Price Transparency 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

SAMARITAN ALBANY GENERAL HOSPITAL

Albany, OR · CCN 380022 · Rates published

37,946 distinct procedures filed
12 distinct payers
1,288,292 rate rows
2026-01-31 last MRF observed
Data quality

391,041 of 1,288,292 rate rows are consumer-grade (30.4%)

897,251 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
professional (physician) fee — not the facility price 601,859
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 288,072
template filing: same amount across many unrelated codes — excluded 4,539
percent-of-charges filed in the dollar field — excluded from medians 1,312
placeholder amount (≤ $0.02) — excluded from medians 1,251
exceeds 10× this hospital's gross charge — excluded from medians 217
per-diem day rate — not a per-procedure price 1
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://samaritanhealth.pt.panaceainc.com/MRFDownload/samaritanhealth/albany
Found on page https://samhealth.org/patient-visitors/make-a-payment/learn-more-about-price-transparency/
Discovered viaCMS hospital list
Last fetch success · 2026-05-18
Content fingerprint da900574282a43bb… · 16,304,520 bytes · first seen 2026-05-17

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
Q2057
HCPCS 		Afamitresgene Autoleucel 3 $863,094.40 $1,001,806.00 $886,213.00 nat. median
$824,563
1.1× median
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 3 $525,772.87 $769,244.06 $662,733.35 nat. median
$754,974
0.9× median
Q2056
HCPCS 		Ciltacabtagene Car-pos T 3 $539,227.01 $735,629.63 $633,773.22 nat. median
$675,122
0.9× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 3 $513,659.78 $731,299.64 $630,042.77 nat. median
$674,188
0.9× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 3 $524,503.71 $724,513.31 $624,196.09 nat. median
$625,184
1.0× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 3 $487,495.47 $693,199.22 $597,217.79 nat. median
$634,511
0.9× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 3 $487,601.95 $636,095.99 $548,021.16 nat. median
$620,080
0.9× median
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 8 $321,203.37 $1,112,527.60 $351,794.17 nat. median
$370,174
1.0× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 8 $183,132.51 $632,232.20 $274,698.76 nat. median
$202,986
1.4× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 8 $240,262.32 $830,964.85 $263,144.45 nat. median
$265,286
1.0× median
J3402
HCPCS 		Inj. Remestemcel-l-rknd/ Td 3 $230,316.80 $267,332.00 $236,486.00 nat. median
$209,753
1.1× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 8 $202,562.77 $699,822.60 $221,854.46 nat. median
$206,368
1.1× median
0424T
HCPCS 		Insj/rplc Nstim Apnea Compl 1 $218,109.98 $218,109.98 $218,109.98 nat. median
$24,752
outlier · 8.8×
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 8 $121,212.12 $416,835.00 $181,818.17 nat. median
$133,176
1.4× median
33276
HCPCS 		Insj Phrnc Nrv Stim Sys 1 $178,453.98 $178,453.98 $178,453.98 nat. median
$43,787
outlier · 4.1×
14
MS_DRG 		Allogeneic Bone Marrow Transplant 8 $112,492.59 $386,503.10 $168,738.89 nat. median
$117,303
1.4× median
7
MS_DRG 		Lung Transplant 8 $112,212.73 $385,529.60 $168,319.10 nat. median
$122,708
1.4× median
38240
HCPCS 		Transplt Allo Hct/donor 1 $167,480.77 $167,480.77 $167,480.77 nat. median
$15,912
outlier · 10.5×
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 8 $93,768.74 $321,370.05 $140,653.10 nat. median
$102,358
1.4× median
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 8 $91,695.29 $314,157.30 $137,542.94 nat. median
$100,136
1.4× median
215
MS_DRG 		Other Heart Assist System Implant 8 $91,232.26 $312,546.60 $136,848.39 nat. median
$99,019
1.4× median
426
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 8 $90,219.70 $309,024.30 $135,329.55 nat. median
$98,905
1.4× median
69930
HCPCS 		Implant Cochlear Device 1 $132,201.33 $132,201.33 $132,201.33 nat. median
$29,663
outlier · 4.5×
0408T
HCPCS 		Insj/rplc Cardiac Modulj Sys 1 $127,201.89 $127,201.89 $127,201.89 nat. median
$32,221
outlier · 3.9×
0571T
HCPCS 		Insj/rplcmt Icds Ss Eltrd 1 $127,201.89 $127,201.89 $127,201.89 nat. median
$32,221
outlier · 3.9×
850
MS_DRG 		Acute Leukemia With Other Procedures 8 $79,504.73 $271,751.05 $119,257.10 nat. median
$83,442
1.4× median
33287
HCPCS 		Rmv&rplcmt Phrnc Nrv Stim Pg 1 $117,327.39 $117,327.39 $117,327.39 nat. median
$29,718
outlier · 3.9×
61886
HCPCS 		Pc Insert/replace Cranial Neurostim Gen/receiv 2+ Electrodes 1 $116,423.99 $116,423.99 $116,423.99 nat. median
$27,077
outlier · 4.3×
0427T
HCPCS 		Insj/rplc Nstim Apnea Pls Gn 1 $116,423.99 $116,423.99 $116,423.99 nat. median
$15,886
outlier · 7.3×
64582
HCPCS 		Opn Mpltj Hpglsl Nstm Ary Pg 1 $116,423.99 $116,423.99 $116,423.99 nat. median
$28,316
outlier · 4.1×
64568
HCPCS 		Opn Impltj Crnl Nrv Nea&pg 1 $116,423.99 $116,423.99 $116,423.99 nat. median
$27,541
outlier · 4.2×
63685
HCPCS 		Pc Insertion Replace Spinal Neurostim Pulse Gen Receiver 1 $116,423.99 $116,423.99 $116,423.99 nat. median
$21,347
outlier · 5.5×
0266T
HCPCS 		Implt/rpl Crtd Sns Dev Total 1 $116,423.99 $116,423.99 $116,423.99 nat. median
$42,941
outlier · 2.7×
0431T
HCPCS 		Rmvl/rplc Nstim Apnea Pls Gn 1 $116,423.99 $116,423.99 $116,423.99 nat. median
$18,872
outlier · 6.2×
0268T
HCPCS 		Implt/rpl Crtd Sns Dev Gen 1 $116,423.99 $116,423.99 $116,423.99 nat. median
$30,333
outlier · 3.8×
456
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 8 $73,206.35 $249,841.40 $109,809.52 nat. median
$81,118
1.4× median
C9760
HCPCS 		Non-blind Interatrial Shunt 1 $109,055.98 $109,055.98 $109,055.98 nat. median
$28,432
outlier · 3.8×
429
MS_DRG 		Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 8 $72,115.77 $246,047.70 $108,173.66 nat. median
$82,712
1.3× median
20
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 8 $69,745.50 $237,802.45 $104,618.25 nat. median
$77,576
1.3× median
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 8 $94,835.57 $325,081.15 $103,867.53 nat. median
$108,660
1.0× median
10
MS_DRG 		Pancreas Transplant 8 $68,998.39 $235,203.50 $103,497.58 nat. median
$68,882
1.5× median
19
MS_DRG 		Simultaneous Pancreas And Kidney Transplant With Hemodialysis 8 $68,610.83 $233,855.35 $102,916.25 nat. median
$71,240
1.4× median
233
MS_DRG 		Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 8 $67,670.36 $230,583.80 $101,505.54 nat. median
$73,807
1.4× median
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 8 $83,229.32 $284,707.45 $100,181.00 nat. median
$93,672
1.1× median
217
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 8 $56,149.75 $190,508.05 $100,181.00 nat. median
$64,510
1.6× median
Q0480
HCPCS 		Driver Pneumatic Vad, Rep 1 $99,999.91 $99,999.91 $99,999.91 nat. median
$111,989
0.9× median
218
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 8 $51,836.62 $175,504.35 $98,736.42 nat. median
$61,920
1.6× median
427
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 8 $61,617.91 $209,529.65 $92,426.86 nat. median
$68,090
1.4× median
275
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 8 $61,315.15 $208,476.50 $91,972.73 nat. median
$68,887
1.3× median
870
MS_DRG 		Septicemia Or Severe Sepsis With Mv >96 Hours 8 $60,378.07 $205,216.75 $90,567.10 nat. median
$66,526
1.4× median

Other procedures at this hospital

Browse this hospital's 37,946 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
             
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 13 8 — — $321,203.37 $1,112,527.60 $351,794.17 2026-01-31
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 14 8 — — $183,132.51 $632,232.20 $274,698.76 2026-01-31
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 13 8 — — $240,262.32 $830,964.85 $263,144.45 2026-01-31
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 13 8 — — $202,562.77 $699,822.60 $221,854.46 2026-01-31
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 14 8 — — $121,212.12 $416,835.00 $181,818.17 2026-01-31
14 MS_DRG Allogeneic Bone Marrow Transplant 14 8 — — $112,492.59 $386,503.10 $168,738.89 2026-01-31
7 MS_DRG Lung Transplant 14 8 — — $112,212.73 $385,529.60 $168,319.10 2026-01-31
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 14 8 — — $93,768.74 $321,370.05 $140,653.10 2026-01-31
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 14 8 — — $91,695.29 $314,157.30 $137,542.94 2026-01-31
215 MS_DRG Other Heart Assist System Implant 14 8 — — $91,232.26 $312,546.60 $136,848.39 2026-01-31
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 14 8 — — $90,219.70 $309,024.30 $135,329.55 2026-01-31
850 MS_DRG Acute Leukemia With Other Procedures 14 8 — — $79,504.73 $271,751.05 $119,257.10 2026-01-31
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 14 8 — — $73,206.35 $249,841.40 $109,809.52 2026-01-31
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 14 8 — — $72,115.77 $246,047.70 $108,173.66 2026-01-31
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 14 8 — — $69,745.50 $237,802.45 $104,618.25 2026-01-31
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 13 8 — — $94,835.57 $325,081.15 $103,867.53 2026-01-31
10 MS_DRG Pancreas Transplant 14 8 — — $68,998.39 $235,203.50 $103,497.58 2026-01-31
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 14 8 — — $68,610.83 $233,855.35 $102,916.25 2026-01-31
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 14 8 — — $67,670.36 $230,583.80 $101,505.54 2026-01-31
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 15 8 — — $83,229.32 $284,707.45 $100,181.00 2026-01-31
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 15 8 — — $56,149.75 $190,508.05 $100,181.00 2026-01-31
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 15 8 — — $51,836.62 $175,504.35 $98,736.42 2026-01-31
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 14 8 — — $61,617.91 $209,529.65 $92,426.86 2026-01-31
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 14 8 — — $61,315.15 $208,476.50 $91,972.73 2026-01-31
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 14 8 — — $60,378.07 $205,216.75 $90,567.10 2026-01-31
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 14 8 — — $58,242.71 $197,788.65 $87,364.07 2026-01-31
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 14 8 — — $57,928.09 $196,694.20 $86,892.14 2026-01-31
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 15 8 — — $46,302.32 $156,252.65 $86,638.00 2026-01-31
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 15 8 — — $67,001.26 $228,256.25 $86,638.00 2026-01-31
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 14 8 — — $56,228.61 $190,782.40 $84,342.92 2026-01-31
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 15 8 — — $43,797.22 $147,538.35 $83,423.28 2026-01-31
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 14 8 — — $53,915.17 $182,734.80 $80,872.76 2026-01-31
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 14 8 — — $53,847.33 $182,498.80 $80,770.99 2026-01-31
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 14 8 — — $53,608.18 $181,666.90 $80,412.27 2026-01-31
231 MS_DRG Coronary Bypass With Ptca With Mcc 15 8 — — $66,524.00 $249,980.05 $80,222.03 2026-01-31
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 14 8 — — $53,425.85 $181,032.65 $80,138.77 2026-01-31
28 MS_DRG Spinal Procedures With Mcc 14 8 — — $52,940.77 $179,345.25 $79,411.15 2026-01-31
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 14 8 — — $52,571.02 $178,059.05 $78,856.54 2026-01-31
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 14 8 — — $52,571.02 $178,059.05 $78,856.54 2026-01-31
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 14 8 — — $52,188.56 $176,728.60 $78,282.84 2026-01-31
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 14 8 — — $51,284.55 $173,583.90 $76,926.82 2026-01-31
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 15 8 — — $40,331.29 $135,481.70 $76,821.50 2026-01-31
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 14 8 — — $50,759.61 $171,757.85 $76,139.42 2026-01-31
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 14 8 — — $50,056.60 $169,312.30 $75,084.89 2026-01-31
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 14 8 — — $49,765.72 $168,300.45 $74,648.57 2026-01-31
653 MS_DRG Major Bladder Procedures With Mcc 14 8 — — $48,659.03 $164,450.70 $72,988.54 2026-01-31
834 MS_DRG Acute Leukemia With Mcc 14 8 — — $48,257.91 $163,055.35 $72,386.86 2026-01-31
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 14 8 — — $48,257.91 $163,055.35 $72,386.86 2026-01-31
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 14 8 — — $48,061.16 $162,370.95 $72,091.74 2026-01-31
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 14 8 — — $47,776.22 $161,379.75 $71,664.33 2026-01-31
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 14 8 — — $47,526.90 $160,512.45 $71,290.35 2026-01-31
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 14 8 — — $47,421.74 $160,146.65 $71,132.60 2026-01-31
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 13 8 — — $64,683.56 $220,193.90 $70,843.90 2026-01-31
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 14 8 — — $47,186.83 $159,329.50 $70,780.25 2026-01-31
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 14 8 — — $47,143.58 $159,179.05 $70,715.38 2026-01-31
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 14 8 — — $47,138.49 $159,161.35 $70,707.74 2026-01-31
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 14 8 — — $46,501.61 $156,945.90 $69,752.42 2026-01-31
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 14 8 — — $45,059.10 $151,927.95 $67,588.65 2026-01-31
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 14 8 — — $44,914.09 $151,423.50 $67,371.13 2026-01-31
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 14 8 — — $44,588.44 $150,290.70 $66,882.66 2026-01-31
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 14 8 — — $44,456.15 $149,830.50 $66,684.23 2026-01-31
232 MS_DRG Coronary Bypass With Ptca Without Mcc 15 8 — — $53,188.40 $180,206.65 $66,524.00 2026-01-31
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 14 8 — — $44,099.12 $148,588.55 $66,148.68 2026-01-31
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 14 8 — — $43,847.25 $147,712.40 $65,770.88 2026-01-31
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 14 8 — — $43,814.18 $147,597.35 $65,721.27 2026-01-31
955 MS_DRG Craniotomy For Multiple Significant Trauma 13 8 — — $59,290.89 $201,434.85 $64,937.64 2026-01-31
245 MS_DRG Aicd Generator Procedures 14 8 — — $42,826.21 $144,160.60 $64,239.32 2026-01-31
228 MS_DRG Other Cardiothoracic Procedures With Mcc 15 8 — — $43,644.57 $147,007.35 $64,157.00 2026-01-31
471 MS_DRG Cervical Spinal Fusion With Mcc 14 8 — — $42,576.04 $143,290.35 $63,864.06 2026-01-31
6 MS_DRG Liver Transplant Without Mcc 14 8 — — $42,507.35 $143,051.40 $63,761.03 2026-01-31
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 13 8 — — $58,023.91 $197,027.55 $63,550.00 2026-01-31
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 14 8 — — $41,882.35 $140,877.25 $62,823.52 2026-01-31
799 MS_DRG Splenic Procedures With Mcc 14 8 — — $41,706.81 $140,266.60 $62,560.21 2026-01-31
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 14 8 — — $41,699.18 $140,240.05 $62,548.76 2026-01-31
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 14 8 — — $41,281.94 $138,788.65 $61,922.90 2026-01-31
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 14 8 — — $41,068.23 $138,045.25 $61,602.35 2026-01-31
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 14 8 — — $40,834.17 $137,231.05 $61,251.26 2026-01-31
163 MS_DRG Major Chest Procedures With Mcc 14 8 — — $40,472.06 $135,971.40 $60,708.09 2026-01-31
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 14 8 — — $40,455.94 $135,915.35 $60,683.92 2026-01-31
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 14 8 — — $40,325.36 $135,461.05 $60,488.04 2026-01-31
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 13 8 — — $55,016.77 $186,566.85 $60,256.46 2026-01-31
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 14 8 — — $39,644.38 $133,092.20 $59,466.57 2026-01-31
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 14 8 — — $39,416.25 $132,298.65 $59,124.38 2026-01-31
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 14 8 — — $39,311.10 $131,932.85 $58,966.65 2026-01-31
901 MS_DRG Wound Debridements For Injuries With Mcc 14 8 — — $38,956.62 $130,699.75 $58,434.93 2026-01-31
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 14 8 — — $38,636.90 $129,587.60 $57,955.36 2026-01-31
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 14 8 — — $38,002.58 $127,381.00 $57,003.87 2026-01-31
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 13 8 — — $51,798.46 $175,371.60 $56,731.65 2026-01-31
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 14 8 — — $37,559.05 $125,838.15 $56,338.57 2026-01-31
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 14 8 — — $37,505.62 $125,652.30 $56,258.43 2026-01-31
140 MS_DRG Major Head And Neck Procedures With Mcc 14 8 — — $37,249.52 $124,761.40 $55,874.28 2026-01-31
31 MS_DRG Ventricular Shunt Procedures With Mcc 14 8 — — $36,922.17 $123,622.70 $55,383.26 2026-01-31
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 14 8 — — $36,913.70 $123,593.20 $55,370.54 2026-01-31
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 14 8 — — $36,668.60 $122,740.65 $55,002.90 2026-01-31
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 14 8 — — $36,256.46 $121,306.95 $54,384.68 2026-01-31
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 14 8 — — $36,185.23 $121,059.15 $54,277.84 2026-01-31
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 14 8 — — $36,013.92 $120,463.25 $54,020.88 2026-01-31
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 14 8 — — $35,877.39 $119,988.30 $53,816.08 2026-01-31
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 15 8 — — $27,726.89 $91,635.85 $52,813.12 2026-01-31
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 14 8 — — $35,167.58 $117,519.15 $52,751.37 2026-01-31
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 14 8 — — $35,143.84 $117,436.55 $52,715.76 2026-01-31
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 14 8 — — $34,845.32 $116,398.15 $52,267.98 2026-01-31
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 14 8 — — $34,776.63 $116,159.20 $52,164.94 2026-01-31
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 14 8 — — $34,561.23 $115,409.90 $51,841.85 2026-01-31
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 14 8 — — $34,545.12 $115,353.85 $51,817.68 2026-01-31
34 MS_DRG Carotid Artery Stent Procedures With Mcc 14 8 — — $34,361.94 $114,716.65 $51,542.92 2026-01-31
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 14 8 — — $34,160.96 $114,017.50 $51,241.44 2026-01-31
904 MS_DRG Skin Grafts For Injuries With Cc/mcc 14 8 — — $34,127.89 $113,902.45 $51,191.83 2026-01-31
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 14 8 — — $34,036.30 $113,583.85 $51,054.44 2026-01-31
33264 HCPCS Pc Rem Pacing Cardio-defrib Gen W Rep 9 7 $65,970.00 $52,776.00 20% off $32,985.00 $127,201.89 $62,671.50 2026-01-31
33289 HCPCS Pc Transcatheter Impl Wireless Press Sensor 9 7 $63,620.00 $50,896.00 20% off $31,810.00 $108,281.38 $60,439.00 2026-01-31
A9543 HCPCS Hc Yttrium 90 Ibrit Tiuxe Dose<41 9 7 $63,580.00 $50,864.00 20% off $31,790.00 $147,322.31 $60,401.00 2026-01-31
36000007 CDM Hc Insert/reposit Gen/lead(s) Def 9 7 $58,180.00 $46,544.00 20% off $29,090.00 $56,725.50 $55,271.00 2026-01-31
33270 HCPCS Pc Ins Rep Subq Defibrillator 9 7 $53,850.00 $43,080.00 20% off $26,925.00 $127,201.89 $51,157.50 2026-01-31
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 6 4 — — $58,013.25 $119,390.49 $62,734.08 2026-01-31
Q2057 HCPCS Afamitresgene Autoleucel 3 3 — — $863,094.40 $1,001,806.00 $886,213.00 2026-01-31
Q2042 HCPCS Tisagenlecleucel Car-pos T 5 3 — — $525,772.87 $769,244.06 $662,733.35 2026-01-31
Q2056 HCPCS Ciltacabtagene Car-pos T 5 3 — — $539,227.01 $735,629.63 $633,773.22 2026-01-31
Q2054 HCPCS Lisocabtagene Mara Car Pos T 5 3 — — $513,659.78 $731,299.64 $630,042.77 2026-01-31
Q2055 HCPCS Idecabtagene Vicleucel Car 5 3 — — $524,503.71 $724,513.31 $624,196.09 2026-01-31
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 5 3 — — $487,495.47 $693,199.22 $597,217.79 2026-01-31
Q2053 HCPCS Brexucabtagene Car Pos T 5 3 — — $487,601.95 $636,095.99 $548,021.16 2026-01-31
J3402 HCPCS Inj. Remestemcel-l-rknd/ Td 3 3 — — $230,316.80 $267,332.00 $236,486.00 2026-01-31
J9029 HCPCS Instill Adstiladrin, Tx Dose 3 3 — — $70,943.36 $82,344.97 $72,843.62 2026-01-31
J9226 HCPCS Supprelin La Implant 5 3 — — $48,490.16 $58,526.85 $51,262.33 2026-01-31
0424T HCPCS Insj/rplc Nstim Apnea Compl 1 1 — — $218,109.98 $218,109.98 $218,109.98 2026-01-31
33276 HCPCS Insj Phrnc Nrv Stim Sys 1 1 — — $178,453.98 $178,453.98 $178,453.98 2026-01-31
38240 HCPCS Transplt Allo Hct/donor 1 1 — — $167,480.77 $167,480.77 $167,480.77 2026-01-31
69930 HCPCS Implant Cochlear Device 1 1 — — $132,201.33 $132,201.33 $132,201.33 2026-01-31
0408T HCPCS Insj/rplc Cardiac Modulj Sys 1 1 — — $127,201.89 $127,201.89 $127,201.89 2026-01-31
0571T HCPCS Insj/rplcmt Icds Ss Eltrd 1 1 — — $127,201.89 $127,201.89 $127,201.89 2026-01-31
33287 HCPCS Rmv&rplcmt Phrnc Nrv Stim Pg 1 1 — — $117,327.39 $117,327.39 $117,327.39 2026-01-31
64582 HCPCS Opn Mpltj Hpglsl Nstm Ary Pg 1 1 — — $116,423.99 $116,423.99 $116,423.99 2026-01-31
64568 HCPCS Opn Impltj Crnl Nrv Nea&pg 1 1 — — $116,423.99 $116,423.99 $116,423.99 2026-01-31
0431T HCPCS Rmvl/rplc Nstim Apnea Pls Gn 1 1 — — $116,423.99 $116,423.99 $116,423.99 2026-01-31
61886 HCPCS Pc Insert/replace Cranial Neurostim Gen/receiv 2+ Electrodes 1 1 — — $116,423.99 $116,423.99 $116,423.99 2026-01-31
0268T HCPCS Implt/rpl Crtd Sns Dev Gen 1 1 — — $116,423.99 $116,423.99 $116,423.99 2026-01-31
0427T HCPCS Insj/rplc Nstim Apnea Pls Gn 1 1 — — $116,423.99 $116,423.99 $116,423.99 2026-01-31
0266T HCPCS Implt/rpl Crtd Sns Dev Total 1 1 — — $116,423.99 $116,423.99 $116,423.99 2026-01-31
63685 HCPCS Pc Insertion Replace Spinal Neurostim Pulse Gen Receiver 1 1 — — $116,423.99 $116,423.99 $116,423.99 2026-01-31
C9760 HCPCS Non-blind Interatrial Shunt 1 1 — — $109,055.98 $109,055.98 $109,055.98 2026-01-31
Q0480 HCPCS Driver Pneumatic Vad, Rep 1 1 — — $99,999.91 $99,999.91 $99,999.91 2026-01-31
0409T HCPCS Insj/rplc Car Modulj Pls Gn 1 1 — — $90,488.33 $90,488.33 $90,488.33 2026-01-31
0414T HCPCS Rmvl & Rpl Car Modulj Pls Gn 1 1 — — $90,488.33 $90,488.33 $90,488.33 2026-01-31
0614T HCPCS Rmvl&rplcmt Ss Impl Dfb Pg 1 1 — — $90,488.33 $90,488.33 $90,488.33 2026-01-31
33240 HCPCS Pc Insert Pulse Generator 1 1 — — $90,488.33 $90,488.33 $90,488.33 2026-01-31
0520T HCPCS Rmv&rplcmt Pg Wcs Lv Battery 1 1 — — $90,488.33 $90,488.33 $90,488.33 2026-01-31
0515T HCPCS Insj Wcs Lv Compl Sys 1 1 — — $90,488.33 $90,488.33 $90,488.33 2026-01-31
27702 HCPCS Pc Ankle Arthroplasty With Implant 1 1 — — $86,837.24 $86,837.24 $86,837.24 2026-01-31
22612 HCPCS Pc Posterior Lumbar Fusion 1 1 — — $86,837.24 $86,837.24 $86,837.24 2026-01-31
27279 HCPCS Pc Arthrodesis Sacroiliac Jt Percu Or Min Invasive 1 1 — — $86,837.24 $86,837.24 $86,837.24 2026-01-31
24363 HCPCS Pc Arthroplasty Elbow W/total Elbow 1 1 — — $86,837.24 $86,837.24 $86,837.24 2026-01-31
24361 HCPCS Reconstruct Elbow Joint 1 1 — — $86,837.24 $86,837.24 $86,837.24 2026-01-31
20696 HCPCS App Mltpln Uni Xtrnl Fix 1st 1 1 — — $86,837.24 $86,837.24 $86,837.24 2026-01-31
28705 HCPCS Pc Arthrodesis Pantalar 1 1 — — $86,837.24 $86,837.24 $86,837.24 2026-01-31
0809T HCPCS Arthrd Si Jt Prq Tfx&implt 1 1 — — $86,837.24 $86,837.24 $86,837.24 2026-01-31
25446 HCPCS Pc Arthroplasty W Prosthetic Rplcmt Dstl Radius & Prtl Carpus 1 1 — — $86,837.24 $86,837.24 $86,837.24 2026-01-31
0775T HCPCS Arthrd Si Jt Prq Iartic Impl 1 1 — — $86,837.24 $86,837.24 $86,837.24 2026-01-31
22867 HCPCS Pc Insert Stabilization Device W Opn Decomp Sngl Level 1 1 — — $86,837.24 $86,837.24 $86,837.24 2026-01-31
24371 HCPCS Revise Reconst Elbow Joint 1 1 — — $86,837.24 $86,837.24 $86,837.24 2026-01-31
21243 HCPCS Reconstruction Of Jaw Joint 1 1 — — $86,837.24 $86,837.24 $86,837.24 2026-01-31
22630 HCPCS Pc Arthrodesis Lumbar 1 1 — — $86,837.24 $86,837.24 $86,837.24 2026-01-31
22856 HCPCS Tot Disc Arthrp 1ntrspc Crv 1 1 — — $86,837.24 $86,837.24 $86,837.24 2026-01-31
25442 HCPCS Pc Arthroplasty W Prosthetic Rplcmt Distal Ulna 1 1 — — $86,837.24 $86,837.24 $86,837.24 2026-01-31
23616 HCPCS Pc Open Tx Prox Humer Fx W/pros Repla 1 1 — — $86,837.24 $86,837.24 $86,837.24 2026-01-31
22633 HCPCS Pc Arthrodesis Single Interspace Lumbar Initial 1 1 — — $86,837.24 $86,837.24 $86,837.24 2026-01-31
63655 HCPCS Pc Laminectomy Implant Neurostim Electrode Plate Paddle Epidural 1 1 — — $85,321.31 $85,321.31 $85,321.31 2026-01-31
64580 HCPCS Opn Impltj Nea Neuromuscular 1 1 — — $85,321.31 $85,321.31 $85,321.31 2026-01-31
61885 HCPCS Pc Implant Neurostim Arrays 1 1 — — $85,321.31 $85,321.31 $85,321.31 2026-01-31
64590 HCPCS Pc Insert/replace Of Periph/gas Neurostim Pulse Gen/rcvr 1 1 — — $85,321.31 $85,321.31 $85,321.31 2026-01-31
61891 HCPCS Rev/rplcmt Sk-mnt Crnl Nstm 1 1 — — $82,654.37 $82,654.37 $82,654.37 2026-01-31
0817T HCPCS Opn Insj/rplcmt Ins Ptn Subf 1 1 — — $82,654.37 $82,654.37 $82,654.37 2026-01-31
0816T HCPCS Opn Insj/rplcmt Ins Ptn Subq 1 1 — — $82,654.37 $82,654.37 $82,654.37 2026-01-31
54401 HCPCS Insert Self-contd Prosthesis 1 1 — — $76,463.55 $76,463.55 $76,463.55 2026-01-31
54416 HCPCS Remv/repl Penis Contain Pros 1 1 — — $76,463.55 $76,463.55 $76,463.55 2026-01-31
54411 HCPCS Remov/replc Penis Pros Comp 1 1 — — $76,463.55 $76,463.55 $76,463.55 2026-01-31
54405 HCPCS Pc Insert Multi Component Penile Prosthesis 1 1 — — $76,463.55 $76,463.55 $76,463.55 2026-01-31
53447 HCPCS Remove/replace Ur Sphincter 1 1 — — $76,463.55 $76,463.55 $76,463.55 2026-01-31
53445 HCPCS Pc Insert Urethral/bladder Neck Sphincter 1 1 — — $76,463.55 $76,463.55 $76,463.55 2026-01-31
53444 HCPCS Insert Tandem Cuff 1 1 — — $76,463.55 $76,463.55 $76,463.55 2026-01-31
54410 HCPCS Pc Remove Replace Inflatable Penile Prosthesis Same Session 1 1 — — $76,463.55 $76,463.55 $76,463.55 2026-01-31
0823T HCPCS Tcat Ins 1chmbr Ldls Pm Ra 1 1 — — $73,622.75 $73,622.75 $73,622.75 2026-01-31
0825T HCPCS Tcat Rmv&rpl1chmb Ldls Pm Ra 1 1 — — $73,622.75 $73,622.75 $73,622.75 2026-01-31
0308T HCPCS Insj Ocular Telescope Prosth 1 1 — — $71,737.62 $71,737.62 $71,737.62 2026-01-31
0618T HCPCS Insj Iris Prosth Sec Io Lens 1 1 — — $71,737.62 $71,737.62 $71,737.62 2026-01-31
0616T HCPCS Insertion Of Iris Prosthesis 1 1 — — $71,737.62 $71,737.62 $71,737.62 2026-01-31
0617T HCPCS Insj Iris Prosth W/rmvl&insj 1 1 — — $71,737.62 $71,737.62 $71,737.62 2026-01-31
27278 HCPCS Arthrd Si Jt Plmt Iartic Dev 1 1 — — $70,414.30 $70,414.30 $70,414.30 2026-01-31
C9758 HCPCS Blind Interatrial Shunt Ide 1 1 — — $69,399.98 $69,399.98 $69,399.98 2026-01-31
C9782 HCPCS Blind Myocar Trpl Bon Marrow 1 1 — — $69,399.98 $69,399.98 $69,399.98 2026-01-31
93590 HCPCS Pc Percu Transcath Closure Paravlvulr Leak Mitral Valve 1 1 — — $68,119.49 $68,119.49 $68,119.49 2026-01-31
37229 HCPCS Pc Revasc Opn/prq Tibial/pero W Athrc Angioplasty Sm Vsl 1 1 — — $68,119.49 $68,119.49 $68,119.49 2026-01-31
37230 HCPCS Pc Revsc Opn/prq Tibal/pero W Stent Angioplasty Sm Vsl 1 1 — — $68,119.49 $68,119.49 $68,119.49 2026-01-31
C9775 HCPCS Revasc Lith-sten-ath Tib/per 1 1 — — $68,119.49 $68,119.49 $68,119.49 2026-01-31
C9773 HCPCS Revasc Lithotr-stent Tib/per 1 1 — — $68,119.49 $68,119.49 $68,119.49 2026-01-31
C9774 HCPCS Revasc Lithotr-ather Tib/per 1 1 — — $68,119.49 $68,119.49 $68,119.49 2026-01-31
C9765 HCPCS Revasc Intra Lithotrip-stent 1 1 — — $68,119.49 $68,119.49 $68,119.49 2026-01-31
0645T HCPCS Tcat Impltj C Sins Rdctj Dev 1 1 — — $68,119.49 $68,119.49 $68,119.49 2026-01-31
C9766 HCPCS Revasc Intra Lithotrip-ather 1 1 — — $68,119.49 $68,119.49 $68,119.49 2026-01-31
37231 HCPCS Pc Revsc Opn/prq Tibal/pero W Stent Arhr Angioplasty Sm Vsl 1 1 — — $68,119.49 $68,119.49 $68,119.49 2026-01-31
37227 HCPCS Fem/popl Revasc Stnt & Ather 1 1 — — $68,119.49 $68,119.49 $68,119.49 2026-01-31
C9767 HCPCS Revasc Lithotrip-stent-ather 1 1 — — $68,119.49 $68,119.49 $68,119.49 2026-01-31
0632T HCPCS Perq Tcat US Abltj Nrv P-art 1 1 — — $68,119.49 $68,119.49 $68,119.49 2026-01-31
33902 HCPCS Perq P-art Revsc 1 Abnor Uni 1 1 — — $68,119.49 $68,119.49 $68,119.49 2026-01-31
93581 HCPCS Transcath Closure Of Vsd 1 1 — — $68,119.49 $68,119.49 $68,119.49 2026-01-31
36836 HCPCS Prq Av Fstl Crtj Uxtr 1 Acs 1 1 — — $68,119.49 $68,119.49 $68,119.49 2026-01-31
93582 HCPCS Perq Transcath Closure Pda 1 1 — — $68,119.49 $68,119.49 $68,119.49 2026-01-31
36837 HCPCS Prq Av Fstl Crt Uxtr Sep Acs 1 1 — — $68,119.49 $68,119.49 $68,119.49 2026-01-31
0793T HCPCS Prq Tcat Thrm Ablt Nrv P-art 1 1 — — $68,119.49 $68,119.49 $68,119.49 2026-01-31
0803T HCPCS Tcat Rmv&rpl2chmb Ldls Pm Rv 1 1 — — $68,119.49 $68,119.49 $68,119.49 2026-01-31
0620T HCPCS Evasc Ven Artlz Tibl/prnl Vn 1 1 — — $68,119.49 $68,119.49 $68,119.49 2026-01-31
0797T HCPCS Tcat Ins 2chmbr Ldls Pm Rv 1 1 — — $68,119.49 $68,119.49 $68,119.49 2026-01-31
62360 HCPCS Insert Spine Infusion Device 1 1 — — $67,171.16 $67,171.16 $67,171.16 2026-01-31
62361 HCPCS Implant Spine Infusion Pump 1 1 — — $67,171.16 $67,171.16 $67,171.16 2026-01-31
62362 HCPCS Implant Spine Infusion Pump 1 1 — — $67,171.16 $67,171.16 $67,171.16 2026-01-31
C9797 HCPCS Vasc Emb/occ W/prs Cath 1 1 — — $66,254.51 $66,254.51 $66,254.51 2026-01-31
19357 HCPCS Pc Breast Reconstruction 1 1 — — $66,161.16 $66,161.16 $66,161.16 2026-01-31
67027 HCPCS Implant Eye Drug System 1 1 — — $63,529.71 $63,529.71 $63,529.71 2026-01-31
27356 HCPCS Pc Excision/curettage Cyst/tumor Femur W/allograft 1 1 — — $51,743.47 $51,743.47 $51,743.47 2026-01-31
24346 HCPCS Pc Reconstruction Medial Collateral L 1 1 — — $51,743.47 $51,743.47 $51,743.47 2026-01-31
C9734 HCPCS U/s Trtmt, Not Leiomyomata 1 1 — — $51,743.47 $51,743.47 $51,743.47 2026-01-31
C9757 HCPCS Spine Device Implant Surgery 1 1 — — $51,743.47 $51,743.47 $51,743.47 2026-01-31
24365 HCPCS Reconstruct Head Of Radius 1 1 — — $51,743.47 $51,743.47 $51,743.47 2026-01-31
69729 HCPCS Impl Oi Implt Sk Tc Esp>=100 1 1 — — $51,743.47 $51,743.47 $51,743.47 2026-01-31
69716 HCPCS Impl Oi Implt Sk Tc Esp<100 1 1 — — $51,743.47 $51,743.47 $51,743.47 2026-01-31
69719 HCPCS Rplcm Oi Implt Sk Tc Esp<100 1 1 — — $51,743.47 $51,743.47 $51,743.47 2026-01-31
64628 HCPCS Trml Dstrj Ios Bvn 1st 2 L/s 1 1 — — $51,743.47 $51,743.47 $51,743.47 2026-01-31
69714 HCPCS Impl Oi Implt Skull Perq Esp 1 1 — — $51,743.47 $51,743.47 $51,743.47 2026-01-31
24362 HCPCS Pc Arthroplasty Elbow W Implant Liga Recon 1 1 — — $51,743.47 $51,743.47 $51,743.47 2026-01-31
27130 HCPCS Pc Hip Replacement Total 1 1 — — $51,743.47 $51,743.47 $51,743.47 2026-01-31
24366 HCPCS Pc Arthroplasty Radial Head With Implant 1 1 — — $51,743.47 $51,743.47 $51,743.47 2026-01-31
24410 HCPCS Mlt Osteot Rlgnm Imed Rd Hum 1 1 — — $51,743.47 $51,743.47 $51,743.47 2026-01-31
22551 HCPCS Arthrd Ant Ntrbdy Cervical 1 1 — — $51,743.47 $51,743.47 $51,743.47 2026-01-31
C9781 HCPCS Arthro/shoul Surg; W/spacer 1 1 — — $51,743.47 $51,743.47 $51,743.47 2026-01-31
22554 HCPCS Pc Arthrodesis Neck Fusion 1 1 — — $51,743.47 $51,743.47 $51,743.47 2026-01-31
0629T HCPCS Perq Njx Algc CT Lmbr 1st 1 1 — — $51,743.47 $51,743.47 $51,743.47 2026-01-31
23491 HCPCS Pc Prophylactic Treatment W/wo Methylmethacrylate Prox Humerus 1 1 — — $51,743.47 $51,743.47 $51,743.47 2026-01-31
25810 HCPCS Pc Arthrodesis Wrist Jt W/iliac/autog 1 1 — — $51,743.47 $51,743.47 $51,743.47 2026-01-31
24586 HCPCS Pc Open Tx Periarticul Fx/disloc Elbo 1 1 — — $51,743.47 $51,743.47 $51,743.47 2026-01-31
0627T HCPCS Perq Njx Algc Fluor Lmbr 1st 1 1 — — $51,743.47 $51,743.47 $51,743.47 2026-01-31
24587 HCPCS Optx Partclr Fx&/dslc Elbw W 1 1 — — $51,743.47 $51,743.47 $51,743.47 2026-01-31
24802 HCPCS Arthrd Elbow Jt Autog Graft 1 1 — — $51,743.47 $51,743.47 $51,743.47 2026-01-31
24579 HCPCS Pc Open Tx Humer Condyl W/wo Fixa 1 1 — — $51,743.47 $51,743.47 $51,743.47 2026-01-31
69730 HCPCS Rplc Oi Implt Sk Tc Esp>=100 1 1 — — $51,743.47 $51,743.47 $51,743.47 2026-01-31
24666 HCPCS Pc Treat Radius Fracture 1 1 — — $51,743.47 $51,743.47 $51,743.47 2026-01-31
23485 HCPCS Pc Revision Of Collar Bone 1 1 — — $51,743.47 $51,743.47 $51,743.47 2026-01-31
23473 HCPCS Pc Revision Total Shoulder Arthroplasty 1 1 — — $51,743.47 $51,743.47 $51,743.47 2026-01-31
25491 HCPCS Prophylactic Tx Ulna 1 1 — — $51,743.47 $51,743.47 $51,743.47 2026-01-31
23472 HCPCS Pc Arthroplasty W/glenoid/prox Hum Re 1 1 — — $51,743.47 $51,743.47 $51,743.47 2026-01-31
22869 HCPCS Pc Insert Stabilization Device Wo Decomp Sngl Level 1 1 — — $51,743.47 $51,743.47 $51,743.47 2026-01-31
20692 HCPCS Pc Apply Bone Fixation Device 1 1 — — $51,743.47 $51,743.47 $51,743.47 2026-01-31
23680 HCPCS Pc Open Treatment Shoulder Disloc W F 1 1 — — $51,743.47 $51,743.47 $51,743.47 2026-01-31
24546 HCPCS Pc Open Tx Hum Supracon Fx W Intercon 1 1 — — $51,743.47 $51,743.47 $51,743.47 2026-01-31
23470 HCPCS Pc Arthroplasty W/prox Humeral Implan 1 1 — — $51,743.47 $51,743.47 $51,743.47 2026-01-31
24545 HCPCS Pc Open Tx Hum Supracon Fx Wo Interco 1 1 — — $51,743.47 $51,743.47 $51,743.47 2026-01-31
29867 HCPCS Allgrft Implnt Knee W/scope 1 1 — — $51,743.47 $51,743.47 $51,743.47 2026-01-31
29889 HCPCS Pc Arthroscopy Aided Pcl Repair/recon 1 1 — — $51,743.47 $51,743.47 $51,743.47 2026-01-31
29907 HCPCS Subtalar Arthro W/fusion 1 1 — — $51,743.47 $51,743.47 $51,743.47 2026-01-31
28737 HCPCS Revision Of Foot Bones 1 1 — — $51,743.47 $51,743.47 $51,743.47 2026-01-31
24435 HCPCS Pc Repair Non-union Humerus W/graft 1 1 — — $51,743.47 $51,743.47 $51,743.47 2026-01-31
29856 HCPCS Tibial Arthroscopy/surgery 1 1 — — $51,743.47 $51,743.47 $51,743.47 2026-01-31
28725 HCPCS Pc Arthrodesis Subtalar 1 1 — — $51,743.47 $51,743.47 $51,743.47 2026-01-31
28730 HCPCS Pc Arthrodesis Midtars/tarsometat Mx 1 1 — — $51,743.47 $51,743.47 $51,743.47 2026-01-31
28320 HCPCS Pc Repair Non/malunion Tarsal Bone(s) 1 1 — — $51,743.47 $51,743.47 $51,743.47 2026-01-31
24430 HCPCS Pc Rpr Of Nonunion/malunion Humerus W 1 1 — — $51,743.47 $51,743.47 $51,743.47 2026-01-31
24516 HCPCS Pc Treatment Of Humeral Shaft Fractur 1 1 — — $51,743.47 $51,743.47 $51,743.47 2026-01-31
28420 HCPCS Pc Open Tx Calcan Fx W/pri Autog Gft 1 1 — — $51,743.47 $51,743.47 $51,743.47 2026-01-31
27759 HCPCS Pc Orif Tibia 1 1 — — $51,743.47 $51,743.47 $51,743.47 2026-01-31
27709 HCPCS Osteotomy Tibia & Fibula 1 1 — — $51,743.47 $51,743.47 $51,743.47 2026-01-31
27827 HCPCS Pc Open Tx Fx Dist Tib W/fix Tib Only 1 1 — — $51,743.47 $51,743.47 $51,743.47 2026-01-31
27828 HCPCS Pc Open Tx Fx Dis Tib W/fix Tib & Fib 1 1 — — $51,743.47 $51,743.47 $51,743.47 2026-01-31
27443 HCPCS Pc Rpr Revise Recontruc Femur And Knee Jt 1 1 — — $51,743.47 $51,743.47 $51,743.47 2026-01-31
27446 HCPCS Pc Arthroplasty Knee Condyl Medial/la 1 1 — — $51,743.47 $51,743.47 $51,743.47 2026-01-31
25391 HCPCS Lengthen Radius Or Ulna 1 1 — — $51,743.47 $51,743.47 $51,743.47 2026-01-31
23802 HCPCS Arthrd Glenohumeral Jt W/grf 1 1 — — $51,743.47 $51,743.47 $51,743.47 2026-01-31
27758 HCPCS Pc Open Tx Tib Shaft Fx W/plate/screw 1 1 — — $51,743.47 $51,743.47 $51,743.47 2026-01-31
27442 HCPCS Pc Revision Of Knee Joint 1 1 — — $51,743.47 $51,743.47 $51,743.47 2026-01-31
27447 HCPCS Pc Arthroplasty Knee Condyl Med & Lat 1 1 — — $51,743.47 $51,743.47 $51,743.47 2026-01-31
27870 HCPCS Pc Arthrodesis Ankle Any Method 1 1 — — $51,743.47 $51,743.47 $51,743.47 2026-01-31
27871 HCPCS Fusion Of Tibiofibular Joint 1 1 — — $51,743.47 $51,743.47 $51,743.47 2026-01-31
27429 HCPCS Reconstruction Knee 1 1 — — $51,743.47 $51,743.47 $51,743.47 2026-01-31
27438 HCPCS Revise Kneecap With Implant 1 1 — — $51,743.47 $51,743.47 $51,743.47 2026-01-31
24575 HCPCS Pc Open Tx Humer Epicond Fx W/wo Fixa 1 1 — — $51,743.47 $51,743.47 $51,743.47 2026-01-31
28715 HCPCS Arthrodesis Triple 1 1 — — $51,743.47 $51,743.47 $51,743.47 2026-01-31
27415 HCPCS Osteochondral Knee Allograft 1 1 — — $51,743.47 $51,743.47 $51,743.47 2026-01-31
27428 HCPCS Pc Ligamnt Recon Knee Intra-articular 1 1 — — $51,743.47 $51,743.47 $51,743.47 2026-01-31
24515 HCPCS Pc Open Tx Humer Fx W/implnt W/wo Cer 1 1 — — $51,743.47 $51,743.47 $51,743.47 2026-01-31
28735 HCPCS Pc Arthrodesis Midtarsl W Osteotomy 1 1 — — $51,743.47 $51,743.47 $51,743.47 2026-01-31
27440 HCPCS Revision Of Knee Joint 1 1 — — $51,743.47 $51,743.47 $51,743.47 2026-01-31
25441 HCPCS Pc Arthroplasty W Prosthetic Rplcmt Distal Radius 1 1 — — $51,743.47 $51,743.47 $51,743.47 2026-01-31
25365 HCPCS Revise Radius & Ulna 1 1 — — $51,743.47 $51,743.47 $51,743.47 2026-01-31
24498 HCPCS Proph Tx W/wo Mthylmthcrylt 1 1 — — $51,743.47 $51,743.47 $51,743.47 2026-01-31
24370 HCPCS Pc Revise Reconst Elbow Joint With Allograft 1 1 — — $51,743.47 $51,743.47 $51,743.47 2026-01-31
25444 HCPCS Pc Arthroplasty W Prosthetic Rplcmt Lunate 1 1 — — $51,743.47 $51,743.47 $51,743.47 2026-01-31
27441 HCPCS Pc Arthroplasty Knee W Debridement N Part Synovectomy 1 1 — — $51,743.47 $51,743.47 $51,743.47 2026-01-31
64596 HCPCS Ins/rplcmt Prq Eltrd Ra Pn 1 1 1 — — $51,469.32 $51,469.32 $51,469.32 2026-01-31
0784T HCPCS Ins/rplmt Eltrd Ra Spi Nstim 1 1 — — $51,469.32 $51,469.32 $51,469.32 2026-01-31
0786T HCPCS Insj/rplcmt Prq Ra Sac Nstim 1 1 — — $51,469.32 $51,469.32 $51,469.32 2026-01-31
33288 HCPCS Rmv&rplcmt Phrnc Nrv Stim Ld 1 1 — — $51,469.32 $51,469.32 $51,469.32 2026-01-31
J9600 HCPCS Porfimer Sodium Injection 1 1 — — $50,602.55 $50,602.55 $50,602.55 2026-01-31
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