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Hospital facility prices. What the hospital charges for the facility side of care — the surgeon’s and anesthesiologist’s fees are billed separately and are not included. How we scope prices →

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Hospital

FRANCES MAHON DEACONESS HOSPITAL

Glasgow, MT · CCN 271316 · Rates published

4,070 distinct procedures filed
18 distinct payers
91,596 rate rows
2026-06-09 last MRF observed
Data quality

88,328 of 91,596 rate rows are consumer-grade (96.4%)

3,268 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 — reasonRows
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 2,870
per-diem day rate — not a per-procedure price 260
percent-of-charges filed in the dollar field — excluded from medians 126
exceeds 10× this hospital's gross charge — excluded from medians 12
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://apps.para-hcfs.com/PTT/FinalLinks/Reports.aspx?dbName=dbFMDHGLASGOWMT&type=CDMWithoutLabel&fileType=CSV
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-10-15
Content fingerprint c731bf093fc24d13… · 28,765,720 bytes · first seen 2026-07-17

Top 50 most expensive offerings

Outliers are flagged where this hospital's filed rate is ≥2× or ≤0.5× the national median for the same code.

Code Description Payers Min $ Max $ Avg median vs national
J9271
HCPCS 		Injection, Pembrolizumab, 1 Mg 18 $15,634.02 $32,967.39 $32,287.65 nat. median
$127
outlier · 254.2×
40701314C
CDM 		Lupron Depot 45 Mg 6mo Kit 18 $15,093.29 $31,827.16 $31,170.93 —
J2327
HCPCS 		Injection, Risankizumab-rzaa, Intravenous, 1 Mg 18 $12,352.23 $26,047.09 $25,510.04 nat. median
$48
outlier · 531.7×
J9144
HCPCS 		Injection, Daratumumab, 10 Mg And Hyaluronidase-fihj 18 $11,835.34 $24,957.13 $24,442.55 nat. median
$114
outlier · 213.5×
J9312
HCPCS 		Injection, Rituximab, 10 Mg 18 $11,279.66 $23,785.37 $23,294.95 nat. median
$739
outlier · 31.5×
J1640
HCPCS 		Injection, Hemin, 1 Mg 18 $10,508.24 $22,158.68 $21,701.80 nat. median
$74
outlier · 294.7×
J3380
HCPCS 		Injection, Vedolizumab, Intravenous, 1 Mg 18 $10,405.20 $21,941.40 $21,489.00 nat. median
$59
outlier · 365.4×
J3101
HCPCS 		Injection, Tenecteplase, 1 Mg 18 $9,306.57 $19,624.72 $19,220.09 nat. median
$498
outlier · 38.6×
J9299
HCPCS 		Injection, Nivolumab, 1 Mg 18 $9,208.95 $19,418.88 $19,018.49 nat. median
$1,811
outlier · 10.5×
J9306
HCPCS 		Injection, Pertuzumab, 1 Mg 18 $8,785.11 $18,525.12 $18,143.16 nat. median
$43
outlier · 425.2×
J2353
HCPCS 		Injection, Octreotide, Depot Form For Intramuscular Injection, 1 Mg 18 $8,299.32 $17,500.74 $17,139.90 nat. median
$1,956
outlier · 8.8×
J0775
HCPCS 		Injection, Collagenase, Clostridium Histolyticum, 0.01 Mg 18 $8,213.76 $17,320.32 $16,963.20 nat. median
$114
outlier · 149.4×
01496
CDM 		Nail, Gamma 10x170mm 3125-0170 18 $7,854.96 $16,563.72 $16,222.20 —
40704511C
CDM 		Lupron Depot 22.5 Mg 3mo Kit 18 $7,546.30 $15,912.85 $15,584.75 —
J1745
HCPCS 		Injection, Infliximab, Excludes Biosimilar, 10 Mg 18 $7,360.92 $15,521.94 $15,201.90 nat. median
$190
outlier · 80.0×
J1602
HCPCS 		Injection, Golimumab, 1 Mg, For Intravenous Use 18 $7,200.84 $15,184.38 $14,871.30 nat. median
$55
outlier · 272.4×
01615
CDM 		Disc, Prestige 6972450 18 $6,900.00 $14,550.00 $14,250.00 —
90377
HCPCS 		Rabies Immune Globulin For Injection Beneath The Skin And/or Into Muscle 18 $6,809.84 $14,359.88 $14,063.80 nat. median
$481
outlier · 29.2×
J1569
HCPCS 		Injection, Immune Globulin, (gammagard Liquid), Non-lyophilized, (e.g., Liquid),… 18 $6,105.58 $12,874.81 $12,609.35 nat. median
$946
outlier · 13.3×
J9354
HCPCS 		Injection, Ado-trastuzumab Emtansine, 1 Mg 18 $4,672.22 $29,591.79 $11,942.76 nat. median
$4,004
outlier · 3.0×
Q5103
HCPCS 		Injection, Infliximab-dyyb, Biosimilar, (inflectra), 10 Mg 18 $5,680.54 $11,978.53 $11,731.55 nat. median
$138
outlier · 85.0×
J9176
HCPCS 		Injection, Elotuzumab, 1 Mg 18 $5,357.16 $11,296.62 $11,063.70 nat. median
$2,022
outlier · 5.5×
J0129
HCPCS 		Injection, Abatacept, 10 Mg (code May Be Used For Medicare When Drug Administere… 18 $5,249.85 $11,070.33 $10,842.07 nat. median
$122
outlier · 88.8×
02680
CDM 		Tprlc 133 T1 51-103150 18 $5,222.38 $11,012.41 $10,785.35 —
07777
CDM 		Stem, Femoral Taperloc 11x142 18 $5,222.38 $11,012.41 $10,785.35 —
J2356
HCPCS 		Injection, Tezepelumab-ekko, 1 Mg 18 $5,120.49 $10,797.56 $10,574.93 nat. median
$43
outlier · 244.2×
09865
CDM 		Tprlc 133 T1 51-1003100 18 $5,097.95 $10,750.03 $10,528.38 —
J2506
HCPCS 		Injection, Pegfilgrastim, Excludes Biosimilar, 0.5 Mg 18 $4,830.00 $10,185.00 $9,975.00 nat. median
$916
outlier · 10.9×
44146
HCPCS 		Partial Removal Of Large Bowel And Reattachment To Rectum And Creation Of Large… 15 $53.00 $10,849.00 $9,136.00 nat. median
$4,162
outlier · 2.2×
02538
CDM 		Stem, Comp Primary 11mm 113651 18 $4,374.60 $9,224.70 $9,034.50 —
407011451
CDM 		Neulasta Onpro 6 Mg/0.6 Ml Kit 18 $4,370.00 $9,215.00 $9,025.00 —
02839
CDM 		Psn Fem Ps Por 42-5008-070-01 18 $4,282.60 $9,030.70 $8,844.50 —
02663
CDM 		Psn Fem Ps Por 42-5008-062-02 18 $4,282.60 $9,030.70 $8,844.50 —
40419996A
CDM 		C-arm Op Angio 18 $4,085.72 $8,615.54 $8,437.90 —
01505
CDM 		Cage, Bullet Capstone 18 $4,048.00 $8,536.00 $8,360.00 —
01227
CDM 		Cage, Capstone 6mm Xo1042206 18 $4,048.00 $8,536.00 $8,360.00 —
01261
CDM 		Capstone Cage 26mm X01042608 18 $4,048.00 $8,536.00 $8,360.00 —
Q5116
HCPCS 		Injection, Trastuzumab-qyyp, Biosimilar, (trazimera), 10 Mg 18 $3,859.52 $8,138.54 $7,970.74 nat. median
$196
outlier · 40.6×
22633
HCPCS 		Fusion Of Spine In Lower Back With Partial Removal Of Spine Bone And Disc 16 $1,699.54 $12,898.13 $7,469.55 nat. median
$15,119
outlier · 0.5×
02755
CDM 		Psn Fem Ps Cmt 42-5706-064-01 18 $3,496.00 $7,372.00 $7,220.00 —
01452
CDM 		Psn Fem Ps Cmt 42-5706-058-02 18 $3,496.00 $7,372.00 $7,220.00 —
44144
HCPCS 		Partial Removal Of Large Bowel With Creation Of 2 Openings From Small Or Large B… 15 $53.00 $8,567.10 $7,214.40 nat. median
$3,579
outlier · 2.0×
J0717
HCPCS 		Injection, Certolizumab Pegol, 1 Mg (code May Be Used For Medicare When Drug Adm… 18 $3,433.44 $14,479.19 $7,090.80 nat. median
$29
outlier · 244.3×
501006212
CDM 		Diet Consult - Ft Pk Tribes 18 $3,422.78 $7,217.61 $7,068.79 —
00999
CDM 		Psn Fem Cr Cmt 42-5026-064-02 18 $3,408.60 $7,187.70 $7,039.50 —
01682
CDM 		Psn Fem Cr Cmt 42-5026-068-01 18 $3,408.60 $7,187.70 $7,039.50 —
01897
CDM 		Psn Fem Cr 42-5026-064-01 18 $3,408.60 $7,187.70 $7,039.50 —
01076
CDM 		Psn Fem Cr 42-5026-062-02 18 $3,408.60 $7,187.70 $7,039.50 —
02036
CDM 		Psn Fem Cr 42-5026-070-02 18 $3,408.60 $7,187.70 $7,039.50 —
02383
CDM 		Psn Fem Cr 42-5026-066-02 18 $3,408.60 $7,187.70 $7,039.50 —

Other procedures at this hospital

Browse this hospital's 4,070 published procedures. Use the slice to choose what to show, then sort or filter any column.

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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
             
J9271 HCPCS Injection, Pembrolizumab, 1 Mg 18 18 $33,987.00 $30,588.30 $15,634.02 $32,967.39 $32,287.65 2026-06-09
40701314C CDM Lupron Depot 45 Mg 6mo Kit 18 18 $32,811.50 $29,530.35 $15,093.29 $31,827.16 $31,170.93 2026-06-09
J2327 HCPCS Injection, Risankizumab-rzaa, Intravenous, 1 Mg 18 18 $26,852.67 $24,167.40 $12,352.23 $26,047.09 $25,510.04 2026-06-09
J9144 HCPCS Injection, Daratumumab, 10 Mg And Hyaluronidase-fihj 18 18 $25,729.00 $23,156.10 $11,835.34 $24,957.13 $24,442.55 2026-06-09
J9312 HCPCS Injection, Rituximab, 10 Mg 18 18 $24,521.00 $22,068.90 $11,279.66 $23,785.37 $23,294.95 2026-06-09
J1640 HCPCS Injection, Hemin, 1 Mg 18 18 $22,844.00 $20,559.60 $10,508.24 $22,158.68 $21,701.80 2026-06-09
J3380 HCPCS Injection, Vedolizumab, Intravenous, 1 Mg 18 18 $22,620.00 $20,358.00 $10,405.20 $21,941.40 $21,489.00 2026-06-09
J3101 HCPCS Injection, Tenecteplase, 1 Mg 18 18 $20,231.67 $18,208.50 $9,306.57 $19,624.72 $19,220.09 2026-06-09
J9299 HCPCS Injection, Nivolumab, 1 Mg 18 18 $20,019.46 $18,017.51 $9,208.95 $19,418.88 $19,018.49 2026-06-09
J9306 HCPCS Injection, Pertuzumab, 1 Mg 18 18 $19,098.06 $17,188.25 $8,785.11 $18,525.12 $18,143.16 2026-06-09
J2353 HCPCS Injection, Octreotide, Depot Form For Intramuscular Injection, 1 Mg 18 18 $18,042.00 $16,237.80 $8,299.32 $17,500.74 $17,139.90 2026-06-09
J0775 HCPCS Injection, Collagenase, Clostridium Histolyticum, 0.01 Mg 18 18 $17,856.00 $16,070.40 $8,213.76 $17,320.32 $16,963.20 2026-06-09
01496 CDM Nail, Gamma 10x170mm 3125-0170 18 18 $17,076.00 $15,368.40 $7,854.96 $16,563.72 $16,222.20 2026-06-09
40704511C CDM Lupron Depot 22.5 Mg 3mo Kit 18 18 $16,405.00 $14,764.50 $7,546.30 $15,912.85 $15,584.75 2026-06-09
J1745 HCPCS Injection, Infliximab, Excludes Biosimilar, 10 Mg 18 18 $16,002.00 $14,401.80 $7,360.92 $15,521.94 $15,201.90 2026-06-09
J1602 HCPCS Injection, Golimumab, 1 Mg, For Intravenous Use 18 18 $15,654.00 $14,088.60 $7,200.84 $15,184.38 $14,871.30 2026-06-09
01615 CDM Disc, Prestige 6972450 18 18 $15,000.00 $13,500.00 $6,900.00 $14,550.00 $14,250.00 2026-06-09
90377 HCPCS Rabies Immune Globulin For Injection Beneath The Skin And/or Into Muscle 18 18 $14,804.00 $13,323.60 $6,809.84 $14,359.88 $14,063.80 2026-06-09
J1569 HCPCS Injection, Immune Globulin, (gammagard Liquid), Non-lyophilized, (e.g., Liquid),… 18 18 $13,273.00 $11,945.70 $6,105.58 $12,874.81 $12,609.35 2026-06-09
J9354 HCPCS Injection, Ado-trastuzumab Emtansine, 1 Mg 36 18 $20,332.00 $18,298.80 $4,672.22 $29,591.79 $11,942.76 2026-06-09
Q5103 HCPCS Injection, Infliximab-dyyb, Biosimilar, (inflectra), 10 Mg 18 18 $12,349.00 $11,114.10 $5,680.54 $11,978.53 $11,731.55 2026-06-09
J9176 HCPCS Injection, Elotuzumab, 1 Mg 18 18 $11,646.00 $10,481.40 $5,357.16 $11,296.62 $11,063.70 2026-06-09
J0129 HCPCS Injection, Abatacept, 10 Mg (code May Be Used For Medicare When Drug Administere… 18 18 $11,412.71 $10,271.44 $5,249.85 $11,070.33 $10,842.07 2026-06-09
02680 CDM Tprlc 133 T1 51-103150 18 18 $11,353.00 $10,217.70 $5,222.38 $11,012.41 $10,785.35 2026-06-09
07777 CDM Stem, Femoral Taperloc 11x142 18 18 $11,353.00 $10,217.70 $5,222.38 $11,012.41 $10,785.35 2026-06-09
J2356 HCPCS Injection, Tezepelumab-ekko, 1 Mg 18 18 $11,131.50 $10,018.35 $5,120.49 $10,797.56 $10,574.93 2026-06-09
09865 CDM Tprlc 133 T1 51-1003100 18 18 $11,082.50 $9,974.25 $5,097.95 $10,750.03 $10,528.38 2026-06-09
J2506 HCPCS Injection, Pegfilgrastim, Excludes Biosimilar, 0.5 Mg 18 18 $10,500.00 $9,450.00 $4,830.00 $10,185.00 $9,975.00 2026-06-09
44146 HCPCS Partial Removal Of Large Bowel And Reattachment To Rectum And Creation Of Large … 15 15 $11,420.00 $10,278.00 $53.00 $10,849.00 $9,136.00 2026-06-09
02538 CDM Stem, Comp Primary 11mm 113651 18 18 $9,510.00 $8,559.00 $4,374.60 $9,224.70 $9,034.50 2026-06-09
407011451 CDM Neulasta Onpro 6 Mg/0.6 Ml Kit 18 18 $9,500.00 $8,550.00 $4,370.00 $9,215.00 $9,025.00 2026-06-09
02663 CDM Psn Fem Ps Por 42-5008-062-02 18 18 $9,310.00 $8,379.00 $4,282.60 $9,030.70 $8,844.50 2026-06-09
02839 CDM Psn Fem Ps Por 42-5008-070-01 18 18 $9,310.00 $8,379.00 $4,282.60 $9,030.70 $8,844.50 2026-06-09
40419996A CDM C-arm Op Angio 18 18 $8,882.00 $7,993.80 $4,085.72 $8,615.54 $8,437.90 2026-06-09
01261 CDM Capstone Cage 26mm X01042608 18 18 $8,800.00 $7,920.00 $4,048.00 $8,536.00 $8,360.00 2026-06-09
01227 CDM Cage, Capstone 6mm Xo1042206 18 18 $8,800.00 $7,920.00 $4,048.00 $8,536.00 $8,360.00 2026-06-09
01505 CDM Cage, Bullet Capstone 18 18 $8,800.00 $7,920.00 $4,048.00 $8,536.00 $8,360.00 2026-06-09
Q5116 HCPCS Injection, Trastuzumab-qyyp, Biosimilar, (trazimera), 10 Mg 18 18 $8,390.25 $7,551.23 $3,859.52 $8,138.54 $7,970.74 2026-06-09
22633 HCPCS Fusion Of Spine In Lower Back With Partial Removal Of Spine Bone And Disc 16 16 $9,054.00 $8,148.60 $1,699.54 $12,898.13 $7,469.55 2026-06-09
02755 CDM Psn Fem Ps Cmt 42-5706-064-01 18 18 $7,600.00 $6,840.00 $3,496.00 $7,372.00 $7,220.00 2026-06-09
01452 CDM Psn Fem Ps Cmt 42-5706-058-02 18 18 $7,600.00 $6,840.00 $3,496.00 $7,372.00 $7,220.00 2026-06-09
44144 HCPCS Partial Removal Of Large Bowel With Creation Of 2 Openings From Small Or Large B… 15 15 $9,018.00 $8,116.20 $53.00 $8,567.10 $7,214.40 2026-06-09
J0717 HCPCS Injection, Certolizumab Pegol, 1 Mg (code May Be Used For Medicare When Drug Adm… 36 18 $11,195.50 $10,075.95 $3,433.44 $14,479.19 $7,090.80 2026-06-09
501006212 CDM Diet Consult - Ft Pk Tribes 18 18 $7,440.83 $6,696.75 $3,422.78 $7,217.61 $7,068.79 2026-06-09
02383 CDM Psn Fem Cr 42-5026-066-02 18 18 $7,410.00 $6,669.00 $3,408.60 $7,187.70 $7,039.50 2026-06-09
01682 CDM Psn Fem Cr Cmt 42-5026-068-01 18 18 $7,410.00 $6,669.00 $3,408.60 $7,187.70 $7,039.50 2026-06-09
02036 CDM Psn Fem Cr 42-5026-070-02 18 18 $7,410.00 $6,669.00 $3,408.60 $7,187.70 $7,039.50 2026-06-09
02757 CDM Psn Fem Cr Cmt 42-5026-070-01 18 18 $7,410.00 $6,669.00 $3,408.60 $7,187.70 $7,039.50 2026-06-09
05061 CDM Psn Fem Cr Cmt 42-5026-058-02 18 18 $7,410.00 $6,669.00 $3,408.60 $7,187.70 $7,039.50 2026-06-09
01897 CDM Psn Fem Cr 42-5026-064-01 18 18 $7,410.00 $6,669.00 $3,408.60 $7,187.70 $7,039.50 2026-06-09
00999 CDM Psn Fem Cr Cmt 42-5026-064-02 18 18 $7,410.00 $6,669.00 $3,408.60 $7,187.70 $7,039.50 2026-06-09
01076 CDM Psn Fem Cr 42-5026-062-02 18 18 $7,410.00 $6,669.00 $3,408.60 $7,187.70 $7,039.50 2026-06-09
27132 HCPCS Total Hip Replacement After Previous Hip Surgery 16 16 $8,515.00 $7,663.50 $53.00 $9,707.30 $7,024.88 2026-06-09
J1561 HCPCS Injection, Immune Globulin, (gamunex-c/gammaked), Non-lyophilized (e.g., Liquid)… 18 18 $7,331.38 $6,598.24 $3,372.43 $7,111.44 $6,964.81 2026-06-09
44206 HCPCS Partial Removal Of Large Bowel With Creation Of Opening From Large Bowel To Skin… 15 15 $8,622.00 $7,759.80 $53.00 $8,190.90 $6,897.60 2026-06-09
44143 HCPCS Partial Removal Of Large Bowel With Creation Of Opening From Large Bowel To Skin 15 15 $8,498.00 $7,648.20 $1,530.32 $8,073.10 $6,798.40 2026-06-09
02193 CDM Pilotgraft Bt Tendon 18 18 $7,120.00 $6,408.00 $3,275.20 $6,906.40 $6,764.00 2026-06-09
02496 CDM Nail, Tibial 320mm 3525-0320s 18 18 $7,052.00 $6,346.80 $3,243.92 $6,840.44 $6,699.40 2026-06-09
22630 HCPCS Fusion Of Lower Spine Bone And Partial Removal Of Spine Bone Or Disc Through Bac… 16 16 $8,102.00 $7,291.80 $53.00 $20,858.55 $6,684.15 2026-06-09
49187 HCPCS Removal Or Destruction Of Growth(s) In The Abdomen, 5.1 To 10.0 Cm 15 15 $7,833.00 $7,049.70 $1,546.03 $7,441.35 $6,658.05 2026-06-09
23472 HCPCS Prosthetic Repair Of Shoulder Joint, Total Shoulder 16 16 $7,893.00 $7,103.70 $1,300.01 $12,898.13 $6,511.73 2026-06-09
01417 CDM Implant, Interphalangeal 2 18 18 $6,600.00 $5,940.00 $3,036.00 $6,402.00 $6,270.00 2026-06-09
01847 CDM Bioinductive Implant 4565 18 18 $6,400.00 $5,760.00 $2,944.00 $6,208.00 $6,080.00 2026-06-09
17999 HCPCS Other Procedure On Skin, Mucous Membrane, And Tissue 11 11 $6,346.00 $5,711.40 $53.00 $6,028.70 $5,901.78 2026-06-09
09866 CDM Cer Bioloxd Option 650-1058 18 18 $6,198.33 $5,578.50 $2,851.23 $6,012.38 $5,888.41 2026-06-09
27486 HCPCS Revision Of Component Of Total Knee Joint Prosthesis 15 15 $7,245.00 $6,520.50 $53.00 $6,882.75 $5,796.00 2026-06-09
09085 CDM Head, Ceramic 36mm 650-1057 18 18 $5,950.00 $5,355.00 $2,737.00 $5,771.50 $5,652.50 2026-06-09
04247 CDM Cer Bioloxd Option 650-1055 18 18 $5,950.00 $5,355.00 $2,737.00 $5,771.50 $5,652.50 2026-06-09
27280 HCPCS Fusion Of Sacroiliac Joint Between Spine And Pelvis With Bone Graft, Open Proced… 15 15 $7,059.00 $6,353.10 $53.00 $6,706.05 $5,647.20 2026-06-09
43840 HCPCS Suture Of Perforated Ulcer, Wound, Or Injury Of Stomach Or Upper Small Bowel 15 15 $7,013.00 $6,311.70 $53.00 $6,662.35 $5,610.40 2026-06-09
49618 HCPCS Repair Of Recurrent Entrapped Hernia Of Abdomen, More Than 10 Cm In Length 15 15 $6,577.00 $5,919.30 $1,131.24 $6,248.15 $5,590.45 2026-06-09
27130 HCPCS Replacement Of Thigh Bone And Hip Joint With Prosthesis 16 16 $6,549.00 $5,894.10 $1,161.75 $9,614.11 $5,402.92 2026-06-09
J9173 HCPCS Injection, Durvalumab, 10 Mg 36 18 $10,183.86 $9,165.47 $1,183.12 $17,261.85 $5,340.43 2026-06-09
08224 CDM Shell, Acetabular G7 010000664 18 18 $5,611.00 $5,049.90 $2,581.06 $5,442.67 $5,330.45 2026-06-09
05145 CDM Screw, T1 5.5x40 54410005540 18 18 $5,564.00 $5,007.60 $2,559.44 $5,397.08 $5,285.80 2026-06-09
01262 CDM Screw, Fas 6.5mm 54410006535 18 18 $5,564.00 $5,007.60 $2,559.44 $5,397.08 $5,285.80 2026-06-09
02699 CDM Plate, Trilock 4cf A-4660.10 18 18 $5,500.00 $4,950.00 $2,530.00 $5,335.00 $5,225.00 2026-06-09
J9355 HCPCS Injection, Trastuzumab, Excludes Biosimilar, 10 Mg 18 18 $5,490.70 $4,941.63 $2,525.72 $5,325.98 $5,216.17 2026-06-09
02710 CDM Fibertak, Shoulder 1.8 Ar-3636 18 18 $5,485.33 $4,936.80 $2,523.25 $5,320.77 $5,211.06 2026-06-09
Q5108 HCPCS Injection, Pegfilgrastim-jmdb (fulphila), Biosimilar, 0.5 Mg 18 18 $5,448.00 $4,903.20 $2,506.08 $5,284.56 $5,175.60 2026-06-09
02878 CDM Vivacit-e Bearing 110031013 18 18 $5,400.00 $4,860.00 $2,484.00 $5,238.00 $5,130.00 2026-06-09
44160 HCPCS Partial Removal Of Small And Large Bowel With Attachment Of Small And Large Bowe… 15 15 $6,355.00 $5,719.50 $53.00 $6,037.25 $5,084.00 2026-06-09
44120 HCPCS Partial Removal Of Small Bowel With Reconnection 15 15 $6,285.00 $5,656.50 $1,135.96 $5,970.75 $5,028.00 2026-06-09
64447 HCPCS Injection Of Anesthetic Agent And/or Steroid Into Thigh Nerve (femoral Nerve) 34 18 $10,903.00 $9,812.70 $60.78 $10,575.91 $5,015.38 2026-06-09
323099291 CDM Trauma Team-no Prenotification 18 18 $5,226.00 $4,703.40 $2,403.96 $5,069.22 $4,964.70 2026-06-09
44145 HCPCS Partial Removal Of Large Bowel And Reattachment To Rectum 16 16 $8,419.00 $7,577.10 $53.00 $7,998.05 $4,929.55 2026-06-09
02745 CDM Fiberstitch 1.5 Ar-4580-24 18 18 $5,135.00 $4,621.50 $2,362.10 $4,980.95 $4,878.25 2026-06-09
27236 HCPCS Treatment Of Upper End Of Broken Thigh Bone With Placement Of Stabilizing Device… 15 15 $6,095.00 $5,485.50 $1,089.63 $5,790.25 $4,876.00 2026-06-09
J9047 HCPCS Injection, Carfilzomib, 1 Mg 36 18 $8,091.90 $7,282.70 $1,998.80 $11,483.41 $4,830.30 2026-06-09
02518 CDM Plate, 62.5mm 7200062 18 18 $5,050.00 $4,545.00 $2,323.00 $4,898.50 $4,797.50 2026-06-09
27125 HCPCS Partial Replacement Of Thigh Bone At Hip Joint With Prosthesis 15 15 $5,975.00 $5,377.50 $53.00 $5,676.25 $4,780.00 2026-06-09
44626 HCPCS Closure Of Surgically Created Large Or Small Bowel Opening With Bowel Removal An… 16 16 $8,168.00 $7,351.20 $53.00 $7,759.60 $4,779.42 2026-06-09
099195 CDM Knee System, 42-5226-005-16 18 18 $5,008.90 $4,508.01 $2,304.09 $4,858.63 $4,758.46 2026-06-09
27250 HCPCS Closed Treatment Of Dislocated Hip 36 18 $9,817.50 $8,835.75 $53.00 $18,144.82 $4,743.65 2026-06-09
03201 CDM Ligament Repair Kit Ar-8978-cp 18 18 $4,984.00 $4,485.60 $2,292.64 $4,834.48 $4,734.80 2026-06-09
01377 CDM Nail, Tibial 170mm 3130-0170s 18 18 $4,973.00 $4,475.70 $2,287.58 $4,823.81 $4,724.35 2026-06-09
27299 HCPCS Other Procedure On Pelvis Or Hip Joint 11 11 $4,991.00 $4,491.90 $53.00 $4,741.45 $4,641.63 2026-06-09
02543 CDM Comp Rvrs 25mm 010000589 18 18 $4,875.00 $4,387.50 $2,242.50 $4,728.75 $4,631.25 2026-06-09
64415 HCPCS Injection Of Anesthetic Agent And/or Steroid Into Arm Nerve Bundle (brachial Ple… 34 18 $10,066.00 $9,059.40 $66.46 $9,764.02 $4,630.36 2026-06-09
49596 HCPCS Initial Repair Of Entrapped Hernia Of Abdomen, More Than 10 Cm In Length 15 15 $5,429.00 $4,886.10 $936.25 $5,157.55 $4,614.65 2026-06-09
63267 HCPCS Removal Of Growth Of Lower Spine Bone Outside Spine Membrane 16 16 $6,906.00 $6,215.40 $53.00 $6,560.70 $4,610.16 2026-06-09
44204 HCPCS Partial Removal Of Large Bowel Using An Endoscope 16 16 $7,877.00 $7,089.30 $1,412.81 $7,483.15 $4,603.55 2026-06-09
09940 CDM Liner, G7 40mm 30124007 18 18 $4,800.00 $4,320.00 $2,208.00 $4,656.00 $4,560.00 2026-06-09
09867 CDM G7 Vit E Liner 30124006 18 18 $4,800.00 $4,320.00 $2,208.00 $4,656.00 $4,560.00 2026-06-09
04256 CDM Liner, G7 Vit E 30123605 18 18 $4,800.00 $4,320.00 $2,208.00 $4,656.00 $4,560.00 2026-06-09
J9227 HCPCS Injection, Isatuximab-irfc, 10 Mg 36 18 $8,695.75 $7,826.18 $950.36 $14,865.74 $4,526.88 2026-06-09
J0897 HCPCS Injection, Denosumab, 1 Mg 36 18 $6,645.77 $5,981.19 $2,153.63 $8,351.44 $4,447.72 2026-06-09
44625 HCPCS Closure Of Surgically Created Large Or Small Bowel Opening With Bowel Removal An… 15 15 $5,537.00 $4,983.30 $53.00 $5,260.15 $4,429.60 2026-06-09
02758 CDM Psn Fem Cr Por 42-5028-062-02 18 18 $4,655.00 $4,189.50 $2,141.30 $4,515.35 $4,422.25 2026-06-09
47600 HCPCS Removal Of Gallbladder 15 15 $5,523.00 $4,970.70 $53.00 $5,246.85 $4,418.40 2026-06-09
02545 CDM Plate, Zevo 19mm 3001019 18 18 $4,624.00 $4,161.60 $2,127.04 $4,485.28 $4,392.80 2026-06-09
00588 CDM Tissue, 345544 Lasr 18 18 $4,600.00 $4,140.00 $2,116.00 $4,462.00 $4,370.00 2026-06-09
323059412 CDM Asst External Cephalic Version 18 18 $4,579.00 $4,121.10 $2,106.34 $4,441.63 $4,350.05 2026-06-09
36558 HCPCS Insertion Of Tunneled Central Venous Tube For Infusion (5 Years Or Older) 54 18 $6,052.00 $5,446.80 $232.43 $6,076.08 $4,341.39 2026-06-09
01815 CDM Plate, Atl Elite 37.5mm 18 18 $4,544.00 $4,089.60 $2,090.24 $4,407.68 $4,316.80 2026-06-09
49002 HCPCS Reopening Of Recent Abdominal Incision 15 15 $5,368.00 $4,831.20 $53.00 $5,099.60 $4,294.40 2026-06-09
02539 CDM Mini Tray Std 110031399 18 18 $4,470.00 $4,023.00 $2,056.20 $4,335.90 $4,246.50 2026-06-09
59510 HCPCS Cesarean Delivery With Care Before And After Delivery 18 18 $7,506.00 $6,755.40 $2,472.47 $7,130.70 $4,217.91 2026-06-09
58150 HCPCS Removal Of Uterus And Cervix Through Abdomen 15 15 $5,241.00 $4,716.90 $932.99 $4,978.95 $4,192.80 2026-06-09
44602 HCPCS Suture Of Tear Of Hole In Small Bowel 16 16 $6,986.00 $6,287.40 $53.00 $6,636.70 $4,129.82 2026-06-09
07691 CDM Speedbridge Implant Ar-2600sbs 18 18 $4,253.33 $3,828.00 $1,956.53 $4,125.73 $4,040.66 2026-06-09
44140 HCPCS Partial Removal Of Large Bowel With Connection 16 16 $6,902.00 $6,211.80 $1,249.83 $6,556.90 $4,030.58 2026-06-09
27828 HCPCS Treatment Of Broken Lower Weight Bearing Joint Of Both Lower Leg Bones 18 18 $6,885.00 $6,196.50 $53.00 $9,024.33 $3,992.25 2026-06-09
49617 HCPCS Repair Of Recurrent Sliding Hernia Of Abdomen, More Than 10 Cm In Length 15 15 $4,696.00 $4,226.40 $808.03 $4,461.20 $3,991.60 2026-06-09
02725 CDM Shell, Acetabular 010000665 18 18 $4,191.33 $3,772.20 $1,928.01 $4,065.59 $3,981.76 2026-06-09
02840 CDM Psn Tib Por 0 42-5350-083-01 18 18 $4,180.00 $3,762.00 $1,922.80 $4,054.60 $3,971.00 2026-06-09
02660 CDM Psn Tib Por 42-5350-071-02 18 18 $4,180.00 $3,762.00 $1,922.80 $4,054.60 $3,971.00 2026-06-09
04054 CDM Shell, Acetabular 010000667 18 18 $4,157.50 $3,741.75 $1,912.45 $4,032.78 $3,949.63 2026-06-09
01152 CDM Liner, G7 46mm 110024465 18 18 $4,080.00 $3,672.00 $1,876.80 $3,957.60 $3,876.00 2026-06-09
49616 HCPCS Repair Of Recurrent Entrapped Hernia Of Abdomen, 3-10 Cm In Length 14 14 $4,558.00 $4,102.20 $782.99 $4,330.10 $3,874.30 2026-06-09
02779 CDM Implant, Interphalangeal 1 18 18 $4,074.00 $3,666.60 $1,874.04 $3,951.78 $3,870.30 2026-06-09
44050 HCPCS Repair Of Twisted Or Herniated Small Bowel 15 15 $4,829.00 $4,346.10 $53.00 $4,587.55 $3,863.20 2026-06-09
09145 CDM Shell, Acetabular 010000666 18 18 $4,056.00 $3,650.40 $1,865.76 $3,934.32 $3,853.20 2026-06-09
09048 CDM Shell, Acetabular G7 010000663 18 18 $4,056.00 $3,650.40 $1,865.76 $3,934.32 $3,853.20 2026-06-09
44238 HCPCS Other Procedure On Bowel Using An Endoscope 11 11 $4,139.00 $3,725.10 $53.00 $3,932.05 $3,849.27 2026-06-09
59400 HCPCS Vaginal Delivery With Care Before And After Delivery 18 18 $6,799.00 $6,119.10 $2,213.78 $6,459.05 $3,803.17 2026-06-09
02542 CDM Cr Vivacit-e 36m 110031424 18 18 $3,960.00 $3,564.00 $1,821.60 $3,841.20 $3,762.00 2026-06-09
22315 HCPCS Closed Treatment Of Broken Or Dislocated Spine Bone With Cast Or Brace And Tract… 36 18 $5,124.50 $4,612.05 $53.00 $6,063.47 $3,758.12 2026-06-09
02038 CDM Prx Hum Lo 73mm 110030200 18 18 $3,920.00 $3,528.00 $1,803.20 $3,802.40 $3,724.00 2026-06-09
01887 CDM Surgimesh Xb R-1415 18 18 $3,900.00 $3,510.00 $1,794.00 $3,783.00 $3,705.00 2026-06-09
27244 HCPCS Treatment Of Broken Neck Of Thigh Bone With Plate/screw Implant 16 16 $6,344.00 $5,709.60 $53.00 $6,026.80 $3,692.65 2026-06-09
27245 HCPCS Treatment Of Broken Neck Of Thigh Bone With Bone Implant 16 16 $6,336.00 $5,702.40 $1,118.01 $6,019.20 $3,688.15 2026-06-09
J9035 HCPCS Injection, Bevacizumab, 10 Mg 36 18 $6,864.00 $6,177.60 $956.80 $11,298.56 $3,687.84 2026-06-09
02537 CDM Comp Rvrs Shldr 36mm 115310 18 18 $3,825.00 $3,442.50 $1,759.50 $3,710.25 $3,633.75 2026-06-09
63012 HCPCS Partial Removal Of Spine Bone With Release Of Lower Spinal Cord Or Nerves 18 18 $6,228.00 $5,605.20 $53.00 $5,916.60 $3,613.75 2026-06-09
27599 HCPCS Other Procedure On Thigh Or Knee 11 11 $3,882.00 $3,493.80 $53.00 $3,687.90 $3,610.26 2026-06-09
23470 HCPCS Partial Replacement Of Shoulder Joint 18 18 $6,126.00 $5,513.40 $53.00 $9,024.33 $3,578.80 2026-06-09
01758 CDM Lantern Surgical Assist 406000 18 18 $3,762.50 $3,386.25 $1,730.75 $3,649.63 $3,574.38 2026-06-09
12037 HCPCS Intermediate Repair Of Wound Of Scalp, Underarms, Trunk, Arms, Or Legs, More Tha… 18 18 $3,748.00 $3,373.20 $1,724.08 $3,635.56 $3,560.60 2026-06-09
02706 CDM Screw, T1 5.5mm 54410005535 18 18 $3,709.00 $3,338.10 $1,706.14 $3,597.73 $3,523.55 2026-06-09
00954 CDM Femoral Std 7mm 12-151307 18 18 $3,704.00 $3,333.60 $1,703.84 $3,592.88 $3,518.80 2026-06-09
44188 HCPCS Creation Of Large Bowel Opening Using An Endoscope 16 16 $5,832.00 $5,248.80 $53.00 $5,540.40 $3,484.60 2026-06-09
49595 HCPCS Initial Repair Of Sliding Hernia Of Abdomen, More Than 10 Cm In Length 15 15 $4,089.00 $3,680.10 $704.19 $4,376.34 $3,475.65 2026-06-09
27446 HCPCS Replacement Of Knee Joint On Side Of Knee 18 18 $5,889.00 $5,300.10 $1,047.22 $9,024.33 $3,444.02 2026-06-09
00874 CDM Echo Fx 11mm 12-151311 18 18 $3,616.00 $3,254.40 $1,663.36 $3,507.52 $3,435.20 2026-06-09
26951 HCPCS Amputation Of Finger Or Thumb With Direct Closure 36 18 $4,925.50 $4,432.95 $53.00 $6,012.06 $3,433.82 2026-06-09
03133 CDM Nail, Tibial Stand. 1822-1034s 18 18 $3,614.00 $3,252.60 $1,662.44 $3,505.58 $3,433.30 2026-06-09
23397 HCPCS Relocation Of Multiple Muscles Of Shoulder Or Upper Arm 18 18 $5,897.00 $5,307.30 $53.00 $5,602.15 $3,430.98 2026-06-09
19307 HCPCS Removal Of Breast And Underarm Lymph Nodes 18 18 $6,107.00 $5,496.30 $53.00 $5,801.65 $3,423.81 2026-06-09
20692 HCPCS Placement Of Multiple Direction External Bone Stabilizing Device To Arm Or Leg 18 18 $5,903.00 $5,312.70 $53.00 $9,024.33 $3,410.30 2026-06-09
28415 HCPCS Treatment Of Broken Heel Bone 18 18 $5,827.00 $5,244.30 $53.00 $5,535.65 $3,379.90 2026-06-09
27827 HCPCS Treatment Of Broken Shin Bone At Lower Weight Bearing Joint 18 18 $5,820.00 $5,238.00 $53.00 $9,024.33 $3,369.62 2026-06-09
49594 HCPCS Initial Repair Of Entrapped Hernia Of Abdomen, 3-10 Cm In Length 15 15 $3,960.00 $3,564.00 $682.15 $3,762.00 $3,366.00 2026-06-09
J9217 HCPCS Leuprolide Acetate (for Depot Suspension), 7.5 Mg 36 18 $5,305.00 $4,774.50 $1,627.02 $6,860.81 $3,360.15 2026-06-09
02869 CDM Swivelock With Tape 4.75mm 18 18 $3,536.00 $3,182.40 $1,626.56 $3,429.92 $3,359.20 2026-06-09
302000020 CDM Intensive Care Unit - General Classification 14 14 $3,512.00 $3,160.80 $2,985.20 $3,512.00 $3,336.40 2026-06-09
301000004 CDM Room & Board - Semi-private (two Beds) - General Classification 14 14 $3,512.00 $3,160.80 $2,985.20 $3,512.00 $3,336.40 2026-06-09
27428 HCPCS Reconstruction Ligaments Inside Knee Joint 18 18 $5,716.00 $5,144.40 $53.00 $8,621.29 $3,332.90 2026-06-09
64895 HCPCS Graft Of Multiple Hand Or Foot Nerves, 4.0 Cm Or Less 18 18 $7,230.00 $6,507.00 $53.00 $6,868.50 $3,331.10 2026-06-09
04465 CDM Orthalign Plus Unit 403001 18 18 $3,500.00 $3,150.00 $1,610.00 $3,395.00 $3,325.00 2026-06-09
63047 HCPCS Partial Removal Of Spine Bone With Release Of Lower Spinal Cord And/or Nerves, 1… 18 18 $5,653.00 $5,087.70 $1,065.16 $5,370.35 $3,297.95 2026-06-09
22850 HCPCS Removal Of Stabilizing Device From Back Of Spine 16 16 $3,995.00 $3,595.50 $53.00 $3,795.25 $3,295.88 2026-06-09
44005 HCPCS Release Of Intestinal Scar Tissue 16 16 $5,620.00 $5,058.00 $53.00 $5,339.00 $3,283.12 2026-06-09
49900 HCPCS Suture Of Postsurgical Opening In Abdominal Wall 15 15 $4,096.00 $3,686.40 $53.00 $3,891.20 $3,276.80 2026-06-09
V5140 HCPCS Binaural, Behind The Ear 18 18 $3,440.00 $3,096.00 $1,582.40 $3,336.80 $3,268.00 2026-06-09
Q0138 HCPCS Injection, Ferumoxytol, For Treatment Of Iron Deficiency Anemia, 1 Mg (non-esrd … 18 18 $3,374.78 $3,037.30 $1,552.40 $3,273.54 $3,206.04 2026-06-09
49185 HCPCS Injection Of Chemical Agent Into Fluid Collection Using Imaging Guidance 16 16 $7,066.00 $6,359.40 $53.00 $6,712.70 $3,197.42 2026-06-09
410002070 CDM Rev - Audiology 18 18 $3,357.59 $3,021.83 $1,544.49 $3,256.86 $3,189.71 2026-06-09
25609 HCPCS Treatment Of 3 Or More Broken Lower Forearm Bone Pieces On Thumb Side Inside Wri… 18 18 $5,467.00 $4,920.30 $53.00 $5,193.65 $3,170.25 2026-06-09
11005 HCPCS Removal Of Infected Skin, Tissue Or Muscle Of Abdomen 15 15 $3,955.00 $3,559.50 $53.00 $3,757.25 $3,164.00 2026-06-09
09981 CDM Psn Asf 10mm 42-5224-007-10 18 18 $3,325.00 $2,992.50 $1,529.50 $3,225.25 $3,158.75 2026-06-09
09282 CDM Psn Asf Ps 42-5124-010-11 18 18 $3,325.00 $2,992.50 $1,529.50 $3,225.25 $3,158.75 2026-06-09
09314 CDM Psn Asf Ps 42-5124-007-12 18 18 $3,325.00 $2,992.50 $1,529.50 $3,225.25 $3,158.75 2026-06-09
44604 HCPCS Suture Of Tear Or Hole In Large Bowel 16 16 $5,394.00 $4,854.60 $53.00 $5,124.30 $3,157.95 2026-06-09
75710 HCPCS Review By Radiologist Of Arm Or Leg Artery Image 36 18 $4,664.50 $4,198.05 $53.00 $8,615.54 $3,146.63 2026-06-09
27503 HCPCS Closed Treatment Of Broken Thigh Bone At Far End With Manipulation 18 18 $3,287.00 $2,958.30 $1,512.02 $3,188.39 $3,122.65 2026-06-09
09536 CDM Mesh, Hernia Parietex 30x20cm 18 18 $3,266.00 $2,939.40 $1,502.36 $3,168.02 $3,102.70 2026-06-09
49406 HCPCS Drainage Of Fluid Collection Of Abdominal Cavity By Tube Using Imaging Guidance 54 18 $4,323.00 $3,890.70 $53.00 $4,298.07 $3,085.79 2026-06-09
08593 CDM Stem, Tibial 42-5320-079-01 18 18 $3,230.00 $2,907.00 $1,485.80 $3,133.10 $3,068.50 2026-06-09
09066 CDM Stem, Tibial 42-5320-075-02 18 18 $3,230.00 $2,907.00 $1,485.80 $3,133.10 $3,068.50 2026-06-09
09181 CDM Stem, Tibial 42-5320-071-01 18 18 $3,230.00 $2,907.00 $1,485.80 $3,133.10 $3,068.50 2026-06-09
08233 CDM Stem, Tibial 42-5320-075-01 18 18 $3,230.00 $2,907.00 $1,485.80 $3,133.10 $3,068.50 2026-06-09
09006 CDM Tibia, 5 Degree 42-5320-071-02 18 18 $3,230.00 $2,907.00 $1,485.80 $3,133.10 $3,068.50 2026-06-09
09165 CDM Stem, Tibial 42-5320-067-02 18 18 $3,230.00 $2,907.00 $1,485.80 $3,133.10 $3,068.50 2026-06-09
22551 HCPCS Fusion Of Upper Spine Bone With Removal Of Disc And Release Of Spinal Cord Or Ne… 18 18 $8,689.00 $7,820.10 $1,604.36 $8,254.55 $3,052.18 2026-06-09
309000025 CDM Nursery - General Classification 14 14 $3,142.00 $2,827.80 $2,670.70 $3,142.00 $2,984.90 2026-06-09
301000003 CDM Room & Board - Semi-private (two Beds) - General Classification 14 14 $3,115.00 $2,803.50 $2,647.75 $3,115.00 $2,959.25 2026-06-09
G0390 HCPCS Trauma Response Team Associated With Hospital Critical Care Service 18 18 $3,114.00 $2,802.60 $1,432.44 $3,020.58 $2,958.30 2026-06-09
24505 HCPCS Closed Treatment Of Broken Middle Part Of Upper Arm Bone With Manipulation 18 18 $3,100.00 $2,790.00 $1,426.00 $3,007.00 $2,945.00 2026-06-09
58552 HCPCS Removal Of Uterus, Tubes, And/or Ovaries Through Vagina Using An Endoscope, 250.… 18 18 $5,019.00 $4,517.10 $877.24 $5,120.50 $2,934.50 2026-06-09
02876 CDM Plate, Metarsal Hook Ar-8956-1 18 18 $3,084.00 $2,775.60 $1,418.64 $2,991.48 $2,929.80 2026-06-09
22856 HCPCS Insertion Of Artificial Upper Spine Disc, Anterior Approach 18 18 $8,864.00 $7,977.60 $53.00 $8,420.80 $2,928.56 2026-06-09
29888 HCPCS Repair Of Anterior Cruciate Ligament Of Knee Using An Endoscope 18 18 $4,996.00 $4,496.40 $889.28 $4,817.25 $2,918.80 2026-06-09
81415 HCPCS Test For Detecting Exome, Sequence Analysis 18 18 $3,057.00 $2,751.30 $1,406.22 $2,965.29 $2,904.15 2026-06-09
323000391 CDM Trauma Activation-no Cc 18 18 $3,054.00 $2,748.60 $1,404.84 $2,962.38 $2,901.30 2026-06-09
25624 HCPCS Closed Treatment Of Broken Wrist Bone Near Base Of Thumb With Manipulation 18 18 $3,049.00 $2,744.10 $1,402.54 $2,957.53 $2,896.55 2026-06-09
24565 HCPCS Closed Treatment Of Broken Outer Part Of Upper Arm Bone At Elbow With Manipulati… 18 18 $3,049.00 $2,744.10 $1,402.54 $2,957.53 $2,896.55 2026-06-09
35045 HCPCS Repair Of Aneurysm Or Forearm Artery With Graft 16 16 $4,908.00 $4,417.20 $53.00 $4,662.60 $2,887.50 2026-06-09
49615 HCPCS Repair Of Recurrent Sliding Hernia Of Abdomen, 3-10 Cm In Length 15 15 $3,394.00 $3,054.60 $583.65 $3,365.12 $2,884.90 2026-06-09
27502 HCPCS Closed Treatment Of Broken Thigh Bone At Midportion With Manipulation 36 18 $3,405.00 $3,064.50 $53.00 $3,607.15 $2,862.35 2026-06-09
01610 HCPCS Anesthesia For Procedure On Nerves, Muscles, Tendons, Fascia, And Bursae Of Shou… 11 11 $3,064.00 $2,757.60 $5.00 $2,910.80 $2,849.52 2026-06-09
02848 CDM Nail, Humerus 9.5m 47-2497-240 18 18 $2,997.00 $2,697.30 $1,378.62 $2,907.09 $2,847.15 2026-06-09
22612 HCPCS Fusion Of Spine In Lower Back 18 18 $8,100.00 $7,290.00 $1,467.19 $7,695.00 $2,843.26 2026-06-09
00600 HCPCS Anesthesia For Other Procedure On Upper Spine 11 11 $3,053.80 $2,748.42 $10.00 $2,901.11 $2,840.03 2026-06-09
81410 HCPCS Test For Detecting Genes Associated With Heart Disease, Genomic Sequence Analysi… 18 18 $2,967.00 $2,670.30 $1,364.82 $2,877.99 $2,818.65 2026-06-09
29807 HCPCS Repair Of Shoulder Socket Using An Endoscope 18 18 $5,285.00 $4,756.50 $53.00 $5,020.75 $2,818.54 2026-06-09
28435 HCPCS Closed Treatment Of Broken Ankle Joint Bone With Manipulation 18 18 $2,965.00 $2,668.50 $1,363.90 $2,876.05 $2,816.75 2026-06-09
27266 HCPCS Closed Treatment Of Dislocated Hip Prosthesis Under Anesthesia 36 18 $3,158.50 $2,842.65 $53.00 $3,208.76 $2,798.37 2026-06-09
02385 CDM Psn Mc Ve Asf 42-5221-008-10 18 18 $2,940.00 $2,646.00 $1,352.40 $2,851.80 $2,793.00 2026-06-09
01246 CDM Psn Mc Ve Asf 42-5221-006-12 18 18 $2,940.00 $2,646.00 $1,352.40 $2,851.80 $2,793.00 2026-06-09
02705 CDM Psn Mc Ve Asf 42-5221-008-11 18 18 $2,940.00 $2,646.00 $1,352.40 $2,851.80 $2,793.00 2026-06-09
02521 CDM Psn Mc Ve Asf 42-5121-009-10 18 18 $2,940.00 $2,646.00 $1,352.40 $2,851.80 $2,793.00 2026-06-09
02694 CDM Psn Mc Ve Asf 42-5221-006-11 18 18 $2,940.00 $2,646.00 $1,352.40 $2,851.80 $2,793.00 2026-06-09
03850 CDM Psn Mc Ve Asf 42-5221-009-10 18 18 $2,940.00 $2,646.00 $1,352.40 $2,851.80 $2,793.00 2026-06-09
07883 CDM Psn Mc Ve Asf 42-5221-003-11 18 18 $2,940.00 $2,646.00 $1,352.40 $2,851.80 $2,793.00 2026-06-09
05055 CDM Psn Mc Asf 10mm 42-5221-003-10 18 18 $2,940.00 $2,646.00 $1,352.40 $2,851.80 $2,793.00 2026-06-09
01683 CDM Psn Mc Ve Asf 42-5121-008-11 18 18 $2,940.00 $2,646.00 $1,352.40 $2,851.80 $2,793.00 2026-06-09
63030 HCPCS Partial Removal Of Spine Bone With Release Of Lower Spinal Cord Or Nerves And/or… 18 18 $4,993.00 $4,493.70 $897.89 $4,743.35 $2,761.34 2026-06-09
27030 HCPCS Incision And Drainage Of Hip Joint 16 16 $4,691.00 $4,221.90 $53.00 $4,456.45 $2,757.80 2026-06-09
27279 HCPCS Fusion Of Pelvic Joint Using Imaging Guidance 18 18 $4,810.00 $4,329.00 $53.00 $12,898.13 $2,747.55 2026-06-09
58140 HCPCS Removal Of Growth Of Uterus Through Abdomen, 1-4 Growths 16 16 $4,679.00 $4,211.10 $53.00 $4,445.05 $2,746.50 2026-06-09
L8606 HCPCS Injectable Bulking Agent, Synthetic Implant, Urinary Tract, 1 Ml Syringe, Includ… 18 18 $2,875.00 $2,587.50 $1,322.50 $2,788.75 $2,731.25 2026-06-09
27822 HCPCS Treatment Of 3 Broken Lower Leg Bones At Ankle 18 18 $4,777.00 $4,299.30 $53.00 $4,821.39 $2,722.65 2026-06-09
63707 HCPCS Repair Of Cerebrospinal Fluid Leak 16 16 $4,578.00 $4,120.20 $53.00 $4,349.10 $2,702.85 2026-06-09
25575 HCPCS Treatment Of Broken Midpart Of Both Forearm Bones With Placement Of Stabilizing … 18 18 $4,633.00 $4,169.70 $53.00 $4,852.90 $2,698.20 2026-06-09
00630 HCPCS Anesthesia For Other Procedure On Lower Spine 11 11 $2,889.88 $2,600.89 $8.00 $2,745.39 $2,687.59 2026-06-09
27535 HCPCS Treatment Of Broken Side Of Upper End Of Shin Bone 16 16 $4,588.00 $4,129.20 $53.00 $4,358.60 $2,678.90 2026-06-09
36573 HCPCS Insertion Of Tube For Infusion With Imaging Guidance And Review By Radiologist, … 54 18 $3,122.00 $2,809.80 $53.00 $5,605.63 $2,658.34 2026-06-09
09962 CDM Screw, Fas 6.5 Ti 54410006540 18 18 $2,782.00 $2,503.80 $1,279.72 $2,698.54 $2,642.90 2026-06-09
44960 HCPCS Removal Of Ruptured Infected Appendix 16 16 $4,528.00 $4,075.20 $53.00 $4,301.60 $2,641.90 2026-06-09
23615 HCPCS Treatment Of Broken Top Of Upper Arm Bone 18 18 $4,526.00 $4,073.40 $53.00 $9,024.33 $2,639.15 2026-06-09
40450548A CDM Carotid Angio W/cont -MRI- 18 18 $2,771.00 $2,493.90 $1,274.66 $2,687.87 $2,632.45 2026-06-09
27566 HCPCS Treatment Of Dislocated Kneecap 18 18 $4,476.00 $4,028.40 $53.00 $5,010.36 $2,629.55 2026-06-09
81229 HCPCS Genome-wide Microarray Analysis For Copy Number And Single Nucleotide Polymorphi… 18 18 $2,755.00 $2,479.50 $1,267.30 $2,672.35 $2,617.25 2026-06-09
02747 CDM Ringloc Bi-polar Hip 11-165226 18 18 $2,747.00 $2,472.30 $1,263.62 $2,664.59 $2,609.65 2026-06-09
09499 CDM Duraseal Spine Sealant 18 18 $2,737.00 $2,463.30 $1,259.02 $2,654.89 $2,600.15 2026-06-09
44620 HCPCS Closure Of Surgically Created Large Or Small Bowel Opening 16 16 $4,450.00 $4,005.00 $53.00 $4,227.50 $2,597.70 2026-06-09
01214 HCPCS Anesthesia For Total Hip Replacement 11 11 $2,789.92 $2,510.93 $8.00 $2,650.42 $2,594.63 2026-06-09
49593 HCPCS Initial Repair Of Sliding Hernia Of Abdomen, 3-10 Cm In Length 15 15 $3,040.00 $2,736.00 $524.89 $4,376.34 $2,584.00 2026-06-09
49614 HCPCS Repair Of Recurrent Entrapped Hernia Of Abdomen, Less Than 3 Cm In Length 15 15 $3,034.00 $2,730.60 $523.89 $3,030.97 $2,578.90 2026-06-09
27758 HCPCS Treatment Broken Middle Part Of Shin Bone With Plate Or Screws 18 18 $4,341.00 $3,906.90 $53.00 $8,872.72 $2,575.88 2026-06-09
36556 HCPCS Insertion Of Non-tunneled Central Venous Tube For Infusion (5 Years Or Older) 52 18 $3,290.00 $2,961.00 $77.47 $3,236.89 $2,574.55 2026-06-09
09032 CDM Ankle Ziptight 909857 18 18 $2,698.75 $2,428.88 $1,241.43 $2,617.79 $2,563.81 2026-06-09
44979 HCPCS Other Procedure On Appendix Using An Endoscope 11 11 $2,715.00 $2,443.50 $53.00 $4,092.02 $2,524.95 2026-06-09
05107 CDM Plate, Distal Rad 8916vnr-03 18 18 $2,650.00 $2,385.00 $1,219.00 $2,570.50 $2,517.50 2026-06-09
01566 CDM Kore Fiber, 2.5cc 423202 18 18 $2,650.00 $2,385.00 $1,219.00 $2,570.50 $2,517.50 2026-06-09
09425 CDM Plate, Distal Ar-8916vsl-03 18 18 $2,650.00 $2,385.00 $1,219.00 $2,570.50 $2,517.50 2026-06-09
23410 HCPCS Repair Of Acute Torn Shoulder Rotator Cuff 18 18 $4,265.00 $3,838.50 $53.00 $4,051.75 $2,475.60 2026-06-09
27381 HCPCS Secondary Suture Of Tendon Below Knee 18 18 $4,276.00 $3,848.40 $53.00 $5,010.36 $2,469.28 2026-06-09
25605 HCPCS Closed Treatment Of Broken Or Growth Plate Separate Of Forearm Bone At Wrist Wit… 36 18 $3,024.00 $2,721.60 $53.00 $3,300.91 $2,459.85 2026-06-09
08954 CDM Syndesmosis Repair Implant 18 18 $2,585.00 $2,326.50 $1,189.10 $2,507.45 $2,455.75 2026-06-09
27301 HCPCS Drainage Of Deep Abscess Or Blood Accumulation Of Thigh Or Knee 36 18 $3,541.50 $3,187.35 $53.00 $4,344.63 $2,447.76 2026-06-09
23675 HCPCS Closed Treatment Of Dislocated Shoulder And Broken Neck Of Upper Arm Bone With M… 36 18 $2,840.00 $2,556.00 $53.00 $2,957.53 $2,446.83 2026-06-09
25690 HCPCS Closed Treatment Of Dislocated Wrist (lunate) Bone With Manipulation 36 18 $2,838.00 $2,554.20 $53.00 $2,957.53 $2,443.11 2026-06-09
27825 HCPCS Closed Treatment Of Broken Shin Bone At Lower Weight Bearing Joint With Manipula… 36 18 $3,208.50 $2,887.65 $53.00 $3,716.07 $2,430.84 2026-06-09
27447 HCPCS Replacement Of Knee Joint, Both Sides Of Knee 18 18 $6,543.00 $5,888.70 $1,159.08 $6,215.85 $2,420.48 2026-06-09
27752 HCPCS Closed Treatment Of Middle Part Of Broken Shin Bone With Manipulation 36 18 $2,925.50 $2,632.95 $53.00 $3,169.96 $2,402.19 2026-06-09
59515 HCPCS Cesarean Delivery With Care After Delivery 17 17 $3,749.00 $3,374.10 $1,224.33 $3,561.55 $2,397.85 2026-06-09
01402 HCPCS Anesthesia For Procedure For Total Knee Joint Replacement 10 10 $2,573.22 $2,315.90 $53.00 $2,444.56 $2,393.09 2026-06-09
24605 HCPCS Repair Of Dislocated Elbow Under Anesthesia 36 18 $2,979.00 $2,681.10 $53.00 $3,300.91 $2,387.64 2026-06-09
44180 HCPCS Release Of Small Bowel Scar Tissue Using An Endoscope 18 18 $4,742.00 $4,267.80 $53.00 $4,504.90 $2,386.16 2026-06-09
25825 HCPCS Fusion Of Part Of Wrist Joint With Patient-derived Bone Graft 18 18 $4,145.00 $3,730.50 $53.00 $5,010.36 $2,383.40 2026-06-09
501006218 CDM Diet Consult - Ft Pk Dialysis 18 18 $2,508.58 $2,257.72 $1,153.95 $2,433.32 $2,383.15 2026-06-09
27848 HCPCS Treatment Of Dislocated Ankle With Repair Or Placement Of Stabilizing Device 18 18 $4,073.00 $3,665.70 $53.00 $4,682.29 $2,378.97 2026-06-09
01210 HCPCS Anesthesia For Other Procedure On Hip Joint 11 11 $2,552.00 $2,296.80 $6.00 $2,424.40 $2,373.36 2026-06-09
28615 HCPCS Treatment Of Dislocated Midfoot Bone 18 18 $4,006.00 $3,605.40 $53.00 $5,010.36 $2,363.88 2026-06-09
01575 CDM Kore Fiber, 5cc 423205 18 18 $2,483.00 $2,234.70 $1,142.18 $2,408.51 $2,358.85 2026-06-09
58554 HCPCS Removal Of Uterus, Tubes, And/or Ovaries Through Vagina Using An Endoscope, More… 18 18 $6,677.00 $6,009.30 $53.00 $6,343.15 $2,356.81 2026-06-09
02599 CDM Screw, Cortical 204.816 18 18 $2,480.00 $2,232.00 $1,140.80 $2,405.60 $2,356.00 2026-06-09
J9030 HCPCS Bcg Live Intravesical Instillation, 1 Mg 18 18 $2,477.00 $2,229.30 $1,139.42 $2,402.69 $2,353.15 2026-06-09
58700 HCPCS Removal Of Uterine Tubes 16 16 $4,009.00 $3,608.10 $53.00 $3,808.55 $2,347.85 2026-06-09
301000002 CDM Room & Board - Semi-private (two Beds) - General Classification 14 14 $2,465.00 $2,218.50 $2,095.25 $2,465.00 $2,341.75 2026-06-09
01630 HCPCS Anesthesia For Other Procedure On Top Of Arm Bone And Shoulder Joint 10 10 $2,497.33 $2,247.60 $53.00 $2,372.46 $2,322.52 2026-06-09
25390 HCPCS Shortening Of One Of The Forearm Bones 18 18 $4,004.00 $3,603.60 $53.00 $5,010.36 $2,322.45 2026-06-09
63042 HCPCS Partial Removal Of Spine Bone With Re-exploration, Release Of Lower Spinal Cord … 18 18 $7,042.00 $6,337.80 $1,219.43 $6,689.90 $2,320.35 2026-06-09
24342 HCPCS Reinsertion Of Torn Upper Arm Tendon 18 18 $3,976.00 $3,578.40 $53.00 $3,777.20 $2,318.07 2026-06-09
26841 HCPCS Fusion Of Thumb At Wrist 18 18 $4,061.00 $3,654.90 $53.00 $5,010.36 $2,315.35 2026-06-09
49000 HCPCS Exploration Of Abdominal Cavity 16 16 $3,967.00 $3,570.30 $53.00 $3,768.65 $2,314.15 2026-06-09
27814 HCPCS Treatment Of Both Broken Lower Leg Bones At Ankle 18 18 $3,920.00 $3,528.00 $53.00 $4,843.35 $2,287.22 2026-06-09
01622 HCPCS Anesthesia For Exam Of Shoulder Joint Using An Endoscope 10 10 $2,447.48 $2,202.73 $53.00 $2,325.11 $2,276.16 2026-06-09
27524 HCPCS Treatment Of Broken Kneecap With Placement Of Stabilizing Device And/or Removal … 18 18 $3,921.00 $3,528.90 $53.00 $3,724.95 $2,274.62 2026-06-09
25505 HCPCS Closed Treatment Of Broken Midpart Of Forearm Bone On Thumb Side With Manipulati… 36 18 $2,728.00 $2,455.20 $53.00 $2,925.52 $2,269.20 2026-06-09
49521 HCPCS Repair Of Trapped Or Strangulated Groin Hernia 18 18 $3,911.00 $3,519.90 $53.00 $4,376.34 $2,243.32 2026-06-09
25565 HCPCS Closed Treatment Of Broken Midpart Of Both Forearm Bones With Manipulation 36 18 $2,730.50 $2,457.45 $53.00 $2,957.53 $2,243.16 2026-06-09
10009 HCPCS Fine Needle Aspiration Biopsy Of Growth Using CT Guidance, First Growth 34 18 $4,873.00 $4,385.70 $53.00 $4,726.81 $2,241.58 2026-06-09
310000030 CDM Labor Room/delivery - General Classification 18 18 $2,359.00 $2,123.10 $1,085.14 $2,288.23 $2,241.05 2026-06-09
25607 HCPCS Treatment Of Broken Forearm Bone On Thumb Side Of Wrist, Above Wrist, With Place… 18 18 $3,789.00 $3,410.10 $53.00 $4,970.99 $2,204.60 2026-06-09
01230 HCPCS Anesthesia For Procedure On Upper 2/3rd Of Thigh Bone 11 11 $2,367.33 $2,130.60 $6.00 $2,248.96 $2,201.62 2026-06-09
29999 HCPCS Other Procedure On Joint Using An Endoscope 11 11 $2,367.00 $2,130.30 $53.00 $2,248.65 $2,201.31 2026-06-09
24575 HCPCS Treatment Of Broken Outer Part Of Upper Arm Bone At Elbow 18 18 $3,758.00 $3,382.20 $53.00 $8,621.29 $2,189.93 2026-06-09
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