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

Carepartners Rehabilitation Hosp

Asheville, NC · CCN 343025 · Rates published

Your selected procedure

You selected 70551 (CPT)

Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material

This hospital’s price: $215 across 1 payer · range $201-$215

Source: https://stctrprodsnsvc00455826e6.blob.core.windows.net/pt-final-posting-files/30-1114775_CAREPARTNERS-REHABILITATION-HOSPITAL_standardcharges.json?si=pt-json-access-policy&spr=https&sv=2024-11-04&sr=c&sig=o5IofreS%2F7ETlsnhPakPWCwHVVUZRobywQ5wUKGjVuQ%3D · observed 2026-09-01

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.

15,216 distinct procedures filed
28 distinct payers
504,830 rate rows
2026-09-01 last MRF observed
Data quality

430,574 of 504,830 rate rows are consumer-grade (85.3%)

74,256 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 55,232
per-diem day rate — not a per-procedure price 9,673
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 9,196
placeholder amount (≤ $0.02) — excluded from medians 147
exceeds 10× this hospital's gross charge — excluded from medians 8
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://www.hcadam.com/api/public/content/569fc7d62b6f4d82af86e4a4132f31f1?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 Latest re-check couldn't be parsed — showing last good data · 2026-09-21
Content fingerprint a2d8455bd74fc706… · 50,241,247 bytes · first seen 2026-05-05

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
845
OTHER 		Inj, Atidarsagene Autotem 10 $4,505,000.00 $4,955,500.00 $4,640,150.00 nat. median
$4,505,000
1.0× median
9138
OTHER 		Inj, Hemgenix, Per Tx Dos 12 $3,691,450.00 $4,429,740.00 $3,820,650.75 nat. median
$3,765,001
1.0× median
714
OTHER 		Inj Delandistrogene Mox R 12 $3,316,897.00 $3,980,276.40 $3,432,988.40 nat. median
$3,391,964
1.0× median
908
OTHER 		Topi Adm Prad Zami Per Tr 12 $3,285,783.00 $3,942,939.60 $3,400,785.41 nat. median
$8,800
outlier · 386.4×
748
OTHER 		Inj, Lovotibeglogene Auto 12 $3,235,304.00 $3,882,364.80 $3,348,539.64 nat. median
$3,351,720
1.0× median
906
OTHER 		Inj Elivaldogene Autoteme 12 $3,180,000.00 $3,816,000.00 $3,291,300.00 nat. median
$2,726
outlier · 1207.2×
746
OTHER 		Inj, Betibeglogene Autote 12 $2,930,260.00 $3,516,312.00 $3,032,819.10 nat. median
$3,001,835
1.0× median
9141
OTHER 		Inj Onase Abepar-xioi Tre 12 $2,680,038.00 $3,216,045.60 $2,773,839.33 nat. median
$2,508,045
1.1× median
922
OTHER 		Inj Onase Abepar-brve Trea 12 $2,664,228.00 $3,197,073.60 $2,757,475.98 nat. median
$167
outlier · 16548.5×
824
OTHER 		Inj, Exagamglogene Autote 12 $2,300,907.00 $2,761,088.40 $2,381,438.75 nat. median
$28,063
outlier · 84.9×
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
$621,313
outlier · 2.2×
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
$599,737
outlier · 2.2×
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
$562,501
outlier · 2.3×
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
$513,770
outlier · 2.3×
2067
OTHER 		Afamitresgene Autoleucel 12 $813,967.40 $976,760.88 $842,456.26 nat. median
$838,386
1.0× median
9194
OTHER 		Tisagenlecleucel Car-pos 12 $611,693.20 $734,031.84 $633,102.47 nat. median
$555,653
1.1× median
9498
OTHER 		Ciltacabtagene Car-pos T 12 $587,977.80 $705,573.36 $608,557.02 nat. median
$553,480
1.1× median
9413
OTHER 		Lisocabtagene Car Pos T 12 $579,570.60 $695,484.72 $599,855.57 nat. median
$542,562
1.1× median
9422
OTHER 		Idecabtagene Vicleucel Ca 12 $567,977.80 $681,573.36 $587,857.02 nat. median
$552,917
1.1× median
9035
OTHER 		Axicabtagene Ciloleucel C 12 $562,500.90 $675,001.08 $582,188.44 nat. median
$513,929
1.1× median
9391
OTHER 		Brexucabtagene Car Pos T 12 $510,103.90 $612,124.68 $527,957.54 nat. median
$483,557
1.1× median
831
OTHER 		Obecbtge Autol Up To 400 12 $278,250.00 $333,900.00 $287,988.75 nat. median
$278,250
1.0× median
897
OTHER 		Revakinagene, Per Implant 12 $261,579.70 $313,895.64 $270,734.99 nat. median
$269,427
1.0× median
886
OTHER 		Inj. Remestemcel-l-rknd/ 12 $203,659.80 $244,391.76 $210,787.89 nat. median
$203,660
1.0× median
J9999
HCPCS 		Carmustine 8 Wafers/box 10 $76,346.29 $250,415.85 $187,964.58 nat. median
$3,398
outlier · 55.3×
C9293
HCPCS 		Glucarpidase 1000 U Inj 10 $76,926.04 $252,317.43 $186,791.83 nat. median
$57,284
outlier · 3.3×
J9029
HCPCS 		Intravesical Instillation, Nadofaragene Firadenovec-vncg, Per Therapeutic Dose 1 $166,116.65 $166,116.65 $166,116.65 nat. median
$66,211
outlier · 2.5×
1908
OTHER 		New Technology - Level 52 12 $142,673.40 $171,208.08 $147,666.97 nat. median
$149,948
1.0× median
1907
OTHER 		New Technology - Level 52 12 $142,673.40 $171,208.08 $147,666.97 nat. median
$149,948
1.0× 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
$63,499
outlier · 2.3×
1906
OTHER 		New Technology - Level 51 12 $128,640.00 $154,368.00 $133,142.40 nat. median
$135,199
1.0× median
1905
OTHER 		New Technology - Level 51 12 $128,640.00 $154,368.00 $133,142.40 nat. median
$135,199
1.0× median
924
OTHER 		Inj Zopapogene Per Ther Do 12 $121,900.00 $146,280.00 $126,166.50 nat. median
$108
outlier · 1167.1×
1903
OTHER 		New Technology - Level 50 12 $114,606.60 $137,527.92 $118,617.83 nat. median
$3,015
outlier · 39.3×
1904
OTHER 		New Technology - Level 50 12 $114,606.60 $137,527.92 $118,617.83 nat. median
$3,015
outlier · 39.3×
Q0480
HCPCS 		Driver For Use With Pneumatic Ventricular Assist Device, Replacement Only 12 $111,503.00 $133,803.60 $115,405.60 nat. median
$108,243
1.1× median
J9226
HCPCS 		Histrelin Implant (supprelin La), 50 Mg 1 $110,645.59 $110,645.59 $110,645.59 nat. median
$57,036
1.9× median
1901
OTHER 		New Technology - Level 49 12 $100,573.20 $120,687.84 $104,093.26 nat. median
$3,015
outlier · 34.5×
1902
OTHER 		New Technology - Level 49 12 $100,573.20 $120,687.84 $104,093.26 nat. median
$3,015
outlier · 34.5×
K1007
HCPCS 		Bilateral Hip, Knee, Ankle, Foot Device, Powered, Includes Pelvic Component, Sin… 12 $95,081.00 $114,097.20 $98,408.83 nat. median
$95,583
1.0× median
1585
OTHER 		New Technology - Level 48 12 $88,878.66 $106,654.39 $91,989.42 nat. median
$93,410
1.0× median
1599
OTHER 		New Technology - Level 48 12 $88,878.66 $106,654.39 $91,989.42 nat. median
$93,410
1.0× median
J2350
HCPCS 		Ocrelizumab 300 Mg Inj 10 $157.62 $123,275.95 $91,705.28 nat. median
$133
outlier · 689.7×
1598
OTHER 		New Technology - Level 47 12 $79,523.07 $95,427.68 $82,306.38 nat. median
$83,578
1.0× median
1584
OTHER 		New Technology - Level 47 12 $79,523.07 $95,427.68 $82,306.38 nat. median
$83,578
1.0× median
J9266
HCPCS 		Pegasparga Single Vl Inj 10 $67,636.40 $102,707.13 $77,781.86 nat. median
$31,084
outlier · 2.5×
926
OTHER 		Gemcitabine Intravesical S 12 $72,984.24 $87,581.09 $75,538.69 nat. median
$91
outlier · 832.9×
1583
OTHER 		New Technology - Level 46 12 $70,167.47 $84,200.96 $72,623.33 nat. median
$73,745
1.0× median
1597
OTHER 		New Technology - Level 46 12 $70,167.47 $84,200.96 $72,623.33 nat. median
$73,745
1.0× median
L8702
HCPCS 		Powered Upper Extremity Range Of Motion Assist Device, Elbow, Wrist, Hand, Finge… 12 $68,801.70 $82,562.04 $71,209.76 nat. median
$68,802
1.0× median

Other procedures at this hospital

Browse this hospital's 15,216 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
             
845 OTHER Inj, Atidarsagene Autotem 12 10 — — $4,505,000.00 $4,955,500.00 $4,640,150.00 2026-09-01
9138 OTHER Inj, Hemgenix, Per Tx Dos 14 12 — — $3,691,450.00 $4,429,740.00 $3,820,650.75 2026-09-01
714 OTHER Inj Delandistrogene Mox R 14 12 — — $3,316,897.00 $3,980,276.40 $3,432,988.40 2026-09-01
908 OTHER Topi Adm Prad Zami Per Tr 14 12 — — $3,285,783.00 $3,942,939.60 $3,400,785.41 2026-09-01
748 OTHER Inj, Lovotibeglogene Auto 14 12 — — $3,235,304.00 $3,882,364.80 $3,348,539.64 2026-09-01
906 OTHER Inj Elivaldogene Autoteme 14 12 — — $3,180,000.00 $3,816,000.00 $3,291,300.00 2026-09-01
746 OTHER Inj, Betibeglogene Autote 14 12 — — $2,930,260.00 $3,516,312.00 $3,032,819.10 2026-09-01
9141 OTHER Inj Onase Abepar-xioi Tre 14 12 — — $2,680,038.00 $3,216,045.60 $2,773,839.33 2026-09-01
922 OTHER Inj Onase Abepar-brve Trea 14 12 — — $2,664,228.00 $3,197,073.60 $2,757,475.98 2026-09-01
824 OTHER Inj, Exagamglogene Autote 14 12 — — $2,300,907.00 $2,761,088.40 $2,381,438.75 2026-09-01
Q2042 HCPCS Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka… 4 1 — — $1,369,371.65 $1,369,371.65 $1,369,371.65 2026-09-01
Q2056 HCPCS Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige… 4 1 — — $1,328,128.35 $1,328,128.35 $1,328,128.35 2026-09-01
Q2041 HCPCS Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via… 4 1 — — $1,279,600.63 $1,279,600.63 $1,279,600.63 2026-09-01
Q2053 HCPCS Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V… 4 1 — — $1,175,752.00 $1,175,752.00 $1,175,752.00 2026-09-01
2067 OTHER Afamitresgene Autoleucel 14 12 — — $813,967.40 $976,760.88 $842,456.26 2026-09-01
9194 OTHER Tisagenlecleucel Car-pos 14 12 — — $611,693.20 $734,031.84 $633,102.47 2026-09-01
9498 OTHER Ciltacabtagene Car-pos T 14 12 — — $587,977.80 $705,573.36 $608,557.02 2026-09-01
9413 OTHER Lisocabtagene Car Pos T 14 12 — — $579,570.60 $695,484.72 $599,855.57 2026-09-01
9422 OTHER Idecabtagene Vicleucel Ca 14 12 — — $567,977.80 $681,573.36 $587,857.02 2026-09-01
9035 OTHER Axicabtagene Ciloleucel C 14 12 — — $562,500.90 $675,001.08 $582,188.44 2026-09-01
9391 OTHER Brexucabtagene Car Pos T 14 12 — — $510,103.90 $612,124.68 $527,957.54 2026-09-01
831 OTHER Obecbtge Autol Up To 400 14 12 — — $278,250.00 $333,900.00 $287,988.75 2026-09-01
897 OTHER Revakinagene, Per Implant 14 12 — — $261,579.70 $313,895.64 $270,734.99 2026-09-01
886 OTHER Inj. Remestemcel-l-rknd/ 14 12 — — $203,659.80 $244,391.76 $210,787.89 2026-09-01
J9999 HCPCS Carmustine 8 Wafers/box 18 10 $305,385.18 $305,385.18 $76,346.29 $250,415.85 $187,964.58 2026-09-01
C9293 HCPCS Glucarpidase 1000 U Inj 22 10 $307,704.18 $307,704.18 $76,926.04 $252,317.43 $186,791.83 2026-09-01
J9029 HCPCS Intravesical Instillation, Nadofaragene Firadenovec-vncg, Per Therapeutic Dose 4 1 — — $166,116.65 $166,116.65 $166,116.65 2026-09-01
1907 OTHER New Technology - Level 52 14 12 — — $142,673.40 $171,208.08 $147,666.97 2026-09-01
1908 OTHER New Technology - Level 52 14 12 — — $142,673.40 $171,208.08 $147,666.97 2026-09-01
Q2043 HCPCS Sipuleucel-t, Minimum Of 50 Million Autologous Cd54+ Cells Activated With Pap-gm… 4 1 — — $145,223.54 $145,223.54 $145,223.54 2026-09-01
1906 OTHER New Technology - Level 51 14 12 — — $128,640.00 $154,368.00 $133,142.40 2026-09-01
1905 OTHER New Technology - Level 51 14 12 — — $128,640.00 $154,368.00 $133,142.40 2026-09-01
924 OTHER Inj Zopapogene Per Ther Do 14 12 — — $121,900.00 $146,280.00 $126,166.50 2026-09-01
1904 OTHER New Technology - Level 50 14 12 — — $114,606.60 $137,527.92 $118,617.83 2026-09-01
1903 OTHER New Technology - Level 50 14 12 — — $114,606.60 $137,527.92 $118,617.83 2026-09-01
Q0480 HCPCS Driver For Use With Pneumatic Ventricular Assist Device, Replacement Only 14 12 — — $111,503.00 $133,803.60 $115,405.60 2026-09-01
J9226 HCPCS Histrelin Implant (supprelin La), 50 Mg 4 1 — — $110,645.59 $110,645.59 $110,645.59 2026-09-01
1902 OTHER New Technology - Level 49 14 12 — — $100,573.20 $120,687.84 $104,093.26 2026-09-01
1901 OTHER New Technology - Level 49 14 12 — — $100,573.20 $120,687.84 $104,093.26 2026-09-01
K1007 HCPCS Bilateral Hip, Knee, Ankle, Foot Device, Powered, Includes Pelvic Component, Sin… 14 12 — — $95,081.00 $114,097.20 $98,408.83 2026-09-01
1585 OTHER New Technology - Level 48 14 12 — — $88,878.66 $106,654.39 $91,989.42 2026-09-01
1599 OTHER New Technology - Level 48 14 12 — — $88,878.66 $106,654.39 $91,989.42 2026-09-01
J2350 HCPCS Ocrelizumab 300 Mg Inj 21 10 $150,336.52 $150,336.52 $157.62 $123,275.95 $91,705.28 2026-09-01
1584 OTHER New Technology - Level 47 14 12 — — $79,523.07 $95,427.68 $82,306.38 2026-09-01
1598 OTHER New Technology - Level 47 14 12 — — $79,523.07 $95,427.68 $82,306.38 2026-09-01
J9266 HCPCS Pegasparga Single Vl Inj 21 10 $125,252.60 $125,252.60 $67,636.40 $102,707.13 $77,781.86 2026-09-01
926 OTHER Gemcitabine Intravesical S 14 12 — — $72,984.24 $87,581.09 $75,538.69 2026-09-01
1597 OTHER New Technology - Level 46 14 12 — — $70,167.47 $84,200.96 $72,623.33 2026-09-01
1583 OTHER New Technology - Level 46 14 12 — — $70,167.47 $84,200.96 $72,623.33 2026-09-01
L8702 HCPCS Powered Upper Extremity Range Of Motion Assist Device, Elbow, Wrist, Hand, Finge… 14 12 — — $68,801.70 $82,562.04 $71,209.76 2026-09-01
717 OTHER Instill Adstiladrin, Tx D 14 12 — — $64,331.61 $77,197.93 $66,583.21 2026-09-01
1596 OTHER New Technology - Level 45 14 12 — — $60,811.87 $72,974.24 $62,940.29 2026-09-01
1582 OTHER New Technology - Level 45 14 12 — — $60,811.87 $72,974.24 $62,940.29 2026-09-01
5244 OTHER Level 4 Blood Product Exc 14 12 — — $60,122.38 $72,146.86 $62,226.67 2026-09-01
J3357 HCPCS Ustekinumab 1 Mg Inj 58 10 $101,787.63 $101,787.63 $378.69 $175,111.30 $61,281.25 2026-09-01
B0404 HCPCS Traumatic Spinal Cord Injury; M < 16.05 & A > 63.5 1 1 — — $60,247.12 $60,247.12 $60,247.12 2026-09-01
B0505 HCPCS Nontraumatic Spinal Cord Injury; M > 23.75 & M < 2 1 1 — — $59,255.18 $59,255.18 $59,255.18 2026-09-01
1643 OTHER Y90 Ibritumomab, Rx 14 12 — — $56,824.55 $68,189.46 $58,813.41 2026-09-01
9273 OTHER Sipuleucel-t Auto Cd54+ 14 12 — — $55,932.43 $67,118.92 $57,890.07 2026-09-01
B0106 HCPCS Stroke; M > 30.05 & M < 34.25 1 1 — — $53,722.64 $53,722.64 $53,722.64 2026-09-01
1581 OTHER New Technology - Level 44 14 12 — — $51,456.27 $61,747.52 $53,257.24 2026-09-01
1595 OTHER New Technology - Level 44 14 12 — — $51,456.27 $61,747.52 $53,257.24 2026-09-01
B1903 HCPCS Guillian Barre; M < 18.05 1 1 — — $52,341.88 $52,341.88 $52,341.88 2026-09-01
B0205 HCPCS Traumatic Brain Injury; M > 28.75 & M < 40.65 1 1 — — $51,679.95 $51,679.95 $51,679.95 2026-09-01
J9119 HCPCS Cemiplimab-rwlc 350mginj 21 10 $84,188.44 $84,188.44 $72.46 $69,034.52 $51,354.95 2026-09-01
L7181 HCPCS Electronic Elbow, Microprocessor Simultaneous Control Of Elbow And Terminal Devi… 14 12 — — $49,605.40 $59,526.48 $51,341.59 2026-09-01
C0404 HCPCS Traumatic Spinal Cord Injury; M < 16.05 & A > 63.5 1 1 — — $49,244.65 $49,244.65 $49,244.65 2026-09-01
B2102 HCPCS Burns; M=12-45 1 1 — — $48,271.67 $48,271.67 $48,271.67 2026-09-01
D0404 HCPCS Traumatic Spinal Cord Injury; M < 16.05 & A > 63.5 1 1 — — $47,949.24 $47,949.24 $47,949.24 2026-09-01
J2327 HCPCS Risankizum-rzaa 1mg Inj 21 10 $78,308.83 $78,308.83 $39.21 $64,213.24 $47,768.39 2026-09-01
B0405 HCPCS Traumatic Spinal Cord Injury; M < 16.05 & A < 63.5 1 1 — — $47,721.64 $47,721.64 $47,721.64 2026-09-01
C0106 HCPCS Stroke; M > 30.05 & M < 34.25 1 1 — — $47,706.47 $47,706.47 $47,706.47 2026-09-01
B0105 HCPCS Stroke; M > 34.25 & M < 38.85 1 1 — — $47,693.19 $47,693.19 $47,693.19 2026-09-01
B0604 HCPCS Neurological; M < 25.85 1 1 — — $46,464.16 $46,464.16 $46,464.16 2026-09-01
C0505 HCPCS Nontraumatic Spinal Cord Injury; M > 23.75 & M < 2 1 1 — — $45,536.70 $45,536.70 $45,536.70 2026-09-01
B1004 HCPCS Amputation, Lower Extremity; M=39-45 1 1 — — $44,825.45 $44,825.45 $44,825.45 2026-09-01
B1504 HCPCS Pulmonary; M < 29.15 1 1 — — $44,429.05 $44,429.05 $44,429.05 2026-09-01
1580 OTHER New Technology - Level 43 14 12 — — $42,100.67 $50,520.80 $43,574.19 2026-09-01
1594 OTHER New Technology - Level 43 14 12 — — $42,100.67 $50,520.80 $43,574.19 2026-09-01
B0704 HCPCS Fracture Of Lower Extremity; M < 28.15 1 1 — — $43,509.18 $43,509.18 $43,509.18 2026-09-01
B1304 HCPCS Rheumatoid, Other Arthritis; M=12-35 1 1 — — $43,456.07 $43,456.07 $43,456.07 2026-09-01
A0404 HCPCS Traumatic Spinal Cord Injury; M < 16.05 & A > 63.5 1 1 — — $43,389.69 $43,389.69 $43,389.69 2026-09-01
D0106 HCPCS Stroke; M > 30.05 & M < 34.25 1 1 — — $43,222.78 $43,222.78 $43,222.78 2026-09-01
B0904 HCPCS Other Orthopedic; M < 24.15 1 1 — — $42,640.51 $42,640.51 $42,640.51 2026-09-01
D0505 HCPCS Nontraumatic Spinal Cord Injury; M > 23.75 & M < 2 1 1 — — $42,363.60 $42,363.60 $42,363.60 2026-09-01
C0105 HCPCS Stroke; M > 34.25 & M < 38.85 1 1 — — $42,352.22 $42,352.22 $42,352.22 2026-09-01
J9228 HCPCS Ipilimumab 1 Mg Inj 55 10 $69,399.15 $69,399.15 $427.29 $227,628.52 $42,333.48 2026-09-01
B2005 HCPCS Miscellaneous; M=12-32 And A Tm81 1 1 — — $41,950.13 $41,950.13 $41,950.13 2026-09-01
941 OTHER Riboflavin Epioxa/hd<=2ml 14 12 — — $40,427.50 $48,513.00 $41,842.46 2026-09-01
B0504 HCPCS Nontraumatic Spinal Cord Injury; M > 29.25 & M < 3 1 1 — — $41,705.46 $41,705.46 $41,705.46 2026-09-01
B1704 HCPCS Major Multiple Trauma,no Brain Or Spinal Cord Inju 1 1 — — $41,637.18 $41,637.18 $41,637.18 2026-09-01
A5104 HCPCS Expired, Not Orthopedic, Length Of Stay Is 16 Days 1 1 — — $41,500.62 $41,500.62 $41,500.62 2026-09-01
L7180 HCPCS Electronic Elbow, Microprocessor Sequential Control Of Elbow And Terminal Device… 14 12 — — $39,992.60 $47,991.12 $41,392.34 2026-09-01
C0205 HCPCS Traumatic Brain Injury; M > 28.75 & M < 40.65 1 1 — — $41,090.95 $41,090.95 $41,090.95 2026-09-01
B0304 HCPCS Nontraumatic Brain Injury; M < 26.15 1 1 — — $41,034.05 $41,034.05 $41,034.05 2026-09-01
A0106 HCPCS Stroke; M > 30.05 & M < 34.25 1 1 — — $40,998.01 $40,998.01 $40,998.01 2026-09-01
L2006 HCPCS Knee Ankle Foot Device, Any Material, Single Or Double Upright, Swing And Stance… 14 12 — — $39,378.40 $47,254.08 $40,756.65 2026-09-01
B1404 HCPCS Cardiac; M < 31.15 1 1 — — $40,717.31 $40,717.31 $40,717.31 2026-09-01
B1204 HCPCS Osteoarthritis; M=39-47 1 1 — — $40,711.62 $40,711.62 $40,711.62 2026-09-01
C2102 HCPCS Burns; M=12-45 1 1 — — $40,582.65 $40,582.65 $40,582.65 2026-09-01
B0204 HCPCS Traumatic Brain Injury; M > 40.65 & M < 44.25 1 1 — — $40,282.97 $40,282.97 $40,282.97 2026-09-01
B2004 HCPCS Miscellaneous; M < 27.85 1 1 — — $40,078.14 $40,078.14 $40,078.14 2026-09-01
B0805 HCPCS Replacement Of Lower Extremity Joint; M > 22.05 & 1 1 — — $39,658.98 $39,658.98 $39,658.98 2026-09-01
B1203 HCPCS Osteoarthritis; M < 30.75 1 1 — — $39,545.18 $39,545.18 $39,545.18 2026-09-01
B1804 HCPCS Major Multiple Trauma With Brain Or Spinal Code In 1 1 — — $39,194.30 $39,194.30 $39,194.30 2026-09-01
A0505 HCPCS Nontraumatic Spinal Cord Injury; M > 23.75 & M < 2 1 1 — — $39,040.67 $39,040.67 $39,040.67 2026-09-01
C0405 HCPCS Traumatic Spinal Cord Injury; M < 16.05 & A < 63.5 1 1 — — $39,006.53 $39,006.53 $39,006.53 2026-09-01
1142 OTHER Supprelin La Implant 14 12 — — $37,491.97 $44,990.36 $38,804.19 2026-09-01
D0105 HCPCS Stroke; M > 34.25 & M < 38.85 1 1 — — $38,371.15 $38,371.15 $38,371.15 2026-09-01
B0104 HCPCS Stroke; M > 38.85 & M < 44.45 1 1 — — $38,268.73 $38,268.73 $38,268.73 2026-09-01
J1930 HCPCS Lanreotide 120 Mg Inj 55 10 $62,502.98 $62,502.98 $124.20 $60,439.35 $38,126.82 2026-09-01
D0405 HCPCS Traumatic Spinal Cord Injury; M < 16.05 & A < 63.5 1 1 — — $37,980.44 $37,980.44 $37,980.44 2026-09-01
D0205 HCPCS Traumatic Brain Injury; M > 28.75 & M < 40.65 1 1 — — $37,540.42 $37,540.42 $37,540.42 2026-09-01
J9022 HCPCS Atezolizumab 10 Mg Inj 55 10 $61,362.10 $61,362.10 $224.39 $68,380.19 $37,430.88 2026-09-01
C1004 HCPCS Amputation, Lower Extremity; M=39-45 1 1 — — $37,246.44 $37,246.44 $37,246.44 2026-09-01
B0403 HCPCS Traumatic Spinal Cord Injury; M > 16.05 & M < 30.3 1 1 — — $37,181.95 $37,181.95 $37,181.95 2026-09-01
B1902 HCPCS Guillian Barre; M > 18.05 & M < 35.95 1 1 — — $36,994.18 $36,994.18 $36,994.18 2026-09-01
C1903 HCPCS Guillian Barre; M < 18.05 1 1 — — $36,992.28 $36,992.28 $36,992.28 2026-09-01
B0603 HCPCS Neurological; M > 25.85 & M < 37.35 1 1 — — $36,738.13 $36,738.13 $36,738.13 2026-09-01
B1103 HCPCS Amputation, Non-lower Extremity; M=12-37 1 1 — — $36,688.82 $36,688.82 $36,688.82 2026-09-01
J3380 HCPCS Vedolizumab 300 Mg IV 21 10 $59,846.88 $59,846.88 $56.80 $49,074.44 $36,506.60 2026-09-01
A0105 HCPCS Stroke; M > 34.25 & M < 38.85 1 1 — — $36,396.74 $36,396.74 $36,396.74 2026-09-01
L8701 HCPCS Powered Upper Extremity Range Of Motion Assist Device, Elbow, Wrist, Hand With S… 14 12 — — $34,970.10 $41,964.12 $36,194.05 2026-09-01
B1703 HCPCS Maj Mult Trauma No Brain Or Spinal Cord Injury; M 1 1 — — $36,184.31 $36,184.31 $36,184.31 2026-09-01
J1303 HCPCS Ravuliz-cwvz 1100mg Inj 55 10 $59,246.46 $59,246.46 $578.70 $164,846.66 $36,140.34 2026-09-01
J1932 HCPCS 505cp Lanreot 120 Mg Inj 21 10 $58,861.81 $58,861.81 $110.78 $48,266.68 $35,905.70 2026-09-01
C1504 HCPCS Pulmonary; M < 29.15 1 1 — — $35,723.42 $35,723.42 $35,723.42 2026-09-01
B1503 HCPCS Pulmonary; M > 29.15 & M < 39.05 1 1 — — $35,429.44 $35,429.44 $35,429.44 2026-09-01
B0903 HCPCS Other Orthopedic; M > 24.15 & M < 34.35 1 1 — — $35,410.48 $35,410.48 $35,410.48 2026-09-01
A0205 HCPCS Traumatic Brain Injury; M > 28.75 & M < 40.65 1 1 — — $35,270.13 $35,270.13 $35,270.13 2026-09-01
B0703 HCPCS Fracture Of Lower Extremity; M > 28.15 & M < 34.15 1 1 — — $35,235.99 $35,235.99 $35,235.99 2026-09-01
C0604 HCPCS Neurological; M < 25.85 1 1 — — $35,188.57 $35,188.57 $35,188.57 2026-09-01
B0503 HCPCS Nontraumatic Spinal Cord Injury; M > 31.25 & M < 4 1 1 — — $34,902.18 $34,902.18 $34,902.18 2026-09-01
C0704 HCPCS Fracture Of Lower Extremity; M < 28.15 1 1 — — $34,788.38 $34,788.38 $34,788.38 2026-09-01
C1304 HCPCS Rheumatoid, Other Arthritis; M=12-35 1 1 — — $34,742.86 $34,742.86 $34,742.86 2026-09-01
C1103 HCPCS Amputation, Non-lower Extremity; M=12-37 1 1 — — $34,733.37 $34,733.37 $34,733.37 2026-09-01
B0303 HCPCS Nontraumatic Brain Injury; M > 26.15 & M < 35.05 1 1 — — $34,636.64 $34,636.64 $34,636.64 2026-09-01
A0405 HCPCS Traumatic Spinal Cord Injury; M < 16.05 & A < 63.5 1 1 — — $34,369.22 $34,369.22 $34,369.22 2026-09-01
C0104 HCPCS Stroke; M > 38.85 & M < 44.45 1 1 — — $33,984.20 $33,984.20 $33,984.20 2026-09-01
1579 OTHER New Technology - Level 42 14 12 — — $32,745.07 $39,294.08 $33,891.15 2026-09-01
1593 OTHER New Technology - Level 42 14 12 — — $32,745.07 $39,294.08 $33,891.15 2026-09-01
D1004 HCPCS Amputation, Lower Extremity; M=39-45 1 1 — — $33,805.91 $33,805.91 $33,805.91 2026-09-01
J3101 HCPCS Tenecteplase 1 Mg Inj 63 10 $57,533.64 $57,533.64 $468.10 $51,437.75 $33,743.48 2026-09-01
B1003 HCPCS Amputation, Lower Extremity; M < 36.25 1 1 — — $33,699.70 $33,699.70 $33,699.70 2026-09-01
B1303 HCPCS Rheumatoid, Other Arthritis; M < 26.15 1 1 — — $33,669.35 $33,669.35 $33,669.35 2026-09-01
C2005 HCPCS Miscellaneous; M=12-32 And A Tm81 1 1 — — $33,642.80 $33,642.80 $33,642.80 2026-09-01
B1803 HCPCS Major Multiple Trauma With Brain Or Spinal Cord In 1 1 — — $33,559.35 $33,559.35 $33,559.35 2026-09-01
D1504 HCPCS Pulmonary; M < 29.15 1 1 — — $33,455.03 $33,455.03 $33,455.03 2026-09-01
C0805 HCPCS Replacement Of Lower Extremity Joint; M > 22.05 & 1 1 — — $33,401.92 $33,401.92 $33,401.92 2026-09-01
J9307 HCPCS Pralatrexate 20 Mg Inj 55 10 $54,403.52 $54,403.52 $723.00 $89,221.75 $33,186.15 2026-09-01
D0604 HCPCS Neurological; M < 25.85 1 1 — — $33,143.98 $33,143.98 $33,143.98 2026-09-01
D0704 HCPCS Fracture Of Lower Extremity; M < 28.15 1 1 — — $33,039.66 $33,039.66 $33,039.66 2026-09-01
C1704 HCPCS Major Multiple Trauma,no Brain Or Spinal Cord Inju 1 1 — — $32,986.56 $32,986.56 $32,986.56 2026-09-01
B2003 HCPCS Miscellaneous; M > 27.85 & M < 38.75 1 1 — — $32,861.38 $32,861.38 $32,861.38 2026-09-01
C1404 HCPCS Cardiac; M < 31.15 1 1 — — $32,800.69 $32,800.69 $32,800.69 2026-09-01
B0203 HCPCS Traumatic Brain Injury; M > 44.25 & C < 23.5 1 1 — — $32,684.99 $32,684.99 $32,684.99 2026-09-01
B1403 HCPCS Cardiac; M > 31.15 & M < 38.55 1 1 — — $32,635.68 $32,635.68 $32,635.68 2026-09-01
5166 OTHER Cochlear Implant Procedur 14 12 — — $31,515.54 $37,818.65 $32,618.58 2026-09-01
C0304 HCPCS Nontraumatic Brain Injury; M < 26.15 1 1 — — $32,521.88 $32,521.88 $32,521.88 2026-09-01
C1204 HCPCS Osteoarthritis; M=39-47 1 1 — — $32,313.25 $32,313.25 $32,313.25 2026-09-01
C0904 HCPCS Other Orthopedic; M < 24.15 1 1 — — $32,298.07 $32,298.07 $32,298.07 2026-09-01
B0402 HCPCS Traumatic Spinal Cord Injury; M > 30.35 & M < 48.4 1 1 — — $32,214.62 $32,214.62 $32,214.62 2026-09-01
A1903 HCPCS Guillian Barre; M < 18.05 1 1 — — $32,167.20 $32,167.20 $32,167.20 2026-09-01
D1903 HCPCS Guillian Barre; M < 18.05 1 1 — — $32,159.62 $32,159.62 $32,159.62 2026-09-01
C2004 HCPCS Miscellaneous; M < 27.85 1 1 — — $32,140.65 $32,140.65 $32,140.65 2026-09-01
C1804 HCPCS Major Multiple Trauma With Brain Or Spinal Code In 1 1 — — $32,064.78 $32,064.78 $32,064.78 2026-09-01
C0504 HCPCS Nontraumatic Spinal Cord Injury; M > 29.25 & M < 3 1 1 — — $32,049.61 $32,049.61 $32,049.61 2026-09-01
C0204 HCPCS Traumatic Brain Injury; M > 40.65 & M < 44.25 1 1 — — $32,028.75 $32,028.75 $32,028.75 2026-09-01
A1504 HCPCS Pulmonary; M < 29.15 1 1 — — $31,981.33 $31,981.33 $31,981.33 2026-09-01
B0804 HCPCS Replacement Of Lower Ext Joint; M > 28.65 & M < 37 1 1 — — $31,840.98 $31,840.98 $31,840.98 2026-09-01
D1304 HCPCS Rheumatoid, Other Arthritis; M=12-35 1 1 — — $31,833.39 $31,833.39 $31,833.39 2026-09-01
A1004 HCPCS Amputation, Lower Extremity; M=39-45 1 1 — — $31,389.58 $31,389.58 $31,389.58 2026-09-01
C1203 HCPCS Osteoarthritis; M < 30.75 1 1 — — $31,385.78 $31,385.78 $31,385.78 2026-09-01
D2005 HCPCS Miscellaneous; M=12-32 And A Tm81 1 1 — — $31,287.16 $31,287.16 $31,287.16 2026-09-01
5232 OTHER Level 2 Icd And Similar P 14 12 — — $30,002.22 $36,002.66 $31,052.30 2026-09-01
B0602 HCPCS Neurological; M > 37.35 & M < 47.75 1 1 — — $30,894.55 $30,894.55 $30,894.55 2026-09-01
B1702 HCPCS Maj Mult Trauma No Brain Or Spinal Cord Injury; M 1 1 — — $30,839.55 $30,839.55 $30,839.55 2026-09-01
B0502 HCPCS Nontraumatic Spinal Cord Injury; M > 40.15 & M < 5 1 1 — — $30,822.48 $30,822.48 $30,822.48 2026-09-01
D0104 HCPCS Stroke; M > 38.85 & M < 44.45 1 1 — — $30,790.24 $30,790.24 $30,790.24 2026-09-01
L5856 HCPCS Addition To Lower Extremity Prosthesis, Endoskeletal Knee-shin System, Microproc… 14 12 — — $29,720.00 $35,664.00 $30,760.20 2026-09-01
843 OTHER Pegaspargase Injection 14 12 — — $29,663.96 $35,596.75 $30,702.20 2026-09-01
D1704 HCPCS Major Multiple Trauma,no Brain Or Spinal Cord Inju 1 1 — — $30,627.12 $30,627.12 $30,627.12 2026-09-01
L6880 HCPCS Electric Hand, Switch Or Myoelectric Controlled, Independently Articulating Digi… 14 12 — — $29,579.70 $35,495.64 $30,614.99 2026-09-01
D2102 HCPCS Burns; M=12-45 1 1 — — $30,604.36 $30,604.36 $30,604.36 2026-09-01
L6700 HCPCS Upper Extremity Addition, External Powered Feature, Myoelectronic Control Module… 14 12 — — $29,510.20 $35,412.24 $30,543.06 2026-09-01
5465 OTHER Level 5 Neurostimulator A 14 12 — — $29,494.52 $35,393.42 $30,526.83 2026-09-01
D0904 HCPCS Other Orthopedic; M < 24.15 1 1 — — $30,509.53 $30,509.53 $30,509.53 2026-09-01
B2101 HCPCS Burns; M > 0 1 1 — — $30,462.11 $30,462.11 $30,462.11 2026-09-01
C0403 HCPCS Traumatic Spinal Cord Injury; M > 16.05 & M < 30.3 1 1 — — $30,391.94 $30,391.94 $30,391.94 2026-09-01
B1502 HCPCS Pulmonary; M > 39.05 & M < 49.25 1 1 — — $30,388.15 $30,388.15 $30,388.15 2026-09-01
D1404 HCPCS Cardiac; M < 31.15 1 1 — — $30,329.35 $30,329.35 $30,329.35 2026-09-01
D0304 HCPCS Nontraumatic Brain Injury; M < 26.15 1 1 — — $30,317.97 $30,317.97 $30,317.97 2026-09-01
A0704 HCPCS Fracture Of Lower Extremity; M < 28.15 1 1 — — $30,190.89 $30,190.89 $30,190.89 2026-09-01
B0103 HCPCS Stroke; M > 44.45 & M < 51.05 & C < 18.5 1 1 — — $29,963.30 $29,963.30 $29,963.30 2026-09-01
D2004 HCPCS Miscellaneous; M < 27.85 1 1 — — $29,891.22 $29,891.22 $29,891.22 2026-09-01
D1103 HCPCS Amputation, Non-lower Extremity; M=12-37 1 1 — — $29,891.22 $29,891.22 $29,891.22 2026-09-01
D0805 HCPCS Replacement Of Lower Extremity Joint; M > 22.05 & 1 1 — — $29,857.08 $29,857.08 $29,857.08 2026-09-01
B0902 HCPCS Other Orthopedic; M > 34.35 & M < 44.75 1 1 — — $29,840.01 $29,840.01 $29,840.01 2026-09-01
D0504 HCPCS Nontraumatic Spinal Cord Injury; M > 29.25 & M < 3 1 1 — — $29,815.36 $29,815.36 $29,815.36 2026-09-01
A0604 HCPCS Neurological; M < 25.85 1 1 — — $29,769.84 $29,769.84 $29,769.84 2026-09-01
J2323 HCPCS Natalizumab 300 Mg Inj 21 10 $48,744.97 $48,744.97 $59.77 $39,970.88 $29,734.43 2026-09-01
D0403 HCPCS Traumatic Spinal Cord Injury; M > 16.05 & M < 30.3 1 1 — — $29,591.55 $29,591.55 $29,591.55 2026-09-01
B1202 HCPCS Osteoarthritis; M > 30.75 & M < 37.65 1 1 — — $29,542.24 $29,542.24 $29,542.24 2026-09-01
D1804 HCPCS Major Multiple Trauma With Brain Or Spinal Code In 1 1 — — $29,496.72 $29,496.72 $29,496.72 2026-09-01
A2102 HCPCS Burns; M=12-45 1 1 — — $29,348.78 $29,348.78 $29,348.78 2026-09-01
J1299 HCPCS Eculizumab 300 Mg Inj 21 10 $48,029.48 $48,029.48 $19,538.39 $39,384.17 $29,297.98 2026-09-01
B0302 HCPCS Nontraumatic Brain Injury; M > 35.05 & M < 41.05 1 1 — — $29,293.78 $29,293.78 $29,293.78 2026-09-01
B1102 HCPCS Amputation, Non-lower Extremity; M < 36.35 1 1 — — $29,291.88 $29,291.88 $29,291.88 2026-09-01
D0204 HCPCS Traumatic Brain Injury; M > 40.65 & M < 44.25 1 1 — — $29,261.53 $29,261.53 $29,261.53 2026-09-01
A0104 HCPCS Stroke; M > 38.85 & M < 44.45 1 1 — — $29,204.63 $29,204.63 $29,204.63 2026-09-01
B1302 HCPCS Rheumatoid, Other Arthritis; M > 26.15 & M < 36.35 1 1 — — $29,132.56 $29,132.56 $29,132.56 2026-09-01
B1603 HCPCS Pain Syndrome: M < 26.75 1 1 — — $29,051.01 $29,051.01 $29,051.01 2026-09-01
A1304 HCPCS Rheumatoid, Other Arthritis; M=12-35 1 1 — — $28,916.34 $28,916.34 $28,916.34 2026-09-01
D1204 HCPCS Osteoarthritis; M=39-47 1 1 — — $28,876.51 $28,876.51 $28,876.51 2026-09-01
B0702 HCPCS Fracture Of Lower Extremity; M > 34.15 & M < 42.15 1 1 — — $28,762.72 $28,762.72 $28,762.72 2026-09-01
J1412 HCPCS Injection, Valoctocogene Roxaparvovec-rvox, Per Ml, Containing Nominal 2 X 10°13… 4 1 — — $28,750.78 $28,750.78 $28,750.78 2026-09-01
C1703 HCPCS Maj Mult Trauma No Brain Or Spinal Cord Injury; M 1 1 — — $28,665.99 $28,665.99 $28,665.99 2026-09-01
A2005 HCPCS Miscellaneous; M=12-32 And A Tm81 1 1 — — $28,641.33 $28,641.33 $28,641.33 2026-09-01
C1503 HCPCS Pulmonary; M > 29.15 & M < 39.05 1 1 — — $28,487.70 $28,487.70 $28,487.70 2026-09-01
A0304 HCPCS Nontraumatic Brain Injury; M < 26.15 1 1 — — $28,383.38 $28,383.38 $28,383.38 2026-09-01
5200 OTHER Implantation Wireless Pa 14 12 — — $27,416.23 $32,899.48 $28,375.80 2026-09-01
B1002 HCPCS Amputation, Lower Extremity; M > 36.25 & M < 47.65 1 1 — — $28,315.11 $28,315.11 $28,315.11 2026-09-01
A1704 HCPCS Major Multiple Trauma,no Brain Or Spinal Cord Inju 1 1 — — $28,195.62 $28,195.62 $28,195.62 2026-09-01
C0703 HCPCS Fracture Of Lower Extremity; M > 28.15 & M < 34.15 1 1 — — $28,172.86 $28,172.86 $28,172.86 2026-09-01
D1203 HCPCS Osteoarthritis; M < 30.75 1 1 — — $28,047.68 $28,047.68 $28,047.68 2026-09-01
B0803 HCPCS Replacement Of Lower Ext Joint; M > 28.65 & M < 37 1 1 — — $28,028.71 $28,028.71 $28,028.71 2026-09-01
C1003 HCPCS Amputation, Lower Extremity; M < 36.25 1 1 — — $28,002.16 $28,002.16 $28,002.16 2026-09-01
B2002 HCPCS Miscellaneous; M > 38.75 & M < 49.15 1 1 — — $27,985.09 $27,985.09 $27,985.09 2026-09-01
A0805 HCPCS Replacement Of Lower Extremity Joint; M > 22.05 & 1 1 — — $27,973.71 $27,973.71 $27,973.71 2026-09-01
A1404 HCPCS Cardiac; M < 31.15 1 1 — — $27,890.26 $27,890.26 $27,890.26 2026-09-01
A0904 HCPCS Other Orthopedic; M < 24.15 1 1 — — $27,833.36 $27,833.36 $27,833.36 2026-09-01
C0603 HCPCS Neurological; M > 25.85 & M < 37.35 1 1 — — $27,823.87 $27,823.87 $27,823.87 2026-09-01
C1102 HCPCS Amputation, Non-lower Extremity; M < 36.35 1 1 — — $27,730.94 $27,730.94 $27,730.94 2026-09-01
A1804 HCPCS Major Multiple Trauma With Brain Or Spinal Code In 1 1 — — $27,685.42 $27,685.42 $27,685.42 2026-09-01
A0204 HCPCS Traumatic Brain Injury; M > 40.65 & M < 44.25 1 1 — — $27,491.96 $27,491.96 $27,491.96 2026-09-01
A0504 HCPCS Nontraumatic Spinal Cord Injury; M > 29.25 & M < 3 1 1 — — $27,476.79 $27,476.79 $27,476.79 2026-09-01
C1803 HCPCS Major Multiple Trauma With Brain Or Spinal Cord In 1 1 — — $27,454.03 $27,454.03 $27,454.03 2026-09-01
C0303 HCPCS Nontraumatic Brain Injury; M > 26.15 & M < 35.05 1 1 — — $27,452.13 $27,452.13 $27,452.13 2026-09-01
A2004 HCPCS Miscellaneous; M < 27.85 1 1 — — $27,362.99 $27,362.99 $27,362.99 2026-09-01
B1402 HCPCS Cardiac; M > 38.55 & M < 48.85 1 1 — — $27,000.73 $27,000.73 $27,000.73 2026-09-01
B1802 HCPCS Maj Mult Trauma W Brain Or Spinal Cord Injury; M > 1 1 — — $26,976.07 $26,976.07 $26,976.07 2026-09-01
C1303 HCPCS Rheumatoid, Other Arthritis; M < 26.15 1 1 — — $26,917.27 $26,917.27 $26,917.27 2026-09-01
5117 OTHER Level 7 Musculoskeletal P 14 12 — — $25,935.34 $31,122.41 $26,843.08 2026-09-01
C0503 HCPCS Nontraumatic Spinal Cord Injury; M > 31.25 & M < 4 1 1 — — $26,822.44 $26,822.44 $26,822.44 2026-09-01
C0903 HCPCS Other Orthopedic; M > 24.15 & M < 34.35 1 1 — — $26,820.54 $26,820.54 $26,820.54 2026-09-01
C0804 HCPCS Replacement Of Lower Ext Joint; M > 28.65 & M < 37 1 1 — — $26,818.65 $26,818.65 $26,818.65 2026-09-01
A0403 HCPCS Traumatic Spinal Cord Injury; M > 16.05 & M < 30.3 1 1 — — $26,776.92 $26,776.92 $26,776.92 2026-09-01
D0703 HCPCS Fracture Of Lower Extremity; M > 28.15 & M < 34.15 1 1 — — $26,757.95 $26,757.95 $26,757.95 2026-09-01
A1204 HCPCS Osteoarthritis; M=39-47 1 1 — — $26,742.78 $26,742.78 $26,742.78 2026-09-01
D1503 HCPCS Pulmonary; M > 29.15 & M < 39.05 1 1 — — $26,678.30 $26,678.30 $26,678.30 2026-09-01
1592 OTHER New Technology - Level 41 14 12 — — $25,728.37 $30,874.04 $26,628.86 2026-09-01
1578 OTHER New Technology - Level 41 14 12 — — $25,728.37 $30,874.04 $26,628.86 2026-09-01
D1703 HCPCS Maj Mult Trauma No Brain Or Spinal Cord Injury; M 1 1 — — $26,615.71 $26,615.71 $26,615.71 2026-09-01
C0103 HCPCS Stroke; M > 44.45 & M < 51.05 & C < 18.5 1 1 — — $26,608.12 $26,608.12 $26,608.12 2026-09-01
C2003 HCPCS Miscellaneous; M > 27.85 & M < 38.75 1 1 — — $26,353.97 $26,353.97 $26,353.97 2026-09-01
C0402 HCPCS Traumatic Spinal Cord Injury; M > 30.35 & M < 48.4 1 1 — — $26,331.21 $26,331.21 $26,331.21 2026-09-01
B0202 HCPCS Traumatic Brain Injury; M > 44.25 & M < 53.35 & C 1 1 — — $26,289.48 $26,289.48 $26,289.48 2026-09-01
C1403 HCPCS Cardiac; M > 31.15 & M < 38.55 1 1 — — $26,289.48 $26,289.48 $26,289.48 2026-09-01
D0603 HCPCS Neurological; M > 25.85 & M < 37.35 1 1 — — $26,206.03 $26,206.03 $26,206.03 2026-09-01
A1103 HCPCS Amputation, Non-lower Extremity; M=12-37 1 1 — — $26,152.92 $26,152.92 $26,152.92 2026-09-01
C1902 HCPCS Guillian Barre; M > 18.05 & M < 35.95 1 1 — — $26,145.34 $26,145.34 $26,145.34 2026-09-01
C1603 HCPCS Pain Syndrome: M < 26.75 1 1 — — $26,035.33 $26,035.33 $26,035.33 2026-09-01
C0203 HCPCS Traumatic Brain Injury; M > 44.25 & C < 23.5 1 1 — — $25,987.91 $25,987.91 $25,987.91 2026-09-01
A1203 HCPCS Osteoarthritis; M < 30.75 1 1 — — $25,976.53 $25,976.53 $25,976.53 2026-09-01
5213 OTHER Level 3 Electrophysiologi 14 12 — — $24,983.19 $29,979.83 $25,857.60 2026-09-01
0128 RC Room & Board - Semi-private (Two Beds) Rehabilitation 3,472 11 — — $2,219.00 $66,040.12 $25,747.04 2026-09-01
0118 RC Room & Board - Private (One Bed) Rehabilitation 3,472 11 — — $2,219.00 $66,040.12 $25,747.04 2026-09-01
0148 RC Room & Board - Deluxe Private Rehabilitation 3,472 11 — — $2,219.00 $66,040.12 $25,747.04 2026-09-01
0138 RC Room & Board - Three And Four Beds Rehabilitation 3,472 11 — — $2,219.00 $66,040.12 $25,747.04 2026-09-01
0158 RC Room & Board - Ward Rehabilitation 3,125 10 — — $2,219.00 $66,040.12 $25,738.03 2026-09-01
B0401 HCPCS Traumatic Spinal Cord Injury; M > 48.45 1 1 — — $25,695.83 $25,695.83 $25,695.83 2026-09-01
B1101 HCPCS Amputation, Non-lower Extremity; M > 36.35 1 1 — — $25,650.31 $25,650.31 $25,650.31 2026-09-01
D0402 HCPCS Traumatic Spinal Cord Injury; M > 30.35 & M < 48.4 1 1 — — $25,638.93 $25,638.93 $25,638.93 2026-09-01
C2101 HCPCS Burns; M > 0 1 1 — — $25,610.48 $25,610.48 $25,610.48 2026-09-01
D0303 HCPCS Nontraumatic Brain Injury; M > 26.15 & M < 35.05 1 1 — — $25,593.41 $25,593.41 $25,593.41 2026-09-01
0024 RC Maj Mult Trauma No Brain Or Spinal Cord Injury; M 1,388 3 — — $3,191.00 $66,040.12 $25,562.17 2026-09-01
A1503 HCPCS Pulmonary; M > 29.15 & M < 39.05 1 1 — — $25,502.37 $25,502.37 $25,502.37 2026-09-01
B0802 HCPCS Replacement Of Lower Extremity Joint; M > 37.05 & 1 1 — — $25,468.23 $25,468.23 $25,468.23 2026-09-01
B1901 HCPCS Guillian Barre; M > 35.95 1 1 — — $25,428.40 $25,428.40 $25,428.40 2026-09-01
D1003 HCPCS Amputation, Lower Extremity; M < 36.25 1 1 — — $25,415.13 $25,415.13 $25,415.13 2026-09-01
D0903 HCPCS Other Orthopedic; M > 24.15 & M < 34.35 1 1 — — $25,335.47 $25,335.47 $25,335.47 2026-09-01
D1803 HCPCS Major Multiple Trauma With Brain Or Spinal Cord In 1 1 — — $25,255.81 $25,255.81 $25,255.81 2026-09-01
B1201 HCPCS Osteoarthritis; M > 37.65 1 1 — — $25,124.94 $25,124.94 $25,124.94 2026-09-01
B1701 HCPCS Major Multiple Trauma No Brain Or Spinal Cord Inju 1 1 — — $25,018.73 $25,018.73 $25,018.73 2026-09-01
D0503 HCPCS Nontraumatic Spinal Cord Injury; M > 31.25 & M < 4 1 1 — — $24,952.34 $24,952.34 $24,952.34 2026-09-01
B1501 HCPCS Pulmonary; M > 49.25 1 1 — — $24,851.82 $24,851.82 $24,851.82 2026-09-01
B0601 HCPCS Neurological; M > 47.75 1 1 — — $24,836.65 $24,836.65 $24,836.65 2026-09-01
B0501 HCPCS Nontraumatic Spinal Cord Injury; M > 51.35 1 1 — — $24,827.16 $24,827.16 $24,827.16 2026-09-01
D1303 HCPCS Rheumatoid, Other Arthritis; M < 26.15 1 1 — — $24,664.05 $24,664.05 $24,664.05 2026-09-01
D2003 HCPCS Miscellaneous; M > 27.85 & M < 38.75 1 1 — — $24,508.53 $24,508.53 $24,508.53 2026-09-01
A1703 HCPCS Maj Mult Trauma No Brain Or Spinal Cord Injury; M 1 1 — — $24,502.84 $24,502.84 $24,502.84 2026-09-01
A0703 HCPCS Fracture Of Lower Extremity; M > 28.15 & M < 34.15 1 1 — — $24,451.63 $24,451.63 $24,451.63 2026-09-01
C1502 HCPCS Pulmonary; M > 39.05 & M < 49.25 1 1 — — $24,434.56 $24,434.56 $24,434.56 2026-09-01
C1702 HCPCS Maj Mult Trauma No Brain Or Spinal Cord Injury; M 1 1 — — $24,430.76 $24,430.76 $24,430.76 2026-09-01
D1403 HCPCS Cardiac; M > 31.15 & M < 38.55 1 1 — — $24,307.48 $24,307.48 $24,307.48 2026-09-01
C1101 HCPCS Amputation, Non-lower Extremity; M > 36.35 1 1 — — $24,284.72 $24,284.72 $24,284.72 2026-09-01
L8614 HCPCS Cochlear Device, Includes All Internal And External Components 14 12 — — $23,437.90 $28,125.48 $24,258.23 2026-09-01
J0391 HCPCS Artesunate 110 Mg Inj 21 10 $39,522.20 $39,522.20 $16,077.63 $32,408.20 $24,108.54 2026-09-01
D0103 HCPCS Stroke; M > 44.45 & M < 51.05 & C < 18.5 1 1 — — $24,106.44 $24,106.44 $24,106.44 2026-09-01
Q0483 HCPCS Monitor/display Module For Use With Electric Ventricular Assist Device, Replacem… 14 12 — — $23,212.40 $27,854.88 $24,024.83 2026-09-01
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