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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

PERKINS COUNTY HEALTH SERVICES

Grant, NE · CCN 281356 · Rates published

Your selected procedure

You selected 27447 (HCPCS)

Pro Fee AS: Total Knee Arthroplasty

This facility filed a payer-negotiated range for this code ($3,404 to $3,404), not a single rate. The comparison board shows the midpoint estimate.

2,056 distinct procedures filed
6 distinct payers
14,094 rate rows
2024-12-28 last MRF observed · ⚠ 20 mo old
Data quality

14,094 of 14,094 rate rows are consumer-grade (100.0%)

Every filed rate row passes our consumer-grade checks — none are excluded from the medians.

⚠ Possibly outdated The most recent machine-readable file we have for this hospital is 20 months old.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://www.pchsgrant.com/docs/476014365_perkins-county-hospital-district_standardcharges.csv
Found on page https://www.pchsgrant.com/getpage.php?name=financial_policy&sub=Patient%2FVisitor%20Info
Discovered viaDiscovered by HANK
Last fetch success · 2026-08-11
Content fingerprint a279c0f44bb0cbbf… · 5,120,263 bytes · first seen 2026-05-08

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
J2350
HCPCS 		Ocrelizumab [300mg] Vl IV 6 $33,475.00 $33,475.00 $33,475.00 nat. median
$331
outlier · 101.2×
C1767
HCPCS 		Adaptive Stim Implantable Neurostim 6 $33,127.50 $33,127.50 $33,127.50 nat. median
$23,668
1.4× median
J9022
HCPCS 		Atezolizumab 1200mg Vl IV 6 $19,697.50 $19,697.50 $19,697.50 nat. median
$5,498
outlier · 3.6×
C1772
HCPCS 		Synchromed Ii Pump Cath Passer Kit 6 $19,353.00 $19,353.00 $19,353.00 nat. median
$10,594
1.8× median
J1930
HCPCS 		Lanreotide [120mg] Syr 6 $18,300.00 $18,300.00 $18,300.00 nat. median
$4,399
outlier · 4.2×
J1944
HCPCS 		Daratumumab Hyaluronidase 1800mg/15ml Vl 6 $18,161.25 $18,161.25 $18,161.25 nat. median
$1,821
outlier · 10.0×
J3380
HCPCS 		Vedolizumab [300mg] Vl IV 6 $16,352.25 $16,352.25 $16,352.25 nat. median
$150
outlier · 109.2×
J3101
HCPCS 		Tenecteplase Inj [50 Mg] Vl 6 $13,804.72 $13,804.72 $13,804.72 nat. median
$3,475
outlier · 4.0×
J9301
HCPCS 		Obinutuzamab [1000mg] Vl IV 6 $13,698.00 $13,698.00 $13,698.00 nat. median
$272
outlier · 50.3×
C1776
HCPCS 		Vega Knee Implants Totalknee Replacement 6 $13,125.00 $13,125.00 $13,125.00 nat. median
$3,398
outlier · 3.9×
24140
HCPCS 		Pro Fee: Medical Epicondylectomy 6 $12,612.00 $12,612.00 $12,612.00 nat. median
$3,556
outlier · 3.5×
J2353
HCPCS 		Octreotide Lar [30mg] Vl 6 $12,065.75 $12,065.75 $12,065.75 nat. median
$5,513
outlier · 2.2×
J9271
HCPCS 		Pembrolizumab [100MG/4mL] Vl IV 6 $11,115.04 $11,115.04 $11,115.04 nat. median
$254
outlier · 43.8×
J9306
HCPCS 		Pertuzumab [420MG/14mL] Vl IV 6 $10,584.00 $10,584.00 $10,584.00 nat. median
$67
outlier · 158.7×
J2406
HCPCS 		Oritavancin [1200mg] Vl IV 6 $9,391.00 $9,391.00 $9,391.00 nat. median
$59
outlier · 160.3×
24101
HCPCS 		Pro Fee: Arthrotomy 6 $9,310.00 $9,310.00 $9,310.00 nat. median
$3,506
outlier · 2.7×
J1569
HCPCS 		Immune Globulin [30GM/300mL] Vl IV 6 $8,957.75 $8,957.75 $8,957.75 nat. median
$1,010
outlier · 8.9×
52234
HCPCS 		Pro Fee: Cystoscopy/ Fulguration 6 $8,863.00 $8,863.00 $8,863.00 nat. median
$3,518
outlier · 2.5×
J2506
HCPCS 		Pegfilgrastim Auto Injector [6mg] Syr 6 $8,274.00 $8,274.00 $8,274.00 nat. median
$1,555
outlier · 5.3×
C1764
HCPCS 		Dnu Loop Recorder 6 $7,943.00 $7,943.00 $7,943.00 nat. median
$7,735
1.0× median
J9217
HCPCS 		Leuprolide [22.5mg] Kit 6 $7,353.75 $7,353.75 $7,353.75 nat. median
$1,518
outlier · 4.8×
10180
HCPCS 		I&d Complex; Post-op Wound Infection 6 $6,905.00 $6,905.00 $6,905.00 nat. median
$2,862
outlier · 2.4×
J1306
HCPCS 		Inclisiran 284mg/1.5ml Vl Sq 6 $6,663.75 $6,663.75 $6,663.75 nat. median
$43
outlier · 154.5×
15273
HCPCS 		Apply Skin Sub Graft T/Arm/Lg Child 6 $6,524.00 $6,524.00 $6,524.00 nat. median
$3,152
outlier · 2.1×
J9299
HCPCS 		Nivolumab [100mg] Vl IV 6 $6,523.25 $6,523.25 $6,523.25 nat. median
$2,649
outlier · 2.5×
J9047
HCPCS 		Carfilzomib [10mg] Vl IV 6 $6,279.25 $6,279.25 $6,279.25 nat. median
$1,500
outlier · 4.2×
J0840
HCPCS 		Crotalidae Polyvalent[1gm/2ml] Vl IV 6 $6,276.50 $6,276.50 $6,276.50 nat. median
$3,427
1.8× median
J1602
HCPCS 		Golimumab 50mg/4ml Vl IV 6 $6,191.50 $6,191.50 $6,191.50 nat. median
$228
outlier · 27.2×
59510
HCPCS 		Pro Fee: C-section Global Care 6 $6,161.00 $6,161.00 $6,161.00 nat. median
$3,552
1.7× median
74174
HCPCS 		CT Angio Abdomen Pelvis 6 $6,067.00 $6,067.00 $6,067.00 nat. median
$982
outlier · 6.2×
74178
HCPCS 		CT Abdomen Pelvis Wwo 6 $5,919.00 $5,919.00 $5,919.00 nat. median
$1,024
outlier · 5.8×
C1778
HCPCS 		Dnu Lead Istim Emanual 6 $5,768.00 $5,768.00 $5,768.00 nat. median
$4,468
1.3× median
C1781
HCPCS 		Strattice 10 X 10 Mesh 6 $5,750.00 $5,750.00 $5,750.00 nat. median
$1,404
outlier · 4.1×
J1568
HCPCS 		Immune Globulin G 30gm/300ml Vl 6 $5,654.25 $5,654.25 $5,654.25 nat. median
$722
outlier · 7.8×
J9033
HCPCS 		Bendamustine [100mg] Vl IV 6 $5,634.75 $5,634.75 $5,634.75 nat. median
$295
outlier · 19.1×
59400
HCPCS 		Pro Fee: Routine OB/Global Care Vaginal 6 $5,581.00 $5,581.00 $5,581.00 nat. median
$3,099
1.8× median
90378
HCPCS 		Palivizumab [100MG/1mL] Vl 6 $5,520.00 $5,520.00 $5,520.00 nat. median
$2,124
outlier · 2.6×
15277
HCPCS 		Apply Skin Graft F/n/hf/g Child 6 $5,225.00 $5,225.00 $5,225.00 nat. median
$2,065
outlier · 2.5×
J3111
HCPCS 		Romosozumab-aqqg 210mg/2.34ml Syr 6 $5,112.25 $5,112.25 $5,112.25 nat. median
$657
outlier · 7.8×
74177
HCPCS 		CT Abdomen Pelvis W 6 $4,949.00 $4,949.00 $4,949.00 nat. median
$968
outlier · 5.1×
44207
HCPCS 		Pro Fee: Laps Colectomy/Coloproctostomy 6 $4,943.00 $4,943.00 $4,943.00 nat. median
$3,946
1.3× median
61563
HCPCS 		Pro Fee: Exc Ben Tumor Cranial Bone Wo 6 $4,939.00 $4,939.00 $4,939.00 nat. median
$3,798
1.3× median
70546
HCPCS 		MRA Head Wwo 6 $4,936.00 $4,936.00 $4,936.00 nat. median
$1,051
outlier · 4.7×
74183
HCPCS 		MRI Abdomen Wwo 6 $4,895.00 $4,895.00 $4,895.00 nat. median
$1,106
outlier · 4.4×
78452
HCPCS 		Nm Myocardial Spect Multiple 6 $4,874.00 $4,874.00 $4,874.00 nat. median
$1,777
outlier · 2.7×
J9263
HCPCS 		Oxaliplatin [100mg] Vl IV 6 $4,827.25 $4,827.25 $4,827.25 nat. median
$102
outlier · 47.2×
70543
HCPCS 		MRI Orbit Face Neck Wwo 6 $4,815.00 $4,815.00 $4,815.00 nat. median
$1,083
outlier · 4.4×
78451
HCPCS 		Nm Myocardial Spect Single 6 $4,806.00 $4,806.00 $4,806.00 nat. median
$1,548
outlier · 3.1×
49520
HCPCS 		Pro Fee: Repair Inguinal Hernia Reduc 6 $4,743.00 $4,743.00 $4,743.00 nat. median
$3,795
1.2× median
72157
HCPCS 		MRI Thoracic Spine Wwo 6 $4,677.00 $4,677.00 $4,677.00 nat. median
$1,116
outlier · 4.2×

Other procedures at this hospital

Browse this hospital's 2,056 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
             
J2350 HCPCS Ocrelizumab [300mg] Vl IV 6 6 $33,475.00 $33,475.00 $33,475.00 $33,475.00 $33,475.00 2024-12-28
C1767 HCPCS Adaptive Stim Implantable Neurostim 6 6 $33,127.50 $33,127.50 $33,127.50 $33,127.50 $33,127.50 2024-12-28
J9022 HCPCS Atezolizumab 1200mg Vl IV 6 6 $19,697.50 $19,697.50 $19,697.50 $19,697.50 $19,697.50 2024-12-28
C1772 HCPCS Synchromed Ii Pump Cath Passer Kit 6 6 $19,353.00 $19,353.00 $19,353.00 $19,353.00 $19,353.00 2024-12-28
J1930 HCPCS Lanreotide [120mg] Syr 6 6 $18,300.00 $18,300.00 $18,300.00 $18,300.00 $18,300.00 2024-12-28
J1944 HCPCS Daratumumab Hyaluronidase 1800mg/15ml Vl 6 6 $18,161.25 $18,161.25 $18,161.25 $18,161.25 $18,161.25 2024-12-28
J3380 HCPCS Vedolizumab [300mg] Vl IV 6 6 $16,352.25 $16,352.25 $16,352.25 $16,352.25 $16,352.25 2024-12-28
J3101 HCPCS Tenecteplase Inj [50 Mg] Vl 6 6 $13,804.72 $13,804.72 $13,804.72 $13,804.72 $13,804.72 2024-12-28
J9301 HCPCS Obinutuzamab [1000mg] Vl IV 6 6 $13,698.00 $13,698.00 $13,698.00 $13,698.00 $13,698.00 2024-12-28
C1776 HCPCS Vega Knee Implants Totalknee Replacement 6 6 $13,125.00 $13,125.00 $13,125.00 $13,125.00 $13,125.00 2024-12-28
24140 HCPCS Pro Fee: Medical Epicondylectomy 6 6 $12,612.00 $12,612.00 $12,612.00 $12,612.00 $12,612.00 2024-12-28
J2353 HCPCS Octreotide Lar [30mg] Vl 6 6 $12,065.75 $12,065.75 $12,065.75 $12,065.75 $12,065.75 2024-12-28
J9271 HCPCS Pembrolizumab [100MG/4mL] Vl IV 6 6 $11,115.04 $11,115.04 $11,115.04 $11,115.04 $11,115.04 2024-12-28
J9306 HCPCS Pertuzumab [420MG/14mL] Vl IV 6 6 $10,584.00 $10,584.00 $10,584.00 $10,584.00 $10,584.00 2024-12-28
J2406 HCPCS Oritavancin [1200mg] Vl IV 6 6 $9,391.00 $9,391.00 $9,391.00 $9,391.00 $9,391.00 2024-12-28
24101 HCPCS Pro Fee: Arthrotomy 6 6 $9,310.00 $9,310.00 $9,310.00 $9,310.00 $9,310.00 2024-12-28
J1569 HCPCS Immune Globulin [30GM/300mL] Vl IV 6 6 $8,957.75 $8,957.75 $8,957.75 $8,957.75 $8,957.75 2024-12-28
52234 HCPCS Pro Fee: Cystoscopy/ Fulguration 6 6 $8,863.00 $8,863.00 $8,863.00 $8,863.00 $8,863.00 2024-12-28
J2506 HCPCS Pegfilgrastim Auto Injector [6mg] Syr 6 6 $8,274.00 $8,274.00 $8,274.00 $8,274.00 $8,274.00 2024-12-28
C1764 HCPCS Dnu Loop Recorder 6 6 $7,943.00 $7,943.00 $7,943.00 $7,943.00 $7,943.00 2024-12-28
J9217 HCPCS Leuprolide [22.5mg] Kit 6 6 $7,353.75 $7,353.75 $7,353.75 $7,353.75 $7,353.75 2024-12-28
10180 HCPCS I&d Complex; Post-op Wound Infection 6 6 $6,905.00 $6,905.00 $6,905.00 $6,905.00 $6,905.00 2024-12-28
J1306 HCPCS Inclisiran 284mg/1.5ml Vl Sq 6 6 $6,663.75 $6,663.75 $6,663.75 $6,663.75 $6,663.75 2024-12-28
15273 HCPCS Apply Skin Sub Graft T/Arm/Lg Child 6 6 $6,524.00 $6,524.00 $6,524.00 $6,524.00 $6,524.00 2024-12-28
J9299 HCPCS Nivolumab [100mg] Vl IV 6 6 $6,523.25 $6,523.25 $6,523.25 $6,523.25 $6,523.25 2024-12-28
J9047 HCPCS Carfilzomib [10mg] Vl IV 6 6 $6,279.25 $6,279.25 $6,279.25 $6,279.25 $6,279.25 2024-12-28
J0840 HCPCS Crotalidae Polyvalent[1gm/2ml] Vl IV 6 6 $6,276.50 $6,276.50 $6,276.50 $6,276.50 $6,276.50 2024-12-28
J1602 HCPCS Golimumab 50mg/4ml Vl IV 6 6 $6,191.50 $6,191.50 $6,191.50 $6,191.50 $6,191.50 2024-12-28
59510 HCPCS Pro Fee: C-section Global Care 6 6 $6,161.00 $6,161.00 $6,161.00 $6,161.00 $6,161.00 2024-12-28
74174 HCPCS CT Angio Abdomen Pelvis 6 6 $6,067.00 $6,067.00 $6,067.00 $6,067.00 $6,067.00 2024-12-28
74178 HCPCS CT Abdomen Pelvis Wwo 6 6 $5,919.00 $5,919.00 $5,919.00 $5,919.00 $5,919.00 2024-12-28
C1778 HCPCS Dnu Lead Istim Emanual 6 6 $5,768.00 $5,768.00 $5,768.00 $5,768.00 $5,768.00 2024-12-28
C1781 HCPCS Strattice 10 X 10 Mesh 6 6 $5,750.00 $5,750.00 $5,750.00 $5,750.00 $5,750.00 2024-12-28
J1568 HCPCS Immune Globulin G 30gm/300ml Vl 6 6 $5,654.25 $5,654.25 $5,654.25 $5,654.25 $5,654.25 2024-12-28
J9033 HCPCS Bendamustine [100mg] Vl IV 6 6 $5,634.75 $5,634.75 $5,634.75 $5,634.75 $5,634.75 2024-12-28
59400 HCPCS Pro Fee: Routine OB/Global Care Vaginal 6 6 $5,581.00 $5,581.00 $5,581.00 $5,581.00 $5,581.00 2024-12-28
90378 HCPCS Palivizumab [100MG/1mL] Vl 6 6 $5,520.00 $5,520.00 $5,520.00 $5,520.00 $5,520.00 2024-12-28
15277 HCPCS Apply Skin Graft F/n/hf/g Child 6 6 $5,225.00 $5,225.00 $5,225.00 $5,225.00 $5,225.00 2024-12-28
J3111 HCPCS Romosozumab-aqqg 210mg/2.34ml Syr 6 6 $5,112.25 $5,112.25 $5,112.25 $5,112.25 $5,112.25 2024-12-28
74177 HCPCS CT Abdomen Pelvis W 6 6 $4,949.00 $4,949.00 $4,949.00 $4,949.00 $4,949.00 2024-12-28
44207 HCPCS Pro Fee: Laps Colectomy/Coloproctostomy 6 6 $4,943.00 $4,943.00 $4,943.00 $4,943.00 $4,943.00 2024-12-28
61563 HCPCS Pro Fee: Exc Ben Tumor Cranial Bone Wo 6 6 $4,939.00 $4,939.00 $4,939.00 $4,939.00 $4,939.00 2024-12-28
70546 HCPCS MRA Head Wwo 6 6 $4,936.00 $4,936.00 $4,936.00 $4,936.00 $4,936.00 2024-12-28
74183 HCPCS MRI Abdomen Wwo 6 6 $4,895.00 $4,895.00 $4,895.00 $4,895.00 $4,895.00 2024-12-28
78452 HCPCS Nm Myocardial Spect Multiple 6 6 $4,874.00 $4,874.00 $4,874.00 $4,874.00 $4,874.00 2024-12-28
J9263 HCPCS Oxaliplatin [100mg] Vl IV 6 6 $4,827.25 $4,827.25 $4,827.25 $4,827.25 $4,827.25 2024-12-28
70543 HCPCS MRI Orbit Face Neck Wwo 6 6 $4,815.00 $4,815.00 $4,815.00 $4,815.00 $4,815.00 2024-12-28
78451 HCPCS Nm Myocardial Spect Single 6 6 $4,806.00 $4,806.00 $4,806.00 $4,806.00 $4,806.00 2024-12-28
49520 HCPCS Pro Fee: Repair Inguinal Hernia Reduc 6 6 $4,743.00 $4,743.00 $4,743.00 $4,743.00 $4,743.00 2024-12-28
72157 HCPCS MRI Thoracic Spine Wwo 6 6 $4,677.00 $4,677.00 $4,677.00 $4,677.00 $4,677.00 2024-12-28
70549 HCPCS MRA Neck Wwo 6 6 $4,640.00 $4,640.00 $4,640.00 $4,640.00 $4,640.00 2024-12-28
44160 HCPCS Pro Fee As: Colectomy-ileocolstomy 12 6 $4,627.00 $4,627.00 $4,627.00 $4,627.00 $4,627.00 2024-12-28
44147 HCPCS Pro Fee: Hemicolectomy Abd/ Anal 6 6 $4,617.00 $4,617.00 $4,617.00 $4,617.00 $4,617.00 2024-12-28
72156 HCPCS MRI Cervical Spine Wwo 6 6 $4,616.00 $4,616.00 $4,616.00 $4,616.00 $4,616.00 2024-12-28
44140 HCPCS Pro Fee As: Colon Resection 12 6 $4,614.00 $4,614.00 $4,614.00 $4,614.00 $4,614.00 2024-12-28
27244 HCPCS Pro Fee: Treat Thigh Fracture 6 6 $4,544.00 $4,544.00 $4,544.00 $4,544.00 $4,544.00 2024-12-28
74185 HCPCS MRA Abdomen Wwo 6 6 $4,542.00 $4,542.00 $4,542.00 $4,542.00 $4,542.00 2024-12-28
27134 HCPCS Pro Fee As: Revise Hip Joint Replacement 12 6 $4,534.00 $4,534.00 $4,534.00 $4,534.00 $4,534.00 2024-12-28
70552 HCPCS MRI Brain W 6 6 $4,519.00 $4,519.00 $4,519.00 $4,519.00 $4,519.00 2024-12-28
J0897 HCPCS Denosumab [120MG/1.7mL] Vl 6 6 $4,443.25 $4,443.25 $4,443.25 $4,443.25 $4,443.25 2024-12-28
71550 HCPCS MRI Chest Wo 6 6 $4,413.00 $4,413.00 $4,413.00 $4,413.00 $4,413.00 2024-12-28
72147 HCPCS MRI Thoracic Spine W 6 6 $4,394.00 $4,394.00 $4,394.00 $4,394.00 $4,394.00 2024-12-28
J9202 HCPCS Goserelin Acetate [10.8mg] Kit 6 6 $4,389.50 $4,389.50 $4,389.50 $4,389.50 $4,389.50 2024-12-28
72158 HCPCS MRI Lumbar Spine Wwo 6 6 $4,389.00 $4,389.00 $4,389.00 $4,389.00 $4,389.00 2024-12-28
70553 HCPCS MRI Brain Wwo 6 6 $4,378.00 $4,378.00 $4,378.00 $4,378.00 $4,378.00 2024-12-28
73223 HCPCS MRI Forearm Wwo Left 12 6 $4,332.00 $4,332.00 $4,332.00 $4,332.00 $4,332.00 2024-12-28
J2796 HCPCS Chemo Romiplostim [250MCG/0.5mL] Vl 6 6 $4,330.50 $4,330.50 $4,330.50 $4,330.50 $4,330.50 2024-12-28
71552 HCPCS MRI Chest Wwo 6 6 $4,328.00 $4,328.00 $4,328.00 $4,328.00 $4,328.00 2024-12-28
49521 HCPCS Pro Fee: Hernia Repair-incarcerate 6 6 $4,302.00 $4,302.00 $4,302.00 $4,302.00 $4,302.00 2024-12-28
44143 HCPCS Pro Fee: Partial Removal Of Colon 6 6 $4,265.00 $4,265.00 $4,265.00 $4,265.00 $4,265.00 2024-12-28
J0875 HCPCS Dalbavancin [500mg] Vl IV 6 6 $4,240.75 $4,240.75 $4,240.75 $4,240.75 $4,240.75 2024-12-28
70548 HCPCS MRA Neck W 6 6 $4,228.00 $4,228.00 $4,228.00 $4,228.00 $4,228.00 2024-12-28
72197 HCPCS MRI Pelvis Wwo 6 6 $4,224.00 $4,224.00 $4,224.00 $4,224.00 $4,224.00 2024-12-28
70551 HCPCS MRI Brain Wo 6 6 $4,170.00 $4,170.00 $4,170.00 $4,170.00 $4,170.00 2024-12-28
44145 HCPCS Pro Fee: Colectomy Part W Coloproctostmy 6 6 $4,154.00 $4,154.00 $4,154.00 $4,154.00 $4,154.00 2024-12-28
47605 HCPCS Pro Fee: Lap Chole Open Approach 6 6 $4,123.00 $4,123.00 $4,123.00 $4,123.00 $4,123.00 2024-12-28
77049 HCPCS MRI Breast Wwo Bilat 6 6 $4,081.00 $4,081.00 $4,081.00 $4,081.00 $4,081.00 2024-12-28
70545 HCPCS MRA Head W 6 6 $4,053.00 $4,053.00 $4,053.00 $4,053.00 $4,053.00 2024-12-28
73723 HCPCS MRI Ankle Wwo Right 12 6 $4,021.00 $4,021.00 $4,021.00 $4,021.00 $4,021.00 2024-12-28
44626 HCPCS Pro Fee: Close Entero; Resect & Cr Anast 6 6 $4,008.00 $4,008.00 $4,008.00 $4,008.00 $4,008.00 2024-12-28
27137 HCPCS Pro Fee: Revise Total Hip Arthropl; Acet 6 6 $3,993.00 $3,993.00 $3,993.00 $3,993.00 $3,993.00 2024-12-28
52601 HCPCS Pro Fee: Prostatectomy (turp) 6 6 $3,984.00 $3,984.00 $3,984.00 $3,984.00 $3,984.00 2024-12-28
73720 HCPCS MRI Femur Wwo Left 12 6 $3,983.00 $3,983.00 $3,983.00 $3,983.00 $3,983.00 2024-12-28
74182 HCPCS MRI Abdomen W 6 6 $3,983.00 $3,983.00 $3,983.00 $3,983.00 $3,983.00 2024-12-28
49507 HCPCS Pro Fee As: Ingunial Hernia/ Incarcerate 12 6 $3,983.00 $3,983.00 $3,983.00 $3,983.00 $3,983.00 2024-12-28
74176 HCPCS CT Abdomen Pelvis 6 6 $3,968.00 $3,968.00 $3,968.00 $3,968.00 $3,968.00 2024-12-28
23472 HCPCS Pro Fee As: Arthroplasty Ghj Tot Shldr R 12 6 $3,950.00 $3,950.00 $3,950.00 $3,950.00 $3,950.00 2024-12-28
J9355 HCPCS Trastuzumab [150mg] Vl IV 6 6 $3,937.00 $3,937.00 $3,937.00 $3,937.00 $3,937.00 2024-12-28
15275 HCPCS Apply Skin Sub Graft Face/Nk/HF/G 6 6 $3,935.00 $3,935.00 $3,935.00 $3,935.00 $3,935.00 2024-12-28
59515 HCPCS Pro Fee: C-section Delivery/ Pp Care 6 6 $3,921.00 $3,921.00 $3,921.00 $3,921.00 $3,921.00 2024-12-28
75635 HCPCS CT Angio Abdominal RunOff 6 6 $3,918.00 $3,918.00 $3,918.00 $3,918.00 $3,918.00 2024-12-28
J0881 HCPCS Darbepoetin [200MCG/0.4mL] Syr 6 6 $3,883.25 $3,883.25 $3,883.25 $3,883.25 $3,883.25 2024-12-28
73220 HCPCS MRI Elbow Wwo Left 12 6 $3,871.00 $3,871.00 $3,871.00 $3,871.00 $3,871.00 2024-12-28
72196 HCPCS MRI Pelvis W 6 6 $3,871.00 $3,871.00 $3,871.00 $3,871.00 $3,871.00 2024-12-28
72146 HCPCS MRI Thoracic Spine Wo 6 6 $3,845.00 $3,845.00 $3,845.00 $3,845.00 $3,845.00 2024-12-28
73722 HCPCS MRI Hip W Left 12 6 $3,845.00 $3,845.00 $3,845.00 $3,845.00 $3,845.00 2024-12-28
58150 HCPCS Pro Fee As: Total Abdominal Hysterectomy 12 6 $3,834.00 $3,834.00 $3,834.00 $3,834.00 $3,834.00 2024-12-28
27486 HCPCS Pro Fee: Revise/Replace Knee Jnt 1 Comp 6 6 $3,816.00 $3,816.00 $3,816.00 $3,816.00 $3,816.00 2024-12-28
49020 HCPCS Pro Fee: Drainage Abdom Abscess Open 6 6 $3,781.00 $3,781.00 $3,781.00 $3,781.00 $3,781.00 2024-12-28
44202 HCPCS Pro Fee: Lap Enterectomy 6 6 $3,747.00 $3,747.00 $3,747.00 $3,747.00 $3,747.00 2024-12-28
73725 HCPCS MRA Lower Extremity Wwo Left 12 6 $3,744.00 $3,744.00 $3,744.00 $3,744.00 $3,744.00 2024-12-28
15734 HCPCS Pro Fee: Muscle Flap; Trunk 6 6 $3,744.00 $3,744.00 $3,744.00 $3,744.00 $3,744.00 2024-12-28
74181 HCPCS MRI Abdomen Wo 6 6 $3,737.00 $3,737.00 $3,737.00 $3,737.00 $3,737.00 2024-12-28
72142 HCPCS MRI Cervical Spine W 6 6 $3,715.00 $3,715.00 $3,715.00 $3,715.00 $3,715.00 2024-12-28
49418 HCPCS Pro Fee: Insert Tun Ip Cath Perc 6 6 $3,693.00 $3,693.00 $3,693.00 $3,693.00 $3,693.00 2024-12-28
70544 HCPCS MRA Head Wo 6 6 $3,674.00 $3,674.00 $3,674.00 $3,674.00 $3,674.00 2024-12-28
50820 HCPCS Pro Fee: Bricker Bowel Constuct 6 6 $3,673.00 $3,673.00 $3,673.00 $3,673.00 $3,673.00 2024-12-28
72141 HCPCS MRI Cervical Spine Wo 6 6 $3,657.00 $3,657.00 $3,657.00 $3,657.00 $3,657.00 2024-12-28
49329 HCPCS Pro Fee: Laparocopy Abd Peritone 6 6 $3,617.00 $3,617.00 $3,617.00 $3,617.00 $3,617.00 2024-12-28
19302 HCPCS Pro Fee: P-mastectomy W Ln Removal 6 6 $3,617.00 $3,617.00 $3,617.00 $3,617.00 $3,617.00 2024-12-28
72148 HCPCS MRI Lumbar Spine Wo 6 6 $3,603.00 $3,603.00 $3,603.00 $3,603.00 $3,603.00 2024-12-28
61500 HCPCS Pro Fee: Removal Of Skull Lesion 6 6 $3,564.00 $3,564.00 $3,564.00 $3,564.00 $3,564.00 2024-12-28
71555 HCPCS MRA Chest Wwo 6 6 $3,548.00 $3,548.00 $3,548.00 $3,548.00 $3,548.00 2024-12-28
58951 HCPCS Pro Fee: Resect Ovarian Malig W Hyster 6 6 $3,548.00 $3,548.00 $3,548.00 $3,548.00 $3,548.00 2024-12-28
70547 HCPCS MRA Neck Wo 6 6 $3,546.00 $3,546.00 $3,546.00 $3,546.00 $3,546.00 2024-12-28
58152 HCPCS Pro Fee: Total Abd Hyster W Bladder Susp 6 6 $3,533.00 $3,533.00 $3,533.00 $3,533.00 $3,533.00 2024-12-28
70498 HCPCS CT Angio Neck 6 6 $3,520.00 $3,520.00 $3,520.00 $3,520.00 $3,520.00 2024-12-28
71275 HCPCS CT Angio Chest W 6 6 $3,517.00 $3,517.00 $3,517.00 $3,517.00 $3,517.00 2024-12-28
72195 HCPCS MRI Pelvis Wo 6 6 $3,507.00 $3,507.00 $3,507.00 $3,507.00 $3,507.00 2024-12-28
15738 HCPCS Pro Fee: Muscle Flap; Lower Extremity 6 6 $3,506.00 $3,506.00 $3,506.00 $3,506.00 $3,506.00 2024-12-28
74170 HCPCS CT Abdomen Wwo 6 6 $3,478.00 $3,478.00 $3,478.00 $3,478.00 $3,478.00 2024-12-28
49594 HCPCS Pro Fee As: Rpr Aa Hrn 1st 3-10 Ncr/strn 12 6 $3,477.00 $3,477.00 $3,477.00 $3,477.00 $3,477.00 2024-12-28
72149 HCPCS MRI Lumbar Spine W 6 6 $3,469.00 $3,469.00 $3,469.00 $3,469.00 $3,469.00 2024-12-28
74175 HCPCS CT Angio Abdomen 6 6 $3,461.00 $3,461.00 $3,461.00 $3,461.00 $3,461.00 2024-12-28
72198 HCPCS MRA Pelvis Wwo 6 6 $3,437.00 $3,437.00 $3,437.00 $3,437.00 $3,437.00 2024-12-28
27415 HCPCS Pro Fee As: Osteochondral Knee Allogrf 12 6 $3,435.00 $3,435.00 $3,435.00 $3,435.00 $3,435.00 2024-12-28
15274 HCPCS Apply Skin Sub Graft T/a/l Child Add 6 6 $3,432.00 $3,432.00 $3,432.00 $3,432.00 $3,432.00 2024-12-28
70542 HCPCS MRI Orbit Face Neck W 6 6 $3,406.00 $3,406.00 $3,406.00 $3,406.00 $3,406.00 2024-12-28
27130 HCPCS Pro Fee As: Total Hip Arthropla 12 6 $3,405.00 $3,405.00 $3,405.00 $3,405.00 $3,405.00 2024-12-28
27447 HCPCS Pro Fee As: Total Knee Arthroplasty 12 6 $3,404.00 $3,404.00 $3,404.00 $3,404.00 $3,404.00 2024-12-28
47563 HCPCS Pro Fee As: Lap Chole Cholangiogram 12 6 $3,403.00 $3,403.00 $3,403.00 $3,403.00 $3,403.00 2024-12-28
J0585 HCPCS Botox [200un] Vl 6 6 $3,398.24 $3,398.24 $3,398.24 $3,398.24 $3,398.24 2024-12-28
52332 HCPCS Pro Fee: Urethral Stent 6 6 $3,362.00 $3,362.00 $3,362.00 $3,362.00 $3,362.00 2024-12-28
59514 HCPCS Pro Fee: C-section Only 6 6 $3,357.00 $3,357.00 $3,357.00 $3,357.00 $3,357.00 2024-12-28
J9264 HCPCS Paclitaxel-protein Bound [100mg] Vl IV 6 6 $3,246.25 $3,246.25 $3,246.25 $3,246.25 $3,246.25 2024-12-28
70496 HCPCS CT Angio Head 6 6 $3,244.00 $3,244.00 $3,244.00 $3,244.00 $3,244.00 2024-12-28
77048 HCPCS MRI Breast Wwo Left 12 6 $3,241.00 $3,241.00 $3,241.00 $3,241.00 $3,241.00 2024-12-28
47562 HCPCS Pro Fee As: Lap Cholecystectomy 12 6 $3,241.00 $3,241.00 $3,241.00 $3,241.00 $3,241.00 2024-12-28
77046 HCPCS MRI Breast Wo Left 6 6 $3,236.00 $3,236.00 $3,236.00 $3,236.00 $3,236.00 2024-12-28
72129 HCPCS CT Thoracis Spine W 6 6 $3,226.00 $3,226.00 $3,226.00 $3,226.00 $3,226.00 2024-12-28
72194 HCPCS CT Pelvis Wwo 6 6 $3,225.00 $3,225.00 $3,225.00 $3,225.00 $3,225.00 2024-12-28
28001 HCPCS I&d Infected Bursa; Foot 6 6 $3,219.00 $3,219.00 $3,219.00 $3,219.00 $3,219.00 2024-12-28
Q5108 HCPCS Pegfilgrastim-jmdb [6MG/.06mL] Syr 6 6 $3,217.00 $3,217.00 $3,217.00 $3,217.00 $3,217.00 2024-12-28
44346 HCPCS Pro Fee: Revisd Colostomy W Rep Pc Herni 6 6 $3,198.00 $3,198.00 $3,198.00 $3,198.00 $3,198.00 2024-12-28
71270 HCPCS CT Chest Wwo 6 6 $3,195.00 $3,195.00 $3,195.00 $3,195.00 $3,195.00 2024-12-28
47379 HCPCS Pro Fee: Laparoscope Procedure Liver 6 6 $3,179.00 $3,179.00 $3,179.00 $3,179.00 $3,179.00 2024-12-28
73225 HCPCS MRA Upper Extremity Wwo 6 6 $3,176.00 $3,176.00 $3,176.00 $3,176.00 $3,176.00 2024-12-28
44205 HCPCS Pro Fee As: Lap Cholectomy Part W Ileum 12 6 $3,162.00 $3,162.00 $3,162.00 $3,162.00 $3,162.00 2024-12-28
73202 HCPCS CT Upper Extremity Wwo Left 12 6 $3,162.00 $3,162.00 $3,162.00 $3,162.00 $3,162.00 2024-12-28
72130 HCPCS CT Thoracis Spine Wwo 6 6 $3,157.00 $3,157.00 $3,157.00 $3,157.00 $3,157.00 2024-12-28
19307 HCPCS Pro Fee: Modified Radical Mastectomy 6 6 $3,141.00 $3,141.00 $3,141.00 $3,141.00 $3,141.00 2024-12-28
78278 HCPCS Nm Gastrointestinal Blood Loss Imaging 6 6 $3,125.00 $3,125.00 $3,125.00 $3,125.00 $3,125.00 2024-12-28
70492 HCPCS CT Soft Tissue Neck Wwo 6 6 $3,112.00 $3,112.00 $3,112.00 $3,112.00 $3,112.00 2024-12-28
49561 HCPCS Pro Fee: Repair Ventral Hernia Incarcer 6 6 $3,076.00 $3,076.00 $3,076.00 $3,076.00 $3,076.00 2024-12-28
44120 HCPCS Pro Fee: Resect Sm Intest;Resect/Anast 6 6 $3,050.00 $3,050.00 $3,050.00 $3,050.00 $3,050.00 2024-12-28
20692 HCPCS Pro Fee: App Bone Fix Device >1 Plane 6 6 $3,047.00 $3,047.00 $3,047.00 $3,047.00 $3,047.00 2024-12-28
49550 HCPCS Pro Fee: Repair Femoral Hernia Any Age 6 6 $3,046.00 $3,046.00 $3,046.00 $3,046.00 $3,046.00 2024-12-28
72133 HCPCS CT Lumbar Spine Wwo 6 6 $3,032.00 $3,032.00 $3,032.00 $3,032.00 $3,032.00 2024-12-28
72132 HCPCS CT Lumbar Spine W 6 6 $3,012.00 $3,012.00 $3,012.00 $3,012.00 $3,012.00 2024-12-28
72126 HCPCS CT Cervical Spine W 6 6 $2,999.00 $2,999.00 $2,999.00 $2,999.00 $2,999.00 2024-12-28
73702 HCPCS CT Hip Wwo 18 6 $2,994.00 $2,994.00 $2,994.00 $2,994.00 $2,994.00 2024-12-28
49203 HCPCS Pro Fee As: Exc Abd Tum 5cm Or Less 12 6 $2,989.00 $2,989.00 $2,989.00 $2,989.00 $2,989.00 2024-12-28
73222 HCPCS MRI Shoulder W Left 12 6 $2,988.00 $2,988.00 $2,988.00 $2,988.00 $2,988.00 2024-12-28
73218 HCPCS MRI Hand Wo Right 12 6 $2,958.00 $2,958.00 $2,958.00 $2,958.00 $2,958.00 2024-12-28
15830 HCPCS Pro Fee: Excision Skin Abdomen 6 6 $2,942.00 $2,942.00 $2,942.00 $2,942.00 $2,942.00 2024-12-28
74160 HCPCS CT Abdomen W 6 6 $2,941.00 $2,941.00 $2,941.00 $2,941.00 $2,941.00 2024-12-28
27025 HCPCS Pro Fee: Ins Hip/Thigh Fascia, Bilat 12 6 $2,940.50 $2,940.50 $2,352.00 $3,529.00 $2,940.50 2024-12-28
0722 RC — 6 6 $2,937.00 $2,937.00 $2,937.00 $2,937.00 $2,937.00 2024-12-28
14301 HCPCS Pro Fee: Skin Tissue Rearrange 30-60sqcm 6 6 $2,917.00 $2,917.00 $2,917.00 $2,917.00 $2,917.00 2024-12-28
72193 HCPCS CT Pelvis W 6 6 $2,917.00 $2,917.00 $2,917.00 $2,917.00 $2,917.00 2024-12-28
44005 HCPCS Pro Fee: Lysis Adhesions 6 6 $2,916.00 $2,916.00 $2,916.00 $2,916.00 $2,916.00 2024-12-28
49320 HCPCS Pro Fee: Diagnostic Laparoscopy 6 6 $2,908.00 $2,908.00 $2,908.00 $2,908.00 $2,908.00 2024-12-28
70540 HCPCS MRI Orbit Face Neck Wo 6 6 $2,903.00 $2,903.00 $2,903.00 $2,903.00 $2,903.00 2024-12-28
43220 HCPCS Pro Fee: Esophagoscopy Flex < 30mm Dilat 6 6 $2,891.00 $2,891.00 $2,891.00 $2,891.00 $2,891.00 2024-12-28
45388 HCPCS Pro Fee: Colonoscopy/ Fuguration 6 6 $2,887.00 $2,887.00 $2,887.00 $2,887.00 $2,887.00 2024-12-28
73718 HCPCS MRI Femur Wo Left 12 6 $2,882.00 $2,882.00 $2,882.00 $2,882.00 $2,882.00 2024-12-28
15956 HCPCS Pro Fee: Exc T P Ulcer W Flap 6 6 $2,881.00 $2,881.00 $2,881.00 $2,881.00 $2,881.00 2024-12-28
29806 HCPCS Pro Fee: Shoulder Capsulor Arthroscopy 6 6 $2,869.00 $2,869.00 $2,869.00 $2,869.00 $2,869.00 2024-12-28
44320 HCPCS Pro Fee As: Colostomy/ Skin Lev Cecostom 12 6 $2,861.00 $2,861.00 $2,861.00 $2,861.00 $2,861.00 2024-12-28
78709 HCPCS Nm Renal Func Scan Multi W Pharm 6 6 $2,848.00 $2,848.00 $2,848.00 $2,848.00 $2,848.00 2024-12-28
45130 HCPCS Pro Fee: Excision Of Rectal Prolapse 6 6 $2,844.00 $2,844.00 $2,844.00 $2,844.00 $2,844.00 2024-12-28
71260 HCPCS CT Chest W 6 6 $2,836.00 $2,836.00 $2,836.00 $2,836.00 $2,836.00 2024-12-28
11643 HCPCS Exc F/e/e/n/l Mal+mrg 2.1-3.0cm 6 6 $2,804.00 $2,804.00 $2,804.00 $2,804.00 $2,804.00 2024-12-28
Q9968 HCPCS Isosulfan Blue 1% [50MG/5mL] Vl 6 6 $2,795.00 $2,795.00 $2,795.00 $2,795.00 $2,795.00 2024-12-28
28299 HCPCS Pro Fee: Correction Hallux Valgus 6 6 $2,786.00 $2,786.00 $2,786.00 $2,786.00 $2,786.00 2024-12-28
49560 HCPCS Pro Fee: Repair Ventral Hernia 6 6 $2,784.00 $2,784.00 $2,784.00 $2,784.00 $2,784.00 2024-12-28
78598 HCPCS Nm Quantitative Lung Scan 6 6 $2,776.00 $2,776.00 $2,776.00 $2,776.00 $2,776.00 2024-12-28
73201 HCPCS CT Upper Extremity W Left 12 6 $2,774.00 $2,774.00 $2,774.00 $2,774.00 $2,774.00 2024-12-28
44625 HCPCS Pro Fee: Close Enterostomy; W Resec&An 6 6 $2,760.00 $2,760.00 $2,760.00 $2,760.00 $2,760.00 2024-12-28
36582 HCPCS Pro Fee: Repl Tunneled Vad W Port 6 6 $2,758.00 $2,758.00 $2,758.00 $2,758.00 $2,758.00 2024-12-28
59409 HCPCS Pro Fee: Vaginal Delivery Only 6 6 $2,742.00 $2,742.00 $2,742.00 $2,742.00 $2,742.00 2024-12-28
70482 HCPCS CT Orbit Mid Ear Wwo 6 6 $2,742.00 $2,742.00 $2,742.00 $2,742.00 $2,742.00 2024-12-28
70491 HCPCS CT Soft Tissue Neck W 6 6 $2,738.00 $2,738.00 $2,738.00 $2,738.00 $2,738.00 2024-12-28
38100 HCPCS Pro Fee: Splenectomy; Total 6 6 $2,738.00 $2,738.00 $2,738.00 $2,738.00 $2,738.00 2024-12-28
0173 RC — 6 6 $2,737.00 $2,737.00 $2,737.00 $2,737.00 $2,737.00 2024-12-28
73721 HCPCS MRI Ankle Wo Right 12 6 $2,723.00 $2,723.00 $2,723.00 $2,723.00 $2,723.00 2024-12-28
59410 HCPCS Pro Fee: Vaginal Delivery Only Incl Pp 6 6 $2,712.00 $2,712.00 $2,712.00 $2,712.00 $2,712.00 2024-12-28
25350 HCPCS Pro Fee: Revise Of Radius 6 6 $2,705.00 $2,705.00 $2,705.00 $2,705.00 $2,705.00 2024-12-28
70470 HCPCS CT Head Or Brain Wwo 6 6 $2,702.00 $2,702.00 $2,702.00 $2,702.00 $2,702.00 2024-12-28
J7318 HCPCS Hyaluronate Sodium 20mg/ml 3mlsyr 6 6 $2,697.25 $2,697.25 $2,697.25 $2,697.25 $2,697.25 2024-12-28
44310 HCPCS Pro Fee: Ileostomy/Jejunostomy Non-tube 6 6 $2,688.00 $2,688.00 $2,688.00 $2,688.00 $2,688.00 2024-12-28
44615 HCPCS Pro Fee: Intest Stricuroplasty; Obstruct 6 6 $2,688.00 $2,688.00 $2,688.00 $2,688.00 $2,688.00 2024-12-28
27654 HCPCS Pro Fee: Repair Achilles Tendon 6 6 $2,686.00 $2,686.00 $2,686.00 $2,686.00 $2,686.00 2024-12-28
36571 HCPCS Pro Fee: Ins Picc Device W Port 5 Yrs/> 6 6 $2,686.00 $2,686.00 $2,686.00 $2,686.00 $2,686.00 2024-12-28
70481 HCPCS CT Orbit Mid Ear W 6 6 $2,678.00 $2,678.00 $2,678.00 $2,678.00 $2,678.00 2024-12-28
70480 HCPCS CT Mastoid 6 6 $2,669.00 $2,669.00 $2,669.00 $2,669.00 $2,669.00 2024-12-28
73701 HCPCS CT Hip W 18 6 $2,666.00 $2,666.00 $2,666.00 $2,666.00 $2,666.00 2024-12-28
70488 HCPCS CT Maxillofacial Wwo 6 6 $2,664.00 $2,664.00 $2,664.00 $2,664.00 $2,664.00 2024-12-28
47600 HCPCS Pro Fee As: Cholecystectomy 12 6 $2,656.00 $2,656.00 $2,656.00 $2,656.00 $2,656.00 2024-12-28
49002 HCPCS Pro Fee: Reopen Recent Laparotomy 6 6 $2,635.00 $2,635.00 $2,635.00 $2,635.00 $2,635.00 2024-12-28
44345 HCPCS Pro Fee As: Revise Colostomy; Comp 12 6 $2,635.00 $2,635.00 $2,635.00 $2,635.00 $2,635.00 2024-12-28
J7325 HCPCS Hyalgan [48MG/6mL] Syr 6 6 $2,635.00 $2,635.00 $2,635.00 $2,635.00 $2,635.00 2024-12-28
19305 HCPCS Pro Fee: Mast Radical 6 6 $2,631.00 $2,631.00 $2,631.00 $2,631.00 $2,631.00 2024-12-28
73221 HCPCS MRI Shoulder Wo Left 12 6 $2,629.00 $2,629.00 $2,629.00 $2,629.00 $2,629.00 2024-12-28
15240 HCPCS Pro Fee: Skin Full Graft Face/Genit/HF 6 6 $2,626.00 $2,626.00 $2,626.00 $2,626.00 $2,626.00 2024-12-28
64635 HCPCS Destroy Lumb/Sac Facet Joint 6 6 $2,624.00 $2,624.00 $2,624.00 $2,624.00 $2,624.00 2024-12-28
78582 HCPCS Nm Lung Scan 6 6 $2,620.00 $2,620.00 $2,620.00 $2,620.00 $2,620.00 2024-12-28
14061 HCPCS Pro Fee: Skin Tissue Rearrangement 6 6 $2,611.00 $2,611.00 $2,611.00 $2,611.00 $2,611.00 2024-12-28
27726 HCPCS Pro Fee: Repair Fibula Nonunion Int Fix 6 6 $2,607.00 $2,607.00 $2,607.00 $2,607.00 $2,607.00 2024-12-28
20225 HCPCS Biopsy Bone Trocar/Needle Deep 6 6 $2,606.00 $2,606.00 $2,606.00 $2,606.00 $2,606.00 2024-12-28
44180 HCPCS Pro Fee: Laparoscopy W Adhesions 6 6 $2,594.00 $2,594.00 $2,594.00 $2,594.00 $2,594.00 2024-12-28
72191 HCPCS CT Angio Pelvis 6 6 $2,592.00 $2,592.00 $2,592.00 $2,592.00 $2,592.00 2024-12-28
78315 HCPCS Nm Bone 3 Phrase Technique 6 6 $2,586.00 $2,586.00 $2,586.00 $2,586.00 $2,586.00 2024-12-28
72125 HCPCS CT Cervical Spine 6 6 $2,560.00 $2,560.00 $2,560.00 $2,560.00 $2,560.00 2024-12-28
0200 RC — 6 6 $2,554.00 $2,554.00 $2,554.00 $2,554.00 $2,554.00 2024-12-28
49566 HCPCS Pro Fee As: Rerepair Ventrl Hern Block 12 6 $2,548.50 $2,548.50 $1,293.00 $3,804.00 $2,548.50 2024-12-28
29827 HCPCS Pro Fee As: Rotator Cuff Rep Arthroscopy 12 6 $2,547.00 $2,547.00 $2,547.00 $2,547.00 $2,547.00 2024-12-28
73206 HCPCS CT Angio Upper Ext W Left 12 6 $2,527.00 $2,527.00 $2,527.00 $2,527.00 $2,527.00 2024-12-28
29877 HCPCS Pro Fee: Arthroscopy Knee; Bilateral 12 6 $2,523.50 $2,523.50 $1,683.00 $3,364.00 $2,523.50 2024-12-28
49653 HCPCS Pro Fee: Lap Vent/Abd Hern Proc Comp 6 6 $2,509.00 $2,509.00 $2,509.00 $2,509.00 $2,509.00 2024-12-28
72131 HCPCS CT Lumbar Spine 6 6 $2,508.00 $2,508.00 $2,508.00 $2,508.00 $2,508.00 2024-12-28
49572 HCPCS Pro Fee: Repair Epigastric Hernia 6 6 $2,497.00 $2,497.00 $2,497.00 $2,497.00 $2,497.00 2024-12-28
27040 HCPCS Pro Fee: Biopsy Soft Tissue Hip 6 6 $2,488.00 $2,488.00 $2,488.00 $2,488.00 $2,488.00 2024-12-28
72128 HCPCS CT Thoracic Spine 6 6 $2,487.00 $2,487.00 $2,487.00 $2,487.00 $2,487.00 2024-12-28
29888 HCPCS Pro Fee: Arthrosc; Ant Cruciate Lig Rep 6 6 $2,476.00 $2,476.00 $2,476.00 $2,476.00 $2,476.00 2024-12-28
49655 HCPCS Pro Fee: Lap Inc Hern Repair Comp 6 6 $2,470.00 $2,470.00 $2,470.00 $2,470.00 $2,470.00 2024-12-28
93306 HCPCS Echo Tte W Doppler Complete W Contrast 6 6 $2,465.00 $2,465.00 $2,465.00 $2,465.00 $2,465.00 2024-12-28
74150 HCPCS CT Abdomen 6 6 $2,459.00 $2,459.00 $2,459.00 $2,459.00 $2,459.00 2024-12-28
10140 HCPCS Incision & Drain Hematoma/Fluid 6 6 $2,455.00 $2,455.00 $2,455.00 $2,455.00 $2,455.00 2024-12-28
23420 HCPCS Pro Fee: Repair Of Shoulder 6 6 $2,453.00 $2,453.00 $2,453.00 $2,453.00 $2,453.00 2024-12-28
49587 HCPCS Pro Fee: Repair Umb Hernia-incarcerated 6 6 $2,443.00 $2,443.00 $2,443.00 $2,443.00 $2,443.00 2024-12-28
19303 HCPCS Pro Fee As: Mastectomy Simple 12 6 $2,432.00 $2,432.00 $2,432.00 $2,432.00 $2,432.00 2024-12-28
44960 HCPCS Pro Fee As: Appendectomy-ruptured 12 6 $2,432.00 $2,432.00 $2,432.00 $2,432.00 $2,432.00 2024-12-28
44604 HCPCS Pro Fee: Suture Large Intestine 6 6 $2,425.00 $2,425.00 $2,425.00 $2,425.00 $2,425.00 2024-12-28
57280 HCPCS Pro Fee: Colpopexy Abdominal Approach 6 6 $2,419.00 $2,419.00 $2,419.00 $2,419.00 $2,419.00 2024-12-28
71250 HCPCS CT Chest 6 6 $2,418.00 $2,418.00 $2,418.00 $2,418.00 $2,418.00 2024-12-28
J1439 HCPCS Ferric Carboxymaltose [750mg] Vl IV 6 6 $2,415.50 $2,415.50 $2,415.50 $2,415.50 $2,415.50 2024-12-28
29879 HCPCS Pro Fee: Knee Arthroscopy Abrasion 6 6 $2,411.00 $2,411.00 $2,411.00 $2,411.00 $2,411.00 2024-12-28
70487 HCPCS CT Maxillofacial W 6 6 $2,384.00 $2,384.00 $2,384.00 $2,384.00 $2,384.00 2024-12-28
78195 HCPCS Nm Sentinel Node Scan 6 6 $2,382.00 $2,382.00 $2,382.00 $2,382.00 $2,382.00 2024-12-28
27720 HCPCS Pro Fee: Repair Nu/mu Tibia; Wo Graft 6 6 $2,366.00 $2,366.00 $2,366.00 $2,366.00 $2,366.00 2024-12-28
14041 HCPCS Pro Fee: Att F/c/m/n/a/g/h/f; 10.1-30sqc 6 6 $2,365.00 $2,365.00 $2,365.00 $2,365.00 $2,365.00 2024-12-28
G0390 HCPCS Trauma Activation Fee/ Full 6 6 $2,356.00 $2,356.00 $2,356.00 $2,356.00 $2,356.00 2024-12-28
J9075 HCPCS Cyclophosphamide [1gm] Vl IV 6 6 $2,355.75 $2,355.75 $2,355.75 $2,355.75 $2,355.75 2024-12-28
92960 HCPCS Cardioversion Electric External 6 6 $2,346.00 $2,346.00 $2,346.00 $2,346.00 $2,346.00 2024-12-28
70460 HCPCS CT Head Or Brain W 6 6 $2,345.00 $2,345.00 $2,345.00 $2,345.00 $2,345.00 2024-12-28
72192 HCPCS CT Pelvis 6 6 $2,338.00 $2,338.00 $2,338.00 $2,338.00 $2,338.00 2024-12-28
49615 HCPCS Pro Fee As: Rpr Aa Hrn 3-10 Rdc 12 6 $2,333.00 $2,333.00 $2,333.00 $2,333.00 $2,333.00 2024-12-28
70490 HCPCS CT Soft Tissue Neck 6 6 $2,332.00 $2,332.00 $2,332.00 $2,332.00 $2,332.00 2024-12-28
23405 HCPCS Pro Fee: Tenotomy Shoulder/ Single 6 6 $2,321.00 $2,321.00 $2,321.00 $2,321.00 $2,321.00 2024-12-28
C8901 HCPCS MRA Abdomen Wo 6 6 $2,298.00 $2,298.00 $2,298.00 $2,298.00 $2,298.00 2024-12-28
78264 HCPCS Nm Gastric Emptying Study 6 6 $2,281.00 $2,281.00 $2,281.00 $2,281.00 $2,281.00 2024-12-28
20220 HCPCS Biopsy Bone Trocar/Needle Superficial 6 6 $2,279.00 $2,279.00 $2,279.00 $2,279.00 $2,279.00 2024-12-28
0750 RC — 6 6 $2,271.00 $2,271.00 $2,271.00 $2,271.00 $2,271.00 2024-12-28
27299 HCPCS Pro Fee: Unlisted Pelvis/ Joint Surgery 6 6 $2,271.00 $2,271.00 $2,271.00 $2,271.00 $2,271.00 2024-12-28
J9312 HCPCS riTUXimab [100MG/10mL] Vl IV 6 6 $2,267.25 $2,267.25 $2,267.25 $2,267.25 $2,267.25 2024-12-28
J7297 HCPCS Levonorgestrel 52mg Vl 6 6 $2,265.00 $2,265.00 $2,265.00 $2,265.00 $2,265.00 2024-12-28
15941 HCPCS Pro Fee: Exc I P Ulcer 1 SUT.Ostectom 6 6 $2,248.00 $2,248.00 $2,248.00 $2,248.00 $2,248.00 2024-12-28
58571 HCPCS Pro Fee As: Tlh W/t/o/ 250g Or Less 12 6 $2,244.00 $2,244.00 $2,244.00 $2,244.00 $2,244.00 2024-12-28
11044 HCPCS Debridement Bone Musc/Fascia 20sq Cm/< 6 6 $2,242.00 $2,242.00 $2,242.00 $2,242.00 $2,242.00 2024-12-28
44620 HCPCS Pro Fee: Close Enterostomy Lg/Sm Intest 6 6 $2,236.00 $2,236.00 $2,236.00 $2,236.00 $2,236.00 2024-12-28
78803 HCPCS Nm Bone Spect Tc99 6 6 $2,233.00 $2,233.00 $2,233.00 $2,233.00 $2,233.00 2024-12-28
49590 HCPCS Pro Fee: Repair Spigelian Hernia 6 6 $2,222.00 $2,222.00 $2,222.00 $2,222.00 $2,222.00 2024-12-28
23410 HCPCS Pro Fee As: Open Repair Rotator Cuff Ac 12 6 $2,220.00 $2,220.00 $2,220.00 $2,220.00 $2,220.00 2024-12-28
28296 HCPCS Pro Fee: Correction Hallux Valgus W Sesm 6 6 $2,215.00 $2,215.00 $2,215.00 $2,215.00 $2,215.00 2024-12-28
J1459 HCPCS Immune Globulin 10% [10GM/100mL] Vliv 6 6 $2,208.50 $2,208.50 $2,208.50 $2,208.50 $2,208.50 2024-12-28
75984 HCPCS Fl Nephrostomy Tube Change 6 6 $2,208.00 $2,208.00 $2,208.00 $2,208.00 $2,208.00 2024-12-28
78472 HCPCS Nm Muga Scan 6 6 $2,205.00 $2,205.00 $2,205.00 $2,205.00 $2,205.00 2024-12-28
23412 HCPCS Pro Fee As: Repair Rotator Cuff 12 6 $2,201.00 $2,201.00 $2,201.00 $2,201.00 $2,201.00 2024-12-28
27880 HCPCS Pro Fee: Amputate Leg Thru Tib &Fib 6 6 $2,200.00 $2,200.00 $2,200.00 $2,200.00 $2,200.00 2024-12-28
73700 HCPCS CT Hip 18 6 $2,198.00 $2,198.00 $2,198.00 $2,198.00 $2,198.00 2024-12-28
15276 HCPCS Apply Skin Sub Graft F/n/hf/g Add 6 6 $2,192.00 $2,192.00 $2,192.00 $2,192.00 $2,192.00 2024-12-28
13160 HCPCS Pro Fee: Lcl Surg Wound/ Deh Extens 6 6 $2,180.00 $2,180.00 $2,180.00 $2,180.00 $2,180.00 2024-12-28
49654 HCPCS Pro Fee: Lap Incisional Hernia Repair 6 6 $2,178.00 $2,178.00 $2,178.00 $2,178.00 $2,178.00 2024-12-28
15220 HCPCS Pro Fee: Full Skin Graft Scalp/ Arm 6 6 $2,172.00 $2,172.00 $2,172.00 $2,172.00 $2,172.00 2024-12-28
14021 HCPCS Pro Fee: Skin Tissue Rearrangement 6 6 $2,172.00 $2,172.00 $2,172.00 $2,172.00 $2,172.00 2024-12-28
14001 HCPCS Pro Fee: Att Trunk; D 10.1-30.0 Sqcm 6 6 $2,165.00 $2,165.00 $2,165.00 $2,165.00 $2,165.00 2024-12-28
99468 HCPCS Pro Fee: Neonatal Critical Care 6 6 $2,162.00 $2,162.00 $2,162.00 $2,162.00 $2,162.00 2024-12-28
51992 HCPCS Pro Fee: Lap Sling Op For Stress Incont 6 6 $2,161.00 $2,161.00 $2,161.00 $2,161.00 $2,161.00 2024-12-28
70450 HCPCS CT Head Or Brain 6 6 $2,155.00 $2,155.00 $2,155.00 $2,155.00 $2,155.00 2024-12-28
27590 HCPCS Pro Fee: Amputate Thigh-femur Any Level 6 6 $2,153.00 $2,153.00 $2,153.00 $2,153.00 $2,153.00 2024-12-28
26123 HCPCS Pro Fee: Release Palm Contracture 6 6 $2,152.00 $2,152.00 $2,152.00 $2,152.00 $2,152.00 2024-12-28
78306 HCPCS Nm Whole Body Bone Scan 6 6 $2,138.00 $2,138.00 $2,138.00 $2,138.00 $2,138.00 2024-12-28
78708 HCPCS Nm Renal Func Scan Single W Pharm 6 6 $2,136.00 $2,136.00 $2,136.00 $2,136.00 $2,136.00 2024-12-28
36561 HCPCS Pro Fee: Port Insertion 6 6 $2,135.00 $2,135.00 $2,135.00 $2,135.00 $2,135.00 2024-12-28
J9035 HCPCS Bevacizumab [100MG/4mL] Vl 6 6 $2,134.75 $2,134.75 $2,134.75 $2,134.75 $2,134.75 2024-12-28
27339 HCPCS Pro Fee: Exc Thigh/ Knee Tum Deep 5cm/> 6 6 $2,132.00 $2,132.00 $2,132.00 $2,132.00 $2,132.00 2024-12-28
78227 HCPCS Nm Hida Scan With Cck 6 6 $2,128.00 $2,128.00 $2,128.00 $2,128.00 $2,128.00 2024-12-28
49593 HCPCS Pro Fee As: Rrp Aa Hrn 1st 3-10 Rdc 12 6 $2,115.00 $2,115.00 $2,115.00 $2,115.00 $2,115.00 2024-12-28
49406 HCPCS Pro Fee: Image Cath Fluid Peri/Retro 6 6 $2,102.00 $2,102.00 $2,102.00 $2,102.00 $2,102.00 2024-12-28
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