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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

6,848 distinct procedures filed
26 distinct payers
186,061 rate rows
2026-10-26 last MRF observed
Data quality

185,781 of 186,061 rate rows are consumer-grade (99.8%)

280 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 135
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 60
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 40
per-diem day rate — not a per-procedure price 28
exceeds 10× this hospital's gross charge — excluded from medians 9
placeholder amount (≤ $0.02) — excluded from medians 8
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 · 2026-11-11
Content fingerprint b9fe6d15fc0eef2c… · 81,449,544 bytes · first seen 2026-11-02

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 22 $16,681.04 $93,054.60 $82,107.00 nat. median
$33,114
outlier · 2.5×
77371
HCPCS 		Complete Single Session Course Of Cranial Lesion Surgery Using Radiation 22 $1,078.50 $81,504.12 $71,915.40 nat. median
$9,357
outlier · 7.7×
J2350
HCPCS 		Injection, Ocrelizumab, 1 Mg 22 $62.81 $74,455.41 $65,695.95 nat. median
$714
outlier · 92.1×
J3241
HCPCS 		Injection, Teprotumumab-trbw, 10 Mg 21 $24,287.45 $63,521.01 $56,047.95 nat. median
$738
outlier · 75.9×
J9298
HCPCS 		Injection, Nivolumab And Relatlimab-rmbw, 3 Mg/1 Mg 21 $21,905.72 $57,291.87 $50,551.65 nat. median
$558
outlier · 90.6×
J9307
HCPCS 		Injection, Pralatrexate, 1 Mg 22 $295.35 $52,223.49 $46,079.55 nat. median
$897
outlier · 51.3×
J9043
HCPCS 		Injection, Cabazitaxel, 1 Mg 22 $180.59 $47,432.04 $41,851.80 nat. median
$742
outlier · 56.4×
J0222
HCPCS 		Injection, Patisiran, 0.1 Mg 21 $15,652.46 $40,937.19 $36,121.05 nat. median
$157
outlier · 230.1×
J9042
HCPCS 		Injection, Brentuximab Vedotin, 1 Mg 22 $170.04 $40,581.72 $35,807.40 nat. median
$1,041
outlier · 34.4×
J9316
HCPCS 		Injection, Pertuzumab, Trastuzumab, And Hyaluronidase-zzxf, Per 10 Mg 21 $13,550.55 $53,161.89 $33,528.93 nat. median
$393
outlier · 85.4×
J9228
HCPCS 		Injection, Ipilimumab, 1 Mg 22 $159.88 $131,913.03 $32,978.64 nat. median
$9,020
outlier · 3.7×
J1930
HCPCS 		Injection, Lanreotide, 1 Mg 22 $68.69 $36,632.28 $32,322.60 nat. median
$5,001
outlier · 6.5×
J9144
HCPCS 		Injection, Daratumumab, 10 Mg And Hyaluronidase-fihj 21 $13,382.85 $35,001.30 $30,883.50 nat. median
$231
outlier · 133.9×
J2323
HCPCS 		Injection, Natalizumab, 1 Mg 22 $25.12 $32,866.44 $28,999.80 nat. median
$252
outlier · 115.2×
J3380
HCPCS 		Injection, Vedolizumab, Intravenous, 1 Mg 22 $24.96 $32,269.74 $28,473.30 nat. median
$204
outlier · 139.8×
J9022
HCPCS 		Injection, Atezolizumab, 10 Mg 22 $82.86 $41,203.41 $27,145.92 nat. median
$7,244
outlier · 3.7×
J9301
HCPCS 		Injection, Obinutuzumab, 10 Mg 22 $68.82 $29,799.30 $26,293.50 nat. median
$299
outlier · 88.0×
J9311
HCPCS 		Injection, Rituximab 10 Mg And Hyaluronidase 22 $49.51 $31,444.56 $25,896.00 nat. median
$2,842
outlier · 9.1×
J9308
HCPCS 		Injection, Ramucirumab, 5 Mg 22 $63.79 $27,067.74 $23,883.30 nat. median
$1,512
outlier · 15.8×
47135
HCPCS 		Transplantation Of Donor Liver 22 $4,910.78 $24,161.73 $22,418.10 nat. median
$6,167
outlier · 3.6×
J9306
HCPCS 		Injection, Pertuzumab, 1 Mg 22 $16.96 $24,177.57 $21,333.15 nat. median
$91
outlier · 234.4×
J9271
HCPCS 		Injection, Pembrolizumab, 1 Mg 22 $54.85 $21,480.69 $18,953.55 nat. median
$323
outlier · 58.7×
J0717
HCPCS 		Injection, Certolizumab Pegol, 1 Mg (code May Be Used For Medicare When Drug Adm… 22 $12.78 $21,335.34 $18,825.30 nat. median
$1,753
outlier · 10.7×
J9356
HCPCS 		Injection, Trastuzumab, 10 Mg And Hyaluronidase-oysk 22 $85.99 $19,559.52 $17,258.40 nat. median
$138
outlier · 125.2×
J2353
HCPCS 		Injection, Octreotide, Depot Form For Intramuscular Injection, 1 Mg 22 $212.29 $26,717.37 $15,743.25 nat. median
$5,554
outlier · 2.8×
J9204
HCPCS 		Injection, Mogamulizumab-kpkc, 1 Mg 21 $6,531.14 $17,081.43 $15,071.85 nat. median
$432
outlier · 34.9×
J3101
HCPCS 		Injection, Tenecteplase, 1 Mg 21 $6,067.43 $17,163.03 $14,807.32 nat. median
$4,042
outlier · 3.7×
J2506
HCPCS 		Injection, Pegfilgrastim, Excludes Biosimilar, 0.5 Mg 21 $6,261.65 $16,376.61 $14,449.95 nat. median
$1,662
outlier · 8.7×
J9304
HCPCS 		Injection, Pemetrexed (pemfexy), 10 Mg 21 $6,154.40 $16,096.11 $14,202.45 nat. median
$66
outlier · 215.0×
Q5117
HCPCS 		Injection, Trastuzumab-anns, Biosimilar, (kanjinti), 10 Mg 21 $6,091.80 $15,932.40 $14,058.00 nat. median
$794
outlier · 17.7×
J9173
HCPCS 		Injection, Durvalumab, 10 Mg 22 $80.51 $15,796.74 $13,938.30 nat. median
$1,119
outlier · 12.5×
J9354
HCPCS 		Injection, Ado-trastuzumab Emtansine, 1 Mg 22 $36.29 $23,059.14 $13,564.32 nat. median
$4,245
outlier · 3.2×
J0896
HCPCS 		Injection, Luspatercept-aamt, 0.25 Mg 21 $5,756.21 $15,054.69 $13,283.55 nat. median
$4,571
outlier · 2.9×
Q5119
HCPCS 		Injection, Rituximab-pvvr, Biosimilar, (ruxience), 10 Mg 21 $5,733.20 $14,994.51 $13,230.45 nat. median
$818
outlier · 16.2×
41155
HCPCS 		Removal Of Tongue, Floor Of Mouth, Jaw Bone, Tissue, And Lymph Nodes 22 $2,578.32 $14,046.57 $13,032.90 nat. median
$4,143
outlier · 3.1×
400048553
CDM 		Hchg Tfh Dressing Incision Prevena Kci 20 $5,555.55 $13,817.65 $12,820.50 nat. median
$12,820
1.0× median
A9592
HCPCS 		Copper Cu-64, Dotatate, Diagnostic, 1 Millicurie 21 $5,525.52 $14,451.36 $12,751.20 nat. median
$1,712
outlier · 7.5×
J2182
HCPCS 		Injection, Mepolizumab, 1 Mg 22 $35.02 $13,912.29 $12,275.55 nat. median
$2,892
outlier · 4.2×
J0775
HCPCS 		Injection, Collagenase, Clostridium Histolyticum, 0.01 Mg 22 $52.32 $13,876.08 $12,243.60 nat. median
$114
outlier · 107.5×
77372
HCPCS 		Complete Single Session Course Of Cranial Lesion Surgery Using Radiation And A M… 22 $818.30 $13,709.82 $12,096.90 nat. median
$9,177
1.3× median
J9319
HCPCS 		Injection, Romidepsin, Lyophilized, 0.1 Mg 21 $5,116.80 $13,382.40 $11,808.00 nat. median
$102
outlier · 116.3×
J9035
HCPCS 		Injection, Bevacizumab, 10 Mg 22 $87.03 $13,336.50 $11,767.50 nat. median
$725
outlier · 16.2×
J9352
HCPCS 		Injection, Trabectedin, 0.1 Mg 22 $320.03 $13,217.16 $11,662.20 nat. median
$1,100
outlier · 10.6×
J9061
HCPCS 		Injection, Amivantamab-vmjw, 2 Mg 21 $5,035.29 $13,169.22 $11,619.90 nat. median
$68
outlier · 171.5×
20956
HCPCS 		Bone Graft Of Pelvic Bone With Microvascular Connection 22 $2,308.30 $12,486.81 $11,585.70 nat. median
$6,913
1.7× median
650001651
CDM 		Hchg Tf Hearing Aid Binaural Level 6 20 $5,004.87 $12,448.01 $11,549.70 nat. median
$11,550
1.0× median
Q2050
HCPCS 		Injection, Doxorubicin Hydrochloride, Liposomal, Not Otherwise Specified, 10 Mg 22 $359.07 $13,063.14 $11,526.30 nat. median
$710
outlier · 16.2×
500001108
CDM 		Gastro - Intestinal (gi) Services - General Classification 20 $4,933.89 $12,271.47 $11,385.90 nat. median
$11,259
1.0× median
31365
HCPCS 		Complete Removal Of Voice Box With Extensive Dissection Of Neck 22 $2,185.17 $11,851.46 $10,996.20 nat. median
$4,041
outlier · 2.7×
500002645
CDM 		Operating Room Services - General Classification 20 $4,665.57 $11,604.11 $10,766.70 nat. median
$10,767
1.0× median

Other procedures at this hospital

Browse this hospital's 6,848 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
             
J9266 HCPCS Injection, Pegaspargase, Per Single Dose Vial 22 22 $91,230.00 $91,230.00 $16,681.04 $93,054.60 $82,107.00 2026-10-26
77371 HCPCS Complete Single Session Course Of Cranial Lesion Surgery Using Radiation 22 22 $79,906.00 $79,906.00 $1,078.50 $81,504.12 $71,915.40 2026-10-26
J2350 HCPCS Injection, Ocrelizumab, 1 Mg 22 22 $72,995.50 $72,995.50 $62.81 $74,455.41 $65,695.95 2026-10-26
J3241 HCPCS Injection, Teprotumumab-trbw, 10 Mg 21 21 $62,275.50 $62,275.50 $24,287.45 $63,521.01 $56,047.95 2026-10-26
J9298 HCPCS Injection, Nivolumab And Relatlimab-rmbw, 3 Mg/1 Mg 21 21 $56,168.50 $56,168.50 $21,905.72 $57,291.87 $50,551.65 2026-10-26
J9307 HCPCS Injection, Pralatrexate, 1 Mg 22 22 $51,199.50 $51,199.50 $295.35 $52,223.49 $46,079.55 2026-10-26
J9043 HCPCS Injection, Cabazitaxel, 1 Mg 22 22 $46,502.00 $46,502.00 $180.59 $47,432.04 $41,851.80 2026-10-26
J0222 HCPCS Injection, Patisiran, 0.1 Mg 21 21 $40,134.50 $40,134.50 $15,652.46 $40,937.19 $36,121.05 2026-10-26
J9042 HCPCS Injection, Brentuximab Vedotin, 1 Mg 22 22 $39,786.00 $39,786.00 $170.04 $40,581.72 $35,807.40 2026-10-26
J9316 HCPCS Injection, Pertuzumab, Trastuzumab, And Hyaluronidase-zzxf, Per 10 Mg 42 21 $43,432.25 $43,432.25 $13,550.55 $53,161.89 $33,528.93 2026-10-26
J9228 HCPCS Injection, Ipilimumab, 1 Mg 43 22 $32,332.00 $32,332.00 $159.88 $131,913.03 $32,978.64 2026-10-26
J1930 HCPCS Injection, Lanreotide, 1 Mg 22 22 $35,914.00 $35,914.00 $68.69 $36,632.28 $32,322.60 2026-10-26
J9144 HCPCS Injection, Daratumumab, 10 Mg And Hyaluronidase-fihj 21 21 $34,315.00 $34,315.00 $13,382.85 $35,001.30 $30,883.50 2026-10-26
J2323 HCPCS Injection, Natalizumab, 1 Mg 22 22 $32,222.00 $32,222.00 $25.12 $32,866.44 $28,999.80 2026-10-26
J3380 HCPCS Injection, Vedolizumab, Intravenous, 1 Mg 22 22 $31,637.00 $31,637.00 $24.96 $32,269.74 $28,473.30 2026-10-26
J9022 HCPCS Injection, Atezolizumab, 10 Mg 43 22 $40,395.50 $40,395.50 $82.86 $41,203.41 $27,145.92 2026-10-26
J9301 HCPCS Injection, Obinutuzumab, 10 Mg 22 22 $29,215.00 $29,215.00 $68.82 $29,799.30 $26,293.50 2026-10-26
J9311 HCPCS Injection, Rituximab 10 Mg And Hyaluronidase 43 22 $26,975.00 $26,975.00 $49.51 $31,444.56 $25,896.00 2026-10-26
J9308 HCPCS Injection, Ramucirumab, 5 Mg 22 22 $26,537.00 $26,537.00 $63.79 $27,067.74 $23,883.30 2026-10-26
47135 HCPCS Transplantation Of Donor Liver 22 22 $24,909.00 $24,909.00 $4,910.78 $24,161.73 $22,418.10 2026-10-26
J9306 HCPCS Injection, Pertuzumab, 1 Mg 22 22 $23,703.50 $23,703.50 $16.96 $24,177.57 $21,333.15 2026-10-26
J9271 HCPCS Injection, Pembrolizumab, 1 Mg 22 22 $21,059.50 $21,059.50 $54.85 $21,480.69 $18,953.55 2026-10-26
J0717 HCPCS Injection, Certolizumab Pegol, 1 Mg (code May Be Used For Medicare When Drug Adm… 22 22 $20,917.00 $20,917.00 $12.78 $21,335.34 $18,825.30 2026-10-26
J9356 HCPCS Injection, Trastuzumab, 10 Mg And Hyaluronidase-oysk 22 22 $19,176.00 $19,176.00 $85.99 $19,559.52 $17,258.40 2026-10-26
J2353 HCPCS Injection, Octreotide, Depot Form For Intramuscular Injection, 1 Mg 64 22 $17,492.50 $17,492.50 $212.29 $26,717.37 $15,743.25 2026-10-26
J9204 HCPCS Injection, Mogamulizumab-kpkc, 1 Mg 21 21 $16,746.50 $16,746.50 $6,531.14 $17,081.43 $15,071.85 2026-10-26
J3101 HCPCS Injection, Tenecteplase, 1 Mg 42 21 $16,192.00 $16,192.00 $6,067.43 $17,163.03 $14,807.32 2026-10-26
J2506 HCPCS Injection, Pegfilgrastim, Excludes Biosimilar, 0.5 Mg 21 21 $16,055.50 $16,055.50 $6,261.65 $16,376.61 $14,449.95 2026-10-26
J9304 HCPCS Injection, Pemetrexed (pemfexy), 10 Mg 21 21 $15,780.50 $15,780.50 $6,154.40 $16,096.11 $14,202.45 2026-10-26
Q5117 HCPCS Injection, Trastuzumab-anns, Biosimilar, (kanjinti), 10 Mg 21 21 $15,620.00 $15,620.00 $6,091.80 $15,932.40 $14,058.00 2026-10-26
J9173 HCPCS Injection, Durvalumab, 10 Mg 22 22 $15,487.00 $15,487.00 $80.51 $15,796.74 $13,938.30 2026-10-26
J9354 HCPCS Injection, Ado-trastuzumab Emtansine, 1 Mg 43 22 $14,129.50 $14,129.50 $36.29 $23,059.14 $13,564.32 2026-10-26
J0896 HCPCS Injection, Luspatercept-aamt, 0.25 Mg 21 21 $14,759.50 $14,759.50 $5,756.21 $15,054.69 $13,283.55 2026-10-26
Q5119 HCPCS Injection, Rituximab-pvvr, Biosimilar, (ruxience), 10 Mg 21 21 $14,700.50 $14,700.50 $5,733.20 $14,994.51 $13,230.45 2026-10-26
41155 HCPCS Removal Of Tongue, Floor Of Mouth, Jaw Bone, Tissue, And Lymph Nodes 22 22 $14,481.00 $14,481.00 $2,578.32 $14,046.57 $13,032.90 2026-10-26
400048553 CDM Hchg Tfh Dressing Incision Prevena Kci 20 20 $14,245.00 $14,245.00 $5,555.55 $13,817.65 $12,820.50 2026-10-26
A9592 HCPCS Copper Cu-64, Dotatate, Diagnostic, 1 Millicurie 21 21 $14,168.00 $14,168.00 $5,525.52 $14,451.36 $12,751.20 2026-10-26
J2182 HCPCS Injection, Mepolizumab, 1 Mg 22 22 $13,639.50 $13,639.50 $35.02 $13,912.29 $12,275.55 2026-10-26
J0775 HCPCS Injection, Collagenase, Clostridium Histolyticum, 0.01 Mg 22 22 $13,604.00 $13,604.00 $52.32 $13,876.08 $12,243.60 2026-10-26
77372 HCPCS Complete Single Session Course Of Cranial Lesion Surgery Using Radiation And A M… 22 22 $13,441.00 $13,441.00 $818.30 $13,709.82 $12,096.90 2026-10-26
J9319 HCPCS Injection, Romidepsin, Lyophilized, 0.1 Mg 21 21 $13,120.00 $13,120.00 $5,116.80 $13,382.40 $11,808.00 2026-10-26
J9035 HCPCS Injection, Bevacizumab, 10 Mg 22 22 $13,075.00 $13,075.00 $87.03 $13,336.50 $11,767.50 2026-10-26
J9352 HCPCS Injection, Trabectedin, 0.1 Mg 22 22 $12,958.00 $12,958.00 $320.03 $13,217.16 $11,662.20 2026-10-26
J9061 HCPCS Injection, Amivantamab-vmjw, 2 Mg 21 21 $12,911.00 $12,911.00 $5,035.29 $13,169.22 $11,619.90 2026-10-26
20956 HCPCS Bone Graft Of Pelvic Bone With Microvascular Connection 22 22 $12,873.00 $12,873.00 $2,308.30 $12,486.81 $11,585.70 2026-10-26
650001651 CDM Hchg Tf Hearing Aid Binaural Level 6 20 20 $12,833.00 $12,833.00 $5,004.87 $12,448.01 $11,549.70 2026-10-26
Q2050 HCPCS Injection, Doxorubicin Hydrochloride, Liposomal, Not Otherwise Specified, 10 Mg 22 22 $12,807.00 $12,807.00 $359.07 $13,063.14 $11,526.30 2026-10-26
500001108 CDM Gastro - Intestinal (gi) Services - General Classification 20 20 $12,651.00 $12,651.00 $4,933.89 $12,271.47 $11,385.90 2026-10-26
31365 HCPCS Complete Removal Of Voice Box With Extensive Dissection Of Neck 22 22 $12,218.00 $12,218.00 $2,185.17 $11,851.46 $10,996.20 2026-10-26
500002645 CDM Operating Room Services - General Classification 20 20 $11,963.00 $11,963.00 $4,665.57 $11,604.11 $10,766.70 2026-10-26
140000008 CDM Intensive Care Unit - General Classification 20 20 $11,898.00 $11,898.00 $4,402.26 $11,541.06 $10,708.20 2026-10-26
400048857 CDM Hchg Tfh Novasure Device Disp 20 20 $11,869.00 $11,869.00 $4,628.91 $11,512.93 $10,682.10 2026-10-26
J9299 HCPCS Injection, Nivolumab, 1 Mg 64 22 $11,818.00 $11,818.00 $32.74 $28,929.75 $10,636.20 2026-10-26
31368 HCPCS Removal Of Voice Box With Extensive Dissection Of Neck 22 22 $11,716.00 $11,716.00 $2,092.30 $11,364.52 $10,544.40 2026-10-26
500001029 CDM Operating Room Services - General Classification 20 20 $11,629.00 $11,629.00 $4,535.31 $11,280.13 $10,466.10 2026-10-26
650001650 CDM Hchg Tf Hearing Aid Binaural Level 5 20 20 $11,412.00 $11,412.00 $4,450.68 $11,069.64 $10,270.80 2026-10-26
44126 HCPCS Partial Removal Of Small Bowel And Reconnection To Correct Congenital Defect 22 22 $11,409.00 $11,409.00 $2,224.19 $11,066.73 $10,268.10 2026-10-26
400066450 CDM Hchg Tfh Pack Procedure Pack Txb 20 20 $11,407.00 $11,407.00 $4,448.73 $11,064.79 $10,266.30 2026-10-26
200003567 CDM Hchg Ed Multi Proc Level 5 20 20 $11,264.00 $11,264.00 $4,392.96 $10,926.08 $10,137.60 2026-10-26
C1880 HCPCS Vena Cava Filter 21 21 $11,123.00 $11,123.00 $4,337.97 $11,345.46 $10,010.70 2026-10-26
J9205 HCPCS Injection, Irinotecan Liposome, 1 Mg 22 22 $10,594.50 $10,594.50 $55.06 $10,806.39 $9,535.05 2026-10-26
41140 HCPCS Complete Removal Of Tongue 22 22 $10,548.00 $10,548.00 $1,904.98 $10,231.56 $9,493.20 2026-10-26
31367 HCPCS Removal Of Voice Box 22 22 $10,544.00 $10,544.00 $1,898.46 $10,227.68 $9,489.60 2026-10-26
A9572 HCPCS Indium In-111 Pentetreotide, Diagnostic, Per Study Dose, Up To 6 Millicuries 21 21 $10,533.00 $10,533.00 $4,107.87 $10,743.66 $9,479.70 2026-10-26
400063167 CDM Hchg Tfh System Control Hemorrhage Jada 2.0 20 20 $10,532.00 $10,532.00 $4,107.48 $10,216.04 $9,478.80 2026-10-26
500002643 CDM Operating Room Services - General Classification 20 20 $10,482.00 $10,482.00 $4,087.98 $10,167.54 $9,433.80 2026-10-26
Q5111 HCPCS Injection, Pegfilgrastim-cbqv (udenyca), Biosimilar, 0.5 Mg 22 22 $10,444.50 $10,444.50 $369.13 $10,653.39 $9,400.05 2026-10-26
59610 HCPCS Vaginal Delivery And Care Before And After Delivery After Previous Cesarean Deli… 22 22 $10,438.00 $10,438.00 $2,261.95 $10,124.86 $9,394.20 2026-10-26
500001027 CDM Operating Room Services - General Classification 20 20 $10,191.00 $10,191.00 $3,974.49 $9,885.27 $9,171.90 2026-10-26
J9034 HCPCS Injection, Bendamustine Hcl (bendeka), 1 Mg 22 22 $10,147.00 $10,147.00 $28.68 $10,349.94 $9,132.30 2026-10-26
J9285 HCPCS Injection, Olaratumab, 10 Mg 22 22 $10,074.00 $10,074.00 $57.37 $10,275.48 $9,066.60 2026-10-26
31370 HCPCS Partial Removal Of Voice Box 22 22 $9,945.00 $9,945.00 $1,791.59 $9,646.65 $8,950.50 2026-10-26
J9358 HCPCS Injection, Fam-trastuzumab Deruxtecan-nxki, 1 Mg 21 21 $9,944.50 $9,944.50 $3,878.36 $10,143.39 $8,950.05 2026-10-26
31360 HCPCS Complete Removal Of Voice Box 22 22 $9,940.00 $9,940.00 $1,782.36 $9,641.80 $8,946.00 2026-10-26
J9177 HCPCS Injection, Enfortumab Vedotin-ejfv, 0.25 Mg 21 21 $9,700.50 $9,700.50 $3,783.20 $9,894.51 $8,730.45 2026-10-26
35216 HCPCS Repair Of Blood Vessel Of Chest 22 22 $9,532.00 $9,532.00 $1,859.98 $9,246.04 $8,578.80 2026-10-26
100001600 CDM Labor Room/delivery - General Classification 20 20 $9,287.00 $9,287.00 $3,621.93 $9,008.39 $8,358.30 2026-10-26
44208 HCPCS Partial Removal Of Large Bowel And Reattachment To Rectum And Creation Of Openin… 22 22 $9,114.00 $9,114.00 $1,765.02 $8,840.58 $8,202.60 2026-10-26
44147 HCPCS Partial Removal Of Large Bowel Through Abdomen And Anus 22 22 $9,039.00 $9,039.00 $1,718.31 $8,767.83 $8,135.10 2026-10-26
35820 HCPCS Exploration Of Chest For Bleeding, Blood Clot, Or Infection After Surgery 22 22 $9,035.00 $9,035.00 $1,821.96 $8,763.95 $8,131.50 2026-10-26
J9317 HCPCS Injection, Sacituzumab Govitecan-hziy, 2.5 Mg 21 21 $8,976.50 $8,976.50 $3,500.84 $9,156.03 $8,078.85 2026-10-26
140000046 CDM Intensive Care Unit - Intermediate ICU 20 20 $8,954.00 $8,954.00 $3,312.98 $8,685.38 $8,058.60 2026-10-26
J9176 HCPCS Injection, Elotuzumab, 1 Mg 43 22 $8,329.00 $8,329.00 $11.11 $11,327.61 $7,995.84 2026-10-26
100001596 CDM Labor Room/delivery - General Classification 20 20 $8,823.00 $8,823.00 $3,440.97 $8,558.31 $7,940.70 2026-10-26
400067129 CDM Hchg Tfh Magtrace 10 Vial 20 20 $8,810.00 $8,810.00 $3,435.90 $8,545.70 $7,929.00 2026-10-26
400065151 CDM Hchg Tfh Pillow Fetal 20 20 $8,766.00 $8,766.00 $3,418.74 $8,503.02 $7,889.40 2026-10-26
27590 HCPCS Amputation Of Thigh Through Thigh Bone 22 22 $8,659.00 $8,659.00 $703.06 $8,399.23 $7,793.10 2026-10-26
27228 HCPCS Treatment Of Broken Bones Of Front And Back Column Or Wall Of Hip Socket With Pl… 22 22 $8,628.00 $8,628.00 $1,652.19 $8,369.16 $7,765.20 2026-10-26
650001649 CDM Hchg Tf Hearing Aid Binaural Level 4 20 20 $8,575.00 $8,575.00 $3,344.25 $8,317.75 $7,717.50 2026-10-26
44141 HCPCS Partial Removal Of Large Bowel With Creation Of Opening To Skin 22 22 $8,539.00 $8,539.00 $1,651.63 $8,282.83 $7,685.10 2026-10-26
44207 HCPCS Partial Removal Of Large Bowel And Reattachment To Rectum Using An Endoscope 22 22 $8,527.00 $8,527.00 $1,614.26 $8,271.19 $7,674.30 2026-10-26
100001599 CDM Labor Room/delivery - General Classification 20 20 $8,514.00 $8,514.00 $3,320.46 $8,258.58 $7,662.60 2026-10-26
59510 HCPCS Cesarean Delivery With Care Before And After Delivery 22 22 $8,506.00 $8,506.00 $2,247.10 $8,250.82 $7,655.40 2026-10-26
27134 HCPCS Revision Of Thigh Bone And Hip Joint Prosthesis 22 22 $8,477.00 $8,477.00 $1,660.90 $8,222.69 $7,629.30 2026-10-26
45110 HCPCS Removal Of Rectum With Creation Of Opening From Large Bowel To Skin Through Abdo… 22 22 $8,419.00 $8,419.00 $1,642.02 $8,166.43 $7,577.10 2026-10-26
90375 HCPCS Rabies Immune Globulin For Injection 22 22 $8,386.00 $8,386.00 $310.78 $8,553.72 $7,547.40 2026-10-26
32652 HCPCS Removal Of Chest Cavity Lining And Lung Lining Using An Endoscope 39 22 $7,918.00 $7,918.00 $1,530.57 $15,363.83 $7,522.10 2026-10-26
27132 HCPCS Total Hip Replacement After Previous Hip Surgery 39 22 $7,916.00 $7,916.00 $1,474.91 $15,358.01 $7,520.20 2026-10-26
44144 HCPCS Partial Removal Of Large Bowel With Creation Of 2 Openings From Small Or Large B… 22 22 $8,310.00 $8,310.00 $1,595.91 $8,060.70 $7,479.00 2026-10-26
23474 HCPCS Revision Of Total Shoulder Repair, Total Shoulder 22 22 $8,290.00 $8,290.00 $1,522.62 $8,041.30 $7,461.00 2026-10-26
44603 HCPCS Suture Of Multiple Tears Or Holes In Small Bowel 39 22 $7,782.00 $7,782.00 $1,447.53 $15,099.02 $7,392.90 2026-10-26
44206 HCPCS Partial Removal Of Large Bowel With Creation Of Opening From Large Bowel To Skin… 22 22 $8,190.00 $8,190.00 $1,564.39 $7,944.30 $7,371.00 2026-10-26
200004110 CDM Tfh Trauma Act Lvl3 Without Cc Full Ems 20 20 $8,174.00 $8,174.00 $3,187.86 $7,928.78 $7,356.60 2026-10-26
200004109 CDM Tfh Trauma Act Lvl3 Without Cc Full 20 20 $8,174.00 $8,174.00 $3,187.86 $7,928.78 $7,356.60 2026-10-26
J1306 HCPCS Injection, Inclisiran, 1 Mg 21 21 $8,130.50 $8,130.50 $3,170.90 $8,293.11 $7,317.45 2026-10-26
500001107 CDM Gastro - Intestinal (gi) Services - General Classification 20 20 $8,126.00 $8,126.00 $3,169.14 $7,882.22 $7,313.40 2026-10-26
100001595 CDM Labor Room/delivery - General Classification 20 20 $8,048.00 $8,048.00 $3,138.72 $7,806.56 $7,243.20 2026-10-26
100001592 CDM Labor Room/delivery - General Classification 20 20 $8,048.00 $8,048.00 $3,138.72 $7,806.56 $7,243.20 2026-10-26
43282 HCPCS Repair Of Hernia Of Muscle At Esophagus And Stomach With Implantation Of Mesh Us… 22 22 $8,047.00 $8,047.00 $1,559.32 $7,805.59 $7,242.30 2026-10-26
C8910 HCPCS Magnetic Resonance Angiography Without Contrast, Chest (excluding Myocardium) 21 21 $7,897.00 $7,897.00 $3,079.83 $8,054.94 $7,107.30 2026-10-26
C8901 HCPCS Magnetic Resonance Angiography Without Contrast, Abdomen 21 21 $7,897.00 $7,897.00 $3,079.83 $8,054.94 $7,107.30 2026-10-26
C8909 HCPCS Magnetic Resonance Angiography With Contrast, Chest (excluding Myocardium) 21 21 $7,897.00 $7,897.00 $3,079.83 $8,054.94 $7,107.30 2026-10-26
C8902 HCPCS Magnetic Resonance Angiography Without Contrast Followed By With Contrast, Abdom… 21 21 $7,897.00 $7,897.00 $3,079.83 $8,054.94 $7,107.30 2026-10-26
C8900 HCPCS Magnetic Resonance Angiography With Contrast, Abdomen 21 21 $7,897.00 $7,897.00 $3,079.83 $8,054.94 $7,107.30 2026-10-26
C8911 HCPCS Magnetic Resonance Angiography Without Contrast Followed By With Contrast, Chest… 21 21 $7,897.00 $7,897.00 $3,079.83 $8,054.94 $7,107.30 2026-10-26
27487 HCPCS Revision Of Thigh And Lower Leg Bone Components Of Total Knee Joint Prosthesis 22 22 $7,777.00 $7,777.00 $1,543.79 $7,543.69 $6,999.30 2026-10-26
60254 HCPCS Removal Of Thyroid And Surrounding Lymph Nodes With Extensive Neck Removal 22 22 $7,776.00 $7,776.00 $1,451.25 $7,542.72 $6,998.40 2026-10-26
44227 HCPCS Closure Of Opening From Large Or Small Bowel To Skin Using An Endoscope 22 22 $7,770.00 $7,770.00 $1,485.20 $7,536.90 $6,993.00 2026-10-26
44143 HCPCS Partial Removal Of Large Bowel With Creation Of Opening From Large Bowel To Skin 22 22 $7,770.00 $7,770.00 $1,494.35 $7,536.90 $6,993.00 2026-10-26
44145 HCPCS Partial Removal Of Large Bowel And Reattachment To Rectum 22 22 $7,743.00 $7,743.00 $1,481.36 $7,510.71 $6,968.70 2026-10-26
100001588 CDM Labor Room/delivery - General Classification 20 20 $7,739.00 $7,739.00 $3,018.21 $7,506.83 $6,965.10 2026-10-26
100001598 CDM Labor Room/delivery - General Classification 20 20 $7,739.00 $7,739.00 $3,018.21 $7,506.83 $6,965.10 2026-10-26
59400 HCPCS Vaginal Delivery With Care Before And After Delivery 22 22 $7,673.00 $7,673.00 $2,156.31 $7,442.81 $6,905.70 2026-10-26
49020 HCPCS Drainage Of Abdominal Abscess Or Infection 22 22 $7,653.00 $7,653.00 $1,453.05 $7,423.41 $6,887.70 2026-10-26
J3358 HCPCS Ustekinumab, For Intravenous Injection, 1 Mg 22 22 $7,604.50 $7,604.50 $16.71 $7,756.59 $6,844.05 2026-10-26
27227 HCPCS Treatment Of Broken Bones Of Front Or Back Column Of Hip Socket Or Across Hip So… 22 22 $7,564.00 $7,564.00 $1,460.49 $7,337.08 $6,807.60 2026-10-26
27091 HCPCS Removal Of Hip Prosthesis, Complicated 22 22 $7,545.00 $7,545.00 $1,409.66 $7,318.65 $6,790.50 2026-10-26
140000110 CDM Room & Board - Private (one Bed) - Pediatric 20 20 $7,545.00 $7,545.00 $2,791.65 $7,318.65 $6,790.50 2026-10-26
140000091 CDM Room & Board - Private (one Bed) - General Classification 20 20 $7,545.00 $7,545.00 $2,791.65 $7,318.65 $6,790.50 2026-10-26
J3240 HCPCS Injection, Thyrotropin Alpha, 0.9 Mg, Provided In 1.1 Mg Vial 22 22 $7,535.50 $7,535.50 $1,720.18 $7,686.21 $6,781.95 2026-10-26
500002641 CDM Operating Room Services - General Classification 20 20 $7,493.00 $7,493.00 $2,922.27 $7,268.21 $6,743.70 2026-10-26
44626 HCPCS Closure Of Surgically Created Large Or Small Bowel Opening With Bowel Removal An… 22 22 $7,461.00 $7,461.00 $1,421.92 $7,237.17 $6,714.90 2026-10-26
400066449 CDM Hchg Tfh Pack Procedure Pack Tx2 20 20 $7,445.00 $7,445.00 $2,903.55 $7,221.65 $6,700.50 2026-10-26
200003566 CDM Hchg Ed Multi Proc Level 4 20 20 $7,430.00 $7,430.00 $2,897.70 $7,207.10 $6,687.00 2026-10-26
J7169 HCPCS Injection, Coagulation Factor Xa (recombinant), Inactivated-zhzo (andexxa), 10 M… 42 21 $10,319.25 $10,319.25 $2,683.01 $14,034.18 $6,638.72 2026-10-26
500001106 CDM Gastro - Intestinal (gi) Services - General Classification 20 20 $7,315.00 $7,315.00 $2,852.85 $7,095.55 $6,583.50 2026-10-26
500001025 CDM Operating Room Services - General Classification 20 20 $7,285.00 $7,285.00 $2,841.15 $7,066.45 $6,556.50 2026-10-26
100001594 CDM Labor Room/delivery - General Classification 20 20 $7,274.00 $7,274.00 $2,836.86 $7,055.78 $6,546.60 2026-10-26
100001591 CDM Labor Room/delivery - General Classification 20 20 $7,274.00 $7,274.00 $2,836.86 $7,055.78 $6,546.60 2026-10-26
C8914 HCPCS Magnetic Resonance Angiography Without Contrast Followed By With Contrast, Lower… 42 21 $10,170.50 $10,170.50 $2,644.59 $13,831.20 $6,543.66 2026-10-26
C8920 HCPCS Magnetic Resonance Angiography Without Contrast Followed By With Contrast, Pelvi… 21 21 $7,264.00 $7,264.00 $2,832.96 $7,409.28 $6,537.60 2026-10-26
27412 HCPCS Implantation Of Self Cartilage Into Knee Joint 22 22 $7,263.00 $7,263.00 $1,466.59 $7,045.11 $6,536.70 2026-10-26
44661 HCPCS Closure Of Abnormal Drainage Tract From Small Bowel To Urinary Bladder With Rese… 22 22 $7,259.00 $7,259.00 $1,382.06 $7,041.23 $6,533.10 2026-10-26
J9330 HCPCS Injection, Temsirolimus, 1 Mg 22 22 $7,258.50 $7,258.50 $63.33 $7,403.67 $6,532.65 2026-10-26
44204 HCPCS Partial Removal Of Large Bowel Using An Endoscope 22 22 $7,242.00 $7,242.00 $1,381.48 $7,024.74 $6,517.80 2026-10-26
J1950 HCPCS Injection, Leuprolide Acetate (for Depot Suspension), Per 3.75 Mg 43 22 $19,145.00 $19,145.00 $1,291.31 $19,527.90 $6,509.64 2026-10-26
27138 HCPCS Revision Of Thigh Bone Prosthesis 22 22 $7,230.00 $7,230.00 $1,340.20 $7,013.10 $6,507.00 2026-10-26
23473 HCPCS Revision Of Total Shoulder Repair 22 22 $7,215.00 $7,215.00 $1,413.43 $6,998.55 $6,493.50 2026-10-26
30462 HCPCS Revision Of Congenital Nasal Defect With Lengthening Of Tip Of Nose 22 22 $7,187.00 $7,187.00 $1,441.83 $6,971.39 $6,468.30 2026-10-26
43281 HCPCS Repair Of Hernia Of Muscle At Esophagus And Stomach Using An Endoscope 22 22 $7,163.00 $7,163.00 $1,387.56 $6,948.11 $6,446.70 2026-10-26
29999 HCPCS Other Procedure On Joint Using An Endoscope 19 19 $7,146.00 $7,146.00 $5,359.50 $7,288.92 $6,431.40 2026-10-26
50543 HCPCS Partial Removal Of Kidney Using An Endoscope 22 22 $7,141.00 $7,141.00 $1,310.71 $6,926.77 $6,426.90 2026-10-26
J9400 HCPCS Injection, Ziv-aflibercept, 1 Mg 43 22 $6,563.00 $6,563.00 $13.07 $13,388.01 $6,300.48 2026-10-26
23472 HCPCS Prosthetic Repair Of Shoulder Joint, Total Shoulder 39 22 $6,629.00 $6,629.00 $1,276.41 $12,858.32 $6,297.55 2026-10-26
100001597 CDM Labor Room/delivery - General Classification 20 20 $6,967.00 $6,967.00 $2,717.13 $6,757.99 $6,270.30 2026-10-26
100001587 CDM Labor Room/delivery - General Classification 20 20 $6,967.00 $6,967.00 $2,717.13 $6,757.99 $6,270.30 2026-10-26
27580 HCPCS Fusion Of Knee Joint 22 22 $6,959.00 $6,959.00 $1,330.94 $6,750.23 $6,263.10 2026-10-26
44055 HCPCS Correction Of Abnormal Rotation Of Small Bowel 22 22 $6,925.00 $6,925.00 $1,342.75 $6,717.25 $6,232.50 2026-10-26
43840 HCPCS Suture Of Perforated Ulcer, Wound, Or Injury Of Stomach Or Upper Small Bowel 39 22 $6,524.00 $6,524.00 $1,240.95 $12,658.50 $6,197.80 2026-10-26
47741 HCPCS Creation Of Drainage Tract From Gallbladder To Small Bowel Using Roux-en-y Conne… 22 22 $6,872.00 $6,872.00 $1,349.99 $6,665.84 $6,184.80 2026-10-26
500002646 CDM Operating Room Services - General Classification 20 20 $6,866.00 $6,866.00 $2,677.74 $6,660.02 $6,179.40 2026-10-26
217529_ERX CDM Vistogard 10 Gram Packet 20 20 $6,822.50 $6,822.50 $2,660.78 $6,617.83 $6,140.25 2026-10-26
38724 HCPCS Removal Of Lymph Nodes, Muscle, And Tissue Of Neck 22 22 $6,808.00 $6,808.00 $1,242.33 $6,603.76 $6,127.20 2026-10-26
J7168 HCPCS Prothrombin Complex Concentrate (human), Kcentra, Per I.u. Of Factor Ix Activity 21 21 $6,804.50 $6,804.50 $2,653.76 $6,940.59 $6,124.05 2026-10-26
27447 HCPCS Replacement Of Knee Joint, Both Sides Of Knee 39 22 $6,437.00 $6,437.00 $1,137.31 $12,484.87 $6,115.15 2026-10-26
400066448 CDM Hchg Tfh Pack Procedure Pack Tx1 20 20 $6,739.00 $6,739.00 $2,628.21 $6,536.83 $6,065.10 2026-10-26
44376 HCPCS Diagnostic Exam Of Small Bowel (including Lower Small Intestine) Using An Endosc… 22 22 $6,727.00 $6,727.00 $256.21 $6,861.54 $6,054.30 2026-10-26
500001130 CDM Gastro - Intestinal (gi) Services - General Classification 20 20 $6,727.00 $6,727.00 $2,623.53 $6,525.19 $6,054.30 2026-10-26
J9303 HCPCS Injection, Panitumumab, 10 Mg 43 22 $5,902.00 $5,902.00 $124.05 $24,078.63 $6,020.04 2026-10-26
27486 HCPCS Revision Of Component Of Total Knee Joint Prosthesis 22 22 $6,687.00 $6,687.00 $1,251.09 $6,486.39 $6,018.30 2026-10-26
500001030 CDM Operating Room Services - General Classification 20 20 $6,676.00 $6,676.00 $2,603.64 $6,475.72 $6,008.40 2026-10-26
77373 HCPCS Delivery Of Radiation Therapy Per Dose To 1 Or More Lesions Not To Exceed 5 Dose… 22 22 $6,630.00 $6,630.00 $1,265.75 $6,762.60 $5,967.00 2026-10-26
77778 HCPCS Complex Application Of Radiation Source 22 22 $6,619.00 $6,619.00 $745.61 $6,751.38 $5,957.10 2026-10-26
C1764 HCPCS Event Recorder, Cardiac (implantable) 21 21 $6,586.00 $6,586.00 $2,568.54 $6,717.72 $5,927.40 2026-10-26
55845 HCPCS Removal Of Prostate Gland And Surrounding Lymph Nodes On Both Sides Of Pelvis Th… 22 22 $6,546.00 $6,546.00 $1,192.05 $6,349.62 $5,891.40 2026-10-26
44602 HCPCS Suture Of Tear Of Hole In Small Bowel 22 22 $6,545.00 $6,545.00 $1,257.09 $6,348.65 $5,890.50 2026-10-26
27130 HCPCS Replacement Of Thigh Bone And Hip Joint With Prosthesis 39 22 $6,181.00 $6,181.00 $1,139.82 $11,992.11 $5,871.95 2026-10-26
27137 HCPCS Revision Of Hip Socket Part Of Hip Prosthesis 22 22 $6,508.00 $6,508.00 $1,291.81 $6,312.76 $5,857.20 2026-10-26
100001593 CDM Labor Room/delivery - General Classification 20 20 $6,502.00 $6,502.00 $2,535.78 $6,306.94 $5,851.80 2026-10-26
100001590 CDM Labor Room/delivery - General Classification 20 20 $6,502.00 $6,502.00 $2,535.78 $6,306.94 $5,851.80 2026-10-26
500001105 CDM Gastro - Intestinal (gi) Services - General Classification 20 20 $6,502.00 $6,502.00 $2,535.78 $6,306.94 $5,851.80 2026-10-26
J9264 HCPCS Injection, Paclitaxel Protein-bound Particles, 1 Mg 22 22 $6,481.00 $6,481.00 $17.01 $6,610.62 $5,832.90 2026-10-26
44202 HCPCS Partial Removal And Reconnection Of Small Bowel Using An Endoscope 22 22 $6,458.00 $6,458.00 $1,258.10 $6,264.26 $5,812.20 2026-10-26
27415 HCPCS Implantation Of Donor Cartilage Cells Into Knee Joint 22 22 $6,446.00 $6,446.00 $1,235.87 $6,252.62 $5,801.40 2026-10-26
J3032 HCPCS Injection, Eptinezumab-jjmr, 1 Mg 21 21 $6,442.50 $6,442.50 $2,512.58 $6,571.35 $5,798.25 2026-10-26
41130 HCPCS Partial Removal Of Tongue 22 22 $6,428.00 $6,428.00 $1,172.61 $6,235.16 $5,785.20 2026-10-26
50545 HCPCS Removal Of Kidney And Lymph Nodes Using An Endoscope 22 22 $6,421.00 $6,421.00 $1,168.93 $6,228.37 $5,778.90 2026-10-26
650001645 CDM Hchg Tf Hearing Aid Monaural Level 6 20 20 $6,416.00 $6,416.00 $2,502.24 $6,223.52 $5,774.40 2026-10-26
500001219 CDM Gastro - Intestinal (gi) Services - General Classification 20 20 $6,399.00 $6,399.00 $2,495.61 $6,207.03 $5,759.10 2026-10-26
J9355 HCPCS Injection, Trastuzumab, Excludes Biosimilar, 10 Mg 22 22 $6,392.50 $6,392.50 $113.11 $6,520.35 $5,753.25 2026-10-26
60600 HCPCS Removal Of Growth Of Carotid Artery 22 22 $6,386.00 $6,386.00 $1,193.13 $6,194.42 $5,747.40 2026-10-26
50240 HCPCS Partial Removal Of Kidney 22 22 $6,351.00 $6,351.00 $1,173.30 $6,160.47 $5,715.90 2026-10-26
42426 HCPCS Removal Of Growth Of Saliva Gland Or Saliva Gland, And Surrounding Lymph Nodes O… 22 22 $6,328.00 $6,328.00 $1,146.93 $6,138.16 $5,695.20 2026-10-26
650001648 CDM Hchg Tf Hearing Aid Binaural Level 3 20 20 $6,324.00 $6,324.00 $2,466.36 $6,134.28 $5,691.60 2026-10-26
69644 HCPCS Repair Of Eardrum, Ear Canal, And Bones With Removal Of Mastoid Bone, With Intac… 22 22 $6,311.00 $6,311.00 $1,358.45 $6,121.67 $5,679.90 2026-10-26
J9217 HCPCS Leuprolide Acetate (for Depot Suspension), 7.5 Mg 85 22 $22,814.00 $22,814.00 $237.49 $31,026.87 $5,669.16 2026-10-26
38720 HCPCS Removal Of Lymph Nodes Of Neck 22 22 $6,296.00 $6,296.00 $1,174.19 $6,107.12 $5,666.40 2026-10-26
J0897 HCPCS Injection, Denosumab, 1 Mg 43 22 $5,882.50 $5,882.50 $23.91 $11,036.91 $5,647.20 2026-10-26
44205 HCPCS Partial Removal Of Small And Large Bowel With Attachment Of Small And Large Bowe… 22 22 $6,260.00 $6,260.00 $1,199.80 $6,072.20 $5,634.00 2026-10-26
28420 HCPCS Treatment Of Broken Heel Bone With Graft 22 22 $6,253.00 $6,253.00 $1,189.05 $6,065.41 $5,627.70 2026-10-26
30420 HCPCS Reshaping Of Bony Cartilage Dividing Nasal Passages 22 22 $6,220.00 $6,220.00 $1,299.05 $6,033.40 $5,598.00 2026-10-26
47610 HCPCS Removal Of Gallbladder With Exploration Of Common Bile Duct 22 22 $6,200.00 $6,200.00 $1,144.46 $6,014.00 $5,580.00 2026-10-26
100001586 CDM Labor Room/delivery - General Classification 20 20 $6,192.00 $6,192.00 $2,414.88 $6,006.24 $5,572.80 2026-10-26
58554 HCPCS Removal Of Uterus, Tubes, And/or Ovaries Through Vagina Using An Endoscope, More… 22 22 $6,182.00 $6,182.00 $1,138.97 $5,996.54 $5,563.80 2026-10-26
31300 HCPCS Removal Of Vocal Cord Growth Or Cartilage Attachment 22 22 $6,175.00 $6,175.00 $1,109.52 $5,989.75 $5,557.50 2026-10-26
50230 HCPCS Removal Of Kidney, Lymph Nodes, And/or Blood Clot From Major Vein With Partial R… 22 22 $6,132.00 $6,132.00 $1,124.66 $5,948.04 $5,518.80 2026-10-26
50948 HCPCS Repositioning Of Ureter Using An Endoscope 22 22 $6,115.00 $6,115.00 $1,114.70 $5,931.55 $5,503.50 2026-10-26
30410 HCPCS Reshaping Of Bone, Cartilage, And/or Tip Of Nose 22 22 $6,083.00 $6,083.00 $1,248.50 $5,900.51 $5,474.70 2026-10-26
58573 HCPCS Removal Of Uterus, Tubes, And/or Ovaries Through Abdomen Using An Endoscope, Mor… 22 22 $6,063.00 $6,063.00 $1,083.05 $5,881.11 $5,456.70 2026-10-26
28705 HCPCS Fusion Of All Bones Of Ankle And Hindfoot 22 22 $6,056.00 $6,056.00 $1,089.57 $5,874.32 $5,450.40 2026-10-26
23335 HCPCS Removal Of Ball And Socket Prosthesis From Shoulder 22 22 $6,053.00 $6,053.00 $1,127.81 $5,871.41 $5,447.70 2026-10-26
44140 HCPCS Partial Removal Of Large Bowel With Connection 22 22 $6,028.00 $6,028.00 $1,220.41 $5,847.16 $5,425.20 2026-10-26
37617 HCPCS Tying Of Major Artery Of The Abdomen 22 22 $5,971.00 $5,971.00 $1,174.06 $5,791.87 $5,373.90 2026-10-26
500002639 CDM Operating Room Services - General Classification 20 20 $5,967.00 $5,967.00 $2,327.13 $5,787.99 $5,370.30 2026-10-26
100001521 CDM Hchg Care High Risk Antenatal Or Postpartal 20 20 $5,965.00 $5,965.00 $2,326.35 $5,786.05 $5,368.50 2026-10-26
27828 HCPCS Treatment Of Broken Lower Weight Bearing Joint Of Both Lower Leg Bones 22 22 $5,903.00 $5,903.00 $1,210.36 $5,725.91 $5,312.70 2026-10-26
27506 HCPCS Treatment Of Broken Shaft Of Thigh Bone With Implant 22 22 $5,897.00 $5,897.00 $1,201.11 $5,720.09 $5,307.30 2026-10-26
19307 HCPCS Removal Of Breast And Underarm Lymph Nodes 39 22 $5,578.00 $5,578.00 $1,101.73 $10,820.35 $5,299.10 2026-10-26
100001589 CDM Labor Room/delivery - General Classification 20 20 $5,881.00 $5,881.00 $2,293.59 $5,704.57 $5,292.90 2026-10-26
23616 HCPCS Treatment Of Broken Upper Arm Bone With Replacement 22 22 $5,870.00 $5,870.00 $1,101.36 $5,693.90 $5,283.00 2026-10-26
32654 HCPCS Control Of Traumatic Bleeding In Chest Using An Endoscope 39 22 $5,547.00 $5,547.00 $1,101.31 $10,759.24 $5,269.65 2026-10-26
58152 HCPCS Removal Of Uterus And Cervix Through Abdomen With Repair Of Vagina 22 22 $5,837.00 $5,837.00 $1,069.60 $5,661.89 $5,253.30 2026-10-26
58291 HCPCS Removal Of Uterus, Tubes, And/or Ovaries Through Vagina, More Than 250.0 G 22 22 $5,814.00 $5,814.00 $1,071.76 $5,639.58 $5,232.60 2026-10-26
29889 HCPCS Repair Of Posterior Cruciate Ligament Of Knee Using An Endoscope 22 22 $5,809.00 $5,809.00 $1,112.60 $5,634.73 $5,228.10 2026-10-26
140000003 CDM Room & Board - Private (one Bed) - Pediatric 20 20 $5,805.00 $5,805.00 $2,147.85 $5,630.85 $5,224.50 2026-10-26
140000065 CDM Room & Board - Private (one Bed) - Obstetrics (ob) 20 20 $5,805.00 $5,805.00 $2,147.85 $5,630.85 $5,224.50 2026-10-26
140000000 CDM Room & Board - Private (one Bed) - General Classification 20 20 $5,805.00 $5,805.00 $2,147.85 $5,630.85 $5,224.50 2026-10-26
140000118 CDM Room & Board - Private (one Bed) - General Classification 20 20 $5,805.00 $5,805.00 $2,147.85 $5,630.85 $5,224.50 2026-10-26
140000135 CDM Nursery - Newborn - Level Iii 20 20 $5,805.00 $5,805.00 $2,147.85 $5,630.85 $5,224.50 2026-10-26
500001023 CDM Operating Room Services - General Classification 20 20 $5,801.00 $5,801.00 $2,262.39 $5,626.97 $5,220.90 2026-10-26
59515 HCPCS Cesarean Delivery With Care After Delivery 22 22 $5,792.00 $5,792.00 $1,184.54 $5,618.24 $5,212.80 2026-10-26
27466 HCPCS Lengthening Of Thigh Bone 22 22 $5,786.00 $5,786.00 $1,120.98 $5,612.42 $5,207.40 2026-10-26
44188 HCPCS Creation Of Large Bowel Opening Using An Endoscope 22 22 $5,771.00 $5,771.00 $1,116.52 $5,597.87 $5,193.90 2026-10-26
27724 HCPCS Repair Of Nonhealed Broken Shin Bone With Self Graft From Hip Or Other Bone 22 22 $5,763.00 $5,763.00 $1,112.91 $5,590.11 $5,186.70 2026-10-26
27470 HCPCS Repair Of Nonhealed Broken Thigh Bone 22 22 $5,752.00 $5,752.00 $1,065.80 $5,579.44 $5,176.80 2026-10-26
27472 HCPCS Repair Of Nonhealed Broken Thigh Bone With Self Bone Graft 22 22 $5,751.00 $5,751.00 $1,134.78 $5,578.47 $5,175.90 2026-10-26
21470 HCPCS Complicated Treatment Of Broken Lower Jaw Bone With Placement Of Stabilizing Dev… 22 22 $5,735.00 $5,735.00 $1,025.54 $5,562.95 $5,161.50 2026-10-26
25025 HCPCS Incision To Relieve Pressure In Top And Palm Side Of Wrist Compartment With Remo… 22 22 $5,728.00 $5,728.00 $1,103.94 $5,556.16 $5,155.20 2026-10-26
44130 HCPCS Creation Of Connection Between 2 Segments Of Small Bowel 22 22 $5,713.00 $5,713.00 $1,201.37 $5,541.61 $5,141.70 2026-10-26
J0630 HCPCS Injection, Calcitonin Salmon, Up To 400 Units 22 22 $5,712.50 $5,712.50 $2,227.88 $5,826.75 $5,141.25 2026-10-26
650001644 CDM Hchg Tf Hearing Aid Monaural Level 5 20 20 $5,708.00 $5,708.00 $2,226.12 $5,536.76 $5,137.20 2026-10-26
38100 HCPCS Removal Of Spleen 22 22 $5,702.00 $5,702.00 $1,047.34 $5,530.94 $5,131.80 2026-10-26
24149 HCPCS Extensive Removal Of Bony Growth And Tissue From Elbow To Increase Elbow Motion 22 22 $5,692.00 $5,692.00 $1,072.92 $5,521.24 $5,122.80 2026-10-26
49186 HCPCS Removal Or Destruction Of Growth(s) In The Abdomen, 5.0 Cm Or Less 21 21 $5,673.00 $5,673.00 $1,194.82 $5,502.81 $5,105.70 2026-10-26
27709 HCPCS Incision Or Partial Removal Of Shin And Outer Lower Leg Bones 22 22 $5,660.00 $5,660.00 $1,032.70 $5,490.20 $5,094.00 2026-10-26
27513 HCPCS Treatment Of Broken Thigh Bone In Knee Area 22 22 $5,657.00 $5,657.00 $1,085.16 $5,487.29 $5,091.30 2026-10-26
21601 HCPCS Removal Of Growth Of Chest Wall And Rib 22 22 $5,634.00 $5,634.00 $1,087.20 $5,464.98 $5,070.60 2026-10-26
55840 HCPCS Removal Of Prostate 22 22 $5,630.00 $5,630.00 $1,030.20 $5,461.10 $5,067.00 2026-10-26
30435 HCPCS Revision To Reshape Nasal Bones After Previous Repair 22 22 $5,623.00 $5,623.00 $1,059.71 $5,454.31 $5,060.70 2026-10-26
44320 HCPCS Creation Of Opening From Large Bowel To Skin 22 22 $5,620.00 $5,620.00 $1,097.16 $5,451.40 $5,058.00 2026-10-26
27244 HCPCS Treatment Of Broken Neck Of Thigh Bone With Plate/screw Implant 22 22 $5,619.00 $5,619.00 $1,100.75 $5,450.43 $5,057.10 2026-10-26
J9047 HCPCS Injection, Carfilzomib, 1 Mg 64 22 $5,601.50 $5,601.50 $42.34 $11,427.06 $5,041.35 2026-10-26
27245 HCPCS Treatment Of Broken Neck Of Thigh Bone With Bone Implant 22 22 $5,601.00 $5,601.00 $1,097.97 $5,432.97 $5,040.90 2026-10-26
42420 HCPCS Removal Of Growth Of Saliva Gland Or Saliva Gland With Release Of Facial Nerve 22 22 $5,569.00 $5,569.00 $1,010.25 $5,401.93 $5,012.10 2026-10-26
35840 HCPCS Exploration Of Abdomen For Bleeding, Blood Clot, Or Infection After Surgery 22 22 $5,566.00 $5,566.00 $1,095.55 $5,399.02 $5,009.40 2026-10-26
50400 HCPCS Simple Reconstruction Of Neck Of Kidney 22 22 $5,557.00 $5,557.00 $1,018.45 $5,390.29 $5,001.30 2026-10-26
27429 HCPCS Reconstruction Of Ligaments Inside And Outside Knee Joint 22 22 $5,552.00 $5,552.00 $1,152.21 $5,385.44 $4,996.80 2026-10-26
44346 HCPCS Revision Of Opening From Large Bowel To Skin With Repair Of Hernia 22 22 $5,548.00 $5,548.00 $1,077.01 $5,381.56 $4,993.20 2026-10-26
27269 HCPCS Treatment Of Broken Head Of Thigh Bone 22 22 $5,539.00 $5,539.00 $1,099.95 $5,372.83 $4,985.10 2026-10-26
58146 HCPCS Removal Of 5 Or More Growths Of Uterus Through Abdomen 22 22 $5,536.00 $5,536.00 $995.60 $5,369.92 $4,982.40 2026-10-26
23395 HCPCS Relocation Of One Muscle Of Shoulder Or Upper Arm 22 22 $5,532.00 $5,532.00 $1,157.42 $5,366.04 $4,978.80 2026-10-26
29867 HCPCS Repair Of Knee Cartilage And Bone With Donor Cartilage Graft Using An Endoscope 22 22 $5,529.00 $5,529.00 $1,157.81 $5,363.13 $4,976.10 2026-10-26
V5258 HCPCS Hearing Aid, Digital, Binaural, Cic 168 21 $6,335.00 $6,335.00 $1,595.88 $10,765.08 $4,943.12 2026-10-26
44120 HCPCS Partial Removal Of Small Bowel With Reconnection 22 22 $5,492.00 $5,492.00 $1,108.14 $5,327.24 $4,942.80 2026-10-26
27488 HCPCS Removal Of Total Knee Joint Prosthesis 22 22 $5,477.00 $5,477.00 $1,080.05 $5,312.69 $4,929.30 2026-10-26
25023 HCPCS Incision To Relieve Pressure In Top Or Palm Side Of Wrist Compartment With Remov… 22 22 $5,471.00 $5,471.00 $1,046.65 $5,306.87 $4,923.90 2026-10-26
J2802 HCPCS Injection, Romiplostim, 1 Microgram 21 21 $5,470.00 $5,470.00 $2,133.30 $5,579.40 $4,923.00 2026-10-26
44160 HCPCS Partial Removal Of Small And Large Bowel With Attachment Of Small And Large Bowe… 22 22 $5,461.00 $5,461.00 $1,130.32 $5,297.17 $4,914.90 2026-10-26
24079 HCPCS Extensive Removal Of Growth Of Upper Arm Or Elbow, 5.0 Cm Or More 22 22 $5,452.00 $5,452.00 $1,200.78 $5,288.44 $4,906.80 2026-10-26
V5261 HCPCS Hearing Aid, Digital, Binaural, Bte 210 21 $6,335.00 $6,335.00 $1,595.88 $10,765.08 $4,888.80 2026-10-26
V5259 HCPCS Hearing Aid, Digital, Binaural, Itc 105 21 $5,432.00 $5,432.00 $1,716.00 $9,711.42 $4,888.80 2026-10-26
69930 HCPCS Insertion Of Cochlear Device 39 22 $5,146.00 $5,146.00 $1,046.04 $9,983.24 $4,888.70 2026-10-26
V5260 HCPCS Hearing Aid, Digital, Binaural, Ite 189 21 $5,432.00 $5,432.00 $1,595.88 $10,765.08 $4,885.89 2026-10-26
27558 HCPCS Treatment Of Dislocated Knee With Ligament Repair And Reconstruction 22 22 $5,425.00 $5,425.00 $1,046.47 $5,262.25 $4,882.50 2026-10-26
27536 HCPCS Treatment Of Broken Shin Bone On Both Sides Of Upper End 22 22 $5,419.00 $5,419.00 $1,071.20 $5,256.43 $4,877.10 2026-10-26
100001585 CDM Labor Room/delivery - General Classification 20 20 $5,418.00 $5,418.00 $2,113.02 $5,255.46 $4,876.20 2026-10-26
27236 HCPCS Treatment Of Upper End Of Broken Thigh Bone With Placement Of Stabilizing Device… 22 22 $5,415.00 $5,415.00 $1,070.13 $5,252.55 $4,873.50 2026-10-26
43332 HCPCS Repair Of Paraesophageal Hernia Through Abdomen 22 22 $5,390.00 $5,390.00 $1,050.90 $5,228.30 $4,851.00 2026-10-26
49618 HCPCS Repair Of Recurrent Entrapped Hernia Of Abdomen, More Than 10 Cm In Length 21 21 $5,372.00 $5,372.00 $1,100.09 $5,210.84 $4,834.80 2026-10-26
58290 HCPCS Removal Of Uterus Through Vagina, More Than 250.0 G 22 22 $5,356.00 $5,356.00 $992.32 $5,195.32 $4,820.40 2026-10-26
28415 HCPCS Treatment Of Broken Heel Bone 22 22 $5,338.00 $5,338.00 $1,034.10 $5,177.86 $4,804.20 2026-10-26
23466 HCPCS Repair And Tightening Of Shoulder Joint Capsule 22 22 $5,331.00 $5,331.00 $1,017.66 $5,171.07 $4,797.90 2026-10-26
30400 HCPCS Reshaping Of Tip Of Nose 22 22 $5,318.00 $5,318.00 $1,065.34 $5,158.46 $4,786.20 2026-10-26
27428 HCPCS Reconstruction Ligaments Inside Knee Joint 22 22 $5,297.00 $5,297.00 $1,022.85 $5,138.09 $4,767.30 2026-10-26
27446 HCPCS Replacement Of Knee Joint On Side Of Knee 22 22 $5,291.00 $5,291.00 $1,028.13 $5,132.27 $4,761.90 2026-10-26
23465 HCPCS Repair Of Shoulder Joint Capsule In The Back Of The Joint 22 22 $5,285.00 $5,285.00 $1,006.27 $5,126.45 $4,756.50 2026-10-26
21365 HCPCS Treatment Of Complicated Broken Cheek Bone With Placement Of Internal Stabilizin… 22 22 $5,284.00 $5,284.00 $948.50 $5,125.48 $4,755.60 2026-10-26
45400 HCPCS Repair Of Rectal Prolapse Using An Endoscope 22 22 $5,278.00 $5,278.00 $1,026.00 $5,119.66 $4,750.20 2026-10-26
45562 HCPCS Repair Of Rectal Wound 22 22 $5,262.00 $5,262.00 $1,097.49 $5,104.14 $4,735.80 2026-10-26
58553 HCPCS Removal Of Uterus Through Vagina Using An Endoscope, More Than 250.0 22 22 $5,257.00 $5,257.00 $966.75 $5,099.29 $4,731.30 2026-10-26
41120 HCPCS Removal Of Less Than Half Of Tongue 22 22 $5,254.00 $5,254.00 $969.22 $5,096.38 $4,728.60 2026-10-26
500002644 CDM Operating Room Services - General Classification 20 20 $5,245.00 $5,245.00 $2,045.55 $5,087.65 $4,720.50 2026-10-26
58546 HCPCS Removal Of Growth Of Uterus Using An Endoscope, More Than 250.0 G 22 22 $5,229.00 $5,229.00 $960.90 $5,072.13 $4,706.10 2026-10-26
J9179 HCPCS Injection, Eribulin Mesylate, 0.1 Mg 22 22 $5,225.50 $5,225.50 $122.02 $5,330.01 $4,702.95 2026-10-26
650001647 CDM Hchg Tf Hearing Aid Binaural Level 2 20 20 $5,188.00 $5,188.00 $2,023.32 $5,032.36 $4,669.20 2026-10-26
47564 HCPCS Removal Of Gallbladder With Exploration Of Common Bile Duct Using An Endoscope 22 22 $5,187.00 $5,187.00 $1,036.14 $5,031.39 $4,668.30 2026-10-26
64857 HCPCS Suture Of Arm Or Leg Peripheral Nerve 22 22 $5,186.00 $5,186.00 $927.10 $5,030.42 $4,667.40 2026-10-26
23470 HCPCS Partial Replacement Of Shoulder Joint 22 22 $5,177.00 $5,177.00 $1,068.40 $5,021.69 $4,659.30 2026-10-26
G0390 HCPCS Trauma Response Team Associated With Hospital Critical Care Service 42 21 $6,499.00 $6,499.00 $1,881.36 $8,337.48 $4,655.16 2026-10-26
27125 HCPCS Partial Replacement Of Thigh Bone At Hip Joint With Prosthesis 22 22 $5,172.00 $5,172.00 $1,017.01 $5,016.84 $4,654.80 2026-10-26
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