Price Transparencybeta Hospital negotiated rates

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

CUBA MEMORIAL HOSPITAL, INC

Cuba, NY · CCN 331301 · Rates published

15,014 distinct procedures filed
24 distinct payers
115,852 rate rows
2026-04-16 last MRF observed
Data quality

63,978 of 115,852 rate rows are consumer-grade (55.2%)

51,874 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 51,829
placeholder amount (≤ $0.02) — excluded from medians 45
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://cumberlandhealthcare.com/wp-content/uploads/2026/04/390831153_cumberland-memorial-hospital_standardcharges.csv
Found on page https://cumberlandhealthcare.com/patients-visitors/price-transparency/
Discovered viaCMS hospital list
Last fetch not_modified · 2026-05-17
Content fingerprint 4d78934a5f4da77f… · 11,323,328 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
J1411
HCPCS 		Inj, Hemgenix, Per Tx Dose 2 $3,499,860.00 $3,710,000.00 $3,570,000.00 nat. median
$3,710,000
1.0× median
J1414
HCPCS 		Inj, Beqvez, Per Tx Dose 1 $3,570,000.00 $3,570,000.00 $3,570,000.00 nat. median
$3,710,000
1.0× median
C9172
HCPCS 		Inj, Beqvez, Per Tx Dose 1 $3,570,000.00 $3,570,000.00 $3,570,000.00 nat. median
$3,570,000
1.0× median
J1413
HCPCS 		Inj Delandistrogene Mox Rokl 2 $3,199,872.00 $3,392,000.00 $3,264,000.00 nat. median
$3,325,455
1.0× median
J3394
HCPCS 		Inj, Lovotibeglogene Autotem 1 $3,162,000.00 $3,162,000.00 $3,162,000.00 nat. median
$3,286,000
1.0× median
J3393
HCPCS 		Inj, Betibeglogene Autotemce 1 $2,856,000.00 $2,856,000.00 $2,856,000.00 nat. median
$3,004,655
1.0× median
J3399
HCPCS 		Inj Onase Abepar-xioi Treat 2 $2,254,321.82 $2,389,676.72 $2,368,485.25 nat. median
$2,468,984
1.0× median
J3392
HCPCS 		Inj, Exagamglogene Autotem 1 $2,244,000.00 $2,244,000.00 $2,244,000.00 nat. median
$2,448,600
0.9× median
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 1 $533,607.40 $640,328.88 $586,968.14 nat. median
$753,246
0.8× median
Q2056
HCPCS 		Ciltacabtagene Car-pos T 2 $478,930.84 $624,133.97 $520,111.64 nat. median
$674,867
0.8× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 2 $457,236.71 $598,089.54 $498,407.95 nat. median
$625,184
0.8× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 2 $447,209.11 $584,701.10 $487,250.92 nat. median
$673,137
0.7× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 2 $423,983.04 $554,170.37 $461,808.63 nat. median
$634,303
0.7× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 2 $423,983.04 $552,511.14 $460,425.95 nat. median
$619,808
0.7× median
A9543
HCPCS 		Y90 Ibritumomab, Rx 2 $52,924.85 $66,156.06 $64,241.18 nat. median
$62,507
1.0× median
Q0480
HCPCS 		Driver Pneumatic Vad, Rep 1 $60,762.30 $60,762.30 $60,762.30 nat. median
$111,989
0.5× median
J9029
HCPCS 		Inj, Adstiladrin, Per Tx Dos 2 $56,247.75 $71,775.91 $59,813.25 nat. median
$69,774
0.9× median
J7330
HCPCS 		Cultured Chondrocytes Implnt 2 $53,297.04 $61,878.30 $56,732.71 nat. median
$76,329
0.7× median
90288
HCPCS 		Botulism Ig IV 1 $48,705.00 $63,030.00 $55,867.50 nat. median
$55,037
1.0× median
560
MS_DRG 		Aftercare, Musculoskeletal System And Connective Tissue With Cc 1 $54,966.40 $54,966.40 $54,966.40 nat. median
$12,148
outlier · 4.5×
Q2043
HCPCS 		Sipuleucel-t Auto Cd54+ 2 $38,660.45 $62,871.51 $52,932.90 nat. median
$66,682
0.8× median
637
MS_DRG 		Diabetes With Mcc 1 $46,721.44 $46,721.44 $46,721.44 nat. median
$14,787
outlier · 3.2×
J9226
HCPCS 		Supprelin La Implant 2 $42,699.81 $51,239.77 $44,695.10 nat. median
$60,368
0.7× median
C1722
HCPCS 		Aicd, Single Chamber 1 $42,845.60 $42,845.60 $42,845.60 nat. median
$20,770
outlier · 2.1×
682
MS_DRG 		Renal Failure With Mcc 1 $31,837.12 $31,837.12 $31,837.12 nat. median
$15,223
outlier · 2.1×
561
MS_DRG 		Aftercare, Musculoskeletal System And Connective Tissue Without Cc/Mcc 3 $18,192.64 $35,695.99 $30,701.75 nat. median
$9,193
outlier · 3.3×
812
MS_DRG 		Red Blood Cell Disorders Without Mcc 1 $29,250.18 $29,250.18 $29,250.18 nat. median
$9,870
outlier · 3.0×
65
MS_DRG 		Intracranial Hemorrhage Or Cerebral Infarction With Cc Or Tpa In 24 Hours 1 $27,870.95 $27,870.95 $27,870.95 nat. median
$11,174
outlier · 2.5×
536
MS_DRG 		Fractures Of Hip And Pelvis Without Mcc 3 $11,748.00 $34,111.20 $26,986.31 nat. median
$8,981
outlier · 3.0×
375
MS_DRG 		Digestive Malignancy With Cc 1 $26,932.80 $26,932.80 $26,932.80 nat. median
$12,916
outlier · 2.1×
641
MS_DRG 		Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes Withou… 2 $25,398.88 $27,450.00 $26,424.44 nat. median
$8,664
outlier · 3.0×
C1721
HCPCS 		Aicd, Dual Chamber 1 $26,400.00 $26,400.00 $26,400.00 nat. median
$22,213
1.2× median
J9266
HCPCS 		Pegaspargase Injection 2 $25,538.24 $30,645.89 $26,024.68 nat. median
$34,109
0.8× median
559
MS_DRG 		Aftercare, Musculoskeletal System And Connective Tissue With Mcc 2 $20,498.00 $30,660.00 $25,579.00 nat. median
$19,047
1.3× median
947
MS_DRG 		Signs And Symptoms With Mcc 2 $21,462.00 $26,517.99 $23,990.00 nat. median
$12,688
1.9× median
999
MS_DRG 		Ungroupable 6 $4,556.00 $92,417.16 $23,882.20 nat. median
$9,134
outlier · 2.6×
534
MS_DRG 		Fractures Of Femur Without Mcc 1 $23,877.84 $23,877.84 $23,877.84 nat. median
$8,990
outlier · 2.7×
J9600
HCPCS 		Porfimer Sodium Injection 2 $22,751.10 $23,789.46 $23,716.38 nat. median
$31,627
0.7× median
548
MS_DRG 		Septic Arthritis With Mcc 1 $22,740.80 $22,740.80 $22,740.80 nat. median
$19,687
1.2× median
950
MS_DRG 		Aftercare Without Cc/Mcc 1 $22,224.02 $22,224.02 $22,224.02 nat. median
$7,552
outlier · 2.9×
557
MS_DRG 		Tendonitis, Myositis And Bursitis With Mcc 1 $21,136.00 $21,136.00 $21,136.00 nat. median
$15,338
1.4× median
C1083
HCPCS 		Yttrium 90 Ibritumomab Tiuxetan 1 $20,787.81 $20,787.81 $20,787.81 nat. median
$20,788
1.0× median
871
MS_DRG 		Septicemia Or Severe Sepsis Without Mv >96 Hours With Mcc 2 $9,524.58 $30,822.50 $20,173.54 nat. median
$19,634
1.0× median
949
MS_DRG 		Aftercare With Cc/Mcc 1 $19,995.20 $19,995.20 $19,995.20 nat. median
$12,475
1.6× median
948
MS_DRG 		Signs And Symptoms Without Mcc 2 $19,238.24 $20,636.59 $19,937.42 nat. median
$8,515
outlier · 2.3×
55
MS_DRG 		Nervous System Neoplasms Without Mcc 1 $18,192.64 $18,192.64 $18,192.64 nat. median
$11,401
1.6× median
872
MS_DRG 		Septicemia Or Severe Sepsis Without Mv >96 Hours Without Mcc 2 $11,112.01 $25,014.88 $18,063.44 nat. median
$11,103
1.6× median
C2619
HCPCS 		Pmkr, Dual, Non Rate-resp 1 $16,907.03 $16,907.03 $16,907.03 nat. median
$7,953
outlier · 2.1×
690
MS_DRG 		Kidney And Urinary Tract Infections Without Mcc 1 $16,863.00 $16,863.00 $16,863.00 nat. median
$8,979
1.9× median
558
MS_DRG 		Tendonitis, Myositis And Bursitis Without Mcc 1 $16,860.23 $16,860.23 $16,860.23 nat. median
$9,623
1.8× median

Other procedures at this hospital

Browse this hospital's 15,014 published procedures. Use the slice to choose what to show, then sort or filter any column.

Slice
Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
Code Type Description Rate rows Payers Gross Cash Min $ Max $ Avg median Last observed
             
J1411 HCPCS Inj, Hemgenix, Per Tx Dose 4 2 — — $3,499,860.00 $3,710,000.00 $3,570,000.00 2026-04-01
J1414 HCPCS Inj, Beqvez, Per Tx Dose 2 1 — — $3,570,000.00 $3,570,000.00 $3,570,000.00 2026-04-01
C9172 HCPCS Inj, Beqvez, Per Tx Dose 2 1 — — $3,570,000.00 $3,570,000.00 $3,570,000.00 2026-04-01
J1413 HCPCS Inj Delandistrogene Mox Rokl 4 2 — — $3,199,872.00 $3,392,000.00 $3,264,000.00 2026-04-01
J3394 HCPCS Inj, Lovotibeglogene Autotem 2 1 — — $3,162,000.00 $3,162,000.00 $3,162,000.00 2026-04-01
J3393 HCPCS Inj, Betibeglogene Autotemce 2 1 — — $2,856,000.00 $2,856,000.00 $2,856,000.00 2026-04-01
J3399 HCPCS Inj Onase Abepar-xioi Treat 4 2 — — $2,254,321.82 $2,389,676.72 $2,368,485.25 2026-04-01
J3392 HCPCS Inj, Exagamglogene Autotem 2 1 — — $2,244,000.00 $2,244,000.00 $2,244,000.00 2026-04-01
Q2042 HCPCS Tisagenlecleucel Car-pos T 4 1 — — $533,607.40 $640,328.88 $586,968.14 2026-04-01
Q2056 HCPCS Ciltacabtagene Car-pos T 6 2 — — $478,930.84 $624,133.97 $520,111.64 2026-04-01
Q2055 HCPCS Idecabtagene Vicleucel Car 6 2 — — $457,236.71 $598,089.54 $498,407.95 2026-04-01
Q2054 HCPCS Lisocabtagene Mara Car Pos T 6 2 — — $447,209.11 $584,701.10 $487,250.92 2026-04-01
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 6 2 — — $423,983.04 $554,170.37 $461,808.63 2026-04-01
Q2053 HCPCS Brexucabtagene Car Pos T 6 2 — — $423,983.04 $552,511.14 $460,425.95 2026-04-01
A9543 HCPCS Y90 Ibritumomab, Rx 6 2 — — $52,924.85 $66,156.06 $64,241.18 2026-04-01
Q0480 HCPCS Driver Pneumatic Vad, Rep 1 1 — — $60,762.30 $60,762.30 $60,762.30 2026-04-01
J9029 HCPCS Inj, Adstiladrin, Per Tx Dos 6 2 — — $56,247.75 $71,775.91 $59,813.25 2026-04-01
J7330 HCPCS Cultured Chondrocytes Implnt 6 2 — — $53,297.04 $61,878.30 $56,732.71 2026-04-01
90288 HCPCS Botulism Ig IV 4 1 — — $48,705.00 $63,030.00 $55,867.50 2026-04-01
560 MS_DRG Aftercare, Musculoskeletal System And Connective Tissue With Cc 1 1 — — $54,966.40 $54,966.40 $54,966.40 2026-04-01
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 8 2 — — $38,660.45 $62,871.51 $52,932.90 2026-04-01
637 MS_DRG Diabetes With Mcc 1 1 — — $46,721.44 $46,721.44 $46,721.44 2026-04-01
J9226 HCPCS Supprelin La Implant 6 2 — — $42,699.81 $51,239.77 $44,695.10 2026-04-01
C1722 HCPCS Aicd, Single Chamber 1 1 — — $42,845.60 $42,845.60 $42,845.60 2026-04-01
682 MS_DRG Renal Failure With Mcc 1 1 — — $31,837.12 $31,837.12 $31,837.12 2026-04-01
561 MS_DRG Aftercare, Musculoskeletal System And Connective Tissue Without Cc/Mcc 3 3 — — $18,192.64 $35,695.99 $30,701.75 2026-04-01
812 MS_DRG Red Blood Cell Disorders Without Mcc 1 1 — — $29,250.18 $29,250.18 $29,250.18 2026-04-01
65 MS_DRG Intracranial Hemorrhage Or Cerebral Infarction With Cc Or Tpa In 24 Hours 1 1 — — $27,870.95 $27,870.95 $27,870.95 2026-04-01
536 MS_DRG Fractures Of Hip And Pelvis Without Mcc 3 3 — — $11,748.00 $34,111.20 $26,986.31 2026-04-01
375 MS_DRG Digestive Malignancy With Cc 1 1 — — $26,932.80 $26,932.80 $26,932.80 2026-04-01
641 MS_DRG Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes Withou… 2 2 — — $25,398.88 $27,450.00 $26,424.44 2026-04-01
C1721 HCPCS Aicd, Dual Chamber 1 1 — — $26,400.00 $26,400.00 $26,400.00 2026-04-01
J9266 HCPCS Pegaspargase Injection 6 2 — — $25,538.24 $30,645.89 $26,024.68 2026-04-01
559 MS_DRG Aftercare, Musculoskeletal System And Connective Tissue With Mcc 2 2 — — $20,498.00 $30,660.00 $25,579.00 2026-04-01
947 MS_DRG Signs And Symptoms With Mcc 2 2 — — $21,462.00 $26,517.99 $23,990.00 2026-04-01
999 MS_DRG Ungroupable 6 6 — — $4,556.00 $92,417.16 $23,882.20 2026-04-01
534 MS_DRG Fractures Of Femur Without Mcc 1 1 — — $23,877.84 $23,877.84 $23,877.84 2026-04-01
J9600 HCPCS Porfimer Sodium Injection 4 2 — — $22,751.10 $23,789.46 $23,716.38 2026-04-01
548 MS_DRG Septic Arthritis With Mcc 1 1 — — $22,740.80 $22,740.80 $22,740.80 2026-04-01
950 MS_DRG Aftercare Without Cc/Mcc 1 1 — — $22,224.02 $22,224.02 $22,224.02 2026-04-01
557 MS_DRG Tendonitis, Myositis And Bursitis With Mcc 1 1 — — $21,136.00 $21,136.00 $21,136.00 2026-04-01
C1083 HCPCS Yttrium 90 Ibritumomab Tiuxetan 1 1 — — $20,787.81 $20,787.81 $20,787.81 2026-04-01
871 MS_DRG Septicemia Or Severe Sepsis Without Mv >96 Hours With Mcc 2 2 — — $9,524.58 $30,822.50 $20,173.54 2026-04-01
949 MS_DRG Aftercare With Cc/Mcc 1 1 — — $19,995.20 $19,995.20 $19,995.20 2026-04-01
948 MS_DRG Signs And Symptoms Without Mcc 2 2 — — $19,238.24 $20,636.59 $19,937.42 2026-04-01
55 MS_DRG Nervous System Neoplasms Without Mcc 1 1 — — $18,192.64 $18,192.64 $18,192.64 2026-04-01
872 MS_DRG Septicemia Or Severe Sepsis Without Mv >96 Hours Without Mcc 2 2 — — $11,112.01 $25,014.88 $18,063.44 2026-04-01
C2619 HCPCS Pmkr, Dual, Non Rate-resp 1 1 — — $16,907.03 $16,907.03 $16,907.03 2026-04-01
690 MS_DRG Kidney And Urinary Tract Infections Without Mcc 1 1 — — $16,863.00 $16,863.00 $16,863.00 2026-04-01
558 MS_DRG Tendonitis, Myositis And Bursitis Without Mcc 1 1 — — $16,860.23 $16,860.23 $16,860.23 2026-04-01
A9604 HCPCS Sm 153 Lexidronam 4 2 — — $16,608.54 $17,259.85 $16,608.54 2026-04-01
J7310 HCPCS Ganciclovir Long Act Implant 2 1 — — $16,320.00 $16,320.00 $16,320.00 2026-04-01
607 MS_DRG Minor Skin Disorders Without Mcc 1 1 — — $14,951.25 $14,951.25 $14,951.25 2026-04-01
194 MS_DRG Simple Pneumonia And Pleurisy With Cc 1 1 — — $14,541.00 $14,541.00 $14,541.00 2026-04-01
C1059 HCPCS Description Not Available 1 1 — — $14,250.00 $14,250.00 $14,250.00 2026-04-01
563 MS_DRG Fracture, Sprain, Strain And Dislocation Except Femur, Hip, Pelvis And Thigh Wit… 3 3 — — $10,838.72 $25,014.88 $13,797.00 2026-04-01
Q0483 HCPCS Monitor Elec Vad, Rep 1 1 — — $12,649.38 $12,649.38 $12,649.38 2026-04-01
C9790 HCPCS Kidney Histotripsy W/image 1 1 — — $12,500.50 $12,500.50 $12,500.50 2026-04-01
0686T HCPCS Histotripsy Mal Hepatcel Tis 1 1 — — $12,500.50 $12,500.50 $12,500.50 2026-04-01
683 MS_DRG Renal Failure With Cc 1 1 — — $12,043.02 $12,043.02 $12,043.02 2026-04-01
J1412 HCPCS Inj Roctavian Ml 2x10^13vc G 4 2 — — $11,327.67 $12,007.81 $11,554.69 2026-04-01
378 MS_DRG Gastrointestinal Hemorrhage With Cc 1 1 — — $11,112.01 $11,112.01 $11,112.01 2026-04-01
Q0489 HCPCS Pwr Pck Base Combo Vad, Rep 1 1 — — $10,966.34 $10,966.34 $10,966.34 2026-04-01
184 MS_DRG Major Chest Trauma With Cc 1 1 — — $10,838.72 $10,838.72 $10,838.72 2026-04-01
552 MS_DRG Medical Back Problems Without Mcc 2 2 — — $4,768.00 $16,644.93 $10,706.47 2026-04-01
Q4244 HCPCS Procenta, Per 200 Mg 2 1 — — $10,098.00 $10,494.00 $10,296.00 2026-04-01
Q0481 HCPCS Microprcsr Cu Elec Vad, Rep 1 1 — — $9,803.28 $9,803.28 $9,803.28 2026-04-01
0315U HCPCS Onc Cutan Sq Cll Ca Mrna 40 2 1 — — $9,252.86 $10,330.85 $9,791.85 2026-04-01
C1777 HCPCS Lead Hv Durataactive 7122q/58 1 1 — — $8,995.58 $8,995.58 $8,995.58 2026-04-01
55970 HCPCS Sex Transformation M To F 2 1 — — $8,627.50 $8,627.50 $8,627.50 2026-04-01
190 MS_DRG Chronic Obstructive Pulmonary Disease With Mcc 1 1 — — $8,430.12 $8,430.12 $8,430.12 2026-04-01
J9216 HCPCS Interferon Gamma 1-b Inj 4 2 — — $7,993.20 $8,306.67 $8,304.94 2026-04-01
C8521 HCPCS Description Not Available 1 1 — — $8,182.98 $8,182.98 $8,182.98 2026-04-01
C8505 HCPCS Description Not Available 1 1 — — $8,182.98 $8,182.98 $8,182.98 2026-04-01
310 MS_DRG Cardiac Arrhythmia And Conduction Disorders Without Cc/Mcc 1 1 — — $7,959.28 $7,959.28 $7,959.28 2026-04-01
593 MS_DRG Skin Ulcers With Cc 1 1 — — $7,937.15 $7,937.15 $7,937.15 2026-04-01
81416 HCPCS Exome Sequence Analysis 3 2 — — $7,917.00 $12,000.00 $7,917.00 2026-04-01
C1786 HCPCS Medtronic Micra Av2 Leadless P 1 1 — — $7,760.80 $7,760.80 $7,760.80 2026-04-01
0094U HCPCS Genome Rapid Sequence Alys 5 3 — — $5,002.36 $10,559.35 $7,582.20 2026-04-01
C1764 HCPCS Event Recorder, Cardiac 1 1 — — $7,414.99 $7,414.99 $7,414.99 2026-04-01
81529 HCPCS Onc Cutan Mlnma Mrna 31 Gene 5 3 — — $4,745.58 $9,971.19 $7,193.00 2026-04-01
39503 HCPCS Repair Of Diaphragm Hernia 5 3 — — $1,568.00 $13,475.06 $6,911.32 2026-04-01
Q0224 HCPCS Inj, Pemivibart, 4500 Mg 4 1 — — $6,210.85 $7,453.02 $6,831.94 2026-04-01
J0600 HCPCS Edetate Calcium Disodium Inj 6 2 — — $5,739.72 $6,913.11 $6,756.10 2026-04-01
61698 HCPCS Brain Aneurysm Repr Complx 5 3 — — $1,568.00 $8,225.40 $6,514.68 2026-04-01
61686 HCPCS Intracranial Vessel Surgery 5 3 — — $1,568.00 $10,882.24 $6,326.55 2026-04-01
47135 HCPCS Transplantation Of Liver 5 3 — — $1,568.00 $11,854.52 $6,280.84 2026-04-01
C8511 HCPCS Description Not Available 1 1 — — $6,137.23 $6,137.23 $6,137.23 2026-04-01
61697 HCPCS Brain Aneurysm Repr Complx 5 3 — — $1,568.00 $8,586.53 $5,925.03 2026-04-01
61682 HCPCS Intracranial Vessel Surgery 5 3 — — $1,568.00 $10,307.39 $5,858.03 2026-04-01
A9572 HCPCS Indium In-111 Pentetreotide 3 2 — — $5,789.52 $5,789.52 $5,789.52 2026-04-01
33935 HCPCS Transplantation Heart/lung 5 3 — — $1,568.00 $9,473.80 $5,767.01 2026-04-01
0326U HCPCS Trgt Gen Seq Alys Pnl 83+ 2 1 — — $5,442.86 $6,076.97 $5,759.91 2026-04-01
49605 HCPCS Repair Umbilical Lesion 5 3 — — $1,568.00 $10,990.54 $5,734.24 2026-04-01
32854 HCPCS Lung Transplant With Bypass 5 3 — — $1,568.00 $8,903.54 $5,682.22 2026-04-01
33945 HCPCS Transplantation Of Heart 5 3 — — $1,568.00 $6,679.08 $5,675.16 2026-04-01
61702 HCPCS Inner Skull Vessel Surgery 5 3 — — $1,568.00 $8,042.84 $5,665.77 2026-04-01
J9015 HCPCS Aldesleukin Injection 4 2 — — $5,551.47 $5,662.50 $5,662.50 2026-04-01
61576 HCPCS Skull Base/brainstem Surgery 5 3 — — $1,568.00 $8,937.17 $5,658.31 2026-04-01
0211U HCPCS Onc Pan-tum Dna&rna Gnrj Seq 3 2 — — $5,578.19 $8,455.00 $5,578.19 2026-04-01
C1895 HCPCS Hv Lead 7120q/65 Durata Active 1 1 — — $5,558.59 $5,558.59 $5,558.59 2026-04-01
81554 HCPCS Pulm Ds Ipf Mrna 190 Gen Alg 5 3 — — $3,628.63 $7,624.28 $5,520.00 2026-04-01
20808 HCPCS Replantation Hand Complete 5 3 — — $3,278.00 $10,661.96 $5,499.59 2026-04-01
47142 HCPCS Partial Removal Donor Liver 5 3 — — $1,568.00 $10,694.89 $5,485.01 2026-04-01
G0390 HCPCS Trauma Activation 2 2 $2,366.60 $2,366.60 $2,088.18 $8,874.75 $5,481.47 2026-04-16
46748 HCPCS Repair Of Cloacal Anomaly 5 3 — — $1,568.00 $8,933.95 $5,430.87 2026-04-01
32853 HCPCS Lung Transplant Double 5 3 — — $1,568.00 $8,282.52 $5,355.08 2026-04-01
J0716 HCPCS Centruroides Immune F(ab) 4 2 — — $5,351.02 $5,560.87 $5,351.02 2026-04-01
61520 HCPCS Removal Of Brain Lesion 5 3 — — $1,568.00 $9,122.89 $5,291.00 2026-04-01
43113 HCPCS Removal Of Esophagus 5 3 — — $1,568.00 $5,591.17 $5,282.42 2026-04-01
26554 HCPCS Double Transfer Toe-hand 5 3 — — $2,567.00 $9,718.93 $5,260.94 2026-04-01
G2072 HCPCS Med Tx Insert/remove Imp 2 1 — — $5,260.62 $5,260.62 $5,260.62 2026-04-01
0335U HCPCS Rare Ds Whl Gen Seq Fetal 5 3 — — $3,446.93 $6,588.77 $5,224.60 2026-04-01
37205 HCPCS Transcatheter Stent 2 1 — — $5,215.67 $5,215.67 $5,215.67 2026-04-01
G0261 HCPCS Prostate Brachy W Iodine See 2 1 — — $5,154.34 $5,154.34 $5,154.34 2026-04-01
61692 HCPCS Intracranial Vessel Surgery 5 3 — — $1,568.00 $8,730.43 $5,142.63 2026-04-01
81552 HCPCS Onc Uveal Mlnma Mrna 15 Gene 3 2 — — $5,130.22 $7,776.00 $5,130.22 2026-04-01
A9515 HCPCS Choline C-11 4 2 — — $5,100.00 $5,100.00 $5,100.00 2026-04-01
43108 HCPCS Removal Of Esophagus 5 3 — — $1,568.00 $5,837.50 $5,058.46 2026-04-01
G2070 HCPCS Med Assist Tx Implant 2 1 — — $5,035.11 $5,035.11 $5,035.11 2026-04-01
81425 HCPCS Genome Sequence Analysis 5 3 — — $3,319.33 $6,324.42 $5,031.20 2026-04-01
S5001 HCPCS Prescription Drug,brand Name 2 1 — — $5,024.19 $5,024.19 $5,024.19 2026-04-01
46746 HCPCS Repair Of Cloacal Anomaly 5 3 — — $1,568.00 $8,764.28 $5,010.65 2026-04-01
S5000 HCPCS Prescription Drug, Generic 2 1 — — $5,003.36 $5,003.36 $5,003.36 2026-04-01
J0225 HCPCS Inj, Vutrisiran, 1 Mg 6 2 — — $4,639.39 $5,567.26 $4,995.58 2026-04-01
47141 HCPCS Partial Removal Donor Liver 5 3 — — $1,568.00 $9,696.76 $4,982.19 2026-04-01
J9225 HCPCS Vantas Implant 4 2 — — $4,971.34 $5,166.29 $4,971.34 2026-04-01
43123 HCPCS Partial Removal Of Esophagus 5 3 — — $1,568.00 $5,754.88 $4,963.07 2026-04-01
43116 HCPCS Partial Removal Of Esophagus 5 3 — — $1,568.00 $6,705.89 $4,928.35 2026-04-01
A9582 HCPCS Iodine I-123 Iobenguane 8 2 — — $4,168.46 $7,162.58 $4,902.72 2026-04-01
43288 HCPCS Esphg Thrsc Moblj 5 3 — — $1,568.00 $5,479.00 $4,844.37 2026-04-01
J9219 HCPCS Leuprolide Acetate Implant 2 1 — — $4,831.40 $4,831.40 $4,831.40 2026-04-01
0300U HCPCS Onc Pan Tum Whl Gen Seq&opt 2 1 — — $4,553.64 $5,084.15 $4,818.90 2026-04-01
61700 HCPCS Brain Aneurysm Repr Simple 5 3 — — $1,568.00 $8,577.03 $4,809.30 2026-04-01
J1162 HCPCS Digoxin Immune Fab (ovine) 6 2 — — $4,593.57 $5,739.60 $4,783.00 2026-04-01
61616 HCPCS Resect/excise Lesion Skull 5 3 — — $1,568.00 $7,610.18 $4,774.41 2026-04-01
61526 HCPCS Removal Of Brain Lesion 5 3 — — $1,568.00 $8,506.88 $4,762.77 2026-04-01
43118 HCPCS Partial Removal Of Esophagus 5 3 — — $1,568.00 $4,926.83 $4,706.93 2026-04-01
26556 HCPCS Toe Joint Transfer 5 3 — — $2,854.00 $8,080.20 $4,685.20 2026-04-01
61613 HCPCS Remove Aneurysm Sinus 5 3 — — $1,568.00 $7,166.44 $4,680.02 2026-04-01
61585 HCPCS Orbitocranial Approach/skull 5 3 — — $1,568.00 $6,866.06 $4,660.04 2026-04-01
61608 HCPCS Resect/excise Cranial Lesion 5 3 — — $1,568.00 $7,430.77 $4,647.89 2026-04-01
43287 HCPCS Esphg Dstl 2/3 W/laps Moblj 5 3 — — $1,568.00 $5,237.46 $4,635.97 2026-04-01
G0339 HCPCS Robot Lin-radsurg Com, First 3 2 — — $2,567.00 $4,602.05 $4,602.05 2026-04-01
46744 HCPCS Repair Of Cloacal Anomaly 5 3 — — $1,568.00 $7,732.69 $4,580.40 2026-04-01
20805 HCPCS Replant Forearm Complete 5 3 — — $3,278.00 $8,604.40 $4,547.42 2026-04-01
61592 HCPCS Orbitocranial Approach/skull 5 3 — — $1,568.00 $7,132.05 $4,541.53 2026-04-01
26551 HCPCS Great Toe-hand Transfer 5 3 — — $2,567.00 $8,296.30 $4,538.25 2026-04-01
26553 HCPCS Single Transfer Toe-hand 5 3 — — $2,567.00 $6,969.13 $4,507.64 2026-04-01
61545 HCPCS Excision Of Brain Tumor 5 3 — — $1,568.00 $7,378.10 $4,496.68 2026-04-01
43112 HCPCS Removal Of Esophagus 5 3 — — $1,568.00 $6,599.99 $4,490.55 2026-04-01
A9507 HCPCS In111 Capromab 3 2 — — $3,193.12 $4,483.93 $4,483.93 2026-04-01
J0480 HCPCS Basiliximab 6 2 — — $4,393.54 $5,272.74 $4,476.64 2026-04-01
0306U HCPCS Onc Mrd Nxt-gnrj Alys 1st 2 1 — — $4,221.97 $4,713.84 $4,467.91 2026-04-01
61521 HCPCS Removal Of Brain Lesion 5 3 — — $1,568.00 $7,487.93 $4,463.50 2026-04-01
0267U HCPCS Rare Do Id Opt Gen Mapg&seq 3 2 — — $4,446.27 $6,739.33 $4,446.27 2026-04-01
61591 HCPCS Infratemporal Approach/skull 5 3 — — $1,568.00 $7,561.34 $4,414.36 2026-04-01
61590 HCPCS Infratemporal Approach/skull 5 3 — — $1,568.00 $7,265.04 $4,374.81 2026-04-01
842 MS_DRG Lymphoma And Non-acute Leukemia Without Cc/Mcc 1 1 — — $4,344.00 $4,344.00 $4,344.00 2026-04-01
37210 HCPCS Embolization Uterine Fibroid 2 1 — — $4,342.17 $4,342.17 $4,342.17 2026-04-01
61530 HCPCS Removal Of Brain Lesion 5 3 — — $1,568.00 $7,194.85 $4,334.17 2026-04-01
63251 HCPCS Revise Spinal Cord Vsls Thrc 5 3 — — $1,568.00 $6,962.88 $4,277.31 2026-04-01
63252 HCPCS Revise Spine Cord Vsl Thrlmb 5 3 — — $3,278.00 $6,939.26 $4,276.42 2026-04-01
C9760 HCPCS Non-blind Interatrial Shunt 1 1 — — $4,276.00 $4,276.00 $4,276.00 2026-04-01
0520T HCPCS Rmvl&rplcmt Pg Wcs New Eltrd 1 1 — — $4,276.00 $4,276.00 $4,276.00 2026-04-01
0409T HCPCS Insj/rplc Car Modulj Pls Gn 1 1 — — $4,276.00 $4,276.00 $4,276.00 2026-04-01
0614T HCPCS Rmvl&rplcmt Ss Impl Dfb Pg 1 1 — — $4,276.00 $4,276.00 $4,276.00 2026-04-01
0571T HCPCS Insj/rplcmt Icds Ss Eltrd 1 1 — — $4,276.00 $4,276.00 $4,276.00 2026-04-01
0916T HCPCS Insj Perm Ccm-d Sys Pg Only 1 1 — — $4,276.00 $4,276.00 $4,276.00 2026-04-01
0414T HCPCS Rmvl & Rpl Car Modulj Pls Gn 1 1 — — $4,276.00 $4,276.00 $4,276.00 2026-04-01
0915T HCPCS Insj Perm Ccm-d Sys Pg&eltrd 1 1 — — $4,276.00 $4,276.00 $4,276.00 2026-04-01
0408T HCPCS Insj/rplc Cardiac Modulj Sys 1 1 — — $4,276.00 $4,276.00 $4,276.00 2026-04-01
0923T HCPCS Rmvl&rplcmt Perm Ccm-d Pg 1 1 — — $4,276.00 $4,276.00 $4,276.00 2026-04-01
S0159 HCPCS Injection , Agalsidase Beta, 35 Mg 2 1 — — $4,250.00 $4,250.00 $4,250.00 2026-04-01
43124 HCPCS Removal Of Esophagus 5 3 — — $1,568.00 $4,879.35 $4,240.03 2026-04-01
C1724 HCPCS Cath Themo Latex Free 7Fr 4Lum 1 1 — — $4,232.59 $4,232.59 $4,232.59 2026-04-01
33877 HCPCS Thoracoabdominal Graft 5 3 — — $1,568.00 $6,230.69 $4,219.28 2026-04-01
61582 HCPCS Craniofacial Approach Skull 5 3 — — $1,568.00 $6,237.02 $4,193.74 2026-04-01
34848 HCPCS Visc & Infraren Abd 4+ Prost 5 3 — — $1,568.00 $4,581.97 $4,189.38 2026-04-01
61606 HCPCS Resect/excise Cranial Lesion 5 3 — — $1,568.00 $6,872.50 $4,187.85 2026-04-01
20973 HCPCS Bone/skin Graft Great Toe 5 3 — — $2,854.00 $7,367.15 $4,184.56 2026-04-01
61583 HCPCS Craniofacial Approach Skull 5 3 — — $1,568.00 $6,587.69 $4,174.87 2026-04-01
43117 HCPCS Partial Removal Of Esophagus 5 3 — — $1,568.00 $6,010.16 $4,170.44 2026-04-01
47140 HCPCS Partial Removal Donor Liver 5 3 — — $1,568.00 $7,999.30 $4,164.56 2026-04-01
32852 HCPCS Lung Transplant With Bypass 5 3 — — $1,568.00 $7,747.47 $4,163.62 2026-04-01
61519 HCPCS Remove Brain Lining Lesion 5 3 — — $1,568.00 $7,000.03 $4,157.42 2026-04-01
0362U HCPCS Onc Pap Thyr Ca RNA 82&10 2 1 — — $3,918.86 $4,375.42 $4,147.14 2026-04-01
0391U HCPCS Onc Sld Tum Dna&rna 437 Gen 2 1 — — $3,918.86 $4,375.42 $4,147.14 2026-04-01
61584 HCPCS Orbitocranial Approach/skull 5 3 — — $1,568.00 $6,331.30 $4,123.30 2026-04-01
J7504 HCPCS Lymphocyte Immune Globulin 6 2 — — $3,254.87 $4,931.03 $4,109.18 2026-04-01
32445 HCPCS Removal Of Lung Extrapleural 5 3 — — $1,568.00 $4,111.73 $4,103.26 2026-04-01
J0801 HCPCS Inj. Acthar Gel To 40 Units 6 2 — — $3,611.16 $4,333.39 $4,092.70 2026-04-01
63250 HCPCS Revise Spinal Cord Vsls Crvl 5 3 — — $1,568.00 $6,600.45 $4,086.85 2026-04-01
61597 HCPCS Transcondylar Approach/skull 5 3 — — $1,568.00 $6,563.61 $4,086.53 2026-04-01
61598 HCPCS Transpetrosal Approach/skull 5 3 — — $1,568.00 $5,936.78 $4,082.33 2026-04-01
33783 HCPCS Nikaidoh Proc W/ostia Implt 5 3 — — $1,568.00 $8,707.81 $4,077.77 2026-04-01
A0431 HCPCS Rotary Wing Air Transport 2 1 — — $4,074.40 $4,074.40 $4,074.40 2026-04-01
43286 HCPCS Esphg Tot W/laps Moblj 5 3 — — $1,568.00 $4,595.32 $4,069.86 2026-04-01
C1785 HCPCS Pacemaker A2Dr01 Ipg Advisa Mr 1 1 — — $4,066.62 $4,066.62 $4,066.62 2026-04-01
61607 HCPCS Resect/excise Cranial Lesion 5 3 — — $1,568.00 $6,357.08 $4,040.39 2026-04-01
43314 HCPCS Tracheo-esophagoplasty Cong 5 3 — — $1,568.00 $7,329.64 $4,020.53 2026-04-01
33622 HCPCS Redo Compl Cardiac Anomaly 5 3 — — $1,568.00 $7,804.48 $4,011.77 2026-04-01
61684 HCPCS Intracranial Vessel Surgery 5 3 — — $1,568.00 $6,787.00 $4,010.73 2026-04-01
47122 HCPCS Extensive Removal Of Liver 5 3 — — $1,568.00 $8,069.27 $4,008.31 2026-04-01
33858 HCPCS As-aort Grf F/aortic Dsj 5 3 — — $1,568.00 $4,850.33 $4,007.82 2026-04-01
C9758 HCPCS Interatrial Shunt Ide 1 1 — — $3,992.00 $3,992.00 $3,992.00 2026-04-01
0268T HCPCS Implt/rpl Crtd Sns Dev Gen 1 1 — — $3,992.00 $3,992.00 $3,992.00 2026-04-01
0266T HCPCS Implt/rpl Crtd Sns Dev Total 1 1 — — $3,992.00 $3,992.00 $3,992.00 2026-04-01
C9782 HCPCS Blind Myocar Trpl Bon Marrow 1 1 — — $3,992.00 $3,992.00 $3,992.00 2026-04-01
34847 HCPCS Visc & Infraren Abd 3 Prosth 5 3 — — $1,568.00 $4,127.12 $3,979.35 2026-04-01
A9570 HCPCS Indium In-111 Auto Wbc 8 2 — — $3,435.33 $4,294.16 $3,976.07 2026-04-01
A9571 HCPCS Indium In-111 Auto Platelet 8 2 — — $3,435.33 $4,294.16 $3,976.07 2026-04-01
20972 HCPCS Bone/skin Graft Metatarsal 5 3 — — $2,854.00 $6,640.21 $3,961.85 2026-04-01
0329U HCPCS Onc Neo Xome&trns Seq Alys 2 1 — — $3,742.49 $4,178.50 $3,960.49 2026-04-01
20970 HCPCS Bone/skin Graft Iliac Crest 5 3 — — $2,567.00 $7,183.61 $3,956.59 2026-04-01
33440 HCPCS Rplcmt A-valve Tlcj Autol Pv 5 3 — — $1,568.00 $5,051.42 $3,953.40 2026-04-01
21160 HCPCS Lefort Iii W/fhd With Lefort I 5 3 — — $2,567.00 $7,552.53 $3,952.95 2026-04-01
63290 HCPCS Bx/exc Xdrl/idrl Lsn Any Lvl 5 3 — — $3,278.00 $6,307.71 $3,938.91 2026-04-01
27077 HCPCS Resect Hip Tum W/innom Bone 5 3 — — $2,854.00 $6,585.50 $3,932.26 2026-04-01
33916 HCPCS Surgery Of Great Vessel 5 3 — — $1,568.00 $4,947.08 $3,923.65 2026-04-01
0340U HCPCS Onc Pan Ca Alys Mrd Plasma 5 3 — — $2,586.22 $4,943.54 $3,920.00 2026-04-01
33411 HCPCS Replacement Of Aortic Valve 5 3 — — $1,568.00 $5,785.21 $3,915.85 2026-04-01
61518 HCPCS Removal Of Brain Lesion 5 3 — — $1,568.00 $6,387.97 $3,910.64 2026-04-01
61581 HCPCS Craniofacial Approach Skull 5 3 — — $1,568.00 $5,963.17 $3,893.14 2026-04-01
63287 HCPCS Bx/exc Idrl Imed Lesn Thrlmb 5 3 — — $3,278.00 $6,227.77 $3,873.27 2026-04-01
81521 HCPCS Onc Breast Mrna 70 Genes 5 3 — — $2,555.21 $4,862.40 $3,873.00 2026-04-01
81523 HCPCS Onc Brst Mrna 70 Cnt 31 Gene 5 3 — — $2,555.21 $5,392.17 $3,873.00 2026-04-01
81541 HCPCS Onc Prostate Mrna 46 Genes 5 3 — — $2,555.21 $4,862.40 $3,873.00 2026-04-01
81522 HCPCS Onc Breast Mrna 12 Genes 5 3 — — $2,555.21 $5,120.56 $3,873.00 2026-04-01
81518 HCPCS Onc Brst Mrna 11 Genes 5 3 — — $2,555.21 $4,868.52 $3,873.00 2026-04-01
20838 HCPCS Replantation Foot Complete 5 3 — — $3,278.00 $6,352.77 $3,868.18 2026-04-01
47130 HCPCS Partial Removal Of Liver 5 3 — — $1,568.00 $7,820.87 $3,866.59 2026-04-01
Q4303 HCPCS Complete Aa, Per Sq Cm 2 1 — — $3,863.54 $3,863.54 $3,863.54 2026-04-01
33928 HCPCS Rmvl & Rplcmt Tot Hrt Sys 3 2 — — $1,568.00 $5,379.66 $3,853.89 2026-04-01
33871 HCPCS Transvrs A-arch Grf Hypthrm 5 3 — — $1,568.00 $4,661.22 $3,851.59 2026-04-01
20969 HCPCS Bone/skin Graft Microvasc 5 3 — — $2,567.00 $7,271.43 $3,832.27 2026-04-01
32851 HCPCS Lung Transplant Single 5 3 — — $1,568.00 $6,867.92 $3,829.74 2026-04-01
Q4351 HCPCS Enclose Tl Matrix, Per Sq Cm 2 1 — — $3,825.00 $3,825.00 $3,825.00 2026-04-01
A9600 HCPCS Sr89 Strontium 4 2 — — $3,825.00 $3,975.00 $3,825.00 2026-04-01
43107 HCPCS Removal Of Esophagus 5 3 — — $1,568.00 $6,099.82 $3,824.00 2026-04-01
44127 HCPCS Enterectomy W/taper Cong 5 3 — — $1,568.00 $6,007.68 $3,823.57 2026-04-01
20957 HCPCS Mt Bone Graft Microvasc 5 3 — — $2,854.00 $6,365.05 $3,821.78 2026-04-01
20802 HCPCS Replantation Arm Complete 5 3 — — $3,278.00 $6,384.23 $3,819.86 2026-04-01
61615 HCPCS Resect/excise Lesion Skull 5 3 — — $1,568.00 $5,693.04 $3,814.74 2026-04-01
45126 HCPCS Pelvic Exenteration 5 3 — — $1,568.00 $6,657.66 $3,808.52 2026-04-01
47785 HCPCS Fuse Bile Ducts And Bowel 5 3 — — $1,568.00 $4,633.39 $3,795.06 2026-04-01
33782 HCPCS Nikaidoh Proc 5 3 — — $1,568.00 $8,056.83 $3,772.21 2026-04-01
33864 HCPCS Ascending Aortic Graft 5 3 — — $1,568.00 $8,107.13 $3,764.10 2026-04-01
J9200 HCPCS Floxuridine Injection 6 2 — — $3,551.00 $4,516.57 $3,763.81 2026-04-01
43313 HCPCS Esophagoplasty Congenital 5 3 — — $1,568.00 $6,710.45 $3,758.70 2026-04-01
61538 HCPCS Removal Of Brain Tissue 5 3 — — $1,568.00 $4,609.02 $3,755.58 2026-04-01
33413 HCPCS Replacement Of Aortic Valve 5 3 — — $1,568.00 $6,791.12 $3,755.17 2026-04-01
20962 HCPCS Other Bone Graft Microvasc 5 3 — — $2,567.00 $6,880.83 $3,695.50 2026-04-01
63285 HCPCS Bx/exc Idrl Imed Lesn Cervl 5 3 — — $1,568.00 $6,124.46 $3,692.86 2026-04-01
S2209 HCPCS Minimally Invasive Direct Co 2 1 — — $3,681.37 $3,681.37 $3,681.37 2026-04-01
33863 HCPCS Ascending Aortic Graft 5 3 — — $1,568.00 $6,744.12 $3,675.51 2026-04-01
61705 HCPCS Revise Circulation To Head 5 3 — — $1,568.00 $6,065.70 $3,673.77 2026-04-01
34846 HCPCS Visc & Infraren Abd 2 Prosth 5 3 — — $1,568.00 $3,769.33 $3,672.28 2026-04-01
33412 HCPCS Replacement Of Aortic Valve 5 3 — — $1,568.00 $6,590.24 $3,672.09 2026-04-01
20956 HCPCS Iliac Bone Graft Microvasc 5 3 — — $2,854.00 $6,757.96 $3,657.86 2026-04-01
63286 HCPCS Bx/exc Idrl Imed Lesn Thrc 5 3 — — $1,568.00 $6,075.79 $3,648.33 2026-04-01
43121 HCPCS Partial Removal Of Esophagus 5 3 — — $1,568.00 $4,497.61 $3,644.95 2026-04-01
21159 HCPCS Lefort Iii W/fhdw/o Lefort I 5 3 — — $2,567.00 $7,571.01 $3,644.25 2026-04-01
48150 HCPCS Partial Removal Of Pancreas 5 3 — — $1,568.00 $7,105.34 $3,641.66 2026-04-01
61536 HCPCS Removal Of Brain Lesion 5 3 — — $1,568.00 $6,041.29 $3,639.51 2026-04-01
61711 HCPCS Fusion Of Skull Arteries 5 3 — — $1,568.00 $6,157.97 $3,637.35 2026-04-01
48153 HCPCS Pancreatectomy 5 3 — — $1,568.00 $7,100.07 $3,626.89 2026-04-01
48160 HCPCS Pancreas Removal/transplant 3 2 — — $1,568.00 $5,829.18 $3,625.74 2026-04-01
0265U HCPCS Rar Do Whl Gn&mtcdrl DNA Als 3 2 — — $3,612.66 $5,475.80 $3,612.66 2026-04-01
61567 HCPCS Incision Of Brain Tissue 5 3 — — $1,568.00 $5,973.06 $3,609.16 2026-04-01
61512 HCPCS Remove Brain Lining Lesion 5 3 — — $1,568.00 $5,992.93 $3,606.00 2026-04-01
33463 HCPCS Valvuloplasty Tricuspid 5 3 — — $1,568.00 $4,054.84 $3,604.04 2026-04-01
61580 HCPCS Craniofacial Approach Skull 5 3 — — $1,568.00 $5,697.69 $3,602.62 2026-04-01
81546 HCPCS Onc Thyr Mrna 10,196 Gen Alg 5 3 — — $2,375.10 $4,990.45 $3,600.00 2026-04-01
0313U HCPCS Onc Pncrs Dna&mrna Seq 74 5 3 — — $2,375.10 $4,539.98 $3,600.00 2026-04-01
47125 HCPCS Partial Removal Of Liver 5 3 — — $1,568.00 $7,223.48 $3,599.14 2026-04-01
33545 HCPCS Repair Of Heart Damage 5 3 — — $1,568.00 $5,533.46 $3,592.44 2026-04-01
C8518 HCPCS Description Not Available 1 1 — — $3,580.05 $3,580.05 $3,580.05 2026-04-01
C8519 HCPCS Description Not Available 1 1 — — $3,580.05 $3,580.05 $3,580.05 2026-04-01
C8750 HCPCS Description Not Available 1 1 — — $3,580.05 $3,580.05 $3,580.05 2026-04-01
41155 HCPCS Tongue Jaw & Neck Surgery 5 3 — — $1,568.00 $5,485.18 $3,577.91 2026-04-01
J9371 HCPCS Inj, Vincristine Sul Lip 1mg 2 1 — — $3,508.13 $3,645.70 $3,576.91 2026-04-01
Q4346 HCPCS Shelter Dm Matrix Per Sq Cm 2 1 — — $3,570.00 $3,570.00 $3,570.00 2026-04-01
Q4349 HCPCS Mantle Dl Matrix Per Sq Cm 2 1 — — $3,570.00 $3,570.00 $3,570.00 2026-04-01
Q4350 HCPCS Palisade Dm Matrix Per Sq Cm 2 1 — — $3,570.00 $3,570.00 $3,570.00 2026-04-01
A9542 HCPCS In111 Ibritumomab, Dx 3 2 — — $3,570.00 $3,570.00 $3,570.00 2026-04-01
32442 HCPCS Sleeve Pneumonectomy 5 3 — — $1,568.00 $4,298.39 $3,567.82 2026-04-01
31395 HCPCS Reconstruct Larynx & Pharynx 5 3 — — $1,568.00 $5,972.87 $3,551.06 2026-04-01
J3316 HCPCS Inj., Triptorelin Xr 3.75 Mg 4 2 — — $3,185.22 $3,790.60 $3,550.36 2026-04-01
47361 HCPCS Repair Liver Wound 5 3 — — $1,568.00 $6,895.04 $3,545.51 2026-04-01
47765 HCPCS Fuse Liver Ducts & Bowel 5 3 — — $1,568.00 $3,747.55 $3,538.92 2026-04-01
63305 HCPCS Remove Vert Idrl Body Thrc 5 3 — — $1,568.00 $5,317.97 $3,523.17 2026-04-01
27076 HCPCS Resect Hip Tum Incl Acetabul 5 3 — — $2,391.07 $3,844.19 $3,516.62 2026-04-01
61596 HCPCS Transcochlear Approach/skull 5 3 — — $1,568.00 $6,126.47 $3,516.47 2026-04-01
A0430 HCPCS Fixed Wing Air Transport 2 1 — — $3,504.42 $3,504.42 $3,504.42 2026-04-01
0037U HCPCS Trgt Gen Seq DNA 324 Genes 5 3 — — $2,309.13 $4,404.46 $3,500.00 2026-04-01
43415 HCPCS Repair Esophagus Wound 5 3 — — $1,568.00 $3,860.22 $3,496.84 2026-04-01
61586 HCPCS Resect Nasopharynx Skull 5 3 — — $1,568.00 $4,953.45 $3,478.83 2026-04-01
61537 HCPCS Removal Of Brain Tissue 5 3 — — $1,568.00 $4,372.37 $3,474.08 2026-04-01
61601 HCPCS Resect/excise Cranial Lesion 5 3 — — $1,568.00 $5,177.32 $3,471.56 2026-04-01
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