Price Transparencybeta Hospital negotiated rates

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

CABINET PEAKS MEDICAL CENTER

Libby, MT · CCN 271320 · Rates published

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You selected 93306 (HCPCS)

ECHOCARDIOGRAPH COMPLETE HC

This hospital’s price: $2,119 across 8 payers · range $558-$2,186

Source: https://cabinetpeaks.pt.panaceainc.com/MRFDownload/cabinetpeaks/cabinetpeaks · observed 2026-04-01

This is the facility’s filed rate for this code. The comparison board’s estimate also adds the surgeon and anesthesia fees, so it is usually higher.

15,970 distinct procedures filed
8 distinct payers
97,417 rate rows
2026-04-01 last MRF observed
Data quality

51,789 of 97,417 rate rows are consumer-grade (53.2%)

45,628 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
professional (physician) fee — not the facility price 40,611
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 4,610
exceeds 10× this hospital's gross charge — excluded from medians 230
placeholder amount (≤ $0.02) — excluded from medians 112
percent-of-charges filed in the dollar field — excluded from medians 40
per-diem day rate — not a per-procedure price 18
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 4
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 2
template filing: same amount across many unrelated codes — excluded 1
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://cabinetpeaks.pt.panaceainc.com/MRFDownload/cabinetpeaks/cabinetpeaks
Found on page https://www.cabinetpeaks.org/
Discovered viaCMS hospital list
Last fetch not_modified · 2026-10-19
Content fingerprint cd810e13bb9a58ce… · 30,277,662 bytes · first seen 2026-05-09

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
J3391
HCPCS 		Inj, Atidarsagene Autotemcel 1 $4,505,000.00 $4,505,000.00 $4,505,000.00 nat. median
$4,505,000
1.0× median
J1411
HCPCS 		Inj, Hemgenix, Per Tx Dose 1 $3,685,266.66 $3,685,266.66 $3,685,266.66 nat. median
$3,703,693
1.0× median
J3389
HCPCS 		Topi Adm Prad Zami Per Treat 1 $3,335,820.00 $3,335,820.00 $3,335,820.00 nat. median
$3,335,820
1.0× median
J1413
HCPCS 		Inj Delandistrogene Mox Rokl 1 $3,327,859.72 $3,327,859.72 $3,327,859.72 nat. median
$3,324,572
1.0× median
J1411N/A
OTHER 		Inj, Hemgenix, Per Tx Dose 1 $3,306,566.25 $3,306,566.25 $3,306,566.25 nat. median
$3,306,566
1.0× median
J3394
HCPCS 		Inj, Lovotibeglogene Autotem 1 $3,252,508.07 $3,252,508.07 $3,252,508.07 nat. median
$3,286,000
1.0× median
J3387
HCPCS 		Inj Elivaldogene Autotemecel 1 $3,180,000.00 $3,180,000.00 $3,180,000.00 nat. median
$3,180,000
1.0× median
J3393
HCPCS 		Inj, Betibeglogene Autotemce 1 $2,939,968.88 $2,939,968.88 $2,939,968.88 nat. median
$2,994,107
1.0× median
J3399
HCPCS 		Inj Onase Abepar-xioi Treat 1 $2,588,981.22 $2,588,981.22 $2,588,981.22 nat. median
$2,466,282
1.0× median
J3392
HCPCS 		Inj, Exagamglogene Autotem 1 $2,332,000.00 $2,332,000.00 $2,332,000.00 nat. median
$2,401,960
1.0× median
Q2057
HCPCS 		Afamitresgene Autoleucel 2 $770,620.00 $2,311,860.00 $770,620.00 nat. median
$809,217
1.0× median
Q2056
HCPCS 		Ciltacabtagene Car-pos T 2 $587,649.57 $1,697,606.85 $587,649.57 nat. median
$646,415
0.9× median
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 2 $566,531.30 $1,775,178.60 $566,531.30 nat. median
$738,272
0.8× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 2 $562,201.24 $1,687,614.57 $562,201.24 nat. median
$640,950
0.9× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 2 $558,081.72 $1,671,953.79 $558,081.72 nat. median
$622,245
0.9× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 2 $532,192.24 $1,599,690.51 $532,192.24 nat. median
$608,101
0.9× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 2 $489,450.20 $1,467,913.83 $489,450.20 nat. median
$591,650
0.8× median
Q0480
HCPCS 		Driver Pneumatic Vad, Rep 1 $337,025.91 $337,025.91 $337,025.91 nat. median
$111,503
outlier · 3.0×
K1007
HCPCS 		Bil Hkaf Pc S/d Micro Sensor 1 $285,243.09 $285,243.09 $285,243.09 nat. median
$97,020
outlier · 2.9×
Q2058
HCPCS 		Obecbtge Autol Up To 400 Mil 1 $278,250.00 $278,250.00 $278,250.00 nat. median
$319,951
0.9× median
J3403
HCPCS 		Revakinagene, Per Implant 1 $265,000.00 $265,000.00 $265,000.00 nat. median
$265,000
1.0× median
L8702
HCPCS 		Ewhf S/d Uprt Micro Sensor 1 $206,405.13 $206,405.13 $206,405.13 nat. median
$70,178
outlier · 2.9×
J3402
HCPCS 		Inj. Remestemcel-l-rknd/ Td 2 $201,669.02 $616,920.00 $201,669.02 nat. median
$209,753
1.0× median
L7181
HCPCS 		Electronic Elbo Simultaneous 1 $149,637.42 $149,637.42 $149,637.42 nat. median
$50,453
outlier · 3.0×
L7180
HCPCS 		Electronic Elbow Sequential 1 $131,132.97 $131,132.97 $131,132.97 nat. median
$46,980
outlier · 2.8×
L2006
HCPCS 		Kaf Sng/dbl Swg/stn Mcpr Cus 1 $120,816.15 $120,816.15 $120,816.15 nat. median
$39,921
outlier · 3.0×
J3399N/A
OTHER 		Inj Onase Abepar-xioi Treat 1 $108,157.44 $108,157.44 $108,157.44 nat. median
$108,157
1.0× median
L8701
HCPCS 		Ewh S/d Uprt Micro Sensor 1 $104,910.39 $104,910.39 $104,910.39 nat. median
$35,670
outlier · 2.9×
L5856
HCPCS 		Elec Knee-shin Swing/stance 1 $89,588.61 $89,588.61 $89,588.61 nat. median
$30,017
outlier · 3.0×
L6880
HCPCS 		Elec Hand Ind Art Digits 1 $89,406.87 $89,406.87 $89,406.87 nat. median
$30,016
outlier · 3.0×
L6700
HCPCS 		Ue Add Ext Power Myoel 1 $88,530.57 $88,530.57 $88,530.57 nat. median
$30,378
outlier · 2.9×
L8614
HCPCS 		Cochlear Device 1 $71,305.14 $71,305.14 $71,305.14 nat. median
$22,385
outlier · 3.2×
A9543N/A
OTHER 		Y90 Ibritumomab, Rx 1 $70,242.17 $70,242.17 $70,242.17 nat. median
$70,242
1.0× median
Q0483
HCPCS 		Monitor Elec Vad, Rep 1 $70,161.51 $70,161.51 $70,161.51 nat. median
$23,335
outlier · 3.0×
L5858
HCPCS 		Stance Phase Only 1 $69,407.82 $69,407.82 $69,407.82 nat. median
$23,235
outlier · 3.0×
L6975
HCPCS 		Interscap-thor Myoelectronic 1 $69,319.77 $69,319.77 $69,319.77 nat. median
$22,861
outlier · 3.0×
C1604N/A
OTHER 		Grft, Trnsmurl/trnsvens Byps 1 $67,945.10 $67,945.10 $67,945.10 nat. median
$67,945
1.0× median
L5973
HCPCS 		Ank-foot Sys Dors-plant Flex 1 $65,134.77 $65,134.77 $65,134.77 nat. median
$21,726
outlier · 3.0×
L6970
HCPCS 		Interscapular-thor Switch CT 1 $64,700.16 $64,700.16 $64,700.16 nat. median
$21,078
outlier · 3.1×
J9029
HCPCS 		Instill Adstiladrin, Tx Dose 2 $64,274.79 $190,026.84 $64,274.79 nat. median
$68,423
0.9× median
38240
HCPCS 		Transplt Allo Hct/donor 1 $64,263.52 $64,263.52 $64,263.52 nat. median
$12,855
outlier · 5.0×
L6965
HCPCS 		Shldr Disartic Myoelectronic 1 $63,911.13 $63,911.13 $63,911.13 nat. median
$20,067
outlier · 3.2×
Q0489
HCPCS 		Pwr Pck Base Combo Vad, Rep 1 $60,826.26 $60,826.26 $60,826.26 nat. median
$20,275
outlier · 3.0×
L6960
HCPCS 		Shldr Disartic Switch Contro 1 $58,988.82 $58,988.82 $58,988.82 nat. median
$16,650
outlier · 3.5×
L6955
HCPCS 		Above Elbow Myoelectronic CT 1 $58,487.28 $58,487.28 $58,487.28 nat. median
$15,745
outlier · 3.7×
A9543
HCPCS 		Y90 Ibritumomab, Rx 1 $56,824.54 $56,824.54 $56,824.54 nat. median
$63,643
0.9× median
Q2043
HCPCS 		Sipuleucel-t Auto Cd54+ 2 $54,404.10 $165,816.96 $54,404.10 nat. median
$65,720
0.8× median
Q0481
HCPCS 		Microprcsr Cu Elec Vad, Rep 1 $54,375.27 $54,375.27 $54,375.27 nat. median
$15,211
outlier · 3.6×
L5859
HCPCS 		Knee-shin Pro Flex/ext Cont 1 $54,186.06 $54,186.06 $54,186.06 nat. median
$18,321
outlier · 3.0×
L6945
HCPCS 		Elbow Disart Myoelectronic C 1 $49,984.59 $49,984.59 $49,984.59 nat. median
$13,929
outlier · 3.6×

Other procedures at this hospital

Browse this hospital's 15,970 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
             
J3391 HCPCS Inj, Atidarsagene Autotemcel 2 1 — — $4,505,000.00 $4,505,000.00 $4,505,000.00 2026-04-01
J1411 HCPCS Inj, Hemgenix, Per Tx Dose 2 1 — — $3,685,266.66 $3,685,266.66 $3,685,266.66 2026-04-01
J3389 HCPCS Topi Adm Prad Zami Per Treat 2 1 — — $3,335,820.00 $3,335,820.00 $3,335,820.00 2026-04-01
J1413 HCPCS Inj Delandistrogene Mox Rokl 2 1 — — $3,327,859.72 $3,327,859.72 $3,327,859.72 2026-04-01
J1411N/A OTHER Inj, Hemgenix, Per Tx Dose 2 1 — — $3,306,566.25 $3,306,566.25 $3,306,566.25 2026-04-01
J3394 HCPCS Inj, Lovotibeglogene Autotem 2 1 — — $3,252,508.07 $3,252,508.07 $3,252,508.07 2026-04-01
J3387 HCPCS Inj Elivaldogene Autotemecel 2 1 — — $3,180,000.00 $3,180,000.00 $3,180,000.00 2026-04-01
J3393 HCPCS Inj, Betibeglogene Autotemce 2 1 — — $2,939,968.88 $2,939,968.88 $2,939,968.88 2026-04-01
J3399 HCPCS Inj Onase Abepar-xioi Treat 2 1 — — $2,588,981.22 $2,588,981.22 $2,588,981.22 2026-04-01
J3392 HCPCS Inj, Exagamglogene Autotem 2 1 — — $2,332,000.00 $2,332,000.00 $2,332,000.00 2026-04-01
Q2057 HCPCS Afamitresgene Autoleucel 3 2 — — $770,620.00 $2,311,860.00 $770,620.00 2026-04-01
Q2056 HCPCS Ciltacabtagene Car-pos T 3 2 — — $587,649.57 $1,697,606.85 $587,649.57 2026-04-01
Q2042 HCPCS Tisagenlecleucel Car-pos T 3 2 — — $566,531.30 $1,775,178.60 $566,531.30 2026-04-01
Q2054 HCPCS Lisocabtagene Mara Car Pos T 3 2 — — $562,201.24 $1,687,614.57 $562,201.24 2026-04-01
Q2055 HCPCS Idecabtagene Vicleucel Car 3 2 — — $558,081.72 $1,671,953.79 $558,081.72 2026-04-01
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 3 2 — — $532,192.24 $1,599,690.51 $532,192.24 2026-04-01
Q2053 HCPCS Brexucabtagene Car Pos T 3 2 — — $489,450.20 $1,467,913.83 $489,450.20 2026-04-01
Q0480 HCPCS Driver Pneumatic Vad, Rep 1 1 — — $337,025.91 $337,025.91 $337,025.91 2026-04-01
K1007 HCPCS Bil Hkaf Pc S/d Micro Sensor 1 1 — — $285,243.09 $285,243.09 $285,243.09 2026-04-01
Q2058 HCPCS Obecbtge Autol Up To 400 Mil 2 1 — — $278,250.00 $278,250.00 $278,250.00 2026-04-01
J3403 HCPCS Revakinagene, Per Implant 2 1 — — $265,000.00 $265,000.00 $265,000.00 2026-04-01
L8702 HCPCS Ewhf S/d Uprt Micro Sensor 1 1 — — $206,405.13 $206,405.13 $206,405.13 2026-04-01
J3402 HCPCS Inj. Remestemcel-l-rknd/ Td 3 2 — — $201,669.02 $616,920.00 $201,669.02 2026-04-01
L7181 HCPCS Electronic Elbo Simultaneous 1 1 — — $149,637.42 $149,637.42 $149,637.42 2026-04-01
L7180 HCPCS Electronic Elbow Sequential 1 1 — — $131,132.97 $131,132.97 $131,132.97 2026-04-01
L2006 HCPCS Kaf Sng/dbl Swg/stn Mcpr Cus 1 1 — — $120,816.15 $120,816.15 $120,816.15 2026-04-01
J3399N/A OTHER Inj Onase Abepar-xioi Treat 2 1 — — $108,157.44 $108,157.44 $108,157.44 2026-04-01
L8701 HCPCS Ewh S/d Uprt Micro Sensor 1 1 — — $104,910.39 $104,910.39 $104,910.39 2026-04-01
L5856 HCPCS Elec Knee-shin Swing/stance 1 1 — — $89,588.61 $89,588.61 $89,588.61 2026-04-01
L6880 HCPCS Elec Hand Ind Art Digits 1 1 — — $89,406.87 $89,406.87 $89,406.87 2026-04-01
L6700 HCPCS Ue Add Ext Power Myoel 1 1 — — $88,530.57 $88,530.57 $88,530.57 2026-04-01
L8614 HCPCS Cochlear Device 1 1 — — $71,305.14 $71,305.14 $71,305.14 2026-04-01
A9543N/A OTHER Y90 Ibritumomab, Rx 2 1 — — $70,242.17 $70,242.17 $70,242.17 2026-04-01
Q0483 HCPCS Monitor Elec Vad, Rep 1 1 — — $70,161.51 $70,161.51 $70,161.51 2026-04-01
L5858 HCPCS Stance Phase Only 1 1 — — $69,407.82 $69,407.82 $69,407.82 2026-04-01
L6975 HCPCS Interscap-thor Myoelectronic 1 1 — — $69,319.77 $69,319.77 $69,319.77 2026-04-01
C1604N/A OTHER Grft, Trnsmurl/trnsvens Byps 2 1 — — $67,945.10 $67,945.10 $67,945.10 2026-04-01
L5973 HCPCS Ank-foot Sys Dors-plant Flex 1 1 — — $65,134.77 $65,134.77 $65,134.77 2026-04-01
L6970 HCPCS Interscapular-thor Switch CT 1 1 — — $64,700.16 $64,700.16 $64,700.16 2026-04-01
J9029 HCPCS Instill Adstiladrin, Tx Dose 3 2 — — $64,274.79 $190,026.84 $64,274.79 2026-04-01
38240 HCPCS Transplt Allo Hct/donor 2 1 — — $64,263.52 $64,263.52 $64,263.52 2026-04-01
L6965 HCPCS Shldr Disartic Myoelectronic 1 1 — — $63,911.13 $63,911.13 $63,911.13 2026-04-01
Q0489 HCPCS Pwr Pck Base Combo Vad, Rep 1 1 — — $60,826.26 $60,826.26 $60,826.26 2026-04-01
L6960 HCPCS Shldr Disartic Switch Contro 1 1 — — $58,988.82 $58,988.82 $58,988.82 2026-04-01
L6955 HCPCS Above Elbow Myoelectronic CT 1 1 — — $58,487.28 $58,487.28 $58,487.28 2026-04-01
A9543 HCPCS Y90 Ibritumomab, Rx 2 1 — — $56,824.54 $56,824.54 $56,824.54 2026-04-01
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 3 2 — — $54,404.10 $165,816.96 $54,404.10 2026-04-01
Q0481 HCPCS Microprcsr Cu Elec Vad, Rep 1 1 — — $54,375.27 $54,375.27 $54,375.27 2026-04-01
L5859 HCPCS Knee-shin Pro Flex/ext Cont 1 1 — — $54,186.06 $54,186.06 $54,186.06 2026-04-01
L6945 HCPCS Elbow Disart Myoelectronic C 1 1 — — $49,984.59 $49,984.59 $49,984.59 2026-04-01
E0766 HCPCS Elec Stim Cancer Treatment 1 1 — — $49,154.19 $49,154.19 $49,154.19 2026-04-01
J7330N/A OTHER Cultured Chondrocytes Implnt 2 1 — — $49,142.15 $49,142.15 $49,142.15 2026-04-01
L6950 HCPCS Above Elbow Switch Control 1 1 — — $48,835.59 $48,835.59 $48,835.59 2026-04-01
0620T OTHER Evasc Ven Artlz Tibl/prnl Vn 2 1 — — $45,000.50 $45,000.50 $45,000.50 2026-04-01
64568 HCPCS Opn Impltj Crnl Nrv Nea&pg 2 1 — — $45,000.50 $45,000.50 $45,000.50 2026-04-01
64654 HCPCS 1st Opn Implt Bat Modulj Sys 2 1 — — $45,000.50 $45,000.50 $45,000.50 2026-04-01
33276 HCPCS Insj Phrnc Nrv Stim Sys 2 1 — — $45,000.50 $45,000.50 $45,000.50 2026-04-01
Q0479 HCPCS Power Module Combo Vad, Rep 1 1 — — $44,829.78 $44,829.78 $44,829.78 2026-04-01
L7191 HCPCS Elbow Child Myoelectronic CT 1 1 — — $43,531.26 $43,531.26 $43,531.26 2026-04-01
J9226 HCPCS Supprelin La Implant 3 2 — — $43,185.33 $135,061.95 $43,185.33 2026-04-01
L6940 HCPCS Elbow Disarticulation Switch 1 1 — — $42,964.86 $42,964.86 $42,964.86 2026-04-01
L7186 HCPCS Electron Elbow Child Switch 1 1 — — $42,487.20 $42,487.20 $42,487.20 2026-04-01
C1825N/A OTHER Gen, Neuro, Carot Sinus Baro 2 1 — — $39,738.29 $39,738.29 $39,738.29 2026-04-01
S2079N/A OTHER Lap Esophagomyotomy 2 1 — — $35,277.19 $35,277.19 $35,277.19 2026-04-01
L5991 HCPCS Low Pros Ext Osseo Connector 1 1 — — $35,265.12 $35,265.12 $35,265.12 2026-04-01
0870T OTHER Imp Subq Prtl Ascts Pmp Sys 2 1 — — $35,000.50 $35,000.50 $35,000.50 2026-04-01
69930 HCPCS Implant Cochlear Device 2 1 — — $33,686.28 $33,686.28 $33,686.28 2026-04-01
L6935 HCPCS Below Elbow Myoelectronic CT 1 1 — — $33,610.11 $33,610.11 $33,610.11 2026-04-01
C1826N/A OTHER Gen, Neuro, Clo Loop, Rechg 2 1 — — $33,128.64 $33,128.64 $33,128.64 2026-04-01
J1413N/A OTHER Inj Delandistrogene Mox Rokl 2 1 — — $33,120.00 $33,120.00 $33,120.00 2026-04-01
S2150N/A OTHER Bmt Harv/transpl 28d Pkg 2 1 — — $32,399.23 $32,399.23 $32,399.23 2026-04-01
L6925 HCPCS Wrist Disart Myoelectronic C 1 1 — — $32,134.80 $32,134.80 $32,134.80 2026-04-01
0915T OTHER Insj Perm Ccm-d Sys Pg&eltrd 2 1 — — $32,068.73 $32,068.73 $32,068.73 2026-04-01
0408T OTHER Insj/rplc Cardiac Modulj Sys 2 1 — — $32,068.73 $32,068.73 $32,068.73 2026-04-01
0571T OTHER Insj/rplcmt Icds Ss Eltrd 2 1 — — $32,068.73 $32,068.73 $32,068.73 2026-04-01
33264 HCPCS Rmvl & Rplcmt Dfb Gen Mlt Ld 2 1 — — $32,068.73 $32,068.73 $32,068.73 2026-04-01
33249 HCPCS Insj/rplcmt Defib W/lead(s) 2 1 — — $32,068.73 $32,068.73 $32,068.73 2026-04-01
33231 HCPCS Insrt Pulse Gen W/mult Leads 2 1 — — $32,068.73 $32,068.73 $32,068.73 2026-04-01
33270 HCPCS Ins/rep Subq Defibrillator 2 1 — — $32,068.73 $32,068.73 $32,068.73 2026-04-01
L5857 HCPCS Elec Knee-shin Swing Only 1 1 — — $31,748.67 $31,748.67 $31,748.67 2026-04-01
L8679 HCPCS Imp Neurosti Pls Gn Any Type 1 1 — — $31,562.67 $31,562.67 $31,562.67 2026-04-01
61891 HCPCS Rev/rplcmt Sk-mnt Crnl Nstm 2 1 — — $31,526.06 $31,526.06 $31,526.06 2026-04-01
0909T OTHER Rplcmt Int Nstim Sys Vgs Nrv 2 1 — — $31,526.06 $31,526.06 $31,526.06 2026-04-01
0908T OTHER Opn Imp Int Nstm Sys Vgs Nrv 2 1 — — $31,526.06 $31,526.06 $31,526.06 2026-04-01
33287 HCPCS Rmv&rplcmt Phrnc Nrv Stim Pg 2 1 — — $31,526.06 $31,526.06 $31,526.06 2026-04-01
64582 HCPCS Opn Mpltj Hpglsl Nstm Ary Pg 2 1 — — $31,526.06 $31,526.06 $31,526.06 2026-04-01
61886 HCPCS Implant Neurostim Arrays 2 1 — — $31,526.06 $31,526.06 $31,526.06 2026-04-01
63685 HCPCS Ins/rplc Spi Npg/rcvr Pocket 2 1 — — $31,526.06 $31,526.06 $31,526.06 2026-04-01
0674T OTHER Laps Insj Nw/rpcmt Prm Isdss 2 1 — — $31,526.06 $31,526.06 $31,526.06 2026-04-01
64656 HCPCS Revj/rplcmt Bat Mod Sys Pg 2 1 — — $31,526.06 $31,526.06 $31,526.06 2026-04-01
61885 HCPCS Insrt/redo Neurostim 1 Array 2 1 — — $31,526.06 $31,526.06 $31,526.06 2026-04-01
L6930 HCPCS Below Elbow Switch Control 1 1 — — $31,305.33 $31,305.33 $31,305.33 2026-04-01
C9775N/A OTHER Revasc Lith-sten-ath Tib/per 2 1 — — $30,885.29 $30,885.29 $30,885.29 2026-04-01
L8619 HCPCS Coch Imp Ext Proc/contr Rplc 1 1 — — $30,610.80 $30,610.80 $30,610.80 2026-04-01
L6920 HCPCS Wrist Disarticul Switch Ctrl 1 1 — — $29,794.77 $29,794.77 $29,794.77 2026-04-01
L7190 HCPCS Elbow Adolescent Myoelectron 1 1 — — $29,659.29 $29,659.29 $29,659.29 2026-04-01
C1822N/A OTHER Gen, Neuro, Hf, Rechg Bat 2 1 — — $29,350.26 $29,350.26 $29,350.26 2026-04-01
33289 HCPCS Tcat Impl Wrls P-art Prs Snr 2 1 — — $29,304.62 $29,304.62 $29,304.62 2026-04-01
C2624N/A OTHER Wireless Pressure Sensor 2 1 — — $29,052.20 $29,052.20 $29,052.20 2026-04-01
J9266 HCPCS Pegaspargase Injection 3 2 — — $28,424.05 $85,272.18 $28,424.05 2026-04-01
C1882N/A OTHER Aicd, Other Than Sing/dual 2 1 — — $27,978.39 $27,978.39 $27,978.39 2026-04-01
22633 HCPCS Arthrd Cmbn 1ntrspc Lumbar 2 1 — — $27,721.73 $27,721.73 $27,721.73 2026-04-01
0956T OTHER Prt Crn Ch Cr&tun Elt S-sclp 2 1 — — $27,721.73 $27,721.73 $27,721.73 2026-04-01
21243 HCPCS Reconstruction Of Jaw Joint 2 1 — — $27,721.73 $27,721.73 $27,721.73 2026-04-01
22630 HCPCS Arthrd Pst Tq 1ntrspc Lum 2 1 — — $27,721.73 $27,721.73 $27,721.73 2026-04-01
22558 HCPCS Arthrd Ant Ntrbd Min Dsc Lum 2 1 — — $27,721.73 $27,721.73 $27,721.73 2026-04-01
20696 HCPCS App Mltpln Uni Xtrnl Fix 1st 2 1 — — $27,721.73 $27,721.73 $27,721.73 2026-04-01
27702 HCPCS Reconstruct Ankle Joint 2 1 — — $27,721.73 $27,721.73 $27,721.73 2026-04-01
0960T OTHER Rpl S-sclp Eltr Ra Rcvr&tlmt 2 1 — — $27,721.73 $27,721.73 $27,721.73 2026-04-01
C9760 HCPCS Non-blind Interatrial Shunt 2 1 — — $27,500.50 $27,500.50 $27,500.50 2026-04-01
0871T OTHER Rplcmt Subq Prtl Ascites Pmp 2 1 — — $27,500.50 $27,500.50 $27,500.50 2026-04-01
C2619N/A OTHER Pmkr, Dual, Non Rate-resp 2 1 — — $27,249.00 $27,249.00 $27,249.00 2026-04-01
L5987 HCPCS Shank Ft W Vert Load Pylon 1 1 — — $26,865.57 $26,865.57 $26,865.57 2026-04-01
93654 HCPCS Compre Ep Eval Tx Vt 2 1 — — $26,703.99 $26,703.99 $26,703.99 2026-04-01
93656 HCPCS Compre Ep Eval Abltj Atr Fib 2 1 — — $26,703.99 $26,703.99 $26,703.99 2026-04-01
93653 HCPCS Compre Ep Eval Tx Svt 2 1 — — $26,703.99 $26,703.99 $26,703.99 2026-04-01
L8627 HCPCS Cid Ext Speech Process Repl 1 1 — — $25,931.31 $25,931.31 $25,931.31 2026-04-01
L5280 HCPCS Hemipelvect Canad Sing Axis 1 1 — — $24,802.35 $24,802.35 $24,802.35 2026-04-01
C1767N/A OTHER Generator, Neuro Non-recharg 2 1 — — $24,667.91 $24,667.91 $24,667.91 2026-04-01
L8609 HCPCS Artificial Cornea 1 1 — — $24,381.00 $24,381.00 $24,381.00 2026-04-01
J9600 HCPCS Porfimer Sodium Injection 2 1 — — $24,228.42 $24,228.42 $24,228.42 2026-04-01
L5250 HCPCS Hip Canad Sing Axi Cons Fric 1 1 — — $23,936.70 $23,936.70 $23,936.70 2026-04-01
L5615 HCPCS Ak 4 Bar Link Hydl Swg/stanc 1 1 — — $23,815.05 $23,815.05 $23,815.05 2026-04-01
L7185 HCPCS Electron Elbow Adolescent Sw 1 1 — — $23,442.45 $23,442.45 $23,442.45 2026-04-01
C1722N/A OTHER Aicd, Single Chamber 2 1 — — $23,100.40 $23,100.40 $23,100.40 2026-04-01
C9095N/A OTHER Inj, Tebentafusp-tebn, 1 Mcg 2 1 — — $22,928.40 $22,928.40 $22,928.40 2026-04-01
0923T OTHER Rmvl&rplcmt Perm Ccm-d Pg 2 1 — — $22,725.36 $22,725.36 $22,725.36 2026-04-01
0916T OTHER Insj Perm Ccm-d Sys Pg Only 2 1 — — $22,725.36 $22,725.36 $22,725.36 2026-04-01
33263 HCPCS Rmvl & Rplcmt Dfb Gen 2 Lead 2 1 — — $22,725.36 $22,725.36 $22,725.36 2026-04-01
33262 HCPCS Rmvl& Replc Pulse Gen 1 Lead 2 1 — — $22,725.36 $22,725.36 $22,725.36 2026-04-01
33240 HCPCS Insrt Pulse Gen W/singl Lead 2 1 — — $22,725.36 $22,725.36 $22,725.36 2026-04-01
33230 HCPCS Insrt Pulse Gen W/dual Leads 2 1 — — $22,725.36 $22,725.36 $22,725.36 2026-04-01
0515T OTHER Insj Wcs Lv Compl Sys 2 1 — — $22,725.36 $22,725.36 $22,725.36 2026-04-01
0614T OTHER Rmvl&rplcmt Ss Impl Dfb Pg 2 1 — — $22,725.36 $22,725.36 $22,725.36 2026-04-01
0409T OTHER Insj/rplc Car Modulj Pls Gn 2 1 — — $22,725.36 $22,725.36 $22,725.36 2026-04-01
0414T OTHER Rmvl & Rpl Car Modulj Pls Gn 2 1 — — $22,725.36 $22,725.36 $22,725.36 2026-04-01
L7170 HCPCS Electronic Elbow Hosmer Swit 1 1 — — $22,595.52 $22,595.52 $22,595.52 2026-04-01
L8682 HCPCS Implt Neurostim Radiofq Rec 1 1 — — $22,551.06 $22,551.06 $22,551.06 2026-04-01
L5827 HCPCS Endo Knee Shin Single Axis 1 1 — — $22,372.47 $22,372.47 $22,372.47 2026-04-01
L5341 HCPCS Hemipelvectomy Canadian Sach 1 1 — — $22,279.38 $22,279.38 $22,279.38 2026-04-01
G0458N/A OTHER Ldr Prostate Brachy Comp Rat 2 1 — — $21,924.12 $21,924.12 $21,924.12 2026-04-01
L5270 HCPCS Tilt Table Locking Hip Sing 1 1 — — $21,834.63 $21,834.63 $21,834.63 2026-04-01
Q0224 HCPCS Inj, Pemivibart, 4500 Mg 1 1 — — $21,717.00 $21,717.00 $21,717.00 2026-04-01
C1820N/A OTHER Generator Neuro Rechg Bat Sy 2 1 — — $21,610.16 $21,610.16 $21,610.16 2026-04-01
C1721N/A OTHER Aicd, Dual Chamber 2 1 — — $21,429.76 $21,429.76 $21,429.76 2026-04-01
C1823N/A OTHER Gen, Neuro, Trans Sen/stim 2 1 — — $21,325.14 $21,325.14 $21,325.14 2026-04-01
C2616N/A OTHER Brachytx, Non-str,yttrium-90 2 1 — — $21,311.03 $21,311.03 $21,311.03 2026-04-01
L7008 HCPCS Pediatric Electric Hand 1 1 — — $21,267.81 $21,267.81 $21,267.81 2026-04-01
54410 HCPCS Remove/replace Penis Prosth 2 1 — — $21,175.04 $21,175.04 $21,175.04 2026-04-01
54411 HCPCS Remov/replc Penis Pros Comp 2 1 — — $21,175.04 $21,175.04 $21,175.04 2026-04-01
54416 HCPCS Remv/repl Penis Contain Pros 2 1 — — $21,175.04 $21,175.04 $21,175.04 2026-04-01
54401 HCPCS Insert Self-contd Prosthesis 2 1 — — $21,175.04 $21,175.04 $21,175.04 2026-04-01
54405 HCPCS Insert Multi-comp Penis Pros 2 1 — — $21,175.04 $21,175.04 $21,175.04 2026-04-01
54417 HCPCS Remv/replc Penis Pros Compl 2 1 — — $21,175.04 $21,175.04 $21,175.04 2026-04-01
53445 HCPCS Insert Uro/ves Nck Sphincter 2 1 — — $21,175.04 $21,175.04 $21,175.04 2026-04-01
53444 HCPCS Insert Tandem Cuff 2 1 — — $21,175.04 $21,175.04 $21,175.04 2026-04-01
53447 HCPCS Remove/replace Ur Sphincter 2 1 — — $21,175.04 $21,175.04 $21,175.04 2026-04-01
J9600N/A OTHER Porfimer Sodium Injection 2 1 — — $20,842.46 $20,842.46 $20,842.46 2026-04-01
L5331 HCPCS Hip Disart Canadian Sach Ft 1 1 — — $20,575.77 $20,575.77 $20,575.77 2026-04-01
C7508N/A OTHER Perq Lumb&thor Vert Aug 2 1 — — $19,903.51 $19,903.51 $19,903.51 2026-04-01
L8683 HCPCS Radiofq Trsmtr For Implt Neu 1 1 — — $19,850.13 $19,850.13 $19,850.13 2026-04-01
64590 HCPCS Ins/rpl Prph Sac/gstr Npg/r 2 1 — — $19,820.31 $19,820.31 $19,820.31 2026-04-01
64580 HCPCS Opn Impltj Nea Neuromuscular 2 1 — — $19,820.31 $19,820.31 $19,820.31 2026-04-01
1013T OTHER Lap Srg Imp/rpl Eso Nea&pg/r 2 1 — — $19,820.31 $19,820.31 $19,820.31 2026-04-01
0816T OTHER Opn Insj/rplcmt Ins Ptn Subq 2 1 — — $19,820.31 $19,820.31 $19,820.31 2026-04-01
63655 HCPCS Implant Neuroelectrodes 2 1 — — $19,820.31 $19,820.31 $19,820.31 2026-04-01
0817T OTHER Opn Insj/rplcmt Ins Ptn Subf 2 1 — — $19,820.31 $19,820.31 $19,820.31 2026-04-01
0680T OTHER Insj/rplcmt Pg Only Isdss 2 1 — — $19,820.31 $19,820.31 $19,820.31 2026-04-01
0796T OTHER Tcat Ins 2chmbr Ldls Pm Ra 2 1 — — $19,678.89 $19,678.89 $19,678.89 2026-04-01
0825T OTHER Tcat Rmv&rpl1chmb Ldls Pm Ra 2 1 — — $19,678.89 $19,678.89 $19,678.89 2026-04-01
0823T OTHER Tcat Ins 1chmbr Ldls Pm Ra 2 1 — — $19,678.89 $19,678.89 $19,678.89 2026-04-01
0795T OTHER Tcat Ins 2chmbr Ldls Pm Cmpl 2 1 — — $19,678.89 $19,678.89 $19,678.89 2026-04-01
0802T OTHER Tcat Rmv&rpl2chmb Ldls Pm Ra 2 1 — — $19,678.89 $19,678.89 $19,678.89 2026-04-01
0801T OTHER Tcat Rmv&rpl 2chmbr Ldls Pm 2 1 — — $19,678.89 $19,678.89 $19,678.89 2026-04-01
0797T OTHER Tcat Ins 2chmbr Ldls Pm Rv 2 1 — — $19,678.89 $19,678.89 $19,678.89 2026-04-01
33274 HCPCS Tcat Insj/rpl Perm Ldls Pm 2 1 — — $19,678.89 $19,678.89 $19,678.89 2026-04-01
33229 HCPCS Remv&replc Pm Gen Mult Leads 2 1 — — $19,678.89 $19,678.89 $19,678.89 2026-04-01
0803T OTHER Tcat Rmv&rpl2chmb Ldls Pm Rv 2 1 — — $19,678.89 $19,678.89 $19,678.89 2026-04-01
33221 HCPCS Insert Pulse Gen Mult Leads 2 1 — — $19,678.89 $19,678.89 $19,678.89 2026-04-01
0525T OTHER Insj/rplcmt Compl Iims 2 1 — — $19,678.89 $19,678.89 $19,678.89 2026-04-01
L6570 HCPCS Scap Thorac Prosth Tiss Shap 1 1 — — $19,322.43 $19,322.43 $19,322.43 2026-04-01
L5702 HCPCS Replace Socket Hip 1 1 — — $19,172.16 $19,172.16 $19,172.16 2026-04-01
C1827N/A OTHER Gen, Neuro, Imp Led, Ex Cntr 2 1 — — $18,969.94 $18,969.94 $18,969.94 2026-04-01
L5961 HCPCS Endo Poly Hip, Pneu/hyd/rot 1 1 — — $18,831.75 $18,831.75 $18,831.75 2026-04-01
C1824N/A OTHER Generator, Ccm, Implant 2 1 — — $18,817.19 $18,817.19 $18,817.19 2026-04-01
C9775 HCPCS Revasc Lith-sten-ath Tib/per 2 1 — — $18,728.69 $18,728.69 $18,728.69 2026-04-01
C9774 HCPCS Revasc Lithotr-ather Tib/per 2 1 — — $18,728.69 $18,728.69 $18,728.69 2026-04-01
C9767 HCPCS Revasc Lithotrip-stent-ather 2 1 — — $18,728.69 $18,728.69 $18,728.69 2026-04-01
C9797 HCPCS Vasc Emb/occ W/prs Cath 2 1 — — $18,728.69 $18,728.69 $18,728.69 2026-04-01
C9765 HCPCS Revasc Intra Lithotrip-stent 2 1 — — $18,728.69 $18,728.69 $18,728.69 2026-04-01
C9766 HCPCS Revasc Intra Lithotrip-ather 2 1 — — $18,728.69 $18,728.69 $18,728.69 2026-04-01
C9773 HCPCS Revasc Lithotr-stent Tib/per 2 1 — — $18,728.69 $18,728.69 $18,728.69 2026-04-01
C9602 HCPCS Perc D-e Cor Stent Ather S 2 1 — — $18,728.69 $18,728.69 $18,728.69 2026-04-01
93591 HCPCS Perq Transcath Cls Aortic 2 1 — — $18,728.69 $18,728.69 $18,728.69 2026-04-01
93590 HCPCS Perq Transcath Cls Mitral 2 1 — — $18,728.69 $18,728.69 $18,728.69 2026-04-01
93580 HCPCS Transcath Closure Of Asd 2 1 — — $18,728.69 $18,728.69 $18,728.69 2026-04-01
93581 HCPCS Transcath Closure Of Vsd 2 1 — — $18,728.69 $18,728.69 $18,728.69 2026-04-01
93582 HCPCS Perq Transcath Closure Pda 2 1 — — $18,728.69 $18,728.69 $18,728.69 2026-04-01
C9607 HCPCS Perc D-e Cor Revasc Chro Sin 2 1 — — $18,728.69 $18,728.69 $18,728.69 2026-04-01
0981T OTHER Tcat Impl Wrls Ivc Snr 2 1 — — $18,728.69 $18,728.69 $18,728.69 2026-04-01
37292 HCPCS Rvsc Evsc Tpvt St Athrc Sf 1 2 1 — — $18,728.69 $18,728.69 $18,728.69 2026-04-01
37294 HCPCS Rvsc Evsc Tpvt St Athr Cpx 1 2 1 — — $18,728.69 $18,728.69 $18,728.69 2026-04-01
37288 HCPCS Revsc Evsc Tpvt Athrc Sf 1st 2 1 — — $18,728.69 $18,728.69 $18,728.69 2026-04-01
37290 HCPCS Revsc Evsc Tpvt Athrc Cplx 1 2 1 — — $18,728.69 $18,728.69 $18,728.69 2026-04-01
37284 HCPCS Revsc Evasc Tpvt St Sf 1st 2 1 — — $18,728.69 $18,728.69 $18,728.69 2026-04-01
37275 HCPCS Rvsc Evsc Fpvt St Athrc Sf 1 2 1 — — $18,728.69 $18,728.69 $18,728.69 2026-04-01
37277 HCPCS Rvsc Evsc Fpvt St Athr Cpx 1 2 1 — — $18,728.69 $18,728.69 $18,728.69 2026-04-01
37271 HCPCS Revsc Evsc Fpvt Athrc Sf 1st 2 1 — — $18,728.69 $18,728.69 $18,728.69 2026-04-01
37286 HCPCS Revsc Evasc Tpvt St Cplx 1st 2 1 — — $18,728.69 $18,728.69 $18,728.69 2026-04-01
37273 HCPCS Revsc Evsc Fpvt Athrc Cplx 1 2 1 — — $18,728.69 $18,728.69 $18,728.69 2026-04-01
0793T OTHER Prq Tcat Thrm Ablt Nrv P-art 2 1 — — $18,728.69 $18,728.69 $18,728.69 2026-04-01
37242 HCPCS Vasc Embolize/occlude Artery 2 1 — — $18,728.69 $18,728.69 $18,728.69 2026-04-01
37182 HCPCS Insert Hepatic Shunt (tips) 2 1 — — $18,728.69 $18,728.69 $18,728.69 2026-04-01
37184 HCPCS Prim Art M-thrmbc 1st Vsl 2 1 — — $18,728.69 $18,728.69 $18,728.69 2026-04-01
36906 HCPCS Thrmbc/nfs Dialysis Circuit 2 1 — — $18,728.69 $18,728.69 $18,728.69 2026-04-01
36836 HCPCS Prq Av Fstl Crtj Uxtr 1 Acs 2 1 — — $18,728.69 $18,728.69 $18,728.69 2026-04-01
36837 HCPCS Prq Av Fstl Crt Uxtr Sep Acs 2 1 — — $18,728.69 $18,728.69 $18,728.69 2026-04-01
33902 HCPCS Perq P-art Revsc 1 Abnor Uni 2 1 — — $18,728.69 $18,728.69 $18,728.69 2026-04-01
92930 HCPCS Prq Tcat Plmt Ntrac St 2+les 2 1 — — $18,728.69 $18,728.69 $18,728.69 2026-04-01
92933 HCPCS Prq Trlml C Athrc St Angiop1 2 1 — — $18,728.69 $18,728.69 $18,728.69 2026-04-01
61624 HCPCS Tcat Perm Occls/embolj Cns 2 1 — — $18,728.69 $18,728.69 $18,728.69 2026-04-01
0645T OTHER Tcat Impltj C Sins Rdctj Dev 2 1 — — $18,728.69 $18,728.69 $18,728.69 2026-04-01
0238T OTHER Trluml Perip Athrc Iliac Art 2 1 — — $18,728.69 $18,728.69 $18,728.69 2026-04-01
0632T OTHER Perq Tcat US Abltj Nrv P-art 2 1 — — $18,728.69 $18,728.69 $18,728.69 2026-04-01
L5230 HCPCS Fem Focal Defic Constant Fri 1 1 — — $18,628.95 $18,628.95 $18,628.95 2026-04-01
L6550 HCPCS Shldr Disar Prosth Tiss Shap 1 1 — — $18,570.63 $18,570.63 $18,570.63 2026-04-01
C1839N/A OTHER Iris Prosthesis 2 1 — — $18,476.68 $18,476.68 $18,476.68 2026-04-01
62360 HCPCS Insert Spine Infusion Device 2 1 — — $18,414.24 $18,414.24 $18,414.24 2026-04-01
62361 HCPCS Implant Spine Infusion Pump 2 1 — — $18,414.24 $18,414.24 $18,414.24 2026-04-01
62362 HCPCS Implant Spine Infusion Pump 2 1 — — $18,414.24 $18,414.24 $18,414.24 2026-04-01
L5980 HCPCS Flex Foot System 1 1 — — $18,156.60 $18,156.60 $18,156.60 2026-04-01
K0891NU OTHER Pwc Gp5 Ped Mult Pow Opt S/b 2 1 — — $18,108.29 $18,108.29 $18,108.29 2026-04-01
22861 HCPCS Rev Rplcm Arthrp 1ntrspc Crv 2 1 — — $17,913.59 $17,913.59 $17,913.59 2026-04-01
22802 HCPCS Arthrd Pst Dfrm 7-12 Vrt Sgm 2 1 — — $17,913.59 $17,913.59 $17,913.59 2026-04-01
22804 HCPCS Arthrd Pst Dfrm 13+ Vrt Sgm 2 1 — — $17,913.59 $17,913.59 $17,913.59 2026-04-01
22808 HCPCS Arthrd Ant Dfrm 2-3 Vrt Sgm 2 1 — — $17,913.59 $17,913.59 $17,913.59 2026-04-01
22862 HCPCS Rev Rplcm Rthrp 1ntrspc Lmbr 2 1 — — $17,913.59 $17,913.59 $17,913.59 2026-04-01
22610 HCPCS Arthrd Pst Tq 1ntrspc Thrc 2 1 — — $17,913.59 $17,913.59 $17,913.59 2026-04-01
22612 HCPCS Arthrd Pst Tq 1ntrspc Lumbar 2 1 — — $17,913.59 $17,913.59 $17,913.59 2026-04-01
22600 HCPCS Arthrd Pst Tq 1ntrspc Crv 2 1 — — $17,913.59 $17,913.59 $17,913.59 2026-04-01
22586 HCPCS Arthrd Pre-sac Ntrbdy L5-s1 2 1 — — $17,913.59 $17,913.59 $17,913.59 2026-04-01
20982 HCPCS Ablate Bone Tumor(s) Perq 2 1 — — $17,913.59 $17,913.59 $17,913.59 2026-04-01
22810 HCPCS Arthrd Ant Dfrm 4-7 Vrt Sgm 2 1 — — $17,913.59 $17,913.59 $17,913.59 2026-04-01
22857 HCPCS Tot Disc Arthrp 1ntrspc Lmbr 2 1 — — $17,913.59 $17,913.59 $17,913.59 2026-04-01
23616 HCPCS Optx Prx Hmrl Fx Fix Rpr Rpl 2 1 — — $17,913.59 $17,913.59 $17,913.59 2026-04-01
C8003 HCPCS Imp Extar Knee Shck Absrb 2 1 — — $17,913.59 $17,913.59 $17,913.59 2026-04-01
20802 HCPCS Replantation Arm Complete 2 1 — — $17,913.59 $17,913.59 $17,913.59 2026-04-01
22533 HCPCS Arthrd Lat Xtrcvtry Tq Lmbr 2 1 — — $17,913.59 $17,913.59 $17,913.59 2026-04-01
22856 HCPCS Tot Disc Arthrp 1ntrspc Crv 2 1 — — $17,913.59 $17,913.59 $17,913.59 2026-04-01
22812 HCPCS Arthrd Ant Dfrm 8+ Vrt Sgm 2 1 — — $17,913.59 $17,913.59 $17,913.59 2026-04-01
22556 HCPCS Arthrd Ant Ntrbd Min Dsc Thc 2 1 — — $17,913.59 $17,913.59 $17,913.59 2026-04-01
22867 HCPCS Insj Stablj Dev W/dcmprn 2 1 — — $17,913.59 $17,913.59 $17,913.59 2026-04-01
0790T OTHER Revj Rplcmt/rmvl Vrt Tethrg 2 1 — — $17,913.59 $17,913.59 $17,913.59 2026-04-01
22800 HCPCS Arthrd Pst Dfrm<6 Vrt Sgm 2 1 — — $17,913.59 $17,913.59 $17,913.59 2026-04-01
25446 HCPCS Arthrp W/prostc Dst Rds&crps 2 1 — — $17,913.59 $17,913.59 $17,913.59 2026-04-01
22836 HCPCS Ant Thrc Vrt Body Tethrg <7 2 1 — — $17,913.59 $17,913.59 $17,913.59 2026-04-01
25442 HCPCS Arthrp W/prostc Dstl Ulna 2 1 — — $17,913.59 $17,913.59 $17,913.59 2026-04-01
0657T OTHER Ant Lmbr Vrt Bdy Teth 8+ Seg 2 1 — — $17,913.59 $17,913.59 $17,913.59 2026-04-01
22837 HCPCS Ant Thrc Vrt Body Tethrg 8+ 2 1 — — $17,913.59 $17,913.59 $17,913.59 2026-04-01
0656T OTHER Ant Lmbr Vrt Bdy Teth <7 Seg 2 1 — — $17,913.59 $17,913.59 $17,913.59 2026-04-01
23472 HCPCS Artho Glenohum Jt Tl Shldr 2 1 — — $17,913.59 $17,913.59 $17,913.59 2026-04-01
22818 HCPCS Kyphectomy 1-2 Segments 2 1 — — $17,913.59 $17,913.59 $17,913.59 2026-04-01
20838 HCPCS Replantation Foot Complete 2 1 — — $17,913.59 $17,913.59 $17,913.59 2026-04-01
28705 HCPCS Arthrodesis Pantalar 2 1 — — $17,913.59 $17,913.59 $17,913.59 2026-04-01
27703 HCPCS Reconstruction Ankle Joint 2 1 — — $17,913.59 $17,913.59 $17,913.59 2026-04-01
20805 HCPCS Replant Forearm Complete 2 1 — — $17,913.59 $17,913.59 $17,913.59 2026-04-01
20808 HCPCS Replantation Hand Complete 2 1 — — $17,913.59 $17,913.59 $17,913.59 2026-04-01
27487 HCPCS Revise/replace Knee Joint 2 1 — — $17,913.59 $17,913.59 $17,913.59 2026-04-01
27290 HCPCS Amputation Of Leg At Hip 2 1 — — $17,913.59 $17,913.59 $17,913.59 2026-04-01
27295 HCPCS Amputation Of Leg At Hip 2 1 — — $17,913.59 $17,913.59 $17,913.59 2026-04-01
24371 HCPCS Revise Reconst Elbow Joint 2 1 — — $17,913.59 $17,913.59 $17,913.59 2026-04-01
27280 HCPCS Arthr Si Jt Opn B1grf Instrm 2 1 — — $17,913.59 $17,913.59 $17,913.59 2026-04-01
22819 HCPCS Kyphectomy 3 Or More 2 1 — — $17,913.59 $17,913.59 $17,913.59 2026-04-01
27278 HCPCS Arthrd Si Jt Plmt Iartic Dev 2 1 — — $17,913.59 $17,913.59 $17,913.59 2026-04-01
27279 HCPCS Arthrd Si Jt Plmt Tartclr Dv 2 1 — — $17,913.59 $17,913.59 $17,913.59 2026-04-01
24361 HCPCS Reconstruct Elbow Joint 2 1 — — $17,913.59 $17,913.59 $17,913.59 2026-04-01
22838 HCPCS Rev Rplc/rmv Thrc Vrt Tethrg 2 1 — — $17,913.59 $17,913.59 $17,913.59 2026-04-01
24363 HCPCS Replace Elbow Joint 2 1 — — $17,913.59 $17,913.59 $17,913.59 2026-04-01
L8690 HCPCS Aud Osseo Dev, Int/ext Comp 1 1 — — $17,801.61 $17,801.61 $17,801.61 2026-04-01
C2616 HCPCS Brachytx, Non-str,yttrium-90 2 1 — — $17,771.01 $17,771.01 $17,771.01 2026-04-01
C9782 HCPCS Blind Myocar Trpl Bon Marrow 2 1 — — $17,500.50 $17,500.50 $17,500.50 2026-04-01
C9758 HCPCS Blind Interatrial Shunt Ide 2 1 — — $17,500.50 $17,500.50 $17,500.50 2026-04-01
C8005 HCPCS Pef Bronch Ablt 3d Nav Ebus 2 1 — — $17,500.50 $17,500.50 $17,500.50 2026-04-01
0888T OTHER Histotripsy Mal Renal Tissue 2 1 — — $17,500.50 $17,500.50 $17,500.50 2026-04-01
0686T OTHER Histotripsy Mal Hepatcel Tis 2 1 — — $17,500.50 $17,500.50 $17,500.50 2026-04-01
L6026 HCPCS Part Hand Myo Exclu Term Dev 1 1 — — $17,493.60 $17,493.60 $17,493.60 2026-04-01
C9607N/A OTHER Perc D-e Cor Revasc Chro Sin 2 1 — — $17,222.19 $17,222.19 $17,222.19 2026-04-01
C9765N/A OTHER Revasc Intra Lithotrip-stent 2 1 — — $17,142.58 $17,142.58 $17,142.58 2026-04-01
L8687N/A OTHER Implt Nrostm Pls Gen Dua Rec 2 1 — — $17,079.06 $17,079.06 $17,079.06 2026-04-01
Q0482 HCPCS Microprcsr Cu Combo Vad, Rep 1 1 — — $17,031.36 $17,031.36 $17,031.36 2026-04-01
C9602N/A OTHER Perc D-e Cor Stent Ather S 2 1 — — $16,983.22 $16,983.22 $16,983.22 2026-04-01
S2152N/A OTHER Solid Organ Transpl Pkg 2 1 — — $16,853.10 $16,853.10 $16,853.10 2026-04-01
66683 HCPCS Implantation Iris Prosthesis 2 1 — — $16,817.36 $16,817.36 $16,817.36 2026-04-01
0308T OTHER Insj Ocular Telescope Prosth 2 1 — — $16,817.36 $16,817.36 $16,817.36 2026-04-01
L6350 HCPCS Thoracic Intern Lock Elbow 1 1 — — $16,799.34 $16,799.34 $16,799.34 2026-04-01
L5600 HCPCS Hip Disart Sach Laminat Mold 1 1 — — $16,330.71 $16,330.71 $16,330.71 2026-04-01
S2115N/A OTHER Periacetabular Osteotomy 2 1 — — $15,853.00 $15,853.00 $15,853.00 2026-04-01
C7539N/A OTHER Insrt A & V Pm W/l Vent Lead 2 1 — — $15,761.47 $15,761.47 $15,761.47 2026-04-01
L5782 HCPCS Hd Low Limb Pros Vacuum Pump 1 1 — — $15,753.00 $15,753.00 $15,753.00 2026-04-01
L5160 HCPCS Mold Socket Bent Knee Shin S 1 1 — — $15,732.15 $15,732.15 $15,732.15 2026-04-01
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