Hospital

HOSPITAL DE LA CONCEPCION

San German, PR · CCN 400021 · Rates published

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This hospital’s price: $295 across 13 payers · range $97-$3,000

Source: https://sthpiprd.blob.core.windows.net/machine-readable-files/8494/660227304_hospital-de-la-concepcion-inc_standardcharges.csv · observed 2024-12-26

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.

10,104 distinct procedures filed

14 distinct payers

96,386 rate rows

2024-12-26 last MRF observed · ⚠ 22 mo old

Data quality

69,765 of 96,386 rate rows are consumer-grade (72.4%)

26,621 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 — reason	Rows
no usable negotiated amount (only an out-of-band fallback) — excluded from medians	16,886
professional (physician) fee — not the facility price	6,441
exceeds 10× this hospital's gross charge — excluded from medians	3,133
per-diem day rate — not a per-procedure price	125
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians	21
placeholder amount (≤ $0.02) — excluded from medians	15

⚠ Possibly outdated The most recent machine-readable file we have for this hospital is 22 months old. CMS requires hospitals to refresh these files at least annually, so newer rates may exist that we haven't ingested yet. The prices below are exactly as last filed.

Data source & audit trail ↓ Download audit trail (JSON)

Source MRF file	https://sthpiprd.blob.core.windows.net/machine-readable-files/8494/660227304_hospital-de-la-concepcion-inc_standardcharges.csv
Found on page	https://search.hospitalpriceindex.com/hpi2/machineReadable/hospitaldelaconcepcion/8494
Discovered via	Discovered by HANK (automated)
Last fetch	not_modified · 2026-10-03
Content fingerprint	4a4e452e77fa680b… · 44,973,202 bytes · first seen 2026-05-15

Top 50 most expensive offerings

Outliers are flagged where this hospital's filed rate is ≥2× or ≤0.5× the national median for the same code.

Code	Description	Payers	Min $	Max $	Avg median	vs national
J1411 HCPCS	Inj, Hemgenix, Per Tx Dose	5	$3,672,900.00	$4,040,190.00	$3,672,900.00	nat. median $3,705,478 1.0× median
C9172 HCPCS	Emergency	5	$3,605,000.00	$3,965,500.00	$3,605,000.00	nat. median $3,605,000 1.0× median
J1413 HCPCS	Inj Delandistrogene Mox Rokl	5	$3,325,454.76	$3,658,000.23	$3,325,454.76	nat. median $3,324,572 1.0× median
J3394 HCPCS	Inj, Lovotibeglogene Autotem	5	$3,286,000.00	$3,614,600.00	$3,286,000.00	nat. median $3,286,000 1.0× median
J3393 HCPCS	Inj, Betibeglogene Autotemce	5	$2,968,000.00	$3,264,800.00	$2,968,000.00	nat. median $2,994,107 1.0× median
J3399 HCPCS	Inj Onase Abepar-xioi Treat	5	$2,388,614.23	$2,627,475.65	$2,388,614.23	nat. median $2,467,386 1.0× median
Q2042 HCPCS	Tisagenlecleucel Car-pos T	5	$529,192.86	$582,112.14	$529,192.86	nat. median $739,258 0.7× median
Q2056 HCPCS	Ciltacabtagene Car-pos T	5	$527,123.43	$579,835.78	$527,123.43	nat. median $646,415 0.8× median
Q2055 HCPCS	Idecabtagene Vicleucel Car	5	$526,587.59	$579,246.35	$526,587.59	nat. median $622,450 0.8× median
Q2054 HCPCS	Lisocabtagene Mara Car Pos T	5	$516,726.08	$568,398.68	$516,726.08	nat. median $640,950 0.8× median
Q2041 HCPCS	Axicabtagene Ciloleucel Car+	5	$489,455.96	$538,401.55	$489,455.96	nat. median $608,239 0.8× median
Q2053 HCPCS	Brexucabtagene Car Pos T	5	$460,530.40	$506,583.44	$460,530.40	nat. median $591,721 0.8× median
Q0480 HCPCS	Driver Pneumatic Vad, Rep	5	$99,999.97	$109,999.97	$99,999.97	nat. median $111,503 0.9× median
K1007 HCPCS	Bil Hkaf Pc S/d Micro Sensor	5	$91,031.93	$100,135.12	$91,031.93	nat. median $96,983 0.9× median
L8702 HCPCS	Ewhf S/d Uprt Micro Sensor	5	$65,871.74	$72,458.91	$65,871.74	nat. median $70,178 0.9× median
A9543 HCPCS	Y90 Ibritumomab, Rx	5	$65,476.58	$72,024.24	$65,476.58	nat. median $63,528 1.0× median
J9029 HCPCS	Instill Adstiladrin, Tx Dose	5	$63,354.77	$69,690.25	$63,354.77	nat. median $68,423 0.9× median
Q2043 HCPCS	Sipuleucel-t Auto Cd54+	5	$55,015.23	$60,516.75	$55,015.23	nat. median $65,720 0.8× median
L7181 HCPCS	Electronic Elbo Simultaneous	5	$50,715.19	$55,786.71	$50,715.19	nat. median $50,516 1.0× median
J9226 HCPCS	Supprelin La Implant	5	$45,350.22	$49,885.24	$45,350.22	nat. median $55,159 0.8× median
L2006 HCPCS	Kaf Sng/dbl Swg/stn Mcpr Cus	5	$42,619.21	$46,881.13	$42,619.21	nat. median $39,921 1.1× median
38240 CPT	Transplt Allo Hct/donor	5	$40,141.98	$44,156.17	$40,141.98	nat. median $12,842 outlier · 3.1×
0266T CPT	Implt/rpl Crtd Sns Dev Total	5	$34,694.49	$38,163.93	$34,694.49	nat. median $42,739 0.8× median
33276 CPT	Insj Phrnc Nrv Stim Sys	5	$34,694.49	$38,163.93	$34,694.49	nat. median $43,278 0.8× median
L8701 HCPCS	Ewh S/d Uprt Micro Sensor	5	$33,480.90	$36,828.99	$33,480.90	nat. median $35,670 0.9× median
L5856 HCPCS	Elec Knee-shin Swing/stance	5	$30,384.84	$33,423.32	$30,384.84	nat. median $30,017 1.0× median
L6880 HCPCS	Elec Hand Ind Art Digits	5	$30,241.38	$33,265.52	$30,241.38	nat. median $30,019 1.0× median
J9266 HCPCS	Pegaspargase Injection	5	$27,070.53	$29,777.59	$27,070.53	nat. median $33,233 0.8× median
69930 CPT	Implant Cochlear Device	5	$24,633.89	$27,097.28	$24,633.89	nat. median $29,189 0.8× median
33270 CPT	Ins/rep Subq Defibrillator	5	$24,167.12	$26,583.84	$24,167.12	nat. median $32,114 0.8× median
33264 CPT	Rmvl & Rplcmt Dfb Gen Mlt Ld	5	$24,167.12	$26,583.84	$24,167.12	nat. median $31,574 0.8× median
0571T CPT	Insj/rplcmt Icds Ss Eltrd	5	$24,167.12	$26,583.84	$24,167.12	nat. median $32,221 0.8× median
0408T CPT	Insj/rplc Cardiac Modulj Sys	5	$24,167.12	$26,583.84	$24,167.12	nat. median $32,041 0.8× median
33231 CPT	Insrt Pulse Gen W/mult Leads	5	$24,167.12	$26,583.84	$24,167.12	nat. median $30,121 0.8× median
J9600 HCPCS	Porfimer Sodium Injection	5	$23,870.14	$26,257.15	$23,870.14	nat. median $30,131 0.8× median
Q0483 HCPCS	Monitor Elec Vad, Rep	5	$23,731.73	$26,104.90	$23,731.73	nat. median $23,335 1.0× median
L5858 HCPCS	Stance Phase Only	5	$23,523.81	$25,876.19	$23,523.81	nat. median $23,237 1.0× median
64568 CPT	Opn Impltj Crnl Nrv Nea&pg	5	$22,810.44	$25,091.48	$22,810.44	nat. median $27,694 0.8× median
63685 CPT	Ins/rplc Spi Npg/rcvr Pocket	5	$22,810.44	$25,091.48	$22,810.44	nat. median $20,965 1.1× median
61886 CPT	Implant Neurostim Arrays	5	$22,810.44	$25,091.48	$22,810.44	nat. median $27,176 0.8× median
64582 CPT	Opn Mpltj Hpglsl Nstm Ary Pg	5	$22,810.44	$25,091.48	$22,810.44	nat. median $28,157 0.8× median
0268T CPT	Implt/rpl Crtd Sns Dev Gen	5	$22,810.44	$25,091.48	$22,810.44	nat. median $29,815 0.8× median
33287 CPT	Rmv&rplcmt Phrnc Nrv Stim Pg	5	$22,810.44	$25,091.48	$22,810.44	nat. median $28,983 0.8× median
L5973 HCPCS	Ank-foot Sys Dors-plant Flex	5	$22,772.24	$25,049.46	$22,772.24	nat. median $21,726 1.0× median
33289 CPT	Tcat Impl Wrls P-art Prs Snr	5	$21,350.34	$23,485.37	$21,350.34	nat. median $27,731 0.8× median
C9760 HCPCS	Non-blind Interatrial Shunt	5	$21,202.34	$23,322.57	$21,202.34	nat. median $27,860 0.8× median
0620T CPT	Evasc Ven Artlz Tibl/prnl Vn	5	$21,202.34	$23,322.57	$21,202.34	nat. median $32,709 0.6× median
Q0489 HCPCS	Pwr Pck Base Combo Vad, Rep	5	$20,574.11	$22,631.52	$20,574.11	nat. median $20,275 1.0× median
Q0481 HCPCS	Microprcsr Cu Elec Vad, Rep	5	$18,392.10	$20,231.31	$18,392.10	nat. median $15,219 1.2× median
L5859 HCPCS	Knee-shin Pro Flex/ext Cont	5	$18,364.82	$20,201.30	$18,364.82	nat. median $18,321 1.0× median

Other procedures at this hospital

Browse this hospital's 10,104 published procedures. Use the slice to choose what to show, then sort or filter any column.

Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
Code	Type	Description	Rate rows	Payers	Gross	Cash	Min $	Max $	Avg median	Last observed

J1411	HCPCS	Inj, Hemgenix, Per Tx Dose	5	5	—	—	$3,672,900.00	$4,040,190.00	$3,672,900.00	2024-12-26
C9172	HCPCS	Emergency	5	5	—	—	$3,605,000.00	$3,965,500.00	$3,605,000.00	2024-12-26
J1413	HCPCS	Inj Delandistrogene Mox Rokl	5	5	—	—	$3,325,454.76	$3,658,000.23	$3,325,454.76	2024-12-26
J3394	HCPCS	Inj, Lovotibeglogene Autotem	5	5	—	—	$3,286,000.00	$3,614,600.00	$3,286,000.00	2024-12-26
J3393	HCPCS	Inj, Betibeglogene Autotemce	5	5	—	—	$2,968,000.00	$3,264,800.00	$2,968,000.00	2024-12-26
J3399	HCPCS	Inj Onase Abepar-xioi Treat	5	5	—	—	$2,388,614.23	$2,627,475.65	$2,388,614.23	2024-12-26
Q2042	HCPCS	Tisagenlecleucel Car-pos T	5	5	—	—	$529,192.86	$582,112.14	$529,192.86	2024-12-26
Q2056	HCPCS	Ciltacabtagene Car-pos T	5	5	—	—	$527,123.43	$579,835.78	$527,123.43	2024-12-26
Q2055	HCPCS	Idecabtagene Vicleucel Car	5	5	—	—	$526,587.59	$579,246.35	$526,587.59	2024-12-26
Q2054	HCPCS	Lisocabtagene Mara Car Pos T	5	5	—	—	$516,726.08	$568,398.68	$516,726.08	2024-12-26
Q2041	HCPCS	Axicabtagene Ciloleucel Car+	5	5	—	—	$489,455.96	$538,401.55	$489,455.96	2024-12-26
Q2053	HCPCS	Brexucabtagene Car Pos T	5	5	—	—	$460,530.40	$506,583.44	$460,530.40	2024-12-26
Q0480	HCPCS	Driver Pneumatic Vad, Rep	5	5	—	—	$99,999.97	$109,999.97	$99,999.97	2024-12-26
K1007	HCPCS	Bil Hkaf Pc S/d Micro Sensor	5	5	—	—	$91,031.93	$100,135.12	$91,031.93	2024-12-26
L8702	HCPCS	Ewhf S/d Uprt Micro Sensor	5	5	—	—	$65,871.74	$72,458.91	$65,871.74	2024-12-26
A9543	HCPCS	Y90 Ibritumomab, Rx	5	5	—	—	$65,476.58	$72,024.24	$65,476.58	2024-12-26
J9029	HCPCS	Instill Adstiladrin, Tx Dose	5	5	—	—	$63,354.77	$69,690.25	$63,354.77	2024-12-26
Q2043	HCPCS	Sipuleucel-t Auto Cd54+	5	5	—	—	$55,015.23	$60,516.75	$55,015.23	2024-12-26
L7181	HCPCS	Electronic Elbo Simultaneous	5	5	—	—	$50,715.19	$55,786.71	$50,715.19	2024-12-26
J9226	HCPCS	Supprelin La Implant	5	5	—	—	$45,350.22	$49,885.24	$45,350.22	2024-12-26
L2006	HCPCS	Kaf Sng/dbl Swg/stn Mcpr Cus	5	5	—	—	$42,619.21	$46,881.13	$42,619.21	2024-12-26
38240	CPT	Transplt Allo Hct/donor	5	5	—	—	$40,141.98	$44,156.17	$40,141.98	2024-12-26
33276	CPT	Insj Phrnc Nrv Stim Sys	5	5	—	—	$34,694.49	$38,163.93	$34,694.49	2024-12-26
0266T	CPT	Implt/rpl Crtd Sns Dev Total	5	5	—	—	$34,694.49	$38,163.93	$34,694.49	2024-12-26
L8701	HCPCS	Ewh S/d Uprt Micro Sensor	5	5	—	—	$33,480.90	$36,828.99	$33,480.90	2024-12-26
L5856	HCPCS	Elec Knee-shin Swing/stance	5	5	—	—	$30,384.84	$33,423.32	$30,384.84	2024-12-26
L6880	HCPCS	Elec Hand Ind Art Digits	5	5	—	—	$30,241.38	$33,265.52	$30,241.38	2024-12-26
J9266	HCPCS	Pegaspargase Injection	5	5	—	—	$27,070.53	$29,777.59	$27,070.53	2024-12-26
69930	CPT	Implant Cochlear Device	5	5	—	—	$24,633.89	$27,097.28	$24,633.89	2024-12-26
0571T	CPT	Insj/rplcmt Icds Ss Eltrd	5	5	—	—	$24,167.12	$26,583.84	$24,167.12	2024-12-26
0408T	CPT	Insj/rplc Cardiac Modulj Sys	5	5	—	—	$24,167.12	$26,583.84	$24,167.12	2024-12-26
33270	CPT	Ins/rep Subq Defibrillator	5	5	—	—	$24,167.12	$26,583.84	$24,167.12	2024-12-26
33264	CPT	Rmvl & Rplcmt Dfb Gen Mlt Ld	5	5	—	—	$24,167.12	$26,583.84	$24,167.12	2024-12-26
33231	CPT	Insrt Pulse Gen W/mult Leads	5	5	—	—	$24,167.12	$26,583.84	$24,167.12	2024-12-26
J9600	HCPCS	Porfimer Sodium Injection	5	5	—	—	$23,870.14	$26,257.15	$23,870.14	2024-12-26
Q0483	HCPCS	Monitor Elec Vad, Rep	5	5	—	—	$23,731.73	$26,104.90	$23,731.73	2024-12-26
L5858	HCPCS	Stance Phase Only	5	5	—	—	$23,523.81	$25,876.19	$23,523.81	2024-12-26
63685	CPT	Ins/rplc Spi Npg/rcvr Pocket	5	5	—	—	$22,810.44	$25,091.48	$22,810.44	2024-12-26
64582	CPT	Opn Mpltj Hpglsl Nstm Ary Pg	5	5	—	—	$22,810.44	$25,091.48	$22,810.44	2024-12-26
61886	CPT	Implant Neurostim Arrays	5	5	—	—	$22,810.44	$25,091.48	$22,810.44	2024-12-26
33287	CPT	Rmv&rplcmt Phrnc Nrv Stim Pg	5	5	—	—	$22,810.44	$25,091.48	$22,810.44	2024-12-26
0268T	CPT	Implt/rpl Crtd Sns Dev Gen	5	5	—	—	$22,810.44	$25,091.48	$22,810.44	2024-12-26
64568	CPT	Opn Impltj Crnl Nrv Nea&pg	5	5	—	—	$22,810.44	$25,091.48	$22,810.44	2024-12-26
L5973	HCPCS	Ank-foot Sys Dors-plant Flex	5	5	—	—	$22,772.24	$25,049.46	$22,772.24	2024-12-26
33289	CPT	Tcat Impl Wrls P-art Prs Snr	5	5	—	—	$21,350.34	$23,485.37	$21,350.34	2024-12-26
C9760	HCPCS	Non-blind Interatrial Shunt	5	5	—	—	$21,202.34	$23,322.57	$21,202.34	2024-12-26
0620T	CPT	Evasc Ven Artlz Tibl/prnl Vn	5	5	—	—	$21,202.34	$23,322.57	$21,202.34	2024-12-26
Q0489	HCPCS	Pwr Pck Base Combo Vad, Rep	5	5	—	—	$20,574.11	$22,631.52	$20,574.11	2024-12-26
Q0481	HCPCS	Microprcsr Cu Elec Vad, Rep	5	5	—	—	$18,392.10	$20,231.31	$18,392.10	2024-12-26
L5859	HCPCS	Knee-shin Pro Flex/ext Cont	5	5	—	—	$18,364.82	$20,201.30	$18,364.82	2024-12-26
93654	CPT	Compre Ep Eval Tx Vt	5	5	—	—	$17,446.65	$19,191.32	$17,446.65	2024-12-26
L6960	HCPCS	Shldr Disartic Switch Contro	5	5	—	—	$17,406.66	$19,147.33	$17,406.66	2024-12-26
L6965	HCPCS	Shldr Disartic Myoelectronic	5	5	—	—	$17,406.66	$19,147.33	$17,406.66	2024-12-26
L7180	HCPCS	Electronic Elbow Sequential	5	5	—	—	$17,406.66	$19,147.33	$17,406.66	2024-12-26
L6955	HCPCS	Above Elbow Myoelectronic CT	5	5	—	—	$17,406.66	$19,147.33	$17,406.66	2024-12-26
L6975	HCPCS	Interscap-thor Myoelectronic	5	5	—	—	$17,406.66	$19,147.33	$17,406.66	2024-12-26
L6970	HCPCS	Interscapular-thor Switch CT	5	5	—	—	$17,406.66	$19,147.33	$17,406.66	2024-12-26
0515T	CPT	Insj Wcs Lv Compl Sys	5	5	—	—	$17,315.17	$19,046.69	$17,315.17	2024-12-26
0409T	CPT	Insj/rplc Car Modulj Pls Gn	5	5	—	—	$17,315.17	$19,046.69	$17,315.17	2024-12-26
0614T	CPT	Rmvl&rplcmt Ss Impl Dfb Pg	5	5	—	—	$17,315.17	$19,046.69	$17,315.17	2024-12-26
33262	CPT	Rmvl& Replc Pulse Gen 1 Lead	5	5	—	—	$17,315.17	$19,046.69	$17,315.17	2024-12-26
0414T	CPT	Rmvl & Rpl Car Modulj Pls Gn	5	5	—	—	$17,315.17	$19,046.69	$17,315.17	2024-12-26
33263	CPT	Rmvl & Rplcmt Dfb Gen 2 Lead	5	5	—	—	$17,315.17	$19,046.69	$17,315.17	2024-12-26
33230	CPT	Insrt Pulse Gen W/dual Leads	5	5	—	—	$17,315.17	$19,046.69	$17,315.17	2024-12-26
33240	CPT	Insrt Pulse Gen W/singl Lead	5	5	—	—	$17,315.17	$19,046.69	$17,315.17	2024-12-26
A9604	HCPCS	Sm 153 Lexidronam	5	5	—	—	$17,259.85	$18,985.84	$17,259.85	2024-12-26
C2616	HCPCS	Brachytx, Non-str,yttrium-90	5	5	—	—	$17,177.01	$18,894.71	$17,177.01	2024-12-26
L6945	HCPCS	Elbow Disart Myoelectronic C	5	5	—	—	$16,857.98	$18,543.78	$16,857.98	2024-12-26
L6950	HCPCS	Above Elbow Switch Control	5	5	—	—	$16,857.98	$18,543.78	$16,857.98	2024-12-26
0817T	CPT	Opn Insj/rplcmt Ins Ptn Subf	5	5	—	—	$16,069.41	$17,676.35	$16,069.41	2024-12-26
61885	CPT	Insrt/redo Neurostim 1 Array	5	5	—	—	$16,069.41	$17,676.35	$16,069.41	2024-12-26
0816T	CPT	Opn Insj/rplcmt Ins Ptn Subq	5	5	—	—	$16,069.41	$17,676.35	$16,069.41	2024-12-26
64590	CPT	Ins/rpl Prph Sac/gstr Npg/r	5	5	—	—	$16,069.41	$17,676.35	$16,069.41	2024-12-26
61891	CPT	Rev/rplcmt Sk-mnt Crnl Nstm	5	5	—	—	$16,069.41	$17,676.35	$16,069.41	2024-12-26
63655	CPT	Implant Neuroelectrodes	5	5	—	—	$16,069.41	$17,676.35	$16,069.41	2024-12-26
64580	CPT	Opn Impltj Nea Neuromuscular	5	5	—	—	$16,069.41	$17,676.35	$16,069.41	2024-12-26
54411	CPT	Remov/replc Penis Pros Comp	5	5	—	—	$14,817.85	$16,299.64	$14,817.85	2024-12-26
54410	CPT	Remove/replace Penis Prosth	5	5	—	—	$14,817.85	$16,299.64	$14,817.85	2024-12-26
54405	CPT	Insert Multi-comp Penis Pros	5	5	—	—	$14,817.85	$16,299.64	$14,817.85	2024-12-26
54416	CPT	Remv/repl Penis Contain Pros	5	5	—	—	$14,817.85	$16,299.64	$14,817.85	2024-12-26
53447	CPT	Remove/replace Ur Sphincter	5	5	—	—	$14,817.85	$16,299.64	$14,817.85	2024-12-26
53445	CPT	Insert Uro/ves Nck Sphincter	5	5	—	—	$14,817.85	$16,299.64	$14,817.85	2024-12-26
53444	CPT	Insert Tandem Cuff	5	5	—	—	$14,817.85	$16,299.64	$14,817.85	2024-12-26
54401	CPT	Insert Self-contd Prosthesis	5	5	—	—	$14,817.85	$16,299.64	$14,817.85	2024-12-26
0797T	CPT	Tcat Ins 2chmbr Ldls Pm Rv	5	5	—	—	$14,313.51	$15,744.86	$14,313.51	2024-12-26
0802T	CPT	Tcat Rmv&rpl2chmb Ldls Pm Ra	5	5	—	—	$14,313.51	$15,744.86	$14,313.51	2024-12-26
0825T	CPT	Tcat Rmv&rpl1chmb Ldls Pm Ra	5	5	—	—	$14,313.51	$15,744.86	$14,313.51	2024-12-26
0796T	CPT	Tcat Ins 2chmbr Ldls Pm Ra	5	5	—	—	$14,313.51	$15,744.86	$14,313.51	2024-12-26
0795T	CPT	Tcat Ins 2chmbr Ldls Pm Cmpl	5	5	—	—	$14,313.51	$15,744.86	$14,313.51	2024-12-26
33221	CPT	Insert Pulse Gen Mult Leads	5	5	—	—	$14,313.51	$15,744.86	$14,313.51	2024-12-26
0801T	CPT	Tcat Rmv&rpl 2chmbr Ldls Pm	5	5	—	—	$14,313.51	$15,744.86	$14,313.51	2024-12-26
33274	CPT	Tcat Insj/rpl Perm Ldls Pm	5	5	—	—	$14,313.51	$15,744.86	$14,313.51	2024-12-26
0823T	CPT	Tcat Ins 1chmbr Ldls Pm Ra	5	5	—	—	$14,313.51	$15,744.86	$14,313.51	2024-12-26
33229	CPT	Remv&replc Pm Gen Mult Leads	5	5	—	—	$14,313.51	$15,744.86	$14,313.51	2024-12-26
0803T	CPT	Tcat Rmv&rpl2chmb Ldls Pm Rv	5	5	—	—	$14,313.51	$15,744.86	$14,313.51	2024-12-26
21243	CPT	Reconstruction Of Jaw Joint	5	5	—	—	$13,689.74	$15,058.71	$13,689.74	2024-12-26
22612	CPT	Arthrd Pst Tq 1ntrspc Lumbar	6	5	—	—	$3,500.00	$15,058.71	$13,689.74	2024-12-26
28705	CPT	Arthrodesis Pantalar	5	5	—	—	$13,689.74	$15,058.71	$13,689.74	2024-12-26
27279	CPT	Arthrd Si Jt Perq/min Nvas	5	5	—	—	$13,689.74	$15,058.71	$13,689.74	2024-12-26
23472	CPT	Reconstruct Shoulder Joint	5	5	—	—	$13,689.74	$15,058.71	$13,689.74	2024-12-26
24361	CPT	Reconstruct Elbow Joint	5	5	—	—	$13,689.74	$15,058.71	$13,689.74	2024-12-26
23616	CPT	Optx Prx Hmrl Fx Fix Rpr Rpl	5	5	—	—	$13,689.74	$15,058.71	$13,689.74	2024-12-26
20696	CPT	App Mltpln Uni Xtrnl Fix 1st	5	5	—	—	$13,689.74	$15,058.71	$13,689.74	2024-12-26
22856	CPT	Tot Disc Arthrp 1ntrspc Crv	6	5	—	—	$3,500.00	$15,058.71	$13,689.74	2024-12-26
22633	CPT	Arthrd Cmbn 1ntrspc Lumbar	6	5	—	—	$3,500.00	$15,058.71	$13,689.74	2024-12-26
22867	CPT	Insj Stablj Dev W/dcmprn	6	5	—	—	$3,500.00	$15,058.71	$13,689.74	2024-12-26
25446	CPT	Arthrp W/prostc Dst Rds&crps	5	5	—	—	$13,689.74	$15,058.71	$13,689.74	2024-12-26
22630	CPT	Arthrd Pst Tq 1ntrspc Lum	6	5	—	—	$3,500.00	$15,058.71	$13,689.74	2024-12-26
27278	CPT	Arthrd Si Jt Prq Wo Tfxj Dev	5	5	—	—	$13,689.74	$15,058.71	$13,689.74	2024-12-26
25442	CPT	Arthrp W/prostc Dstl Ulna	5	5	—	—	$13,689.74	$15,058.71	$13,689.74	2024-12-26
24371	CPT	Revise Reconst Elbow Joint	5	5	—	—	$13,689.74	$15,058.71	$13,689.74	2024-12-26
24363	CPT	Replace Elbow Joint	5	5	—	—	$13,689.74	$15,058.71	$13,689.74	2024-12-26
27702	CPT	Reconstruct Ankle Joint	5	5	—	—	$13,689.74	$15,058.71	$13,689.74	2024-12-26
C9758	HCPCS	Blind Interatrial Shunt Ide	5	5	—	—	$13,492.54	$14,841.79	$13,492.54	2024-12-26
0888T	CPT	Histotripsy Mal Renal Tissue	5	5	—	—	$13,492.54	$14,841.79	$13,492.54	2024-12-26
C9782	HCPCS	Blind Myocar Trpl Bon Marrow	5	5	—	—	$13,492.54	$14,841.79	$13,492.54	2024-12-26
0686T	CPT	Histotripsy Mal Hepatcel Tis	5	5	—	—	$13,492.54	$14,841.79	$13,492.54	2024-12-26
L7191	HCPCS	Elbow Child Myoelectronic CT	5	5	—	—	$13,238.49	$14,562.34	$13,238.49	2024-12-26
19357	CPT	Tiss Xpndr Plmt Brst Rcnstj	5	5	—	—	$12,944.76	$14,239.24	$12,944.76	2024-12-26
L6940	HCPCS	Elbow Disarticulation Switch	5	5	—	—	$12,939.57	$14,233.53	$12,939.57	2024-12-26
C9775	HCPCS	Revasc Lith-sten-ath Tib/per	5	5	—	—	$12,881.00	$14,169.10	$12,881.00	2024-12-26
37230	CPT	Tib/per Revasc W/stent	5	5	—	—	$12,881.00	$14,169.10	$12,881.00	2024-12-26
0632T	CPT	Perq Tcat US Abltj Nrv P-art	5	5	—	—	$12,881.00	$14,169.10	$12,881.00	2024-12-26
C9797	HCPCS	Vasc Emb/occ W/prs Cath	5	5	—	—	$12,881.00	$14,169.10	$12,881.00	2024-12-26
C9773	HCPCS	Revasc Lithotr-stent Tib/per	5	5	—	—	$12,881.00	$14,169.10	$12,881.00	2024-12-26
93581	CPT	Transcath Closure Of Vsd	5	5	—	—	$12,881.00	$14,169.10	$12,881.00	2024-12-26
C9774	HCPCS	Revasc Lithotr-ather Tib/per	5	5	—	—	$12,881.00	$14,169.10	$12,881.00	2024-12-26
C9767	HCPCS	Revasc Lithotrip-stent-ather	5	5	—	—	$12,881.00	$14,169.10	$12,881.00	2024-12-26
C9766	HCPCS	Revasc Intra Lithotrip-ather	5	5	—	—	$12,881.00	$14,169.10	$12,881.00	2024-12-26
C9765	HCPCS	Revasc Intra Lithotrip-stent	5	5	—	—	$12,881.00	$14,169.10	$12,881.00	2024-12-26
93580	CPT	Transcath Closure Of Asd	5	5	—	—	$12,881.00	$14,169.10	$12,881.00	2024-12-26
93590	CPT	Perq Transcath Cls Mitral	5	5	—	—	$12,881.00	$14,169.10	$12,881.00	2024-12-26
93591	CPT	Perq Transcath Cls Aortic	5	5	—	—	$12,881.00	$14,169.10	$12,881.00	2024-12-26
93582	CPT	Perq Transcath Closure Pda	5	5	—	—	$12,881.00	$14,169.10	$12,881.00	2024-12-26
92933	CPT	Prq Card Stent/ath/angio	5	5	—	—	$12,881.00	$14,169.10	$12,881.00	2024-12-26
37231	CPT	Tib/per Revasc Stent & Ather	5	5	—	—	$12,881.00	$14,169.10	$12,881.00	2024-12-26
36837	CPT	Prq Av Fstl Crt Uxtr Sep Acs	5	5	—	—	$12,881.00	$14,169.10	$12,881.00	2024-12-26
C9607	HCPCS	Perc D-e Cor Revasc Chro Sin	5	5	—	—	$12,881.00	$14,169.10	$12,881.00	2024-12-26
33902	CPT	Perq P-art Revsc 1 Abnor Uni	5	5	—	—	$12,881.00	$14,169.10	$12,881.00	2024-12-26
37184	CPT	Prim Art M-thrmbc 1st Vsl	5	5	—	—	$12,881.00	$14,169.10	$12,881.00	2024-12-26
C9602	HCPCS	Perc D-e Cor Stent Ather S	5	5	—	—	$12,881.00	$14,169.10	$12,881.00	2024-12-26
0793T	CPT	Prq Tcat Thrm Ablt Nrv P-art	5	5	—	—	$12,881.00	$14,169.10	$12,881.00	2024-12-26
0645T	CPT	Tcat Impltj C Sins Rdctj Dev	5	5	—	—	$12,881.00	$14,169.10	$12,881.00	2024-12-26
0238T	CPT	Trluml Perip Athrc Iliac Art	5	5	—	—	$12,881.00	$14,169.10	$12,881.00	2024-12-26
L7190	HCPCS	Elbow Adolescent Myoelectron	5	5	—	—	$12,836.97	$14,120.67	$12,836.97	2024-12-26
L7186	HCPCS	Electron Elbow Child Switch	5	5	—	—	$12,804.38	$14,084.82	$12,804.38	2024-12-26
0308T	CPT	Insj Ocular Telescope Prosth	5	5	—	—	$12,744.60	$14,019.06	$12,744.60	2024-12-26
0616T	CPT	Emergency	5	5	—	—	$12,744.60	$14,019.06	$12,744.60	2024-12-26
0617T	CPT	Emergency	5	5	—	—	$12,744.60	$14,019.06	$12,744.60	2024-12-26
0618T	CPT	Emergency	5	5	—	—	$12,744.60	$14,019.06	$12,744.60	2024-12-26
L5280	HCPCS	Hemipelvect Canad Sing Axis	5	5	—	—	$12,210.58	$13,431.64	$12,210.58	2024-12-26
J1412	HCPCS	Inj Roctavian Ml 2x10^13vc G	5	5	—	—	$12,007.81	$13,208.59	$12,007.81	2024-12-26
81416	CPT	Exome Sequence Analysis	5	5	—	—	$12,000.00	$13,200.00	$12,000.00	2024-12-26
L5250	HCPCS	Hip Canad Sing Axi Cons Fric	5	5	—	—	$11,846.10	$13,030.71	$11,846.10	2024-12-26
67027	CPT	Implant Eye Drug System	5	5	—	—	$11,594.32	$12,753.75	$11,594.32	2024-12-26
L5991	HCPCS	Low Pros Ext Osseo Connector	5	5	—	—	$11,254.44	$12,379.88	$11,254.44	2024-12-26
L5857	HCPCS	Elec Knee-shin Swing Only	5	5	—	—	$10,781.66	$11,859.83	$10,781.66	2024-12-26
L6920	HCPCS	Wrist Disarticul Switch Ctrl	5	5	—	—	$10,023.61	$11,025.97	$10,023.61	2024-12-26
64596	CPT	Ins/rplcmt Prq Eltrd Ra Pn 1	5	5	—	—	$10,006.51	$11,007.16	$10,006.51	2024-12-26
64569	CPT	Revise/repl Vagus N Eltrd	5	5	—	—	$10,006.51	$11,007.16	$10,006.51	2024-12-26
64575	CPT	Opn Impltj Nea Perph Nerve	5	5	—	—	$10,006.51	$11,007.16	$10,006.51	2024-12-26
64553	CPT	Implant Neuroelectrodes	5	5	—	—	$10,006.51	$11,007.16	$10,006.51	2024-12-26
33288	CPT	Rmv&rplcmt Phrnc Nrv Stim Ld	5	5	—	—	$10,006.51	$11,007.16	$10,006.51	2024-12-26
64583	CPT	Rev/rplct Hpglsl Nstm Ary Pg	5	5	—	—	$10,006.51	$11,007.16	$10,006.51	2024-12-26
0786T	CPT	Insj/rplcmt Prq Ra Sac Nstim	5	5	—	—	$10,006.51	$11,007.16	$10,006.51	2024-12-26
43647	CPT	Lap Impl Electrode Antrum	5	5	—	—	$10,006.51	$11,007.16	$10,006.51	2024-12-26
0784T	CPT	Ins/rplmt Eltrd Ra Spi Nstim	5	5	—	—	$10,006.51	$11,007.16	$10,006.51	2024-12-26
61888	CPT	Revise/remove Neuroreceiver	5	5	—	—	$10,006.51	$11,007.16	$10,006.51	2024-12-26
0398T	CPT	Emergency	5	5	—	—	$10,006.51	$11,007.16	$10,006.51	2024-12-26
27442	CPT	Revision Of Knee Joint	6	5	—	—	$4,100.00	$10,634.75	$9,667.95	2024-12-26
69714	CPT	Impl Oi Implt Skull Perq Esp	5	5	—	—	$9,667.95	$10,634.75	$9,667.95	2024-12-26
24802	CPT	Fusion/graft Of Elbow Joint	5	5	—	—	$9,667.95	$10,634.75	$9,667.95	2024-12-26
24362	CPT	Reconstruct Elbow Joint	5	5	—	—	$9,667.95	$10,634.75	$9,667.95	2024-12-26
69716	CPT	Impl Oi Implt Sk Tc Esp<100	5	5	—	—	$9,667.95	$10,634.75	$9,667.95	2024-12-26
69719	CPT	Rplcm Oi Implt Sk Tc Esp<100	5	5	—	—	$9,667.95	$10,634.75	$9,667.95	2024-12-26
24346	CPT	Reconstruct Elbow Med Ligmnt	5	5	—	—	$9,667.95	$10,634.75	$9,667.95	2024-12-26
64628	CPT	Trml Dstrj Ios Bvn 1st 2 L/s	5	5	—	—	$9,667.95	$10,634.75	$9,667.95	2024-12-26
24366	CPT	Reconstruct Head Of Radius	5	5	—	—	$9,667.95	$10,634.75	$9,667.95	2024-12-26
C9757	HCPCS	Spine Device Implant Surgery	5	5	—	—	$9,667.95	$10,634.75	$9,667.95	2024-12-26
24516	CPT	Treat Humerus Fracture	8	8	$1,788.78	$1,788.78	$9,667.95	$10,634.75	$9,667.95	2024-12-26
27827	CPT	Treat Lower Leg Fracture	5	5	—	—	$9,667.95	$10,634.75	$9,667.95	2024-12-26
24365	CPT	Reconstruct Head Of Radius	5	5	—	—	$9,667.95	$10,634.75	$9,667.95	2024-12-26
24435	CPT	Repair Humerus With Graft	5	5	—	—	$9,667.95	$10,634.75	$9,667.95	2024-12-26
24546	CPT	Treat Humerus Fracture	5	5	—	—	$9,667.95	$10,634.75	$9,667.95	2024-12-26
27356	CPT	Remove Femur Lesion/graft	5	5	—	—	$9,667.95	$10,634.75	$9,667.95	2024-12-26
24575	CPT	Treat Humerus Fracture	5	5	—	—	$9,667.95	$10,634.75	$9,667.95	2024-12-26
69729	CPT	Impl Oi Implt Sk Tc Esp>=100	5	5	—	—	$9,667.95	$10,634.75	$9,667.95	2024-12-26
22554	CPT	Arthrd Ant Ntrbd Min Dsc Crv	6	5	—	—	$3,500.00	$10,634.75	$9,667.95	2024-12-26
27871	CPT	Fusion Of Tibiofibular Joint	5	5	—	—	$9,667.95	$10,634.75	$9,667.95	2024-12-26
69730	CPT	Rplc Oi Implt Sk Tc Esp>=100	5	5	—	—	$9,667.95	$10,634.75	$9,667.95	2024-12-26
23802	CPT	Arthrd Glenohumeral Jt W/grf	5	5	—	—	$9,667.95	$10,634.75	$9,667.95	2024-12-26
24579	CPT	Treat Humerus Fracture	5	5	—	—	$9,667.95	$10,634.75	$9,667.95	2024-12-26
24498	CPT	Reinforce Humerus	5	5	—	—	$9,667.95	$10,634.75	$9,667.95	2024-12-26
24545	CPT	Treat Humerus Fracture	5	5	—	—	$9,667.95	$10,634.75	$9,667.95	2024-12-26
27828	CPT	Treat Lower Leg Fracture	5	5	—	—	$9,667.95	$10,634.75	$9,667.95	2024-12-26
25810	CPT	Arthrd Wrst Iliac/oth Agrft	5	5	—	—	$9,667.95	$10,634.75	$9,667.95	2024-12-26
23615	CPT	Optx Prox Humrl Fx W/int Fix	5	5	—	—	$9,667.95	$10,634.75	$9,667.95	2024-12-26
24666	CPT	Treat Radius Fracture	5	5	—	—	$9,667.95	$10,634.75	$9,667.95	2024-12-26
23473	CPT	Revis Reconst Shoulder Joint	5	5	—	—	$9,667.95	$10,634.75	$9,667.95	2024-12-26
23470	CPT	Reconstruct Shoulder Joint	5	5	—	—	$9,667.95	$10,634.75	$9,667.95	2024-12-26
28730	CPT	Fusion Of Foot Bones	5	5	—	—	$9,667.95	$10,634.75	$9,667.95	2024-12-26
20692	CPT	Appl Mltpln Uni Ext Fixj Sys	5	5	—	—	$9,667.95	$10,634.75	$9,667.95	2024-12-26
23485	CPT	Revision Of Collar Bone	5	5	—	—	$9,667.95	$10,634.75	$9,667.95	2024-12-26
0629T	CPT	Perq Njx Algc CT Lmbr 1st	5	5	—	—	$9,667.95	$10,634.75	$9,667.95	2024-12-26
24370	CPT	Revise Reconst Elbow Joint	5	5	—	—	$9,667.95	$10,634.75	$9,667.95	2024-12-26
28715	CPT	Arthrodesis Triple	5	5	—	—	$9,667.95	$10,634.75	$9,667.95	2024-12-26
0627T	CPT	Perq Njx Algc Fluor Lmbr 1st	5	5	—	—	$9,667.95	$10,634.75	$9,667.95	2024-12-26
C9781	HCPCS	Arthro/shoul Surg; W/spacer	5	5	—	—	$9,667.95	$10,634.75	$9,667.95	2024-12-26
24587	CPT	Treat Elbow Fracture	5	5	—	—	$9,667.95	$10,634.75	$9,667.95	2024-12-26
23680	CPT	Optx Sho Dislc Neck Fx Fixj	5	5	—	—	$9,667.95	$10,634.75	$9,667.95	2024-12-26
23491	CPT	Reinforce Shoulder Bones	5	5	—	—	$9,667.95	$10,634.75	$9,667.95	2024-12-26
C9734	HCPCS	U/s Trtmt, Not Leiomyomata	5	5	—	—	$9,667.95	$10,634.75	$9,667.95	2024-12-26
24430	CPT	Repair Of Humerus	5	5	—	—	$9,667.95	$10,634.75	$9,667.95	2024-12-26
25491	CPT	Prophylactic Tx Ulna	5	5	—	—	$9,667.95	$10,634.75	$9,667.95	2024-12-26
24586	CPT	Treat Elbow Fracture	5	5	—	—	$9,667.95	$10,634.75	$9,667.95	2024-12-26
0737T	CPT	Xenograft Impltj Artclr Surf	5	5	—	—	$9,667.95	$10,634.75	$9,667.95	2024-12-26
25444	CPT	Arthrp W/prostc Lunate	5	5	—	—	$9,667.95	$10,634.75	$9,667.95	2024-12-26
25441	CPT	Arthrp W/prostc Dstl Rds	5	5	—	—	$9,667.95	$10,634.75	$9,667.95	2024-12-26
22551	CPT	Arthrd Ant Ntrbdy Cervical	6	5	—	—	$3,500.00	$10,634.75	$9,667.95	2024-12-26
24515	CPT	Treat Humerus Fracture	5	5	—	—	$9,667.95	$10,634.75	$9,667.95	2024-12-26
24410	CPT	Revision Of Humerus	5	5	—	—	$9,667.95	$10,634.75	$9,667.95	2024-12-26
25365	CPT	Revise Radius & Ulna	5	5	—	—	$9,667.95	$10,634.75	$9,667.95	2024-12-26
29907	CPT	Subtalar Arthro W/fusion	5	5	—	—	$9,667.95	$10,634.75	$9,667.95	2024-12-26
25391	CPT	Lengthen Radius Or Ulna	5	5	—	—	$9,667.95	$10,634.75	$9,667.95	2024-12-26
29867	CPT	Allgrft Implnt Knee W/scope	5	5	—	—	$9,667.95	$10,634.75	$9,667.95	2024-12-26
29889	CPT	Knee Arthroscopy/surgery	5	5	—	—	$9,667.95	$10,634.75	$9,667.95	2024-12-26
28735	CPT	Fusion Of Foot Bones	5	5	—	—	$9,667.95	$10,634.75	$9,667.95	2024-12-26
28725	CPT	Arthrodesis Subtalar	5	5	—	—	$9,667.95	$10,634.75	$9,667.95	2024-12-26
28737	CPT	Revision Of Foot Bones	5	5	—	—	$9,667.95	$10,634.75	$9,667.95	2024-12-26
28320	CPT	Repair Of Foot Bones	5	5	—	—	$9,667.95	$10,634.75	$9,667.95	2024-12-26
27870	CPT	Fusion Of Ankle Joint Open	5	5	—	—	$9,667.95	$10,634.75	$9,667.95	2024-12-26
28420	CPT	Treat/graft Heel Fracture	5	5	—	—	$9,667.95	$10,634.75	$9,667.95	2024-12-26
29856	CPT	Tibial Arthroscopy/surgery	5	5	—	—	$9,667.95	$10,634.75	$9,667.95	2024-12-26
27709	CPT	Osteotomy Tibia & Fibula	5	5	—	—	$9,667.95	$10,634.75	$9,667.95	2024-12-26
22869	CPT	Insj Stablj Dev Without Dcmprn	6	5	—	—	$3,500.00	$10,634.75	$9,667.95	2024-12-26
27429	CPT	Reconstruction Knee	5	5	—	—	$9,667.95	$10,634.75	$9,667.95	2024-12-26
27758	CPT	Treatment Of Tibia Fracture	5	5	—	—	$9,667.95	$10,634.75	$9,667.95	2024-12-26
27415	CPT	Osteochondral Knee Allograft	5	5	—	—	$9,667.95	$10,634.75	$9,667.95	2024-12-26
27428	CPT	Reconstruction Knee	5	5	—	—	$9,667.95	$10,634.75	$9,667.95	2024-12-26
27759	CPT	Treatment Of Tibia Fracture	5	5	—	—	$9,667.95	$10,634.75	$9,667.95	2024-12-26
54417	CPT	Remv/replc Penis Pros Compl	5	5	—	—	$9,429.73	$10,372.70	$9,429.73	2024-12-26
54400	CPT	Insert Semi-rigid Prosthesis	5	5	—	—	$9,429.73	$10,372.70	$9,429.73	2024-12-26
53451	CPT	Tprnl Balo Cntnc Dev Bi	5	5	—	—	$9,429.73	$10,372.70	$9,429.73	2024-12-26
53440	CPT	Male Sling Procedure	5	5	—	—	$9,429.73	$10,372.70	$9,429.73	2024-12-26
65770	CPT	Keratoprosthesis	5	5	—	—	$9,106.76	$10,017.44	$9,106.76	2024-12-26
L5987	HCPCS	Shank Ft W Vert Load Pylon	5	5	—	—	$9,105.30	$10,015.83	$9,105.30	2024-12-26
62362	CPT	Implant Spine Infusion Pump	10	8	—	—	$2,884.00	$14,410.86	$8,800.40	2024-12-26
62361	CPT	Implant Spine Infusion Pump	10	8	—	—	$2,884.00	$14,410.86	$8,800.40	2024-12-26
62360	CPT	Insert Spine Infusion Device	10	8	—	—	$2,884.00	$14,410.86	$8,800.40	2024-12-26
0315U	CPT	Onc Cutan Sq Cll Ca Mrna 40	5	5	—	—	$8,500.00	$9,350.00	$8,500.00	2024-12-26
0211U	CPT	Onc Pan-tum Dna&rna Gnrj Seq	5	5	—	—	$8,455.00	$9,300.50	$8,455.00	2024-12-26
L6925	HCPCS	Wrist Disart Myoelectronic C	5	5	—	—	$8,444.07	$9,288.48	$8,444.07	2024-12-26
L7185	HCPCS	Electron Elbow Adolescent Sw	5	5	—	—	$8,404.71	$9,245.18	$8,404.71	2024-12-26
L6935	HCPCS	Below Elbow Myoelectronic CT	5	5	—	—	$8,237.60	$9,061.36	$8,237.60	2024-12-26
L5600	HCPCS	Hip Disart Sach Laminat Mold	5	5	—	—	$8,201.15	$9,021.27	$8,201.15	2024-12-26
0237T	CPT	Trluml Perip Athrc Brchiocph	5	5	—	—	$8,081.27	$8,889.39	$8,081.27	2024-12-26
0236T	CPT	Trluml Perip Athrc Abd Aorta	5	5	—	—	$8,081.27	$8,889.39	$8,081.27	2024-12-26
0234T	CPT	Trluml Perip Athrc Renal Art	5	5	—	—	$8,081.27	$8,889.39	$8,081.27	2024-12-26
92987	CPT	Revision Of Mitral Valve	5	5	—	—	$8,081.27	$8,889.39	$8,081.27	2024-12-26
92943	CPT	Prq Card Revasc Chronic 1vsl	5	5	—	—	$8,081.27	$8,889.39	$8,081.27	2024-12-26
61626	CPT	Transcath Occlusion Non-cns	5	5	—	—	$8,081.27	$8,889.39	$8,081.27	2024-12-26
61623	CPT	Endovasc Tempory Vessel Occl	5	5	—	—	$8,081.27	$8,889.39	$8,081.27	2024-12-26
92924	CPT	Prq Card Angio/athrect 1 Art	5	5	—	—	$8,081.27	$8,889.39	$8,081.27	2024-12-26
92990	CPT	Revision Of Pulmonary Valve	5	5	—	—	$8,081.27	$8,889.39	$8,081.27	2024-12-26
C9783	HCPCS	Blind Cor Sinus Reducer Impl	5	5	—	—	$8,081.27	$8,889.39	$8,081.27	2024-12-26
92937	CPT	Prq Revasc Byp Graft 1 Vsl	5	5	—	—	$8,081.27	$8,889.39	$8,081.27	2024-12-26
C9772	HCPCS	Revasc Lithotrip Tibi/perone	5	5	—	—	$8,081.27	$8,889.39	$8,081.27	2024-12-26
92997	CPT	Pul Art Balloon Repr Percut	5	5	—	—	$8,081.27	$8,889.39	$8,081.27	2024-12-26
33903	CPT	Perq P-art Revsc 1 Abnor Bi	5	5	—	—	$8,081.27	$8,889.39	$8,081.27	2024-12-26
33900	CPT	Perq P-art Revsc 1 Nm Nt Uni	5	5	—	—	$8,081.27	$8,889.39	$8,081.27	2024-12-26
33901	CPT	Perq P-art Revsc 1 Nm Nt Bi	5	5	—	—	$8,081.27	$8,889.39	$8,081.27	2024-12-26
37187	CPT	Venous Mech Thrombectomy	5	5	—	—	$8,081.27	$8,889.39	$8,081.27	2024-12-26
C9600	HCPCS	Perc Drug-el Cor Stent Sing	5	5	—	—	$8,081.27	$8,889.39	$8,081.27	2024-12-26
C9604	HCPCS	Perc D-e Cor Revasc T Cabg S	5	5	—	—	$8,081.27	$8,889.39	$8,081.27	2024-12-26
C9764	HCPCS	Revasc Intravasc Lithotripsy	5	5	—	—	$8,081.27	$8,889.39	$8,081.27	2024-12-26
0505T	CPT	Ev Fempop Artl Revsc	5	5	—	—	$8,081.27	$8,889.39	$8,081.27	2024-12-26
L8627	HCPCS	Cid Ext Speech Process Repl	5	5	—	—	$7,935.24	$8,728.76	$7,935.24	2024-12-26
0525T	CPT	Insj/rplcmt Compl Iims	5	5	—	—	$7,844.07	$8,628.48	$7,844.07	2024-12-26
0520T	CPT	Rmv&rplcmt Pg Wcs Lv Battery	5	5	—	—	$7,844.07	$8,628.48	$7,844.07	2024-12-26
0517T	CPT	Insj Wcs Lv Both Compnt Pg	5	5	—	—	$7,844.07	$8,628.48	$7,844.07	2024-12-26
0516T	CPT	Insj Wcs Lv Eltrd Only	5	5	—	—	$7,844.07	$8,628.48	$7,844.07	2024-12-26
33214	CPT	Upgrade Of Pacemaker System	5	5	—	—	$7,844.07	$8,628.48	$7,844.07	2024-12-26
33224	CPT	Insert Pacing Lead & Connect	5	5	—	—	$7,844.07	$8,628.48	$7,844.07	2024-12-26
33208	CPT	Insrt Heart Pm Atrial & Vent	5	5	—	—	$7,844.07	$8,628.48	$7,844.07	2024-12-26
33207	CPT	Insert Heart Pm Ventricular	5	5	—	—	$7,844.07	$8,628.48	$7,844.07	2024-12-26
33213	CPT	Insert Pulse Gen Dual Leads	5	5	—	—	$7,844.07	$8,628.48	$7,844.07	2024-12-26
0519T	CPT	Rmv&rplcmt Pg Wcs Lv Both	5	5	—	—	$7,844.07	$8,628.48	$7,844.07	2024-12-26
33228	CPT	Remv&replc Pm Gen Dual Lead	5	5	—	—	$7,844.07	$8,628.48	$7,844.07	2024-12-26
33206	CPT	Insert Heart Pm Atrial	5	5	—	—	$7,844.07	$8,628.48	$7,844.07	2024-12-26
81552	CPT	Onc Uveal Mlnma Mrna 15 Gene	5	5	—	—	$7,776.00	$8,553.60	$7,776.00	2024-12-26
93653	CPT	Eps Ablation 3DMapp Without IrrigC	27	14	$10,500.00	$10,500.00	$2,000.00	$19,191.32	$7,750.00	2024-12-26
93656	CPT	Eps Ablation 3DMapp W IrrigCat	27	14	$10,500.00	$10,500.00	$2,000.00	$19,191.32	$7,750.00	2024-12-26
0094U	CPT	Genome Rapid Sequence Alys	5	5	—	—	$7,582.20	$8,340.42	$7,582.20	2024-12-26
58673	CPT	Laparoscopy Salpingostomy	6	6	—	—	$1,100.00	$8,317.75	$7,561.59	2024-12-26
58674	CPT	Laps Abltj Uterine Fibroids	6	6	—	—	$1,100.00	$8,317.75	$7,561.59	2024-12-26
58572	CPT	Tlh Uterus Over 250 G	5	5	—	—	$7,561.59	$8,317.75	$7,561.59	2024-12-26
58571	CPT	Tlh W/t/o 250 G Or Less	5	5	—	—	$7,561.59	$8,317.75	$7,561.59	2024-12-26
58573	CPT	Tlh W/t/o Uterus Over 250 G	5	5	—	—	$7,561.59	$8,317.75	$7,561.59	2024-12-26
58546	CPT	Laparo-myomectomy Complex	5	5	—	—	$7,561.59	$8,317.75	$7,561.59	2024-12-26
58552	CPT	Laparo-vag Hyst Incl T/o	5	5	—	—	$7,561.59	$8,317.75	$7,561.59	2024-12-26

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