|
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
|
$4,524,496.00
|
$2,705,294.50
|
2025-01-31
|
|
Q2056
|
CPT
|
Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige…
|
7
|
3
|
—
|
—
|
$93.00
|
$988,128.75
|
$492,900.00
|
2025-01-31
|
|
Q2042
|
CPT
|
Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka…
|
7
|
3
|
—
|
—
|
$93.00
|
$974,249.94
|
$466,069.91
|
2025-01-31
|
|
Q2055
|
CPT
|
Idecabtagene Vicleucel, Up To 460 Million Autologous B-cell Maturation Antigen (…
|
7
|
3
|
—
|
—
|
$93.00
|
$917,688.81
|
$460,226.56
|
2025-01-31
|
|
Q2054
|
CPT
|
Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi…
|
7
|
3
|
—
|
—
|
$93.00
|
$911,125.88
|
$454,489.31
|
2025-01-31
|
|
Q2053
|
CPT
|
Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V…
|
7
|
3
|
—
|
—
|
$93.00
|
$901,003.38
|
$449,440.00
|
2025-01-31
|
|
Q2041
|
CPT
|
Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via…
|
7
|
3
|
—
|
—
|
$93.00
|
$901,003.38
|
$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
|
|
K0743
|
CPT
|
Suction Pump, Home Model, Portable, For Use On Wounds
|
51
|
27
|
—
|
—
|
$55,038.90
|
$55,038.90
|
$55,038.90
|
2025-01-31
|
|
Q2043
|
CPT
|
Sipuleucel-t, Minimum Of 50 Million Autologous Cd54+ Cells Activated With Pap-gm…
|
7
|
3
|
—
|
—
|
$93.00
|
$106,375.56
|
$53,062.44
|
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…
|
51
|
27
|
—
|
—
|
$35,930.29
|
$35,930.29
|
$35,930.29
|
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
|
Autologous Cultured Chondrocytes, Implant
|
2
|
1
|
—
|
—
|
$93.00
|
$56,957.17
|
$28,525.08
|
2025-01-31
|
|
33270
|
CPT
|
Insrt/rpl Sq Defib W/ele
|
55
|
27
|
$84,103.00
|
$63,077.25
25% off
|
$6,674.00
|
$49,134.00
|
$27,904.00
|
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
|
$51,646.63
|
$25,762.46
|
2025-01-31
|
|
C9608
|
CPT
|
Percutaneous Transluminal Revascularization Of Chronic Total Occlusion, Coronary…
|
55
|
27
|
—
|
—
|
$15,663.00
|
$34,745.00
|
$25,204.00
|
2025-01-31
|
|
J9600
|
CPT
|
Injection, Porfimer Sodium, 75 Mg
|
7
|
3
|
—
|
—
|
$93.00
|
$42,198.11
|
$22,490.02
|
2025-01-31
|
|
33264
|
CPT
|
Rem/repl Aicd Mult Ld
|
7
|
3
|
$54,152.00
|
$40,614.00
25% off
|
$93.00
|
$49,134.00
|
$22,152.00
|
2025-01-31
|
|
33231
|
CPT
|
Ins Aicd W/multi Lds
|
7
|
3
|
$54,152.00
|
$40,614.00
25% off
|
$93.00
|
$49,134.00
|
$22,152.00
|
2025-01-31
|
|
33271
|
CPT
|
Ins Sq Defib Elec
|
7
|
3
|
$15,476.00
|
$11,607.00
25% off
|
$93.00
|
$49,134.00
|
$22,152.00
|
2025-01-31
|
|
33262
|
CPT
|
Rem/repl Aicd Singl Ld
|
7
|
3
|
$54,152.00
|
$40,614.00
25% off
|
$93.00
|
$49,134.00
|
$22,152.00
|
2025-01-31
|
|
33249
|
CPT
|
Insrt/rplc Aicd & Lds
|
7
|
3
|
$87,497.00
|
$65,622.75
25% off
|
$93.00
|
$49,134.00
|
$22,152.00
|
2025-01-31
|
|
33272
|
CPT
|
Rmv Sq Defib Elec
|
7
|
3
|
$7,566.00
|
$5,674.50
25% off
|
$93.00
|
$49,134.00
|
$22,152.00
|
2025-01-31
|
|
33263
|
CPT
|
Rem/repl Aicd Dual Ld
|
7
|
3
|
$54,152.00
|
$40,614.00
25% off
|
$93.00
|
$49,134.00
|
$22,152.00
|
2025-01-31
|
|
33240
|
CPT
|
Insrt Aicd W/exis Ld
|
7
|
3
|
$62,230.00
|
$46,672.50
25% off
|
$93.00
|
$49,134.00
|
$22,152.00
|
2025-01-31
|
|
33230
|
CPT
|
Ins Aicd W/dual Lds
|
7
|
3
|
$55,670.00
|
$41,752.50
25% off
|
$93.00
|
$49,134.00
|
$22,152.00
|
2025-01-31
|
|
C9600
|
CPT
|
Perc Cor Drug-elut Stnt
|
55
|
27
|
$40,043.00
|
$30,032.25
25% off
|
$6,674.00
|
$34,745.00
|
$20,709.50
|
2025-01-31
|
|
C9607
|
CPT
|
Per Cor Revas Chronc Sng
|
55
|
27
|
$31,800.00
|
$23,850.00
25% off
|
$6,674.00
|
$34,745.00
|
$20,709.50
|
2025-01-31
|
|
C9605
|
CPT
|
Per Cor Revas Cabg Addl
|
55
|
27
|
$33,794.00
|
$25,345.50
25% off
|
$6,674.00
|
$34,745.00
|
$20,709.50
|
2025-01-31
|
|
C9601
|
CPT
|
Perc Drug-elut Stnt Addl
|
55
|
27
|
$32,033.00
|
$24,024.75
25% off
|
$6,674.00
|
$34,745.00
|
$20,709.50
|
2025-01-31
|
|
C9603
|
CPT
|
Perc Cor Ather Stnt Add
|
55
|
27
|
$34,085.00
|
$25,563.75
25% off
|
$6,674.00
|
$34,745.00
|
$20,709.50
|
2025-01-31
|
|
C9602
|
CPT
|
Perc Cor Ath D-e Stnt
|
55
|
27
|
$29,586.00
|
$22,189.50
25% off
|
$6,674.00
|
$34,745.00
|
$20,709.50
|
2025-01-31
|
|
C9606
|
CPT
|
Per Cor Revas D-e W/ami
|
55
|
27
|
$31,800.00
|
$23,850.00
25% off
|
$6,674.00
|
$34,745.00
|
$20,709.50
|
2025-01-31
|
|
C9604
|
CPT
|
Perc Cor Revasc D-e Cabg
|
55
|
27
|
$35,245.00
|
$26,433.75
25% off
|
$6,674.00
|
$34,745.00
|
$20,709.50
|
2025-01-31
|
|
33206
|
CPT
|
Ins/rpl Pm W/trnsv Ld At
|
55
|
27
|
$36,217.00
|
$27,162.75
25% off
|
$6,674.00
|
$32,989.00
|
$19,831.50
|
2025-01-31
|
|
0333
|
RC
|
Radiology Therapeutic And/of Chemotherapy Administration Radiation Therapy
|
7
|
3
|
—
|
—
|
$12,202.00
|
$27,201.00
|
$19,701.50
|
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
|
|
0DQ67ZZ
|
OTHER
|
Repair Stomach, Via Natural Or Artificial Opening
|
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
|
|
0D160ZA
|
OTHER
|
Bypass Stomach To Jejunum, Open 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
|
|
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
|
|
0DN67ZZ
|
OTHER
|
Release Stomach, Via Natural Or Artificial Opening
|
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
|
|
0DQ64ZZ
|
OTHER
|
Repair Stomach, Percutaneous Endoscopic Approach
|
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
|
|
0DL63DZ
|
OTHER
|
Occlusion Of Stomach With Intraluminal Device, Percutaneous Approach
|
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
|
|
0DQ68ZZ
|
OTHER
|
Repair Stomach, Via Natural Or Artificial Opening Endoscopic
|
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
|
|
0DQ63ZZ
|
OTHER
|
Repair Stomach, Percutaneous 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
|
|
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
|
|
0DU60JZ
|
OTHER
|
Supplement Stomach With Synthetic Substitute, Open Approach
|
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
|
|
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
|
|
0DU607Z
|
OTHER
|
Supplement Stomach With Autologous Tissue Substitute, Open Approach
|
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
|
|
0DL70ZZ
|
OTHER
|
Occlusion Of Stomach, Pylorus, Open Approach
|
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
|
|
0DL74ZZ
|
OTHER
|
Occlusion Of Stomach, Pylorus, Percutaneous Endoscopic Approach
|
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
|
|
0DL73ZZ
|
OTHER
|
Occlusion Of Stomach, Pylorus, Percutaneous Approach
|
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
|
|
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
|
|
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
|
|
0DF63ZZ
|
OTHER
|
Fragmentation In Stomach, Percutaneous Approach
|
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
|
|
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
|
|
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
|
|
0DN68ZZ
|
OTHER
|
Release Stomach, Via Natural Or Artificial Opening Endoscopic
|
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
|
|
0DY60Z2
|
OTHER
|
Transplantation Of Stomach, Zooplastic, Open Approach
|
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
|
|
0DV64ZZ
|
OTHER
|
Restriction Of Stomach, Percutaneous Endoscopic 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
|
|
0DV60CZ
|
OTHER
|
Restriction Of Stomach With Extraluminal Device, Open 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
|
|
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
|
|
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
|
|
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
|
|
0DL67ZZ
|
OTHER
|
Occlusion Of Stomach, Via Natural Or Artificial Opening
|
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
|
|
0DB63ZZ
|
OTHER
|
Excision Of Stomach, Percutaneous 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
|
|
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
|
|
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
|
|
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
|
|
0D763DZ
|
OTHER
|
Dilation Of Stomach With Intraluminal Device, 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
|
|
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
|
|
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
|
|
0D160Z9
|
OTHER
|
Bypass Stomach To Duodenum, 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
|
|
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
|
|
0D760ZZ
|
OTHER
|
Dilation Of Stomach, Open 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
|
|
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
|
|
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
|
|
0D760DZ
|
OTHER
|
Dilation Of Stomach With Intraluminal Device, Open 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
|
|
0D763ZZ
|
OTHER
|
Dilation Of Stomach, Percutaneous Approach
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
0DU64KZ
|
OTHER
|
Supplement Stomach With Nonautologous Tissue Substitute, Percutaneous Endoscopic…
|
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
|
|
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
|
|
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
|
|
0DY60Z0
|
OTHER
|
Transplantation Of Stomach, Allogeneic, Open Approach
|
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
|
|
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
|
|
0DM60ZZ
|
OTHER
|
Reattachment Of Stomach, Open Approach
|
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
|
|
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
|
|
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
|
|
0DV63CZ
|
OTHER
|
Restriction Of Stomach With Extraluminal Device, Percutaneous Approach
|
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
|
|
0DV63DZ
|
OTHER
|
Restriction Of Stomach With Intraluminal Device, Percutaneous 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
|
|
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
|
|
0D764ZZ
|
OTHER
|
Dilation Of Stomach, Percutaneous Endoscopic Approach
|
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
|
|
0DF64ZZ
|
OTHER
|
Fragmentation 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
|
|
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
|
|
0DU64JZ
|
OTHER
|
Supplement Stomach With Synthetic Substitute, Percutaneous Endoscopic Approach
|
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
|
|
0DL60DZ
|
OTHER
|
Occlusion Of Stomach With Intraluminal Device, 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
|
|
0DV63ZZ
|
OTHER
|
Restriction Of Stomach, Percutaneous Approach
|
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
|
|
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
|
|
0DL63CZ
|
OTHER
|
Occlusion Of Stomach With Extraluminal Device, Percutaneous 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
|
|
0DF60ZZ
|
OTHER
|
Fragmentation In Stomach, Open Approach
|
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
|
|
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
|
|
0DL60ZZ
|
OTHER
|
Occlusion Of Stomach, Open Approach
|
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
|
|
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
|
|
0D767ZZ
|
OTHER
|
Dilation 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
|
|
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
|
|
0DL63ZZ
|
OTHER
|
Occlusion Of Stomach, Percutaneous Approach
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
0DH63DZ
|
OTHER
|
Insertion Of Intraluminal Device Into Stomach, Percutaneous 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
|
|
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
|
|
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
|
|
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
|
|
0DN60ZZ
|
OTHER
|
Release Stomach, Open 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
|
|
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
|
|
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
|
|
0DB60ZZ
|
OTHER
|
Excision Of Stomach, Open 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
|
|
0DH60DZ
|
OTHER
|
Insertion Of Intraluminal Device Into Stomach, Open Approach
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
0D164Z9
|
OTHER
|
Bypass Stomach To Duodenum, Percutaneous Endoscopic Approach
|
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
|
|
0D164ZB
|
OTHER
|
Bypass Stomach To Ileum, Percutaneous Endoscopic Approach
|
1
|
1
|
—
|
—
|
$18,858.00
|
$18,858.00
|
$18,858.00
|
2025-01-31
|
|
93612
|
CPT
|
Intraventricular Pacing
|
7
|
3
|
$14,383.00
|
$10,787.25
25% off
|
$62.23
|
$29,129.00
|
$17,645.87
|
2025-01-31
|
|
93600
|
CPT
|
His Bundle Recording
|
7
|
3
|
$12,553.00
|
$9,414.75
25% off
|
$75.24
|
$29,129.00
|
$17,645.87
|
2025-01-31
|
|
93610
|
CPT
|
Cath Atrial Pacing
|
7
|
3
|
$14,396.00
|
$10,797.00
25% off
|
$53.28
|
$29,129.00
|
$17,645.87
|
2025-01-31
|
|
93619
|
CPT
|
Comp Ep Without Induc/arryth
|
7
|
3
|
$40,150.00
|
$30,112.50
25% off
|
$93.00
|
$29,129.00
|
$17,645.87
|
2025-01-31
|
|
93602
|
CPT
|
Intra-arterial Recording
|
7
|
3
|
$10,824.00
|
$8,118.00
25% off
|
$43.97
|
$29,129.00
|
$17,645.87
|
2025-01-31
|
|
93620
|
CPT
|
Ep Comp Study W/inductn
|
7
|
3
|
$45,000.00
|
$33,750.00
25% off
|
$93.00
|
$29,129.00
|
$17,645.87
|
2025-01-31
|
|
93624
|
CPT
|
Ep Drug Follow-up Study
|
7
|
3
|
$9,108.00
|
$6,831.00
25% off
|
$72.48
|
$29,129.00
|
$17,645.87
|
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
|
|
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
|
|
C9760
|
CPT
|
Non-randomized, Non-blinded Procedure For Nyha Class Ii, Iii, IV Heart Failure; …
|
55
|
27
|
—
|
—
|
$10,636.00
|
$22,810.00
|
$16,723.00
|
2025-01-31
|
|
33289
|
CPT
|
Tcat Impl Wrls P-art Prs Snr
|
55
|
27
|
$80,752.00
|
$60,564.00
25% off
|
$10,636.00
|
$22,810.00
|
$16,723.00
|
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
|
|
92944
|
CPT
|
Revas Perc Trans Occ Add
|
6
|
3
|
$26,301.00
|
$19,725.75
25% off
|
$720.41
|
$28,357.00
|
$15,766.00
|
2025-01-31
|
|
92934
|
CPT
|
Cor Ather Stnt Aplst Add
|
6
|
3
|
$24,247.00
|
$18,185.25
25% off
|
$718.91
|
$28,357.00
|
$15,766.00
|
2025-01-31
|
|
33214
|
CPT
|
Conversion To Two Chamber Pacemaker System
|
7
|
3
|
—
|
—
|
$93.00
|
$32,989.00
|
$14,873.00
|
2025-01-31
|
|
33208
|
CPT
|
Ins/rpl Pmw/trnsv Ld A-v
|
7
|
3
|
$40,847.00
|
$30,635.25
25% off
|
$93.00
|
$32,989.00
|
$14,873.00
|
2025-01-31
|
|
33227
|
CPT
|
Rem/repl Pm Gen Sgl Ld
|
7
|
3
|
$13,012.00
|
$9,759.00
25% off
|
$93.00
|
$32,989.00
|
$14,873.00
|
2025-01-31
|
|
33221
|
CPT
|
Insrt Pulse Gen Mult Lds
|
7
|
3
|
$41,520.00
|
$31,140.00
25% off
|
$93.00
|
$32,989.00
|
$14,873.00
|
2025-01-31
|
|
33207
|
CPT
|
Ins/rpl Pm W/trnsv Ld Ve
|
7
|
3
|
$24,425.00
|
$18,318.75
25% off
|
$93.00
|
$32,989.00
|
$14,873.00
|
2025-01-31
|
|
C9782
|
CPT
|
Blinded Procedure For New York Heart Association (nyha) Class Ii Or Iii Heart Fa…
|
55
|
27
|
—
|
—
|
$8,999.00
|
$19,301.00
|
$14,150.00
|
2025-01-31
|
|
C9758
|
CPT
|
Blinded Procedure For Nyha Class Iii/iv Heart Failure; Transcatheter Implantatio…
|
55
|
27
|
—
|
—
|
$8,999.00
|
$19,301.00
|
$14,150.00
|
2025-01-31
|
|
36906
|
CPT
|
Thro+stn+img
|
55
|
27
|
$59,391.00
|
$44,543.25
25% off
|
$8,999.00
|
$19,301.00
|
$14,150.00
|
2025-01-31
|
|
33968
|
CPT
|
Perc Iabp Removal
|
55
|
27
|
$4,300.00
|
$3,225.00
25% off
|
$8,999.00
|
$19,301.00
|
$14,150.00
|
2025-01-31
|
|
33274
|
CPT
|
Transcath Ins/rpl Perm Ldls Pm
|
55
|
27
|
$57,139.00
|
$42,854.25
25% off
|
$8,999.00
|
$19,301.00
|
$14,150.00
|
2025-01-31
|
|
92925
|
CPT
|
Cor Atherect Aplas Add
|
6
|
3
|
$30,162.00
|
$22,621.50
25% off
|
$687.51
|
$24,568.00
|
$13,659.00
|
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
|
|
93615
|
CPT
|
Insertion Of Probe In Esophagus For Recording Electrical Impulses To Upper And L…
|
7
|
3
|
—
|
—
|
$12.69
|
$29,129.00
|
$13,132.00
|
2025-01-31
|
|
93603
|
CPT
|
Insertion Of Catheter For Recording Of Right Lower Heart Chamber Rhythm
|
7
|
3
|
—
|
—
|
$65.99
|
$29,129.00
|
$13,132.00
|
2025-01-31
|
|
93609
|
CPT
|
Ep Cardiac Mapping
|
7
|
3
|
$11,206.00
|
$8,404.50
25% off
|
$93.00
|
$29,129.00
|
$13,132.00
|
2025-01-31
|
|
93616
|
CPT
|
Insertion Of Probe In Esophagus For Recording Electrical Impulses To Upper And L…
|
7
|
3
|
—
|
—
|
$21.07
|
$29,129.00
|
$13,132.00
|
2025-01-31
|
|
93618
|
CPT
|
Inductn Arrhythmia By Ep
|
7
|
3
|
$4,549.00
|
$3,411.75
25% off
|
$93.00
|
$29,129.00
|
$13,132.00
|
2025-01-31
|
|
93621
|
CPT
|
Comp Ep Eval/la Frm Cs R
|
7
|
3
|
$20,278.00
|
$15,208.50
25% off
|
$37.46
|
$29,129.00
|
$13,132.00
|
2025-01-31
|
|
93623
|
CPT
|
Ep Post Drug Infusion
|
7
|
3
|
$3,880.00
|
$2,910.00
25% off
|
$50.78
|
$29,129.00
|
$13,132.00
|
2025-01-31
|
|
93631
|
CPT
|
Intra-operative Heart Pacing And Mapping Of Abnormal Heart Rhythm For Surgical C…
|
7
|
3
|
—
|
—
|
$93.00
|
$29,129.00
|
$13,132.00
|
2025-01-31
|
|
93622
|
CPT
|
Comp Ep Eval/lv Record
|
7
|
3
|
$25,372.00
|
$19,029.00
25% off
|
$54.85
|
$29,129.00
|
$13,132.00
|
2025-01-31
|
|
37231
|
CPT
|
Revasc Tibper Stnt Ather
|
7
|
3
|
$41,145.00
|
$30,858.75
25% off
|
$93.00
|
$19,301.00
|
$13,127.05
|
2025-01-31
|
|
0520T
|
CPT
|
Removal And Replacement Of Pulse Generator Components Of Wireless Heart Stimulat…
|
6
|
2
|
—
|
—
|
$93.00
|
$22,810.00
|
$13,115.50
|
2025-01-31
|
|
0424T
|
CPT
|
Insertion Or Replacement Of Complete Neurostimulator System For Treatment Of Cen…
|
6
|
2
|
—
|
—
|
$93.00
|
$22,810.00
|
$13,115.50
|
2025-01-31
|
|
0515T
|
CPT
|
Insertion Of Complete Wireless Heart Stimulator System For Pacing Of Lower Left …
|
6
|
2
|
—
|
—
|
$93.00
|
$22,810.00
|
$13,115.50
|
2025-01-31
|
|
0408T
|
CPT
|
Insertion Or Replacement Of Pulse Generator And Electrodes Of Heart Contractilit…
|
6
|
2
|
—
|
—
|
$93.00
|
$22,810.00
|
$13,115.50
|
2025-01-31
|
|
0571T
|
CPT
|
Insertion Or Replacement Of Implantable Cardioverter-defibrillator System With E…
|
6
|
2
|
—
|
—
|
$93.00
|
$22,810.00
|
$13,115.50
|
2025-01-31
|
|
0414T
|
CPT
|
Replacement Of Pulse Generator Of Heart Contractility Modulator System
|
6
|
2
|
—
|
—
|
$93.00
|
$22,810.00
|
$13,115.50
|
2025-01-31
|
|
0100T
|
CPT
|
Insertion Of Retinal Prosthesis Receiver Pulse Generator And Retinal Electrode A…
|
6
|
2
|
—
|
—
|
$93.00
|
$22,810.00
|
$13,115.50
|
2025-01-31
|
|
0409T
|
CPT
|
Insertion Or Replacement Of Pulse Generator Of Heart Contractility Modulator Sys…
|
6
|
2
|
—
|
—
|
$93.00
|
$22,810.00
|
$13,115.50
|
2025-01-31
|
|
0614T
|
CPT
|
Removal And Replacement Of Substernal Implantable Defibrillator Pulse Generator
|
6
|
2
|
—
|
—
|
$93.00
|
$22,810.00
|
$13,115.50
|
2025-01-31
|
|
S1034
|
CPT
|
Artificial Pancreas Device System (e.g., Low Glucose Suspend (lgs) Feature) Incl…
|
51
|
27
|
—
|
—
|
$13,104.50
|
$13,104.50
|
$13,104.50
|
2025-01-31
|
|
37227
|
CPT
|
Revasc Fempop Stnt Ather
|
55
|
27
|
$77,944.00
|
$58,458.00
25% off
|
$6,674.00
|
$19,301.00
|
$12,987.50
|
2025-01-31
|
|
92943
|
CPT
|
Revas Perc Trans Tot Occ
|
7
|
3
|
$31,073.00
|
$23,304.75
25% off
|
$93.00
|
$28,357.00
|
$12,786.00
|
2025-01-31
|
|
92938
|
CPT
|
Insertion Of Stent, Removal Of Plaque And/or Balloon Dilation Of Coronary Vessel…
|
7
|
3
|
—
|
—
|
$66.58
|
$28,357.00
|
$12,786.00
|
2025-01-31
|
|
92929
|
CPT
|
Cor Stnt Angio Add
|
7
|
3
|
$23,515.00
|
$17,636.25
25% off
|
$93.00
|
$28,357.00
|
$12,786.00
|
2025-01-31
|
|
92928
|
CPT
|
Cor Stnt Angio Init
|
7
|
3
|
$25,449.00
|
$19,086.75
25% off
|
$93.00
|
$28,357.00
|
$12,786.00
|
2025-01-31
|
|
0686T
|
CPT
|
Acoustic Energy Destruction Of Malignant Liver Tissue Using Imaging Guidance
|
55
|
27
|
—
|
—
|
$12,500.50
|
$12,500.50
|
$12,500.50
|
2025-01-31
|
|
E0770
|
CPT
|
Functional Electrical Stimulator, Transcutaneous Stimulation Of Nerve And/or Mus…
|
51
|
27
|
—
|
—
|
$12,056.14
|
$12,056.14
|
$12,056.14
|
2025-01-31
|
|
81416
|
CPT
|
Test For Detecting Exome, Sequence Analysis, Each Comparator Exome
|
10
|
5
|
—
|
—
|
$93.00
|
$16,296.00
|
$12,000.00
|
2025-01-31
|
|
0238T
|
CPT
|
Atherect Iliac Open Perc
|
55
|
27
|
$31,073.00
|
$23,304.75
25% off
|
$7,200.00
|
$15,442.00
|
$11,321.00
|
2025-01-31
|
|
0793T
|
CPT
|
Percutaneous Transcatheter Thermal Ablation Of Nerves Innervating The Pulmonary …
|
55
|
27
|
—
|
—
|
$7,200.00
|
$15,442.00
|
$11,321.00
|
2025-01-31
|
|
0620T
|
CPT
|
Insertion Of Stent To Shunt Arterial Blood To Deep Vein Of Lower Leg Via Cathete…
|
55
|
27
|
—
|
—
|
$7,200.00
|
$15,442.00
|
$11,321.00
|
2025-01-31
|
|
C9792
|
CPT
|
Blinded Or Nonblinded Procedure For Symptomatic New York Heart Association (nyha…
|
55
|
27
|
—
|
—
|
$7,200.00
|
$15,442.00
|
$11,321.00
|
2025-01-31
|
|
C9783
|
CPT
|
Blinded Procedure For Transcatheter Implantation Of Coronary Sinus Reduction Dev…
|
55
|
27
|
—
|
—
|
$7,200.00
|
$15,442.00
|
$11,321.00
|
2025-01-31
|
|
C9780
|
CPT
|
Insertion Of Central Venous Catheter Through Central Venous Occlusion Via Inferi…
|
55
|
27
|
—
|
—
|
$7,200.00
|
$15,442.00
|
$11,321.00
|
2025-01-31
|
|
61624
|
CPT
|
Occlsn/embl Cath Cns
|
55
|
27
|
$18,394.00
|
$13,795.50
25% off
|
$7,200.00
|
$15,442.00
|
$11,321.00
|
2025-01-31
|
|
C9774
|
CPT
|
Revasc Intravasc Litho+ather
|
55
|
27
|
$46,058.00
|
$34,543.50
25% off
|
$7,200.00
|
$15,442.00
|
$11,321.00
|
2025-01-31
|
|
0632T
|
CPT
|
Destruction Of Nerves To Main Arteries Of Lung, Accessed Through Skin Via Cathet…
|
55
|
27
|
—
|
—
|
$7,200.00
|
$15,442.00
|
$11,321.00
|
2025-01-31
|
|
C9773
|
CPT
|
Revasc Intravasc Litho+stnt
|
55
|
27
|
$47,204.00
|
$35,403.00
25% off
|
$7,200.00
|
$15,442.00
|
$11,321.00
|
2025-01-31
|
|
C9772
|
CPT
|
Revasc Intravasc Litho+plasty
|
55
|
27
|
$32,180.00
|
$24,135.00
25% off
|
$7,200.00
|
$15,442.00
|
$11,321.00
|
2025-01-31
|
|
C9767
|
CPT
|
Revasc Litho+stnt+ather
|
55
|
27
|
$63,973.00
|
$47,979.75
25% off
|
$7,200.00
|
$15,442.00
|
$11,321.00
|
2025-01-31
|
|
C9766
|
CPT
|
Revasc Intravasc Litho+ather
|
55
|
27
|
$48,784.00
|
$36,588.00
25% off
|
$7,200.00
|
$15,442.00
|
$11,321.00
|
2025-01-31
|
|
53451
|
CPT
|
Insertion Of Adjustable Balloon Continence Device On Both Sides Of Urethra Using…
|
55
|
27
|
—
|
—
|
$7,200.00
|
$15,442.00
|
$11,321.00
|
2025-01-31
|
|
C9775
|
CPT
|
Revasc Intvasc Lith+stnt+ather
|
55
|
27
|
$96,986.00
|
$72,739.50
25% off
|
$7,200.00
|
$15,442.00
|
$11,321.00
|
2025-01-31
|
|
C9765
|
CPT
|
Intravasc Litho+stent
|
55
|
27
|
$44,523.00
|
$33,392.25
25% off
|
$7,200.00
|
$15,442.00
|
$11,321.00
|
2025-01-31
|
|
0645T
|
CPT
|
Implantation Of Coronary Sinus Reduction Device In Heart Through Catheter
|
55
|
27
|
—
|
—
|
$7,200.00
|
$15,442.00
|
$11,321.00
|
2025-01-31
|
|
0803T
|
CPT
|
Transcatheter Removal And Replacement Of Permanent Dual-chamber Leadless Pacemak…
|
55
|
27
|
—
|
—
|
$7,200.00
|
$15,442.00
|
$11,321.00
|
2025-01-31
|
|
37238
|
CPT
|
Open/perc Pl St 1st Vn
|
55
|
27
|
$41,680.00
|
$31,260.00
25% off
|
$7,200.00
|
$15,442.00
|
$11,321.00
|
2025-01-31
|
|
36836
|
CPT
|
Prq Av Fstl Crtj Uxtr Sgl Acc
|
55
|
27
|
$49,389.00
|
$37,041.75
25% off
|
$7,200.00
|
$15,442.00
|
$11,321.00
|
2025-01-31
|
|
36837
|
CPT
|
Prq Av Fstl Crt Uxtr Sepr Acc
|
55
|
27
|
$47,717.00
|
$35,787.75
25% off
|
$7,200.00
|
$15,442.00
|
$11,321.00
|
2025-01-31
|
|
0797T
|
CPT
|
Transcatheter Insertion Of Permanent Dual-chamber Leadless Pacemaker, Including …
|
55
|
27
|
—
|
—
|
$7,200.00
|
$15,442.00
|
$11,321.00
|
2025-01-31
|
|
33285
|
CPT
|
Insrt Subq Car Rhythm Mntr
|
55
|
27
|
$28,594.00
|
$21,445.50
25% off
|
$7,200.00
|
$15,442.00
|
$11,321.00
|
2025-01-31
|
|
0308T
|
CPT
|
Insertion Of Prosthetic Telescope In Eye For The Treatment Of Central Vision
|
6
|
2
|
—
|
—
|
$93.00
|
$19,301.00
|
$11,097.00
|
2025-01-31
|
|
0431T
|
CPT
|
Replacement Of Pulse Generator Of Neurostimulator System For Treatment Of Centra…
|
6
|
2
|
—
|
—
|
$93.00
|
$19,301.00
|
$11,097.00
|
2025-01-31
|
|
0268T
|
CPT
|
Implantation Or Replacement Of Carotid Sinus Baroreflex Activation Device Pulse …
|
6
|
2
|
—
|
—
|
$93.00
|
$19,301.00
|
$11,097.00
|
2025-01-31
|
|
0427T
|
CPT
|
Insertion Or Replacement Of Pulse Generator Of Neurostimulator System For Treatm…
|
6
|
2
|
—
|
—
|
$93.00
|
$19,301.00
|
$11,097.00
|
2025-01-31
|
|
0266T
|
CPT
|
Insertion Or Replacement Of Carotid Sinus Baroreflex Activation Device
|
6
|
2
|
—
|
—
|
$93.00
|
$19,301.00
|
$11,097.00
|
2025-01-31
|
|
92921
|
CPT
|
Cor Angplsty Add
|
7
|
3
|
$20,320.00
|
$15,240.00
25% off
|
$93.00
|
$24,568.00
|
$11,077.00
|
2025-01-31
|
|
92920
|
CPT
|
Cor Angplsty Init
|
7
|
3
|
$20,320.00
|
$15,240.00
25% off
|
$93.00
|
$24,568.00
|
$11,077.00
|
2025-01-31
|
|
37236
|
CPT
|
Open/perc Pl St 1st Ar
|
55
|
27
|
$43,401.00
|
$32,550.75
25% off
|
$6,674.00
|
$15,442.00
|
$11,058.00
|
2025-01-31
|
|
37230
|
CPT
|
Revasc Tibper W/stent
|
55
|
27
|
$34,256.00
|
$25,692.00
25% off
|
$6,674.00
|
$15,442.00
|
$11,058.00
|
2025-01-31
|
|
37221
|
CPT
|
Revasc Iliac W/stent
|
55
|
27
|
$26,518.00
|
$19,888.50
25% off
|
$6,674.00
|
$15,442.00
|
$11,058.00
|
2025-01-31
|
|
37226
|
CPT
|
Fem/pop W/stent
|
55
|
27
|
$49,221.00
|
$36,915.75
25% off
|
$6,674.00
|
$15,442.00
|
$11,058.00
|
2025-01-31
|
|
33212
|
CPT
|
Ins/pm Gen W/exist Ld
|
8
|
4
|
$16,914.00
|
$12,685.50
25% off
|
$93.00
|
$32,989.00
|
$10,773.50
|
2025-01-31
|
|
33213
|
CPT
|
Ins/pmgen W/exisduallds
|
8
|
4
|
$33,567.00
|
$25,175.25
25% off
|
$93.00
|
$32,989.00
|
$10,773.50
|
2025-01-31
|
|
0627T
|
CPT
|
Injection Of Cell Or Tissue-based Material Into Spinal Disc Of Lower Back Access…
|
55
|
27
|
—
|
—
|
$6,791.00
|
$14,566.00
|
$10,678.50
|
2025-01-31
|
|
0629T
|
CPT
|
Injection Of Cell Or Tissue-based Material Into Spinal Disc Of Lower Back Access…
|
55
|
27
|
—
|
—
|
$6,791.00
|
$14,566.00
|
$10,678.50
|
2025-01-31
|
|
0274T
|
CPT
|
Removal Of Bone From Upper Or Middle Spine For Decompression Of Nerve Tissue Usi…
|
55
|
27
|
—
|
—
|
$6,791.00
|
$14,566.00
|
$10,678.50
|
2025-01-31
|
|
C9785
|
CPT
|
Endoscopic Outlet Reduction, Gastric Pouch Application, With Endoscopy And Intra…
|
55
|
27
|
—
|
—
|
$6,791.00
|
$14,566.00
|
$10,678.50
|
2025-01-31
|
|
C9784
|
CPT
|
Gastric Restrictive Procedure, Endoscopic Sleeve Gastroplasty, With Esophagogast…
|
55
|
27
|
—
|
—
|
$6,791.00
|
$14,566.00
|
$10,678.50
|
2025-01-31
|
|
C9781
|
CPT
|
Arthroscopy, Shoulder, Surgical; With Implantation Of Subacromial Spacer (e.g., …
|
55
|
27
|
—
|
—
|
$6,791.00
|
$14,566.00
|
$10,678.50
|
2025-01-31
|
|
60699
|
CPT
|
CT Ablt Adrenal Mass
|
55
|
27
|
$15,755.00
|
$11,816.25
25% off
|
$6,791.00
|
$14,566.00
|
$10,678.50
|
2025-01-31
|
|
0744T
|
CPT
|
Insertion Of Bioprosthetic Valve, Open, Femoral Vein, Including Duplex Ultrasoun…
|
55
|
27
|
—
|
—
|
$6,791.00
|
$14,566.00
|
$10,678.50
|
2025-01-31
|
|
C9764
|
CPT
|
Revasc Intrvasc Litho
|
55
|
27
|
$29,451.00
|
$22,088.25
25% off
|
$6,791.00
|
$14,566.00
|
$10,678.50
|
2025-01-31
|
|
C9740
|
CPT
|
Cystourethroscopy, With Insertion Of Transprostatic Implant; 4 Or More Implants
|
55
|
27
|
—
|
—
|
$6,791.00
|
$14,566.00
|
$10,678.50
|
2025-01-31
|
|
C9757
|
CPT
|
Laminotomy (hemilaminectomy), With Decompression Of Nerve Root(s), Including Par…
|
55
|
27
|
—
|
—
|
$6,791.00
|
$14,566.00
|
$10,678.50
|
2025-01-31
|
|
36224
|
CPT
|
Arterio Ic Nkhd
|
55
|
27
|
$27,776.00
|
$20,832.00
25% off
|
$6,791.00
|
$14,566.00
|
$10,678.50
|
2025-01-31
|
|
37224
|
CPT
|
Revasc Fempop W/tla
|
55
|
27
|
$21,559.00
|
$16,169.25
25% off
|
$6,674.00
|
$14,566.00
|
$10,620.00
|
2025-01-31
|
|
37220
|
CPT
|
Iliac O/p Init
|
55
|
27
|
$28,376.00
|
$21,282.00
25% off
|
$6,674.00
|
$14,566.00
|
$10,620.00
|
2025-01-31
|
|
36226
|
CPT
|
Arteriog Vert Sel
|
55
|
27
|
$24,333.00
|
$18,249.75
25% off
|
$6,674.00
|
$14,566.00
|
$10,620.00
|
2025-01-31
|
|
36223
|
CPT
|
Arteriogr Car Hd Sel
|
55
|
27
|
$12,038.00
|
$9,028.50
25% off
|
$6,674.00
|
$14,566.00
|
$10,620.00
|
2025-01-31
|
|
36902
|
CPT
|
Dial-circ Bal-plasty+s&i
|
55
|
27
|
$26,206.00
|
$19,654.50
25% off
|
$6,674.00
|
$14,566.00
|
$10,620.00
|
2025-01-31
|
|
37243
|
CPT
|
Occlusion Of Tumors Or Obstructed Blood Vessel With Radiological Supervision And…
|
7
|
3
|
—
|
—
|
$93.00
|
$15,442.00
|
$10,557.00
|
2025-01-31
|
|
37225
|
CPT
|
Revasc Fempop W/ather
|
7
|
3
|
$29,814.00
|
$22,360.50
25% off
|
$93.00
|
$15,442.00
|
$10,427.93
|
2025-01-31
|
|
37229
|
CPT
|
Revasc Tibper W/ather
|
7
|
3
|
$29,814.00
|
$22,360.50
25% off
|
$93.00
|
$15,442.00
|
$10,324.41
|
2025-01-31
|
|
222
|
MS_DRG
|
Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock…
|
20
|
12
|
—
|
—
|
$5,337.00
|
$26,481.00
|
$10,266.50
|
2025-01-31
|
|
223
|
MS_DRG
|
Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock…
|
20
|
12
|
—
|
—
|
$5,337.00
|
$26,481.00
|
$10,266.50
|
2025-01-31
|
|
224
|
MS_DRG
|
Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh…
|
20
|
12
|
—
|
—
|
$5,337.00
|
$26,481.00
|
$10,266.50
|
2025-01-31
|