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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

3,378 distinct procedures filed
17 distinct payers
44,849 rate rows
2026-09-09 last MRF observed
Data quality

3,264 of 44,849 rate rows are consumer-grade (7.3%)

41,585 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 41,341
per-diem day rate — not a per-procedure price 244
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 success · 2026-11-03
Content fingerprint 88b47e801f2de2d6… · 15,520,081 bytes · first seen 2026-11-03

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
981
LOCAL 		Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 13 $115,873.96 $115,873.96 $115,873.96 nat. median
$701
outlier · 165.3×
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
$53,973
1.7× median
207
LOCAL 		Respiratory System Diagnosis With Ventilator Support >96 Hours 13 $90,258.74 $90,258.74 $90,258.74 nat. median
$90,259
1.0× median
163
LOCAL 		Major Chest Procedures With Mcc 13 $83,256.13 $83,256.13 $83,256.13 nat. median
$900
outlier · 92.5×
853
LOCAL 		Infectious And Parasitic Diseases With O.r. Procedures With Mcc 13 $79,192.62 $79,192.62 $79,192.62 nat. median
$8
outlier · 10205.2×
653
LOCAL 		Major Bladder Procedures With Mcc 13 $72,605.31 $72,605.31 $72,605.31 nat. median
$72,605
1.0× median
628
LOCAL 		Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 13 $72,605.31 $72,605.31 $72,605.31 nat. median
$900
outlier · 80.7×
205
LOCAL 		Other Respiratory System Diagnoses With Mcc 13 $68,495.84 $68,495.84 $68,495.84 nat. median
$2,621
outlier · 26.1×
385
LOCAL 		Inflammatory Bowel Disease With Mcc 13 $68,442.08 $68,442.08 $68,442.08 nat. median
$68,442
1.0× median
D1004
HCPCS 		Amputation Lower Extremity M <47.50- Tier Tier 3 4 $37,531.74 $59,559.15 $59,559.15 nat. median
$33,640
1.8× median
C0205
HCPCS 		Traumatic Brain Injury M <35.50- Tier Tier 2 4 $57,546.28 $57,546.28 $57,546.28 nat. median
$41,257
1.4× median
94
LOCAL 		Bacterial And Tuberculous Infections Of Nervous System With Mcc 13 $55,947.70 $55,947.70 $55,947.70 nat. median
$900
outlier · 62.2×
939
LOCAL 		O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 13 $54,043.61 $54,043.61 $54,043.61 nat. median
$54,044
1.0× median
539
LOCAL 		Osteomyelitis With Mcc* 13 $45,204.17 $58,994.67 $52,099.42 nat. median
$47,206
1.1× median
919
LOCAL 		Complications Of Treatment With Mcc* 13 $50,954.62 $50,954.62 $50,954.62 nat. median
$111
outlier · 459.4×
C0604
HCPCS 		Neurological M <43.50- Tier Tier 2 4 $33,243.76 $68,333.88 $50,788.82 nat. median
$35,373
1.4× median
208
LOCAL 		Respiratory System Diagnosis With Ventilator Support <=96 Hours 13 $49,785.83 $49,785.83 $49,785.83 nat. median
$2,406
outlier · 20.7×
A0106
HCPCS 		Stroke M <41.50 And A <84.50- Tier None 4 $49,262.18 $51,854.53 $49,262.18 nat. median
$41,164
1.2× median
D0505
HCPCS 		Non-traumatic Spinal Cord Injury M <39.50- Tier Tier 3 4 $48,974.99 $48,974.99 $48,974.99 nat. median
$42,157
1.2× median
908
LOCAL 		Other O.r. Procedures For Injuries With Cc* 13 $48,588.99 $48,588.99 $48,588.99 nat. median
$48,589
1.0× median
D0106
HCPCS 		Stroke M <41.50 And A <84.50- Tier Tier 3 4 $40,833.94 $51,796.51 $48,335.61 nat. median
$43,282
1.1× median
D1705
HCPCS 		Major Multiple Trauma Without Brain Or Spinal Cord Injury M <36.50- Tier Tier 3 4 $46,258.82 $46,258.82 $46,258.82 nat. median
$70
outlier · 660.8×
393
LOCAL 		Other Digestive System Diagnoses With Mcc 13 $43,133.53 $49,153.22 $46,143.38 nat. median
$47,648
1.0× median
288
LOCAL 		Acute And Subacute Endocarditis With Mcc 13 $45,828.68 $45,828.68 $45,828.68 nat. median
$45,829
1.0× median
A1806
HCPCS 		Major Multiple Trauma With Brain Or Spinal Cord Injury M <30.50- Tier None 4 $45,462.23 $45,462.23 $45,462.23 nat. median
$48,032
0.9× median
C1704
HCPCS 		Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=36.50 And M <41.50… 4 $45,395.47 $45,395.47 $45,395.47 nat. median
$33,120
1.4× median
576
LOCAL 		Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 13 $44,512.04 $44,512.04 $44,512.04 nat. median
$44,512
1.0× median
637
LOCAL 		Diabetes With Mcc 13 $43,652.02 $43,652.02 $43,652.02 nat. median
$43,652
1.0× median
C1804
HCPCS 		Major Multiple Trauma With Brain Or Spinal Cord Injury M >=40.50 And M <45.50- T… 4 $42,616.33 $42,616.33 $42,616.33 nat. median
$32,161
1.3× median
907
LOCAL 		Other O.r. Procedures For Injuries With Mcc* 13 $40,591.37 $40,591.37 $40,591.37 nat. median
$40,591
1.0× 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
$38,527
1.0× median
70
LOCAL 		Other Cerebrovascular Disorders With Mcc* 13 $39,466.46 $39,466.46 $39,466.46 nat. median
$7,797
outlier · 5.1×
D0604
HCPCS 		Neurological M <43.50- Tier Tier 3 4 $31,312.17 $49,920.10 $38,825.09 nat. median
$106
outlier · 364.7×
177
LOCAL 		Respiratory Infections And Inflammations With Mcc* 13 $38,443.88 $38,443.88 $38,443.88 nat. median
$38,266
1.0× median
56
LOCAL 		Degenerative Nervous System Disorders With Mcc 13 $37,522.87 $37,522.87 $37,522.87 nat. median
$3,190
outlier · 11.8×
559
LOCAL 		Aftercare, Musculoskeletal System And Connective Tissue With Mcc 13 $37,364.53 $37,364.53 $37,364.53 nat. median
$33,655
1.1× median
D0104
HCPCS 		Stroke M >=41.50 And M <50.50- Tier Tier 3 4 $30,948.19 $37,211.00 $37,211.00 nat. median
$30,813
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
$39,097
0.9× median
291
LOCAL 		Heart Failure And Shock With Mcc* 13 $36,767.34 $36,767.34 $36,767.34 nat. median
$23,347
1.6× median
565
LOCAL 		Other Musculoskeletal System And Connective Tissue Diagnoses With Cc* 13 $36,718.75 $36,718.75 $36,718.75 nat. median
$36,719
1.0× median
D2005
HCPCS 		Miscellaneous M <46.50 And A <77.50- Tier Tier 3 4 $33,240.87 $41,636.41 $35,797.56 nat. median
$31,413
1.1× median
D2003
HCPCS 		Miscellaneous M >=46.50 And M <55.50- Tier Tier 3 4 $24,287.35 $35,487.30 $35,487.30 nat. median
$24,717
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
$37,536
0.9× median
D0103
HCPCS 		Stroke M >=50.50 And M <63.50- Tier Tier 3 4 $23,378.99 $35,294.72 $35,294.72 nat. median
$24,162
1.5× median
189
LOCAL 		Pulmonary Edema And Respiratory Failure 13 $25,134.28 $44,021.35 $34,577.82 nat. median
$2,583
outlier · 13.4×
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
$88
outlier · 386.1×
901
LOCAL 		Wound Debridements For Injuries With Mcc 13 $33,842.46 $33,842.46 $33,842.46 nat. median
$3,091
outlier · 10.9×
A0405
HCPCS 		Traumatic Spinal Cord Injury M >=31.50 And M <41.50- Tier None 4 $33,248.46 $33,248.46 $33,248.46 nat. median
$34,966
1.0× median
949
LOCAL 		Aftercare With Cc/mcc 13 $33,174.97 $33,174.97 $33,174.97 nat. median
$32,692
1.0× median
C0902
HCPCS 		Other Orthopedic M >=51.50 And M <63.50- Tier Tier 2 4 $32,942.18 $32,942.18 $32,942.18 nat. median
$22,793
1.4× median

Other procedures at this hospital

Browse this hospital's 3,378 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
             
92606 HCPCS Non-speech Device Service 3 2 — — $90.00 $140.00 $140.00 2026-09-09
94060 HCPCS Evaluation Of Wheezing 2 1 — — $140.00 $140.00 $140.00 2026-09-09
94010 HCPCS Breathing Capacity Test 2 1 — — $140.00 $140.00 $140.00 2026-09-09
0412 RC Respiratory Services - Inhalation Services 1 1 — — $140.00 $140.00 $140.00 2026-08-10
0410 RC Respiratory Services - General Classification 1 1 — — $140.00 $140.00 $140.00 2026-08-10
94640 HCPCS Airway Inhalation Treatment 2 1 — — $140.00 $140.00 $140.00 2026-09-09
92605 HCPCS Ex For Nonspeech Device Rx 3 2 — — $90.00 $140.00 $140.00 2026-09-09
94660 HCPCS Pos Airway Pressure Cpap 2 1 — — $140.00 $140.00 $140.00 2026-09-09
94664 HCPCS Evaluate Pt Use Of Inhaler 2 1 — — $140.00 $140.00 $140.00 2026-09-09
92597 HCPCS Oral Speech Device Eval 3 2 — — $90.00 $140.00 $140.00 2026-09-09
97113 HCPCS Aquatic Therapy/exercises 44 13 — — $90.00 $140.00 $90.00 2026-09-09
97112 HCPCS Neuromuscular Reeducation 46 14 — — $90.00 $140.00 $90.00 2026-09-09
0430 RC Occupational Therapy - General Classification 31 14 — — $90.00 $140.00 $90.00 2026-08-10
0420 RC Physical Therapy - General Classification 31 14 — — $90.00 $140.00 $90.00 2026-08-10
0440 RC Speech Therapy - Language Pathology - General Classification 31 14 — — $90.00 $140.00 $90.00 2026-08-10
97537 HCPCS Community/work Reintegration 44 13 — — $90.00 $140.00 $90.00 2026-09-09
97530 HCPCS Therapeutic Activities 46 14 — — $90.00 $140.00 $90.00 2026-09-09
97535 HCPCS Self Care Mngment Training 46 14 — — $90.00 $140.00 $90.00 2026-09-09
97140 HCPCS Manual Therapy 1/> Regions 44 13 — — $90.00 $140.00 $90.00 2026-09-09
97129 HCPCS Ther Ivntj 1st 15 Min 44 13 — — $90.00 $140.00 $90.00 2026-09-09
97116 HCPCS Gait Training Therapy 46 14 — — $90.00 $140.00 $90.00 2026-09-09
97032 HCPCS Appl Modality 1+estim Ea 15 44 13 — — $90.00 $140.00 $90.00 2026-09-09
97110 HCPCS Therapeutic Exercises 46 14 — — $90.00 $140.00 $90.00 2026-09-09
97124 HCPCS Massage Therapy 44 13 — — $90.00 $140.00 $90.00 2026-09-09
92607 HCPCS Ex For Speech Device Rx 1hr 44 13 — — $90.00 $140.00 $90.00 2026-09-09
92526 HCPCS Oral Function Therapy 46 14 — — $90.00 $140.00 $90.00 2026-09-09
92507 HCPCS Speech/hearing Therapy 46 14 — — $90.00 $140.00 $90.00 2026-09-09
97166 HCPCS Ot Eval Mod Complex 45 Min 46 14 — — $150.00 $150.00 $150.00 2026-09-09
92522 HCPCS Evaluate Speech Production 44 13 — — $150.00 $150.00 $150.00 2026-09-09
92521 HCPCS Evaluation Of Speech Fluency 3 2 — — $150.00 $150.00 $150.00 2026-09-09
92524 HCPCS Behavral Qualit Analys Voice 44 13 — — $150.00 $150.00 $150.00 2026-09-09
97161 HCPCS Pt Eval Low Complex 20 Min 46 14 — — $150.00 $150.00 $150.00 2026-09-09
97163 HCPCS Pt Eval High Complex 45 Min 46 14 — — $150.00 $150.00 $150.00 2026-09-09
97162 HCPCS Pt Eval Mod Complex 30 Min 46 14 — — $150.00 $150.00 $150.00 2026-09-09
97165 HCPCS Ot Eval Low Complex 30 Min 46 14 — — $150.00 $150.00 $150.00 2026-09-09
0424 RC Physical Therapy - Evaluation Or Re-evaluation 31 14 — — $150.00 $150.00 $150.00 2026-08-10
0444 RC Speech Therapy - Language Pathology - Evaluation Or Reevaluation 19 9 — — $150.00 $150.00 $150.00 2026-08-10
0434 RC Occupational Therapy - Evaluation Or Reevaluation 31 14 — — $150.00 $150.00 $150.00 2026-08-10
97168 HCPCS Ot Re-eval Est Plan Care 44 13 — — $150.00 $150.00 $150.00 2026-09-09
97164 HCPCS Pt Re-eval Est Plan Care 46 14 — — $150.00 $150.00 $150.00 2026-09-09
96105 HCPCS Assessment Of Aphasia 44 13 — — $150.00 $150.00 $150.00 2026-09-09
92523 HCPCS Speech Sound Lang Comprehen 46 14 — — $150.00 $150.00 $150.00 2026-09-09
97167 HCPCS Ot Eval High Complex 60 Min 44 13 — — $150.00 $150.00 $150.00 2026-09-09
0809 RC Inpatient Renal Dialysis - Other 3 2 — — $600.00 $600.00 $600.00 2026-08-10
0808 RC Inpatient Renal Dialysis - Other 2 1 — — $600.00 $600.00 $600.00 2026-08-10
0806 RC Inpatient Renal Dialysis - Continuation 2 1 — — $600.00 $600.00 $600.00 2026-08-10
0802 RC Inpatient Renal Dialysis - Peritoneal Dialysis (non-capd) 3 2 — — $600.00 $600.00 $600.00 2026-08-10
0801 RC Inpatient Renal Dialysis - Hemodialysis 3 2 — — $600.00 $600.00 $600.00 2026-08-10
0803 RC Inpatient Renal Dialysis - Continuous Ambulatory Peritoneal Dialysis (capd) 3 2 — — $600.00 $600.00 $600.00 2026-08-10
0807 RC Inpatient Renal Dialysis - Observation/Hourly 2 1 — — $600.00 $600.00 $600.00 2026-08-10
0800 RC Inpatient Renal Dialysis - General Classification 3 2 — — $600.00 $600.00 $600.00 2026-08-10
0805 RC Inpatient Renal Dialysis - Treatment 2 1 — — $600.00 $600.00 $600.00 2026-08-10
0804 RC Inpatient Renal Dialysis - Continuous Cycling Peritoneal Dialysis (ccpd) 3 2 — — $600.00 $600.00 $600.00 2026-08-10
951 LOCAL Other Factors Influencing Health Status 28 13 — — $1,376.31 $1,376.31 $1,376.31 2026-08-10
0110 RC Room & Board - Private (One Bed) - General Classification 34 15 — — $1,159.20 $1,529.60 $1,529.60 2026-08-10
0111 RC Room & Board - Private (One Bed) - Medical/Surgical/GYN 34 15 — — $1,650.00 $1,650.00 $1,650.00 2026-08-10
0118 RC Room & Board - Private (One Bed) - Rehabilitation 8 3 — — $1,500.00 $1,700.00 $1,500.00 2026-08-10
0120 RC Room & Board - Semi-private (Two Beds) - General Classification 34 15 — — $1,722.50 $1,722.50 $1,722.50 2026-08-10
0138 RC Room & Board - Three And Four Beds - Rehabilitation 8 3 — — $1,772.50 $1,772.50 $1,772.50 2026-08-10
0158 RC Room & Board - Ward - Rehabilitation 8 3 — — $1,772.50 $1,772.50 $1,772.50 2026-08-10
0128 RC Room & Board - Semi-private (Two Beds) - Rehabilitation 8 3 — — $1,772.50 $1,772.50 $1,772.50 2026-08-10
0148 RC Room & Board - Deluxe Private - Rehabilitation 8 3 — — $1,772.50 $1,772.50 $1,772.50 2026-08-10
0180 RC Leave Of Absence - General Classification 25 10 — — $1,800.00 $1,800.00 $1,800.00 2026-08-10
0206 RC Intensive Care Unit - Intermediate ICU 34 15 — — $1,545.60 $1,872.80 $1,872.80 2026-08-10
0214 RC Coronary Care Unit - Intermediate Ccu 6 4 — — $2,027.00 $2,027.00 $2,027.00 2026-08-10
0200 RC Intensive Care Unit - General Classification 34 15 — — $1,932.00 $2,162.50 $2,162.50 2026-08-10
640 LOCAL Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes With M… 28 13 — — $8,684.45 $8,684.45 $8,684.45 2026-08-10
371 LOCAL Major Gastrointestinal Disorders And Peritoneal Infections With Mcc* 28 13 — — $8,693.32 $8,693.32 $8,693.32 2026-08-10
D1401 HCPCS Cardiac M >=68.50- Tier Tier 3 4 4 — — $14,456.46 $14,456.46 $14,456.46 2026-09-09
200 LOCAL Pneumothorax With Cc 28 13 — — $15,139.39 $15,139.39 $15,139.39 2026-08-10
D2001 HCPCS Miscellaneous M >=66.50- Tier Tier 3 4 4 — — $15,882.75 $15,882.75 $15,882.75 2026-09-09
D0101 HCPCS Stroke M >=72.50- Tier Tier 3 4 4 — — $15,990.49 $15,990.49 $15,990.49 2026-09-09
D0701 HCPCS Fracture Of Lower Extremity M >=61.50- Tier Tier 3 4 4 — — $16,590.67 $16,590.67 $16,590.67 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
D0802 HCPCS Replacement Of Lower-extremity Joint M >=57.50 And M <63.50- Tier Tier 3 4 4 — — $17,634.22 $17,634.22 $17,634.22 2026-09-09
A0902 HCPCS Other Orthopedic M >=51.50 And M <63.50- Tier None 4 4 — — $19,726.01 $19,726.01 $19,726.01 2026-09-09
A0602 HCPCS Neurological M >=52.50 And M <64.50- Tier None 4 4 — — $20,017.44 $20,017.44 $20,017.44 2026-09-09
D0601 HCPCS Neurological M >=64.50- Tier Tier 3 4 4 — — $20,024.24 $20,024.24 $20,024.24 2026-09-09
A2002 HCPCS Miscellaneous M >=55.50 And M <66.50- Tier None 4 4 — — $21,005.13 $21,005.13 $21,005.13 2026-09-09
A0102 HCPCS Stroke M >=63.50 And M <72.50- Tier None 10 4 — — $16,828.84 $21,192.28 $16,828.84 2026-09-09
917 LOCAL Poisoning And Toxic Effects Of Drugs With Mcc* 28 13 — — $21,332.78 $21,332.78 $21,332.78 2026-08-10
A2003 HCPCS Miscellaneous M >=46.50 And M <55.50- Tier None 10 4 — — $21,197.31 $21,663.15 $21,197.31 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
D1402 HCPCS Cardiac M >=55.50 And M <68.50- Tier Tier 3 4 4 — — $22,336.59 $22,336.59 $22,336.59 2026-09-09
C1802 HCPCS Major Multiple Trauma With Brain Or Spinal Cord Injury M >=55.50 And M <67.50- T… 4 4 — — $22,629.89 $22,629.89 $22,629.89 2026-09-09
D0203 HCPCS Traumatic Brain Injury M >=49.50 And M <61.50- Tier Tier 3 4 4 — — $22,848.29 $22,848.29 $22,848.29 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
A0103 HCPCS Stroke M >=50.50 And M <63.50- Tier None 10 4 — — $21,602.26 $23,225.62 $21,602.26 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
A0804 HCPCS Replacement Of Lower-extremity Joint M >=42.50 And M <51.50- Tier None 4 4 — — $23,505.56 $23,505.56 $23,505.56 2026-09-09
C0302 HCPCS Non-traumatic Brain Injury M >=52.50 And M <65.50- Tier Tier 2 10 4 — — $21,933.75 $23,788.63 $21,933.75 2026-09-09
A0401 HCPCS Traumatic Spinal Cord Injury M >=56.50- Tier None 4 4 — — $23,918.87 $23,918.87 $23,918.87 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
D0602 HCPCS Neurological M >=52.50 And M <64.50- Tier Tier 3 10 4 — — $20,819.24 $25,316.46 $20,819.24 2026-09-09
D0902 HCPCS Other Orthopedic M >=51.50 And M <63.50- Tier Tier 3 10 4 — — $20,170.59 $25,420.74 $20,170.59 2026-09-09
A0302 HCPCS Non-traumatic Brain Injury M >=52.50 And M <65.50- Tier None 4 4 — — $25,732.74 $25,732.74 $25,732.74 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
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
D0302 HCPCS Non-traumatic Brain Injury M >=52.50 And M <65.50- Tier Tier 3 4 4 — — $26,203.49 $26,203.49 $26,203.49 2026-09-09
A0904 HCPCS Other Orthopedic M <44.5- Tier None 10 4 — — $2,629.51 $26,295.06 $26,295.06 2026-09-09
D0804 HCPCS Replacement Of Lower-extremity Joint M >=42.50 And M <51.50- Tier Tier 3 10 4 — — $24,042.67 $26,305.85 $26,305.85 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
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
920 LOCAL Complications Of Treatment With Cc* 28 13 — — $27,125.90 $27,125.90 $27,125.90 2026-08-10
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
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
699 LOCAL Other Kidney And Urinary Tract Diagnoses With Cc 28 13 — — $28,340.85 $28,340.85 $28,340.85 2026-08-10
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
D1404 HCPCS Cardiac M <45.50- Tier Tier 3 6 4 — — $28,653.10 $28,653.10 $28,653.10 2026-09-09
C0303 HCPCS Non-traumatic Brain Injury M >=42.50 And M <52.50- Tier Tier 2 4 4 — — $28,722.58 $28,722.58 $28,722.58 2026-09-09
D0803 HCPCS Replacement Of Lower-extremity Joint M >=51.50 And M <57.50- Tier Tier 3 4 4 — — $29,351.45 $29,351.45 $29,351.45 2026-09-09
C0603 HCPCS Neurological M >=43.50 And M <52.50- Tier Tier 2 10 4 — — $29,080.97 $29,544.28 $29,080.97 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
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
C0703 HCPCS Fracture Of Lower Extremity M >=41.50 And M <52.50- Tier Tier 2 4 4 — — $30,161.04 $30,161.04 $30,161.04 2026-09-09
D2002 HCPCS Miscellaneous M >=55.50 And M <66.50- Tier Tier 3 10 4 — — $28,801.63 $30,382.01 $30,382.01 2026-09-09
C0904 HCPCS Other Orthopedic M <44.5- Tier Tier 2 10 4 — — $30,513.02 $30,513.02 $30,513.02 2026-09-09
D2004 HCPCS Miscellaneous M <46.50 And A >=77.50- Tier Tier 3 10 4 — — $28,239.19 $30,675.82 $28,239.19 2026-09-09
D0603 HCPCS Neurological M >=43.50 And M <52.50- Tier Tier 3 10 4 — — $28,871.01 $30,773.10 $30,773.10 2026-09-09
A0104 HCPCS Stroke M >=41.50 And M <50.50- Tier None 4 4 — — $30,969.87 $30,969.87 $30,969.87 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
A2005 HCPCS Miscellaneous M <46.50 And A <77.50- Tier None 10 4 — — $27,058.38 $31,211.35 $27,058.38 2026-09-09
C2004 HCPCS Miscellaneous M <46.50 And A >=77.50- Tier Tier 2 4 4 — — $31,829.78 $31,829.78 $31,829.78 2026-09-09
D0903 HCPCS Other Orthopedic M >=44.50 And M <51.50- Tier Tier 3 10 4 — — $28,251.13 $32,447.57 $28,251.13 2026-09-09
C2005 HCPCS Miscellaneous M <46.50 And A <77.50- Tier Tier 2 4 4 — — $32,524.53 $32,524.53 $32,524.53 2026-09-09
D0703 HCPCS Fracture Of Lower Extremity M >=41.50 And M <52.50- Tier Tier 3 10 4 — — $28,231.04 $32,549.21 $32,549.21 2026-09-09
C1403 HCPCS Cardiac M >=45.50 And M <55.50- Tier Tier 2 4 4 — — $32,670.92 $32,670.92 $32,670.92 2026-09-09
560 LOCAL Aftercare, Musculoskeletal System And Connective Tissue With Cc 28 13 — — $32,819.66 $32,819.66 $32,819.66 2026-08-10
C0902 HCPCS Other Orthopedic M >=51.50 And M <63.50- Tier Tier 2 4 4 — — $32,942.18 $32,942.18 $32,942.18 2026-09-09
949 LOCAL Aftercare With Cc/mcc 28 13 — — $33,174.97 $33,174.97 $33,174.97 2026-08-10
A0405 HCPCS Traumatic Spinal Cord Injury M >=31.50 And M <41.50- Tier None 4 4 — — $33,248.46 $33,248.46 $33,248.46 2026-09-09
A0604 HCPCS Neurological M <43.50- Tier None 10 4 — — $27,571.50 $33,325.34 $29,424.72 2026-09-09
901 LOCAL Wound Debridements For Injuries With Mcc 28 13 — — $33,842.46 $33,842.46 $33,842.46 2026-08-10
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
D0704 HCPCS Fracture Of Lower Extremity M <41.50- Tier Tier 3 10 4 — — $31,213.62 $34,781.26 $31,213.62 2026-09-09
D0904 HCPCS Other Orthopedic M <44.5- Tier Tier 3 10 4 — — $28,823.33 $35,291.00 $32,026.21 2026-09-09
D0103 HCPCS Stroke M >=50.50 And M <63.50- Tier Tier 3 10 4 — — $23,378.99 $35,294.72 $35,294.72 2026-09-09
D0205 HCPCS Traumatic Brain Injury M <35.50- Tier Tier 3 10 4 — — $35,465.63 $35,465.63 $35,465.63 2026-09-09
D2003 HCPCS Miscellaneous M >=46.50 And M <55.50- Tier Tier 3 10 4 — — $24,287.35 $35,487.30 $35,487.30 2026-09-09
565 LOCAL Other Musculoskeletal System And Connective Tissue Diagnoses With Cc* 28 13 — — $36,718.75 $36,718.75 $36,718.75 2026-08-10
291 LOCAL Heart Failure And Shock With Mcc* 28 13 — — $36,767.34 $36,767.34 $36,767.34 2026-08-10
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
D0104 HCPCS Stroke M >=41.50 And M <50.50- Tier Tier 3 10 4 — — $30,948.19 $37,211.00 $37,211.00 2026-09-09
559 LOCAL Aftercare, Musculoskeletal System And Connective Tissue With Mcc 28 13 — — $37,364.53 $37,364.53 $37,364.53 2026-08-10
56 LOCAL Degenerative Nervous System Disorders With Mcc 28 13 — — $37,522.87 $37,522.87 $37,522.87 2026-08-10
177 LOCAL Respiratory Infections And Inflammations With Mcc* 28 13 — — $38,443.88 $38,443.88 $38,443.88 2026-08-10
A0704 HCPCS Fracture Of Lower Extremity M <41.50- Tier None 10 4 — — $28,522.30 $38,651.56 $28,522.30 2026-09-09
D0303 HCPCS Non-traumatic Brain Injury M >=42.50 And M <52.50- Tier Tier 3 10 4 — — $25,128.01 $39,109.65 $25,128.01 2026-09-09
70 LOCAL Other Cerebrovascular Disorders With Mcc* 28 13 — — $39,466.46 $39,466.46 $39,466.46 2026-08-10
907 LOCAL Other O.r. Procedures For Injuries With Mcc* 28 13 — — $40,591.37 $40,591.37 $40,591.37 2026-08-10
D2005 HCPCS Miscellaneous M <46.50 And A <77.50- Tier Tier 3 10 4 — — $33,240.87 $41,636.41 $35,797.56 2026-09-09
314 LOCAL Other Circulatory System Diagnoses With Mcc 28 13 — — $10,827.44 $41,866.10 $26,346.77 2026-08-10
C1804 HCPCS Major Multiple Trauma With Brain Or Spinal Cord Injury M >=40.50 And M <45.50- T… 4 4 — — $42,616.33 $42,616.33 $42,616.33 2026-09-09
862 LOCAL Postoperative And Post-traumatic Infections With Mcc 28 13 — — $10,635.23 $43,249.95 $26,942.59 2026-08-10
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
637 LOCAL Diabetes With Mcc 28 13 — — $43,652.02 $43,652.02 $43,652.02 2026-08-10
189 LOCAL Pulmonary Edema And Respiratory Failure 28 13 — — $25,134.28 $44,021.35 $34,577.82 2026-08-10
576 LOCAL Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 28 13 — — $44,512.04 $44,512.04 $44,512.04 2026-08-10
C1704 HCPCS Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=36.50 And M <41.50… 4 4 — — $45,395.47 $45,395.47 $45,395.47 2026-09-09
A1806 HCPCS Major Multiple Trauma With Brain Or Spinal Cord Injury M <30.50- Tier None 4 4 — — $45,462.23 $45,462.23 $45,462.23 2026-09-09
288 LOCAL Acute And Subacute Endocarditis With Mcc 28 13 — — $45,828.68 $45,828.68 $45,828.68 2026-08-10
D1705 HCPCS Major Multiple Trauma Without Brain Or Spinal Cord Injury M <36.50- Tier Tier 3 4 4 — — $46,258.82 $46,258.82 $46,258.82 2026-09-09
C0704 HCPCS Fracture Of Lower Extremity M <41.50- Tier Tier 2 10 4 — — $32,865.69 $47,777.19 $32,865.69 2026-09-09
908 LOCAL Other O.r. Procedures For Injuries With Cc* 28 13 — — $48,588.99 $48,588.99 $48,588.99 2026-08-10
D0505 HCPCS Non-traumatic Spinal Cord Injury M <39.50- Tier Tier 3 4 4 — — $48,974.99 $48,974.99 $48,974.99 2026-09-09
393 LOCAL Other Digestive System Diagnoses With Mcc 28 13 — — $43,133.53 $49,153.22 $46,143.38 2026-08-10
208 LOCAL Respiratory System Diagnosis With Ventilator Support <=96 Hours 28 13 — — $49,785.83 $49,785.83 $49,785.83 2026-08-10
D0604 HCPCS Neurological M <43.50- Tier Tier 3 10 4 — — $31,312.17 $49,920.10 $38,825.09 2026-09-09
919 LOCAL Complications Of Treatment With Mcc* 28 13 — — $50,954.62 $50,954.62 $50,954.62 2026-08-10
D0106 HCPCS Stroke M <41.50 And A <84.50- Tier Tier 3 10 4 — — $40,833.94 $51,796.51 $48,335.61 2026-09-09
A0106 HCPCS Stroke M <41.50 And A <84.50- Tier None 10 4 — — $49,262.18 $51,854.53 $49,262.18 2026-09-09
939 LOCAL O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 28 13 — — $54,043.61 $54,043.61 $54,043.61 2026-08-10
94 LOCAL Bacterial And Tuberculous Infections Of Nervous System With Mcc 28 13 — — $55,947.70 $55,947.70 $55,947.70 2026-08-10
C0205 HCPCS Traumatic Brain Injury M <35.50- Tier Tier 2 4 4 — — $57,546.28 $57,546.28 $57,546.28 2026-09-09
539 LOCAL Osteomyelitis With Mcc* 28 13 — — $45,204.17 $58,994.67 $52,099.42 2026-08-10
D1004 HCPCS Amputation Lower Extremity M <47.50- Tier Tier 3 10 4 — — $37,531.74 $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
385 LOCAL Inflammatory Bowel Disease With Mcc 28 13 — — $68,442.08 $68,442.08 $68,442.08 2026-08-10
205 LOCAL Other Respiratory System Diagnoses With Mcc 28 13 — — $68,495.84 $68,495.84 $68,495.84 2026-08-10
653 LOCAL Major Bladder Procedures With Mcc 28 13 — — $72,605.31 $72,605.31 $72,605.31 2026-08-10
628 LOCAL Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 28 13 — — $72,605.31 $72,605.31 $72,605.31 2026-08-10
853 LOCAL Infectious And Parasitic Diseases With O.r. Procedures With Mcc 28 13 — — $79,192.62 $79,192.62 $79,192.62 2026-08-10
163 LOCAL Major Chest Procedures With Mcc 28 13 — — $83,256.13 $83,256.13 $83,256.13 2026-08-10
207 LOCAL Respiratory System Diagnosis With Ventilator Support >96 Hours 28 13 — — $90,258.74 $90,258.74 $90,258.74 2026-08-10
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
981 LOCAL Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 28 13 — — $115,873.96 $115,873.96 $115,873.96 2026-08-10
36600 HCPCS Withdrawal Of Arterial Blood 0 0 — — — — — 2026-08-10
36597 HCPCS Reposition Venous Catheter 0 0 — — — — — 2026-08-10
25608 HCPCS Treat Fx Rad Intra-articul 0 0 — — — — — 2026-08-10
36590 HCPCS Removal Tunneled Cv Cath 0 0 — — — — — 2026-08-10
36589 HCPCS Removal Tunneled Cv Cath 0 0 — — — — — 2026-08-10
25607 HCPCS Treat Fx Rad Extra-articul 0 0 — — — — — 2026-08-10
19083 HCPCS Bx Breast 1st Lesion US Imag 0 0 — — — — — 2026-08-10
36573 HCPCS Insj Picc Rs&i 5 Yr+ 0 0 — — — — — 2026-08-10
36569 HCPCS Insj Picc 5 Yr+ Without Imaging 0 0 — — — — — 2026-08-10
24685 HCPCS Treat Ulnar Fracture 0 0 — — — — — 2026-08-10
36561 HCPCS Insert Tunneled Cv Cath 0 0 — — — — — 2026-08-10
36558 HCPCS Insert Tunneled Cv Cath 0 0 — — — — — 2026-08-10
24615 HCPCS Treat Elbow Dislocation 0 0 — — — — — 2026-08-10
19081 HCPCS Bx Breast 1st Lesion Strtctc 0 0 — — — — — 2026-08-10
11406 HCPCS Exc Tr-ext B9+marg >4.0 Cm 0 0 — — — — — 2026-08-10
36556 HCPCS Insert Non-tunnel Cv Cath 0 0 — — — — — 2026-08-10
36514 HCPCS Apheresis Plasma 0 0 — — — — — 2026-08-10
24516 HCPCS Treat Humerus Fracture 0 0 — — — — — 2026-08-10
36460 HCPCS Intrauterine Transfusion Ftl 0 0 — — — — — 2026-08-10
36430 HCPCS Transfusion Bld/bld Compnt 0 0 — — — — — 2026-08-10
24430 HCPCS Repair Of Humerus 0 0 — — — — — 2026-08-10
16020 HCPCS Dress/debrid P-thick Burn S 0 0 — — — — — 2026-08-10
36415 HCPCS Routine Venipuncture 0 0 — — — — — 2026-08-10
36248 HCPCS Ins Cath Abd/l-ext Art Addl 0 0 — — — — — 2026-08-10
24344 HCPCS Reconstruct Elbow Lat Ligmnt 0 0 — — — — — 2026-08-10
36247 HCPCS Ins Cath Abd/l-ext Art 3rd 0 0 — — — — — 2026-08-10
36225 HCPCS Place Cath Subclavian Art 0 0 — — — — — 2026-08-10
23650 HCPCS Cltx Sho Dslc W/mnpj Wo Anes 0 0 — — — — — 2026-08-10
15853 HCPCS Removal Sutr/stapl Xreq Anes 0 0 — — — — — 2026-08-10
11045 HCPCS Dbrdmt Subq Tiss Each Addl 0 0 — — — — — 2026-08-10
00410 HCPCS Anesth Correct Heart Rhythm 0 0 — — — — — 2026-08-10
58120 HCPCS Dilation And Curettage 0 0 — — — — — 2026-08-10
57522 HCPCS Conization Of Cervix 0 0 — — — — — 2026-08-10
36200 HCPCS Place Catheter In Aorta 0 0 — — — — — 2026-08-10
57461 HCPCS Conz Of Cervix W/scope Leep 0 0 — — — — — 2026-08-10
57288 HCPCS Repair Bladder Defect 0 0 — — — — — 2026-08-10
58301 HCPCS Remove Intrauterine Device 0 0 — — — — — 2026-08-10
58550 HCPCS Laparo-asst Vag Hysterectomy 0 0 — — — — — 2026-08-10
58552 HCPCS Laparo-vag Hyst Incl T/o 0 0 — — — — — 2026-08-10
58554 HCPCS Laparo-vag Hyst W/t/o Compl 0 0 — — — — — 2026-08-10
58558 HCPCS Hysteroscopy Biopsy 0 0 — — — — — 2026-08-10
58561 HCPCS Hysteroscopy Remove Myoma 0 0 — — — — — 2026-08-10
58563 HCPCS Hysteroscopy Ablation 0 0 — — — — — 2026-08-10
58570 HCPCS Tlh Uterus 250 G Or Less 0 0 — — — — — 2026-08-10
58571 HCPCS Tlh W/t/o 250 G Or Less 0 0 — — — — — 2026-08-10
58661 HCPCS Laparoscopy Remove Adnexa 0 0 — — — — — 2026-08-10
58662 HCPCS Laparoscopy Excise Lesions 0 0 — — — — — 2026-08-10
59012 HCPCS Fetal Cord Puncture Prenatal 0 0 — — — — — 2026-08-10
59025 HCPCS Fetal Non-stress Test 0 0 — — — — — 2026-08-10
59820 HCPCS Care Of Miscarriage 0 0 — — — — — 2026-08-10
59897 HCPCS Unlisted Fetal Invas Px W/us 0 0 — — — — — 2026-08-10
60220 HCPCS Partial Removal Of Thyroid 0 0 — — — — — 2026-08-10
61782 HCPCS Scan Proc Cranial Extra 0 0 — — — — — 2026-08-10
62270 HCPCS Dx Lmbr Spi Pnxr 0 0 — — — — — 2026-08-10
62328 HCPCS Dx Lmbr Spi Pnxr W/fluor/ct 0 0 — — — — — 2026-08-10
64450 HCPCS Njx Aa&/strd Other Pn/branch 0 0 — — — — — 2026-08-10
64718 HCPCS Revise Ulnar Nerve At Elbow 0 0 — — — — — 2026-08-10
64721 HCPCS Carpal Tunnel Surgery 0 0 — — — — — 2026-08-10
65426 HCPCS Removal Of Eye Lesion 0 0 — — — — — 2026-08-10
65730 HCPCS Corneal Transplant 0 0 — — — — — 2026-08-10
65755 HCPCS Corneal Transplant 0 0 — — — — — 2026-08-10
65756 HCPCS Corneal Trnspl Endothelial 0 0 — — — — — 2026-08-10
65820 HCPCS Relieve Inner Eye Pressure 0 0 — — — — — 2026-08-10
66170 HCPCS Glaucoma Surgery 0 0 — — — — — 2026-08-10
66180 HCPCS Aqueous Shunt Eye W/graft 0 0 — — — — — 2026-08-10
66250 HCPCS Follow-up Surgery Of Eye 0 0 — — — — — 2026-08-10
66500 HCPCS Incision Of Iris 0 0 — — — — — 2026-08-10
66625 HCPCS Removal Of Iris 0 0 — — — — — 2026-08-10
36012 HCPCS Place Catheter In Vein 0 0 — — — — — 2026-08-10
23515 HCPCS Optx Clavicular Fx W/int Fix 0 0 — — — — — 2026-08-10
57260 HCPCS Cmbn Ant Pst Colprhy 0 0 — — — — — 2026-08-10
55880 HCPCS Abltj Mal Prst8 Tiss Hifu 0 0 — — — — — 2026-08-10
33228 HCPCS Remv&replc Pm Gen Dual Lead 0 0 — — — — — 2026-08-10
55700 HCPCS Biopsy Of Prostate 0 0 — — — — — 2026-08-10
55040 HCPCS Removal Of Hydrocele 0 0 — — — — — 2026-08-10
33227 HCPCS Remove&replace Pm Gen Singl 0 0 — — — — — 2026-08-10
23412 HCPCS Repair Rotator Cuff Chronic 0 0 — — — — — 2026-08-10
15772 HCPCS Grfg Autol Fat Lipo Ea Addl 0 0 — — — — — 2026-08-10
54161 HCPCS Circum 28 Days Or Older 0 0 — — — — — 2026-08-10
53445 HCPCS Insert Uro/ves Nck Sphincter 0 0 — — — — — 2026-08-10
33207 HCPCS Insert Heart Pm Ventricular 0 0 — — — — — 2026-08-10
52601 HCPCS Prostatectomy (turp) 0 0 — — — — — 2026-08-10
52356 HCPCS Cysto/uretero W/lithotripsy 0 0 — — — — — 2026-08-10
32555 HCPCS Aspirate Pleura With Imaging 0 0 — — — — — 2026-08-10
22552 HCPCS Arthrd Ant Ntrbd Cervical Ea 0 0 — — — — — 2026-08-10
52332 HCPCS Cystoscopy And Treatment 0 0 — — — — — 2026-08-10
52317 HCPCS Remove Bladder Stone 0 0 — — — — — 2026-08-10
32408 HCPCS Core Ndl Bx Lng/med Perq 0 0 — — — — — 2026-08-10
52310 HCPCS Cystoscopy And Treatment 0 0 — — — — — 2026-08-10
52240 HCPCS Cystoscopy And Treatment 0 0 — — — — — 2026-08-10
31500 HCPCS Insert Emergency Airway 0 0 — — — — — 2026-08-10
22548 HCPCS Arthrd Ant Toral/xoral C1-c2 0 0 — — — — — 2026-08-10
15771 HCPCS Grfg Autol Fat Lipo 50 Cc/< 0 0 — — — — — 2026-08-10
10061 HCPCS I&d Abscess Comp/multiple 0 0 — — — — — 2026-08-10
52235 HCPCS Cystoscopy And Treatment 0 0 — — — — — 2026-08-10
52234 HCPCS Cystoscopy And Treatment 0 0 — — — — — 2026-08-10
31288 HCPCS Nasal/sinus Endoscopy Surg 0 0 — — — — — 2026-08-10
52224 HCPCS Cystoscopy And Treatment 0 0 — — — — — 2026-08-10
52204 HCPCS Cystoscopy W/biopsy(s) 0 0 — — — — — 2026-08-10
31276 HCPCS Nsl/sins Ndsc Frnt Tiss Rmvl 0 0 — — — — — 2026-08-10
22515 HCPCS Perq Vertebral Augmentation 0 0 — — — — — 2026-08-10
51798 HCPCS US Urine Capacity Measure 0 0 — — — — — 2026-08-10
51702 HCPCS Insert Temp Bladder Cath 0 0 — — — — — 2026-08-10
31267 HCPCS Endoscopy Maxillary Sinus 0 0 — — — — — 2026-08-10
51102 HCPCS Drain Bl W/cath Insertion 0 0 — — — — — 2026-08-10
50949 HCPCS Unlisted Laps Px Ureter 0 0 — — — — — 2026-08-10
31259 HCPCS Nsl/sins Ndsc Sphn Tiss Rmvl 0 0 — — — — — 2026-08-10
22514 HCPCS Perq Vertebral Augmentation 0 0 — — — — — 2026-08-10
14020 HCPCS Tis Trnfr S/a/l 10 Sq Cm/< 0 0 — — — — — 2026-08-10
50590 HCPCS Fragmenting Of Kidney Stone 0 0 — — — — — 2026-08-10
50543 HCPCS Laparo Partial Nephrectomy 0 0 — — — — — 2026-08-10
31257 HCPCS Nsl/sins Ndsc Tot W/sphendt 0 0 — — — — — 2026-08-10
50435 HCPCS Exchange Nephrostomy Cath 0 0 — — — — — 2026-08-10
49651 HCPCS Lap Ing Hernia Repair Recur 0 0 — — — — — 2026-08-10
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