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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

INCLINE VILLAGE COMMUNITY HOSPITAL

Incline Village, NV · CCN 291301 · Rates published

6,789 distinct procedures filed
22 distinct payers
199,482 rate rows
2025-09-04 last MRF observed
Data quality

199,129 of 199,482 rate rows are consumer-grade (99.8%)

353 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
percent-of-charges filed in the dollar field — excluded from medians 289
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 51
placeholder amount (≤ $0.02) — excluded from medians 9
exceeds 10× this hospital's gross charge — excluded from medians 4
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://apps.para-hcfs.com/PTT/FinalLinks/Reports.aspx?dbName=dbIVHINCLNEVILLAGENV&type=CDMWithoutLabel&fileType=CSV
Found on page https://www.tfhd.com/shoppable-services/
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-05-15
Content fingerprint c3182397e7991fa5… · 68,880,402 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
J9266
HCPCS 		Injection, Pegaspargase, Per Single Dose Vial 19 $16,681.04 $93,054.60 $82,107.00 nat. median
$34,109
outlier · 2.4×
77371
HCPCS 		Complete Single Session Course Of Cranial Lesion Surgery Using Radiation 19 $1,078.50 $77,623.02 $68,490.90 nat. median
$9,046
outlier · 7.6×
J2350
HCPCS 		Injection, Ocrelizumab, 1 Mg 19 $62.81 $74,455.41 $65,695.95 nat. median
$712
outlier · 92.3×
J3241
HCPCS 		Injection, Teprotumumab-trbw, 10 Mg 18 $54,802.44 $63,521.01 $56,047.95 nat. median
$705
outlier · 79.5×
J9298
HCPCS 		Injection, Nivolumab And Relatlimab-rmbw, 3 Mg/1 Mg 18 $49,428.28 $57,291.87 $50,551.65 nat. median
$562
outlier · 90.0×
J9307
HCPCS 		Injection, Pralatrexate, 1 Mg 19 $295.35 $52,223.49 $46,079.55 nat. median
$827
outlier · 55.7×
J9043
HCPCS 		Injection, Cabazitaxel, 1 Mg 19 $180.59 $47,432.04 $41,851.80 nat. median
$739
outlier · 56.7×
J9316
HCPCS 		Injection, Pertuzumab, Trastuzumab, And Hyaluronidase-zzxf, Per 10 Mg 18 $30,575.60 $53,161.89 $40,652.53 nat. median
$283
outlier · 143.7×
J0222
HCPCS 		Injection, Patisiran, 0.1 Mg 18 $35,318.36 $40,937.19 $36,121.05 nat. median
$156
outlier · 231.7×
J9042
HCPCS 		Injection, Brentuximab Vedotin, 1 Mg 19 $170.04 $40,581.72 $35,807.40 nat. median
$1,050
outlier · 34.1×
J9228
HCPCS 		Injection, Ipilimumab, 1 Mg 19 $159.88 $131,913.03 $32,978.64 nat. median
$9,906
outlier · 3.3×
J1930
HCPCS 		Injection, Lanreotide, 1 Mg 19 $68.69 $36,632.28 $32,322.60 nat. median
$5,898
outlier · 5.5×
J9144
HCPCS 		Injection, Daratumumab, 10 Mg And Hyaluronidase-fihj 18 $30,197.20 $35,001.30 $30,883.50 nat. median
$233
outlier · 132.5×
J2323
HCPCS 		Injection, Natalizumab, 1 Mg 19 $25.12 $32,866.44 $28,999.80 nat. median
$201
outlier · 144.5×
J9022
HCPCS 		Injection, Atezolizumab, 10 Mg 19 $82.86 $41,203.41 $28,842.54 nat. median
$6,951
outlier · 4.1×
J3380
HCPCS 		Injection, Vedolizumab, Intravenous, 1 Mg 19 $24.96 $32,269.74 $28,473.30 nat. median
$288
outlier · 98.9×
J9311
HCPCS 		Injection, Rituximab 10 Mg And Hyaluronidase 19 $49.51 $31,444.56 $27,128.64 nat. median
$1,507
outlier · 18.0×
J9301
HCPCS 		Injection, Obinutuzumab, 10 Mg 19 $68.82 $29,799.30 $26,293.50 nat. median
$314
outlier · 83.7×
J9308
HCPCS 		Injection, Ramucirumab, 5 Mg 19 $63.79 $27,067.74 $23,883.30 nat. median
$1,489
outlier · 16.0×
47135
HCPCS 		Transplantation Of Donor Liver 19 $6,855.86 $24,197.46 $21,350.70 nat. median
$6,112
outlier · 3.5×
J9306
HCPCS 		Injection, Pertuzumab, 1 Mg 19 $16.96 $24,177.57 $21,333.15 nat. median
$87
outlier · 246.1×
J9271
HCPCS 		Injection, Pembrolizumab, 1 Mg 19 $54.85 $21,480.69 $18,953.55 nat. median
$736
outlier · 25.7×
J0717
HCPCS 		Injection, Certolizumab Pegol, 1 Mg (code May Be Used For Medicare When Drug Adm… 19 $12.78 $21,335.34 $18,825.30 nat. median
$1,372
outlier · 13.7×
J9356
HCPCS 		Injection, Trastuzumab, 10 Mg And Hyaluronidase-oysk 19 $85.99 $19,559.52 $17,258.40 nat. median
$126
outlier · 137.0×
J2353
HCPCS 		Injection, Octreotide, Depot Form For Intramuscular Injection, 1 Mg 19 $212.29 $26,717.37 $15,743.25 nat. median
$5,975
outlier · 2.6×
J9204
HCPCS 		Injection, Mogamulizumab-kpkc, 1 Mg 18 $14,736.92 $17,081.43 $15,071.85 nat. median
$463
outlier · 32.6×
J3101
HCPCS 		Injection, Tenecteplase, 1 Mg 18 $13,690.60 $17,163.03 $14,949.05 nat. median
$5,949
outlier · 2.5×
J2506
HCPCS 		Injection, Pegfilgrastim, Excludes Biosimilar, 0.5 Mg 18 $14,128.84 $16,376.61 $14,449.95 nat. median
$2,076
outlier · 7.0×
J9354
HCPCS 		Injection, Ado-trastuzumab Emtansine, 1 Mg 19 $36.29 $23,059.14 $14,412.09 nat. median
$4,302
outlier · 3.4×
J9304
HCPCS 		Injection, Pemetrexed (pemfexy), 10 Mg 18 $13,886.84 $16,096.11 $14,202.45 nat. median
$66
outlier · 214.4×
Q5117
HCPCS 		Injection, Trastuzumab-anns, Biosimilar, (kanjinti), 10 Mg 18 $13,745.60 $15,932.40 $14,058.00 nat. median
$936
outlier · 15.0×
J9173
HCPCS 		Injection, Durvalumab, 10 Mg 19 $80.51 $15,796.74 $13,938.30 nat. median
$1,153
outlier · 12.1×
J0896
HCPCS 		Injection, Luspatercept-aamt, 0.25 Mg 18 $12,988.36 $15,054.69 $13,283.55 nat. median
$4,612
outlier · 2.9×
Q5119
HCPCS 		Injection, Rituximab-pvvr, Biosimilar, (ruxience), 10 Mg 18 $12,936.44 $14,994.51 $13,230.45 nat. median
$934
outlier · 14.2×
41155
HCPCS 		Removal Of Tongue, Floor Of Mouth, Jaw Bone, Tissue, And Lymph Nodes 19 $3,835.03 $14,066.82 $12,411.90 nat. median
$4,088
outlier · 3.0×
J2182
HCPCS 		Injection, Mepolizumab, 1 Mg 19 $35.02 $13,912.29 $12,275.55 nat. median
$3,098
outlier · 4.0×
J0775
HCPCS 		Injection, Collagenase, Clostridium Histolyticum, 0.01 Mg 19 $52.32 $13,876.08 $12,243.60 nat. median
$121
outlier · 101.4×
400048553
CDM 		Hchg Tfh Dressing Incision Prevena Kci 17 $11,938.96 $13,159.99 $12,210.30 nat. median
$12,210
1.0× median
A9592
HCPCS 		Copper Cu-64, Dotatate, Diagnostic, 1 Millicurie 18 $11,873.84 $13,762.86 $12,143.70 nat. median
$1,740
outlier · 7.0×
J9319
HCPCS 		Injection, Romidepsin, Lyophilized, 0.1 Mg 18 $11,545.60 $13,382.40 $11,808.00 nat. median
$93
outlier · 127.1×
J9035
HCPCS 		Injection, Bevacizumab, 10 Mg 19 $87.03 $13,336.50 $11,767.50 nat. median
$767
outlier · 15.3×
J9352
HCPCS 		Injection, Trabectedin, 0.1 Mg 19 $320.03 $13,217.16 $11,662.20 nat. median
$1,059
outlier · 11.0×
J9061
HCPCS 		Injection, Amivantamab-vmjw, 2 Mg 18 $11,361.68 $13,169.22 $11,619.90 nat. median
$63
outlier · 183.8×
Q2050
HCPCS 		Injection, Doxorubicin Hydrochloride, Liposomal, Not Otherwise Specified, 10 Mg 19 $359.07 $13,063.14 $11,526.30 nat. median
$728
outlier · 15.8×
77372
HCPCS 		Complete Single Session Course Of Cranial Lesion Surgery Using Radiation And A M… 19 $818.30 $13,057.02 $11,520.90 nat. median
$9,062
1.3× median
20956
HCPCS 		Bone Graft Of Pelvic Bone With Microvascular Connection 19 $3,418.23 $12,505.20 $11,034.00 nat. median
$6,673
1.7× median
650001651
CDM 		Hchg Tf Hearing Aid Binaural Level 6 17 $10,755.36 $11,855.34 $10,999.80 nat. median
$11,000
1.0× median
500001108
CDM 		Gastro - Intestinal (gi) Services - General Classification 17 $10,603.12 $11,687.53 $10,844.10 nat. median
$10,844
1.0× median
J9299
HCPCS 		Injection, Nivolumab, 1 Mg 19 $32.74 $28,929.75 $10,636.20 nat. median
$2,947
outlier · 3.6×
31365
HCPCS 		Complete Removal Of Voice Box With Extensive Dissection Of Neck 19 $3,285.20 $11,868.72 $10,472.40 nat. median
$4,041
outlier · 2.6×

Other procedures at this hospital

Browse this hospital's 6,789 published procedures. Use the slice to choose what to show, then sort or filter any column.

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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
             
100001521 CDM Hchg Care High Risk Antenatal Or Postpartal 17 17 $5,681.00 $5,681.00 $4,999.28 $5,510.57 $5,112.90 2025-09-04
100001585 CDM Labor Room/delivery - General Classification 17 17 $5,160.00 $5,160.00 $4,540.80 $5,005.20 $4,644.00 2025-09-04
100001586 CDM Labor Room/delivery - General Classification 17 17 $5,897.00 $5,897.00 $5,189.36 $5,720.09 $5,307.30 2025-09-04
100001587 CDM Labor Room/delivery - General Classification 17 17 $6,635.00 $6,635.00 $5,838.80 $6,435.95 $5,971.50 2025-09-04
100001588 CDM Labor Room/delivery - General Classification 17 17 $7,370.00 $7,370.00 $6,485.60 $7,148.90 $6,633.00 2025-09-04
100001589 CDM Labor Room/delivery - General Classification 17 17 $5,601.00 $5,601.00 $4,928.88 $5,432.97 $5,040.90 2025-09-04
100001590 CDM Labor Room/delivery - General Classification 17 17 $6,192.00 $6,192.00 $5,448.96 $6,006.24 $5,572.80 2025-09-04
100001591 CDM Labor Room/delivery - General Classification 17 17 $6,928.00 $6,928.00 $6,096.64 $6,720.16 $6,235.20 2025-09-04
100001592 CDM Labor Room/delivery - General Classification 17 17 $7,665.00 $7,665.00 $6,745.20 $7,435.05 $6,898.50 2025-09-04
100001593 CDM Labor Room/delivery - General Classification 17 17 $6,192.00 $6,192.00 $5,448.96 $6,006.24 $5,572.80 2025-09-04
100001594 CDM Labor Room/delivery - General Classification 17 17 $6,928.00 $6,928.00 $6,096.64 $6,720.16 $6,235.20 2025-09-04
100001595 CDM Labor Room/delivery - General Classification 17 17 $7,665.00 $7,665.00 $6,745.20 $7,435.05 $6,898.50 2025-09-04
100001596 CDM Labor Room/delivery - General Classification 17 17 $8,403.00 $8,403.00 $7,394.64 $8,150.91 $7,562.70 2025-09-04
100001597 CDM Labor Room/delivery - General Classification 17 17 $6,635.00 $6,635.00 $5,838.80 $6,435.95 $5,971.50 2025-09-04
100001598 CDM Labor Room/delivery - General Classification 17 17 $7,370.00 $7,370.00 $6,485.60 $7,148.90 $6,633.00 2025-09-04
100001599 CDM Labor Room/delivery - General Classification 17 17 $8,109.00 $8,109.00 $7,135.92 $7,865.73 $7,298.10 2025-09-04
100001600 CDM Labor Room/delivery - General Classification 17 17 $8,845.00 $8,845.00 $7,783.60 $8,579.65 $7,960.50 2025-09-04
140000000 CDM Room & Board - Private (one Bed) - General Classification 19 19 $5,529.00 $5,529.00 $2,045.73 $5,363.13 $4,976.10 2025-09-04
140000003 CDM Room & Board - Private (one Bed) - Pediatric 19 19 $5,529.00 $5,529.00 $2,045.73 $5,363.13 $4,976.10 2025-09-04
140000008 CDM Intensive Care Unit - General Classification 19 19 $11,331.00 $11,331.00 $4,192.47 $10,991.07 $10,197.90 2025-09-04
140000046 CDM Intensive Care Unit - Intermediate ICU 19 19 $8,528.00 $8,528.00 $3,155.36 $8,272.16 $7,675.20 2025-09-04
140000065 CDM Room & Board - Private (one Bed) - Obstetrics (ob) 19 19 $5,529.00 $5,529.00 $2,045.73 $5,363.13 $4,976.10 2025-09-04
140000091 CDM Room & Board - Private (one Bed) - General Classification 19 19 $7,186.00 $7,186.00 $2,658.82 $6,970.42 $6,467.40 2025-09-04
140000110 CDM Room & Board - Private (one Bed) - Pediatric 19 19 $7,186.00 $7,186.00 $2,658.82 $6,970.42 $6,467.40 2025-09-04
140000118 CDM Room & Board - Private (one Bed) - General Classification 19 19 $5,529.00 $5,529.00 $2,045.73 $5,363.13 $4,976.10 2025-09-04
140000135 CDM Nursery - Newborn - Level Iii 19 19 $5,529.00 $5,529.00 $2,045.73 $5,363.13 $4,976.10 2025-09-04
19307 HCPCS Removal Of Breast And Underarm Lymph Nodes 38 19 $5,312.00 $5,312.00 $1,528.73 $5,418.24 $4,780.80 2025-09-04
200003566 CDM Hchg Ed Multi Proc Level 4 17 17 $6,192.00 $6,192.00 $5,448.96 $6,006.24 $5,572.80 2025-09-04
200003567 CDM Hchg Ed Multi Proc Level 5 17 17 $9,387.00 $9,387.00 $8,260.56 $9,105.39 $8,448.30 2025-09-04
200004109 CDM Tfh Trauma Act Lvl3 Without Cc Full 17 17 $7,785.00 $7,785.00 $6,850.80 $7,551.45 $7,006.50 2025-09-04
200004110 CDM Tfh Trauma Act Lvl3 Without Cc Full Ems 17 17 $7,785.00 $7,785.00 $6,850.80 $7,551.45 $7,006.50 2025-09-04
20956 HCPCS Bone Graft Of Pelvic Bone With Microvascular Connection 38 19 $12,260.00 $12,260.00 $3,418.23 $12,505.20 $11,034.00 2025-09-04
21365 HCPCS Treatment Of Complicated Broken Cheek Bone With Placement Of Internal Stabilizin… 38 19 $5,032.00 $5,032.00 $1,415.18 $5,132.64 $4,528.80 2025-09-04
21470 HCPCS Complicated Treatment Of Broken Lower Jaw Bone With Placement Of Stabilizing Dev… 38 19 $5,462.00 $5,462.00 $1,521.46 $5,571.24 $4,915.80 2025-09-04
21601 HCPCS Removal Of Growth Of Chest Wall And Rib 38 19 $5,366.00 $5,366.00 $1,475.46 $5,473.32 $4,829.40 2025-09-04
217529_ERX CDM Triamcinolone Acet 40 Mg/ml Vl 17 17 $6,822.50 $6,822.50 $6,003.80 $6,617.83 $6,140.25 2025-09-04
23335 HCPCS Removal Of Ball And Socket Prosthesis From Shoulder 38 19 $5,765.00 $5,765.00 $1,652.37 $5,880.30 $5,188.50 2025-09-04
23465 HCPCS Repair Of Shoulder Joint Capsule In The Back Of The Joint 38 19 $5,033.00 $5,033.00 $1,463.40 $5,133.66 $4,529.70 2025-09-04
23466 HCPCS Repair And Tightening Of Shoulder Joint Capsule 38 19 $5,077.00 $5,077.00 $1,468.11 $5,178.54 $4,569.30 2025-09-04
23470 HCPCS Partial Replacement Of Shoulder Joint 38 19 $4,930.00 $4,930.00 $1,563.48 $5,028.60 $4,437.00 2025-09-04
23472 HCPCS Prosthetic Repair Of Shoulder Joint, Total Shoulder 57 19 $6,313.00 $6,313.00 $1,880.47 $12,877.50 $5,807.96 2025-09-04
23473 HCPCS Revision Of Total Shoulder Repair 38 19 $6,871.00 $6,871.00 $2,089.95 $7,008.42 $6,183.90 2025-09-04
23474 HCPCS Revision Of Total Shoulder Repair, Total Shoulder 38 19 $7,895.00 $7,895.00 $2,255.01 $8,052.90 $7,105.50 2025-09-04
23616 HCPCS Treatment Of Broken Upper Arm Bone With Replacement 38 19 $5,590.00 $5,590.00 $1,612.24 $5,701.80 $5,031.00 2025-09-04
24149 HCPCS Extensive Removal Of Bony Growth And Tissue From Elbow To Increase Elbow Motion 38 19 $5,421.00 $5,421.00 $1,553.70 $5,529.42 $4,878.90 2025-09-04
25025 HCPCS Incision To Relieve Pressure In Top And Palm Side Of Wrist Compartment With Remo… 38 19 $5,455.00 $5,455.00 $1,605.62 $5,564.10 $4,909.50 2025-09-04
27091 HCPCS Removal Of Hip Prosthesis, Complicated 38 19 $7,186.00 $7,186.00 $2,072.24 $7,329.72 $6,467.40 2025-09-04
27125 HCPCS Partial Replacement Of Thigh Bone At Hip Joint With Prosthesis 38 19 $4,926.00 $4,926.00 $1,479.59 $5,024.52 $4,433.40 2025-09-04
27130 HCPCS Replacement Of Thigh Bone And Hip Joint With Prosthesis 76 19 $8,830.50 $8,830.50 $1,672.81 $12,009.48 $5,798.69 2025-09-04
27132 HCPCS Total Hip Replacement After Previous Hip Surgery 76 19 $11,309.00 $11,309.00 $2,171.70 $15,380.58 $7,425.91 2025-09-04
27134 HCPCS Revision Of Thigh Bone And Hip Joint Prosthesis 38 19 $8,073.00 $8,073.00 $2,467.13 $8,234.46 $7,265.70 2025-09-04
27137 HCPCS Revision Of Hip Socket Part Of Hip Prosthesis 38 19 $6,198.00 $6,198.00 $1,904.69 $6,321.96 $5,578.20 2025-09-04
27138 HCPCS Revision Of Thigh Bone Prosthesis 38 19 $6,886.00 $6,886.00 $1,977.99 $7,023.72 $6,197.40 2025-09-04
27227 HCPCS Treatment Of Broken Bones Of Front Or Back Column Of Hip Socket Or Across Hip So… 38 19 $7,204.00 $7,204.00 $2,147.73 $7,348.08 $6,483.60 2025-09-04
27228 HCPCS Treatment Of Broken Bones Of Front And Back Column Or Wall Of Hip Socket With Pl… 38 19 $8,217.00 $8,217.00 $2,436.47 $8,381.34 $7,395.30 2025-09-04
27236 HCPCS Treatment Of Upper End Of Broken Thigh Bone With Placement Of Stabilizing Device… 38 19 $5,157.00 $5,157.00 $1,558.85 $5,260.14 $4,641.30 2025-09-04
27244 HCPCS Treatment Of Broken Neck Of Thigh Bone With Plate/screw Implant 38 19 $5,351.00 $5,351.00 $1,603.73 $5,458.02 $4,815.90 2025-09-04
27245 HCPCS Treatment Of Broken Neck Of Thigh Bone With Bone Implant 38 19 $5,334.00 $5,334.00 $1,601.69 $5,440.68 $4,800.60 2025-09-04
27269 HCPCS Treatment Of Broken Head Of Thigh Bone 38 19 $5,275.00 $5,275.00 $1,616.92 $5,380.50 $4,747.50 2025-09-04
27412 HCPCS Implantation Of Self Cartilage Into Knee Joint 38 19 $6,917.00 $6,917.00 $2,147.97 $7,055.34 $6,225.30 2025-09-04
27415 HCPCS Implantation Of Donor Cartilage Cells Into Knee Joint 38 19 $6,139.00 $6,139.00 $1,795.27 $6,261.78 $5,525.10 2025-09-04
27428 HCPCS Reconstruction Ligaments Inside Knee Joint 38 19 $5,045.00 $5,045.00 $1,469.22 $5,145.90 $4,540.50 2025-09-04
27429 HCPCS Reconstruction Of Ligaments Inside And Outside Knee Joint 38 19 $5,288.00 $5,288.00 $1,656.32 $5,393.76 $4,759.20 2025-09-04
27446 HCPCS Replacement Of Knee Joint On Side Of Knee 38 19 $5,039.00 $5,039.00 $1,499.05 $5,139.78 $4,535.10 2025-09-04
27447 HCPCS Replacement Of Knee Joint, Both Sides Of Knee 76 19 $9,194.00 $9,194.00 $1,670.69 $12,503.16 $6,038.05 2025-09-04
27466 HCPCS Lengthening Of Thigh Bone 38 19 $5,510.00 $5,510.00 $1,549.37 $5,620.20 $4,959.00 2025-09-04
27470 HCPCS Repair Of Nonhealed Broken Thigh Bone 38 19 $5,478.00 $5,478.00 $1,543.47 $5,587.56 $4,930.20 2025-09-04
27472 HCPCS Repair Of Nonhealed Broken Thigh Bone With Self Bone Graft 38 19 $5,477.00 $5,477.00 $1,651.77 $5,586.54 $4,929.30 2025-09-04
27486 HCPCS Revision Of Component Of Total Knee Joint Prosthesis 38 19 $6,369.00 $6,369.00 $1,830.95 $6,496.38 $5,732.10 2025-09-04
27487 HCPCS Revision Of Thigh And Lower Leg Bone Components Of Total Knee Joint Prosthesis 38 19 $7,407.00 $7,407.00 $2,276.79 $7,555.14 $6,666.30 2025-09-04
27488 HCPCS Removal Of Total Knee Joint Prosthesis 38 19 $5,216.00 $5,216.00 $1,569.55 $5,320.32 $4,694.40 2025-09-04
27506 HCPCS Treatment Of Broken Shaft Of Thigh Bone With Implant 38 19 $5,616.00 $5,616.00 $1,748.43 $5,728.32 $5,054.40 2025-09-04
27513 HCPCS Treatment Of Broken Thigh Bone In Knee Area 38 19 $5,388.00 $5,388.00 $1,603.62 $5,495.76 $4,849.20 2025-09-04
27536 HCPCS Treatment Of Broken Shin Bone On Both Sides Of Upper End 38 19 $5,161.00 $5,161.00 $1,553.74 $5,264.22 $4,644.90 2025-09-04
27558 HCPCS Treatment Of Dislocated Knee With Ligament Repair And Reconstruction 38 19 $5,167.00 $5,167.00 $1,544.68 $5,270.34 $4,650.30 2025-09-04
27580 HCPCS Fusion Of Knee Joint 38 19 $6,628.00 $6,628.00 $1,921.28 $6,760.56 $5,965.20 2025-09-04
27590 HCPCS Amputation Of Thigh Through Thigh Bone 38 19 $8,247.00 $8,247.00 $1,001.57 $8,411.94 $7,422.30 2025-09-04
27709 HCPCS Incision Or Partial Removal Of Shin And Outer Lower Leg Bones 38 19 $5,390.00 $5,390.00 $1,490.99 $5,497.80 $4,851.00 2025-09-04
27724 HCPCS Repair Of Nonhealed Broken Shin Bone With Self Graft From Hip Or Other Bone 38 19 $5,489.00 $5,489.00 $1,632.88 $5,598.78 $4,940.10 2025-09-04
27828 HCPCS Treatment Of Broken Lower Weight Bearing Joint Of Both Lower Leg Bones 38 19 $5,622.00 $5,622.00 $1,729.96 $5,734.44 $5,059.80 2025-09-04
28415 HCPCS Treatment Of Broken Heel Bone 38 19 $5,084.00 $5,084.00 $1,468.84 $5,185.68 $4,575.60 2025-09-04
28420 HCPCS Treatment Of Broken Heel Bone With Graft 38 19 $5,955.00 $5,955.00 $1,697.06 $6,074.10 $5,359.50 2025-09-04
28705 HCPCS Fusion Of All Bones Of Ankle And Hindfoot 38 19 $5,768.00 $5,768.00 $1,593.46 $5,883.36 $5,191.20 2025-09-04
29867 HCPCS Repair Of Knee Cartilage And Bone With Donor Cartilage Graft Using An Endoscope 38 19 $5,266.00 $5,266.00 $1,675.24 $5,371.32 $4,739.40 2025-09-04
29889 HCPCS Repair Of Posterior Cruciate Ligament Of Knee Using An Endoscope 38 19 $5,532.00 $5,532.00 $1,606.45 $5,642.64 $4,978.80 2025-09-04
29999 HCPCS Other Procedure On Joint Using An Endoscope 17 17 $6,806.00 $6,806.00 $5,989.28 $6,942.12 $6,125.40 2025-09-04
30400 HCPCS Reshaping Of Tip Of Nose 38 19 $5,065.00 $5,065.00 $1,459.68 $5,166.30 $4,558.50 2025-09-04
30410 HCPCS Reshaping Of Bone, Cartilage, And/or Tip Of Nose 38 19 $5,793.00 $5,793.00 $1,835.38 $5,908.86 $5,213.70 2025-09-04
30420 HCPCS Reshaping Of Bony Cartilage Dividing Nasal Passages 38 19 $5,924.00 $5,924.00 $1,872.25 $6,042.48 $5,331.60 2025-09-04
30435 HCPCS Revision To Reshape Nasal Bones After Previous Repair 38 19 $5,355.00 $5,355.00 $1,625.28 $5,462.10 $4,819.50 2025-09-04
30462 HCPCS Revision Of Congenital Nasal Defect With Lengthening Of Tip Of Nose 38 19 $6,845.00 $6,845.00 $2,069.40 $6,981.90 $6,160.50 2025-09-04
31300 HCPCS Removal Of Vocal Cord Growth Or Cartilage Attachment 38 19 $5,881.00 $5,881.00 $1,624.86 $5,998.62 $5,292.90 2025-09-04
31360 HCPCS Complete Removal Of Voice Box 38 19 $9,467.00 $9,467.00 $2,662.35 $9,656.34 $8,520.30 2025-09-04
31365 HCPCS Complete Removal Of Voice Box With Extensive Dissection Of Neck 38 19 $11,636.00 $11,636.00 $3,285.20 $11,868.72 $10,472.40 2025-09-04
31367 HCPCS Removal Of Voice Box 38 19 $10,042.00 $10,042.00 $2,816.73 $10,242.84 $9,037.80 2025-09-04
31368 HCPCS Removal Of Voice Box With Extensive Dissection Of Neck 38 19 $11,158.00 $11,158.00 $3,110.93 $11,381.16 $10,042.20 2025-09-04
31370 HCPCS Partial Removal Of Voice Box 38 19 $9,471.00 $9,471.00 $2,643.18 $9,660.42 $8,523.90 2025-09-04
32652 HCPCS Removal Of Chest Cavity Lining And Lung Lining Using An Endoscope 76 19 $11,313.00 $11,313.00 $2,104.93 $15,386.70 $7,427.89 2025-09-04
32654 HCPCS Control Of Traumatic Bleeding In Chest Using An Endoscope 76 19 $7,923.50 $7,923.50 $1,522.44 $10,775.28 $5,203.76 2025-09-04
35216 HCPCS Repair Of Blood Vessel Of Chest 38 19 $9,078.00 $9,078.00 $2,632.82 $9,259.56 $8,170.20 2025-09-04
35820 HCPCS Exploration Of Chest For Bleeding, Blood Clot, Or Infection After Surgery 38 19 $8,605.00 $8,605.00 $2,538.66 $8,777.10 $7,744.50 2025-09-04
35840 HCPCS Exploration Of Abdomen For Bleeding, Blood Clot, Or Infection After Surgery 38 19 $5,301.00 $5,301.00 $1,559.75 $5,407.02 $4,770.90 2025-09-04
37617 HCPCS Tying Of Major Artery Of The Abdomen 38 19 $5,687.00 $5,687.00 $1,682.82 $5,800.74 $5,118.30 2025-09-04
38100 HCPCS Removal Of Spleen 38 19 $5,430.00 $5,430.00 $1,480.91 $5,538.60 $4,887.00 2025-09-04
38720 HCPCS Removal Of Lymph Nodes Of Neck 38 19 $5,996.00 $5,996.00 $1,745.85 $6,115.92 $5,396.40 2025-09-04
38724 HCPCS Removal Of Lymph Nodes, Muscle, And Tissue Of Neck 38 19 $6,484.00 $6,484.00 $1,885.33 $6,613.68 $5,835.60 2025-09-04
400000002 CDM Hchg Miscellaneous Sup Implants Rev Cd 278 17 17 $5,300.06 $5,300.06 $4,664.05 $5,141.06 $4,770.05 2025-09-04
400048553 CDM Hchg Tfh Dressing Incision Prevena Kci 17 17 $13,567.00 $13,567.00 $11,938.96 $13,159.99 $12,210.30 2025-09-04
400048857 CDM Hchg Tfh Novasure Device Disp 17 17 $11,304.00 $11,304.00 $9,947.52 $10,964.88 $10,173.60 2025-09-04
400063167 CDM Hchg Tfh System Control Hemorrhage Jada 2.0 17 17 $10,030.00 $10,030.00 $8,826.40 $9,729.10 $9,027.00 2025-09-04
400065151 CDM Hchg Tfh Pillow Fetal 17 17 $8,349.00 $8,349.00 $7,347.12 $8,098.53 $7,514.10 2025-09-04
400066448 CDM Hchg Tfh Pack Procedure Pack Tx1 17 17 $6,418.00 $6,418.00 $5,647.84 $6,225.46 $5,776.20 2025-09-04
400066449 CDM Hchg Tfh Pack Procedure Pack Tx2 17 17 $7,090.00 $7,090.00 $6,239.20 $6,877.30 $6,381.00 2025-09-04
400066450 CDM Hchg Tfh Pack Procedure Pack Tx3 17 17 $10,864.00 $10,864.00 $9,560.32 $10,538.08 $9,777.60 2025-09-04
41120 HCPCS Removal Of Less Than Half Of Tongue 38 19 $5,004.00 $5,004.00 $1,371.99 $5,104.08 $4,503.60 2025-09-04
41130 HCPCS Partial Removal Of Tongue 38 19 $6,122.00 $6,122.00 $1,695.60 $6,244.44 $5,509.80 2025-09-04
41140 HCPCS Complete Removal Of Tongue 38 19 $10,046.00 $10,046.00 $2,808.49 $10,246.92 $9,041.40 2025-09-04
41155 HCPCS Removal Of Tongue, Floor Of Mouth, Jaw Bone, Tissue, And Lymph Nodes 38 19 $13,791.00 $13,791.00 $3,835.03 $14,066.82 $12,411.90 2025-09-04
42420 HCPCS Removal Of Growth Of Saliva Gland Or Saliva Gland With Release Of Facial Nerve 38 19 $5,304.00 $5,304.00 $1,543.75 $5,410.08 $4,773.60 2025-09-04
42426 HCPCS Removal Of Growth Of Saliva Gland Or Saliva Gland, And Surrounding Lymph Nodes O… 38 19 $6,027.00 $6,027.00 $1,368.17 $5,846.19 $5,424.30 2025-09-04
43281 HCPCS Repair Of Hernia Of Muscle At Esophagus And Stomach Using An Endoscope 38 19 $6,822.00 $6,822.00 $1,967.85 $6,958.44 $6,139.80 2025-09-04
43282 HCPCS Repair Of Hernia Of Muscle At Esophagus And Stomach With Implantation Of Mesh Us… 38 19 $7,664.00 $7,664.00 $2,217.69 $7,817.28 $6,897.60 2025-09-04
43332 HCPCS Repair Of Paraesophageal Hernia Through Abdomen 38 19 $5,133.00 $5,133.00 $1,471.96 $5,235.66 $4,619.70 2025-09-04
43840 HCPCS Suture Of Perforated Ulcer, Wound, Or Injury Of Stomach Or Upper Small Bowel 76 19 $9,321.00 $9,321.00 $1,753.91 $12,677.58 $6,119.81 2025-09-04
44055 HCPCS Correction Of Abnormal Rotation Of Small Bowel 38 19 $6,595.00 $6,595.00 $1,919.96 $6,726.90 $5,935.50 2025-09-04
44120 HCPCS Partial Removal Of Small Bowel With Reconnection 38 19 $5,230.00 $5,230.00 $1,572.84 $5,334.60 $4,707.00 2025-09-04
44126 HCPCS Partial Removal Of Small Bowel And Reconnection To Correct Congenital Defect 38 19 $10,866.00 $10,866.00 $2,328.00 $10,540.02 $9,779.40 2025-09-04
44140 HCPCS Partial Removal Of Large Bowel With Connection 38 19 $5,741.00 $5,741.00 $1,727.41 $5,855.82 $5,166.90 2025-09-04
44141 HCPCS Partial Removal Of Large Bowel With Creation Of Opening To Skin 38 19 $8,132.00 $8,132.00 $2,322.65 $8,294.64 $7,318.80 2025-09-04
44143 HCPCS Partial Removal Of Large Bowel With Creation Of Opening From Large Bowel To Skin 38 19 $7,400.00 $7,400.00 $2,117.41 $7,548.00 $6,660.00 2025-09-04
44144 HCPCS Partial Removal Of Large Bowel With Creation Of 2 Openings From Small Or Large B… 38 19 $7,914.00 $7,914.00 $2,262.05 $8,072.28 $7,122.60 2025-09-04
44145 HCPCS Partial Removal Of Large Bowel And Reattachment To Rectum 38 19 $7,374.00 $7,374.00 $2,116.31 $7,521.48 $6,636.60 2025-09-04
44147 HCPCS Partial Removal Of Large Bowel Through Abdomen And Anus 38 19 $8,609.00 $8,609.00 $2,480.79 $8,781.18 $7,748.10 2025-09-04
44160 HCPCS Partial Removal Of Small And Large Bowel With Attachment Of Small And Large Bowe… 38 19 $5,201.00 $5,201.00 $1,599.24 $5,305.02 $4,680.90 2025-09-04
44188 HCPCS Creation Of Large Bowel Opening Using An Endoscope 38 19 $5,496.00 $5,496.00 $1,560.80 $5,605.92 $4,946.40 2025-09-04
44202 HCPCS Partial Removal And Reconnection Of Small Bowel Using An Endoscope 38 19 $6,150.00 $6,150.00 $1,784.05 $6,273.00 $5,535.00 2025-09-04
44204 HCPCS Partial Removal Of Large Bowel Using An Endoscope 38 19 $6,897.00 $6,897.00 $1,970.23 $7,034.94 $6,207.30 2025-09-04
44205 HCPCS Partial Removal Of Small And Large Bowel With Attachment Of Small And Large Bowe… 38 19 $5,962.00 $5,962.00 $1,712.23 $6,081.24 $5,365.80 2025-09-04
44206 HCPCS Partial Removal Of Large Bowel With Creation Of Opening From Large Bowel To Skin… 38 19 $7,800.00 $7,800.00 $2,226.69 $7,956.00 $7,020.00 2025-09-04
44207 HCPCS Partial Removal Of Large Bowel And Reattachment To Rectum Using An Endoscope 38 19 $8,121.00 $8,121.00 $2,316.72 $8,283.42 $7,308.90 2025-09-04
44208 HCPCS Partial Removal Of Large Bowel And Reattachment To Rectum And Creation Of Openin… 38 19 $8,680.00 $8,680.00 $2,519.44 $8,853.60 $7,812.00 2025-09-04
44227 HCPCS Closure Of Opening From Large Or Small Bowel To Skin Using An Endoscope 38 19 $7,400.00 $7,400.00 $2,122.28 $7,548.00 $6,660.00 2025-09-04
44320 HCPCS Creation Of Opening From Large Bowel To Skin 38 19 $5,352.00 $5,352.00 $1,547.75 $5,459.04 $4,816.80 2025-09-04
44346 HCPCS Revision Of Opening From Large Bowel To Skin With Repair Of Hernia 38 19 $5,284.00 $5,284.00 $1,525.92 $5,389.68 $4,755.60 2025-09-04
44376 HCPCS Diagnostic Exam Of Small Bowel (including Lower Small Intestine) Using An Endosc… 19 19 $6,407.00 $6,407.00 $256.21 $6,535.14 $5,766.30 2025-09-04
44602 HCPCS Suture Of Tear Of Hole In Small Bowel 38 19 $6,233.00 $6,233.00 $1,801.25 $6,357.66 $5,609.70 2025-09-04
44603 HCPCS Suture Of Multiple Tears Or Holes In Small Bowel 76 19 $11,118.00 $11,118.00 $2,074.55 $15,121.50 $7,299.84 2025-09-04
44626 HCPCS Closure Of Surgically Created Large Or Small Bowel Opening With Bowel Removal An… 38 19 $7,106.00 $7,106.00 $1,521.45 $6,892.82 $6,395.40 2025-09-04
44661 HCPCS Closure Of Abnormal Drainage Tract From Small Bowel To Urinary Bladder With Rese… 38 19 $6,913.00 $6,913.00 $1,980.91 $7,051.26 $6,221.70 2025-09-04
45110 HCPCS Removal Of Rectum With Creation Of Opening From Large Bowel To Skin Through Abdo… 38 19 $8,018.00 $8,018.00 $2,329.64 $8,178.36 $7,216.20 2025-09-04
45400 HCPCS Repair Of Rectal Prolapse Using An Endoscope 38 19 $5,027.00 $5,027.00 $1,457.89 $5,127.54 $4,524.30 2025-09-04
45562 HCPCS Repair Of Rectal Wound 38 19 $5,011.00 $5,011.00 $1,513.77 $5,111.22 $4,509.90 2025-09-04
47135 HCPCS Transplantation Of Donor Liver 38 19 $23,723.00 $23,723.00 $6,855.86 $24,197.46 $21,350.70 2025-09-04
47564 HCPCS Removal Of Gallbladder With Exploration Of Common Bile Duct Using An Endoscope 38 19 $4,940.00 $4,940.00 $1,448.24 $5,038.80 $4,446.00 2025-09-04
47610 HCPCS Removal Of Gallbladder With Exploration Of Common Bile Duct 38 19 $5,905.00 $5,905.00 $1,617.71 $6,023.10 $5,314.50 2025-09-04
47741 HCPCS Creation Of Drainage Tract From Gallbladder To Small Bowel Using Roux-en-y Conne… 38 19 $6,545.00 $6,545.00 $1,900.31 $6,675.90 $5,890.50 2025-09-04
49020 HCPCS Drainage Of Abdominal Abscess Or Infection 38 19 $7,289.00 $7,289.00 $2,054.25 $7,434.78 $6,560.10 2025-09-04
49618 HCPCS Repair Of Recurrent Entrapped Hernia Of Abdomen, More Than 10 Cm In Length 36 18 $5,116.00 $5,116.00 $1,596.27 $5,218.32 $4,604.40 2025-09-04
500001023 CDM Operating Room Services - General Classification 17 17 $5,525.00 $5,525.00 $4,862.00 $5,359.25 $4,972.50 2025-09-04
500001025 CDM Operating Room Services - General Classification 17 17 $6,938.00 $6,938.00 $6,105.44 $6,729.86 $6,244.20 2025-09-04
500001027 CDM Operating Room Services - General Classification 17 17 $9,706.00 $9,706.00 $8,541.28 $9,414.82 $8,735.40 2025-09-04
500001029 CDM Operating Room Services - General Classification 17 17 $11,075.00 $11,075.00 $9,746.00 $10,742.75 $9,967.50 2025-09-04
500001030 CDM Operating Room Services - General Classification 17 17 $6,358.00 $6,358.00 $5,595.04 $6,167.26 $5,722.20 2025-09-04
500001105 CDM Gastro - Intestinal (gi) Services - General Classification 17 17 $6,192.00 $6,192.00 $5,448.96 $6,006.24 $5,572.80 2025-09-04
500001106 CDM Gastro - Intestinal (gi) Services - General Classification 17 17 $6,967.00 $6,967.00 $6,130.96 $6,757.99 $6,270.30 2025-09-04
500001107 CDM Gastro - Intestinal (gi) Services - General Classification 17 17 $7,739.00 $7,739.00 $6,810.32 $7,506.83 $6,965.10 2025-09-04
500001108 CDM Gastro - Intestinal (gi) Services - General Classification 17 17 $12,049.00 $12,049.00 $10,603.12 $11,687.53 $10,844.10 2025-09-04
500001130 CDM Gastro - Intestinal (gi) Services - General Classification 17 17 $6,407.00 $6,407.00 $5,638.16 $6,214.79 $5,766.30 2025-09-04
500001219 CDM Gastro - Intestinal (gi) Services - General Classification 17 17 $6,094.00 $6,094.00 $5,362.72 $5,911.18 $5,484.60 2025-09-04
500002639 CDM Operating Room Services - General Classification 17 17 $5,683.00 $5,683.00 $5,001.04 $5,512.51 $5,114.70 2025-09-04
500002641 CDM Operating Room Services - General Classification 17 17 $7,136.00 $7,136.00 $6,279.68 $6,921.92 $6,422.40 2025-09-04
500002643 CDM Operating Room Services - General Classification 17 17 $9,983.00 $9,983.00 $8,785.04 $9,683.51 $8,984.70 2025-09-04
500002644 CDM Operating Room Services - General Classification 17 17 $4,995.00 $4,995.00 $4,395.60 $4,845.15 $4,495.50 2025-09-04
500002645 CDM Operating Room Services - General Classification 17 17 $11,393.00 $11,393.00 $10,025.84 $11,051.21 $10,253.70 2025-09-04
500002646 CDM Operating Room Services - General Classification 17 17 $6,539.00 $6,539.00 $5,754.32 $6,342.83 $5,885.10 2025-09-04
50230 HCPCS Removal Of Kidney, Lymph Nodes, And/or Blood Clot From Major Vein With Partial R… 38 19 $5,840.00 $5,840.00 $1,648.32 $5,956.80 $5,256.00 2025-09-04
50240 HCPCS Partial Removal Of Kidney 38 19 $6,049.00 $6,049.00 $1,715.46 $6,169.98 $5,444.10 2025-09-04
50400 HCPCS Simple Reconstruction Of Neck Of Kidney 38 19 $5,292.00 $5,292.00 $1,491.72 $5,397.84 $4,762.80 2025-09-04
50543 HCPCS Partial Removal Of Kidney Using An Endoscope 38 19 $6,801.00 $6,801.00 $1,921.47 $6,937.02 $6,120.90 2025-09-04
50545 HCPCS Removal Of Kidney And Lymph Nodes Using An Endoscope 38 19 $6,115.00 $6,115.00 $1,719.18 $6,237.30 $5,503.50 2025-09-04
50948 HCPCS Repositioning Of Ureter Using An Endoscope 38 19 $5,824.00 $5,824.00 $1,645.35 $5,940.48 $5,241.60 2025-09-04
55840 HCPCS Removal Of Prostate 38 19 $5,362.00 $5,362.00 $1,513.08 $5,469.24 $4,825.80 2025-09-04
55845 HCPCS Removal Of Prostate Gland And Surrounding Lymph Nodes On Both Sides Of Pelvis Th… 38 19 $6,234.00 $6,234.00 $1,756.66 $6,358.68 $5,610.60 2025-09-04
58146 HCPCS Removal Of 5 Or More Growths Of Uterus Through Abdomen 38 19 $5,272.00 $5,272.00 $1,491.53 $5,377.44 $4,744.80 2025-09-04
58152 HCPCS Removal Of Uterus And Cervix Through Abdomen With Repair Of Vagina 38 19 $5,559.00 $5,559.00 $1,599.08 $5,670.18 $5,003.10 2025-09-04
58290 HCPCS Removal Of Uterus Through Vagina, More Than 250.0 G 38 19 $5,101.00 $5,101.00 $1,486.80 $5,203.02 $4,590.90 2025-09-04
58291 HCPCS Removal Of Uterus, Tubes, And/or Ovaries Through Vagina, More Than 250.0 G 38 19 $5,537.00 $5,537.00 $1,605.42 $5,647.74 $4,983.30 2025-09-04
58546 HCPCS Removal Of Growth Of Uterus Using An Endoscope, More Than 250.0 G 38 19 $4,980.00 $4,980.00 $1,438.44 $5,079.60 $4,482.00 2025-09-04
58553 HCPCS Removal Of Uterus Through Vagina Using An Endoscope, More Than 250.0 38 19 $5,007.00 $5,007.00 $1,446.53 $5,107.14 $4,506.30 2025-09-04
58554 HCPCS Removal Of Uterus, Tubes, And/or Ovaries Through Vagina Using An Endoscope, More… 38 19 $5,888.00 $5,888.00 $1,685.38 $6,005.76 $5,299.20 2025-09-04
58573 HCPCS Removal Of Uterus, Tubes, And/or Ovaries Through Abdomen Using An Endoscope, Mor… 38 19 $5,774.00 $5,774.00 $1,578.03 $5,889.48 $5,196.60 2025-09-04
59400 HCPCS Vaginal Delivery With Care Before And After Delivery 38 19 $7,308.00 $7,308.00 $2,990.41 $7,454.16 $6,577.20 2025-09-04
59510 HCPCS Cesarean Delivery With Care Before And After Delivery 38 19 $8,101.00 $8,101.00 $3,315.85 $8,263.02 $7,290.90 2025-09-04
59515 HCPCS Cesarean Delivery With Care After Delivery 38 19 $5,516.00 $5,516.00 $1,713.22 $5,626.32 $4,964.40 2025-09-04
60254 HCPCS Removal Of Thyroid And Surrounding Lymph Nodes With Extensive Neck Removal 38 19 $7,406.00 $7,406.00 $2,151.40 $7,554.12 $6,665.40 2025-09-04
60600 HCPCS Removal Of Growth Of Carotid Artery 38 19 $6,082.00 $6,082.00 $1,723.44 $6,203.64 $5,473.80 2025-09-04
64857 HCPCS Suture Of Arm Or Leg Peripheral Nerve 38 19 $4,939.00 $4,939.00 $1,365.93 $5,037.78 $4,445.10 2025-09-04
650001644 CDM Hchg Tf Hearing Aid Monaural Level 5 17 17 $5,436.00 $5,436.00 $4,783.68 $5,272.92 $4,892.40 2025-09-04
650001645 CDM Hchg Tf Hearing Aid Monaural Level 6 17 17 $6,110.00 $6,110.00 $5,376.80 $5,926.70 $5,499.00 2025-09-04
650001647 CDM Hchg Tf Hearing Aid Binaural Level 2 17 17 $4,941.00 $4,941.00 $4,348.08 $4,792.77 $4,446.90 2025-09-04
650001648 CDM Hchg Tf Hearing Aid Binaural Level 3 17 17 $6,023.00 $6,023.00 $5,300.24 $5,842.31 $5,420.70 2025-09-04
650001649 CDM Hchg Tf Hearing Aid Binaural Level 4 17 17 $8,167.00 $8,167.00 $7,186.96 $7,921.99 $7,350.30 2025-09-04
650001650 CDM Hchg Tf Hearing Aid Binaural Level 5 17 17 $10,869.00 $10,869.00 $9,564.72 $10,542.93 $9,782.10 2025-09-04
650001651 CDM Hchg Tf Hearing Aid Binaural Level 6 17 17 $12,222.00 $12,222.00 $10,755.36 $11,855.34 $10,999.80 2025-09-04
690 MS_DRG Kidney And Urinary Tract Infections Without Mcc 19 19 $10,618.50 $10,618.50 $3,928.85 $15,589.89 $9,556.65 2025-09-04
69644 HCPCS Repair Of Eardrum, Ear Canal, And Bones With Removal Of Mastoid Bone, With Intac… 38 19 $6,010.00 $6,010.00 $1,960.78 $6,130.20 $5,409.00 2025-09-04
77371 HCPCS Complete Single Session Course Of Cranial Lesion Surgery Using Radiation 19 19 $76,101.00 $76,101.00 $1,078.50 $77,623.02 $68,490.90 2025-09-04
77372 HCPCS Complete Single Session Course Of Cranial Lesion Surgery Using Radiation And A M… 19 19 $12,801.00 $12,801.00 $818.30 $13,057.02 $11,520.90 2025-09-04
77373 HCPCS Delivery Of Radiation Therapy Per Dose To 1 Or More Lesions Not To Exceed 5 Dose… 19 19 $6,314.00 $6,314.00 $1,265.75 $6,440.28 $5,682.60 2025-09-04
77385 HCPCS Delivery Of Simple High Precision Radiation Treatment 19 19 $4,951.00 $4,951.00 $322.57 $5,050.02 $4,455.90 2025-09-04
77386 HCPCS Delivery Of Complex High Precision Radiation Treatment 19 19 $4,951.00 $4,951.00 $387.08 $5,050.02 $4,455.90 2025-09-04
77778 HCPCS Complex Application Of Radiation Source 19 19 $6,304.00 $6,304.00 $745.61 $6,430.08 $5,673.60 2025-09-04
90375 HCPCS Rabies Immune Globulin For Injection 19 19 $8,386.00 $8,386.00 $310.78 $8,553.72 $7,547.40 2025-09-04
90396 HCPCS Varicella (chicken Pox) Zoster Immune Globulin For Injection Into Muscle 18 18 $5,014.00 $5,014.00 $4,412.32 $5,114.28 $4,512.60 2025-09-04
A9572 HCPCS Indium In-111 Pentetreotide, Diagnostic, Per Study Dose, Up To 6 Millicuries 18 18 $10,031.00 $10,031.00 $8,827.28 $10,231.62 $9,027.90 2025-09-04
A9592 HCPCS Copper Cu-64, Dotatate, Diagnostic, 1 Millicurie 18 18 $13,493.00 $13,493.00 $11,873.84 $13,762.86 $12,143.70 2025-09-04
C1764 HCPCS Event Recorder, Cardiac (implantable) 18 18 $6,272.00 $6,272.00 $5,519.36 $6,397.44 $5,644.80 2025-09-04
C1880 HCPCS Vena Cava Filter 18 18 $10,593.00 $10,593.00 $9,321.84 $10,804.86 $9,533.70 2025-09-04
C8900 HCPCS Magnetic Resonance Angiography With Contrast, Abdomen 18 18 $7,521.00 $7,521.00 $6,618.48 $7,671.42 $6,768.90 2025-09-04
C8901 HCPCS Magnetic Resonance Angiography Without Contrast, Abdomen 18 18 $7,521.00 $7,521.00 $6,618.48 $7,671.42 $6,768.90 2025-09-04
C8902 HCPCS Magnetic Resonance Angiography Without Contrast Followed By With Contrast, Abdom… 18 18 $7,521.00 $7,521.00 $6,618.48 $7,671.42 $6,768.90 2025-09-04
C8909 HCPCS Magnetic Resonance Angiography With Contrast, Chest (excluding Myocardium) 18 18 $7,521.00 $7,521.00 $6,618.48 $7,671.42 $6,768.90 2025-09-04
C8910 HCPCS Magnetic Resonance Angiography Without Contrast, Chest (excluding Myocardium) 18 18 $7,521.00 $7,521.00 $6,618.48 $7,671.42 $6,768.90 2025-09-04
C8911 HCPCS Magnetic Resonance Angiography Without Contrast Followed By With Contrast, Chest… 18 18 $7,521.00 $7,521.00 $6,618.48 $7,671.42 $6,768.90 2025-09-04
C8914 HCPCS Magnetic Resonance Angiography Without Contrast Followed By With Contrast, Lower… 54 18 $6,458.00 $6,458.00 $5,683.04 $13,172.28 $6,135.10 2025-09-04
C8920 HCPCS Magnetic Resonance Angiography Without Contrast Followed By With Contrast, Pelvi… 18 18 $6,918.00 $6,918.00 $6,087.84 $7,056.36 $6,226.20 2025-09-04
G0390 HCPCS Trauma Response Team Associated With Hospital Critical Care Service 36 18 $6,189.50 $6,189.50 $4,042.72 $7,940.70 $5,768.34 2025-09-04
J0222 HCPCS Injection, Patisiran, 0.1 Mg 18 18 $40,134.50 $40,134.50 $35,318.36 $40,937.19 $36,121.05 2025-09-04
J0630 HCPCS Injection, Calcitonin Salmon, Up To 400 Units 19 19 $5,712.50 $5,712.50 $2,691.50 $5,826.75 $5,141.25 2025-09-04
J0717 HCPCS Injection, Certolizumab Pegol, 1 Mg (code May Be Used For Medicare When Drug Adm… 19 19 $20,917.00 $20,917.00 $12.78 $21,335.34 $18,825.30 2025-09-04
J0775 HCPCS Injection, Collagenase, Clostridium Histolyticum, 0.01 Mg 19 19 $13,604.00 $13,604.00 $52.32 $13,876.08 $12,243.60 2025-09-04
J0896 HCPCS Injection, Luspatercept-aamt, 0.25 Mg 18 18 $14,759.50 $14,759.50 $12,988.36 $15,054.69 $13,283.55 2025-09-04
J0897 HCPCS Injection, Denosumab, 1 Mg 37 19 $5,882.50 $5,882.50 $23.91 $11,036.91 $6,000.15 2025-09-04
J1306 HCPCS Injection, Inclisiran, 1 Mg 18 18 $8,130.50 $8,130.50 $7,154.84 $8,293.11 $7,317.45 2025-09-04
J1930 HCPCS Injection, Lanreotide, 1 Mg 19 19 $35,914.00 $35,914.00 $68.69 $36,632.28 $32,322.60 2025-09-04
J1950 HCPCS Injection, Leuprolide Acetate (for Depot Suspension), Per 3.75 Mg 37 19 $19,145.00 $19,145.00 $1,291.31 $19,527.90 $6,509.64 2025-09-04
J2182 HCPCS Injection, Mepolizumab, 1 Mg 19 19 $13,639.50 $13,639.50 $35.02 $13,912.29 $12,275.55 2025-09-04
J2323 HCPCS Injection, Natalizumab, 1 Mg 19 19 $32,222.00 $32,222.00 $25.12 $32,866.44 $28,999.80 2025-09-04
J2350 HCPCS Injection, Ocrelizumab, 1 Mg 19 19 $72,995.50 $72,995.50 $62.81 $74,455.41 $65,695.95 2025-09-04
J2353 HCPCS Injection, Octreotide, Depot Form For Intramuscular Injection, 1 Mg 55 19 $17,492.50 $17,492.50 $212.29 $26,717.37 $15,743.25 2025-09-04
J2506 HCPCS Injection, Pegfilgrastim, Excludes Biosimilar, 0.5 Mg 18 18 $16,055.50 $16,055.50 $14,128.84 $16,376.61 $14,449.95 2025-09-04
J2783 HCPCS Injection, Rasburicase, 0.5 Mg 36 18 $7,398.75 $7,398.75 $2,170.52 $12,577.62 $6,683.56 2025-09-04
J2802 HCPCS Injection, Romiplostim, 1 Microgram 18 18 $5,470.00 $5,470.00 $4,813.60 $5,579.40 $4,923.00 2025-09-04
J3032 HCPCS Injection, Eptinezumab-jjmr, 1 Mg 18 18 $6,442.50 $6,442.50 $5,669.40 $6,571.35 $5,798.25 2025-09-04
J3101 HCPCS Injection, Tenecteplase, 1 Mg 36 18 $16,192.00 $16,192.00 $13,690.60 $17,163.03 $14,949.05 2025-09-04
J3240 HCPCS Injection, Thyrotropin Alpha, 0.9 Mg, Provided In 1.1 Mg Vial 19 19 $7,535.50 $7,535.50 $1,720.18 $7,686.21 $6,781.95 2025-09-04
J3241 HCPCS Injection, Teprotumumab-trbw, 10 Mg 18 18 $62,275.50 $62,275.50 $54,802.44 $63,521.01 $56,047.95 2025-09-04
J3358 HCPCS Ustekinumab, For Intravenous Injection, 1 Mg 19 19 $7,604.50 $7,604.50 $16.71 $7,756.59 $6,844.05 2025-09-04
J3380 HCPCS Injection, Vedolizumab, Intravenous, 1 Mg 19 19 $31,637.00 $31,637.00 $24.96 $32,269.74 $28,473.30 2025-09-04
J7168 HCPCS Prothrombin Complex Concentrate (human), Kcentra, Per I.u. Of Factor Ix Activity 18 18 $6,804.50 $6,804.50 $5,987.96 $6,940.59 $6,124.05 2025-09-04
J7169 HCPCS Injection, Coagulation Factor Xa (recombinant), Inactivated-zhzo (andexxa), 10 M… 36 18 $10,319.25 $10,319.25 $6,053.96 $14,034.18 $9,562.51 2025-09-04
J9022 HCPCS Injection, Atezolizumab, 10 Mg 37 19 $40,395.50 $40,395.50 $82.86 $41,203.41 $28,842.54 2025-09-04
J9034 HCPCS Injection, Bendamustine Hcl (bendeka), 1 Mg 19 19 $10,147.00 $10,147.00 $28.68 $10,349.94 $9,132.30 2025-09-04
J9035 HCPCS Injection, Bevacizumab, 10 Mg 19 19 $13,075.00 $13,075.00 $87.03 $13,336.50 $11,767.50 2025-09-04
J9042 HCPCS Injection, Brentuximab Vedotin, 1 Mg 19 19 $39,786.00 $39,786.00 $170.04 $40,581.72 $35,807.40 2025-09-04
J9043 HCPCS Injection, Cabazitaxel, 1 Mg 19 19 $46,502.00 $46,502.00 $180.59 $47,432.04 $41,851.80 2025-09-04
J9047 HCPCS Injection, Carfilzomib, 1 Mg 55 19 $5,601.50 $5,601.50 $42.34 $11,427.06 $5,041.35 2025-09-04
J9061 HCPCS Injection, Amivantamab-vmjw, 2 Mg 18 18 $12,911.00 $12,911.00 $11,361.68 $13,169.22 $11,619.90 2025-09-04
J9144 HCPCS Injection, Daratumumab, 10 Mg And Hyaluronidase-fihj 18 18 $34,315.00 $34,315.00 $30,197.20 $35,001.30 $30,883.50 2025-09-04
J9173 HCPCS Injection, Durvalumab, 10 Mg 19 19 $15,487.00 $15,487.00 $80.51 $15,796.74 $13,938.30 2025-09-04
J9176 HCPCS Injection, Elotuzumab, 1 Mg 37 19 $8,329.00 $8,329.00 $11.11 $11,327.61 $8,495.58 2025-09-04
J9177 HCPCS Injection, Enfortumab Vedotin-ejfv, 0.25 Mg 18 18 $9,700.50 $9,700.50 $8,536.44 $9,894.51 $8,730.45 2025-09-04
J9179 HCPCS Injection, Eribulin Mesylate, 0.1 Mg 19 19 $5,225.50 $5,225.50 $122.02 $5,330.01 $4,702.95 2025-09-04
J9204 HCPCS Injection, Mogamulizumab-kpkc, 1 Mg 18 18 $16,746.50 $16,746.50 $14,736.92 $17,081.43 $15,071.85 2025-09-04
J9205 HCPCS Injection, Irinotecan Liposome, 1 Mg 19 19 $10,594.50 $10,594.50 $55.06 $10,806.39 $9,535.05 2025-09-04
J9217 HCPCS Leuprolide Acetate (for Depot Suspension), 7.5 Mg 73 19 $22,814.00 $22,814.00 $237.49 $31,026.87 $5,669.16 2025-09-04
J9228 HCPCS Injection, Ipilimumab, 1 Mg 37 19 $32,332.00 $32,332.00 $159.88 $131,913.03 $32,978.64 2025-09-04
J9264 HCPCS Injection, Paclitaxel Protein-bound Particles, 1 Mg 19 19 $6,481.00 $6,481.00 $17.01 $6,610.62 $5,832.90 2025-09-04
J9266 HCPCS Injection, Pegaspargase, Per Single Dose Vial 19 19 $91,230.00 $91,230.00 $16,681.04 $93,054.60 $82,107.00 2025-09-04
J9271 HCPCS Injection, Pembrolizumab, 1 Mg 19 19 $21,059.50 $21,059.50 $54.85 $21,480.69 $18,953.55 2025-09-04
J9285 HCPCS Injection, Olaratumab, 10 Mg 19 19 $10,074.00 $10,074.00 $57.37 $10,275.48 $9,066.60 2025-09-04
J9298 HCPCS Injection, Nivolumab And Relatlimab-rmbw, 3 Mg/1 Mg 18 18 $56,168.50 $56,168.50 $49,428.28 $57,291.87 $50,551.65 2025-09-04
J9299 HCPCS Injection, Nivolumab, 1 Mg 55 19 $11,818.00 $11,818.00 $32.74 $28,929.75 $10,636.20 2025-09-04
J9301 HCPCS Injection, Obinutuzumab, 10 Mg 19 19 $29,215.00 $29,215.00 $68.82 $29,799.30 $26,293.50 2025-09-04
J9303 HCPCS Injection, Panitumumab, 10 Mg 37 19 $5,902.00 $5,902.00 $124.05 $24,078.63 $6,020.04 2025-09-04
J9304 HCPCS Injection, Pemetrexed (pemfexy), 10 Mg 18 18 $15,780.50 $15,780.50 $13,886.84 $16,096.11 $14,202.45 2025-09-04
J9306 HCPCS Injection, Pertuzumab, 1 Mg 19 19 $23,703.50 $23,703.50 $16.96 $24,177.57 $21,333.15 2025-09-04
J9307 HCPCS Injection, Pralatrexate, 1 Mg 19 19 $51,199.50 $51,199.50 $295.35 $52,223.49 $46,079.55 2025-09-04
J9308 HCPCS Injection, Ramucirumab, 5 Mg 19 19 $26,537.00 $26,537.00 $63.79 $27,067.74 $23,883.30 2025-09-04
J9311 HCPCS Injection, Rituximab 10 Mg And Hyaluronidase 37 19 $26,975.00 $26,975.00 $49.51 $31,444.56 $27,128.64 2025-09-04
J9316 HCPCS Injection, Pertuzumab, Trastuzumab, And Hyaluronidase-zzxf, Per 10 Mg 36 18 $43,432.25 $43,432.25 $30,575.60 $53,161.89 $40,652.53 2025-09-04
J9317 HCPCS Injection, Sacituzumab Govitecan-hziy, 2.5 Mg 18 18 $8,976.50 $8,976.50 $7,899.32 $9,156.03 $8,078.85 2025-09-04
J9319 HCPCS Injection, Romidepsin, Lyophilized, 0.1 Mg 18 18 $13,120.00 $13,120.00 $11,545.60 $13,382.40 $11,808.00 2025-09-04
J9330 HCPCS Injection, Temsirolimus, 1 Mg 19 19 $7,258.50 $7,258.50 $63.33 $7,403.67 $6,532.65 2025-09-04
J9349 HCPCS Injection, Tafasitamab-cxix, 2 Mg 18 18 $5,071.00 $5,071.00 $4,462.48 $5,172.42 $4,563.90 2025-09-04
J9352 HCPCS Injection, Trabectedin, 0.1 Mg 19 19 $12,958.00 $12,958.00 $320.03 $13,217.16 $11,662.20 2025-09-04
J9354 HCPCS Injection, Ado-trastuzumab Emtansine, 1 Mg 37 19 $14,129.50 $14,129.50 $36.29 $23,059.14 $14,412.09 2025-09-04
J9355 HCPCS Injection, Trastuzumab, Excludes Biosimilar, 10 Mg 19 19 $6,392.50 $6,392.50 $113.11 $6,520.35 $5,753.25 2025-09-04
J9356 HCPCS Injection, Trastuzumab, 10 Mg And Hyaluronidase-oysk 19 19 $19,176.00 $19,176.00 $85.99 $19,559.52 $17,258.40 2025-09-04
J9358 HCPCS Injection, Fam-trastuzumab Deruxtecan-nxki, 1 Mg 18 18 $9,944.50 $9,944.50 $8,751.16 $10,143.39 $8,950.05 2025-09-04
J9400 HCPCS Injection, Ziv-aflibercept, 1 Mg 37 19 $6,563.00 $6,563.00 $13.07 $13,388.01 $6,694.26 2025-09-04
Q2050 HCPCS Injection, Doxorubicin Hydrochloride, Liposomal, Not Otherwise Specified, 10 Mg 19 19 $12,807.00 $12,807.00 $359.07 $13,063.14 $11,526.30 2025-09-04
Q5111 HCPCS Injection, Pegfilgrastim-cbqv (udenyca), Biosimilar, 0.5 Mg 19 19 $10,444.50 $10,444.50 $369.13 $10,653.39 $9,400.05 2025-09-04
Q5117 HCPCS Injection, Trastuzumab-anns, Biosimilar, (kanjinti), 10 Mg 18 18 $15,620.00 $15,620.00 $13,745.60 $15,932.40 $14,058.00 2025-09-04
Q5119 HCPCS Injection, Rituximab-pvvr, Biosimilar, (ruxience), 10 Mg 18 18 $14,700.50 $14,700.50 $12,936.44 $14,994.51 $13,230.45 2025-09-04
V5254 HCPCS Hearing Aid, Digital, Monaural, Cic 396 18 $4,985.00 $4,985.00 $1,827.76 $10,252.02 $4,590.08 2025-09-04
V5258 HCPCS Hearing Aid, Digital, Binaural, Cic 144 18 $6,033.00 $6,033.00 $3,429.36 $10,252.02 $5,671.15 2025-09-04
V5259 HCPCS Hearing Aid, Digital, Binaural, Itc 90 18 $5,173.00 $5,173.00 $3,687.20 $9,249.36 $4,655.70 2025-09-04
V5260 HCPCS Hearing Aid, Digital, Binaural, Ite 162 18 $5,173.00 $5,173.00 $3,429.36 $10,252.02 $4,655.70 2025-09-04
V5261 HCPCS Hearing Aid, Digital, Binaural, Bte 180 18 $6,033.00 $6,033.00 $3,429.36 $10,252.02 $5,671.15 2025-09-04
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