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Hospital

MOBRIDGE REGIONAL HOSPITAL - CAH

Mobridge, SD · CCN 431325 · Rates published

4,924 distinct procedures filed
15 distinct payers
132,500 rate rows
2026-05-12 last MRF observed
Data quality

132,346 of 132,500 rate rows are consumer-grade (99.9%)

154 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 90
percent-of-charges filed in the dollar field — excluded from medians 64
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://apps.para-hcfs.com/PTT/FinalLinks/Reports.aspx?dbName=dbMRHMOBRIDGESD&type=CDMWithoutLabel&fileType=CSV
Found on page https://apps.para-hcfs.com/PTT/FinalLinks/Mobridge_Regional.aspx
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-05-19
Content fingerprint 109c934202418b49… · 29,236,287 bytes · first seen 2026-05-17

Top 50 most expensive offerings

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

Code Description Payers Min $ Max $ Avg median vs national
J3245
HCPCS 		Injection, Tildrakizumab, 1 Mg 9 $14,977.68 $38,232.49 $30,743.65 nat. median
$256
outlier · 120.1×
J2507
HCPCS 		Injection, Pegloticase, 1 Mg 9 $12,773.70 $32,606.55 $26,219.70 nat. median
$8,536
outlier · 3.1×
J2997
HCPCS 		Injection, Alteplase Recombinant, 1 Mg 9 $8,031.63 $20,501.78 $16,485.97 nat. median
$545
outlier · 30.2×
J3380
HCPCS 		Injection, Vedolizumab, Intravenous, 1 Mg 9 $7,909.62 $20,190.35 $16,235.54 nat. median
$280
outlier · 57.9×
C1785
HCPCS 		Pacemaker, Dual Chamber, Rate-responsive (implantable) 9 $6,874.96 $17,549.24 $14,111.76 nat. median
$6,506
outlier · 2.2×
C1786
HCPCS 		Pacemaker, Single Chamber, Rate-responsive (implantable) 9 $6,874.96 $17,549.24 $14,111.76 nat. median
$7,726
1.8× median
49605
HCPCS 		Repair Of Large Defect Of Abdominal Wall At Navel 9 $6,165.50 $15,738.25 $12,655.50 nat. median
$4,895
outlier · 2.6×
J9271
HCPCS 		Injection, Pembrolizumab, 1 Mg 9 $5,074.16 $12,952.46 $10,415.38 nat. median
$736
outlier · 14.1×
Q5115
HCPCS 		Injection, Rituximab-abbs, Biosimilar, (truxima), 10 Mg 9 $3,861.41 $9,856.75 $7,926.05 nat. median
$884
outlier · 9.0×
Q5111
HCPCS 		Injection, Pegfilgrastim-cbqv (udenyca), Biosimilar, 0.5 Mg 9 $3,813.30 $9,733.95 $7,827.30 nat. median
$2,102
outlier · 3.7×
J3101
HCPCS 		Injection, Tenecteplase, 1 Mg 9 $2,930.16 $19,330.57 $7,572.80 nat. median
$5,957
1.3× median
C1726
HCPCS 		Catheter, Balloon Dilatation, Non-vascular 9 $3,668.90 $9,365.35 $7,530.90 nat. median
$554
outlier · 13.6×
J2506
HCPCS 		Injection, Pegfilgrastim, Excludes Biosimilar, 0.5 Mg 9 $3,517.63 $11,691.41 $7,400.90 nat. median
$2,076
outlier · 3.6×
C9363
HCPCS 		Skin Substitute, Integra Meshed Bilayer Wound Matrix, Per Square Centimeter 9 $3,464.84 $8,844.46 $7,112.04 nat. median
$944
outlier · 7.5×
J9299
HCPCS 		Injection, Nivolumab, 1 Mg 9 $2,849.97 $17,439.49 $7,002.77 nat. median
$2,944
outlier · 2.4×
27939262
CDM 		Amnio Graft 10.0x5.0 9 $3,282.82 $8,379.83 $6,738.42 nat. median
$6,738
1.0× median
J1437
HCPCS 		Injection, Ferric Derisomaltose, 10 Mg 9 $3,208.38 $8,189.81 $6,585.62 nat. median
$42
outlier · 158.5×
20816
HCPCS 		Reattachment Of Cutoff Finger 9 $3,140.32 $8,016.08 $6,445.92 nat. median
$3,796
1.7× median
J2182
HCPCS 		Injection, Mepolizumab, 1 Mg 9 $3,117.21 $7,957.08 $6,398.48 nat. median
$3,087
outlier · 2.1×
27813206
CDM 		Trilliant Sterile SUPPLY(modify Per Patient) 9 $3,104.22 $7,923.93 $6,371.82 nat. median
$3,104
outlier · 2.1×
J1306
HCPCS 		Injection, Inclisiran, 1 Mg 9 $3,082.25 $7,867.84 $6,326.72 nat. median
$57
outlier · 111.9×
37618
HCPCS 		Tying Of Major Arm Or Leg Artery 9 $2,950.70 $7,532.05 $6,056.70 nat. median
$2,550
outlier · 2.4×
J0840
HCPCS 		Injection, Crotalidae Polyvalent Immune Fab (ovine), Up To 1 Gram 9 $2,922.28 $7,459.49 $5,998.36 nat. median
$3,427
1.8× median
27086860
CDM 		Miacalcin 400 Unit/2 Ml Vial 9 $2,862.18 $7,306.08 $5,874.99 nat. median
$5,875
1.0× median
28431647
CDM 		Calcitonin-salmon 400 Unit/2ml 9 $2,861.17 $7,303.52 $5,872.93 nat. median
$5,873
1.0× median
2843012
CDM 		Synagis 100 Mg/ml Vial 9 $2,714.96 $6,930.29 $5,572.81 nat. median
$5,573
1.0× median
78452
HCPCS 		Nuclear Medicine Studies Of Heart Muscle At Rest And With Stress And Spect 9 $2,695.72 $6,881.18 $5,533.32 nat. median
$1,767
outlier · 3.1×
45110
HCPCS 		Removal Of Rectum With Creation Of Opening From Large Bowel To Skin Through Abdo… 9 $2,679.00 $6,838.50 $5,499.00 nat. median
$3,275
1.7× median
44204
HCPCS 		Partial Removal Of Large Bowel Using An Endoscope 9 $2,551.70 $6,513.55 $5,237.70 nat. median
$3,787
1.4× median
J1951
HCPCS 		Injection, Leuprolide Acetate For Depot Suspension (fensolvi), 0.25 Mg 9 $2,477.34 $6,323.74 $5,212.19 nat. median
$188
outlier · 27.7×
J0139
HCPCS 		Injection, Adalimumab, 1 Mg 9 $2,531.07 $6,460.89 $5,195.35 nat. median
$3,402
1.5× median
44202
HCPCS 		Partial Removal And Reconnection Of Small Bowel Using An Endoscope 9 $2,521.68 $6,436.92 $5,176.08 nat. median
$3,950
1.3× median
C8911
HCPCS 		Magnetic Resonance Angiography Without Contrast Followed By With Contrast, Chest… 9 $2,451.38 $7,585.40 $5,157.57 nat. median
$932
outlier · 5.5×
44143
HCPCS 		Partial Removal Of Large Bowel With Creation Of Opening From Large Bowel To Skin 9 $2,509.14 $6,404.91 $5,150.34 nat. median
$3,062
1.7× median
43631
HCPCS 		Removal Of Lower Part Of Stomach With Reattachment Of Remaining Stomach To First… 9 $2,486.72 $6,347.68 $5,104.32 nat. median
$2,915
1.8× median
44144
HCPCS 		Partial Removal Of Large Bowel With Creation Of 2 Openings From Small Or Large B… 9 $2,477.98 $6,325.37 $5,086.38 nat. median
$3,063
1.7× median
72159
HCPCS 		MRI Scan Of Blood Vessels Of Spinal Canal 9 $2,451.38 $6,257.47 $5,031.78 nat. median
$1,136
outlier · 4.4×
58152
HCPCS 		Removal Of Uterus And Cervix Through Abdomen With Repair Of Vagina 9 $2,449.48 $6,252.62 $5,027.88 nat. median
$3,342
1.5× median
35207
HCPCS 		Repair Of Blood Vessel Of Hand Or Finger 9 $2,373.48 $6,058.62 $4,871.88 nat. median
$3,496
1.4× median
Q5127
HCPCS 		Injection, Pegfilgrastim-fpgk (stimufend), Biosimilar, 0.5 Mg 9 $2,358.80 $6,021.14 $4,841.74 nat. median
$418
outlier · 11.6×
74178
HCPCS 		CT Scan Of Abdomen And Pelvis Before And After Contrast 9 $2,328.26 $5,943.19 $4,779.06 nat. median
$979
outlier · 4.9×
44207
HCPCS 		Partial Removal Of Large Bowel And Reattachment To Rectum Using An Endoscope 9 $2,328.26 $5,943.19 $4,779.06 nat. median
$4,027
1.2× median
58200
HCPCS 		Removal Of Uterus Through Abdomen With Partial Removal Of Vagina 9 $2,322.18 $5,927.67 $4,766.58 nat. median
$3,769
1.3× median
C8908
HCPCS 		Magnetic Resonance Imaging Without Contrast Followed By With Contrast, Breast; B… 9 $2,318.76 $5,918.94 $4,759.56 nat. median
$928
outlier · 5.1×
35221
HCPCS 		Repair Of Blood Vessel Of Abdomen 9 $2,260.62 $8,796.93 $4,756.23 nat. median
$3,289
1.4× median
25024
HCPCS 		Incision Of Tissue Of Forearm And/or Wrist Muscle Compartment On Both Sides Of T… 9 $2,316.48 $5,913.12 $4,754.88 nat. median
$3,487
1.4× median
44160
HCPCS 		Partial Removal Of Small And Large Bowel With Attachment Of Small And Large Bowe… 9 $2,304.32 $5,882.08 $4,729.92 nat. median
$3,050
1.6× median
44140
HCPCS 		Partial Removal Of Large Bowel With Connection 9 $2,299.00 $5,868.50 $4,719.00 nat. median
$2,728
1.7× median
43324
HCPCS 		43324 Pf Esoph. Fundoplasty 9 $2,217.30 $5,659.95 $4,551.30 nat. median
$4,474
1.0× median
44141
HCPCS 		Partial Removal Of Large Bowel With Creation Of Opening To Skin 9 $2,199.82 $5,615.33 $4,515.42 nat. median
$3,147
1.4× median

Other procedures at this hospital

Browse this hospital's 4,924 published procedures. Use the slice to choose what to show, then sort or filter any column.

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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
             
J3245 HCPCS Injection, Tildrakizumab, 1 Mg 18 9 $39,414.94 $39,414.94 $14,977.68 $38,232.49 $30,743.65 2026-05-12
J2507 HCPCS Injection, Pegloticase, 1 Mg 18 9 $33,615.00 $33,615.00 $12,773.70 $32,606.55 $26,219.70 2026-05-12
J2997 HCPCS Injection, Alteplase Recombinant, 1 Mg 18 9 $21,135.86 $21,135.86 $8,031.63 $20,501.78 $16,485.97 2026-05-12
J3380 HCPCS Injection, Vedolizumab, Intravenous, 1 Mg 18 9 $20,814.79 $20,814.79 $7,909.62 $20,190.35 $16,235.54 2026-05-12
C1786 HCPCS Pacemaker, Single Chamber, Rate-responsive (implantable) 18 9 $18,092.00 $18,092.00 $6,874.96 $17,549.24 $14,111.76 2026-05-12
C1785 HCPCS Pacemaker, Dual Chamber, Rate-responsive (implantable) 18 9 $18,092.00 $18,092.00 $6,874.96 $17,549.24 $14,111.76 2026-05-12
49605 HCPCS Repair Of Large Defect Of Abdominal Wall At Navel 18 9 $16,225.00 $16,225.00 $6,165.50 $15,738.25 $12,655.50 2026-05-12
J9271 HCPCS Injection, Pembrolizumab, 1 Mg 18 9 $13,353.05 $13,353.05 $5,074.16 $12,952.46 $10,415.38 2026-05-12
Q5115 HCPCS Injection, Rituximab-abbs, Biosimilar, (truxima), 10 Mg 18 9 $10,161.60 $10,161.60 $3,861.41 $9,856.75 $7,926.05 2026-05-12
Q5111 HCPCS Injection, Pegfilgrastim-cbqv (udenyca), Biosimilar, 0.5 Mg 18 9 $10,035.00 $10,035.00 $3,813.30 $9,733.95 $7,827.30 2026-05-12
J3101 HCPCS Injection, Tenecteplase, 1 Mg 54 9 $16,157.78 $16,157.78 $2,930.16 $19,330.57 $7,572.80 2026-05-12
C1726 HCPCS Catheter, Balloon Dilatation, Non-vascular 18 9 $9,655.00 $9,655.00 $3,668.90 $9,365.35 $7,530.90 2026-05-12
J2506 HCPCS Injection, Pegfilgrastim, Excludes Biosimilar, 0.5 Mg 36 9 $10,654.95 $10,654.95 $3,517.63 $11,691.41 $7,400.90 2026-05-12
C9363 HCPCS Skin Substitute, Integra Meshed Bilayer Wound Matrix, Per Square Centimeter 18 9 $9,118.00 $9,118.00 $3,464.84 $8,844.46 $7,112.04 2026-05-12
J9299 HCPCS Injection, Nivolumab, 1 Mg 36 9 $12,739.40 $12,739.40 $2,849.97 $17,439.49 $7,002.77 2026-05-12
27939262 CDM Amnio Graft 10.0x5.0 18 9 $8,639.00 $8,639.00 $3,282.82 $8,379.83 $6,738.42 2026-05-12
J1437 HCPCS Injection, Ferric Derisomaltose, 10 Mg 18 9 $8,443.10 $8,443.10 $3,208.38 $8,189.81 $6,585.62 2026-05-12
20816 HCPCS Reattachment Of Cutoff Finger 18 9 $8,264.00 $8,264.00 $3,140.32 $8,016.08 $6,445.92 2026-05-12
J2182 HCPCS Injection, Mepolizumab, 1 Mg 18 9 $8,203.18 $8,203.18 $3,117.21 $7,957.08 $6,398.48 2026-05-12
27813206 CDM Trilliant Sterile SUPPLY(modify Per Patient) 18 9 $8,169.00 $8,169.00 $3,104.22 $7,923.93 $6,371.82 2026-05-12
J1306 HCPCS Injection, Inclisiran, 1 Mg 18 9 $8,111.18 $8,111.18 $3,082.25 $7,867.84 $6,326.72 2026-05-12
37618 HCPCS Tying Of Major Arm Or Leg Artery 18 9 $7,765.00 $7,765.00 $2,950.70 $7,532.05 $6,056.70 2026-05-12
J0840 HCPCS Injection, Crotalidae Polyvalent Immune Fab (ovine), Up To 1 Gram 18 9 $7,690.20 $7,690.20 $2,922.28 $7,459.49 $5,998.36 2026-05-12
27086860 CDM Miacalcin 400 Unit/2 Ml Vial 18 9 $7,532.04 $7,532.04 $2,862.18 $7,306.08 $5,874.99 2026-05-12
28431647 CDM Calcitonin-salmon 400 Unit/2ml 18 9 $7,529.40 $7,529.40 $2,861.17 $7,303.52 $5,872.93 2026-05-12
2843012 CDM Synagis 100 Mg/ml Vial 18 9 $7,144.63 $7,144.63 $2,714.96 $6,930.29 $5,572.81 2026-05-12
78452 HCPCS Nuclear Medicine Studies Of Heart Muscle At Rest And With Stress And Spect 18 9 $7,094.00 $7,094.00 $2,695.72 $6,881.18 $5,533.32 2026-05-12
45110 HCPCS Removal Of Rectum With Creation Of Opening From Large Bowel To Skin Through Abdo… 18 9 $7,050.00 $7,050.00 $2,679.00 $6,838.50 $5,499.00 2026-05-12
44204 HCPCS Partial Removal Of Large Bowel Using An Endoscope 18 9 $6,715.00 $6,715.00 $2,551.70 $6,513.55 $5,237.70 2026-05-12
J1951 HCPCS Injection, Leuprolide Acetate For Depot Suspension (fensolvi), 0.25 Mg 32 9 $6,519.32 $6,519.32 $2,477.34 $6,323.74 $5,212.19 2026-05-12
J0139 HCPCS Injection, Adalimumab, 1 Mg 18 9 $6,660.71 $6,660.71 $2,531.07 $6,460.89 $5,195.35 2026-05-12
44202 HCPCS Partial Removal And Reconnection Of Small Bowel Using An Endoscope 18 9 $6,636.00 $6,636.00 $2,521.68 $6,436.92 $5,176.08 2026-05-12
C8911 HCPCS Magnetic Resonance Angiography Without Contrast Followed By With Contrast, Chest… 36 9 $7,135.50 $7,135.50 $2,451.38 $7,585.40 $5,157.57 2026-05-12
44143 HCPCS Partial Removal Of Large Bowel With Creation Of Opening From Large Bowel To Skin 18 9 $6,603.00 $6,603.00 $2,509.14 $6,404.91 $5,150.34 2026-05-12
43631 HCPCS Removal Of Lower Part Of Stomach With Reattachment Of Remaining Stomach To First… 18 9 $6,544.00 $6,544.00 $2,486.72 $6,347.68 $5,104.32 2026-05-12
44144 HCPCS Partial Removal Of Large Bowel With Creation Of 2 Openings From Small Or Large B… 18 9 $6,521.00 $6,521.00 $2,477.98 $6,325.37 $5,086.38 2026-05-12
72159 HCPCS MRI Scan Of Blood Vessels Of Spinal Canal 18 9 $6,451.00 $6,451.00 $2,451.38 $6,257.47 $5,031.78 2026-05-12
58152 HCPCS Removal Of Uterus And Cervix Through Abdomen With Repair Of Vagina 18 9 $6,446.00 $6,446.00 $2,449.48 $6,252.62 $5,027.88 2026-05-12
35207 HCPCS Repair Of Blood Vessel Of Hand Or Finger 18 9 $6,246.00 $6,246.00 $2,373.48 $6,058.62 $4,871.88 2026-05-12
Q5127 HCPCS Injection, Pegfilgrastim-fpgk (stimufend), Biosimilar, 0.5 Mg 18 9 $6,207.36 $6,207.36 $2,358.80 $6,021.14 $4,841.74 2026-05-12
44207 HCPCS Partial Removal Of Large Bowel And Reattachment To Rectum Using An Endoscope 18 9 $6,127.00 $6,127.00 $2,328.26 $5,943.19 $4,779.06 2026-05-12
74178 HCPCS CT Scan Of Abdomen And Pelvis Before And After Contrast 18 9 $6,127.00 $6,127.00 $2,328.26 $5,943.19 $4,779.06 2026-05-12
58200 HCPCS Removal Of Uterus Through Abdomen With Partial Removal Of Vagina 18 9 $6,111.00 $6,111.00 $2,322.18 $5,927.67 $4,766.58 2026-05-12
C8908 HCPCS Magnetic Resonance Imaging Without Contrast Followed By With Contrast, Breast; B… 18 9 $6,102.00 $6,102.00 $2,318.76 $5,918.94 $4,759.56 2026-05-12
35221 HCPCS Repair Of Blood Vessel Of Abdomen 36 9 $7,509.00 $7,509.00 $2,260.62 $8,796.93 $4,756.23 2026-05-12
25024 HCPCS Incision Of Tissue Of Forearm And/or Wrist Muscle Compartment On Both Sides Of T… 18 9 $6,096.00 $6,096.00 $2,316.48 $5,913.12 $4,754.88 2026-05-12
44160 HCPCS Partial Removal Of Small And Large Bowel With Attachment Of Small And Large Bowe… 18 9 $6,064.00 $6,064.00 $2,304.32 $5,882.08 $4,729.92 2026-05-12
44140 HCPCS Partial Removal Of Large Bowel With Connection 18 9 $6,050.00 $6,050.00 $2,299.00 $5,868.50 $4,719.00 2026-05-12
43324 HCPCS 43324 Pf Esoph. Fundoplasty 18 9 $5,835.00 $5,835.00 $2,217.30 $5,659.95 $4,551.30 2026-05-12
44141 HCPCS Partial Removal Of Large Bowel With Creation Of Opening To Skin 18 9 $5,789.00 $5,789.00 $2,199.82 $5,615.33 $4,515.42 2026-05-12
38724 HCPCS Removal Of Lymph Nodes, Muscle, And Tissue Of Neck 18 9 $5,733.00 $5,733.00 $2,178.54 $5,561.01 $4,471.74 2026-05-12
J1599 HCPCS Injection, Immune Globulin, Intravenous, Non-lyophilized (e.g., Liquid), Not Oth… 18 9 $5,727.00 $5,727.00 $2,176.26 $5,555.19 $4,467.06 2026-05-12
J1944 HCPCS Injection, Aripiprazole Lauroxil, (aristada), 1 Mg 36 9 $6,504.67 $6,504.67 $2,120.40 $7,206.46 $4,461.21 2026-05-12
44603 HCPCS Suture Of Multiple Tears Or Holes In Small Bowel 18 9 $5,674.00 $5,674.00 $2,156.12 $5,503.78 $4,425.72 2026-05-12
Q5122 HCPCS Injection, Pegfilgrastim-apgf (nyvepria), Biosimilar, 0.5 Mg 18 9 $5,667.00 $5,667.00 $2,153.46 $5,496.99 $4,420.26 2026-05-12
42420 HCPCS Removal Of Growth Of Saliva Gland Or Saliva Gland With Release Of Facial Nerve 18 9 $5,622.00 $5,622.00 $2,136.36 $5,453.34 $4,385.16 2026-05-12
58150 HCPCS Removal Of Uterus And Cervix Through Abdomen 18 9 $5,598.00 $5,598.00 $2,127.24 $5,430.06 $4,366.44 2026-05-12
43860 HCPCS Revision Of Surgically Created Connection Of Stomach To Small Bowel 18 9 $5,488.00 $5,488.00 $2,085.44 $5,323.36 $4,280.64 2026-05-12
70549 HCPCS MRI Scan Of Blood Vessels Of Neck Before And After Contrast 18 9 $5,484.00 $5,484.00 $2,083.92 $5,319.48 $4,277.52 2026-05-12
70546 HCPCS MRI Scan Of Blood Vessels Of Head Before And After Contrast 18 9 $5,484.00 $5,484.00 $2,083.92 $5,319.48 $4,277.52 2026-05-12
44120 HCPCS Partial Removal Of Small Bowel With Reconnection 18 9 $5,456.00 $5,456.00 $2,073.28 $5,292.32 $4,255.68 2026-05-12
58260 HCPCS Removal Of Uterus Through Vagina, 250.0 G Or Less 18 9 $5,412.00 $5,412.00 $2,056.56 $5,249.64 $4,221.36 2026-05-12
J0401 HCPCS Injection, Aripiprazole (abilify Maintena), 1 Mg 36 9 $6,114.33 $6,114.33 $1,992.34 $6,776.09 $4,191.78 2026-05-12
47563 HCPCS Removal Of Gallbladder With X-ray Study Of Bile Ducts Using An Endoscope 18 9 $5,330.00 $5,330.00 $2,025.40 $5,170.10 $4,157.40 2026-05-12
44205 HCPCS Partial Removal Of Small And Large Bowel With Attachment Of Small And Large Bowe… 18 9 $5,299.00 $5,299.00 $2,013.62 $5,140.03 $4,133.22 2026-05-12
70336 HCPCS MRI Scan Of Jaw Joint 18 9 $5,274.00 $5,274.00 $2,004.12 $5,115.78 $4,113.72 2026-05-12
44005 HCPCS Release Of Intestinal Scar Tissue 18 9 $5,220.00 $5,220.00 $1,983.60 $5,063.40 $4,071.60 2026-05-12
C8909 HCPCS Magnetic Resonance Angiography With Contrast, Chest (excluding Myocardium) 18 9 $5,217.00 $5,217.00 $1,982.46 $5,060.49 $4,069.26 2026-05-12
44625 HCPCS Closure Of Surgically Created Large Or Small Bowel Opening With Bowel Removal An… 18 9 $5,211.00 $5,211.00 $1,980.18 $5,054.67 $4,064.58 2026-05-12
Q5108 HCPCS Injection, Pegfilgrastim-jmdb (fulphila), Biosimilar, 0.5 Mg 36 9 $7,530.00 $7,530.00 $1,909.50 $9,733.95 $4,059.72 2026-05-12
27045 HCPCS Removal Of Growth Of Muscle Of Pelvis And Hip, 5.0 Cm Or More 18 9 $5,181.00 $5,181.00 $1,968.78 $5,025.57 $4,041.18 2026-05-12
19303 HCPCS Simple Complete Removal Of Breast 18 9 $5,168.00 $5,168.00 $1,963.84 $5,012.96 $4,031.04 2026-05-12
2976532 CDM Assisted Living Double Charge 18 9 $5,164.00 $5,164.00 $1,962.32 $5,009.08 $4,027.92 2026-05-12
70543 HCPCS MRI Scan Of Bone Of Eye Socket, Face, And/or Neck Before And After Contrast 18 9 $5,160.00 $5,160.00 $1,960.80 $5,005.20 $4,024.80 2026-05-12
C8902 HCPCS Magnetic Resonance Angiography Without Contrast Followed By With Contrast, Abdom… 18 9 $5,160.00 $5,160.00 $1,960.80 $5,005.20 $4,024.80 2026-05-12
70553 HCPCS MRI Scan Of Brain Before And After Contrast 18 9 $5,160.00 $5,160.00 $1,960.80 $5,005.20 $4,024.80 2026-05-12
73225 HCPCS MRI Scan Of Blood Vessels Of Arm 18 9 $5,160.00 $5,160.00 $1,960.80 $5,005.20 $4,024.80 2026-05-12
C8914 HCPCS Magnetic Resonance Angiography Without Contrast Followed By With Contrast, Lower… 18 9 $5,160.00 $5,160.00 $1,960.80 $5,005.20 $4,024.80 2026-05-12
72198 HCPCS MRI Scan Of Blood Vessels Of Pelvis 18 9 $5,160.00 $5,160.00 $1,960.80 $5,005.20 $4,024.80 2026-05-12
70545 HCPCS MRI Scan Of Blood Vessels Of Head With Contrast 18 9 $5,160.00 $5,160.00 $1,960.80 $5,005.20 $4,024.80 2026-05-12
78451 HCPCS Nuclear Medicine Study Of Heart Muscle At Rest And With Stress And Spect 18 9 $5,160.00 $5,160.00 $1,960.80 $5,005.20 $4,024.80 2026-05-12
45550 HCPCS Suture Of Rectum To Sacrum With Removal Of Large Bowel 18 9 $5,129.00 $5,129.00 $1,949.02 $4,975.13 $4,000.62 2026-05-12
47610 HCPCS Removal Of Gallbladder With Exploration Of Common Bile Duct 18 9 $5,124.00 $5,124.00 $1,947.12 $4,970.28 $3,996.72 2026-05-12
C8910 HCPCS Magnetic Resonance Angiography Without Contrast, Chest (excluding Myocardium) 18 9 $5,081.00 $5,081.00 $1,930.78 $4,928.57 $3,963.18 2026-05-12
47605 HCPCS Removal Of Gallbladder With X-ray Study Of Bile Ducts 18 9 $4,960.00 $4,960.00 $1,884.80 $4,811.20 $3,868.80 2026-05-12
27939261 CDM Amnio Graft 5.0x5.0 18 9 $4,940.00 $4,940.00 $1,877.20 $4,791.80 $3,853.20 2026-05-12
J9217 HCPCS Leuprolide Acetate (for Depot Suspension), 7.5 Mg 90 9 $4,920.84 $4,920.84 $95.00 $19,049.16 $3,838.26 2026-05-12
70552 HCPCS MRI Scan Of Brain With Contrast 18 9 $4,838.00 $4,838.00 $1,838.44 $4,692.86 $3,773.64 2026-05-12
75635 HCPCS CT Scan Of Abdominal Aorta And Both Leg Arteries With Contrast 18 9 $4,838.00 $4,838.00 $1,838.44 $4,692.86 $3,773.64 2026-05-12
70547 HCPCS MRI Scan Of Blood Vessels Of Neck Without Contrast 18 9 $4,838.00 $4,838.00 $1,838.44 $4,692.86 $3,773.64 2026-05-12
70544 HCPCS MRI Scan Of Blood Vessels Of Head Without Contrast 18 9 $4,838.00 $4,838.00 $1,838.44 $4,692.86 $3,773.64 2026-05-12
70542 HCPCS MRI Scan Of Bone Of Eye Socket, Face, And/or Neck With Contrast 18 9 $4,838.00 $4,838.00 $1,838.44 $4,692.86 $3,773.64 2026-05-12
74183 HCPCS MRI Scan Of Abdomen Before And After Contrast 18 9 $4,838.00 $4,838.00 $1,838.44 $4,692.86 $3,773.64 2026-05-12
J1602 HCPCS Injection, Golimumab, 1 Mg, For Intravenous Use 18 9 $4,806.06 $4,806.06 $1,826.30 $4,661.88 $3,748.73 2026-05-12
81229 HCPCS Genome-wide Microarray Analysis For Copy Number And Single Nucleotide Polymorphi… 18 9 $4,766.00 $4,766.00 $1,811.08 $4,623.02 $3,717.48 2026-05-12
81408 HCPCS Molecular Pathology Procedure Level 9 Genetic Analysis 18 9 $4,755.00 $4,755.00 $1,806.90 $4,612.35 $3,708.90 2026-05-12
74174 HCPCS CT Scan Of Blood Vessels Of Abdomen And Pelvis With Contrast 36 9 $4,722.50 $4,722.50 $1,750.66 $4,692.86 $3,683.30 2026-05-12
2867783 CDM Zzzopt-ease Vena Cava Filter 18 9 $4,701.00 $4,701.00 $1,786.38 $4,559.97 $3,666.78 2026-05-12
19307 HCPCS Removal Of Breast And Underarm Lymph Nodes 18 9 $4,701.00 $4,701.00 $1,786.38 $4,559.97 $3,666.78 2026-05-12
49020 HCPCS Drainage Of Abdominal Abscess Or Infection 18 9 $4,653.00 $4,653.00 $1,768.14 $4,513.41 $3,629.34 2026-05-12
43640 HCPCS Severing Of Vagus Nerve To Stomach 18 9 $4,630.00 $4,630.00 $1,759.40 $4,491.10 $3,611.40 2026-05-12
70540 HCPCS MRI Scan Of Bone Of Eye Socket, Face, And/or Neck Without Contrast 18 9 $4,515.00 $4,515.00 $1,715.70 $4,379.55 $3,521.70 2026-05-12
73723 HCPCS MRI Scan Of Leg Joint Before And After Contrast 18 9 $4,515.00 $4,515.00 $1,715.70 $4,379.55 $3,521.70 2026-05-12
71552 HCPCS MRI Scan Of Chest Before And After Contrast 18 9 $4,515.00 $4,515.00 $1,715.70 $4,379.55 $3,521.70 2026-05-12
73223 HCPCS MRI Scan Of Arm Joint Before And After Contrast 18 9 $4,515.00 $4,515.00 $1,715.70 $4,379.55 $3,521.70 2026-05-12
73220 HCPCS MRI Scan Of Arm Before And After Contrast 18 9 $4,515.00 $4,515.00 $1,715.70 $4,379.55 $3,521.70 2026-05-12
72156 HCPCS MRI Scan Of Upper Spinal Canal Before And After Contrast 18 9 $4,515.00 $4,515.00 $1,715.70 $4,379.55 $3,521.70 2026-05-12
72157 HCPCS MRI Scan Of Middle Spinal Canal Before And After Contrast 18 9 $4,515.00 $4,515.00 $1,715.70 $4,379.55 $3,521.70 2026-05-12
72158 HCPCS MRI Scan Of Lower Spinal Canal Before And After Contrast 18 9 $4,515.00 $4,515.00 $1,715.70 $4,379.55 $3,521.70 2026-05-12
73720 HCPCS MRI Scan Of Leg Before And After Contrast 18 9 $4,515.00 $4,515.00 $1,715.70 $4,379.55 $3,521.70 2026-05-12
72197 HCPCS MRI Scan Of Pelvis Before And After Contrast 18 9 $4,515.00 $4,515.00 $1,715.70 $4,379.55 $3,521.70 2026-05-12
74182 HCPCS MRI Scan Of Abdomen With Contrast 18 9 $4,515.00 $4,515.00 $1,715.70 $4,379.55 $3,521.70 2026-05-12
70551 HCPCS MRI Scan Of Brain Without Contrast 18 9 $4,515.00 $4,515.00 $1,715.70 $4,379.55 $3,521.70 2026-05-12
35206 HCPCS Repair Of Blood Vessel Of Arm 18 9 $4,514.00 $4,514.00 $1,715.32 $4,378.58 $3,520.92 2026-05-12
27592 HCPCS Amputation Of Thigh Through Thigh Bone Leaving Wound 18 9 $4,505.00 $4,505.00 $1,711.90 $4,369.85 $3,513.90 2026-05-12
60220 HCPCS Removal Of Thyroid Lobe On Side Of Neck 18 9 $4,458.00 $4,458.00 $1,694.04 $4,324.26 $3,477.24 2026-05-12
15120 HCPCS Partial Thickness Self Skin Graft To Face, Scalp, Eyelids, Mouth, Neck, Ears, Ar… 36 9 $6,938.00 $6,938.00 $1,082.24 $10,697.16 $3,476.60 2026-05-12
43502 HCPCS Suture Of Lacerated Stomach 18 9 $4,385.00 $4,385.00 $1,666.30 $4,253.45 $3,420.30 2026-05-12
58960 HCPCS Exam Of Abdominal Cavity With Removal Or Biopsy Of Abdominal Lining Or Lymph Nod… 18 9 $4,372.00 $4,372.00 $1,661.36 $4,240.84 $3,410.16 2026-05-12
47600 HCPCS Removal Of Gallbladder 18 9 $4,362.00 $4,362.00 $1,657.56 $4,231.14 $3,402.36 2026-05-12
2841931 CDM 00078-0149-23 - Calcitonin 200 Intl units/mL Inj Sol 1ml[mrhc] 18 9 $4,351.55 $4,351.55 $1,653.59 $4,221.00 $3,394.21 2026-05-12
J0875 HCPCS Injection, Dalbavancin, 5 Mg 18 9 $4,284.91 $4,284.91 $1,628.27 $4,156.36 $3,342.23 2026-05-12
49659 HCPCS Other Repair Of Hernia Using An Endoscope 18 9 $4,262.00 $4,262.00 $1,619.56 $4,134.14 $3,324.36 2026-05-12
J0202 HCPCS Injection, Alemtuzumab, 1 Mg 18 9 $4,251.00 $4,251.00 $1,615.38 $4,123.47 $3,315.78 2026-05-12
44310 HCPCS Creation Of Opening From Small Bowel To Skin 18 9 $4,225.00 $4,225.00 $1,605.50 $4,098.25 $3,295.50 2026-05-12
66984 HCPCS Removal Of Cataract With Insertion Of Prosthetic Lens 18 9 $4,204.00 $4,204.00 $1,597.52 $4,077.88 $3,279.12 2026-05-12
72147 HCPCS MRI Scan Of Middle Spinal Canal With Contrast 18 9 $4,195.00 $4,195.00 $1,594.10 $4,069.15 $3,272.10 2026-05-12
72149 HCPCS MRI Scan Of Lower Spinal Canal With Contrast 18 9 $4,195.00 $4,195.00 $1,594.10 $4,069.15 $3,272.10 2026-05-12
74175 HCPCS CT Scan Of Blood Vessels Of Abdomen With Contrast 18 9 $4,195.00 $4,195.00 $1,594.10 $4,069.15 $3,272.10 2026-05-12
74181 HCPCS MRI Scan Of Abdomen Without Contrast 18 9 $4,195.00 $4,195.00 $1,594.10 $4,069.15 $3,272.10 2026-05-12
72196 HCPCS MRI Scan Of Pelvis With Contrast 18 9 $4,195.00 $4,195.00 $1,594.10 $4,069.15 $3,272.10 2026-05-12
73722 HCPCS MRI Scan Of Leg Joint With Contrast 18 9 $4,195.00 $4,195.00 $1,594.10 $4,069.15 $3,272.10 2026-05-12
72142 HCPCS MRI Scan Of Upper Spinal Canal With Contrast 18 9 $4,195.00 $4,195.00 $1,594.10 $4,069.15 $3,272.10 2026-05-12
73719 HCPCS MRI Scan Of Leg With Contrast 18 9 $4,195.00 $4,195.00 $1,594.10 $4,069.15 $3,272.10 2026-05-12
73219 HCPCS MRI Scan Of Arm With Contrast 18 9 $4,195.00 $4,195.00 $1,594.10 $4,069.15 $3,272.10 2026-05-12
73222 HCPCS MRI Scan Of Arm Joint With Contrast 18 9 $4,195.00 $4,195.00 $1,594.10 $4,069.15 $3,272.10 2026-05-12
C8905 HCPCS Magnetic Resonance Imaging Without Contrast Followed By With Contrast, Breast; U… 18 9 $4,167.00 $4,167.00 $1,583.46 $4,041.99 $3,250.26 2026-05-12
71551 HCPCS MRI Scan Of Chest With Contrast 18 9 $4,133.00 $4,133.00 $1,570.54 $4,009.01 $3,223.74 2026-05-12
J1950 HCPCS Injection, Leuprolide Acetate (for Depot Suspension), Per 3.75 Mg 54 9 $4,131.82 $4,131.82 $588.62 $11,994.60 $3,222.82 2026-05-12
59515 HCPCS Cesarean Delivery With Care After Delivery 18 9 $4,112.00 $4,112.00 $1,562.56 $3,988.64 $3,207.36 2026-05-12
51840 HCPCS Simple Suture Of Bladder Neck To Vaginal Wall And Pubic Bone With Urethra Suspen… 18 9 $4,112.00 $4,112.00 $1,562.56 $3,988.64 $3,207.36 2026-05-12
49606 HCPCS Repair Of Defect Of Abdominal Wall At Navel With Removal Of Prosthesis 18 9 $4,110.00 $4,110.00 $1,561.80 $3,986.70 $3,205.80 2026-05-12
27880 HCPCS Amputation Of Both Lower Leg Bones 18 9 $4,106.00 $4,106.00 $1,560.28 $3,982.82 $3,202.68 2026-05-12
J2315 HCPCS Injection, Naltrexone, Depot Form, 1 Mg 18 9 $4,071.82 $4,071.82 $1,547.29 $3,949.67 $3,176.02 2026-05-12
C8906 HCPCS Magnetic Resonance Imaging With Contrast, Breast; Bilateral 18 9 $4,070.00 $4,070.00 $1,546.60 $3,947.90 $3,174.60 2026-05-12
43840 HCPCS Suture Of Perforated Ulcer, Wound, Or Injury Of Stomach Or Upper Small Bowel 18 9 $4,025.00 $4,025.00 $1,529.50 $3,904.25 $3,139.50 2026-05-12
C8900 HCPCS Magnetic Resonance Angiography With Contrast, Abdomen 18 9 $3,998.00 $3,998.00 $1,519.24 $3,878.06 $3,118.44 2026-05-12
44602 HCPCS Suture Of Tear Of Hole In Small Bowel 18 9 $3,978.00 $3,978.00 $1,511.64 $3,858.66 $3,102.84 2026-05-12
71275 HCPCS CT Scan Of Blood Vessels Of Chest With Contrast 36 9 $4,239.50 $4,239.50 $1,471.36 $4,468.79 $3,095.66 2026-05-12
77047 HCPCS MRI Scan Of Both Breasts Without Contrast 18 9 $3,935.00 $3,935.00 $1,495.30 $3,816.95 $3,069.30 2026-05-12
58720 HCPCS Removal Of Uterine Tubes And Ovaries 18 9 $3,913.00 $3,913.00 $1,486.94 $3,795.61 $3,052.14 2026-05-12
95811 HCPCS Sleep Study In Sleep Lab With Continuous Airway Pressure (6 Years Or Older) 18 9 $3,894.00 $3,894.00 $1,479.72 $3,777.18 $3,037.32 2026-05-12
0191T HCPCS Insertion Of Anterior Segment Aqueous Drainage Device, Without Extraocular Reser… 18 9 $3,883.00 $3,883.00 $1,475.54 $3,766.51 $3,028.74 2026-05-12
43610 HCPCS Removal Of Stomach Ulcer Or Growth 18 9 $3,877.00 $3,877.00 $1,473.26 $3,760.69 $3,024.06 2026-05-12
28499496 CDM Staple Nitinol 10x10 Fuseforce 18 9 $3,876.00 $3,876.00 $1,472.88 $3,759.72 $3,023.28 2026-05-12
49616 HCPCS Repair Of Recurrent Entrapped Hernia Of Abdomen, 3-10 Cm In Length 18 9 $3,875.00 $3,875.00 $1,472.50 $3,758.75 $3,022.50 2026-05-12
72195 HCPCS MRI Scan Of Pelvis Without Contrast 18 9 $3,872.00 $3,872.00 $1,471.36 $3,755.84 $3,020.16 2026-05-12
70498 HCPCS CT Scan Of Blood Vessels Of Neck With Contrast 18 9 $3,872.00 $3,872.00 $1,471.36 $3,755.84 $3,020.16 2026-05-12
72148 HCPCS MRI Scan Of Lower Spinal Canal Without Contrast 18 9 $3,872.00 $3,872.00 $1,471.36 $3,755.84 $3,020.16 2026-05-12
73718 HCPCS MRI Scan Of Leg Without Contrast 18 9 $3,872.00 $3,872.00 $1,471.36 $3,755.84 $3,020.16 2026-05-12
73218 HCPCS MRI Scan Of Arm Without Contrast 18 9 $3,872.00 $3,872.00 $1,471.36 $3,755.84 $3,020.16 2026-05-12
70496 HCPCS CT Scan Of Blood Vessels Of Head With Contrast 18 9 $3,872.00 $3,872.00 $1,471.36 $3,755.84 $3,020.16 2026-05-12
72146 HCPCS MRI Scan Of Middle Spinal Canal Without Contrast 18 9 $3,872.00 $3,872.00 $1,471.36 $3,755.84 $3,020.16 2026-05-12
73221 HCPCS MRI Scan Of Arm Joint Without Contrast 18 9 $3,872.00 $3,872.00 $1,471.36 $3,755.84 $3,020.16 2026-05-12
71550 HCPCS MRI Scan Of Chest Without Contrast 18 9 $3,872.00 $3,872.00 $1,471.36 $3,755.84 $3,020.16 2026-05-12
59100 HCPCS Incision Of Uterus 18 9 $3,872.00 $3,872.00 $1,471.36 $3,755.84 $3,020.16 2026-05-12
72141 HCPCS MRI Scan Of Upper Spinal Canal Without Contrast 18 9 $3,872.00 $3,872.00 $1,471.36 $3,755.84 $3,020.16 2026-05-12
73721 HCPCS MRI Scan Of Leg Joint Without Contrast 18 9 $3,872.00 $3,872.00 $1,471.36 $3,755.84 $3,020.16 2026-05-12
49010 HCPCS Exploration Behind Abdominal Cavity 18 9 $3,871.00 $3,871.00 $1,470.98 $3,754.87 $3,019.38 2026-05-12
C8901 HCPCS Magnetic Resonance Angiography Without Contrast, Abdomen 18 9 $3,864.00 $3,864.00 $1,468.32 $3,748.08 $3,013.92 2026-05-12
28296333 CDM Broad Straight Plate 6 Holes (t10) 18 9 $3,798.00 $3,798.00 $1,443.24 $3,684.06 $2,962.44 2026-05-12
2843013 CDM Synagis 50 Mg/0.5 Ml Vial 18 9 $3,790.73 $3,790.73 $1,440.48 $3,677.01 $2,956.77 2026-05-12
44346 HCPCS Revision Of Opening From Large Bowel To Skin With Repair Of Hernia 18 9 $3,785.00 $3,785.00 $1,438.30 $3,671.45 $2,952.30 2026-05-12
90378 HCPCS Respiratory Syncytial Virus Antibody For Injection Into Tissue Or Muscle 18 9 $3,756.00 $3,756.00 $1,427.28 $3,643.32 $2,929.68 2026-05-12
49000 HCPCS Exploration Of Abdominal Cavity 36 9 $3,755.50 $3,755.50 $1,423.10 $3,653.02 $2,929.29 2026-05-12
J9355 HCPCS Injection, Trastuzumab, Excludes Biosimilar, 10 Mg 18 9 $3,755.20 $3,755.20 $1,426.98 $3,642.54 $2,929.06 2026-05-12
59514 HCPCS Cesarean Delivery 18 9 $3,716.00 $3,716.00 $1,412.08 $3,604.52 $2,898.48 2026-05-12
59620 HCPCS Cesarean Delivery Following Vaginal Delivery Attempt After Previous Cesarean Del… 18 9 $3,714.00 $3,714.00 $1,411.32 $3,602.58 $2,896.92 2026-05-12
49402 HCPCS Removal Of Foreign Body In Abdominal Cavity 18 9 $3,713.00 $3,713.00 $1,410.94 $3,601.61 $2,896.14 2026-05-12
27725434 CDM Ib Kit, Bc, W/cc Ft And Jumpstart 18 9 $3,700.00 $3,700.00 $1,406.00 $3,589.00 $2,886.00 2026-05-12
59400 HCPCS Vaginal Delivery With Care Before And After Delivery 18 9 $3,675.00 $3,675.00 $1,396.50 $3,564.75 $2,866.50 2026-05-12
27502 HCPCS Closed Treatment Of Broken Thigh Bone At Midportion With Manipulation 18 9 $3,648.00 $3,648.00 $1,386.24 $3,538.56 $2,845.44 2026-05-12
27596 HCPCS Re-amputation Of Thigh Through Thigh Bone 18 9 $3,647.00 $3,647.00 $1,385.86 $3,537.59 $2,844.66 2026-05-12
27590 HCPCS Amputation Of Thigh Through Thigh Bone 18 9 $3,645.00 $3,645.00 $1,385.10 $3,535.65 $2,843.10 2026-05-12
58925 HCPCS Removal Of Cysts Of Ovaries 18 9 $3,636.00 $3,636.00 $1,381.68 $3,526.92 $2,836.08 2026-05-12
44604 HCPCS Suture Of Tear Or Hole In Large Bowel 18 9 $3,629.00 $3,629.00 $1,379.02 $3,520.13 $2,830.62 2026-05-12
58940 HCPCS Removal Of Ovaries 18 9 $3,629.00 $3,629.00 $1,379.02 $3,520.13 $2,830.62 2026-05-12
52224 HCPCS Destruction Of Growth Of Bladder And Urethra Using An Endoscope, Less Than 0.5 C… 18 9 $3,628.00 $3,628.00 $1,378.64 $3,519.16 $2,829.84 2026-05-12
24495 HCPCS Incision Of Tissue Of Forearm Muscle With Exploration Of Artery 18 9 $3,628.00 $3,628.00 $1,378.64 $3,519.16 $2,829.84 2026-05-12
44626 HCPCS Closure Of Surgically Created Large Or Small Bowel Opening With Bowel Removal An… 18 9 $3,627.00 $3,627.00 $1,378.26 $3,518.19 $2,829.06 2026-05-12
49653 HCPCS Laparoscopy, Surgical, Repair, Ventral, Umbilical, Spigelian Or Epigastric Herni… 18 9 $3,612.00 $3,612.00 $1,372.56 $3,503.64 $2,817.36 2026-05-12
58262 HCPCS Removal Of Uterus, Tubes, And/or Ovaries Through Vagina, 250.0 G Or Less 18 9 $3,612.00 $3,612.00 $1,372.56 $3,503.64 $2,817.36 2026-05-12
28480037 CDM Surgical Outreach 18 9 $3,600.00 $3,600.00 $1,368.00 $3,492.00 $2,808.00 2026-05-12
11012 HCPCS Removal Of Foreign Material From Skin, Tissue, Muscle, And Bone At Open Broken A… 18 9 $3,593.00 $3,593.00 $1,365.34 $3,485.21 $2,802.54 2026-05-12
15944 HCPCS Removal Of Pressure Sore Tissue Of Lower Pelvic Bone With Skin Graft 18 9 $3,573.00 $3,573.00 $1,357.74 $3,465.81 $2,786.94 2026-05-12
44050 HCPCS Repair Of Twisted Or Herniated Small Bowel 18 9 $3,570.00 $3,570.00 $1,356.60 $3,462.90 $2,784.60 2026-05-12
26080 HCPCS Incision Of Finger Joint For Exploration, Fluid Drainage, Or Removal Of Foreign … 18 9 $3,558.00 $3,558.00 $1,352.04 $3,451.26 $2,775.24 2026-05-12
15574 HCPCS Creation Of Flap Graft To Forehead, Cheeks, Chin, Mouth, Neck, Underarms, Genita… 18 9 $3,549.00 $3,549.00 $1,348.62 $3,442.53 $2,768.22 2026-05-12
72133 HCPCS CT Scan Of Lower Spine Before And After Contrast 18 9 $3,548.00 $3,548.00 $1,348.24 $3,441.56 $2,767.44 2026-05-12
72130 HCPCS CT Scan Of Middle Spine Before And After Contrast 18 9 $3,548.00 $3,548.00 $1,348.24 $3,441.56 $2,767.44 2026-05-12
72127 HCPCS CT Scan Of Upper Spine Before And After Contrast 18 9 $3,548.00 $3,548.00 $1,348.24 $3,441.56 $2,767.44 2026-05-12
72194 HCPCS CT Scan Of Pelvis Before And After Contrast 18 9 $3,548.00 $3,548.00 $1,348.24 $3,441.56 $2,767.44 2026-05-12
J9312 HCPCS Injection, Rituximab, 10 Mg 36 9 $6,271.62 $6,271.62 $476.52 $10,950.56 $2,753.14 2026-05-12
35606 HCPCS Bypass Of Diseased Or Blocked Neck To Chest Artery With Other Than Vein 18 9 $3,513.00 $3,513.00 $1,334.94 $3,407.61 $2,740.14 2026-05-12
J1439 HCPCS Injection, Ferric Carboxymaltose, 1 Mg 18 9 $3,485.14 $3,485.14 $1,324.35 $3,380.59 $2,718.41 2026-05-12
15115 HCPCS Outer Layer Self Skin Graft Of Face, Scalp, Eyelids, Mouth, Neck, Ears, Around E… 36 9 $4,782.00 $4,782.00 $1,288.20 $5,988.78 $2,710.30 2026-05-12
2976529 CDM Rent/Month - VisionCare Charge 18 9 $3,461.89 $3,461.89 $1,315.52 $3,358.03 $2,700.27 2026-05-12
1101859 CDM Room/bed: Intensive Care Unit 18 9 $3,460.00 $3,460.00 $1,314.80 $3,356.20 $2,698.80 2026-05-12
26350 HCPCS Repair Of Finger Tendon Of Under Side Of Hand Other Than Upper Most Part Of Palm… 18 9 $3,457.00 $3,457.00 $1,313.66 $3,353.29 $2,696.46 2026-05-12
14060 HCPCS Repair Of Wound Of Eyelids, Nose, Ears, Or Lips By Transferring Skin, 10.0 Sq Cm… 18 9 $3,446.00 $3,446.00 $1,309.48 $3,342.62 $2,687.88 2026-05-12
J0129 HCPCS Injection, Abatacept, 10 Mg (code May Be Used For Medicare When Drug Administere… 18 9 $3,442.68 $3,442.68 $1,308.22 $3,339.40 $2,685.29 2026-05-12
44620 HCPCS Closure Of Surgically Created Large Or Small Bowel Opening 18 9 $3,410.00 $3,410.00 $1,295.80 $3,307.70 $2,659.80 2026-05-12
1101862 CDM Room/bed: Obstetrics 18 9 $3,408.00 $3,408.00 $1,295.04 $3,305.76 $2,658.24 2026-05-12
95810 HCPCS Sleep Study In Sleep Lab (6 Years Or Older) 36 9 $3,374.50 $3,374.50 $1,250.96 $3,353.29 $2,631.95 2026-05-12
15837 HCPCS Removal Of Extra Skin And Tissue Of Forearm Or Hand 18 9 $3,368.00 $3,368.00 $1,279.84 $3,266.96 $2,627.04 2026-05-12
64788 HCPCS Removal Of Growth Of Skin Nerve Or Nerve Lining 18 9 $3,358.00 $3,358.00 $1,276.04 $3,257.26 $2,619.24 2026-05-12
52601 HCPCS Removal Of Prostate Gland Using An Electrocautery Knife Through Urethra With Con… 18 9 $3,358.00 $3,358.00 $1,276.04 $3,257.26 $2,619.24 2026-05-12
58673 HCPCS Repair Of Uterine Tube Using An Endoscope 18 9 $3,354.00 $3,354.00 $1,274.52 $3,253.38 $2,616.12 2026-05-12
70548 HCPCS MRI Scan Of Blood Vessels Of Neck With Contrast 18 9 $3,332.00 $3,332.00 $1,266.16 $3,232.04 $2,598.96 2026-05-12
49557 HCPCS Repair Of Trapped Recurrent Femoral Groin Hernia 18 9 $3,330.00 $3,330.00 $1,265.40 $3,230.10 $2,597.40 2026-05-12
58600 HCPCS Tying Or Incision Of Fallopian Tubes 18 9 $3,328.00 $3,328.00 $1,264.64 $3,228.16 $2,595.84 2026-05-12
44110 HCPCS Removal Of Growth Of Small Or Large Bowels 18 9 $3,314.00 $3,314.00 $1,259.32 $3,214.58 $2,584.92 2026-05-12
49900 HCPCS Suture Of Postsurgical Opening In Abdominal Wall 18 9 $3,302.00 $3,302.00 $1,254.76 $3,202.94 $2,575.56 2026-05-12
58661 HCPCS Removal Of Ovaries And/or Tubes Using An Endoscope 18 9 $3,301.00 $3,301.00 $1,254.38 $3,201.97 $2,574.78 2026-05-12
49507 HCPCS Repair Of Trapped Groin Hernia (5 Years Or Older) 18 9 $3,276.00 $3,276.00 $1,244.88 $3,177.72 $2,555.28 2026-05-12
44320 HCPCS Creation Of Opening From Large Bowel To Skin 18 9 $3,263.00 $3,263.00 $1,239.94 $3,165.11 $2,545.14 2026-05-12
2867852 CDM Anesthesia Mask Sz 2 Infant 18 9 $3,259.00 $3,259.00 $1,238.42 $3,161.23 $2,542.02 2026-05-12
51045 HCPCS Incision Of Bladder With Insertion Of Tube Or Stent In Ureter 18 9 $3,257.00 $3,257.00 $1,237.66 $3,159.29 $2,540.46 2026-05-12
25675 HCPCS Closed Treatment Of Dislocated Forearm Bone At Wrist With Manipulation 18 9 $3,257.00 $3,257.00 $1,237.66 $3,159.29 $2,540.46 2026-05-12
47350 HCPCS Suture Of Simple Liver Wound To Control Bleeding 18 9 $3,255.00 $3,255.00 $1,236.90 $3,157.35 $2,538.90 2026-05-12
15260 HCPCS Full Thickness Skin Graft To Nose, Ears, Eyelids, Or Lips, 20.0 Sq Cm Or Less 18 9 $3,242.00 $3,242.00 $1,231.96 $3,144.74 $2,528.76 2026-05-12
72132 HCPCS CT Scan Of Lower Spine With Contrast 18 9 $3,227.00 $3,227.00 $1,226.26 $3,130.19 $2,517.06 2026-05-12
72129 HCPCS CT Scan Of Middle Spine With Contrast 18 9 $3,227.00 $3,227.00 $1,226.26 $3,130.19 $2,517.06 2026-05-12
74170 HCPCS CT Scan Of Abdomen Before And After Contrast 18 9 $3,227.00 $3,227.00 $1,226.26 $3,130.19 $2,517.06 2026-05-12
72126 HCPCS CT Scan Of Upper Spine With Contrast 18 9 $3,227.00 $3,227.00 $1,226.26 $3,130.19 $2,517.06 2026-05-12
71270 HCPCS CT Scan Of Chest Before And After Contrast 18 9 $3,227.00 $3,227.00 $1,226.26 $3,130.19 $2,517.06 2026-05-12
73702 HCPCS CT Scan Of Leg Before And After Contrast 18 9 $3,227.00 $3,227.00 $1,226.26 $3,130.19 $2,517.06 2026-05-12
73202 HCPCS CT Scan Of Arm Before And After Contrast 18 9 $3,227.00 $3,227.00 $1,226.26 $3,130.19 $2,517.06 2026-05-12
72193 HCPCS CT Scan Of Pelvis With Contrast 18 9 $3,227.00 $3,227.00 $1,226.26 $3,130.19 $2,517.06 2026-05-12
82710 HCPCS Stool Fat Or Lipids Analysis, Quantitative 18 9 $3,213.00 $3,213.00 $1,220.94 $3,116.61 $2,506.14 2026-05-12
47562 HCPCS Removal Of Gallbladder Using An Endoscope 36 9 $4,046.00 $4,046.00 $1,190.16 $4,811.20 $2,504.03 2026-05-12
44970 HCPCS Removal Of Appendix Using An Endoscope 18 9 $3,173.00 $3,173.00 $1,205.74 $3,077.81 $2,474.94 2026-05-12
24341 HCPCS Repair Of Tendon Or Muscle Of Upper Arm Or Elbow 18 9 $3,160.00 $3,160.00 $1,200.80 $3,065.20 $2,464.80 2026-05-12
J9263 HCPCS Injection, Oxaliplatin, 0.5 Mg 36 9 $4,551.31 $4,551.31 $1,154.01 $5,883.77 $2,453.72 2026-05-12
54530 HCPCS Removal Of Growth Of Testicle Through Groin 18 9 $3,140.00 $3,140.00 $1,193.20 $3,045.80 $2,449.20 2026-05-12
58660 HCPCS Removal Of Scar Tissue Of Ovaries Or Fallopian Tubes Using An Endoscope 18 9 $3,132.00 $3,132.00 $1,190.16 $3,038.04 $2,442.96 2026-05-12
57270 HCPCS Repair Of Protrusion Of Intestine Into Rectum Or Vagina Through Abdomen 18 9 $3,094.00 $3,094.00 $1,175.72 $3,001.18 $2,413.32 2026-05-12
15110 HCPCS Outer Layer Self Skin Graft Of Trunk, Arms, Or Legs, 100.0 Sq Cm Or 1% Body Area… 36 9 $4,416.50 $4,416.50 $1,010.42 $5,988.78 $2,404.77 2026-05-12
15100 HCPCS Partial Thickness Self Skin Graft To Trunk, Arms, Or Legs, 100.0 Sq Cm Or 1% Bod… 36 9 $4,450.00 $4,450.00 $1,035.88 $5,988.78 $2,404.77 2026-05-12
49505 HCPCS Repair Of Groin Hernia (5 Years Or Older) 36 9 $3,079.50 $3,079.50 $1,142.28 $3,058.41 $2,402.01 2026-05-12
59120 HCPCS Removal Of Ovarian Or Tubal Pregnancy With Removal Of Ovaries 18 9 $3,075.00 $3,075.00 $1,168.50 $2,982.75 $2,398.50 2026-05-12
J9035 HCPCS Injection, Bevacizumab, 10 Mg 36 9 $4,796.64 $4,796.64 $732.51 $7,435.65 $2,391.39 2026-05-12
59410 HCPCS Vaginal Delivery With Post Delivery Care 18 9 $3,060.00 $3,060.00 $1,162.80 $2,968.20 $2,386.80 2026-05-12
44960 HCPCS Removal Of Ruptured Infected Appendix 18 9 $3,040.00 $3,040.00 $1,155.20 $2,948.80 $2,371.20 2026-05-12
J2802 HCPCS Injection, Romiplostim, 1 Microgram 18 9 $3,020.11 $3,020.11 $1,147.64 $2,929.51 $2,355.69 2026-05-12
25265 HCPCS Repair Of Forearm And/or Wrist Tendon Or Muscle On The Underside Of The Wrist (f… 18 9 $2,996.00 $2,996.00 $1,138.48 $2,906.12 $2,336.88 2026-05-12
54640 HCPCS Repositioning And Suture Of Misplaced Testicle 18 9 $2,992.00 $2,992.00 $1,136.96 $2,902.24 $2,333.76 2026-05-12
59614 HCPCS Vaginal Delivery And Care After Delivery After Prior Cesarean Delivery 18 9 $2,991.00 $2,991.00 $1,136.58 $2,901.27 $2,332.98 2026-05-12
49615 HCPCS Repair Of Recurrent Sliding Hernia Of Abdomen, 3-10 Cm In Length 18 9 $2,982.00 $2,982.00 $1,133.16 $2,892.54 $2,325.96 2026-05-12
66830 HCPCS Removal Of Recurring Cataract In Lens Capsule With Sectioning Of Cornea And Scle… 18 9 $2,977.00 $2,977.00 $1,131.26 $2,887.69 $2,322.06 2026-05-12
T2031 HCPCS Assisted Living; Waiver, Per Diem 18 9 $2,977.00 $2,977.00 $1,131.26 $2,887.69 $2,322.06 2026-05-12
66985 HCPCS Insertion Of Prosthetic Lens 18 9 $2,977.00 $2,977.00 $1,131.26 $2,887.69 $2,322.06 2026-05-12
J9202 HCPCS Goserelin Acetate Implant, Per 3.6 Mg 36 9 $4,335.05 $4,335.05 $868.85 $6,192.13 $2,321.82 2026-05-12
78582 HCPCS Nuclear Medicine Study Of Lung Ventilation And Circulation 18 9 $2,970.00 $2,970.00 $1,128.60 $2,880.90 $2,316.60 2026-05-12
58662 HCPCS Destruction Or Removal Of Ovary Or Growth Of Pelvis Using An Endoscope 18 9 $2,948.00 $2,948.00 $1,120.24 $2,859.56 $2,299.44 2026-05-12
49520 HCPCS Repair Of Groin Hernia That Is Not Trapped 18 9 $2,947.00 $2,947.00 $1,119.86 $2,858.59 $2,298.66 2026-05-12
A0433 HCPCS Advanced Life Support, Level 2 (als 2) 18 9 $2,947.00 $2,947.00 $1,119.86 $2,858.59 $2,298.66 2026-05-12
2978818 CDM Multifocal Zma00 18 9 $2,940.00 $2,940.00 $1,117.20 $2,851.80 $2,293.20 2026-05-12
49595 HCPCS Initial Repair Of Sliding Hernia Of Abdomen, More Than 10 Cm In Length 18 9 $2,938.00 $2,938.00 $1,116.44 $2,849.86 $2,291.64 2026-05-12
2867834 CDM Harmonic Lap Shear 5mm 36m 18 9 $2,935.00 $2,935.00 $1,115.30 $2,846.95 $2,289.30 2026-05-12
58180 HCPCS Removal Of Uterus Through Abdomen 18 9 $2,931.00 $2,931.00 $1,113.78 $2,843.07 $2,286.18 2026-05-12
2976535 CDM Senior Living Double Charge 18 9 $2,931.00 $2,931.00 $1,113.78 $2,843.07 $2,286.18 2026-05-12
26910 HCPCS Amputation Of Finger Or Thumb 18 9 $2,924.00 $2,924.00 $1,111.12 $2,836.28 $2,280.72 2026-05-12
49540 HCPCS Repair Of Abdominal Muscle Hernia 18 9 $2,911.00 $2,911.00 $1,106.18 $2,823.67 $2,270.58 2026-05-12
15240 HCPCS Full Thickness Skin Graft To Forehead, Cheeks, Chin, Mouth, Neck, Underarms, Gen… 18 9 $2,908.00 $2,908.00 $1,105.04 $2,820.76 $2,268.24 2026-05-12
72128 HCPCS CT Scan Of Middle Spine Without Contrast 18 9 $2,905.00 $2,905.00 $1,103.90 $2,817.85 $2,265.90 2026-05-12
73201 HCPCS CT Scan Of Arm With Contrast 18 9 $2,905.00 $2,905.00 $1,103.90 $2,817.85 $2,265.90 2026-05-12
72192 HCPCS CT Scan Of Pelvis Without Contrast 18 9 $2,905.00 $2,905.00 $1,103.90 $2,817.85 $2,265.90 2026-05-12
70470 HCPCS CT Scan Of Head Or Brain Before And After Contrast 18 9 $2,905.00 $2,905.00 $1,103.90 $2,817.85 $2,265.90 2026-05-12
71260 HCPCS CT Scan Of Chest With Contrast 18 9 $2,905.00 $2,905.00 $1,103.90 $2,817.85 $2,265.90 2026-05-12
72125 HCPCS CT Scan Of Upper Spine Without Contrast 18 9 $2,905.00 $2,905.00 $1,103.90 $2,817.85 $2,265.90 2026-05-12
70492 HCPCS CT Scan Of Soft Tissue Of Neck Before And After Contrast 18 9 $2,905.00 $2,905.00 $1,103.90 $2,817.85 $2,265.90 2026-05-12
73701 HCPCS CT Scan Of Leg With Contrast Material 18 9 $2,905.00 $2,905.00 $1,103.90 $2,817.85 $2,265.90 2026-05-12
72131 HCPCS CT Scan Of Lower Spine Without Contrast 18 9 $2,905.00 $2,905.00 $1,103.90 $2,817.85 $2,265.90 2026-05-12
70488 HCPCS CT Scan Of Face Before And After Contrast 18 9 $2,905.00 $2,905.00 $1,103.90 $2,817.85 $2,265.90 2026-05-12
43246 HCPCS Insertion Of Stomach Tube Using A Flexible Endoscope 18 9 $2,885.00 $2,885.00 $1,096.30 $2,798.45 $2,250.30 2026-05-12
26973880 CDM Solyx Sis System 18 9 $2,874.00 $2,874.00 $1,092.12 $2,787.78 $2,241.72 2026-05-12
49320 HCPCS Diagnostic Exam Of Abdomen Using An Endoscope 18 9 $2,842.00 $2,842.00 $1,079.96 $2,756.74 $2,216.76 2026-05-12
24073 HCPCS Removal Of Growth Of Muscle Of Upper Arm Or Elbow, 5.0 Cm Or More 18 9 $2,835.00 $2,835.00 $1,077.30 $2,749.95 $2,211.30 2026-05-12
27602 HCPCS Incision Of Connective Tissue Of Front And/or Side And Back Of Lower Leg To Reli… 18 9 $2,834.00 $2,834.00 $1,076.92 $2,748.98 $2,210.52 2026-05-12
58700 HCPCS Removal Of Uterine Tubes 18 9 $2,826.00 $2,826.00 $1,073.88 $2,741.22 $2,204.28 2026-05-12
49521 HCPCS Repair Of Trapped Or Strangulated Groin Hernia 18 9 $2,823.00 $2,823.00 $1,072.74 $2,738.31 $2,201.94 2026-05-12
44950 HCPCS Removal Of Appendix 18 9 $2,785.00 $2,785.00 $1,058.30 $2,701.45 $2,172.30 2026-05-12
2867603 CDM Gore-tex Stretch Vascular Graft Twl(thinwall Limbs) 18 9 $2,783.00 $2,783.00 $1,057.54 $2,699.51 $2,170.74 2026-05-12
76400 HCPCS MRI Bone Marrow Blood Supply 18 9 $2,779.00 $2,779.00 $1,056.02 $2,695.63 $2,167.62 2026-05-12
C8903 HCPCS Magnetic Resonance Imaging With Contrast, Breast; Unilateral 18 9 $2,779.00 $2,779.00 $1,056.02 $2,695.63 $2,167.62 2026-05-12
27939260 CDM Amnio Graft 3.5x3.5 18 9 $2,745.00 $2,745.00 $1,043.10 $2,662.65 $2,141.10 2026-05-12
90396 HCPCS Varicella (chicken Pox) Zoster Immune Globulin For Injection Into Muscle 18 9 $2,737.00 $2,737.00 $1,040.06 $2,654.89 $2,134.86 2026-05-12
57240 HCPCS Repair Of Bladder Hernia Into Vaginal Wall 18 9 $2,707.00 $2,707.00 $1,028.66 $2,625.79 $2,111.46 2026-05-12
59409 HCPCS Vaginal Delivery 18 9 $2,707.00 $2,707.00 $1,028.66 $2,625.79 $2,111.46 2026-05-12
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