Hospital

MONROE REGIONAL HOSPITAL

Aberdeen, MS · CCN 251302 · Rates published

2,228 distinct procedures filed

7 distinct payers

112,853 rate rows

2026-09-21 last MRF observed

Data quality

111,354 of 112,853 rate rows are consumer-grade (98.7%)

1,499 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	1,240
template filing: same amount across many unrelated codes — excluded	208
placeholder amount (≤ $0.02) — excluded from medians	35
per-diem day rate — not a per-procedure price	13
exceeds 10× this hospital's gross charge — excluded from medians	3

Data source & audit trail ↓ Download audit trail (JSON)

Source MRF file	https://monroeregionalhospital.com/wp-content/uploads/2026/06/821859395_monroe-regional-hospital_standardcharges.csv
Found on page	https://monroeregionalhospital.com/patients-visitors/price-transparency/
Discovered via	CMS hospital list
Last fetch	Latest re-check couldn't be parsed — showing last good data · 2026-10-01
Content fingerprint	6f4c9d81e84146d8… · 16,374,534 bytes · first seen 2026-06-22

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
0278 RC		4	$6,749.14	$27,752.40	$14,299.46	nat. median $1,512 outlier · 9.5×
58552 HCPCS	Hc Lap Vag Hy Ut 250 Or Less W/rem Tub/o	7	$803.34	$22,715.55	$13,851.44	nat. median $10,168 1.4× median
58571 HCPCS	Hc Lap Total Hyst Uterus 250	7	$753.92	$22,715.55	$13,851.44	nat. median $10,013 1.4× median
58554 HCPCS	Hc Lap Vag Hyst Ut 250g; Tube(s)/ovary(s	7	$1,066.26	$22,715.55	$13,851.44	nat. median $9,620 1.4× median
58570 HCPCS	Hc Lap Total Hysterectomy Ut	7	$662.92	$22,715.55	$13,851.44	nat. median $9,932 1.4× median
J2997 HCPCS	Alteplase 50 Mg Inj (activase)	7	$182.96	$39,977.82	$9,195.54	nat. median $428 outlier · 21.5×
J3101 HCPCS	Tenecteplase 50 Mg Kit	7	$4,939.20	$8,820.00	$8,100.00	nat. median $498 outlier · 16.3×
43659 HCPCS	Unlisted Laproscopy Stoma	6	$4,446.00	$13,049.10	$8,038.24	nat. median $6,622 1.2× median
21048 HCPCS	Exc Of Ben Tum Cyst Max I	7	$823.39	$13,096.58	$7,986.00	nat. median $5,865 1.4× median
58671 HCPCS	Hc Lap, Surg; W/occlusion Of Oviducts	7	$303.11	$13,051.12	$7,958.29	nat. median $5,708 1.4× median
58661 HCPCS	Hc Laparoscopy, Prtl/tot Oop	7	$536.47	$13,051.12	$7,958.29	nat. median $5,852 1.4× median
38740 HCPCS	Axilary Lymphadenectomy;	7	$605.21	$13,050.00	$7,957.60	nat. median $5,726 1.4× median
J1306 HCPCS	Leqvio 284 Mg/1.5 Ml Injection	7	$18.42	$12,269.70	$7,481.79	nat. median $25 outlier · 296.9×
57250 HCPCS	Posterior Colporrhaphy-re	7	$498.37	$11,533.50	$7,032.87	nat. median $5,113 1.4× median
57530 HCPCS	Trachelectomy(cervicectom	7	$306.21	$11,533.50	$7,032.87	nat. median $4,901 1.4× median
57240 HCPCS	Anterior Colporrhaphy-rep	7	$498.24	$11,533.50	$7,032.87	nat. median $5,027 1.4× median
58260 HCPCS	Hc Vaginal Hysterectomy Uter	7	$679.15	$11,533.28	$7,032.73	nat. median $5,217 1.3× median
J3110 HCPCS	Teriparatide 600 Mcg/2.4 Ml Pnij,340b	6	$136.92	$11,393.19	$7,018.21	nat. median $5,225 1.3× median
58150 HCPCS	Hc Total Abd Hysterectomy With	5	$850.62	$9,429.30	$5,867.12	nat. median $3,499 1.7× median
15877 HCPCS	Suction Assisted Lipectom	4	$4,901.88	$8,038.80	$5,850.46	nat. median $4,054 1.4× median
15879 HCPCS	Suctio Assisted Lipectomy	4	$4,901.88	$8,038.80	$5,850.46	nat. median $4,125 1.4× median
15876 HCPCS	Suctio Asst Liptmy Head A	4	$4,901.88	$8,038.80	$5,850.46	nat. median $3,806 1.5× median
35903 HCPCS	Exc Of Infected Graft, Ex	7	$469.92	$8,838.90	$5,389.76	nat. median $3,456 1.6× median
49402 HCPCS	Rem Of Pertoneal Foreign	7	$723.96	$8,395.20	$5,119.21	nat. median $3,766 1.4× median
15273 HCPCS	Appl Subs Skn T-a-l >100c	7	$284.72	$8,038.80	$4,901.88	nat. median $2,471 2.0× median
15757 HCPCS	Pf Free Skin Flap W Mcrovasc	7	$1,783.66	$9,348.12	$4,579.48	nat. median $2,708 1.7× median
36565 HCPCS	Insertion Of Central Veno	7	$746.83	$7,482.15	$4,562.45	nat. median $3,407 1.3× median
29870 HCPCS	Arthro Knee Diagn W Wo Sy	7	$527.61	$7,391.25	$4,507.02	nat. median $3,592 1.3× median
27630 HCPCS	Excision Of Cyst Ganglion	7	$497.60	$7,391.12	$4,506.94	nat. median $3,184 1.4× median
30520 HCPCS	Septoplasty Submucous Res	7	$544.48	$7,072.20	$4,312.47	nat. median $3,617 1.2× median
57558 HCPCS	Hc Dilation & Curettage Of Cervical Stum	7	$132.74	$6,745.05	$4,112.98	nat. median $3,253 1.3× median
58120 HCPCS	Hc Dilation And Curettage No	7	$265.00	$6,745.05	$4,112.98	nat. median $3,366 1.2× median
59160 HCPCS	Hc D & C After Delivery, Curretage Postp	7	$231.13	$6,745.05	$4,112.98	nat. median $3,185 1.3× median
57415 HCPCS	Removal Impacted Vaginal	7	$141.32	$6,745.05	$4,112.98	nat. median $3,307 1.2× median
59812 HCPCS	Hc Tx Incom Abortion, Any Trim, Com Surg	7	$317.48	$6,745.05	$4,112.98	nat. median $3,343 1.2× median
57200 HCPCS	Colporrhaphy, Suture Of V	7	$273.44	$6,745.05	$4,112.98	nat. median $3,248 1.3× median
58600 HCPCS	Hc Lig/transection Fall Tube, Abd Or Val	7	$302.56	$6,745.05	$4,112.98	nat. median $3,339 1.2× median
J1439 HCPCS	Injectafer 750 Mg (ferric Carboxymaltose,340b	7	$819.52	$6,316.33	$3,851.56	nat. median $5 outlier · 766.5×
24076 HCPCS	Exc Tumor Soft Tissue Arm	7	$466.27	$6,261.08	$3,817.86	nat. median $2,895 1.3× median
19307 HCPCS	Pf Mastectomy Mod Rad Incl A	7	$952.24	$10,047.78	$3,660.80	nat. median $6,381 0.6× median
58285 HCPCS	Hc Vaginal Hysterectomy, Rad	5	$1,203.81	$5,749.42	$3,577.42	nat. median $3,740 1.0× median
J0897 HCPCS	Denosumab 60 Mg/ml Syrg	7	$1,659.60	$5,524.38	$3,368.64	nat. median $86 outlier · 39.2×
58145 HCPCS	Hc Myomec, Ex 1-4 Myomas Toto Wt 250 Vag	7	$454.56	$5,396.85	$3,290.88	nat. median $3,376 1.0× median
43860 HCPCS	Pf Revision Gastrojejunal An	7	$1,326.17	$8,212.72	$3,290.84	nat. median $2,824 1.2× median
D2740 HCPCS	Hc Ceramic Crowns	4	$2,726.72	$4,471.67	$3,254.38	nat. median $59 outlier · 54.9×
29806 HCPCS	Pf Shoulder Arthroscopy	7	$857.08	$16,151.40	$3,190.90	nat. median $7,073 outlier · 0.5×
15824 HCPCS	Phytidectomy Forehead	4	$2,671.83	$4,381.65	$3,188.87	nat. median $2,683 1.2× median
21933 HCPCS	Exc Soft Tiss Of Back;5cm Or Grtr	7	$598.20	$6,261.08	$3,144.87	nat. median $3,035 1.0× median
19303 HCPCS	Pf Mastectomy Simple Compl	7	$776.51	$7,262.60	$3,028.41	nat. median $6,248 outlier · 0.5×
59300 HCPCS	Episiotomy Vag Repair Oth	7	$197.89	$4,815.86	$2,936.60	nat. median $3,106 0.9× median

Other procedures at this hospital

Browse this hospital's 2,228 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

58570	HCPCS	Hc Lap Total Hysterectomy Ut	7	7	$25,239.50	$25,239.50	$662.92	$22,715.55	$13,851.44	2026-09-21
58554	HCPCS	Hc Lap Vag Hyst Ut 250g; Tube(s)/ovary(s	7	7	$25,239.50	$25,239.50	$1,066.26	$22,715.55	$13,851.44	2026-09-21
58552	HCPCS	Hc Lap Vag Hy Ut 250 Or Less W/rem Tub/o	7	7	$25,239.50	$25,239.50	$803.34	$22,715.55	$13,851.44	2026-09-21
58571	HCPCS	Hc Lap Total Hyst Uterus 250	7	7	$25,239.50	$25,239.50	$753.92	$22,715.55	$13,851.44	2026-09-21
J2997	HCPCS	Alteplase 50 Mg Inj (activase)	35	7	$21,748.62	$21,748.62	$182.96	$39,977.82	$9,195.54	2026-09-21
J3101	HCPCS	Tenecteplase 50 Mg Kit	14	7	$9,000.00	$9,000.00	$4,939.20	$8,820.00	$8,100.00	2026-09-21
21048	HCPCS	Exc Of Ben Tum Cyst Max I	7	7	$14,551.75	$14,551.75	$823.39	$13,096.58	$7,986.00	2026-09-21
58671	HCPCS	Hc Lap, Surg; W/occlusion Of Oviducts	7	7	$14,501.25	$14,501.25	$303.11	$13,051.12	$7,958.29	2026-09-21
58661	HCPCS	Hc Laparoscopy, Prtl/tot Oop	7	7	$14,501.25	$14,501.25	$536.47	$13,051.12	$7,958.29	2026-09-21
38740	HCPCS	Axilary Lymphadenectomy;	7	7	$14,500.00	$14,500.00	$605.21	$13,050.00	$7,957.60	2026-09-21
J1306	HCPCS	Leqvio 284 Mg/1.5 Ml Injection	14	7	$13,633.00	$13,633.00	$18.42	$12,269.70	$7,481.79	2026-09-21
57240	HCPCS	Anterior Colporrhaphy-rep	7	7	$12,815.00	$12,815.00	$498.24	$11,533.50	$7,032.87	2026-09-21
57250	HCPCS	Posterior Colporrhaphy-re	7	7	$12,815.00	$12,815.00	$498.37	$11,533.50	$7,032.87	2026-09-21
57530	HCPCS	Trachelectomy(cervicectom	7	7	$12,815.00	$12,815.00	$306.21	$11,533.50	$7,032.87	2026-09-21
58260	HCPCS	Hc Vaginal Hysterectomy Uter	7	7	$12,814.75	$12,814.75	$679.15	$11,533.28	$7,032.73	2026-09-21
35903	HCPCS	Exc Of Infected Graft, Ex	7	7	$9,821.00	$9,821.00	$469.92	$8,838.90	$5,389.76	2026-09-21
49402	HCPCS	Rem Of Pertoneal Foreign	7	7	$9,328.00	$9,328.00	$723.96	$8,395.20	$5,119.21	2026-09-21
15273	HCPCS	Appl Subs Skn T-a-l >100c	7	7	$8,932.00	$8,932.00	$284.72	$8,038.80	$4,901.88	2026-09-21
15757	HCPCS	Pf Free Skin Flap W Mcrovasc	13	7	$8,177.65	$8,177.65	$1,783.66	$9,348.12	$4,579.48	2026-09-21
36565	HCPCS	Insertion Of Central Veno	7	7	$8,313.50	$8,313.50	$746.83	$7,482.15	$4,562.45	2026-09-21
29870	HCPCS	Arthro Knee Diagn W Wo Sy	7	7	$8,212.50	$8,212.50	$527.61	$7,391.25	$4,507.02	2026-09-21
27630	HCPCS	Excision Of Cyst Ganglion	7	7	$8,212.35	$8,212.35	$497.60	$7,391.12	$4,506.94	2026-09-21
30520	HCPCS	Septoplasty Submucous Res	7	7	$7,858.00	$7,858.00	$544.48	$7,072.20	$4,312.47	2026-09-21
57200	HCPCS	Colporrhaphy, Suture Of V	7	7	$7,494.50	$7,494.50	$273.44	$6,745.05	$4,112.98	2026-09-21
58120	HCPCS	Hc Dilation And Curettage No	7	7	$7,494.50	$7,494.50	$265.00	$6,745.05	$4,112.98	2026-09-21
57415	HCPCS	Removal Impacted Vaginal	7	7	$7,494.50	$7,494.50	$141.32	$6,745.05	$4,112.98	2026-09-21
57558	HCPCS	Hc Dilation & Curettage Of Cervical Stum	7	7	$7,494.50	$7,494.50	$132.74	$6,745.05	$4,112.98	2026-09-21
59160	HCPCS	Hc D & C After Delivery, Curretage Postp	7	7	$7,494.50	$7,494.50	$231.13	$6,745.05	$4,112.98	2026-09-21
59812	HCPCS	Hc Tx Incom Abortion, Any Trim, Com Surg	7	7	$7,494.50	$7,494.50	$317.48	$6,745.05	$4,112.98	2026-09-21
58600	HCPCS	Hc Lig/transection Fall Tube, Abd Or Val	7	7	$7,494.50	$7,494.50	$302.56	$6,745.05	$4,112.98	2026-09-21
J1439	HCPCS	Injectafer 750 Mg (ferric Carboxymaltose,340b	7	7	$7,018.14	$7,018.14	$819.52	$6,316.33	$3,851.56	2026-09-21
24076	HCPCS	Exc Tumor Soft Tissue Arm	7	7	$6,956.75	$6,956.75	$466.27	$6,261.08	$3,817.86	2026-09-21
19307	HCPCS	Pf Mastectomy Mod Rad Incl A	17	7	$11,164.20	$11,164.20	$952.24	$10,047.78	$3,660.80	2026-09-21
J0897	HCPCS	Denosumab 60 Mg/ml Syrg	14	7	$6,138.20	$6,138.20	$1,659.60	$5,524.38	$3,368.64	2026-09-21
58145	HCPCS	Hc Myomec, Ex 1-4 Myomas Toto Wt 250 Vag	7	7	$5,996.50	$5,996.50	$454.56	$5,396.85	$3,290.88	2026-09-21
43860	HCPCS	Pf Revision Gastrojejunal An	13	7	$5,876.50	$5,876.50	$1,326.17	$8,212.72	$3,290.84	2026-09-21
29806	HCPCS	Pf Shoulder Arthroscopy	17	7	$3,545.45	$3,545.45	$857.08	$16,151.40	$3,190.90	2026-09-21
21933	HCPCS	Exc Soft Tiss Of Back;5cm Or Grtr	15	7	$5,730.45	$5,730.45	$598.20	$6,261.08	$3,144.87	2026-09-21
19303	HCPCS	Pf Mastectomy Simple Compl	17	7	$3,364.90	$3,364.90	$776.51	$7,262.60	$3,028.41	2026-09-21
59300	HCPCS	Episiotomy Vag Repair Oth	7	7	$5,350.95	$5,350.95	$197.89	$4,815.86	$2,936.60	2026-09-21
28153	HCPCS	Rsctn Condyle Dstl End Ph	7	7	$5,339.45	$5,339.45	$351.66	$4,805.50	$2,930.29	2026-09-21
J0586	HCPCS	Abobotulinumtoxina, Inj, 5 Units Dysport	14	7	$5,154.00	$5,154.00	$42.65	$4,638.60	$2,828.52	2026-09-21
J0875	HCPCS	Dalvance 500 Mg Inj (dalbavancin)	14	7	$3,141.00	$3,141.00	$1,723.78	$3,141.00	$2,826.90	2026-09-21
59612	HCPCS	Vag Delivery After C Sect	7	7	$4,986.40	$4,986.40	$747.35	$4,487.76	$2,736.53	2026-09-21
59409	HCPCS	OB Care Vaginal Delivery	7	7	$4,986.40	$4,986.40	$658.36	$4,487.76	$2,736.53	2026-09-21
14060	HCPCS	Adj Tis Trn Lid 10 Cm	7	7	$4,868.50	$4,868.50	$687.99	$4,381.65	$2,671.83	2026-09-21
15277	HCPCS	Appl Subs Skn F-s-hnd-ft-	7	7	$4,868.50	$4,868.50	$319.57	$4,381.65	$2,671.83	2026-09-21
15271	HCPCS	Appl Subs Skn T-a-l 100cm	7	7	$4,868.50	$4,868.50	$139.11	$4,381.65	$2,671.83	2026-09-21
23412	HCPCS	Rep Of Rup Musc Cuff Open	13	7	$13,046.75	$13,046.75	$691.70	$11,742.08	$2,647.53	2026-09-21
38745	HCPCS	Pf Axillary Lymphadenectomy;	17	7	$2,941.70	$2,941.70	$715.82	$13,050.00	$2,647.53	2026-09-21
15830	HCPCS	Pf Excsn Excss Skin Subq Tis	17	7	$2,780.70	$2,780.70	$948.28	$14,140.80	$2,502.63	2026-09-21
29862	HCPCS	Pf Artho Hip Surgical W Deb	17	7	$2,779.55	$2,779.55	$657.95	$16,151.40	$2,501.60	2026-09-21
42104	HCPCS	Hc Excision, Les Palate, Uvula; Wo Clos	7	7	$4,128.00	$4,128.00	$190.94	$3,715.20	$2,471.33	2026-09-21
J0840	HCPCS	Crofab Solr (snake Antivenom)	14	7	$4,422.00	$4,422.00	$1,779.64	$3,979.80	$2,426.79	2026-09-21
58925	HCPCS	Pf Ovarian Cystectomy	17	7	$2,618.55	$2,618.55	$623.79	$11,533.28	$2,356.70	2026-09-21
44180	HCPCS	Pf Enterolysis Laparosc Surg	17	7	$2,606.00	$2,606.00	$746.25	$13,050.00	$2,345.40	2026-09-21
24342	HCPCS	Pf Repair Of Ruputred Tenton	17	7	$2,588.65	$2,588.65	$629.72	$11,742.08	$2,329.78	2026-09-21
J0585	HCPCS	Onabotulinumtoxin A, 150 Units No WASTE,Pharmacy, 340b	42	7	$4,537.50	$4,537.50	$637.98	$5,445.00	$2,324.00	2026-09-21
J2426	HCPCS	Paliperidone Palmi 156 Mg/ml Syrg (inveg	28	7	$9,283.86	$9,283.86	$22.10	$12,532.91	$2,304.03	2026-09-21
27236	HCPCS	Pf Opn Trt Of For Frac Pro E	13	7	$4,068.70	$4,068.70	$966.34	$7,802.86	$2,278.47	2026-09-21
60220	HCPCS	Pf Total Thyroid Lobectomy U	17	7	$2,527.70	$2,527.70	$573.80	$13,051.04	$2,274.93	2026-09-21
38221	HCPCS	Bone Marrow Bx	7	7	$4,118.00	$4,118.00	$146.17	$3,706.20	$2,259.96	2026-09-21
21011	HCPCS	Exc Tumor Soft Tissue Of	7	7	$4,118.00	$4,118.00	$344.58	$3,706.20	$2,259.96	2026-09-21
38220	HCPCS	Bone Marrow Aspirate	7	7	$4,118.00	$4,118.00	$146.44	$3,706.20	$2,259.96	2026-09-21
27327	HCPCS	Excision Of Tissue To Kne	7	7	$4,117.80	$4,117.80	$469.24	$3,706.02	$2,259.85	2026-09-21
60240	HCPCS	Pf Thyroidectomy Total	17	7	$2,500.10	$2,500.10	$744.49	$13,051.04	$2,250.09	2026-09-21
40819	HCPCS	Hc Frenulectomy	7	7	$4,058.50	$4,058.50	$243.71	$3,652.65	$2,227.30	2026-09-21
29827	HCPCS	Pf Arthro Shldr Surg Rotator	17	7	$2,439.15	$2,439.15	$865.13	$16,151.40	$2,195.24	2026-09-21
87536	HCPCS	Hic Viral Load	7	7	$3,988.00	$3,988.00	$76.59	$3,589.20	$2,188.61	2026-09-21
60650	HCPCS	Pf Laparoscopy Surgical W/ad	13	7	$3,903.10	$3,903.10	$970.31	$7,278.12	$2,185.74	2026-09-21
59820	HCPCS	Hc Trmt Of Missed Ab, Surgical, 1st Trim	15	7	$2,832.50	$2,832.50	$345.91	$5,396.85	$2,124.38	2026-09-21
29807	HCPCS	Pf Arthro Shdlr Surg Rpr Sla	17	7	$2,336.80	$2,336.80	$836.70	$16,151.40	$2,103.12	2026-09-21
58660	HCPCS	Pf Laparoscopy W Lysis Of Ad	17	7	$2,321.85	$2,321.85	$557.87	$13,051.12	$2,089.66	2026-09-21
25606	HCPCS	Pf Percutaneous Skeletal Fix	17	7	$2,281.60	$2,281.60	$544.95	$7,391.25	$2,053.44	2026-09-21
24359	HCPCS	Pf Repair Elbow Deb Open With	17	7	$2,265.50	$2,265.50	$540.69	$7,998.48	$2,038.95	2026-09-21
29876	HCPCS	Pf Arthroscopy Knee Srg Syno	17	7	$2,263.20	$2,263.20	$530.70	$7,391.25	$2,036.88	2026-09-21
11044	HCPCS	Debrid Bone; First 20sqcm Or Less	15	7	$3,600.00	$3,600.00	$213.10	$3,706.20	$1,975.68	2026-09-21
23420	HCPCS	Pf Recon Complet Shldr Chrni	17	7	$2,187.30	$2,187.30	$791.00	$16,151.40	$1,968.57	2026-09-21
28805	HCPCS	Amputation Foot Transmeta	15	7	$2,618.55	$2,618.55	$578.84	$7,391.25	$1,963.91	2026-09-21
35207	HCPCS	Pf Repair Of Artery Of Hand	15	7	$2,605.90	$2,605.90	$612.42	$10,158.52	$1,954.42	2026-09-21
19301	HCPCS	Pf Mastectomy Partieal	17	7	$2,170.05	$2,170.05	$533.83	$5,544.50	$1,953.04	2026-09-21
26951	HCPCS	Pf Amp Finger Or Thumb Pri	17	7	$2,170.05	$2,170.05	$553.73	$7,391.12	$1,953.04	2026-09-21
36561	HCPCS	Pf Insert Tun Cent Cath Ven	21	7	$7,715.35	$7,715.35	$316.25	$7,482.60	$1,939.50	2026-09-21
44025	HCPCS	Pf Colotomy For Exp Biopsy O	13	7	$3,458.05	$3,458.05	$797.11	$5,945.04	$1,936.51	2026-09-21
59414	HCPCS	Pf Delivery Placenta	17	7	$2,130.95	$2,130.95	$73.43	$4,487.76	$1,917.86	2026-09-21
21490	HCPCS	Pf Opn Trt Temporomndiblr Di	17	7	$2,106.80	$2,106.80	$651.00	$9,826.29	$1,896.12	2026-09-21
54065	HCPCS	Hc Destruct Of Lesion(s), Penis, Exts	7	7	$3,430.75	$3,430.75	$197.95	$3,087.68	$1,882.80	2026-09-21
87633	HCPCS	Resp Virus Panel (rpp)	7	7	$3,430.00	$3,430.00	$375.10	$3,087.00	$1,882.38	2026-09-21
47564	HCPCS	Pf Lap Surg Chlestcmy W Expl	17	7	$2,090.00	$2,090.00	$906.59	$13,050.90	$1,881.00	2026-09-21
29828	HCPCS	Pf Arthrscpy Shldr Surgcl Bi	17	7	$2,083.80	$2,083.80	$742.46	$16,151.40	$1,875.42	2026-09-21
44206	HCPCS	Pf Lap Colectolmy Partial Hartmann Type	13	7	$3,296.00	$3,296.00	$1,402.23	$8,318.30	$1,845.76	2026-09-21
25116	HCPCS	Pf Rad Exc Bursa Syn Wst Fra	17	7	$2,040.10	$2,040.10	$493.19	$7,391.25	$1,836.09	2026-09-21
47563	HCPCS	Pf Laparoscopic Cholecystect	17	7	$2,015.00	$2,015.00	$583.31	$13,050.90	$1,813.50	2026-09-21
44207	HCPCS	Pf Lap Colectomy Partial	9	7	$4,220.00	$4,220.00	$1,462.35	$3,798.00	$1,769.44	2026-09-21
29825	HCPCS	Pf Shoulder Arthroscopy/shou	17	7	$1,952.70	$1,952.70	$476.53	$13,534.70	$1,757.43	2026-09-21
29822	HCPCS	Pf Arthroscopy Shoulder Sur	17	7	$1,952.70	$1,952.70	$440.11	$7,560.00	$1,757.43	2026-09-21
14350	HCPCS	Filleted Fingertip/toe Fl	7	7	$3,153.30	$3,153.30	$563.42	$2,837.97	$1,730.53	2026-09-21
78452	HCPCS	Xr Myocardial Perfusion-mult,technical Component	7	7	$3,122.00	$3,122.00	$297.90	$2,809.80	$1,713.35	2026-09-21
78451	HCPCS	Xr Cardiovascular SPECT;SING,Technical Component	7	7	$3,122.00	$3,122.00	$209.20	$2,809.80	$1,713.35	2026-09-21
29883	HCPCS	Pf Arthrscp Knee Surg W Mens	17	7	$1,899.80	$1,899.80	$680.72	$7,391.25	$1,709.82	2026-09-21
43281	HCPCS	Pf Lap, Para Hernia Without Mesh	11	7	$3,094.50	$3,094.50	$1,241.80	$3,094.50	$1,698.26	2026-09-21
49651	HCPCS	Pf Lap Repair Recur Ingl Her	17	7	$1,866.45	$1,866.45	$458.53	$13,050.00	$1,679.80	2026-09-21
49020	HCPCS	Pf Drainage Of Peri Abs Or	13	7	$2,996.00	$2,996.00	$1,290.56	$4,100.67	$1,677.76	2026-09-21
29873	HCPCS	Pf Arthroscopy Knee Surg For	17	7	$1,864.15	$1,864.15	$434.82	$7,391.25	$1,677.74	2026-09-21
59410	HCPCS	Vag Delivery Only Ppc	7	7	$3,050.95	$3,050.95	$874.17	$2,745.86	$1,674.36	2026-09-21
29820	HCPCS	Pf Arthroscopy Sld Surgica	17	7	$1,859.55	$1,859.55	$435.20	$16,151.40	$1,673.60	2026-09-21
58180	HCPCS	Hc Supra Crvcl Abd Hysterect	11	7	$2,214.90	$2,214.90	$783.25	$2,755.17	$1,661.18	2026-09-21
44960	HCPCS	Pf Appendectomy For Ruptured	13	7	$2,953.20	$2,953.20	$710.96	$5,184.32	$1,653.79	2026-09-21
45393	HCPCS	Colonoscopy With Decompress	7	7	$3,012.00	$3,012.00	$202.83	$2,710.80	$1,652.99	2026-09-21
48140	HCPCS	Pf Pancreatectomy W/wo Splen	13	7	$2,940.00	$2,940.00	$1,268.57	$6,520.50	$1,646.40	2026-09-21
44661	HCPCS	Pf Close Fitula With Intestine	13	7	$2,935.00	$2,935.00	$1,251.00	$7,035.93	$1,643.60	2026-09-21
44143	HCPCS	Pf Colostomy Close Dis Seg	9	7	$3,128.00	$3,128.00	$1,331.65	$2,815.20	$1,629.45	2026-09-21
44204	HCPCS	Pf Laparoscopy Colectomy Par	13	7	$2,902.00	$2,902.00	$1,240.97	$8,318.30	$1,625.12	2026-09-21
24358	HCPCS	Pf Tenotomy Elbow Lateral/	17	7	$1,799.75	$1,799.75	$432.84	$7,045.24	$1,619.78	2026-09-21
29894	HCPCS	Pf Arth Akl Sur W Rem Of Lse	17	7	$1,758.35	$1,758.35	$412.42	$7,391.25	$1,582.52	2026-09-21
49255	HCPCS	Pf Omentectomy Epiplo Resect	13	7	$2,814.05	$2,814.05	$643.69	$4,126.54	$1,575.87	2026-09-21
29875	HCPCS	Pf Arthroscopy Knee Surgical	17	7	$1,702.00	$1,702.00	$403.63	$7,391.25	$1,531.80	2026-09-21
32557	HCPCS	CT Pleural Drainage WITH,Technical Component	7	7	$2,778.00	$2,778.00	$559.27	$2,500.20	$1,524.57	2026-09-21
41010	HCPCS	Hc Incision Of Lingual Frenum	7	7	$2,763.25	$2,763.25	$182.11	$2,486.92	$1,516.47	2026-09-21
47562	HCPCS	Pf Laparoscopic Cholecystect	17	7	$1,684.75	$1,684.75	$536.26	$13,050.90	$1,516.28	2026-09-21
43280	HCPCS	Pf Laparoscopy Fundoplasty	11	7	$2,762.00	$2,762.00	$872.84	$2,762.00	$1,515.79	2026-09-21
25210	HCPCS	Pf Carpectomy 1 Bone	17	7	$1,658.30	$1,658.30	$402.80	$7,998.48	$1,492.47	2026-09-21
64718	HCPCS	Hc Neurop/trans; Ulnar Nerve	15	7	$2,026.30	$2,026.30	$489.05	$4,642.42	$1,488.08	2026-09-21
73706	HCPCS	CTA Lower Ext BILAT,Bilateral Procedure, Technical Component	21	7	$2,709.30	$2,709.30	$135.66	$4,876.74	$1,486.87	2026-09-21
43611	HCPCS	Pf Excis Malig Tumor Stomach	13	7	$2,626.60	$2,626.60	$994.89	$4,975.24	$1,470.90	2026-09-21
67312	HCPCS	Pf Strbisms Recssn Resctn 2	17	7	$1,630.70	$1,630.70	$510.16	$5,410.98	$1,467.63	2026-09-21
27360	HCPCS	Pf Prtl Excis Bone Fmur Prxm	17	7	$1,630.00	$1,630.00	$725.02	$7,391.12	$1,467.00	2026-09-21
49557	HCPCS	Pf Rpr Rcrnt Femrl Hernia In	17	7	$1,627.25	$1,627.25	$586.06	$8,395.20	$1,464.52	2026-09-21
44202	HCPCS	Pf Laparoscopic Resection	13	7	$2,606.00	$2,606.00	$1,121.92	$4,749.62	$1,459.36	2026-09-21
73220	HCPCS	MRI Upper Ext Non Joint Wo/w Con BILAT,Bilateral Procedure, Technical Component	21	7	$2,645.50	$2,645.50	$259.12	$4,761.90	$1,451.85	2026-09-21
27784	HCPCS	Pf Opn Trt Prox Fibula Fx W	17	7	$1,610.00	$1,610.00	$576.81	$10,851.98	$1,449.00	2026-09-21
43249	HCPCS	Pf Upper Gi Endo Balloon Dil	15	7	$1,938.00	$1,938.00	$144.46	$4,204.80	$1,445.58	2026-09-21
23410	HCPCS	Pf Opn Rpr Ruptrd Msctndens	17	7	$1,600.00	$1,600.00	$665.39	$16,151.40	$1,440.00	2026-09-21
24615	HCPCS	Pf Opn Trt Acut Chrnc Elbw D	17	7	$1,599.65	$1,599.65	$580.78	$21,535.20	$1,439.68	2026-09-21
11005	HCPCS	Pf Subcut Tis; Abd Wall W/with	13	7	$2,561.05	$2,561.05	$624.06	$4,204.17	$1,434.19	2026-09-21
26045	HCPCS	Pf Fascrotomy Palmar Open Pa	17	7	$1,592.75	$1,592.75	$385.84	$7,391.25	$1,433.48	2026-09-21
35221	HCPCS	Pf Repair Blood Vessel Intra	9	7	$11,234.35	$11,234.35	$1,177.64	$10,110.92	$1,433.38	2026-09-21
24000	HCPCS	Pf Athrotomy Elbow Including	17	7	$1,582.40	$1,582.40	$391.02	$7,998.48	$1,424.16	2026-09-21
44140	HCPCS	Pf Colectomy Partial With An	13	7	$2,535.50	$2,535.50	$1,086.00	$7,948.80	$1,419.88	2026-09-21
11772	HCPCS	Pf Exc Of Pilomidal Cyst/sin	17	7	$1,576.00	$1,576.00	$586.20	$6,261.30	$1,418.40	2026-09-21
29882	HCPCS	Pf Knee Arthroscopy/surgery	17	7	$1,574.35	$1,574.35	$559.65	$7,391.25	$1,416.92	2026-09-21
46260	HCPCS	Pf Hemorrhoidectomy 2 Or Mo	17	7	$1,574.35	$1,574.35	$389.93	$8,235.00	$1,416.92	2026-09-21
15120	HCPCS	Pf Split Thk Auto Gft Face S	17	7	$1,572.00	$1,572.00	$640.99	$8,038.80	$1,414.80	2026-09-21
23405	HCPCS	Tenotomy Shldr Area Sngl	21	7	$17,946.00	$17,946.00	$499.61	$21,534.75	$1,414.50	2026-09-21
44205	HCPCS	Pf Laparoscopy Colectomy Par	13	7	$2,524.00	$2,524.00	$1,078.18	$6,883.78	$1,413.44	2026-09-21
73202	HCPCS	CT Upper Ext Wo/w IV Con BILAT,Bilateral Procedure, Technical Component	21	7	$2,575.10	$2,575.10	$135.66	$4,635.18	$1,413.22	2026-09-21
49250	HCPCS	Pf Umbilectomy Omphalectomy	17	7	$1,562.85	$1,562.85	$483.25	$5,701.82	$1,406.56	2026-09-21
26123	HCPCS	Pf Fasciectomy Partial Parlm	17	7	$1,551.50	$1,551.50	$682.11	$7,391.25	$1,396.35	2026-09-21
55520	HCPCS	Pf Exc Of Lesion Of Spermati	17	7	$1,545.60	$1,545.60	$372.01	$8,149.50	$1,391.04	2026-09-21
44130	HCPCS	Pf Anastomosis Of Intestine	13	7	$2,474.00	$2,474.00	$1,066.69	$6,064.06	$1,385.44	2026-09-21
14061	HCPCS	Adj Tissue Trans Nose Ear	15	7	$1,841.00	$1,841.00	$730.46	$4,381.65	$1,380.75	2026-09-21
67318	HCPCS	Pf Strbismus Srg Suprior Obl	17	7	$1,529.50	$1,529.50	$528.88	$5,410.98	$1,376.55	2026-09-21
67316	HCPCS	Pf Strbisms Recssn Resctn 2	15	7	$1,834.25	$1,834.25	$545.56	$5,410.98	$1,375.69	2026-09-21
43830	HCPCS	Pf Gastrostomy Open Without Cons	11	7	$2,504.70	$2,504.70	$568.35	$2,254.23	$1,374.58	2026-09-21
29824	HCPCS	Pf Surg Shldr Arthroscpy Dis	17	7	$1,524.90	$1,524.90	$549.53	$7,391.25	$1,372.41	2026-09-21
67314	HCPCS	Pf Strbisms Recssn Resctn 1	17	7	$1,518.00	$1,518.00	$354.52	$5,410.98	$1,366.20	2026-09-21
11012	HCPCS	Pf Debride Inc Rem Mat Fx/di	17	7	$1,503.05	$1,503.05	$380.64	$6,261.30	$1,352.74	2026-09-21
24357	HCPCS	Pf Tenotomy Elbow Lateral M	17	7	$1,501.90	$1,501.90	$337.80	$7,998.48	$1,351.71	2026-09-21
29879	HCPCS	Pf Knee Arthrscpy Surg Abrsn	17	7	$1,493.85	$1,493.85	$537.84	$7,391.25	$1,344.46	2026-09-21
45171	HCPCS	Pf Excision Of Recal Tumor T	17	7	$1,491.55	$1,491.55	$495.33	$6,329.25	$1,342.40	2026-09-21
64774	HCPCS	Pf Excision Of Neuroma	17	7	$1,477.75	$1,477.75	$348.09	$4,297.32	$1,329.98	2026-09-21
21336	HCPCS	Pf Open Trt Nasal Sept Al Fx	17	7	$1,476.60	$1,476.60	$503.50	$5,689.40	$1,328.94	2026-09-21
47610	HCPCS	Pf Cholecystectomy W/explr C	13	7	$2,358.00	$2,358.00	$1,016.42	$7,851.51	$1,320.48	2026-09-21
44160	HCPCS	Pf Colectomy Partial W Rem	13	7	$2,338.00	$2,338.00	$1,005.19	$7,722.14	$1,309.28	2026-09-21
72198	HCPCS	MRA Pelvis Wo/w Con CON,Technical Component	7	7	$2,384.00	$2,384.00	$192.63	$2,145.60	$1,308.34	2026-09-21
71551	HCPCS	MRI Chest W CON,Technical Component	7	7	$2,384.00	$2,384.00	$246.20	$2,145.60	$1,308.34	2026-09-21
73219	HCPCS	MRI Upper Ext Non Joint W Con BILAT,Bilateral Procedure, Technical Component	21	7	$2,384.00	$2,384.00	$214.91	$3,886.74	$1,308.34	2026-09-21
73222	HCPCS	MRI Upper Ext Joint W Con BILAT,Bilateral Procedure, Technical Component	21	7	$2,384.00	$2,384.00	$200.26	$3,886.74	$1,308.34	2026-09-21
11771	HCPCS	Pf Exc Of Pilonidal Cyst/sin	17	7	$1,446.70	$1,446.70	$453.30	$6,261.30	$1,302.03	2026-09-21
73701	HCPCS	CT Lower Ext W IV Con BILAT,Bilateral Procedure, Technical Component	21	7	$2,370.50	$2,370.50	$94.89	$4,266.90	$1,300.93	2026-09-21
49083	HCPCS	CT Paracentesis W IMAGING,Technical Component	7	7	$2,358.00	$2,358.00	$247.87	$2,122.20	$1,294.07	2026-09-21
44120	HCPCS	Pf Enterectomy	13	7	$2,302.00	$2,302.00	$990.22	$7,064.91	$1,289.12	2026-09-21
49650	HCPCS	Pf Lap Repair Initi Ingl Her	17	7	$1,431.75	$1,431.75	$351.41	$13,050.00	$1,288.58	2026-09-21
15240	HCPCS	Full Thck Head Hand 20 Sq	15	7	$1,715.00	$1,715.00	$724.38	$4,381.65	$1,286.25	2026-09-21
27632	HCPCS	Pf Exc Tum Soft Tiss Of Leg	17	7	$1,416.80	$1,416.80	$332.99	$6,261.03	$1,275.12	2026-09-21
29823	HCPCS	Pf Arthro Shdlr Srg Debrid E	17	7	$1,415.65	$1,415.65	$481.27	$12,395.16	$1,274.08	2026-09-21
64702	HCPCS	Hc Neuroplasty;digital 1 Or	15	7	$1,695.10	$1,695.10	$416.39	$4,642.42	$1,271.32	2026-09-21
73201	HCPCS	CT Upper Ext W IV Con BILAT,Bilateral Procedure, Technical Component	21	7	$2,315.50	$2,315.50	$123.08	$4,167.90	$1,270.75	2026-09-21
44320	HCPCS	Pf Colostomy Of Skin	13	7	$2,259.00	$2,259.00	$971.16	$7,401.28	$1,265.04	2026-09-21
29877	HCPCS	Pf Arthsc Knee Dbrid Shv Art	17	7	$1,401.85	$1,401.85	$504.50	$7,391.25	$1,261.66	2026-09-21
26990	HCPCS	Pf I & D Plvis Jnt Deep Abs	17	7	$1,397.25	$1,397.25	$543.84	$4,799.30	$1,257.52	2026-09-21
49440	HCPCS	Insertion Gastro Tube Per	15	7	$1,664.00	$1,664.00	$191.14	$4,204.80	$1,248.00	2026-09-21
24071	HCPCS	Pf Exc Tumor Sft Tiss Upp Ar	17	7	$1,380.00	$1,380.00	$329.71	$6,261.30	$1,242.00	2026-09-21
11404	HCPCS	Exc Benign Les Inc Marg T	25	7	$3,600.00	$3,600.00	$156.59	$4,941.00	$1,234.68	2026-09-21
11422	HCPCS	Exc Bn Sclp Nk Hnd Ft Gn 1.1 To 2.0 Cm	25	7	$2,640.00	$2,640.00	$128.18	$4,941.00	$1,234.68	2026-09-21
26410	HCPCS	Pf Rep Ext Tendon Hnd Wo Fr	19	7	$4,152.65	$4,152.65	$469.05	$4,879.35	$1,219.57	2026-09-21
26145	HCPCS	Pf Tendon Excision Palm/fing	15	7	$1,691.65	$1,691.65	$421.80	$3,883.32	$1,219.57	2026-09-21
24535	HCPCS	Clsd Trt Of Supracondylar	19	7	$4,066.00	$4,066.00	$509.00	$4,879.35	$1,219.57	2026-09-21
26525	HCPCS	Pf Release Finger Contractur	15	7	$2,098.75	$2,098.75	$534.36	$3,883.32	$1,219.57	2026-09-21
27502	HCPCS	Cls Trt Femrl Shft Fx W M	15	7	$1,757.20	$1,757.20	$614.47	$4,165.88	$1,219.57	2026-09-21
23605	HCPCS	Clsd Trtm Of Hum Fx W Man	19	7	$4,319.40	$4,319.40	$384.39	$4,165.88	$1,219.57	2026-09-21
36820	HCPCS	Pf Arteriovenous Anastomosis, Open; By	17	7	$1,352.00	$1,352.00	$581.01	$12,409.20	$1,216.80	2026-09-21
21931	HCPCS	Exc,tumor, Soft Tiss Of Back;3cm Or Grtr	15	7	$1,620.35	$1,620.35	$382.06	$3,706.20	$1,215.26	2026-09-21
67311	HCPCS	Pf Strbisms Recssn Resctn 1	17	7	$1,348.95	$1,348.95	$354.52	$5,410.98	$1,214.06	2026-09-21
44970	HCPCS	Pf Laparoscopy Appendectomy	17	7	$1,347.80	$1,347.80	$488.72	$10,436.94	$1,213.02	2026-09-21
49521	HCPCS	Pf Repair Recurrent Ing Hern	17	7	$1,345.00	$1,345.00	$583.16	$8,395.20	$1,210.50	2026-09-21
85245	HCPCS	Ristocetin Cofactor	7	7	$2,194.00	$2,194.00	$20.65	$1,974.60	$1,204.07	2026-09-21
14021	HCPCS	Adj Tissue Trsf Scl Arm L	15	7	$1,590.50	$1,590.50	$645.45	$4,381.65	$1,192.88	2026-09-21
49507	HCPCS	Pf Rpr I/hern Init Block >5	17	7	$1,320.20	$1,320.20	$477.40	$8,395.20	$1,188.18	2026-09-21
58662	HCPCS	Pf Lap Surg W/fulguration Of Lesions	17	7	$1,320.00	$1,320.00	$580.55	$13,051.12	$1,188.00	2026-09-21
14040	HCPCS	Pf Adj Tissue Trans Or Rearr	11	7	$2,159.70	$2,159.70	$568.90	$1,943.73	$1,185.24	2026-09-21
73722	HCPCS	MRI Lower Ext Joint W Con BILAT,Bilateral Procedure, Technical Component	21	7	$2,159.30	$2,159.30	$202.23	$3,886.74	$1,185.03	2026-09-21
47605	HCPCS	Pf Cholecystectomy W/cholang	13	7	$2,100.00	$2,100.00	$913.42	$6,210.00	$1,176.00	2026-09-21
15650	HCPCS	Pf Trans Int Of Any Pedical	17	7	$1,305.25	$1,305.25	$391.76	$4,688.55	$1,174.72	2026-09-21
43453	HCPCS	Dilate Esoph Over Guide W	15	7	$1,559.00	$1,559.00	$81.54	$4,205.25	$1,169.25	2026-09-21
29845	HCPCS	Pf Arhtscpy Wrist Synovectmy	17	7	$1,297.20	$1,297.20	$476.99	$6,447.02	$1,167.48	2026-09-21
27532	HCPCS	Pf Cls Trt Tib Fx Wo W Man	17	7	$1,294.90	$1,294.90	$506.22	$4,165.88	$1,165.41	2026-09-21
49550	HCPCS	Pf Rpr Rem Hernia Init Reduc	17	7	$1,293.75	$1,293.75	$470.27	$8,395.20	$1,164.38	2026-09-21
29880	HCPCS	Pf Arthrscpy Menisctmy Med &	17	7	$1,289.15	$1,289.15	$456.35	$7,391.25	$1,160.24	2026-09-21
49525	HCPCS	Pf Rpr Inguinal Hernia Slidi	17	7	$1,286.85	$1,286.85	$466.80	$8,395.20	$1,158.16	2026-09-21
26037	HCPCS	Pf Decompressive Fasciotomy	17	7	$1,284.55	$1,284.55	$459.14	$9,855.00	$1,156.10	2026-09-21
26715	HCPCS	Pf Opn Trt Metcrpphlng Dislo	17	7	$1,278.80	$1,278.80	$467.47	$9,855.00	$1,150.92	2026-09-21
48510	HCPCS	Pf External Drainage Pseudys	13	7	$2,054.00	$2,054.00	$885.56	$5,030.10	$1,150.24	2026-09-21
28825	HCPCS	Pf Amputation Toe Interphala	17	7	$1,276.50	$1,276.50	$167.26	$7,391.25	$1,148.85	2026-09-21
14020	HCPCS	Pf Adj Tiss Trnf Cl Arm Lg 1	17	7	$1,276.00	$1,276.00	$521.97	$4,381.65	$1,148.40	2026-09-21
23530	HCPCS	Pf Opn Trt Sternoclvclr Disl	17	7	$1,265.00	$1,265.00	$469.22	$10,851.98	$1,138.50	2026-09-21
67900	HCPCS	Repair Of Brow Ptosis	7	7	$1,513.40	$1,513.40	$582.79	$1,513.40	$1,135.05	2026-09-21
15823	HCPCS	Pf Bleph Upper Lid Minor Bil	17	7	$1,251.20	$1,251.20	$488.97	$4,637.84	$1,126.08	2026-09-21
47600	HCPCS	Pf Cholecystectomy	13	7	$2,000.00	$2,000.00	$868.40	$2,725.16	$1,120.00	2026-09-21
11047	HCPCS	Pf Debrid Skin Sbq Tis Musc	13	7	$3,140.00	$3,140.00	$90.25	$2,826.00	$1,119.44	2026-09-21
49422	HCPCS	Pf Removal Of Tunneled Intra	17	7	$1,238.55	$1,238.55	$178.43	$7,482.60	$1,114.70	2026-09-21
29881	HCPCS	Pf Arthrscpy Menisctmy Med O	17	7	$1,236.25	$1,236.25	$439.61	$7,391.25	$1,112.62	2026-09-21
26540	HCPCS	Pf Repair Ruptured Collatera	17	7	$1,235.00	$1,235.00	$551.95	$7,391.12	$1,111.50	2026-09-21
26236	HCPCS	Partial Exc Distal Phanla	15	7	$1,481.20	$1,481.20	$361.06	$3,680.46	$1,110.90	2026-09-21
15821	HCPCS	Pf Bleph Lwr Lid W Extsv Hrn	17	7	$1,233.95	$1,233.95	$488.53	$4,637.84	$1,110.56	2026-09-21
49002	HCPCS	Pf Reopening Of Recent Lapar	13	7	$1,967.00	$1,967.00	$845.01	$4,522.95	$1,101.52	2026-09-21
44310	HCPCS	Pf Ileostomy Of Jejunostomy	13	7	$1,965.00	$1,965.00	$841.94	$6,620.90	$1,100.40	2026-09-21
15260	HCPCS	Pf Graft, Nose Eye Lip <20cm	11	7	$1,995.00	$1,995.00	$759.27	$1,795.50	$1,094.86	2026-09-21
25066	HCPCS	Pf Bpsy Sft Tissue Of Forarm	17	7	$1,212.10	$1,212.10	$302.13	$6,261.30	$1,090.89	2026-09-21
29874	HCPCS	Pf Knee Arthroscopy Surg Rem	17	7	$1,212.10	$1,212.10	$435.79	$7,390.80	$1,090.89	2026-09-21
44950	HCPCS	Pf Appendectomy	17	7	$1,207.50	$1,207.50	$521.06	$8,395.20	$1,086.75	2026-09-21
J1442	HCPCS	Filgrastim 300 Mcg/ml Soln,340b	7	7	$1,978.20	$1,978.20	$293.12	$1,780.38	$1,085.63	2026-09-21
44005	HCPCS	Pf Enterolysis Intes Adhesio	9	7	$2,010.70	$2,010.70	$884.51	$1,809.63	$1,085.17	2026-09-21
21040	HCPCS	Excision Of Sebacous Cyst	13	7	$7,858.00	$7,858.00	$424.43	$7,072.20	$1,081.00	2026-09-21
23071	HCPCS	Exc Tumor Sft Tiss Shld A	15	7	$1,440.95	$1,440.95	$341.58	$5,392.35	$1,080.71	2026-09-21
19350	HCPCS	Nipple Areola Reconstruct	7	7	$1,437.50	$1,437.50	$787.91	$1,437.50	$1,078.12	2026-09-21
21012	HCPCS	Pf Exc Tumor Soft Tissue Of	17	7	$1,196.00	$1,196.00	$274.20	$3,706.20	$1,076.40	2026-09-21
25520	HCPCS	Pf Cls Trt Rdial Fx & Disloc	17	7	$1,186.80	$1,186.80	$472.43	$4,807.35	$1,068.12	2026-09-21
49520	HCPCS	Pf Repair Recurrent Inguinal	17	7	$1,183.00	$1,183.00	$514.41	$8,395.20	$1,064.70	2026-09-21
43255	HCPCS	Pf Upper Gi Endo Control Ble	17	7	$1,182.00	$1,182.00	$188.14	$4,204.80	$1,063.80	2026-09-21
24105	HCPCS	Pf Excision Olecranon Bursa	17	7	$1,181.05	$1,181.05	$293.02	$7,391.25	$1,062.94	2026-09-21
26991	HCPCS	Pf I & D Pelvis Hip Infecte	17	7	$1,179.90	$1,179.90	$506.61	$4,799.30	$1,061.91	2026-09-21
47100	HCPCS	Pf Bx Liver Wedge	13	7	$1,892.90	$1,892.90	$685.12	$2,725.16	$1,060.02	2026-09-21
29846	HCPCS	Pf Wrist Arthrscpy Excis Rpr	17	7	$1,176.45	$1,176.45	$426.11	$7,391.25	$1,058.80	2026-09-21
46255	HCPCS	Pf Hemorrhoidectomy Internal	17	7	$1,175.30	$1,175.30	$361.45	$6,329.25	$1,057.77	2026-09-21
20103	HCPCS	Pf Exp Penetrating Wound Ext	21	7	$2,440.00	$2,440.00	$329.78	$2,253.20	$1,057.74	2026-09-21
22902	HCPCS	Pf Exc Tumor Sft Tiss Abd Wa	17	7	$1,171.85	$1,171.85	$339.15	$4,164.84	$1,054.66	2026-09-21
49040	HCPCS	Pf Drainage Of Subiap Or Sub	13	7	$1,883.00	$1,883.00	$814.90	$5,801.18	$1,054.48	2026-09-21
27552	HCPCS	Cls Trt Knee Disloc W Ane	15	7	$1,403.00	$1,403.00	$516.86	$3,360.64	$1,052.25	2026-09-21
49505	HCPCS	Pf Repair Init Ing Hernia >5	17	7	$1,167.25	$1,167.25	$424.79	$8,395.20	$1,050.52	2026-09-21
27328	HCPCS	Pf Exc Tumor Sf Tiss Knee Ar	17	7	$1,161.00	$1,161.00	$505.82	$6,261.30	$1,044.90	2026-09-21
15820	HCPCS	Pf Blepharoplasty Lower Eyel	17	7	$1,160.35	$1,160.35	$455.63	$4,637.84	$1,044.32	2026-09-21
43659	HCPCS	Unlisted Laproscopy Stoma	6	6	$14,499.00	$14,499.00	$4,446.00	$13,049.10	$8,038.24	2026-09-21
J3110	HCPCS	Teriparatide 600 Mcg/2.4 Ml Pnij,340b	6	6	$12,659.10	$12,659.10	$136.92	$11,393.19	$7,018.21	2026-09-21
49329	HCPCS	Unlisted Laparoscopy Abd	12	6	$7,809.47	$7,809.47	$614.08	$13,050.00	$2,782.48	2026-09-21
D4210	HCPCS	Gingivectomy 4 Or More	6	6	$4,771.00	$4,771.00	$2,471.33	$4,293.90	$2,645.04	2026-09-21
D4211	HCPCS	Gingivectomy 1-3 Teeth	6	6	$3,578.25	$3,578.25	$1,963.74	$3,220.42	$2,471.33	2026-09-21
D7450	HCPCS	Rem Ben Odon Cyst Up To 1	6	6	$3,578.25	$3,578.25	$1,963.74	$3,220.42	$2,471.33	2026-09-21
D7451	HCPCS	Rem Ben Odon Cyst Greater	6	6	$3,578.25	$3,578.25	$1,963.74	$3,220.42	$2,471.33	2026-09-21
D7260	HCPCS	Hc Oroantral Fistula Closure	6	6	$4,128.00	$4,128.00	$1,266.98	$3,715.20	$2,288.56	2026-09-21
44238	HCPCS	Pf Lap, Intestine Wo Rectum	6	6	$1,953.95	$1,953.95	$1,072.33	$1,953.95	$1,612.01	2026-09-21
23929	HCPCS	Unlisted Procedure Should	10	6	$7,285.25	$7,285.25	$182.80	$6,556.72	$1,610.97	2026-09-21
D3330	HCPCS	Root Canal Molar	6	6	$1,811.25	$1,811.25	$994.01	$1,630.12	$1,266.98	2026-09-21
D7210	HCPCS	Surg Removal Of Erupted T	6	6	$1,695.00	$1,695.00	$930.22	$1,525.50	$1,128.79	2026-09-21
D7310	HCPCS	Alveoloplasty In Conj W E	6	6	$1,695.00	$1,695.00	$930.22	$1,525.50	$1,128.79	2026-09-21
D7311	HCPCS	Alveoloplasty In Conj W E	6	6	$1,695.00	$1,695.00	$930.22	$1,525.50	$1,128.79	2026-09-21
58150	HCPCS	Hc Total Abd Hysterectomy With	5	5	$10,477.00	$10,477.00	$850.62	$9,429.30	$5,867.12	2026-09-21
58285	HCPCS	Hc Vaginal Hysterectomy, Rad	5	5	$6,388.25	$6,388.25	$1,203.81	$5,749.42	$3,577.42	2026-09-21
43848	HCPCS	Pf Revision Open Gastric Res	11	5	$3,642.50	$3,642.50	$1,624.08	$8,656.74	$2,731.88	2026-09-21
58750	HCPCS	Hc Tubal Ligation Reversal	5	5	$4,600.00	$4,600.00	$735.40	$4,140.00	$2,576.00	2026-09-21
58720	HCPCS	Hc Salpingo-oophorectomy,com	5	5	$4,564.35	$4,564.35	$633.56	$4,107.92	$2,556.04	2026-09-21
77012	HCPCS	CT Guidance For Needle PL,Technical Component	5	5	$4,128.30	$4,128.30	$47.03	$3,715.47	$2,311.85	2026-09-21
15241	HCPCS	Full Thck Head Han Ea 20	5	5	$3,950.25	$3,950.25	$158.70	$3,555.22	$2,212.14	2026-09-21
35556	HCPCS	Hc Bypass Graft, With Vein, Femoral Poplil	5	5	$3,214.50	$3,214.50	$1,156.98	$2,893.05	$1,800.12	2026-09-21
64778	HCPCS	Digit Nerve Surgery Add O	5	5	$3,092.35	$3,092.35	$142.00	$2,783.12	$1,731.72	2026-09-21
44602	HCPCS	Suture Of Sm Int For Perf	5	5	$2,440.50	$2,440.50	$1,174.40	$2,196.45	$1,366.68	2026-09-21
43772	HCPCS	Laparoscopy,surg-removal	11	5	$1,786.00	$1,786.00	$808.82	$8,097.75	$1,339.50	2026-09-21
35656	HCPCS	Hc Bypass Graft W Other Than Vein Femora	5	5	$2,244.00	$2,244.00	$890.69	$2,019.60	$1,256.64	2026-09-21
57267	HCPCS	Insertion Of Mesh<repair	5	5	$2,087.25	$2,087.25	$203.42	$1,878.52	$1,168.86	2026-09-21
15839	HCPCS	Inj Sgl Tendon Orign Inser	7	5	$2,043.00	$2,043.00	$706.54	$1,838.70	$1,121.20	2026-09-21
0278	RC	—	32	4	$20,662.00	$20,662.00	$6,749.14	$27,752.40	$14,299.46	2026-09-21
15876	HCPCS	Suctio Asst Liptmy Head A	4	4	$8,932.00	$8,932.00	$4,901.88	$8,038.80	$5,850.46	2026-09-21
15877	HCPCS	Suction Assisted Lipectom	4	4	$8,932.00	$8,932.00	$4,901.88	$8,038.80	$5,850.46	2026-09-21
15879	HCPCS	Suctio Assisted Lipectomy	4	4	$8,932.00	$8,932.00	$4,901.88	$8,038.80	$5,850.46	2026-09-21
D2740	HCPCS	Hc Ceramic Crowns	4	4	$4,968.52	$4,968.52	$2,726.72	$4,471.67	$3,254.38	2026-09-21
15824	HCPCS	Phytidectomy Forehead	4	4	$4,868.50	$4,868.50	$2,671.83	$4,381.65	$3,188.87	2026-09-21
J7307	HCPCS	Nexplanon Implant	4	4	$5,830.00	$5,830.00	$1,156.28	$5,247.00	$2,764.39	2026-09-21
D8080	HCPCS	Comp Ortho Treatment Of T	4	4	$4,140.00	$4,140.00	$2,272.03	$3,726.00	$2,711.70	2026-09-21
C8914	HCPCS	MRA Lower Xtr Wo W Con	4	4	$2,645.50	$2,645.50	$1,451.85	$2,380.95	$1,732.80	2026-09-21
C8902	HCPCS	MRA Wo W Con Abdom	4	4	$2,645.50	$2,645.50	$1,451.85	$2,380.95	$1,732.80	2026-09-21
C8911	HCPCS	MRA Wout W Con Chest Excl	4	4	$2,645.50	$2,645.50	$1,451.85	$2,380.95	$1,732.80	2026-09-21
D7912	HCPCS	Complicated Suture, Great	4	4	$2,641.55	$2,641.55	$1,449.68	$2,377.40	$1,730.22	2026-09-21
C8913	HCPCS	MRA Wout Con Lower Extrem	4	4	$2,384.00	$2,384.00	$1,308.34	$2,145.60	$1,561.52	2026-09-21
C8900	HCPCS	MRA W Con Abdomen	4	4	$2,384.00	$2,384.00	$1,308.34	$2,145.60	$1,561.52	2026-09-21
C8901	HCPCS	MRA Wo Con Abdomen	4	4	$2,384.00	$2,384.00	$1,308.34	$2,145.60	$1,561.52	2026-09-21
C8909	HCPCS	MRA W Con Chest Exclud My	4	4	$2,384.00	$2,384.00	$1,308.34	$2,145.60	$1,561.52	2026-09-21
C8910	HCPCS	MRA Wo Con Chest Exclu My	4	4	$2,384.00	$2,384.00	$1,308.34	$2,145.60	$1,561.52	2026-09-21
C8912	HCPCS	MRA W Con Lower Extremity	4	4	$2,384.00	$2,384.00	$1,308.34	$2,145.60	$1,561.52	2026-09-21
G0379	HCPCS	Direct Admit To Obs	4	4	$2,018.00	$2,018.00	$1,107.48	$1,816.20	$1,321.79	2026-09-21
J1327	HCPCS	Eptifibatide 2 Mg/ml Soln	16	4	$1,904.55	$1,904.55	$506.20	$2,598.05	$1,207.18	2026-09-21

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