Hospital

COPIAH COUNTY MEDICAL CENTER

Hazlehurst, MS · CCN 251327 · Rates published

5,330 distinct procedures filed

16 distinct payers

22,089 rate rows

2026-07-30 last MRF observed

Data quality

18,100 of 22,089 rate rows are consumer-grade (81.9%)

3,989 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	3,938
percent-of-charges filed in the dollar field — excluded from medians	39
per-diem day rate — not a per-procedure price	9
exceeds 10× this hospital's gross charge — excluded from medians	3

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

Source MRF file	https://copiahcountymedicalcenter.pg.quadax.revenuemasters.com/cdm-files/646001347_copiah-county-medical-center_standardcharges.csv
Found on page	https://copiahcountymedicalcenter.pg.quadax.revenuemasters.com/disclaimer?
Discovered via	Discovered by HANK
Last fetch	not_modified · 2026-08-14
Content fingerprint	dd4f03d355d58498… · 6,232,375 bytes · first seen 2026-05-08

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
28103 HCPCS	Exc Bone Cyst Ben Tmor W Allgr	11	$2,781.00	$17,251.79	$2,781.00	nat. median $6,817 outlier · 0.4×
28102 HCPCS	Exc Bone Cyst Ben Tumr W/graft	11	$2,781.00	$17,251.79	$2,781.00	nat. median $7,011 outlier · 0.4×
27691 HCPCS	Tendon Transfer Single, Deep	11	$2,670.30	$17,046.79	$2,670.30	nat. median $6,958 outlier · 0.4×
27650 HCPCS	Repair Ruptured Achille Tendon	11	$2,670.30	$17,046.79	$2,670.30	nat. median $6,655 outlier · 0.4×
27654 HCPCS	Repair Secondary Achill Tendon	11	$2,670.30	$17,046.79	$2,670.30	nat. median $6,820 outlier · 0.4×
27690 HCPCS	Tendon Transfer,single, Superf	11	$2,670.30	$17,046.79	$2,670.30	nat. median $6,708 outlier · 0.4×
A9551 HCPCS	Dmsa	11	$2,616.84	$8,965.10	$2,616.84	nat. median $976 outlier · 2.7×
19357 HCPCS	Breast Reconstructon;incl Sub	11	$2,438.10	$33,988.58	$2,438.10	nat. median $13,653 outlier · 0.2×
27652 HCPCS	Repair Rupt Achi Tendon &graft	11	$2,259.90	$16,286.79	$2,259.90	nat. median $6,923 outlier · 0.3×
19307 HCPCS	Mastect Mod Rad,incl Lymph Nod	11	$2,212.65	$15,145.14	$2,212.65	nat. median $6,808 outlier · 0.3×
49568 HCPCS	Impl Mesh Pros Opn Incis Herni	11	$2,052.00	$7,030.00	$2,052.00	nat. median $2,475 0.8× median
49587 HCPCS	Rpr Umbilcl Hernia> 5yrs Incar	11	$2,030.40	$6,956.00	$2,030.40	nat. median $3,652 0.6× median
49505 HCPCS	Rpr Intl Ingnal Herna>5 Yr Red	11	$2,030.40	$6,956.00	$2,030.40	nat. median $3,824 0.5× median
49507 HCPCS	Rpr Intl Ingnal Hernia >5 Yrs	11	$2,030.40	$6,956.00	$2,030.40	nat. median $3,900 0.5× median
49561 HCPCS	Repair Ini Ventral Herni Incar	11	$2,030.40	$6,956.00	$2,030.40	nat. median $3,190 0.6× median
49585 HCPCS	Rpr Umbilcl Hernia> 5yrs Reduc	11	$2,030.40	$6,956.00	$2,030.40	nat. median $3,157 0.6× median
46750 HCPCS	Sphincteroplasty Anal Adult	11	$2,004.75	$6,868.13	$2,004.75	nat. median $3,144 0.6× median
75635 HCPCS	CTA With Runoff	13	$136.13	$6,512.00	$1,900.80	nat. median $719 outlier · 2.6×
28298 HCPCS	Correc Hv W/wo Ses Phal Osteot	11	$1,827.90	$15,486.79	$1,827.90	nat. median $6,697 outlier · 0.3×
28296 HCPCS	Correc Hv W/wo Sesamoid W Oste	11	$1,827.90	$6,262.25	$1,827.90	nat. median $3,804 outlier · 0.5×
28292 HCPCS	Corr Hv W/wo Sesamoid, Kelle	11	$1,827.90	$6,262.25	$1,827.90	nat. median $3,590 0.5× median
28299 HCPCS	Correc Hv W/wo Ses Dbl Osteoto	11	$1,827.90	$15,486.79	$1,827.90	nat. median $6,823 outlier · 0.3×
27880 HCPCS	Amputation, Leg, Thro Tibi&fib	11	$1,772.55	$6,072.63	$1,772.55	nat. median $3,578 outlier · 0.5×
27680 HCPCS	Tenolysis, Leg Ankle, Single,	11	$1,759.05	$6,026.38	$1,759.05	nat. median $3,524 outlier · 0.5×
27681 HCPCS	Tenolysis Leg Ankle Multip Ten	11	$1,759.05	$6,026.38	$1,759.05	nat. median $3,448 0.5× median
27626 HCPCS	Arthrotomy, Synov Ankl Tenosyn	11	$1,759.05	$6,026.38	$1,759.05	nat. median $3,666 outlier · 0.5×
27612 HCPCS	Arthrotomy-post Caps Rel Ank	11	$1,759.05	$6,026.38	$1,759.05	nat. median $3,546 outlier · 0.5×
27625 HCPCS	Arthrotomy, W Synovectomy, Ank	11	$1,759.05	$6,026.38	$1,759.05	nat. median $3,559 outlier · 0.5×
27695 HCPCS	Rep, Prim-disrupt Ligamnt, Ank	11	$1,759.05	$15,359.29	$1,759.05	nat. median $6,586 outlier · 0.3×
27696 HCPCS	Rep Prim Disrupt Collateral	11	$1,759.05	$15,359.29	$1,759.05	nat. median $6,816 outlier · 0.3×
27610 HCPCS	Arthrotomy, Ankl W Expl Drn	11	$1,759.05	$6,026.38	$1,759.05	nat. median $3,394 0.5× median
27698 HCPCS	Rep Secnd,disrupt Ligame, Ank	11	$1,759.05	$15,359.29	$1,759.05	nat. median $6,623 outlier · 0.3×
27676 HCPCS	Rep Disl Peron Tend W Fib Oste	11	$1,759.05	$15,359.29	$1,759.05	nat. median $6,423 outlier · 0.3×
78813 HCPCS	PET Scan (outside Facility)	11	$1,589.49	$5,445.48	$1,589.49	nat. median $1,853 0.9× median
19101 HCPCS	Biopsy Breast Open Incisional	11	$1,570.05	$5,378.88	$1,570.05	nat. median $3,661 outlier · 0.4×
19120 HCPCS	Excision Of Cyst Fibroadenoma	11	$1,570.05	$5,378.88	$1,570.05	nat. median $3,662 outlier · 0.4×
19300 HCPCS	Excision Gynecomastia	11	$423.90	$5,448.25	$1,521.28	nat. median $3,839 outlier · 0.4×
45347 HCPCS	Sigmoid W Transendo Stent	11	$1,512.00	$5,180.00	$1,512.00	nat. median $5,390 outlier · 0.3×
44402 HCPCS	Colonoscopy Transendoscopic Pl	11	$1,512.00	$5,180.00	$1,512.00	nat. median $5,543 outlier · 0.3×
46320 HCPCS	Enucleation Ext Thromb Hemorr	11	$1,494.45	$5,119.88	$1,494.45	nat. median $1,327 1.1× median
46040 HCPCS	Incision Ischio Abcess	11	$1,494.45	$5,119.88	$1,494.45	nat. median $1,717 0.9× median
46230 HCPCS	Exc Tags Multi Papillae	11	$1,494.45	$5,119.88	$1,494.45	nat. median $2,649 0.6× median
46250 HCPCS	Hemorrhoidectomy Extrnl >2	11	$1,494.45	$5,119.88	$1,494.45	nat. median $2,853 0.5× median
46255 HCPCS	Hemorrhoidectomy Simple	11	$1,494.45	$5,119.88	$1,494.45	nat. median $2,847 0.5× median
46288 HCPCS	Closure Anal Fistula W Flap	11	$1,494.45	$5,119.88	$1,494.45	nat. median $3,182 outlier · 0.5×
46260 HCPCS	Hemorrhoidectmy, Int/ext, 2+ C	11	$1,494.45	$5,119.88	$1,494.45	nat. median $3,072 outlier · 0.5×
46020 HCPCS	Placement Of Seton	11	$1,493.91	$5,118.03	$1,493.91	nat. median $2,829 0.5× median
45905 HCPCS	Dilation Anal Sphinctr Anesth	11	$1,493.10	$5,115.25	$1,493.10	nat. median $1,419 1.1× median
25071 HCPCS	Excis Tumor Wrist >=3 Cm	11	$1,466.10	$5,022.75	$1,466.10	nat. median $2,148 0.7× median
27614 HCPCS	Bx Sft Tiss Leg Or Ankle Deep	11	$1,466.10	$5,022.75	$1,466.10	nat. median $2,968 outlier · 0.5×

Other procedures at this hospital

Browse this hospital's 5,330 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

44363	HCPCS	Endoscopy W Rem Foreign Body	11	11	$2,090.00	$2,090.00	$564.30	$1,933.25	$564.30	2026-07-15
44364	HCPCS	Endoscopy Tumor Rem Snare Tech	11	11	$2,090.00	$2,090.00	$564.30	$1,933.25	$564.30	2026-07-15
72130	HCPCS	CT T Spine W/o,w	11	11	$2,090.00	$2,090.00	$564.30	$1,933.25	$564.30	2026-07-15
25635	HCPCS	Clsd Tx-carpal Bn Frac	11	11	$2,120.00	$2,120.00	$572.40	$1,961.00	$572.40	2026-07-15
15830	HCPCS	Mini Abdominoplasty	11	11	$2,130.00	$2,130.00	$575.10	$12,112.64	$575.10	2026-07-15
44340	HCPCS	Rev-colostmy-simple	11	11	$2,150.00	$2,150.00	$580.50	$7,276.84	$580.50	2026-07-15
43247	HCPCS	Endo W/rem Of Foreign Body Bat	11	11	$2,170.00	$2,170.00	$585.90	$2,673.26	$585.90	2026-07-15
44388	HCPCS	Colonoscopy Stoma Diag	11	11	$2,175.00	$2,175.00	$587.25	$2,631.97	$587.25	2026-07-15
44394	HCPCS	Colonoscopy Stoma Tumor Snare	11	11	$2,175.00	$2,175.00	$587.25	$3,084.90	$587.25	2026-07-15
43217	HCPCS	Esophagoscopy Tumor Rem Snare	11	11	$2,185.00	$2,185.00	$589.95	$2,021.13	$589.95	2026-07-15
28344	HCPCS	Reconstrn, Toe(s); Polydactyly	11	11	$2,185.00	$2,185.00	$589.95	$2,021.13	$589.95	2026-07-15
21930	HCPCS	Exc, Tumr Sft Tis-back/flank	11	11	$2,195.00	$2,195.00	$592.65	$2,030.38	$592.65	2026-07-15
45334	HCPCS	Sigmoid Flex Control Bleeding	33	11	$2,185.00	$2,185.00	$549.45	$3,094.90	$592.65	2026-07-15
70336	HCPCS	MRI Tmj	11	11	$2,200.00	$2,200.00	$594.00	$2,035.00	$594.00	2026-07-15
72198	HCPCS	MRA Pelvis W Or Without	11	11	$2,200.00	$2,200.00	$594.00	$2,035.00	$594.00	2026-07-15
74160	HCPCS	CT Abdomen With Contrast	11	11	$2,200.00	$2,200.00	$594.00	$2,035.00	$594.00	2026-07-15
27550	HCPCS	Closed Tx-knee Dislo Wo Anesth	11	11	$2,200.00	$2,200.00	$594.00	$2,035.00	$594.00	2026-07-15
72193	HCPCS	CT Pelvis W Contrast	11	11	$2,200.00	$2,200.00	$594.00	$2,035.00	$594.00	2026-07-15
23660	HCPCS	Reduction Of Shoulder	11	11	$2,217.50	$2,217.50	$598.73	$13,210.54	$598.73	2026-07-15
44389	HCPCS	Colonoscopy Stoma Biopsy	11	11	$2,220.00	$2,220.00	$599.40	$3,107.40	$599.40	2026-07-15
45382	HCPCS	Colon / Control Bleeding Batch	11	11	$2,230.00	$2,230.00	$602.10	$3,112.40	$602.10	2026-07-15
64635	HCPCS	Rfa (lumbar/sacral)	11	11	$2,230.00	$2,230.00	$602.10	$2,062.75	$602.10	2026-07-15
44365	HCPCS	Endoscopy Tumor Rem Hot Forcep	11	11	$2,235.00	$2,235.00	$603.45	$2,067.38	$603.45	2026-07-15
59414	HCPCS	Delivery Of Placenta	11	11	$2,235.00	$2,235.00	$603.45	$2,067.38	$603.45	2026-07-15
59409	HCPCS	Vaginal Delivery Only	11	11	$2,235.00	$2,235.00	$603.45	$2,067.38	$603.45	2026-07-15
27781	HCPCS	Clsd Trmt Prox Fibula/shaft Fx	11	11	$2,237.00	$2,237.00	$603.99	$2,069.23	$603.99	2026-07-15
49900	HCPCS	Suture, Secondary, Abd Repair	11	11	$2,238.00	$2,238.00	$604.26	$2,070.15	$604.26	2026-07-15
45384	HCPCS	Colon Rem Lesion(s Cautery Bat	11	11	$2,245.00	$2,245.00	$606.15	$3,119.90	$606.15	2026-07-15
19301	HCPCS	Mastectomy, Prtial Eg, Lumpect	11	11	$2,245.00	$2,245.00	$606.15	$2,076.63	$606.15	2026-07-15
43245	HCPCS	Upper Gi Endo Dilat Gastr Out	11	11	$2,250.00	$2,250.00	$607.50	$2,081.25	$607.50	2026-07-15
43251	HCPCS	Endo Rem- Lesion(s)snare Batc	11	11	$2,250.00	$2,250.00	$607.50	$2,081.25	$607.50	2026-07-15
45385	HCPCS	Colon Rem Lesion(s),snare Batc	13	13	$2,255.00	$2,255.00	$608.85	$3,124.90	$608.85	2026-07-15
19110	HCPCS	Nppl Expl,w/wo Exc Solit L Dct	11	11	$2,260.00	$2,260.00	$610.20	$2,090.50	$610.20	2026-07-15
67900	HCPCS	Rep-brow Ptosis (supraciliary	11	11	$2,270.00	$2,270.00	$612.90	$2,099.75	$612.90	2026-07-15
46280	HCPCS	Anal Fistula Surgical Treatmnt	11	11	$2,270.00	$2,270.00	$612.90	$2,099.75	$612.90	2026-07-15
55040	HCPCS	Excision Of Hydrocele; Unilate	11	11	$2,280.00	$2,280.00	$615.60	$2,109.00	$615.60	2026-07-15
19081	HCPCS	Stereo Breast Bx Guide 1st Les	11	11	$2,280.00	$2,280.00	$615.60	$2,109.00	$615.60	2026-07-15
25028	HCPCS	I&d Hematoma, Forearm, Wrist	11	11	$2,282.00	$2,282.00	$616.14	$2,110.85	$616.14	2026-07-15
46030	HCPCS	Rem Anal Seton Oth Marker	11	11	$2,285.00	$2,285.00	$616.95	$3,139.90	$616.95	2026-07-15
26910	HCPCS	Finger Amputation	11	11	$2,294.00	$2,294.00	$619.38	$2,121.95	$619.38	2026-07-15
71551	HCPCS	MRI Chest/w	11	11	$2,310.00	$2,310.00	$623.70	$2,493.39	$623.70	2026-07-15
71260	HCPCS	CT Thorax With	12	12	$2,310.00	$2,310.00	$136.13	$2,136.75	$623.70	2026-07-15
27050	HCPCS	Arthrot, W Biop; Sacroilic Jnt	11	11	$2,310.00	$2,310.00	$623.70	$2,136.75	$623.70	2026-07-15
45379	HCPCS	Colonoscopy Flex Splen Rem Fb	11	11	$2,315.00	$2,315.00	$625.05	$3,154.90	$625.05	2026-07-15
43216	HCPCS	Esophagoscopy Tum Rem Hot Biop	11	11	$2,320.00	$2,320.00	$626.40	$2,146.00	$626.40	2026-07-15
44360	HCPCS	Small Intest Endo Diag	11	11	$2,320.00	$2,320.00	$626.40	$2,146.00	$626.40	2026-07-15
10140	HCPCS	Incis Drain Hema Seroma Fluid	11	11	$2,325.00	$2,325.00	$627.75	$2,150.63	$627.75	2026-07-15
44361	HCPCS	Small Intest Endo W Biopsy	11	11	$2,340.00	$2,340.00	$631.80	$2,164.50	$631.80	2026-07-15
45378	HCPCS	Colon Diagnostic Batch	33	11	$2,338.00	$2,338.00	$630.99	$2,714.47	$631.80	2026-07-15
36576	HCPCS	Rep- Cent V Acss Dev/sub Port	11	11	$2,345.00	$2,345.00	$633.15	$2,169.13	$633.15	2026-07-15
45505	HCPCS	Proctoplsty/prolpse-mucos Memb	11	11	$2,350.00	$2,350.00	$634.50	$2,173.75	$634.50	2026-07-15
27884	HCPCS	Revison Of Amputation	11	11	$2,355.00	$2,355.00	$635.85	$2,178.38	$635.85	2026-07-15
26735	HCPCS	Fracture Reduction-finger	11	11	$2,360.00	$2,360.00	$637.20	$2,183.00	$637.20	2026-07-15
43255	HCPCS	Endoscopy Ugi W/contl-bleed Ba	11	11	$2,385.00	$2,385.00	$643.95	$2,206.13	$643.95	2026-07-15
43201	HCPCS	Esophagoscopy W Submucosal Inj	11	11	$2,400.00	$2,400.00	$648.00	$2,220.00	$648.00	2026-07-15
19340	HCPCS	Capsulectomy With New Implants	11	11	$2,410.00	$2,410.00	$650.70	$12,252.64	$650.70	2026-07-15
45305	HCPCS	Proctosigmoid Rigid W Biopsy	11	11	$2,415.00	$2,415.00	$652.05	$3,204.90	$652.05	2026-07-15
74181	HCPCS	MRI Abdomen Without	11	11	$2,420.00	$2,420.00	$653.40	$2,238.50	$653.40	2026-07-15
73721	HCPCS	MRI Lowr Ext Joint Without	12	12	$2,420.00	$2,420.00	$184.20	$2,238.50	$653.40	2026-07-15
74185	HCPCS	MRA Abdomen W Or Without	11	11	$2,420.00	$2,420.00	$653.40	$2,238.50	$653.40	2026-07-15
70540	HCPCS	MRI Nck/fce/orb Without	11	11	$2,420.00	$2,420.00	$653.40	$2,238.50	$653.40	2026-07-15
21012	HCPCS	Exc, Tumr, Sft Tiss-face/ Sclp	11	11	$2,425.00	$2,425.00	$654.75	$2,243.13	$654.75	2026-07-15
38510	HCPCS	Excision Of Lymph Node	11	11	$2,430.00	$2,430.00	$656.10	$2,247.75	$656.10	2026-07-15
45380	HCPCS	Colonoscopy W Biopsy, Sing/mul	12	12	$2,430.00	$2,430.00	$656.10	$3,212.40	$656.10	2026-07-15
24071	HCPCS	Exci-tumr Sft Tis/upr Arm/area	11	11	$2,450.00	$2,450.00	$661.50	$2,266.25	$661.50	2026-07-15
15572	HCPCS	Form Dirct/tube Ped W/wo Trans	11	11	$2,450.00	$2,450.00	$661.50	$7,426.84	$661.50	2026-07-15
99291	HCPCS	Critical Care, First Hour	17	13	$2,460.00	$2,460.00	$153.37	$2,657.41	$664.20	2026-07-15
11772	HCPCS	Debridement Pilonidal Cyst	22	11	$2,210.00	$2,210.00	$526.50	$2,284.75	$666.90	2026-07-15
52000	HCPCS	Cystourethroscopy (outside Fac	11	11	$2,475.00	$2,475.00	$668.25	$2,289.38	$668.25	2026-07-15
33234	HCPCS	Rem-transvnos Pacemkr Electrde	11	11	$2,500.00	$2,500.00	$675.00	$7,415.13	$675.00	2026-07-15
93306	HCPCS	Echocardiogram	13	13	$2,530.00	$2,530.00	$417.82	$2,340.25	$683.10	2026-07-15
73218	HCPCS	MRI Upper Extremity Without	11	11	$2,530.00	$2,530.00	$683.10	$2,340.25	$683.10	2026-07-15
93320	HCPCS	Echo Complete	11	11	$2,530.00	$2,530.00	$683.10	$2,340.25	$683.10	2026-07-15
74175	HCPCS	CTA Abdomen W Contrast	11	11	$2,530.00	$2,530.00	$683.10	$2,340.25	$683.10	2026-07-15
15570	HCPCS	Format Dir Or Tube Ped W/wo Tr	11	11	$2,550.00	$2,550.00	$688.50	$4,373.79	$688.50	2026-07-15
45990	HCPCS	Anorectal Exm Surg,req Anes,dx	11	11	$2,565.00	$2,565.00	$692.55	$2,372.63	$692.55	2026-07-15
93308	HCPCS	Echocardiogram W/Bubble Study	11	11	$2,600.00	$2,600.00	$702.00	$2,405.00	$702.00	2026-07-15
72159	HCPCS	MRA Spinal W Or Without	11	11	$2,640.00	$2,640.00	$712.80	$2,442.00	$712.80	2026-07-15
70544	HCPCS	MRA Brain Without	11	11	$2,640.00	$2,640.00	$712.80	$2,442.00	$712.80	2026-07-15
43215	HCPCS	Esophagoscopy Remove Fb	11	11	$2,660.00	$2,660.00	$718.20	$2,460.50	$718.20	2026-07-15
28160	HCPCS	Hemiphalangectomy	11	11	$2,660.00	$2,660.00	$718.20	$2,460.50	$718.20	2026-07-15
28285	HCPCS	Correction, Hammertoe	11	11	$2,700.00	$2,700.00	$729.00	$2,497.50	$729.00	2026-07-15
43246	HCPCS	Endo/place Gastrostomy Tub Bat	22	11	$2,300.00	$2,300.00	$508.95	$2,511.38	$733.05	2026-07-15
72149	HCPCS	MRI L-spine/w	11	11	$2,750.00	$2,750.00	$742.50	$2,543.75	$742.50	2026-07-15
72142	HCPCS	MRI C-spine/w	11	11	$2,750.00	$2,750.00	$742.50	$2,543.75	$742.50	2026-07-15
72147	HCPCS	MRI T-spine/w	11	11	$2,750.00	$2,750.00	$742.50	$2,543.75	$742.50	2026-07-15
70552	HCPCS	MRI Brain/w	11	11	$2,750.00	$2,750.00	$742.50	$2,543.75	$742.50	2026-07-15
22902	HCPCS	Exce Tumor Sft Tissue Abd Wall	11	11	$2,760.00	$2,760.00	$745.20	$2,553.00	$745.20	2026-07-15
28108	HCPCS	Excsn/curettage Bone Cyst/toe	11	11	$2,785.00	$2,785.00	$751.95	$2,576.13	$751.95	2026-07-15
15120	HCPCS	Skin Splt A-grft Face//nck/hf	11	11	$2,785.00	$2,785.00	$751.95	$7,594.34	$751.95	2026-07-15
15576	HCPCS	Form Dir Or Tube Pedi W/wo Eye	11	11	$2,825.00	$2,825.00	$762.75	$4,511.29	$762.75	2026-07-15
22901	HCPCS	Excis Soft Tissue Abdomen 5cm	11	11	$2,860.00	$2,860.00	$772.20	$2,645.50	$772.20	2026-07-15
70548	HCPCS	MRA Neck/w	11	11	$2,860.00	$2,860.00	$772.20	$2,645.50	$772.20	2026-07-15
19083	HCPCS	Biopsy, Breast, Wplace Of Br	23	12	$2,870.00	$2,870.00	$587.25	$2,654.75	$774.90	2026-07-15
38525	HCPCS	Biopsy/exc-lymph Node; Open	11	11	$2,870.00	$2,870.00	$774.90	$2,654.75	$774.90	2026-07-15
70547	HCPCS	MRA Neck Without	11	11	$2,900.00	$2,900.00	$783.00	$2,682.50	$783.00	2026-07-15
44366	HCPCS	Small Intest Endo Contr Bleed	11	11	$2,910.00	$2,910.00	$785.70	$2,691.75	$785.70	2026-07-15
28805	HCPCS	Amputation, Foot; Transmetatar	11	11	$2,910.00	$2,910.00	$785.70	$2,691.75	$785.70	2026-07-15
28005	HCPCS	Incision Of Bone	11	11	$2,922.00	$2,922.00	$788.94	$2,702.85	$788.94	2026-07-15
43226	HCPCS	Esophagoscopy Ins Guide Wire	11	11	$2,940.00	$2,940.00	$793.80	$2,719.50	$793.80	2026-07-15
27328	HCPCS	Exc-tumor, Sft Tiss/thigh/knee	11	11	$2,940.00	$2,940.00	$793.80	$2,719.50	$793.80	2026-07-15
26160	HCPCS	Exci Les Tndn Sheath/jnt Hnd/f	11	11	$2,955.00	$2,955.00	$797.85	$2,733.38	$797.85	2026-07-15
73719	HCPCS	MRI Lowr Ext Not Jnt W	11	11	$2,970.00	$2,970.00	$801.90	$2,747.25	$801.90	2026-07-15
49560	HCPCS	Full Abdominoplasty	11	11	$2,970.00	$2,970.00	$801.90	$2,747.25	$801.90	2026-07-15
70545	HCPCS	MRA Brain/w	11	11	$2,970.00	$2,970.00	$801.90	$2,747.25	$801.90	2026-07-15
73722	HCPCS	MRI Lower Joint/w	11	11	$2,970.00	$2,970.00	$801.90	$2,823.39	$801.90	2026-07-15
74176	HCPCS	CT Abd & Pelvis Without	13	13	$2,970.00	$2,970.00	$184.20	$2,747.25	$801.90	2026-07-15
10081	HCPCS	I & D Of Pilonidal Cyst Comp	22	11	$2,135.00	$2,135.00	$334.80	$2,802.75	$818.10	2026-07-15
27301	HCPCS	I&d Dp Abscess Bursa Hematoma	11	11	$3,036.00	$3,036.00	$819.72	$2,808.30	$819.72	2026-07-15
44369	HCPCS	Endoscopy W Ablation Tumors	11	11	$3,055.00	$3,055.00	$824.85	$2,825.88	$824.85	2026-07-15
73720	HCPCS	MRI Lowr Ext W/wo-nonjoint	11	11	$3,080.00	$3,080.00	$831.60	$2,849.00	$831.60	2026-07-15
72195	HCPCS	MRI Pelvis Without	11	11	$3,080.00	$3,080.00	$831.60	$2,849.00	$831.60	2026-07-15
73221	HCPCS	MRI Up Ext Jnt Without	12	12	$3,080.00	$3,080.00	$181.55	$2,849.00	$831.60	2026-07-15
74183	HCPCS	MRI Abdomen W/wo	12	12	$3,080.00	$3,080.00	$594.59	$2,849.00	$831.60	2026-07-15
72197	HCPCS	MRI Pelvis W/wo	12	12	$3,080.00	$3,080.00	$284.93	$2,849.00	$831.60	2026-07-15
70543	HCPCS	MRI Nck/fce/orb W/wo	11	11	$3,080.00	$3,080.00	$831.60	$2,849.00	$831.60	2026-07-15
72196	HCPCS	MRI Pelvis W	11	11	$3,080.00	$3,080.00	$831.60	$2,849.00	$831.60	2026-07-15
71552	HCPCS	MRI Chest W/wo	11	11	$3,080.00	$3,080.00	$831.60	$2,849.00	$831.60	2026-07-15
70551	HCPCS	MRI Brain Without	12	12	$3,080.00	$3,080.00	$184.20	$2,849.00	$831.60	2026-07-15
73220	HCPCS	MRI Upper Extremity W&without	12	12	$3,080.00	$3,080.00	$272.15	$2,849.00	$831.60	2026-07-15
73223	HCPCS	MRI Up Ext Jnt W,without	11	11	$3,080.00	$3,080.00	$831.60	$2,849.00	$831.60	2026-07-15
73222	HCPCS	MRI Upper Ext Any Joint W	11	11	$3,080.00	$3,080.00	$831.60	$2,878.39	$831.60	2026-07-15
28192	HCPCS	Rem - Foreign Body/ Foot; Deep	11	11	$3,100.00	$3,100.00	$837.00	$2,867.50	$837.00	2026-07-15
27618	HCPCS	Exc, Tumor-sft Tiss/leg/ankle	11	11	$3,105.00	$3,105.00	$838.35	$2,872.13	$838.35	2026-07-15
10121	HCPCS	Incision Foreign Body Comp	22	11	$3,172.50	$3,172.50	$855.90	$2,936.88	$857.25	2026-07-15
70496	HCPCS	CTA Head W,without	13	13	$3,190.00	$3,190.00	$135.90	$2,950.75	$861.30	2026-07-15
74182	HCPCS	MRI Abdomen, W	11	11	$3,190.00	$3,190.00	$861.30	$2,950.75	$861.30	2026-07-15
25565	HCPCS	Clsed Tx-rad& Ulnar Shft Fract	11	11	$3,195.00	$3,195.00	$862.65	$2,955.38	$862.65	2026-07-15
19316	HCPCS	Mastopexy	55	11	$2,745.00	$2,745.00	$530.55	$12,870.14	$877.50	2026-07-15
15877	HCPCS	Abdominoplasty W Liposuction	11	11	$3,250.00	$3,250.00	$877.50	$7,826.84	$877.50	2026-07-15
25606	HCPCS	Perc Skele Fix-dist Rad Fract	11	11	$3,290.00	$3,290.00	$888.30	$3,043.25	$888.30	2026-07-15
72141	HCPCS	MRI C-spine Without	13	13	$3,300.00	$3,300.00	$181.55	$3,052.50	$891.00	2026-07-15
71275	HCPCS	CT Chest Pe High Res	12	12	$3,300.00	$3,300.00	$135.66	$3,052.50	$891.00	2026-07-15
72148	HCPCS	MRI L-spine Without	13	13	$3,300.00	$3,300.00	$181.55	$3,052.50	$891.00	2026-07-15
28173	HCPCS	Rad Resection-tumor; Metatars	11	11	$3,325.00	$3,325.00	$897.75	$3,075.63	$897.75	2026-07-15
27603	HCPCS	I&d Leg Or Ankle, Deep Abscess	11	11	$3,370.00	$3,370.00	$909.90	$3,117.25	$909.90	2026-07-15
46910	HCPCS	Destr Les Anus, Electrodesicca	11	11	$3,380.00	$3,380.00	$912.60	$4,788.79	$912.60	2026-07-15
73718	HCPCS	MRI Lowr Ext Without	11	11	$3,410.00	$3,410.00	$920.70	$3,154.25	$920.70	2026-07-15
70498	HCPCS	CTA Neck W.wo	13	13	$3,410.00	$3,410.00	$135.90	$3,154.25	$920.70	2026-07-15
73206	HCPCS	CTA Uppr Ext Shldr Arm Hand	11	11	$3,410.00	$3,410.00	$920.70	$3,154.25	$920.70	2026-07-15
27825	HCPCS	Closed Treatment Fracture Of W	11	11	$3,430.00	$3,430.00	$926.10	$3,172.75	$926.10	2026-07-15
52332	HCPCS	Cystourethrosco W Stint(outsid	11	11	$3,455.00	$3,455.00	$932.85	$3,195.88	$932.85	2026-07-15
11424	HCPCS	Excis Ben Les Scalp 3.1 4.0 Cm	11	11	$3,470.00	$3,470.00	$936.90	$3,209.75	$936.90	2026-07-15
11423	HCPCS	Excis Ben Les Scalp 2.1 3.0 Cm	11	11	$3,470.00	$3,470.00	$936.90	$3,209.75	$936.90	2026-07-15
11406	HCPCS	Excis Ben Les Trunk Ls 4.0 Cm	11	11	$3,470.00	$3,470.00	$936.90	$3,209.75	$936.90	2026-07-15
11404	HCPCS	Excis Ben Les Trunk 3.1 4.0 Cm	11	11	$3,470.00	$3,470.00	$936.90	$3,209.75	$936.90	2026-07-15
11644	HCPCS	Excis Mal Les Face 3.1 4.0 Cm	11	11	$3,470.00	$3,470.00	$936.90	$3,209.75	$936.90	2026-07-15
11624	HCPCS	Excis Mal Les Scalp 3.1 4.0 Cm	11	11	$3,470.00	$3,470.00	$936.90	$3,209.75	$936.90	2026-07-15
11623	HCPCS	Excis Mal Les Scalp 2.1 3.0 Cm	11	11	$3,470.00	$3,470.00	$936.90	$3,209.75	$936.90	2026-07-15
11606	HCPCS	Excis Mal Les Trunk Grt 4.0 Cm	11	11	$3,470.00	$3,470.00	$936.90	$3,209.75	$936.90	2026-07-15
64721	HCPCS	Neuroplasty Medn Nrv Crp Tnnl	11	11	$3,510.00	$3,510.00	$947.70	$3,246.75	$947.70	2026-07-15
72146	HCPCS	MRI T-spine Without	11	11	$3,520.00	$3,520.00	$950.40	$3,256.00	$950.40	2026-07-15
70549	HCPCS	MRA Neck W/wo	11	11	$3,520.00	$3,520.00	$950.40	$3,256.00	$950.40	2026-07-15
15833	HCPCS	Exc, Excessive Skn&subcut Tiss	11	11	$3,555.00	$3,555.00	$959.85	$3,288.38	$959.85	2026-07-15
49000	HCPCS	Exp Lap-celiotomy W Or Wo Biop	11	11	$3,680.00	$3,680.00	$993.60	$3,404.00	$993.60	2026-07-15
10180	HCPCS	I&d Post Op Wnd Infect Complex	11	11	$3,690.00	$3,690.00	$996.30	$3,413.25	$996.30	2026-07-15
70546	HCPCS	MRA Brain W/wo	11	11	$3,740.00	$3,740.00	$1,009.80	$3,459.50	$1,009.80	2026-07-15
24076	HCPCS	Exci Soft Tis Tum Up Arm Elbow	11	11	$3,760.00	$3,760.00	$1,015.20	$3,478.00	$1,015.20	2026-07-15
22903	HCPCS	Excis Abd Les Sc 3cm/>	11	11	$3,785.00	$3,785.00	$1,021.95	$3,501.13	$1,021.95	2026-07-15
54700	HCPCS	I & D Of Epididymis, Testis	22	11	$2,605.00	$2,605.00	$383.40	$3,505.75	$1,023.30	2026-07-15
57250	HCPCS	Post Colporrhapy Rep-rectocele	11	11	$3,865.00	$3,865.00	$1,043.55	$3,575.13	$1,043.55	2026-07-15
38745	HCPCS	Axillary Lymphadenectomy; Comp	11	11	$3,895.00	$3,895.00	$1,051.65	$3,602.88	$1,051.65	2026-07-15
26055	HCPCS	Tendon Sheath Incision	11	11	$3,900.00	$3,900.00	$1,053.00	$3,607.50	$1,053.00	2026-07-15
14040	HCPCS	Adj Tis Trn Fore 10 Cm	11	11	$3,915.00	$3,915.00	$1,057.05	$5,056.29	$1,057.05	2026-07-15
14061	HCPCS	Adj Tis Trn Lid 10.1-30.0 Cm	11	11	$3,915.00	$3,915.00	$1,057.05	$5,056.29	$1,057.05	2026-07-15
14000	HCPCS	Adj Tis Trn Trunk 10 Cm	11	11	$3,915.00	$3,915.00	$1,057.05	$5,056.29	$1,057.05	2026-07-15
15740	HCPCS	Flap Island Pedicle	11	11	$3,915.00	$3,915.00	$1,057.05	$5,056.29	$1,057.05	2026-07-15
15261	HCPCS	Full Thick Lid Lip Ea 20 Sq Cm	11	11	$3,915.00	$3,915.00	$1,057.05	$3,621.38	$1,057.05	2026-07-15
15260	HCPCS	Full Thick Lid Lip 20 Sq Cm	11	11	$3,915.00	$3,915.00	$1,057.05	$5,056.29	$1,057.05	2026-07-15
15240	HCPCS	Full Thick Head Hand 20 Sq Cm	11	11	$3,915.00	$3,915.00	$1,057.05	$5,056.29	$1,057.05	2026-07-15
15220	HCPCS	Full Thck Arm Leg 20 Sq Cm	11	11	$3,915.00	$3,915.00	$1,057.05	$5,056.29	$1,057.05	2026-07-15
15201	HCPCS	Full Graft Trunk Ea 20 Sq Cm	11	11	$3,915.00	$3,915.00	$1,057.05	$3,621.38	$1,057.05	2026-07-15
15200	HCPCS	Full Graft Trunk 20 Sq Cm	11	11	$3,915.00	$3,915.00	$1,057.05	$5,056.29	$1,057.05	2026-07-15
14060	HCPCS	Adj Tis Trn Lid 10 Cm	11	11	$3,915.00	$3,915.00	$1,057.05	$5,056.29	$1,057.05	2026-07-15
14041	HCPCS	Adj Tis Trn Fore 10.1-30.0 Cm	11	11	$3,915.00	$3,915.00	$1,057.05	$5,056.29	$1,057.05	2026-07-15
14021	HCPCS	Adj Tis Trn Scalp 10.1-30.0 Cm	11	11	$3,915.00	$3,915.00	$1,057.05	$5,056.29	$1,057.05	2026-07-15
14020	HCPCS	Adj Tis Trn Scalp 10 Cm	11	11	$3,915.00	$3,915.00	$1,057.05	$5,056.29	$1,057.05	2026-07-15
14001	HCPCS	Adj Tis Trn Trunk 10.1-30.0 Cm	11	11	$3,915.00	$3,915.00	$1,057.05	$5,056.29	$1,057.05	2026-07-15
27596	HCPCS	Amp-thigh Through Fem, Any Lvl	11	11	$4,020.00	$4,020.00	$1,085.40	$3,718.50	$1,085.40	2026-07-15
15100	HCPCS	Skin Splt Grft Trnk/arm/leg	11	11	$4,025.00	$4,025.00	$1,086.75	$5,111.29	$1,086.75	2026-07-15
28035	HCPCS	Release, Tarsal Tunnel	11	11	$4,035.00	$4,035.00	$1,089.45	$3,732.38	$1,089.45	2026-07-15
74178	HCPCS	CT Abd & Pelvis W/wo Contrast	11	11	$4,070.00	$4,070.00	$1,098.90	$3,764.75	$1,098.90	2026-07-15
21932	HCPCS	Exc/tmr-sft Tis Bck/flank/subf	11	11	$4,085.00	$4,085.00	$1,102.95	$3,778.63	$1,102.95	2026-07-15
25075	HCPCS	Excis Sft Tis Tum Forearm/wrst	11	11	$4,110.00	$4,110.00	$1,109.70	$3,801.75	$1,109.70	2026-07-15
28043	HCPCS	Excis Tumor Foot Subc	11	11	$4,110.00	$4,110.00	$1,109.70	$3,801.75	$1,109.70	2026-07-15
19303	HCPCS	Mastectomy, Simple, Complete	11	11	$4,135.00	$4,135.00	$1,116.45	$13,115.14	$1,116.45	2026-07-15
73723	HCPCS	MRI Lower Extremity Bilat W/wo	22	11	$3,630.00	$3,630.00	$831.60	$3,866.50	$1,128.60	2026-07-15
81162	HCPCS	Brca Gene	14	14	$3,771.42	$3,771.42	$1,018.28	$3,488.56	$1,145.57	2026-07-15
11646	HCPCS	Excis Mal Les Face Grt 4.0 Cm	11	11	$4,329.00	$4,329.00	$1,168.83	$4,004.33	$1,168.83	2026-07-15
49020	HCPCS	I&d Peritoneal Abscess	11	11	$4,378.00	$4,378.00	$1,182.06	$4,049.65	$1,182.06	2026-07-15
19125	HCPCS	Excis Breast Lesion	11	11	$4,425.00	$4,425.00	$1,194.75	$4,093.13	$1,194.75	2026-07-15
26990	HCPCS	Drainage Of Pelvis Lesion	11	11	$4,440.00	$4,440.00	$1,198.80	$4,107.00	$1,198.80	2026-07-15
11005	HCPCS	Deb Skin, Subcu Tiss Musc& Fas	11	11	$4,470.00	$4,470.00	$1,206.90	$4,134.75	$1,206.90	2026-07-15
74177	HCPCS	CT Abd & Pelvis / W	12	12	$4,510.00	$4,510.00	$272.15	$4,171.75	$1,217.70	2026-07-15
45130	HCPCS	Exc-rect Procidenta W Anastmos	11	11	$4,525.00	$4,525.00	$1,221.75	$4,185.63	$1,221.75	2026-07-15
11450	HCPCS	Excis Sweat Gland Les Smpl/int	12	12	$4,595.00	$4,595.00	$1,045.58	$4,250.38	$1,240.65	2026-07-15
11451	HCPCS	Exc -skin/subcu Hidradenitis C	11	11	$4,635.00	$4,635.00	$1,251.45	$4,287.38	$1,251.45	2026-07-15
28114	HCPCS	Ostectomy-part Excis All Metat	11	11	$4,715.00	$4,715.00	$1,273.05	$4,361.38	$1,273.05	2026-07-15
28112	HCPCS	Ostectomy, Compl Exc Oth Metat	11	11	$4,715.00	$4,715.00	$1,273.05	$4,361.38	$1,273.05	2026-07-15
28090	HCPCS	Excis Lesion Tendon Shealth Ft	11	11	$4,715.00	$4,715.00	$1,273.05	$4,361.38	$1,273.05	2026-07-15
28113	HCPCS	Ostectomy-compl Exci 5th Memat	11	11	$4,715.00	$4,715.00	$1,273.05	$4,361.38	$1,273.05	2026-07-15
28011	HCPCS	Tenotomy/percut/toe/multip Ten	11	11	$4,715.00	$4,715.00	$1,273.05	$4,361.38	$1,273.05	2026-07-15
28110	HCPCS	Ostectomy-part Excis Fifth Met	11	11	$4,715.00	$4,715.00	$1,273.05	$4,361.38	$1,273.05	2026-07-15
28008	HCPCS	Fasciotomy, Foot And/or Toe	11	11	$4,715.00	$4,715.00	$1,273.05	$4,361.38	$1,273.05	2026-07-15
28111	HCPCS	Ostectomy, Comp Exci 1st Metat	11	11	$4,715.00	$4,715.00	$1,273.05	$4,361.38	$1,273.05	2026-07-15
28086	HCPCS	Synovectomy/tend Sheath/ft/fle	11	11	$4,715.00	$4,715.00	$1,273.05	$4,361.38	$1,273.05	2026-07-15
28088	HCPCS	Synovectomy/tend Sheath/ft/ext	11	11	$4,715.00	$4,715.00	$1,273.05	$4,361.38	$1,273.05	2026-07-15
28010	HCPCS	Tenotomy/percut/toe/sngle Tend	11	11	$4,715.00	$4,715.00	$1,273.05	$4,361.38	$1,273.05	2026-07-15
28080	HCPCS	Exc Interdigital Neuroma/sngle	11	11	$4,715.00	$4,715.00	$1,273.05	$4,361.38	$1,273.05	2026-07-15
28092	HCPCS	Excis Lesion Tendon Toe(s) Ea	11	11	$4,715.00	$4,715.00	$1,273.05	$4,361.38	$1,273.05	2026-07-15
28100	HCPCS	Exc Bone Cyst Ot Ben Tumr/talu	11	11	$4,715.00	$4,715.00	$1,273.05	$4,361.38	$1,273.05	2026-07-15
25620	HCPCS	Open Tx Distal Radial Fractre	11	11	$4,745.00	$4,745.00	$1,281.15	$4,389.13	$1,281.15	2026-07-15
27675	HCPCS	Repair Disloc Peroneal Tendon	11	11	$4,750.00	$4,750.00	$1,282.50	$4,393.75	$1,282.50	2026-07-15
27607	HCPCS	Incision, Leg Or Ankle	11	11	$4,750.00	$4,750.00	$1,282.50	$4,393.75	$1,282.50	2026-07-15
27604	HCPCS	I & D Leg,ankle, Infect Bursa	11	11	$4,750.00	$4,750.00	$1,282.50	$4,393.75	$1,282.50	2026-07-15
27606	HCPCS	Tenotomy, Perc Achi Tend W/gen	11	11	$4,750.00	$4,750.00	$1,282.50	$4,393.75	$1,282.50	2026-07-15
11426	HCPCS	Excis Ben Les Scalp Ls 4.0 Cm	11	11	$4,760.00	$4,760.00	$1,285.20	$4,403.00	$1,285.20	2026-07-15
26951	HCPCS	Amp, Fngr-thmb- Prim/secn, Any	11	11	$4,760.00	$4,760.00	$1,285.20	$4,403.00	$1,285.20	2026-07-15
11626	HCPCS	Excis Mal Les Scalp Grt 4.0 Cm	11	11	$4,760.00	$4,760.00	$1,285.20	$4,403.00	$1,285.20	2026-07-15
11446	HCPCS	Excis Ben Les Face Less 4.0 Cm	11	11	$4,765.00	$4,765.00	$1,286.55	$4,407.63	$1,286.55	2026-07-15
36561	HCPCS	Insert-tunneld Cent Ins Cent>5	11	11	$4,820.00	$4,820.00	$1,301.40	$4,458.50	$1,301.40	2026-07-15
A9521	HCPCS	Exametazime Brain	21	11	$3,512.00	$3,512.00	$948.24	$4,490.88	$1,310.85	2026-07-15
46947	HCPCS	Hemorrhoidopexy By Stapling	11	11	$4,875.00	$4,875.00	$1,316.25	$4,509.38	$1,316.25	2026-07-15
27295	HCPCS	Disarticulation Of Hip	11	11	$4,898.00	$4,898.00	$1,322.46	$4,530.65	$1,322.46	2026-07-15
11770	HCPCS	Exc Pilonidal Cyst Or Sinus Si	11	11	$4,910.00	$4,910.00	$1,325.70	$4,541.75	$1,325.70	2026-07-15
15620	HCPCS	Delay Sect Of Flap Head Chk	11	11	$4,925.00	$4,925.00	$1,329.75	$5,561.29	$1,329.75	2026-07-15
72156	HCPCS	MRI C-spine W/wo	12	12	$4,950.00	$4,950.00	$990.00	$4,578.75	$1,336.50	2026-07-15
72157	HCPCS	MRI T-spine W/wo	11	11	$4,950.00	$4,950.00	$1,336.50	$4,578.75	$1,336.50	2026-07-15
74174	HCPCS	CTA Abd & Pelvis W/wo	11	11	$4,950.00	$4,950.00	$1,336.50	$4,578.75	$1,336.50	2026-07-15
11771	HCPCS	Excis Pilonidal Cyst/sinus Ex	11	11	$4,950.00	$4,950.00	$1,336.50	$4,578.75	$1,336.50	2026-07-15
24073	HCPCS	Exc Tmr Sft Tiss/upr Arm/elbw	11	11	$5,050.00	$5,050.00	$1,363.50	$4,671.25	$1,363.50	2026-07-15
45910	HCPCS	Dilate Rectal Strict W Anes	11	11	$5,055.00	$5,055.00	$1,364.85	$4,675.88	$1,364.85	2026-07-15
52353	HCPCS	Cystourethroscopy W/lthrtsy(ou	11	11	$5,060.00	$5,060.00	$1,366.20	$4,680.50	$1,366.20	2026-07-15
70553	HCPCS	MRI Pituitary W/wo	12	12	$5,060.00	$5,060.00	$1,169.18	$4,680.50	$1,366.20	2026-07-15
13160	HCPCS	Close Secdry Wound Comp Or Ext	11	11	$5,065.00	$5,065.00	$1,367.55	$5,631.29	$1,367.55	2026-07-15
14302	HCPCS	Adj Tiss Tran Any Area Ea Ad30	11	11	$5,065.00	$5,065.00	$1,367.55	$4,685.13	$1,367.55	2026-07-15
15823	HCPCS	Bleph Upper Lid Minor Bil	11	11	$5,065.00	$5,065.00	$1,367.55	$5,631.29	$1,367.55	2026-07-15
15822	HCPCS	Bleph Upper Eyelid	22	11	$3,095.00	$3,095.00	$303.75	$5,631.29	$1,367.55	2026-07-15
14301	HCPCS	Adj Tiss Tran Any Area30.1- 60	11	11	$5,065.00	$5,065.00	$1,367.55	$8,734.34	$1,367.55	2026-07-15
27590	HCPCS	Amputation, Thigh, Thro Femur	11	11	$5,090.00	$5,090.00	$1,374.30	$4,708.25	$1,374.30	2026-07-15
28810	HCPCS	Amputation Metatarsal W Toe	11	11	$5,100.00	$5,100.00	$1,377.00	$4,717.50	$1,377.00	2026-07-15
28308	HCPCS	Osteotomy	11	11	$5,135.00	$5,135.00	$1,386.45	$4,749.88	$1,386.45	2026-07-15
28104	HCPCS	Excis Bone Cyst Ben Tumor	11	11	$5,135.00	$5,135.00	$1,386.45	$4,749.88	$1,386.45	2026-07-15
28315	HCPCS	Sesamoidectomy, First Toe	11	11	$5,135.00	$5,135.00	$1,386.45	$4,749.88	$1,386.45	2026-07-15
28060	HCPCS	Fasciectomy Plantar Fascia Par	11	11	$5,135.00	$5,135.00	$1,386.45	$4,749.88	$1,386.45	2026-07-15
72158	HCPCS	MRI L-spine W/wo	13	13	$5,170.00	$5,170.00	$284.93	$4,782.25	$1,395.90	2026-07-15
78802	HCPCS	White Blood Cell Study-wb	11	11	$5,289.00	$5,289.00	$1,428.03	$4,892.33	$1,428.03	2026-07-15
78451	HCPCS	Myocardial Perfusion Single	11	11	$5,289.00	$5,289.00	$1,428.03	$4,892.33	$1,428.03	2026-07-15
78452	HCPCS	Myocardial Rest/stress Multipl	11	11	$5,289.00	$5,289.00	$1,428.03	$4,892.33	$1,428.03	2026-07-15
20525	HCPCS	Remove For Body Tendon Compl	11	11	$5,430.00	$5,430.00	$1,466.10	$5,022.75	$1,466.10	2026-07-15
27614	HCPCS	Bx Sft Tiss Leg Or Ankle Deep	11	11	$5,430.00	$5,430.00	$1,466.10	$5,022.75	$1,466.10	2026-07-15
25071	HCPCS	Excis Tumor Wrist >=3 Cm	11	11	$5,430.00	$5,430.00	$1,466.10	$5,022.75	$1,466.10	2026-07-15
45905	HCPCS	Dilation Anal Sphinctr Anesth	11	11	$5,530.00	$5,530.00	$1,493.10	$5,115.25	$1,493.10	2026-07-15
46020	HCPCS	Placement Of Seton	11	11	$5,533.00	$5,533.00	$1,493.91	$5,118.03	$1,493.91	2026-07-15
46320	HCPCS	Enucleation Ext Thromb Hemorr	11	11	$5,535.00	$5,535.00	$1,494.45	$5,119.88	$1,494.45	2026-07-15
46288	HCPCS	Closure Anal Fistula W Flap	11	11	$5,535.00	$5,535.00	$1,494.45	$5,119.88	$1,494.45	2026-07-15
46040	HCPCS	Incision Ischio Abcess	11	11	$5,535.00	$5,535.00	$1,494.45	$5,119.88	$1,494.45	2026-07-15
46230	HCPCS	Exc Tags Multi Papillae	11	11	$5,535.00	$5,535.00	$1,494.45	$5,119.88	$1,494.45	2026-07-15
46260	HCPCS	Hemorrhoidectmy, Int/ext, 2+ C	11	11	$5,535.00	$5,535.00	$1,494.45	$5,119.88	$1,494.45	2026-07-15
46255	HCPCS	Hemorrhoidectomy Simple	11	11	$5,535.00	$5,535.00	$1,494.45	$5,119.88	$1,494.45	2026-07-15
46250	HCPCS	Hemorrhoidectomy Extrnl >2	11	11	$5,535.00	$5,535.00	$1,494.45	$5,119.88	$1,494.45	2026-07-15
44402	HCPCS	Colonoscopy Transendoscopic Pl	11	11	$5,600.00	$5,600.00	$1,512.00	$5,180.00	$1,512.00	2026-07-15
45347	HCPCS	Sigmoid W Transendo Stent	11	11	$5,600.00	$5,600.00	$1,512.00	$5,180.00	$1,512.00	2026-07-15
19300	HCPCS	Excision Gynecomastia	22	11	$3,730.00	$3,730.00	$423.90	$5,448.25	$1,521.28	2026-07-15
19101	HCPCS	Biopsy Breast Open Incisional	11	11	$5,815.00	$5,815.00	$1,570.05	$5,378.88	$1,570.05	2026-07-15
19120	HCPCS	Excision Of Cyst Fibroadenoma	11	11	$5,815.00	$5,815.00	$1,570.05	$5,378.88	$1,570.05	2026-07-15
78813	HCPCS	PET Scan (outside Facility)	11	11	$5,887.00	$5,887.00	$1,589.49	$5,445.48	$1,589.49	2026-07-15
27625	HCPCS	Arthrotomy, W Synovectomy, Ank	11	11	$6,515.00	$6,515.00	$1,759.05	$6,026.38	$1,759.05	2026-07-15
27696	HCPCS	Rep Prim Disrupt Collateral	11	11	$6,515.00	$6,515.00	$1,759.05	$15,359.29	$1,759.05	2026-07-15
27698	HCPCS	Rep Secnd,disrupt Ligame, Ank	11	11	$6,515.00	$6,515.00	$1,759.05	$15,359.29	$1,759.05	2026-07-15
27610	HCPCS	Arthrotomy, Ankl W Expl Drn	11	11	$6,515.00	$6,515.00	$1,759.05	$6,026.38	$1,759.05	2026-07-15
27695	HCPCS	Rep, Prim-disrupt Ligamnt, Ank	11	11	$6,515.00	$6,515.00	$1,759.05	$15,359.29	$1,759.05	2026-07-15
27612	HCPCS	Arthrotomy-post Caps Rel Ank	11	11	$6,515.00	$6,515.00	$1,759.05	$6,026.38	$1,759.05	2026-07-15
27626	HCPCS	Arthrotomy, Synov Ankl Tenosyn	11	11	$6,515.00	$6,515.00	$1,759.05	$6,026.38	$1,759.05	2026-07-15
27680	HCPCS	Tenolysis, Leg Ankle, Single,	11	11	$6,515.00	$6,515.00	$1,759.05	$6,026.38	$1,759.05	2026-07-15
27681	HCPCS	Tenolysis Leg Ankle Multip Ten	11	11	$6,515.00	$6,515.00	$1,759.05	$6,026.38	$1,759.05	2026-07-15
27676	HCPCS	Rep Disl Peron Tend W Fib Oste	11	11	$6,515.00	$6,515.00	$1,759.05	$15,359.29	$1,759.05	2026-07-15
27880	HCPCS	Amputation, Leg, Thro Tibi&fib	11	11	$6,565.00	$6,565.00	$1,772.55	$6,072.63	$1,772.55	2026-07-15
28292	HCPCS	Corr Hv W/wo Sesamoid, Kelle	11	11	$6,770.00	$6,770.00	$1,827.90	$6,262.25	$1,827.90	2026-07-15
28299	HCPCS	Correc Hv W/wo Ses Dbl Osteoto	11	11	$6,770.00	$6,770.00	$1,827.90	$15,486.79	$1,827.90	2026-07-15
28298	HCPCS	Correc Hv W/wo Ses Phal Osteot	11	11	$6,770.00	$6,770.00	$1,827.90	$15,486.79	$1,827.90	2026-07-15
28296	HCPCS	Correc Hv W/wo Sesamoid W Oste	11	11	$6,770.00	$6,770.00	$1,827.90	$6,262.25	$1,827.90	2026-07-15
75635	HCPCS	CTA With Runoff	13	13	$7,040.00	$7,040.00	$136.13	$6,512.00	$1,900.80	2026-07-15
46750	HCPCS	Sphincteroplasty Anal Adult	11	11	$7,425.00	$7,425.00	$2,004.75	$6,868.13	$2,004.75	2026-07-15
49561	HCPCS	Repair Ini Ventral Herni Incar	11	11	$7,520.00	$7,520.00	$2,030.40	$6,956.00	$2,030.40	2026-07-15
49587	HCPCS	Rpr Umbilcl Hernia> 5yrs Incar	11	11	$7,520.00	$7,520.00	$2,030.40	$6,956.00	$2,030.40	2026-07-15
49507	HCPCS	Rpr Intl Ingnal Hernia >5 Yrs	11	11	$7,520.00	$7,520.00	$2,030.40	$6,956.00	$2,030.40	2026-07-15
49505	HCPCS	Rpr Intl Ingnal Herna>5 Yr Red	11	11	$7,520.00	$7,520.00	$2,030.40	$6,956.00	$2,030.40	2026-07-15
49585	HCPCS	Rpr Umbilcl Hernia> 5yrs Reduc	11	11	$7,520.00	$7,520.00	$2,030.40	$6,956.00	$2,030.40	2026-07-15
49568	HCPCS	Impl Mesh Pros Opn Incis Herni	11	11	$7,600.00	$7,600.00	$2,052.00	$7,030.00	$2,052.00	2026-07-15
19307	HCPCS	Mastect Mod Rad,incl Lymph Nod	11	11	$8,195.00	$8,195.00	$2,212.65	$15,145.14	$2,212.65	2026-07-15
27652	HCPCS	Repair Rupt Achi Tendon &graft	11	11	$8,370.00	$8,370.00	$2,259.90	$16,286.79	$2,259.90	2026-07-15
19357	HCPCS	Breast Reconstructon;incl Sub	11	11	$9,030.00	$9,030.00	$2,438.10	$33,988.58	$2,438.10	2026-07-15
A9551	HCPCS	Dmsa	11	11	$9,692.00	$9,692.00	$2,616.84	$8,965.10	$2,616.84	2026-07-15
27691	HCPCS	Tendon Transfer Single, Deep	11	11	$9,890.00	$9,890.00	$2,670.30	$17,046.79	$2,670.30	2026-07-15
27690	HCPCS	Tendon Transfer,single, Superf	11	11	$9,890.00	$9,890.00	$2,670.30	$17,046.79	$2,670.30	2026-07-15
27650	HCPCS	Repair Ruptured Achille Tendon	11	11	$9,890.00	$9,890.00	$2,670.30	$17,046.79	$2,670.30	2026-07-15
27654	HCPCS	Repair Secondary Achill Tendon	11	11	$9,890.00	$9,890.00	$2,670.30	$17,046.79	$2,670.30	2026-07-15
28103	HCPCS	Exc Bone Cyst Ben Tmor W Allgr	11	11	$10,300.00	$10,300.00	$2,781.00	$17,251.79	$2,781.00	2026-07-15
28102	HCPCS	Exc Bone Cyst Ben Tumr W/graft	11	11	$10,300.00	$10,300.00	$2,781.00	$17,251.79	$2,781.00	2026-07-15

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