Price Transparency Hospital negotiated rates

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

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Hospital

South Texas Rehabiltation Hospital

Brownsville, TX · CCN 453092 · Rates published

3,093 distinct procedures filed
42 distinct payers
28,427 rate rows
2026-05-06 last MRF observed
Data quality

4,638 of 28,427 rate rows are consumer-grade (16.3%)

23,789 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 23,356
per-diem day rate — not a per-procedure price 433
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://ernesthealth.com/pricing/2026/470944648_south-texas-rehabilitation-hospital_standard-charges.json
Found on page https://strh.ernesthealth.com/price-transparency/
Discovered viaCMS hospital list
Last fetch not_modified · 2026-05-17
Content fingerprint c92ed7ca5bf27dad… · 8,863,897 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
B0407
LOCAL 		Traumatic Spinal Cord Injury M <24.50 And A >=61.50- Tier Tier 1 10 $79,919.92 $79,919.92 $79,919.92 nat. median
$79,920
1.0× median
C0407
LOCAL 		Traumatic Spinal Cord Injury M <24.50 And A >=61.50- Tier Tier 2 10 $54,419.98 $54,419.98 $54,419.98 nat. median
$70,083
0.8× median
B0106
LOCAL 		Stroke M <41.50 And A <84.50- Tier Tier 1 10 $46,733.67 $46,733.67 $46,733.67 nat. median
$53,762
0.9× median
C0106
LOCAL 		Stroke M <41.50 And A <84.50- Tier Tier 2 10 $40,530.17 $40,530.17 $40,530.17 nat. median
$46,986
0.9× median
B0604
LOCAL 		Neurological M <43.50- Tier Tier 1 10 $40,044.57 $40,044.57 $40,044.57 nat. median
$46,423
0.9× median
C0105
LOCAL 		Stroke M <41.50 And A >=84.50- Tier Tier 2 10 $39,371.07 $39,371.07 $39,371.07 nat. median
$41,402
1.0× median
B0305
LOCAL 		Non-traumatic Brain Injury M <42.50 And A <78.50- Tier Tier 1 10 $38,341.74 $38,341.74 $38,341.74 nat. median
$44,232
0.9× median
C0505
LOCAL 		Non-traumatic Spinal Cord Injury M <39.50- Tier Tier 2 10 $37,732.32 $37,732.32 $37,732.32 nat. median
$43,704
0.9× median
B1004
LOCAL 		Amputation Lower Extremity M <47.50- Tier Tier 1 10 $37,000.70 $37,000.70 $37,000.70 nat. median
$42,470
0.9× median
D0106
LOCAL 		Stroke M <41.50 And A <84.50- Tier Tier 3 10 $36,296.94 $37,037.69 $36,667.32 nat. median
$42,703
0.9× median
B1404
LOCAL 		Cardiac M <45.50- Tier Tier 1 10 $34,503.54 $37,851.24 $36,177.39 nat. median
$39,603
0.9× median
B2005
LOCAL 		Miscellaneous M <46.50 And A <77.50- Tier Tier 1 10 $35,715.94 $35,715.94 $35,715.94 nat. median
$40,995
0.9× median
A0106
LOCAL 		Stroke M <41.50 And A <84.50- Tier None 4 $1,579.24 $35,296.27 $34,720.55 nat. median
$39,573
0.9× median
C1004
LOCAL 		Amputation Lower Extremity M <47.50- Tier Tier 2 10 $34,624.68 $34,624.68 $34,624.68 nat. median
$35,393
1.0× median
B0904
LOCAL 		Other Orthopedic M <44.5- Tier Tier 1 10 $34,436.01 $34,436.01 $34,436.01 nat. median
$40,010
0.9× median
B2004
LOCAL 		Miscellaneous M <46.50 And A >=77.50- Tier Tier 1 10 $33,884.48 $33,884.48 $33,884.48 nat. median
$39,191
0.9× median
D0105
LOCAL 		Stroke M <41.50 And A >=84.50- Tier Tier 3 10 $31,911.49 $35,670.22 $33,790.86 nat. median
$37,662
0.9× median
A0505
LOCAL 		Non-traumatic Spinal Cord Injury M <39.50- Tier None 10 $32,848.96 $32,848.96 $32,848.96 nat. median
$37,907
0.9× median
C1705
LOCAL 		Major Multiple Trauma Without Brain Or Spinal Cord Injury M <36.50- Tier Tier 2 10 $32,771.77 $32,771.77 $32,771.77 nat. median
$37,992
0.9× median
D0205
LOCAL 		Traumatic Brain Injury M <35.50- Tier Tier 3 10 $31,737.86 $31,737.86 $31,737.86 nat. median
$36,592
0.9× median
A0105
LOCAL 		Stroke M <41.50 And A >=84.50- Tier None 10 $31,033.57 $31,033.57 $31,033.57 nat. median
$35,375
0.9× median
D1705
LOCAL 		Major Multiple Trauma Without Brain Or Spinal Cord Injury M <36.50- Tier Tier 3 10 $30,350.19 $30,350.19 $30,350.19 nat. median
$34,992
0.9× median
C0604
LOCAL 		Neurological M <43.50- Tier Tier 2 10 $29,980.36 $29,980.36 $29,980.36 nat. median
$34,756
0.9× median
A0205
LOCAL 		Traumatic Brain Injury M <35.50- Tier None 10 $29,880.67 $29,880.67 $29,880.67 nat. median
$33,234
0.9× median
C2004
LOCAL 		Miscellaneous M <46.50 And A >=77.50- Tier Tier 2 10 $29,878.29 $29,878.29 $29,878.29 nat. median
$31,232
1.0× median
C0205
LOCAL 		Traumatic Brain Injury M <35.50- Tier Tier 2 10 $24,033.17 $34,942.52 $29,487.85 nat. median
$40,508
0.7× median
C0704
LOCAL 		Fracture Of Lower Extremity M <41.50- Tier Tier 2 10 $28,948.05 $28,948.05 $28,948.05 nat. median
$33,146
0.9× median
C0904
LOCAL 		Other Orthopedic M <44.5- Tier Tier 2 10 $27,581.29 $30,024.63 $28,802.96 nat. median
$31,818
0.9× median
C2005
LOCAL 		Miscellaneous M <46.50 And A <77.50- Tier Tier 2 10 $28,528.38 $28,528.38 $28,528.38 nat. median
$32,921
0.9× median
D1704
LOCAL 		Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=36.50 And M <41.50… 10 $28,471.30 $28,471.30 $28,471.30 nat. median
$29,818
1.0× median
B2003
LOCAL 		Miscellaneous M >=46.50 And M <55.50- Tier Tier 1 10 $28,340.24 $28,340.24 $28,340.24 nat. median
$32,854
0.9× median
D0305
LOCAL 		Non-traumatic Brain Injury M <42.50 And A <78.50- Tier Tier 3 10 $28,177.84 $28,177.84 $28,177.84 nat. median
$32,319
0.9× median
B1403
LOCAL 		Cardiac M >=45.50 And M <55.50- Tier Tier 1 10 $28,158.55 $28,158.55 $28,158.55 nat. median
$32,487
0.9× median
D0604
LOCAL 		Neurological M <43.50- Tier Tier 3 10 $27,988.10 $27,988.10 $27,988.10 nat. median
$32,269
0.9× median
D1504
LOCAL 		Pulmonary M <45.50- Tier Tier 3 10 $27,915.74 $27,915.74 $27,915.74 nat. median
$32,186
0.9× median
C0304
LOCAL 		Non-traumatic Brain Injury M <42.50 And A >=78.50- Tier Tier 2 10 $27,814.44 $27,814.44 $27,814.44 nat. median
$32,043
0.9× median
D0505
LOCAL 		Non-traumatic Spinal Cord Injury M <39.50- Tier Tier 3 10 $19,950.96 $35,646.80 $27,798.88 nat. median
$41,099
0.7× median
A1705
LOCAL 		Major Multiple Trauma Without Brain Or Spinal Cord Injury M <36.50- Tier None 10 $27,534.66 $27,534.66 $27,534.66 nat. median
$31,920
0.9× median
C1404
LOCAL 		Cardiac M <45.50- Tier Tier 2 10 $27,180.91 $27,180.91 $27,180.91 nat. median
$30,962
0.9× median
D0704
LOCAL 		Fracture Of Lower Extremity M <41.50- Tier Tier 3 10 $26,873.66 $27,422.10 $27,147.88 nat. median
$31,616
0.9× median
D2005
LOCAL 		Miscellaneous M <46.50 And A <77.50- Tier Tier 3 10 $26,650.28 $26,650.28 $26,650.28 nat. median
$30,727
0.9× median
C0805
LOCAL 		Replacement Of Lower-extremity Joint M <42.50- Tier Tier 2 10 $26,595.61 $26,595.61 $26,595.61 nat. median
$30,832
0.9× median
A0305
LOCAL 		Non-traumatic Brain Injury M <42.50 And A <78.50- Tier None 10 $26,558.63 $26,558.63 $26,558.63 nat. median
$30,648
0.9× median
A0604
LOCAL 		Neurological M <43.50- Tier None 10 $25,241.71 $27,674.35 $26,458.03 nat. median
$28,952
0.9× median
D0304
LOCAL 		Non-traumatic Brain Injury M <42.50 And A >=78.50- Tier Tier 3 10 $25,550.44 $25,550.44 $25,550.44 nat. median
$29,475
0.9× median
D0904
LOCAL 		Other Orthopedic M <44.5- Tier Tier 3 10 $25,193.86 $25,708.02 $25,450.94 nat. median
$29,640
0.9× median
A0704
LOCAL 		Fracture Of Lower Extremity M <41.50- Tier None 10 $25,261.32 $25,334.97 $25,298.15 nat. median
$29,236
0.9× median
D2004
LOCAL 		Miscellaneous M <46.50 And A >=77.50- Tier Tier 3 10 $25,283.52 $25,283.52 $25,283.52 nat. median
$29,151
0.9× median
D0104
LOCAL 		Stroke M >=41.50 And M <50.50- Tier Tier 3 10 $22,574.59 $26,040.87 $24,307.73 nat. median
$30,024
0.8× median
A2005
LOCAL 		Miscellaneous M <46.50 And A <77.50- Tier None 10 $24,257.64 $24,257.64 $24,257.64 nat. median
$27,843
0.9× median

Other procedures at this hospital

Browse this hospital's 3,093 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
             
B0407 LOCAL Traumatic Spinal Cord Injury M <24.50 And A >=61.50- Tier Tier 1 22 10 — — $79,919.92 $79,919.92 $79,919.92 2026-03-17
C0407 LOCAL Traumatic Spinal Cord Injury M <24.50 And A >=61.50- Tier Tier 2 22 10 — — $54,419.98 $54,419.98 $54,419.98 2026-03-17
B0106 LOCAL Stroke M <41.50 And A <84.50- Tier Tier 1 22 10 — — $46,733.67 $46,733.67 $46,733.67 2026-03-17
C0106 LOCAL Stroke M <41.50 And A <84.50- Tier Tier 2 22 10 — — $40,530.17 $40,530.17 $40,530.17 2026-03-17
B0604 LOCAL Neurological M <43.50- Tier Tier 1 22 10 — — $40,044.57 $40,044.57 $40,044.57 2026-03-17
C0105 LOCAL Stroke M <41.50 And A >=84.50- Tier Tier 2 22 10 — — $39,371.07 $39,371.07 $39,371.07 2026-03-17
B0305 LOCAL Non-traumatic Brain Injury M <42.50 And A <78.50- Tier Tier 1 22 10 — — $38,341.74 $38,341.74 $38,341.74 2026-03-17
C0505 LOCAL Non-traumatic Spinal Cord Injury M <39.50- Tier Tier 2 22 10 — — $37,732.32 $37,732.32 $37,732.32 2026-03-17
B1004 LOCAL Amputation Lower Extremity M <47.50- Tier Tier 1 22 10 — — $37,000.70 $37,000.70 $37,000.70 2026-03-17
D0106 LOCAL Stroke M <41.50 And A <84.50- Tier Tier 3 22 10 — — $36,296.94 $37,037.69 $36,667.32 2026-03-17
B1404 LOCAL Cardiac M <45.50- Tier Tier 1 22 10 — — $34,503.54 $37,851.24 $36,177.39 2026-03-17
B2005 LOCAL Miscellaneous M <46.50 And A <77.50- Tier Tier 1 22 10 — — $35,715.94 $35,715.94 $35,715.94 2026-03-17
A0106 LOCAL Stroke M <41.50 And A <84.50- Tier None 4 4 — — $1,579.24 $35,296.27 $34,720.55 2026-03-17
C1004 LOCAL Amputation Lower Extremity M <47.50- Tier Tier 2 22 10 — — $34,624.68 $34,624.68 $34,624.68 2026-03-17
B0904 LOCAL Other Orthopedic M <44.5- Tier Tier 1 22 10 — — $34,436.01 $34,436.01 $34,436.01 2026-03-17
B2004 LOCAL Miscellaneous M <46.50 And A >=77.50- Tier Tier 1 22 10 — — $33,884.48 $33,884.48 $33,884.48 2026-03-17
D0105 LOCAL Stroke M <41.50 And A >=84.50- Tier Tier 3 22 10 — — $31,911.49 $35,670.22 $33,790.86 2026-03-17
A0505 LOCAL Non-traumatic Spinal Cord Injury M <39.50- Tier None 22 10 — — $32,848.96 $32,848.96 $32,848.96 2026-03-17
C1705 LOCAL Major Multiple Trauma Without Brain Or Spinal Cord Injury M <36.50- Tier Tier 2 22 10 — — $32,771.77 $32,771.77 $32,771.77 2026-03-17
D0205 LOCAL Traumatic Brain Injury M <35.50- Tier Tier 3 22 10 — — $31,737.86 $31,737.86 $31,737.86 2026-03-17
A0105 LOCAL Stroke M <41.50 And A >=84.50- Tier None 22 10 — — $31,033.57 $31,033.57 $31,033.57 2026-03-17
D1705 LOCAL Major Multiple Trauma Without Brain Or Spinal Cord Injury M <36.50- Tier Tier 3 22 10 — — $30,350.19 $30,350.19 $30,350.19 2026-03-17
C0604 LOCAL Neurological M <43.50- Tier Tier 2 22 10 — — $29,980.36 $29,980.36 $29,980.36 2026-03-17
A0205 LOCAL Traumatic Brain Injury M <35.50- Tier None 22 10 — — $29,880.67 $29,880.67 $29,880.67 2026-03-17
C2004 LOCAL Miscellaneous M <46.50 And A >=77.50- Tier Tier 2 22 10 — — $29,878.29 $29,878.29 $29,878.29 2026-03-17
C0205 LOCAL Traumatic Brain Injury M <35.50- Tier Tier 2 22 10 — — $24,033.17 $34,942.52 $29,487.85 2026-03-17
C0704 LOCAL Fracture Of Lower Extremity M <41.50- Tier Tier 2 22 10 — — $28,948.05 $28,948.05 $28,948.05 2026-03-17
C0904 LOCAL Other Orthopedic M <44.5- Tier Tier 2 22 10 — — $27,581.29 $30,024.63 $28,802.96 2026-03-17
C2005 LOCAL Miscellaneous M <46.50 And A <77.50- Tier Tier 2 22 10 — — $28,528.38 $28,528.38 $28,528.38 2026-03-17
D1704 LOCAL Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=36.50 And M <41.50… 22 10 — — $28,471.30 $28,471.30 $28,471.30 2026-03-17
B2003 LOCAL Miscellaneous M >=46.50 And M <55.50- Tier Tier 1 22 10 — — $28,340.24 $28,340.24 $28,340.24 2026-03-17
D0305 LOCAL Non-traumatic Brain Injury M <42.50 And A <78.50- Tier Tier 3 22 10 — — $28,177.84 $28,177.84 $28,177.84 2026-03-17
B1403 LOCAL Cardiac M >=45.50 And M <55.50- Tier Tier 1 22 10 — — $28,158.55 $28,158.55 $28,158.55 2026-03-17
D0604 LOCAL Neurological M <43.50- Tier Tier 3 22 10 — — $27,988.10 $27,988.10 $27,988.10 2026-03-17
D1504 LOCAL Pulmonary M <45.50- Tier Tier 3 22 10 — — $27,915.74 $27,915.74 $27,915.74 2026-03-17
C0304 LOCAL Non-traumatic Brain Injury M <42.50 And A >=78.50- Tier Tier 2 22 10 — — $27,814.44 $27,814.44 $27,814.44 2026-03-17
D0505 LOCAL Non-traumatic Spinal Cord Injury M <39.50- Tier Tier 3 22 10 — — $19,950.96 $35,646.80 $27,798.88 2026-03-17
A1705 LOCAL Major Multiple Trauma Without Brain Or Spinal Cord Injury M <36.50- Tier None 22 10 — — $27,534.66 $27,534.66 $27,534.66 2026-03-17
C1404 LOCAL Cardiac M <45.50- Tier Tier 2 22 10 — — $27,180.91 $27,180.91 $27,180.91 2026-03-17
D0704 LOCAL Fracture Of Lower Extremity M <41.50- Tier Tier 3 22 10 — — $26,873.66 $27,422.10 $27,147.88 2026-03-17
D2005 LOCAL Miscellaneous M <46.50 And A <77.50- Tier Tier 3 22 10 — — $26,650.28 $26,650.28 $26,650.28 2026-03-17
C0805 LOCAL Replacement Of Lower-extremity Joint M <42.50- Tier Tier 2 22 10 — — $26,595.61 $26,595.61 $26,595.61 2026-03-17
A0305 LOCAL Non-traumatic Brain Injury M <42.50 And A <78.50- Tier None 22 10 — — $26,558.63 $26,558.63 $26,558.63 2026-03-17
A0604 LOCAL Neurological M <43.50- Tier None 22 10 — — $25,241.71 $27,674.35 $26,458.03 2026-03-17
D0304 LOCAL Non-traumatic Brain Injury M <42.50 And A >=78.50- Tier Tier 3 22 10 — — $25,550.44 $25,550.44 $25,550.44 2026-03-17
D0904 LOCAL Other Orthopedic M <44.5- Tier Tier 3 22 10 — — $25,193.86 $25,708.02 $25,450.94 2026-03-17
A0704 LOCAL Fracture Of Lower Extremity M <41.50- Tier None 22 10 — — $25,261.32 $25,334.97 $25,298.15 2026-03-17
D2004 LOCAL Miscellaneous M <46.50 And A >=77.50- Tier Tier 3 22 10 — — $25,283.52 $25,283.52 $25,283.52 2026-03-17
D0104 LOCAL Stroke M >=41.50 And M <50.50- Tier Tier 3 22 10 — — $22,574.59 $26,040.87 $24,307.73 2026-03-17
A2005 LOCAL Miscellaneous M <46.50 And A <77.50- Tier None 22 10 — — $24,257.64 $24,257.64 $24,257.64 2026-03-17
D0805 LOCAL Replacement Of Lower-extremity Joint M <42.50- Tier Tier 3 22 10 — — $24,247.99 $24,247.99 $24,247.99 2026-03-17
A0304 LOCAL Non-traumatic Brain Injury M <42.50 And A >=78.50- Tier None 22 10 — — $24,082.37 $24,082.37 $24,082.37 2026-03-17
C1503 LOCAL Pulmonary M >=45.50 And M <56.50- Tier Tier 2 22 10 — — $23,968.21 $23,968.21 $23,968.21 2026-03-17
C0603 LOCAL Neurological M >=43.50 And M <52.50- Tier Tier 2 22 10 — — $23,905.50 $23,905.50 $23,905.50 2026-03-17
D1203 LOCAL Osteoarthritis M <49.50 And A >=74.50- Tier Tier 3 22 10 — — $23,868.52 $23,868.52 $23,868.52 2026-03-17
B2002 LOCAL Miscellaneous M >=55.50 And M <66.50- Tier Tier 1 22 10 — — $23,665.91 $23,665.91 $23,665.91 2026-03-17
A0504 LOCAL Non-traumatic Spinal Cord Injury M >=39.50 And M <48.50- Tier None 22 10 — — $23,640.19 $23,640.19 $23,640.19 2026-03-17
D0603 LOCAL Neurological M >=43.50 And M <52.50- Tier Tier 3 22 10 — — $22,316.84 $24,361.40 $23,339.12 2026-03-17
A0204 LOCAL Traumatic Brain Injury M >=35.50 And M <49.50- Tier None 22 10 — — $23,328.24 $23,328.24 $23,328.24 2026-03-17
A0904 LOCAL Other Orthopedic M <44.5- Tier None 22 10 — — $23,050.78 $23,521.20 $23,285.99 2026-03-17
D0503 LOCAL Non-traumatic Spinal Cord Injury M >=48.50 And M <53.50- Tier Tier 3 22 10 — — $23,195.96 $23,195.96 $23,195.96 2026-03-17
A2004 LOCAL Miscellaneous M <46.50 And A >=77.50- Tier None 22 10 — — $23,013.08 $23,013.08 $23,013.08 2026-03-17
D0703 LOCAL Fracture Of Lower Extremity M >=41.50 And M <52.50- Tier Tier 3 22 10 — — $22,447.08 $22,447.08 $22,447.08 2026-03-17
D1404 LOCAL Cardiac M <45.50- Tier Tier 3 22 10 — — $19,492.76 $25,272.26 $22,382.51 2026-03-17
D0303 LOCAL Non-traumatic Brain Injury M >=42.50 And M <52.50- Tier Tier 3 22 10 — — $22,037.05 $22,037.05 $22,037.05 2026-03-17
D0903 LOCAL Other Orthopedic M >=44.50 And M <51.50- Tier Tier 3 22 10 — — $21,454.97 $21,454.97 $21,454.97 2026-03-17
A0503 LOCAL Non-traumatic Spinal Cord Injury M >=48.50 And M <53.50- Tier None 22 10 — — $21,376.39 $21,376.39 $21,376.39 2026-03-17
D2003 LOCAL Miscellaneous M >=46.50 And M <55.50- Tier Tier 3 22 10 — — $21,146.24 $21,146.24 $21,146.24 2026-03-17
A0804 LOCAL Replacement Of Lower-extremity Joint M >=42.50 And M <51.50- Tier None 22 10 — — $20,879.19 $20,879.19 $20,879.19 2026-03-17
A0703 LOCAL Fracture Of Lower Extremity M >=41.50 And M <52.50- Tier None 22 10 — — $20,739.43 $20,739.43 $20,739.43 2026-03-17
A1803 LOCAL Major Multiple Trauma With Brain Or Spinal Cord Injury M >=45.50 And M <55.50- T… 22 10 — — $20,636.52 $20,636.52 $20,636.52 2026-03-17
D1403 LOCAL Cardiac M >=45.50 And M <55.50- Tier Tier 3 22 10 — — $20,625.27 $20,625.27 $20,625.27 2026-03-17
D0103 LOCAL Stroke M >=50.50 And M <63.50- Tier Tier 3 22 10 — — $20,404.98 $20,404.98 $20,404.98 2026-03-17
A1502 LOCAL Pulmonary M >=56.50 And M <68.50- Tier None 22 10 — — $20,339.73 $20,339.73 $20,339.73 2026-03-17
A0603 LOCAL Neurological M >=43.50 And M <52.50- Tier None 22 10 — — $20,126.80 $20,126.80 $20,126.80 2026-03-17
D0203 LOCAL Traumatic Brain Injury M >=49.50 And M <61.50- Tier Tier 3 22 10 — — $19,977.26 $19,977.26 $19,977.26 2026-03-17
D0804 LOCAL Replacement Of Lower-extremity Joint M >=42.50 And M <51.50- Tier Tier 3 22 10 — — $19,586.72 $20,218.45 $19,902.58 2026-03-17
A0903 LOCAL Other Orthopedic M >=44.50 And M <51.50- Tier None 22 10 — — $19,629.94 $19,629.94 $19,629.94 2026-03-17
D0803 LOCAL Replacement Of Lower-extremity Joint M >=51.50 And M <57.50- Tier Tier 3 22 10 — — $18,046.10 $18,046.10 $18,046.10 2026-03-17
D2002 LOCAL Miscellaneous M >=55.50 And M <66.50- Tier Tier 3 22 10 — — $17,658.59 $17,658.59 $17,658.59 2026-03-17
D1402 LOCAL Cardiac M >=55.50 And M <68.50- Tier Tier 3 22 10 — — $16,519.09 $18,694.65 $17,606.87 2026-03-17
A1702 LOCAL Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=50.50 And M <57.50… 22 10 — — $17,446.34 $17,446.34 $17,446.34 2026-03-17
D1004 LOCAL Amputation Lower Extremity M <47.50- Tier Tier 3 22 10 — — $6,470.13 $27,952.73 $17,211.43 2026-03-17
A0602 LOCAL Neurological M >=52.50 And M <64.50- Tier None 22 10 — — $17,081.33 $17,081.33 $17,081.33 2026-03-17
B0902 LOCAL Other Orthopedic M >=51.50 And M <63.50- Tier Tier 1 22 10 — — $16,923.88 $16,923.88 $16,923.88 2026-03-17
A0702 LOCAL Fracture Of Lower Extremity M >=52.50 And M <61.50- Tier None 22 10 — — $16,864.25 $16,864.25 $16,864.25 2026-03-17
A0803 LOCAL Replacement Of Lower-extremity Joint M >=51.50 And M <57.50- Tier None 22 10 — — $16,832.10 $16,832.10 $16,832.10 2026-03-17
A0902 LOCAL Other Orthopedic M >=51.50 And M <63.50- Tier None 22 10 — — $16,438.15 $16,438.15 $16,438.15 2026-03-17
D0802 LOCAL Replacement Of Lower-extremity Joint M >=57.50 And M <63.50- Tier Tier 3 22 10 — — $16,213.03 $16,213.03 $16,213.03 2026-03-17
A2002 LOCAL Miscellaneous M >=55.50 And M <66.50- Tier None 22 10 — — $16,073.14 $16,073.14 $16,073.14 2026-03-17
D0602 LOCAL Neurological M >=52.50 And M <64.50- Tier Tier 3 22 10 — — $12,114.19 $18,940.13 $15,527.16 2026-03-17
A1704 LOCAL Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=36.50 And M <41.50… 22 10 — — $15,250.48 $15,250.48 $15,250.48 2026-03-17
A1404 LOCAL Cardiac M <45.50- Tier None 22 10 — — $4,152.55 $23,254.28 $13,703.42 2026-03-17
A0104 LOCAL Stroke M >=41.50 And M <50.50- Tier None 22 10 — — $2,087.39 $24,817.21 $13,452.30 2026-03-17
A0303 LOCAL Non-traumatic Brain Injury M >=42.50 And M <52.50- Tier None 22 10 — — $2,225.36 $20,769.98 $11,497.67 2026-03-17
A2003 LOCAL Miscellaneous M >=46.50 And M <55.50- Tier None 22 10 — — $6,083.59 $6,083.59 $6,083.59 2026-03-17
A0805 LOCAL Replacement Of Lower-extremity Joint M <42.50- Tier None 22 10 — — $2,786.21 $2,786.21 $2,786.21 2026-03-17
0148 RC Room & Board - Deluxe Private - Rehabilitation 12 6 — — $1,650.00 $1,650.00 $1,650.00 2026-03-17
0118 RC Room & Board - Private (One Bed) - Rehabilitation 12 6 — — $1,650.00 $1,650.00 $1,650.00 2026-03-17
0158 RC Room & Board - Ward - Rehabilitation 12 6 — — $1,650.00 $1,650.00 $1,650.00 2026-03-17
0138 RC Room & Board - Three And Four Beds - Rehabilitation 12 6 — — $1,650.00 $1,650.00 $1,650.00 2026-03-17
0128 RC Room & Board - Semi-private (Two Beds) - Rehabilitation 12 6 — — $1,625.00 $1,625.00 $1,625.00 2026-03-17
128 OTHER R&b - Semi Pvt - Irf 5 5 $2,065.00 — $1,300.00 $1,300.00 $1,300.00 2026-05-06
118 OTHER R&b - Private - Irf 5 5 $2,065.00 — $1,300.00 $1,300.00 $1,300.00 2026-05-06
0803 RC Inpatient Renal Dialysis - Continuous Ambulatory Peritoneal Dialysis (capd) 10 5 — — $550.00 $600.00 $600.00 2026-03-17
0802 RC Inpatient Renal Dialysis - Peritoneal Dialysis (non-capd) 10 5 — — $550.00 $600.00 $600.00 2026-03-17
0806 RC Inpatient Renal Dialysis - Continuation 8 3 — — $600.00 $600.00 $600.00 2026-03-17
0807 RC Inpatient Renal Dialysis - Observation/Hourly 8 3 — — $600.00 $600.00 $600.00 2026-03-17
0808 RC Inpatient Renal Dialysis - Other 8 3 — — $600.00 $600.00 $600.00 2026-03-17
0800 RC Inpatient Renal Dialysis - General Classification 10 5 — — $550.00 $600.00 $600.00 2026-03-17
0801 RC Inpatient Renal Dialysis - Hemodialysis 10 5 — — $550.00 $600.00 $600.00 2026-03-17
0809 RC Inpatient Renal Dialysis - Other 10 5 — — $550.00 $600.00 $600.00 2026-03-17
0804 RC Inpatient Renal Dialysis - Continuous Cycling Peritoneal Dialysis (ccpd) 10 5 — — $550.00 $600.00 $600.00 2026-03-17
0805 RC Inpatient Renal Dialysis - Treatment 8 3 — — $600.00 $600.00 $600.00 2026-03-17
97164 HCPCS Pt Re-eval Est Plan Care 65 17 — — $120.00 $150.00 $135.00 2026-03-17
96105 HCPCS Assessment Of Aphasia 61 15 — — $120.00 $150.00 $135.00 2026-03-17
92522 HCPCS Evaluate Speech Production 61 15 — — $120.00 $150.00 $135.00 2026-03-17
92521 HCPCS Evaluation Of Speech Fluency 2 2 — — $120.00 $150.00 $135.00 2026-03-17
92523 HCPCS Speech Sound Lang Comprehen 64 16 — — $120.00 $150.00 $135.00 2026-03-17
92524 HCPCS Behavral Qualit Analys Voice 61 15 — — $120.00 $150.00 $135.00 2026-03-17
97168 HCPCS Ot Re-eval Est Plan Care 62 16 — — $120.00 $150.00 $135.00 2026-03-17
97167 HCPCS Ot Eval High Complex 60 Min 62 16 — — $120.00 $150.00 $135.00 2026-03-17
97113 HCPCS Aquatic Therapy/exercises 62 16 — — $90.00 $155.00 $122.50 2026-03-17
97165 HCPCS Ot Eval Low Complex 30 Min 65 17 — — $92.90 $150.00 $121.45 2026-03-17
97166 HCPCS Ot Eval Mod Complex 45 Min 65 17 — — $92.90 $150.00 $121.45 2026-03-17
97162 HCPCS Pt Eval Mod Complex 30 Min 65 17 — — $90.57 $150.00 $120.28 2026-03-17
97161 HCPCS Pt Eval Low Complex 20 Min 65 17 — — $90.57 $150.00 $120.28 2026-03-17
97163 HCPCS Pt Eval High Complex 45 Min 65 17 — — $90.57 $150.00 $120.28 2026-03-17
0410 RC Respiratory Services - General Classification 60 14 — — $120.00 $120.00 $120.00 2026-03-17
0424 RC Physical Therapy - Evaluation Or Re-evaluation 70 20 — — $62.00 $150.00 $106.00 2026-03-17
0444 RC Speech Therapy - Language Pathology - Evaluation Or Reevaluation 70 20 — — $62.00 $150.00 $106.00 2026-03-17
0434 RC Occupational Therapy - Evaluation Or Reevaluation 70 20 — — $62.00 $150.00 $106.00 2026-03-17
92606 HCPCS Non-speech Device Service 2 2 — — $90.00 $120.00 $105.00 2026-03-17
97124 HCPCS Massage Therapy 62 16 — — $90.00 $120.00 $105.00 2026-03-17
97535 HCPCS Self Care Mngment Training 65 17 — — $90.00 $120.00 $105.00 2026-03-17
97129 HCPCS Ther Ivntj 1st 15 Min 62 16 — — $90.00 $120.00 $105.00 2026-03-17
97537 HCPCS Community/work Reintegration 62 16 — — $90.00 $120.00 $105.00 2026-03-17
92605 HCPCS Ex For Nonspeech Device Rx 2 2 — — $90.00 $120.00 $105.00 2026-03-17
92607 HCPCS Ex For Speech Device Rx 1hr 61 15 — — $90.00 $120.00 $105.00 2026-03-17
92597 HCPCS Oral Speech Device Eval 2 2 — — $90.00 $120.00 $105.00 2026-03-17
92526 HCPCS Oral Function Therapy 66 18 — — $70.00 $120.00 $95.00 2026-03-17
92507 HCPCS Speech/hearing Therapy 65 17 — — $70.00 $120.00 $95.00 2026-03-17
430 OTHER *ot Electric Stim/manual 24 10 $111.00 — $90.00 $90.00 $90.00 2026-05-06
0429 RC Physical Therapy - Other 6 5 — — $85.00 $95.00 $90.00 2026-03-17
0430 RC Occupational Therapy - General Classification 70 20 — — $60.00 $120.00 $90.00 2026-03-17
0442 RC Speech Therapy - Language Pathology - Hourly Charge 6 5 — — $85.00 $95.00 $90.00 2026-03-17
440 OTHER St Cog Tx Ea Addl 15min 12 10 $65.00 — $90.00 $90.00 $90.00 2026-05-06
420 OTHER Pt Adl Slf Care Trn 15min 12 10 $100.00 — $90.00 $90.00 $90.00 2026-05-06
0449 RC Speech Therapy - Language Pathology - Other 6 5 — — $85.00 $95.00 $90.00 2026-03-17
0443 RC Speech Therapy - Language Pathology - Group Rate 6 5 — — $85.00 $95.00 $90.00 2026-03-17
0439 RC Occupational Therapy - Other 6 5 — — $85.00 $95.00 $90.00 2026-03-17
0440 RC Speech Therapy - Language Pathology - General Classification 70 20 — — $60.00 $120.00 $90.00 2026-03-17
0432 RC Occupational Therapy - Hourly Charge 6 5 — — $85.00 $95.00 $90.00 2026-03-17
0423 RC Physical Therapy - Group Rate 6 5 — — $85.00 $95.00 $90.00 2026-03-17
0422 RC Physical Therapy - Hourly Charge 6 5 — — $85.00 $95.00 $90.00 2026-03-17
0420 RC Physical Therapy - General Classification 70 20 — — $60.00 $120.00 $90.00 2026-03-17
0433 RC Occupational Therapy - Group Rate 6 5 — — $85.00 $95.00 $90.00 2026-03-17
97110 HCPCS Therapeutic Exercises 66 18 — — $53.20 $120.00 $86.60 2026-03-17
0441 RC Speech Therapy - Language Pathology - Visit Charge 8 5 — — $60.00 $95.00 $77.50 2026-03-17
0431 RC Occupational Therapy - Visit Charge 8 5 — — $60.00 $95.00 $77.50 2026-03-17
0421 RC Physical Therapy - Visit Charge 67 17 — — $60.00 $95.00 $77.50 2026-03-17
97530 HCPCS Therapeutic Activities 65 17 — — $31.82 $120.00 $75.91 2026-03-17
97112 HCPCS Neuromuscular Reeducation 65 17 — — $29.59 $120.00 $74.80 2026-03-17
97116 HCPCS Gait Training Therapy 65 17 — — $26.60 $120.00 $73.30 2026-03-17
97140 HCPCS Manual Therapy 1/> Regions 62 16 — — $25.12 $120.00 $72.56 2026-03-17
424 OTHER Pt Eval High Complex 1unit 15 12 $260.00 — $72.50 $72.50 $72.50 2026-05-06
434 OTHER Ot Eval High Complex 1unit 12 10 $260.00 — $72.50 $72.50 $72.50 2026-05-06
444 OTHER St Aphasia Assessment 1unit 12 10 $260.00 — $72.50 $72.50 $72.50 2026-05-06
97032 HCPCS Appl Modality 1+estim Ea 15 59 15 — — $13.20 $120.00 $66.60 2026-03-17
36589 HCPCS Removal Tunneled Cv Cath 0 0 — — — — — 2026-03-17
36573 HCPCS Insj Picc Rs&i 5 Yr+ 0 0 — — — — — 2026-03-17
24615 HCPCS Treat Elbow Dislocation 0 0 — — — — — 2026-03-17
36569 HCPCS Insj Picc 5 Yr+ Without Imaging 0 0 — — — — — 2026-03-17
36561 HCPCS Insert Tunneled Cv Cath 0 0 — — — — — 2026-03-17
24516 HCPCS Treat Humerus Fracture 0 0 — — — — — 2026-03-17
15853 HCPCS Removal Sutr/stapl Xreq Anes 0 0 — — — — — 2026-03-17
36558 HCPCS Insert Tunneled Cv Cath 0 0 — — — — — 2026-03-17
36556 HCPCS Insert Non-tunnel Cv Cath 0 0 — — — — — 2026-03-17
24430 HCPCS Repair Of Humerus 0 0 — — — — — 2026-03-17
36514 HCPCS Apheresis Plasma 0 0 — — — — — 2026-03-17
36460 HCPCS Intrauterine Transfusion Ftl 0 0 — — — — — 2026-03-17
24344 HCPCS Reconstruct Elbow Lat Ligmnt 0 0 — — — — — 2026-03-17
15772 HCPCS Grfg Autol Fat Lipo Ea Addl 0 0 — — — — — 2026-03-17
10060 HCPCS I&d Abscess Simple/single 0 0 — — — — — 2026-03-17
36430 HCPCS Transfusion Bld/bld Compnt 0 0 — — — — — 2026-03-17
36415 HCPCS Routine Venipuncture 0 0 — — — — — 2026-03-17
23650 HCPCS Cltx Sho Dslc W/mnpj Wo Anes 0 0 — — — — — 2026-03-17
36248 HCPCS Ins Cath Abd/l-ext Art Addl 0 0 — — — — — 2026-03-17
36247 HCPCS Ins Cath Abd/l-ext Art 3rd 0 0 — — — — — 2026-03-17
23515 HCPCS Optx Clavicular Fx W/int Fix 0 0 — — — — — 2026-03-17
15771 HCPCS Grfg Autol Fat Lipo 50 Cc/< 0 0 — — — — — 2026-03-17
36225 HCPCS Place Cath Subclavian Art 0 0 — — — — — 2026-03-17
36200 HCPCS Place Catheter In Aorta 0 0 — — — — — 2026-03-17
23412 HCPCS Repair Rotator Cuff Chronic 0 0 — — — — — 2026-03-17
36012 HCPCS Place Catheter In Vein 0 0 — — — — — 2026-03-17
33228 HCPCS Remv&replc Pm Gen Dual Lead 0 0 — — — — — 2026-03-17
22552 HCPCS Arthrd Ant Ntrbd Cervical Ea 0 0 — — — — — 2026-03-17
14020 HCPCS Tis Trnfr S/a/l 10 Sq Cm/< 0 0 — — — — — 2026-03-17
10005 HCPCS Fna Bx W/us Gdn 1st Les 0 0 — — — — — 2026-03-17
00410 HCPCS Anesth Correct Heart Rhythm 0 0 — — — — — 2026-03-17
33227 HCPCS Remove&replace Pm Gen Singl 0 0 — — — — — 2026-03-17
33207 HCPCS Insert Heart Pm Ventricular 0 0 — — — — — 2026-03-17
22548 HCPCS Arthrd Ant Toral/xoral C1-c2 0 0 — — — — — 2026-03-17
32555 HCPCS Aspirate Pleura With Imaging 0 0 — — — — — 2026-03-17
32408 HCPCS Core Ndl Bx Lng/med Perq 0 0 — — — — — 2026-03-17
22515 HCPCS Perq Vertebral Augmentation 0 0 — — — — — 2026-03-17
14000 HCPCS Tis Trnfr Trunk 10 Sq Cm/< 0 0 — — — — — 2026-03-17
52332 HCPCS Cystoscopy And Treatment 0 0 — — — — — 2026-03-17
31500 HCPCS Insert Emergency Airway 0 0 — — — — — 2026-03-17
52317 HCPCS Remove Bladder Stone 0 0 — — — — — 2026-03-17
52310 HCPCS Cystoscopy And Treatment 0 0 — — — — — 2026-03-17
31288 HCPCS Nasal/sinus Endoscopy Surg 0 0 — — — — — 2026-03-17
22514 HCPCS Perq Vertebral Augmentation 0 0 — — — — — 2026-03-17
52356 HCPCS Cysto/uretero W/lithotripsy 0 0 — — — — — 2026-03-17
52601 HCPCS Prostatectomy (turp) 0 0 — — — — — 2026-03-17
53445 HCPCS Insert Uro/ves Nck Sphincter 0 0 — — — — — 2026-03-17
54161 HCPCS Circum 28 Days Or Older 0 0 — — — — — 2026-03-17
55040 HCPCS Removal Of Hydrocele 0 0 — — — — — 2026-03-17
55700 HCPCS Biopsy Of Prostate 0 0 — — — — — 2026-03-17
55880 HCPCS Abltj Mal Prst8 Tiss Hifu 0 0 — — — — — 2026-03-17
57260 HCPCS Cmbn Ant Pst Colprhy 0 0 — — — — — 2026-03-17
57288 HCPCS Repair Bladder Defect 0 0 — — — — — 2026-03-17
57461 HCPCS Conz Of Cervix W/scope Leep 0 0 — — — — — 2026-03-17
57522 HCPCS Conization Of Cervix 0 0 — — — — — 2026-03-17
58120 HCPCS Dilation And Curettage 0 0 — — — — — 2026-03-17
58301 HCPCS Remove Intrauterine Device 0 0 — — — — — 2026-03-17
58550 HCPCS Laparo-asst Vag Hysterectomy 0 0 — — — — — 2026-03-17
58552 HCPCS Laparo-vag Hyst Incl T/o 0 0 — — — — — 2026-03-17
58554 HCPCS Laparo-vag Hyst W/t/o Compl 0 0 — — — — — 2026-03-17
58558 HCPCS Hysteroscopy Biopsy 0 0 — — — — — 2026-03-17
58561 HCPCS Hysteroscopy Remove Myoma 0 0 — — — — — 2026-03-17
58563 HCPCS Hysteroscopy Ablation 0 0 — — — — — 2026-03-17
58570 HCPCS Tlh Uterus 250 G Or Less 0 0 — — — — — 2026-03-17
58571 HCPCS Tlh W/t/o 250 G Or Less 0 0 — — — — — 2026-03-17
58661 HCPCS Laparoscopy Remove Adnexa 0 0 — — — — — 2026-03-17
58662 HCPCS Laparoscopy Excise Lesions 0 0 — — — — — 2026-03-17
59012 HCPCS Fetal Cord Puncture Prenatal 0 0 — — — — — 2026-03-17
59025 HCPCS Fetal Non-stress Test 0 0 — — — — — 2026-03-17
59820 HCPCS Care Of Miscarriage 0 0 — — — — — 2026-03-17
59897 HCPCS Unlisted Fetal Invas Px W/us 0 0 — — — — — 2026-03-17
60220 HCPCS Partial Removal Of Thyroid 0 0 — — — — — 2026-03-17
61782 HCPCS Scan Proc Cranial Extra 0 0 — — — — — 2026-03-17
62270 HCPCS Dx Lmbr Spi Pnxr 0 0 — — — — — 2026-03-17
62328 HCPCS Dx Lmbr Spi Pnxr W/fluor/ct 0 0 — — — — — 2026-03-17
64450 HCPCS Njx Aa&/strd Other Pn/branch 0 0 — — — — — 2026-03-17
64718 HCPCS Revise Ulnar Nerve At Elbow 0 0 — — — — — 2026-03-17
64721 HCPCS Carpal Tunnel Surgery 0 0 — — — — — 2026-03-17
65091 HCPCS Revise Eye 0 0 — — — — — 2026-03-17
65093 HCPCS Revise Eye With Implant 0 0 — — — — — 2026-03-17
65101 HCPCS Removal Of Eye 0 0 — — — — — 2026-03-17
65103 HCPCS Remove Eye/insert Implant 0 0 — — — — — 2026-03-17
65105 HCPCS Remove Eye/attach Implant 0 0 — — — — — 2026-03-17
65110 HCPCS Removal Of Eye 0 0 — — — — — 2026-03-17
65112 HCPCS Remove Eye/revise Socket 0 0 — — — — — 2026-03-17
52240 HCPCS Cystoscopy And Treatment 0 0 — — — — — 2026-03-17
52235 HCPCS Cystoscopy And Treatment 0 0 — — — — — 2026-03-17
31276 HCPCS Nsl/sins Ndsc Frnt Tiss Rmvl 0 0 — — — — — 2026-03-17
52234 HCPCS Cystoscopy And Treatment 0 0 — — — — — 2026-03-17
52224 HCPCS Cystoscopy And Treatment 0 0 — — — — — 2026-03-17
31267 HCPCS Endoscopy Maxillary Sinus 0 0 — — — — — 2026-03-17
22513 HCPCS Perq Vertebral Augmentation 0 0 — — — — — 2026-03-17
12032 HCPCS Intmd Rpr S/a/t/ext 2.6-7.5 0 0 — — — — — 2026-03-17
0671T HCPCS Insj Ant Sgm Aq DRG Dev 1+ 0 0 — — — — — 2026-03-17
52204 HCPCS Cystoscopy W/biopsy(s) 0 0 — — — — — 2026-03-17
51798 HCPCS US Urine Capacity Measure 0 0 — — — — — 2026-03-17
31259 HCPCS Nsl/sins Ndsc Sphn Tiss Rmvl 0 0 — — — — — 2026-03-17
51702 HCPCS Insert Temp Bladder Cath 0 0 — — — — — 2026-03-17
51102 HCPCS Drain Bl W/cath Insertion 0 0 — — — — — 2026-03-17
31257 HCPCS Nsl/sins Ndsc Tot W/sphendt 0 0 — — — — — 2026-03-17
22224 HCPCS Osteot Dsc Ant 1vrt Sgm Lmbr 0 0 — — — — — 2026-03-17
50949 HCPCS Unlisted Laps Px Ureter 0 0 — — — — — 2026-03-17
50590 HCPCS Fragmenting Of Kidney Stone 0 0 — — — — — 2026-03-17
31256 HCPCS Exploration Maxillary Sinus 0 0 — — — — — 2026-03-17
50543 HCPCS Laparo Partial Nephrectomy 0 0 — — — — — 2026-03-17
50435 HCPCS Exchange Nephrostomy Cath 0 0 — — — — — 2026-03-17
31254 HCPCS Nsl/sins Ndsc W/prtl Ethmdct 0 0 — — — — — 2026-03-17
21931 HCPCS Exc Back Les Sc 3 Cm/> 0 0 — — — — — 2026-03-17
12013 HCPCS Rpr F/e/e/n/l/m 2.6-5.0 Cm 0 0 — — — — — 2026-03-17
49651 HCPCS Lap Ing Hernia Repair Recur 0 0 — — — — — 2026-03-17
49650 HCPCS Lap Ing Hernia Repair Init 0 0 — — — — — 2026-03-17
31237 HCPCS Nsl/sins Ndsc Surg Bx Polypc 0 0 — — — — — 2026-03-17
49594 HCPCS Rpr Aa Hrn 1st 3-10 Ncr/strn 0 0 — — — — — 2026-03-17
49592 HCPCS Rpr Aa Hrn 1st < 3 Ncr/strn 0 0 — — — — — 2026-03-17
30801 HCPCS Ablate Inf Turbinate Superf 0 0 — — — — — 2026-03-17
21552 HCPCS Exc Neck Les Sc 3 Cm/> 0 0 — — — — — 2026-03-17
49591 HCPCS Rpr Aa Hrn 1st < 3 Cm Rdc 0 0 — — — — — 2026-03-17
49520 HCPCS Rerepair Ing Hernia Reduce 0 0 — — — — — 2026-03-17
30520 HCPCS Repair Of Nasal Septum 0 0 — — — — — 2026-03-17
49507 HCPCS Prp I/hern Init Block >5 Yr 0 0 — — — — — 2026-03-17
49505 HCPCS Prp I/hern Init Reduc >5 Yr 0 0 — — — — — 2026-03-17
30140 HCPCS Resect Inferior Turbinate 0 0 — — — — — 2026-03-17
21014 HCPCS Exc Face Tum Deep 2 Cm/> 0 0 — — — — — 2026-03-17
12011 HCPCS Rpr F/e/e/n/l/m 2.5 Cm/< 0 0 — — — — — 2026-03-17
00921 HCPCS Anesth Vasectomy 0 0 — — — — — 2026-03-17
00402 HCPCS Anesth Surgery Of Breast 0 0 — — — — — 2026-03-17
00320 HCPCS Anesth Neck Organ 1yr/> 0 0 — — — — — 2026-03-17
49422 HCPCS Remove Tunneled Ip Cath 0 0 — — — — — 2026-03-17
49324 HCPCS Lap Insert Tunnel Ip Cath 0 0 — — — — — 2026-03-17
30130 HCPCS Excise Inferior Turbinate 0 0 — — — — — 2026-03-17
49322 HCPCS Laparoscopy Aspiration 0 0 — — — — — 2026-03-17
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