Hospital

GLENDIVE MEDICAL CENTER

Glendive, MT · CCN 271332 · Rates published

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You selected 93306 (CPT)

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This hospital’s price: $1,415 across 200 payers · range $581-$1,444

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.

3,148 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⚠ Possibly outdated The most recent machine-readable file we have for this hospital is 16 months old.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
63685 CPT	63685 Ins/rplc Spi Npg/rcvr Pocket	299	$41,192.99	$41,192.99	$41,192.99	nat. median $21,151 1.9× median
64568 CPT	64568 Inc Impltj Crnl Nrv Nstim Eltrds & Pulse Gener	299	$41,192.99	$41,192.99	$41,192.99	nat. median $27,744 1.5× median
64590 CPT	64590 Ins/rpl Prph Sac/gstr Npg/r	299	$29,019.49	$29,019.49	$29,019.49	nat. median $17,881 1.6× median
63655 CPT	63655 Lam Impltj Nstim Eltrds Plate/paddle Edrl	314	$29,019.49	$29,019.49	$29,019.49	nat. median $18,275 1.6× median
61885 CPT	61885 Insj/rplcmt Crnl Npgr 1 Eltrd Ra	299	$29,019.49	$29,019.49	$29,019.49	nat. median $19,880 1.5× median
22630 CPT	22630 Arthrodesis Posterior Interbody Lumbar	314	$24,722.07	$24,722.07	$24,722.07	nat. median $16,988 1.5× median
27702 CPT	27702 Arthroplasty Ankle W/implant	314	$24,722.07	$24,722.07	$24,722.07	nat. median $15,861 1.6× median
22633 CPT	22633 Arthdsis Post/posterolatrl/postinterbody Lumbar	314	$24,722.07	$24,722.07	$24,722.07	nat. median $17,527 1.4× median
23472 CPT	23472 Arthroplasty Glenohumeral Joint Total Shoulder	314	$24,722.07	$24,722.07	$24,722.07	nat. median $16,661 1.5× median
28705 CPT	28705 Arthrodesis Pantalar	314	$24,722.07	$24,722.07	$24,722.07	nat. median $12,699 1.9× median
22856 CPT	22856 Tot Disc Arthrp Art Disc Ant Appro 1 Ntrspc Crv	314	$24,722.07	$24,722.07	$24,722.07	nat. median $16,840 1.5× median
23616 CPT	23616 Open Prox Humeral Fracture Prosthetic Rplcmt	314	$24,722.07	$24,722.07	$24,722.07	nat. median $12,868 1.9× median
22612 CPT	22612 Arthrodesis Posterior/posterolateral Lumbar	314	$24,722.07	$24,722.07	$24,722.07	nat. median $15,407 1.6× median
63664 CPT	63664 Revise Spine Eltrd Plate	314	$18,070.59	$18,070.59	$18,070.59	nat. median $11,660 1.5× median
64569 CPT	64569 Revise/repl Vagus N Eltrd	314	$18,070.59	$18,070.59	$18,070.59	nat. median $11,470 1.6× median
27828 CPT	27828 Open Treatment Fracture Distal Tibia & Fibula	314	$17,459.19	$17,459.19	$17,459.19	nat. median $10,579 1.7× median
20692 CPT	20692 Application Multiplane External Fixation System	314	$17,459.19	$17,459.19	$17,459.19	nat. median $8,586 outlier · 2.0×
27441 CPT	Revision Of Knee Joint	314	$17,459.19	$17,459.19	$17,459.19	nat. median $11,361 1.5× median
24587 CPT	24587 Optx Priarticular Fx&/dislc Elbw W/implt Arthrp	314	$17,459.19	$17,459.19	$17,459.19	nat. median $11,502 1.5× median
24516 CPT	24516 Tx Humeral Shaft Fx W/insj Imed Implt +-cerclage	314	$17,459.19	$17,459.19	$17,459.19	nat. median $11,350 1.5× median
23615 CPT	Treat Humerus Fracture	314	$17,459.19	$17,459.19	$17,459.19	nat. median $11,353 1.5× median
24346 CPT	24346 Reconstruct Ligament Elbow Medial W/graft Tend	314	$17,459.19	$17,459.19	$17,459.19	nat. median $11,524 1.5× median
24515 CPT	24515 Optx Humeral Shft Fx W/plate/screws +-cerclage	314	$17,459.19	$17,459.19	$17,459.19	nat. median $11,515 1.5× median
27447 CPT	Total Knee Arthroplasty	314	$17,459.19	$17,459.19	$17,459.19	nat. median $12,737 1.4× median
27415 CPT	27415 Osteochondral Allograft Knee Open	314	$17,459.19	$17,459.19	$17,459.19	nat. median $11,834 1.5× median
24546 CPT	24546 Open Tx Humeral Supracondylar Fracture W/xtn	314	$17,459.19	$17,459.19	$17,459.19	nat. median $11,505 1.5× median
25810 CPT	25810 Arthrd Wrst W/iliac/oth Agrft	314	$17,459.19	$17,459.19	$17,459.19	nat. median $11,309 1.5× median
24666 CPT	24666 Open Tx Radial Head/neck Fracture Prosthetic	314	$17,459.19	$17,459.19	$17,459.19	nat. median $10,890 1.6× median
22551 CPT	22551 Arthrd Ant Interbody Decompress Cervical Below C2	314	$17,459.19	$17,459.19	$17,459.19	nat. median $12,536 1.4× median
28320 CPT	Repair Of Foot Bones	314	$17,459.19	$17,459.19	$17,459.19	nat. median $10,570 1.7× median
28735 CPT	Fusion Of Foot Bones	314	$17,459.19	$17,459.19	$17,459.19	nat. median $11,242 1.6× median
27758 CPT	27758 Optx Tibl Shft Fx W/plate/screws +-cerclage	314	$17,459.19	$17,459.19	$17,459.19	nat. median $10,516 1.7× median
27871 CPT	Fusion Of Tibiofibular Joint	314	$17,459.19	$17,459.19	$17,459.19	nat. median $11,137 1.6× median
27759 CPT	27759 Oen Tibial Shaft Fx With IM Rodding	314	$17,459.19	$17,459.19	$17,459.19	nat. median $10,737 1.6× median
27130 CPT	Total Hip Arthroplasty	314	$17,459.19	$17,459.19	$17,459.19	nat. median $13,097 1.3× median
28725 CPT	Fusion Of Foot Bones	314	$17,459.19	$17,459.19	$17,459.19	nat. median $10,575 1.7× median
24575 CPT	24575 Open Tx Humeral Epicondylar Fracture	314	$17,459.19	$17,459.19	$17,459.19	nat. median $10,594 1.6× median
28730 CPT	Fusion Of Foot Bones	314	$17,459.19	$17,459.19	$17,459.19	nat. median $10,716 1.6× median
27870 CPT	Fusion Of Ankle Joint Open	314	$17,459.19	$17,459.19	$17,459.19	nat. median $10,976 1.6× median
29907 CPT	29907 Arthroscopy Subtalar Joint Subtalar Arthrodesis	314	$17,459.19	$17,459.19	$17,459.19	nat. median $11,388 1.5× median
27446 CPT	27446 Arthrp Knee Condyle&plateau Medial/lat Cmprt	314	$17,459.19	$17,459.19	$17,459.19	nat. median $12,435 1.4× median
24586 CPT	24586 Optx Periarticular Fracture &/dislocation Elbow	314	$17,459.19	$17,459.19	$17,459.19	nat. median $11,249 1.6× median
24545 CPT	24545 Open Tx Humeral Supracondylar Fracture Without Xtn	314	$17,459.19	$17,459.19	$17,459.19	nat. median $11,403 1.5× median
24579 CPT	24579 Open Treatment Humeral Condylar Fracture	314	$17,459.19	$17,459.19	$17,459.19	nat. median $11,120 1.6× median
27827 CPT	Treat Lower Leg Fracture	314	$17,459.19	$17,459.19	$17,459.19	nat. median $10,873 1.6× median
27438 CPT	27438 Arthroplasty Patella W/prosthesis	314	$17,459.19	$17,459.19	$17,459.19	nat. median $11,492 1.5× median
23470 CPT	23470 Arthroplasty Glenohumrl Jt Hemiarthroplasty	314	$17,459.19	$17,459.19	$17,459.19	nat. median $12,423 1.4× median
24435 CPT	24435 Repair Non/malunion Humerus W/iliac/oth Agrft	314	$17,459.19	$17,459.19	$17,459.19	nat. median $11,647 1.5× median
27442 CPT	27442 Arthroplasty Fem Condyles/tibial Plateau Knee	314	$17,459.19	$17,459.19	$17,459.19	nat. median $11,338 1.5× median
28715 CPT	28715 Arthrodesis Triple	314	$17,459.19	$17,459.19	$17,459.19	nat. median $11,408 1.5× median

Other procedures at this hospital

Browse this hospital's 3,148 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

63685	CPT	63685 Ins/rplc Spi Npg/rcvr Pocket	299	299	$1,888.00	—	$41,192.99	$41,192.99	$41,192.99	2025-07-02
64568	CPT	64568 Inc Impltj Crnl Nrv Nstim Eltrds & Pulse Gener	299	299	$3,284.00	—	$41,192.99	$41,192.99	$41,192.99	2025-07-02
64590	CPT	64590 Ins/rpl Prph Sac/gstr Npg/r	299	299	$843.00	—	$29,019.49	$29,019.49	$29,019.49	2025-07-02
63655	CPT	63655 Lam Impltj Nstim Eltrds Plate/paddle Edrl	314	314	$4,368.00	—	$29,019.49	$29,019.49	$29,019.49	2025-07-02
61885	CPT	61885 Insj/rplcmt Crnl Npgr 1 Eltrd Ra	299	299	$2,717.00	—	$29,019.49	$29,019.49	$29,019.49	2025-07-02
22630	CPT	22630 Arthrodesis Posterior Interbody Lumbar	314	314	$8,293.00	—	$24,722.07	$24,722.07	$24,722.07	2025-07-02
27702	CPT	27702 Arthroplasty Ankle W/implant	314	314	$5,121.00	—	$24,722.07	$24,722.07	$24,722.07	2025-07-02
22633	CPT	22633 Arthdsis Post/posterolatrl/postinterbody Lumbar	314	314	$9,762.00	—	$24,722.07	$24,722.07	$24,722.07	2025-07-02
23472	CPT	23472 Arthroplasty Glenohumeral Joint Total Shoulder	314	314	$7,637.00	—	$24,722.07	$24,722.07	$24,722.07	2025-07-02
28705	CPT	28705 Arthrodesis Pantalar	314	314	$6,475.00	—	$24,722.07	$24,722.07	$24,722.07	2025-07-02
22856	CPT	22856 Tot Disc Arthrp Art Disc Ant Appro 1 Ntrspc Crv	314	314	$8,618.00	—	$24,722.07	$24,722.07	$24,722.07	2025-07-02
23616	CPT	23616 Open Prox Humeral Fracture Prosthetic Rplcmt	314	314	$6,505.00	—	$24,722.07	$24,722.07	$24,722.07	2025-07-02
22612	CPT	22612 Arthrodesis Posterior/posterolateral Lumbar	314	314	$8,367.00	—	$24,722.07	$24,722.07	$24,722.07	2025-07-02
63664	CPT	63664 Revise Spine Eltrd Plate	314	314	$4,601.00	—	$18,070.59	$18,070.59	$18,070.59	2025-07-02
64569	CPT	64569 Revise/repl Vagus N Eltrd	314	314	$3,985.00	—	$18,070.59	$18,070.59	$18,070.59	2025-07-02
27828	CPT	27828 Open Treatment Fracture Distal Tibia & Fibula	314	314	$35,411.92	—	$17,459.19	$17,459.19	$17,459.19	2025-07-02
20692	CPT	20692 Application Multiplane External Fixation System	314	314	$5,873.00	—	$17,459.19	$17,459.19	$17,459.19	2025-07-02
27441	CPT	Revision Of Knee Joint	314	314	$25,670.50	—	$17,459.19	$17,459.19	$17,459.19	2025-07-02
24587	CPT	24587 Optx Priarticular Fx&/dislc Elbw W/implt Arthrp	314	314	$5,718.00	—	$17,459.19	$17,459.19	$17,459.19	2025-07-02
24516	CPT	24516 Tx Humeral Shaft Fx W/insj Imed Implt +-cerclage	314	314	$38,271.50	—	$17,459.19	$17,459.19	$17,459.19	2025-07-02
23615	CPT	Treat Humerus Fracture	315	314	$38,271.50	—	$17,459.19	$17,459.19	$17,459.19	2025-07-02
24346	CPT	24346 Reconstruct Ligament Elbow Medial W/graft Tend	314	314	$20,342.50	—	$17,459.19	$17,459.19	$17,459.19	2025-07-02
24515	CPT	24515 Optx Humeral Shft Fx W/plate/screws +-cerclage	314	314	$38,271.50	—	$17,459.19	$17,459.19	$17,459.19	2025-07-02
27447	CPT	Total Knee Arthroplasty	316	314	$54,146.45	—	$17,459.19	$17,459.19	$17,459.19	2025-07-02
27415	CPT	27415 Osteochondral Allograft Knee Open	314	314	$7,217.00	—	$17,459.19	$17,459.19	$17,459.19	2025-07-02
24546	CPT	24546 Open Tx Humeral Supracondylar Fracture W/xtn	314	314	$38,271.50	—	$17,459.19	$17,459.19	$17,459.19	2025-07-02
25810	CPT	25810 Arthrd Wrst W/iliac/oth Agrft	314	314	$4,547.00	—	$17,459.19	$17,459.19	$17,459.19	2025-07-02
24666	CPT	24666 Open Tx Radial Head/neck Fracture Prosthetic	314	314	$3,848.00	—	$17,459.19	$17,459.19	$17,459.19	2025-07-02
22551	CPT	22551 Arthrd Ant Interbody Decompress Cervical Below C2	314	314	$8,983.00	—	$17,459.19	$17,459.19	$17,459.19	2025-07-02
28320	CPT	Repair Of Foot Bones	315	314	$50,464.50	—	$17,459.19	$17,459.19	$17,459.19	2025-07-02
28735	CPT	Fusion Of Foot Bones	315	314	$67,706.00	—	$17,459.19	$17,459.19	$17,459.19	2025-07-02
27758	CPT	27758 Optx Tibl Shft Fx W/plate/screws +-cerclage	314	314	$35,411.92	—	$17,459.19	$17,459.19	$17,459.19	2025-07-02
27871	CPT	Fusion Of Tibiofibular Joint	315	314	$81,473.50	—	$17,459.19	$17,459.19	$17,459.19	2025-07-02
27759	CPT	27759 Oen Tibial Shaft Fx With IM Rodding	314	314	$5,248.00	—	$17,459.19	$17,459.19	$17,459.19	2025-07-02
27130	CPT	Total Hip Arthroplasty	317	314	$30,538.08	—	$17,459.19	$17,459.19	$17,459.19	2025-07-02
28725	CPT	Fusion Of Foot Bones	315	314	$74,373.00	—	$17,459.19	$17,459.19	$17,459.19	2025-07-02
24575	CPT	24575 Open Tx Humeral Epicondylar Fracture	314	314	$38,271.50	—	$17,459.19	$17,459.19	$17,459.19	2025-07-02
28730	CPT	Fusion Of Foot Bones	316	314	$75,749.00	—	$17,459.19	$17,459.19	$17,459.19	2025-07-02
27870	CPT	Fusion Of Ankle Joint Open	315	314	$90,287.00	—	$17,459.19	$17,459.19	$17,459.19	2025-07-02
29907	CPT	29907 Arthroscopy Subtalar Joint Subtalar Arthrodesis	314	314	$4,602.00	—	$17,459.19	$17,459.19	$17,459.19	2025-07-02
27446	CPT	27446 Arthrp Knee Condyle&plateau Medial/lat Cmprt	314	314	$6,093.00	—	$17,459.19	$17,459.19	$17,459.19	2025-07-02
24586	CPT	24586 Optx Periarticular Fracture &/dislocation Elbow	314	314	$5,714.00	—	$17,459.19	$17,459.19	$17,459.19	2025-07-02
24545	CPT	24545 Open Tx Humeral Supracondylar Fracture Without Xtn	314	314	$38,271.50	—	$17,459.19	$17,459.19	$17,459.19	2025-07-02
24579	CPT	24579 Open Treatment Humeral Condylar Fracture	314	314	$38,271.50	—	$17,459.19	$17,459.19	$17,459.19	2025-07-02
27827	CPT	Treat Lower Leg Fracture	315	314	$34,013.00	—	$17,459.19	$17,459.19	$17,459.19	2025-07-02
27438	CPT	27438 Arthroplasty Patella W/prosthesis	314	314	$4,423.00	—	$17,459.19	$17,459.19	$17,459.19	2025-07-02
23470	CPT	23470 Arthroplasty Glenohumrl Jt Hemiarthroplasty	314	314	$6,316.00	—	$17,459.19	$17,459.19	$17,459.19	2025-07-02
24435	CPT	24435 Repair Non/malunion Humerus W/iliac/oth Agrft	314	314	$5,647.00	—	$17,459.19	$17,459.19	$17,459.19	2025-07-02
27442	CPT	27442 Arthroplasty Fem Condyles/tibial Plateau Knee	314	314	$4,584.00	—	$17,459.19	$17,459.19	$17,459.19	2025-07-02
28715	CPT	28715 Arthrodesis Triple	314	314	$5,010.00	—	$17,459.19	$17,459.19	$17,459.19	2025-07-02
43210	CPT	Egd Esophagogastrc Fndoplsty	314	314	$8,831.00	—	$13,655.34	$13,655.34	$13,655.34	2025-07-02
58573	CPT	58573 Laparoscopy Tot Hysterectomy >250 G W Tube/ovary	314	314	$6,372.00	—	$13,655.34	$13,655.34	$13,655.34	2025-07-02
58552	CPT	58552 Laps W/vag Hyst 250 Gm/< Rmvl Tube & Ovary	314	314	$5,189.00	—	$13,655.34	$13,655.34	$13,655.34	2025-07-02
58571	CPT	58571 Laps Total Hysterectomy 250 G/<w Tube/ovary	314	314	$4,685.00	—	$13,655.34	$13,655.34	$13,655.34	2025-07-02
58570	CPT	58570 Laparoscopy W Total Hysterectomy Uterus 250 G/<	314	314	$4,309.00	—	$13,655.34	$13,655.34	$13,655.34	2025-07-02
47564	CPT	47564 Laps Surg Cholecstc W/expl Common Dux	314	314	$24,643.96	—	$13,655.34	$13,655.34	$13,655.34	2025-07-02
51860	CPT	51860 Cstorr Sutr Bldr Wnd Inj/rpt Smpl	314	314	$3,921.00	—	$12,220.79	$12,220.79	$12,220.79	2025-07-02
44950	CPT	Appendectomy	314	314	$24,771.00	—	$10,036.27	$10,036.27	$10,036.27	2025-07-02
49521	CPT	Rerepair Ing Hernia Blocked	314	314	$22,535.00	—	$10,036.27	$10,036.27	$10,036.27	2025-07-02
49500	CPT	49500 Rpr 1st Ingun Hrna Age 6 Mo-5 Yrs Rdc	314	314	$22,535.00	—	$10,036.27	$10,036.27	$10,036.27	2025-07-02
58292	CPT	Vag Hyst T/o & Repair Compl	314	314	$17,856.00	—	$10,024.28	$10,024.28	$10,024.28	2025-07-02
58290	CPT	Vag Hyst Complex	314	314	$17,856.00	—	$10,024.28	$10,024.28	$10,024.28	2025-07-02
57283	CPT	57283 Colpopexy Vag Intra-prtl Appr	314	314	$3,686.00	—	$10,024.28	$10,024.28	$10,024.28	2025-07-02
27784	CPT	27784 Open Treatment Proximal Fibula/shaft Fracture	314	314	$38,209.75	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
27566	CPT	27566 Optx Patellar Dislc +-prtl/tot Patellectomy	314	314	$4,769.00	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
25449	CPT	25449p Revj Arthrp W/removal Implant Wrist Joint	314	314	$5,452.00	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
27065	CPT	Remove Hip Bone Les Super	314	314	$27,693.67	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
27814	CPT	Treatment Of Ankle Fracture	315	314	$32,406.83	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
27405	CPT	27405 Rpr Primary Torn Ligm&/capsule Knee Collateral	314	314	$3,548.00	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
27418	CPT	27418 Anterior Tibial Tubercleplasty	314	314	$4,351.00	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
63042	CPT	63042 Lamot Prtl Ffd Hrna8 Reexpl 1 Ntrspc Lmbr	314	314	$6,827.00	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
63012	CPT	63012 Lam W/rmvl Abnormal Facets Lmbr	314	314	$6,282.00	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
25526	CPT	25526 Open Rdl Shaft Fx Open Rad/uln Jt Dislocate	314	314	$5,014.00	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
27420	CPT	27420 Rcnstj Dislocating Patella	314	314	$3,907.00	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
27696	CPT	27696 Rpr Prim Disrupted Ligm Ankle Bth Coltrl Ligms	314	314	$2,928.00	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
27690	CPT	27690 Tr/trnspl 1 Tdn W/musc Redirion/rerouting Supfc	314	314	$3,406.00	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
25609	CPT	25609p Optx Dstl Radl I-artic Fx/epiphysl Sep 3 Frag	314	314	$5,505.00	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
24582	CPT	24582 Prq Skel Fixj Humrl Cndylr Fx Medial/lat W/mnpj	314	314	$4,248.00	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
25515	CPT	Treat Fracture Of Radius	315	314	$15,375.00	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
28238	CPT	Revision Of Foot Tendon	316	314	$45,862.50	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
27335	CPT	Remove Knee Joint Lining	314	314	$25,670.50	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
27705	CPT	Incision Of Tibia	315	314	$112,689.00	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
25670	CPT	25670 Open Tx Radiocarpal/intercarpal Dislc 1+ Bones	314	314	$3,189.00	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
27676	CPT	Repair Lower Leg Tendons	315	314	$41,544.00	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
27698	CPT	Repair Of Ankle Ligament	316	314	$23,948.50	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
27695	CPT	Repair Of Ankle Ligament	315	314	$11,442.50	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
27823	CPT	Treatment Of Ankle Fracture	315	314	$28,464.00	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
25320	CPT	25320 Capsl-rhphy/rcnstj Wrst Opn Carpl Ins	314	314	$5,156.00	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
27422	CPT	Revision Of Unstable Kneecap	315	314	$19,005.00	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
28291	CPT	Corrj Halux Rigdus W/implt	316	314	$20,330.00	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
23515	CPT	Treat Clavicle Fracture	316	314	$19,350.50	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
26500	CPT	Hand Tendon Reconstruction	314	314	$8,915.50	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
27665	CPT	Repair Of Leg Tendon Each	315	314	$27,237.00	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
23412	CPT	Repair Rotator Cuff Chronic	316	314	$31,674.90	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
23410	CPT	Repair Rotator Cuff Acute	315	314	$26,414.50	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
27650	CPT	27650 Repair Primary Open/prq Ruptured Achilles Tendon	314	314	$3,448.00	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
23532	CPT	Treat Clavicle Dislocation	314	314	$26,694.06	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
27664	CPT	Repair Of Leg Tendon Each	315	314	$27,237.00	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
23405	CPT	Incision Of Tendon & Muscle	315	314	$20,329.00	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
23585	CPT	23585 Open Tx Scapular Fx W/internal Fixation If Pfrmd	314	314	$4,684.00	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
25360	CPT	25360 Revision Of Ulna	314	314	$3,431.00	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
23630	CPT	Treat Humerus Fracture	316	314	$19,881.50	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
25440	CPT	25440 Rpr Nonunion Scaphoid Carpal Bone +-rdl Stylodc	314	314	$4,026.00	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
28262	CPT	28262p Capsul Midfoot W/pst Talotibl Capsul&tdn Lngth	314	314	$5,926.00	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
27659	CPT	Repair Of Leg Tendon Each	315	314	$27,237.00	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
27350	CPT	27350 Patellectomy/hemipatellectomy	314	314	$3,426.00	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
27652	CPT	27652 Rpr Primary Open/prq Ruptured Achilles W/graft	314	314	$27,237.00	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
26358	CPT	26358 Rpr/advmnt Flxr Tdn Zone 2 2w/fr Grf Ea Tdn	314	314	$8,915.50	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
27756	CPT	27756 Prq Skel Fixj Tibl Shft Fx	314	314	$3,014.00	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
27722	CPT	Repair/graft Of Tibia	314	314	$34,013.00	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
27829	CPT	Treat Lower Leg Joint	315	314	$34,013.00	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
24341	CPT	24341 Repair Tendon/muscle Upper Arm/elbow Ea	314	314	$3,907.00	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
25652	CPT	25652 Open Treatment Ulnar Styloid Fracture	314	314	$3,262.00	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
63045	CPT	63045 Lam Facetec&foramot 1 Sgm Crv	314	314	$6,763.00	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
27381	CPT	27381 Sutr Infrapatellar Tdn 2 Rcnstj W/fscal/tdn Grf	314	314	$4,247.00	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
27720	CPT	27720 Repair Nonunion/malunion Tibia Without Graft	314	314	$34,013.00	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
24344	CPT	Reconstruct Elbow Lat Ligmnt	314	314	$20,342.50	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
63047	CPT	63047 Lam Facetec&foramot 1 Sgm Lmbr	314	314	$5,804.00	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
24340	CPT	Repair Of Biceps Tendon	315	314	$14,574.50	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
24345	CPT	24345 Repair Medial Collateral Ligament Elbow	314	314	$3,681.00	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
27386	CPT	Repair/graft Of Thigh Muscle	315	314	$17,405.00	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
27385	CPT	Repair Of Thigh Muscle	316	314	$19,090.00	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
20690	CPT	Apply Bone Fixation Device	315	314	$138,146.50	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
27792	CPT	Treatment Of Ankle Fracture	316	314	$23,436.50	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
24538	CPT	24538 Prq Skel Fixj Sprcndylr/transcndylr Humeral Fx	314	314	$38,271.50	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
27691	CPT	Revise Lower Leg Tendon	315	314	$66,234.01	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
25607	CPT	Treat Fx Rad Extra-articul	316	314	$17,626.50	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
27822	CPT	27822 Open Tx Trimalleolar Ankle Fx Without Fixj Pst Lip	314	314	$4,544.00	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
27380	CPT	Repair Of Kneecap Tendon	315	314	$16,728.13	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
24400	CPT	Revision Of Humerus	314	314	$38,271.50	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
27416	CPT	27416 Osteochondral Autograft Knee Open Mosaicplasty	314	314	$5,153.00	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
23455	CPT	23455 Capsulorrhaphy Anterior W/labral Repair	314	314	$5,224.00	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
27826	CPT	27826 Open Treatment Fracture Distal Tibia Fibula	314	314	$38,209.75	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
29828	CPT	Arthroscopy Biceps Tenodesis	315	314	$40,993.00	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
27179	CPT	Revise Head/neck Of Femur	314	314	$43,625.50	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
29888	CPT	Knee Arthroscopy/surgery	316	314	$34,817.00	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
29807	CPT	Shoulder Arthroscopy/surgery	316	314	$24,129.63	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
20902	CPT	20902 Bone Graft Any Donor Area Major/large	314	314	$67,564.50	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
24665	CPT	24665 Open Tx Radial Head/neck Fracture	314	314	$3,434.00	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
29820	CPT	Shoulder Arthroscopy/surgery	315	314	$23,404.50	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
28755	CPT	Fusion Of Big Toe Joint	315	314	$60,672.50	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
27524	CPT	Treat Kneecap Fracture	315	314	$29,685.00	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
28740	CPT	Fusion Of Foot Bones	316	314	$62,704.80	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
28760	CPT	28760 Arthrd W/xtnsr Hallucis Longus Tr 1st Metar Nck	314	314	$2,997.00	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
25545	CPT	25545 Open Treatment Of Ulnar Shaft Fracture	314	314	$3,263.00	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
25574	CPT	25574 Open Tx Radial & Ulnar Shaft Fx Fixj Radius/ulna	314	314	$3,533.00	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
28615	CPT	28615 Open Treatment Tarsometatarsal Joint Dislocation	314	314	$4,263.00	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
24685	CPT	Treat Ulnar Fracture	315	314	$26,644.20	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
24635	CPT	24635 Open Tx Monteggia Fracture Dislocation Elbow	314	314	$3,536.00	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
28750	CPT	Fusion Of Big Toe Joint	317	314	$59,771.60	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
25608	CPT	Treat Fx Rad Intra-articul	314	314	$29,174.50	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
25575	CPT	25575 Open Tx Rdl& Ulnar Shaft Fx Fixj Radius &ulna	314	314	$4,729.00	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
28531	CPT	Treat Sesamoid Bone Fracture	314	314	$10,386.50	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
20900	CPT	Removal Of Bone For Graft	314	314	$67,564.50	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
20973	CPT	Bone/skin Graft Great Toe	314	314	$67,564.50	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
28585	CPT	28585p Open Treatment Talotarsal Joint Dislocation	314	314	$3,710.00	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
29827	CPT	29827 Arthroscopy Shoulder Rotator Cuff Repair	314	314	$5,622.00	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
27235	CPT	27235 Prq Skel Fixj Fem Fx Prox End Nck	314	314	$38,189.15	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
29806	CPT	Shoulder Arthroscopy/surgery	315	314	$24,863.75	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
28322	CPT	28322 Rpr Non/mal Metar +-b1 Grf	314	314	$10,386.50	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
27832	CPT	Treat Lower Leg Dislocation	314	314	$35,411.92	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
28415	CPT	28415 Open Treatment Calcaneal Fracture	314	314	$5,873.00	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
28445	CPT	28445 Open Treatment Talus Fracture	314	314	$5,441.00	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
28310	CPT	Revision Of Big Toe	314	314	$67,564.50	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
26546	CPT	26546 Rpr Non-union Mtcrpl/phalanx	314	314	$5,443.00	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
27769	CPT	27769 Open Treatment Posterior Malleolus Fracture	314	314	$3,829.00	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
27427	CPT	27427 Ligamentous Reconstruction Knee Extra-articular	314	314	$3,736.00	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
28307	CPT	Incision Of Metatarsal	315	314	$86,659.00	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
27033	CPT	27033 Arthrotomy Hip Exploration/removal Foreign Body	314	314	$5,115.00	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
27889	CPT	Amputation Of Foot At Ankle	314	314	$44,942.00	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
27726	CPT	Repair Fibula Nonunion	315	314	$38,209.75	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
28309	CPT	28309 Osteotomy Metatarsals Multi	314	314	$4,785.00	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
28102	CPT	28102 Exc/curtg Cst/b9 Tum Talus/clcns W/iliac/agrft	314	314	$3,343.00	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
28465	CPT	28465 Open Tx Tarsal Fracture Xcp Talus &calcaneus Ea	314	314	$3,308.00	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
27654	CPT	Repair Of Achilles Tendon	315	314	$27,237.00	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
28299	CPT	Correction Hallux Valgus	316	314	$67,564.50	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
27766	CPT	27766 Open Treatment Medial Malleolus Fracture	314	314	$3,167.00	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
24342	CPT	Repair Of Ruptured Tendon	316	314	$15,591.50	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
28306	CPT	Incision Of Metatarsal	315	314	$46,818.50	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
26530	CPT	26530 Arthroplasty Metacarpophalangeal Joint Each	314	314	$2,825.00	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
28304	CPT	Incision Of Midfoot Bones	316	314	$70,460.50	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
25628	CPT	25628 Open Tx Carpal Scaphoid Navicular Fracture	314	314	$3,773.00	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
23430	CPT	Repair Biceps Tendon	316	314	$20,969.00	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
23180	CPT	23180 Partial Excision Bone Clavicle	314	314	$3,490.00	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
28300	CPT	Incision Of Heel Bone	316	314	$66,234.01	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
23440	CPT	23440 Resection/transplantation Long Tendon Biceps	314	314	$3,972.00	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
26372	CPT	Repair/graft Hand Tendon	314	314	$8,915.50	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
23420	CPT	23420 Reconstruction Rotator Cuff Avulsion Chronic	314	314	$5,107.00	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
28297	CPT	Correction Hallux Valgus	315	314	$45,225.50	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
27848	CPT	27848 Optx Ankle Dislc W/rpr/int/xtrnl Fixj	314	314	$4,197.00	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
28485	CPT	Treat Metatarsal Fracture	315	314	$10,386.50	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
25820	CPT	25820 Arthrodesis Wrist Limited Without Bone Graft	314	314	$3,310.00	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
28298	CPT	Correction Hallux Valgus	316	314	$46,368.00	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
26841	CPT	Fusion Of Thumb	315	314	$31,153.00	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
25405	CPT	25405 Rpr Nonunion/malunion Radius/ulna W/autograft	314	314	$5,446.00	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
25337	CPT	25337 Rcnstj Stablj Dstl U/dstl Jt 2 Soft Tiss Stablj	314	314	$4,643.00	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
23552	CPT	Treat Clavicle Dislocation	314	314	$26,694.06	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
23550	CPT	23550 Open Tx Acromioclavicular Dislc Acute/chronic	314	314	$3,007.00	—	$9,490.38	$9,490.38	$9,490.38	2025-07-02
64555	CPT	64555-percutaneous Implantation Of Neurostimulator Electrode Array; Peripheral N…	314	314	$1,797.00	—	$9,072.62	$9,072.62	$9,072.62	2025-07-02
63650	CPT	63650 Prq Impltj Nstim Eltrd Ra Edrl	314	314	$2,171.00	—	$9,072.62	$9,072.62	$9,072.62	2025-07-02
64856	CPT	64856 Sutr Prph Nrv Arm/leg Xcp Sciatic W/trpos	314	314	$5,318.00	—	$8,836.89	$8,836.89	$8,836.89	2025-07-02
62230	CPT	62230 Rplcmt/revj Csf Shunt Valve/cath Shunt Sys	314	314	$4,415.00	—	$8,836.89	$8,836.89	$8,836.89	2025-07-02
19318	CPT	Reduction Of Large Breast	314	314	$23,058.00	—	$8,650.69	$8,650.69	$8,650.69	2025-07-02
19302	CPT	P-mastectomy W/ln Removal	314	314	$23,058.00	—	$8,650.69	$8,650.69	$8,650.69	2025-07-02
19303	CPT	19303 Mast Simple Complete	314	314	$5,065.00	—	$8,650.69	$8,650.69	$8,650.69	2025-07-02
19380	CPT	Revise Breast Reconstruction	314	314	$23,058.00	—	$8,650.69	$8,650.69	$8,650.69	2025-07-02
42844	CPT	Extensive Surgery Of Throat	314	314	$4,687.00	—	$7,768.63	$7,768.63	$7,768.63	2025-07-02
41120	CPT	Partial Removal Of Tongue	314	314	$4,687.00	—	$7,768.63	$7,768.63	$7,768.63	2025-07-02
42820	CPT	Remove Tonsils And Adenoids	314	314	$10,843.76	—	$7,768.63	$7,768.63	$7,768.63	2025-07-02
42825	CPT	42825 Tonsillectomy Primary Or Secondary; Younger Than Age 12	314	314	$1,370.00	—	$7,768.63	$7,768.63	$7,768.63	2025-07-02
59151	CPT	Treat Ectopic Pregnancy	314	314	$18,593.50	—	$7,654.29	$7,654.29	$7,654.29	2025-07-02
58661	CPT	Laparoscopy Remove Adnexa	316	314	$18,172.00	—	$7,654.29	$7,654.29	$7,654.29	2025-07-02
58662	CPT	58662 Laps Fulg/exc Ovary Viscera/prtl Surf	314	314	$3,753.00	—	$7,654.29	$7,654.29	$7,654.29	2025-07-02
58660	CPT	58660 Laparoscopy Lysis	314	314	$3,575.00	—	$7,654.29	$7,654.29	$7,654.29	2025-07-02
58670	CPT	Laparoscopy Tubal Cautery	314	314	$16,304.75	—	$7,654.29	$7,654.29	$7,654.29	2025-07-02
58550	CPT	58550 Laps W/vag Hyst 250 Gm/<	314	314	$4,656.00	—	$7,654.29	$7,654.29	$7,654.29	2025-07-02
49650	CPT	49650 Laps Surg Rpr 1st Ingun Hrna	314	314	$2,275.00	—	$7,654.29	$7,654.29	$7,654.29	2025-07-02
49594	CPT	Rpr Aa Hrn 1st 3-10 Ncr/strn	314	314	$28,445.00	—	$7,654.29	$7,654.29	$7,654.29	2025-07-02
49592	CPT	Rpr Aa Hrn 1st < 3 Ncr/strn	314	314	$18,402.25	—	$7,654.29	$7,654.29	$7,654.29	2025-07-02
49651	CPT	Lap Ing Hernia Repair Recur	314	314	$22,535.00	—	$7,654.29	$7,654.29	$7,654.29	2025-07-02
49491	CPT	Rpr Hern Preemie Reduc	314	314	$22,535.00	—	$7,654.29	$7,654.29	$7,654.29	2025-07-02
49329	CPT	Laparo Proc Abdm/per/oment	314	314	$12,423.00	—	$7,654.29	$7,654.29	$7,654.29	2025-07-02
49325	CPT	Lap Revision Perm Ip Cath	314	314	$32,632.50	—	$7,654.29	$7,654.29	$7,654.29	2025-07-02
49320	CPT	Diag Laparo Separate Proc	314	314	$53,637.05	—	$7,654.29	$7,654.29	$7,654.29	2025-07-02
49321	CPT	Laparoscopy Biopsy	314	314	$12,923.50	—	$7,654.29	$7,654.29	$7,654.29	2025-07-02
47562	CPT	Laparoscopic Cholecystectomy	314	314	$24,643.96	—	$7,654.29	$7,654.29	$7,654.29	2025-07-02
47563	CPT	47563 Laps Surg Cholecstc W/cholangrph	314	314	$3,800.00	—	$7,654.29	$7,654.29	$7,654.29	2025-07-02
49322	CPT	Laparoscopy Aspiration	314	314	$19,485.00	—	$7,654.29	$7,654.29	$7,654.29	2025-07-02
44970	CPT	Laparoscopy Appendectomy	314	314	$31,155.90	—	$7,654.29	$7,654.29	$7,654.29	2025-07-02
47379	CPT	47379 Unlis Laparoscopic Px Lvr	314	314	$3,985.00	—	$7,654.29	$7,654.29	$7,654.29	2025-07-02
44238	CPT	Laparoscope Proc Intestine	314	314	$44,042.20	—	$7,654.29	$7,654.29	$7,654.29	2025-07-02
44180	CPT	Lap Enterolysis	314	314	$19,323.00	—	$7,654.29	$7,654.29	$7,654.29	2025-07-02
44186	CPT	44186 Laps Jejunostomy	314	314	$3,452.00	—	$7,654.29	$7,654.29	$7,654.29	2025-07-02
44370	CPT	Small Bowel Endoscopy/stent	314	314	$8,831.00	—	$7,560.45	$7,560.45	$7,560.45	2025-07-02
44379	CPT	S Bowel Endoscope W/stent	314	314	$8,831.00	—	$7,560.45	$7,560.45	$7,560.45	2025-07-02
43212	CPT	Esophagoscop Stent Placement	314	314	$13,573.00	—	$7,560.45	$7,560.45	$7,560.45	2025-07-02
58925	CPT	58925 Ovarian Cstc Uni/bi	314	314	$3,997.00	—	$6,598.25	$6,598.25	$6,598.25	2025-07-02
58561	CPT	58561 Hystsc Rmvl Leiomyomata	314	314	$1,907.00	—	$6,598.25	$6,598.25	$6,598.25	2025-07-02
58291	CPT	58291 Vag Hyst > 250 Gm Rmvl Tube&/ovary	314	314	$17,856.00	—	$6,598.25	$6,598.25	$6,598.25	2025-07-02
58294	CPT	Vag Hyst W/enterocele Compl	314	314	$17,856.00	—	$6,598.25	$6,598.25	$6,598.25	2025-07-02
58563	CPT	Hysteroscopy Ablation	314	314	$19,626.00	—	$6,598.25	$6,598.25	$6,598.25	2025-07-02
58263	CPT	Vag Hyst W/t/o & Vag Repair	314	314	$17,856.00	—	$6,598.25	$6,598.25	$6,598.25	2025-07-02
58270	CPT	Vag Hyst W/enterocele Repair	314	314	$17,856.00	—	$6,598.25	$6,598.25	$6,598.25	2025-07-02
58262	CPT	58262 Hysterectomy Vaginal	314	314	$17,856.00	—	$6,598.25	$6,598.25	$6,598.25	2025-07-02
57240	CPT	57240 Ant Colporrhaphy Rpr Cstocele +-rpr Urethrocele	314	314	$3,184.00	—	$6,598.25	$6,598.25	$6,598.25	2025-07-02
57260	CPT	57260 Cmbn Anteropost Colporrhaphy	314	314	$4,082.00	—	$6,598.25	$6,598.25	$6,598.25	2025-07-02
57288	CPT	57288 Sling Opration F/strs Incont	314	314	$3,854.00	—	$6,598.25	$6,598.25	$6,598.25	2025-07-02
58260	CPT	Vaginal Hysterectomy	314	314	$17,856.00	—	$6,598.25	$6,598.25	$6,598.25	2025-07-02
J1162	HCPCS	Digoxin Immune Fab (ovine)	314	314	$4,585.50	—	$6,354.53	$6,354.53	$6,354.53	2025-07-02
43195	CPT	Esophagoscopy Rigid Balloon	314	314	$13,573.00	—	$5,080.45	$5,080.45	$5,080.45	2025-07-02
43870	CPT	Repair Stomach Opening	314	314	$41,952.50	—	$5,080.45	$5,080.45	$5,080.45	2025-07-02
38510	CPT	38510 Bx/exc Lymph Node Opn Dp Crv Node	314	314	$2,200.00	—	$5,056.54	$5,056.54	$5,056.54	2025-07-02
38525	CPT	38525 Biopsy/removal Lymph Nodes	314	314	$2,311.00	—	$5,056.54	$5,056.54	$5,056.54	2025-07-02
38500	CPT	Biopsy/removal Lymph Nodes	314	314	$6,947.00	—	$5,056.54	$5,056.54	$5,056.54	2025-07-02
19300	CPT	19300 Mastectomy Gynecomastia	314	314	$23,058.00	—	$5,056.54	$5,056.54	$5,056.54	2025-07-02
19301	CPT	Partial Mastectomy	316	314	$10,185.40	—	$5,056.54	$5,056.54	$5,056.54	2025-07-02
19120	CPT	Removal Of Breast Lesion	315	314	$23,058.00	—	$5,056.54	$5,056.54	$5,056.54	2025-07-02
19125	CPT	19125p Exc Brst Les Preop Plmt Rad Marker Opn 1 Les	314	314	$23,058.00	—	$5,056.54	$5,056.54	$5,056.54	2025-07-02
19110	CPT	Nipple Exploration	314	314	$23,058.00	—	$5,056.54	$5,056.54	$5,056.54	2025-07-02
19112	CPT	Excise Breast Duct Fistula	314	314	$23,058.00	—	$5,056.54	$5,056.54	$5,056.54	2025-07-02
19101	CPT	19101 Biopsy Breast Open Incisional	314	314	$1,174.00	—	$5,056.54	$5,056.54	$5,056.54	2025-07-02
43886	CPT	Revise Gastric Port Open	314	314	$41,952.50	—	$4,759.24	$4,759.24	$4,759.24	2025-07-02
15958	CPT	Remove Thigh Pressure Sore	314	314	$27,693.67	—	$4,759.24	$4,759.24	$4,759.24	2025-07-02
15953	CPT	Remove Thigh Pressure Sore	314	314	$27,693.67	—	$4,759.24	$4,759.24	$4,759.24	2025-07-02
15944	CPT	Remove Hip Pressure Sore	314	314	$27,693.67	—	$4,759.24	$4,759.24	$4,759.24	2025-07-02
15273	CPT	Skin Sub Grft T/arm/lg Child	314	314	$33,669.00	—	$4,759.24	$4,759.24	$4,759.24	2025-07-02
52234	CPT	52234 Scope Bladder Removal Of Tumorssmall	314	314	$1,288.00	—	$4,624.64	$4,624.64	$4,624.64	2025-07-02
55540	CPT	Revise Hernia & Sperm Veins	314	314	$22,535.00	—	$4,589.49	$4,589.49	$4,589.49	2025-07-02
55040	CPT	55040 Exc Hydrocele Uni	314	314	$1,768.00	—	$4,589.49	$4,589.49	$4,589.49	2025-07-02
49613	CPT	Rpr Aa Hrn Rcr < 3 Rdc	314	314	$14,996.50	—	$4,589.49	$4,589.49	$4,589.49	2025-07-02
49615	CPT	Rpr Aa Hrn Rcr 3-10 Rdc	314	314	$51,529.50	—	$4,589.49	$4,589.49	$4,589.49	2025-07-02
49553	CPT	49553 Rpr 1st Fem Hrna Any Age Ncrc8	314	314	$3,343.00	—	$4,589.49	$4,589.49	$4,589.49	2025-07-02
49591	CPT	Rpr Aa Hrn 1st < 3 Cm Rdc	314	314	$15,472.29	—	$4,589.49	$4,589.49	$4,589.49	2025-07-02
49593	CPT	49593p Rpr Aa Hernia 1st 3-10 Cm Reducible	314	314	$3,033.00	—	$4,589.49	$4,589.49	$4,589.49	2025-07-02
49501	CPT	Rpr Ing Hernia Init Blocked	314	314	$22,535.00	—	$4,589.49	$4,589.49	$4,589.49	2025-07-02
49505	CPT	Prp I/hern Init Reduc >5 Yr	317	314	$21,220.00	—	$4,589.49	$4,589.49	$4,589.49	2025-07-02
49507	CPT	49507 Repair Initial Inguinal Hernia Incarcerated	314	314	$22,535.00	—	$4,589.49	$4,589.49	$4,589.49	2025-07-02
49496	CPT	Rpr Ing Hernia Baby Blocked	314	314	$22,535.00	—	$4,589.49	$4,589.49	$4,589.49	2025-07-02
49520	CPT	Rerepair Ing Hernia Reduce	315	314	$22,535.00	—	$4,589.49	$4,589.49	$4,589.49	2025-07-02
49426	CPT	Revise Abdomen-venous Shunt	314	314	$32,632.50	—	$4,589.49	$4,589.49	$4,589.49	2025-07-02
49418	CPT	49418 Insert Tun Ip Cath Perc	314	314	$2,288.00	—	$4,589.49	$4,589.49	$4,589.49	2025-07-02
49402	CPT	Remove Foreign Body Adbomen	314	314	$29,400.35	—	$4,589.49	$4,589.49	$4,589.49	2025-07-02
49492	CPT	Rpr Ing Hern Premie Blocked	314	314	$22,535.00	—	$4,589.49	$4,589.49	$4,589.49	2025-07-02
49495	CPT	Rpr Ing Hernia Baby Reduc	314	314	$22,535.00	—	$4,589.49	$4,589.49	$4,589.49	2025-07-02
47490	CPT	CT Cholecystostomy Percutaneous	314	314	$30,531.35	—	$4,589.49	$4,589.49	$4,589.49	2025-07-02
47531	CPT	Injection For Cholangiogram	314	314	$666.00	—	$4,589.49	$4,589.49	$4,589.49	2025-07-02
47532	CPT	Injection For Cholangiogram	314	314	$1,602.00	—	$4,589.49	$4,589.49	$4,589.49	2025-07-02
47533	CPT	Ir Biliary Drainage Percutaneous	314	314	$2,004.00	—	$4,589.49	$4,589.49	$4,589.49	2025-07-02
47534	CPT	Ir Biliary Drain Int/ext Cath Placement	314	314	$2,791.00	—	$4,589.49	$4,589.49	$4,589.49	2025-07-02
49525	CPT	Repair Ing Hernia Sliding	314	314	$22,535.00	—	$4,589.49	$4,589.49	$4,589.49	2025-07-02
32550	CPT	Insert Pleural Cath	315	314	$12,034.50	—	$4,589.49	$4,589.49	$4,589.49	2025-07-02
49550	CPT	Rpr Rem Hernia Init Reduce	315	314	$16,507.00	—	$4,589.49	$4,589.49	$4,589.49	2025-07-02
J2507	HCPCS	Pegloticase 8mg/ml 1ml Vial (g/k)	314	314	$39,044.50	—	$4,526.80	$4,526.80	$4,526.80	2025-07-02
63688	CPT	63688 Rev/rmv Imp Sp Npg/r Dtch Cn	314	314	$1,948.00	—	$4,513.70	$4,513.70	$4,513.70	2025-07-02
63662	CPT	63662 Remove Spine Eltrd Plate	314	314	$4,419.00	—	$4,513.70	$4,513.70	$4,513.70	2025-07-02
26478	CPT	Lengthening Of Hand Tendon	314	314	$8,915.50	—	$4,293.89	$4,293.89	$4,293.89	2025-07-02
26477	CPT	Tendon Shortening	314	314	$8,915.50	—	$4,293.89	$4,293.89	$4,293.89	2025-07-02
26499	CPT	Revision Of Finger	314	314	$8,915.50	—	$4,293.89	$4,293.89	$4,293.89	2025-07-02
26479	CPT	Shortening Of Hand Tendon	314	314	$8,915.50	—	$4,293.89	$4,293.89	$4,293.89	2025-07-02
25130	CPT	25130 Excision/curettage Cyst/tumor Carpal Bones	314	314	$2,349.00	—	$4,293.89	$4,293.89	$4,293.89	2025-07-02

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