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

CENTRO MEDICO DEL NORESTE

Fajardo, PR · CCN 400140 · Rates published

1,462 distinct procedures filed
51 distinct payers
40,892 rate rows
2025-11-28 last MRF observed
Data quality

26,080 of 40,892 rate rows are consumer-grade (63.8%)

14,812 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 7,841
per-diem day rate — not a per-procedure price 6,589
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 351
exceeds 10× this hospital's gross charge — excluded from medians 31
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://caribbeanmedicalcenter.com/wp-content/uploads/2026/01/660559417_Caribbean_Medical_Center_standarcharges1.csv
Discovered viaDiscovered by HANK (automated)
Last fetch not_modified · 2026-05-18
Content fingerprint 1e6cc38a1a32e634… · 9,146,795 bytes · first seen 2026-05-13

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
J2997
HCPCS 		Activase Inj 100mg (tpa) 24 $3,693.00 $13,212.43 $8,632.12 nat. median
$545
outlier · 15.8×
J3101
HCPCS 		Tnkase Kit 50mg 28 $6,790.41 $6,790.41 $6,790.41 nat. median
$5,949
1.1× median
J2783
HCPCS 		Rasburicase Inj 1.5mg, 7.5mg 29 $6,762.60 $6,762.60 $6,762.60 nat. median
$1,635
outlier · 4.1×
L8699
HCPCS 		L8699 Prosthetic Implant Nos 22 $300.00 $5,000.00 $5,000.00 nat. median
$1,704
outlier · 2.9×
C1785
HCPCS 		C1785- Pacemaker Dual Chamber 11 $300.00 $5,000.00 $5,000.00 nat. median
$6,506
0.8× median
C1786
HCPCS 		C1786 Pacemaker Single Chamber 13 $300.00 $5,000.00 $5,000.00 nat. median
$7,726
0.6× median
C1882
HCPCS 		C1882 Aicd, Other Than Sing/dual 12 $300.00 $10,000.00 $5,000.00 nat. median
$27,112
outlier · 0.2×
C1722
HCPCS 		C1722 Aicd, Single Chamber 10 $300.00 $5,000.00 $5,000.00 nat. median
$20,768
outlier · 0.2×
C2621
HCPCS 		C2621 Pacemaker, Other Than Single Or Dual Chamber 13 $300.00 $5,000.00 $5,000.00 nat. median
$10,188
outlier · 0.5×
J1569
HCPCS 		Gammagard Liq 10g 100ml 29 $889.20 $3,779.65 $3,779.65 nat. median
$1,048
outlier · 3.6×
J0630
HCPCS 		Miacalcin Inj 400 Unit/2ml 4 $1,296.36 $1,296.36 $1,296.36 nat. median
$1,885
0.7× median
44188
CPT 		Laparascopy Colostomy 44188 23 $500.00 $1,500.00 $1,158.79 nat. median
$3,039
outlier · 0.4×
58578
CPT 		Unlisted Laparoscopy Procedure Uterus 58578 22 $500.00 $2,980.22 $1,112.47 nat. median
$6,770
outlier · 0.2×
58575
CPT 		Laps Tot Hysterectomy Resj Malignancy W/omntc 58575 18 $500.00 $2,402.78 $1,112.47 nat. median
$5,149
outlier · 0.2×
58554
CPT 		Lap Hysterectomy With Removal Of Tube 58554 24 $500.00 $2,402.78 $1,112.47 nat. median
$9,792
outlier · 0.1×
49325
CPT 		Laps W/revision Intraperitoneal Catheter 49325 18 $500.00 $1,500.00 $1,112.47 nat. median
$6,065
outlier · 0.2×
44979
CPT 		Unlisted Laparascopy Procedure, Appendix 44979 22 $500.00 $2,980.22 $1,112.47 nat. median
$6,574
outlier · 0.2×
58572
CPT 		Laparoscopy Total Hysterectimy Uterus > 250 Gm 58572 18 $500.00 $2,402.78 $1,093.95 nat. median
$10,424
outlier · 0.1×
58573
CPT 		Laparoscopy Tot Hysterectomy > 250 G W/tube/ovar 58573 18 $500.00 $2,402.78 $1,093.95 nat. median
$10,006
outlier · 0.1×
49327
CPT 		Laps W/insertion Ntrstl Dev W/img Guid 1/mlt 49327 17 $500.00 $1,500.00 $1,093.95 nat. median
$1,995
0.5× median
44204
CPT 		Laparoscopy Colectomy Partial 44204 24 $500.00 $1,500.00 $1,093.95 nat. median
$3,782
outlier · 0.3×
47379
CPT 		Unlis Laparoscopic Procedure Liver 47379 22 $500.00 $2,980.22 $1,093.95 nat. median
$6,447
outlier · 0.2×
58559
CPT 		Hystsc Lss Intrauterine Ads 58559 18 $500.00 $1,361.00 $1,093.95 nat. median
$4,823
outlier · 0.2×
47560
CPT 		Lap Sirg W/gid Transhepatc Chlnggrph 47560 21 $500.00 $1,500.00 $1,093.95 nat. median
$3,412
outlier · 0.3×
47561
CPT 		Lap Sirg W/gid Transhepatc Cholangiogrph 47561 21 $500.00 $1,500.00 $1,093.95 nat. median
$3,554
outlier · 0.3×
49326
CPT 		Laparoscopy W/omentopexy 49326 17 $500.00 $1,500.00 $1,093.95 nat. median
$2,495
outlier · 0.4×
58553
CPT 		Lap With Vaginal Hysterectomy 58553 24 $500.00 $2,402.78 $1,077.36 nat. median
$9,923
outlier · 0.1×
58546
CPT 		Lap Myomectomy; 5 Or More Intramural 58546 24 $500.00 $2,402.78 $1,063.99 nat. median
$9,982
outlier · 0.1×
47564
CPT 		Lap, Cholecys W Exploration 47564 24 $350.00 $1,500.00 $1,050.20 nat. median
$9,414
outlier · 0.1×
36514
CPT 		36514 Plasmapheresis 18 $450.00 $1,389.15 $1,050.00 nat. median
$2,184
outlier · 0.5×
58542
CPT 		Laps Supracrv Hysterect 250 Gm/< Rmvl Tube/ Ovar 58542 18 $500.00 $2,402.78 $1,039.42 nat. median
$10,024
outlier · 0.1×
58544
CPT 		Laps Supracrv Hysterec > 250 G Rmvl Tube/ovary 58544 18 $500.00 $2,402.78 $1,039.42 nat. median
$10,428
outlier · 0.1×
58541
CPT 		Laparoscopy Supracervical Hysterectomy 250 Gm 58541 18 $500.00 $1,500.00 $1,039.42 nat. median
$9,965
outlier · 0.1×
58571
CPT 		Laps Total Hysterect 250 Gm/< W/rmvl Tube/ovary 58571 18 $500.00 $2,402.78 $1,039.42 nat. median
$9,808
outlier · 0.1×
58543
CPT 		Laps Supracervical Hysterectomy >250 58543 18 $500.00 $2,402.78 $1,039.42 nat. median
$10,463
outlier · 0.1×
58570
CPT 		Laparoscopy W Total Hysterectomy Uterus 250 Gm 58570 18 $500.00 $2,402.78 $1,039.42 nat. median
$9,652
outlier · 0.1×
27130
CPT 		Arthrp Acetblr/prox Fem Prostc 27130 23 $500.00 $1,736.44 $1,000.00 nat. median
$13,091
outlier · 0.1×
27236
CPT 		Hip Bipolar Replacement 27236 23 $500.00 $1,736.44 $1,000.00 nat. median
$4,896
outlier · 0.2×
27125
CPT 		Bipolar Hemiarthroplasty Hip Partial 27125 23 $500.00 $1,736.44 $1,000.00 nat. median
$6,065
outlier · 0.2×
27827
CPT 		Open Treatment Fracture Distal Tibia Only 27827 24 $500.00 $3,616.01 $1,000.00 nat. median
$11,070
outlier · 0.1×
27506
CPT 		Optx Fem Shft Fx W/insj Imed Implt W/wo Screw 27506 23 $500.00 $1,736.44 $1,000.00 nat. median
$4,702
outlier · 0.2×
27447
CPT 		Arthrp Knee Condyleplatu Mediallat 27447 24 $500.00 $6,947.52 $1,000.00 nat. median
$12,648
outlier · 0.1×
27245
CPT 		Tx Inter/subtrchntric Fem Fx Imed 27245 23 $500.00 $1,736.44 $1,000.00 nat. median
$4,765
outlier · 0.2×
29806
CPT 		Arthroscopy Shoulder Surgical Capsulorrhaphy 29806 24 $500.00 $1,941.29 $994.26 nat. median
$7,171
outlier · 0.1×
29827
CPT 		Arthroscopy With Rotator Cuff Repair 29827 24 $500.00 $1,941.29 $993.67 nat. median
$7,155
outlier · 0.1×
44207
CPT 		Laps Colectomy Prtl W/colopxtstmy Lw Anast 44207 18 $500.00 $1,500.00 $984.90 nat. median
$4,023
outlier · 0.2×
44206
CPT 		Laps Colectomy Prtl W/end Clst Clsr Dstl Sgm 44206 18 $500.00 $1,500.00 $984.90 nat. median
$4,052
outlier · 0.2×
44203
CPT 		Laps Ea Sm Int Rescjanast 44203 18 $500.00 $1,500.00 $984.90 nat. median
$2,910
outlier · 0.3×
44213
CPT 		Laps Moblj Splenic Flxr Pfrmd W/prtl Colectomy 44213 18 $500.00 $1,500.00 $984.90 nat. median
$2,069
outlier · 0.5×
58548
CPT 		Laps W/rad Hyst W/bilat Lmphadec Rmvl Tube/ovary 58548 18 $500.00 $1,500.00 $984.90 nat. median
$5,211
outlier · 0.2×

Other procedures at this hospital

Browse this hospital's 1,462 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
             
J2997 HCPCS Activase Inj 100mg (tpa) 38 24 $13,212.43 — $3,693.00 $13,212.43 $8,632.12 2025-11-28
J3101 HCPCS Tnkase Kit 50mg 32 28 $6,000.00 — $6,790.41 $6,790.41 $6,790.41 2025-11-28
J2783 HCPCS Rasburicase Inj 1.5mg, 7.5mg 34 29 $6,762.60 — $6,762.60 $6,762.60 $6,762.60 2025-11-28
L8699 HCPCS L8699 Prosthetic Implant Nos 39 22 $5,000.00 — $300.00 $5,000.00 $5,000.00 2025-11-28
C1882 HCPCS C1882 Aicd, Other Than Sing/dual 15 12 $10,000.00 — $300.00 $10,000.00 $5,000.00 2025-11-28
C1785 HCPCS C1785- Pacemaker Dual Chamber 14 11 $5,000.00 — $300.00 $5,000.00 $5,000.00 2025-11-28
C2621 HCPCS C2621 Pacemaker, Other Than Single Or Dual Chamber 15 13 $5,000.00 — $300.00 $5,000.00 $5,000.00 2025-11-28
C1722 HCPCS C1722 Aicd, Single Chamber 13 10 $5,000.00 — $300.00 $5,000.00 $5,000.00 2025-11-28
C1786 HCPCS C1786 Pacemaker Single Chamber 16 13 $5,000.00 — $300.00 $5,000.00 $5,000.00 2025-11-28
J1569 HCPCS Gammagard Liq 10g 100ml 34 29 $3,779.65 — $889.20 $3,779.65 $3,779.65 2025-11-28
J0630 HCPCS Miacalcin Inj 400 Unit/2ml 5 4 $203.97 — $1,296.36 $1,296.36 $1,296.36 2025-11-28
44188 CPT Laparascopy Colostomy 44188 27 23 $867.60 — $500.00 $1,500.00 $1,158.79 2025-11-28
58578 CPT Unlisted Laparoscopy Procedure Uterus 58578 26 22 $867.60 — $500.00 $2,980.22 $1,112.47 2025-11-28
44979 CPT Unlisted Laparascopy Procedure, Appendix 44979 26 22 $1,300.00 — $500.00 $2,980.22 $1,112.47 2025-11-28
58554 CPT Lap Hysterectomy With Removal Of Tube 58554 34 24 $1,500.00 — $500.00 $2,402.78 $1,112.47 2025-11-28
49325 CPT Laps W/revision Intraperitoneal Catheter 49325 22 18 $1,300.00 — $500.00 $1,500.00 $1,112.47 2025-11-28
58575 CPT Laps Tot Hysterectomy Resj Malignancy W/omntc 58575 22 18 $1,300.00 — $500.00 $2,402.78 $1,112.47 2025-11-28
47561 CPT Lap Sirg W/gid Transhepatc Cholangiogrph 47561 25 21 $1,300.00 — $500.00 $1,500.00 $1,093.95 2025-11-28
47560 CPT Lap Sirg W/gid Transhepatc Chlnggrph 47560 25 21 $1,300.00 — $500.00 $1,500.00 $1,093.95 2025-11-28
58573 CPT Laparoscopy Tot Hysterectomy > 250 G W/tube/ovar 58573 25 18 $1,300.00 — $500.00 $2,402.78 $1,093.95 2025-11-28
44204 CPT Laparoscopy Colectomy Partial 44204 33 24 $1,300.00 — $500.00 $1,500.00 $1,093.95 2025-11-28
58572 CPT Laparoscopy Total Hysterectimy Uterus > 250 Gm 58572 25 18 $1,300.00 — $500.00 $2,402.78 $1,093.95 2025-11-28
49327 CPT Laps W/insertion Ntrstl Dev W/img Guid 1/mlt 49327 21 17 $1,300.00 — $500.00 $1,500.00 $1,093.95 2025-11-28
47379 CPT Unlis Laparoscopic Procedure Liver 47379 26 22 $867.60 — $500.00 $2,980.22 $1,093.95 2025-11-28
58559 CPT Hystsc Lss Intrauterine Ads 58559 22 18 $1,300.00 — $500.00 $1,361.00 $1,093.95 2025-11-28
49326 CPT Laparoscopy W/omentopexy 49326 21 17 $1,300.00 — $500.00 $1,500.00 $1,093.95 2025-11-28
58553 CPT Lap With Vaginal Hysterectomy 58553 34 24 $1,500.00 — $500.00 $2,402.78 $1,077.36 2025-11-28
58546 CPT Lap Myomectomy; 5 Or More Intramural 58546 34 24 $1,300.00 — $500.00 $2,402.78 $1,063.99 2025-11-28
47564 CPT Lap, Cholecys W Exploration 47564 34 24 $1,300.00 — $350.00 $1,500.00 $1,050.20 2025-11-28
36514 CPT 36514 Plasmapheresis 22 18 $2,652.00 — $450.00 $1,389.15 $1,050.00 2025-11-28
58541 CPT Laparoscopy Supracervical Hysterectomy 250 Gm 58541 28 18 $1,300.00 — $500.00 $1,500.00 $1,039.42 2025-11-28
58570 CPT Laparoscopy W Total Hysterectomy Uterus 250 Gm 58570 28 18 $1,300.00 — $500.00 $2,402.78 $1,039.42 2025-11-28
58542 CPT Laps Supracrv Hysterect 250 Gm/< Rmvl Tube/ Ovar 58542 28 18 $1,300.00 — $500.00 $2,402.78 $1,039.42 2025-11-28
58543 CPT Laps Supracervical Hysterectomy >250 58543 28 18 $1,300.00 — $500.00 $2,402.78 $1,039.42 2025-11-28
58544 CPT Laps Supracrv Hysterec > 250 G Rmvl Tube/ovary 58544 28 18 $1,300.00 — $500.00 $2,402.78 $1,039.42 2025-11-28
58571 CPT Laps Total Hysterect 250 Gm/< W/rmvl Tube/ovary 58571 28 18 $1,300.00 — $500.00 $2,402.78 $1,039.42 2025-11-28
27506 CPT Optx Fem Shft Fx W/insj Imed Implt W/wo Screw 27506 27 23 $867.60 — $500.00 $1,736.44 $1,000.00 2025-11-28
27245 CPT Tx Inter/subtrchntric Fem Fx Imed 27245 27 23 $867.60 — $500.00 $1,736.44 $1,000.00 2025-11-28
27447 CPT Arthrp Knee Condyleplatu Mediallat 27447 28 24 $867.60 — $500.00 $6,947.52 $1,000.00 2025-11-28
27827 CPT Open Treatment Fracture Distal Tibia Only 27827 28 24 $867.60 — $500.00 $3,616.01 $1,000.00 2025-11-28
27236 CPT Hip Bipolar Replacement 27236 27 23 $867.60 — $500.00 $1,736.44 $1,000.00 2025-11-28
27130 CPT Arthrp Acetblr/prox Fem Prostc 27130 27 23 $867.60 — $500.00 $1,736.44 $1,000.00 2025-11-28
27125 CPT Bipolar Hemiarthroplasty Hip Partial 27125 27 23 $867.60 — $500.00 $1,736.44 $1,000.00 2025-11-28
29806 CPT Arthroscopy Shoulder Surgical Capsulorrhaphy 29806 28 24 $867.60 — $500.00 $1,941.29 $994.26 2025-11-28
29827 CPT Arthroscopy With Rotator Cuff Repair 29827 28 24 $860.67 — $500.00 $1,941.29 $993.67 2025-11-28
44206 CPT Laps Colectomy Prtl W/end Clst Clsr Dstl Sgm 44206 27 18 $1,300.00 — $500.00 $1,500.00 $984.90 2025-11-28
44205 CPT Laps Colectomy Prtl W/rmvl Terminal Ileum 44205 27 18 $1,300.00 — $500.00 $1,500.00 $984.90 2025-11-28
44207 CPT Laps Colectomy Prtl W/colopxtstmy Lw Anast 44207 27 18 $1,300.00 — $500.00 $1,500.00 $984.90 2025-11-28
58548 CPT Laps W/rad Hyst W/bilat Lmphadec Rmvl Tube/ovary 58548 27 18 $1,300.00 — $500.00 $1,500.00 $984.90 2025-11-28
44203 CPT Laps Ea Sm Int Rescjanast 44203 27 18 $1,300.00 — $500.00 $1,500.00 $984.90 2025-11-28
44213 CPT Laps Moblj Splenic Flxr Pfrmd W/prtl Colectomy 44213 27 18 $1,300.00 — $500.00 $1,500.00 $984.90 2025-11-28
25609 CPT Distal Radial W Int Fixation Of 3 More Frag 25609 28 24 $867.60 — $500.00 $2,750.43 $977.50 2025-11-28
58150 CPT Hysterectomy Total Abdominal 58150 27 23 $867.60 — $500.00 $1,371.78 $960.24 2025-11-28
58560 CPT Hysteroscopy Div/rescj Intrauterine Septum 58560 22 18 $1,300.00 — $500.00 $1,361.00 $942.30 2025-11-28
58563 CPT Hysteroscopy Endometrial Ablation 58563 22 18 $1,300.00 — $500.00 $1,361.00 $942.30 2025-11-28
58565 CPT Hysteroscopy Bi Tube Occlusion W/perm Implnts 58565 22 18 $1,300.00 — $500.00 $1,361.00 $942.30 2025-11-28
47579 CPT Unlisted Laparoscopy Procedure Biliary Tract 47579 22 18 $1,300.00 — $500.00 $2,980.22 $938.48 2025-11-28
49324 CPT Laps Insertion Tunneled Intraperitoneal Catheter 49324 28 18 $1,300.00 — $350.00 $1,500.00 $938.48 2025-11-28
43280 CPT Laps Surg Esopg/gstr Fundoplasty 43280 28 18 $1,300.00 — $500.00 $5,020.14 $938.48 2025-11-28
49656 CPT Laps Rpr Recurrent Incisional Hernia Redicible 49656 28 18 $1,300.00 — $500.00 $2,402.78 $938.48 2025-11-28
49654 CPT Laparoscopy Repair Incisional Hernia Redicible 49654 28 18 $1,300.00 — $500.00 $2,402.78 $938.48 2025-11-28
58662 CPT Laps Fulg/exc Ovary Viscera/peritoneal Surface 58662 28 18 $1,300.00 — $350.00 $1,500.00 $938.48 2025-11-28
58672 CPT Laparoscopy Fimbrioplasty 58672 28 18 $1,300.00 — $350.00 $1,500.00 $938.48 2025-11-28
49657 CPT Laps Rpr Recurrent Incal Hrna Ncrc8/strangulated 49657 28 18 $1,300.00 — $500.00 $2,402.78 $938.48 2025-11-28
55550 CPT Laps Ligation Spermatic Veins Varicocele 55550 28 18 $1,300.00 — $350.00 $1,500.00 $938.48 2025-11-28
49655 CPT Laps Rpr Incisional Hernia Ncrc8/strangulated 49655 28 18 $1,300.00 — $500.00 $2,402.78 $938.48 2025-11-28
44202 CPT Laps Enterect Rescj 1 Small Intest Rescj Ana 44202 27 18 $1,300.00 — $500.00 $1,500.00 $938.00 2025-11-28
58552 CPT Laparo-vag Hyst Incl T/o 58552 34 24 $1,500.00 — $500.00 $2,402.78 $933.21 2025-11-28
58960 CPT Lapt Stg/restg Ovarian 58960 27 23 $867.60 — $500.00 $1,500.00 $913.14 2025-11-28
C1748 HCPCS Sten 2 1 $900.00 — $900.00 $900.00 $900.00 2025-11-28
29828 CPT Arthroscopy Shoulder Biceps Tenodesis 21 17 $867.60 — $500.00 $1,736.44 $900.00 2025-11-28
29884 CPT Arthroscopy Knee W.lysis Adhesions W/wo Manj Spx 21 17 $867.60 — $500.00 $1,736.44 $900.00 2025-11-28
29879 CPT Arthrs Knee Abrasion Arthrp/mlt Drlg/micro 21 17 $867.60 — $500.00 $1,736.44 $900.00 2025-11-28
29867 CPT Arthroscopy Knee Osteochondral Allograft 21 17 $867.60 — $500.00 $1,736.44 $900.00 2025-11-28
29821 CPT Arthroxcopy Shoulder Surg Synovectomy Complete 21 17 $867.60 — $500.00 $1,736.44 $900.00 2025-11-28
29882 CPT Arthroscopy Knee W/meniscus Rpr Medial/lateral 21 17 $867.60 — $500.00 $1,736.44 $900.00 2025-11-28
29823 CPT Arthroscopy Shoulder Surg Debridement Extensive 21 17 $867.60 — $500.00 $1,736.44 $900.00 2025-11-28
29888 CPT Arthrs Aided Ant Cruciate Ligm Rpr/agmntj/rcnstj 21 17 $867.60 — $500.00 $1,736.44 $900.00 2025-11-28
38572 CPT Lap, Lymphadenectomy And Periaortic 38572 34 24 $1,300.00 — $500.00 $2,402.78 $890.96 2025-11-28
49653 CPT Lap Rpr Hrna X CPT Incal/ingun 49653 34 24 $1,500.00 — $500.00 $1,500.00 $874.87 2025-11-28
1900019208T-A CDM Telemetry Room 1 1 $850.00 — $873.00 $873.00 $873.00 2025-11-28
1900019209T-B CDM Telemetry Room 1 1 $850.00 — $873.00 $873.00 $873.00 2025-11-28
1900019218T-B CDM Telemetry Room 1 1 $850.00 — $873.00 $873.00 $873.00 2025-11-28
1900019208T-B CDM Telemetry Room 1 1 $850.00 — $873.00 $873.00 $873.00 2025-11-28
1900019219T-A CDM Telemetry Room 1 1 $850.00 — $873.00 $873.00 $873.00 2025-11-28
1900019216T-B CDM Telemetry Room 1 1 $850.00 — $873.00 $873.00 $873.00 2025-11-28
1900019216T-A CDM Telemetry Room 1 1 $850.00 — $873.00 $873.00 $873.00 2025-11-28
1900019214T-B CDM Telemetry Room 1 1 $850.00 — $873.00 $873.00 $873.00 2025-11-28
1900019217T-B CDM Telemetry Room 1 1 $850.00 — $873.00 $873.00 $873.00 2025-11-28
1900019220T-A CDM Telemetry Room 1 1 $850.00 — $873.00 $873.00 $873.00 2025-11-28
1900019213T-B CDM Telemetry Room 1 1 $850.00 — $873.00 $873.00 $873.00 2025-11-28
12000224T-A CDM Telemetry Room 1 1 $850.00 — $873.00 $873.00 $873.00 2025-11-28
1900019221T-A CDM Telemetry Room 1 1 $850.00 — $873.00 $873.00 $873.00 2025-11-28
1900019222T-B CDM Telemetry Room 1 1 $850.00 — $873.00 $873.00 $873.00 2025-11-28
1900019214T-A CDM Telemetry Room 1 1 $850.00 — $873.00 $873.00 $873.00 2025-11-28
1900019207T-A CDM Telemetry Room 1 1 $850.00 — $873.00 $873.00 $873.00 2025-11-28
1900019207T-B CDM Telemetry Room 1 1 $850.00 — $873.00 $873.00 $873.00 2025-11-28
1900019224T-A CDM Telemetry Room 1 1 $850.00 — $873.00 $873.00 $873.00 2025-11-28
1900019217T-A CDM Telemetry Room 1 1 $850.00 — $873.00 $873.00 $873.00 2025-11-28
1900019215T-A CDM Telemetry Room 1 1 $850.00 — $873.00 $873.00 $873.00 2025-11-28
1900019212T-B CDM Telemetry Room 1 1 $850.00 — $873.00 $873.00 $873.00 2025-11-28
1900019211T-B CDM Telemetry Room 1 1 $850.00 — $873.00 $873.00 $873.00 2025-11-28
1900019211T-A CDM Telemetry Room 1 1 $850.00 — $873.00 $873.00 $873.00 2025-11-28
1900019210T-B CDM Telemetry Room 1 1 $850.00 — $873.00 $873.00 $873.00 2025-11-28
1900019210T-A CDM Telemetry Room 1 1 $850.00 — $873.00 $873.00 $873.00 2025-11-28
1900019222T-A CDM Telemetry Room 1 1 $850.00 — $873.00 $873.00 $873.00 2025-11-28
1900019213T-A CDM Telemetry Room 1 1 $850.00 — $873.00 $873.00 $873.00 2025-11-28
1900019212T-A CDM Telemetry Room 1 1 $850.00 — $873.00 $873.00 $873.00 2025-11-28
1900019209T-A CDM Telemetry Room 1 1 $850.00 — $873.00 $873.00 $873.00 2025-11-28
1900019219T-B CDM Telemetry Room 1 1 $850.00 — $873.00 $873.00 $873.00 2025-11-28
1900019223T-A CDM Telemetry Room 1 1 $850.00 — $873.00 $873.00 $873.00 2025-11-28
1900019218T-A CDM Telemetry Room 1 1 $850.00 — $873.00 $873.00 $873.00 2025-11-28
1900019221T-B CDM Telemetry Room 1 1 $850.00 — $873.00 $873.00 $873.00 2025-11-28
1900019215T-B CDM Telemetry Room 1 1 $850.00 — $873.00 $873.00 $873.00 2025-11-28
1900019220T-B CDM Telemetry Room 1 1 $850.00 — $873.00 $873.00 $873.00 2025-11-28
27880 CPT Amputation Leg, Through Tibia And Fibula 27880 27 23 $867.60 — $500.00 $1,736.44 $870.49 2025-11-28
44180 CPT Laparoscopy Enterolysis 44180 31 24 $867.60 — $500.00 $2,980.22 $870.43 2025-11-28
58545 CPT Laparoscopic Myomectomy 1 To 4 Intramural 58545 34 24 $1,300.00 — $500.00 $1,500.00 $853.76 2025-11-28
59150 CPT Laps Tx Extopix Preg Without Salping/oophorectormy 59150 25 18 $867.60 — $500.00 $1,500.00 $850.00 2025-11-28
58550 CPT Laparoscopy With Vaginal Hysterectomy 58550 34 24 $1,300.00 — $500.00 $1,500.00 $850.00 2025-11-28
12000208A CDM Semiprivado 4 4 $800.00 — $605.00 $867.60 $830.40 2025-11-28
12000221B CDM Semiprivado 4 4 $800.00 — $605.00 $867.60 $830.40 2025-11-28
12000208B CDM Semiprivado 4 4 $800.00 — $605.00 $867.60 $830.40 2025-11-28
20000229B CDM Semiprivado 4 4 $800.00 — $605.00 $867.60 $830.40 2025-11-28
20000232B CDM Semiprivado 4 4 $800.00 — $605.00 $867.60 $830.40 2025-11-28
12000209A CDM Semiprivado 4 4 $800.00 — $605.00 $867.60 $830.40 2025-11-28
20000236A CDM Semiprivado 4 4 $800.00 — $605.00 $867.60 $830.40 2025-11-28
20000235A CDM Semiprivado 4 4 $800.00 — $605.00 $867.60 $830.40 2025-11-28
12000209B CDM Semiprivado 4 4 $800.00 — $605.00 $867.60 $830.40 2025-11-28
20000235B CDM Semiprivado 4 4 $800.00 — $605.00 $867.60 $830.40 2025-11-28
12000219A CDM Semiprivado 4 4 $800.00 — $605.00 $867.60 $830.40 2025-11-28
20000240B CDM Semiprivado 4 4 $800.00 — $605.00 $867.60 $830.40 2025-11-28
13000130002 CDM Semiprivado 4 4 $800.00 — $605.00 $867.60 $830.40 2025-11-28
12000207A CDM Semiprivado 4 4 $800.00 — $605.00 $867.60 $830.40 2025-11-28
12000219B CDM Semiprivado 4 4 $800.00 — $605.00 $867.60 $830.40 2025-11-28
13000130001 CDM Semiprivado 4 4 $800.00 — $605.00 $867.60 $830.40 2025-11-28
12000212A CDM Semiprivado 4 4 $800.00 — $605.00 $867.60 $830.40 2025-11-28
20000238B CDM Semiprivado 4 4 $800.00 — $605.00 $867.60 $830.40 2025-11-28
12000212B CDM Semiprivado 4 4 $800.00 — $605.00 $867.60 $830.40 2025-11-28
13000130051 CDM Semiprivado 4 4 $800.00 — $605.00 $867.60 $830.40 2025-11-28
12000218A CDM Semiprivado 4 4 $800.00 — $605.00 $867.60 $830.40 2025-11-28
12000218B CDM Semiprivado 4 4 $800.00 — $605.00 $867.60 $830.40 2025-11-28
12000207B CDM Semiprivado 4 4 $800.00 — $605.00 $867.60 $830.40 2025-11-28
20000226A CDM Semiprivado 4 4 $800.00 — $605.00 $867.60 $830.40 2025-11-28
20000225A CDM Semiprivado 4 4 $800.00 — $605.00 $867.60 $830.40 2025-11-28
20000238A CDM Semiprivado 4 4 $800.00 — $605.00 $867.60 $830.40 2025-11-28
13050130533 CDM Semiprivado 4 4 $800.00 — $605.00 $867.60 $830.40 2025-11-28
13050130544 CDM Semiprivado 4 4 $800.00 — $605.00 $867.60 $830.40 2025-11-28
20000237B CDM Semiprivado 4 4 $800.00 — $605.00 $867.60 $830.40 2025-11-28
13000130054 CDM Semiprivado 4 4 $800.00 — $605.00 $867.60 $830.40 2025-11-28
13050130511 CDM Semiprivado 4 4 $800.00 — $605.00 $867.60 $830.40 2025-11-28
20000232A CDM Semiprivado 4 4 $800.00 — $605.00 $867.60 $830.40 2025-11-28
13050130522 CDM Semiprivado 4 4 $800.00 — $605.00 $867.60 $830.40 2025-11-28
12000216B CDM Semiprivado 4 4 $800.00 — $605.00 $867.60 $830.40 2025-11-28
20000226B CDM Semiprivado 4 4 $800.00 — $605.00 $867.60 $830.40 2025-11-28
13050130555 CDM Semiprivado 4 4 $800.00 — $605.00 $867.60 $830.40 2025-11-28
12000217B CDM Semiprivado 4 4 $800.00 — $605.00 $867.60 $830.40 2025-11-28
13000130052 CDM Semiprivado 4 4 $800.00 — $605.00 $867.60 $830.40 2025-11-28
20000227A CDM Semiprivado 4 4 $800.00 — $605.00 $867.60 $830.40 2025-11-28
20000228A CDM Semiprivado 4 4 $800.00 — $605.00 $867.60 $830.40 2025-11-28
20000228B CDM Semiprivado 4 4 $800.00 — $605.00 $867.60 $830.40 2025-11-28
13000130053 CDM Semiprivado 4 4 $800.00 — $605.00 $867.60 $830.40 2025-11-28
20000236B CDM Semiprivado 4 4 $800.00 — $605.00 $867.60 $830.40 2025-11-28
20000240A CDM Semiprivado 4 4 $800.00 — $605.00 $867.60 $830.40 2025-11-28
12000213B CDM Semiprivado 4 4 $800.00 — $605.00 $867.60 $830.40 2025-11-28
12000214B CDM Semiprivado 4 4 $800.00 — $605.00 $867.60 $830.40 2025-11-28
13000130003 CDM Semiprivado 4 4 $800.00 — $605.00 $867.60 $830.40 2025-11-28
20000230A CDM Semiprivado 4 4 $800.00 — $605.00 $867.60 $830.40 2025-11-28
20000230B CDM Semiprivado 4 4 $800.00 — $605.00 $867.60 $830.40 2025-11-28
13000130004 CDM Semiprivado 4 4 $800.00 — $605.00 $867.60 $830.40 2025-11-28
1600016024B CDM Semiprivado 4 4 $800.00 — $605.00 $867.60 $830.40 2025-11-28
12000215B CDM Semiprivado 4 4 $800.00 — $605.00 $867.60 $830.40 2025-11-28
20000227B CDM Semiprivado 4 4 $800.00 — $605.00 $867.60 $830.40 2025-11-28
12000216A CDM Semiprivado 4 4 $800.00 — $605.00 $867.60 $830.40 2025-11-28
20000231A CDM Semiprivado 4 4 $800.00 — $605.00 $867.60 $830.40 2025-11-28
20000231B CDM Semiprivado 4 4 $800.00 — $605.00 $867.60 $830.40 2025-11-28
20000239A CDM Semiprivado 4 4 $800.00 — $605.00 $867.60 $830.40 2025-11-28
12000215A CDM Semiprivado 4 4 $800.00 — $605.00 $867.60 $830.40 2025-11-28
20000229A CDM Semiprivado 4 4 $800.00 — $605.00 $867.60 $830.40 2025-11-28
20000239B CDM Semiprivado 4 4 $800.00 — $605.00 $867.60 $830.40 2025-11-28
12000214A CDM Semiprivado 4 4 $800.00 — $605.00 $867.60 $830.40 2025-11-28
12000217A CDM Semiprivado 4 4 $800.00 — $605.00 $867.60 $830.40 2025-11-28
12000221A CDM Semiprivado 4 4 $800.00 — $605.00 $867.60 $830.40 2025-11-28
20000237A CDM Semiprivado 4 4 $800.00 — $605.00 $867.60 $830.40 2025-11-28
12000213A CDM Semiprivado 4 4 $800.00 — $605.00 $867.60 $830.40 2025-11-28
20000225B CDM Semiprivado 4 4 $800.00 — $605.00 $867.60 $830.40 2025-11-28
23615 CPT Open Treatment Proximal Humeral Fracture 23615 28 24 $867.60 — $500.00 $5,094.57 $826.05 2025-11-28
J0714 HCPCS Ceftazidime And Avibactam 1gm 32 21 $380.00 — $379.79 $800.00 $800.00 2025-11-28
27822 CPT Open Tx Trimalleolar Ankle Fx Without Fixj Pst L 27822 28 24 $867.60 — $500.00 $1,941.29 $799.38 2025-11-28
58562 CPT Hysteroscopy Removal Impacted Foreigh Body 58562 22 18 $1,300.00 — $500.00 $1,361.00 $795.50 2025-11-28
58275 CPT Vaginal Hysterectomy 58275 27 23 $867.60 — $500.00 $1,361.00 $790.65 2025-11-28
58561 CPT Hysteroscopy Removal Leiomyomata 58561 23 18 $1,300.00 — $350.00 $1,361.00 $790.65 2025-11-28
26615 CPT Open Tx Metacarpal Fracture Single Ea Bone 26615 22 18 $867.60 — $500.00 $1,736.44 $790.65 2025-11-28
58180 CPT Supracervical Abdl Hyster W/wo Rmvl Tube 58180 27 23 $867.60 — $500.00 $1,361.00 $790.65 2025-11-28
58260 CPT Vaginal Hysterectomy Uterus 250 Gm 58260 22 18 $1,300.00 — $500.00 $1,361.00 $786.83 2025-11-28
58579 CPT Unlisted Hysteroscopy Procedure Uterus 58579 22 18 $1,300.00 — $107.60 $1,361.00 $786.83 2025-11-28
58292 CPT Vag Hyst > 250 Gm Rmvl Tube/ovary W/rpr Entrcle 58292 22 18 $1,300.00 — $500.00 $4,114.10 $786.83 2025-11-28
58263 CPT Vag Hyst 250 Gm/ < W/rmvl Tube Ovary W/rpr Ntrcl 58263 22 18 $1,300.00 — $500.00 $2,675.44 $786.83 2025-11-28
58290 CPT Vaginal Hysterectomy Uterus > 250 Gm 58290 22 18 $1,300.00 — $500.00 $4,114.10 $786.83 2025-11-28
58291 CPT Vag Hyst > 250 Gm Rmvl Tube/ovary 58291 22 18 $1,300.00 — $500.00 $2,675.44 $786.83 2025-11-28
58262 CPT Vag Hyst 250 Gm/ < W/rmvl Tube/ovary 58262 22 18 $1,300.00 — $500.00 $1,361.00 $786.83 2025-11-28
58270 CPT Vaginal Hysteretomy 250 Gm/ < W/rpr Enterocele 58270 22 18 $1,300.00 — $500.00 $2,675.44 $786.83 2025-11-28
29874 CPT Arthroscopy Knee Removal Loose/foreign Body 21 17 $867.60 — $500.00 $1,736.44 $783.00 2025-11-28
29825 CPT Sho Arthrs Srg Lssrescj Ads 21 17 $867.60 — $500.00 $1,736.44 $783.00 2025-11-28
58293 CPT Vag Hyst > 250gm Colpourtcstopexy W/wo Ndsc Ctr 58293 21 17 $1,300.00 — $500.00 $1,361.00 $783.00 2025-11-28
58285 CPT Vaginal Hysterectomy Radical Shauta Operation 58285 21 17 $1,300.00 — $500.00 $1,361.00 $783.00 2025-11-28
58280 CPT Vag Hyster W/tot/prtl Vaginect W/rpr Enterocele 58280 21 17 $1,300.00 — $500.00 $1,361.00 $783.00 2025-11-28
58267 CPT Vag Hyst 250 Gm/< W/colpo-urtcstopexy 58267 21 17 $1,300.00 — $500.00 $1,361.00 $783.00 2025-11-28
58240 CPT Pel Exntj Gynecologic Mal 58240 21 17 $1,300.00 — $500.00 $1,316.00 $783.00 2025-11-28
58200 CPT Tot Abd Hyst W/paraortic Pelvic Lymph Node Sam 58200 21 17 $1,300.00 — $500.00 $1,361.00 $783.00 2025-11-28
49329 CPT Unlisted Laparoscopic Px Abd Pertoneum Omentum 49329 32 23 $1,300.00 — $500.00 $2,980.22 $783.00 2025-11-28
58210 CPT Rad Abdl Hyst W/bi Pel Lmphadec 58210 21 17 $1,300.00 — $500.00 $1,361.00 $783.00 2025-11-28
58152 CPT Tot Abd Hyst W/wo Rmvl Tube Ovary W/colpurethrxy 58152 21 17 $1,300.00 — $500.00 $1,361.00 $783.00 2025-11-28
60240 CPT Thyroidectomy Total 60240 28 24 $867.60 — $500.00 $1,495.97 $771.50 2025-11-28
58555 CPT Hysteroscopy Diagnostic Separate Procedure 58555 28 18 $1,300.00 — $350.00 $1,361.00 $771.50 2025-11-28
25608 CPT Optx Dstl Radl I-artic Fx/epiphysl Sep 2 Fra 25608 28 24 $867.60 — $500.00 $2,720.61 $767.47 2025-11-28
29881 CPT Arthroscopy Knee Surgery 29881 28 24 $867.60 — $500.00 $1,736.44 $767.00 2025-11-28
29880 CPT Arthroscopy Knee W/meniscectomy 29880 28 24 $867.60 — $500.00 $1,736.44 $767.00 2025-11-28
29876 CPT Arthroscopy Knee Synovectomy 29876 28 24 $867.60 — $500.00 $1,736.44 $767.00 2025-11-28
29844 CPT Arthroscopy Wrist Surgical Synovectomy 29844 28 24 $867.60 — $462.50 $1,736.44 $767.00 2025-11-28
28022 CPT Arthrt W/expl Drg/rmvl Fb 28022 28 24 $867.60 — $307.10 $1,736.44 $767.00 2025-11-28
25105 CPT Arthrotomy Wrist Joint With Synovectomy 25105 28 24 $867.60 — $446.76 $1,736.44 $767.00 2025-11-28
43653 CPT Lap, Castrotomy, Without Gastric Tube 43653 34 24 $1,300.00 — $350.00 $1,500.00 $766.50 2025-11-28
49650 CPT Lap Repair Initial Inguinal Hernia 49650 34 24 $1,300.00 — $401.44 $1,500.00 $766.50 2025-11-28
43652 CPT Lap, Transection Of Vagus Nerves, 43652 34 24 $1,300.00 — $350.00 $2,980.22 $766.50 2025-11-28
44970 CPT Lap, Surgical, Appendectomy 44970 34 24 $1,300.00 — $350.00 $2,980.22 $766.50 2025-11-28
58660 CPT Laps Lss Ads Spx 58660 46 27 $1,300.00 — $500.00 $1,500.00 $766.50 2025-11-28
49322 CPT Lap With Aspiration Of Cavity Or Cyst 49322 34 24 $1,500.00 — $349.94 $1,500.00 $766.50 2025-11-28
49321 CPT Lap Surgical With Biopsy 49321 34 24 $1,500.00 — $325.57 $1,500.00 $766.50 2025-11-28
49323 CPT Lap W Drainage Of Lymphocele 49323 34 24 $1,500.00 — $500.00 $2,980.22 $766.50 2025-11-28
49651 CPT Lap Repair Recurrent Inguinal Hernia 49651 34 24 $1,300.00 — $500.00 $1,500.00 $766.50 2025-11-28
47563 CPT Lap, Cholecystectomy With Cholangiography 47563 34 24 $1,300.00 — $500.00 $1,500.00 $766.50 2025-11-28
47570 CPT Lap Cholecystoenterostomy 47570 32 24 $1,300.00 — $350.00 $1,500.00 $766.50 2025-11-28
43651 CPT Lap, Surgical Transection Of Vagus 43651 34 24 $1,300.00 — $350.00 $2,980.22 $766.50 2025-11-28
38571 CPT Laparoscopy, Lymphadenectomy 38571 34 24 $1,300.00 — $500.00 $2,402.78 $766.50 2025-11-28
38570 CPT Lap, Lymph Node Biop 38570 34 24 $1,300.00 — $480.88 $1,500.00 $766.50 2025-11-28
27886 CPT Amp Leg Thru Tibiafibula Re-amputation 21 17 $867.60 — $500.00 $1,736.44 $760.00 2025-11-28
25575 CPT Open Tx Radialulnar Shaft Fx W/fixj 25575 28 24 $867.60 — $500.00 $1,941.29 $760.00 2025-11-28
27590 CPT Amputation Thigh Thr Femur 27590 27 23 $867.60 — $500.00 $1,736.44 $759.29 2025-11-28
14301 CPT Adjnt Tis Trns/reargmt Any Area 30.1-60 Sqcm 14301 28 24 $867.60 — $500.00 $1,007.21 $757.00 2025-11-28
57260 CPT Combined Anteroposterior Colporrhaphy 57260 28 24 $867.60 — $500.00 $1,311.99 $757.00 2025-11-28
23420 CPT Reconstruction Rotator Cuff 23420 28 24 $867.60 — $500.00 $1,941.29 $757.00 2025-11-28
23410 CPT Open Repair Of Rotator Cuff Acute 23410 28 24 $867.60 — $500.00 $1,941.29 $757.00 2025-11-28
57265 CPT With Enterocele Repair 57265 28 24 $867.60 — $500.00 $1,311.90 $757.00 2025-11-28
32652 CPT Thorascopy Surgical With Total Pulmonary 32652 28 24 $867.60 — $500.00 $1,577.14 $757.00 2025-11-28
38745 CPT Lt Axillary Lymphadenectomy Complete 38745 28 24 $867.60 — $500.00 $1,452.61 $757.00 2025-11-28
52601 CPT Trurl Electrosurg Rescj Prostate Bleed 52601 28 24 $867.60 — $500.00 $1,253.34 $757.00 2025-11-28
60212 CPT Prtl Thyroid Lobec Uni W/contratlat Stot 60212 28 24 $867.60 — $500.00 $1,495.97 $757.00 2025-11-28
58673 CPT Laparascopic Salpingostomy 58673 34 24 $867.60 — $500.00 $1,500.00 $755.94 2025-11-28
58294 CPT Vaginal Hysterectomy> 250 Gm Rpr Enterocele 58294 22 18 $1,300.00 — $500.00 $2,675.44 $755.00 2025-11-28
29826 CPT Arthroscopy Shoulder W/coracoacrm Ligmnt 29826 27 23 $867.60 — $167.65 $1,736.44 $754.00 2025-11-28
44143 CPT Colectomy Prtl W/end Colostomy 44143 27 23 $867.60 — $500.00 $1,578.12 $754.00 2025-11-28
44120 CPT Entrc Rescj Small Intestine 1 Rescj Anast 44120 27 23 $867.60 — $500.00 $1,160.32 $754.00 2025-11-28
44140 CPT Colectomy Partial With Anastomosis 44140 27 23 $867.60 — $500.00 $1,271.84 $754.00 2025-11-28
44005 CPT Enterolss Fring Intstinal Adhesion Spx 44005 27 23 $867.60 — $500.00 $1,037.45 $754.00 2025-11-28
43832 CPT Gastrostomy Opn W/constj Gstr Tube 43832 27 23 $867.60 — $500.00 $981.82 $754.00 2025-11-28
44050 CPT Reduction Of Volvulus Laparotomy 44050 27 23 $867.60 — $500.00 $884.25 $754.00 2025-11-28
26115 CPT Exc Tum/vasc Mal Sft Tiss Hand/fingr Subq <1.5cm 21 17 $867.60 — $500.00 $1,736.44 $754.00 2025-11-28
58943 CPT Oophorectomy Prtl/tot Uni/bi Ovarian 58943 27 23 $867.60 — $500.00 $1,107.21 $754.00 2025-11-28
58740 CPT Lysis Of Adhesions Salpinx/ovary 58740 27 23 $867.60 — $500.00 $833.88 $754.00 2025-11-28
49205 CPT Exc/destruction Open Abdominal Tumors 49205 27 23 $867.60 — $500.00 $1,671.63 $754.00 2025-11-28
47600 CPT Open Cholecystectomy 47600 27 23 $867.60 — $500.00 $1,008.27 $754.00 2025-11-28
35840 CPT Wound Exploratoy 35840 27 23 $867.60 — $500.00 $1,136.15 $754.00 2025-11-28
35558 CPT Bypass W/vein Femoral-femoral 35558 27 23 $867.60 — $500.00 $1,190.31 $754.00 2025-11-28
33249 CPT Insj/rplcmt Perm Dfb W/trnsvns Lds 1/dual 33249 27 23 $867.60 — $500.00 $868.24 $754.00 2025-11-28
32651 CPT Thoracoscopy W/partial Pulmonary 32651 27 23 $867.60 — $500.00 $1,037.72 $754.00 2025-11-28
49900 CPT Abdominal Wall Suture 49900 27 23 $867.60 — $500.00 $790.65 $754.00 2025-11-28
28810 CPT Amputation Metatarsal With Toe Single 28810 28 24 $867.60 — $408.34 $1,736.44 $752.00 2025-11-28
28805 CPT Amputation Foor Transmetarsal 28805 28 24 $867.60 — $500.00 $1,736.44 $752.00 2025-11-28
14061 CPT Adjt Tis Rea Eye/nose/ear/lip10.1-30.0 Sqcm 14061 28 24 $1,300.00 — $500.00 $790.65 $752.00 2025-11-28
27814 CPT Open Treatment Bimalleolar Ankle Fracture 27814 28 24 $867.60 — $500.00 $1,941.29 $752.00 2025-11-28
27792 CPT Open Tx Distal Fibular Fracture Lat 27792 28 24 $867.60 — $500.00 $1,941.29 $752.00 2025-11-28
27766 CPT Open Treatment Of Medial Malleolus Fracture 27766 28 24 $867.60 — $500.00 $1,941.29 $752.00 2025-11-28
27752 CPT Cltx Tibial Shaft Fx W/manj W/wo Skel Tracj 27752 28 24 $867.60 — $458.12 $1,736.44 $752.00 2025-11-28
27235 CPT Prq Skel Fixj Femoral Fx Prox End Neck 27235 28 24 $867.60 — $436.46 $3,695.96 $752.00 2025-11-28
19499 CPT Unlisted Procedure Breast 19499 26 22 $867.60 — $500.00 $1,826.07 $752.00 2025-11-28
26951 CPT Amp F/th 1/2 Jt/phalanx W/neurect W/dir Clsr 26951 28 24 $867.60 — $500.00 $1,736.44 $752.00 2025-11-28
25628 CPT Open Tx Carpal Scaphoid Navicular Fx 25628 28 24 $867.60 — $500.00 $1,941.29 $752.00 2025-11-28
25607 CPT Open Reduc With Internal Fixation 25607 28 24 $867.60 — $500.00 $1,736.44 $752.00 2025-11-28
25515 CPT Open Treatment Of Radial Shaft Fracture 25515 28 24 $867.70 — $500.00 $1,941.29 $752.00 2025-11-28
25077 CPT Rad Resect Tumor Soft Tiss Forearm & Wrist 25077 28 24 $867.60 — $387.26 $832.84 $752.00 2025-11-28
28800 CPT Amputation Foor Midtarsal 28800 27 23 $867.60 — $500.00 $1,736.44 $750.00 2025-11-28
60500 CPT Explore Parathyroid Glands 21 17 $867.60 — $500.00 $1,000.00 $750.00 2025-11-28
60252 CPT Removal Of Thyroid 60252 21 17 $867.60 — $510.00 $1,000.00 $750.00 2025-11-28
27248 CPT Open Treatment Greater Trochanteric 27248 27 23 $867.60 — $500.00 $1,736.44 $750.00 2025-11-28
42415 CPT Excise Parotid Gland/lesion 21 17 $867.60 — $500.00 $1,000.00 $750.00 2025-11-28
41153 CPT Tongue Mouth Neck Surgery 21 17 $867.60 — $500.00 $1,000.00 $750.00 2025-11-28
31535 CPT Laryngoscopy W/biopsy 21 17 $867.60 — $510.00 $1,289.00 $750.00 2025-11-28
31267 CPT Endoscopy Maxillary Sinus 21 17 $867.60 — $500.00 $1,000.00 $750.00 2025-11-28
31255 CPT Nsl/sins Ndsc W/tot Ethmdct 21 17 $867.60 — $500.00 $1,000.00 $750.00 2025-11-28
30140 CPT Resect Inferior Turbinate 21 17 $867.60 — $500.00 $1,000.00 $750.00 2025-11-28
49255 CPT Omentectomy, Resection Of Omentum 49255 28 24 $867.60 — $500.00 $867.60 $747.14 2025-11-28
11005 CPT Debridement Abdominal Wall 11005 27 23 $867.60 — $500.00 $790.65 $745.45 2025-11-28
66982 CPT Cataract Removal Insertion Of Lens 66982 28 24 $867.60 — $500.00 $790.65 $743.64 2025-11-28
59120 CPT Tx Ectopic Pregnancy Abd/vag 59120 27 23 $867.60 — $500.00 $790.65 $743.33 2025-11-28
17000170003 CDM ICU Room 4 4 $900.00 — $650.00 $873.00 $742.50 2025-11-28
17000170004 CDM ICU Room 4 4 $900.00 — $650.00 $873.00 $742.50 2025-11-28
17000170005 CDM ICU Room 4 4 $900.00 — $650.00 $873.00 $742.50 2025-11-28
17000170001 CDM ICU Room 4 4 $900.00 — $650.00 $873.00 $742.50 2025-11-28
17000170002 CDM ICU Room 4 4 $900.00 — $650.00 $873.00 $742.50 2025-11-28
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