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

16,740 distinct procedures filed
8 distinct payers
97,417 rate rows
2026-04-01 last MRF observed
Data quality

51,791 of 97,417 rate rows are consumer-grade (53.2%)

45,626 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
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 · 2026-05-17
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
$3,710,000
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
$3,325,455
1.0× median
J1411N/A
HCPCS 		Inj, Hemgenix, Per Tx Dose 1 $3,306,566.25 $3,306,566.25 $3,306,566.25 —
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
$3,004,655
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
$2,468,984
1.0× median
J3392
HCPCS 		Inj, Exagamglogene Autotem 1 $2,332,000.00 $2,332,000.00 $2,332,000.00 nat. median
$2,448,600
1.0× median
Q2057
HCPCS 		Afamitresgene Autoleucel 2 $770,620.00 $2,311,860.00 $770,620.00 nat. median
$824,563
0.9× median
Q2056
HCPCS 		Ciltacabtagene Car-pos T 2 $587,649.57 $1,697,606.85 $587,649.57 nat. median
$674,867
0.9× median
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 2 $566,531.30 $1,775,178.60 $566,531.30 nat. median
$753,246
0.8× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 2 $562,201.24 $1,687,614.57 $562,201.24 nat. median
$673,137
0.8× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 2 $558,081.72 $1,671,953.79 $558,081.72 nat. median
$625,184
0.9× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 2 $532,192.24 $1,599,690.51 $532,192.24 nat. median
$634,303
0.8× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 2 $489,450.20 $1,467,913.83 $489,450.20 nat. median
$619,808
0.8× median
Q0480
HCPCS 		Driver Pneumatic Vad, Rep 1 $337,025.91 $337,025.91 $337,025.91 nat. median
$111,989
outlier · 3.0×
K1007
HCPCS 		Bil Hkaf Pc S/d Micro Sensor 1 $285,243.09 $285,243.09 $285,243.09 nat. median
$96,983
outlier · 2.9×
Q2058
HCPCS 		Obecbtge Autol Up To 400 Mil 1 $278,250.00 $278,250.00 $278,250.00 nat. median
$324,450
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
$70,825
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
$50,598
outlier · 3.0×
L7180
HCPCS 		Electronic Elbow Sequential 1 $131,132.97 $131,132.97 $131,132.97 nat. median
$49,027
outlier · 2.7×
L2006
HCPCS 		Kaf Sng/dbl Swg/stn Mcpr Cus 1 $120,816.15 $120,816.15 $120,816.15 nat. median
$39,823
outlier · 3.0×
J3399N/A
HCPCS 		Inj Onase Abepar-xioi Treat 1 $108,157.44 $108,157.44 $108,157.44 —
L8701
HCPCS 		Ewh S/d Uprt Micro Sensor 1 $104,910.39 $104,910.39 $104,910.39 nat. median
$35,999
outlier · 2.9×
L5856
HCPCS 		Elec Knee-shin Swing/stance 1 $89,588.61 $89,588.61 $89,588.61 nat. median
$30,273
outlier · 3.0×
L6880
HCPCS 		Elec Hand Ind Art Digits 1 $89,406.87 $89,406.87 $89,406.87 nat. median
$30,168
outlier · 3.0×
L6700
HCPCS 		Ue Add Ext Power Myoel 1 $88,530.57 $88,530.57 $88,530.57 nat. median
$30,667
outlier · 2.9×
L8614
HCPCS 		Cochlear Device 1 $71,305.14 $71,305.14 $71,305.14 nat. median
$23,403
outlier · 3.0×
A9543N/A
HCPCS 		Y90 Ibritumomab, Rx 1 $70,242.17 $70,242.17 $70,242.17 —
Q0483
HCPCS 		Monitor Elec Vad, Rep 1 $70,161.51 $70,161.51 $70,161.51 nat. median
$23,616
outlier · 3.0×
L5858
HCPCS 		Stance Phase Only 1 $69,407.82 $69,407.82 $69,407.82 nat. median
$23,442
outlier · 3.0×
L6975
HCPCS 		Interscap-thor Myoelectronic 1 $69,319.77 $69,319.77 $69,319.77 nat. median
$23,177
outlier · 3.0×
C1604N/A
HCPCS 		Grft, Trnsmurl/trnsvens Byps 1 $67,945.10 $67,945.10 $67,945.10 —
L5973
HCPCS 		Ank-foot Sys Dors-plant Flex 1 $65,134.77 $65,134.77 $65,134.77 nat. median
$21,820
outlier · 3.0×
L6970
HCPCS 		Interscapular-thor Switch CT 1 $64,700.16 $64,700.16 $64,700.16 nat. median
$22,513
outlier · 2.9×
J9029
HCPCS 		Instill Adstiladrin, Tx Dose 2 $64,274.79 $190,026.84 $64,274.79 nat. median
$69,774
0.9× median
38240
HCPCS 		Transplt Allo Hct/donor 1 $64,263.52 $64,263.52 $64,263.52 nat. median
$15,979
outlier · 4.0×
L6965
HCPCS 		Shldr Disartic Myoelectronic 1 $63,911.13 $63,911.13 $63,911.13 nat. median
$22,149
outlier · 2.9×
Q0489
HCPCS 		Pwr Pck Base Combo Vad, Rep 1 $60,826.26 $60,826.26 $60,826.26 nat. median
$20,518
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
$16,060
outlier · 3.6×
A9543
HCPCS 		Y90 Ibritumomab, Rx 1 $56,824.54 $56,824.54 $56,824.54 nat. median
$62,507
0.9× median
Q2043
HCPCS 		Sipuleucel-t Auto Cd54+ 2 $54,404.10 $165,816.96 $54,404.10 nat. median
$66,682
0.8× median
Q0481
HCPCS 		Microprcsr Cu Elec Vad, Rep 1 $54,375.27 $54,375.27 $54,375.27 nat. median
$15,051
outlier · 3.6×
L5859
HCPCS 		Knee-shin Pro Flex/ext Cont 1 $54,186.06 $54,186.06 $54,186.06 nat. median
$18,334
outlier · 3.0×
L6945
HCPCS 		Elbow Disart Myoelectronic C 1 $49,984.59 $49,984.59 $49,984.59 nat. median
$14,026
outlier · 3.6×

Other procedures at this hospital

Browse this hospital's 16,740 published procedures. Use the slice to choose what to show, then sort or filter any column.

Slice
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 HCPCS 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 HCPCS 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 HCPCS 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 HCPCS 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 HCPCS 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
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
0620T HCPCS Evasc Ven Artlz Tibl/prnl Vn 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 HCPCS Gen, Neuro, Carot Sinus Baro 2 1 — — $39,738.29 $39,738.29 $39,738.29 2026-04-01
S2079N/A HCPCS 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 HCPCS 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 HCPCS Gen, Neuro, Clo Loop, Rechg 2 1 — — $33,128.64 $33,128.64 $33,128.64 2026-04-01
J1413N/A HCPCS Inj Delandistrogene Mox Rokl 2 1 — — $33,120.00 $33,120.00 $33,120.00 2026-04-01
S2150N/A HCPCS 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
33249 HCPCS Insj/rplcmt Defib W/lead(s) 2 1 — — $32,068.73 $32,068.73 $32,068.73 2026-04-01
0915T HCPCS Insj Perm Ccm-d Sys Pg&eltrd 2 1 — — $32,068.73 $32,068.73 $32,068.73 2026-04-01
0408T HCPCS Insj/rplc Cardiac Modulj Sys 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
0571T HCPCS Insj/rplcmt Icds Ss Eltrd 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
33264 HCPCS Rmvl & Rplcmt Dfb Gen Mlt Ld 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
61885 HCPCS Insrt/redo Neurostim 1 Array 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
33287 HCPCS Rmv&rplcmt Phrnc Nrv Stim Pg 2 1 — — $31,526.06 $31,526.06 $31,526.06 2026-04-01
0908T HCPCS Opn Imp Int Nstm Sys Vgs Nrv 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
0909T HCPCS Rplcmt Int Nstim Sys Vgs Nrv 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
64656 HCPCS Revj/rplcmt Bat Mod Sys Pg 2 1 — — $31,526.06 $31,526.06 $31,526.06 2026-04-01
0674T HCPCS Laps Insj Nw/rpcmt Prm Isdss 2 1 — — $31,526.06 $31,526.06 $31,526.06 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
L6930 HCPCS Below Elbow Switch Control 1 1 — — $31,305.33 $31,305.33 $31,305.33 2026-04-01
C9775N/A HCPCS 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 HCPCS 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 HCPCS 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 HCPCS Aicd, Other Than Sing/dual 2 1 — — $27,978.39 $27,978.39 $27,978.39 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
0960T HCPCS Rpl S-sclp Eltr Ra Rcvr&tlmt 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
20696 HCPCS App Mltpln Uni Xtrnl Fix 1st 2 1 — — $27,721.73 $27,721.73 $27,721.73 2026-04-01
0956T HCPCS Prt Crn Ch Cr&tun Elt S-sclp 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
22633 HCPCS Arthrd Cmbn 1ntrspc Lumbar 2 1 — — $27,721.73 $27,721.73 $27,721.73 2026-04-01
0871T HCPCS Rplcmt Subq Prtl Ascites Pmp 2 1 — — $27,500.50 $27,500.50 $27,500.50 2026-04-01
C9760 HCPCS Non-blind Interatrial Shunt 2 1 — — $27,500.50 $27,500.50 $27,500.50 2026-04-01
C2619N/A HCPCS 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
93653 HCPCS Compre Ep Eval Tx Svt 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
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 HCPCS 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 HCPCS Aicd, Single Chamber 2 1 — — $23,100.40 $23,100.40 $23,100.40 2026-04-01
C9095N/A HCPCS Inj, Tebentafusp-tebn, 1 Mcg 2 1 — — $22,928.40 $22,928.40 $22,928.40 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
33230 HCPCS Insrt Pulse Gen W/dual Leads 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
0409T HCPCS Insj/rplc Car Modulj Pls Gn 2 1 — — $22,725.36 $22,725.36 $22,725.36 2026-04-01
0614T HCPCS Rmvl&rplcmt Ss Impl Dfb Pg 2 1 — — $22,725.36 $22,725.36 $22,725.36 2026-04-01
0916T HCPCS Insj Perm Ccm-d Sys Pg Only 2 1 — — $22,725.36 $22,725.36 $22,725.36 2026-04-01
0923T HCPCS Rmvl&rplcmt Perm Ccm-d Pg 2 1 — — $22,725.36 $22,725.36 $22,725.36 2026-04-01
0515T HCPCS Insj Wcs Lv Compl Sys 2 1 — — $22,725.36 $22,725.36 $22,725.36 2026-04-01
0414T HCPCS 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 HCPCS 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 HCPCS Generator Neuro Rechg Bat Sy 2 1 — — $21,610.16 $21,610.16 $21,610.16 2026-04-01
C1721N/A HCPCS Aicd, Dual Chamber 2 1 — — $21,429.76 $21,429.76 $21,429.76 2026-04-01
C1823N/A HCPCS Gen, Neuro, Trans Sen/stim 2 1 — — $21,325.14 $21,325.14 $21,325.14 2026-04-01
C2616N/A HCPCS 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
53444 HCPCS Insert Tandem Cuff 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
54416 HCPCS Remv/repl Penis Contain Pros 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
54401 HCPCS Insert Self-contd Prosthesis 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
53445 HCPCS Insert Uro/ves Nck Sphincter 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 HCPCS 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 HCPCS 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
0680T HCPCS Insj/rplcmt Pg Only Isdss 2 1 — — $19,820.31 $19,820.31 $19,820.31 2026-04-01
0816T HCPCS Opn Insj/rplcmt Ins Ptn Subq 2 1 — — $19,820.31 $19,820.31 $19,820.31 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
63655 HCPCS Implant Neuroelectrodes 2 1 — — $19,820.31 $19,820.31 $19,820.31 2026-04-01
0817T HCPCS Opn Insj/rplcmt Ins Ptn Subf 2 1 — — $19,820.31 $19,820.31 $19,820.31 2026-04-01
1013T HCPCS Lap Srg Imp/rpl Eso Nea&pg/r 2 1 — — $19,820.31 $19,820.31 $19,820.31 2026-04-01
0801T HCPCS Tcat Rmv&rpl 2chmbr Ldls Pm 2 1 — — $19,678.89 $19,678.89 $19,678.89 2026-04-01
0796T HCPCS Tcat Ins 2chmbr Ldls Pm Ra 2 1 — — $19,678.89 $19,678.89 $19,678.89 2026-04-01
0797T HCPCS Tcat Ins 2chmbr Ldls Pm Rv 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
33221 HCPCS Insert Pulse Gen Mult Leads 2 1 — — $19,678.89 $19,678.89 $19,678.89 2026-04-01
0803T HCPCS Tcat Rmv&rpl2chmb 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
0823T HCPCS Tcat Ins 1chmbr Ldls Pm Ra 2 1 — — $19,678.89 $19,678.89 $19,678.89 2026-04-01
0525T HCPCS Insj/rplcmt Compl Iims 2 1 — — $19,678.89 $19,678.89 $19,678.89 2026-04-01
0825T HCPCS Tcat Rmv&rpl1chmb Ldls Pm Ra 2 1 — — $19,678.89 $19,678.89 $19,678.89 2026-04-01
0802T HCPCS Tcat Rmv&rpl2chmb Ldls Pm Ra 2 1 — — $19,678.89 $19,678.89 $19,678.89 2026-04-01
0795T HCPCS Tcat Ins 2chmbr Ldls Pm Cmpl 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 HCPCS 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 HCPCS Generator, Ccm, Implant 2 1 — — $18,817.19 $18,817.19 $18,817.19 2026-04-01
36906 HCPCS Thrmbc/nfs Dialysis Circuit 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
37286 HCPCS Revsc Evasc Tpvt St Cplx 1st 2 1 — — $18,728.69 $18,728.69 $18,728.69 2026-04-01
0981T HCPCS Tcat Impl Wrls Ivc Snr 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
37182 HCPCS Insert Hepatic Shunt (tips) 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
37184 HCPCS Prim Art M-thrmbc 1st Vsl 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
37271 HCPCS Revsc Evsc Fpvt Athrc Sf 1st 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
C9775 HCPCS Revasc Lith-sten-ath Tib/per 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
37290 HCPCS Revsc Evsc Tpvt Athrc Cplx 1 2 1 — — $18,728.69 $18,728.69 $18,728.69 2026-04-01
0645T HCPCS Tcat Impltj C Sins Rdctj Dev 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 HCPCS Prq Tcat Thrm Ablt Nrv P-art 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
0632T HCPCS Perq Tcat US Abltj Nrv P-art 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
93581 HCPCS Transcath Closure Of Vsd 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
93590 HCPCS Perq Transcath Cls Mitral 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
37292 HCPCS Rvsc Evsc Tpvt St Athrc Sf 1 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
C9773 HCPCS Revasc Lithotr-stent Tib/per 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
C9607 HCPCS Perc D-e Cor Revasc Chro Sin 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
37275 HCPCS Rvsc Evsc Fpvt St Athrc Sf 1 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
C9602 HCPCS Perc D-e Cor Stent Ather S 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
93580 HCPCS Transcath Closure Of Asd 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
93591 HCPCS Perq Transcath Cls Aortic 2 1 — — $18,728.69 $18,728.69 $18,728.69 2026-04-01
0238T HCPCS Trluml Perip Athrc Iliac Art 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
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 HCPCS 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 HCPCS Pwc Gp5 Ped Mult Pow Opt S/b 2 1 — — $18,108.29 $18,108.29 $18,108.29 2026-04-01
24363 HCPCS Replace Elbow Joint 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
0657T HCPCS Ant Lmbr Vrt Bdy Teth 8+ Seg 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
24361 HCPCS Reconstruct Elbow Joint 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
22612 HCPCS Arthrd Pst Tq 1ntrspc Lumbar 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
23616 HCPCS Optx Prx Hmrl Fx Fix Rpr Rpl 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
20802 HCPCS Replantation Arm 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
23472 HCPCS Artho Glenohum Jt Tl Shldr 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
27487 HCPCS Revise/replace Knee Joint 2 1 — — $17,913.59 $17,913.59 $17,913.59 2026-04-01
0656T HCPCS Ant Lmbr Vrt Bdy Teth <7 Seg 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
27295 HCPCS Amputation Of Leg At Hip 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
27290 HCPCS Amputation Of Leg At Hip 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
22867 HCPCS Insj Stablj Dev W/dcmprn 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
22857 HCPCS Tot Disc Arthrp 1ntrspc Lmbr 2 1 — — $17,913.59 $17,913.59 $17,913.59 2026-04-01
22861 HCPCS Rev Rplcm Arthrp 1ntrspc Crv 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
27280 HCPCS Arthr Si Jt Opn B1grf Instrm 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
22856 HCPCS Tot Disc Arthrp 1ntrspc Crv 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
22836 HCPCS Ant Thrc Vrt Body Tethrg <7 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
22818 HCPCS Kyphectomy 1-2 Segments 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
22812 HCPCS Arthrd Ant Dfrm 8+ Vrt Sgm 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
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
22810 HCPCS Arthrd Ant Dfrm 4-7 Vrt Sgm 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
C8003 HCPCS Imp Extar Knee Shck Absrb 2 1 — — $17,913.59 $17,913.59 $17,913.59 2026-04-01
0790T HCPCS Revj Rplcmt/rmvl Vrt Tethrg 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
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
0686T HCPCS Histotripsy Mal Hepatcel Tis 2 1 — — $17,500.50 $17,500.50 $17,500.50 2026-04-01
0888T HCPCS Histotripsy Mal Renal Tissue 2 1 — — $17,500.50 $17,500.50 $17,500.50 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
L6026 HCPCS Part Hand Myo Exclu Term Dev 1 1 — — $17,493.60 $17,493.60 $17,493.60 2026-04-01
C9607N/A HCPCS Perc D-e Cor Revasc Chro Sin 2 1 — — $17,222.19 $17,222.19 $17,222.19 2026-04-01
C9765N/A HCPCS Revasc Intra Lithotrip-stent 2 1 — — $17,142.58 $17,142.58 $17,142.58 2026-04-01
L8687N/A HCPCS 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 HCPCS Perc D-e Cor Stent Ather S 2 1 — — $16,983.22 $16,983.22 $16,983.22 2026-04-01
S2152N/A HCPCS 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 HCPCS 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 HCPCS Periacetabular Osteotomy 2 1 — — $15,853.00 $15,853.00 $15,853.00 2026-04-01
C7539N/A HCPCS 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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