Hospital

HURON VALLEY-SINAI HOSPITAL

Commerce Township, MI · CCN 230277 · Rates published

20,588 distinct procedures filed

24 distinct payers

1,035,697 rate rows

2025-01-31 last MRF observed · ⚠ 17 mo old

Data quality

427,940 of 1,035,697 rate rows are consumer-grade (41.3%)

607,757 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 — reason	Rows
no usable negotiated amount (only an out-of-band fallback) — excluded from medians	599,504
template filing: same amount across many unrelated codes — excluded	7,628
placeholder amount (≤ $0.02) — excluded from medians	358
per-diem day rate — not a per-procedure price	198
exceeds 10× this hospital's gross charge — excluded from medians	69

⚠ Possibly outdated The most recent machine-readable file we have for this hospital is 17 months old.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://mrfs.hyvehealthcare.com/TenetHealth/272844563_huron-valley---sinai-hospital_standardcharges.json
Found on page	https://www.dmc.org/patients/pricing-info-estimates/hospital-pricing-information
Discovered via	CMS hospital list
Last fetch	not_modified · 2026-05-19
Content fingerprint	a0829fe630566e12… · 905,490,230 bytes · first seen 2026-05-17

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
J1411 CPT	Injection, Etranacogene Dezaparvovec-drlb, Per Therapeutic Dose	2	$93.00	$4,200,000.00	$4,200,000.00	nat. median $3,710,000 1.1× median
J3399 CPT	Injection, Onasemnogene Abeparvovec-xioi, Per Treatment, Up To 5x10^15 Vector Ge…	3	$93.00	$3,625,391.50	$2,705,294.50	nat. median $2,469,189 1.1× median
Q2056 CPT	Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige…	3	$93.00	$791,768.50	$492,900.00	nat. median $675,122 0.7× median
Q2042 CPT	Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka…	3	$93.00	$780,647.75	$466,069.91	nat. median $754,974 0.6× median
Q2055 CPT	Idecabtagene Vicleucel, Up To 460 Million Autologous B-cell Maturation Antigen (…	3	$93.00	$735,326.38	$460,226.56	nat. median $625,184 0.7× median
Q2054 CPT	Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi…	3	$93.00	$730,067.63	$454,489.31	nat. median $674,188 0.7× median
Q2041 CPT	Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via…	3	$93.00	$721,956.69	$449,440.00	nat. median $634,511 0.7× median
Q2053 CPT	Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V…	3	$93.00	$721,956.69	$449,440.00	nat. median $620,080 0.7× median
C9081 CPT	Idecabtagene Vicleucel, Up To 460 Million Autologous Anti-bcma Car-positive Viab…	1	$93.00	$481,552.44	$240,822.72	nat. median $30,475 outlier · 7.9×
C9098 CPT	Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige…	1	$93.00	$471,508.13	$235,800.57	nat. median $57,174 outlier · 4.1×
C9076 CPT	Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi…	1	$93.00	$470,991.56	$235,542.28	nat. median $30,475 outlier · 7.7×
A9543 CPT	Yttrium Y-90 Ibritumomab Tiuxetan, Therapeutic, Per Treatment Dose, Up To 40 Mil…	2	$93.00	$65,476.58	$65,476.58	nat. median $62,507 1.0× median
Q2043 CPT	Sipuleucel-t, Minimum Of 50 Million Autologous Cd54+ Cells Activated With Pap-gm…	3	$93.00	$85,236.69	$53,062.44	nat. median $66,682 0.8× median
K0743 CPT	Suction Pump, Home Model, Portable, For Use On Wounds	24	$47,583.90	$47,583.90	$47,583.90	nat. median $795 outlier · 59.9×
J9226 CPT	Histrelin Implant (supprelin La), 50 Mg	2	$93.00	$44,362.52	$42,755.33	nat. median $60,368 0.7× median
Q0480 CPT	Driver For Use With Pneumatic Ventricular Assist Device, Replacement Only	1	$93.00	$79,397.77	$39,745.39	nat. median $111,989 outlier · 0.4×
L5969 CPT	Addition, Endoskeletal Ankle-foot Or Ankle System, Power Assist, Includes Any Ty…	24	$31,063.54	$31,063.54	$31,063.54	nat. median $15,234 outlier · 2.0×
J9029 CPT	Injection, Nadofaragene Firadenovec-vncg, Per Therapeutic Dose	1	$93.00	$60,839.76	$30,466.38	nat. median $69,774 outlier · 0.4×
J7330 CPT	Imp Chondrocytes Autolgs Cult	1	$93.00	$56,957.17	$28,525.08	nat. median $76,377 outlier · 0.4×
C9150 CPT	Xenon Xe-129 Hyperpolarized Gas, Diagnostic, Per Study Dose	1	$93.00	$52,727.79	$26,410.40	nat. median $775 outlier · 34.1×
J9266 CPT	Injection, Pegaspargase, Per Single Dose Vial	3	$93.00	$41,383.45	$25,762.46	nat. median $34,109 0.8× median
33264 CPT	Rem/repl Aicd Mult Ld	3	$93.00	$54,456.00	$22,828.00	nat. median $31,873 0.7× median
33270 CPT	Insrt/rpl Sq Defib W/ele	3	$93.00	$54,456.00	$22,828.00	nat. median $32,221 0.7× median
33240 CPT	Insrt Aicd W/exis Ld	3	$93.00	$54,456.00	$22,828.00	nat. median $22,134 1.0× median
33262 CPT	Rem/repl Aicd Singl Ld	3	$93.00	$54,456.00	$22,828.00	nat. median $23,398 1.0× median
33249 CPT	Insrt/rplc Aicd & Lds	3	$93.00	$54,456.00	$22,828.00	nat. median $31,833 0.7× median
33231 CPT	Ins Aicd W/multi Lds	3	$93.00	$54,456.00	$22,828.00	nat. median $30,121 0.8× median
33271 CPT	Ins Sq Defib Elec	3	$93.00	$54,456.00	$22,828.00	nat. median $8,455 outlier · 2.7×
33272 CPT	Rmv Sq Defib Elec	3	$93.00	$54,456.00	$22,828.00	nat. median $4,249 outlier · 5.4×
33263 CPT	Rem/repl Aicd Dual Ld	3	$93.00	$54,456.00	$22,828.00	nat. median $23,504 1.0× median
33230 CPT	Ins Aicd W/dual Lds	3	$93.00	$54,456.00	$22,828.00	nat. median $22,359 1.0× median
C9760 CPT	Non-randomized, Non-blinded Procedure For Nyha Class Ii, Iii, IV Heart Failure;…	24	$13,558.00	$32,035.00	$22,796.50	nat. median $28,432 0.8× median
C9605 CPT	Percutaneous Transluminal Revascularization Of Or Through Coronary Artery Bypass…	24	$13,308.00	$31,748.00	$22,528.00	nat. median $11,264 2.0× median
C9603 CPT	Percutaneous Transluminal Coronary Atherectomy, With Drug-eluting Intracoronary…	24	$13,308.00	$31,748.00	$22,528.00	nat. median $12,340 1.8× median
C9608 CPT	Percutaneous Transluminal Revascularization Of Chronic Total Occlusion, Coronary…	24	$13,308.00	$31,748.00	$22,528.00	nat. median $11,821 1.9× median
J9600 CPT	Injection, Porfimer Sodium, 75 Mg	3	$93.00	$33,812.54	$22,490.02	nat. median $31,644 0.7× median
93624 CPT	Ep Drug Follow-up Study	24	$13,036.00	$31,099.00	$22,067.50	nat. median $7,829 outlier · 2.8×
M1085 CPT	Ro - Cervical Cancer	2	$12,321.00	$29,395.00	$20,858.00	nat. median $4,744 outlier · 4.4×
M1087 CPT	Ro - Colorectal Cancer	2	$12,321.00	$29,395.00	$20,858.00	nat. median $3,971 outlier · 5.3×
M1073 CPT	Ro - Anal Cancer	2	$12,321.00	$29,395.00	$20,858.00	nat. median $4,248 outlier · 4.9×
M1075 CPT	Ro - Bladder Cancer	2	$12,321.00	$29,395.00	$20,858.00	nat. median $4,325 outlier · 4.8×
M1099 CPT	Ro - Pancreatic Cancer	2	$12,321.00	$29,395.00	$20,858.00	nat. median $4,604 outlier · 4.5×
M1101 CPT	Ro - Prostate Cancer	2	$12,321.00	$29,395.00	$20,858.00	nat. median $6,251 outlier · 3.3×
M1083 CPT	Ro - Cns Tumor	2	$12,321.00	$29,395.00	$20,858.00	nat. median $4,426 outlier · 4.7×
M1095 CPT	Ro - Lung Cancer	2	$12,321.00	$29,395.00	$20,858.00	nat. median $3,696 outlier · 5.6×
M1079 CPT	Ro - Brain Metastases	2	$12,321.00	$29,395.00	$20,858.00	nat. median $3,180 outlier · 6.6×
M1081 CPT	Ro - Breast Cancer	2	$12,321.00	$29,395.00	$20,858.00	nat. median $3,239 outlier · 6.4×
M1103 CPT	Ro - Upper Gi Cancer	2	$12,321.00	$29,395.00	$20,858.00	nat. median $4,783 outlier · 4.4×
M1105 CPT	Ro - Uterine Cancer	2	$12,321.00	$29,395.00	$20,858.00	nat. median $4,639 outlier · 4.5×
M1077 CPT	Ro - Bone Metastases	2	$12,321.00	$29,395.00	$20,858.00	nat. median $2,052 outlier · 10.2×

Other procedures at this hospital

Browse this hospital's 20,588 published procedures. Use the slice to choose what to show, then sort or filter any column.

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

J1411	CPT	Injection, Etranacogene Dezaparvovec-drlb, Per Therapeutic Dose	6	2	—	—	$93.00	$4,200,000.00	$4,200,000.00	2025-01-31
J3399	CPT	Injection, Onasemnogene Abeparvovec-xioi, Per Treatment, Up To 5x10^15 Vector Ge…	7	3	—	—	$93.00	$3,625,391.50	$2,705,294.50	2025-01-31
Q2056	CPT	Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige…	7	3	—	—	$93.00	$791,768.50	$492,900.00	2025-01-31
Q2042	CPT	Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka…	7	3	—	—	$93.00	$780,647.75	$466,069.91	2025-01-31
Q2055	CPT	Idecabtagene Vicleucel, Up To 460 Million Autologous B-cell Maturation Antigen (…	7	3	—	—	$93.00	$735,326.38	$460,226.56	2025-01-31
Q2054	CPT	Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi…	7	3	—	—	$93.00	$730,067.63	$454,489.31	2025-01-31
Q2053	CPT	Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V…	7	3	—	—	$93.00	$721,956.69	$449,440.00	2025-01-31
Q2041	CPT	Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via…	7	3	—	—	$93.00	$721,956.69	$449,440.00	2025-01-31
C9081	CPT	Idecabtagene Vicleucel, Up To 460 Million Autologous Anti-bcma Car-positive Viab…	2	1	—	—	$93.00	$481,552.44	$240,822.72	2025-01-31
C9098	CPT	Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige…	2	1	—	—	$93.00	$471,508.13	$235,800.57	2025-01-31
C9076	CPT	Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi…	2	1	—	—	$93.00	$470,991.56	$235,542.28	2025-01-31
A9543	CPT	Yttrium Y-90 Ibritumomab Tiuxetan, Therapeutic, Per Treatment Dose, Up To 40 Mil…	6	2	—	—	$93.00	$65,476.58	$65,476.58	2025-01-31
Q2043	CPT	Sipuleucel-t, Minimum Of 50 Million Autologous Cd54+ Cells Activated With Pap-gm…	7	3	—	—	$93.00	$85,236.69	$53,062.44	2025-01-31
K0743	CPT	Suction Pump, Home Model, Portable, For Use On Wounds	49	24	—	—	$47,583.90	$47,583.90	$47,583.90	2025-01-31
J9226	CPT	Histrelin Implant (supprelin La), 50 Mg	3	2	—	—	$93.00	$44,362.52	$42,755.33	2025-01-31
Q0480	CPT	Driver For Use With Pneumatic Ventricular Assist Device, Replacement Only	2	1	—	—	$93.00	$79,397.77	$39,745.39	2025-01-31
L5969	CPT	Addition, Endoskeletal Ankle-foot Or Ankle System, Power Assist, Includes Any Ty…	49	24	—	—	$31,063.54	$31,063.54	$31,063.54	2025-01-31
J9029	CPT	Injection, Nadofaragene Firadenovec-vncg, Per Therapeutic Dose	2	1	—	—	$93.00	$60,839.76	$30,466.38	2025-01-31
J7330	CPT	Imp Chondrocytes Autolgs Cult	2	1	$266,173.00	$199,629.75 25% off	$93.00	$56,957.17	$28,525.08	2025-01-31
C9150	CPT	Xenon Xe-129 Hyperpolarized Gas, Diagnostic, Per Study Dose	2	1	—	—	$93.00	$52,727.79	$26,410.40	2025-01-31
J9266	CPT	Injection, Pegaspargase, Per Single Dose Vial	7	3	—	—	$93.00	$41,383.45	$25,762.46	2025-01-31
33249	CPT	Insrt/rplc Aicd & Lds	7	3	$101,418.00	$76,063.50 25% off	$93.00	$54,456.00	$22,828.00	2025-01-31
33240	CPT	Insrt Aicd W/exis Ld	7	3	$71,571.00	$53,678.25 25% off	$93.00	$54,456.00	$22,828.00	2025-01-31
33262	CPT	Rem/repl Aicd Singl Ld	7	3	$50,112.00	$37,584.00 25% off	$93.00	$54,456.00	$22,828.00	2025-01-31
33271	CPT	Ins Sq Defib Elec	7	3	$15,213.00	$11,409.75 25% off	$93.00	$54,456.00	$22,828.00	2025-01-31
33231	CPT	Ins Aicd W/multi Lds	7	3	$58,991.00	$44,243.25 25% off	$93.00	$54,456.00	$22,828.00	2025-01-31
33264	CPT	Rem/repl Aicd Mult Ld	7	3	$104,144.00	$78,108.00 25% off	$93.00	$54,456.00	$22,828.00	2025-01-31
33272	CPT	Rmv Sq Defib Elec	7	3	$7,755.00	$5,816.25 25% off	$93.00	$54,456.00	$22,828.00	2025-01-31
33263	CPT	Rem/repl Aicd Dual Ld	7	3	$42,287.00	$31,715.25 25% off	$93.00	$54,456.00	$22,828.00	2025-01-31
33230	CPT	Ins Aicd W/dual Lds	7	3	$58,991.00	$44,243.25 25% off	$93.00	$54,456.00	$22,828.00	2025-01-31
33270	CPT	Insrt/rpl Sq Defib W/ele	7	3	$76,561.00	$57,420.75 25% off	$93.00	$54,456.00	$22,828.00	2025-01-31
C9760	CPT	Non-randomized, Non-blinded Procedure For Nyha Class Ii, Iii, IV Heart Failure; …	53	24	—	—	$13,558.00	$32,035.00	$22,796.50	2025-01-31
C9605	CPT	Percutaneous Transluminal Revascularization Of Or Through Coronary Artery Bypass…	53	24	—	—	$13,308.00	$31,748.00	$22,528.00	2025-01-31
C9608	CPT	Percutaneous Transluminal Revascularization Of Chronic Total Occlusion, Coronary…	53	24	—	—	$13,308.00	$31,748.00	$22,528.00	2025-01-31
C9603	CPT	Percutaneous Transluminal Coronary Atherectomy, With Drug-eluting Intracoronary …	53	24	—	—	$13,308.00	$31,748.00	$22,528.00	2025-01-31
J9600	CPT	Injection, Porfimer Sodium, 75 Mg	7	3	—	—	$93.00	$33,812.54	$22,490.02	2025-01-31
93624	CPT	Ep Drug Follow-up Study	53	24	$23,744.00	$17,808.00 25% off	$13,036.00	$31,099.00	$22,067.50	2025-01-31
M1087	CPT	Ro - Colorectal Cancer	5	2	$0.01	—	$12,321.00	$29,395.00	$20,858.00	2025-01-31
M1103	CPT	Ro - Upper Gi Cancer	5	2	$0.01	—	$12,321.00	$29,395.00	$20,858.00	2025-01-31
M1075	CPT	Ro - Bladder Cancer	5	2	$0.01	—	$12,321.00	$29,395.00	$20,858.00	2025-01-31
M1079	CPT	Ro - Brain Metastases	5	2	$0.01	—	$12,321.00	$29,395.00	$20,858.00	2025-01-31
M1085	CPT	Ro - Cervical Cancer	5	2	$0.01	—	$12,321.00	$29,395.00	$20,858.00	2025-01-31
0333	RC	Radiology Therapeutic And/of Chemotherapy Administration Radiation Therapy	5	2	—	—	$12,321.00	$29,395.00	$20,858.00	2025-01-31
M1095	CPT	Ro - Lung Cancer	5	2	$0.01	—	$12,321.00	$29,395.00	$20,858.00	2025-01-31
M1105	CPT	Ro - Uterine Cancer	5	2	$0.01	—	$12,321.00	$29,395.00	$20,858.00	2025-01-31
M1099	CPT	Ro - Pancreatic Cancer	5	2	$0.01	—	$12,321.00	$29,395.00	$20,858.00	2025-01-31
M1081	CPT	Ro - Breast Cancer	5	2	$0.01	—	$12,321.00	$29,395.00	$20,858.00	2025-01-31
M1073	CPT	Ro - Anal Cancer	5	2	$0.01	—	$12,321.00	$29,395.00	$20,858.00	2025-01-31
M1083	CPT	Ro - Cns Tumor	5	2	$0.01	—	$12,321.00	$29,395.00	$20,858.00	2025-01-31
M1101	CPT	Ro - Prostate Cancer	5	2	$0.01	—	$12,321.00	$29,395.00	$20,858.00	2025-01-31
M1077	CPT	Ro - Bone Metastases	5	2	$0.01	—	$12,321.00	$29,395.00	$20,858.00	2025-01-31
M1097	CPT	Ro - Lymphoma	5	2	$0.01	—	$12,321.00	$29,395.00	$20,858.00	2025-01-31
M1089	CPT	Ro - Head And Neck Cancer	5	2	$0.01	—	$12,321.00	$29,395.00	$20,858.00	2025-01-31
92934	CPT	Removal Of Plaque And Insertion Of Stent In Major Coronary Artery Or Branch, Acc…	5	2	—	—	$621.54	$31,099.00	$19,700.00	2025-01-31
92944	CPT	Insertion Of Stent, Removal Of Plaque And/or Balloon Dilation Of Coronary Vessel…	5	2	—	—	$622.83	$31,099.00	$19,700.00	2025-01-31
C9602	CPT	Perc Cor Ath D-e Stnt	53	24	$29,346.00	$22,009.50 25% off	$6,674.00	$31,748.00	$19,211.00	2025-01-31
C9607	CPT	Per Cor Revas Chronc Sng	53	24	$27,174.00	$20,380.50 25% off	$6,674.00	$31,748.00	$19,211.00	2025-01-31
C9606	CPT	Per Cor Revas D-e W/ami	53	24	$57,008.00	$42,756.00 25% off	$6,674.00	$31,748.00	$19,211.00	2025-01-31
C9601	CPT	Perc Drug-elut Stnt Addl	53	24	$29,346.00	$22,009.50 25% off	$6,674.00	$31,748.00	$19,211.00	2025-01-31
C9604	CPT	Perc Cor Revasc D-e Cabg	53	24	$29,346.00	$22,009.50 25% off	$6,674.00	$31,748.00	$19,211.00	2025-01-31
C9600	CPT	Perc Cor Drug-elut Stnt	53	24	$29,346.00	$22,009.50 25% off	$6,674.00	$31,748.00	$19,211.00	2025-01-31
0DU60JZ	OTHER	Supplement Stomach With Synthetic Substitute, Open Approach	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0DQ64ZZ	OTHER	Repair Stomach, Percutaneous Endoscopic Approach	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0D164ZL	OTHER	Bypass Stomach To Transverse Colon, Percutaneous Endoscopic Approach	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0DH60DZ	OTHER	Insertion Of Intraluminal Device Into Stomach, Open Approach	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0D160ZB	OTHER	Bypass Stomach To Ileum, Open Approach	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0DB67Z3	OTHER	Excision Of Stomach, Via Natural Or Artificial Opening, Vertical	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0DY60Z0	OTHER	Transplantation Of Stomach, Allogeneic, Open Approach	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0D1687L	OTHER	Bypass Stomach To Transverse Colon With Autologous Tissue Substitute, Via Natura…	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0DL74ZZ	OTHER	Occlusion Of Stomach, Pylorus, Percutaneous Endoscopic Approach	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0D168KL	OTHER	Bypass Stomach To Transverse Colon With Nonautologous Tissue Substitute, Via Nat…	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0DF67ZZ	OTHER	Fragmentation In Stomach, Via Natural Or Artificial Opening	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0DU687Z	OTHER	Supplement Stomach With Autologous Tissue Substitute, Via Natural Or Artificial …	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0D164JB	OTHER	Bypass Stomach To Ileum With Synthetic Substitute, Percutaneous Endoscopic Appro…	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0DV68ZZ	OTHER	Restriction Of Stomach, Via Natural Or Artificial Opening Endoscopic	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0DL64CZ	OTHER	Occlusion Of Stomach With Extraluminal Device, Percutaneous Endoscopic Approach	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0DY60Z2	OTHER	Transplantation Of Stomach, Zooplastic, Open Approach	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0D164KL	OTHER	Bypass Stomach To Transverse Colon With Nonautologous Tissue Substitute, Percuta…	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0DL73ZZ	OTHER	Occlusion Of Stomach, Pylorus, Percutaneous Approach	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0DN68ZZ	OTHER	Release Stomach, Via Natural Or Artificial Opening Endoscopic	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0DL74CZ	OTHER	Occlusion Of Stomach, Pylorus With Extraluminal Device, Percutaneous Endoscopic …	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0DF68ZZ	OTHER	Fragmentation In Stomach, Via Natural Or Artificial Opening Endoscopic	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0D164ZA	OTHER	Bypass Stomach To Jejunum, Percutaneous Endoscopic Approach	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0DL70DZ	OTHER	Occlusion Of Stomach, Pylorus With Intraluminal Device, Open Approach	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0D1607B	OTHER	Bypass Stomach To Ileum With Autologous Tissue Substitute, Open Approach	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0DF64ZZ	OTHER	Fragmentation In Stomach, Percutaneous Endoscopic Approach	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0D160Z9	OTHER	Bypass Stomach To Duodenum, Open Approach	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0DL68DZ	OTHER	Occlusion Of Stomach With Intraluminal Device, Via Natural Or Artificial Opening…	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0D164ZB	OTHER	Bypass Stomach To Ileum, Percutaneous Endoscopic Approach	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0DU60KZ	OTHER	Supplement Stomach With Nonautologous Tissue Substitute, Open Approach	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0D164Z9	OTHER	Bypass Stomach To Duodenum, Percutaneous Endoscopic Approach	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0D164KB	OTHER	Bypass Stomach To Ileum With Nonautologous Tissue Substitute, Percutaneous Endos…	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0DV64CZ	OTHER	Restriction Of Stomach With Extraluminal Device, Percutaneous Endoscopic Approac…	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0DL73CZ	OTHER	Occlusion Of Stomach, Pylorus With Extraluminal Device, Percutaneous Approach	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0DV64DZ	OTHER	Restriction Of Stomach With Intraluminal Device, Percutaneous Endoscopic Approac…	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0DB60Z3	OTHER	Excision Of Stomach, Open Approach, Vertical	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0DU68KZ	OTHER	Supplement Stomach With Nonautologous Tissue Substitute, Via Natural Or Artifici…	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0D160J9	OTHER	Bypass Stomach To Duodenum With Synthetic Substitute, Open Approach	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0DB63Z3	OTHER	Excision Of Stomach, Percutaneous Approach, Vertical	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0DP643Z	OTHER	Removal Of Infusion Device From Stomach, Percutaneous Endoscopic Approach	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0D760ZZ	OTHER	Dilation Of Stomach, Open Approach	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0DV60ZZ	OTHER	Restriction Of Stomach, Open Approach	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0D168JB	OTHER	Bypass Stomach To Ileum With Synthetic Substitute, Via Natural Or Artificial Ope…	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0DV60CZ	OTHER	Restriction Of Stomach With Extraluminal Device, Open Approach	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0DL67DZ	OTHER	Occlusion Of Stomach With Intraluminal Device, Via Natural Or Artificial Opening	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0DL74DZ	OTHER	Occlusion Of Stomach, Pylorus With Intraluminal Device, Percutaneous Endoscopic …	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0DN64ZZ	OTHER	Release Stomach, Percutaneous Endoscopic Approach	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0D768DZ	OTHER	Dilation Of Stomach With Intraluminal Device, Via Natural Or Artificial Opening …	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0DL64ZZ	OTHER	Occlusion Of Stomach, Percutaneous Endoscopic Approach	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0DL64DZ	OTHER	Occlusion Of Stomach With Intraluminal Device, Percutaneous Endoscopic Approach	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0D164KA	OTHER	Bypass Stomach To Jejunum With Nonautologous Tissue Substitute, Percutaneous End…	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0DP64CZ	OTHER	Removal Of Extraluminal Device From Stomach, Percutaneous Endoscopic Approach	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0DQ60ZZ	OTHER	Repair Stomach, Open Approach	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0D160ZA	OTHER	Bypass Stomach To Jejunum, Open Approach	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0DU607Z	OTHER	Supplement Stomach With Autologous Tissue Substitute, Open Approach	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0DL78DZ	OTHER	Occlusion Of Stomach, Pylorus With Intraluminal Device, Via Natural Or Artificia…	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0DB60ZZ	OTHER	Excision Of Stomach, Open Approach	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0DY60Z1	OTHER	Transplantation Of Stomach, Syngeneic, Open Approach	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0D764DZ	OTHER	Dilation Of Stomach With Intraluminal Device, Percutaneous Endoscopic Approach	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0DU64JZ	OTHER	Supplement Stomach With Synthetic Substitute, Percutaneous Endoscopic Approach	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0DV63DZ	OTHER	Restriction Of Stomach With Intraluminal Device, Percutaneous Approach	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0D168KB	OTHER	Bypass Stomach To Ileum With Nonautologous Tissue Substitute, Via Natural Or Art…	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0DB67ZZ	OTHER	Excision Of Stomach, Via Natural Or Artificial Opening	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0DU67JZ	OTHER	Supplement Stomach With Synthetic Substitute, Via Natural Or Artificial Opening	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0DQ68ZZ	OTHER	Repair Stomach, Via Natural Or Artificial Opening Endoscopic	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0DU67KZ	OTHER	Supplement Stomach With Nonautologous Tissue Substitute, Via Natural Or Artifici…	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0D164JL	OTHER	Bypass Stomach To Transverse Colon With Synthetic Substitute, Percutaneous Endos…	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0DL63CZ	OTHER	Occlusion Of Stomach With Extraluminal Device, Percutaneous Approach	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0DN63ZZ	OTHER	Release Stomach, Percutaneous Approach	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0DF60ZZ	OTHER	Fragmentation In Stomach, Open Approach	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0D767ZZ	OTHER	Dilation Of Stomach, Via Natural Or Artificial Opening	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0DH67DZ	OTHER	Insertion Of Intraluminal Device Into Stomach, Via Natural Or Artificial Opening	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0DH68DZ	OTHER	Insertion Of Intraluminal Device Into Stomach, Via Natural Or Artificial Opening…	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0DV64ZZ	OTHER	Restriction Of Stomach, Percutaneous Endoscopic Approach	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0D764ZZ	OTHER	Dilation Of Stomach, Percutaneous Endoscopic Approach	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0D1687A	OTHER	Bypass Stomach To Jejunum With Autologous Tissue Substitute, Via Natural Or Arti…	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0DL60CZ	OTHER	Occlusion Of Stomach With Extraluminal Device, Open Approach	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0D16879	OTHER	Bypass Stomach To Duodenum With Autologous Tissue Substitute, Via Natural Or Art…	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0D1647B	OTHER	Bypass Stomach To Ileum With Autologous Tissue Substitute, Percutaneous Endoscop…	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0D1647A	OTHER	Bypass Stomach To Jejunum With Autologous Tissue Substitute, Percutaneous Endosc…	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0DQ67ZZ	OTHER	Repair Stomach, Via Natural Or Artificial Opening	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0DU677Z	OTHER	Supplement Stomach With Autologous Tissue Substitute, Via Natural Or Artificial …	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0D1607A	OTHER	Bypass Stomach To Jejunum With Autologous Tissue Substitute, Open Approach	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0DL67ZZ	OTHER	Occlusion Of Stomach, Via Natural Or Artificial Opening	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0DB68Z3	OTHER	Excision Of Stomach, Via Natural Or Artificial Opening Endoscopic, Vertical	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0D768ZZ	OTHER	Dilation Of Stomach, Via Natural Or Artificial Opening Endoscopic	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0D168ZB	OTHER	Bypass Stomach To Ileum, Via Natural Or Artificial Opening Endoscopic	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0D1647L	OTHER	Bypass Stomach To Transverse Colon With Autologous Tissue Substitute, Percutaneo…	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0D16079	OTHER	Bypass Stomach To Duodenum With Autologous Tissue Substitute, Open Approach	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0D168ZA	OTHER	Bypass Stomach To Jejunum, Via Natural Or Artificial Opening Endoscopic	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0DU647Z	OTHER	Supplement Stomach With Autologous Tissue Substitute, Percutaneous Endoscopic Ap…	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0D168ZL	OTHER	Bypass Stomach To Transverse Colon, Via Natural Or Artificial Opening Endoscopic	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0D1687B	OTHER	Bypass Stomach To Ileum With Autologous Tissue Substitute, Via Natural Or Artifi…	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0DF63ZZ	OTHER	Fragmentation In Stomach, Percutaneous Approach	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0DW643Z	OTHER	Revision Of Infusion Device In Stomach, Percutaneous Endoscopic Approach	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0DM64ZZ	OTHER	Reattachment Of Stomach, Percutaneous Endoscopic Approach	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0DB64Z3	OTHER	Excision Of Stomach, Percutaneous Endoscopic Approach, Vertical	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0D1607L	OTHER	Bypass Stomach To Transverse Colon With Autologous Tissue Substitute, Open Appro…	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0D168Z9	OTHER	Bypass Stomach To Duodenum, Via Natural Or Artificial Opening Endoscopic	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0DL63ZZ	OTHER	Occlusion Of Stomach, Percutaneous Approach	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0D160ZL	OTHER	Bypass Stomach To Transverse Colon, Open Approach	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0DU68JZ	OTHER	Supplement Stomach With Synthetic Substitute, Via Natural Or Artificial Opening …	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0DL60DZ	OTHER	Occlusion Of Stomach With Intraluminal Device, Open Approach	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0DU64KZ	OTHER	Supplement Stomach With Nonautologous Tissue Substitute, Percutaneous Endoscopic…	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0DL77ZZ	OTHER	Occlusion Of Stomach, Pylorus, Via Natural Or Artificial Opening	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0D168JA	OTHER	Bypass Stomach To Jejunum With Synthetic Substitute, Via Natural Or Artificial O…	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0DW64CZ	OTHER	Revision Of Extraluminal Device In Stomach, Percutaneous Endoscopic Approach	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0DL70ZZ	OTHER	Occlusion Of Stomach, Pylorus, Open Approach	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0D164K9	OTHER	Bypass Stomach To Duodenum With Nonautologous Tissue Substitute, Percutaneous En…	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0DV63CZ	OTHER	Restriction Of Stomach With Extraluminal Device, Percutaneous Approach	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0DV67ZZ	OTHER	Restriction Of Stomach, Via Natural Or Artificial Opening	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0D160KB	OTHER	Bypass Stomach To Ileum With Nonautologous Tissue Substitute, Open Approach	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0DH63DZ	OTHER	Insertion Of Intraluminal Device Into Stomach, Percutaneous Approach	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0DH64DZ	OTHER	Insertion Of Intraluminal Device Into Stomach, Percutaneous Endoscopic Approach	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0DB63ZZ	OTHER	Excision Of Stomach, Percutaneous Approach	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0DN67ZZ	OTHER	Release Stomach, Via Natural Or Artificial Opening	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0D760DZ	OTHER	Dilation Of Stomach With Intraluminal Device, Open Approach	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0DL60ZZ	OTHER	Occlusion Of Stomach, Open Approach	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0D160KA	OTHER	Bypass Stomach To Jejunum With Nonautologous Tissue Substitute, Open Approach	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0D160JL	OTHER	Bypass Stomach To Transverse Colon With Synthetic Substitute, Open Approach	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0DL77DZ	OTHER	Occlusion Of Stomach, Pylorus With Intraluminal Device, Via Natural Or Artificia…	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0D168KA	OTHER	Bypass Stomach To Jejunum With Nonautologous Tissue Substitute, Via Natural Or A…	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0D763ZZ	OTHER	Dilation Of Stomach, Percutaneous Approach	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0D168JL	OTHER	Bypass Stomach To Transverse Colon With Synthetic Substitute, Via Natural Or Art…	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0D168K9	OTHER	Bypass Stomach To Duodenum With Nonautologous Tissue Substitute, Via Natural Or …	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0D160JB	OTHER	Bypass Stomach To Ileum With Synthetic Substitute, Open Approach	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0D763DZ	OTHER	Dilation Of Stomach With Intraluminal Device, Percutaneous Approach	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0DL63DZ	OTHER	Occlusion Of Stomach With Intraluminal Device, Percutaneous Approach	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0DV63ZZ	OTHER	Restriction Of Stomach, Percutaneous Approach	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0D160K9	OTHER	Bypass Stomach To Duodenum With Nonautologous Tissue Substitute, Open Approach	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0D164JA	OTHER	Bypass Stomach To Jejunum With Synthetic Substitute, Percutaneous Endoscopic App…	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0D160JA	OTHER	Bypass Stomach To Jejunum With Synthetic Substitute, Open Approach	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0D16479	OTHER	Bypass Stomach To Duodenum With Autologous Tissue Substitute, Percutaneous Endos…	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0D164J9	OTHER	Bypass Stomach To Duodenum With Synthetic Substitute, Percutaneous Endoscopic Ap…	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0DM60ZZ	OTHER	Reattachment Of Stomach, Open Approach	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0DL70CZ	OTHER	Occlusion Of Stomach, Pylorus With Extraluminal Device, Open Approach	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0DL68ZZ	OTHER	Occlusion Of Stomach, Via Natural Or Artificial Opening Endoscopic	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0D160KL	OTHER	Bypass Stomach To Transverse Colon With Nonautologous Tissue Substitute, Open Ap…	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0DV60DZ	OTHER	Restriction Of Stomach With Intraluminal Device, Open Approach	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0DL78ZZ	OTHER	Occlusion Of Stomach, Pylorus, Via Natural Or Artificial Opening Endoscopic	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0DN60ZZ	OTHER	Release Stomach, Open Approach	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0D767DZ	OTHER	Dilation Of Stomach With Intraluminal Device, Via Natural Or Artificial Opening	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0D168J9	OTHER	Bypass Stomach To Duodenum With Synthetic Substitute, Via Natural Or Artificial …	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0DL73DZ	OTHER	Occlusion Of Stomach, Pylorus With Intraluminal Device, Percutaneous Approach	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
0DQ63ZZ	OTHER	Repair Stomach, Percutaneous Approach	1	1	—	—	$18,858.00	$18,858.00	$18,858.00	2025-01-31
C9782	CPT	Blinded Procedure For New York Heart Association (nyha) Class Ii Or Iii Heart Fa…	53	24	—	—	$10,848.00	$25,629.00	$18,238.50	2025-01-31
33274	CPT	Transcath Ins/rpl Perm Ldls Pm	53	24	$47,179.00	$35,384.25 25% off	$10,848.00	$25,629.00	$18,238.50	2025-01-31
92925	CPT	Removal Of Plaque Of Major Coronary Artery Or Branch, Accessed Through The Skin,…	5	2	—	—	$594.39	$28,603.00	$18,120.00	2025-01-31
A9604	CPT	Samarium Sm-153 Lexidronam, Therapeutic, Per Treatment Dose, Up To 150 Millicuri…	6	2	—	—	$93.00	$17,259.85	$17,259.85	2025-01-31
0408T	CPT	Insertion Or Replacement Of Pulse Generator And Electrodes Of Heart Contractilit…	6	2	—	—	$93.00	$32,035.00	$17,023.50	2025-01-31
0424T	CPT	Insertion Or Replacement Of Complete Neurostimulator System For Treatment Of Cen…	6	2	—	—	$93.00	$32,035.00	$17,023.50	2025-01-31
0614T	CPT	Removal And Replacement Of Substernal Implantable Defibrillator Pulse Generator	6	2	—	—	$93.00	$32,035.00	$17,023.50	2025-01-31
0571T	CPT	Insertion Or Replacement Of Implantable Cardioverter-defibrillator System With E…	6	2	—	—	$93.00	$32,035.00	$17,023.50	2025-01-31
0409T	CPT	Insertion Or Replacement Of Pulse Generator Of Heart Contractility Modulator Sys…	6	2	—	—	$93.00	$32,035.00	$17,023.50	2025-01-31
0414T	CPT	Replacement Of Pulse Generator Of Heart Contractility Modulator System	6	2	—	—	$93.00	$32,035.00	$17,023.50	2025-01-31
L7181	CPT	Electronic Elbow, Microprocessor Simultaneous Control Of Elbow And Terminal Devi…	2	1	—	—	$93.00	$33,437.89	$16,765.44	2025-01-31
0520T	CPT	Removal And Replacement Of Pulse Generator Components Of Wireless Heart Stimulat…	8	3	—	—	$93.00	$32,035.00	$16,677.40	2025-01-31
0515T	CPT	Insertion Of Complete Wireless Heart Stimulator System For Pacing Of Lower Left …	8	3	—	—	$93.00	$32,035.00	$16,677.40	2025-01-31
L7180	CPT	Electronic Elbow, Microprocessor Sequential Control Of Elbow And Terminal Device	2	1	—	—	$93.00	$32,476.78	$16,284.89	2025-01-31
93612	CPT	Intraventricular Pacing	7	3	$14,429.00	$10,821.75 25% off	$62.23	$31,099.00	$15,255.74	2025-01-31
93602	CPT	Intra-arterial Recording	7	3	$10,863.00	$8,147.25 25% off	$43.97	$31,099.00	$15,255.74	2025-01-31
93600	CPT	His Bundle Recording	7	3	$12,598.00	$9,448.50 25% off	$75.24	$31,099.00	$15,255.74	2025-01-31
C9758	CPT	Blinded Procedure For Nyha Class Iii/iv Heart Failure; Transcatheter Implantatio…	53	24	—	—	$3,875.16	$25,629.00	$14,752.08	2025-01-31
93619	CPT	Comp Ep Without Induc/arryth	8	4	$15,038.00	$11,278.50 25% off	$93.00	$31,099.00	$14,145.87	2025-01-31
93620	CPT	Ep Comp Study W/inductn	8	4	$15,038.00	$11,278.50 25% off	$93.00	$31,099.00	$14,145.87	2025-01-31
37227	CPT	Revasc Fempop Stnt Ather	7	3	$35,362.00	$26,521.50 25% off	$93.00	$25,629.00	$14,095.58	2025-01-31
33206	CPT	Ins/rpl Pm W/trnsv Ld At	7	3	$36,342.00	$27,256.50 25% off	$93.00	$32,720.00	$13,716.00	2025-01-31
33221	CPT	Insrt Pulse Gen Mult Lds	7	3	$41,660.00	$31,245.00 25% off	$93.00	$32,720.00	$13,716.00	2025-01-31
33227	CPT	Rem/repl Pm Gen Sgl Ld	7	3	$34,741.00	$26,055.75 25% off	$93.00	$32,720.00	$13,716.00	2025-01-31
33208	CPT	Ins/rpl Pmw/trnsv Ld A-v	7	3	$39,700.00	$29,775.00 25% off	$93.00	$32,720.00	$13,716.00	2025-01-31
33207	CPT	Ins/rpl Pm W/trnsv Ld Ve	7	3	$37,634.00	$28,225.50 25% off	$93.00	$32,720.00	$13,716.00	2025-01-31
0431T	CPT	Replacement Of Pulse Generator Of Neurostimulator System For Treatment Of Centra…	6	2	—	—	$93.00	$25,629.00	$13,620.50	2025-01-31
0427T	CPT	Insertion Or Replacement Of Pulse Generator Of Neurostimulator System For Treatm…	6	2	—	—	$93.00	$25,629.00	$13,620.50	2025-01-31
0266T	CPT	Insertion Or Replacement Of Carotid Sinus Baroreflex Activation Device	6	2	—	—	$93.00	$25,629.00	$13,620.50	2025-01-31
0308T	CPT	Insertion Of Prosthetic Telescope In Eye For The Treatment Of Central Vision	8	3	—	—	$93.00	$29,430.17	$13,620.50	2025-01-31
C2616	CPT	Brachytherapy Source, Non-stranded, Yttrium-90, Per Source	49	24	—	—	$6,963.77	$20,217.41	$13,590.59	2025-01-31
33289	CPT	Tcat Impl Wrls P-art Prs Snr	7	3	$81,037.00	$60,777.75 25% off	$93.00	$32,035.00	$13,558.00	2025-01-31
L2006	CPT	Knee Ankle Foot Device, Any Material, Single Or Double Upright, Swing And Stance…	2	1	—	—	$93.00	$26,949.13	$13,521.07	2025-01-31
0803T	CPT	Transcatheter Removal And Replacement Of Permanent Dual-chamber Leadless Pacemak…	53	24	—	—	$7,904.00	$18,672.00	$13,288.00	2025-01-31
C9792	CPT	Blinded Or Nonblinded Procedure For Symptomatic New York Heart Association (nyha…	53	24	—	—	$7,904.00	$18,672.00	$13,288.00	2025-01-31
C9783	CPT	Blinded Procedure For Transcatheter Implantation Of Coronary Sinus Reduction Dev…	53	24	—	—	$7,904.00	$18,672.00	$13,288.00	2025-01-31
0797T	CPT	Transcatheter Insertion Of Permanent Dual-chamber Leadless Pacemaker, Including …	53	24	—	—	$7,904.00	$18,672.00	$13,288.00	2025-01-31
C9780	CPT	Insertion Of Central Venous Catheter Through Central Venous Occlusion Via Inferi…	53	24	—	—	$7,904.00	$18,672.00	$13,288.00	2025-01-31
0793T	CPT	Percutaneous Transcatheter Thermal Ablation Of Nerves Innervating The Pulmonary …	53	24	—	—	$7,904.00	$18,672.00	$13,288.00	2025-01-31
C9767	CPT	Revascularization, Endovascular, Open Or Percutaneous, Lower Extremity Artery(ie…	53	24	—	—	$7,904.00	$18,672.00	$13,288.00	2025-01-31
37238	CPT	Open/perc Pl St 1st Vn	53	24	$29,289.00	$21,966.75 25% off	$7,904.00	$18,672.00	$13,288.00	2025-01-31
C9765	CPT	Revascularization, Endovascular, Open Or Percutaneous, Lower Extremity Artery(ie…	53	24	—	—	$7,904.00	$18,672.00	$13,288.00	2025-01-31
C9766	CPT	Revascularization, Endovascular, Open Or Percutaneous, Lower Extremity Artery(ie…	53	24	—	—	$7,904.00	$18,672.00	$13,288.00	2025-01-31
37229	CPT	Revasc Tibper W/ather	53	24	$52,833.00	$39,624.75 25% off	$7,904.00	$18,672.00	$13,288.00	2025-01-31
0632T	CPT	Destruction Of Nerves To Main Arteries Of Lung, Accessed Through Skin Via Cathet…	53	24	—	—	$7,904.00	$18,672.00	$13,288.00	2025-01-31
37221	CPT	Revasc Iliac W/stent	53	24	$17,414.00	$13,060.50 25% off	$7,904.00	$18,672.00	$13,288.00	2025-01-31
37225	CPT	Revasc Fempop W/ather	53	24	$27,051.00	$20,288.25 25% off	$7,904.00	$18,672.00	$13,288.00	2025-01-31
0645T	CPT	Implantation Of Coronary Sinus Reduction Device In Heart Through Catheter	53	24	—	—	$7,904.00	$18,672.00	$13,288.00	2025-01-31
37231	CPT	Removal Of Plaque And Insertion Of Stents Into Artery In One Leg, Endovascular, …	9	4	—	—	$93.00	$25,629.00	$13,127.05	2025-01-31
92928	CPT	Cor Stnt Angio Init	7	3	$19,812.00	$14,859.00 25% off	$93.00	$31,099.00	$13,036.00	2025-01-31
92929	CPT	Cor Stnt Angio Add	7	3	$19,812.00	$14,859.00 25% off	$93.00	$31,099.00	$13,036.00	2025-01-31
92938	CPT	Insertion Of Stent, Removal Of Plaque And/or Balloon Dilation Of Coronary Vessel…	7	3	—	—	$66.58	$31,099.00	$13,036.00	2025-01-31
93618	CPT	Inductn Arrhythmia By Ep	7	3	$10,501.00	$7,875.75 25% off	$93.00	$31,099.00	$13,036.00	2025-01-31
93622	CPT	Comp Ep Eval/lv Record	7	3	$17,213.00	$12,909.75 25% off	$54.85	$31,099.00	$13,036.00	2025-01-31
93610	CPT	Insertion Of Temporary Pacemaker Electrode For Diagnostic Upper Heart Pacing	9	4	—	—	$25.74	$31,099.00	$13,036.00	2025-01-31
60699	CPT	Other Procedure On Endocrine System	53	24	—	—	$7,743.00	$18,294.00	$13,018.50	2025-01-31
33216	CPT	Insrt Tran Elctrd Sngl	53	24	$22,570.00	$16,927.50 25% off	$7,743.00	$18,294.00	$13,018.50	2025-01-31
C9784	CPT	Gastric Restrictive Procedure, Endoscopic Sleeve Gastroplasty, With Esophagogast…	53	24	—	—	$7,743.00	$18,294.00	$13,018.50	2025-01-31
C9785	CPT	Endoscopic Outlet Reduction, Gastric Pouch Application, With Endoscopy And Intra…	53	24	—	—	$7,743.00	$18,294.00	$13,018.50	2025-01-31
22869	CPT	Insrt Stablize Devce Lumb Sngl	53	24	$37,648.00	$28,236.00 25% off	$7,743.00	$18,294.00	$13,018.50	2025-01-31
37234	CPT	Revasc Tibper Wstentadd	53	24	$18,858.00	$14,143.50 25% off	$7,743.00	$18,294.00	$13,018.50	2025-01-31
37228	CPT	Revasc Tibper W/tla	53	24	$31,868.00	$23,901.00 25% off	$7,743.00	$18,294.00	$13,018.50	2025-01-31
0275T	CPT	Perc Laminectomy Lumbar	53	24	$32,938.00	$24,703.50 25% off	$7,743.00	$18,294.00	$13,018.50	2025-01-31
20983	CPT	Perc Cryo Ablate Bone	53	24	$26,831.00	$20,123.25 25% off	$7,743.00	$18,294.00	$13,018.50	2025-01-31
37223	CPT	Iliac Stent/add	53	24	$29,279.00	$21,959.25 25% off	$7,743.00	$18,294.00	$13,018.50	2025-01-31
37224	CPT	Revasc Fempop W/tla	53	24	$18,858.00	$14,143.50 25% off	$7,743.00	$18,294.00	$13,018.50	2025-01-31
C9781	CPT	Arthroscopy, Shoulder, Surgical; With Implantation Of Subacromial Spacer (e.g., …	53	24	—	—	$7,743.00	$18,294.00	$13,018.50	2025-01-31
37220	CPT	Revasc Iliac Initial	53	24	$24,729.00	$18,546.75 25% off	$7,743.00	$18,294.00	$13,018.50	2025-01-31
37184	CPT	Thromb Noncor Initl Vsl	53	24	$21,884.00	$16,413.00 25% off	$7,743.00	$18,294.00	$13,018.50	2025-01-31
37244	CPT	Vasc Emb/occ Bleed	53	24	$27,402.00	$20,551.50 25% off	$6,674.00	$18,672.00	$12,673.00	2025-01-31
37211	CPT	Tcath Tx Init Noncor Art	53	24	$11,127.00	$8,345.25 25% off	$6,674.00	$18,294.00	$12,484.00	2025-01-31
36902	CPT	Dial-circ Bal-plasty+s&i	53	24	$27,529.00	$20,646.75 25% off	$6,674.00	$18,294.00	$12,484.00	2025-01-31
C9764	CPT	Revasc Intrvasc Litho	53	24	$23,994.00	$17,995.50 25% off	$6,674.00	$18,294.00	$12,484.00	2025-01-31
81416	CPT	Test For Detecting Exome, Sequence Analysis, Each Comparator Exome	8	4	—	—	$93.00	$16,296.00	$12,000.00	2025-01-31
92920	CPT	Cor Angplsty Init	7	3	$18,658.00	$13,993.50 25% off	$93.00	$28,603.00	$11,990.00	2025-01-31
92921	CPT	Cor Angplsty Add	7	3	$18,658.00	$13,993.50 25% off	$93.00	$28,603.00	$11,990.00	2025-01-31
36837	CPT	Percutaneous Arteriovenous Fistula Creation, Upper Extremity, Separate Access Si…	9	4	—	—	$93.00	$18,672.00	$11,945.00	2025-01-31
Q0483	CPT	Monitor/display Module For Use With Electric Ventricular Assist Device, Replacem…	4	2	—	—	$93.00	$23,338.48	$11,842.88	2025-01-31
0620T	CPT	Insertion Of Stent To Shunt Arterial Blood To Deep Vein Of Lower Leg Via Cathete…	53	24	—	—	$4,979.84	$18,672.00	$11,825.92	2025-01-31
C9775	CPT	Revascularization, Endovascular, Open Or Percutaneous, Tibial/peroneal Artery(ie…	53	24	—	—	$4,979.84	$18,672.00	$11,825.92	2025-01-31
C9773	CPT	Revascularization, Endovascular, Open Or Percutaneous, Tibial/peroneal Artery(ie…	53	24	—	—	$4,979.84	$18,672.00	$11,825.92	2025-01-31
C9774	CPT	Revascularization, Endovascular, Open Or Percutaneous, Tibial/peroneal Artery(ie…	53	24	—	—	$4,979.84	$18,672.00	$11,825.92	2025-01-31
0268T	CPT	Implantation Or Replacement Of Carotid Sinus Baroreflex Activation Device Pulse …	8	3	—	—	$93.00	$25,629.00	$11,505.11	2025-01-31
37230	CPT	Insertion Of Stents Into Artery In One Leg, Endovascular, Accessed Through The S…	9	4	—	—	$93.00	$18,672.00	$11,408.89	2025-01-31
59898	CPT	Other Maternity Care And Delivery Procedure Using An Endoscope	53	24	—	—	$6,775.00	$16,008.00	$11,391.50	2025-01-31
60659	CPT	Other Procedure On Endocrine System Using An Endoscope	53	24	—	—	$6,775.00	$16,008.00	$11,391.50	2025-01-31
47579	CPT	Other Procedure On Bile Duct Using An Endoscope	53	24	—	—	$6,775.00	$16,008.00	$11,391.50	2025-01-31
69710	CPT	Implantation Or Replacement Of Temporal Bone Conduction Hearing Device	53	24	—	—	$6,775.00	$16,008.00	$11,391.50	2025-01-31
45499	CPT	Other Procedure On Rectum Using An Endoscope	53	24	—	—	$6,775.00	$16,008.00	$11,391.50	2025-01-31
38589	CPT	Other Procedure On Lymphatic System Using An Endoscope	53	24	—	—	$6,775.00	$16,008.00	$11,391.50	2025-01-31
54699	CPT	Other Procedure On Testicle Using An Endoscope	53	24	—	—	$6,775.00	$16,008.00	$11,391.50	2025-01-31
38129	CPT	Other Procedure On Spleen Using An Endoscope	53	24	—	—	$6,775.00	$16,008.00	$11,391.50	2025-01-31
55559	CPT	Other Procedure On Sperm Cord Using An Endoscope	53	24	—	—	$6,775.00	$16,008.00	$11,391.50	2025-01-31
S1034	CPT	Artificial Pancreas Device System (e.g., Low Glucose Suspend (lgs) Feature) Incl…	49	24	—	—	$11,329.50	$11,329.50	$11,329.50	2025-01-31
53451	CPT	Insertion Of Adjustable Balloon Continence Device On Both Sides Of Urethra Using…	53	24	—	—	$3,636.29	$18,672.00	$11,154.15	2025-01-31

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