|
166
|
MS_DRG
|
Other Respiratory System O.r. Procedures With Mcc
|
1
|
1
|
—
|
—
|
$115,900.21
|
$115,900.21
|
$115,900.21
|
2025-12-15
|
|
981
|
MS_DRG
|
Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc
|
1
|
1
|
—
|
—
|
$112,764.34
|
$112,764.34
|
$112,764.34
|
2025-12-15
|
|
207
|
MS_DRG
|
Respiratory System Diagnosis With Ventilator Support >96 Hours
|
1
|
1
|
—
|
—
|
$104,144.50
|
$104,144.50
|
$104,144.50
|
2025-12-15
|
|
D0407
|
LOCAL
|
Traumatic Spinal Cord Injury M <24.50 And A >=61.50
|
1
|
1
|
—
|
—
|
$74,644.00
|
$74,644.00
|
$74,644.00
|
2025-12-15
|
|
622
|
MS_DRG
|
Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor…
|
1
|
1
|
—
|
—
|
$64,796.17
|
$64,796.17
|
$64,796.17
|
2025-12-15
|
|
463
|
MS_DRG
|
Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …
|
1
|
1
|
—
|
—
|
$63,240.94
|
$63,240.94
|
$63,240.94
|
2025-12-15
|
|
939
|
MS_DRG
|
O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc
|
1
|
1
|
—
|
—
|
$58,412.61
|
$58,412.61
|
$58,412.61
|
2025-12-15
|
|
C1904
|
LOCAL
|
Guillain-barr� M <38.50
|
1
|
1
|
—
|
—
|
$55,159.88
|
$55,159.88
|
$55,159.88
|
2025-12-15
|
|
C1806
|
LOCAL
|
Major Multiple Trauma With Brain Or Spinal Cord Injury M <30.50
|
1
|
1
|
—
|
—
|
$53,809.43
|
$53,809.43
|
$53,809.43
|
2025-12-15
|
|
393
|
MS_DRG
|
Other Digestive System Diagnoses With Mcc
|
1
|
1
|
—
|
—
|
$53,126.86
|
$53,126.86
|
$53,126.86
|
2025-12-15
|
|
438
|
MS_DRG
|
Disorders Of Pancreas Except Malignancy With Mcc*
|
1
|
1
|
—
|
—
|
$52,628.78
|
$52,628.78
|
$52,628.78
|
2025-12-15
|
|
813
|
MS_DRG
|
Coagulation Disorders
|
1
|
1
|
—
|
—
|
$48,110.48
|
$48,110.48
|
$48,110.48
|
2025-12-15
|
|
808
|
MS_DRG
|
Major Hematological And Immunological Diagnoses Except Sickle Cell Crisis And Co…
|
1
|
1
|
—
|
—
|
$48,110.48
|
$48,110.48
|
$48,110.48
|
2025-12-15
|
|
441
|
MS_DRG
|
Disorders Of Liver Except Malignancy, Cirrhosis Or Alcoholic Hepatitis With Mcc*
|
1
|
1
|
—
|
—
|
$48,079.99
|
$48,079.99
|
$48,079.99
|
2025-12-15
|
|
189
|
MS_DRG
|
Pulmonary Edema And Respiratory Failure
|
3
|
3
|
—
|
—
|
$47,993.58
|
$47,993.58
|
$47,993.58
|
2025-12-15
|
|
280
|
MS_DRG
|
Acute Myocardial Infarction, Discharged Alive With Mcc
|
1
|
1
|
—
|
—
|
$46,595.91
|
$46,595.91
|
$46,595.91
|
2025-12-15
|
|
D0106
|
LOCAL
|
Stroke M <41.50 And A <84.50
|
1
|
1
|
—
|
—
|
$46,167.15
|
$46,167.15
|
$46,167.15
|
2025-12-15
|
|
637
|
MS_DRG
|
Diabetes With Mcc
|
1
|
1
|
—
|
—
|
$46,011.43
|
$46,011.43
|
$46,011.43
|
2025-12-15
|
|
388
|
MS_DRG
|
Gastrointestinal Obstruction With Mcc*
|
1
|
1
|
—
|
—
|
$45,122.00
|
$45,122.00
|
$45,122.00
|
2025-12-15
|
|
B2005
|
LOCAL
|
Miscellaneous M <46.50 And A <77.50
|
1
|
1
|
—
|
—
|
$44,329.97
|
$44,329.97
|
$44,329.97
|
2025-12-15
|
|
C0505
|
LOCAL
|
Non-traumatic Spinal Cord Injury M <39.50
|
1
|
1
|
—
|
—
|
$44,144.68
|
$44,144.68
|
$44,144.68
|
2025-12-15
|
|
682
|
MS_DRG
|
Renal Failure With Mcc*
|
1
|
1
|
—
|
—
|
$43,815.81
|
$43,815.81
|
$43,815.81
|
2025-12-15
|
|
C0205
|
LOCAL
|
Traumatic Brain Injury M <35.50
|
1
|
1
|
—
|
—
|
$43,555.55
|
$43,555.55
|
$43,555.55
|
2025-12-15
|
|
C0405
|
LOCAL
|
Traumatic Spinal Cord Injury M >=31.50 And M <41.50
|
1
|
1
|
—
|
—
|
$43,366.38
|
$43,366.38
|
$43,366.38
|
2025-12-15
|
|
B1404
|
LOCAL
|
Cardiac M <45.50
|
1
|
1
|
—
|
—
|
$43,008.38
|
$43,008.38
|
$43,008.38
|
2025-12-15
|
|
A0106
|
LOCAL
|
Stroke M <41.50 And A <84.50
|
2
|
2
|
—
|
—
|
$39,214.26
|
$42,854.03
|
$41,034.15
|
2025-12-15
|
|
B0904
|
LOCAL
|
Other Orthopedic M <44.5
|
1
|
1
|
—
|
—
|
$42,741.34
|
$42,741.34
|
$42,741.34
|
2025-12-15
|
|
871
|
MS_DRG
|
Septicemia Or Severe Sepsis Without Mv >96 Hours With Mcc
|
1
|
1
|
—
|
—
|
$41,940.39
|
$41,940.39
|
$41,940.39
|
2025-12-15
|
|
698
|
MS_DRG
|
Other Kidney And Urinary Tract Diagnoses With Mcc
|
1
|
1
|
—
|
—
|
$41,742.17
|
$41,742.17
|
$41,742.17
|
2025-12-15
|
|
D0505
|
LOCAL
|
Non-traumatic Spinal Cord Injury M <39.50
|
1
|
1
|
—
|
—
|
$41,403.87
|
$41,403.87
|
$41,403.87
|
2025-12-15
|
|
308
|
MS_DRG
|
Cardiac Arrhythmia And Conduction Disorders With Mcc
|
1
|
1
|
—
|
—
|
$41,106.86
|
$41,106.86
|
$41,106.86
|
2025-12-15
|
|
559
|
MS_DRG
|
Aftercare, Musculoskeletal System And Connective Tissue With Mcc
|
1
|
1
|
—
|
—
|
$40,385.16
|
$40,385.16
|
$40,385.16
|
2025-12-15
|
|
291
|
MS_DRG
|
Heart Failure And Shock With Mcc*
|
2
|
2
|
—
|
—
|
$39,739.68
|
$39,739.68
|
$39,739.68
|
2025-12-15
|
|
292
|
MS_DRG
|
Heart Failure And Shock With Cc*
|
1
|
1
|
—
|
—
|
$38,621.55
|
$38,621.55
|
$38,621.55
|
2025-12-15
|
|
C0305
|
LOCAL
|
Non-traumatic Brain Injury M <42.50 And A <78.50
|
2
|
2
|
—
|
—
|
$38,073.24
|
$38,269.64
|
$38,171.44
|
2025-12-15
|
|
A0105
|
LOCAL
|
Stroke M <41.50 And A >=84.50
|
1
|
1
|
—
|
—
|
$37,716.01
|
$37,716.01
|
$37,716.01
|
2025-12-15
|
|
B1004
|
LOCAL
|
Amputation Lower Extremity M <47.50
|
1
|
1
|
—
|
—
|
$37,625.07
|
$37,625.07
|
$37,625.07
|
2025-12-15
|
|
444
|
MS_DRG
|
Disorders Of The Biliary Tract With Mcc
|
1
|
1
|
—
|
—
|
$37,493.24
|
$37,493.24
|
$37,493.24
|
2025-12-15
|
|
391
|
MS_DRG
|
Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders With Mcc
|
1
|
1
|
—
|
—
|
$36,893.51
|
$36,893.51
|
$36,893.51
|
2025-12-15
|
|
949
|
MS_DRG
|
Aftercare With Cc/mcc
|
2
|
2
|
—
|
—
|
$36,410.68
|
$36,410.68
|
$36,410.68
|
2025-12-15
|
|
C0604
|
LOCAL
|
Neurological M <43.50
|
1
|
1
|
—
|
—
|
$36,271.14
|
$36,271.14
|
$36,271.14
|
2025-12-15
|
|
560
|
MS_DRG
|
Aftercare, Musculoskeletal System And Connective Tissue With Cc
|
1
|
1
|
—
|
—
|
$36,100.65
|
$36,100.65
|
$36,100.65
|
2025-12-15
|
|
552
|
MS_DRG
|
Medical Back Problems Without Mcc
|
1
|
1
|
—
|
—
|
$36,019.33
|
$36,019.33
|
$36,019.33
|
2025-12-15
|
|
377
|
MS_DRG
|
Gastrointestinal Hemorrhage With Mcc
|
1
|
1
|
—
|
—
|
$36,019.33
|
$36,019.33
|
$36,019.33
|
2025-12-15
|
|
C2005
|
LOCAL
|
Miscellaneous M <46.50 And A <77.50
|
1
|
1
|
—
|
—
|
$35,560.37
|
$35,560.37
|
$35,560.37
|
2025-12-15
|
|
696
|
MS_DRG
|
Kidney And Urinary Tract Signs And Symptoms Without Mcc
|
1
|
1
|
—
|
—
|
$35,511.09
|
$35,511.09
|
$35,511.09
|
2025-12-15
|
|
D1004
|
LOCAL
|
Amputation Lower Extremity M <47.50
|
1
|
1
|
—
|
—
|
$34,842.82
|
$34,842.82
|
$34,842.82
|
2025-12-15
|
|
C0304
|
LOCAL
|
Non-traumatic Brain Injury M <42.50 And A >=78.50
|
1
|
1
|
—
|
—
|
$34,522.76
|
$34,522.76
|
$34,522.76
|
2025-12-15
|
|
C0904
|
LOCAL
|
Other Orthopedic M <44.5
|
2
|
2
|
—
|
—
|
$34,379.83
|
$34,427.23
|
$34,403.53
|
2025-12-15
|
|
D0604
|
LOCAL
|
Neurological M <43.50
|
2
|
2
|
—
|
—
|
$29,469.37
|
$34,372.49
|
$31,920.93
|
2025-12-15
|
|
B2003
|
LOCAL
|
Miscellaneous M >=46.50 And M <55.50
|
1
|
1
|
—
|
—
|
$34,079.41
|
$34,079.41
|
$34,079.41
|
2025-12-15
|
|
C0106
|
LOCAL
|
Stroke M <41.50 And A <84.50
|
1
|
1
|
—
|
—
|
$34,013.88
|
$34,013.88
|
$34,013.88
|
2025-12-15
|
|
C0204
|
LOCAL
|
Traumatic Brain Injury M >=35.50 And M <49.50
|
3
|
3
|
—
|
—
|
$16,607.95
|
$33,860.18
|
$25,405.30
|
2025-12-15
|
|
B0602
|
LOCAL
|
Neurological M >=52.50 And M <64.50
|
1
|
1
|
—
|
—
|
$33,634.65
|
$33,634.65
|
$33,634.65
|
2025-12-15
|
|
D1705
|
LOCAL
|
Major Multiple Trauma Without Brain Or Spinal Cord Injury M <36.50
|
2
|
2
|
—
|
—
|
$30,862.34
|
$32,853.45
|
$31,857.89
|
2025-12-15
|
|
D2005
|
LOCAL
|
Miscellaneous M <46.50 And A <77.50
|
2
|
2
|
—
|
—
|
$9,301.48
|
$32,181.24
|
$20,741.36
|
2025-12-15
|
|
D0304
|
LOCAL
|
Non-traumatic Brain Injury M <42.50 And A >=78.50
|
1
|
1
|
—
|
—
|
$31,712.73
|
$31,712.73
|
$31,712.73
|
2025-12-15
|
|
A0704
|
LOCAL
|
Fracture Of Lower Extremity M <41.50
|
1
|
1
|
—
|
—
|
$31,579.82
|
$31,579.82
|
$31,579.82
|
2025-12-15
|
|
D0104
|
LOCAL
|
Stroke M >=41.50 And M <50.50
|
2
|
2
|
—
|
—
|
$27,269.59
|
$31,445.35
|
$29,357.47
|
2025-12-15
|
|
D0704
|
LOCAL
|
Fracture Of Lower Extremity M <41.50
|
1
|
1
|
—
|
—
|
$31,165.40
|
$31,165.40
|
$31,165.40
|
2025-12-15
|
|
A1004
|
LOCAL
|
Amputation Lower Extremity M <47.50
|
1
|
1
|
—
|
—
|
$31,084.06
|
$31,084.06
|
$31,084.06
|
2025-12-15
|
|
B0302
|
LOCAL
|
Non-traumatic Brain Injury M >=52.50 And M <65.50
|
1
|
1
|
—
|
—
|
$31,062.71
|
$31,062.71
|
$31,062.71
|
2025-12-15
|
|
D0204
|
LOCAL
|
Traumatic Brain Injury M >=35.50 And M <49.50
|
3
|
3
|
—
|
—
|
$27,311.52
|
$30,965.44
|
$30,908.03
|
2025-12-15
|
|
607
|
MS_DRG
|
Minor Skin Disorders Without Mcc
|
1
|
1
|
—
|
—
|
$30,855.56
|
$30,855.56
|
$30,855.56
|
2025-12-15
|
|
950
|
MS_DRG
|
Aftercare Without Cc/mcc
|
1
|
1
|
—
|
—
|
$30,855.56
|
$30,855.56
|
$30,855.56
|
2025-12-15
|
|
101
|
MS_DRG
|
Seizures Without Mcc
|
1
|
1
|
—
|
—
|
$30,855.56
|
$30,855.56
|
$30,855.56
|
2025-12-15
|
|
442
|
MS_DRG
|
Disorders Of Liver Except Malignancy, Cirrhosis Or Alcoholic Hepatitis With Cc*
|
1
|
1
|
—
|
—
|
$30,855.56
|
$30,855.56
|
$30,855.56
|
2025-12-15
|
|
947
|
MS_DRG
|
Signs And Symptoms With Mcc
|
1
|
1
|
—
|
—
|
$30,855.56
|
$30,855.56
|
$30,855.56
|
2025-12-15
|
|
B0803
|
LOCAL
|
Replacement Of Lower-extremity Joint M >=51.50 And M <57.50
|
1
|
1
|
—
|
—
|
$30,617.05
|
$30,617.05
|
$30,617.05
|
2025-12-15
|
|
D1804
|
LOCAL
|
Major Multiple Trauma With Brain Or Spinal Cord Injury M >=40.50 And M <45.50
|
1
|
1
|
—
|
—
|
$30,590.04
|
$30,590.04
|
$30,590.04
|
2025-12-15
|
|
C2004
|
LOCAL
|
Miscellaneous M <46.50 And A >=77.50
|
1
|
1
|
—
|
—
|
$30,573.67
|
$30,573.67
|
$30,573.67
|
2025-12-15
|
|
C1703
|
LOCAL
|
Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=41.50 And M <50.50
|
1
|
1
|
—
|
—
|
$29,728.51
|
$29,728.51
|
$29,728.51
|
2025-12-15
|
|
C0603
|
LOCAL
|
Neurological M >=43.50 And M <52.50
|
2
|
2
|
—
|
—
|
$28,608.84
|
$29,671.06
|
$29,139.95
|
2025-12-15
|
|
C0703
|
LOCAL
|
Fracture Of Lower Extremity M >=41.50 And M <52.50
|
1
|
1
|
—
|
—
|
$29,537.44
|
$29,537.44
|
$29,537.44
|
2025-12-15
|
|
B1402
|
LOCAL
|
Cardiac M >=55.50 And M <68.50
|
2
|
2
|
—
|
—
|
$27,373.27
|
$29,271.03
|
$28,322.15
|
2025-12-15
|
|
A1704
|
LOCAL
|
Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=36.50 And M <41.50
|
1
|
1
|
—
|
—
|
$29,122.23
|
$29,122.23
|
$29,122.23
|
2025-12-15
|
|
D0904
|
LOCAL
|
Other Orthopedic M <44.5
|
2
|
2
|
—
|
—
|
$4,984.08
|
$29,040.61
|
$17,012.35
|
2025-12-15
|
|
A1705
|
LOCAL
|
Major Multiple Trauma Without Brain Or Spinal Cord Injury M <36.50
|
1
|
1
|
—
|
—
|
$29,034.18
|
$29,034.18
|
$29,034.18
|
2025-12-15
|
|
A0204
|
LOCAL
|
Traumatic Brain Injury M >=35.50 And M <49.50
|
2
|
2
|
—
|
—
|
$27,560.60
|
$28,988.10
|
$28,274.35
|
2025-12-15
|
|
C0704
|
LOCAL
|
Fracture Of Lower Extremity M <41.50
|
1
|
1
|
—
|
—
|
$28,976.96
|
$28,976.96
|
$28,976.96
|
2025-12-15
|
|
683
|
MS_DRG
|
Renal Failure With Cc*
|
2
|
2
|
—
|
—
|
$28,710.77
|
$28,710.77
|
$28,710.77
|
2025-12-15
|
|
C0903
|
LOCAL
|
Other Orthopedic M >=44.50 And M <51.50
|
1
|
1
|
—
|
—
|
$28,691.63
|
$28,691.63
|
$28,691.63
|
2025-12-15
|
|
A0604
|
LOCAL
|
Neurological M <43.50
|
1
|
1
|
—
|
—
|
$28,513.85
|
$28,513.85
|
$28,513.85
|
2025-12-15
|
|
D1703
|
LOCAL
|
Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=41.50 And M <50.50
|
1
|
1
|
—
|
—
|
$28,361.84
|
$28,361.84
|
$28,361.84
|
2025-12-15
|
|
C2003
|
LOCAL
|
Miscellaneous M >=46.50 And M <55.50
|
1
|
1
|
—
|
—
|
$28,249.24
|
$28,249.24
|
$28,249.24
|
2025-12-15
|
|
D2004
|
LOCAL
|
Miscellaneous M <46.50 And A >=77.50
|
2
|
2
|
—
|
—
|
$26,151.19
|
$28,243.29
|
$27,197.24
|
2025-12-15
|
|
A0904
|
LOCAL
|
Other Orthopedic M <44.5
|
1
|
1
|
—
|
—
|
$28,220.94
|
$28,220.94
|
$28,220.94
|
2025-12-15
|
|
B2002
|
LOCAL
|
Miscellaneous M >=55.50 And M <66.50
|
1
|
1
|
—
|
—
|
$28,149.79
|
$28,149.79
|
$28,149.79
|
2025-12-15
|
|
872
|
MS_DRG
|
Septicemia Or Severe Sepsis Without Mv >96 Hours Without Mcc
|
1
|
1
|
—
|
—
|
$28,050.05
|
$28,050.05
|
$28,050.05
|
2025-12-15
|
|
561
|
MS_DRG
|
Aftercare, Musculoskeletal System And Connective Tissue Without Cc/mcc
|
1
|
1
|
—
|
—
|
$28,044.96
|
$28,044.96
|
$28,044.96
|
2025-12-15
|
|
A0104
|
LOCAL
|
Stroke M >=41.50 And M <50.50
|
1
|
1
|
—
|
—
|
$28,034.33
|
$28,034.33
|
$28,034.33
|
2025-12-15
|
|
A0403
|
LOCAL
|
Traumatic Spinal Cord Injury M >=41.50 And M <47.50
|
1
|
1
|
—
|
—
|
$27,769.43
|
$27,769.43
|
$27,769.43
|
2025-12-15
|
|
D0603
|
LOCAL
|
Neurological M >=43.50 And M <52.50
|
1
|
1
|
—
|
—
|
$27,699.25
|
$27,699.25
|
$27,699.25
|
2025-12-15
|
|
A0505
|
LOCAL
|
Non-traumatic Spinal Cord Injury M <39.50
|
1
|
1
|
—
|
—
|
$27,520.76
|
$27,520.76
|
$27,520.76
|
2025-12-15
|
|
A0805
|
LOCAL
|
Replacement Of Lower-extremity Joint M <42.50
|
1
|
1
|
—
|
—
|
$27,101.46
|
$27,101.46
|
$27,101.46
|
2025-12-15
|
|
D0903
|
LOCAL
|
Other Orthopedic M >=44.50 And M <51.50
|
1
|
1
|
—
|
—
|
$26,743.45
|
$26,743.45
|
$26,743.45
|
2025-12-15
|
|
B0202
|
LOCAL
|
Traumatic Brain Injury M >=61.50 And M <73.50
|
1
|
1
|
—
|
—
|
$26,729.41
|
$26,729.41
|
$26,729.41
|
2025-12-15
|
|
282
|
MS_DRG
|
Acute Myocardial Infarction, Discharged Alive Without Cc/mcc
|
1
|
1
|
—
|
—
|
$26,565.97
|
$26,565.97
|
$26,565.97
|
2025-12-15
|
|
434
|
MS_DRG
|
Cirrhosis And Alcoholic Hepatitis Without Cc/mcc*
|
1
|
1
|
—
|
—
|
$26,565.97
|
$26,565.97
|
$26,565.97
|
2025-12-15
|
|
644
|
MS_DRG
|
Endocrine Disorders With Cc
|
1
|
1
|
—
|
—
|
$26,565.97
|
$26,565.97
|
$26,565.97
|
2025-12-15
|
|
D2003
|
LOCAL
|
Miscellaneous M >=46.50 And M <55.50
|
2
|
2
|
—
|
—
|
$25,416.95
|
$26,459.17
|
$25,938.06
|
2025-12-15
|
|
D1003
|
LOCAL
|
Amputation Lower Extremity M >=47.50 And M <55.50
|
1
|
1
|
—
|
—
|
$26,352.06
|
$26,352.06
|
$26,352.06
|
2025-12-15
|
|
D0305
|
LOCAL
|
Non-traumatic Brain Injury M <42.50 And A <78.50
|
1
|
1
|
—
|
—
|
$25,826.05
|
$25,826.05
|
$25,826.05
|
2025-12-15
|
|
D1403
|
LOCAL
|
Cardiac M >=45.50 And M <55.50
|
1
|
1
|
—
|
—
|
$25,599.70
|
$25,599.70
|
$25,599.70
|
2025-12-15
|
|
D1303
|
LOCAL
|
Rheumatoid Other Arthritis M >=44.50 And M <51.50 And A >=64.50
|
1
|
1
|
—
|
—
|
$25,578.24
|
$25,578.24
|
$25,578.24
|
2025-12-15
|
|
D1603
|
LOCAL
|
Pain Syndrome M >=43.50 And M <58.50
|
1
|
1
|
—
|
—
|
$25,528.27
|
$25,528.27
|
$25,528.27
|
2025-12-15
|
|
D0103
|
LOCAL
|
Stroke M >=50.50 And M <63.50
|
1
|
1
|
—
|
—
|
$25,434.63
|
$25,434.63
|
$25,434.63
|
2025-12-15
|
|
C0602
|
LOCAL
|
Neurological M >=52.50 And M <64.50
|
1
|
1
|
—
|
—
|
$25,290.32
|
$25,290.32
|
$25,290.32
|
2025-12-15
|
|
A0603
|
LOCAL
|
Neurological M >=43.50 And M <52.50
|
2
|
2
|
—
|
—
|
$20,210.49
|
$24,981.00
|
$22,595.75
|
2025-12-15
|
|
A0703
|
LOCAL
|
Fracture Of Lower Extremity M >=41.50 And M <52.50
|
1
|
1
|
—
|
—
|
$24,928.26
|
$24,928.26
|
$24,928.26
|
2025-12-15
|
|
C0203
|
LOCAL
|
Traumatic Brain Injury M >=49.50 And M <61.50
|
1
|
1
|
—
|
—
|
$24,675.19
|
$24,675.19
|
$24,675.19
|
2025-12-15
|
|
D1502
|
LOCAL
|
Pulmonary M >=56.50 And M <68.50
|
1
|
1
|
—
|
—
|
$24,617.78
|
$24,617.78
|
$24,617.78
|
2025-12-15
|
|
D0303
|
LOCAL
|
Non-traumatic Brain Injury M >=42.50 And M <52.50
|
1
|
1
|
—
|
—
|
$24,525.89
|
$24,525.89
|
$24,525.89
|
2025-12-15
|
|
A0103
|
LOCAL
|
Stroke M >=50.50 And M <63.50
|
2
|
2
|
—
|
—
|
$24,144.70
|
$24,238.06
|
$24,191.38
|
2025-12-15
|
|
C0702
|
LOCAL
|
Fracture Of Lower Extremity M >=52.50 And M <61.50
|
1
|
1
|
—
|
—
|
$24,019.58
|
$24,019.58
|
$24,019.58
|
2025-12-15
|
|
D0703
|
LOCAL
|
Fracture Of Lower Extremity M >=41.50 And M <52.50
|
2
|
2
|
—
|
—
|
$20,985.06
|
$23,800.00
|
$22,392.53
|
2025-12-15
|
|
C0302
|
LOCAL
|
Non-traumatic Brain Injury M >=52.50 And M <65.50
|
1
|
1
|
—
|
—
|
$23,716.36
|
$23,716.36
|
$23,716.36
|
2025-12-15
|
|
C2002
|
LOCAL
|
Miscellaneous M >=55.50 And M <66.50
|
1
|
1
|
—
|
—
|
$23,663.16
|
$23,663.16
|
$23,663.16
|
2025-12-15
|
|
B2001
|
LOCAL
|
Miscellaneous M >=66.50
|
1
|
1
|
—
|
—
|
$23,558.03
|
$23,558.03
|
$23,558.03
|
2025-12-15
|
|
A0203
|
LOCAL
|
Traumatic Brain Injury M >=49.50 And M <61.50
|
1
|
1
|
—
|
—
|
$23,344.47
|
$23,344.47
|
$23,344.47
|
2025-12-15
|
|
A1703
|
LOCAL
|
Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=41.50 And M <50.50
|
1
|
1
|
—
|
—
|
$23,072.77
|
$23,072.77
|
$23,072.77
|
2025-12-15
|
|
A0504
|
LOCAL
|
Non-traumatic Spinal Cord Injury M >=39.50 And M <48.50
|
1
|
1
|
—
|
—
|
$22,923.25
|
$22,923.25
|
$22,923.25
|
2025-12-15
|
|
D0302
|
LOCAL
|
Non-traumatic Brain Injury M >=52.50 And M <65.50
|
2
|
2
|
—
|
—
|
$19,890.31
|
$22,828.94
|
$21,359.62
|
2025-12-15
|
|
C1802
|
LOCAL
|
Major Multiple Trauma With Brain Or Spinal Cord Injury M >=55.50 And M <67.50
|
1
|
1
|
—
|
—
|
$22,647.96
|
$22,647.96
|
$22,647.96
|
2025-12-15
|
|
C1402
|
LOCAL
|
Cardiac M >=55.50 And M <68.50
|
2
|
2
|
—
|
—
|
$22,502.27
|
$22,598.54
|
$22,550.40
|
2025-12-15
|
|
A0804
|
LOCAL
|
Replacement Of Lower-extremity Joint M >=42.50 And M <51.50
|
1
|
1
|
—
|
—
|
$22,429.17
|
$22,429.17
|
$22,429.17
|
2025-12-15
|
|
D0902
|
LOCAL
|
Other Orthopedic M >=51.50 And M <63.50
|
1
|
1
|
—
|
—
|
$22,394.10
|
$22,394.10
|
$22,394.10
|
2025-12-15
|
|
C1404
|
LOCAL
|
Cardiac M <45.50
|
1
|
1
|
—
|
—
|
$22,234.25
|
$22,234.25
|
$22,234.25
|
2025-12-15
|
|
A1403
|
LOCAL
|
Cardiac M >=45.50 And M <55.50
|
1
|
1
|
—
|
—
|
$22,216.56
|
$22,216.56
|
$22,216.56
|
2025-12-15
|
|
D1002
|
LOCAL
|
Amputation Lower Extremity M >=55.50 And M <64.50
|
1
|
1
|
—
|
—
|
$22,145.90
|
$22,145.90
|
$22,145.90
|
2025-12-15
|
|
B1401
|
LOCAL
|
Cardiac M >=68.50
|
1
|
1
|
—
|
—
|
$22,047.73
|
$22,047.73
|
$22,047.73
|
2025-12-15
|
|
D2002
|
LOCAL
|
Miscellaneous M >=55.50 And M <66.50
|
1
|
1
|
—
|
—
|
$22,011.27
|
$22,011.27
|
$22,011.27
|
2025-12-15
|
|
A1702
|
LOCAL
|
Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=50.50 And M <57.50
|
1
|
1
|
—
|
—
|
$21,746.71
|
$21,746.71
|
$21,746.71
|
2025-12-15
|
|
A0502
|
LOCAL
|
Non-traumatic Spinal Cord Injury M >=53.50 And M <60.50
|
1
|
1
|
—
|
—
|
$21,624.44
|
$21,624.44
|
$21,624.44
|
2025-12-15
|
|
A0602
|
LOCAL
|
Neurological M >=52.50 And M <64.50
|
1
|
1
|
—
|
—
|
$21,291.72
|
$21,291.72
|
$21,291.72
|
2025-12-15
|
|
A0702
|
LOCAL
|
Fracture Of Lower Extremity M >=52.50 And M <61.50
|
1
|
1
|
—
|
—
|
$21,021.15
|
$21,021.15
|
$21,021.15
|
2025-12-15
|
|
D1402
|
LOCAL
|
Cardiac M >=55.50 And M <68.50
|
1
|
1
|
—
|
—
|
$21,011.12
|
$21,011.12
|
$21,011.12
|
2025-12-15
|
|
A2003
|
LOCAL
|
Miscellaneous M >=46.50 And M <55.50
|
1
|
1
|
—
|
—
|
$20,903.15
|
$20,903.15
|
$20,903.15
|
2025-12-15
|
|
D0401
|
LOCAL
|
Traumatic Spinal Cord Injury M >=56.50
|
1
|
1
|
—
|
—
|
$20,777.92
|
$20,777.92
|
$20,777.92
|
2025-12-15
|
|
C1501
|
LOCAL
|
Pulmonary M >=68.50
|
1
|
1
|
—
|
—
|
$20,709.65
|
$20,709.65
|
$20,709.65
|
2025-12-15
|
|
A0803
|
LOCAL
|
Replacement Of Lower-extremity Joint M >=51.50 And M <57.50
|
1
|
1
|
—
|
—
|
$20,537.03
|
$20,537.03
|
$20,537.03
|
2025-12-15
|
|
A0902
|
LOCAL
|
Other Orthopedic M >=51.50 And M <63.50
|
1
|
1
|
—
|
—
|
$20,490.01
|
$20,490.01
|
$20,490.01
|
2025-12-15
|
|
A0302
|
LOCAL
|
Non-traumatic Brain Injury M >=52.50 And M <65.50
|
1
|
1
|
—
|
—
|
$20,450.71
|
$20,450.71
|
$20,450.71
|
2025-12-15
|
|
D0502
|
LOCAL
|
Non-traumatic Spinal Cord Injury M >=53.50 And M <60.50
|
1
|
1
|
—
|
—
|
$20,447.38
|
$20,447.38
|
$20,447.38
|
2025-12-15
|
|
D0504
|
LOCAL
|
Non-traumatic Spinal Cord Injury M >=39.50 And M <48.50
|
1
|
1
|
—
|
—
|
$20,291.56
|
$20,291.56
|
$20,291.56
|
2025-12-15
|
|
D0802
|
LOCAL
|
Replacement Of Lower-extremity Joint M >=57.50 And M <63.50
|
1
|
1
|
—
|
—
|
$20,123.31
|
$20,123.31
|
$20,123.31
|
2025-12-15
|
|
A2002
|
LOCAL
|
Miscellaneous M >=55.50 And M <66.50
|
2
|
2
|
—
|
—
|
$3,412.75
|
$20,072.03
|
$11,742.39
|
2025-12-15
|
|
D0202
|
LOCAL
|
Traumatic Brain Injury M >=61.50 And M <73.50
|
1
|
1
|
—
|
—
|
$19,994.94
|
$19,994.94
|
$19,994.94
|
2025-12-15
|
|
C1701
|
LOCAL
|
Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=57.50
|
1
|
1
|
—
|
—
|
$19,799.18
|
$19,799.18
|
$19,799.18
|
2025-12-15
|
|
D0102
|
LOCAL
|
Stroke M >=63.50 And M <72.50
|
2
|
2
|
—
|
—
|
$19,648.32
|
$19,732.39
|
$19,690.35
|
2025-12-15
|
|
A1402
|
LOCAL
|
Cardiac M >=55.50 And M <68.50
|
1
|
1
|
—
|
—
|
$19,367.05
|
$19,367.05
|
$19,367.05
|
2025-12-15
|
|
D1701
|
LOCAL
|
Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=57.50
|
1
|
1
|
—
|
—
|
$19,083.37
|
$19,083.37
|
$19,083.37
|
2025-12-15
|
|
C0902
|
LOCAL
|
Other Orthopedic M >=51.50 And M <63.50
|
1
|
1
|
—
|
—
|
$19,021.85
|
$19,021.85
|
$19,021.85
|
2025-12-15
|
|
C2001
|
LOCAL
|
Miscellaneous M >=66.50
|
1
|
1
|
—
|
—
|
$18,898.58
|
$18,898.58
|
$18,898.58
|
2025-12-15
|
|
D1702
|
LOCAL
|
Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=50.50 And M <57.50
|
1
|
1
|
—
|
—
|
$18,895.00
|
$18,895.00
|
$18,895.00
|
2025-12-15
|
|
A0102
|
LOCAL
|
Stroke M >=63.50 And M <72.50
|
2
|
2
|
—
|
—
|
$3,475.70
|
$18,806.39
|
$11,141.04
|
2025-12-15
|
|
A0202
|
LOCAL
|
Traumatic Brain Injury M >=61.50 And M <73.50
|
1
|
1
|
—
|
—
|
$18,793.63
|
$18,793.63
|
$18,793.63
|
2025-12-15
|
|
A0802
|
LOCAL
|
Replacement Of Lower-extremity Joint M >=57.50 And M <63.50
|
1
|
1
|
—
|
—
|
$18,768.20
|
$18,768.20
|
$18,768.20
|
2025-12-15
|
|
C1901
|
LOCAL
|
Guillain-barr� M >=66.50
|
1
|
1
|
—
|
—
|
$18,636.88
|
$18,636.88
|
$18,636.88
|
2025-12-15
|
|
D0501
|
LOCAL
|
Non-traumatic Spinal Cord Injury M >=60.50
|
1
|
1
|
—
|
—
|
$18,626.49
|
$18,626.49
|
$18,626.49
|
2025-12-15
|
|
C0301
|
LOCAL
|
Non-traumatic Brain Injury M >=65.50
|
2
|
2
|
—
|
—
|
$18,611.30
|
$18,612.60
|
$18,611.95
|
2025-12-15
|
|
D0701
|
LOCAL
|
Fracture Of Lower Extremity M >=61.50
|
1
|
1
|
—
|
—
|
$18,421.56
|
$18,421.56
|
$18,421.56
|
2025-12-15
|
|
D0601
|
LOCAL
|
Neurological M >=64.50
|
1
|
1
|
—
|
—
|
$18,373.29
|
$18,373.29
|
$18,373.29
|
2025-12-15
|
|
A0903
|
LOCAL
|
Other Orthopedic M >=44.50 And M <51.50
|
1
|
1
|
—
|
—
|
$17,914.38
|
$17,914.38
|
$17,914.38
|
2025-12-15
|
|
C1401
|
LOCAL
|
Cardiac M >=68.50
|
1
|
1
|
—
|
—
|
$17,767.50
|
$17,767.50
|
$17,767.50
|
2025-12-15
|
|
D0301
|
LOCAL
|
Non-traumatic Brain Injury M >=65.50
|
1
|
1
|
—
|
—
|
$17,582.70
|
$17,582.70
|
$17,582.70
|
2025-12-15
|
|
D2001
|
LOCAL
|
Miscellaneous M >=66.50
|
2
|
2
|
—
|
—
|
$14,711.59
|
$17,578.71
|
$16,145.15
|
2025-12-15
|
|
A1404
|
LOCAL
|
Cardiac M <45.50
|
1
|
1
|
—
|
—
|
$17,523.83
|
$17,523.83
|
$17,523.83
|
2025-12-15
|
|
D0801
|
LOCAL
|
Replacement Of Lower-extremity Joint M >=63.50
|
1
|
1
|
—
|
—
|
$17,444.88
|
$17,444.88
|
$17,444.88
|
2025-12-15
|
|
D0803
|
LOCAL
|
Replacement Of Lower-extremity Joint M >=51.50 And M <57.50
|
1
|
1
|
—
|
—
|
$17,307.92
|
$17,307.92
|
$17,307.92
|
2025-12-15
|
|
D1301
|
LOCAL
|
Rheumatoid Other Arthritis M >=62.50
|
1
|
1
|
—
|
—
|
$17,249.05
|
$17,249.05
|
$17,249.05
|
2025-12-15
|
|
A0701
|
LOCAL
|
Fracture Of Lower Extremity M >=61.50
|
1
|
1
|
—
|
—
|
$17,020.55
|
$17,020.55
|
$17,020.55
|
2025-12-15
|
|
A0601
|
LOCAL
|
Neurological M >=64.50
|
1
|
1
|
—
|
—
|
$16,750.06
|
$16,750.06
|
$16,750.06
|
2025-12-15
|
|
A0901
|
LOCAL
|
Other Orthopedic M >=63.50
|
1
|
1
|
—
|
—
|
$16,381.25
|
$16,381.25
|
$16,381.25
|
2025-12-15
|
|
D0203
|
LOCAL
|
Traumatic Brain Injury M >=49.50 And M <61.50
|
1
|
1
|
—
|
—
|
$16,281.74
|
$16,281.74
|
$16,281.74
|
2025-12-15
|
|
A0301
|
LOCAL
|
Non-traumatic Brain Injury M >=65.50
|
1
|
1
|
—
|
—
|
$16,245.05
|
$16,245.05
|
$16,245.05
|
2025-12-15
|
|
D0702
|
LOCAL
|
Fracture Of Lower Extremity M >=52.50 And M <61.50
|
1
|
1
|
—
|
—
|
$16,116.61
|
$16,116.61
|
$16,116.61
|
2025-12-15
|
|
A2001
|
LOCAL
|
Miscellaneous M >=66.50
|
1
|
1
|
—
|
—
|
$16,068.51
|
$16,068.51
|
$16,068.51
|
2025-12-15
|
|
B2004
|
LOCAL
|
Miscellaneous M <46.50 And A >=77.50
|
1
|
1
|
—
|
—
|
$15,891.97
|
$15,891.97
|
$15,891.97
|
2025-12-15
|
|
D0101
|
LOCAL
|
Stroke M >=72.50
|
1
|
1
|
—
|
—
|
$15,485.16
|
$15,485.16
|
$15,485.16
|
2025-12-15
|
|
C1705
|
LOCAL
|
Major Multiple Trauma Without Brain Or Spinal Cord Injury M <36.50
|
2
|
2
|
—
|
—
|
$7,336.15
|
$15,366.05
|
$11,351.10
|
2025-12-15
|
|
C0501
|
LOCAL
|
Non-traumatic Spinal Cord Injury M >=60.50
|
1
|
1
|
—
|
—
|
$15,235.23
|
$15,235.23
|
$15,235.23
|
2025-12-15
|
|
D0105
|
LOCAL
|
Stroke M <41.50 And A >=84.50
|
1
|
1
|
—
|
—
|
$15,220.95
|
$15,220.95
|
$15,220.95
|
2025-12-15
|
|
D0901
|
LOCAL
|
Other Orthopedic M >=63.50
|
1
|
1
|
—
|
—
|
$14,983.84
|
$14,983.84
|
$14,983.84
|
2025-12-15
|
|
A0101
|
LOCAL
|
Stroke M >=72.50
|
1
|
1
|
—
|
—
|
$14,819.83
|
$14,819.83
|
$14,819.83
|
2025-12-15
|
|
C1403
|
LOCAL
|
Cardiac M >=45.50 And M <55.50
|
1
|
1
|
—
|
—
|
$14,813.24
|
$14,813.24
|
$14,813.24
|
2025-12-15
|
|
D0602
|
LOCAL
|
Neurological M >=52.50 And M <64.50
|
1
|
1
|
—
|
—
|
$14,726.09
|
$14,726.09
|
$14,726.09
|
2025-12-15
|
|
C0202
|
LOCAL
|
Traumatic Brain Injury M >=61.50 And M <73.50
|
1
|
1
|
—
|
—
|
$13,759.55
|
$13,759.55
|
$13,759.55
|
2025-12-15
|
|
C0502
|
LOCAL
|
Non-traumatic Spinal Cord Injury M >=53.50 And M <60.50
|
1
|
1
|
—
|
—
|
$13,454.65
|
$13,454.65
|
$13,454.65
|
2025-12-15
|
|
C1004
|
LOCAL
|
Amputation Lower Extremity M <47.50
|
1
|
1
|
—
|
—
|
$13,214.50
|
$13,214.50
|
$13,214.50
|
2025-12-15
|
|
D0804
|
LOCAL
|
Replacement Of Lower-extremity Joint M >=42.50 And M <51.50
|
1
|
1
|
—
|
—
|
$10,617.01
|
$10,617.01
|
$10,617.01
|
2025-12-15
|
|
B0203
|
LOCAL
|
Traumatic Brain Injury M >=49.50 And M <61.50
|
1
|
1
|
—
|
—
|
$8,286.41
|
$8,286.41
|
$8,286.41
|
2025-12-15
|
|
D1401
|
LOCAL
|
Cardiac M >=68.50
|
1
|
1
|
—
|
—
|
$8,283.79
|
$8,283.79
|
$8,283.79
|
2025-12-15
|
|
C0601
|
LOCAL
|
Neurological M >=64.50
|
1
|
1
|
—
|
—
|
$4,984.71
|
$4,984.71
|
$4,984.71
|
2025-12-15
|
|
C1504
|
LOCAL
|
Pulmonary M <45.50
|
1
|
1
|
—
|
—
|
$3,473.20
|
$3,473.20
|
$3,473.20
|
2025-12-15
|
|
A1701
|
LOCAL
|
Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=57.50
|
1
|
1
|
—
|
—
|
$3,412.75
|
$3,412.75
|
$3,412.75
|
2025-12-15
|
|
D0205
|
LOCAL
|
Traumatic Brain Injury M <35.50
|
1
|
1
|
—
|
—
|
$3,123.23
|
$3,123.23
|
$3,123.23
|
2025-12-15
|
|
64644
|
CPT
|
Injection 1 Extre 5 Muscles
|
1
|
1
|
$2,122.00
|
$2,122.00
|
$841.85
|
$841.85
|
$841.85
|
2025-12-15
|
|
64642
|
CPT
|
Injection 1 Ex 4 Muscles
|
2
|
2
|
$2,122.00
|
$2,122.00
|
$841.85
|
$841.85
|
$841.85
|
2025-12-15
|
|
92523
|
CPT
|
St Speech Sound Lang Comp Eval
|
11
|
10
|
$609.00
|
$609.00
|
$100.00
|
$395.85
|
$228.15
|
2025-12-15
|
|
20610
|
CPT
|
Major Joint Injection
|
1
|
1
|
$904.00
|
$904.00
|
$366.07
|
$366.07
|
$366.07
|
2025-12-15
|
|
97167
|
CPT
|
Ot Ot Eval High Complex 60 Min
|
4
|
4
|
$387.00
|
$387.00
|
$90.00
|
$251.55
|
$103.88
|
2025-12-15
|
|
97161
|
CPT
|
Pt Pt Eval Low Complex 20 Min
|
13
|
9
|
$365.00
|
$365.00
|
$60.95
|
$237.46
|
$101.06
|
2025-12-15
|
|
97163
|
CPT
|
Pt Pt Eval High Complex 45 Min
|
8
|
7
|
$365.00
|
$365.00
|
$89.45
|
$237.25
|
$101.92
|
2025-12-15
|
|
97162
|
CPT
|
Pt Pt Eval Mod Complex 30 Min
|
18
|
13
|
$365.00
|
$365.00
|
$60.95
|
$237.25
|
$101.06
|
2025-12-15
|
|
74230
|
CPT
|
Mbs -swallowing Function, Phar
|
2
|
2
|
$456.00
|
$456.00
|
$209.18
|
$209.18
|
$209.18
|
2025-12-15
|
|
99213
|
CPT
|
Psych - Est Pt Visit - Lvl 3
|
2
|
1
|
$550.00
|
$550.00
|
$58.12
|
$158.78
|
$108.45
|
2025-12-15
|
|
73502
|
CPT
|
X-ray Hip Uni 2-3 Views
|
23
|
14
|
$150.00
|
$150.00
|
$32.46
|
$145.05
|
$82.61
|
2025-12-15
|
|
73521
|
CPT
|
X-ray Hips Bi 2 Views
|
6
|
6
|
$150.00
|
$150.00
|
$35.69
|
$135.39
|
$124.68
|
2025-12-15
|
|
97166
|
CPT
|
Ot Ot Eval Mod Complex 45 Min
|
13
|
10
|
$387.00
|
$387.00
|
$58.92
|
$134.00
|
$103.35
|
2025-12-15
|
|
92507
|
CPT
|
St Speech/hearing Indiv Therpy
|
7
|
6
|
$337.00
|
$337.00
|
$59.61
|
$130.62
|
$78.50
|
2025-12-15
|
|
72190
|
CPT
|
X-ray Pelvis Min 3v
|
1
|
1
|
$150.00
|
$150.00
|
$124.68
|
$124.68
|
$124.68
|
2025-12-15
|
|
72170
|
CPT
|
X-ray Pelvis
|
3
|
3
|
$150.00
|
$150.00
|
$29.35
|
$124.68
|
$124.68
|
2025-12-15
|
|
72100
|
CPT
|
X-ray L-s Spine 2/3 Vws
|
8
|
7
|
$150.00
|
$150.00
|
$11.91
|
$124.68
|
$118.59
|
2025-12-15
|
|
72070
|
CPT
|
X-ray Thorac Spine 2vws
|
3
|
2
|
$150.00
|
$150.00
|
$33.21
|
$124.68
|
$33.21
|
2025-12-15
|
|
92522
|
CPT
|
St Evaluate Speech Production
|
4
|
4
|
$609.00
|
$609.00
|
$83.50
|
$115.11
|
$111.96
|
2025-12-15
|
|
92524
|
CPT
|
St Behavioral/qualitative Eval
|
1
|
1
|
$609.00
|
$609.00
|
$112.73
|
$112.73
|
$112.73
|
2025-12-15
|
|
97165
|
CPT
|
Ot Ot Eval Low Complex 30 Min
|
6
|
5
|
$388.00
|
$388.00
|
$58.92
|
$103.88
|
$103.35
|
2025-12-15
|
|
73030
|
CPT
|
X-ray Shoulder
|
1
|
1
|
$150.00
|
$150.00
|
$103.78
|
$103.78
|
$103.78
|
2025-12-15
|
|
71045
|
CPT
|
X-ray Chest 1 View
|
1
|
1
|
$150.00
|
$150.00
|
$103.78
|
$103.78
|
$103.78
|
2025-12-15
|
|
72040
|
CPT
|
X-ray Neck Spine 2-3 Vw
|
5
|
4
|
$150.00
|
$150.00
|
$31.28
|
$103.78
|
$103.78
|
2025-12-15
|
|
73560
|
CPT
|
X-ray Knee 1 Or 2
|
1
|
1
|
$150.00
|
$150.00
|
$103.78
|
$103.78
|
$103.78
|
2025-12-15
|
|
73562
|
CPT
|
X-ray Knee 3
|
24
|
13
|
$270.00
|
$270.00
|
$10.14
|
$103.78
|
$73.97
|
2025-12-15
|
|
73552
|
CPT
|
X-ray Femur 2/>
|
2
|
2
|
$150.00
|
$150.00
|
$35.43
|
$103.78
|
$69.60
|
2025-12-15
|
|
97164
|
CPT
|
Pt Pt Re-eval Est Plan Care
|
7
|
5
|
$252.00
|
$252.00
|
$41.66
|
$101.92
|
$69.77
|
2025-12-15
|
|
97542
|
CPT
|
Cota Wheelchair Mngment Traini
|
8
|
8
|
$141.00
|
$141.00
|
$32.03
|
$101.52
|
$32.03
|
2025-12-15
|
|
92611
|
CPT
|
St Motion Fluoroscopy/swallow
|
4
|
3
|
$737.00
|
$737.00
|
$92.04
|
$94.32
|
$93.18
|
2025-12-15
|
|
92526
|
CPT
|
St Oral Function Therapy
|
2
|
2
|
$372.00
|
$372.00
|
$86.89
|
$86.89
|
$86.89
|
2025-12-15
|
|
92508
|
CPT
|
St Speech/hearing Group Therpy
|
2
|
2
|
$102.00
|
$102.00
|
$24.83
|
$76.74
|
$50.78
|
2025-12-15
|
|
92610
|
CPT
|
St Evaluate Swallowing Functio
|
2
|
1
|
$609.00
|
$609.00
|
$59.15
|
$70.91
|
$65.03
|
2025-12-15
|
|
97112
|
CPT
|
Cota Neuromuscular Reeducation
|
12
|
8
|
$150.00
|
$150.00
|
$13.00
|
$64.38
|
$33.76
|
2025-12-15
|
|
97110
|
CPT
|
Cota Therapeutic Exercises
|
16
|
12
|
$131.00
|
$131.00
|
$13.00
|
$60.61
|
$29.96
|
2025-12-15
|
|
97530
|
CPT
|
Cota Therapeutic Activities
|
11
|
8
|
$169.00
|
$169.00
|
$26.40
|
$58.25
|
$36.30
|
2025-12-15
|
|
97763
|
CPT
|
Cota OrthCOTAic/prosthetic(s)
|
1
|
1
|
$227.00
|
$227.00
|
$54.40
|
$54.40
|
$54.40
|
2025-12-15
|
|
97116
|
CPT
|
Lpt Gait Training Therapy
|
9
|
7
|
$129.00
|
$129.00
|
$13.00
|
$53.42
|
$29.96
|
2025-12-15
|
|
97140
|
CPT
|
Cota Manual Therapy 1/> Region
|
11
|
9
|
$120.00
|
$120.00
|
$17.52
|
$51.64
|
$28.58
|
2025-12-15
|
|
97113
|
CPT
|
Cota Aquatic Therapy/exercises
|
8
|
7
|
$124.00
|
$124.00
|
$13.00
|
$47.90
|
$38.36
|
2025-12-15
|
|
G0281
|
HCPCS
|
Pt Elec Stim Unattend For Pres
|
2
|
2
|
$59.00
|
$59.00
|
$12.00
|
$38.35
|
$25.18
|
2025-12-15
|
|
G0283
|
HCPCS
|
Pt Elec Stim Other Than Wound
|
1
|
1
|
$59.00
|
$59.00
|
$38.14
|
$38.14
|
$38.14
|
2025-12-15
|
|
97535
|
CPT
|
Cota Self Care Mngment Trainin
|
4
|
4
|
$223.00
|
$223.00
|
$26.36
|
$37.69
|
$33.47
|
2025-12-15
|
|
97032
|
CPT
|
Cota Electrical Stimulation
|
2
|
2
|
$63.00
|
$63.00
|
$20.62
|
$27.10
|
$23.86
|
2025-12-15
|
|
97129
|
CPT
|
St Ther Int 1st 15min Foc Cogn
|
2
|
2
|
$62.00
|
$62.00
|
$20.05
|
$20.05
|
$20.05
|
2025-12-15
|
|
97130
|
CPT
|
St Ther Int Add 15min Foc Cog
|
2
|
2
|
$97.00
|
$97.00
|
$18.75
|
$18.75
|
$18.75
|
2025-12-15
|
|
97035
|
CPT
|
Cota Ultrasound Therapy
|
1
|
1
|
$62.00
|
$62.00
|
$14.78
|
$14.78
|
$14.78
|
2025-12-15
|
|
97016
|
CPT
|
Ot Vasopneumatic Device Therap
|
2
|
2
|
$53.00
|
$53.00
|
$12.35
|
$12.35
|
$12.35
|
2025-12-15
|
|
J0585
|
HCPCS
|
Onabotulinumtoxina 1 Unit Vial1un
|
2
|
2
|
$26.00
|
$26.00
|
$6.51
|
$6.51
|
$6.51
|
2025-12-15
|