Hospital

MEDICAL CITY FORT WORTH

Fort Worth, TX · CCN 450672 · Rates published

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You selected 93306 (CPT)

ECHO2D COMP W CF DOP

This hospital’s price: $4,599 across 31 payers · range $725-$10,359

Source: https://stctrprodsnsvc00455826e6.blob.core.windows.net/pt-final-posting-files/62-1682202_MEDICAL-CITY-FORT-WORTH_standardcharges.json?si=pt-json-access-policy&spr=https&sv=2024-11-04&sr=c&sig=o5IofreS%2F7ETlsnhPakPWCwHVVUZRobywQ5wUKGjVuQ%3D · observed 2026-03-01

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.

40,965 distinct procedures filed

60 distinct payers

1,373,470 rate rows

2026-07-17 last MRF observed

Data quality

1,350,884 of 1,373,470 rate rows are consumer-grade (98.4%)

22,586 rows are marked excluded from the consumer medians — these stay visible in the raw drill-down with the same reason shown here, so nothing is silently hidden.

Excluded — reason	Rows
no usable negotiated amount (only an out-of-band fallback) — excluded from medians	21,826
template filing: same amount across many unrelated codes — excluded	620
per-diem day rate — not a per-procedure price	88
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians	45
placeholder amount (≤ $0.02) — excluded from medians	6
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only	1

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

Source MRF file	https://stctrprodsnsvc00455826e6.blob.core.windows.net/pt-final-posting-files/62-1682202_MEDICAL-CITY-FORT-WORTH_standardcharges.json?si=pt-json-access-policy&spr=https&sv=2024-11-04&sr=c&sig=o5IofreS%2F7ETlsnhPakPWCwHVVUZRobywQ5wUKGjVuQ%3D
Found on page	https://www.medicalcityhealthcare.com/patient-resources/patient-financial-resources/pricing-transparency-cms-required-file-of-standard-charges
Discovered via	Discovered by HANK
Last fetch	Latest re-check couldn't be parsed — showing last good data · 2026-10-03
Content fingerprint	b42e25d7209682f4… · 1,255,037,737 bytes · first seen 2026-05-09

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
443630 CDM	Kit Hrt Implant Lvas	26	$134,999.86	$999,999.00	$449,999.55	nat. median $260 outlier · 1733.7×
433810 CDM	Kit Vlv Aor 18fr 29mm	2	$315,591.15	$446,591.25	$381,091.20	nat. median $96,174 outlier · 4.0×
248063 CDM	Kit Cath Rt Heart	2	$298,390.00	$447,585.00	$372,987.50	nat. median $5,511 outlier · 67.7×
229028 CDM	Occluder Cardiac Lt 25mm	1	$321,570.00	$321,570.00	$321,570.00	nat. median $124,641 outlier · 2.6×
868801 CDM	Kit Aor Vlv 18fr 26mm	2	$297,727.50	$315,591.15	$306,659.33	nat. median $150,523 outlier · 2.0×
C1605 HCPCS	Pacemaker Dual Chmbr	2	$297,727.50	$315,591.15	$306,659.33	nat. median $21,751 outlier · 14.1×
C1604 HCPCS	System Graft Stent Case	25	$80,386.43	$595,455.00	$305,766.14	nat. median $28,000 outlier · 10.9×
471441 CDM	Valve Aor Tavr 34mm	27	$80,386.43	$595,455.00	$297,727.50	nat. median $123,886 outlier · 2.4×
877268 CDM	Valve Tavr 26mm	27	$80,386.43	$595,455.00	$297,727.50	nat. median $110,488 outlier · 2.7×
249246 CDM	Valve Tavr 26mm	27	$80,386.43	$595,455.00	$297,727.50	nat. median $3,784 outlier · 78.7×
870432 CDM	Valve Tavr 20mm	27	$80,386.43	$595,455.00	$297,727.50	nat. median $54,788 outlier · 5.4×
863553 CDM	Valve Tavr 23mm	27	$80,386.43	$595,455.00	$297,727.50	nat. median $2,193 outlier · 135.8×
863528 CDM	Valve Tavr 26mm	27	$80,386.43	$595,455.00	$297,727.50	nat. median $175,659 1.7× median
877269 CDM	Valve Tavr 29mm	27	$80,386.43	$595,455.00	$297,727.50	nat. median $110,488 outlier · 2.7×
482360 CDM	Valve Heart Trnscth 23mm	27	$80,386.43	$595,455.00	$297,727.50	nat. median $5,274 outlier · 56.4×
249249 CDM	Valve Tavr 20mm	27	$80,386.43	$595,455.00	$297,727.50	nat. median $3,481 outlier · 85.5×
483500 CDM	Valve Aor Ultr/trnc 26mm	27	$80,386.43	$595,455.00	$297,727.50	nat. median $8,050 outlier · 37.0×
868805 CDM	Valve 29mm Ascendra Aor	27	$80,386.43	$595,455.00	$297,727.50	nat. median $178,928 1.7× median
270574 CDM	Valve Tavr 29mm	27	$80,386.43	$595,455.00	$297,727.50	nat. median $13,512 outlier · 22.0×
484417 CDM	Valve Aortic 23mm	27	$80,386.43	$595,455.00	$297,727.50	nat. median $297,728 1.0× median
249248 CDM	Valve Tavr 29mm	27	$80,386.43	$595,455.00	$297,727.50	nat. median $3,481 outlier · 85.5×
244392 CDM	Valve Tavr Size 34mm	27	$80,386.43	$595,455.00	$297,727.50	nat. median $157,200 1.9× median
868803 CDM	Valve Aor Sapien 23mm	27	$80,386.43	$595,455.00	$297,727.50	nat. median $3,459 outlier · 86.1×
482359 CDM	Valve Heart Trnscth 20mm	27	$80,386.43	$595,455.00	$297,727.50	nat. median $5,004 outlier · 59.5×
249245 CDM	Valve Tavr 23mm	27	$80,386.43	$595,455.00	$297,727.50	nat. median $3,481 outlier · 85.5×
173852 CDM	Valve Aor 23mm Sapien 3	27	$80,386.43	$595,455.00	$297,727.50	nat. median $175,659 1.7× median
877267 CDM	Valve Tavr 23mm	27	$80,386.43	$595,455.00	$297,727.50	nat. median $110,488 outlier · 2.7×
437822 CDM	Valve Aor Tavr 23mm	27	$80,386.43	$595,455.00	$297,727.50	nat. median $200,000 1.5× median
868804 CDM	Valve Aor Sapien 26mm	27	$80,386.43	$595,455.00	$297,727.50	nat. median $19,516 outlier · 15.3×
427323 CDM	Valve Tavr 34mm	27	$80,386.43	$595,455.00	$297,727.50	nat. median $178,928 1.7× median
451361 CDM	Valve Tavr 26mm	27	$80,386.43	$595,455.00	$297,727.50	nat. median $297,728 1.0× median
482361 CDM	Valve Heart Trnscth 26mm	27	$80,386.43	$595,455.00	$297,727.50	nat. median $4,883 outlier · 61.0×
270575 CDM	Valve Tavr 34mm	27	$80,386.43	$595,455.00	$297,727.50	nat. median $821 outlier · 362.8×
245978 CDM	Stent Eprsth 24f 34mm	27	$80,386.43	$595,455.00	$297,727.50	nat. median $233,406 1.3× median
471443 CDM	Valve Aor Tavr 26mm	27	$80,386.43	$595,455.00	$297,727.50	nat. median $117,465 outlier · 2.5×
244560 CDM	Valve Tavr Sz 29mm	27	$80,386.43	$595,455.00	$297,727.50	nat. median $157,200 1.9× median
863855 CDM	Valve Tavr 29mm	27	$80,386.43	$595,455.00	$297,727.50	nat. median $157,200 1.9× median
244847 CDM	Valve Tavr Sz 23mm	27	$80,386.43	$595,455.00	$297,727.50	nat. median $5,859 outlier · 50.8×
244845 CDM	Valve Tavr Sz 26mm	27	$80,386.43	$595,455.00	$297,727.50	nat. median $506 outlier · 588.3×
100929 CDM	Valve Hrt Trnscath 20mm	27	$80,386.43	$595,455.00	$297,727.50	nat. median $515 outlier · 577.8×
471442 CDM	Valve Aor Tavr 29mm	27	$80,386.43	$595,455.00	$297,727.50	nat. median $148,864 outlier · 2.0×
276210 CDM	Valve Aortic 23mm	27	$80,386.43	$595,455.00	$297,727.50	nat. median $297,728 1.0× median
237603 CDM	Valve Tavr 29mm	27	$80,386.43	$595,455.00	$297,727.50	nat. median $200,371 1.5× median
202862 CDM	Pump Heart 21fr 85mm	2	$281,522.50	$298,413.85	$289,968.17	nat. median $289,968 1.0× median
876617 CDM	Kit Aor Vlv 14fr 29mm	27	$80,386.43	$595,455.00	$282,841.12	nat. median $112,586 outlier · 2.5×
C1825 HCPCS	System Gen Neo2	25	$72,337.05	$535,830.00	$275,148.70	nat. median $53,185 outlier · 5.2×
868802 CDM	Kit Aor Vlv 20fr 29mm	26	$80,386.43	$595,455.00	$267,954.75	nat. median $198,610 1.3× median
868799 CDM	Kit Aor Vlv 16fr 23mm	27	$80,386.43	$595,455.00	$267,954.75	nat. median $198,610 1.3× median
263045 CDM	System Pascal Implant	27	$72,337.05	$535,830.00	$267,915.00	nat. median $2,056 outlier · 130.3×
173851 CDM	Valve Aor Sys 23mm	27	$72,337.05	$535,830.00	$267,915.00	nat. median $105 outlier · 2562.6×

Other procedures at this hospital

Browse this hospital's 40,965 published procedures. Use the slice to choose what to show, then sort or filter any column.

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

443630	CDM	Kit Hrt Implant Lvas	45	26	$999,999.00	$999,999.00	$134,999.86	$999,999.00	$449,999.55	2026-03-01
433810	CDM	Kit Vlv Aor 18fr 29mm	2	2	$595,455.00	$595,455.00	$315,591.15	$446,591.25	$381,091.20	2026-03-01
248063	CDM	Kit Cath Rt Heart	2	2	$596,780.00	$596,780.00	$298,390.00	$447,585.00	$372,987.50	2026-03-01
229028	CDM	Occluder Cardiac Lt 25mm	1	1	$428,760.00	$428,760.00	$321,570.00	$321,570.00	$321,570.00	2026-03-01
C1605	HCPCS	Pacemaker Dual Chmbr	2	2	$595,455.00	$595,455.00	$297,727.50	$315,591.15	$306,659.33	2026-03-01
868801	CDM	Kit Aor Vlv 18fr 26mm	2	2	$595,455.00	$595,455.00	$297,727.50	$315,591.15	$306,659.33	2026-03-01
C1604	HCPCS	System Graft Stent Case	42	25	$595,455.00	$595,455.00	$80,386.43	$595,455.00	$305,766.14	2026-07-17
249246	CDM	Valve Tavr 26mm	47	27	$595,455.00	$595,455.00	$80,386.43	$595,455.00	$297,727.50	2026-03-01
868804	CDM	Valve Aor Sapien 26mm	47	27	$595,455.00	$595,455.00	$80,386.43	$595,455.00	$297,727.50	2026-03-01
173852	CDM	Valve Aor 23mm Sapien 3	47	27	$595,455.00	$595,455.00	$80,386.43	$595,455.00	$297,727.50	2026-03-01
863855	CDM	Valve Tavr 29mm	47	27	$595,455.00	$595,455.00	$80,386.43	$595,455.00	$297,727.50	2026-03-01
483500	CDM	Valve Aor Ultr/trnc 26mm	47	27	$595,455.00	$595,455.00	$80,386.43	$595,455.00	$297,727.50	2026-03-01
451361	CDM	Valve Tavr 26mm	47	27	$595,455.00	$595,455.00	$80,386.43	$595,455.00	$297,727.50	2026-03-01
863528	CDM	Valve Tavr 26mm	47	27	$595,455.00	$595,455.00	$80,386.43	$595,455.00	$297,727.50	2026-03-01
244847	CDM	Valve Tavr Sz 23mm	47	27	$595,455.00	$595,455.00	$80,386.43	$595,455.00	$297,727.50	2026-03-01
868805	CDM	Valve 29mm Ascendra Aor	47	27	$595,455.00	$595,455.00	$80,386.43	$595,455.00	$297,727.50	2026-03-01
100929	CDM	Valve Hrt Trnscath 20mm	47	27	$595,455.00	$595,455.00	$80,386.43	$595,455.00	$297,727.50	2026-03-01
270575	CDM	Valve Tavr 34mm	47	27	$595,455.00	$595,455.00	$80,386.43	$595,455.00	$297,727.50	2026-03-01
471441	CDM	Valve Aor Tavr 34mm	47	27	$595,455.00	$595,455.00	$80,386.43	$595,455.00	$297,727.50	2026-03-01
437822	CDM	Valve Aor Tavr 23mm	47	27	$595,455.00	$595,455.00	$80,386.43	$595,455.00	$297,727.50	2026-03-01
249249	CDM	Valve Tavr 20mm	47	27	$595,455.00	$595,455.00	$80,386.43	$595,455.00	$297,727.50	2026-03-01
244392	CDM	Valve Tavr Size 34mm	47	27	$595,455.00	$595,455.00	$80,386.43	$595,455.00	$297,727.50	2026-03-01
237603	CDM	Valve Tavr 29mm	47	27	$595,455.00	$595,455.00	$80,386.43	$595,455.00	$297,727.50	2026-03-01
877269	CDM	Valve Tavr 29mm	47	27	$595,455.00	$595,455.00	$80,386.43	$595,455.00	$297,727.50	2026-03-01
249248	CDM	Valve Tavr 29mm	47	27	$595,455.00	$595,455.00	$80,386.43	$595,455.00	$297,727.50	2026-03-01
482359	CDM	Valve Heart Trnscth 20mm	47	27	$595,455.00	$595,455.00	$80,386.43	$595,455.00	$297,727.50	2026-03-01
244560	CDM	Valve Tavr Sz 29mm	47	27	$595,455.00	$595,455.00	$80,386.43	$595,455.00	$297,727.50	2026-03-01
868803	CDM	Valve Aor Sapien 23mm	47	27	$595,455.00	$595,455.00	$80,386.43	$595,455.00	$297,727.50	2026-03-01
870432	CDM	Valve Tavr 20mm	47	27	$595,455.00	$595,455.00	$80,386.43	$595,455.00	$297,727.50	2026-03-01
471442	CDM	Valve Aor Tavr 29mm	47	27	$595,455.00	$595,455.00	$80,386.43	$595,455.00	$297,727.50	2026-03-01
482361	CDM	Valve Heart Trnscth 26mm	47	27	$595,455.00	$595,455.00	$80,386.43	$595,455.00	$297,727.50	2026-03-01
276210	CDM	Valve Aortic 23mm	47	27	$595,455.00	$595,455.00	$80,386.43	$595,455.00	$297,727.50	2026-03-01
471443	CDM	Valve Aor Tavr 26mm	47	27	$595,455.00	$595,455.00	$80,386.43	$595,455.00	$297,727.50	2026-03-01
245978	CDM	Stent Eprsth 24f 34mm	47	27	$595,455.00	$595,455.00	$80,386.43	$595,455.00	$297,727.50	2026-03-01
877268	CDM	Valve Tavr 26mm	47	27	$595,455.00	$595,455.00	$80,386.43	$595,455.00	$297,727.50	2026-03-01
249245	CDM	Valve Tavr 23mm	47	27	$595,455.00	$595,455.00	$80,386.43	$595,455.00	$297,727.50	2026-03-01
482360	CDM	Valve Heart Trnscth 23mm	47	27	$595,455.00	$595,455.00	$80,386.43	$595,455.00	$297,727.50	2026-03-01
863553	CDM	Valve Tavr 23mm	47	27	$595,455.00	$595,455.00	$80,386.43	$595,455.00	$297,727.50	2026-03-01
877267	CDM	Valve Tavr 23mm	47	27	$595,455.00	$595,455.00	$80,386.43	$595,455.00	$297,727.50	2026-03-01
244845	CDM	Valve Tavr Sz 26mm	47	27	$595,455.00	$595,455.00	$80,386.43	$595,455.00	$297,727.50	2026-03-01
270574	CDM	Valve Tavr 29mm	47	27	$595,455.00	$595,455.00	$80,386.43	$595,455.00	$297,727.50	2026-03-01
484417	CDM	Valve Aortic 23mm	47	27	$595,455.00	$595,455.00	$80,386.43	$595,455.00	$297,727.50	2026-03-01
427323	CDM	Valve Tavr 34mm	47	27	$595,455.00	$595,455.00	$80,386.43	$595,455.00	$297,727.50	2026-03-01
202862	CDM	Pump Heart 21fr 85mm	2	2	$563,045.00	$563,045.00	$281,522.50	$298,413.85	$289,968.17	2026-03-01
876617	CDM	Kit Aor Vlv 14fr 29mm	46	27	$595,455.00	$595,455.00	$80,386.43	$595,455.00	$282,841.12	2026-03-01
C1825	HCPCS	System Gen Neo2	42	25	$535,830.00	$535,830.00	$72,337.05	$535,830.00	$275,148.70	2026-03-01
868799	CDM	Kit Aor Vlv 16fr 23mm	45	27	$595,455.00	$595,455.00	$80,386.43	$595,455.00	$267,954.75	2026-03-01
868802	CDM	Kit Aor Vlv 20fr 29mm	45	26	$595,455.00	$595,455.00	$80,386.43	$595,455.00	$267,954.75	2026-03-01
270573	CDM	Valve Tavr 26mm	47	27	$535,830.00	$535,830.00	$72,337.05	$535,830.00	$267,915.00	2026-03-01
263045	CDM	System Pascal Implant	47	27	$535,830.00	$535,830.00	$72,337.05	$535,830.00	$267,915.00	2026-03-01
267982	CDM	System Trcsd 1clip 1cath	47	27	$535,830.00	$535,830.00	$72,337.05	$535,830.00	$267,915.00	2026-03-01
173851	CDM	Valve Aor Sys 23mm	47	27	$535,830.00	$535,830.00	$72,337.05	$535,830.00	$267,915.00	2026-03-01
271390	CDM	Valve Tavr 23mm	47	27	$535,830.00	$535,830.00	$72,337.05	$535,830.00	$267,915.00	2026-03-01
231955	CDM	Graft Bn Algrf Whl	45	27	$591,339.00	$591,339.00	$79,830.76	$591,339.00	$266,102.55	2026-03-01
484215	CDM	Synchrony 2 Flexsoft	47	27	$508,963.00	$508,963.00	$68,710.01	$508,963.00	$254,481.50	2026-03-01
254780	CDM	Coil Embl 4mm 9mm	1	1	$338,304.00	$338,304.00	$253,728.00	$253,728.00	$253,728.00	2026-03-01
634520	CDM	Impl Pulsar Ci Ear 100 H	2	2	$382,640.00	$382,640.00	$202,799.20	$286,980.00	$244,889.60	2026-03-01
217160	CDM	Kit Pt Replacement R16	46	27	$505,748.00	$505,748.00	$68,275.98	$505,748.00	$240,230.30	2026-03-01
472854	CDM	Imp Gen Pc Plus Verc	2	2	$375,025.00	$375,025.00	$198,763.25	$281,268.75	$240,016.00	2026-03-01
858902	CDM	Graft Evas 31x14.5m 13cm	1	1	$309,446.00	$309,446.00	$232,084.50	$232,084.50	$232,084.50	2026-03-01
444728	CDM	Occluder Cv 18x18mm	1	1	$309,446.00	$309,446.00	$232,084.50	$232,084.50	$232,084.50	2026-03-01
483501	CDM	Valve Aor Ultr/trnc 20mm	47	27	$438,750.00	$438,750.00	$59,231.25	$438,750.00	$219,375.00	2026-03-01
483428	CDM	Valve Aor Ultr/trnc 23mm	47	27	$438,750.00	$438,750.00	$59,231.25	$438,750.00	$219,375.00	2026-03-01
721922	CDM	Gft Bfur 34-18x155 24fr	1	1	$289,476.00	$289,476.00	$217,107.00	$217,107.00	$217,107.00	2026-03-01
244198	CDM	Cannula W Dltr Buble Trp	2	2	$346,115.00	$346,115.00	$173,057.50	$259,586.25	$216,321.88	2026-03-01
856935	CDM	Gft Evas 38x159 24fr	2	2	$345,559.00	$345,559.00	$172,779.50	$259,169.25	$215,974.38	2026-03-01
229036	CDM	Occluder Cardiac Lt 16mm	1	1	$428,760.00	$428,760.00	$214,380.00	$214,380.00	$214,380.00	2026-03-01
229031	CDM	Occluder Cardiac Lt 18mm	1	1	$428,760.00	$428,760.00	$214,380.00	$214,380.00	$214,380.00	2026-03-01
229023	CDM	Occluder Cardiac Lt 34mm	1	1	$428,760.00	$428,760.00	$214,380.00	$214,380.00	$214,380.00	2026-03-01
472852	CDM	Stent 34mmx34mmx15cm	47	27	$427,617.00	$427,617.00	$57,728.29	$427,617.00	$213,808.50	2026-03-01
473614	CDM	Stent Eprsth 40x40x20cm	47	27	$419,232.00	$419,232.00	$56,596.32	$419,232.00	$209,616.00	2026-03-01
205115	CDM	Stnt Thorac 28x28mm 10cm	47	27	$419,232.00	$419,232.00	$56,596.32	$419,232.00	$209,616.00	2026-03-01
425506	CDM	Device Embl Pipln 14x4mm	2	2	$327,019.00	$327,019.00	$173,320.07	$245,264.25	$209,292.16	2026-03-01
462517	CDM	Implnt Cstm Crnmxf Mdpr	1	1	$417,885.00	$417,885.00	$208,942.50	$208,942.50	$208,942.50	2026-03-01
263480	CDM	Device Clsr 20mm	40	24	$404,940.00	$404,940.00	$54,666.90	$404,940.00	$207,936.69	2026-03-01
263484	CDM	Device Clsr 35mm	40	24	$404,940.00	$404,940.00	$54,666.90	$404,940.00	$207,936.69	2026-03-01
263485	CDM	Device Clsr 40mm	42	25	$404,940.00	$404,940.00	$54,666.90	$404,940.00	$207,936.69	2026-03-01
263483	CDM	Device Clsr 31mm	42	25	$404,940.00	$404,940.00	$54,666.90	$404,940.00	$207,936.69	2026-03-01
263481	CDM	Device Clsr 24mm	40	24	$404,940.00	$404,940.00	$54,666.90	$404,940.00	$207,936.69	2026-03-01
470702	CDM	Device Embl 14x3.5mm Pl	2	2	$326,334.00	$326,334.00	$163,167.00	$244,750.50	$203,958.75	2026-03-01
229026	CDM	Occluder Cardiac Lt 28mm	46	27	$428,760.00	$428,760.00	$57,882.60	$428,760.00	$203,661.00	2026-03-01
229025	CDM	Occluder Cardiac Lt 31mm	46	27	$428,760.00	$428,760.00	$57,882.60	$428,760.00	$203,661.00	2026-03-01
C1822	HCPCS	Implant Pulse 8.5x15.5in	1	1	$407,170.00	$407,170.00	$203,585.00	$203,585.00	$203,585.00	2026-03-01
263482	CDM	Device Clsr 27mm	41	24	$404,940.00	$404,940.00	$54,666.90	$404,940.00	$202,470.00	2026-03-01
866357	CDM	Set Pump 21fr 5.0	67	36	$596,780.00	$596,780.00	$41,774.60	$596,780.00	$199,921.30	2026-03-01
722072	CDM	Set Vntrc Asst 2.5in	67	36	$596,780.00	$596,780.00	$41,774.60	$596,780.00	$199,921.30	2026-03-01
862710	CDM	Set Vntrc 17.4x13.8in	67	36	$596,780.00	$596,780.00	$41,774.60	$596,780.00	$199,921.30	2026-03-01
282860	CDM	System Dlv Cath 1 Clip	67	36	$596,780.00	$596,780.00	$41,774.60	$596,780.00	$199,921.30	2026-03-01
870622	CDM	Graft Evas 26x14.5m 12cm	2	2	$309,626.00	$309,626.00	$164,101.78	$232,219.50	$198,160.64	2026-03-01
857807	CDM	Graft Evas 35x14.5m 14cm	2	2	$309,446.00	$309,446.00	$164,006.38	$232,084.50	$198,045.44	2026-03-01
C1735	HCPCS	Catheter Renal 6fr	2	2	$381,920.00	$381,920.00	$190,960.00	$202,417.60	$196,688.80	2026-03-01
428878	CDM	Impt Crnl Peek Cstm	1	1	$261,518.00	$261,518.00	$196,138.50	$196,138.50	$196,138.50	2026-03-01
426570	CDM	Graft Evas 26x12mm 12cm	2	2	$309,446.00	$309,446.00	$154,723.00	$232,084.50	$193,403.75	2026-03-01
444727	CDM	Occluder Cv 35x18mm	2	2	$309,446.00	$309,446.00	$154,723.00	$232,084.50	$193,403.75	2026-03-01
229029	CDM	Occluder Cardiac Lt 22mm	45	26	$428,760.00	$428,760.00	$57,882.60	$428,760.00	$192,942.00	2026-03-01
229030	CDM	Occluder Cardiac Lt 20mm	45	26	$428,760.00	$428,760.00	$57,882.60	$428,760.00	$192,942.00	2026-03-01
856932	CDM	Gft Evas 40x159 24fr	47	27	$384,098.00	$384,098.00	$51,853.23	$384,098.00	$192,049.00	2026-03-01
254667	CDM	Cath Vasc Assist Strl	65	35	$596,780.00	$596,780.00	$41,774.60	$596,780.00	$190,372.82	2026-03-01
265596	CDM	Kit Lo Prfl Comp Shth 7f	64	35	$596,780.00	$596,780.00	$41,774.60	$596,780.00	$190,372.82	2026-03-01
422506	CDM	Kit Pmp Rt Hrt 22f 170cm	65	35	$596,780.00	$596,780.00	$41,774.60	$596,780.00	$190,372.82	2026-03-01
C2616	HCPCS	$15,932.00	1	1	$236,680.57	$380,383.00	$190,191.50	$190,191.50	$190,191.50	2026-07-17
745288	CDM	Stent Eprsth 34mm 10cm	42	25	$354,918.00	$354,918.00	$47,913.93	$354,918.00	$182,250.40	2026-03-01
466742	CDM	Stent Eprsth 21mm 10cm	42	25	$354,918.00	$354,918.00	$47,913.93	$354,918.00	$182,250.40	2026-03-01
253624	CDM	Coil Embl Endo 8mm	3	3	$338,304.00	$338,304.00	$169,152.00	$253,728.00	$179,301.12	2026-03-01
C1833	HCPCS	Monitor Imp Cardiac	36	25	$320,379.00	$320,379.00	$43,251.17	$320,379.00	$176,208.45	2026-07-17
231983	CDM	Device Embl 4.5mm 20mm	1	1	$342,651.00	$342,651.00	$171,325.50	$171,325.50	$171,325.50	2026-03-01
470701	CDM	Dev Embl Ped 12x3.25mm	2	2	$326,334.00	$326,334.00	$163,167.00	$172,957.02	$168,062.01	2026-03-01
C1736	HCPCS	System Renal Denervation	61	33	$477,400.00	$477,400.00	$33,418.00	$477,400.00	$167,090.00	2026-03-01
101061	CDM	Valve Aortic 23mm	47	27	$333,480.00	$333,480.00	$45,019.80	$333,480.00	$166,740.00	2026-03-01
203965	CDM	Valve Aortic 21mm	47	27	$333,480.00	$333,480.00	$45,019.80	$333,480.00	$166,740.00	2026-03-01
204057	CDM	Valve Aortic 27mm	47	27	$333,480.00	$333,480.00	$45,019.80	$333,480.00	$166,740.00	2026-03-01
482623	CDM	Valve Aortic 29mm	47	27	$333,480.00	$333,480.00	$45,019.80	$333,480.00	$166,740.00	2026-03-01
588652	CDM	Graft Evas 16cm 28.5mm	1	1	$220,436.00	$220,436.00	$165,327.00	$165,327.00	$165,327.00	2026-03-01
243960	CDM	Processor Kit 2 Ears	2	2	$319,221.00	$319,221.00	$159,610.50	$169,187.13	$164,398.82	2026-03-01
858921	CDM	Graft Evas 12cm 28.5mm	3	3	$309,626.00	$309,626.00	$154,813.00	$232,219.50	$164,101.78	2026-03-01
747478	CDM	Graft Evas 18cm 26mm	3	3	$309,626.00	$309,626.00	$154,813.00	$232,219.50	$164,101.78	2026-03-01
856438	CDM	Graft Evas 14cm 26mm	3	3	$309,626.00	$309,626.00	$154,813.00	$232,219.50	$164,101.78	2026-03-01
216750	CDM	Graft Endo Aaa 36x14mm	1	1	$309,626.00	$309,626.00	$164,101.78	$164,101.78	$164,101.78	2026-03-01
216652	CDM	Graft Endo Aaa 32x14mm	3	3	$309,626.00	$309,626.00	$154,813.00	$232,219.50	$164,101.78	2026-03-01
870719	CDM	Graft Evas 28.5x12m 18cm	3	3	$309,446.00	$309,446.00	$154,723.00	$232,084.50	$164,006.38	2026-03-01
870971	CDM	Graft Evas 26x12mm 16cm	3	3	$309,446.00	$309,446.00	$154,723.00	$232,084.50	$164,006.38	2026-03-01
235623	CDM	Device Embl 4mm 14mm	46	27	$342,651.00	$342,651.00	$46,257.89	$342,651.00	$162,759.23	2026-03-01
730191	CDM	Device Ast Vent 00551042	2	2	$259,335.00	$259,335.00	$129,667.50	$194,501.25	$162,084.38	2026-03-01
429437	CDM	Device Embl Piplin 4mmx2	2	2	$314,700.00	$314,700.00	$157,350.00	$166,791.00	$162,070.50	2026-03-01
278538	CDM	Implant Spn Cerv Sys 4mm	1	1	$215,905.00	$215,905.00	$161,928.75	$161,928.75	$161,928.75	2026-03-01
862304	CDM	Coil Embl 5x25mm	1	1	$321,343.00	$321,343.00	$160,671.50	$160,671.50	$160,671.50	2026-03-01
751731	CDM	Set Pump Asst 2.5in	67	36	$477,400.00	$477,400.00	$33,418.00	$477,400.00	$159,929.00	2026-03-01
240399	CDM	Cannula Introd 29fx46cm	2	2	$310,310.00	$310,310.00	$155,155.00	$164,464.30	$159,809.65	2026-03-01
426111	CDM	Graft Stnt 28x20x100mm	2	2	$309,626.00	$309,626.00	$154,813.00	$164,101.78	$159,457.39	2026-03-01
872929	CDM	Implant Crnial Cstm Pmma	2	2	$309,626.00	$309,626.00	$154,813.00	$164,101.78	$159,457.39	2026-03-01
870836	CDM	Graft Evas 23x12mm 18cm	2	2	$309,446.00	$309,446.00	$154,723.00	$164,006.38	$159,364.69	2026-03-01
880573	CDM	Implant Cranial Med	1	1	$315,000.00	$315,000.00	$157,500.00	$157,500.00	$157,500.00	2026-03-01
714698	CDM	Implant Cranial Plate	2	2	$251,065.00	$251,065.00	$125,532.50	$188,298.75	$156,915.62	2026-03-01
220119	CDM	Kit Pt Sonnet Eas 2proc	2	2	$303,266.00	$303,266.00	$151,633.00	$160,730.98	$156,181.99	2026-03-01
442680	CDM	Valve Intuity Elte 23mm	47	27	$309,626.00	$309,626.00	$41,799.51	$309,626.00	$154,813.00	2026-03-01
218838	CDM	Stent Aaa Xcldr 12cm	47	27	$309,626.00	$309,626.00	$41,799.51	$309,626.00	$154,813.00	2026-03-01
484234	CDM	Valve Aortic 25mm	47	27	$309,626.00	$309,626.00	$41,799.51	$309,626.00	$154,813.00	2026-03-01
435490	CDM	Valve Intuity Elte 27mm	47	27	$309,626.00	$309,626.00	$41,799.51	$309,626.00	$154,813.00	2026-03-01
441774	CDM	Valve Intuity Elte 25mm	47	27	$309,626.00	$309,626.00	$41,799.51	$309,626.00	$154,813.00	2026-03-01
468690	CDM	Device Embl 16x4.25mm	1	1	$309,626.00	$309,626.00	$154,813.00	$154,813.00	$154,813.00	2026-03-01
870437	CDM	Graft Evas 23x12mm 14cm	47	27	$309,626.00	$309,626.00	$41,799.51	$309,626.00	$154,813.00	2026-03-01
723216	CDM	Stent Endpros L135 L55 O	47	27	$309,626.00	$309,626.00	$41,799.51	$309,626.00	$154,813.00	2026-03-01
211753	CDM	Graft Endo Aaa 28.5x12mm	47	27	$309,626.00	$309,626.00	$41,799.51	$309,626.00	$154,813.00	2026-03-01
244942	CDM	Device Embl 4.25mm 12mm	1	1	$309,626.00	$309,626.00	$154,813.00	$154,813.00	$154,813.00	2026-03-01
873698	CDM	Graft Evas 14.5mm 14cm	47	27	$309,446.00	$309,446.00	$41,775.21	$309,446.00	$154,723.00	2026-03-01
747006	CDM	Graft Evas 13cm 31mm	47	27	$309,446.00	$309,446.00	$41,775.21	$309,446.00	$154,723.00	2026-03-01
857849	CDM	Graft Evas 35x14.5m 18cm	47	27	$309,446.00	$309,446.00	$41,775.21	$309,446.00	$154,723.00	2026-03-01
849424	CDM	Graft Evas 18cm 26mm	47	27	$309,446.00	$309,446.00	$41,775.21	$309,446.00	$154,723.00	2026-03-01
727311	CDM	Gft Bfur 34-20x155 24fr	2	2	$300,312.00	$300,312.00	$150,156.00	$159,165.36	$154,660.68	2026-03-01
746378	CDM	Gft Bif 25-13x124mm 18fr	1	1	$308,826.00	$308,826.00	$154,413.00	$154,413.00	$154,413.00	2026-03-01
733362	CDM	Gft Bfur 36-20x155 24fr	3	3	$290,030.00	$290,030.00	$145,015.00	$217,522.50	$153,715.90	2026-03-01
423389	CDM	Valve Aor Perceval Sm	47	27	$303,408.00	$303,408.00	$40,960.08	$303,408.00	$151,704.00	2026-03-01
423391	CDM	Vlv Aor22.5+mm21-23mm Md	47	27	$303,408.00	$303,408.00	$40,960.08	$303,408.00	$151,704.00	2026-03-01
423388	CDM	Valve Aor Xlarge	47	27	$303,408.00	$303,408.00	$40,960.08	$303,408.00	$151,704.00	2026-03-01
423392	CDM	Valve Aor24+mm 23-25mm	47	27	$303,408.00	$303,408.00	$40,960.08	$303,408.00	$151,704.00	2026-03-01
722219	CDM	Cstm Skull Implnt Sz Xl	3	3	$283,757.00	$283,757.00	$141,878.50	$212,817.75	$150,391.21	2026-03-01
588642	CDM	Graft Evas 14cm 28.5mm	3	3	$281,736.00	$281,736.00	$140,868.00	$211,302.00	$149,320.08	2026-03-01
281234	CDM	Implant Cmpnt Spn	1	1	$297,754.00	$297,754.00	$148,877.00	$148,877.00	$148,877.00	2026-03-01
C1830	HCPCS	Generator Nrstm 53x48mm	42	25	$310,735.00	$310,735.00	$6,666.50	$310,735.00	$147,599.12	2026-03-01
870461	CDM	Graft Evas 26x14.5m 16cm	46	26	$309,626.00	$309,626.00	$41,799.51	$309,626.00	$147,072.35	2026-03-01
856437	CDM	Graft Evas 16cm 25.5mm	46	27	$309,626.00	$309,626.00	$41,799.51	$309,626.00	$147,072.35	2026-03-01
742019	CDM	Graft Evas 18cm 28.5mm	46	27	$309,626.00	$309,626.00	$41,799.51	$309,626.00	$147,072.35	2026-03-01
216719	CDM	Graft Endo Aaa 26x12mm	46	26	$309,626.00	$309,626.00	$41,799.51	$309,626.00	$147,072.35	2026-03-01
423117	CDM	Graft Evas 10cm 14.5mm	46	27	$309,626.00	$309,626.00	$41,799.51	$309,626.00	$147,072.35	2026-03-01
871572	CDM	Graft Evas 14.5mm 16cm	46	26	$309,626.00	$309,626.00	$41,799.51	$309,626.00	$147,072.35	2026-03-01
738989	CDM	Graft Evas 14cm 28.5mm	46	27	$309,626.00	$309,626.00	$41,799.51	$309,626.00	$147,072.35	2026-03-01
747574	CDM	Graft Evas 14cm 23mm	46	27	$309,626.00	$309,626.00	$41,799.51	$309,626.00	$147,072.35	2026-03-01
231788	CDM	Graft Endo Aaa 23x12mm	46	27	$309,626.00	$309,626.00	$41,799.51	$309,626.00	$147,072.35	2026-03-01
875911	CDM	Graft Evas 23x14.5m14cm	46	26	$309,626.00	$309,626.00	$41,799.51	$309,626.00	$147,072.35	2026-03-01
861960	CDM	Graft Evas 35x14.5m 16cm	46	27	$309,446.00	$309,446.00	$41,775.21	$309,446.00	$146,986.85	2026-03-01
857566	CDM	Graft Evas 31x14.5m 15cm	46	26	$309,446.00	$309,446.00	$41,775.21	$309,446.00	$146,986.85	2026-03-01
870016	CDM	Graft Evas 23x14.5m 16cm	46	27	$309,446.00	$309,446.00	$41,775.21	$309,446.00	$146,986.85	2026-03-01
444705	CDM	Device Anrsm Dvrsn 5x12	45	27	$326,334.00	$326,334.00	$44,055.09	$326,334.00	$146,850.30	2026-03-01
856502	CDM	Gft Bif 36-16x166mm 20fr	46	27	$308,826.00	$308,826.00	$41,691.51	$308,826.00	$146,692.35	2026-03-01
249629	CDM	Spacer Spn 10d 8x22x55mm	47	27	$291,844.00	$291,844.00	$39,398.94	$291,844.00	$145,922.00	2026-03-01
464968	CDM	Dvc Revasc 6x40mm 200cm	1	1	$194,112.00	$194,112.00	$145,584.00	$145,584.00	$145,584.00	2026-03-01
717764	CDM	Gft Bfur 34-16x155 24fr	1	1	$289,476.00	$289,476.00	$144,738.00	$144,738.00	$144,738.00	2026-03-01
856933	CDM	Gft Evas 40x114 24fr	45	26	$320,915.00	$320,915.00	$43,323.53	$320,915.00	$144,411.75	2026-03-01
853422	CDM	Dev Emb Pipeln 2.50x10mm	1	1	$190,288.00	$190,288.00	$142,716.00	$142,716.00	$142,716.00	2026-03-01
879763	CDM	Amniofix 9x20cm	1	1	$268,175.00	$268,175.00	$142,132.75	$142,132.75	$142,132.75	2026-03-01
850516	CDM	Device Vntrc Asst 2 Lvas	45	27	$315,315.00	$315,315.00	$42,567.53	$315,315.00	$141,891.75	2026-03-01
C1820	HCPCS	Neurostm Impl Ipg Restr	628	25	$311,400.00	$311,400.00	$14,180.00	$535,830.00	$141,609.29	2026-03-01
428985	CDM	Implant Cranial Peek	46	27	$297,754.00	$297,754.00	$40,196.79	$297,754.00	$141,433.15	2026-03-01
C1767	HCPCS	Neurostim Rechargeable	557	25	$306,504.00	$306,504.00	$15,679.71	$535,830.00	$139,581.03	2026-03-01
872152	CDM	Kit Implant Crnmxf Lg	45	26	$309,626.00	$309,626.00	$41,799.51	$309,626.00	$139,331.70	2026-03-01
221145	CDM	Graft Evasc 20x12mmx12cm	45	26	$309,626.00	$309,626.00	$41,799.51	$309,626.00	$139,331.70	2026-03-01
870599	CDM	Graft Evas 14.5mm 12cm	45	27	$309,446.00	$309,446.00	$41,775.21	$309,446.00	$139,250.70	2026-03-01
872483	CDM	Graft Evas 26x12mm 14cm	45	26	$309,446.00	$309,446.00	$41,775.21	$309,446.00	$139,250.70	2026-03-01
876981	CDM	Graft Evas 26x14.5m 14cm	45	26	$309,446.00	$309,446.00	$41,775.21	$309,446.00	$139,250.70	2026-03-01
870013	CDM	Graft Evas 14.5mm 18cm	45	26	$309,446.00	$309,446.00	$41,775.21	$309,446.00	$139,250.70	2026-03-01
873077	CDM	Graft Evas 26x12mm 18cm	45	27	$309,446.00	$309,446.00	$41,775.21	$309,446.00	$139,250.70	2026-03-01
859730	CDM	Graft Evas 31x14.5m 17cm	45	26	$309,446.00	$309,446.00	$41,775.21	$309,446.00	$139,250.70	2026-03-01
870017	CDM	Graft Evas 23x14.5m 18cm	45	27	$309,446.00	$309,446.00	$41,775.21	$309,446.00	$139,250.70	2026-03-01
244943	CDM	Device Embl 4mm 10mm	44	26	$309,626.00	$309,626.00	$41,799.51	$309,626.00	$138,402.82	2026-03-01
748844	CDM	Coil Embl 15cm 4mm	2	2	$221,364.00	$221,364.00	$110,682.00	$166,023.00	$138,352.50	2026-03-01
870014	CDM	Graft Evas 23x12mm 16cm	44	26	$309,446.00	$309,446.00	$41,775.21	$309,446.00	$138,322.36	2026-03-01
870031	CDM	Graft Evas 26x14.5m 18cm	44	26	$309,446.00	$309,446.00	$41,775.21	$309,446.00	$138,322.36	2026-03-01
235251	CDM	Cage Spn Mtl 12x14x40mm	1	1	$184,264.00	$184,264.00	$138,198.00	$138,198.00	$138,198.00	2026-03-01
L8614	HCPCS	Processor Snd Dual Kt	573	32	$338,358.00	$338,358.00	$13,900.14	$508,963.00	$137,979.45	2026-07-17
588582	CDM	Graft Evas 18cm 26mm	3	3	$259,136.00	$259,136.00	$129,568.00	$194,352.00	$137,342.08	2026-03-01
279200	CDM	Device Imp Spn 30mm	45	26	$297,754.00	$297,754.00	$40,196.79	$297,754.00	$133,989.30	2026-03-01
Q0479	HCPCS	Module Power Unit	2	2	$259,431.00	$259,431.00	$129,715.50	$137,498.43	$133,606.96	2026-07-17
433202	CDM	Device Revascular 3x23mm	2	2	$208,155.00	$208,155.00	$110,322.15	$156,116.25	$133,219.20	2026-03-01
749569	CDM	Dev Revsc Soltr 2-4x31	2	2	$208,155.00	$208,155.00	$110,322.15	$156,116.25	$133,219.20	2026-03-01
715204	CDM	Gft Bfur 36-18x155 24fr	46	27	$279,414.00	$279,414.00	$37,720.89	$279,414.00	$132,721.65	2026-03-01
716694	CDM	Gft Bfur 32-20x155 24fr	45	27	$291,024.00	$291,024.00	$39,288.24	$291,024.00	$130,960.80	2026-03-01
869123	CDM	Graft Evas 15cm 31mm	47	27	$259,136.00	$259,136.00	$34,983.36	$259,136.00	$129,568.00	2026-03-01
647364	CDM	Gft Evas 135x26x15mm	1	1	$240,714.00	$240,714.00	$127,578.42	$127,578.42	$127,578.42	2026-03-01
233339	CDM	Cage Spnl Long 9mm	1	1	$169,706.00	$169,706.00	$127,279.50	$127,279.50	$127,279.50	2026-03-01
446607	CDM	Cage Spnl 39mmx15mm Mdln	1	1	$169,706.00	$169,706.00	$127,279.50	$127,279.50	$127,279.50	2026-03-01
715873	CDM	Gft Bfur 24-12x185 22fr	46	27	$267,030.00	$267,030.00	$36,049.05	$267,030.00	$126,839.25	2026-03-01
751387	CDM	Dev Emb Pipln 18x4.25mm	2	2	$196,377.00	$196,377.00	$104,079.81	$147,282.75	$125,681.28	2026-03-01
710411	CDM	Stnt Bfr Anrx 135 22x13	47	27	$250,776.00	$250,776.00	$33,854.76	$250,776.00	$125,388.00	2026-03-01
467631	CDM	Cage Spn Cncrd 9x8x23	45	26	$278,549.00	$278,549.00	$37,604.11	$278,549.00	$125,347.05	2026-03-01
865173	CDM	Disc Intvrtb 17mm 5mm	1	1	$166,306.00	$166,306.00	$124,729.50	$124,729.50	$124,729.50	2026-03-01
471525	CDM	Kit Sterial 8 Fr	1	1	$165,685.00	$165,685.00	$124,263.75	$124,263.75	$124,263.75	2026-03-01
454241	CDM	Valve Aortic 29mm	47	27	$248,285.00	$248,285.00	$33,518.47	$248,285.00	$124,142.50	2026-03-01
710302	CDM	Stnt Bfr Anrx 165 20x12	47	27	$246,906.00	$246,906.00	$33,332.31	$246,906.00	$123,453.00	2026-03-01
849670	CDM	Stnt Bfr Anrx 165 24x14	47	27	$246,906.00	$246,906.00	$33,332.31	$246,906.00	$123,453.00	2026-03-01
647353	CDM	Stnt Bfr Anrx 165 22x13	47	27	$246,906.00	$246,906.00	$33,332.31	$246,906.00	$123,453.00	2026-03-01
647374	CDM	Stnt Bfr Anrx 165 26x15	47	27	$246,906.00	$246,906.00	$33,332.31	$246,906.00	$123,453.00	2026-03-01
588572	CDM	Graft Evas 16cm 26mm	46	26	$259,136.00	$259,136.00	$34,983.36	$259,136.00	$123,089.60	2026-03-01
588602	CDM	Graft Evas 18cm 26mm	46	27	$259,136.00	$259,136.00	$34,983.36	$259,136.00	$123,089.60	2026-03-01
424841	CDM	Stent Aaa Ova 20mm	47	27	$244,553.00	$244,553.00	$33,014.65	$244,553.00	$122,276.50	2026-03-01
317287	CDM	Matrix Tiss Amn 3x6cm	2	2	$194,569.00	$194,569.00	$97,284.50	$145,926.75	$121,605.62	2026-03-01
714673	CDM	Gft Bfur 30-18x140 24fr	45	26	$270,126.00	$270,126.00	$36,467.01	$270,126.00	$121,556.70	2026-03-01
716438	CDM	Gft Bfur 32-18x155 24fr	45	27	$270,126.00	$270,126.00	$36,467.01	$270,126.00	$121,556.70	2026-03-01
711991	CDM	Combo Valve	2	2	$188,721.00	$188,721.00	$100,022.13	$141,540.75	$120,781.44	2026-03-01
274540	CDM	Stent Graft 15x6mm	47	27	$241,488.00	$241,488.00	$32,600.88	$241,488.00	$120,744.00	2026-03-01
710301	CDM	Stnt Bfr Anrx 135 20x12	47	27	$240,714.00	$240,714.00	$32,496.39	$240,714.00	$120,357.00	2026-03-01
710303	CDM	Stnt Bfr Anrx 135 26x15	47	27	$240,714.00	$240,714.00	$32,496.39	$240,714.00	$120,357.00	2026-03-01
647384	CDM	Stnt Bfr Anrx 165 28x16	47	27	$240,714.00	$240,714.00	$32,496.39	$240,714.00	$120,357.00	2026-03-01
710304	CDM	Stnt Bfr Anrx 135 28x16	47	27	$240,714.00	$240,714.00	$32,496.39	$240,714.00	$120,357.00	2026-03-01
850996	CDM	Stnt Bfr Anrx 135 24x14	47	27	$240,714.00	$240,714.00	$32,496.39	$240,714.00	$120,357.00	2026-03-01
708518	CDM	Graft Evas 12cm 28.5mm	45	26	$266,876.00	$266,876.00	$36,028.26	$266,876.00	$120,094.20	2026-03-01
709536	CDM	Graft Evas 12cm 26mm	46	27	$252,789.00	$252,789.00	$34,126.51	$252,789.00	$120,074.77	2026-03-01
872928	CDM	Implant Cranial Peek	3	3	$224,324.00	$224,324.00	$112,162.00	$168,243.00	$118,891.72	2026-03-01
477867	CDM	Cage Spn 18x28-41mm	1	1	$158,000.00	$158,000.00	$118,500.00	$118,500.00	$118,500.00	2026-03-01
A9543	HCPCS	Y90 Ibritum Tiu Tx 40mci	47	32	$236,737.91	$236,737.91	$16,571.65	$236,737.91	$118,368.96	2026-07-17
714690	CDM	Occluder Cv Vsd 7x6mm	45	26	$262,851.00	$262,851.00	$35,484.89	$262,851.00	$118,282.95	2026-03-01
425157	CDM	Icd Crd 5.23x7.14x0.99	45	27	$261,551.00	$261,551.00	$35,309.39	$261,551.00	$117,697.95	2026-03-01
464930	CDM	Valve Aortic 19mm	47	27	$234,260.00	$234,260.00	$31,625.10	$234,260.00	$117,130.00	2026-03-01
588542	CDM	Graft Evas 14cm 23mm	3	3	$220,436.00	$220,436.00	$110,218.00	$165,327.00	$116,831.08	2026-03-01
265418	CDM	Valve Mitral 27mm	47	27	$233,534.00	$233,534.00	$31,527.09	$233,534.00	$116,767.00	2026-03-01
Q0495	HCPCS	$4,305.83	1	1	$130,654.96	$233,488.00	$116,744.00	$116,744.00	$116,744.00	2026-07-17
223667	CDM	Cage Spnl 20mm	3	3	$220,139.00	$220,139.00	$110,069.50	$165,104.25	$116,673.67	2026-03-01
435785	CDM	Omni Vbr 0 26mm Het	1	1	$230,216.00	$230,216.00	$115,108.00	$115,108.00	$115,108.00	2026-03-01
265452	CDM	Cage Spnl Exp 18mm	45	26	$254,619.00	$254,619.00	$34,373.57	$254,619.00	$114,578.55	2026-03-01
158329	CDM	Graft Evas 14cm 26mm	46	27	$240,838.00	$240,838.00	$32,513.13	$240,838.00	$114,398.05	2026-03-01
240852	CDM	Graft Bn Lgii 8cc 3x4in	2	2	$180,940.00	$180,940.00	$90,470.00	$135,705.00	$113,087.50	2026-03-01
454262	CDM	Valve Aortic 25mm	47	27	$222,912.00	$222,912.00	$30,093.12	$222,912.00	$111,456.00	2026-03-01
225880	CDM	Valve Aortic 23mm	47	27	$222,912.00	$222,912.00	$30,093.12	$222,912.00	$111,456.00	2026-03-01
254704	CDM	Valve Mitral 25mm	47	27	$222,912.00	$222,912.00	$30,093.12	$222,912.00	$111,456.00	2026-03-01
254706	CDM	Valve Mitral Size 33	47	27	$222,912.00	$222,912.00	$30,093.12	$222,912.00	$111,456.00	2026-03-01
464932	CDM	Valve Aortic 21mm	47	27	$222,912.00	$222,912.00	$30,093.12	$222,912.00	$111,456.00	2026-03-01
254387	CDM	Valve Mitral 31mm	47	27	$222,912.00	$222,912.00	$30,093.12	$222,912.00	$111,456.00	2026-03-01
225334	CDM	Valve Aortic 27mm	47	27	$222,912.00	$222,912.00	$30,093.12	$222,912.00	$111,456.00	2026-03-01
254705	CDM	Valve Mitral 29mm	47	27	$222,912.00	$222,912.00	$30,093.12	$222,912.00	$111,456.00	2026-03-01
480857	CDM	Cage Spn 21x25x16mm Xpd	3	3	$209,226.00	$209,226.00	$104,613.00	$156,919.50	$110,889.78	2026-03-01
423052	CDM	Valve Aortic 19mm	47	27	$221,210.00	$221,210.00	$29,863.35	$221,210.00	$110,605.00	2026-03-01
232509	CDM	Cage Spnl Long 7mm	2	2	$169,706.00	$169,706.00	$89,944.18	$127,279.50	$108,611.84	2026-03-01
451271	CDM	Cage Spn 33x11x8mm 3d	2	2	$169,706.00	$169,706.00	$89,944.18	$127,279.50	$108,611.84	2026-03-01
588562	CDM	Graft Evas 14cm 26mm	45	27	$240,838.00	$240,838.00	$32,513.13	$240,838.00	$108,377.10	2026-03-01
100411	CDM	Disc Spn Intbrtb 19x5x17	2	2	$166,306.00	$166,306.00	$88,142.18	$124,729.50	$106,435.84	2026-03-01
864406	CDM	Disc Intvrtb 15x5x13mm	2	2	$166,306.00	$166,306.00	$88,142.18	$124,729.50	$106,435.84	2026-03-01
259503	CDM	Endcap Spn Ylw 13mm	1	1	$200,628.00	$200,628.00	$106,332.84	$106,332.84	$106,332.84	2026-03-01
429274	CDM	Cage Spn 34x24x6mm 10d	2	2	$169,706.00	$169,706.00	$84,853.00	$127,279.50	$106,066.25	2026-03-01
716499	CDM	Spacer Spnl 27x10x8mm T-	47	27	$211,094.00	$211,094.00	$28,497.69	$211,094.00	$105,547.00	2026-03-01
718691	CDM	dcnrstm Impl Prcsn Pls	45	26	$234,522.00	$234,522.00	$31,660.47	$234,522.00	$105,534.90	2026-03-01
423057	CDM	Valve Aortic 29mm	47	27	$210,374.00	$210,374.00	$28,400.49	$210,374.00	$105,187.00	2026-03-01
436441	CDM	Spacer Spn 20mm 26-34mm	47	27	$210,317.00	$210,317.00	$28,392.79	$210,317.00	$105,158.50	2026-03-01
218198	CDM	Spacer Spn 20mm 41mm	47	27	$210,317.00	$210,317.00	$28,392.79	$210,317.00	$105,158.50	2026-03-01
879277	CDM	Spacer Spn 20x31x20mm	47	27	$210,317.00	$210,317.00	$28,392.79	$210,317.00	$105,158.50	2026-03-01
710065	CDM	Gft Stntflr 19f24x13.5	1	1	$140,070.00	$140,070.00	$105,052.50	$105,052.50	$105,052.50	2026-03-01
234750	CDM	Graft Evas 13.5cm 18mm	1	1	$140,070.00	$140,070.00	$105,052.50	$105,052.50	$105,052.50	2026-03-01
588552	CDM	Graft Evas 16cm 23mm	46	26	$220,436.00	$220,436.00	$29,758.86	$220,436.00	$104,707.10	2026-03-01
588592	CDM	Graft Evas 16cm 26mm	46	27	$220,436.00	$220,436.00	$29,758.86	$220,436.00	$104,707.10	2026-03-01
C1882	HCPCS	Crt-d Crd 5.37x8.08x0.99	1,461	25	$314,448.00	$314,448.00	$12,401.50	$583,590.00	$104,653.59	2026-03-01
244561	CDM	Retrvr Revac .021in 32mm	3	3	$197,145.00	$197,145.00	$98,572.50	$147,858.75	$104,486.85	2026-03-01
209	MS_DRG	Complex Aortic Arch Procedures	6	2	—	—	$104,389.76	$106,270.66	$104,389.76	2026-03-01
219543	CDM	Cage 36x26x13mm 12deg	2	2	$162,912.00	$162,912.00	$86,343.36	$122,184.00	$104,263.68	2026-03-01
445228	CDM	Matrix Tiss Amn 3x8cm	45	26	$231,388.00	$231,388.00	$31,237.38	$231,388.00	$104,124.60	2026-03-01
253158	CDM	Impl Disc Spn Ht 4 Sz2	2	2	$166,306.00	$166,306.00	$83,153.00	$124,729.50	$103,941.25	2026-03-01
563181	CDM	Cnla Vntrc Art 42f	2	2	$165,975.00	$165,975.00	$82,987.50	$124,481.25	$103,734.38	2026-03-01
718836	CDM	Valve Aor 29mm	47	27	$207,432.00	$207,432.00	$28,003.32	$207,432.00	$103,716.00	2026-03-01
232021	CDM	End Cap 13 Mm 35-51mm	46	26	$217,097.00	$217,097.00	$29,308.10	$217,097.00	$103,121.07	2026-03-01
37231	CPT	Stent/ath/tib/peron Ini	92	29	$187,322.55	$187,322.55	$25,288.54	$250,878.42	$103,027.40	2026-07-17
223668	CDM	Graft Drms Ptch 16x20cm	45	26	$228,154.00	$228,154.00	$30,800.79	$228,154.00	$102,669.30	2026-03-01
272157	CDM	Ins/repl Spnl Neurostm	2	2	$159,539.52	$159,539.52	$84,555.95	$119,654.64	$102,105.29	2026-03-01
718112	CDM	Valve Aort Mos Ultra 29	47	27	$204,182.00	$204,182.00	$27,564.57	$204,182.00	$102,091.00	2026-03-01
241867	CDM	Cage Spn 6d 8x22x55mm	1	1	$135,760.00	$135,760.00	$101,820.00	$101,820.00	$101,820.00	2026-03-01
284770	CDM	Cage Spn 12x14mm 38-54mm	45	26	$225,070.00	$225,070.00	$30,384.45	$225,070.00	$101,281.50	2026-03-01
710071	CDM	Graft Aorta-iliac Vein	47	27	$202,008.00	$202,008.00	$27,271.08	$202,008.00	$101,004.00	2026-03-01
37227	CPT	Revsc Fm/pop W Stn/at Bi	93	29	$183,454.16	$183,454.16	$24,766.31	$245,697.54	$100,899.79	2026-07-17
212	MS_DRG	Concomitant Aortic And Mitral Valve Procedures	6	2	—	—	$100,338.32	$102,146.21	$100,338.32	2026-03-01
851885	CDM	Graft Cv 10x40 Thor Aor	2	2	$156,761.00	$156,761.00	$83,083.33	$117,570.75	$100,327.04	2026-03-01
877893	CDM	Allogft Plvs Hmi Frz Lr	2	2	$194,001.00	$194,001.00	$97,000.50	$102,820.53	$99,910.51	2026-03-01
484440	CDM	Procssr Dual Naida Ciq90	66	36	$303,266.00	$303,266.00	$21,228.62	$303,266.00	$99,167.98	2026-03-01
741540	CDM	Valve Trfcta 20x35x29mm	47	27	$197,990.00	$197,990.00	$26,728.65	$197,990.00	$98,995.00	2026-03-01
741537	CDM	Valve Trfcta 17x28x23mm	47	27	$197,990.00	$197,990.00	$26,728.65	$197,990.00	$98,995.00	2026-03-01

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