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

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Hospital

Advanced Care Hospital Of Montana

Billings, MT · CCN 272001 · Rates published

1,011 distinct procedures filed
17 distinct payers
40,904 rate rows
2026-09-09 last MRF observed
Data quality

2,549 of 40,904 rate rows are consumer-grade (6.2%)

38,355 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
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 38,180
per-diem day rate — not a per-procedure price 175
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://ernesthealth.com/pricing/2026/205292745_advanced-care-hospital-of-montana_standard-charges.json
Found on page https://achm.ernesthealth.com/price-transparency/
Discovered viaCMS hospital list
Last fetch not_modified · 2026-09-21
Content fingerprint 9326fa4892bc9e6e… · 15,134,596 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
C1806
HCPCS 		Major Multiple Trauma With Brain Or Spinal Cord Injury M <30.50- Tier Tier 2 4 $91,582.88 $91,582.88 $91,582.88 nat. median
$59,476
1.5× median
D1004
HCPCS 		Amputation Lower Extremity M <47.50- Tier Tier 3 4 $59,559.15 $59,559.15 $59,559.15 nat. median
$34,358
1.7× median
C0604
HCPCS 		Neurological M <43.50- Tier Tier 2 4 $33,243.76 $68,333.88 $50,788.82 nat. median
$35,764
1.4× median
A0106
HCPCS 		Stroke M <41.50 And A <84.50- Tier None 4 $49,262.18 $49,262.18 $49,262.18 nat. median
$41,668
1.2× median
D0106
HCPCS 		Stroke M <41.50 And A <84.50- Tier Tier 3 4 $40,833.94 $50,836.17 $45,835.06 nat. median
$43,929
1.0× median
D0604
HCPCS 		Neurological M <43.50- Tier Tier 3 4 $31,312.17 $49,920.10 $40,616.14 nat. median
$30,918
1.3× median
D0105
HCPCS 		Stroke M <41.50 And A >=84.50- Tier Tier 3 4 $36,250.45 $43,566.71 $39,908.58 nat. median
$38,998
1.0× median
D2005
HCPCS 		Miscellaneous M <46.50 And A <77.50- Tier Tier 3 4 $33,851.28 $41,636.41 $37,743.85 nat. median
$31,799
1.2× median
D0104
HCPCS 		Stroke M >=41.50 And M <50.50- Tier Tier 3 4 $37,211.00 $37,211.00 $37,211.00 nat. median
$31,294
1.2× median
A0505
HCPCS 		Non-traumatic Spinal Cord Injury M <39.50- Tier None 4 $36,882.96 $36,882.96 $36,882.96 nat. median
$39,679
0.9× median
D2003
HCPCS 		Miscellaneous M >=46.50 And M <55.50- Tier Tier 3 4 $35,487.30 $35,487.30 $35,487.30 nat. median
$25,005
1.4× median
D0205
HCPCS 		Traumatic Brain Injury M <35.50- Tier Tier 3 4 $35,465.63 $35,465.63 $35,465.63 nat. median
$38,154
0.9× median
D0103
HCPCS 		Stroke M >=50.50 And M <63.50- Tier Tier 3 4 $35,294.72 $35,294.72 $35,294.72 nat. median
$24,500
1.4× median
D1703
HCPCS 		Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=41.50 And M <50.50… 4 $33,981.85 $33,981.85 $33,981.85 nat. median
$25,290
1.3× median
C0704
HCPCS 		Fracture Of Lower Extremity M <41.50- Tier Tier 2 4 $32,865.69 $32,865.69 $32,865.69 nat. median
$34,816
0.9× median
D0703
HCPCS 		Fracture Of Lower Extremity M >=41.50 And M <52.50- Tier Tier 3 4 $32,549.21 $32,549.21 $32,549.21 nat. median
$125
outlier · 260.3×
D0704
HCPCS 		Fracture Of Lower Extremity M <41.50- Tier Tier 3 4 $31,213.62 $31,213.62 $31,213.62 nat. median
$31,214
1.0× median
A1705
HCPCS 		Major Multiple Trauma Without Brain Or Spinal Cord Injury M <36.50- Tier None 4 $31,009.35 $31,009.35 $31,009.35 nat. median
$33,508
0.9× median
D0904
HCPCS 		Other Orthopedic M <44.5- Tier Tier 3 4 $28,823.33 $33,093.84 $30,958.58 nat. median
$31,008
1.0× median
D0603
HCPCS 		Neurological M >=43.50 And M <52.50- Tier Tier 3 4 $30,773.10 $30,773.10 $30,773.10 nat. median
$24,699
1.2× median
A0604
HCPCS 		Neurological M <43.50- Tier None 4 $28,124.51 $33,325.34 $30,724.92 nat. median
$30,256
1.0× median
C0904
HCPCS 		Other Orthopedic M <44.5- Tier Tier 2 4 $30,513.02 $30,513.02 $30,513.02 nat. median
$32,826
0.9× median
D2002
HCPCS 		Miscellaneous M >=55.50 And M <66.50- Tier Tier 3 4 $30,382.01 $30,382.01 $30,382.01 nat. median
$21,212
1.4× median
A1802
HCPCS 		Major Multiple Trauma With Brain Or Spinal Cord Injury M >=55.50 And M <67.50- T… 4 $30,028.51 $30,028.51 $30,028.51 nat. median
$19,678
1.5× median
A1004
HCPCS 		Amputation Lower Extremity M <47.50- Tier None 4 $29,654.73 $29,654.73 $29,654.73 nat. median
$31,429
0.9× median
C0603
HCPCS 		Neurological M >=43.50 And M <52.50- Tier Tier 2 4 $29,080.97 $29,080.97 $29,080.97 nat. median
$28,279
1.0× median
D1404
HCPCS 		Cardiac M <45.50- Tier Tier 3 4 $28,653.10 $28,653.10 $28,653.10 nat. median
$30,825
0.9× median
D0304
HCPCS 		Non-traumatic Brain Injury M <42.50 And A >=78.50- Tier Tier 3 4 $28,642.35 $28,642.35 $28,642.35 nat. median
$30,932
0.9× median
A0704
HCPCS 		Fracture Of Lower Extremity M <41.50- Tier None 4 $28,522.30 $28,522.30 $28,522.30 nat. median
$30,471
0.9× median
D0903
HCPCS 		Other Orthopedic M >=44.50 And M <51.50- Tier Tier 3 4 $28,251.13 $28,251.13 $28,251.13 nat. median
$25,750
1.1× median
D2004
HCPCS 		Miscellaneous M <46.50 And A >=77.50- Tier Tier 3 4 $28,239.19 $28,239.19 $28,239.19 nat. median
$30,380
0.9× median
D0805
HCPCS 		Replacement Of Lower-extremity Joint M <42.50- Tier Tier 3 4 $28,206.94 $28,206.94 $28,206.94 nat. median
$30,345
0.9× median
A0805
HCPCS 		Replacement Of Lower-extremity Joint M <42.50- Tier None 4 $27,737.98 $27,737.98 $27,737.98 nat. median
$27,974
1.0× median
A2005
HCPCS 		Miscellaneous M <46.50 And A <77.50- Tier None 4 $27,058.38 $27,058.38 $27,058.38 nat. median
$273
outlier · 99.3×
A0304
HCPCS 		Non-traumatic Brain Injury M <42.50 And A >=78.50- Tier None 4 $26,814.69 $26,814.69 $26,814.69 nat. median
$28,847
0.9× median
A1404
HCPCS 		Cardiac M <45.50- Tier None 4 $26,348.81 $26,348.81 $26,348.81 nat. median
$27,968
0.9× median
D0804
HCPCS 		Replacement Of Lower-extremity Joint M >=42.50 And M <51.50- Tier Tier 3 4 $26,305.85 $26,305.85 $26,305.85 nat. median
$22,376
1.2× median
A0904
HCPCS 		Other Orthopedic M <44.5- Tier None 4 $26,295.06 $26,295.06 $26,295.06 nat. median
$28,288
0.9× median
A0204
HCPCS 		Traumatic Brain Injury M >=35.50 And M <49.50- Tier None 4 $25,972.53 $25,972.53 $25,972.53 nat. median
$27,941
0.9× median
A2004
HCPCS 		Miscellaneous M <46.50 And A >=77.50- Tier None 4 $25,850.69 $25,850.69 $25,850.69 nat. median
$440
outlier · 58.7×
D0303
HCPCS 		Non-traumatic Brain Injury M >=42.50 And M <52.50- Tier Tier 3 4 $25,128.01 $25,128.01 $25,128.01 nat. median
$26,012
1.0× median
D0102
HCPCS 		Stroke M >=63.50 And M <72.50- Tier Tier 3 4 $23,920.56 $23,920.56 $23,920.56 nat. median
$19,086
1.3× median
D1303
HCPCS 		Rheumatoid Other Arthritis M >=44.50 And M <51.50 And A >=64.50- Tier Tier 3 4 $23,300.92 $23,300.92 $23,300.92 nat. median
$25,067
0.9× median
D1403
HCPCS 		Cardiac M >=45.50 And M <55.50- Tier Tier 3 4 $22,964.05 $22,964.05 $22,964.05 nat. median
$24,705
0.9× median
A0603
HCPCS 		Neurological M >=43.50 And M <52.50- Tier None 4 $22,238.36 $22,238.36 $22,238.36 nat. median
$23,924
0.9× median
C0302
HCPCS 		Non-traumatic Brain Injury M >=52.50 And M <65.50- Tier Tier 2 4 $21,933.75 $21,933.75 $21,933.75 nat. median
$23,596
0.9× median
A0103
HCPCS 		Stroke M >=50.50 And M <63.50- Tier None 4 $21,602.26 $21,602.26 $21,602.26 nat. median
$23,240
0.9× median
A2003
HCPCS 		Miscellaneous M >=46.50 And M <55.50- Tier None 4 $21,197.31 $21,197.31 $21,197.31 nat. median
$22,892
0.9× median
D0602
HCPCS 		Neurological M >=52.50 And M <64.50- Tier Tier 3 4 $20,819.24 $20,819.24 $20,819.24 nat. median
$20,962
1.0× median
D0902
HCPCS 		Other Orthopedic M >=51.50 And M <63.50- Tier Tier 3 4 $20,170.59 $20,170.59 $20,170.59 nat. median
$21,608
0.9× median

Other procedures at this hospital

Browse this hospital's 1,011 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
             
C1806 HCPCS Major Multiple Trauma With Brain Or Spinal Cord Injury M <30.50- Tier Tier 2 6 4 — — $91,582.88 $91,582.88 $91,582.88 2026-09-09
D1004 HCPCS Amputation Lower Extremity M <47.50- Tier Tier 3 6 4 — — $59,559.15 $59,559.15 $59,559.15 2026-09-09
C0604 HCPCS Neurological M <43.50- Tier Tier 2 6 4 — — $33,243.76 $68,333.88 $50,788.82 2026-09-09
A0106 HCPCS Stroke M <41.50 And A <84.50- Tier None 6 4 — — $49,262.18 $49,262.18 $49,262.18 2026-09-09
D0106 HCPCS Stroke M <41.50 And A <84.50- Tier Tier 3 6 4 — — $40,833.94 $50,836.17 $45,835.06 2026-09-09
D0604 HCPCS Neurological M <43.50- Tier Tier 3 6 4 — — $31,312.17 $49,920.10 $40,616.14 2026-09-09
D0105 HCPCS Stroke M <41.50 And A >=84.50- Tier Tier 3 6 4 — — $36,250.45 $43,566.71 $39,908.58 2026-09-09
D2005 HCPCS Miscellaneous M <46.50 And A <77.50- Tier Tier 3 6 4 — — $33,851.28 $41,636.41 $37,743.85 2026-09-09
D0104 HCPCS Stroke M >=41.50 And M <50.50- Tier Tier 3 6 4 — — $37,211.00 $37,211.00 $37,211.00 2026-09-09
A0505 HCPCS Non-traumatic Spinal Cord Injury M <39.50- Tier None 6 4 — — $36,882.96 $36,882.96 $36,882.96 2026-09-09
D2003 HCPCS Miscellaneous M >=46.50 And M <55.50- Tier Tier 3 6 4 — — $35,487.30 $35,487.30 $35,487.30 2026-09-09
D0205 HCPCS Traumatic Brain Injury M <35.50- Tier Tier 3 6 4 — — $35,465.63 $35,465.63 $35,465.63 2026-09-09
D0103 HCPCS Stroke M >=50.50 And M <63.50- Tier Tier 3 6 4 — — $35,294.72 $35,294.72 $35,294.72 2026-09-09
D1703 HCPCS Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=41.50 And M <50.50… 6 4 — — $33,981.85 $33,981.85 $33,981.85 2026-09-09
C0704 HCPCS Fracture Of Lower Extremity M <41.50- Tier Tier 2 6 4 — — $32,865.69 $32,865.69 $32,865.69 2026-09-09
D0703 HCPCS Fracture Of Lower Extremity M >=41.50 And M <52.50- Tier Tier 3 6 4 — — $32,549.21 $32,549.21 $32,549.21 2026-09-09
D0704 HCPCS Fracture Of Lower Extremity M <41.50- Tier Tier 3 6 4 — — $31,213.62 $31,213.62 $31,213.62 2026-09-09
A1705 HCPCS Major Multiple Trauma Without Brain Or Spinal Cord Injury M <36.50- Tier None 6 4 — — $31,009.35 $31,009.35 $31,009.35 2026-09-09
D0904 HCPCS Other Orthopedic M <44.5- Tier Tier 3 6 4 — — $28,823.33 $33,093.84 $30,958.58 2026-09-09
D0603 HCPCS Neurological M >=43.50 And M <52.50- Tier Tier 3 6 4 — — $30,773.10 $30,773.10 $30,773.10 2026-09-09
A0604 HCPCS Neurological M <43.50- Tier None 6 4 — — $28,124.51 $33,325.34 $30,724.92 2026-09-09
C0904 HCPCS Other Orthopedic M <44.5- Tier Tier 2 6 4 — — $30,513.02 $30,513.02 $30,513.02 2026-09-09
D2002 HCPCS Miscellaneous M >=55.50 And M <66.50- Tier Tier 3 6 4 — — $30,382.01 $30,382.01 $30,382.01 2026-09-09
A1802 HCPCS Major Multiple Trauma With Brain Or Spinal Cord Injury M >=55.50 And M <67.50- T… 6 4 — — $30,028.51 $30,028.51 $30,028.51 2026-09-09
A1004 HCPCS Amputation Lower Extremity M <47.50- Tier None 6 4 — — $29,654.73 $29,654.73 $29,654.73 2026-09-09
C0603 HCPCS Neurological M >=43.50 And M <52.50- Tier Tier 2 6 4 — — $29,080.97 $29,080.97 $29,080.97 2026-09-09
D1404 HCPCS Cardiac M <45.50- Tier Tier 3 6 4 — — $28,653.10 $28,653.10 $28,653.10 2026-09-09
D0304 HCPCS Non-traumatic Brain Injury M <42.50 And A >=78.50- Tier Tier 3 6 4 — — $28,642.35 $28,642.35 $28,642.35 2026-09-09
A0704 HCPCS Fracture Of Lower Extremity M <41.50- Tier None 6 4 — — $28,522.30 $28,522.30 $28,522.30 2026-09-09
D0903 HCPCS Other Orthopedic M >=44.50 And M <51.50- Tier Tier 3 6 4 — — $28,251.13 $28,251.13 $28,251.13 2026-09-09
D2004 HCPCS Miscellaneous M <46.50 And A >=77.50- Tier Tier 3 6 4 — — $28,239.19 $28,239.19 $28,239.19 2026-09-09
D0805 HCPCS Replacement Of Lower-extremity Joint M <42.50- Tier Tier 3 6 4 — — $28,206.94 $28,206.94 $28,206.94 2026-09-09
A0805 HCPCS Replacement Of Lower-extremity Joint M <42.50- Tier None 6 4 — — $27,737.98 $27,737.98 $27,737.98 2026-09-09
A2005 HCPCS Miscellaneous M <46.50 And A <77.50- Tier None 6 4 — — $27,058.38 $27,058.38 $27,058.38 2026-09-09
A0304 HCPCS Non-traumatic Brain Injury M <42.50 And A >=78.50- Tier None 6 4 — — $26,814.69 $26,814.69 $26,814.69 2026-09-09
A1404 HCPCS Cardiac M <45.50- Tier None 6 4 — — $26,348.81 $26,348.81 $26,348.81 2026-09-09
D0804 HCPCS Replacement Of Lower-extremity Joint M >=42.50 And M <51.50- Tier Tier 3 6 4 — — $26,305.85 $26,305.85 $26,305.85 2026-09-09
A0904 HCPCS Other Orthopedic M <44.5- Tier None 6 4 — — $26,295.06 $26,295.06 $26,295.06 2026-09-09
A0204 HCPCS Traumatic Brain Injury M >=35.50 And M <49.50- Tier None 6 4 — — $25,972.53 $25,972.53 $25,972.53 2026-09-09
A2004 HCPCS Miscellaneous M <46.50 And A >=77.50- Tier None 6 4 — — $25,850.69 $25,850.69 $25,850.69 2026-09-09
D0303 HCPCS Non-traumatic Brain Injury M >=42.50 And M <52.50- Tier Tier 3 6 4 — — $25,128.01 $25,128.01 $25,128.01 2026-09-09
D0102 HCPCS Stroke M >=63.50 And M <72.50- Tier Tier 3 6 4 — — $23,920.56 $23,920.56 $23,920.56 2026-09-09
D1303 HCPCS Rheumatoid Other Arthritis M >=44.50 And M <51.50 And A >=64.50- Tier Tier 3 6 4 — — $23,300.92 $23,300.92 $23,300.92 2026-09-09
D1403 HCPCS Cardiac M >=45.50 And M <55.50- Tier Tier 3 6 4 — — $22,964.05 $22,964.05 $22,964.05 2026-09-09
A0603 HCPCS Neurological M >=43.50 And M <52.50- Tier None 6 4 — — $22,238.36 $22,238.36 $22,238.36 2026-09-09
C0302 HCPCS Non-traumatic Brain Injury M >=52.50 And M <65.50- Tier Tier 2 6 4 — — $21,933.75 $21,933.75 $21,933.75 2026-09-09
A0103 HCPCS Stroke M >=50.50 And M <63.50- Tier None 6 4 — — $21,602.26 $21,602.26 $21,602.26 2026-09-09
A2003 HCPCS Miscellaneous M >=46.50 And M <55.50- Tier None 6 4 — — $21,197.31 $21,197.31 $21,197.31 2026-09-09
D0602 HCPCS Neurological M >=52.50 And M <64.50- Tier Tier 3 6 4 — — $20,819.24 $20,819.24 $20,819.24 2026-09-09
D0902 HCPCS Other Orthopedic M >=51.50 And M <63.50- Tier Tier 3 6 4 — — $20,170.59 $20,170.59 $20,170.59 2026-09-09
A0202 HCPCS Traumatic Brain Injury M >=61.50 And M <73.50- Tier None 6 4 — — $16,950.68 $16,950.68 $16,950.68 2026-09-09
A0102 HCPCS Stroke M >=63.50 And M <72.50- Tier None 6 4 — — $16,828.84 $16,828.84 $16,828.84 2026-09-09
97166 HCPCS Ot Eval Mod Complex 45 Min 15 6 — — $150.00 $150.00 $150.00 2026-09-09
97165 HCPCS Ot Eval Low Complex 30 Min 15 6 — — $150.00 $150.00 $150.00 2026-09-09
97161 HCPCS Pt Eval Low Complex 20 Min 15 6 — — $150.00 $150.00 $150.00 2026-09-09
97163 HCPCS Pt Eval High Complex 45 Min 15 6 — — $150.00 $150.00 $150.00 2026-09-09
97162 HCPCS Pt Eval Mod Complex 30 Min 15 6 — — $150.00 $150.00 $150.00 2026-09-09
97168 HCPCS Ot Re-eval Est Plan Care 15 6 — — $150.00 $150.00 $150.00 2026-09-09
97167 HCPCS Ot Eval High Complex 60 Min 15 6 — — $150.00 $150.00 $150.00 2026-09-09
97164 HCPCS Pt Re-eval Est Plan Care 15 6 — — $150.00 $150.00 $150.00 2026-09-09
92524 HCPCS Behavral Qualit Analys Voice 15 6 — — $150.00 $150.00 $150.00 2026-09-09
96105 HCPCS Assessment Of Aphasia 15 6 — — $150.00 $150.00 $150.00 2026-09-09
92523 HCPCS Speech Sound Lang Comprehen 15 6 — — $150.00 $150.00 $150.00 2026-09-09
92522 HCPCS Evaluate Speech Production 15 6 — — $150.00 $150.00 $150.00 2026-09-09
92521 HCPCS Evaluation Of Speech Fluency 1 1 — — $150.00 $150.00 $150.00 2026-09-09
94010 HCPCS Breathing Capacity Test 1 1 — — $140.00 $140.00 $140.00 2026-09-09
94060 HCPCS Evaluation Of Wheezing 1 1 — — $140.00 $140.00 $140.00 2026-09-09
97124 HCPCS Massage Therapy 15 6 — — $140.00 $140.00 $140.00 2026-09-09
94664 HCPCS Evaluate Pt Use Of Inhaler 1 1 — — $140.00 $140.00 $140.00 2026-09-09
94640 HCPCS Airway Inhalation Treatment 1 1 — — $140.00 $140.00 $140.00 2026-09-09
97032 HCPCS Appl Modality 1+estim Ea 15 15 6 — — $140.00 $140.00 $140.00 2026-09-09
97112 HCPCS Neuromuscular Reeducation 15 6 — — $140.00 $140.00 $140.00 2026-09-09
97140 HCPCS Manual Therapy 1/> Regions 15 6 — — $140.00 $140.00 $140.00 2026-09-09
97129 HCPCS Ther Ivntj 1st 15 Min 15 6 — — $140.00 $140.00 $140.00 2026-09-09
97110 HCPCS Therapeutic Exercises 15 6 — — $140.00 $140.00 $140.00 2026-09-09
97537 HCPCS Community/work Reintegration 15 6 — — $140.00 $140.00 $140.00 2026-09-09
97535 HCPCS Self Care Mngment Training 15 6 — — $140.00 $140.00 $140.00 2026-09-09
97530 HCPCS Therapeutic Activities 15 6 — — $140.00 $140.00 $140.00 2026-09-09
92605 HCPCS Ex For Nonspeech Device Rx 1 1 — — $140.00 $140.00 $140.00 2026-09-09
92597 HCPCS Oral Speech Device Eval 1 1 — — $140.00 $140.00 $140.00 2026-09-09
97116 HCPCS Gait Training Therapy 15 6 — — $140.00 $140.00 $140.00 2026-09-09
97113 HCPCS Aquatic Therapy/exercises 15 6 — — $140.00 $140.00 $140.00 2026-09-09
92526 HCPCS Oral Function Therapy 15 6 — — $140.00 $140.00 $140.00 2026-09-09
94660 HCPCS Pos Airway Pressure Cpap 1 1 — — $140.00 $140.00 $140.00 2026-09-09
92607 HCPCS Ex For Speech Device Rx 1hr 15 6 — — $140.00 $140.00 $140.00 2026-09-09
92606 HCPCS Non-speech Device Service 1 1 — — $140.00 $140.00 $140.00 2026-09-09
92507 HCPCS Speech/hearing Therapy 15 6 — — $140.00 $140.00 $140.00 2026-09-09
90999 HCPCS Unlisted Dialysis Procedure 0 0 — — — — — 2026-09-09
90993 HCPCS Dialysis Training Incompl 0 0 — — — — — 2026-09-09
83036 HCPCS Hemoglobin Glycosylated A1c 0 0 — — — — — 2026-09-09
90937 HCPCS Hemodialysis Repeated Eval 0 0 — — — — — 2026-09-09
90935 HCPCS Hemodialysis One Evaluation 0 0 — — — — — 2026-09-09
82962 HCPCS Glucose Blood Test 0 0 — — — — — 2026-09-09
73610 HCPCS X-ray Exam Of Ankle 0 0 — — — — — 2026-09-09
90676 HCPCS Rabies Vaccine Id 0 0 — — — — — 2026-09-09
90675 HCPCS Rabies Vaccine IM 0 0 — — — — — 2026-09-09
82948 HCPCS Reagent Strip/blood Glucose 0 0 — — — — — 2026-09-09
90396 HCPCS Varicella-zoster Ig IM 0 0 — — — — — 2026-09-09
90378 HCPCS Rsv Mab IM 50mg 0 0 — — — — — 2026-09-09
82945 HCPCS Glucose Other Fluid 0 0 — — — — — 2026-09-09
73560 HCPCS X-ray Exam Of Knee 1 Or 2 0 0 — — — — — 2026-09-09
70470 HCPCS CT Head/brain Without & With Contrast 0 0 — — — — — 2026-09-09
90377 HCPCS Rabies Ig Ht&sol Human Im/sc 0 0 — — — — — 2026-09-09
A2002 HCPCS Miscellaneous M >=55.50 And M <66.50- Tier None 0 0 — — — — — 2026-09-09
90376 HCPCS Rabies Ig Heat Treated 0 0 — — — — — 2026-09-09
82805 HCPCS Blood Gases W/o2 Saturation 0 0 — — — — — 2026-09-09
A1904 HCPCS Guillain-barré M <38.50- Tier None 0 0 — — — — — 2026-09-09
A1902 HCPCS Guillain-barré M >=51.50 And M <66.50- Tier None 0 0 — — — — — 2026-09-09
A2101 HCPCS Burns M >=52.50- Tier None 0 0 — — — — — 2026-09-09
A5001 HCPCS Short-stay Cases, Length Of Stay Is 3 Days Or Fewer- Tier None 0 0 — — — — — 2026-09-09
A5102 HCPCS Expired, Orthopedic, Length Of Stay Is 14 Days Or More- Tier None 0 0 — — — — — 2026-09-09
97533 HCPCS Sensory Integration 0 0 — — — — — 2026-09-09
A9515 HCPCS Choline C-11 0 0 — — — — — 2026-09-09
A9521 HCPCS Tc99m Exametazime 0 0 — — — — — 2026-09-09
97542 HCPCS Wheelchair Mngment Training 0 0 — — — — — 2026-09-09
97550 HCPCS Caregiver Traing 1st 30 Min 0 0 — — — — — 2026-09-09
97750 HCPCS Physical Performance Test 0 0 — — — — — 2026-09-09
97760 HCPCS Orthotic Mgmt&traing 1st Enc 0 0 — — — — — 2026-09-09
97761 HCPCS Prosthetic Traing 1st Enc 0 0 — — — — — 2026-09-09
97763 HCPCS Orthc/prostc Mgmt Sbsq Enc 0 0 — — — — — 2026-09-09
99199 HCPCS Unlisted Special Svc Px/rprt 0 0 — — — — — 2026-09-09
99223 HCPCS 1st Hosp Ip/obs High 75 0 0 — — — — — 2026-09-09
99231 HCPCS Sbsq Hosp Ip/obs Sf/low 25 0 0 — — — — — 2026-09-09
99232 HCPCS Sbsq Hosp Ip/obs Moderate 35 0 0 — — — — — 2026-09-09
99499 HCPCS Unlisted E&m Service 0 0 — — — — — 2026-09-09
A0101 HCPCS Stroke M >=72.50- Tier None 0 0 — — — — — 2026-09-09
90375 HCPCS Rabies Ig Im/sc 0 0 — — — — — 2026-09-09
A1806 HCPCS Major Multiple Trauma With Brain Or Spinal Cord Injury M <30.50- Tier None 0 0 — — — — — 2026-09-09
A1804 HCPCS Major Multiple Trauma With Brain Or Spinal Cord Injury M >=40.50 And M <45.50- T… 0 0 — — — — — 2026-09-09
90371 HCPCS Hep B Ig IM 0 0 — — — — — 2026-09-09
82803 HCPCS Blood Gases Any Combination 0 0 — — — — — 2026-09-09
73100 HCPCS X-ray Exam Of Wrist 0 0 — — — — — 2026-09-09
A1803 HCPCS Major Multiple Trauma With Brain Or Spinal Cord Injury M >=45.50 And M <55.50- T… 0 0 — — — — — 2026-09-09
97130 HCPCS Ther Ivntj Ea Addl 15 Min 0 0 — — — — — 2026-09-09
87635 HCPCS Sars-cov-2 Covid-19 Amp Prb 0 0 — — — — — 2026-09-09
A1703 HCPCS Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=41.50 And M <50.50… 0 0 — — — — — 2026-09-09
A1701 HCPCS Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=57.50- Tier None 0 0 — — — — — 2026-09-09
87633 HCPCS Resp Virus 12-25 Targets 0 0 — — — — — 2026-09-09
82728 HCPCS Assay Of Ferritin 0 0 — — — — — 2026-09-09
A1603 HCPCS Pain Syndrome M >=43.50 And M <58.50- Tier None 0 0 — — — — — 2026-09-09
A1601 HCPCS Pain Syndrome M >=65.50- Tier None 0 0 — — — — — 2026-09-09
87493 HCPCS C Diff Amplified Probe 0 0 — — — — — 2026-09-09
A1503 HCPCS Pulmonary M >=45.50 And M <56.50- Tier None 0 0 — — — — — 2026-09-09
A1501 HCPCS Pulmonary M >=68.50- Tier None 0 0 — — — — — 2026-09-09
87340 HCPCS Hepatitis B Surface Ag Ia 0 0 — — — — — 2026-09-09
82330 HCPCS Assay Of Calcium 0 0 — — — — — 2026-09-09
73030 HCPCS X-ray Exam Of Shoulder 0 0 — — — — — 2026-09-09
29130 HCPCS Application Of Finger Splint 0 0 — — — — — 2026-09-09
20561 HCPCS Ndl Insj Without Njx 3+ Musc 0 0 — — — — — 2026-09-09
97035 HCPCS App Mdlty 1+ultrasound Ea 15 0 0 — — — — — 2026-09-09
97033 HCPCS App Mdlty 1+iontphrsis Ea 15 0 0 — — — — — 2026-09-09
87086 HCPCS Urine Culture/colony Count 0 0 — — — — — 2026-09-09
A1304 HCPCS Rheumatoid Other Arthritis M <44.50 And A >=64.50- Tier None 0 0 — — — — — 2026-09-09
97018 HCPCS Paraffin Bath Therapy 0 0 — — — — — 2026-09-09
87070 HCPCS Culture Othr Specimn Aerobic 0 0 — — — — — 2026-09-09
81001 HCPCS Urinalysis Auto W/scope 0 0 — — — — — 2026-09-09
97014 HCPCS Electric Stimulation Therapy 0 0 — — — — — 2026-09-09
97012 HCPCS Mechanical Traction Therapy 0 0 — — — — — 2026-09-09
87040 HCPCS Blood Culture For Bacteria 0 0 — — — — — 2026-09-09
96125 HCPCS Cognitive Test By Hc Pro 0 0 — — — — — 2026-09-09
A1101 HCPCS Amputation Non-lower Extremity M >=58.50- Tier None 0 0 — — — — — 2026-09-09
86905 HCPCS Blood Typing Rbc Antigens 0 0 — — — — — 2026-09-09
80202 HCPCS Assay Of Vancomycin 0 0 — — — — — 2026-09-09
72170 HCPCS X-ray Exam Of Pelvis 0 0 — — — — — 2026-09-09
95992 HCPCS Canalith Repositioning Proc 0 0 — — — — — 2026-09-09
A1001 HCPCS Amputation Lower Extremity M >=64.50- Tier None 0 0 — — — — — 2026-09-09
86140 HCPCS C-reactive Protein 0 0 — — — — — 2026-09-09
A0903 HCPCS Other Orthopedic M >=44.50 And M <51.50- Tier None 0 0 — — — — — 2026-09-09
A0902 HCPCS Other Orthopedic M >=51.50 And M <63.50- Tier None 0 0 — — — — — 2026-09-09
A0901 HCPCS Other Orthopedic M >=63.50- Tier None 0 0 — — — — — 2026-09-09
860 APR_DRG Rehabilitation 0 0 — — — — — 2026-09-09
A1002 HCPCS Amputation Lower Extremity M >=55.50 And M <64.50- Tier None 0 0 — — — — — 2026-09-09
A1003 HCPCS Amputation Lower Extremity M >=47.50 And M <55.50- Tier None 0 0 — — — — — 2026-09-09
80069 HCPCS Renal Function Panel 0 0 — — — — — 2026-09-09
A0804 HCPCS Replacement Of Lower-extremity Joint M >=42.50 And M <51.50- Tier None 0 0 — — — — — 2026-09-09
A1102 HCPCS Amputation Non-lower Extremity M >=52.50 And M <58.50- Tier None 0 0 — — — — — 2026-09-09
A1103 HCPCS Amputation Non-lower Extremity M <52.50- Tier None 0 0 — — — — — 2026-09-09
A1201 HCPCS Osteoarthritis M >=61.50- Tier None 0 0 — — — — — 2026-09-09
A1202 HCPCS Osteoarthritis M >=49.50 And M <61.50- Tier None 0 0 — — — — — 2026-09-09
A1203 HCPCS Osteoarthritis M <49.50 And A >=74.50- Tier None 0 0 — — — — — 2026-09-09
A1204 HCPCS Osteoarthritis M <49.50 And A <74.50- Tier None 0 0 — — — — — 2026-09-09
A1301 HCPCS Rheumatoid Other Arthritis M >=62.50- Tier None 0 0 — — — — — 2026-09-09
A1302 HCPCS Rheumatoid Other Arthritis M >=51.50 And M <62.50- Tier None 0 0 — — — — — 2026-09-09
A1303 HCPCS Rheumatoid Other Arthritis M >=44.50 And M <51.50 And A >=64.50- Tier None 0 0 — — — — — 2026-09-09
A0803 HCPCS Replacement Of Lower-extremity Joint M >=51.50 And M <57.50- Tier None 0 0 — — — — — 2026-09-09
A1305 HCPCS Rheumatoid Other Arthritis M <51.50 And A <64.50- Tier None 0 0 — — — — — 2026-09-09
A1401 HCPCS Cardiac M >=68.50- Tier None 0 0 — — — — — 2026-09-09
A1402 HCPCS Cardiac M >=55.50 And M <68.50- Tier None 0 0 — — — — — 2026-09-09
A1403 HCPCS Cardiac M >=45.50 And M <55.50- Tier None 0 0 — — — — — 2026-09-09
A0802 HCPCS Replacement Of Lower-extremity Joint M >=57.50 And M <63.50- Tier None 0 0 — — — — — 2026-09-09
85610 HCPCS Prothrombin Time 0 0 — — — — — 2026-09-09
A1502 HCPCS Pulmonary M >=56.50 And M <68.50- Tier None 0 0 — — — — — 2026-09-09
A0801 HCPCS Replacement Of Lower-extremity Joint M >=63.50- Tier None 0 0 — — — — — 2026-09-09
A1504 HCPCS Pulmonary M <45.50- Tier None 0 0 — — — — — 2026-09-09
94003 HCPCS Vent Mgmt Inpat Subq Day 0 0 — — — — — 2026-09-09
A1602 HCPCS Pain Syndrome M >=58.50 And M <65.50- Tier None 0 0 — — — — — 2026-09-09
A0703 HCPCS Fracture Of Lower Extremity M >=41.50 And M <52.50- Tier None 0 0 — — — — — 2026-09-09
A1604 HCPCS Pain Syndrome M <43.50- Tier None 0 0 — — — — — 2026-09-09
A0702 HCPCS Fracture Of Lower Extremity M >=52.50 And M <61.50- Tier None 0 0 — — — — — 2026-09-09
A1702 HCPCS Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=50.50 And M <57.50… 0 0 — — — — — 2026-09-09
94002 HCPCS Vent Mgmt Inpat Init Day 0 0 — — — — — 2026-09-09
A1704 HCPCS Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=36.50 And M <41.50… 0 0 — — — — — 2026-09-09
85027 HCPCS Complete Cbc Automated 0 0 — — — — — 2026-09-09
A1801 HCPCS Major Multiple Trauma With Brain Or Spinal Cord Injury M >=67.50- Tier None 0 0 — — — — — 2026-09-09
80053 HCPCS Comprehen Metabolic Panel 0 0 — — — — — 2026-09-09
72158 HCPCS MRI Lumbar Spine Without & With Contrast 0 0 — — — — — 2026-09-09
29126 HCPCS Apply Forearm Splint 0 0 — — — — — 2026-09-09
A1805 HCPCS Major Multiple Trauma With Brain Or Spinal Cord Injury M >=30.50 And M <40.50- T… 0 0 — — — — — 2026-09-09
A0701 HCPCS Fracture Of Lower Extremity M >=61.50- Tier None 0 0 — — — — — 2026-09-09
A1901 HCPCS Guillain-barré M >=66.50- Tier None 0 0 — — — — — 2026-09-09
93971 HCPCS Extremity Study 0 0 — — — — — 2026-09-09
A1903 HCPCS Guillain-barré M >=38.50 And M <51.50- Tier None 0 0 — — — — — 2026-09-09
A0602 HCPCS Neurological M >=52.50 And M <64.50- Tier None 0 0 — — — — — 2026-09-09
A2001 HCPCS Miscellaneous M >=66.50- Tier None 0 0 — — — — — 2026-09-09
93970 HCPCS Extremity Study 0 0 — — — — — 2026-09-09
85025 HCPCS Complete Cbc W/auto Diff Wbc 0 0 — — — — — 2026-09-09
A0601 HCPCS Neurological M >=64.50- Tier None 0 0 — — — — — 2026-09-09
93926 HCPCS Lower Extremity Study 0 0 — — — — — 2026-09-09
A0504 HCPCS Non-traumatic Spinal Cord Injury M >=39.50 And M <48.50- Tier None 0 0 — — — — — 2026-09-09
A2102 HCPCS Burns M <52.50- Tier None 0 0 — — — — — 2026-09-09
A0503 HCPCS Non-traumatic Spinal Cord Injury M >=48.50 And M <53.50- Tier None 0 0 — — — — — 2026-09-09
A5101 HCPCS Expired, Orthopedic, Length Of Stay Is 13 Days Or Fewer- Tier None 0 0 — — — — — 2026-09-09
92612 HCPCS Endoscopy Swallow (fees) Vid 0 0 — — — — — 2026-09-09
A5103 HCPCS Expired, Not Orthopedic, Length Of Stay Is 15 Days Or Fewer- Tier None 0 0 — — — — — 2026-09-09
A5104 HCPCS Expired, Not Orthopedic, Length Of Stay Is 16 Days Or More- Tier None 0 0 — — — — — 2026-09-09
A9513 HCPCS Lutetium Lu 177 Dotatat Ther 0 0 — — — — — 2026-09-09
84481 HCPCS Free Assay (ft-3) 0 0 — — — — — 2026-09-09
A9517 HCPCS I131 Iodide Cap, Rx 0 0 — — — — — 2026-09-09
80048 HCPCS Metabolic Panel Total Ca 0 0 — — — — — 2026-09-09
A9530 HCPCS I131 Iodide Sol, Rx 0 0 — — — — — 2026-09-09
A9542 HCPCS In111 Ibritumomab, Dx 0 0 — — — — — 2026-09-09
A9543 HCPCS Y90 Ibritumomab, Rx 0 0 — — — — — 2026-09-09
A9547 HCPCS In111 Oxyquinoline 0 0 — — — — — 2026-09-09
A9548 HCPCS In111 Pentetate 0 0 — — — — — 2026-09-09
A9557 HCPCS Tc99m Bicisate 0 0 — — — — — 2026-09-09
A9563 HCPCS P32 Na Phosphate 0 0 — — — — — 2026-09-09
A9568 HCPCS Technetium Tc99m Arcitumomab 0 0 — — — — — 2026-09-09
A9569 HCPCS Technetium Tc-99m Auto Wbc 0 0 — — — — — 2026-09-09
A9570 HCPCS Indium In-111 Auto Wbc 0 0 — — — — — 2026-09-09
A9572 HCPCS Indium In-111 Pentetreotide 0 0 — — — — — 2026-09-09
A9582 HCPCS Iodine I-123 Iobenguane 0 0 — — — — — 2026-09-09
A9584 HCPCS Iodine I-123 Ioflupane 0 0 — — — — — 2026-09-09
A9586 HCPCS Florbetapir F18 0 0 — — — — — 2026-09-09
A9587 HCPCS Gallium Ga-68 0 0 — — — — — 2026-09-09
A9588 HCPCS Fluciclovine F-18 0 0 — — — — — 2026-09-09
A9591 HCPCS Fluoroestradiol F 18 0 0 — — — — — 2026-09-09
A9592 HCPCS Copper Cu 64 Dotatate Diag 0 0 — — — — — 2026-09-09
A9593 HCPCS Gallium Ga-68 Psma-11 Ucsf 0 0 — — — — — 2026-09-09
A9594 HCPCS Gallium Ga-68 Psma-11, Ucla 0 0 — — — — — 2026-09-09
A9595 HCPCS Piflu F-18, Dia 1 Millicurie 0 0 — — — — — 2026-09-09
A9596 HCPCS Gallium Illuccix 1 Millicure 0 0 — — — — — 2026-09-09
A9601 HCPCS Flortaucipir Inj 1 Millicuri 0 0 — — — — — 2026-09-09
A9602 HCPCS Fluorodopa F-18 Diag Per Mci 0 0 — — — — — 2026-09-09
A9604 HCPCS Sm 153 Lexidronam 0 0 — — — — — 2026-09-09
A0502 HCPCS Non-traumatic Spinal Cord Injury M >=53.50 And M <60.50- Tier None 0 0 — — — — — 2026-09-09
A0501 HCPCS Non-traumatic Spinal Cord Injury M >=60.50- Tier None 0 0 — — — — — 2026-09-09
92610 HCPCS Evaluate Swallowing Function 0 0 — — — — — 2026-09-09
A0407 HCPCS Traumatic Spinal Cord Injury M <24.50 And A >=61.50- Tier None 0 0 — — — — — 2026-09-09
A0406 HCPCS Traumatic Spinal Cord Injury M >=24.50 And M <31.50 And A >=61.50- Tier None 0 0 — — — — — 2026-09-09
92609 HCPCS Use Of Speech Device Service 0 0 — — — — — 2026-09-09
84443 HCPCS Assay Thyroid Stim Hormone 0 0 — — — — — 2026-09-09
A0405 HCPCS Traumatic Spinal Cord Injury M >=31.50 And M <41.50- Tier None 0 0 — — — — — 2026-09-09
B0701 HCPCS Fracture Of Lower Extremity M >=61.50- Tier Tier 1 0 0 — — — — — 2026-09-09
A0404 HCPCS Traumatic Spinal Cord Injury M <31.50 And A <61.50- Tier None 0 0 — — — — — 2026-09-09
A0403 HCPCS Traumatic Spinal Cord Injury M >=41.50 And M <47.50- Tier None 0 0 — — — — — 2026-09-09
B0601 HCPCS Neurological M >=64.50- Tier Tier 1 0 0 — — — — — 2026-09-09
A0402 HCPCS Traumatic Spinal Cord Injury M >=47.50 And M <56.50- Tier None 0 0 — — — — — 2026-09-09
84145 HCPCS Procalcitonin (pct) 0 0 — — — — — 2026-09-09
76700 HCPCS US Exam Abdom Complete 0 0 — — — — — 2026-09-09
71046 HCPCS X-ray Exam Chest 2 Views 0 0 — — — — — 2026-09-09
A0401 HCPCS Traumatic Spinal Cord Injury M >=56.50- Tier None 0 0 — — — — — 2026-09-09
B0502 HCPCS Non-traumatic Spinal Cord Injury M >=53.50 And M <60.50- Tier Tier 1 0 0 — — — — — 2026-09-09
A0305 HCPCS Non-traumatic Brain Injury M <42.50 And A <78.50- Tier None 0 0 — — — — — 2026-09-09
B0407 HCPCS Traumatic Spinal Cord Injury M <24.50 And A >=61.50- Tier Tier 1 0 0 — — — — — 2026-09-09
B0406 HCPCS Traumatic Spinal Cord Injury M >=24.50 And M <31.50 And A >=61.50- Tier Tier 1 0 0 — — — — — 2026-09-09
B0405 HCPCS Traumatic Spinal Cord Injury M >=31.50 And M <41.50- Tier Tier 1 0 0 — — — — — 2026-09-09
A0303 HCPCS Non-traumatic Brain Injury M >=42.50 And M <52.50- Tier None 0 0 — — — — — 2026-09-09
84134 HCPCS Assay Of Prealbumin 0 0 — — — — — 2026-09-09
B0404 HCPCS Traumatic Spinal Cord Injury M <31.50 And A <61.50- Tier Tier 1 0 0 — — — — — 2026-09-09
B0403 HCPCS Traumatic Spinal Cord Injury M >=41.50 And M <47.50- Tier Tier 1 0 0 — — — — — 2026-09-09
A0302 HCPCS Non-traumatic Brain Injury M >=52.50 And M <65.50- Tier None 0 0 — — — — — 2026-09-09
B0501 HCPCS Non-traumatic Spinal Cord Injury M >=60.50- Tier Tier 1 0 0 — — — — — 2026-09-09
B0402 HCPCS Traumatic Spinal Cord Injury M >=47.50 And M <56.50- Tier Tier 1 0 0 — — — — — 2026-09-09
B0503 HCPCS Non-traumatic Spinal Cord Injury M >=48.50 And M <53.50- Tier Tier 1 0 0 — — — — — 2026-09-09
B0504 HCPCS Non-traumatic Spinal Cord Injury M >=39.50 And M <48.50- Tier Tier 1 0 0 — — — — — 2026-09-09
B0505 HCPCS Non-traumatic Spinal Cord Injury M <39.50- Tier Tier 1 0 0 — — — — — 2026-09-09
B0401 HCPCS Traumatic Spinal Cord Injury M >=56.50- Tier Tier 1 0 0 — — — — — 2026-09-09
B0602 HCPCS Neurological M >=52.50 And M <64.50- Tier Tier 1 0 0 — — — — — 2026-09-09
B0603 HCPCS Neurological M >=43.50 And M <52.50- Tier Tier 1 0 0 — — — — — 2026-09-09
B0604 HCPCS Neurological M <43.50- Tier Tier 1 0 0 — — — — — 2026-09-09
A0301 HCPCS Non-traumatic Brain Injury M >=65.50- Tier None 0 0 — — — — — 2026-09-09
B0702 HCPCS Fracture Of Lower Extremity M >=52.50 And M <61.50- Tier Tier 1 0 0 — — — — — 2026-09-09
B0703 HCPCS Fracture Of Lower Extremity M >=41.50 And M <52.50- Tier Tier 1 0 0 — — — — — 2026-09-09
B0704 HCPCS Fracture Of Lower Extremity M <41.50- Tier Tier 1 0 0 — — — — — 2026-09-09
B0801 HCPCS Replacement Of Lower-extremity Joint M >=63.50- Tier Tier 1 0 0 — — — — — 2026-09-09
B0802 HCPCS Replacement Of Lower-extremity Joint M >=57.50 And M <63.50- Tier Tier 1 0 0 — — — — — 2026-09-09
B0803 HCPCS Replacement Of Lower-extremity Joint M >=51.50 And M <57.50- Tier Tier 1 0 0 — — — — — 2026-09-09
B0804 HCPCS Replacement Of Lower-extremity Joint M >=42.50 And M <51.50- Tier Tier 1 0 0 — — — — — 2026-09-09
B0805 HCPCS Replacement Of Lower-extremity Joint M <42.50- Tier Tier 1 0 0 — — — — — 2026-09-09
B0305 HCPCS Non-traumatic Brain Injury M <42.50 And A <78.50- Tier Tier 1 0 0 — — — — — 2026-09-09
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