,453.02 2025-08-12
28725 CPT Fusion Of Foot Bones 2 2 — — $12,453.02 $12,453.02 $12,453.02 2025-08-12
28297 CPT Correction Hallux Valgus 2 2 — — $12,453.02 $12,453.02 $12,453.02 2025-08-12
27870 CPT Fusion Of Ankle Joint Open 2 2 — — $12,453.02 $12,453.02 $12,453.02 2025-08-12
27871 CPT Fusion Of Tibiofibular Joint 2 2 — — $12,453.02 $12,453.02 $12,453.02 2025-08-12
28320 CPT Repair Of Foot Bones 2 2 — — $12,453.02 $12,453.02 $12,453.02 2025-08-12
28730 CPT Fusion Of Foot Bones 2 2 — — $12,453.02 $12,453.02 $12,453.02 2025-08-12
24587 CPT Treat Elbow Fracture 2 2 — — $12,453.02 $12,453.02 $12,453.02 2025-08-12
27758 CPT Treatment Of Tibia Fracture 2 2 — — $12,453.02 $12,453.02 $12,453.02 2025-08-12
27759 CPT Treatment Of Tibia Fracture 2 2 — — $12,453.02 $12,453.02 $12,453.02 2025-08-12
27447 CPT Total Knee Arthroplasty 2 2 — — $12,453.02 $12,453.02 $12,453.02 2025-08-12
27446 CPT Revision Of Knee Joint 2 2 — — $12,453.02 $12,453.02 $12,453.02 2025-08-12
27827 CPT Treat Lower Leg Fracture 2 2 — — $12,453.02 $12,453.02 $12,453.02 2025-08-12
64628 CPT Trml Dstrj Ios Bvn 1st 2 L/s 2 2 — — $12,453.02 $12,453.02 $12,453.02 2025-08-12
27440 CPT Revision Of Knee Joint 2 2 — — $12,453.02 $12,453.02 $12,453.02 2025-08-12
27428 CPT Reconstruction Knee 2 2 — — $12,453.02 $12,453.02 $12,453.02 2025-08-12
27441 CPT Revision Of Knee Joint 2 2 — — $12,453.02 $12,453.02 $12,453.02 2025-08-12
24365 CPT Reconstruct Head Of Radius 2 2 — — $12,453.02 $12,453.02 $12,453.02 2025-08-12
27415 CPT Osteochondral Knee Allograft 2 2 — — $12,453.02 $12,453.02 $12,453.02 2025-08-12
24498 CPT Reinforce Humerus 2 2 — — $12,453.02 $12,453.02 $12,453.02 2025-08-12
27356 CPT Remove Femur Lesion/graft 2 2 — — $12,453.02 $12,453.02 $12,453.02 2025-08-12
27442 CPT Revision Of Knee Joint 2 2 — — $12,453.02 $12,453.02 $12,453.02 2025-08-12
27828 CPT Treat Lower Leg Fracture 2 2 — — $12,453.02 $12,453.02 $12,453.02 2025-08-12
27709 CPT Incision Of Tibia & Fibula 2 2 — — $12,453.02 $12,453.02 $12,453.02 2025-08-12
24515 CPT Treat Humerus Fracture 2 2 — — $12,453.02 $12,453.02 $12,453.02 2025-08-12
J1412 HCPCS Apc 2 2 — — $12,368.21 $12,368.21 $12,368.21 2025-08-12
L7191 HCPCS Elbow Child Myoelectronic CT 2 2 — — $12,296.88 $12,296.88 $12,296.88 2025-08-12
0675T CPT Laps Insj Nw/rpcmt Isdss 1ld 2 2 — — $12,069.26 $12,069.26 $12,069.26 2025-08-12
61888 CPT Revise/remove Neuroreceiver 2 2 — — $12,069.26 $12,069.26 $12,069.26 2025-08-12
61715 CPT Apc 2 2 — — $12,069.26 $12,069.26 $12,069.26 2025-08-12
63664 CPT Revise Spine Eltrd Plate 2 2 — — $12,069.26 $12,069.26 $12,069.26 2025-08-12
43647 CPT Lap Impl Electrode Antrum 2 2 — — $12,069.26 $12,069.26 $12,069.26 2025-08-12
33288 CPT Fee Schedule 2 2 — — $12,069.26 $12,069.26 $12,069.26 2025-08-12
64583 CPT Rev/rplct Hpglsl Nstm Ary Pg 2 2 — — $12,069.26 $12,069.26 $12,069.26 2025-08-12
64575 CPT Opn Impltj Nea Perph Nerve 2 2 — — $12,069.26 $12,069.26 $12,069.26 2025-08-12
0784T CPT Apc 2 2 — — $12,069.26 $12,069.26 $12,069.26 2025-08-12
64553 CPT Implant Neuroelectrodes 2 2 — — $12,069.26 $12,069.26 $12,069.26 2025-08-12
64596 CPT Apc 2 2 — — $12,069.26 $12,069.26 $12,069.26 2025-08-12
64569 CPT Revise/repl Vagus N Eltrd 2 2 — — $12,069.26 $12,069.26 $12,069.26 2025-08-12
81416 CPT Exome Sequence Analysis 2 2 — — $12,000.00 $12,000.00 $12,000.00 2025-08-12
L6950 HCPCS Above Elbow Switch Control 2 2 — — $11,977.47 $11,977.47 $11,977.47 2025-08-12
L7186 HCPCS Electron Elbow Child Switch 2 2 — — $11,680.78 $11,680.78 $11,680.78 2025-08-12
L5991 HCPCS Apc 2 2 — — $11,524.55 $11,524.55 $11,524.55 2025-08-12
L6940 HCPCS Elbow Disarticulation Switch 2 2 — — $11,391.90 $11,391.90 $11,391.90 2025-08-12
A9697 HCPCS Apc 2 2 — — $11,379.91 $11,379.91 $11,379.91 2025-08-12
J0401 HCPCS Aripiprazole ER 400 Mg IM Prsy 11 6 $12,593.07 $12,593.07 $7.24 $11,837.49 $11,270.80 2025-08-12
61626 CPT Transcath Occlusion Non-cns 2 2 — — $10,975.86 $10,975.86 $10,975.86 2025-08-12
0237T CPT Trluml Perip Athrc Brchiocph 2 2 — — $10,975.86 $10,975.86 $10,975.86 2025-08-12
0236T CPT Trluml Perip Athrc Abd Aorta 2 2 — — $10,975.86 $10,975.86 $10,975.86 2025-08-12
0234T CPT Trluml Perip Athrc Renal Art 2 2 — — $10,975.86 $10,975.86 $10,975.86 2025-08-12
92987 CPT Revision Of Mitral Valve 2 2 — — $10,975.86 $10,975.86 $10,975.86 2025-08-12
92990 CPT Revision Of Pulmonary Valve 2 2 — — $10,975.86 $10,975.86 $10,975.86 2025-08-12
92943 CPT Prq Card Revasc Chronic 1vsl 2 2 — — $10,975.86 $10,975.86 $10,975.86 2025-08-12
92997 CPT Pul Art Balloon Repr Percut 2 2 — — $10,975.86 $10,975.86 $10,975.86 2025-08-12
61623 CPT Endovasc Tempory Vessel Occl 2 2 — — $10,975.86 $10,975.86 $10,975.86 2025-08-12
92937 CPT Prq Revasc Byp Graft 1 Vsl 2 2 — — $10,975.86 $10,975.86 $10,975.86 2025-08-12
92924 CPT Prq Card Angio/athrect 1 Art 2 2 — — $10,975.86 $10,975.86 $10,975.86 2025-08-12
92928 CPT Prq Card Stent W/angio 1 Vsl 2 2 — — $10,975.86 $10,975.86 $10,975.86 2025-08-12
C9783 HCPCS Blind Cor Sinus Reducer Impl 2 2 — — $10,975.86 $10,975.86 $10,975.86 2025-08-12
C9772 HCPCS Revasc Lithotrip Tibi/perone 2 2 — — $10,975.86 $10,975.86 $10,975.86 2025-08-12
37243 CPT Vasc Embolize/occlude Organ 2 2 — — $10,975.86 $10,975.86 $10,975.86 2025-08-12
37244 CPT Vasc Embolize/occlude Bleed 2 2 — — $10,975.86 $10,975.86 $10,975.86 2025-08-12
37238 CPT Open/perq Place Stent Same 2 2 — — $10,975.86 $10,975.86 $10,975.86 2025-08-12
37241 CPT Vasc Embolize/occlude Venous 2 2 — — $10,975.86 $10,975.86 $10,975.86 2025-08-12
C9764 HCPCS Revasc Intravasc Lithotripsy 2 2 — — $10,975.86 $10,975.86 $10,975.86 2025-08-12
37228 CPT Tib/per Revasc W/tla 2 2 — — $10,975.86 $10,975.86 $10,975.86 2025-08-12
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