Hospital

GLENDIVE MEDICAL CENTER

Glendive, MT · CCN 271332 · Rates published

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You selected 29806 (CPT)

Shoulder arthroscopy/surgery

This hospital’s price: $23,621 across 199 payers · range $9,697-$24,118

Source: https://cdn.accureg.net/trans/glendive/81-6016016_Glendive-Medical-Center_standardcharges.json · observed 2025-07-02

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.

3,146 distinct procedures filed

314 distinct payers

1,068,923 rate rows

2025-07-02 last MRF observed · ⚠ 16 mo old

Data quality

1,068,163 of 1,068,923 rate rows are consumer-grade (99.9%)

760 rows are marked excluded from the consumer medians — these stay visible in the raw drill-down with the same reason shown here, so nothing is silently hidden.

Excluded — reason	Rows
percent-of-charges filed in the dollar field — excluded from medians	598
exceeds 10× this hospital's gross charge — excluded from medians	75
no usable negotiated amount (only an out-of-band fallback) — excluded from medians	72
placeholder amount (≤ $0.02) — excluded from medians	15

⚠ Possibly outdated The most recent machine-readable file we have for this hospital is 16 months old. CMS requires hospitals to refresh these files at least annually, so newer rates may exist that we haven't ingested yet. The prices below are exactly as last filed.

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

Source MRF file	https://cdn.accureg.net/trans/glendive/81-6016016_Glendive-Medical-Center_standardcharges.json
Found on page	https://pricetransparency.accureg.net/glendive
Discovered via	Discovered by HANK (automated)
Last fetch	Latest re-check couldn't be parsed — showing last good data · 2026-10-31
Content fingerprint	9e16bc8a7af197a6… · 583,294,177 bytes · first seen 2026-05-23

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
27626 CPT	Remove Ankle Joint Lining	314	$4,293.89	$139,683.88	$56,161.56	nat. median $3,643 outlier · 15.4×
20690 CPT	Apply Bone Fixation Device	314	$9,490.38	$134,002.11	$53,877.14	nat. median $6,388 outlier · 8.4×
27256 CPT	Treat Hip Dislocation	314	$312.84	$123,784.61	$49,769.07	nat. median $393 outlier · 126.6×
27257 CPT	Treat Hip Dislocation	314	$2,132.07	$123,784.61	$49,769.07	nat. median $1,857 outlier · 26.8×
27705 CPT	Incision Of Tibia	314	$9,490.38	$109,308.33	$43,948.71	nat. median $6,820 outlier · 6.4×
27870 CPT	Fusion Of Ankle Joint Open	314	$17,459.19	$87,578.39	$35,211.93	nat. median $10,862 outlier · 3.2×
27871 CPT	Fusion Of Tibiofibular Joint	314	$17,459.19	$85,716.96	$34,463.52	nat. median $11,150 outlier · 3.1×
28307 CPT	Incision Of Metatarsal	314	$9,490.38	$84,059.23	$33,797.01	nat. median $6,344 outlier · 5.3×
27330 CPT	Biopsy Knee Joint Lining	314	$4,293.89	$82,548.46	$33,189.59	nat. median $3,551 outlier · 9.3×
28730 CPT	Fusion Of Foot Bones	314	$17,459.19	$73,476.53	$29,542.11	nat. median $10,797 outlier · 2.7×
28725 CPT	Fusion Of Foot Bones	314	$17,459.19	$72,141.81	$29,005.47	nat. median $10,483 outlier · 2.8×
27130 CPT	Total Hip Arthroplasty	314	$11,909.85	$70,857.00	$28,488.90	nat. median $13,117 outlier · 2.2×
27599 CPT	Leg Surgery Procedure	314	$312.84	$70,444.31	$28,322.97	nat. median $618 outlier · 45.8×
28285 CPT	Repair Of Hammertoe	314	$4,293.89	$69,540.85	$27,959.72	nat. median $3,594 outlier · 7.8×
28300 CPT	Incision Of Heel Bone	314	$9,490.38	$68,716.26	$27,628.19	nat. median $6,724 outlier · 4.1×
28304 CPT	Incision Of Midfoot Bones	314	$9,490.38	$68,346.69	$27,479.60	nat. median $6,764 outlier · 4.1×
31645 CPT	Brnchsc W/ther Aspir 1st	314	$2,251.54	$67,713.03	$27,224.83	nat. median $2,126 outlier · 12.8×
28735 CPT	Fusion Of Foot Bones	314	$17,459.19	$65,674.82	$26,405.34	nat. median $11,242 outlier · 2.3×
27687 CPT	Revision Of Calf Tendon	314	$4,293.89	$65,551.15	$26,355.62	nat. median $3,567 outlier · 7.4×
20962 CPT	Other Bone Graft Microvasc	299	$26,350.16	$65,537.57	$26,350.16	nat. median $6,625 outlier · 4.0×
28299 CPT	Correction Hallux Valgus	314	$9,490.38	$65,537.57	$26,350.16	nat. median $6,845 outlier · 3.8×
28341 CPT	Resect Enlarged Toe	314	$4,293.89	$65,537.57	$26,350.16	nat. median $3,490 outlier · 7.6×
28298 CPT	Correction Hallux Valgus	314	$9,490.38	$65,537.57	$26,350.16	nat. median $6,642 outlier · 4.0×
20150 CPT	Excise Epiphyseal Bar	314	$4,293.89	$65,537.57	$26,350.16	nat. median $3,543 outlier · 7.4×
28175 CPT	Resect Phalanx Of Toe Tumor	314	$2,132.07	$65,537.57	$26,350.16	nat. median $2,068 outlier · 12.7×
20900 CPT	Removal Of Bone For Graft	314	$9,490.38	$65,537.57	$26,350.16	nat. median $6,211 outlier · 4.2×
28312 CPT	Revision Of Toe	314	$4,293.89	$65,537.57	$26,350.16	nat. median $3,338 outlier · 7.9×
11047 CPT	Deb Bone Add-on	299	$26,350.16	$65,537.57	$26,350.16	nat. median $936 outlier · 28.2×
28295 CPT	Correction Hallux Valgus	314	$4,293.89	$65,537.57	$26,350.16	nat. median $3,674 outlier · 7.2×
20973 CPT	Bone/skin Graft Great Toe	314	$9,490.38	$65,537.57	$26,350.16	nat. median $7,174 outlier · 3.7×
28310 CPT	Revision Of Big Toe	314	$9,490.38	$65,537.57	$26,350.16	nat. median $6,095 outlier · 4.3×
28150 CPT	Removal Of Toe	314	$4,293.89	$65,537.57	$26,350.16	nat. median $3,228 outlier · 8.2×
27691 CPT	Revise Lower Leg Tendon	314	$9,490.38	$64,246.99	$25,831.26	nat. median $6,958 outlier · 3.7×
28750 CPT	Fusion Of Big Toe Joint	314	$9,490.38	$62,825.62	$25,259.79	nat. median $7,026 outlier · 3.6×
28740 CPT	Fusion Of Foot Bones	314	$9,490.38	$60,823.66	$24,454.87	nat. median $6,895 outlier · 3.5×
27664 CPT	Repair Of Leg Tendon Each	314	$9,490.38	$60,302.57	$24,245.36	nat. median $6,422 outlier · 3.8×
28755 CPT	Fusion Of Big Toe Joint	314	$9,490.38	$58,852.33	$23,662.28	nat. median $6,216 outlier · 3.8×
43755 CPT	Dx Gastr Intub W/asp Specs	314	$207.22	$56,198.65	$22,595.33	nat. median $211 outlier · 107.2×
28238 CPT	Revision Of Foot Tendon	314	$9,490.38	$54,917.84	$22,080.37	nat. median $6,752 outlier · 3.3×
27487 CPT	Revise/replace Knee Joint	299	$19,713.59	$53,790.02	$21,626.92	nat. median $12,322 1.8× median
27486 CPT	Revise/replace Knee Joint	299	$12,959.60	$53,735.37	$21,604.94	nat. median $9,279 outlier · 2.3×
28122 CPT	Partial Removal Of Foot Bone	314	$4,293.89	$64,124.76	$21,335.39	nat. median $3,458 outlier · 6.2×
28296 CPT	Correction Hallux Valgus	314	$4,293.89	$52,637.54	$21,163.55	nat. median $3,792 outlier · 5.6×
0055T CPT	Bone Srgry Cmptr Ct/mri Imag	299	$21,152.86	$52,610.95	$21,152.86	nat. median $1,454 outlier · 14.5×
45136 CPT	Excise Ileoanal Reservior	299	$21,142.29	$52,584.67	$21,142.29	nat. median $3,284 outlier · 6.4×
44126 CPT	Enterectomy Without Taper Cong	299	$21,142.29	$52,584.67	$21,142.29	nat. median $3,779 outlier · 5.6×
44111 CPT	Excision Of Bowel Lesion(s)	299	$21,142.29	$52,584.67	$21,142.29	nat. median $2,767 outlier · 7.6×
44128 CPT	Enterectomy Cong Add-on	299	$21,142.29	$52,584.67	$21,142.29	nat. median $2,550 outlier · 8.3×
44125 CPT	Removal Of Small Intestine	299	$21,142.29	$52,584.67	$21,142.29	nat. median $2,768 outlier · 7.6×
44121 CPT	Removal Of Small Intestine	299	$21,142.29	$52,584.67	$21,142.29	nat. median $1,368 outlier · 15.5×

Other procedures at this hospital

Browse this hospital's 3,146 published procedures. Use the slice to choose what to show, then sort or filter any column.

Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
Code	Type	Description	Rate rows	Payers	Gross	Cash	Min $	Max $	Avg median	Last observed

27626	CPT	Remove Ankle Joint Lining	314	314	$144,004.00	—	$4,293.89	$139,683.88	$56,161.56	2025-07-02
20690	CPT	Apply Bone Fixation Device	315	314	$138,146.50	—	$9,490.38	$134,002.11	$53,877.14	2025-07-02
27256	CPT	Treat Hip Dislocation	314	314	$127,613.00	—	$312.84	$123,784.61	$49,769.07	2025-07-02
27257	CPT	Treat Hip Dislocation	314	314	$127,613.00	—	$2,132.07	$123,784.61	$49,769.07	2025-07-02
27705	CPT	Incision Of Tibia	315	314	$112,689.00	—	$9,490.38	$109,308.33	$43,948.71	2025-07-02
27870	CPT	Fusion Of Ankle Joint Open	315	314	$90,287.00	—	$17,459.19	$87,578.39	$35,211.93	2025-07-02
27871	CPT	Fusion Of Tibiofibular Joint	614	314	$81,473.50	—	$17,459.19	$85,716.96	$34,463.52	2025-07-02
28307	CPT	Incision Of Metatarsal	315	314	$86,659.00	—	$9,490.38	$84,059.23	$33,797.01	2025-07-02
27330	CPT	Biopsy Knee Joint Lining	314	314	$85,101.50	—	$4,293.89	$82,548.46	$33,189.59	2025-07-02
28730	CPT	Fusion Of Foot Bones	912	314	$63,986.60	—	$17,459.19	$73,476.53	$29,542.11	2025-07-02
28725	CPT	Fusion Of Foot Bones	315	314	$74,373.00	—	$17,459.19	$72,141.81	$29,005.47	2025-07-02
27130	CPT	Total Hip Arthroplasty	1,510	314	$50,022.08	—	$11,909.85	$70,857.00	$28,488.90	2025-07-02
27599	CPT	Leg Surgery Procedure	314	314	$72,623.00	—	$312.84	$70,444.31	$28,322.97	2025-07-02
28285	CPT	Repair Of Hammertoe	613	314	$67,564.50	—	$4,293.89	$69,540.85	$27,959.72	2025-07-02
28300	CPT	Incision Of Heel Bone	912	314	$66,815.25	—	$9,490.38	$68,716.26	$27,628.19	2025-07-02
28304	CPT	Incision Of Midfoot Bones	912	314	$63,305.60	—	$9,490.38	$68,346.69	$27,479.60	2025-07-02
31645	CPT	Brnchsc W/ther Aspir 1st	314	314	$69,807.25	—	$2,251.54	$67,713.03	$27,224.83	2025-07-02
28735	CPT	Fusion Of Foot Bones	315	314	$67,706.00	—	$17,459.19	$65,674.82	$26,405.34	2025-07-02
27687	CPT	Revision Of Calf Tendon	614	314	$62,789.00	—	$4,293.89	$65,551.15	$26,355.62	2025-07-02
20962	CPT	Other Bone Graft Microvasc	299	299	$67,564.50	—	$26,350.16	$65,537.57	$26,350.16	2025-07-02
28299	CPT	Correction Hallux Valgus	1,211	314	$58,848.50	—	$9,490.38	$65,537.57	$26,350.16	2025-07-02
28341	CPT	Resect Enlarged Toe	314	314	$67,564.50	—	$4,293.89	$65,537.57	$26,350.16	2025-07-02
28298	CPT	Correction Hallux Valgus	913	314	$52,844.10	—	$9,490.38	$65,537.57	$26,350.16	2025-07-02
20150	CPT	Excise Epiphyseal Bar	314	314	$67,564.50	—	$4,293.89	$65,537.57	$26,350.16	2025-07-02
28175	CPT	Resect Phalanx Of Toe Tumor	314	314	$67,564.50	—	$2,132.07	$65,537.57	$26,350.16	2025-07-02
20900	CPT	Removal Of Bone For Graft	613	314	$67,564.50	—	$9,490.38	$65,537.57	$26,350.16	2025-07-02
28312	CPT	Revision Of Toe	614	314	$67,564.50	—	$4,293.89	$65,537.57	$26,350.16	2025-07-02
11047	CPT	Deb Bone Add-on	299	299	$67,564.50	—	$26,350.16	$65,537.57	$26,350.16	2025-07-02
28295	CPT	Correction Hallux Valgus	614	314	$67,564.50	—	$4,293.89	$65,537.57	$26,350.16	2025-07-02
20973	CPT	Bone/skin Graft Great Toe	314	314	$67,564.50	—	$9,490.38	$65,537.57	$26,350.16	2025-07-02
28310	CPT	Revision Of Big Toe	314	314	$67,564.50	—	$9,490.38	$65,537.57	$26,350.16	2025-07-02
28150	CPT	Removal Of Toe	314	314	$67,564.50	—	$4,293.89	$65,537.57	$26,350.16	2025-07-02
27691	CPT	Revise Lower Leg Tendon	315	314	$66,234.01	—	$9,490.38	$64,246.99	$25,831.26	2025-07-02
28750	CPT	Fusion Of Big Toe Joint	1,211	314	$59,771.60	—	$9,490.38	$62,825.62	$25,259.79	2025-07-02
28740	CPT	Fusion Of Foot Bones	912	314	$45,408.50	—	$9,490.38	$60,823.66	$24,454.87	2025-07-02
27664	CPT	Repair Of Leg Tendon Each	614	314	$27,237.00	—	$9,490.38	$60,302.57	$24,245.36	2025-07-02
28755	CPT	Fusion Of Big Toe Joint	613	314	$60,672.50	—	$9,490.38	$58,852.33	$23,662.28	2025-07-02
43755	CPT	Dx Gastr Intub W/asp Specs	314	314	$57,936.75	—	$207.22	$56,198.65	$22,595.33	2025-07-02
28238	CPT	Revision Of Foot Tendon	614	314	$45,862.50	—	$9,490.38	$54,917.84	$22,080.37	2025-07-02
27487	CPT	Revise/replace Knee Joint	599	299	$50,547.67	—	$19,713.59	$53,790.02	$21,626.92	2025-07-02
27486	CPT	Revise/replace Knee Joint	599	299	$33,229.75	—	$12,959.60	$53,735.37	$21,604.94	2025-07-02
28122	CPT	Partial Removal Of Foot Bone	613	314	$66,108.00	—	$4,293.89	$64,124.76	$21,335.39	2025-07-02
28296	CPT	Correction Hallux Valgus	315	314	$54,265.50	—	$4,293.89	$52,637.54	$21,163.55	2025-07-02
0055T	CPT	Bone Srgry Cmptr Ct/mri Imag	299	299	$54,238.09	—	$21,152.86	$52,610.95	$21,152.86	2025-07-02
45136	CPT	Excise Ileoanal Reservior	299	299	$54,211.00	—	$21,142.29	$52,584.67	$21,142.29	2025-07-02
44126	CPT	Enterectomy Without Taper Cong	299	299	$54,211.00	—	$21,142.29	$52,584.67	$21,142.29	2025-07-02
44111	CPT	Excision Of Bowel Lesion(s)	299	299	$54,211.00	—	$21,142.29	$52,584.67	$21,142.29	2025-07-02
44128	CPT	Enterectomy Cong Add-on	299	299	$54,211.00	—	$21,142.29	$52,584.67	$21,142.29	2025-07-02
44125	CPT	Removal Of Small Intestine	299	299	$54,211.00	—	$21,142.29	$52,584.67	$21,142.29	2025-07-02
44121	CPT	Removal Of Small Intestine	299	299	$54,211.00	—	$21,142.29	$52,584.67	$21,142.29	2025-07-02
44130	CPT	Bowel To Bowel Fusion	299	299	$54,211.00	—	$21,142.29	$52,584.67	$21,142.29	2025-07-02
44110	CPT	Excise Intestine Lesion(s)	299	299	$54,211.00	—	$21,142.29	$52,584.67	$21,142.29	2025-07-02
44899	CPT	Bowel Surgery Procedure	299	299	$54,211.00	—	$21,142.29	$52,584.67	$21,142.29	2025-07-02
44127	CPT	Enterectomy W/taper Cong	299	299	$54,211.00	—	$21,142.29	$52,584.67	$21,142.29	2025-07-02
27447	CPT	Total Knee Arthroplasty	1,211	314	$51,622.13	—	$17,459.19	$52,522.06	$21,117.12	2025-07-02
27654	CPT	Repair Of Achilles Tendon	614	314	$27,237.00	—	$9,490.38	$51,129.51	$20,557.22	2025-07-02
49615	CPT	Rpr Aa Hrn Rcr 3-10 Rdc	314	314	$51,529.50	—	$4,589.49	$49,983.62	$20,096.51	2025-07-02
20615	CPT	Treatment Of Bone Cyst	314	314	$51,178.50	—	$933.34	$49,643.15	$19,959.62	2025-07-02
28320	CPT	Repair Of Foot Bones	315	314	$50,464.50	—	$17,459.19	$48,950.57	$19,681.16	2025-07-02
20985	CPT	Cptr-asst Dir Ms Px	299	299	$50,311.31	—	$19,621.41	$48,801.97	$19,621.41	2025-07-02
44155	CPT	Removal Of Colon/ileostomy	299	299	$50,301.83	—	$19,617.71	$48,792.78	$19,617.71	2025-07-02
28060	CPT	Partial Removal Foot Fascia	614	314	$19,808.55	—	$4,293.89	$65,089.91	$19,214.29	2025-07-02
44238	CPT	Laparoscope Proc Intestine	613	314	$44,042.20	—	$7,654.29	$47,029.97	$18,908.96	2025-07-02
27829	CPT	Treat Lower Leg Joint	614	314	$34,013.00	—	$9,490.38	$46,618.36	$18,743.47	2025-07-02
28200	CPT	Repair Of Foot Tendon	315	314	$46,853.00	—	$4,293.89	$45,447.41	$18,272.67	2025-07-02
28306	CPT	Incision Of Metatarsal	315	314	$46,818.50	—	$9,490.38	$45,413.95	$18,259.22	2025-07-02
27488	CPT	27488 Rmvl Prosth Tot Kne Prosth Mma +-insj Spacer	598	299	$42,011.83	—	$2,462.46	$75,378.38	$18,215.68	2025-07-02
64447	CPT	Njx Aa&/strd Femoral Nerve	314	314	$46,490.50	—	$917.39	$45,095.79	$18,131.30	2025-07-02
27187	CPT	Reinforce Hip Bones	299	299	$46,212.73	—	$18,022.96	$44,826.35	$18,022.96	2025-07-02
28297	CPT	Correction Hallux Valgus	315	314	$45,225.50	—	$9,490.38	$43,868.74	$17,637.95	2025-07-02
27889	CPT	Amputation Of Foot At Ankle	314	314	$44,942.00	—	$9,490.38	$43,593.74	$17,527.38	2025-07-02
27177	CPT	Treat Slipped Epiphysis	299	299	$44,364.71	—	$17,302.24	$43,033.77	$17,302.24	2025-07-02
44137	CPT	Remove Intestinal Allograft	299	299	$44,042.20	—	$17,176.46	$42,720.93	$17,176.46	2025-07-02
36568	CPT	Insj Picc <5 Yr Without Imaging	314	314	$43,697.00	—	$2,124.55	$42,386.09	$17,041.83	2025-07-02
36570	CPT	Insert Picvad Cath	314	314	$43,697.00	—	$4,228.43	$42,386.09	$17,041.83	2025-07-02
27269	CPT	Optx Thigh Fx	299	299	$43,625.50	—	$17,013.95	$42,316.74	$17,013.95	2025-07-02
27161	CPT	Incision Of Neck Of Femur	299	299	$43,625.50	—	$17,013.95	$42,316.74	$17,013.95	2025-07-02
27179	CPT	Revise Head/neck Of Femur	314	314	$43,625.50	—	$9,490.38	$42,316.74	$17,013.95	2025-07-02
27181	CPT	Treat Slipped Epiphysis	299	299	$43,625.50	—	$17,013.95	$42,316.74	$17,013.95	2025-07-02
27178	CPT	Treat Slipped Epiphysis	299	299	$43,625.50	—	$17,013.95	$42,316.74	$17,013.95	2025-07-02
44133	CPT	Enterectomy Live Donor	299	299	$43,454.59	—	$16,947.29	$42,150.95	$16,947.29	2025-07-02
44132	CPT	Enterectomy Cadaver Donor	299	299	$43,454.59	—	$16,947.29	$42,150.95	$16,947.29	2025-07-02
27519	CPT	Treat Thigh Fx Growth Plate	299	299	$42,822.20	—	$16,700.66	$41,537.53	$16,700.66	2025-07-02
27450	CPT	Incision Of Thigh	299	299	$42,822.20	—	$16,700.66	$41,537.53	$16,700.66	2025-07-02
27465	CPT	Shortening Of Thigh Bone	299	299	$42,632.67	—	$16,626.74	$41,353.69	$16,626.74	2025-07-02
27254	CPT	Treat Hip Dislocation	299	299	$42,601.08	—	$16,614.42	$41,323.05	$16,614.42	2025-07-02
27814	CPT	Treatment Of Ankle Fracture	613	314	$32,406.83	—	$9,490.38	$41,289.99	$16,601.13	2025-07-02
43848	CPT	Revision Gastroplasty	299	299	$41,952.50	—	$16,361.48	$40,693.93	$16,361.48	2025-07-02
50526	CPT	Close Nephrovisceral Fistula	299	299	$41,952.50	—	$16,361.48	$40,693.93	$16,361.48	2025-07-02
43886	CPT	Revise Gastric Port Open	314	314	$41,952.50	—	$4,759.24	$40,693.93	$16,361.48	2025-07-02
43880	CPT	Repair Stomach-bowel Fistula	299	299	$41,952.50	—	$16,361.48	$40,693.93	$16,361.48	2025-07-02
43860	CPT	Revise Stomach-bowel Fusion	299	299	$41,952.50	—	$16,361.48	$40,693.93	$16,361.48	2025-07-02
43501	CPT	Surgical Repair Of Stomach	299	299	$41,952.50	—	$16,361.48	$40,693.93	$16,361.48	2025-07-02
43360	CPT	Gastrointestinal Repair	299	299	$41,952.50	—	$16,361.48	$40,693.93	$16,361.48	2025-07-02
43502	CPT	Surgical Repair Of Stomach	299	299	$41,952.50	—	$16,361.48	$40,693.93	$16,361.48	2025-07-02
43865	CPT	Revise Stomach-bowel Fusion	299	299	$41,952.50	—	$16,361.48	$40,693.93	$16,361.48	2025-07-02
28110	CPT	Part Removal Of Metatarsal	613	314	$46,312.00	—	$4,293.89	$44,922.64	$16,354.20	2025-07-02
27676	CPT	Repair Lower Leg Tendons	315	314	$41,544.00	—	$9,490.38	$40,297.68	$16,202.16	2025-07-02
49320	CPT	Diag Laparo Separate Proc	613	314	$53,637.05	—	$6,489.31	$52,027.94	$16,140.07	2025-07-02
27675	CPT	Repair Lower Leg Tendons	614	314	$16,496.50	—	$4,293.89	$39,973.70	$16,001.61	2025-07-02
29828	CPT	Arthroscopy Biceps Tenodesis	315	314	$40,993.00	—	$9,490.38	$39,763.21	$15,987.27	2025-07-02
47620	CPT	Removal Of Gallbladder	299	299	$39,743.00	—	$15,499.77	$38,550.71	$15,499.77	2025-07-02
47612	CPT	Removal Of Gallbladder	299	299	$39,743.00	—	$15,499.77	$38,550.71	$15,499.77	2025-07-02
47600	CPT	Removal Of Gallbladder	598	299	$38,129.25	—	$14,241.05	$38,550.71	$15,499.77	2025-07-02
47610	CPT	Removal Of Gallbladder	299	299	$39,743.00	—	$15,499.77	$38,550.71	$15,499.77	2025-07-02
49606	CPT	Repair Umbilical Lesion	299	299	$39,287.50	—	$15,322.13	$38,108.88	$15,322.13	2025-07-02
49605	CPT	Repair Umbilical Lesion	299	299	$39,287.50	—	$15,322.13	$38,108.88	$15,322.13	2025-07-02
J2507	HCPCS	Pegloticase 8mg/ml 1ml Vial (g/k)	314	314	$39,044.50	—	$4,526.80	$37,873.17	$15,227.36	2025-07-02
44143	CPT	Partial Removal Of Colon	299	299	$38,949.50	—	$15,190.31	$37,781.02	$15,190.31	2025-07-02
28289	CPT	Corrj Halux Rigdus Without Implt	315	314	$38,553.50	—	$4,293.89	$37,396.90	$15,035.87	2025-07-02
23412	CPT	Repair Rotator Cuff Chronic	912	314	$33,299.00	—	$9,490.38	$37,353.38	$15,018.37	2025-07-02
28008	CPT	Incision Of Foot Fascia	912	314	$27,742.00	—	$4,293.89	$41,531.23	$14,982.62	2025-07-02
24546	CPT	24546 Open Tx Humeral Supracondylar Fracture W/xtn	613	314	$38,271.50	—	$2,126.67	$37,123.36	$14,925.89	2025-07-02
24515	CPT	24515 Optx Humeral Shft Fx W/plate/screws +-cerclage	613	314	$38,271.50	—	$1,800.63	$37,123.36	$14,925.89	2025-07-02
24400	CPT	Revision Of Humerus	314	314	$38,271.50	—	$9,490.38	$37,123.36	$14,925.89	2025-07-02
23615	CPT	Treat Humerus Fracture	614	314	$38,271.50	—	$8,907.34	$37,123.36	$14,925.89	2025-07-02
24579	CPT	24579 Open Treatment Humeral Condylar Fracture	613	314	$38,271.50	—	$1,702.74	$37,123.36	$14,925.89	2025-07-02
24575	CPT	24575 Open Tx Humeral Epicondylar Fracture	613	314	$38,271.50	—	$1,499.16	$37,123.36	$14,925.89	2025-07-02
24516	CPT	24516 Tx Humeral Shaft Fx W/insj Imed Implt +-cerclage	613	314	$38,271.50	—	$1,759.68	$37,123.36	$14,925.89	2025-07-02
24470	CPT	Revision Of Elbow Joint	314	314	$38,271.50	—	$4,293.89	$37,123.36	$14,925.89	2025-07-02
24545	CPT	24545 Open Tx Humeral Supracondylar Fracture Without Xtn	613	314	$38,271.50	—	$1,904.37	$37,123.36	$14,925.89	2025-07-02
27726	CPT	Repair Fibula Nonunion	614	314	$38,209.75	—	$9,490.38	$37,063.46	$14,901.80	2025-07-02
27888	CPT	Amputation Of Foot At Ankle	299	299	$38,197.00	—	$14,896.83	$37,051.09	$14,896.83	2025-07-02
24925	CPT	Amputation Follow-up Surgery	314	314	$37,809.50	—	$4,293.89	$36,675.22	$14,745.71	2025-07-02
27698	CPT	Repair Of Ankle Ligament	614	314	$23,948.50	—	$9,339.92	$34,860.99	$14,016.28	2025-07-02
27830	CPT	Treat Lower Leg Dislocation	314	314	$35,695.00	—	$312.84	$34,624.15	$13,921.05	2025-07-02
27831	CPT	Treat Lower Leg Dislocation	314	314	$35,695.00	—	$4,293.89	$34,624.15	$13,921.05	2025-07-02
27538	CPT	Treat Knee Fracture(s)	314	314	$35,695.00	—	$312.84	$34,624.15	$13,921.05	2025-07-02
28119	CPT	Removal Of Heel Spur	614	314	$35,649.00	—	$4,293.89	$34,579.53	$13,903.11	2025-07-02
44160	CPT	44160 Colct Prtl W/rmvl Terminal Ile W/ileoclst	598	299	$30,448.00	—	$2,607.15	$52,584.67	$13,813.37	2025-07-02
27758	CPT	27758 Optx Tibl Shft Fx W/plate/screws +-cerclage	613	314	$35,411.92	—	$1,833.00	$34,349.56	$13,810.65	2025-07-02
27828	CPT	27828 Open Treatment Fracture Distal Tibia & Fibula	613	314	$35,411.92	—	$2,702.70	$34,349.56	$13,810.65	2025-07-02
27455	CPT	Realignment Of Knee	299	299	$35,411.92	—	$13,810.65	$34,349.56	$13,810.65	2025-07-02
27832	CPT	Treat Lower Leg Dislocation	314	314	$35,411.92	—	$9,490.38	$34,349.56	$13,810.65	2025-07-02
44120	CPT	44120 Removal Of Small Intestine	598	299	$30,346.00	—	$2,527.59	$52,584.67	$13,714.43	2025-07-02
29888	CPT	Knee Arthroscopy/surgery	614	314	$34,817.00	—	$9,490.38	$33,772.49	$13,578.63	2025-07-02
11044	CPT	Deb Bone 20 Sq Cm/<	613	314	$67,564.50	—	$2,150.76	$65,537.57	$13,551.39	2025-07-02
10180	CPT	Complex Drainage Wound	613	314	$42,108.16	—	$3,769.44	$40,844.92	$13,544.60	2025-07-02
27882	CPT	Amputation Of Lower Leg	299	299	$34,063.39	—	$13,284.72	$33,041.49	$13,284.72	2025-07-02
27880	CPT	Amputation Of Lower Leg	599	299	$26,289.50	—	$10,252.91	$33,041.49	$13,284.72	2025-07-02
27881	CPT	Amputation Of Lower Leg	299	299	$34,063.39	—	$13,284.72	$33,041.49	$13,284.72	2025-07-02
27535	CPT	Treat Knee Fracture	599	299	$27,208.50	—	$10,611.32	$32,992.61	$13,265.07	2025-07-02
27827	CPT	Treat Lower Leg Fracture	614	314	$34,013.00	—	$6,134.31	$32,992.61	$13,265.07	2025-07-02
27722	CPT	Repair/graft Of Tibia	314	314	$34,013.00	—	$9,490.38	$32,992.61	$13,265.07	2025-07-02
27725	CPT	Repair Of Lower Leg	299	299	$34,013.00	—	$13,265.07	$32,992.61	$13,265.07	2025-07-02
15273	CPT	Skin Sub Grft T/arm/lg Child	314	314	$33,669.00	—	$4,759.24	$32,658.93	$13,130.91	2025-07-02
44188	CPT	Lap Colostomy	299	299	$33,291.00	—	$12,983.49	$32,292.27	$12,983.49	2025-07-02
58661	CPT	Laparoscopy Remove Adnexa	1,211	314	$18,172.00	—	$6,885.55	$32,268.99	$12,974.13	2025-07-02
J9043	HCPCS	Cabazitaxel 60mg (g/k)	314	314	$33,045.50	—	$281.40	$32,054.14	$12,887.75	2025-07-02
44970	CPT	Laparoscopy Appendectomy	613	314	$31,155.90	—	$7,654.29	$31,953.99	$12,847.48	2025-07-02
C1713	HCPCS	Anchor/screw Bn/bntis/bn	299	299	$32,766.00	—	$12,778.74	$31,783.02	$12,778.74	2025-07-02
49426	CPT	Revise Abdomen-venous Shunt	314	314	$32,632.50	—	$4,589.49	$31,653.53	$12,726.68	2025-07-02
49412	CPT	Ins Device For Rt Guide Open	299	299	$32,632.50	—	$12,726.68	$31,653.53	$12,726.68	2025-07-02
49429	CPT	Removal Of Shunt	314	314	$32,632.50	—	$4,228.43	$31,653.53	$12,726.68	2025-07-02
49436	CPT	Embedded Ip Cath Exit-site	314	314	$32,632.50	—	$2,524.23	$31,653.53	$12,726.68	2025-07-02
49325	CPT	Lap Revision Perm Ip Cath	314	314	$32,632.50	—	$7,654.29	$31,653.53	$12,726.68	2025-07-02
44850	CPT	Repair Of Mesentery	299	299	$32,632.50	—	$12,726.68	$31,653.53	$12,726.68	2025-07-02
27899	CPT	Leg/ankle Surgery Procedure	314	314	$32,197.80	—	$312.84	$31,231.87	$12,557.14	2025-07-02
44800	CPT	44800 Exc Meckel's Diverticulum/omphalomesenteric Duct	598	299	$29,140.50	—	$1,587.30	$52,584.67	$12,545.09	2025-07-02
28308	CPT	Incision Of Metatarsal	315	314	$31,638.33	—	$4,293.89	$30,689.18	$12,338.95	2025-07-02
Q4104	HCPCS	Integra Bmwd	299	299	$31,619.00	—	$12,331.41	$30,670.43	$12,331.41	2025-07-02
36500	CPT	Insertion Of Catheter Vein	299	299	$31,530.23	—	$12,296.79	$30,584.32	$12,296.79	2025-07-02
28092	CPT	Removal Of Toe Lesions	314	314	$31,453.50	—	$2,132.07	$30,509.90	$12,266.87	2025-07-02
28800	CPT	Amputation Of Midfoot	299	299	$31,452.00	—	$12,266.28	$30,508.44	$12,266.28	2025-07-02
28805	CPT	Amputation Thru Metatarsal	913	314	$27,437.00	—	$4,293.89	$30,508.44	$12,266.28	2025-07-02
54700	CPT	Drainage Of Scrotum	315	314	$31,355.00	—	$2,701.98	$30,414.35	$12,228.45	2025-07-02
28080	CPT	Removal Of Foot Lesion	315	314	$31,258.50	—	$2,132.07	$30,320.75	$12,190.82	2025-07-02
26841	CPT	Fusion Of Thumb	315	314	$31,153.00	—	$9,490.38	$30,218.41	$12,149.67	2025-07-02
10060	CPT	Drainage Of Skin Abscess	613	314	$38,802.66	—	$265.58	$37,638.58	$12,139.23	2025-07-02
15275	CPT	Skin Sub Graft Face/nk/hf/g	613	314	$31,091.00	—	$2,419.16	$30,158.27	$12,125.49	2025-07-02
37760	CPT	Ligate Leg Veins Radical	314	314	$30,580.75	—	$4,228.43	$29,663.33	$11,926.49	2025-07-02
27632	CPT	Exc Leg/ankle Les Sc 3 Cm/>	314	314	$30,580.75	—	$3,769.44	$29,663.33	$11,926.49	2025-07-02
37761	CPT	Ligate Leg Veins Open	314	314	$30,580.75	—	$4,228.43	$29,663.33	$11,926.49	2025-07-02
49440	CPT	Place Gastrostomy Tube Perc	314	314	$30,547.50	—	$2,524.23	$29,631.08	$11,913.53	2025-07-02
44202	CPT	Lap Enterectomy	598	299	$23,938.00	—	$3,444.09	$37,873.65	$11,896.81	2025-07-02
27592	CPT	Amputate Leg At Thigh	299	299	$30,332.20	—	$11,829.56	$29,422.23	$11,829.56	2025-07-02
27591	CPT	Amputate Leg At Thigh	299	299	$30,332.20	—	$11,829.56	$29,422.23	$11,829.56	2025-07-02
58940	CPT	Removal Of Ovary(s)	300	299	$30,021.00	—	$11,708.19	$29,120.37	$11,708.19	2025-07-02
28485	CPT	Treat Metatarsal Fracture	912	314	$29,971.92	—	$4,050.74	$42,580.09	$11,689.05	2025-07-02
43840	CPT	43840 Repair Of Stomach Lesion	598	299	$24,584.75	—	$2,814.63	$40,693.93	$11,680.99	2025-07-02
27524	CPT	Treat Kneecap Fracture	315	314	$29,685.00	—	$9,490.38	$28,794.45	$11,577.15	2025-07-02
27513	CPT	27513 Open Tx Femoral Supracondylar Fracture W Xtn	598	299	$24,677.10	—	$2,547.48	$41,537.53	$11,518.35	2025-07-02
44005	CPT	Freeing Of Bowel Adhesion	299	299	$29,419.50	—	$11,473.61	$28,536.92	$11,473.61	2025-07-02
49402	CPT	Remove Foreign Body Adbomen	314	314	$29,400.35	—	$4,589.49	$28,518.34	$11,466.14	2025-07-02
27244	CPT	27244 Tx Inter/pr/subtrchntric Fem Fx Screw Implt	598	299	$24,532.54	—	$2,520.96	$41,323.05	$11,442.25	2025-07-02
27245	CPT	27245 Tx Inter/pr/subtrchntric Fem Fx Imed Impltscrew	598	299	$24,529.54	—	$2,518.62	$41,323.05	$11,439.34	2025-07-02
29893	CPT	Scope Plantar Fasciotomy	614	314	$13,604.50	—	$4,293.89	$28,322.55	$11,387.42	2025-07-02
25608	CPT	Treat Fx Rad Intra-articul	314	314	$29,174.50	—	$9,490.38	$28,299.27	$11,378.06	2025-07-02
27236	CPT	27236 Optx Fem Fx Prox End Nck Int Fixj/prostc Rplcmt	598	299	$24,441.04	—	$2,449.59	$41,323.05	$11,353.49	2025-07-02
43194	CPT	Esophagoscp Rig Trnso Rem Fb	314	314	$28,997.00	—	$2,524.23	$28,127.09	$11,308.83	2025-07-02
27603	CPT	Drain Lower Leg Lesion	613	314	$28,554.50	—	$3,769.44	$27,697.87	$11,136.26	2025-07-02
27823	CPT	Treatment Of Ankle Fracture	315	314	$28,464.00	—	$9,490.38	$27,610.08	$11,100.96	2025-07-02
49594	CPT	Rpr Aa Hrn 1st 3-10 Ncr/strn	314	314	$28,445.00	—	$7,654.29	$27,591.65	$11,093.55	2025-07-02
15002	CPT	Wound Prep Trk/arm/leg	613	314	$28,415.44	—	$2,419.16	$27,562.98	$11,082.02	2025-07-02
27364	CPT	Resect Thigh/knee Tum 5 Cm/>	314	314	$28,415.44	—	$3,769.44	$27,562.98	$11,082.02	2025-07-02
27616	CPT	Resect Leg/ankle Tum 5 Cm/>	314	314	$28,415.44	—	$3,769.44	$27,562.98	$11,082.02	2025-07-02
27634	CPT	Exc Leg/ankle Tum Dep 5 Cm/>	314	314	$28,415.44	—	$3,769.44	$27,562.98	$11,082.02	2025-07-02
27615	CPT	Resect Leg/ankle Tum < 5 Cm	314	314	$28,415.44	—	$3,769.44	$27,562.98	$11,082.02	2025-07-02
27618	CPT	Exc Leg/ankle Tum < 3 Cm	613	314	$28,415.44	—	$2,150.76	$27,562.98	$11,082.02	2025-07-02
15005	CPT	Wnd Prep F/n/hf/g Addl Cm	299	299	$28,415.44	—	$11,082.02	$27,562.98	$11,082.02	2025-07-02
15004	CPT	Wound Prep F/n/hf/g	613	314	$28,415.44	—	$833.15	$27,562.98	$11,082.02	2025-07-02
15003	CPT	Wound Prep Addl 100 Cm	299	299	$28,415.44	—	$11,082.02	$27,562.98	$11,082.02	2025-07-02
25447	CPT	Repair Wrist Joints	315	314	$28,063.00	—	$4,293.89	$27,221.11	$10,944.57	2025-07-02
27511	CPT	27511 Open Tx Femoral Supracondylar Fracture Without Xtn	598	299	$24,038.60	—	$2,049.45	$41,537.53	$10,899.01	2025-07-02
11750	CPT	Removal Of Nail Bed	613	314	$11,178.00	—	$528.96	$28,322.55	$10,842.66	2025-07-02
11730	CPT	Removal Of Nail Plate	613	314	$11,178.00	—	$265.58	$55,910.32	$10,842.66	2025-07-02
27514	CPT	27514 Open Tx Femoral Fracture Distal Med/lat Condyle	598	299	$23,956.60	—	$1,985.49	$41,537.53	$10,819.47	2025-07-02
27086	CPT	Remove Hip Foreign Body	314	314	$27,693.67	—	$3,769.44	$26,862.86	$10,800.53	2025-07-02
27065	CPT	Remove Hip Bone Les Super	314	314	$27,693.67	—	$9,490.38	$26,862.86	$10,800.53	2025-07-02
15956	CPT	Remove Thigh Pressure Sore	314	314	$27,693.67	—	$2,419.16	$26,862.86	$10,800.53	2025-07-02
15952	CPT	Remove Thigh Pressure Sore	314	314	$27,693.67	—	$2,419.16	$26,862.86	$10,800.53	2025-07-02
15945	CPT	Remove Hip Pressure Sore	314	314	$27,693.67	—	$2,419.16	$26,862.86	$10,800.53	2025-07-02
15958	CPT	Remove Thigh Pressure Sore	314	314	$27,693.67	—	$4,759.24	$26,862.86	$10,800.53	2025-07-02
15953	CPT	Remove Thigh Pressure Sore	314	314	$27,693.67	—	$4,759.24	$26,862.86	$10,800.53	2025-07-02
15951	CPT	Remove Thigh Pressure Sore	314	314	$27,693.67	—	$3,769.44	$26,862.86	$10,800.53	2025-07-02
15950	CPT	Remove Thigh Pressure Sore	314	314	$27,693.67	—	$2,150.76	$26,862.86	$10,800.53	2025-07-02
15946	CPT	Remove Hip Pressure Sore	314	314	$27,693.67	—	$2,419.16	$26,862.86	$10,800.53	2025-07-02
15944	CPT	Remove Hip Pressure Sore	314	314	$27,693.67	—	$4,759.24	$26,862.86	$10,800.53	2025-07-02
15941	CPT	Remove Hip Pressure Sore	314	314	$27,693.67	—	$3,769.44	$26,862.86	$10,800.53	2025-07-02
15940	CPT	Remove Hip Pressure Sore	314	314	$27,693.67	—	$3,769.44	$26,862.86	$10,800.53	2025-07-02
C1776	HCPCS	Fem Comp Sz5 Lt Cr Legion Ox__71421235	299	299	$27,607.00	—	$10,766.73	$26,778.79	$10,766.73	2025-07-02
29822	CPT	Shoulder Arthroscopy/surgery	912	314	$18,474.74	—	$4,293.89	$26,651.88	$10,715.71	2025-07-02
27134	CPT	27134 Revj Tot Hip Arthrp Bth +-agrft/algrft	598	299	$19,801.40	—	$3,929.25	$28,641.97	$10,644.30	2025-07-02
27659	CPT	Repair Of Leg Tendon Each	614	314	$27,237.00	—	$8,252.01	$26,419.89	$10,622.43	2025-07-02
27665	CPT	Repair Of Leg Tendon Each	614	314	$27,237.00	—	$5,596.70	$26,419.89	$10,622.43	2025-07-02
44950	CPT	Appendectomy	613	314	$24,771.00	—	$9,660.69	$26,193.88	$10,531.56	2025-07-02
44660	CPT	Repair Bowel-bladder Fistula	299	299	$26,879.00	—	$10,482.81	$26,072.63	$10,482.81	2025-07-02
44650	CPT	Repair Bowel Fistula	299	299	$26,879.00	—	$10,482.81	$26,072.63	$10,482.81	2025-07-02
50830	CPT	Revise Urine Flow	299	299	$26,879.00	—	$10,482.81	$26,072.63	$10,482.81	2025-07-02
23552	CPT	Treat Clavicle Dislocation	314	314	$26,694.06	—	$9,490.38	$25,893.24	$10,410.68	2025-07-02
11042	CPT	Deb Subq Tissue 20 Sq Cm/<	613	314	$26,694.06	—	$528.96	$25,893.24	$10,410.68	2025-07-02
23532	CPT	Treat Clavicle Dislocation	314	314	$26,694.06	—	$9,490.38	$25,893.24	$10,410.68	2025-07-02
24685	CPT	Treat Ulnar Fracture	315	314	$26,644.20	—	$9,490.38	$25,844.87	$10,391.24	2025-07-02
11603	CPT	Exc Tr-ext Mal+marg 2.1-3 Cm	314	314	$26,629.63	—	$933.34	$25,830.74	$10,385.56	2025-07-02
11602	CPT	Exc Tr-ext Mal+marg 1.1-2 Cm	314	314	$26,629.63	—	$528.96	$25,830.74	$10,385.56	2025-07-02
11601	CPT	Exc Tr-ext Mal+marg 0.6-1 Cm	314	314	$26,629.63	—	$933.34	$25,830.74	$10,385.56	2025-07-02
23410	CPT	Repair Rotator Cuff Acute	315	314	$26,414.50	—	$9,490.38	$25,622.07	$10,301.66	2025-07-02
44141	CPT	Partial Removal Of Colon	299	299	$26,367.50	—	$10,283.33	$25,576.48	$10,283.33	2025-07-02
28124	CPT	Partial Removal Of Toe	613	314	$67,564.50	—	$4,131.66	$65,537.57	$10,276.18	2025-07-02
25248	CPT	Remove Forearm Foreign Body	314	314	$26,316.15	—	$2,132.07	$25,526.67	$10,263.30	2025-07-02
28825	CPT	Partial Amputation Of Toe	613	314	$26,234.00	—	$4,293.89	$25,446.98	$10,231.26	2025-07-02
27132	CPT	27132 Conv Previous Hip Tot Hip Arthrp +-agrft/algrft	598	299	$19,675.54	—	$3,437.07	$29,621.94	$10,229.23	2025-07-02
27248	CPT	27248 Open Treatment Greater Trochanteric Fracture	598	299	$23,262.54	—	$1,530.36	$41,323.05	$10,210.35	2025-07-02
J9042	HCPCS	Brentuximab Vedotin 50mg Vial (g/k)	314	314	$26,015.00	—	$311.82	$25,234.55	$10,145.85	2025-07-02
27441	CPT	Revision Of Knee Joint	314	314	$25,670.50	—	$10,011.50	$24,900.39	$10,011.50	2025-07-02
27332	CPT	Removal Of Knee Cartilage	314	314	$25,670.50	—	$4,293.89	$24,900.39	$10,011.50	2025-07-02
27333	CPT	Removal Of Knee Cartilage	314	314	$25,670.50	—	$4,293.89	$24,900.39	$10,011.50	2025-07-02
27334	CPT	Remove Knee Joint Lining	314	314	$25,670.50	—	$4,293.89	$24,900.39	$10,011.50	2025-07-02
27335	CPT	Remove Knee Joint Lining	314	314	$25,670.50	—	$9,490.38	$24,900.39	$10,011.50	2025-07-02
J2350	HCPCS	Injection Ocrelizumab 1 Mg	314	314	$25,657.00	—	$77.74	$24,887.29	$10,006.23	2025-07-02
10061	CPT	Drainage Of Skin Abscess	613	314	$38,802.66	—	$528.96	$37,638.58	$9,967.96	2025-07-02
27724	CPT	27724 Rpr Non/mal Tibia W/iliac/oth Agrft	598	299	$20,320.50	—	$2,584.92	$32,992.61	$9,847.11	2025-07-02
27125	CPT	27125 Hemiarthroplasty Hip Partial	598	299	$20,770.25	—	$2,320.89	$34,521.82	$9,826.19	2025-07-02
28046	CPT	Resect Foot/toe Tumor < 3 Cm	314	314	$25,194.65	—	$3,769.44	$24,438.81	$9,825.91	2025-07-02
28047	CPT	Resect Foot/toe Tumor 3 Cm/>	314	314	$25,194.65	—	$3,769.44	$24,438.81	$9,825.91	2025-07-02
43500	CPT	43500 Gstrt W/expl/fb Rmvl	598	299	$21,936.60	—	$1,619.67	$38,528.59	$9,759.65	2025-07-02
11600	CPT	Exc Tr-ext Mal+marg 0.5 Cm/<	314	314	$25,019.96	—	$933.34	$24,269.36	$9,757.78	2025-07-02
11402	CPT	Exc Tr-ext B9+marg 1.1-2 Cm	613	314	$25,019.96	—	$933.34	$24,269.36	$9,757.78	2025-07-02
J1950	HCPCS	Leuprolide 11.25 Mg/3 Months Kit (ped) (g/k)	314	314	$24,959.00	—	$2,102.95	$24,210.23	$9,734.01	2025-07-02
49000	CPT	49000 Expl Lapt Expl Celiotomy +-bx Spx	598	299	$21,895.60	—	$1,587.69	$38,528.59	$9,719.88	2025-07-02
29806	CPT	Shoulder Arthroscopy/surgery	315	314	$24,863.75	—	$9,490.38	$24,117.84	$9,696.86	2025-07-02
11201	CPT	Remove Skin Tags Add-on	299	299	$24,805.38	—	$9,674.10	$24,061.22	$9,674.10	2025-07-02
15999	CPT	Removal Of Pressure Sore	314	314	$24,805.38	—	$933.34	$24,061.22	$9,674.10	2025-07-02
27536	CPT	27536 Optx Tibl Fx Prox Bicondylar +-int Fixj	598	299	$20,131.00	—	$2,437.11	$32,992.61	$9,663.30	2025-07-02
27138	CPT	27138 Revj Tot Hip Arthrp Fem Only +-algrft	598	299	$18,788.90	—	$3,139.50	$28,641.97	$9,662.17	2025-07-02
47564	CPT	47564 Laps Surg Cholecstc W/expl Common Dux	613	314	$24,643.96	—	$2,303.73	$23,904.64	$9,611.14	2025-07-02
47562	CPT	Laparoscopic Cholecystectomy	613	314	$24,643.96	—	$7,654.29	$23,904.64	$9,611.14	2025-07-02
28113	CPT	Part Removal Of Metatarsal	315	314	$24,429.00	—	$4,293.89	$23,696.13	$9,527.31	2025-07-02
44227	CPT	44227 Laps Clsr Ntrstm Lg/sm Int W/rescj&anast	598	299	$17,842.00	—	$3,433.95	$26,072.63	$9,511.83	2025-07-02
27235	CPT	27235 Prq Skel Fixj Fem Fx Prox End Nck	613	314	$38,189.15	—	$1,860.69	$37,043.48	$9,490.38	2025-07-02
27784	CPT	27784 Open Treatment Proximal Fibula/shaft Fracture	613	314	$38,209.75	—	$1,455.48	$37,063.46	$9,490.38	2025-07-02
24538	CPT	24538 Prq Skel Fixj Sprcndylr/transcndylr Humeral Fx	613	314	$38,271.50	—	$1,561.56	$37,123.36	$9,490.38	2025-07-02
27826	CPT	27826 Open Treatment Fracture Distal Tibia Fibula	613	314	$38,209.75	—	$1,742.13	$37,063.46	$9,490.38	2025-07-02
27652	CPT	27652 Rpr Primary Open/prq Ruptured Achilles W/graft	613	314	$27,237.00	—	$1,359.54	$26,419.89	$9,490.38	2025-07-02
20902	CPT	20902 Bone Graft Any Donor Area Major/large	613	314	$67,564.50	—	$579.15	$65,537.57	$9,490.38	2025-07-02
27720	CPT	27720 Repair Nonunion/malunion Tibia Without Graft	613	314	$34,013.00	—	$1,793.61	$32,992.61	$9,490.38	2025-07-02
28820	CPT	Amputation Of Toe	613	314	$24,220.81	—	$4,293.89	$23,494.19	$9,446.12	2025-07-02
29807	CPT	Shoulder Arthroscopy/surgery	614	314	$24,129.63	—	$8,362.77	$23,405.74	$9,410.56	2025-07-02
20680	CPT	Removal Of Support Implant	1,211	314	$20,702.25	—	$3,769.44	$59,737.45	$9,357.66	2025-07-02
25607	CPT	Treat Fx Rad Extra-articul	614	314	$17,626.50	—	$6,874.34	$22,886.18	$9,201.66	2025-07-02
27792	CPT	Treatment Of Ankle Fracture	614	314	$23,436.50	—	$6,926.40	$22,733.41	$9,140.24	2025-07-02
29820	CPT	Shoulder Arthroscopy/surgery	315	314	$23,404.50	—	$9,127.76	$22,702.37	$9,127.76	2025-07-02
49520	CPT	Rerepair Ing Hernia Reduce	912	314	$22,535.00	—	$4,589.49	$22,673.75	$9,116.25	2025-07-02
29880	CPT	Knee Arthroscopy/surgery	912	314	$14,131.36	—	$4,293.89	$22,499.64	$9,046.25	2025-07-02
19126	CPT	Excision Addl Breast Lesion	299	299	$23,058.00	—	$8,992.62	$22,366.26	$8,992.62	2025-07-02
19318	CPT	Reduction Of Large Breast	314	314	$23,058.00	—	$8,650.69	$22,366.26	$8,992.62	2025-07-02
19380	CPT	Revise Breast Reconstruction	314	314	$23,058.00	—	$8,650.69	$22,366.26	$8,992.62	2025-07-02
19302	CPT	P-mastectomy W/ln Removal	314	314	$23,058.00	—	$8,650.69	$22,366.26	$8,992.62	2025-07-02
19110	CPT	Nipple Exploration	314	314	$23,058.00	—	$5,056.54	$22,366.26	$8,992.62	2025-07-02
19112	CPT	Excise Breast Duct Fistula	314	314	$23,058.00	—	$5,056.54	$22,366.26	$8,992.62	2025-07-02
31899	CPT	Airways Surgical Procedure	314	314	$22,979.31	—	$262.77	$22,289.93	$8,961.93	2025-07-02
J9309	HCPCS	Inj Polatuzumab Vedotin 1mg	314	314	$22,821.00	—	$168.71	$22,136.37	$8,900.19	2025-07-02
J9217	HCPCS	Leuprolide 45mg/6month Kit (uro) (g/k)	314	314	$22,624.50	—	$229.46	$21,945.77	$8,823.56	2025-07-02
44640	CPT	44640 Clsr Intstinal Cutan Fstl	598	299	$17,126.00	—	$2,875.47	$26,072.63	$8,817.31	2025-07-02
49521	CPT	Rerepair Ing Hernia Blocked	314	314	$22,535.00	—	$8,788.65	$21,858.95	$8,788.65	2025-07-02
49495	CPT	Rpr Ing Hernia Baby Reduc	314	314	$22,535.00	—	$4,589.49	$21,858.95	$8,788.65	2025-07-02
49651	CPT	Lap Ing Hernia Repair Recur	314	314	$22,535.00	—	$7,654.29	$21,858.95	$8,788.65	2025-07-02
49505	CPT	Prp I/hern Init Reduc >5 Yr	1,510	314	$21,220.00	—	$4,589.49	$21,858.95	$8,788.65	2025-07-02
49501	CPT	Rpr Ing Hernia Init Blocked	314	314	$22,535.00	—	$4,589.49	$21,858.95	$8,788.65	2025-07-02
49500	CPT	49500 Rpr 1st Ingun Hrna Age 6 Mo-5 Yrs Rdc	613	314	$22,535.00	—	$850.59	$21,858.95	$8,788.65	2025-07-02

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