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

9,963 distinct procedures filed
6 distinct payers
110,773 rate rows
2025-08-12 last MRF observed
Data quality

29,112 of 110,773 rate rows are consumer-grade (26.3%)

81,661 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 81,550
per-diem day rate — not a per-procedure price 62
placeholder amount (≤ $0.02) — excluded from medians 36
percent-of-charges filed in the dollar field — excluded from medians 10
exceeds 10× this hospital's gross charge — excluded from medians 3
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 not_modified · 2026-05-15
Content fingerprint 4d104daa73808e77… · 35,477,797 bytes · first seen 2026-05-06

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 		Inj, Atidarsagene Autotemcel 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 		Inj, Hemgenix, Per Tx Dose 2 $3,685,266.67 $3,685,266.67 $3,685,266.67 nat. median
$3,710,000
1.0× median
J1413
HCPCS 		Inj Delandistrogene Mox Rokl 2 $3,324,571.90 $3,324,571.90 $3,324,571.90 nat. median
$3,325,455
1.0× median
J3394
HCPCS 		Inj, Lovotibeglogene Autotem 2 $3,261,355.00 $3,261,355.00 $3,261,355.00 nat. median
$3,286,000
1.0× median
J3393
HCPCS 		Inj, Betibeglogene Autotemce 2 $2,950,686.67 $2,950,686.67 $2,950,686.67 nat. median
$3,004,655
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
$2,468,984
1.0× median
J3392
HCPCS 		Inj, Exagamglogene Autotem 2 $2,332,000.00 $2,332,000.00 $2,332,000.00 nat. median
$2,448,600
1.0× median
Q2057
HCPCS 		Afamitresgene Autoleucel 2 $770,620.00 $770,620.00 $770,620.00 nat. median
$824,563
0.9× median
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 2 $578,324.58 $578,324.58 $578,324.58 nat. median
$753,246
0.8× median
Q2056
HCPCS 		Ciltacabtagene Car-pos T 2 $553,378.83 $553,378.83 $553,378.83 nat. median
$674,867
0.8× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 2 $541,635.66 $541,635.66 $541,635.66 nat. median
$673,137
0.8× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 2 $541,260.45 $541,260.45 $541,260.45 nat. median
$625,184
0.9× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 2 $533,076.48 $533,076.48 $533,076.48 nat. median
$634,303
0.8× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 2 $489,720.00 $489,720.00 $489,720.00 nat. median
$619,808
0.8× median
Q2058
HCPCS 		Obecbtge Autol Up To 400 Mil 2 $270,375.00 $270,375.00 $270,375.00 nat. median
$324,450
0.8× median
Q0480
HCPCS 		Driver Pneumatic Vad, Rep 2 $106,120.90 $106,120.90 $106,120.90 nat. median
$111,989
0.9× 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
$70,825
1.0× median
J9029
HCPCS 		Instill Adstiladrin, Tx Dose 2 $63,431.05 $63,431.05 $63,431.05 nat. median
$69,774
0.9× median
38240
CPT 		Transplt Allo Hct/donor 2 $57,240.31 $57,240.31 $57,240.31 nat. median
$15,979
outlier · 3.6×
A9543
HCPCS 		Y90 Ibritumomab, Rx 2 $56,824.55 $56,824.55 $56,824.55 nat. median
$62,507
0.9× median
Q2043
HCPCS 		Sipuleucel-t Auto Cd54+ 2 $55,945.97 $55,945.97 $55,945.97 nat. median
$66,682
0.8× median
L7181
HCPCS 		Electronic Elbo Simultaneous 2 $47,211.27 $47,211.27 $47,211.27 nat. median
$50,598
0.9× median
J9226
HCPCS 		Supprelin La Implant 2 $45,560.39 $45,560.39 $45,560.39 nat. median
$60,368
0.8× median
L7180
HCPCS 		Electronic Elbow Sequential 2 $45,177.95 $45,177.95 $45,177.95 nat. median
$49,027
0.9× median
0266T
CPT 		Apc 2 $43,553.28 $43,553.28 $43,553.28 nat. median
$42,941
1.0× median
33276
CPT 		Insj Phrnc Nrv Stim Sys 2 $43,553.28 $43,553.28 $43,553.28 nat. median
$43,787
1.0× median
L2006
HCPCS 		Kaf Sng/dbl Swg/stn Mcpr Cus 2 $39,823.40 $39,823.40 $39,823.40 nat. median
$39,823
1.0× median
L8701
HCPCS 		Ewh S/d Uprt Micro Sensor 2 $34,284.44 $34,284.44 $34,284.44 nat. median
$35,999
1.0× median
0620T
CPT 		Evasc Ven Artlz Tibl/prnl Vn 2 $33,874.88 $33,874.88 $33,874.88 nat. median
$33,076
1.0× median
0915T
CPT 		Insj Perm Ccm-d Sys Pg&eltrd 2 $31,030.48 $31,030.48 $31,030.48 nat. median
$32,560
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
0571T
CPT 		Insj/rplcmt Icds Ss Eltrd 2 $31,030.48 $31,030.48 $31,030.48 nat. median
$32,221
1.0× median
33270
CPT 		Ins/rep Subq Defibrillator 2 $31,030.48 $31,030.48 $31,030.48 nat. median
$32,221
1.0× median
33264
CPT 		Rmvl & Rplcmt Dfb Gen Mlt Ld 2 $31,030.48 $31,030.48 $31,030.48 nat. median
$31,873
1.0× median
0408T
CPT 		Insj/rplc Cardiac Modulj Sys 2 $31,030.48 $31,030.48 $31,030.48 nat. median
$32,221
1.0× median
33249
CPT 		Insj/rplcmt Defib W/lead(s) 2 $31,030.48 $31,030.48 $31,030.48 nat. median
$31,833
1.0× median
69930
CPT 		Implant Cochlear Device 2 $30,784.88 $30,784.88 $30,784.88 nat. median
$29,690
1.0× median
64582
CPT 		Opn Mpltj Hpglsl Nstm Ary Pg 2 $29,493.56 $29,493.56 $29,493.56 nat. median
$28,316
1.0× median
64568
CPT 		Opn Impltj Crnl Nrv Nea&pg 2 $29,493.56 $29,493.56 $29,493.56 nat. median
$27,591
1.1× median
0674T
CPT 		Laps Insj Nw/rpcmt Prm Isdss 2 $29,493.56 $29,493.56 $29,493.56 nat. median
$25,200
1.2× median
0268T
CPT 		Apc 2 $29,493.56 $29,493.56 $29,493.56 nat. median
$30,333
1.0× median
61886
CPT 		Implant Neurostim Arrays 2 $29,493.56 $29,493.56 $29,493.56 nat. median
$27,109
1.1× median
33287
CPT 		Rmv&rplcmt Phrnc Nrv Stim Pg 2 $29,493.56 $29,493.56 $29,493.56 nat. median
$29,698
1.0× median
63685
CPT 		Ins/rplc Spi Npg/rcvr Pocket 2 $29,493.56 $29,493.56 $29,493.56 nat. median
$21,357
1.4× median
L6700
HCPCS 		Ue Add Ext Power Myoel 2 $28,931.56 $28,931.56 $28,931.56 nat. median
$30,667
0.9× median
L5856
HCPCS 		Elec Knee-shin Swing/stance 2 $28,607.84 $28,607.84 $28,607.84 nat. median
$30,273
0.9× median
J9266
HCPCS 		Pegaspargase Injection 2 $28,424.06 $28,424.06 $28,424.06 nat. median
$34,109
0.8× median
L6880
HCPCS 		Elec Hand Ind Art Digits 2 $28,151.96 $28,151.96 $28,151.96 nat. median
$30,168
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
             
J0401 HCPCS Aripiprazole ER 400 Mg IM Susr (combined) 11 6 $12,593.07 $12,593.07 $7.24 $11,837.49 $11,270.80 2025-08-12
J3391 HCPCS Inj, Atidarsagene Autotemcel 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 Inj, Hemgenix, Per Tx Dose 2 2 — — $3,685,266.67 $3,685,266.67 $3,685,266.67 2025-08-12
J1413 HCPCS Inj Delandistrogene Mox Rokl 2 2 — — $3,324,571.90 $3,324,571.90 $3,324,571.90 2025-08-12
J3394 HCPCS Inj, Lovotibeglogene Autotem 2 2 — — $3,261,355.00 $3,261,355.00 $3,261,355.00 2025-08-12
J3393 HCPCS Inj, Betibeglogene Autotemce 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 Inj, Exagamglogene Autotem 2 2 — — $2,332,000.00 $2,332,000.00 $2,332,000.00 2025-08-12
Q2057 HCPCS Afamitresgene Autoleucel 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 Ciltacabtagene Car-pos T 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 Obecbtge Autol Up To 400 Mil 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 Instill Adstiladrin, Tx Dose 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 Insj Phrnc Nrv Stim Sys 2 2 — — $43,553.28 $43,553.28 $43,553.28 2025-08-12
0266T CPT Apc 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 Insj Perm Ccm-d Sys Pg&eltrd 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 Ins/rplc Spi Npg/rcvr Pocket 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 Rmv&rplcmt Phrnc Nrv Stim Pg 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 Apc 2 2 — — $29,493.56 $29,493.56 $29,493.56 2025-08-12
L6700 HCPCS Ue Add Ext Power Myoel 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 Prt Crn Ch Cr&tun Elt S-sclp 2 2 — — $21,776.88 $21,776.88 $21,776.88 2025-08-12
0960T CPT Rpl S-sclp Eltr Ra Rcvr&tlmt 2 2 — — $21,776.88 $21,776.88 $21,776.88 2025-08-12
0923T CPT Rmvl&rplcmt Perm Ccm-d Pg 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 Insj Perm Ccm-d Sys Pg Only 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 Opn Insj/rplcmt Ins Ptn Subf 2 2 — — $20,754.74 $20,754.74 $20,754.74 2025-08-12
64590 CPT Ins/rpl Prph Sac/gstr Npg/r 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 Opn Insj/rplcmt Ins Ptn Subq 2 2 — — $20,754.74 $20,754.74 $20,754.74 2025-08-12
61891 CPT Rev/rplcmt Sk-mnt Crnl Nstm 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 Tcat Ins 1chmbr Ldls Pm Ra 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 Tcat Rmv&rpl1chmb Ldls Pm Ra 2 2 — — $18,457.83 $18,457.83 $18,457.83 2025-08-12
0796T CPT Tcat Ins 2chmbr Ldls Pm Ra 2 2 — — $18,457.83 $18,457.83 $18,457.83 2025-08-12
0801T CPT Tcat Rmv&rpl 2chmbr Ldls Pm 2 2 — — $18,457.83 $18,457.83 $18,457.83 2025-08-12
0802T CPT Tcat Rmv&rpl2chmb Ldls Pm Ra 2 2 — — $18,457.83 $18,457.83 $18,457.83 2025-08-12
0797T CPT Tcat Ins 2chmbr Ldls Pm Rv 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 Tcat Rmv&rpl2chmb Ldls Pm Rv 2 2 — — $18,457.83 $18,457.83 $18,457.83 2025-08-12
0795T CPT Tcat Ins 2chmbr Ldls Pm Cmpl 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 Arthrodesis Pantalar 2 2 — — $17,798.63 $17,798.63 $17,798.63 2025-08-12
27278 CPT Arthrd Si Jt Plmt Iartic Dev 2 2 — — $17,798.63 $17,798.63 $17,798.63 2025-08-12
C8003 HCPCS Imp Extar Knee Shck Absrb 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 Arthrd Si Jt Plmt Tartclr Dv 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 1ntrspc Crv 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 Arthrp W/prostc Dstl Ulna 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 Optx Prx Hmrl Fx Fix Rpr Rpl 2 2 — — $17,798.63 $17,798.63 $17,798.63 2025-08-12
25446 CPT Arthrp W/prostc Dst Rds&crps 2 2 — — $17,798.63 $17,798.63 $17,798.63 2025-08-12
20696 CPT App Mltpln Uni Xtrnl Fix 1st 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 Fee Schedule 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 Vasc Emb/occ W/prs Cath 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 Tcat Impl Wrls Ivc Snr 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 Trlml C Athrc St Angiop1 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 Fee Schedule 2 2 — — $17,379.23 $17,379.23 $17,379.23 2025-08-12
37231 CPT Fee Schedule 2 2 — — $17,379.23 $17,379.23 $17,379.23 2025-08-12
37227 CPT Fee Schedule 2 2 — — $17,379.23 $17,379.23 $17,379.23 2025-08-12
37225 CPT Fee Schedule 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 Prq Av Fstl Crtj Uxtr 1 Acs 2 2 — — $17,379.23 $17,379.23 $17,379.23 2025-08-12
36837 CPT Prq Av Fstl Crt Uxtr Sep Acs 2 2 — — $17,379.23 $17,379.23 $17,379.23 2025-08-12
33902 CPT Perq P-art Revsc 1 Abnor Uni 2 2 — — $17,379.23 $17,379.23 $17,379.23 2025-08-12
0793T CPT Prq Tcat Thrm Ablt Nrv P-art 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 Pef Bronch Ablt 3d Nav Ebus 2 2 — — $16,937.68 $16,937.68 $16,937.68 2025-08-12
0888T CPT Histotripsy Mal Renal Tissue 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 Implantation Iris Prosthesis 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 Keratoprosthesis 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 Ablt Trurl Prst8 Tis Trnsdcr 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 Impl Oi Implt Skull 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 Impl Oi Implt Sk Tc Esp<100 2 2 — — $12,453.02 $12,453.02 $12,453.02 2025-08-12
29889 CPT Arthrs Aid Pcl Rpr/agmntj 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 Mlt Osteot Rlgnm Imed Rd Hum 2 2 — — $12,453.02 $12,453.02 $12,453.02 2025-08-12
24575 CPT Optx Humeral Epcndylr Fx 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 Arthrd Glenohumeral Jt W/grf 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 Optx Sho Dislc Neck Fx Fixj 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 Impl Oi Implt Sk Tc Esp>=100 2 2 — — $12,453.02 $12,453.02 $12,453.02 2025-08-12
24430 CPT Rpr Non/mal Humerus Wo Graft 2 2 — — $12,453.02 $12,453.02 $12,453.02 2025-08-12
24516 CPT Tx Humrl Shaft Fx Imed Implt 2 2 — — $12,453.02 $12,453.02 $12,453.02 2025-08-12
24579 CPT Optx Humrl Cndylr 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 Rplcm Oi Implt Sk Tc Esp<100 2 2 — — $12,453.02 $12,453.02 $12,453.02 2025-08-12
25810 CPT Arthrd Wrst Iliac/oth Agrft 2 2 — — $12,453.02 $12,453.02 $12,453.02 2025-08-12
69730 CPT Rplc Oi Implt Sk Tc Esp>=100 2 2 — — $12,453.02 $12,453.02 $12,453.02 2025-08-12
24666 CPT Optx Radial Head/nck Fx Rplc 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 Device Implant Surgery 2 2 — — $12,453.02 $12,453.02 $12,453.02 2025-08-12
25491 CPT Prophylactic Tx 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 Optx Prox Humrl Fx W/int Fix 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 Optx Hum Fx Wo Ntrcndylr Xtn 2 2 — — $12,453.02 $12,453.02 $12,453.02 2025-08-12
25444 CPT Arthrp W/prostc Lunate 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 Arthrp W/prostc Dstl Rds 2 2 — — $12,453.02 $12,453.02 $12,453.02 2025-08-12
24546 CPT Optx Hum Fx W/ntrcndylr Xtn 2 2 — — $12,453.02 $12,453.02 $12,453.02 2025-08-12
20692 CPT Appl Mltpln Uni Ext Fixj Sys 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 Arthrd Elbow Jt Autog Graft 2 2 — — $12,453.02 $12,453.02 $12,453.02 2025-08-12
24435 CPT Rpr Non/mal Hum With Agrft 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 Optx Partclr Fx&/dislc Elbow 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 Arthrodesis Triple 2 2 — — $12,453.02 $12,453.02 $12,453.02 2025-08-12
28420 CPT Optx Calcaneal Fx W/bone Grf 2 2 — — $12,453.02 $12,453.02 $12,453.02 2025-08-12
28725 CPT Arthrodesis Subtalar 2 2 — — $12,453.02 $12,453.02 $12,453.02 2025-08-12
28297 CPT Cor Hlx Vlgs Jt Arthrd 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 Optx Partclr Fx&/dslc Elbw W 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 Proph Tx W/wo Mthylmthcrylt 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 Osteotomy Tibia & Fibula 2 2 — — $12,453.02 $12,453.02 $12,453.02 2025-08-12
24515 CPT Optx Humrl Shft Fx Plate/scr 2 2 — — $12,453.02 $12,453.02 $12,453.02 2025-08-12
J1412 HCPCS Inj Roctavian Ml 2x10^13vc G 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 Mrgfus Strtctc Ablt Trgt Icr 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 Rmv&rplcmt Phrnc Nrv Stim Ld 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 Ins/rplmt Eltrd Ra Spi Nstim 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 Ins/rplcmt Prq Eltrd Ra Pn 1 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 Low Pros Ext Osseo Connector 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 Inj, Magtrace Per Study Dose 2 2 — — $11,379.91 $11,379.91 $11,379.91 2025-08-12
61626 CPT Tcat Perm Occls/embol Noncns 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 Trluml Revsc Ch Occ Ant 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 Evasc Temp Balo Artl Occ H/n 2 2 — — $10,975.86 $10,975.86 $10,975.86 2025-08-12
92937 CPT Prq Trluml Revsc Cab Grf 1 2 2 — — $10,975.86 $10,975.86 $10,975.86 2025-08-12
92924 CPT Prq Trluml C Athrc 1 Art&/br 2 2 — — $10,975.86 $10,975.86 $10,975.86 2025-08-12
92928 CPT Prq Tcat Plmt Ntrac St 1 Les 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 Fee Schedule 2 2 — — $10,975.86 $10,975.86 $10,975.86 2025-08-12
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