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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

Rehabilitation Hospital Of Southern New Mexico,inc

Las Cruces, NM · CCN 323032 · Rates published

2,173 distinct procedures filed
19 distinct payers
20,180 rate rows
2026-03-17 last MRF observed
Data quality

7,087 of 20,180 rate rows are consumer-grade (35.1%)

13,093 rows are marked excluded from the consumer medians — these stay visible in the raw drill-down with the same reason shown here, so nothing is silently hidden.

Excluded — reasonRows
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 12,802
per-diem day rate — not a per-procedure price 291
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://ernesthealth.com/pricing/2026/201563733_rehabilitation-hospital-of-southern-new-mexico_standard-charges.json
Found on page https://rhsnm.ernesthealth.com/price-transparency/
Discovered viaCMS hospital list
Last fetch success · 2026-08-14
Content fingerprint 4c255b30f5065125… · 7,007,850 bytes · first seen 2026-05-09

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
B0205
HCPCS 		Traumatic Brain Injury M <35.50- Tier Tier 1 9 $56,709.09 $56,709.09 $56,709.09 nat. median
$51,427
1.1× median
B0106
HCPCS 		Stroke M <41.50 And A <84.50- Tier Tier 1 9 $49,685.40 $50,699.39 $50,192.39 nat. median
$54,008
0.9× median
C1806
HCPCS 		Major Multiple Trauma With Brain Or Spinal Cord Injury M <30.50- Tier Tier 2 9 $47,887.41 $47,887.41 $47,887.41 nat. median
$53,363
0.9× median
B0704
HCPCS 		Fracture Of Lower Extremity M <41.50- Tier Tier 1 9 $47,743.19 $47,743.19 $47,743.19 nat. median
$43,685
1.1× median
D1806
HCPCS 		Major Multiple Trauma With Brain Or Spinal Cord Injury M <30.50- Tier Tier 3 9 $45,462.69 $45,462.69 $45,462.69 nat. median
$49,816
0.9× median
B2004
HCPCS 		Miscellaneous M <46.50 And A >=77.50- Tier Tier 1 9 $43,978.26 $43,978.26 $43,978.26 nat. median
$40,136
1.1× median
C0106
HCPCS 		Stroke M <41.50 And A <84.50- Tier Tier 2 9 $43,969.48 $43,969.48 $43,969.48 nat. median
$47,992
0.9× median
B0604
HCPCS 		Neurological M <43.50- Tier Tier 1 9 $43,442.67 $43,442.67 $43,442.67 nat. median
$46,532
0.9× median
D0106
HCPCS 		Stroke M <41.50 And A <84.50- Tier Tier 3 9 $40,180.63 $46,480.35 $43,330.49 nat. median
$43,248
1.0× median
B2005
HCPCS 		Miscellaneous M <46.50 And A <77.50- Tier Tier 1 9 $38,746.73 $46,032.43 $42,389.58 nat. median
$41,996
1.0× median
A1806
HCPCS 		Major Multiple Trauma With Brain Or Spinal Cord Injury M <30.50- Tier None 9 $42,151.81 $42,151.81 $42,151.81 nat. median
$47,794
0.9× median
C1705
HCPCS 		Major Multiple Trauma Without Brain Or Spinal Cord Injury M <36.50- Tier Tier 2 9 $42,138.47 $42,138.47 $42,138.47 nat. median
$38,430
1.1× median
B0305
HCPCS 		Non-traumatic Brain Injury M <42.50 And A <78.50- Tier Tier 1 9 $41,595.34 $41,595.34 $41,595.34 nat. median
$44,642
0.9× median
B1004
HCPCS 		Amputation Lower Extremity M <47.50- Tier Tier 1 9 $40,140.51 $40,140.51 $40,140.51 nat. median
$44,520
0.9× median
D1705
HCPCS 		Major Multiple Trauma Without Brain Or Spinal Cord Injury M <36.50- Tier Tier 3 9 $39,124.86 $39,124.86 $39,124.86 nat. median
$70
outlier · 558.9×
D0105
HCPCS 		Stroke M <41.50 And A >=84.50- Tier Tier 3 9 $35,325.95 $42,105.17 $38,715.56 nat. median
$38,441
1.0× median
D0505
HCPCS 		Non-traumatic Spinal Cord Injury M <39.50- Tier Tier 3 9 $38,671.72 $38,671.72 $38,671.72 nat. median
$42,129
0.9× median
C0205
HCPCS 		Traumatic Brain Injury M <35.50- Tier Tier 2 9 $37,907.67 $37,907.67 $37,907.67 nat. median
$41,257
0.9× median
B1404
HCPCS 		Cardiac M <45.50- Tier Tier 1 9 $37,431.45 $37,431.45 $37,431.45 nat. median
$40,776
0.9× median
B0904
HCPCS 		Other Orthopedic M <44.5- Tier Tier 1 9 $37,358.18 $37,358.18 $37,358.18 nat. median
$42,453
0.9× median
A0106
HCPCS 		Stroke M <41.50 And A <84.50- Tier None 9 $33,457.72 $38,291.44 $35,874.58 nat. median
$41,164
0.9× median
B0104
HCPCS 		Stroke M >=41.50 And M <50.50- Tier Tier 1 9 $35,646.92 $35,646.92 $35,646.92 nat. median
$38,533
0.9× median
A0505
HCPCS 		Non-traumatic Spinal Cord Injury M <39.50- Tier None 9 $34,923.72 $35,636.45 $35,280.08 nat. median
$39,053
0.9× median
A1504
HCPCS 		Pulmonary M <45.50- Tier None 9 $35,093.54 $35,093.54 $35,093.54 nat. median
$32,009
1.1× median
C0604
HCPCS 		Neurological M <43.50- Tier Tier 2 9 $32,524.43 $36,245.42 $34,384.93 nat. median
$35,373
1.0× median
C1805
HCPCS 		Major Multiple Trauma With Brain Or Spinal Cord Injury M >=30.50 And M <40.50- T… 9 $33,719.35 $33,719.35 $33,719.35 nat. median
$37,575
0.9× median
B0703
HCPCS 		Fracture Of Lower Extremity M >=41.50 And M <52.50- Tier Tier 1 9 $33,232.66 $33,232.66 $33,232.66 nat. median
$35,625
0.9× median
C1004
HCPCS 		Amputation Lower Extremity M <47.50- Tier Tier 2 9 $33,197.78 $33,197.78 $33,197.78 nat. median
$36,994
0.9× median
C0305
HCPCS 		Non-traumatic Brain Injury M <42.50 And A <78.50- Tier Tier 2 9 $32,612.46 $33,278.02 $32,945.24 nat. median
$35,676
0.9× median
A1705
HCPCS 		Major Multiple Trauma Without Brain Or Spinal Cord Injury M <36.50- Tier None 9 $29,871.19 $36,017.60 $32,944.39 nat. median
$32,762
1.0× median
D0604
HCPCS 		Neurological M <43.50- Tier Tier 3 9 $29,278.95 $36,369.32 $32,824.14 nat. median
$104
outlier · 314.4×
B0303
HCPCS 		Non-traumatic Brain Injury M >=42.50 And M <52.50- Tier Tier 1 9 $32,529.67 $32,529.67 $32,529.67 nat. median
$35,035
0.9× median
A0205
HCPCS 		Traumatic Brain Injury M <35.50- Tier None 9 $32,416.28 $32,416.28 $32,416.28 nat. median
$35,382
0.9× median
D1805
HCPCS 		Major Multiple Trauma With Brain Or Spinal Cord Injury M >=30.50 And M <40.50- T… 9 $32,011.58 $32,011.58 $32,011.58 nat. median
$35,077
0.9× median
B0602
HCPCS 		Neurological M >=52.50 And M <64.50- Tier Tier 1 9 $29,398.46 $33,901.00 $31,649.73 nat. median
$31,406
1.0× median
C0704
HCPCS 		Fracture Of Lower Extremity M <41.50- Tier Tier 2 9 $31,404.53 $31,404.53 $31,404.53 nat. median
$34,618
0.9× median
A0304
HCPCS 		Non-traumatic Brain Injury M <42.50 And A >=78.50- Tier None 9 $31,145.46 $31,145.46 $31,145.46 nat. median
$28,628
1.1× median
D0305
HCPCS 		Non-traumatic Brain Injury M <42.50 And A <78.50- Tier Tier 3 9 $30,568.96 $30,568.96 $30,568.96 nat. median
$32,986
0.9× median
C0603
HCPCS 		Neurological M >=43.50 And M <52.50- Tier Tier 2 9 $30,531.50 $30,531.50 $30,531.50 nat. median
$28,131
1.1× median
D0304
HCPCS 		Non-traumatic Brain Injury M <42.50 And A >=78.50- Tier Tier 3 9 $27,718.60 $33,268.31 $30,493.46 nat. median
$30,379
1.0× median
D1004
HCPCS 		Amputation Lower Extremity M <47.50- Tier Tier 3 9 $30,324.74 $30,324.74 $30,324.74 nat. median
$33,636
0.9× median
D1504
HCPCS 		Pulmonary M <45.50- Tier Tier 3 9 $30,284.62 $30,284.62 $30,284.62 nat. median
$33,251
0.9× median
C0304
HCPCS 		Non-traumatic Brain Injury M <42.50 And A >=78.50- Tier Tier 2 9 $30,174.72 $30,174.72 $30,174.72 nat. median
$32,729
0.9× median
C0904
HCPCS 		Other Orthopedic M <44.5- Tier Tier 2 9 $29,921.78 $29,921.78 $29,921.78 nat. median
$32,429
0.9× median
D0704
HCPCS 		Fracture Of Lower Extremity M <41.50- Tier Tier 3 9 $29,749.09 $29,749.09 $29,749.09 nat. median
$30,260
1.0× median
A1805
HCPCS 		Major Multiple Trauma With Brain Or Spinal Cord Injury M >=30.50 And M <40.50- T… 9 $29,681.05 $29,681.05 $29,681.05 nat. median
$33,150
0.9× median
D0805
HCPCS 		Replacement Of Lower-extremity Joint M <42.50- Tier Tier 3 9 $26,305.63 $32,762.57 $29,534.10 nat. median
$29,473
1.0× median
C1404
HCPCS 		Cardiac M <45.50- Tier Tier 2 9 $29,487.43 $29,487.43 $29,487.43 nat. median
$32,640
0.9× median
C0504
HCPCS 		Non-traumatic Spinal Cord Injury M >=39.50 And M <48.50- Tier Tier 2 9 $29,457.77 $29,457.77 $29,457.77 nat. median
$32,179
0.9× median
C2004
HCPCS 		Miscellaneous M <46.50 And A >=77.50- Tier Tier 2 9 $29,361.83 $29,361.83 $29,361.83 nat. median
$32,130
0.9× median

Other procedures at this hospital

Browse this hospital's 2,173 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
             
B0205 HCPCS Traumatic Brain Injury M <35.50- Tier Tier 1 20 9 — — $56,709.09 $56,709.09 $56,709.09 2026-03-17
B0106 HCPCS Stroke M <41.50 And A <84.50- Tier Tier 1 20 9 — — $49,685.40 $50,699.39 $50,192.39 2026-03-17
C1806 HCPCS Major Multiple Trauma With Brain Or Spinal Cord Injury M <30.50- Tier Tier 2 20 9 — — $47,887.41 $47,887.41 $47,887.41 2026-03-17
B0704 HCPCS Fracture Of Lower Extremity M <41.50- Tier Tier 1 20 9 — — $47,743.19 $47,743.19 $47,743.19 2026-03-17
D1806 HCPCS Major Multiple Trauma With Brain Or Spinal Cord Injury M <30.50- Tier Tier 3 20 9 — — $45,462.69 $45,462.69 $45,462.69 2026-03-17
B2004 HCPCS Miscellaneous M <46.50 And A >=77.50- Tier Tier 1 20 9 — — $43,978.26 $43,978.26 $43,978.26 2026-03-17
C0106 HCPCS Stroke M <41.50 And A <84.50- Tier Tier 2 20 9 — — $43,969.48 $43,969.48 $43,969.48 2026-03-17
B0604 HCPCS Neurological M <43.50- Tier Tier 1 20 9 — — $43,442.67 $43,442.67 $43,442.67 2026-03-17
D0106 HCPCS Stroke M <41.50 And A <84.50- Tier Tier 3 20 9 — — $40,180.63 $46,480.35 $43,330.49 2026-03-17
B2005 HCPCS Miscellaneous M <46.50 And A <77.50- Tier Tier 1 20 9 — — $38,746.73 $46,032.43 $42,389.58 2026-03-17
A1806 HCPCS Major Multiple Trauma With Brain Or Spinal Cord Injury M <30.50- Tier None 20 9 — — $42,151.81 $42,151.81 $42,151.81 2026-03-17
C1705 HCPCS Major Multiple Trauma Without Brain Or Spinal Cord Injury M <36.50- Tier Tier 2 20 9 — — $42,138.47 $42,138.47 $42,138.47 2026-03-17
B0305 HCPCS Non-traumatic Brain Injury M <42.50 And A <78.50- Tier Tier 1 20 9 — — $41,595.34 $41,595.34 $41,595.34 2026-03-17
B1004 HCPCS Amputation Lower Extremity M <47.50- Tier Tier 1 20 9 — — $40,140.51 $40,140.51 $40,140.51 2026-03-17
D1705 HCPCS Major Multiple Trauma Without Brain Or Spinal Cord Injury M <36.50- Tier Tier 3 20 9 — — $39,124.86 $39,124.86 $39,124.86 2026-03-17
D0105 HCPCS Stroke M <41.50 And A >=84.50- Tier Tier 3 20 9 — — $35,325.95 $42,105.17 $38,715.56 2026-03-17
D0505 HCPCS Non-traumatic Spinal Cord Injury M <39.50- Tier Tier 3 20 9 — — $38,671.72 $38,671.72 $38,671.72 2026-03-17
C0205 HCPCS Traumatic Brain Injury M <35.50- Tier Tier 2 20 9 — — $37,907.67 $37,907.67 $37,907.67 2026-03-17
B1404 HCPCS Cardiac M <45.50- Tier Tier 1 20 9 — — $37,431.45 $37,431.45 $37,431.45 2026-03-17
B0904 HCPCS Other Orthopedic M <44.5- Tier Tier 1 20 9 — — $37,358.18 $37,358.18 $37,358.18 2026-03-17
A0106 HCPCS Stroke M <41.50 And A <84.50- Tier None 20 9 — — $33,457.72 $38,291.44 $35,874.58 2026-03-17
B0104 HCPCS Stroke M >=41.50 And M <50.50- Tier Tier 1 20 9 — — $35,646.92 $35,646.92 $35,646.92 2026-03-17
A0505 HCPCS Non-traumatic Spinal Cord Injury M <39.50- Tier None 20 9 — — $34,923.72 $35,636.45 $35,280.08 2026-03-17
A1504 HCPCS Pulmonary M <45.50- Tier None 20 9 — — $35,093.54 $35,093.54 $35,093.54 2026-03-17
C0604 HCPCS Neurological M <43.50- Tier Tier 2 20 9 — — $32,524.43 $36,245.42 $34,384.93 2026-03-17
C1805 HCPCS Major Multiple Trauma With Brain Or Spinal Cord Injury M >=30.50 And M <40.50- T… 20 9 — — $33,719.35 $33,719.35 $33,719.35 2026-03-17
B0703 HCPCS Fracture Of Lower Extremity M >=41.50 And M <52.50- Tier Tier 1 20 9 — — $33,232.66 $33,232.66 $33,232.66 2026-03-17
C1004 HCPCS Amputation Lower Extremity M <47.50- Tier Tier 2 20 9 — — $33,197.78 $33,197.78 $33,197.78 2026-03-17
C0305 HCPCS Non-traumatic Brain Injury M <42.50 And A <78.50- Tier Tier 2 20 9 — — $32,612.46 $33,278.02 $32,945.24 2026-03-17
A1705 HCPCS Major Multiple Trauma Without Brain Or Spinal Cord Injury M <36.50- Tier None 20 9 — — $29,871.19 $36,017.60 $32,944.39 2026-03-17
D0604 HCPCS Neurological M <43.50- Tier Tier 3 20 9 — — $29,278.95 $36,369.32 $32,824.14 2026-03-17
B0303 HCPCS Non-traumatic Brain Injury M >=42.50 And M <52.50- Tier Tier 1 20 9 — — $32,529.67 $32,529.67 $32,529.67 2026-03-17
A0205 HCPCS Traumatic Brain Injury M <35.50- Tier None 20 9 — — $32,416.28 $32,416.28 $32,416.28 2026-03-17
D1805 HCPCS Major Multiple Trauma With Brain Or Spinal Cord Injury M >=30.50 And M <40.50- T… 20 9 — — $32,011.58 $32,011.58 $32,011.58 2026-03-17
B0602 HCPCS Neurological M >=52.50 And M <64.50- Tier Tier 1 20 9 — — $29,398.46 $33,901.00 $31,649.73 2026-03-17
C0704 HCPCS Fracture Of Lower Extremity M <41.50- Tier Tier 2 20 9 — — $31,404.53 $31,404.53 $31,404.53 2026-03-17
A0304 HCPCS Non-traumatic Brain Injury M <42.50 And A >=78.50- Tier None 20 9 — — $31,145.46 $31,145.46 $31,145.46 2026-03-17
D0305 HCPCS Non-traumatic Brain Injury M <42.50 And A <78.50- Tier Tier 3 20 9 — — $30,568.96 $30,568.96 $30,568.96 2026-03-17
C0603 HCPCS Neurological M >=43.50 And M <52.50- Tier Tier 2 20 9 — — $30,531.50 $30,531.50 $30,531.50 2026-03-17
D0304 HCPCS Non-traumatic Brain Injury M <42.50 And A >=78.50- Tier Tier 3 20 9 — — $27,718.60 $33,268.31 $30,493.46 2026-03-17
D1004 HCPCS Amputation Lower Extremity M <47.50- Tier Tier 3 20 9 — — $30,324.74 $30,324.74 $30,324.74 2026-03-17
D1504 HCPCS Pulmonary M <45.50- Tier Tier 3 20 9 — — $30,284.62 $30,284.62 $30,284.62 2026-03-17
C0304 HCPCS Non-traumatic Brain Injury M <42.50 And A >=78.50- Tier Tier 2 20 9 — — $30,174.72 $30,174.72 $30,174.72 2026-03-17
C0904 HCPCS Other Orthopedic M <44.5- Tier Tier 2 20 9 — — $29,921.78 $29,921.78 $29,921.78 2026-03-17
D0704 HCPCS Fracture Of Lower Extremity M <41.50- Tier Tier 3 20 9 — — $29,749.09 $29,749.09 $29,749.09 2026-03-17
A1805 HCPCS Major Multiple Trauma With Brain Or Spinal Cord Injury M >=30.50 And M <40.50- T… 20 9 — — $29,681.05 $29,681.05 $29,681.05 2026-03-17
D0805 HCPCS Replacement Of Lower-extremity Joint M <42.50- Tier Tier 3 20 9 — — $26,305.63 $32,762.57 $29,534.10 2026-03-17
C1404 HCPCS Cardiac M <45.50- Tier Tier 2 20 9 — — $29,487.43 $29,487.43 $29,487.43 2026-03-17
C0504 HCPCS Non-traumatic Spinal Cord Injury M >=39.50 And M <48.50- Tier Tier 2 20 9 — — $29,457.77 $29,457.77 $29,457.77 2026-03-17
C2004 HCPCS Miscellaneous M <46.50 And A >=77.50- Tier Tier 2 20 9 — — $29,361.83 $29,361.83 $29,361.83 2026-03-17
A0104 HCPCS Stroke M >=41.50 And M <50.50- Tier None 20 9 — — $26,923.15 $31,405.70 $29,164.42 2026-03-17
C2003 HCPCS Miscellaneous M >=46.50 And M <55.50- Tier Tier 2 20 9 — — $28,918.56 $28,918.56 $28,918.56 2026-03-17
D2005 HCPCS Miscellaneous M <46.50 And A <77.50- Tier Tier 3 20 9 — — $28,911.77 $28,911.77 $28,911.77 2026-03-17
A0305 HCPCS Non-traumatic Brain Injury M <42.50 And A <78.50- Tier None 20 9 — — $28,236.09 $28,812.34 $28,524.22 2026-03-17
D0104 HCPCS Stroke M >=41.50 And M <50.50- Tier Tier 3 20 9 — — $28,250.64 $28,250.64 $28,250.64 2026-03-17
D1704 HCPCS Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=36.50 And M <41.50… 20 9 — — $28,057.01 $28,057.01 $28,057.01 2026-03-17
D0904 HCPCS Other Orthopedic M <44.5- Tier Tier 3 20 9 — — $27,889.55 $27,889.55 $27,889.55 2026-03-17
D0504 HCPCS Non-traumatic Spinal Cord Injury M >=39.50 And M <48.50- Tier Tier 3 20 9 — — $27,830.24 $27,830.24 $27,830.24 2026-03-17
D2004 HCPCS Miscellaneous M <46.50 And A >=77.50- Tier Tier 3 20 9 — — $27,429.03 $27,429.03 $27,429.03 2026-03-17
D1404 HCPCS Cardiac M <45.50- Tier Tier 3 20 9 — — $27,416.82 $27,416.82 $27,416.82 2026-03-17
A0604 HCPCS Neurological M <43.50- Tier None 20 9 — — $27,383.67 $27,383.67 $27,383.67 2026-03-17
A0704 HCPCS Fracture Of Lower Extremity M <41.50- Tier None 20 9 — — $26,935.15 $27,484.85 $27,210.00 2026-03-17
A1004 HCPCS Amputation Lower Extremity M <47.50- Tier None 20 9 — — $27,169.11 $27,169.11 $27,169.11 2026-03-17
D0204 HCPCS Traumatic Brain Injury M >=35.50 And M <49.50- Tier Tier 3 20 9 — — $26,879.54 $26,879.54 $26,879.54 2026-03-17
D1804 HCPCS Major Multiple Trauma With Brain Or Spinal Cord Injury M >=40.50 And M <45.50- T… 20 9 — — $26,403.32 $26,403.32 $26,403.32 2026-03-17
A2005 HCPCS Miscellaneous M <46.50 And A <77.50- Tier None 20 9 — — $26,316.10 $26,316.10 $26,316.10 2026-03-17
A0504 HCPCS Non-traumatic Spinal Cord Injury M >=39.50 And M <48.50- Tier None 20 9 — — $25,646.25 $25,646.25 $25,646.25 2026-03-17
A0904 HCPCS Other Orthopedic M <44.5- Tier None 20 9 — — $25,517.16 $25,517.16 $25,517.16 2026-03-17
A0204 HCPCS Traumatic Brain Injury M >=35.50 And M <49.50- Tier None 20 9 — — $25,307.83 $25,307.83 $25,307.83 2026-03-17
A1404 HCPCS Cardiac M <45.50- Tier None 20 9 — — $25,227.59 $25,227.59 $25,227.59 2026-03-17
A2004 HCPCS Miscellaneous M <46.50 And A >=77.50- Tier None 20 9 — — $24,965.93 $24,965.93 $24,965.93 2026-03-17
C0503 HCPCS Non-traumatic Spinal Cord Injury M >=48.50 And M <53.50- Tier Tier 2 20 9 — — $24,781.02 $24,781.02 $24,781.02 2026-03-17
A0805 HCPCS Replacement Of Lower-extremity Joint M <42.50- Tier None 20 9 — — $24,535.06 $24,535.06 $24,535.06 2026-03-17
A1804 HCPCS Major Multiple Trauma With Brain Or Spinal Cord Injury M >=40.50 And M <45.50- T… 20 9 — — $24,480.98 $24,480.98 $24,480.98 2026-03-17
A0303 HCPCS Non-traumatic Brain Injury M >=42.50 And M <52.50- Tier None 20 9 — — $22,532.48 $26,292.06 $24,412.27 2026-03-17
D0703 HCPCS Fracture Of Lower Extremity M >=41.50 And M <52.50- Tier Tier 3 20 9 — — $24,351.90 $24,351.90 $24,351.90 2026-03-17
D0205 HCPCS Traumatic Brain Injury M <35.50- Tier Tier 3 20 9 — — $7,445.55 $41,193.59 $24,319.57 2026-03-17
D0603 HCPCS Neurological M >=43.50 And M <52.50- Tier Tier 3 20 9 — — $24,210.60 $24,210.60 $24,210.60 2026-03-17
D0804 HCPCS Replacement Of Lower-extremity Joint M >=42.50 And M <51.50- Tier Tier 3 20 9 — — $21,934.15 $26,304.54 $24,119.35 2026-03-17
C1403 HCPCS Cardiac M >=45.50 And M <55.50- Tier Tier 2 20 9 — — $24,065.81 $24,065.81 $24,065.81 2026-03-17
D0303 HCPCS Non-traumatic Brain Injury M >=42.50 And M <52.50- Tier Tier 3 20 9 — — $23,907.07 $23,907.07 $23,907.07 2026-03-17
A0603 HCPCS Neurological M >=43.50 And M <52.50- Tier None 20 9 — — $21,834.72 $25,830.02 $23,832.37 2026-03-17
D0503 HCPCS Non-traumatic Spinal Cord Injury M >=48.50 And M <53.50- Tier Tier 3 20 9 — — $23,411.66 $23,411.66 $23,411.66 2026-03-17
D0903 HCPCS Other Orthopedic M >=44.50 And M <51.50- Tier Tier 3 20 9 — — $23,275.60 $23,275.60 $23,275.60 2026-03-17
D2003 HCPCS Miscellaneous M >=46.50 And M <55.50- Tier Tier 3 20 9 — — $22,940.67 $22,940.67 $22,940.67 2026-03-17
A0703 HCPCS Fracture Of Lower Extremity M >=41.50 And M <52.50- Tier None 20 9 — — $22,499.34 $22,499.34 $22,499.34 2026-03-17
A1703 HCPCS Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=41.50 And M <50.50… 20 9 — — $22,490.62 $22,490.62 $22,490.62 2026-03-17
D1403 HCPCS Cardiac M >=45.50 And M <55.50- Tier Tier 3 20 9 — — $22,375.49 $22,375.49 $22,375.49 2026-03-17
D0203 HCPCS Traumatic Brain Injury M >=49.50 And M <61.50- Tier Tier 3 20 9 — — $21,672.49 $21,672.49 $21,672.49 2026-03-17
A0105 HCPCS Stroke M <41.50 And A >=84.50- Tier None 20 9 — — $9,311.36 $33,667.02 $21,489.19 2026-03-17
A0903 HCPCS Other Orthopedic M >=44.50 And M <51.50- Tier None 20 9 — — $21,295.70 $21,295.70 $21,295.70 2026-03-17
A0103 HCPCS Stroke M >=50.50 And M <63.50- Tier None 20 9 — — $21,095.09 $21,095.09 $21,095.09 2026-03-17
A2003 HCPCS Miscellaneous M >=46.50 And M <55.50- Tier None 20 9 — — $20,880.53 $20,880.53 $20,880.53 2026-03-17
D0103 HCPCS Stroke M >=50.50 And M <63.50- Tier Tier 3 20 9 — — $19,147.00 $22,136.50 $20,641.75 2026-03-17
D0102 HCPCS Stroke M >=63.50 And M <72.50- Tier Tier 3 20 9 — — $20,606.16 $20,606.16 $20,606.16 2026-03-17
A1403 HCPCS Cardiac M >=45.50 And M <55.50- Tier None 20 9 — — $20,589.21 $20,589.21 $20,589.21 2026-03-17
A0804 HCPCS Replacement Of Lower-extremity Joint M >=42.50 And M <51.50- Tier None 20 9 — — $20,456.64 $20,456.64 $20,456.64 2026-03-17
D0502 HCPCS Non-traumatic Spinal Cord Injury M >=53.50 And M <60.50- Tier Tier 3 20 9 — — $20,425.24 $20,425.24 $20,425.24 2026-03-17
A0203 HCPCS Traumatic Brain Injury M >=49.50 And M <61.50- Tier None 20 9 — — $19,996.22 $20,404.31 $20,200.26 2026-03-17
D0302 HCPCS Non-traumatic Brain Injury M >=52.50 And M <65.50- Tier Tier 3 20 9 — — $19,868.78 $19,868.78 $19,868.78 2026-03-17
D0803 HCPCS Replacement Of Lower-extremity Joint M >=51.50 And M <57.50- Tier Tier 3 20 9 — — $19,577.46 $19,577.46 $19,577.46 2026-03-17
D0602 HCPCS Neurological M >=52.50 And M <64.50- Tier Tier 3 20 9 — — $18,542.79 $20,547.35 $19,545.07 2026-03-17
A0302 HCPCS Non-traumatic Brain Injury M >=52.50 And M <65.50- Tier None 20 9 — — $18,726.19 $18,726.19 $18,726.19 2026-03-17
A0702 HCPCS Fracture Of Lower Extremity M >=52.50 And M <61.50- Tier None 20 9 — — $18,295.32 $18,295.32 $18,295.32 2026-03-17
A0803 HCPCS Replacement Of Lower-extremity Joint M >=51.50 And M <57.50- Tier None 20 9 — — $18,260.43 $18,260.43 $18,260.43 2026-03-17
A0902 HCPCS Other Orthopedic M >=51.50 And M <63.50- Tier None 20 9 — — $17,833.05 $17,833.05 $17,833.05 2026-03-17
A2002 HCPCS Miscellaneous M >=55.50 And M <66.50- Tier None 20 9 — — $17,437.07 $17,437.07 $17,437.07 2026-03-17
A2001 HCPCS Miscellaneous M >=66.50- Tier None 20 9 — — $16,887.02 $16,887.02 $16,887.02 2026-03-17
A0301 HCPCS Non-traumatic Brain Injury M >=65.50- Tier None 20 9 — — $14,483.80 $14,483.80 $14,483.80 2026-03-17
0545 RC Ambulance - Air Ambulance 1 1 — — $2,300.00 $2,300.00 $2,300.00 2026-03-17
0128 RC Room & Board - Semi-private (Two Beds) - Rehabilitation 19 8 — — $1,200.00 $1,200.00 $1,200.00 2026-03-17
0148 RC Room & Board - Deluxe Private - Rehabilitation 19 8 — — $1,170.00 $1,170.00 $1,170.00 2026-03-17
0158 RC Room & Board - Ward - Rehabilitation 19 8 — — $1,170.00 $1,170.00 $1,170.00 2026-03-17
0138 RC Room & Board - Three And Four Beds - Rehabilitation 19 8 — — $1,150.00 $1,150.00 $1,150.00 2026-03-17
0118 RC Room & Board - Private (One Bed) - Rehabilitation 19 8 — — $824.50 $1,103.00 $1,103.00 2026-03-17
0805 RC Inpatient Renal Dialysis - Treatment 3 2 — — $500.00 $600.00 $500.00 2026-03-17
0808 RC Inpatient Renal Dialysis - Other 3 2 — — $500.00 $600.00 $500.00 2026-03-17
0807 RC Inpatient Renal Dialysis - Observation/Hourly 3 2 — — $500.00 $600.00 $500.00 2026-03-17
0806 RC Inpatient Renal Dialysis - Continuation 3 2 — — $500.00 $600.00 $500.00 2026-03-17
0809 RC Inpatient Renal Dialysis - Other 11 5 — — $350.00 $600.00 $475.00 2026-03-17
0804 RC Inpatient Renal Dialysis - Continuous Cycling Peritoneal Dialysis (ccpd) 11 5 — — $350.00 $600.00 $475.00 2026-03-17
0803 RC Inpatient Renal Dialysis - Continuous Ambulatory Peritoneal Dialysis (capd) 11 5 — — $350.00 $600.00 $475.00 2026-03-17
0800 RC Inpatient Renal Dialysis - General Classification 9 4 — — $350.00 $600.00 $475.00 2026-03-17
0802 RC Inpatient Renal Dialysis - Peritoneal Dialysis (non-capd) 11 5 — — $350.00 $600.00 $475.00 2026-03-17
0801 RC Inpatient Renal Dialysis - Hemodialysis 13 5 — — $338.00 $600.00 $469.00 2026-03-17
0547 RC Ambulance - Pharmacy 1 1 — — $350.00 $350.00 $350.00 2026-03-17
0549 RC Ambulance - Other 1 1 — — $350.00 $350.00 $350.00 2026-03-17
0546 RC Ambulance - Neonatal Ambulance 1 1 — — $350.00 $350.00 $350.00 2026-03-17
0543 RC Ambulance - Heart Mobile 1 1 — — $350.00 $350.00 $350.00 2026-03-17
0542 RC Ambulance - Medical Transport 1 1 — — $350.00 $350.00 $350.00 2026-03-17
0548 RC Ambulance - EKG Transmission 1 1 — — $350.00 $350.00 $350.00 2026-03-17
0540 RC Ambulance - General Classification 1 1 — — $350.00 $350.00 $350.00 2026-03-17
92523 HCPCS Speech Sound Lang Comprehen 38 15 — — $77.25 $299.00 $188.12 2026-03-17
92507 HCPCS Speech/hearing Therapy 38 15 — — $77.25 $239.20 $158.22 2026-03-17
97165 HCPCS Ot Eval Low Complex 30 Min 38 15 — — $77.25 $209.30 $143.28 2026-03-17
97113 HCPCS Aquatic Therapy/exercises 37 15 — — $77.25 $179.88 $128.56 2026-03-17
97166 HCPCS Ot Eval Mod Complex 45 Min 38 15 — — $77.25 $167.01 $122.13 2026-03-17
97162 HCPCS Pt Eval Mod Complex 30 Min 38 15 — — $77.25 $165.46 $121.36 2026-03-17
92522 HCPCS Evaluate Speech Production 37 15 — — $77.25 $150.00 $113.62 2026-03-17
97168 HCPCS Ot Re-eval Est Plan Care 37 15 — — $77.25 $150.00 $113.62 2026-03-17
97167 HCPCS Ot Eval High Complex 60 Min 37 15 — — $77.25 $150.00 $113.62 2026-03-17
97163 HCPCS Pt Eval High Complex 45 Min 38 15 — — $77.25 $150.00 $113.62 2026-03-17
97161 HCPCS Pt Eval Low Complex 20 Min 38 15 — — $77.25 $150.00 $113.62 2026-03-17
97164 HCPCS Pt Re-eval Est Plan Care 38 15 — — $77.25 $150.00 $113.62 2026-03-17
92524 HCPCS Behavral Qualit Analys Voice 37 15 — — $77.25 $150.00 $113.62 2026-03-17
96105 HCPCS Assessment Of Aphasia 37 15 — — $77.25 $150.00 $113.62 2026-03-17
0449 RC Speech Therapy - Language Pathology - Other 10 4 — — $100.00 $110.00 $107.00 2026-03-17
0429 RC Physical Therapy - Other 10 4 — — $100.00 $110.00 $107.00 2026-03-17
0423 RC Physical Therapy - Group Rate 10 4 — — $100.00 $110.00 $107.00 2026-03-17
0433 RC Occupational Therapy - Group Rate 10 4 — — $100.00 $110.00 $107.00 2026-03-17
0422 RC Physical Therapy - Hourly Charge 10 4 — — $100.00 $110.00 $107.00 2026-03-17
0432 RC Occupational Therapy - Hourly Charge 10 4 — — $100.00 $110.00 $107.00 2026-03-17
0442 RC Speech Therapy - Language Pathology - Hourly Charge 10 4 — — $100.00 $110.00 $107.00 2026-03-17
0439 RC Occupational Therapy - Other 10 4 — — $100.00 $110.00 $107.00 2026-03-17
0443 RC Speech Therapy - Language Pathology - Group Rate 10 4 — — $100.00 $110.00 $107.00 2026-03-17
0446 RC Speech-language Pathology - Continuation 7 3 — — $100.00 $110.00 $105.00 2026-03-17
0448 RC Speech-language Pathology - Other 7 3 — — $100.00 $110.00 $105.00 2026-03-17
0445 RC Speech-language Pathology - Treatment 7 3 — — $100.00 $110.00 $105.00 2026-03-17
0436 RC Occupational Therapy - Continuation 7 3 — — $100.00 $110.00 $105.00 2026-03-17
0437 RC Occupational Therapy - Observation/Hourly 7 3 — — $100.00 $110.00 $105.00 2026-03-17
0427 RC Physical Therapy - Observation/Hourly 7 3 — — $100.00 $110.00 $105.00 2026-03-17
0438 RC Occupational Therapy - Other 7 3 — — $100.00 $110.00 $105.00 2026-03-17
0425 RC Physical Therapy - Treatment 7 3 — — $100.00 $110.00 $105.00 2026-03-17
0428 RC Physical Therapy - Other 7 3 — — $100.00 $110.00 $105.00 2026-03-17
0426 RC Physical Therapy - Continuation 7 3 — — $100.00 $110.00 $105.00 2026-03-17
0435 RC Occupational Therapy - Treatment 7 3 — — $100.00 $110.00 $105.00 2026-03-17
0447 RC Speech-language Pathology - Observation/Hourly 7 3 — — $100.00 $110.00 $105.00 2026-03-17
97130 HCPCS Ther Ivntj Ea Addl 15 Min 36 14 — — $19.32 $179.40 $99.36 2026-03-17
95992 HCPCS Canalith Repositioning Proc 36 14 — — $77.25 $110.83 $94.04 2026-03-17
0444 RC Speech Therapy - Language Pathology - Evaluation Or Reevaluation 53 16 — — $19.32 $150.00 $84.66 2026-03-17
0434 RC Occupational Therapy - Evaluation Or Reevaluation 54 16 — — $19.32 $150.00 $84.66 2026-03-17
0424 RC Physical Therapy - Evaluation Or Re-evaluation 54 16 — — $19.32 $150.00 $84.66 2026-03-17
92607 HCPCS Ex For Speech Device Rx 1hr 37 15 — — $77.25 $90.00 $83.62 2026-03-17
92526 HCPCS Oral Function Therapy 38 15 — — $77.25 $90.00 $83.62 2026-03-17
97537 HCPCS Community/work Reintegration 37 15 — — $77.25 $90.00 $83.62 2026-03-17
92606 HCPCS Non-speech Device Service 5 2 — — $77.25 $90.00 $77.25 2026-03-17
97012 HCPCS Mechanical Traction Therapy 36 14 — — $77.25 $77.25 $77.25 2026-03-17
96125 HCPCS Cognitive Test By Hc Pro 36 14 — — $77.25 $77.25 $77.25 2026-03-17
90913 HCPCS Bfb Training Ea Addl 15 Min 4 1 — — $77.25 $77.25 $77.25 2026-03-17
20561 HCPCS Ndl Insj Without Njx 3+ Musc 36 14 — — $77.25 $77.25 $77.25 2026-03-17
20560 HCPCS Ndl Insj Without Njx 1 Or 2 Musc 36 14 — — $77.25 $77.25 $77.25 2026-03-17
97761 HCPCS Prosthetic Traing 1st Enc 36 14 — — $77.25 $77.25 $77.25 2026-03-17
97760 HCPCS Orthotic Mgmt&traing 1st Enc 36 14 — — $77.25 $77.25 $77.25 2026-03-17
97763 HCPCS Orthc/prostc Mgmt Sbsq Enc 36 14 — — $77.25 $77.25 $77.25 2026-03-17
97551 HCPCS Caregiver Traing Ea Addl 15 4 1 — — $77.25 $77.25 $77.25 2026-03-17
97750 HCPCS Physical Performance Test 36 14 — — $77.25 $77.25 $77.25 2026-03-17
92605 HCPCS Ex For Nonspeech Device Rx 5 2 — — $77.25 $90.00 $77.25 2026-03-17
92597 HCPCS Oral Speech Device Eval 5 2 — — $77.25 $90.00 $77.25 2026-03-17
92608 HCPCS Ex For Speech Device Rx Addl 4 1 — — $77.25 $77.25 $77.25 2026-03-17
92521 HCPCS Evaluation Of Speech Fluency 5 2 — — $77.25 $150.00 $77.25 2026-03-17
92609 HCPCS Use Of Speech Device Service 36 14 — — $77.25 $77.25 $77.25 2026-03-17
97033 HCPCS App Mdlty 1+iontphrsis Ea 15 36 14 — — $77.25 $77.25 $77.25 2026-03-17
90912 HCPCS Bfb Training 1st 15 Min 4 1 — — $77.25 $77.25 $77.25 2026-03-17
90901 HCPCS Biofeedback Train Any Meth 4 1 — — $77.25 $77.25 $77.25 2026-03-17
92610 HCPCS Evaluate Swallowing Function 37 14 — — $77.25 $77.25 $77.25 2026-03-17
0441 RC Speech Therapy - Language Pathology - Visit Charge 18 5 — — $31.00 $110.00 $70.50 2026-03-17
0431 RC Occupational Therapy - Visit Charge 18 5 — — $31.00 $110.00 $70.50 2026-03-17
97124 HCPCS Massage Therapy 37 15 — — $49.39 $90.00 $69.69 2026-03-17
0440 RC Speech Therapy - Language Pathology - General Classification 55 17 — — $19.32 $120.00 $69.66 2026-03-17
0430 RC Occupational Therapy - General Classification 55 17 — — $19.32 $120.00 $69.66 2026-03-17
0420 RC Physical Therapy - General Classification 55 17 — — $19.32 $120.00 $69.66 2026-03-17
0410 RC Respiratory Services - General Classification 38 15 — — $19.32 $120.00 $69.66 2026-03-17
97112 HCPCS Neuromuscular Reeducation 38 15 — — $19.32 $110.74 $65.03 2026-03-17
0421 RC Physical Therapy - Visit Charge 53 15 — — $19.32 $110.00 $64.66 2026-03-17
97110 HCPCS Therapeutic Exercises 38 15 — — $19.32 $96.70 $58.01 2026-03-17
97032 HCPCS Appl Modality 1+estim Ea 15 37 15 — — $23.86 $90.00 $56.93 2026-03-17
97535 HCPCS Self Care Mngment Training 38 15 — — $19.32 $90.00 $54.66 2026-03-17
97530 HCPCS Therapeutic Activities 38 15 — — $19.32 $90.00 $54.66 2026-03-17
97129 HCPCS Ther Ivntj 1st 15 Min 37 15 — — $19.32 $90.00 $54.66 2026-03-17
97116 HCPCS Gait Training Therapy 38 15 — — $19.32 $90.00 $54.66 2026-03-17
97140 HCPCS Manual Therapy 1/> Regions 37 15 — — $19.32 $90.00 $54.66 2026-03-17
97533 HCPCS Sensory Integration 36 14 — — $29.82 $77.25 $53.53 2026-03-17
94003 HCPCS Vent Mgmt Inpat Subq Day 37 14 — — $19.32 $19.32 $19.32 2026-03-17
0301 RC Laboratory - Chemistry 40 14 — — $19.32 $19.32 $19.32 2026-03-17
0300 RC Laboratory - General Classification 40 14 — — $19.32 $19.32 $19.32 2026-03-17
29130 HCPCS Application Of Finger Splint 36 14 — — $19.32 $19.32 $19.32 2026-03-17
29126 HCPCS Apply Forearm Splint 36 14 — — $19.32 $19.32 $19.32 2026-03-17
29125 HCPCS Apply Forearm Splint 37 14 — — $19.32 $19.32 $19.32 2026-03-17
99499 HCPCS Unlisted E&m Service 36 14 — — $19.32 $19.32 $19.32 2026-03-17
97550 HCPCS Caregiver Traing 1st 30 Min 36 14 — — $19.32 $19.32 $19.32 2026-03-17
99199 HCPCS Unlisted Special Svc Px/rprt 37 14 — — $19.32 $19.32 $19.32 2026-03-17
97542 HCPCS Wheelchair Mngment Training 36 14 — — $19.32 $19.32 $19.32 2026-03-17
99223 HCPCS 1st Hosp Ip/obs High 75 36 14 — — $19.32 $19.32 $19.32 2026-03-17
97035 HCPCS App Mdlty 1+ultrasound Ea 15 36 14 — — $19.32 $19.32 $19.32 2026-03-17
97014 HCPCS Electric Stimulation Therapy 36 14 — — $19.32 $19.32 $19.32 2026-03-17
94002 HCPCS Vent Mgmt Inpat Init Day 37 14 — — $19.32 $19.32 $19.32 2026-03-17
93970 HCPCS Extremity Study 37 14 — — $19.32 $19.32 $19.32 2026-03-17
93926 HCPCS Lower Extremity Study 37 14 — — $19.32 $19.32 $19.32 2026-03-17
93971 HCPCS Extremity Study 37 14 — — $19.32 $19.32 $19.32 2026-03-17
99231 HCPCS Sbsq Hosp Ip/obs Sf/low 25 36 14 — — $19.32 $19.32 $19.32 2026-03-17
99232 HCPCS Sbsq Hosp Ip/obs Moderate 35 36 14 — — $19.32 $19.32 $19.32 2026-03-17
71046 HCPCS X-ray Exam Chest 2 Views 37 14 — — $19.32 $19.32 $19.32 2026-03-17
90935 HCPCS Hemodialysis One Evaluation 37 14 — — $19.32 $19.32 $19.32 2026-03-17
87635 HCPCS Sars-cov-2 Covid-19 Amp Prb 37 14 — — $19.32 $19.32 $19.32 2026-03-17
87086 HCPCS Urine Culture/colony Count 37 14 — — $19.32 $19.32 $19.32 2026-03-17
87493 HCPCS C Diff Amplified Probe 36 14 — — $19.32 $19.32 $19.32 2026-03-17
87040 HCPCS Blood Culture For Bacteria 37 14 — — $19.32 $19.32 $19.32 2026-03-17
85027 HCPCS Complete Cbc Automated 37 14 — — $19.32 $19.32 $19.32 2026-03-17
11721 HCPCS Debride Nail 6 Or More 36 14 — — $19.32 $19.32 $19.32 2026-03-17
85610 HCPCS Prothrombin Time 37 14 — — $19.32 $19.32 $19.32 2026-03-17
87070 HCPCS Culture Othr Specimn Aerobic 37 14 — — $19.32 $19.32 $19.32 2026-03-17
84145 HCPCS Procalcitonin (pct) 37 14 — — $19.32 $19.32 $19.32 2026-03-17
83880 HCPCS Assay Of Natriuretic Peptide 37 14 — — $19.32 $19.32 $19.32 2026-03-17
84443 HCPCS Assay Thyroid Stim Hormone 37 14 — — $19.32 $19.32 $19.32 2026-03-17
82962 HCPCS Glucose Blood Test 36 14 — — $19.32 $19.32 $19.32 2026-03-17
82805 HCPCS Blood Gases W/o2 Saturation 37 14 — — $19.32 $19.32 $19.32 2026-03-17
83036 HCPCS Hemoglobin Glycosylated A1c 37 14 — — $19.32 $19.32 $19.32 2026-03-17
84481 HCPCS Free Assay (ft-3) 37 14 — — $19.32 $19.32 $19.32 2026-03-17
80202 HCPCS Assay Of Vancomycin 37 14 — — $19.32 $19.32 $19.32 2026-03-17
80048 HCPCS Metabolic Panel Total Ca 37 14 — — $19.32 $19.32 $19.32 2026-03-17
81001 HCPCS Urinalysis Auto W/scope 37 14 — — $19.32 $19.32 $19.32 2026-03-17
73560 HCPCS X-ray Exam Of Knee 1 Or 2 37 14 — — $19.32 $19.32 $19.32 2026-03-17
73100 HCPCS X-ray Exam Of Wrist 37 14 — — $19.32 $19.32 $19.32 2026-03-17
73610 HCPCS X-ray Exam Of Ankle 37 14 — — $19.32 $19.32 $19.32 2026-03-17
72170 HCPCS X-ray Exam Of Pelvis 37 14 — — $19.32 $19.32 $19.32 2026-03-17
72158 HCPCS MRI Lumbar Spine Without & With Contrast 36 14 — — $19.32 $19.32 $19.32 2026-03-17
73030 HCPCS X-ray Exam Of Shoulder 37 14 — — $19.32 $19.32 $19.32 2026-03-17
74018 HCPCS X-ray Exam Abdomen 1 View 37 14 — — $19.32 $19.32 $19.32 2026-03-17
74177 HCPCS CT Abd & Pelv W/contrast 37 14 — — $19.32 $19.32 $19.32 2026-03-17
76700 HCPCS US Exam Abdom Complete 37 14 — — $19.32 $19.32 $19.32 2026-03-17
80053 HCPCS Comprehen Metabolic Panel 37 14 — — $19.32 $19.32 $19.32 2026-03-17
80069 HCPCS Renal Function Panel 37 14 — — $19.32 $19.32 $19.32 2026-03-17
82728 HCPCS Assay Of Ferritin 37 14 — — $19.32 $19.32 $19.32 2026-03-17
82803 HCPCS Blood Gases Any Combination 37 14 — — $19.32 $19.32 $19.32 2026-03-17
82945 HCPCS Glucose Other Fluid 37 14 — — $19.32 $19.32 $19.32 2026-03-17
82948 HCPCS Reagent Strip/blood Glucose 37 14 — — $19.32 $19.32 $19.32 2026-03-17
83735 HCPCS Assay Of Magnesium 37 14 — — $19.32 $19.32 $19.32 2026-03-17
70470 HCPCS CT Head/brain Without & With Contrast 36 14 — — $19.32 $19.32 $19.32 2026-03-17
84100 HCPCS Assay Of Phosphorus 37 14 — — $19.32 $19.32 $19.32 2026-03-17
84134 HCPCS Assay Of Prealbumin 37 14 — — $19.32 $19.32 $19.32 2026-03-17
82330 HCPCS Assay Of Calcium 37 14 — — $19.32 $19.32 $19.32 2026-03-17
85025 HCPCS Complete Cbc W/auto Diff Wbc 37 14 — — $19.32 $19.32 $19.32 2026-03-17
86140 HCPCS C-reactive Protein 37 14 — — $19.32 $19.32 $19.32 2026-03-17
86905 HCPCS Blood Typing Rbc Antigens 37 14 — — $19.32 $19.32 $19.32 2026-03-17
92612 HCPCS Endoscopy Swallow (fees) Vid 36 14 — — $19.32 $19.32 $19.32 2026-03-17
87340 HCPCS Hepatitis B Surface Ag Ia 37 14 — — $19.32 $19.32 $19.32 2026-03-17
87633 HCPCS Resp Virus 12-25 Targets 36 14 — — $19.32 $19.32 $19.32 2026-03-17
71045 HCPCS X-ray Exam Chest 1 View 37 14 — — $19.32 $19.32 $19.32 2026-03-17
97018 HCPCS Paraffin Bath Therapy 36 14 — — $9.32 $19.32 $14.32 2026-03-17
66625 HCPCS Removal Of Iris 0 0 — — — — — 2026-03-17
66500 HCPCS Incision Of Iris 0 0 — — — — — 2026-03-17
36600 HCPCS Withdrawal Of Arterial Blood 0 0 — — — — — 2026-03-17
66250 HCPCS Follow-up Surgery Of Eye 0 0 — — — — — 2026-03-17
66180 HCPCS Aqueous Shunt Eye W/graft 0 0 — — — — — 2026-03-17
36597 HCPCS Reposition Venous Catheter 0 0 — — — — — 2026-03-17
25608 HCPCS Treat Fx Rad Intra-articul 0 0 — — — — — 2026-03-17
66170 HCPCS Glaucoma Surgery 0 0 — — — — — 2026-03-17
65820 HCPCS Relieve Inner Eye Pressure 0 0 — — — — — 2026-03-17
36590 HCPCS Removal Tunneled Cv Cath 0 0 — — — — — 2026-03-17
65756 HCPCS Corneal Trnspl Endothelial 0 0 — — — — — 2026-03-17
65755 HCPCS Corneal Transplant 0 0 — — — — — 2026-03-17
36589 HCPCS Removal Tunneled Cv Cath 0 0 — — — — — 2026-03-17
25607 HCPCS Treat Fx Rad Extra-articul 0 0 — — — — — 2026-03-17
19083 HCPCS Bx Breast 1st Lesion US Imag 0 0 — — — — — 2026-03-17
65730 HCPCS Corneal Transplant 0 0 — — — — — 2026-03-17
65426 HCPCS Removal Of Eye Lesion 0 0 — — — — — 2026-03-17
36573 HCPCS Insj Picc Rs&i 5 Yr+ 0 0 — — — — — 2026-03-17
64721 HCPCS Carpal Tunnel Surgery 0 0 — — — — — 2026-03-17
64718 HCPCS Revise Ulnar Nerve At Elbow 0 0 — — — — — 2026-03-17
36569 HCPCS Insj Picc 5 Yr+ Without Imaging 0 0 — — — — — 2026-03-17
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