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 →

Export CSV
Hospital

BLUE RIDGE REGIONAL HOSPITAL

Spruce Pine, NC · CCN 341329 · Rates published

Your selected procedure

You selected 27447 (CPT)

Arthroplasty, knee, condyle and plateau; medial AND lateral compartments with or without patella resurfacing (total knee arthroplasty)

This hospital’s price: $14,000 across 10 payers · range $2,550-$17,052

Source: https://stctrprodsnsvc00455826e6.blob.core.windows.net/pt-final-posting-files/83-2048759_BLUE-RIDGE-REGIONAL-HOSPITAL_standardcharges.json?si=pt-json-access-policy&spr=https&sv=2024-11-04&sr=c&sig=o5IofreS%2F7ETlsnhPakPWCwHVVUZRobywQ5wUKGjVuQ%3D · observed 2026-03-01

This is the facility’s filed rate for this code. The comparison board’s estimate also adds the surgeon and anesthesia fees, so it is usually higher.

26,265 distinct procedures filed
33 distinct payers
1,759,933 rate rows
2026-03-01 last MRF observed
Data quality

1,696,580 of 1,759,933 rate rows are consumer-grade (96.4%)

63,353 rows are marked excluded from the consumer medians — these stay visible in the raw drill-down with the same reason shown here, so nothing is silently hidden.

Excluded — reasonRows
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 36,823
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 18,125
below 25% of the Medicare reference for this DRG — likely a mislabeled per-diem; excluded from rankings 4,199
per-diem day rate — not a per-procedure price 3,563
placeholder amount (≤ $0.02) — excluded from medians 228
template filing: same amount across many unrelated codes — excluded 205
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 168
percent-of-charges filed in the dollar field — excluded from medians 26
exceeds 10× this hospital's gross charge — excluded from medians 16
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://www.hcadam.com/api/public/content/e7b100f7065547c1acb149d7b943ff17?download=true
Found on page https://www.missionhealth.org/patient-resources/patient-financial-resources/pricing-transparency-cms-required-file-of-standard-charges
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-08-01
Content fingerprint 23ce8bb2757f724c… · 577,426,455 bytes · first seen 2026-07-31

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
9141
OTHER 		Inj Onase Abepar-xioi Tre 1 $4,299,505.20 $4,299,505.20 $4,299,505.20 nat. median
$2,588,981
1.7× median
Q2042
HCPCS 		Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka… 1 $1,369,371.65 $1,369,371.65 $1,369,371.65 nat. median
$691,418
2.0× median
Q2056
HCPCS 		Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige… 1 $1,328,128.35 $1,328,128.35 $1,328,128.35 nat. median
$631,793
outlier · 2.1×
Q2041
HCPCS 		Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via… 1 $1,279,600.63 $1,279,600.63 $1,279,600.63 nat. median
$588,565
outlier · 2.2×
Q2053
HCPCS 		Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V… 1 $1,175,752.00 $1,175,752.00 $1,175,752.00 nat. median
$577,541
outlier · 2.0×
9194
OTHER 		Tisagenlecleucel Car-pos 1 $952,547.22 $952,547.22 $952,547.22 nat. median
$576,820
1.7× median
9498
OTHER 		Ciltacabtagene Car-pos T 1 $948,822.12 $948,822.12 $948,822.12 nat. median
$587,650
1.6× median
9422
OTHER 		Idecabtagene Vicleucel Ca 1 $947,857.68 $947,857.68 $947,857.68 nat. median
$560,872
1.7× median
9413
OTHER 		Lisocabtagene Car Pos T 1 $930,106.98 $930,106.98 $930,106.98 nat. median
$562,201
1.7× median
9035
OTHER 		Axicabtagene Ciloleucel C 1 $881,020.80 $881,020.80 $881,020.80 nat. median
$533,230
1.7× median
9391
OTHER 		Brexucabtagene Car Pos T 1 $828,954.72 $828,954.72 $828,954.72 nat. median
$492,768
1.7× median
1907
OTHER 		New Technology - Level 52 1 $274,500.90 $274,500.90 $274,500.90 nat. median
$155,877
1.8× median
1908
OTHER 		New Technology - Level 52 1 $274,500.90 $274,500.90 $274,500.90 nat. median
$155,877
1.8× median
1906
OTHER 		New Technology - Level 51 1 $247,500.90 $247,500.90 $247,500.90 nat. median
$140,545
1.8× median
1905
OTHER 		New Technology - Level 51 1 $247,500.90 $247,500.90 $247,500.90 nat. median
$140,545
1.8× median
1903
OTHER 		New Technology - Level 50 1 $220,500.90 $220,500.90 $220,500.90 nat. median
$122,500
1.8× median
1904
OTHER 		New Technology - Level 50 1 $220,500.90 $220,500.90 $220,500.90 nat. median
$122,500
1.8× median
1902
OTHER 		New Technology - Level 49 1 $193,500.90 $193,500.90 $193,500.90 nat. median
$107,500
1.8× median
1901
OTHER 		New Technology - Level 49 1 $193,500.90 $193,500.90 $193,500.90 nat. median
$107,500
1.8× median
1585
OTHER 		New Technology - Level 48 1 $171,000.90 $171,000.90 $171,000.90 nat. median
$97,104
1.8× median
1599
OTHER 		New Technology - Level 48 1 $171,000.90 $171,000.90 $171,000.90 nat. median
$97,104
1.8× median
J9029
HCPCS 		Intravesical Instillation, Nadofaragene Firadenovec-vncg, Per Therapeutic Dose 1 $166,116.65 $166,116.65 $166,116.65 nat. median
$69,291
outlier · 2.4×
516430
CDM 		Kit Implnt Hrtmt 3 Kit 19 $59,995.33 $364,495.82 $163,912.66 nat. median
$162,274
1.0× median
1598
OTHER 		New Technology - Level 47 1 $153,000.90 $153,000.90 $153,000.90 nat. median
$86,882
1.8× median
1584
OTHER 		New Technology - Level 47 1 $153,000.90 $153,000.90 $153,000.90 nat. median
$86,882
1.8× median
Q2043
HCPCS 		Sipuleucel-t, Minimum Of 50 Million Autologous Cd54+ Cells Activated With Pap-gm… 1 $145,223.54 $145,223.54 $145,223.54 nat. median
$65,655
outlier · 2.2×
456896
CDM 		Device Vntrc Asst Hrtmt 19 $52,224.24 $317,283.30 $142,681.34 nat. median
$66,206
outlier · 2.2×
1597
OTHER 		New Technology - Level 46 1 $135,000.90 $135,000.90 $135,000.90 nat. median
$76,661
1.8× median
1583
OTHER 		New Technology - Level 46 1 $135,000.90 $135,000.90 $135,000.90 nat. median
$76,661
1.8× median
494847
CDM 		Syst Imp Hrtmt2 Lft Vent 19 $49,225.26 $299,063.26 $134,487.84 nat. median
$132,044
1.0× median
C9293
HCPCS 		Glucarpidase 1000 U Inj 18 $45,585.80 $276,933.76 $125,851.01 nat. median
$24,377
outlier · 5.2×
J9999
HCPCS 		Carmustine Wafers 8/box 18 $45,242.25 $274,846.66 $124,902.54 nat. median
$2,547
outlier · 49.0×
1643
OTHER 		Y90 Ibritumomab, Rx 1 $117,857.84 $117,857.84 $117,857.84 nat. median
$60,802
1.9× median
1596
OTHER 		New Technology - Level 45 1 $117,000.90 $117,000.90 $117,000.90 nat. median
$66,440
1.8× median
1582
OTHER 		New Technology - Level 45 1 $117,000.90 $117,000.90 $117,000.90 nat. median
$66,440
1.8× median
717
OTHER 		Instill Adstiladrin, Tx D 1 $114,038.59 $114,038.59 $114,038.59 nat. median
$63,355
1.8× median
J9226
HCPCS 		Histrelin Implant (supprelin La), 50 Mg 1 $110,645.59 $110,645.59 $110,645.59 nat. median
$55,200
outlier · 2.0×
9273
OTHER 		Sipuleucel-t Auto Cd54+ 1 $99,027.41 $99,027.41 $99,027.41 nat. median
$56,116
1.8× median
1581
OTHER 		New Technology - Level 44 1 $99,000.90 $99,000.90 $99,000.90 nat. median
$56,212
1.8× median
1595
OTHER 		New Technology - Level 44 1 $99,000.90 $99,000.90 $99,000.90 nat. median
$56,218
1.8× median
5244
OTHER 		Level 4 Blood Product Exc 1 $93,719.11 $93,719.11 $93,719.11 nat. median
$64,263
1.5× median
1142
OTHER 		Supprelin La Implant 1 $81,630.38 $81,630.38 $81,630.38 nat. median
$45,350
1.8× median
1594
OTHER 		New Technology - Level 43 1 $81,000.90 $81,000.90 $81,000.90 nat. median
$45,997
1.8× median
1580
OTHER 		New Technology - Level 43 1 $81,000.90 $81,000.90 $81,000.90 nat. median
$45,997
1.8× median
1593
OTHER 		New Technology - Level 42 1 $63,000.90 $63,000.90 $63,000.90 nat. median
$35,775
1.8× median
1579
OTHER 		New Technology - Level 42 1 $63,000.90 $63,000.90 $63,000.90 nat. median
$35,775
1.8× median
551981
CDM 		Pump Heart 21fr 85mm 20 $21,890.40 $139,608.00 $60,046.62 nat. median
$60,047
1.0× median
A9543
HCPCS 		Y90 Ibritum Tiu Tx 40mci 19 $21,389.77 $129,942.84 $58,688.18 nat. median
$63,643
0.9× median
5166
OTHER 		Cochlear Implant Procedur 1 $57,512.52 $57,512.52 $57,512.52 nat. median
$34,116
1.7× median
5232
OTHER 		Level 2 Icd And Similar P 1 $56,422.76 $56,422.76 $56,422.76 nat. median
$32,779
1.7× median

Other procedures at this hospital

Browse this hospital's 26,265 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
             
9141 OTHER Inj Onase Abepar-xioi Tre 1 1 — — $4,299,505.20 $4,299,505.20 $4,299,505.20 2024-10-01
Q2042 HCPCS Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka… 8 1 — — $1,369,371.65 $1,369,371.65 $1,369,371.65 2026-03-01
Q2056 HCPCS Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige… 8 1 — — $1,328,128.35 $1,328,128.35 $1,328,128.35 2026-03-01
Q2041 HCPCS Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via… 8 1 — — $1,279,600.63 $1,279,600.63 $1,279,600.63 2026-03-01
Q2053 HCPCS Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V… 8 1 — — $1,175,752.00 $1,175,752.00 $1,175,752.00 2026-03-01
9194 OTHER Tisagenlecleucel Car-pos 1 1 — — $952,547.22 $952,547.22 $952,547.22 2024-10-01
9498 OTHER Ciltacabtagene Car-pos T 1 1 — — $948,822.12 $948,822.12 $948,822.12 2024-10-01
9422 OTHER Idecabtagene Vicleucel Ca 1 1 — — $947,857.68 $947,857.68 $947,857.68 2024-10-01
9413 OTHER Lisocabtagene Car Pos T 1 1 — — $930,106.98 $930,106.98 $930,106.98 2024-10-01
9035 OTHER Axicabtagene Ciloleucel C 1 1 — — $881,020.80 $881,020.80 $881,020.80 2024-10-01
9391 OTHER Brexucabtagene Car Pos T 1 1 — — $828,954.72 $828,954.72 $828,954.72 2024-10-01
1907 OTHER New Technology - Level 52 1 1 — — $274,500.90 $274,500.90 $274,500.90 2024-10-01
1908 OTHER New Technology - Level 52 1 1 — — $274,500.90 $274,500.90 $274,500.90 2024-10-01
1906 OTHER New Technology - Level 51 1 1 — — $247,500.90 $247,500.90 $247,500.90 2024-10-01
1905 OTHER New Technology - Level 51 1 1 — — $247,500.90 $247,500.90 $247,500.90 2024-10-01
1904 OTHER New Technology - Level 50 1 1 — — $220,500.90 $220,500.90 $220,500.90 2024-10-01
1903 OTHER New Technology - Level 50 1 1 — — $220,500.90 $220,500.90 $220,500.90 2024-10-01
1902 OTHER New Technology - Level 49 1 1 — — $193,500.90 $193,500.90 $193,500.90 2024-10-01
1901 OTHER New Technology - Level 49 1 1 — — $193,500.90 $193,500.90 $193,500.90 2024-10-01
1599 OTHER New Technology - Level 48 1 1 — — $171,000.90 $171,000.90 $171,000.90 2024-10-01
1585 OTHER New Technology - Level 48 1 1 — — $171,000.90 $171,000.90 $171,000.90 2024-10-01
J9029 HCPCS Intravesical Instillation, Nadofaragene Firadenovec-vncg, Per Therapeutic Dose 8 1 — — $166,116.65 $166,116.65 $166,116.65 2026-03-01
516430 CDM Kit Implnt Hrtmt 3 Kit 80 19 $374,970.83 $374,970.83 $59,995.33 $364,495.82 $163,912.66 2026-03-01
1584 OTHER New Technology - Level 47 1 1 — — $153,000.90 $153,000.90 $153,000.90 2024-10-01
1598 OTHER New Technology - Level 47 1 1 — — $153,000.90 $153,000.90 $153,000.90 2024-10-01
Q2043 HCPCS Sipuleucel-t, Minimum Of 50 Million Autologous Cd54+ Cells Activated With Pap-gm… 8 1 — — $145,223.54 $145,223.54 $145,223.54 2026-03-01
456896 CDM Device Vntrc Asst Hrtmt 80 19 $326,401.50 $326,401.50 $52,224.24 $317,283.30 $142,681.34 2026-03-01
1583 OTHER New Technology - Level 46 1 1 — — $135,000.90 $135,000.90 $135,000.90 2024-10-01
1597 OTHER New Technology - Level 46 1 1 — — $135,000.90 $135,000.90 $135,000.90 2024-10-01
494847 CDM Syst Imp Hrtmt2 Lft Vent 80 19 $307,657.85 $307,657.85 $49,225.26 $299,063.26 $134,487.84 2026-03-01
C9293 HCPCS Glucarpidase 1000 U Inj 61 18 $284,911.28 $284,911.28 $45,585.80 $276,933.76 $125,851.01 2026-03-01
J9999 HCPCS Carmustine Wafers 8/box 61 18 $282,764.06 $282,764.06 $45,242.25 $274,846.66 $124,902.54 2026-03-01
1643 OTHER Y90 Ibritumomab, Rx 1 1 — — $117,857.84 $117,857.84 $117,857.84 2024-10-01
1582 OTHER New Technology - Level 45 1 1 — — $117,000.90 $117,000.90 $117,000.90 2024-10-01
1596 OTHER New Technology - Level 45 1 1 — — $117,000.90 $117,000.90 $117,000.90 2024-10-01
717 OTHER Instill Adstiladrin, Tx D 1 1 — — $114,038.59 $114,038.59 $114,038.59 2024-10-01
J9226 HCPCS Histrelin Implant (supprelin La), 50 Mg 8 1 — — $110,645.59 $110,645.59 $110,645.59 2026-03-01
9273 OTHER Sipuleucel-t Auto Cd54+ 1 1 — — $99,027.41 $99,027.41 $99,027.41 2024-10-01
1595 OTHER New Technology - Level 44 1 1 — — $99,000.90 $99,000.90 $99,000.90 2024-10-01
1581 OTHER New Technology - Level 44 1 1 — — $99,000.90 $99,000.90 $99,000.90 2024-10-01
5244 OTHER Level 4 Blood Product Exc 1 1 — — $93,719.11 $93,719.11 $93,719.11 2024-10-01
1142 OTHER Supprelin La Implant 1 1 — — $81,630.38 $81,630.38 $81,630.38 2024-10-01
1580 OTHER New Technology - Level 43 1 1 — — $81,000.90 $81,000.90 $81,000.90 2024-10-01
1594 OTHER New Technology - Level 43 1 1 — — $81,000.90 $81,000.90 $81,000.90 2024-10-01
1593 OTHER New Technology - Level 42 1 1 — — $63,000.90 $63,000.90 $63,000.90 2024-10-01
1579 OTHER New Technology - Level 42 1 1 — — $63,000.90 $63,000.90 $63,000.90 2024-10-01
551981 CDM Pump Heart 21fr 85mm 82 20 $136,815.00 $136,815.00 $21,890.40 $139,608.00 $60,046.62 2026-03-01
A9543 HCPCS Y90 Ibritum Tiu Tx 40mci 63 19 $133,686.05 $133,686.05 $21,389.77 $129,942.84 $58,688.18 2026-03-01
5166 OTHER Cochlear Implant Procedur 1 1 — — $57,512.52 $57,512.52 $57,512.52 2024-10-01
5232 OTHER Level 2 Icd And Similar P 1 1 — — $56,422.76 $56,422.76 $56,422.76 2024-10-01
J2350 HCPCS Ocrelizumab 300 Mg Inj 69 18 $139,200.48 $139,200.48 $157.62 $135,302.87 $55,624.51 2026-03-01
451503 CDM Valve Heart Sapien Trans 80 19 $127,042.50 $127,042.50 $20,326.80 $123,493.50 $55,534.65 2026-03-01
463213 CDM Valve Xt Sapien 23mm Ta 80 19 $127,042.50 $127,042.50 $20,326.80 $123,493.50 $55,534.65 2026-03-01
469507 CDM Valve 29mm Thv 80 19 $127,042.50 $127,042.50 $20,326.80 $123,493.50 $55,534.65 2026-03-01
485646 CDM Valve Hrt W Cert Sys 26a 80 19 $127,042.50 $127,042.50 $20,326.80 $123,493.50 $55,534.65 2026-03-01
485943 CDM Valve Heart W/cert 29a 80 19 $127,042.50 $127,042.50 $20,326.80 $123,493.50 $55,534.65 2026-03-01
485942 CDM Valve Hrt W/cert Sys 23a 80 19 $127,042.50 $127,042.50 $20,326.80 $123,493.50 $55,534.65 2026-03-01
457578 CDM Valve Hrt Sapien 23mm As 80 19 $127,042.50 $127,042.50 $20,326.80 $123,493.50 $55,534.65 2026-03-01
451502 CDM Valve Heart Sapien Trans 80 19 $127,042.50 $127,042.50 $20,326.80 $123,493.50 $55,534.65 2026-03-01
463214 CDM Valve Xt Sapien 26mm Ta 80 19 $127,042.50 $127,042.50 $20,326.80 $123,493.50 $55,534.65 2026-03-01
463212 CDM Valve 29mm Sapien Xt Trn 80 19 $127,042.50 $127,042.50 $20,326.80 $123,493.50 $55,534.65 2026-03-01
463209 CDM Valve 23mm Sapien Xt Trn 80 19 $127,042.50 $127,042.50 $20,326.80 $123,493.50 $55,534.65 2026-03-01
457579 CDM Valve Hrt Sapien 26mm As 80 19 $127,042.50 $127,042.50 $20,326.80 $123,493.50 $55,534.65 2026-03-01
485939 CDM Valve Hrt W/cert Sys 20a 80 19 $127,042.50 $127,042.50 $20,326.80 $123,493.50 $55,534.65 2026-03-01
463210 CDM Valve 26mm Sapien Xt Trn 80 19 $127,042.50 $127,042.50 $20,326.80 $123,493.50 $55,534.65 2026-03-01
441861 CDM Valve Pulm 23mm Sapien R 80 19 $127,042.50 $127,042.50 $20,326.80 $123,493.50 $55,534.65 2026-03-01
469508 CDM Valve Aor 20mm Edwrd Sap 80 19 $127,042.50 $127,042.50 $20,326.80 $123,493.50 $55,534.65 2026-03-01
463211 CDM Valve 29mm Sapien Xt Trn 80 19 $127,042.50 $127,042.50 $20,326.80 $123,493.50 $55,534.65 2026-03-01
496433 CDM Valve Ao 9000tfx 23mm 80 19 $127,042.50 $127,042.50 $20,326.80 $123,493.50 $55,534.65 2026-03-01
469504 CDM Valve 23mm Thv 80 19 $127,042.50 $127,042.50 $20,326.80 $123,493.50 $55,534.65 2026-03-01
441862 CDM Valve Pulm 26mm Sapien R 80 19 $127,042.50 $127,042.50 $20,326.80 $123,493.50 $55,534.65 2026-03-01
J9266 HCPCS Pegaspargase Singl Vial 69 18 $115,974.63 $115,974.63 $18,555.94 $112,727.34 $55,111.14 2026-03-01
544809 CDM Valve Tavr 25mm 80 19 $123,133.50 $123,133.50 $19,701.36 $119,693.70 $53,825.90 2026-03-01
5465 OTHER Level 5 Neurostimulator A 1 1 — — $53,255.32 $53,255.32 $53,255.32 2024-10-01
545488 CDM Valve Aor Tavr 26mm 80 19 $117,270.00 $117,270.00 $18,763.20 $113,994.00 $51,262.76 2026-03-01
547215 CDM Valve Mitral 29m 80 19 $117,270.00 $117,270.00 $18,763.20 $113,994.00 $51,262.76 2026-03-01
547229 CDM Valve Mitral 46.5x39.5mm 80 19 $117,270.00 $117,270.00 $18,763.20 $113,994.00 $51,262.76 2026-03-01
547223 CDM Valve Mitral 36.5x52.5mm 80 19 $117,270.00 $117,270.00 $18,763.20 $113,994.00 $51,262.76 2026-03-01
777080 CDM Valve Tavor Aor 29mm 80 19 $117,270.00 $117,270.00 $18,763.20 $113,994.00 $51,262.76 2026-03-01
487218 CDM Valve Tavr 34mm 80 19 $117,270.00 $117,270.00 $18,763.20 $113,994.00 $51,262.76 2026-03-01
487214 CDM Valve Aor Evolut Pro 23m 80 19 $117,270.00 $117,270.00 $18,763.20 $113,994.00 $51,262.76 2026-03-01
575013 CDM Valve Tavr 23mm 42 19 $117,270.00 $117,270.00 $18,763.20 $105,543.00 $50,273.65 2024-10-01
5200 OTHER Implantation Wireless Pa 1 1 — — $49,846.45 $49,846.45 $49,846.45 2024-10-01
1578 OTHER New Technology - Level 41 1 1 — — $49,500.90 $49,500.90 $49,500.90 2024-10-01
1592 OTHER New Technology - Level 41 1 1 — — $49,500.90 $49,500.90 $49,500.90 2024-10-01
843 OTHER Pegaspargase Injection 1 1 — — $48,726.95 $48,726.95 $48,726.95 2024-10-01
488819 CDM Set Pump 21fr 5.0 82 20 $109,452.00 $109,452.00 $17,512.32 $111,686.40 $48,037.29 2026-03-01
856 OTHER Porfimer Sodium Injection 1 1 — — $42,966.25 $42,966.25 $42,966.25 2024-10-01
371977 CDM Set Vntrc 17.4x13.8in 82 20 $97,725.00 $97,725.00 $15,636.00 $99,720.00 $42,890.44 2026-03-01
5213 OTHER Level 3 Electrophysiologi 1 1 — — $40,732.54 $40,732.54 $40,732.54 2024-10-01
1591 OTHER New Technology - Level 40 1 1 — — $40,500.90 $40,500.90 $40,500.90 2024-10-01
1577 OTHER New Technology - Level 40 1 1 — — $40,500.90 $40,500.90 $40,500.90 2024-10-01
5231 OTHER Level 1 Icd And Similar P 1 1 — — $40,425.57 $40,425.57 $40,425.57 2024-10-01
544807 CDM Valve Heart 29 Mm 80 19 $89,907.00 $89,907.00 $14,385.12 $87,395.40 $39,301.44 2026-03-01
544808 CDM Valve Tavr 27mm 80 19 $89,907.00 $89,907.00 $14,385.12 $87,395.40 $39,301.44 2026-03-01
5464 OTHER Level 4 Neurostimulator A 1 1 — — $37,517.11 $37,517.11 $37,517.11 2024-10-01
5378 OTHER Level 8 Urology And Relat 1 1 — — $34,595.10 $34,595.10 $34,595.10 2024-10-01
C1822 HCPCS Pulse Gen Imp 400 19 $82,329.00 $82,329.00 $11,257.92 $85,495.50 $34,477.94 2026-03-01
443520 CDM Pump Cath Lv Impella 9fr 82 20 $78,180.00 $78,180.00 $12,508.80 $79,776.00 $34,312.35 2026-03-01
772801 CDM Kit Impl Neurostim 80 19 $77,320.02 $77,320.02 $12,371.20 $75,160.04 $33,799.24 2026-03-01
5224 OTHER Level 4 Pacemaker And Sim 1 1 — — $33,417.63 $33,417.63 $33,417.63 2024-10-01
J3357 HCPCS Ustekinumab 1 Mg Sq 197 19 $94,247.81 $94,247.81 $317.88 $192,195.33 $33,218.95 2026-03-01
514663 CDM Cap Endrnt Grft 162698 80 19 $73,489.20 $73,489.20 $11,758.27 $71,436.24 $32,124.66 2026-03-01
5116 OTHER Level 6 Musculoskeletal P 1 1 — — $31,961.30 $31,961.30 $31,961.30 2024-10-01
1590 OTHER New Technology - Level 39 1 1 — — $31,500.90 $31,500.90 $31,500.90 2024-10-01
1576 OTHER New Technology - Level 39 1 1 — — $31,500.90 $31,500.90 $31,500.90 2024-10-01
J9119 HCPCS Cemiplimab-rwlc 350mginj 69 18 $77,952.26 $77,952.26 $72.46 $75,769.60 $31,149.72 2026-03-01
1295 OTHER Sm 153 Lexidronam 1 1 — — $31,067.73 $31,067.73 $31,067.73 2024-10-01
2616 OTHER Brachytx, Non-str,yttrium 1 1 — — $30,918.62 $30,918.62 $30,918.62 2024-10-01
5471 OTHER Implantation Of Drug Infu 1 1 — — $30,586.28 $30,586.28 $30,586.28 2024-10-01
903264 CDM Ep Generator Subcutaneo 43 20 $71,174.00 $71,174.00 $11,387.84 $64,056.60 $30,512.29 2024-10-01
5094 OTHER Level 4 Breast/Lymphatic 1 1 — — $30,222.02 $30,222.02 $30,222.02 2024-10-01
5194 OTHER Level 4 Endovascular Proc 1 1 — — $30,073.16 $30,073.16 $30,073.16 2024-10-01
337140 CDM Stnt Prox Str24x24x152 80 19 $68,682.11 $68,682.11 $10,989.14 $66,763.44 $30,023.32 2026-03-01
903280 CDM Ep Generator Bi-vent 20 43 20 $69,489.00 $69,489.00 $11,118.24 $62,540.10 $29,789.93 2024-10-01
5496 OTHER Level 6 Intraocular Proce 1 1 — — $29,754.70 $29,754.70 $29,754.70 2024-10-01
438918 CDM Stent Graft Evas 199mm 3 80 19 $67,527.98 $67,527.98 $10,804.48 $65,641.54 $29,518.81 2026-03-01
773094 CDM Device Clsr 12fr 20mm 80 19 $66,453.00 $66,453.00 $10,632.48 $64,596.60 $29,048.89 2026-03-01
773098 CDM Device Clsr 12f 35mm 80 19 $66,453.00 $66,453.00 $10,632.48 $64,596.60 $29,048.89 2026-03-01
773095 CDM Device Clsr 12fr 24mm 80 19 $66,453.00 $66,453.00 $10,632.48 $64,596.60 $29,048.89 2026-03-01
773096 CDM Device Clsr 12fr 27mm 80 19 $66,453.00 $66,453.00 $10,632.48 $64,596.60 $29,048.89 2026-03-01
773097 CDM Device Clsr 12fr 31mm 80 19 $66,453.00 $66,453.00 $10,632.48 $64,596.60 $29,048.89 2026-03-01
J2327 HCPCS Risankizum-rzaa 1mg Inj 69 18 $72,508.18 $72,508.18 $39.21 $70,477.95 $28,974.27 2026-03-01
337142 CDM Stent Evas Cls 150x40x40 80 19 $65,896.94 $65,896.94 $10,543.51 $64,056.08 $28,805.82 2026-03-01
337141 CDM Stnt Clsweb Tpr42x38x150 80 19 $65,896.94 $65,896.94 $10,543.51 $64,056.08 $28,805.82 2026-03-01
337145 CDM Stnt Clsweb Tpr44x40x150 80 19 $65,896.94 $65,896.94 $10,543.51 $64,056.08 $28,805.82 2026-03-01
J1412 HCPCS Injection, Valoctocogene Roxaparvovec-rvox, Per Ml, Containing Nominal 2 X 10°13… 8 1 — — $28,750.78 $28,750.78 $28,750.78 2026-03-01
418030 CDM Stent Graft Evas 161mm 2 80 19 $63,032.63 $63,032.63 $10,085.22 $61,271.78 $27,553.73 2026-03-01
430213 CDM Stent Grf Mn Prx Thr 38m 80 19 $63,032.63 $63,032.63 $10,085.22 $61,271.78 $27,553.73 2026-03-01
421752 CDM Stent Aaa 40x40x159mm Ta 80 19 $63,032.63 $63,032.63 $10,085.22 $61,271.78 $27,553.73 2026-03-01
903642 CDM MRI Biv Icd Generator 42 19 $63,231.00 $63,231.00 $10,116.96 $56,907.90 $27,107.13 2024-10-01
5495 OTHER Level 5 Intraocular Proce 1 1 — — $27,069.16 $27,069.16 $27,069.16 2024-10-01
534130 CDM Device Embl 25mm 3.5mm P 80 19 $60,511.32 $60,511.32 $9,681.81 $58,820.90 $26,451.58 2026-03-01
534224 CDM Device Embl 25mm 5mm Pip 80 19 $60,511.32 $60,511.32 $9,681.81 $58,820.90 $26,451.58 2026-03-01
336178 CDM Device Embl 4x30mm 80 19 $60,511.32 $60,511.32 $9,681.81 $58,820.90 $26,451.58 2026-03-01
322980 CDM Device Embl Pln 30x4.25 80 19 $60,511.32 $60,511.32 $9,681.81 $58,820.90 $26,451.58 2026-03-01
336176 CDM Device Embl 5x35mm 80 19 $60,511.32 $60,511.32 $9,681.81 $58,820.90 $26,451.58 2026-03-01
551864 CDM Device Embl Ped25x4.75mm 80 19 $60,511.32 $60,511.32 $9,681.81 $58,820.90 $26,451.58 2026-03-01
337143 CDM Stent Gft Vlnt 100x46x46 80 19 $60,326.62 $60,326.62 $9,652.26 $58,641.36 $26,370.85 2026-03-01
337144 CDM Stnt Distal Str40x40x107 80 19 $60,326.62 $60,326.62 $9,652.26 $58,641.36 $26,370.85 2026-03-01
479247 CDM Graft Evas 28.5x12m 12cm 80 19 $59,480.25 $59,480.25 $9,516.84 $57,814.08 $25,999.85 2026-03-01
482281 CDM Graft Evas 18cm 23mm 12m 80 19 $59,480.25 $59,480.25 $9,516.84 $57,814.08 $25,999.85 2026-03-01
482285 CDM Graft Evas 14cm 26mm 12m 80 19 $59,480.25 $59,480.25 $9,516.84 $57,814.08 $25,999.85 2026-03-01
432594 CDM Graft Evas 12cm 28.5mm 80 19 $59,480.25 $59,480.25 $9,516.84 $57,814.08 $25,999.85 2026-03-01
482291 CDM Graft Evas 28.5x12m 16cm 80 19 $59,480.25 $59,480.25 $9,516.84 $57,814.08 $25,999.85 2026-03-01
432598 CDM Graft Evas 16cm 28.5mm 1 80 19 $59,480.25 $59,480.25 $9,516.84 $57,814.08 $25,999.85 2026-03-01
482282 CDM Graft Excldr 12x23x15.5 80 19 $59,480.25 $59,480.25 $9,516.84 $57,814.08 $25,999.85 2026-03-01
472352 CDM Stent Gft Ilic 14cm 23mm 80 19 $59,480.25 $59,480.25 $9,516.84 $57,814.08 $25,999.85 2026-03-01
477230 CDM Graft Evs 16cm 26x14.5mm 80 19 $59,480.25 $59,480.25 $9,516.84 $57,814.08 $25,999.85 2026-03-01
479246 CDM Graft Evas 26x12mm 12cm 80 19 $59,480.25 $59,480.25 $9,516.84 $57,814.08 $25,999.85 2026-03-01
482284 CDM Graft Evas 16cm 23mm 14. 80 19 $59,480.25 $59,480.25 $9,516.84 $57,814.08 $25,999.85 2026-03-01
482288 CDM Graft Evas 14cm 26mm 14. 80 19 $59,480.25 $59,480.25 $9,516.84 $57,814.08 $25,999.85 2026-03-01
421811 CDM Graft Evas 16cm 26mm 14. 80 19 $59,480.25 $59,480.25 $9,516.84 $57,814.08 $25,999.85 2026-03-01
474489 CDM Graft Evas 18cm 28.5mm 1 80 19 $59,480.25 $59,480.25 $9,516.84 $57,814.08 $25,999.85 2026-03-01
468315 CDM Graft Evas 13cm 31mm 14. 80 19 $59,480.25 $59,480.25 $9,516.84 $57,814.08 $25,999.85 2026-03-01
420304 CDM Stent Aaa Exldr C3 23x12 80 19 $59,480.25 $59,480.25 $9,516.84 $57,814.08 $25,999.85 2026-03-01
432590 CDM Graft Evas 18cm 26mm 80 19 $59,480.25 $59,480.25 $9,516.84 $57,814.08 $25,999.85 2026-03-01
477365 CDM Graft Evas 14cm 35mm 14. 80 19 $59,480.25 $59,480.25 $9,516.84 $57,814.08 $25,999.85 2026-03-01
429542 CDM Graft Evas 14cm 23x14.5m 80 19 $59,480.25 $59,480.25 $9,516.84 $57,814.08 $25,999.85 2026-03-01
476296 CDM Graft Evas 16cm 23mm 12m 80 19 $59,480.25 $59,480.25 $9,516.84 $57,814.08 $25,999.85 2026-03-01
429860 CDM Graft Evas 18cm 23mm 80 19 $59,480.25 $59,480.25 $9,516.84 $57,814.08 $25,999.85 2026-03-01
399606 CDM Stent Grft Main C3 28mmx 80 19 $59,480.25 $59,480.25 $9,516.84 $57,814.08 $25,999.85 2026-03-01
432593 CDM Graft Evas 18cm 26mm 80 19 $59,480.25 $59,480.25 $9,516.84 $57,814.08 $25,999.85 2026-03-01
473999 CDM Graft Evas 18x23x14.5mm 80 19 $59,480.25 $59,480.25 $9,516.84 $57,814.08 $25,999.85 2026-03-01
482292 CDM Graft Evas 18cm 28.5mm 1 80 19 $59,480.25 $59,480.25 $9,516.84 $57,814.08 $25,999.85 2026-03-01
432588 CDM Graft Evas 14cm 26mm 80 19 $59,480.25 $59,480.25 $9,516.84 $57,814.08 $25,999.85 2026-03-01
476745 CDM Graft Evas 12cm 23mm 12m 80 19 $59,480.25 $59,480.25 $9,516.84 $57,814.08 $25,999.85 2026-03-01
428598 CDM Graft Evas 13cm 31mm 14. 80 19 $59,480.25 $59,480.25 $9,516.84 $57,814.08 $25,999.85 2026-03-01
432599 CDM Graft Evas 12cm 28.5mm 80 19 $59,480.25 $59,480.25 $9,516.84 $57,814.08 $25,999.85 2026-03-01
423167 CDM Graft Excluder Stent Trk 80 19 $59,480.25 $59,480.25 $9,516.84 $57,814.08 $25,999.85 2026-03-01
474099 CDM Graft Evas 14 Cm 28.5 14 80 19 $59,480.25 $59,480.25 $9,516.84 $57,814.08 $25,999.85 2026-03-01
476831 CDM Graft Evas 10cm 12mm Aaa 80 19 $59,480.25 $59,480.25 $9,516.84 $57,814.08 $25,999.85 2026-03-01
468669 CDM Graft Evas 14cm 23mm 14. 80 19 $59,480.25 $59,480.25 $9,516.84 $57,814.08 $25,999.85 2026-03-01
432583 CDM Graft Evas 14cm 23mm 80 19 $59,480.25 $59,480.25 $9,516.84 $57,814.08 $25,999.85 2026-03-01
482289 CDM Graft Evs 18cm 26x14.5mm 80 19 $59,480.25 $59,480.25 $9,516.84 $57,814.08 $25,999.85 2026-03-01
429502 CDM Stnt/gft Eprsth 17cm 31m 80 19 $59,480.25 $59,480.25 $9,516.84 $57,814.08 $25,999.85 2026-03-01
432586 CDM Graft Evas 18cm 23mm 80 19 $59,480.25 $59,480.25 $9,516.84 $57,814.08 $25,999.85 2026-03-01
432587 CDM Graft Evas 12cm 26mm 80 19 $59,480.25 $59,480.25 $9,516.84 $57,814.08 $25,999.85 2026-03-01
482334 CDM Graft Evas 16cm 35mm 14. 80 19 $59,480.25 $59,480.25 $9,516.84 $57,814.08 $25,999.85 2026-03-01
432589 CDM Graft Evas 16cm 26mm 80 19 $59,480.25 $59,480.25 $9,516.84 $57,814.08 $25,999.85 2026-03-01
482331 CDM Graft Evas 10cm 10mm Gor 80 19 $59,480.25 $59,480.25 $9,516.84 $57,814.08 $25,999.85 2026-03-01
429513 CDM Graft Evas 18cm 28.5mm 80 19 $59,480.25 $59,480.25 $9,516.84 $57,814.08 $25,999.85 2026-03-01
432584 CDM Graft Evas 12cm 23x14.5m 80 19 $59,480.25 $59,480.25 $9,516.84 $57,814.08 $25,999.85 2026-03-01
480996 CDM Graft Evas 12cm 28.5mm 1 80 19 $59,480.25 $59,480.25 $9,516.84 $57,814.08 $25,999.85 2026-03-01
482290 CDM Graft Excluder 14cm 28.5 80 19 $59,480.25 $59,480.25 $9,516.84 $57,814.08 $25,999.85 2026-03-01
432597 CDM Graft Evas 16cm 28.5mm 80 19 $59,480.25 $59,480.25 $9,516.84 $57,814.08 $25,999.85 2026-03-01
430572 CDM Graft Evas 15cm 31mm 14. 80 19 $59,480.25 $59,480.25 $9,516.84 $57,814.08 $25,999.85 2026-03-01
478737 CDM Graft Evas 10cm 14.5mm 80 19 $59,480.25 $59,480.25 $9,516.84 $57,814.08 $25,999.85 2026-03-01
459060 CDM Graft Evas 17cm 31x14.5 80 19 $59,480.25 $59,480.25 $9,516.84 $57,814.08 $25,999.85 2026-03-01
432585 CDM Graft Evas 16cm 23mm 80 19 $59,480.25 $59,480.25 $9,516.84 $57,814.08 $25,999.85 2026-03-01
473744 CDM Graft Excluder 16cm 28.5 80 19 $59,480.25 $59,480.25 $9,516.84 $57,814.08 $25,999.85 2026-03-01
459377 CDM Graft Evas 15cm 31x14.5 80 19 $59,480.25 $59,480.25 $9,516.84 $57,814.08 $25,999.85 2026-03-01
432591 CDM Graft Evas 12cm 26mm 14. 80 19 $59,480.25 $59,480.25 $9,516.84 $57,814.08 $25,999.85 2026-03-01
467555 CDM Graft Evas 12cm 26x14.5 80 19 $59,480.25 $59,480.25 $9,516.84 $57,814.08 $25,999.85 2026-03-01
456456 CDM Graft Evas 18cm 35mm 14. 80 19 $59,480.25 $59,480.25 $9,516.84 $57,814.08 $25,999.85 2026-03-01
432582 CDM Graft Evas 12cm 23mm 80 19 $59,480.25 $59,480.25 $9,516.84 $57,814.08 $25,999.85 2026-03-01
432595 CDM Graft Evas 14cm 28.5mm 80 19 $59,480.25 $59,480.25 $9,516.84 $57,814.08 $25,999.85 2026-03-01
432592 CDM Stent Excluder Gore C3 D 80 19 $59,480.25 $59,480.25 $9,516.84 $57,814.08 $25,999.85 2026-03-01
495522 CDM Kit Nucleus 6 Processor 82 20 $59,185.13 $59,185.13 $9,469.62 $60,400.47 $25,977.24 2026-03-01
495512 CDM Kit Nucleus 7 Processor 82 20 $59,185.13 $59,185.13 $9,469.62 $60,400.47 $25,977.24 2026-03-01
421582 CDM Graft Evas 166mm 23x16mm 80 19 $59,361.23 $59,361.23 $9,497.80 $57,698.40 $25,947.82 2026-03-01
421470 CDM Graft Evas 145mm 25mm 16 80 19 $59,361.23 $59,361.23 $9,497.80 $57,698.40 $25,947.82 2026-03-01
421342 CDM Graft Evas 145mm 28mm 16 80 19 $59,361.23 $59,361.23 $9,497.80 $57,698.40 $25,947.82 2026-03-01
421581 CDM Stent Graft Endurant Mai 80 19 $59,361.23 $59,361.23 $9,497.80 $57,698.40 $25,947.82 2026-03-01
421585 CDM Graft Evas 145mm 23x13mm 80 19 $59,361.23 $59,361.23 $9,497.80 $57,698.40 $25,947.82 2026-03-01
421591 CDM Graft Evas 145mm 32mm 16 80 19 $59,361.23 $59,361.23 $9,497.80 $57,698.40 $25,947.82 2026-03-01
421590 CDM Stent Graft Endurant Mai 80 19 $59,361.23 $59,361.23 $9,497.80 $57,698.40 $25,947.82 2026-03-01
421615 CDM Graft Evas 145mm 28x13mm 80 19 $59,361.23 $59,361.23 $9,497.80 $57,698.40 $25,947.82 2026-03-01
421586 CDM Stent Graft Endurant Mai 80 19 $59,361.23 $59,361.23 $9,497.80 $57,698.40 $25,947.82 2026-03-01
421620 CDM Graft Evas 145mm 36mm 16 80 19 $59,361.23 $59,361.23 $9,497.80 $57,698.40 $25,947.82 2026-03-01
421624 CDM Graft Endur Main 32mmx20 80 19 $59,361.23 $59,361.23 $9,497.80 $57,698.40 $25,947.82 2026-03-01
421602 CDM Graft Evas 166mm 28x13mm 80 19 $59,361.23 $59,361.23 $9,497.80 $57,698.40 $25,947.82 2026-03-01
421589 CDM Graft Evas 166mm 20x36mm 80 19 $59,361.23 $59,361.23 $9,497.80 $57,698.40 $25,947.82 2026-03-01
421584 CDM Stent Graft Endurant Mai 80 19 $59,361.23 $59,361.23 $9,497.80 $57,698.40 $25,947.82 2026-03-01
421617 CDM Graft Evas 124mm 28x13mm 80 19 $59,361.23 $59,361.23 $9,497.80 $57,698.40 $25,947.82 2026-03-01
421619 CDM Graft Evas Endurant Stnt 80 19 $59,361.23 $59,361.23 $9,497.80 $57,698.40 $25,947.82 2026-03-01
421625 CDM Stent Graft End Main 25x 80 19 $59,361.23 $59,361.23 $9,497.80 $57,698.40 $25,947.82 2026-03-01
421992 CDM Stent Graft Endurant Mai 80 19 $59,361.23 $59,361.23 $9,497.80 $57,698.40 $25,947.82 2026-03-01
421596 CDM Stnet Graft Endurant Mai 80 19 $59,361.23 $59,361.23 $9,497.80 $57,698.40 $25,947.82 2026-03-01
421593 CDM Stent Graft Endurant Mai 80 19 $59,361.23 $59,361.23 $9,497.80 $57,698.40 $25,947.82 2026-03-01
421682 CDM Stent Graft Endurant Mai 80 19 $59,361.23 $59,361.23 $9,497.80 $57,698.40 $25,947.82 2026-03-01
421686 CDM Graft Evas 166mm 25x13mm 80 19 $59,361.23 $59,361.23 $9,497.80 $57,698.40 $25,947.82 2026-03-01
421687 CDM Graft Vasc Aaa 32x16x166 80 19 $59,361.23 $59,361.23 $9,497.80 $57,698.40 $25,947.82 2026-03-01
368334 CDM Graft Evas 145mm 28x20mm 80 19 $59,361.23 $59,361.23 $9,497.80 $57,698.40 $25,947.82 2026-03-01
421681 CDM Graft Evas 28mm 16mm End 80 19 $59,361.23 $59,361.23 $9,497.80 $57,698.40 $25,947.82 2026-03-01
449767 CDM Graft Evas 124mm 32-20mm 80 19 $59,361.23 $59,361.23 $9,497.80 $57,698.40 $25,947.82 2026-03-01
421622 CDM Stent Graft Endurant Mai 80 19 $59,361.23 $59,361.23 $9,497.80 $57,698.40 $25,947.82 2026-03-01
421627 CDM Stent Graft End Main 25m 80 19 $59,361.23 $59,361.23 $9,497.80 $57,698.40 $25,947.82 2026-03-01
J9228 HCPCS Ipilimumab 1 Mg Injjw 191 18 $64,258.47 $64,258.47 $190.40 $249,836.18 $25,677.69 2026-03-01
545213 CDM Coil Emb Endo Sn Ly Sphr 80 19 $58,439.55 $58,439.55 $9,350.33 $56,807.01 $25,545.94 2026-03-01
545198 CDM Coil Emb Endo Sn Ly 8mmx 80 19 $58,439.55 $58,439.55 $9,350.33 $56,807.01 $25,545.94 2026-03-01
545183 CDM Device Embl 3mm 4mm Web 80 19 $58,439.55 $58,439.55 $9,350.33 $56,807.01 $25,545.94 2026-03-01
545195 CDM Coil Emb Endo Sn Ly 8mm 80 19 $58,439.55 $58,439.55 $9,350.33 $56,807.01 $25,545.94 2026-03-01
336174 CDM Device Embl Pln 4.5x12mm 80 19 $57,403.67 $57,403.67 $9,184.59 $55,800.06 $25,093.12 2026-03-01
336177 CDM Device Embl 4.25x10mm 80 19 $57,403.67 $57,403.67 $9,184.59 $55,800.06 $25,093.12 2026-03-01
442536 CDM Pros Knee Amk 1488-01 80 19 $56,616.43 $56,616.43 $9,058.63 $55,034.82 $24,748.99 2026-03-01
398227 CDM Graft Cv 120mm 25x16mm 2 80 19 $56,534.50 $56,534.50 $9,045.52 $54,950.85 $24,712.21 2026-03-01
C1767 HCPCS Gwire Vasc .018in 200cm 1,604 20 $61,566.75 $61,566.75 $807.20 $140,888.99 $24,688.27 2026-03-01
418419 CDM Stent Graft Evas 111mmx4 80 19 $56,387.33 $56,387.33 $9,021.97 $54,812.11 $24,648.85 2026-03-01
443409 CDM Graft Evas 112mm 36mm 32 80 19 $56,387.33 $56,387.33 $9,021.97 $54,812.11 $24,648.85 2026-03-01
566176 CDM Device Emblz 5mm 20mm 80 19 $56,230.97 $56,230.97 $8,996.96 $54,660.12 $24,580.50 2026-03-01
534460 CDM Device Embl 12mm 3.25mm 80 19 $55,585.98 $55,585.98 $8,893.76 $54,033.16 $24,298.55 2026-03-01
496750 CDM Device Embl 10mm 2.5mm P 80 19 $55,585.98 $55,585.98 $8,893.76 $54,033.16 $24,298.55 2026-03-01
519194 CDM Device Embl 12mm 2.5mm P 80 19 $55,585.98 $55,585.98 $8,893.76 $54,033.16 $24,298.55 2026-03-01
551863 CDM Device Embl 16mm 2.5mm P 80 19 $55,585.98 $55,585.98 $8,893.76 $54,033.16 $24,298.55 2026-03-01
318042 CDM Device Embl Pipln 4x18mm 80 19 $55,585.98 $55,585.98 $8,893.76 $54,033.16 $24,298.55 2026-03-01
867960 CDM Dev Embl 16x5mm 80 19 $55,585.98 $55,585.98 $8,893.76 $54,033.16 $24,298.55 2026-03-01
534231 CDM Device Embl 20mm 5mm Pip 80 19 $55,585.98 $55,585.98 $8,893.76 $54,033.16 $24,298.55 2026-03-01
517339 CDM Device Embl 14mm 3.5mm P 80 19 $55,585.98 $55,585.98 $8,893.76 $54,033.16 $24,298.55 2026-03-01
534459 CDM Device Embl 10mm 2.75mm 80 19 $55,585.98 $55,585.98 $8,893.76 $54,033.16 $24,298.55 2026-03-01
494621 CDM Device Embl 10mm 3.25mm 80 19 $55,585.98 $55,585.98 $8,893.76 $54,033.16 $24,298.55 2026-03-01
517537 CDM Device Embl 16mm 3.75mm 80 19 $55,585.98 $55,585.98 $8,893.76 $54,033.16 $24,298.55 2026-03-01
515340 CDM Device Embl 12mm 3.5mm 80 19 $55,585.98 $55,585.98 $8,893.76 $54,033.16 $24,298.55 2026-03-01
534450 CDM Device Embl 12mm 5mm Pip 80 19 $55,585.98 $55,585.98 $8,893.76 $54,033.16 $24,298.55 2026-03-01
514609 CDM Device Embl 18mm 4.25mm 80 19 $55,585.98 $55,585.98 $8,893.76 $54,033.16 $24,298.55 2026-03-01
517271 CDM Device Embl 12mm 4mm Pip 80 19 $55,585.98 $55,585.98 $8,893.76 $54,033.16 $24,298.55 2026-03-01
336175 CDM Device Embl 4.75x12mm 80 19 $55,585.98 $55,585.98 $8,893.76 $54,033.16 $24,298.55 2026-03-01
514684 CDM Cap Endrnt Grft 162699 42 19 $56,456.40 $56,456.40 $9,033.02 $50,810.76 $24,202.86 2024-10-01
514675 CDM Cap Endrnt Grft 162700 80 19 $55,312.35 $55,312.35 $8,849.98 $53,767.17 $24,178.93 2026-03-01
551728 CDM Device Embl 5x18mm 80 19 $53,553.30 $53,553.30 $8,568.53 $52,057.26 $23,409.99 2026-03-01
547294 CDM Graft Bn Hum Hd 80 19 $53,529.25 $53,529.25 $8,564.68 $52,029.78 $23,398.56 2026-03-01
5463 OTHER Level 3 Neurostimulator A 1 1 — — $23,362.11 $23,362.11 $23,362.11 2024-10-01
398129 CDM Graft Cv 135mm 28x16mm 2 80 19 $53,301.26 $53,301.26 $8,528.20 $51,808.18 $23,298.90 2026-03-01
C1772 HCPCS Pump Infs 18ml DRG Dlv 160 19 $55,130.10 $55,130.10 $7,606.81 $57,264.57 $23,233.75 2026-03-01
379403 CDM Graft Cv L12cm Od23x14.5 80 19 $52,844.88 $52,844.88 $8,455.18 $51,364.58 $23,099.41 2026-03-01
359955 CDM Graft Cv Excluder L16cm 80 19 $52,844.88 $52,844.88 $8,455.18 $51,364.58 $23,099.41 2026-03-01
359923 CDM Graft Evas 14cm 23mm 12m 80 19 $52,844.88 $52,844.88 $8,455.18 $51,364.58 $23,099.41 2026-03-01
359967 CDM Graft Evas 18cm 26mm 12m 80 19 $52,844.88 $52,844.88 $8,455.18 $51,364.58 $23,099.41 2026-03-01
359969 CDM Graft Cv Excluder L16cm 80 19 $52,844.88 $52,844.88 $8,455.18 $51,364.58 $23,099.41 2026-03-01
417828 CDM Graft Evas 17cm 31mm 14. 80 19 $52,844.88 $52,844.88 $8,455.18 $51,364.58 $23,099.41 2026-03-01
359924 CDM Graft Evas 16cm 26mm 12m 80 19 $52,844.88 $52,844.88 $8,455.18 $51,364.58 $23,099.41 2026-03-01
359925 CDM Graft Evas 18cm 28.5mm 1 80 19 $52,844.88 $52,844.88 $8,455.18 $51,364.58 $23,099.41 2026-03-01
398371 CDM Graft Evas 13cm 31mm 80 19 $52,844.88 $52,844.88 $8,455.18 $51,364.58 $23,099.41 2026-03-01
374005 CDM Graft Evas 12cm 26mm 12m 80 19 $52,844.88 $52,844.88 $8,455.18 $51,364.58 $23,099.41 2026-03-01
359943 CDM Graft Evas 16cm 28.5mm 1 80 19 $52,844.88 $52,844.88 $8,455.18 $51,364.58 $23,099.41 2026-03-01
355852 CDM Graft Evas 14cm 26mm 12m 80 19 $52,844.88 $52,844.88 $8,455.18 $51,364.58 $23,099.41 2026-03-01
359832 CDM Stnt/gft Eprsth 14cm 26m 80 19 $52,844.88 $52,844.88 $8,455.18 $51,364.58 $23,099.41 2026-03-01
378444 CDM Graft Evas 12cm 28.5mm 1 80 19 $52,844.88 $52,844.88 $8,455.18 $51,364.58 $23,099.41 2026-03-01
359851 CDM Graft Evas 18cm 23mm 12m 80 19 $52,844.88 $52,844.88 $8,455.18 $51,364.58 $23,099.41 2026-03-01
397692 CDM Graft Evas 15cm 31mm 14. 80 19 $52,844.88 $52,844.88 $8,455.18 $51,364.58 $23,099.41 2026-03-01
359926 CDM Stnt/gft Eprsth 14cm 28. 80 19 $52,844.88 $52,844.88 $8,455.18 $51,364.58 $23,099.41 2026-03-01
359927 CDM Graft Evas 16cm 23mm 12m 80 19 $52,844.88 $52,844.88 $8,455.18 $51,364.58 $23,099.41 2026-03-01
379406 CDM Graft Evas 12cm 23mm 12m 80 19 $52,844.88 $52,844.88 $8,455.18 $51,364.58 $23,099.41 2026-03-01
414085 CDM Graft Cv 18cm 23x14.5mm 80 19 $52,844.88 $52,844.88 $8,455.18 $51,364.58 $23,099.41 2026-03-01
388684 CDM Graft Cv Ilc L14cm Od26m 80 19 $52,844.88 $52,844.88 $8,455.18 $51,364.58 $23,099.41 2026-03-01
355097 CDM Graft Evas 16cm 28.5mm 1 80 19 $52,844.88 $52,844.88 $8,455.18 $51,364.58 $23,099.41 2026-03-01
359872 CDM Graft Cv Excluder L18cm 80 19 $52,844.88 $52,844.88 $8,455.18 $51,364.58 $23,099.41 2026-03-01
379957 CDM Graft Evas 12cm 28.5mm 1 80 19 $52,844.88 $52,844.88 $8,455.18 $51,364.58 $23,099.41 2026-03-01
359973 CDM Graft Evas 14cm 28.5mm 1 80 19 $52,844.88 $52,844.88 $8,455.18 $51,364.58 $23,099.41 2026-03-01
359950 CDM Graft Evas 14cm 23mm 14. 80 19 $52,844.88 $52,844.88 $8,455.18 $51,364.58 $23,099.41 2026-03-01
359928 CDM Graft Evas 18cm 28.5mm 1 80 19 $52,844.88 $52,844.88 $8,455.18 $51,364.58 $23,099.41 2026-03-01
533182 CDM System Mech Thrmb 43 20 $53,559.00 $53,559.00 $8,569.44 $48,203.10 $22,960.74 2024-10-01
C1820 HCPCS Generator Nrstm Prcsn Sp 960 19 $56,997.00 $56,997.00 $6.78 $79,016.58 $22,797.10 2026-03-01
903271 CDM Sir-spheres Microspheres 43 20 $52,974.00 $52,974.00 $8,475.84 $47,676.60 $22,709.95 2024-10-01
5115 OTHER Level 5 Musculoskeletal P 1 1 — — $22,571.68 $22,571.68 $22,571.68 2024-10-01
1575 OTHER New Technology - Level 38 1 1 — — $22,500.90 $22,500.90 $22,500.90 2024-10-01
1589 OTHER New Technology - Level 38 1 1 — — $22,500.90 $22,500.90 $22,500.90 2024-10-01
390893 CDM Stent Talent Biforcated 80 19 $51,327.38 $51,327.38 $8,212.38 $49,889.59 $22,436.08 2026-03-01
779339 CDM Cannula Dual 31fr 51cm 82 20 $50,817.00 $50,817.00 $8,130.72 $51,854.40 $22,303.03 2026-03-01
779338 CDM Cannula Introd 29fx46cm 82 20 $50,817.00 $50,817.00 $8,130.72 $51,854.40 $22,303.03 2026-03-01
See an error in this hospital's data? Submit a correction