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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

GLEN ROSE MEDICAL CENTER

Glen Rose, TX · CCN 450451 · Rates published

2,697 distinct procedures filed
8 distinct payers
50,733 rate rows
2025-08-22 last MRF observed
Data quality

50,733 of 50,733 rate rows are consumer-grade (100.0%)

Every filed rate row passes our consumer-grade checks — none are excluded from the medians.

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Source MRF file https://secure.claraprice.net/price-transparency/NUH2773072790/machine-readable/463085950_glen-rose-medical-center_standardcharges.json
Found on page https://secure.claraprice.net/price-transparency/glen-rose
Discovered viaDiscovered by HANK
Last fetch Latest re-check couldn't be parsed — showing last good data · 2026-05-19
Content fingerprint 9d507f7798a1bbbf… · 253,267 bytes · first seen 2026-05-18

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
L8687
HCPCS 		Implantable Nero Pgen 2ar Recharge +Ext 8 $82,355.00 $170,080.00 $125,322.00 nat. median
$14,605
outlier · 8.6×
L8679
HCPCS 		Implantable Nero Pulse Generator 8 $82,355.00 $170,080.00 $125,322.00 nat. median
$10,682
outlier · 11.7×
L8686
HCPCS 		Implantable Nero Pgen 1array No-recharge 8 $82,355.00 $170,080.00 $125,322.00 nat. median
$7,058
outlier · 17.8×
L8688
HCPCS 		Implantable Nero Pgen 2ar No-recharge+ex 8 $82,355.00 $170,080.00 $125,322.00 nat. median
$12,140
outlier · 10.3×
38240
CPT 		Bone Marrrow/blood Derive 8 $65,298.00 $134,855.00 $99,367.00 nat. median
$15,979
outlier · 6.2×
49560
CPT 		Rep Init Inc/ven Hernia W/52 Modifier 8 $5,172.00 $295,841.00 $76,965.50 nat. median
$3,216
outlier · 23.9×
63685
CPT 		Ins/rep Spinal Neurostim 8 $47,849.00 $98,819.00 $72,814.00 nat. median
$21,357
outlier · 3.4×
27279
CPT 		Arthrodesis Sacroiliac Jt Perq/min Nvas 8 $34,853.00 $71,979.00 $53,037.00 nat. median
$17,268
outlier · 3.1×
64590
CPT 		Ins/plce Perip/gast Neuro Replacement 8 $33,284.00 $68,739.00 $50,650.00 nat. median
$18,334
outlier · 2.8×
63655
CPT 		Laminectomy For Implant Neuro Electrodes 8 $33,173.00 $68,510.00 $50,481.00 nat. median
$19,095
outlier · 2.6×
44150
CPT 		Colectomy Total Abdominal Without Proctectom 8 $32,164.00 $66,426.00 $48,945.00 nat. median
$3,295
outlier · 14.9×
64575
CPT 		Inc For Implant Of Neurostim 8 $31,332.00 $64,706.00 $47,678.00 nat. median
$11,956
outlier · 4.0×
54401
CPT 		Insert Penile Prosth Infl 8 $29,688.00 $61,312.00 $45,177.00 nat. median
$18,813
outlier · 2.4×
54410
CPT 		Penile Pros Replacement 8 $29,688.00 $61,312.00 $45,177.00 nat. median
$18,645
outlier · 2.4×
54405
CPT 		Insert Penile Prosth Mult 8 $29,688.00 $61,312.00 $45,177.00 nat. median
$18,902
outlier · 2.4×
23470
CPT 		Arthroplasty Glenohumeral 8 $20,044.00 $41,394.00 $30,501.00 nat. median
$12,607
outlier · 2.4×
24579
CPT 		Opn Tx Humeral Condyl Fx 8 $20,044.00 $41,394.00 $30,501.00 nat. median
$11,303
outlier · 2.7×
23472
CPT 		Reconstruct Shoulder, Total Ip Only 8 $20,044.00 $41,394.00 $30,501.00 nat. median
$16,400
1.9× median
24515
CPT 		Opn Tx Humeral Shaft Fx W 8 $20,044.00 $41,394.00 $30,501.00 nat. median
$11,226
outlier · 2.7×
24666
CPT 		Opn Tx Radial Head/neck Fracture 8 $20,044.00 $41,394.00 $30,501.00 nat. median
$11,037
outlier · 2.8×
29867
CPT 		Arthrscpy Knee Ostechnd A 8 $20,044.00 $41,394.00 $30,501.00 nat. median
$12,315
outlier · 2.5×
20692
CPT 		Apply Bone Fixation Devic 8 $20,044.00 $41,394.00 $30,501.00 nat. median
$8,456
outlier · 3.6×
28735
CPT 		Midtarsal Fusion 8 $20,044.00 $41,394.00 $30,501.00 nat. median
$11,242
outlier · 2.7×
28725
CPT 		Subtalar Fusion 8 $20,044.00 $41,394.00 $30,501.00 nat. median
$10,168
outlier · 3.0×
28737
CPT 		Arthrodesis W/tendon 8 $20,044.00 $41,394.00 $30,501.00 nat. median
$11,425
outlier · 2.7×
29889
CPT 		Knee Arthroscopy- Posterior Cruciate Lig 8 $20,044.00 $41,394.00 $30,501.00 nat. median
$11,803
outlier · 2.6×
28715
CPT 		Triple Arthrodesis 8 $20,044.00 $41,394.00 $30,501.00 nat. median
$11,408
outlier · 2.7×
23615
CPT 		Orif Proximal Humeral Fx Left 8 $20,043.00 $41,394.00 $30,501.00 nat. median
$11,037
outlier · 2.8×
27759
CPT 		Tibial Shaft Fract W/wo R 8 $20,044.00 $41,394.00 $30,501.00 nat. median
$11,037
outlier · 2.8×
27415
CPT 		Osteochon Allograft With Rt Modifier 8 $20,044.00 $41,394.00 $30,501.00 nat. median
$12,082
outlier · 2.5×
27429
CPT 		Intr&extr-artclr Lig Rcns 8 $20,044.00 $41,394.00 $30,501.00 nat. median
$11,583
outlier · 2.6×
24516
CPT 		Tx Humeral Shaft Fx W/imp 8 $20,044.00 $41,394.00 $30,501.00 nat. median
$11,436
outlier · 2.7×
24586
CPT 		Treatment Of Fracture 8 $20,044.00 $41,394.00 $30,501.00 nat. median
$11,555
outlier · 2.6×
27428
CPT 		Reconstruction Kneelt 8 $20,044.00 $41,394.00 $30,501.00 nat. median
$11,739
outlier · 2.6×
27446
CPT 		Arthro Knee Condyle & Pla 8 $20,044.00 $41,394.00 $30,501.00 nat. median
$12,483
outlier · 2.4×
27447
CPT 		Total Knee Replacmnt 8 $20,044.00 $41,394.00 $30,501.00 nat. median
$12,649
outlier · 2.4×
27827
CPT 		Opn Tx Of Fx Wt Bear Tibi 8 $20,044.00 $41,394.00 $30,501.00 nat. median
$11,070
outlier · 2.8×
27870
CPT 		Arthrodesis 8 $20,044.00 $41,394.00 $30,501.00 nat. median
$10,943
outlier · 2.8×
24430
CPT 		Nonunion Of Fracture 8 $20,044.00 $41,394.00 $30,501.00 nat. median
$11,674
outlier · 2.6×
27130
CPT 		Total Hip Replacement 8 $20,044.00 $41,394.00 $30,501.00 nat. median
$13,100
outlier · 2.3×
28730
CPT 		Arthrd Midtarsl/tarsomettrsl Mult Rt 8 $20,044.00 $41,394.00 $30,501.00 nat. median
$10,278
outlier · 3.0×
C1820
HCPCS 		Eterna System 8 $19,734.00 $40,755.00 $30,030.00 nat. median
$22,013
1.4× median
60212
CPT 		Partial Thyroid W/contra 8 $19,340.00 $39,942.00 $29,431.00 nat. median
$6,103
outlier · 4.8×
54400
CPT 		Insert Penile Prosth Non- 8 $18,670.00 $38,557.00 $28,410.00 nat. median
$12,604
outlier · 2.3×
33228
CPT 		Rmvl Perm Pm Pls Gen W Repl Dual Chamber 8 $16,902.00 $34,906.00 $25,720.00 nat. median
$11,435
outlier · 2.2×
33208
CPT 		Dual Chamber Pacemaker Insertion 8 $16,902.00 $34,906.00 $25,720.00 nat. median
$11,773
outlier · 2.2×
33207
CPT 		Dual Chamber Pacemaker Insertion 8 $16,856.00 $34,811.00 $25,650.00 nat. median
$11,490
outlier · 2.2×
J2997
HCPCS 		Activase (t-pa) 100 Mg 8 $16,808.00 $34,712.00 $25,577.00 nat. median
$545
outlier · 46.9×
37244
CPT 		Vasc Embolize/occlude Bleed 8 $16,327.00 $33,719.00 $24,846.00 nat. median
$12,234
outlier · 2.0×
19325
CPT 		Breast Augment W/implant 8 $14,494.00 $29,933.00 $22,056.00 nat. median
$8,985
outlier · 2.5×

Other procedures at this hospital

Browse this hospital's 2,697 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
             
15830 CPT Exc Excess Skin & Sq;abd 14 8 $19,556.00 $19,556.00 $8,996.00 $18,578.00 $13,689.00 2025-08-22
19302 CPT Mast/w Axil/lymphadenecto 14 8 $19,556.00 $19,556.00 $8,996.00 $18,578.00 $13,689.00 2025-08-22
19303 CPT Mastectomy Simple Complet 14 8 $19,556.00 $19,556.00 $8,996.00 $18,578.00 $13,689.00 2025-08-22
19307 CPT Mast Mod/rad Excl Pect Ma 14 8 $19,556.00 $19,556.00 $8,996.00 $18,578.00 $13,689.00 2025-08-22
19316 CPT Suspension Of Breast 14 8 $19,556.00 $19,556.00 $8,996.00 $18,578.00 $13,689.00 2025-08-22
19318 CPT Reduction Mammaplasty 14 8 $19,556.00 $19,556.00 $8,996.00 $18,578.00 $13,689.00 2025-08-22
19325 CPT Breast Augment W/implant 14 8 $31,508.00 $31,508.00 $14,494.00 $29,933.00 $22,056.00 2025-08-22
19380 CPT Revise Breast Reconstruct 14 8 $19,556.00 $19,556.00 $8,996.00 $18,578.00 $13,689.00 2025-08-22
20690 CPT Appl Uniplane Uni Ext Fix 14 8 $22,134.00 $22,134.00 $10,182.00 $21,027.00 $15,494.00 2025-08-22
20692 CPT Apply Bone Fixation Devic 14 8 $43,573.00 $43,573.00 $20,044.00 $41,394.00 $30,501.00 2025-08-22
20900 CPT Rem Of Bone For Graft 14 8 $22,134.00 $22,134.00 $10,182.00 $21,027.00 $15,494.00 2025-08-22
20902 CPT Bone Graft Major Or Large 14 8 $22,134.00 $22,134.00 $10,182.00 $21,027.00 $15,494.00 2025-08-22
20982 CPT Ablation Bone Tumor Radio 14 8 $22,134.00 $22,134.00 $10,182.00 $21,027.00 $15,494.00 2025-08-22
21210 CPT Graft Bone;nasal Maxillar 14 8 $17,972.00 $17,972.00 $8,267.00 $17,073.00 $12,580.00 2025-08-22
21365 CPT Opn Red Of Malar & Zygoma 14 8 $17,972.00 $17,972.00 $8,267.00 $17,073.00 $12,580.00 2025-08-22
21390 CPT Opn Tx Orbital Fx 14 8 $17,140.00 $17,140.00 $7,884.00 $16,283.00 $11,998.00 2025-08-22
22513 CPT Percut/verteb/augmentatio Thoracic 14 8 $22,887.00 $22,887.00 $10,528.00 $21,743.00 $16,021.00 2025-08-22
22514 CPT Percut/verteb/augmentatio Lumbar 14 8 $22,887.00 $22,887.00 $10,528.00 $21,743.00 $16,021.00 2025-08-22
23405 CPT Tenotomy, Shoulder Area, Single Tendon 14 8 $22,134.00 $22,134.00 $10,182.00 $21,027.00 $15,494.00 2025-08-22
23410 CPT Rep Ruptured Rotator Cuff W/mod Lt & 73 14 8 $22,134.00 $22,134.00 $10,182.00 $21,027.00 $15,494.00 2025-08-22
23412 CPT Rep Of Rotator Cuff Opn Lt 14 8 $22,134.00 $22,134.00 $10,182.00 $21,027.00 $15,494.00 2025-08-22
23415 CPT Coracoacromial Lig Releas 14 8 $22,134.00 $22,134.00 $10,182.00 $21,027.00 $15,494.00 2025-08-22
23420 CPT Rep Shoulder Cuff Avulsio 14 8 $22,134.00 $22,134.00 $10,182.00 $21,027.00 $15,494.00 2025-08-22
23430 CPT Tenodesis Of Long Tendon W/mod Lt 14 8 $22,134.00 $22,134.00 $10,182.00 $21,027.00 $15,494.00 2025-08-22
23455 CPT Capsulorrhapy W/labral Re 14 8 $22,134.00 $22,134.00 $10,182.00 $21,027.00 $15,494.00 2025-08-22
23470 CPT Arthroplasty Glenohumeral 14 8 $43,573.00 $43,573.00 $20,044.00 $41,394.00 $30,501.00 2025-08-22
23472 CPT Reconstruct Shoulder, Total Ip Only 14 8 $43,573.00 $43,573.00 $20,044.00 $41,394.00 $30,501.00 2025-08-22
23515 CPT Opn Tx Clavicular Fx W/wo 14 8 $22,134.00 $22,134.00 $10,182.00 $21,027.00 $15,494.00 2025-08-22
23550 CPT Opn Tx Acromioclavicular 14 8 $22,134.00 $22,134.00 $10,182.00 $21,027.00 $15,494.00 2025-08-22
23615 CPT Orif Proximal Humeral Fx Left 24 8 $43,573.00 $43,573.00 $20,043.00 $41,394.00 $30,501.00 2025-08-22
23660 CPT Open Red Disloc Shlder 14 8 $22,134.00 $22,134.00 $10,182.00 $21,027.00 $15,494.00 2025-08-22
23670 CPT Opn Tx Shldr Disloc/w Fx 14 8 $22,134.00 $22,134.00 $10,182.00 $21,027.00 $15,494.00 2025-08-22
24342 CPT Repair Rupt Bicep/tricep W/wo Grft W/lt 14 8 $22,134.00 $22,134.00 $10,182.00 $21,027.00 $15,494.00 2025-08-22
24430 CPT Nonunion Of Fracture 14 8 $43,573.00 $43,573.00 $20,044.00 $41,394.00 $30,501.00 2025-08-22
24515 CPT Opn Tx Humeral Shaft Fx W 14 8 $43,573.00 $43,573.00 $20,044.00 $41,394.00 $30,501.00 2025-08-22
24516 CPT Tx Humeral Shaft Fx W/imp 14 8 $43,573.00 $43,573.00 $20,044.00 $41,394.00 $30,501.00 2025-08-22
24538 CPT Clsd Supracondylar Hum Fx With Perc Fix 14 8 $22,134.00 $22,134.00 $10,182.00 $21,027.00 $15,494.00 2025-08-22
24579 CPT Opn Tx Humeral Condyl Fx 14 8 $43,573.00 $43,573.00 $20,044.00 $41,394.00 $30,501.00 2025-08-22
24586 CPT Treatment Of Fracture 14 8 $43,573.00 $43,573.00 $20,044.00 $41,394.00 $30,501.00 2025-08-22
24665 CPT Orif Radial Head/neck Fx W/mod Lt 14 8 $22,134.00 $22,134.00 $10,182.00 $21,027.00 $15,494.00 2025-08-22
24666 CPT Opn Tx Radial Head/neck Fracture 14 8 $43,573.00 $43,573.00 $20,044.00 $41,394.00 $30,501.00 2025-08-22
24685 CPT Opn Tx Ulnar Fx Proximal W/mod Rt 14 8 $22,134.00 $22,134.00 $10,182.00 $21,027.00 $15,494.00 2025-08-22
25263 CPT Rep Forearm Tendon/muscle 14 8 $22,134.00 $22,134.00 $10,182.00 $21,027.00 $15,494.00 2025-08-22
25390 CPT Osteoplasty Radius Or Uln 14 8 $22,134.00 $22,134.00 $10,182.00 $21,027.00 $15,494.00 2025-08-22
25400 CPT Rep Nonunion/malunion Rad 14 8 $22,134.00 $22,134.00 $10,182.00 $21,027.00 $15,494.00 2025-08-22
25440 CPT Rep Nonunion Carpal Bone 14 8 $22,134.00 $22,134.00 $10,182.00 $21,027.00 $15,494.00 2025-08-22
25515 CPT Treat Fracture Of Radius 14 8 $22,134.00 $22,134.00 $10,182.00 $21,027.00 $15,494.00 2025-08-22
25545 CPT Opn Red Fx Rad/ulna W/int W/mod Lt 14 8 $22,134.00 $22,134.00 $10,182.00 $21,027.00 $15,494.00 2025-08-22
25575 CPT Opn Tx Radial & Ulnar Sha 14 8 $22,134.00 $22,134.00 $10,182.00 $21,027.00 $15,494.00 2025-08-22
25607 CPT Opn Repair Radius/ulna W/rt Modifier 14 8 $22,134.00 $22,134.00 $10,182.00 $21,027.00 $15,494.00 2025-08-22
25608 CPT Orif Dstl Rad Fx Intraart 2 Frags 50 Mod 14 8 $22,134.00 $22,134.00 $10,182.00 $21,027.00 $15,494.00 2025-08-22
25609 CPT Orif Dstl Radius Fx =>3 Frags 14 8 $22,134.00 $22,134.00 $10,182.00 $21,027.00 $15,494.00 2025-08-22
25628 CPT Opn Tx Carpal Scaphoid Fx 14 8 $22,134.00 $22,134.00 $10,182.00 $21,027.00 $15,494.00 2025-08-22
25652 CPT Opn Tx Ulnar Styloid Fxrt 14 8 $22,134.00 $22,134.00 $10,182.00 $21,027.00 $15,494.00 2025-08-22
26352 CPT Rep Or Advance Flexor Tendon W/free Graf 14 8 $22,134.00 $22,134.00 $10,182.00 $21,027.00 $15,494.00 2025-08-22
26531 CPT Arthroplasty Metacarp W/i 14 8 $22,134.00 $22,134.00 $10,182.00 $21,027.00 $15,494.00 2025-08-22
27130 CPT Total Hip Replacement 14 8 $43,573.00 $43,573.00 $20,044.00 $41,394.00 $30,501.00 2025-08-22
27235 CPT Percutaneous Tx Of Femoral Fractu Rt 14 8 $22,134.00 $22,134.00 $10,182.00 $21,027.00 $15,494.00 2025-08-22
27236 CPT Open Tx Of Femoral Fractu 14 8 $22,133.00 $22,133.00 $10,181.00 $21,026.00 $15,493.00 2025-08-22
27279 CPT Arthrodesis Sacroiliac Jt Perq/min Nvas 14 8 $75,767.00 $75,767.00 $34,853.00 $71,979.00 $53,037.00 2025-08-22
27350 CPT Patellectomy/orhemipatell 14 8 $22,134.00 $22,134.00 $10,182.00 $21,027.00 $15,494.00 2025-08-22
27380 CPT Suture Infrapatellar Tendon Left 14 8 $22,134.00 $22,134.00 $10,182.00 $21,027.00 $15,494.00 2025-08-22
27400 CPT Trnsfr Tendn/musc Hamstri 14 8 $22,134.00 $22,134.00 $10,182.00 $21,027.00 $15,494.00 2025-08-22
27405 CPT Repair Prim Torn Ligamnt Knee W/mod Lt 14 8 $22,134.00 $22,134.00 $10,182.00 $21,027.00 $15,494.00 2025-08-22
27415 CPT Osteochon Allograft With Rt Modifier 14 8 $43,573.00 $43,573.00 $20,044.00 $41,394.00 $30,501.00 2025-08-22
27418 CPT Repair Degenerated Kneecap W/mod Rt 14 8 $22,134.00 $22,134.00 $10,182.00 $21,027.00 $15,494.00 2025-08-22
27422 CPT Patella Stabilization 14 8 $22,134.00 $22,134.00 $10,182.00 $21,027.00 $15,494.00 2025-08-22
27427 CPT Ligamentous Reconst;knee 14 8 $22,134.00 $22,134.00 $10,182.00 $21,027.00 $15,494.00 2025-08-22
27428 CPT Reconstruction Kneelt 14 8 $43,573.00 $43,573.00 $20,044.00 $41,394.00 $30,501.00 2025-08-22
27429 CPT Intr&extr-artclr Lig Rcns 14 8 $43,573.00 $43,573.00 $20,044.00 $41,394.00 $30,501.00 2025-08-22
27446 CPT Arthro Knee Condyle & Pla 14 8 $43,573.00 $43,573.00 $20,044.00 $41,394.00 $30,501.00 2025-08-22
27447 CPT Total Knee Replacmnt 14 8 $43,573.00 $43,573.00 $20,044.00 $41,394.00 $30,501.00 2025-08-22
27486 CPT Rev Of Tot Knee Arthropla 14 8 $15,074.00 $15,074.00 $6,934.00 $14,320.00 $10,552.00 2025-08-22
27524 CPT Opn Tx Patellar Fx W/inte Left 14 8 $22,134.00 $22,134.00 $10,182.00 $21,027.00 $15,494.00 2025-08-22
27596 CPT Reamputation Femur/knee W/mod Lt 14 8 $22,133.00 $22,133.00 $10,181.00 $21,026.00 $15,493.00 2025-08-22
27650 CPT Prim Repr Achilles Tendon 14 8 $22,134.00 $22,134.00 $10,182.00 $21,027.00 $15,494.00 2025-08-22
27654 CPT Repair Achilles Tendon/gr 14 8 $22,134.00 $22,134.00 $10,182.00 $21,027.00 $15,494.00 2025-08-22
27691 CPT Repair Deep Tendon 14 8 $22,134.00 $22,134.00 $10,182.00 $21,027.00 $15,494.00 2025-08-22
27695 CPT Prim Repr Collatral Lig A 14 8 $22,134.00 $22,134.00 $10,182.00 $21,027.00 $15,494.00 2025-08-22
27696 CPT Repair Colateral Lig 14 8 $22,134.00 $22,134.00 $10,182.00 $21,027.00 $15,494.00 2025-08-22
27698 CPT Sut Sec Rep Torn Rupt Sev 14 8 $22,134.00 $22,134.00 $10,182.00 $21,027.00 $15,494.00 2025-08-22
27759 CPT Tibial Shaft Fract W/wo R 14 8 $43,573.00 $43,573.00 $20,044.00 $41,394.00 $30,501.00 2025-08-22
27766 CPT Opn Tx Fx Med Malleolus W/mod Rt 14 8 $22,134.00 $22,134.00 $10,182.00 $21,027.00 $15,494.00 2025-08-22
27792 CPT Treatment Of Ankle Fractu 14 8 $22,134.00 $22,134.00 $10,182.00 $21,027.00 $15,494.00 2025-08-22
27814 CPT Open Tx/ankle Fx W/mod Lt 14 8 $22,134.00 $22,134.00 $10,182.00 $21,027.00 $15,494.00 2025-08-22
27822 CPT Opn Tx Trimalleolar Ankle 14 8 $22,134.00 $22,134.00 $10,182.00 $21,027.00 $15,494.00 2025-08-22
27823 CPT Open Reduction W/fixation 14 8 $22,134.00 $22,134.00 $10,182.00 $21,027.00 $15,494.00 2025-08-22
27827 CPT Opn Tx Of Fx Wt Bear Tibi 14 8 $43,573.00 $43,573.00 $20,044.00 $41,394.00 $30,501.00 2025-08-22
27829 CPT Open Trmt Distal Tibiofib 14 8 $22,134.00 $22,134.00 $10,182.00 $21,027.00 $15,494.00 2025-08-22
27870 CPT Arthrodesis 14 8 $43,573.00 $43,573.00 $20,044.00 $41,394.00 $30,501.00 2025-08-22
28202 CPT Rep Flexor Tendon Foot With Free Graft 14 8 $22,134.00 $22,134.00 $10,182.00 $21,027.00 $15,494.00 2025-08-22
28238 CPT Recon Tibial Tendon W/lt Mod 14 8 $22,134.00 $22,134.00 $10,182.00 $21,027.00 $15,494.00 2025-08-22
28297 CPT Hallux Valgus Rep Lapidus 14 8 $22,134.00 $22,134.00 $10,182.00 $21,027.00 $15,494.00 2025-08-22
28298 CPT Hallus Valqus (Bunion), By Phalanx Osteo 14 8 $22,134.00 $22,134.00 $10,182.00 $21,027.00 $15,494.00 2025-08-22
28299 CPT Osteotomy Double 14 8 $22,134.00 $22,134.00 $10,182.00 $21,027.00 $15,494.00 2025-08-22
28300 CPT Incision Of Heel Bone 14 8 $22,134.00 $22,134.00 $10,182.00 $21,027.00 $15,494.00 2025-08-22
28304 CPT Incision Of Mid Foot Bone 14 8 $22,134.00 $22,134.00 $10,182.00 $21,027.00 $15,494.00 2025-08-22
28305 CPT Osteotomy W/autograft 14 8 $22,134.00 $22,134.00 $10,182.00 $21,027.00 $15,494.00 2025-08-22
28306 CPT Osteotomy W/wo Correction 14 8 $22,134.00 $22,134.00 $10,182.00 $21,027.00 $15,494.00 2025-08-22
28415 CPT Open Trmt Fracture/wfix 14 8 $22,134.00 $22,134.00 $10,182.00 $21,027.00 $15,494.00 2025-08-22
28465 CPT Opn Tx Tarsal Bone Fx W/w 14 8 $22,134.00 $22,134.00 $10,182.00 $21,027.00 $15,494.00 2025-08-22
28485 CPT Opn Tx Metatarsal Fx W/wo With Rt Modifier 14 8 $22,134.00 $22,134.00 $10,182.00 $21,027.00 $15,494.00 2025-08-22
28715 CPT Triple Arthrodesis 14 8 $43,573.00 $43,573.00 $20,044.00 $41,394.00 $30,501.00 2025-08-22
28725 CPT Subtalar Fusion 14 8 $43,573.00 $43,573.00 $20,044.00 $41,394.00 $30,501.00 2025-08-22
28730 CPT Arthrd Midtarsl/tarsomettrsl Mult Rt 14 8 $43,573.00 $43,573.00 $20,044.00 $41,394.00 $30,501.00 2025-08-22
28735 CPT Midtarsal Fusion 14 8 $43,573.00 $43,573.00 $20,044.00 $41,394.00 $30,501.00 2025-08-22
28737 CPT Arthrodesis W/tendon 14 8 $43,573.00 $43,573.00 $20,044.00 $41,394.00 $30,501.00 2025-08-22
28740 CPT Arthrodesis Midtarsal/tar 14 8 $22,134.00 $22,134.00 $10,182.00 $21,027.00 $15,494.00 2025-08-22
28750 CPT Arthrodesis Great Toe 14 8 $22,134.00 $22,134.00 $10,182.00 $21,027.00 $15,494.00 2025-08-22
29806 CPT Arthro Shldr Surg Capsulo 14 8 $22,134.00 $22,134.00 $10,182.00 $21,027.00 $15,494.00 2025-08-22
29807 CPT Arthro Shldr Rpr Slap Les 14 8 $22,134.00 $22,134.00 $10,182.00 $21,027.00 $15,494.00 2025-08-22
29820 CPT Arthoscopy Shoulder-lt Synovectomy, Part 14 8 $22,134.00 $22,134.00 $10,182.00 $21,027.00 $15,494.00 2025-08-22
29826 CPT Shaving Of Shoulder Bone Using Endoscope 14 8 $16,439.00 $16,439.00 $7,562.00 $15,617.00 $11,507.00 2025-08-22
29827 CPT Shoulder Arthroscopy/surg-rt 14 8 $22,134.00 $22,134.00 $10,182.00 $21,027.00 $15,494.00 2025-08-22
29828 CPT Arthroscopy Shoulder Debridement Lmtd Rt 14 8 $22,134.00 $22,134.00 $10,182.00 $21,027.00 $15,494.00 2025-08-22
29867 CPT Arthrscpy Knee Ostechnd A 14 8 $43,573.00 $43,573.00 $20,044.00 $41,394.00 $30,501.00 2025-08-22
29887 CPT Drill Osteochon Intern Fix 14 8 $22,134.00 $22,134.00 $10,182.00 $21,027.00 $15,494.00 2025-08-22
29888 CPT Arthroscopy-acl Reconstru Rt 28 8 $23,625.00 $23,625.00 $10,182.00 $23,860.00 $16,463.00 2025-08-22
29889 CPT Knee Arthroscopy- Posterior Cruciate Lig 14 8 $43,573.00 $43,573.00 $20,044.00 $41,394.00 $30,501.00 2025-08-22
30400 CPT Rhinoplasty 14 8 $17,972.00 $17,972.00 $8,267.00 $17,073.00 $12,580.00 2025-08-22
30410 CPT Rhinoplasty Complete 14 8 $17,972.00 $17,972.00 $8,267.00 $17,073.00 $12,580.00 2025-08-22
30420 CPT Rhinoplasty Primary;incl 14 8 $17,972.00 $17,972.00 $8,267.00 $17,073.00 $12,580.00 2025-08-22
30450 CPT Rhinoplasty Major Rev(nas 14 8 $17,972.00 $17,972.00 $8,267.00 $17,073.00 $12,580.00 2025-08-22
30580 CPT Repair Fistula Oromaxilla 14 8 $17,972.00 $17,972.00 $8,267.00 $17,073.00 $12,580.00 2025-08-22
30600 CPT Repair Fistula, Oronasal 14 8 $17,972.00 $17,972.00 $8,267.00 $17,073.00 $12,580.00 2025-08-22
31032 CPT Sinusotomy Axil;rad Rem P 14 8 $17,972.00 $17,972.00 $8,267.00 $17,073.00 $12,580.00 2025-08-22
31050 CPT Sinustomy Sphenoid W/wo B 14 8 $17,972.00 $17,972.00 $8,267.00 $17,073.00 $12,580.00 2025-08-22
31051 CPT Sinus/sphenoid W/mucos St 14 8 $17,972.00 $17,972.00 $8,267.00 $17,073.00 $12,580.00 2025-08-22
31090 CPT Exploration Of Sinuses 14 8 $17,972.00 $17,972.00 $8,267.00 $17,073.00 $12,580.00 2025-08-22
31253 CPT A/p Totl Nasal W/expl/tiss Remv W/mod Rt 14 8 $20,578.00 $20,578.00 $9,466.00 $19,549.00 $14,405.00 2025-08-22
31254 CPT Nasal/sinus Endoscopy 14 8 $20,578.00 $20,578.00 $9,466.00 $19,549.00 $14,405.00 2025-08-22
31255 CPT Nasal/sinus Endo Complete Left 14 8 $20,578.00 $20,578.00 $9,466.00 $19,549.00 $14,405.00 2025-08-22
31267 CPT Nasal/sinus Endoscopy 14 8 $20,578.00 $20,578.00 $9,466.00 $19,549.00 $14,405.00 2025-08-22
31276 CPT Nasal/sinus Endoscopy 14 8 $20,578.00 $20,578.00 $9,466.00 $19,549.00 $14,405.00 2025-08-22
31287 CPT Nasal/sinsus Endo W/sphen W/50 14 8 $20,578.00 $20,578.00 $9,466.00 $19,549.00 $14,405.00 2025-08-22
31288 CPT Nasal/sinus Endosur Rt 14 8 $20,578.00 $20,578.00 $9,466.00 $19,549.00 $14,405.00 2025-08-22
31297 CPT Sinus Endo W/balloon Dil W/50 59 Mod 14 8 $20,578.00 $20,578.00 $9,466.00 $19,549.00 $14,405.00 2025-08-22
32601 CPT Thoracbscopy Diagnostic 14 8 $17,880.00 $17,880.00 $8,225.00 $16,986.00 $12,516.00 2025-08-22
32607 CPT Thoracbscopy W/bx Infiltrate 14 8 $17,880.00 $17,880.00 $8,225.00 $16,986.00 $12,516.00 2025-08-22
32608 CPT Thoracbscopy W/bx Nodule 14 8 $17,880.00 $17,880.00 $8,225.00 $16,986.00 $12,516.00 2025-08-22
33207 CPT Dual Chamber Pacemaker Insertion 14 8 $36,643.00 $36,643.00 $16,856.00 $34,811.00 $25,650.00 2025-08-22
33208 CPT Dual Chamber Pacemaker Insertion 14 8 $36,743.00 $36,743.00 $16,902.00 $34,906.00 $25,720.00 2025-08-22
33228 CPT Rmvl Perm Pm Pls Gen W Repl Dual Chamber 14 8 $36,743.00 $36,743.00 $16,902.00 $34,906.00 $25,720.00 2025-08-22
33282 CPT Implantation Cardiac 14 8 $28,134.00 $28,134.00 $12,942.00 $26,727.00 $19,694.00 2025-08-22
33285 CPT Insert Subcutaneous Cardiac Rhythm Moni 14 8 $28,830.00 $28,830.00 $13,262.00 $27,389.00 $20,181.00 2025-08-22
37244 CPT Vasc Embolize/occlude Bleed 14 8 $35,494.00 $35,494.00 $16,327.00 $33,719.00 $24,846.00 2025-08-22
38240 CPT Bone Marrrow/blood Derive 14 8 $141,953.00 $141,953.00 $65,298.00 $134,855.00 $99,367.00 2025-08-22
38570 CPT Laparoscopy Lymp Node Bio 14 8 $17,880.00 $17,880.00 $8,225.00 $16,986.00 $12,516.00 2025-08-22
38571 CPT Laparoscopy Lymphadenectomy 14 8 $31,474.00 $31,474.00 $14,478.00 $29,900.00 $22,032.00 2025-08-22
38589 CPT Unlisted Laparoscopy Lymphatic System 14 8 $17,880.00 $17,880.00 $8,225.00 $16,986.00 $12,516.00 2025-08-22
38745 CPT Rad Exc Of Axillary Lymph 14 8 $17,880.00 $17,880.00 $8,225.00 $16,986.00 $12,516.00 2025-08-22
40527 CPT Exc Of Lip Full Thick Rec 14 8 $17,972.00 $17,972.00 $8,267.00 $17,073.00 $12,580.00 2025-08-22
41120 CPT Partial Removal Of Tongue 14 8 $17,972.00 $17,972.00 $8,267.00 $17,073.00 $12,580.00 2025-08-22
42145 CPT Palatopharyngoplasty 14 8 $17,972.00 $17,972.00 $8,267.00 $17,073.00 $12,580.00 2025-08-22
42410 CPT Exc Parotid Tumor Gland;l 14 8 $17,972.00 $17,972.00 $8,267.00 $17,073.00 $12,580.00 2025-08-22
42415 CPT Exc Parotid Gland/lesion 14 8 $17,972.00 $17,972.00 $8,267.00 $17,073.00 $12,580.00 2025-08-22
42420 CPT Exc Parotid Tumor/gland 14 8 $17,972.00 $17,972.00 $8,267.00 $17,073.00 $12,580.00 2025-08-22
42425 CPT Tot En Bloc Rem W/sacrifi 14 8 $17,972.00 $17,972.00 $8,267.00 $17,073.00 $12,580.00 2025-08-22
42440 CPT Exc Submaxillary Gland 14 8 $17,972.00 $17,972.00 $8,267.00 $17,073.00 $12,580.00 2025-08-22
42815 CPT Excision Of Neck Cyst 14 8 $17,972.00 $17,972.00 $8,267.00 $17,073.00 $12,580.00 2025-08-22
42820 CPT Removal Of Tonsils And Adenoid Glands, Patient Younger Than Age 12 14 8 $17,972.00 $17,972.00 $8,267.00 $17,073.00 $12,580.00 2025-08-22
42825 CPT Tonsilectmy;prim/sec<12yr 14 8 $17,972.00 $17,972.00 $8,267.00 $17,073.00 $12,580.00 2025-08-22
42830 CPT Rem Adenoids Prim Yngr/12 14 8 $13,759.00 $13,759.00 $6,329.00 $13,071.00 $9,631.00 2025-08-22
42842 CPT Extensive Surgery Of Throat 14 8 $17,972.00 $17,972.00 $8,267.00 $17,073.00 $12,580.00 2025-08-22
42844 CPT Extensive Surgery Of Throat 14 8 $17,972.00 $17,972.00 $8,267.00 $17,073.00 $12,580.00 2025-08-22
42870 CPT Excision Of Lingual Tonsil 14 8 $17,972.00 $17,972.00 $8,267.00 $17,073.00 $12,580.00 2025-08-22
42890 CPT Partial Removal Of Pharynx 14 8 $17,972.00 $17,972.00 $8,267.00 $17,073.00 $12,580.00 2025-08-22
43108 CPT Removal Of Esophagus 14 8 $14,687.00 $14,687.00 $6,756.00 $13,953.00 $10,281.00 2025-08-22
43113 CPT Removal Of Esophagus 14 8 $14,361.00 $14,361.00 $6,606.00 $13,643.00 $10,053.00 2025-08-22
43116 CPT Partial Removal Of Esophagus 14 8 $16,416.00 $16,416.00 $7,551.00 $15,595.00 $11,491.00 2025-08-22
43123 CPT Partial Removal Of Esophagus 14 8 $14,886.00 $14,886.00 $6,848.00 $14,142.00 $10,420.00 2025-08-22
43280 CPT Laparoscopy Fundoplasty 14 8 $31,474.00 $31,474.00 $14,478.00 $29,900.00 $22,032.00 2025-08-22
43450 CPT Dilate Esophagus 28 8 $22,451.50 $22,451.50 $1,315.00 $39,942.00 $11,028.00 2025-08-22
44150 CPT Colectomy Total Abdominal Without Proctectom 14 8 $69,922.00 $69,922.00 $32,164.00 $66,426.00 $48,945.00 2025-08-22
44180 CPT Lap Enterolysis W/mod 74 14 8 $17,880.00 $17,880.00 $8,225.00 $16,986.00 $12,516.00 2025-08-22
44238 CPT Unlisted Laparoscopy, Intestine Exc Rect 14 8 $19,022.00 $19,022.00 $8,750.00 $18,071.00 $13,315.00 2025-08-22
44970 CPT Laparoscopy Surg Appendec 28 8 $17,407.00 $17,407.00 $7,790.00 $16,986.00 $12,439.00 2025-08-22
44979 CPT Unlisted Laparoscopy Proc. Appendec 14 8 $17,880.00 $17,880.00 $8,225.00 $16,986.00 $12,516.00 2025-08-22
47379 CPT Clsd Percutane/ndl Bx Liv 14 8 $17,880.00 $17,880.00 $8,225.00 $16,986.00 $12,516.00 2025-08-22
47562 CPT Removal Of Gallbladder Using An Endoscope 14 8 $17,880.00 $17,880.00 $8,225.00 $16,986.00 $12,516.00 2025-08-22
47563 CPT Lap Chole W/graphy 14 8 $17,880.00 $17,880.00 $8,225.00 $16,986.00 $12,516.00 2025-08-22
47564 CPT Lap Choly W/expl Of Common Duct 14 8 $17,880.00 $17,880.00 $8,225.00 $16,986.00 $12,516.00 2025-08-22
47579 CPT Lap Procedure Of Biliary Trc Unlisted 14 8 $17,880.00 $17,880.00 $8,225.00 $16,986.00 $12,516.00 2025-08-22
49320 CPT Lap/abd/perit/omen Diagns 14 8 $17,880.00 $17,880.00 $8,225.00 $16,986.00 $12,516.00 2025-08-22
49321 CPT Lap Abd Peritoneum & Omen 14 8 $17,880.00 $17,880.00 $8,225.00 $16,986.00 $12,516.00 2025-08-22
49322 CPT Lap W/aspir Of Cavity Or Cyst 14 8 $17,880.00 $17,880.00 $8,225.00 $16,986.00 $12,516.00 2025-08-22
49329 CPT Unlisted Lap Procedure Abd, Peritoneum 14 8 $17,880.00 $17,880.00 $8,225.00 $16,986.00 $12,516.00 2025-08-22
49560 CPT Rep Init Inc/ven Hernia W/52 Modifier 28 8 $161,327.50 $161,327.50 $5,172.00 $295,841.00 $76,965.50 2025-08-22
49565 CPT Rep Rec Incis/ventral Her 14 8 $17,880.00 $17,880.00 $8,225.00 $16,986.00 $12,516.00 2025-08-22
49566 CPT Rep Rec Inc/ventrl Hernia 14 8 $17,880.00 $17,880.00 $8,225.00 $16,986.00 $12,516.00 2025-08-22
49592 CPT Repair Ant Abd Hernia 1st W/prost <3 Cm 14 8 $18,034.00 $18,034.00 $8,296.00 $17,132.00 $12,624.00 2025-08-22
49594 CPT Rpr Aa Hernia 1st 3-10 Ncr/strn 14 8 $18,034.00 $18,034.00 $8,296.00 $17,132.00 $12,624.00 2025-08-22
49650 CPT Lap Inguinal Hernia Initial 14 8 $17,880.00 $17,880.00 $8,225.00 $16,986.00 $12,516.00 2025-08-22
49651 CPT Lap Inguinal Hernia Recurrent 14 8 $17,880.00 $17,880.00 $8,225.00 $16,986.00 $12,516.00 2025-08-22
49652 CPT Lap Repr Hernia Ingun 14 8 $17,880.00 $17,880.00 $8,225.00 $16,986.00 $12,516.00 2025-08-22
49653 CPT Hernia-umbilical-incarcerated 14 8 $17,880.00 $17,880.00 $8,225.00 $16,986.00 $12,516.00 2025-08-22
49654 CPT Lap Inc Hernia Repair 14 8 $31,474.00 $31,474.00 $14,478.00 $29,900.00 $22,032.00 2025-08-22
49655 CPT Lap Inc Hernia Repair Comp 14 8 $31,474.00 $31,474.00 $14,478.00 $29,900.00 $22,032.00 2025-08-22
49656 CPT Lap Inc Hernia Repair Recur 14 8 $31,474.00 $31,474.00 $14,478.00 $29,900.00 $22,032.00 2025-08-22
49657 CPT Incarcerated Or Strangula 14 8 $31,474.00 $31,474.00 $14,478.00 $29,900.00 $22,032.00 2025-08-22
49659 CPT Unlisted Lap Hernioplasty 14 8 $17,880.00 $17,880.00 $8,225.00 $16,986.00 $12,516.00 2025-08-22
50080 CPT Removal Kidney Stone 14 8 $29,164.00 $29,164.00 $13,415.00 $27,706.00 $20,415.00 2025-08-22
50543 CPT Laparoscopy Partial Nephrectomy 14 8 $31,474.00 $31,474.00 $14,478.00 $29,900.00 $22,032.00 2025-08-22
50553 CPT Kidney Endoscopy With 50 Modifier 14 8 $14,950.00 $14,950.00 $6,877.00 $14,203.00 $10,465.00 2025-08-22
50957 CPT Endo/w/fulguration 14 8 $15,590.00 $15,590.00 $7,171.00 $14,811.00 $10,913.00 2025-08-22
50961 CPT Endo/w/removal Fb 14 8 $15,590.00 $15,590.00 $7,171.00 $14,811.00 $10,913.00 2025-08-22
51050 CPT Cystolithotomy Cysto W/re 14 8 $15,590.00 $15,590.00 $7,171.00 $14,811.00 $10,913.00 2025-08-22
51860 CPT Cystorrhaphy Suture Of Bladder 14 8 $15,590.00 $15,590.00 $7,171.00 $14,811.00 $10,913.00 2025-08-22
51990 CPT Lap Surg;urethral Suspens 14 8 $17,880.00 $17,880.00 $8,225.00 $16,986.00 $12,516.00 2025-08-22
52240 CPT Transureth Exc Lg Bladd T 14 8 $15,590.00 $15,590.00 $7,171.00 $14,811.00 $10,913.00 2025-08-22
52325 CPT Cystourethroscopy W Frag 14 8 $15,590.00 $15,590.00 $7,171.00 $14,811.00 $10,913.00 2025-08-22
52353 CPT Cysto W/lithotripsy 14 8 $15,590.00 $15,590.00 $7,171.00 $14,811.00 $10,913.00 2025-08-22
52356 CPT Cysto W/uretero W/lithotripsy -mod Lt 14 8 $15,590.00 $15,590.00 $7,171.00 $14,811.00 $10,913.00 2025-08-22
52601 CPT Prostatectomy (Turp) 14 8 $15,590.00 $15,590.00 $7,171.00 $14,811.00 $10,913.00 2025-08-22
52630 CPT Transurethral Resection 14 8 $15,590.00 $15,590.00 $7,171.00 $14,811.00 $10,913.00 2025-08-22
52647 CPT Turp Non Contact Laser Co 14 8 $15,590.00 $15,590.00 $7,171.00 $14,811.00 $10,913.00 2025-08-22
52648 CPT Laser Vaporization 14 8 $15,590.00 $15,590.00 $7,171.00 $14,811.00 $10,913.00 2025-08-22
52649 CPT Enucleation W/morcellatio 14 8 $15,590.00 $15,590.00 $7,171.00 $14,811.00 $10,913.00 2025-08-22
53446 CPT Remove Uro Sphincter 14 8 $15,590.00 $15,590.00 $7,171.00 $14,811.00 $10,913.00 2025-08-22
54400 CPT Insert Penile Prosth Non- 14 8 $40,586.00 $40,586.00 $18,670.00 $38,557.00 $28,410.00 2025-08-22
54401 CPT Insert Penile Prosth Infl 14 8 $64,539.00 $64,539.00 $29,688.00 $61,312.00 $45,177.00 2025-08-22
54405 CPT Insert Penile Prosth Mult 14 8 $64,539.00 $64,539.00 $29,688.00 $61,312.00 $45,177.00 2025-08-22
54410 CPT Penile Pros Replacement 14 8 $64,539.00 $64,539.00 $29,688.00 $61,312.00 $45,177.00 2025-08-22
54660 CPT Testicular Prosthesis 14 8 $15,590.00 $15,590.00 $7,171.00 $14,811.00 $10,913.00 2025-08-22
55866 CPT Surgical Removal Of Prostate And Surrounding Lymph Nodes Using An Endoscope 14 8 $31,474.00 $31,474.00 $14,478.00 $29,900.00 $22,032.00 2025-08-22
57120 CPT Colpocleisis 14 8 $15,582.00 $15,582.00 $7,168.00 $14,803.00 $10,907.00 2025-08-22
57220 CPT Plastic Op On Uretheral S 14 8 $15,582.00 $15,582.00 $7,168.00 $14,803.00 $10,907.00 2025-08-22
57240 CPT Repair Bladder And Vigina 14 8 $15,582.00 $15,582.00 $7,168.00 $14,803.00 $10,907.00 2025-08-22
57250 CPT Repair Of Rectum & Vagina 14 8 $15,582.00 $15,582.00 $7,168.00 $14,803.00 $10,907.00 2025-08-22
57260 CPT Repair Of Vagina 14 8 $15,582.00 $15,582.00 $7,168.00 $14,803.00 $10,907.00 2025-08-22
57265 CPT Comb Antero Colpo W/enter 14 8 $15,582.00 $15,582.00 $7,168.00 $14,803.00 $10,907.00 2025-08-22
57268 CPT Rep Enterocele Vag Approa 14 8 $15,582.00 $15,582.00 $7,168.00 $14,803.00 $10,907.00 2025-08-22
57282 CPT Rep Of Vaginal Prolapse 14 8 $23,989.00 $23,989.00 $11,035.00 $22,790.00 $16,792.00 2025-08-22
57285 CPT Repair Paravag Defect Vag 14 8 $23,989.00 $23,989.00 $11,035.00 $22,790.00 $16,792.00 2025-08-22
57288 CPT Repair Bladder Defect 14 8 $15,582.00 $15,582.00 $7,168.00 $14,803.00 $10,907.00 2025-08-22
57425 CPT Laparoscopy Copopexy (Vag Susp) 14 8 $31,474.00 $31,474.00 $14,478.00 $29,900.00 $22,032.00 2025-08-22
57426 CPT Revision W/removal Of Prosth Vag Graft 14 8 $23,989.00 $23,989.00 $11,035.00 $22,790.00 $16,792.00 2025-08-22
57530 CPT Removal Of Cervix 14 8 $15,582.00 $15,582.00 $7,168.00 $14,803.00 $10,907.00 2025-08-22
58260 CPT Vag Hyst Uterus 250g Or < 14 8 $15,582.00 $15,582.00 $7,168.00 $14,803.00 $10,907.00 2025-08-22
58262 CPT Vag Hyst Uterus 250g<w/re 14 8 $15,582.00 $15,582.00 $7,168.00 $14,803.00 $10,907.00 2025-08-22
58270 CPT Hysterectomy W Repair 250 Gm/ 14 8 $15,582.00 $15,582.00 $7,168.00 $14,803.00 $10,907.00 2025-08-22
58290 CPT Vag Hyst Uterus /250grams 14 8 $23,989.00 $23,989.00 $11,035.00 $22,790.00 $16,792.00 2025-08-22
58291 CPT Vag Hyst W/rem Tube/ovary 250 Gm/ 14 8 $15,582.00 $15,582.00 $7,168.00 $14,803.00 $10,907.00 2025-08-22
58350 CPT Chromotubation Of Oviduct 14 8 $15,582.00 $15,582.00 $7,168.00 $14,803.00 $10,907.00 2025-08-22
58353 CPT Endo Ablation Therm Without H 14 8 $15,582.00 $15,582.00 $7,168.00 $14,803.00 $10,907.00 2025-08-22
58356 CPT Endometrial Cryo W/us 14 8 $15,582.00 $15,582.00 $7,168.00 $14,803.00 $10,907.00 2025-08-22
58542 CPT Lsh W/t/o Ut 250 G Or Less 14 8 $31,442.00 $31,442.00 $14,463.00 $29,870.00 $22,009.00 2025-08-22
58545 CPT Laparoscopy Excision 14 8 $17,880.00 $17,880.00 $8,225.00 $16,986.00 $12,516.00 2025-08-22
58546 CPT Laparo-myomectomy Complex 14 8 $31,442.00 $31,442.00 $14,463.00 $29,870.00 $22,009.00 2025-08-22
58550 CPT Laporscopy Hysterectomy 14 8 $17,880.00 $17,880.00 $8,225.00 $16,986.00 $12,516.00 2025-08-22
58552 CPT Lavh;w/rem Tube & Or Ovar 14 8 $31,474.00 $31,474.00 $14,478.00 $29,900.00 $22,032.00 2025-08-22
58554 CPT Lavh W/removal Tube(s)/ov 14 8 $31,474.00 $31,474.00 $14,478.00 $29,900.00 $22,032.00 2025-08-22
58561 CPT Hsc Removal Of Myoma 14 8 $15,582.00 $15,582.00 $7,168.00 $14,803.00 $10,907.00 2025-08-22
58563 CPT Hysteroscopy/endometrial 14 8 $15,582.00 $15,582.00 $7,168.00 $14,803.00 $10,907.00 2025-08-22
58570 CPT Lap Total Hyst 250g Or Less 14 8 $31,474.00 $31,474.00 $14,478.00 $29,900.00 $22,032.00 2025-08-22
58571 CPT Lap Totalhyst 250g/less W/tube/ov Remov 14 8 $31,474.00 $31,474.00 $14,478.00 $29,900.00 $22,032.00 2025-08-22
58572 CPT Lap Tot Hyst Uterus>250g 14 8 $31,474.00 $31,474.00 $14,478.00 $29,900.00 $22,032.00 2025-08-22
58573 CPT Lap Tot Hyst W/t/o Ut>250g 14 8 $31,474.00 $31,474.00 $14,478.00 $29,900.00 $22,032.00 2025-08-22
58578 CPT Laparoscopiclysis Of Peri 14 8 $17,880.00 $17,880.00 $8,225.00 $16,986.00 $12,516.00 2025-08-22
58660 CPT Lap-surg-w/lysis/adhesion 14 8 $17,880.00 $17,880.00 $8,225.00 $16,986.00 $12,516.00 2025-08-22
58661 CPT Lap Unilat Salpingo-ooph 14 8 $17,880.00 $17,880.00 $8,225.00 $16,986.00 $12,516.00 2025-08-22
58662 CPT Lap W/fulguration Or Exc 14 8 $17,880.00 $17,880.00 $8,225.00 $16,986.00 $12,516.00 2025-08-22
58670 CPT Laparoscopy W Fulguration 14 8 $17,880.00 $17,880.00 $8,225.00 $16,986.00 $12,516.00 2025-08-22
58671 CPT Lap W/occlusion Ovidct De 14 8 $17,880.00 $17,880.00 $8,225.00 $16,986.00 $12,516.00 2025-08-22
58679 CPT Unlisted Lap Oviduct/ovar 14 8 $17,880.00 $17,880.00 $8,225.00 $16,986.00 $12,516.00 2025-08-22
58920 CPT Partial Removal Of Ovary(s) 14 8 $23,989.00 $23,989.00 $11,035.00 $22,790.00 $16,792.00 2025-08-22
58925 CPT Ovarian Cysts,uni/bilateral 14 8 $15,582.00 $15,582.00 $7,168.00 $14,803.00 $10,907.00 2025-08-22
60200 CPT Exc Of Cyst/adenoma Thyro 14 8 $17,880.00 $17,880.00 $8,225.00 $16,986.00 $12,516.00 2025-08-22
60210 CPT Prtl Thyroid Lobectomy Rt 14 8 $17,880.00 $17,880.00 $8,225.00 $16,986.00 $12,516.00 2025-08-22
60212 CPT Partial Thyroid W/contra 14 8 $42,044.00 $42,044.00 $19,340.00 $39,942.00 $29,431.00 2025-08-22
60220 CPT Tot Thyroid Lobectomy Uni 14 8 $17,880.00 $17,880.00 $8,225.00 $16,986.00 $12,516.00 2025-08-22
60225 CPT Tot Thyroid Lobectomy 14 8 $17,880.00 $17,880.00 $8,225.00 $16,986.00 $12,516.00 2025-08-22
60240 CPT Thyroidectomy Total Or Co 14 8 $17,880.00 $17,880.00 $8,225.00 $16,986.00 $12,516.00 2025-08-22
60280 CPT Exc Thyroglossal Duct Cys 14 8 $17,880.00 $17,880.00 $8,225.00 $16,986.00 $12,516.00 2025-08-22
60281 CPT Recurrent Thyroglossal 14 8 $17,880.00 $17,880.00 $8,225.00 $16,986.00 $12,516.00 2025-08-22
60500 CPT Parathyroidectomy Explora 14 8 $17,972.00 $17,972.00 $8,267.00 $17,073.00 $12,580.00 2025-08-22
60502 CPT Re-expl Of Parathroids 14 8 $17,972.00 $17,972.00 $8,267.00 $17,073.00 $12,580.00 2025-08-22
62365 CPT Rem Of Subcutaneous Reser 14 8 $20,151.00 $20,151.00 $9,269.00 $19,143.00 $14,106.00 2025-08-22
63650 CPT Perc Implantation Of Neurostim Epid 14 8 $21,859.00 $21,859.00 $10,055.00 $20,766.00 $15,301.00 2025-08-22
63655 CPT Laminectomy For Implant Neuro Electrodes 14 8 $72,116.00 $72,116.00 $33,173.00 $68,510.00 $50,481.00 2025-08-22
63663 CPT Rev Incl Repl Spinal Neurostim 14 8 $21,859.00 $21,859.00 $10,055.00 $20,766.00 $15,301.00 2025-08-22
63685 CPT Ins/rep Spinal Neurostim 14 8 $104,020.00 $104,020.00 $47,849.00 $98,819.00 $72,814.00 2025-08-22
64561 CPT Sacral Nerve (Transforaminal)test 14 8 $21,859.00 $21,859.00 $10,055.00 $20,766.00 $15,301.00 2025-08-22
64575 CPT Inc For Implant Of Neurostim 14 8 $68,112.00 $68,112.00 $31,332.00 $64,706.00 $47,678.00 2025-08-22
64581 CPT Sacral Nerve (Transforaminal Placement) 14 8 $21,859.00 $21,859.00 $10,055.00 $20,766.00 $15,301.00 2025-08-22
64590 CPT Ins/plce Perip/gast Neuro Replacement 14 8 $72,357.00 $72,357.00 $33,284.00 $68,739.00 $50,650.00 2025-08-22
64636 CPT Dest By Neuro Ag Para Facet Jt Nerv Addi 28 8 $16,659.00 $16,659.00 $5,109.00 $21,101.00 $10,384.50 2025-08-22
67036 CPT Vitrectomy Mechanical Par 14 8 $13,839.00 $13,839.00 $6,366.00 $13,147.00 $9,687.00 2025-08-22
69631 CPT Repair Eardrum Structures 14 8 $17,972.00 $17,972.00 $8,267.00 $17,073.00 $12,580.00 2025-08-22
69641 CPT Tmpanoplasty W/mastoidect 14 8 $17,972.00 $17,972.00 $8,267.00 $17,073.00 $12,580.00 2025-08-22
C1767 HCPCS Interstim Neurostimulator 3058 Replace 14 8 $19,694.00 $19,694.00 $9,059.00 $18,709.00 $13,786.00 2025-08-22
C1820 HCPCS Eterna System 14 8 $42,900.00 $42,900.00 $19,734.00 $40,755.00 $30,030.00 2025-08-22
J0840 HCPCS Antivenin (Wyeth) (Crofab) Ea 1ea 14 8 $13,623.00 $13,623.00 $6,267.00 $12,942.00 $9,536.00 2025-08-22
J2997 HCPCS Activase (t-pa) 100 Mg 14 8 $36,539.00 $36,539.00 $16,808.00 $34,712.00 $25,577.00 2025-08-22
J3101 HCPCS Tnkase (Tenecteplase) Vial 50mg 14 8 $18,674.00 $18,674.00 $8,590.00 $17,740.00 $13,072.00 2025-08-22
L8679 HCPCS Implantable Nero Pulse Generator 14 8 $179,032.00 $179,032.00 $82,355.00 $170,080.00 $125,322.00 2025-08-22
L8680 HCPCS Implantable Nero Electrode, Each 14 8 $16,965.00 $16,965.00 $7,804.00 $16,117.00 $11,876.00 2025-08-22
L8686 HCPCS Implantable Nero Pgen 1array No-recharge 14 8 $179,032.00 $179,032.00 $82,355.00 $170,080.00 $125,322.00 2025-08-22
L8687 HCPCS Implantable Nero Pgen 2ar Recharge +Ext 14 8 $179,032.00 $179,032.00 $82,355.00 $170,080.00 $125,322.00 2025-08-22
L8688 HCPCS Implantable Nero Pgen 2ar No-recharge+ex 14 8 $179,032.00 $179,032.00 $82,355.00 $170,080.00 $125,322.00 2025-08-22
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