Price Transparencybeta Hospital negotiated rates

Hospital facility prices. What the hospital charges for the facility side of care — the surgeon’s and anesthesiologist’s fees are billed separately and are not included. How we scope prices →

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Hospital

MONUMENT HEALTH SPEARFISH HOSPITAL

Spearfish, SD · CCN 430048 · Rates published

Your selected procedure

You selected 70551 (HCPCS)

MRI Brain Brain Stem W/O Contrast Material

This hospital’s price: $3,612 across 33 payers · range $261-$5,915

Source: https://monument.health/wp-content/uploads/2025/07/460360899_Monument-Health-Network-Inc-Spearfish-Hospital_standardcharges.csv · observed 2026-09-01

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

7,893 distinct procedures filed
60 distinct payers
364,287 rate rows
2026-09-01 last MRF observed
Data quality

208,022 of 364,287 rate rows are consumer-grade (57.1%)

156,265 rows are marked excluded from the consumer medians — these stay visible in the raw drill-down with the same reason shown here, so nothing is silently hidden.

Excluded — reasonRows
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 116,802
placeholder amount (≤ $0.02) — excluded from medians 32,285
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 3,568
exceeds 10× this hospital's gross charge — excluded from medians 1,745
per-diem day rate — not a per-procedure price 687
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 471
template filing: same amount across many unrelated codes — excluded 390
percent-of-charges filed in the dollar field — excluded from medians 267
exceeds 3× this hospital's gross charge for a DRG stay — excluded 50
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://apps.para-hcfs.com/PTT/FinalLinks/Reports.aspx?dbName=dbSRHSPEARFISHSD&type=CDMWithoutLabel&fileType=CSV
Found on page https://monument.health/price-transparency-cost-estimate
Discovered viaCMS hospital list
Last fetch not_modified · 2026-10-12
Content fingerprint 63fc44746002b8d8… · 52,920,908 bytes · first seen 2026-09-25

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
J7330
HCPCS 		1 Membrane Maci Implant 32 $38,843.55 $142,856.30 $111,218.58 nat. median
$92,809
1.2× median
33264
HCPCS 		Removal And Replacement Of Multiple Lead Defibrillator 22 $31,601.47 $110,175.20 $90,934.85 nat. median
$32,779
outlier · 2.8×
33249
HCPCS 		Insertion Of Implantable Defibrillator System 22 $30,096.78 $104,929.25 $86,605.02 nat. median
$32,069
outlier · 2.7×
33289
HCPCS 		Insertion Of Wireless Pressure Sensor Into Lung Artery Through Tube With Review… 22 $5,681.83 $87,888.63 $72,540.27 nat. median
$28,889
outlier · 2.5×
33263
HCPCS 		Removal And Replacement Of Dual Lead Defibrillator 22 $22,567.44 $78,679.00 $64,938.96 nat. median
$23,924
outlier · 2.7×
33262
HCPCS 		Removal And Replacement Of Single Lead Defibrillator 22 $22,567.44 $78,679.00 $64,938.96 nat. median
$23,514
outlier · 2.8×
33240
HCPCS 		Insertion Of Defibrillator With Existing Single Lead 22 $22,567.44 $78,679.00 $64,938.96 nat. median
$23,398
outlier · 2.8×
33230
HCPCS 		Insertion Of Defibrillator With Existing Dual Leads 22 $22,567.44 $78,679.00 $64,938.96 nat. median
$23,060
outlier · 2.8×
230
APR_DRG 		Major Small Bowel Procedures 2 $62,372.70 $62,372.70 $62,372.70 nat. median
$28,305
outlier · 2.2×
362
APR_DRG 		Mastectomy Procedures 2 $59,948.60 $59,948.60 $59,948.60 nat. median
$18,859
outlier · 3.2×
23474
CPT 		Revis Shoulder Arthrplsty Humeral&Glenoid Compnt 28 $28,831.00 $56,492.47 $56,492.47 nat. median
$12,255
outlier · 4.6×
325
APR_DRG 		Non-elective Or Complex Knee Joint Replacement 2 $53,625.00 $53,625.00 $53,625.00 nat. median
$38,879
1.4× median
40814
CPT 		Excis Mouth Mucosa/Sub,Complx Repr 33 $5,531.00 $52,621.32 $52,621.32 nat. median
$3,229
outlier · 16.3×
40818
CPT 		Excise Oral Mucosa For Graft 33 $5,529.00 $52,620.32 $52,620.32 nat. median
$656
outlier · 80.3×
64582
CPT 		Open Impltj Hpglsl Nrv Nstim Ra Pg&Respir Sensor 33 $5,853.00 $54,884.00 $52,358.35 nat. median
$29,815
1.8× median
37231
HCPCS 		Removal Of Plaque And Insertion Of Stents In Artery Of Leg, Initial Vessel 20 $12,461.74 $60,473.98 $52,214.11 nat. median
$19,288
outlier · 2.7×
37230
HCPCS 		Insertion Of Stent In Artery Of Leg, Initial Vessel 20 $12,461.74 $58,147.23 $50,205.17 nat. median
$17,953
outlier · 2.8×
220
APR_DRG 		Major Stomach, Esophageal And Duodenal Procedures 2 $49,145.89 $49,145.89 $49,145.89 nat. median
$25,653
1.9× median
93656
HCPCS 		Comprehensive Electrophysiologic Evaluation With Catheter Destruction Of Abnorma… 22 $15,980.37 $55,713.88 $45,984.33 nat. median
$26,469
1.7× median
93654
HCPCS 		Comprehensive Electrophysiologic Evaluation With Catheter Destruction Of Abnorma… 22 $15,980.37 $55,713.88 $45,984.33 nat. median
$26,477
1.7× median
93653
HCPCS 		Comprehensive Electrophysiologic Evaluation With Catheter Destruction Of Abnorma… 22 $15,980.37 $55,713.88 $45,984.33 nat. median
$25,502
1.8× median
850
APR_DRG 		Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal… 2 $45,314.00 $45,314.00 $45,314.00 nat. median
$30,434
1.5× median
0238T
OTHER 		Catheter Removal Of Plaque From Groin Artery, Accessed Through The Skin Or Open… 22 $12,461.74 $54,343.45 $44,853.23 nat. median
$20,987
outlier · 2.1×
323
APR_DRG 		Non-elective Or Complex Hip Joint Replacement 2 $44,701.00 $44,701.00 $44,701.00 nat. median
$20,743
outlier · 2.2×
37229
HCPCS 		Removal Of Plaque In Artery Of Leg, Initial Vessel 20 $12,461.74 $50,691.38 $43,767.68 nat. median
$18,507
outlier · 2.4×
37227
HCPCS 		Removal Of Plaque And Insertion Of Stents In Arteries Of Leg 20 $12,461.74 $50,691.38 $43,767.68 nat. median
$19,510
outlier · 2.2×
C9773
HCPCS 		Revascularization, Endovascular, Open Or Percutaneous, Tibial/peroneal Artery(i… 22 $12,461.74 $51,951.10 $42,878.67 nat. median
$20,101
outlier · 2.1×
C9774
HCPCS 		Revascularization, Endovascular, Open Or Percutaneous, Tibial/peroneal Artery(ie… 22 $12,461.74 $51,951.10 $42,878.67 nat. median
$20,557
outlier · 2.1×
C9775
HCPCS 		Revascularization, Endovascular, Open Or Percutaneous, Tibial/peroneal Artery(ie… 22 $12,461.74 $51,951.10 $42,878.67 nat. median
$23,462
1.8× median
C9767
HCPCS 		Revascularization, Endovascular, Open Or Percutaneous, Lower Extremity Artery(ie… 22 $12,461.74 $51,496.00 $42,503.04 nat. median
$19,649
outlier · 2.2×
92933
HCPCS 		Removal Of Plaque, Insertion Of Stent And Balloon Dilation Of Single Coronary Ar… 22 $14,553.88 $50,740.58 $41,879.54 nat. median
$19,143
outlier · 2.2×
324
APR_DRG 		Elective Hip Joint Replacement 2 $41,344.00 $41,344.00 $41,344.00 nat. median
$23,403
1.8× median
26045
CPT 		Release Palm Contract,Open,Partial 31 $5,476.00 $41,001.18 $41,001.18 nat. median
$3,417
outlier · 12.0×
261
APR_DRG 		Major Biliary Tract Procedures 2 $40,230.00 $40,230.00 $40,230.00 nat. median
$10,430
outlier · 3.9×
27416
CPT 		Osteochondral Knee Autograft 33 $5,477.00 $39,835.73 $39,835.73 nat. median
$6,844
outlier · 5.8×
36836
HCPCS 		Creation Of Opening Between Artery And Vein In Arm With Single Access To Both Bl… 21 $13,444.62 $46,873.25 $39,785.10 nat. median
$18,385
outlier · 2.2×
36906
HCPCS 		Removal And/or Dissolving Of Blood Clot In Hemodialysis Circuit And Balloon Dila… 21 $13,444.62 $46,873.25 $39,785.10 nat. median
$18,501
outlier · 2.2×
229
APR_DRG 		Other Digestive System And Abdominal Procedures 2 $39,780.14 $39,780.14 $39,780.14 nat. median
$33,977
1.2× median
326
APR_DRG 		Elective Knee Joint Replacement 2 $39,299.00 $39,299.00 $39,299.00 nat. median
$19,344
outlier · 2.0×
23472
CPT 		Reconstr Total Shoulder Implant 33 $5,479.00 $39,158.43 $39,158.43 nat. median
$16,735
outlier · 2.3×
23120
CPT 		Partial Removal, Clavicle 33 $5,476.00 $39,148.62 $39,148.62 nat. median
$3,459
outlier · 11.3×
27405
CPT 		Repair Collat Ligamt/Capsule,Knee 33 $5,477.00 $39,068.81 $39,068.81 nat. median
$6,466
outlier · 6.0×
27415
CPT 		Osteochondral Knee Allograft 31 $5,478.00 $38,745.22 $38,745.22 nat. median
$9,751
outlier · 4.0×
C2616
HCPCS 		Brachytherapy Source, Non-stranded, Yttrium-90, Per Source 21 $12,835.16 $44,748.43 $37,981.59 nat. median
$22,121
1.7× median
313
APR_DRG 		Knee And Lower Leg Procedures Except Foot 2 $37,718.00 $37,718.00 $37,718.00 nat. median
$20,451
1.8× median
23412
CPT 		Repair Rotator Cuff,Chronic 33 $5,477.00 $37,533.72 $37,533.72 nat. median
$6,466
outlier · 5.8×
C9606
HCPCS 		Percutaneous Transluminal Revascularization Of Acute Total/subtotal Occlusion Du… 20 $12,443.55 $43,383.13 $37,457.62 nat. median
$17,051
outlier · 2.2×
20985
CPT 		Cptr-asst Surgical Navigation Image-less 26 $37,441.64 $37,441.64 $37,441.64 nat. median
$600
outlier · 62.4×
43644
CPT 		Lap Gastric Bypass/roux-en-y 28 $12,239.00 $37,146.39 $37,146.39 nat. median
$7,257
outlier · 5.1×
320
APR_DRG 		Other Musculoskeletal System And Connective Tissue Procedures 2 $36,291.08 $36,291.08 $36,291.08 nat. median
$19,353
1.9× median

Other procedures at this hospital

Browse this hospital's 7,893 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
             
J7330 HCPCS 1 Membrane Maci Implant 70 32 $135,312.00 $135,312.00 $38,843.55 $142,856.30 $111,218.58 2026-09-01
33264 HCPCS Removal And Replacement Of Multiple Lead Defibrillator 22 22 $107,488.00 $85,990.40 20% off $31,601.47 $110,175.20 $90,934.85 2026-09-01
33249 HCPCS Insertion Of Implantable Defibrillator System 22 22 $102,370.00 $81,896.00 20% off $30,096.78 $104,929.25 $86,605.02 2026-09-01
33289 HCPCS Insertion Of Wireless Pressure Sensor Into Lung Artery Through Tube With Review … 22 22 $85,745.00 $68,596.00 20% off $5,681.83 $87,888.63 $72,540.27 2026-09-01
33263 HCPCS Removal And Replacement Of Dual Lead Defibrillator 22 22 $76,760.00 $61,408.00 20% off $22,567.44 $78,679.00 $64,938.96 2026-09-01
33262 HCPCS Removal And Replacement Of Single Lead Defibrillator 22 22 $76,760.00 $61,408.00 20% off $22,567.44 $78,679.00 $64,938.96 2026-09-01
33240 HCPCS Insertion Of Defibrillator With Existing Single Lead 22 22 $76,760.00 $61,408.00 20% off $22,567.44 $78,679.00 $64,938.96 2026-09-01
33230 HCPCS Insertion Of Defibrillator With Existing Dual Leads 22 22 $76,760.00 $61,408.00 20% off $22,567.44 $78,679.00 $64,938.96 2026-09-01
230 APR_DRG Major Small Bowel Procedures 4 2 $59,245.71 $59,245.71 $62,372.70 $62,372.70 $62,372.70 2025-07-01
362 APR_DRG Mastectomy Procedures 4 2 $64,761.60 $64,761.60 $59,948.60 $59,948.60 $59,948.60 2025-07-01
23474 CPT Revis Shoulder Arthrplsty Humeral&Glenoid Compnt 80 28 $86,756.57 $86,756.57 $28,831.00 $56,492.47 $56,492.47 2025-07-01
325 APR_DRG Non-elective Or Complex Knee Joint Replacement 4 2 $50,023.25 $50,023.25 $53,625.00 $53,625.00 $53,625.00 2025-07-01
40814 CPT Excis Mouth Mucosa/Sub,Complx Repr 94 33 $102,795.49 $102,795.49 $5,531.00 $52,621.32 $52,621.32 2025-07-01
40818 CPT Excise Oral Mucosa For Graft 94 33 $102,795.49 $102,795.49 $5,529.00 $52,620.32 $52,620.32 2025-07-01
64582 CPT Open Impltj Hpglsl Nrv Nstim Ra Pg&Respir Sensor 94 33 $101,921.34 $101,921.34 $5,853.00 $54,884.00 $52,358.35 2025-07-01
37231 HCPCS Removal Of Plaque And Insertion Of Stents In Artery Of Leg, Initial Vessel 20 20 $58,999.00 $47,199.20 20% off $12,461.74 $60,473.98 $52,214.11 2026-09-01
37230 HCPCS Insertion Of Stent In Artery Of Leg, Initial Vessel 20 20 $56,729.00 $45,383.20 20% off $12,461.74 $58,147.23 $50,205.17 2026-09-01
220 APR_DRG Major Stomach, Esophageal And Duodenal Procedures 4 2 $51,827.52 $51,827.52 $49,145.89 $49,145.89 $49,145.89 2025-07-01
93656 HCPCS Comprehensive Electrophysiologic Evaluation With Catheter Destruction Of Abnorma… 22 22 $54,355.00 $43,484.00 20% off $15,980.37 $55,713.88 $45,984.33 2026-09-01
93654 HCPCS Comprehensive Electrophysiologic Evaluation With Catheter Destruction Of Abnorma… 22 22 $54,355.00 $43,484.00 20% off $15,980.37 $55,713.88 $45,984.33 2026-09-01
93653 HCPCS Comprehensive Electrophysiologic Evaluation With Catheter Destruction Of Abnorma… 22 22 $54,355.00 $43,484.00 20% off $15,980.37 $55,713.88 $45,984.33 2026-09-01
850 APR_DRG Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal… 4 2 $34,641.45 $34,641.45 $45,314.00 $45,314.00 $45,314.00 2025-07-01
0238T OTHER Catheter Removal Of Plaque From Groin Artery, Accessed Through The Skin Or Open … 22 22 $53,018.00 $42,414.40 20% off $12,461.74 $54,343.45 $44,853.23 2026-09-01
323 APR_DRG Non-elective Or Complex Hip Joint Replacement 4 2 $58,985.77 $58,985.77 $44,701.00 $44,701.00 $44,701.00 2025-07-01
37227 HCPCS Removal Of Plaque And Insertion Of Stents In Arteries Of Leg 20 20 $49,455.00 $39,564.00 20% off $12,461.74 $50,691.38 $43,767.68 2026-09-01
37229 HCPCS Removal Of Plaque In Artery Of Leg, Initial Vessel 20 20 $49,455.00 $39,564.00 20% off $12,461.74 $50,691.38 $43,767.68 2026-09-01
C9774 HCPCS Revascularization, Endovascular, Open Or Percutaneous, Tibial/peroneal Artery(ie… 22 22 $50,684.00 $40,547.20 20% off $12,461.74 $51,951.10 $42,878.67 2026-09-01
C9773 HCPCS Revascularization, Endovascular, Open Or Percutaneous, Tibial/peroneal Artery(i… 22 22 $50,684.00 $40,547.20 20% off $12,461.74 $51,951.10 $42,878.67 2026-09-01
C9775 HCPCS Revascularization, Endovascular, Open Or Percutaneous, Tibial/peroneal Artery(ie… 22 22 $50,684.00 $40,547.20 20% off $12,461.74 $51,951.10 $42,878.67 2026-09-01
C9767 HCPCS Revascularization, Endovascular, Open Or Percutaneous, Lower Extremity Artery(ie… 22 22 $50,240.00 $40,192.00 20% off $12,461.74 $51,496.00 $42,503.04 2026-09-01
92933 HCPCS Removal Of Plaque, Insertion Of Stent And Balloon Dilation Of Single Coronary Ar… 22 22 $49,503.00 $39,602.40 20% off $14,553.88 $50,740.58 $41,879.54 2026-09-01
324 APR_DRG Elective Hip Joint Replacement 4 2 $71,583.79 $71,583.79 $41,344.00 $41,344.00 $41,344.00 2025-07-01
26045 CPT Release Palm Contract,Open,Partial 90 31 $78,893.19 $78,893.19 $5,476.00 $41,001.18 $41,001.18 2025-07-01
261 APR_DRG Major Biliary Tract Procedures 4 2 $100,203.64 $100,203.64 $40,230.00 $40,230.00 $40,230.00 2025-07-01
27416 CPT Osteochondral Knee Autograft 94 33 $76,489.12 $76,489.12 $5,477.00 $39,835.73 $39,835.73 2025-07-01
36836 HCPCS Creation Of Opening Between Artery And Vein In Arm With Single Access To Both Bl… 21 21 $45,730.00 $36,584.00 20% off $13,444.62 $46,873.25 $39,785.10 2026-09-01
36906 HCPCS Removal And/or Dissolving Of Blood Clot In Hemodialysis Circuit And Balloon Dila… 21 21 $45,730.00 $36,584.00 20% off $13,444.62 $46,873.25 $39,785.10 2026-09-01
229 APR_DRG Other Digestive System And Abdominal Procedures 4 2 $49,621.90 $49,621.90 $39,780.14 $39,780.14 $39,780.14 2025-07-01
326 APR_DRG Elective Knee Joint Replacement 4 2 $62,909.10 $62,909.10 $39,299.00 $39,299.00 $39,299.00 2025-07-01
23472 CPT Reconstr Total Shoulder Implant 94 33 $75,090.59 $75,090.59 $5,479.00 $39,158.43 $39,158.43 2025-07-01
23120 CPT Partial Removal, Clavicle 94 33 $75,073.46 $75,073.46 $5,476.00 $39,148.62 $39,148.62 2025-07-01
27405 CPT Repair Collat Ligamt/Capsule,Knee 94 33 $74,907.86 $74,907.86 $5,477.00 $39,068.81 $39,068.81 2025-07-01
27415 CPT Osteochondral Knee Allograft 90 31 $74,239.65 $74,239.65 $5,478.00 $38,745.22 $38,745.22 2025-07-01
C2616 HCPCS Brachytherapy Source, Non-stranded, Yttrium-90, Per Source 21 21 $43,657.00 $34,925.60 20% off $12,835.16 $44,748.43 $37,981.59 2026-09-01
313 APR_DRG Knee And Lower Leg Procedures Except Foot 4 2 $113,045.40 $113,045.40 $37,718.00 $37,718.00 $37,718.00 2025-07-01
23412 CPT Repair Rotator Cuff,Chronic 94 33 $71,742.74 $71,742.74 $5,477.00 $37,533.72 $37,533.72 2025-07-01
C9606 HCPCS Percutaneous Transluminal Revascularization Of Acute Total/subtotal Occlusion Du… 20 20 $42,325.00 $33,860.00 20% off $12,443.55 $43,383.13 $37,457.62 2026-09-01
20985 CPT Cptr-asst Surgical Navigation Image-less 76 26 $55,521.72 $55,521.72 $37,441.64 $37,441.64 $37,441.64 2025-07-01
43644 CPT Lap Gastric Bypass/roux-en-y 80 28 $63,973.00 $63,973.00 $12,239.00 $37,146.39 $37,146.39 2025-07-01
320 APR_DRG Other Musculoskeletal System And Connective Tissue Procedures 4 2 $31,922.79 $31,922.79 $36,291.08 $36,291.08 $36,291.08 2025-07-01
64628 HCPCS Heat Destruction Of Intraosseous Basivertebral Nerve In Bones Of Spine In Lower … 21 21 $41,638.00 $33,310.40 $12,241.57 $42,678.95 $36,225.06 2026-09-01
60271 CPT Thyroidectomy=Substernal,Transcerv 90 31 $68,972.26 $68,972.26 $5,532.00 $36,217.56 $36,217.56 2025-07-01
29883 CPT Knee Scope,Med+Lat Menis Repair 94 33 $68,613.81 $68,613.81 $5,476.00 $36,015.69 $36,015.69 2025-07-01
23630 CPT Open Rx Gr Tuberosity Fx 90 31 $68,287.18 $68,287.18 $5,477.00 $35,857.78 $35,857.78 2025-07-01
23430 CPT Repair Biceps Long Tendon 94 33 $68,287.18 $68,287.18 $5,477.00 $35,857.78 $35,857.78 2025-07-01
23410 CPT Repair Rotator Cuff,Acute 94 33 $68,287.18 $68,287.18 $5,477.00 $35,857.78 $35,857.78 2025-07-01
93580 HCPCS Repair Of Congenital Abnormality In Wall Between Upper Heart Chambers With Impla… 22 22 $42,325.00 $33,860.00 20% off $12,443.55 $43,383.13 $35,806.95 2026-09-01
C9602 HCPCS Percutaneous Transluminal Coronary Atherectomy, With Drug Eluting Intracoronary … 22 22 $42,325.00 $33,860.00 20% off $12,443.55 $43,383.13 $35,806.95 2026-09-01
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 4 4 $65,816.93 $52,653.54 20% off $34,586.26 $51,609.80 $35,450.91 2026-09-01
231 APR_DRG Major Large Bowel Procedures 4 2 $60,330.91 $55,579.69 $35,314.00 $35,314.00 $35,314.00 2025-07-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 18 9 $113,045.40 $113,045.40 $35,094.46 $62,694.50 $35,094.46 2026-09-01
23130 CPT Partial Removal/Repair,Acromion 90 31 $66,233.23 $66,233.23 $5,476.00 $34,861.12 $34,861.12 2025-07-01
27447 CPT Total Knee Arthroplasty 94 33 $66,115.56 $66,115.56 $5,478.00 $34,805.04 $34,805.04 2025-07-01
224 APR_DRG Peritoneal Adhesiolysis 4 2 $47,437.96 $47,437.96 $33,432.00 $33,432.00 $33,432.00 2025-07-01
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 4 4 $47,922.36 $38,337.89 $32,382.14 $47,922.36 $33,191.69 2026-09-01
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With McC 14 5 $63,000.72 $63,000.72 $33,002.17 $58,408.50 $33,002.17 2025-07-01
23473 CPT Revis Shoulder Arthrplsty Humeral/Glenoid Compnt 90 31 $61,960.23 $61,960.23 $5,478.00 $32,789.71 $32,789.71 2025-07-01
37244 HCPCS Occlusion Of Artery Or Vein Bleeding With Review By Radiologist 22 22 $38,708.00 $30,966.40 $11,380.15 $39,675.70 $32,746.97 2026-09-01
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 18 9 $70,062.43 $70,062.43 $32,497.30 $57,514.95 $32,497.30 2026-09-01
383 APR_DRG Cellulitis And Other Skin Infections 4 2 $22,153.96 $22,153.96 $32,361.93 $32,361.93 $32,361.93 2025-07-01
951 APR_DRG Moderately Extensive O.r. Procedure Unrelated To Principal Diagnosis 4 2 $49,651.84 $49,651.84 $32,267.00 $32,267.00 $32,267.00 2025-07-01
64575 HCPCS Insertion Of Peripheral Nerve Neurostimulator Electrode 22 22 $37,968.00 $30,374.40 $7,426.82 $38,917.20 $32,120.93 2026-09-01
691 APR_DRG Lymphoma, Myeloma And Non-acute Leukemia 4 2 $37,468.27 $37,468.27 $31,829.00 $31,829.00 $31,829.00 2025-07-01
27130 CPT Total Hip Arthroplasty 94 33 $59,510.96 $59,510.96 $5,478.00 $31,601.83 $31,601.83 2025-07-01
27846 CPT Open Rx Ankle Dislocatn 94 33 $59,463.06 $59,463.06 $5,477.00 $31,578.08 $31,578.08 2025-07-01
37241 HCPCS Occlusion Of Vein With Review By Radiologist 22 22 $37,219.00 $29,775.20 20% off $10,942.39 $38,149.48 $31,487.28 2026-09-01
61626 HCPCS Occlusion Of Head Or Neck Artery 22 22 $37,219.00 $29,775.20 20% off $10,942.39 $38,149.48 $31,487.28 2026-09-01
461 APR_DRG Kidney And Urinary Tract Malignancy 4 2 $27,875.88 $27,875.88 $31,420.98 $31,420.98 $31,420.98 2025-07-01
27477 CPT Surgery To Stop Tib/Fib Growth 94 33 $58,974.40 $58,974.40 $5,477.00 $31,341.07 $31,341.07 2025-07-01
64590 HCPCS Insertion Or Replacement Of Peripheral, Sacral, Or Gastric Neurostimulator Gener… 22 22 $37,002.00 $29,601.60 20% off $10,878.59 $37,927.05 $31,303.69 2026-09-01
27827 CPT Open Treatment Fracture Distal Tibia Only 90 31 $58,362.07 $58,362.07 $5,478.00 $31,044.60 $31,044.60 2025-07-01
308 APR_DRG Hip And Femur Fracture Repair 4 2 $59,397.00 $53,592.56 $30,935.00 $30,935.00 $30,935.00 2025-07-01
793 APR_DRG Moderately Extensive O.r. Procedures For Other Complications Of Treatment 4 2 $35,386.98 $35,386.98 $30,889.00 $30,889.00 $30,889.00 2025-07-01
37221 HCPCS Insertion Of Stent In Groin Artery, Initial Vessel 20 20 $34,819.00 $27,855.20 20% off $10,236.79 $35,689.48 $30,814.81 2026-09-01
29888 CPT Knee Scope,Aid Ant Cruciate Repair 94 33 $57,870.76 $57,870.76 $5,477.00 $30,805.83 $30,805.83 2025-07-01
24515 CPT Open Fixatn Mid Humerus Fracture 90 31 $57,706.70 $57,706.70 $5,478.00 $30,726.74 $30,726.74 2025-07-01
23615 CPT Open Treatment Prox Humeral Fracture 94 33 $57,706.70 $57,706.70 $5,478.00 $30,726.74 $30,726.74 2025-07-01
28309 CPT Osteotomy Metatarsals,Multiple 90 31 $56,828.70 $56,828.70 $5,477.00 $30,300.42 $30,300.42 2025-07-01
29882 CPT Knee Scope,Med Or Lat Menis Repair 94 33 $56,610.85 $56,610.85 $5,476.00 $30,194.26 $30,194.26 2025-07-01
33208 HCPCS Insertion Of Pacemaker And Upper And Lower Heart Chamber Electrode 22 22 $35,532.00 $28,425.60 20% off $10,446.41 $36,420.30 $30,060.07 2026-09-01
33224 HCPCS Insertion Of Left Lower Heart Electrode And Attachment To Pacemaker Or Defibrill… 22 22 $33,841.00 $27,072.80 20% off $9,949.25 $59,952.31 $29,949.28 2026-09-01
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 18 9 $62,522.91 $62,522.91 $29,837.11 $52,806.85 $29,837.11 2026-09-01
227 APR_DRG Hernia Procedures Except Inguinal, Femoral And Umbilical 4 2 $59,541.04 $59,541.04 $29,379.00 $29,379.00 $29,379.00 2025-07-01
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 18 9 $90,365.28 $90,365.28 $29,315.34 $51,883.40 $29,315.34 2026-09-01
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 4 4 $185,567.31 $148,453.85 $28,301.94 $42,232.30 $29,009.48 2026-09-01
33207 HCPCS Insertion Of Pacemaker And Lower Heart Chamber Electrode 22 22 $33,841.00 $27,072.80 20% off $9,949.25 $34,687.03 $28,629.49 2026-09-01
33228 HCPCS Removal And Replacement Of Dual Lead Permanent Pacemaker 22 22 $33,841.00 $27,072.80 20% off $9,949.25 $34,687.03 $28,629.49 2026-09-01
33206 HCPCS Insertion Of Pacemaker And Upper Heart Chamber Electrode 22 22 $33,841.00 $27,072.80 20% off $9,949.25 $34,687.03 $28,629.49 2026-09-01
33213 HCPCS Insertion Of Pacemaker Pulse Generator With Existing Dual Leads 22 22 $33,841.00 $27,072.80 20% off $9,949.25 $34,687.03 $28,629.49 2026-09-01
J2350 HCPCS Ocrelizumab 30 Mg/ml Intravenous Solution 48 19 $48,299.85 $48,299.85 $1,754.10 $45,402.00 $28,509.42 2026-07-30
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 4 4 $54,459.70 $43,567.76 $27,739.48 $41,393.00 $28,432.96 2026-09-01
403 APR_DRG Procedures For Obesity 4 2 $57,174.64 $53,683.49 $28,243.00 $28,243.00 $28,243.00 2025-07-01
43775 CPT Lap, Gast Restrict Proc, Longitudinal Gastrectomy 80 28 $46,892.24 $46,892.24 $10,704.00 $28,094.76 $28,094.76 2025-07-01
0076T OTHER Insertion Of Stents Into Vertebral Artery Via Catheter, Open Or Accessed Through… 20 20 $31,700.00 $25,360.00 20% off $9,319.80 $32,492.50 $28,054.50 2026-09-01
27427 CPT Ligmt Revision,knee,extra-artic 94 33 $51,974.66 $51,974.66 $5,477.00 $27,946.21 $27,946.21 2025-07-01
27418 CPT Repair Anter Tibial Tubercle 94 33 $51,974.66 $51,974.66 $5,477.00 $27,946.21 $27,946.21 2025-07-01
4810002100_2 CDM Hc Ep Lab Level 5 First 15 Min 20 20 $33,017.00 $26,413.60 20% off $9,707.00 $32,026.49 $27,932.38 2026-09-01
69643 CPT Tympanoplas/Mastoidec,Intact Wall 94 33 $51,711.90 $51,711.90 $5,532.00 $27,846.27 $27,846.27 2025-07-01
37226 HCPCS Insertion Of Stent In Arteries Of Leg 20 20 $31,363.00 $25,090.40 $9,220.72 $32,147.08 $27,756.26 2026-09-01
77372 HCPCS Complete Single Session Course Of Cranial Lesion Surgery Using Radiation And A M… 22 22 $32,765.00 $26,212.00 20% off $1,262.00 $33,584.13 $27,719.19 2026-09-01
314 APR_DRG Foot And Toe Procedures 4 2 $102,799.90 $102,799.90 $27,652.00 $27,652.00 $27,652.00 2025-07-01
37225 HCPCS Removal Of Plaque In Arteries Of Leg 20 20 $31,199.00 $24,959.20 20% off $9,172.51 $31,978.98 $27,611.11 2026-09-01
37236 HCPCS Insertion Of Stent In Artery (except Lower Extremity, Chest, Heart, Neck And Bra… 22 22 $32,618.00 $26,094.40 $9,589.69 $33,433.45 $27,594.83 2026-09-01
37242 HCPCS Occlusion Of Artery With Review By Radiologist 22 22 $32,618.00 $26,094.40 $9,589.69 $33,433.45 $27,594.83 2026-09-01
634 APR_DRG Neonate Birth Weight > 2499 Grams With Respiratory Distress Syndrome Or Other Ma… 4 2 $15,481.19 $12,544.94 $27,492.00 $27,492.00 $27,492.00 2025-07-01
92987 HCPCS Balloon Dilation Repair Of Mitral Valve 22 22 $32,477.00 $25,981.60 20% off $9,548.24 $33,288.93 $27,475.54 2026-09-01
92928 HCPCS Insertion Of Stents With Balloon Dilation Of Coronary Artery Or Branch, Single A… 22 22 $32,477.00 $25,981.60 20% off $9,548.24 $33,288.93 $27,475.54 2026-09-01
37243 HCPCS Occlusion Of Growths Or Obstructed Vessels With Review By Radiologist 22 22 $32,448.00 $25,958.40 $9,539.71 $33,259.20 $27,451.01 2026-09-01
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 4 4 $73,448.04 $58,758.43 20% off $26,727.36 $39,882.70 $27,395.54 2026-09-01
36905 HCPCS Removal And/or Dissolving Of Blood Clot In Hemodialysis Circuit And Balloon Dila… 21 21 $31,199.00 $24,959.20 20% off $9,172.51 $31,978.98 $27,143.13 2026-09-01
27566 CPT Open Rx Kneecap Dislocatn 94 33 $50,196.90 $50,196.90 $5,477.00 $27,084.01 $27,084.01 2025-07-01
57288 CPT Sling Oper Stres Incontinence 90 31 $49,672.66 $49,672.66 $5,799.00 $26,990.74 $26,990.74 2025-07-01
335 MS_DRG Peritoneal Adhesiolysis With Mcc 4 4 $51,646.42 $41,317.14 $26,323.39 $39,279.90 $26,981.47 2026-09-01
462 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without McC 14 5 $94,325.38 $94,325.38 $18,608.31 $32,933.70 $26,910.35 2025-07-01
15769 CPT Grafting Of Autologous Soft Tiss By Direct Exc 94 33 $51,711.90 $51,711.90 $3,619.00 $26,889.77 $26,889.77 2025-07-01
C9772 HCPCS Revascularization, Endovascular, Open Or Percutaneous, Tibial/peroneal Artery(ie… 22 22 $31,699.00 $25,359.20 20% off $9,319.51 $32,491.48 $26,817.36 2026-09-01
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 14 5 $157,451.54 $157,451.54 $26,704.54 $47,262.70 $26,704.54 2025-07-01
0075T OTHER Insertion Of Stents Into Vertebral Artery Via Catheter, Open Or Accessed Through… 20 20 $30,144.00 $24,115.20 20% off $8,862.34 $30,897.60 $26,677.44 2026-09-01
317 APR_DRG Tendon, Muscle And Other Soft Tissue Procedures 4 2 $73,822.01 $73,822.01 $26,548.00 $26,548.00 $26,548.00 2025-07-01
223 APR_DRG Other Small And Large Bowel Procedures 4 2 $38,460.59 $38,460.59 $26,429.00 $26,429.00 $26,429.00 2025-07-01
43282 HCPCS Repair Of Hernia Of Muscle At Esophagus And Stomach With Implantation Of Mesh Us… 21 21 $30,056.00 $24,044.80 20% off $8,836.46 $30,807.40 $26,148.72 2026-09-01
37238 HCPCS Insertion Of Stent In Vein With Review By Radiologist, Initial Vein 22 22 $30,902.00 $24,721.60 20% off $5,435.88 $31,674.55 $26,143.09 2026-09-01
92937 HCPCS Removal Of Plaque, Insertion Of Stent And/or Balloon Dilation Of Single Coronary… 22 22 $30,854.00 $24,683.20 20% off $9,071.08 $31,625.35 $26,102.49 2026-09-01
C9604 HCPCS Percutaneous Transluminal Revascularization Of Or Through Coronary Artery Bypass… 22 22 $30,854.00 $24,683.20 20% off $9,071.08 $31,625.35 $26,102.49 2026-09-01
711 APR_DRG Post-operative, Post-trauma, Other Device Infections With O.r. Procedure 4 2 $90,399.05 $90,399.05 $25,770.00 $25,770.00 $25,770.00 2025-07-01
28725 CPT Fusion Foot Bones,Subtalar 90 31 $47,211.40 $47,211.40 $5,478.00 $25,636.53 $25,636.53 2025-07-01
69645 CPT Tympanoplas/Mastoidec,Radical/Comple 94 33 $46,938.16 $46,938.16 $5,532.00 $25,530.99 $25,530.99 2025-07-01
233 APR_DRG Appendectomy With Complex Principal Diagnosis 4 2 $26,431.98 $26,431.98 $25,484.00 $25,484.00 $25,484.00 2025-07-01
29877 CPT Knee Scope,Shave Articular Cart 94 33 $46,773.87 $46,773.87 $5,476.00 $25,423.33 $25,423.33 2025-07-01
28297 CPT Corrj Hallux Valgus W/Sesmdc W/1metar Medial Cnf 94 33 $46,601.43 $46,601.43 $5,478.00 $25,340.69 $25,340.69 2025-07-01
263 APR_DRG Cholecystectomy 4 2 $56,588.80 $48,964.91 $25,304.00 $25,304.00 $25,304.00 2025-07-01
61645 HCPCS Removal Of Blood Clot And Injection To Dissolve Blood Clot From Head Artery Usin… 22 22 $29,671.00 $23,736.80 20% off $660.27 $30,412.78 $25,101.67 2026-09-01
61624 HCPCS Occlusion Of Central Nervous System Or Spinal Cord Artery 22 22 $29,671.00 $23,736.80 20% off $8,723.27 $30,412.78 $25,101.67 2026-09-01
30930 CPT Theraputic Fracture Infer Turbinate 94 33 $45,902.17 $45,902.17 $5,531.00 $25,028.06 $25,028.06 2025-07-01
19325 HCPCS Insertion Of Breast Implant 22 22 $29,570.00 $23,656.00 20% off $8,693.58 $30,309.25 $25,016.22 2026-09-01
27409 CPT Repair Collat & Cruciate Lig,Knee 94 33 $45,897.29 $45,897.29 $5,477.00 $24,998.67 $24,998.67 2025-07-01
37228 HCPCS Balloon Dilation Of Artery Of Leg, Initial Vessel 20 20 $28,227.00 $22,581.60 20% off $8,298.74 $28,932.68 $24,980.90 2026-09-01
30420 CPT Reconstr Nose+Maj Septal Repair 94 33 $45,456.69 $45,456.69 $5,532.00 $24,812.49 $24,812.49 2025-07-01
28730 CPT Fusion Foot Bones,Midtarsal,Multi 94 33 $45,411.06 $45,411.06 $5,478.00 $24,763.37 $24,763.37 2025-07-01
28298 CPT Corrj Hallux Valgus W/Sesmdc W/Prox Phlnx Osteot 94 33 $45,411.06 $45,411.06 $5,477.00 $24,762.87 $24,762.87 2025-07-01
661 APR_DRG Coagulation And Platelet Disorders 4 2 $27,277.78 $27,277.78 $24,718.00 $24,718.00 $24,718.00 2025-07-01
29874 CPT Knee Scope,Remv Loose Body 94 33 $45,273.07 $45,273.07 $5,476.00 $24,695.44 $24,695.44 2025-07-01
43280 HCPCS Strengthening Of Muscle Between Esophagus And Stomach By Wrapping Part Of Stomac… 21 21 $28,373.00 $22,698.40 $8,341.66 $29,082.33 $24,684.51 2026-09-01
35646 HCPCS Bypass Of Diseased Or Blocked Artery Aorta To Upper Leg And Opposite Upper Leg A… 22 22 $28,980.00 $23,184.00 20% off $1,361.93 $29,704.50 $24,517.08 2026-09-01
710 APR_DRG Infectious And Parasitic Diseases Including HIV With O.r. Procedure 4 2 $70,062.43 $70,062.43 $24,482.00 $24,482.00 $24,482.00 2025-07-01
58573 CPT Laparoscopy Tot Hysterectomy Uterus >250 Gram W Tube/Ovary 94 33 $44,412.46 $44,412.46 $5,743.00 $24,411.55 $24,411.55 2025-07-01
61650 HCPCS Infusion Of Chemical Agent Into Artery Of Brain With Insertion Of Tube And Imagi… 22 22 $28,529.00 $22,823.20 20% off $452.64 $29,242.23 $24,135.53 2026-09-01
61651 HCPCS Infusion Of Chemical Agent Into Artery Of Brain With Insertion Of Tube And Imagi… 22 22 $28,529.00 $22,823.20 20% off $193.40 $29,242.23 $24,135.53 2026-09-01
61635 HCPCS Insertion Of Stent In Blood Vessel Of Head 22 22 $28,529.00 $22,823.20 20% off $1,194.95 $29,242.23 $24,135.53 2026-09-01
61630 HCPCS Balloon Dilation Of Blood Vessel In Head 22 22 $28,529.00 $22,823.20 20% off $1,103.28 $29,242.23 $24,135.53 2026-09-01
61623 HCPCS Balloon Occlusion Of Head Or Neck Artery With Review By Radiologist 22 22 $28,529.00 $22,823.20 20% off $8,387.53 $29,242.23 $24,135.53 2026-09-01
37234 HCPCS Insertion Of Stent In Artery Of Leg, Each Additional Vessel 20 20 $27,146.00 $21,716.80 20% off $7,980.92 $27,824.65 $24,024.21 2026-09-01
43279 CPT Lap, Esophagomyotomy W Fundoplasty 80 28 $36,863.24 $36,863.24 $12,239.00 $23,998.18 $23,998.18 2025-07-01
500 MS_DRG Soft Tissue Procedures With Mcc 4 4 $57,536.95 $46,029.56 20% off $23,329.77 $34,812.80 $23,913.01 2026-09-01
92924 HCPCS Removal Of Plaque With Balloon Dilation Of Single Coronary Artery Or Branch 22 22 $27,769.00 $22,215.20 20% off $8,164.09 $28,463.23 $23,492.57 2026-09-01
43611 CPT Excis Stoamch Malig 80 28 $36,195.96 $36,195.96 $11,775.00 $23,442.53 $23,442.53 2025-07-01
33217 HCPCS Insertion Of 2 Electrodes For Permanent Pacemaker Or Defibrillator 21 21 $26,870.00 $21,496.00 20% off $7,899.78 $27,541.75 $23,376.90 2026-09-01
64415 CPT Single Nerve Block Injection Arm Nerve 102 36 $45,301.06 $45,301.06 $571.20 $23,320.02 $23,320.02 2026-07-30
C1767 HCPCS Hc Mh Pt Trial Kit 4 1 $1.00 $1.00 $0.94 $46,397.46 $23,199.20 2025-07-01
27486 CPT Revise Knee Joint Replace,1 Part 76 26 $34,469.49 $34,469.49 $23,180.99 $23,180.99 $23,180.99 2025-07-01
57250 CPT Post Colporrhaphy,Rectum/Vagina 94 33 $43,258.37 $43,258.37 $4,386.00 $23,173.31 $23,173.31 2025-07-01
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 18 9 $136,189.66 $136,189.66 $23,074.88 $40,838.80 $23,074.88 2026-09-01
29807 CPT Shldr Arthroscop,Surg,Repair,Slap Lesion 90 31 $41,876.58 $41,876.58 $5,477.00 $23,048.65 $23,048.65 2025-07-01
28304 CPT Osteotomy Midtarsal Bones 94 33 $41,740.64 $41,740.64 $5,477.00 $22,982.71 $22,982.71 2025-07-01
33225 HCPCS Insertion Of Left Lower Heart Electrode For Pacemaker Or Defibrillator 21 21 $26,360.00 $21,088.00 20% off $352.10 $27,019.00 $22,933.20 2026-09-01
27829 CPT Open Tx Distal Tibiofibular Joint Disruption 94 33 $41,635.75 $41,635.75 $5,477.00 $22,931.84 $22,931.84 2025-07-01
469 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc… 4 4 $44,533.32 $35,626.66 $22,359.66 $33,365.20 $22,918.65 2026-09-01
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 14 5 $100,203.64 $100,203.64 $22,750.64 $40,264.95 $22,750.64 2025-07-01
27814 CPT Open Treatment Bimalleolar Ankle Fracture 94 33 $41,025.38 $41,025.38 $5,477.00 $22,635.81 $22,635.81 2025-07-01
C9600 HCPCS Percutaneous Transcatheter Placement Of Drug Eluting Intracoronary Stent(s), Wit… 22 22 $26,380.00 $21,104.00 20% off $7,755.72 $27,039.50 $22,317.48 2026-09-01
33216 HCPCS Insertion Of 1 Electrode For Permanent Pacemaker Or Defibrillator 21 21 $25,590.00 $20,472.00 20% off $7,523.46 $26,229.75 $22,263.30 2026-09-01
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 18 9 $94,619.68 $94,619.68 $22,256.16 $39,389.80 $22,256.16 2026-09-01
570 MS_DRG Skin Debridement With Mcc 4 4 $47,171.73 $37,737.38 20% off $21,680.73 $32,352.10 $22,222.75 2026-09-01
29806 CPT Shldr Arthroscop,Surg,Capsulorrhaphy 94 33 $40,107.19 $40,107.19 $5,477.00 $22,190.49 $22,190.49 2025-07-01
29828 CPT Arthroscopy Shoulder Surgical Biceps Tenodesis 94 33 $40,072.66 $40,072.66 $5,477.00 $22,173.74 $22,173.74 2025-07-01
43648 CPT Lap Revise/Remove Gastric Neurostim Antrum 94 33 $39,710.83 $39,710.83 $5,743.00 $22,131.25 $22,131.25 2025-07-01
23485 CPT Osteotomy Clavicle W Bone Graft 90 31 $39,975.73 $39,975.73 $5,478.00 $22,127.22 $22,127.22 2025-07-01
29827 CPT Shldr Arthroscop,Surg,W/Rotat Cuff Repr 94 33 $39,657.17 $39,657.17 $5,477.00 $21,972.24 $21,972.24 2025-07-01
29826 CPT Shldr Arthroscop,Part Acromioplas 80 28 $39,272.77 $39,272.77 $5,637.00 $21,865.80 $21,865.80 2025-07-01
33227 HCPCS Removal And Replacement Of Single Lead Permanent Pacemaker 22 22 $25,590.00 $20,472.00 20% off $7,523.46 $26,229.75 $21,707.67 2026-09-01
33233 HCPCS Removal Of Permanent Pacemaker Pulse Generator 22 22 $25,590.00 $20,472.00 20% off $7,523.46 $26,229.75 $21,649.14 2026-09-01
222 APR_DRG Other Stomach, Esophageal And Duodenal Procedures 4 2 $76,034.07 $76,034.07 $21,649.00 $21,649.00 $21,649.00 2025-07-01
58262 CPT Vag Hyst,Rmv Tube/Ovary 94 33 $38,209.11 $38,209.11 $5,799.00 $21,430.92 $21,430.92 2025-07-01
51860 CPT Repair Bladder Wound/Inj,Simple 94 33 $38,209.11 $38,209.11 $5,758.00 $21,410.42 $21,410.42 2025-07-01
31253 CPT Nasal/Sinus Ndsc Tot W/Frnt Sins Expl Tiss Rmvl 94 33 $38,328.06 $38,328.06 $5,521.00 $21,349.60 $21,349.60 2025-07-01
513 APR_DRG Uterine And Adnexa Procedures For Non-malignancy Except Leiomyoma 4 2 $34,579.16 $34,579.16 $21,275.00 $21,275.00 $21,275.00 2025-07-01
29824 CPT Shldr Arthroscop,Surg,Dis Claviculectomy 94 33 $38,147.35 $38,147.35 $5,476.00 $21,239.47 $21,239.47 2025-07-01
28270 CPT Capsulotomy Metatarsophalangeal Joint, W/wo Tenorrhaphy, Ea Joint 94 33 $38,139.50 $38,139.50 $5,476.00 $21,235.66 $21,235.66 2025-07-01
29821 CPT Shldr Arthroscop,Full Synovect 94 33 $38,041.95 $38,041.95 $5,476.00 $21,188.35 $21,188.35 2025-07-01
31259 CPT Nasal/Sinus Ndsc Tot W/Sphendt W/Sphen Tiss Rmvl 94 33 $37,917.67 $37,917.67 $5,521.00 $21,150.56 $21,150.56 2025-07-01
60240 CPT Thyroidectomy 94 33 $37,571.13 $37,571.13 $5,742.00 $21,092.99 $21,092.99 2025-07-01
19303 CPT Mastectomy, Simple, Complete 94 33 $37,806.30 $37,806.30 $5,454.00 $21,063.06 $21,063.06 2025-07-01
58150 CPT Total Abdom Hysterectomy 80 28 $30,470.43 $30,470.43 $13,993.00 $21,003.28 $21,003.28 2025-07-01
4810001900_2 CDM Hc Ep Lab Level 4 First 15 Min 20 20 $24,745.00 $19,796.00 20% off $7,275.03 $24,002.65 $20,934.27 2026-09-01
23515 CPT Open Treatment Clavicular Fracture Internal Fx 94 33 $37,373.23 $37,373.23 $5,477.00 $20,864.51 $20,864.51 2025-07-01
60500 CPT Explore Parathyroid Glands 94 33 $37,224.26 $37,224.26 $5,532.00 $20,819.76 $20,819.76 2025-07-01
208 MS_DRG Respiratory System Diagnosis With Ventilator Support <=96 Hours 4 4 $63,585.03 $50,868.02 20% off $20,262.43 $30,235.70 $20,768.98 2026-09-01
49659 CPT Lap,Hernia Repair Proc,Unlist 94 33 $36,839.76 $36,839.76 $5,742.00 $20,738.28 $20,738.28 2025-07-01
49595 CPT Rpr Aa Hernia 1st > 10 Cm Reducible 90 31 $36,839.76 $36,839.76 $5,721.00 $20,727.78 $20,727.78 2025-07-01
28300 CPT Osteotomy Heel Bone 94 33 $37,084.32 $37,084.32 $5,477.00 $20,724.40 $20,724.40 2025-07-01
28238 CPT Reconst Post Tib Tend,Excis Acc Tar Nav 94 33 $37,084.32 $37,084.32 $5,477.00 $20,724.40 $20,724.40 2025-07-01
11044 CPT Debridement Bone Muscle &/Fascia 20 Sq Cm/< 94 33 $38,190.44 $38,190.44 $4,311.00 $20,677.87 $20,677.87 2025-07-01
20900 CPT Remv Bone For Graft Minor 94 33 $38,886.35 $38,886.35 $3,619.00 $20,669.38 $20,669.38 2025-07-01
43282 CPT Lap, Repair Paraesophageal Hernia, Incl Fundoplasty With Mesh 94 33 $36,454.74 $36,454.74 $5,743.00 $20,552.04 $20,552.04 2025-07-01
31257 CPT Nasal/Sinus Ndsc Total With Sphenoidotomy 94 33 $36,460.56 $36,460.56 $5,521.00 $20,443.88 $20,443.88 2025-07-01
28415 CPT Open Treatment Calcaneal Fracture 94 33 $36,265.75 $36,265.75 $5,477.00 $20,327.38 $20,327.38 2025-07-01
38120 CPT Lap,Splenectomy 94 33 $35,844.40 $35,844.40 $5,743.00 $20,256.04 $20,256.04 2025-07-01
330 MS_DRG Major Small And Large Bowel Procedures With Cc 18 9 $59,245.71 $59,245.71 $15,358.78 $27,182.55 $20,161.90 2026-09-01
64712 CPT Neuroplasty Sciatic Nerve,Open 94 33 $35,555.54 $35,555.54 $5,817.00 $20,152.93 $20,152.93 2025-07-01
33210 HCPCS Insertion Of Temporary Pacemaker Lead In Single Heart Chamber 21 21 $23,152.00 $18,521.60 20% off $6,806.69 $23,730.80 $20,142.24 2026-09-01
27822 CPT Open Tx Trimalleolar Ankle Fx Without Fix Pst Lip 90 31 $35,816.19 $35,816.19 $5,477.00 $20,109.35 $20,109.35 2025-07-01
43281 CPT Lap, Repair Paraesophageal Hernia, Incl Fundoplasty Without Mesh 94 33 $35,459.23 $35,459.23 $5,743.00 $20,069.24 $20,069.24 2025-07-01
27305 CPT Fasciotomy,Iliotibial,Open 94 33 $35,634.89 $35,634.89 $5,476.00 $20,020.92 $20,020.92 2025-07-01
27299 CPT Hc Pelvis/Hip Joint Surgery Unlisted 90 31 $35,634.89 $35,634.89 $5,474.00 $20,019.92 $20,019.92 2025-07-01
4810001500_2 CDM Hc Cath Lab Level 5 First 15 Min 20 20 $23,550.00 $18,840.00 20% off $6,923.70 $22,843.50 $19,923.30 2026-09-01
27654 CPT Repair Achilles Tendon,Secondary 94 33 $35,104.12 $35,104.12 $5,477.00 $19,763.99 $19,763.99 2025-07-01
28119 CPT Ostectomy Calcaneus Spur W/wo Plntar Fascial Rls 94 33 $35,104.12 $35,104.12 $5,476.00 $19,763.49 $19,763.49 2025-07-01
23550 CPT Open Rx A-c Jt Disloc 94 33 $35,083.43 $35,083.43 $5,477.00 $19,753.96 $19,753.96 2025-07-01
29823 CPT Surgical Arthroscopy Shoulder Xtnsv Dbrdmt 3+ 94 33 $35,083.43 $35,083.43 $5,476.00 $19,753.46 $19,753.46 2025-07-01
31276 CPT Nasal/Sinus Ndsc W/Rmvl Tiss From Frontal Sinus 94 33 $36,460.56 $36,460.56 $3,984.00 $19,675.38 $19,675.38 2025-07-01
49653 CPT Lap, Ventral Hernia Repair,Incarcerated 80 28 $29,890.29 $29,890.29 $10,315.00 $19,654.29 $19,654.29 2025-07-01
28735 CPT Fusion Foot Bones,Midtarsal,Osteotmy 94 33 $34,807.48 $34,807.48 $5,478.00 $19,620.62 $19,620.62 2025-07-01
58552 CPT Lap,Vag Hyst,Uterus 250gms/<,salp-ooph 94 33 $34,457.53 $34,457.53 $5,743.00 $19,583.40 $19,583.40 2025-07-01
69631 CPT Tympanoplasty 94 33 $34,564.18 $34,564.18 $5,532.00 $19,529.62 $19,529.62 2025-07-01
36903 HCPCS Insertion Of Needle And/or Tube Into Hemodialysis Circuit And Insertion Of Stent… 22 22 $23,045.00 $18,436.00 20% off $6,775.23 $23,621.13 $19,496.07 2026-09-01
95 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Cc 4 4 $27,753.61 $22,202.89 $19,012.93 $27,753.61 $19,488.25 2026-09-01
27334 CPT Rmv Knee Synovium,Ant/Post 94 33 $34,469.49 $34,469.49 $5,476.00 $19,455.71 $19,455.71 2025-07-01
21615 HCPCS Removal Of First And/or Extra Rib At Neck 21 21 $22,240.14 $17,792.11 20% off $6,538.60 $22,796.14 $19,348.92 2026-09-01
58291 CPT Vag Hyst,Uterus >250 Gms,Rem Tube/Ovary 94 33 $33,809.56 $33,809.56 $5,799.00 $19,297.13 $19,297.13 2025-07-01
49594 CPT Rpr Aa Hernia 1st 3-10 Cm Ncrc8/Strangulated 94 33 $33,770.84 $33,770.84 $5,742.00 $19,249.85 $19,249.85 2025-07-01
519 APR_DRG Uterine And Adnexa Procedures For Leiomyoma 4 2 $29,005.61 $29,005.61 $19,228.00 $19,228.00 $19,228.00 2025-07-01
37183 HCPCS Revision Of Shunts To Bypass Blood Flow To Liver With Review By Radiologist 21 21 $22,098.00 $17,678.40 $6,227.69 $22,650.45 $19,225.26 2026-09-01
493 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Cc 4 4 $80,535.64 $64,428.51 20% off $18,695.22 $27,897.10 $19,162.59 2026-09-01
24341 CPT Repair Tendon/Muscle Upper Arm/Elbow Ea 90 31 $33,853.91 $33,853.91 $5,477.00 $19,157.65 $19,157.65 2025-07-01
28750 CPT Fusion Big Toe,mt-p Jt 94 33 $33,763.25 $33,763.25 $5,477.00 $19,113.68 $19,113.68 2025-07-01
480 MS_DRG Hip And Femur Procedures Except Major Joint With Mcc 18 9 $55,053.13 $55,053.13 $19,109.94 $33,821.50 $19,109.94 2026-09-01
353 MS_DRG Hernia Procedures Except Inguinal And Femoral With McC 14 5 $21,343.15 $21,343.15 $19,057.96 $33,729.50 $19,057.96 2025-07-01
36023 HCPCS Operating Room Services - General Classification 19 19 $21,151.00 $16,920.80 20% off $6,218.39 $21,679.78 $19,035.90 2026-09-01
380 APR_DRG Skin Ulcers 4 2 $34,143.92 $34,143.92 $19,023.00 $19,023.00 $19,023.00 2025-07-01
43210 CPT Egd Partial/Compl Esophagogastric Fundoplasty 94 33 $33,278.29 $33,278.29 $5,743.00 $19,011.47 $19,011.47 2025-07-01
58571 CPT Laparoscopy W Tot Hysterectuterus <=250 Gram W Tube/Ovary 94 33 $33,197.41 $33,197.41 $5,743.00 $18,972.24 $18,972.24 2025-07-01
58554 CPT Lap,Vag Hyst,Uterus >250gms,salp-ooph 94 33 $33,149.73 $33,149.73 $5,743.00 $18,949.13 $18,949.13 2025-07-01
521 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc 18 9 $92,828.61 $92,828.61 $18,939.05 $33,519.05 $18,939.05 2026-09-01
252 APR_DRG Malfunction, Reaction And Complication Of Gastrointestinal Device Or Procedure 4 2 $35,895.31 $35,895.31 $18,817.00 $18,817.00 $18,817.00 2025-07-01
43659 CPT Lap,Stomach,Other,without Tube 94 33 $32,860.57 $32,860.57 $5,742.00 $18,808.40 $18,808.40 2025-07-01
37233 HCPCS Removal Of Plaque In Artery Of Leg, Each Additional Vessel 20 20 $21,239.00 $16,991.20 $6,244.27 $21,769.98 $18,796.51 2026-09-01
60280 CPT Excis Thyroid Duct Cyst/Sinus 94 33 $32,829.52 $32,829.52 $5,742.00 $18,793.31 $18,793.31 2025-07-01
43772 CPT Lap, Remove Adjust Gast Restrict Device 90 31 $32,770.98 $32,770.98 $5,680.00 $18,733.92 $18,733.92 2025-07-01
24685 CPT Open Tx Ulnar Fracture Prox End 94 33 $32,947.07 $32,947.07 $5,477.00 $18,717.83 $18,717.83 2025-07-01
206 APR_DRG Malfunction, Reaction, Complication Of Cardiac Or Vascular Device Or Procedure 4 2 $33,832.20 $33,832.20 $18,680.00 $18,680.00 $18,680.00 2025-07-01
25575 HCPCS Treatment Of Broken Midpart Of Both Forearm Bones With Placement Of Stabilizing … 22 22 $22,075.00 $17,660.00 20% off $6,490.05 $22,626.88 $18,675.45 2026-09-01
27792 CPT Open Tx Distal Fibular Fracture Lat Malleolus 94 33 $32,684.49 $32,684.49 $5,477.00 $18,590.49 $18,590.49 2025-07-01
42450 CPT Excision Sublingual Gland 94 33 $32,609.50 $32,609.50 $5,532.00 $18,581.60 $18,581.60 2025-07-01
31267 CPT Nasal/Sinus Endoscopy,Rmv Tiss Maxill Sinus 94 33 $34,022.14 $34,022.14 $3,984.00 $18,492.73 $18,492.73 2025-07-01
37216 HCPCS Insertion Of Stent In Neck Artery With Review By Radiologist 20 20 $20,825.00 $16,660.00 20% off $6,122.55 $21,345.63 $18,430.12 2026-09-01
C9781 HCPCS Arthroscopy, Shoulder, Surgical; With Implantation Of Subacromial Spacer (e.g., … 21 21 $21,151.00 $16,920.80 20% off $6,218.39 $21,679.78 $18,401.37 2026-09-01
27070 HCPCS Partial Removal Of Superficial Cyst Or Growth Of Hip, Pubic, Or Head Of Thigh Bo… 21 21 $21,149.00 $16,919.20 $3,580.21 $21,677.73 $18,399.63 2026-09-01
137 APR_DRG Major Respiratory Infections And Inflammations 4 2 $8,523.85 $23,476.89 $18,394.00 $18,394.00 $18,394.00 2025-07-01
22015 HCPCS Drainage Of Abscess Of Deep Tissue Of Lower Spine Or Sacrum 21 21 $21,129.00 $16,903.20 $6,211.93 $21,657.23 $18,382.23 2026-09-01
517 APR_DRG Dilation And Curettage For Non-obstetric Diagnoses 4 2 $42,691.69 $42,691.69 $18,313.00 $18,313.00 $18,313.00 2025-07-01
49585 CPT Repair Umbilical Hern,5+Y/O,Reduc 80 28 $28,428.20 $28,428.20 $9,028.00 $18,301.68 $18,301.68 2025-07-01
27386 CPT Fix Quad/Hamstr Musc Rupt,Second 94 33 $32,051.36 $32,051.36 $5,477.00 $18,283.42 $18,283.42 2025-07-01
81529 HCPCS Mrna Gene Analysis Of 31 Genes In Skin Melanoma Tissue Specimen 22 22 $21,579.00 $17,263.20 $132.50 $22,118.48 $18,255.83 2026-09-01
49654 CPT Lap, Incisional Hernia Repair,Reducible 80 28 $26,918.95 $26,918.95 $10,315.00 $18,213.19 $18,213.19 2025-07-01
540 APR_DRG Cesarean Section Without Sterilization 4 2 $27,997.58 $27,997.58 $18,199.03 $18,199.03 $18,199.03 2025-07-01
28740 CPT Fusion Foot Bone,Midtarsal,1 Jt 90 31 $31,838.33 $31,838.33 $5,477.00 $18,180.08 $18,180.08 2025-07-01
28615 CPT Open Treatment Tarsometatarsal Joint Dislocation 90 31 $31,838.33 $31,838.33 $5,477.00 $18,180.08 $18,180.08 2025-07-01
190 APR_DRG Acute Myocardial Infarction 4 2 $19,046.45 $19,046.45 $18,141.00 $18,141.00 $18,141.00 2025-07-01
60220 CPT Thyroid Lobectomy,Unilat 94 33 $31,460.04 $31,460.04 $5,742.00 $18,129.12 $18,129.12 2025-07-01
58572 CPT Laparoscopy Total Hysterectomy Uterus > 250 Gram 94 33 $31,324.68 $31,324.68 $5,743.00 $18,063.97 $18,063.97 2025-07-01
27650 CPT Repair Achilles Tendon,Primary 94 33 $31,535.93 $31,535.93 $5,477.00 $18,033.42 $18,033.42 2025-07-01
417 MS_DRG Laparoscopic Cholecystectomy Without C.d.e. With Mcc 4 4 $46,540.81 $37,232.65 $17,591.68 $26,250.40 $18,031.47 2026-09-01
49593 CPT Rpr Aa Hernia 1st 3-10 Cm Reducible 94 33 $31,275.08 $31,275.08 $5,721.00 $18,028.92 $18,028.92 2025-07-01
541 APR_DRG Vaginal Delivery With Sterilization And/Or D&c 4 2 $28,777.22 $30,752.08 $18,024.00 $18,024.00 $18,024.00 2025-07-01
42 APR_DRG Degenerative Nervous System Disorders Except Multiple Sclerosis 4 2 $18,563.33 $18,563.33 $17,968.00 $17,968.00 $17,968.00 2025-07-01
23405 HCPCS Incision Of Shoulder Tendon 21 21 $20,647.00 $16,517.60 20% off $6,070.22 $21,163.18 $17,962.89 2026-09-01
23462 CPT Repair Shldr Capsu,Ant,Coracoid Xfer 94 33 $31,377.82 $31,377.82 $5,477.00 $17,956.74 $17,956.74 2025-07-01
63650 HCPCS Insertion Of Spinal Neurostimulator Electrode Array Through Skin 22 22 $21,187.00 $16,949.60 20% off $6,228.98 $21,716.68 $17,924.20 2026-09-01
547 APR_DRG Antepartum With O.r. Procedure 4 2 $14,274.66 $14,274.66 $17,902.00 $17,902.00 $17,902.00 2025-07-01
539 APR_DRG Cesarean Section With Sterilization 4 2 $26,660.96 $28,290.29 $17,898.00 $17,898.00 $17,898.00 2025-07-01
58545 CPT Lap,Myomectomy 1-4,tot Wt 250 Gms 94 33 $30,981.99 $30,981.99 $5,742.00 $17,897.28 $17,897.28 2025-07-01
28210 HCPCS Repair Of Tendon On Top Side Of Foot With Graft 22 22 $21,151.00 $16,920.80 20% off $6,218.39 $21,679.78 $17,893.74 2026-09-01
38525 CPT Bx/Remv,Lymph Node,Deep Axill 94 33 $31,297.61 $31,297.61 $5,303.00 $17,830.85 $17,830.85 2025-07-01
29828 HCPCS Release Of Tendon Connecting Biceps Muscle And Shoulder Using An Endoscope 22 22 $21,063.00 $16,850.40 $5,806.53 $21,589.58 $17,819.30 2026-09-01
813 APR_DRG Other Complications Of Treatment 4 2 $27,511.90 $27,511.90 $17,800.00 $17,800.00 $17,800.00 2025-07-01
27687 CPT Gastrocnemius Recession 94 33 $30,971.76 $30,971.76 $5,476.00 $17,759.31 $17,759.31 2025-07-01
619 MS_DRG O.r. Procedures For Obesity With McC 14 5 $86,936.63 $86,936.63 $17,716.17 $31,354.75 $17,716.17 2025-07-01
47379 CPT Unlisted Laparoscopic Proc, Liver 90 31 $30,531.26 $30,531.26 $5,742.00 $17,678.67 $17,678.67 2025-07-01
29856 CPT Tibial Scope/Surg/Fx Aid,Bicondylar 94 33 $30,778.18 $30,778.18 $5,478.00 $17,666.42 $17,666.42 2025-07-01
64555 HCPCS Insertion Of Peripheral Nerve Neurostimulator Electrode Through Skin 22 22 $20,815.00 $16,652.00 20% off $6,119.61 $21,335.38 $17,609.49 2026-09-01
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