|
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
|