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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

LAKE CHELAN COMMUNITY HOSPITAL

Chelan, WA · CCN 501334 · Rates published

Your selected procedure

You selected 29806 (HCPCS)

Repair of shoulder joint capsule using an endoscope

This hospital’s price: $975 across 11 payers · range $621-$3,051

Source: https://apps.para-hcfs.com/PTT/FinalLinks/Reports.aspx?dbName=dbLCCHCHELANWA&type=CDMWithoutLabel&fileType=CSV · observed 2026-09-01

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

4,467 distinct procedures filed
16 distinct payers
77,818 rate rows
2026-07-31 last MRF observed
Data quality

74,793 of 77,818 rate rows are consumer-grade (96.1%)

3,025 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
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 2,655
per-diem day rate — not a per-procedure price 241
percent-of-charges filed in the dollar field — excluded from medians 48
exceeds 10× this hospital's gross charge — excluded from medians 45
exceeds 3× this hospital's gross charge for a DRG stay — excluded 36
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://apps.para-hcfs.com/PTT/FinalLinks/Reports.aspx?dbName=dbLCCHCHELANWA&type=CDMWithoutLabel&fileType=CSV
Found on page https://apps.para-hcfs.com/PTT/FinalLinks/LakeChelanComm.aspx
Discovered viaCMS hospital list
Last fetch not_modified · 2026-11-07
Content fingerprint fed24a184d4ae50f… · 34,548,950 bytes · first seen 2026-11-03

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
166
MS_DRG 		Other Respiratory System O.r. Procedures With Mcc 1 $134,955.54 $134,955.54 $134,955.54 nat. median
$35,655
outlier · 3.8×
564
MS_DRG 		Other Musculoskeletal System And Connective Tissue Diagnoses With Mcc 1 $95,615.71 $95,615.71 $95,615.71 nat. median
$14,969
outlier · 6.4×
337
MS_DRG 		Peritoneal Adhesiolysis Without Cc/mcc 1 $88,601.65 $88,601.65 $88,601.65 nat. median
$15,105
outlier · 5.9×
945
MS_DRG 		Rehabilitation With Cc/mcc 1 $82,772.27 $82,772.27 $82,772.27 nat. median
$14,820
outlier · 5.6×
340
MS_DRG 		Appendectomy With Complicated Principal Diagnosis Without Cc/mcc 1 $71,805.34 $71,805.34 $71,805.34 nat. median
$8,325
outlier · 8.6×
468
MS_DRG 		Revision Of Hip Or Knee Replacement Without Cc/mcc 1 $71,805.02 $71,805.02 $71,805.02 nat. median
$25,684
outlier · 2.8×
464
MS_DRG 		Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective… 1 $70,376.05 $70,376.05 $70,376.05 nat. median
$28,658
outlier · 2.5×
199
MS_DRG 		Pneumothorax With Mcc 1 $48,590.61 $48,590.61 $48,590.61 nat. median
$16,714
outlier · 2.9×
381
MS_DRG 		Complicated Peptic Ulcer With Cc 1 $41,651.94 $41,651.94 $41,651.94 nat. median
$10,990
outlier · 3.8×
389
MS_DRG 		Gastrointestinal Obstruction With Cc 1 $37,937.16 $37,937.16 $37,937.16 nat. median
$8,333
outlier · 4.6×
439
MS_DRG 		Disorders Of Pancreas Except Malignancy With Cc 1 $31,258.22 $31,258.22 $31,258.22 nat. median
$8,912
outlier · 3.5×
809
MS_DRG 		Major Hematological And Immunological Diagnoses Except Sickle Cell Crisis And Co… 1 $28,704.73 $28,704.73 $28,704.73 nat. median
$12,501
outlier · 2.3×
432
MS_DRG 		Cirrhosis And Alcoholic Hepatitis With Mcc 1 $28,640.44 $28,640.44 $28,640.44 nat. median
$18,763
1.5× median
65
MS_DRG 		Intracranial Hemorrhage Or Cerebral Infarction With Cc Or Tpa In 24 Hours 1 $28,003.04 $28,003.04 $28,003.04 nat. median
$10,441
outlier · 2.7×
291
MS_DRG 		Heart Failure And Shock With Mcc 1 $27,924.47 $27,924.47 $27,924.47 nat. median
$12,730
outlier · 2.2×
29002104
CDM 		13 $16,877.14 $33,754.27 $27,310.27 —
308
MS_DRG 		Cardiac Arrhythmia And Conduction Disorders With Mcc 1 $27,288.99 $27,288.99 $27,288.99 nat. median
$11,953
outlier · 2.3×
191
MS_DRG 		Chronic Obstructive Pulmonary Disease With Cc 1 $26,918.02 $26,918.02 $26,918.02 nat. median
$8,824
outlier · 3.1×
788
MS_DRG 		Cesarean Section Without Sterilization Without Cc/mcc 1 $26,335.77 $26,335.77 $26,335.77 nat. median
$9,590
outlier · 2.7×
872
MS_DRG 		Septicemia Or Severe Sepsis Without Mv >96 Hours Without Mcc 1 $26,022.43 $26,022.43 $26,022.43 nat. median
$10,374
outlier · 2.5×
177
MS_DRG 		Respiratory Infections And Inflammations With Mcc 1 $25,790.33 $25,790.33 $25,790.33 nat. median
$15,338
1.7× median
193
MS_DRG 		Simple Pneumonia And Pleurisy With Mcc 1 $25,100.22 $25,100.22 $25,100.22 nat. median
$12,837
2.0× median
638
MS_DRG 		Diabetes With Cc 1 $24,886.07 $24,886.07 $24,886.07 nat. median
$9,200
outlier · 2.7×
29002303
CDM 		13 $13,994.15 $27,988.29 $22,645.07 —
29002183
CDM 		13 $13,729.07 $27,458.15 $22,216.14 —
27364
HCPCS 		Extensive Removal Of Growth Of Thigh Or Knee, 5.0 Cm Or More 13 $13,049.19 $23,289.25 $21,115.96 nat. median
$3,356
outlier · 6.3×
37244
HCPCS 		Occlusion Of Artery Or Vein Bleeding With Review By Radiologist 13 $366.91 $35,355.27 $19,809.90 nat. median
$12,421
1.6× median
445
MS_DRG 		Disorders Of The Biliary Tract With Cc 1 $18,636.82 $18,636.82 $18,636.82 nat. median
$11,023
1.7× median
Q4282
HCPCS 		Cygnus Dual, Per Square Centimeter 13 $4,537.50 $33,129.00 $18,562.50 nat. median
$625
outlier · 29.7×
29001705
CDM 		13 $10,741.50 $19,170.65 $17,381.70 nat. median
$6
outlier · 2709.5×
29000423
CDM 		13 $10,520.04 $21,040.09 $17,023.34 —
J3101
HCPCS 		Injection, Tenecteplase, 1 Mg 13 $10,039.18 $17,917.20 $16,245.22 nat. median
$4,042
outlier · 4.0×
440
MS_DRG 		Disorders Of Pancreas Except Malignancy Without Cc/mcc 2 $7,736.32 $23,843.17 $15,789.74 nat. median
$6,860
outlier · 2.3×
805
MS_DRG 		Vaginal Delivery Without Sterilization Or D&c With Mcc 1 $15,653.12 $15,653.12 $15,653.12 nat. median
$9,891
1.6× median
390
MS_DRG 		Gastrointestinal Obstruction Without Cc/mcc 1 $15,523.82 $15,523.82 $15,523.82 nat. median
$6,114
outlier · 2.5×
683
MS_DRG 		Renal Failure With Cc 1 $15,161.85 $15,161.85 $15,161.85 nat. median
$9,083
1.7× median
66
MS_DRG 		Intracranial Hemorrhage Or Cerebral Infarction Without Cc/mcc 1 $15,052.26 $15,052.26 $15,052.26 nat. median
$7,555
2.0× median
178
MS_DRG 		Respiratory Infections And Inflammations With Cc 1 $15,036.01 $15,036.01 $15,036.01 nat. median
$10,168
1.5× median
433
MS_DRG 		Cirrhosis And Alcoholic Hepatitis With Cc 1 $15,020.41 $15,020.41 $15,020.41 nat. median
$10,736
1.4× median
281
MS_DRG 		Acute Myocardial Infarction, Discharged Alive With Cc 1 $14,738.97 $14,738.97 $14,738.97 nat. median
$9,688
1.5× median
189
MS_DRG 		Pulmonary Edema And Respiratory Failure 1 $14,629.03 $14,629.03 $14,629.03 nat. median
$12,249
1.2× median
29002140
CDM 		13 $8,835.75 $17,671.50 $14,297.85 —
29002264
CDM 		13 $8,835.75 $17,671.50 $14,297.85 —
29002346
CDM 		13 $8,835.75 $17,671.50 $14,297.85 —
185
MS_DRG 		Major Chest Trauma Without Cc/mcc 1 $14,111.38 $14,111.38 $14,111.38 nat. median
$8,258
1.7× median
190
MS_DRG 		Chronic Obstructive Pulmonary Disease With Mcc 1 $14,075.04 $14,075.04 $14,075.04 nat. median
$11,040
1.3× median
33300
HCPCS 		Repair Of Wound To Heart 13 $1,354.55 $25,043.22 $14,031.96 nat. median
$4,104
outlier · 3.4×
29001647
CDM 		13 $8,201.16 $16,402.32 $13,270.97 —
282
MS_DRG 		Acute Myocardial Infarction, Discharged Alive Without Cc/mcc 1 $13,011.88 $13,011.88 $13,011.88 nat. median
$7,940
1.6× median
536
MS_DRG 		Fractures Of Hip And Pelvis Without Mcc 1 $12,954.31 $12,954.31 $12,954.31 nat. median
$8,421
1.5× median

Other procedures at this hospital

Browse this hospital's 4,467 published procedures. Use the slice to choose what to show, then sort or filter any column.

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Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
Code Type Description Rate rows Payers Gross Cash Min $ Max $ Avg median Last observed
             
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 1 1 $48,580.02 $48,580.02 $134,955.54 $134,955.54 $134,955.54 2026-03-12
564 MS_DRG Other Musculoskeletal System And Connective Tissue Diagnoses With Mcc 1 1 $32,797.15 $32,797.15 $95,615.71 $95,615.71 $95,615.71 2026-03-12
337 MS_DRG Peritoneal Adhesiolysis Without Cc/mcc 1 1 $41,487.73 $41,487.73 $88,601.65 $88,601.65 $88,601.65 2026-03-12
945 MS_DRG Rehabilitation With Cc/mcc 1 1 $27,806.03 $27,806.03 $82,772.27 $82,772.27 $82,772.27 2026-03-12
340 MS_DRG Appendectomy With Complicated Principal Diagnosis Without Cc/mcc 1 1 $32,543.74 $32,543.74 $71,805.34 $71,805.34 $71,805.34 2026-03-12
468 MS_DRG Revision Of Hip Or Knee Replacement Without Cc/mcc 1 1 $73,358.23 $73,358.23 $71,805.02 $71,805.02 $71,805.02 2026-03-12
464 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 1 1 $72,332.63 $72,332.63 $70,376.05 $70,376.05 $70,376.05 2026-03-12
199 MS_DRG Pneumothorax With Mcc 1 1 $17,181.33 $17,181.33 $48,590.61 $48,590.61 $48,590.61 2026-03-12
381 MS_DRG Complicated Peptic Ulcer With Cc 1 1 $18,094.98 $18,094.98 $41,651.94 $41,651.94 $41,651.94 2026-03-12
389 MS_DRG Gastrointestinal Obstruction With Cc 1 1 $14,380.20 $14,380.20 $37,937.16 $37,937.16 $37,937.16 2026-03-12
439 MS_DRG Disorders Of Pancreas Except Malignancy With Cc 1 1 $15,553.58 $15,553.58 $31,258.22 $31,258.22 $31,258.22 2026-03-12
809 MS_DRG Major Hematological And Immunological Diagnoses Except Sickle Cell Crisis And Co… 1 1 $13,000.09 $13,000.09 $28,704.73 $28,704.73 $28,704.73 2026-03-12
432 MS_DRG Cirrhosis And Alcoholic Hepatitis With Mcc 1 1 $12,935.80 $12,935.80 $28,640.44 $28,640.44 $28,640.44 2026-03-12
65 MS_DRG Intracranial Hemorrhage Or Cerebral Infarction With Cc Or Tpa In 24 Hours 1 1 $12,298.40 $12,298.40 $28,003.04 $28,003.04 $28,003.04 2026-03-12
291 MS_DRG Heart Failure And Shock With Mcc 1 1 $12,219.83 $12,219.83 $27,924.47 $27,924.47 $27,924.47 2026-03-12
29002104 CDM — 13 13 $30,685.70 $30,685.70 $16,877.14 $33,754.27 $27,310.27 2026-03-12
308 MS_DRG Cardiac Arrhythmia And Conduction Disorders With Mcc 1 1 $11,584.35 $11,584.35 $27,288.99 $27,288.99 $27,288.99 2026-03-12
191 MS_DRG Chronic Obstructive Pulmonary Disease With Cc 1 1 $11,213.38 $11,213.38 $26,918.02 $26,918.02 $26,918.02 2026-03-12
788 MS_DRG Cesarean Section Without Sterilization Without Cc/mcc 1 1 $27,690.60 $27,690.60 $26,335.77 $26,335.77 $26,335.77 2026-03-12
872 MS_DRG Septicemia Or Severe Sepsis Without Mv >96 Hours Without Mcc 1 1 $10,317.79 $10,317.79 $26,022.43 $26,022.43 $26,022.43 2026-03-12
177 MS_DRG Respiratory Infections And Inflammations With Mcc 1 1 $10,085.69 $10,085.69 $25,790.33 $25,790.33 $25,790.33 2026-03-12
193 MS_DRG Simple Pneumonia And Pleurisy With Mcc 1 1 $9,395.58 $9,395.58 $25,100.22 $25,100.22 $25,100.22 2026-03-12
638 MS_DRG Diabetes With Cc 1 1 $9,181.43 $9,181.43 $24,886.07 $24,886.07 $24,886.07 2026-03-12
29002303 CDM — 13 13 $25,443.90 $25,443.90 $13,994.15 $27,988.29 $22,645.07 2026-03-12
29002183 CDM — 13 13 $24,961.95 $24,961.95 $13,729.07 $27,458.15 $22,216.14 2026-03-12
27364 HCPCS Extensive Removal Of Growth Of Thigh Or Knee, 5.0 Cm Or More 13 13 $23,725.80 $23,725.80 $13,049.19 $23,289.25 $21,115.96 2026-03-12
37244 HCPCS Occlusion Of Artery Or Vein Bleeding With Review By Radiologist 24 13 $36,018.00 $36,018.00 $366.91 $35,355.27 $19,809.90 2026-03-12
445 MS_DRG Disorders Of The Biliary Tract With Cc 1 1 $19,572.36 $19,572.36 $18,636.82 $18,636.82 $18,636.82 2026-03-12
Q4282 HCPCS Cygnus Dual, Per Square Centimeter 39 13 $22,200.00 $22,200.00 $4,537.50 $33,129.00 $18,562.50 2026-03-12
29001705 CDM — 13 13 $19,530.00 $19,530.00 $10,741.50 $19,170.65 $17,381.70 2026-03-12
29000423 CDM — 13 13 $19,127.35 $19,127.35 $10,520.04 $21,040.09 $17,023.34 2026-03-12
J3101 HCPCS Injection, Tenecteplase, 1 Mg 13 13 $18,253.06 $18,253.06 $10,039.18 $17,917.20 $16,245.22 2026-03-12
440 MS_DRG Disorders Of Pancreas Except Malignancy Without Cc/mcc 2 2 $8,138.53 $8,138.53 $7,736.32 $23,843.17 $15,789.74 2026-03-12
805 MS_DRG Vaginal Delivery Without Sterilization Or D&c With Mcc 1 1 $7,800.80 $7,800.80 $15,653.12 $15,653.12 $15,653.12 2026-03-12
390 MS_DRG Gastrointestinal Obstruction Without Cc/mcc 1 1 $7,671.50 $7,671.50 $15,523.82 $15,523.82 $15,523.82 2026-03-12
683 MS_DRG Renal Failure With Cc 1 1 $7,309.53 $7,309.53 $15,161.85 $15,161.85 $15,161.85 2026-03-12
66 MS_DRG Intracranial Hemorrhage Or Cerebral Infarction Without Cc/mcc 1 1 $7,199.94 $7,199.94 $15,052.26 $15,052.26 $15,052.26 2026-03-12
178 MS_DRG Respiratory Infections And Inflammations With Cc 1 1 $7,183.69 $7,183.69 $15,036.01 $15,036.01 $15,036.01 2026-03-12
433 MS_DRG Cirrhosis And Alcoholic Hepatitis With Cc 1 1 $7,168.09 $7,168.09 $15,020.41 $15,020.41 $15,020.41 2026-03-12
281 MS_DRG Acute Myocardial Infarction, Discharged Alive With Cc 1 1 $6,886.65 $6,886.65 $14,738.97 $14,738.97 $14,738.97 2026-03-12
189 MS_DRG Pulmonary Edema And Respiratory Failure 1 1 $6,776.71 $6,776.71 $14,629.03 $14,629.03 $14,629.03 2026-03-12
29002140 CDM — 13 13 $16,065.00 $16,065.00 $8,835.75 $17,671.50 $14,297.85 2026-03-12
29002264 CDM — 13 13 $16,065.00 $16,065.00 $8,835.75 $17,671.50 $14,297.85 2026-03-12
29002346 CDM — 13 13 $16,065.00 $16,065.00 $8,835.75 $17,671.50 $14,297.85 2026-03-12
185 MS_DRG Major Chest Trauma Without Cc/mcc 1 1 $6,259.06 $6,259.06 $14,111.38 $14,111.38 $14,111.38 2026-03-12
190 MS_DRG Chronic Obstructive Pulmonary Disease With Mcc 1 1 $6,222.72 $6,222.72 $14,075.04 $14,075.04 $14,075.04 2026-03-12
33300 HCPCS Repair Of Wound To Heart 24 13 $25,512.65 $25,512.65 $1,354.55 $25,043.22 $14,031.96 2026-03-12
29001647 CDM — 13 13 $14,911.20 $14,911.20 $8,201.16 $16,402.32 $13,270.97 2026-03-12
282 MS_DRG Acute Myocardial Infarction, Discharged Alive Without Cc/mcc 1 1 $5,159.56 $5,159.56 $13,011.88 $13,011.88 $13,011.88 2026-03-12
536 MS_DRG Fractures Of Hip And Pelvis Without Mcc 1 1 $5,101.99 $5,101.99 $12,954.31 $12,954.31 $12,954.31 2026-03-12
391 MS_DRG Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders With Mcc 1 1 $5,040.67 $5,040.67 $12,892.99 $12,892.99 $12,892.99 2026-03-12
28615 HCPCS Treatment Of Dislocated Midfoot Bone 24 13 $23,327.40 $23,327.40 $491.20 $22,898.18 $12,830.07 2026-03-12
27350 HCPCS Removal Of Kneecap 24 13 $23,326.75 $23,326.75 $389.52 $22,897.54 $12,829.71 2026-03-12
779 MS_DRG Abortion Without D&c 1 1 $4,857.88 $4,857.88 $12,710.20 $12,710.20 $12,710.20 2026-03-12
28730 HCPCS Fusion Of Multiple Foot Joints 24 13 $23,041.10 $23,041.10 $427.28 $22,617.14 $12,672.61 2026-03-12
29002141 CDM — 13 13 $13,991.90 $13,991.90 $7,695.55 $15,391.09 $12,452.79 2026-03-12
29002265 CDM — 13 13 $13,991.85 $13,991.85 $7,695.52 $15,391.04 $12,452.75 2026-03-12
29002343 CDM — 13 13 $13,991.85 $13,991.85 $7,695.52 $15,391.04 $12,452.75 2026-03-12
29002329 CDM — 13 13 $13,991.85 $13,991.85 $7,695.52 $15,391.04 $12,452.75 2026-03-12
776 MS_DRG Postpartum And Post Abortion Diagnoses Without O.r. Procedures 1 1 $4,384.56 $4,384.56 $12,236.88 $12,236.88 $12,236.88 2026-03-12
28740 HCPCS Fusion Of Foot In Midfoot Region 24 13 $22,210.20 $22,210.20 $362.80 $21,801.53 $12,215.61 2026-03-12
28297 HCPCS Correction Of Bunion With Forefoot And Midfoot Bone Fusion 24 13 $22,210.20 $22,210.20 $568.55 $21,801.53 $12,215.61 2026-03-12
29002344 CDM — 13 13 $13,632.30 $13,632.30 $7,497.77 $14,995.53 $12,132.75 2026-03-12
26500 HCPCS Repair Of Ligament Surrounding Finger Tendon 24 13 $21,206.80 $21,206.80 $410.27 $20,816.59 $11,663.74 2026-03-12
24342 HCPCS Reinsertion Of Torn Upper Arm Tendon 24 13 $21,206.80 $21,206.80 $457.75 $20,816.59 $11,663.74 2026-03-12
29150784 CDM — 13 13 $13,063.65 $13,063.65 $7,185.01 $14,370.02 $11,626.65 2026-03-12
29002184 CDM — 13 13 $12,908.10 $12,908.10 $7,099.46 $14,198.91 $11,488.21 2026-03-12
29002200 CDM — 13 13 $12,908.10 $12,908.10 $7,099.46 $14,198.91 $11,488.21 2026-03-12
C1762 HCPCS Connective Tissue, Human (includes Fascia Lata) 26 13 $15,628.80 $15,628.80 $6,644.88 $21,093.60 $11,204.54 2026-03-12
29002304 CDM — 13 13 $12,533.25 $12,533.25 $6,893.29 $13,786.58 $11,154.59 2026-03-12
29000722 CDM — 13 13 $12,301.75 $12,301.75 $6,765.96 $12,075.40 $10,948.56 2026-03-12
29000742 CDM — 13 13 $12,301.75 $12,301.75 $6,765.96 $12,075.40 $10,948.56 2026-03-12
29000507 CDM — 13 13 $12,301.75 $12,301.75 $6,765.96 $13,531.93 $10,948.56 2026-03-12
47563 HCPCS Removal Of Gallbladder With X-ray Study Of Bile Ducts Using An Endoscope 24 13 $19,763.90 $19,763.90 $414.01 $19,400.24 $10,870.15 2026-03-12
29000407 CDM — 13 13 $12,081.60 $12,081.60 $6,644.88 $13,289.76 $10,752.62 2026-03-12
29007165 CDM — 13 13 $12,046.70 $12,046.70 $6,625.69 $11,825.04 $10,721.56 2026-03-12
29867 HCPCS Repair Of Knee Cartilage And Bone With Donor Cartilage Graft Using An Endoscope 24 13 $19,276.55 $19,276.55 $749.52 $18,921.86 $10,602.10 2026-03-12
19371 HCPCS Removal Of Capsule Around Breast Implant 13 13 $11,814.30 $11,814.30 $6,497.87 $11,596.92 $10,514.73 2026-03-12
49505 HCPCS Repair Of Groin Hernia (5 Years Or Older) 24 13 $19,101.40 $19,101.40 $303.92 $18,749.93 $10,505.77 2026-03-12
29002286 CDM — 13 13 $11,745.00 $11,745.00 $6,459.75 $12,919.50 $10,453.05 2026-03-12
394 MS_DRG Other Digestive System Diagnoses With Cc 2 2 $6,401.67 $6,401.67 $6,106.75 $14,253.99 $10,180.37 2026-03-12
29002246 CDM — 13 13 $11,379.00 $11,379.00 $6,258.45 $12,516.90 $10,127.31 2026-03-12
29002285 CDM — 13 13 $11,340.00 $11,340.00 $6,237.00 $12,474.00 $10,092.60 2026-03-12
566 MS_DRG Other Musculoskeletal System And Connective Tissue Diagnoses Without Cc/mcc 2 2 $4,020.24 $4,020.24 $8,056.40 $11,872.56 $9,964.48 2026-03-12
21552 HCPCS Removal Of Growth Of Soft Tissue Under Skin Of Neck Or Front Of Chest, 3.0 Cm Or… 24 13 $17,934.95 $17,934.95 $261.86 $17,604.95 $9,864.22 2026-03-12
29002266 CDM — 13 13 $11,067.00 $11,067.00 $6,086.85 $12,173.70 $9,849.63 2026-03-12
29002330 CDM — 13 13 $11,067.00 $11,067.00 $6,086.85 $12,173.70 $9,849.63 2026-03-12
29002347 CDM — 13 13 $11,067.00 $11,067.00 $6,086.85 $12,173.70 $9,849.63 2026-03-12
29002201 CDM — 13 13 $11,044.05 $11,044.05 $6,074.23 $12,148.46 $9,829.20 2026-03-12
29002186 CDM — 13 13 $11,044.05 $11,044.05 $6,074.23 $12,148.46 $9,829.20 2026-03-12
27792 HCPCS Treatment Of Broken Outer Lower Leg Bone At Ankle 24 13 $17,842.85 $17,842.85 $381.67 $17,514.54 $9,813.57 2026-03-12
27814 HCPCS Treatment Of Both Broken Lower Leg Bones At Ankle 24 13 $17,793.85 $17,793.85 $450.83 $17,466.44 $9,786.62 2026-03-12
29002267 CDM — 13 13 $10,980.30 $10,980.30 $6,039.17 $12,078.33 $9,772.47 2026-03-12
29002331 CDM — 13 13 $10,980.30 $10,980.30 $6,039.17 $12,078.33 $9,772.47 2026-03-12
29002364 CDM — 13 13 $10,980.30 $10,980.30 $6,039.17 $12,078.33 $9,772.47 2026-03-12
29002143 CDM — 13 13 $10,980.30 $10,980.30 $6,039.17 $12,078.33 $9,772.47 2026-03-12
29001885 CDM — 13 13 $10,872.75 $10,872.75 $5,980.01 $11,960.03 $9,676.75 2026-03-12
29002121 CDM — 13 13 $10,872.75 $10,872.75 $5,980.01 $11,960.03 $9,676.75 2026-03-12
27446 HCPCS Replacement Of Knee Joint On Side Of Knee 24 13 $17,534.05 $17,534.05 $669.52 $17,211.42 $9,643.73 2026-03-12
29150257 CDM — 13 13 $10,780.10 $10,780.10 $5,929.06 $10,581.75 $9,594.29 2026-03-12
29000156 CDM — 13 13 $10,774.65 $10,774.65 $5,926.06 $10,576.40 $9,589.44 2026-03-12
29020168 CDM — 13 13 $10,774.65 $10,774.65 $5,926.06 $10,576.40 $9,589.44 2026-03-12
29000700 CDM — 13 13 $10,738.70 $10,738.70 $5,906.29 $11,812.57 $9,557.44 2026-03-12
29002302 CDM — 13 13 $10,722.75 $10,722.75 $5,897.51 $11,795.03 $9,543.25 2026-03-12
29001936 CDM — 13 13 $10,627.50 $10,627.50 $5,845.13 $11,690.25 $9,458.48 2026-03-12
47562 HCPCS Removal Of Gallbladder Using An Endoscope 24 13 $17,095.50 $17,095.50 $381.11 $16,780.94 $9,402.53 2026-03-12
29000674 CDM — 13 13 $10,480.35 $10,480.35 $5,764.19 $11,528.39 $9,327.51 2026-03-12
29001981 CDM — 13 13 $10,473.72 $10,473.72 $5,760.55 $10,281.00 $9,321.61 2026-03-12
C1776 HCPCS Joint Device (implantable) 104 13 $11,192.12 $11,192.12 $3,514.89 $50,645.76 $9,321.14 2026-03-12
29150258 CDM — 13 13 $10,379.00 $10,379.00 $5,708.45 $10,188.03 $9,237.31 2026-03-12
29000128 CDM — 13 13 $10,355.00 $10,355.00 $5,695.25 $11,390.50 $9,215.95 2026-03-12
29000420 CDM — 13 13 $10,302.00 $10,302.00 $5,666.10 $11,332.20 $9,168.78 2026-03-12
29380076 CDM — 13 13 $10,087.95 $10,087.95 $5,548.37 $11,096.75 $8,978.28 2026-03-12
A4264 HCPCS Permanent Implantable Contraceptive Intratubal Occlusion Device(s) And Delivery … 13 13 $10,082.50 $10,082.50 $5,545.38 $11,090.75 $8,973.43 2026-03-12
Q5123 HCPCS Injection, Rituximab-arrx, Biosimilar, (riabni), 10 Mg 26 13 $12,924.90 $12,924.90 $4,739.13 $16,916.11 $8,968.15 2026-03-12
29380078 CDM — 13 13 $9,968.05 $9,968.05 $5,482.43 $10,964.86 $8,871.56 2026-03-12
29380079 CDM — 13 13 $9,968.05 $9,968.05 $5,482.43 $10,964.86 $8,871.56 2026-03-12
29000237 CDM — 13 13 $9,891.75 $9,891.75 $5,440.46 $9,709.74 $8,803.66 2026-03-12
29380077 CDM — 13 13 $9,592.00 $9,592.00 $5,275.60 $10,551.20 $8,536.88 2026-03-12
25100000 CDM Biktarvy 50-200-25 Mg Tablet 13 13 $9,554.90 $9,554.90 $5,255.20 $9,379.09 $8,503.86 2026-03-12
25006668 CDM Biktarvy 50-200-25 Mg Tablet 13 13 $9,554.90 $9,554.90 $5,255.20 $9,379.09 $8,503.86 2026-03-12
C1716 HCPCS — 13 13 $9,537.50 $9,537.50 $5,245.63 $10,491.25 $8,488.38 2026-03-12
25609 HCPCS Treatment Of 3 Or More Broken Lower Forearm Bone Pieces On Thumb Side Inside Wri… 24 13 $15,369.95 $15,369.95 $624.29 $15,087.14 $8,453.47 2026-03-12
29020000 CDM — 13 13 $9,481.95 $9,481.95 $5,215.07 $9,307.48 $8,438.94 2026-03-12
26608 HCPCS Treatment Of Broken Finger Bone With Stabilizing Device Accessed Through Skin 24 13 $15,276.00 $15,276.00 $291.58 $14,994.92 $8,401.80 2026-03-12
29001564 CDM — 13 13 $9,360.95 $9,360.95 $5,148.52 $10,297.05 $8,331.25 2026-03-12
29002187 CDM — 13 13 $9,320.25 $9,320.25 $5,126.14 $10,252.28 $8,295.02 2026-03-12
59812 HCPCS Treatment Of Miscarriage 13 13 $9,299.65 $9,299.65 $5,114.81 $9,128.54 $8,276.69 2026-03-12
59412 HCPCS Turning Of Fetus Through External Manipulation 13 13 $9,299.65 $9,299.65 $5,114.81 $9,128.54 $8,276.69 2026-03-12
29009041 CDM — 13 13 $9,210.50 $9,210.50 $5,065.78 $10,131.55 $8,197.35 2026-03-12
29888 HCPCS Repair Of Anterior Cruciate Ligament Of Knee Using An Endoscope 24 13 $14,875.30 $14,875.30 $569.89 $14,601.59 $8,181.42 2026-03-12
446 MS_DRG Disorders Of The Biliary Tract Without Cc/mcc 1 1 $8,554.80 $8,554.80 $8,132.64 $8,132.64 $8,132.64 2026-03-12
58615 HCPCS Tying Of Fallopian Tubes By Device Through Vagina 13 13 $9,111.65 $9,111.65 $5,011.41 $8,944.00 $8,109.37 2026-03-12
27416 HCPCS Implantation Of Self Cartilage Cells Into Knee Bone 24 13 $14,690.90 $14,690.90 $575.69 $14,420.59 $8,080.00 2026-03-12
29000238 CDM — 13 13 $9,028.50 $9,028.50 $4,965.68 $9,931.35 $8,035.37 2026-03-12
29000630 CDM — 13 13 $8,887.90 $8,887.90 $4,888.35 $9,776.69 $7,910.23 2026-03-12
29000419 CDM — 13 13 $8,882.45 $8,882.45 $4,885.35 $9,770.70 $7,905.38 2026-03-12
44970 HCPCS Removal Of Appendix Using An Endoscope 24 13 $14,338.65 $14,338.65 $348.03 $14,074.82 $7,886.26 2026-03-12
59612 HCPCS Vaginal Delivery After Previous Cesarean Delivery 13 13 $8,855.70 $8,855.70 $4,870.64 $8,692.76 $7,881.57 2026-03-12
J1950 HCPCS Injection, Leuprolide Acetate (for Depot Suspension), Per 3.75 Mg 13 13 $8,831.20 $8,831.20 $4,857.16 $8,668.71 $7,859.77 2026-03-12
29020068 CDM — 13 13 $8,788.75 $8,788.75 $4,833.81 $8,627.04 $7,821.99 2026-03-12
29002188 CDM — 13 13 $8,703.15 $8,703.15 $4,786.73 $9,573.47 $7,745.80 2026-03-12
29002204 CDM — 13 13 $8,703.15 $8,703.15 $4,786.73 $9,573.47 $7,745.80 2026-03-12
29002105 CDM — 13 13 $8,676.40 $8,676.40 $4,772.02 $9,544.04 $7,722.00 2026-03-12
29001956 CDM — 13 13 $8,609.95 $8,609.95 $4,735.47 $9,470.95 $7,662.86 2026-03-12
Q4197 HCPCS Puraply Xt 1 Sq Cm 13 13 $8,500.00 $8,500.00 $4,675.00 $8,343.60 $7,565.00 2026-03-12
29002301 CDM — 13 13 $8,450.70 $8,450.70 $4,647.89 $9,295.77 $7,521.12 2026-03-12
29001937 CDM — 13 13 $8,447.50 $8,447.50 $4,646.13 $9,292.25 $7,518.28 2026-03-12
25575 HCPCS Treatment Of Broken Midpart Of Both Forearm Bones With Placement Of Stabilizing … 24 13 $13,620.30 $13,620.30 $536.25 $13,369.69 $7,491.17 2026-03-12
29002182 CDM — 13 13 $8,364.00 $8,364.00 $4,600.20 $9,200.40 $7,443.96 2026-03-12
29380074 CDM — 13 13 $8,301.45 $8,301.45 $4,565.80 $9,131.60 $7,388.29 2026-03-12
29150006 CDM — 13 13 $8,262.20 $8,262.20 $4,544.21 $9,088.42 $7,353.36 2026-03-12
29150004 CDM — 13 13 $8,262.20 $8,262.20 $4,544.21 $9,088.42 $7,353.36 2026-03-12
29150009 CDM — 13 13 $8,262.20 $8,262.20 $4,544.21 $9,088.42 $7,353.36 2026-03-12
29150005 CDM — 13 13 $8,262.20 $8,262.20 $4,544.21 $9,088.42 $7,353.36 2026-03-12
29150011 CDM — 13 13 $8,262.20 $8,262.20 $4,544.21 $9,088.42 $7,353.36 2026-03-12
29150010 CDM — 13 13 $8,262.20 $8,262.20 $4,544.21 $9,088.42 $7,353.36 2026-03-12
32110 HCPCS Repair Of Tear Of Lung And/or Control Of Traumatic Bleeding Through Chest 26 13 $11,497.73 $11,497.73 $834.56 $17,709.49 $7,314.55 2026-03-12
29000808 CDM — 13 13 $8,194.65 $8,194.65 $4,507.06 $9,014.12 $7,293.24 2026-03-12
29000522 CDM — 13 13 $8,194.65 $8,194.65 $4,507.06 $9,014.12 $7,293.24 2026-03-12
29000409 CDM — 13 13 $8,194.65 $8,194.65 $4,507.06 $9,014.12 $7,293.24 2026-03-12
29000807 CDM — 13 13 $8,194.65 $8,194.65 $4,507.06 $9,014.12 $7,293.24 2026-03-12
29000806 CDM — 13 13 $8,194.65 $8,194.65 $4,507.06 $9,014.12 $7,293.24 2026-03-12
29000723 CDM — 13 13 $8,194.65 $8,194.65 $4,507.06 $8,043.87 $7,293.24 2026-03-12
29000743 CDM — 13 13 $8,194.65 $8,194.65 $4,507.06 $8,043.87 $7,293.24 2026-03-12
29000608 CDM — 13 13 $8,194.65 $8,194.65 $4,507.06 $9,014.12 $7,293.24 2026-03-12
29000810 CDM — 13 13 $8,194.65 $8,194.65 $4,507.06 $9,014.12 $7,293.24 2026-03-12
29000509 CDM — 13 13 $8,194.65 $8,194.65 $4,507.06 $9,014.12 $7,293.24 2026-03-12
29001553 CDM — 13 13 $8,011.50 $8,011.50 $4,406.33 $8,812.65 $7,130.24 2026-03-12
29000537 CDM — 13 13 $7,989.70 $7,989.70 $4,394.34 $8,788.67 $7,110.83 2026-03-12
29877 HCPCS Removal Or Shaving Of Knee Joint Cartilage Using An Endoscope 24 13 $12,835.80 $12,835.80 $368.78 $12,599.62 $7,059.69 2026-03-12
29883 HCPCS Repair Of Inside And Outside Knee Joint Cartilage Using An Endoscope 24 13 $12,786.70 $12,786.70 $494.38 $12,551.42 $7,032.69 2026-03-12
29380437 CDM — 13 13 $7,626.75 $7,626.75 $4,194.71 $8,389.43 $6,787.81 2026-03-12
81420 HCPCS Test For Detecting Genes Associated With Fetal Disease, Aneuploidy Genomic Seque… 13 13 $7,617.30 $7,617.30 $4,189.52 $7,477.14 $6,779.40 2026-03-12
29001978 CDM — 13 13 $7,570.05 $7,570.05 $4,163.53 $7,430.76 $6,737.34 2026-03-12
29000220 CDM — 13 13 $7,548.25 $7,548.25 $4,151.54 $7,409.36 $6,717.94 2026-03-12
27829 HCPCS Treatment Of Ligament Tear At Ankle Joint 24 13 $12,201.95 $12,201.95 $417.94 $11,977.43 $6,711.07 2026-03-12
29000388 CDM — 13 13 $7,518.00 $7,518.00 $4,134.90 $8,269.80 $6,691.02 2026-03-12
29002100 CDM — 13 13 $7,382.60 $7,382.60 $4,060.43 $8,120.86 $6,570.51 2026-03-12
29001970 CDM — 13 13 $7,382.60 $7,382.60 $4,060.43 $8,120.86 $6,570.51 2026-03-12
29002049 CDM — 13 13 $7,362.95 $7,362.95 $4,049.62 $7,227.47 $6,553.03 2026-03-12
29000418 CDM — 13 13 $7,323.75 $7,323.75 $4,028.06 $8,056.13 $6,518.14 2026-03-12
J7298 HCPCS Levonorgestrel-releasing Intrauterine Contraceptive System (mirena), 52 Mg 13 13 $7,287.78 $7,287.78 $4,008.28 $7,153.68 $6,486.12 2026-03-12
29000350 CDM — 13 13 $7,236.55 $7,236.55 $3,980.10 $7,960.21 $6,440.53 2026-03-12
29150001 CDM — 13 13 $7,221.25 $7,221.25 $3,971.69 $7,088.38 $6,426.91 2026-03-12
29000012 CDM — 13 13 $7,151.50 $7,151.50 $3,933.33 $7,866.65 $6,364.84 2026-03-12
29131 HCPCS Application Of Hinged Finger Splint 13 13 $7,114.55 $7,114.55 $3,913.00 $6,983.64 $6,331.95 2026-03-12
29000236 CDM — 13 13 $7,085.00 $7,085.00 $3,896.75 $6,954.64 $6,305.65 2026-03-12
29001998 CDM — 13 13 $7,057.75 $7,057.75 $3,881.76 $6,927.89 $6,281.40 2026-03-12
29370015 CDM — 13 13 $7,057.75 $7,057.75 $3,881.76 $6,927.89 $6,281.40 2026-03-12
29002337 CDM — 13 13 $7,050.00 $7,050.00 $3,877.50 $7,755.00 $6,274.50 2026-03-12
29002106 CDM — 13 13 $7,040.35 $7,040.35 $3,872.19 $7,744.39 $6,265.91 2026-03-12
29000380 CDM — 13 13 $7,035.95 $7,035.95 $3,869.77 $7,739.55 $6,262.00 2026-03-12
29380014 CDM — 13 13 $7,035.30 $7,035.30 $3,869.42 $7,738.83 $6,261.42 2026-03-12
395 MS_DRG Other Digestive System Diagnoses Without Cc/mcc 1 1 $6,524.03 $6,524.03 $6,214.79 $6,214.79 $6,214.79 2026-03-12
29887 HCPCS Repair Of Knee Joint With Bone Graft And Internal Stabilizing Device Using An En… 24 13 $11,287.60 $11,287.60 $446.91 $11,079.91 $6,208.18 2026-03-12
55540 HCPCS Removal Of Spermatic Cord Venous Dilation Or Suturing Spermatic Veins With Herni… 24 13 $11,285.60 $11,285.60 $322.61 $11,077.95 $6,207.08 2026-03-12
38531 HCPCS Biopsy Or Removal Of Lymph Nodes Of Groin 24 13 $11,194.75 $11,194.75 $259.62 $10,988.77 $6,157.11 2026-03-12
29150703 CDM — 13 13 $6,894.25 $6,894.25 $3,791.84 $7,583.68 $6,135.88 2026-03-12
29150704 CDM — 13 13 $6,894.25 $6,894.25 $3,791.84 $7,583.68 $6,135.88 2026-03-12
J7168 HCPCS Prothrombin Complex Concentrate (human), Kcentra, Per I.u. Of Factor Ix Activity 13 13 $6,820.00 $6,820.00 $3,751.00 $6,694.51 $6,069.80 2026-03-12
29002342 CDM — 13 13 $6,816.15 $6,816.15 $3,748.88 $7,497.77 $6,066.37 2026-03-12
29001938 CDM — 13 13 $6,812.50 $6,812.50 $3,746.88 $7,493.75 $6,063.13 2026-03-12
32160 HCPCS Massage Of Heart Muscle Through Chest 24 13 $10,885.90 $10,885.90 $455.50 $10,685.60 $5,987.25 2026-03-12
J2997 HCPCS Injection, Alteplase Recombinant, 1 Mg 26 13 $10,738.73 $10,738.73 $187.88 $20,746.96 $5,980.02 2026-03-12
29001886 CDM — 13 13 $6,703.50 $6,703.50 $3,686.93 $7,373.85 $5,966.12 2026-03-12
29002102 CDM — 13 13 $6,581.45 $6,581.45 $3,619.80 $7,239.60 $5,857.49 2026-03-12
29001971 CDM — 13 13 $6,570.55 $6,570.55 $3,613.80 $7,227.61 $5,847.79 2026-03-12
29002101 CDM — 13 13 $6,523.65 $6,523.65 $3,588.01 $6,403.61 $5,806.05 2026-03-12
29001969 CDM — 13 13 $6,523.65 $6,523.65 $3,588.01 $7,176.02 $5,806.05 2026-03-12
29882 HCPCS Repair Of Inside Or Outside Knee Joint Cartilage Using An Endoscope 24 13 $10,546.15 $10,546.15 $407.09 $10,352.10 $5,800.38 2026-03-12
29000575 CDM — 13 13 $6,512.75 $6,512.75 $3,582.01 $7,164.03 $5,796.35 2026-03-12
C1768 HCPCS Graft, Vascular 325 13 $7,745.28 $7,745.28 $107.91 $16,247.88 $5,779.80 2026-03-12
27422 HCPCS Repair Of Dislocating Kneecap With Realignment 24 13 $10,486.75 $10,486.75 $440.55 $10,293.79 $5,767.71 2026-03-12
29002144 CDM — 13 13 $6,468.56 $6,468.56 $3,557.71 $7,115.42 $5,757.02 2026-03-12
29002190 CDM — 13 13 $6,448.82 $6,448.82 $3,546.85 $6,330.16 $5,739.45 2026-03-12
29000515 CDM — 13 13 $6,447.35 $6,447.35 $3,546.04 $7,092.09 $5,738.14 2026-03-12
29380429 CDM — 13 13 $6,403.75 $6,403.75 $3,522.06 $7,044.13 $5,699.34 2026-03-12
59409 HCPCS Vaginal Delivery 37 13 $9,080.85 $9,080.85 $701.64 $9,562.01 $5,691.81 2026-03-12
29000848 CDM — 13 13 $6,390.70 $6,390.70 $3,514.89 $7,029.77 $5,687.72 2026-03-12
29000693 CDM — 13 13 $6,390.70 $6,390.70 $3,514.89 $7,029.77 $5,687.72 2026-03-12
29000843 CDM — 13 13 $6,390.70 $6,390.70 $3,514.89 $7,029.77 $5,687.72 2026-03-12
29000724 CDM — 13 13 $6,390.70 $6,390.70 $3,514.89 $6,273.11 $5,687.72 2026-03-12
29000814 CDM — 13 13 $6,390.70 $6,390.70 $3,514.89 $7,029.77 $5,687.72 2026-03-12
29000508 CDM — 13 13 $6,390.70 $6,390.70 $3,514.89 $7,029.77 $5,687.72 2026-03-12
29000812 CDM — 13 13 $6,390.70 $6,390.70 $3,514.89 $7,029.77 $5,687.72 2026-03-12
29000411 CDM — 13 13 $6,390.70 $6,390.70 $3,514.89 $7,029.77 $5,687.72 2026-03-12
29000813 CDM — 13 13 $6,390.70 $6,390.70 $3,514.89 $7,029.77 $5,687.72 2026-03-12
29000387 CDM — 13 13 $6,390.70 $6,390.70 $3,514.89 $7,029.77 $5,687.72 2026-03-12
29000845 CDM — 13 13 $6,390.70 $6,390.70 $3,514.89 $7,029.77 $5,687.72 2026-03-12
29000741 CDM — 13 13 $6,390.70 $6,390.70 $3,514.89 $6,273.11 $5,687.72 2026-03-12
29000523 CDM — 13 13 $6,390.70 $6,390.70 $3,514.89 $7,029.77 $5,687.72 2026-03-12
29000297 CDM — 13 13 $6,376.50 $6,376.50 $3,507.08 $7,014.15 $5,675.09 2026-03-12
29000737 CDM — 13 13 $6,374.35 $6,374.35 $3,505.89 $7,011.79 $5,673.17 2026-03-12
Q4160 HCPCS Nushield, Per Square Centimeter 104 13 $7,400.00 $7,400.00 $1,420.82 $11,190.24 $5,646.02 2026-03-12
29001977 CDM — 13 13 $6,322.00 $6,322.00 $3,477.10 $6,205.68 $5,626.58 2026-03-12
29000607 CDM — 13 13 $6,322.00 $6,322.00 $3,477.10 $6,205.68 $5,626.58 2026-03-12
27652 HCPCS Repair Of Ruptured Achilles Tendon With Graft 24 13 $10,162.95 $10,162.95 $392.52 $9,975.95 $5,589.62 2026-03-12
29000421 CDM — 13 13 $6,271.90 $6,271.90 $3,449.55 $6,156.50 $5,581.99 2026-03-12
29000400 CDM — 13 13 $6,254.45 $6,254.45 $3,439.95 $6,879.90 $5,566.46 2026-03-12
29000394 CDM — 13 13 $6,254.45 $6,254.45 $3,439.95 $6,879.90 $5,566.46 2026-03-12
28122 HCPCS Partial Removal Of Foot Or Heel Bone 24 13 $10,034.35 $10,034.35 $260.56 $9,849.72 $5,518.89 2026-03-12
29875 HCPCS Partial Removal Of Knee Joint Lining Using An Endoscope 24 13 $10,032.70 $10,032.70 $296.07 $9,848.10 $5,517.99 2026-03-12
27340 HCPCS Removal Of Fluid-filled Sac From Joint At Front Of Knee 24 13 $10,032.70 $10,032.70 $99.00 $9,848.10 $5,517.99 2026-03-12
24105 HCPCS Removal Of Fluid-filled Sac Of Elbow 24 13 $10,032.70 $10,032.70 $220.00 $9,848.10 $5,517.99 2026-03-12
J2993 HCPCS Injection, Reteplase, 18.1 Mg 13 13 $6,197.65 $6,197.65 $3,408.71 $6,083.61 $5,515.91 2026-03-12
25606 HCPCS Placement Of Stabilizing Device For Broken Forearm Bone On Thumb Side At Wrist 24 13 $10,005.95 $10,005.95 $402.05 $9,821.84 $5,503.27 2026-03-12
29879 HCPCS Repair Of Knee Joint With Drilling And Or Scraping Of Joint Using An Endoscope 24 13 $10,000.25 $10,000.25 $392.33 $9,816.25 $5,500.14 2026-03-12
29881 HCPCS Removal Of Knee Cartilage Using An Endoscope 24 13 $9,979.70 $9,979.70 $322.42 $9,796.07 $5,488.84 2026-03-12
J1568 HCPCS Injection, Immune Globulin, (octagam), Intravenous, Non-lyophilized (e.g., Liqui… 26 13 $8,304.60 $8,304.60 $2,287.89 $12,220.33 $5,465.22 2026-03-12
56440 HCPCS Creation Of Drainage Tract For Gland Cyst Of Female Genitals 24 13 $9,741.55 $9,741.55 $105.61 $9,562.31 $5,357.85 2026-03-12
29871 HCPCS Exam, Washing, And Drainage Of Infected Knee Joint Using An Endoscope 24 13 $9,705.10 $9,705.10 $307.47 $9,526.53 $5,337.81 2026-03-12
25447 HCPCS Replacement Of Joint Between Wrist And Fingers Using Tissue 24 13 $9,705.10 $9,705.10 $476.63 $9,526.53 $5,337.81 2026-03-12
26350 HCPCS Repair Of Finger Tendon Of Under Side Of Hand Other Than Upper Most Part Of Palm… 24 13 $9,704.80 $9,704.80 $446.16 $9,526.23 $5,337.64 2026-03-12
26356 HCPCS Primary Repair Of Finger Tendon On Underside Of The Hand Without A Graft In Zone… 24 13 $9,704.80 $9,704.80 $476.63 $9,526.23 $5,337.64 2026-03-12
29000241 CDM — 13 13 $5,967.75 $5,967.75 $3,282.26 $6,564.53 $5,311.30 2026-03-12
32100 HCPCS Incision And Exploration Of Chest Cavity 24 13 $9,544.10 $9,544.10 $459.06 $9,368.49 $5,249.26 2026-03-12
29001134 CDM — 13 13 $5,886.00 $5,886.00 $3,237.30 $5,777.70 $5,238.54 2026-03-12
29150765 CDM — 13 13 $5,886.00 $5,886.00 $3,237.30 $5,777.70 $5,238.54 2026-03-12
26735 HCPCS Treatment Of Broken Finger At Midportion Or Part Near Hand 24 13 $9,516.25 $9,516.25 $357.75 $9,341.15 $5,233.94 2026-03-12
70542 HCPCS MRI Orbit/face/neck With Contrast 13 13 $5,868.45 $5,868.45 $3,227.65 $5,760.47 $5,222.92 2026-03-12
29000543 CDM — 13 13 $5,853.30 $5,853.30 $3,219.32 $6,438.63 $5,209.44 2026-03-12
Q4180 HCPCS Revita, Per Square Centimeter 78 13 $7,155.85 $7,155.85 $1,384.85 $10,311.40 $5,191.43 2026-03-12
J7307 HCPCS Etonogestrel (contraceptive) Implant System, Including Implant And Supplies 13 13 $5,822.80 $5,822.80 $3,202.54 $6,405.08 $5,182.29 2026-03-12
2000111 CDM — 13 13 $5,820.10 $5,820.10 $3,201.06 $5,713.01 $5,179.89 2026-03-12
29000245 CDM — 13 13 $5,810.80 $5,810.80 $3,195.94 $6,391.88 $5,171.61 2026-03-12
29006785 CDM — 13 13 $5,803.20 $5,803.20 $3,191.76 $6,383.52 $5,164.85 2026-03-12
J7300 HCPCS Intrauterine Copper Contraceptive 13 13 $5,784.65 $5,784.65 $3,181.56 $5,678.21 $5,148.34 2026-03-12
27767 HCPCS Closed Treatment Of Back Portion Of Shin Bone At Ankle 24 13 $9,337.90 $9,337.90 $181.87 $9,166.08 $5,135.85 2026-03-12
29002341 CDM — 13 13 $5,765.55 $5,765.55 $3,171.05 $6,342.11 $5,131.34 2026-03-12
29000381 CDM — 13 13 $5,748.70 $5,748.70 $3,161.79 $5,642.92 $5,116.34 2026-03-12
59514 HCPCS Cesarean Delivery 24 13 $9,299.65 $9,299.65 $796.91 $9,128.54 $5,114.81 2026-03-12
29006778 CDM — 13 13 $5,742.15 $5,742.15 $3,158.18 $6,316.37 $5,110.51 2026-03-12
29000399 CDM — 13 13 $5,738.00 $5,738.00 $3,155.90 $6,311.80 $5,106.82 2026-03-12
Q4196 HCPCS Puraply Am, Per Square Centimeter 91 13 $6,600.00 $6,600.00 $1,485.00 $17,492.11 $5,048.35 2026-03-12
29880 HCPCS Removal Of Both Knee Cartilages Using An Endoscope 24 13 $9,171.10 $9,171.10 $334.20 $9,002.35 $5,044.11 2026-03-12
2000110 CDM — 13 13 $5,659.30 $5,659.30 $3,112.62 $5,555.17 $5,036.78 2026-03-12
29002189 CDM — 13 13 $5,651.03 $5,651.03 $3,108.07 $5,547.05 $5,029.42 2026-03-12
29370016 CDM — 13 13 $5,613.50 $5,613.50 $3,087.43 $5,510.21 $4,996.02 2026-03-12
59414 HCPCS Delivery Of Placenta 24 13 $9,080.85 $9,080.85 $79.49 $8,913.76 $4,994.47 2026-03-12
33020 HCPCS Removal Of Blood Clot Or Foreign Body In Heart Sac 24 13 $9,055.05 $9,055.05 $465.04 $8,888.44 $4,980.28 2026-03-12
11462 HCPCS Removal Of Skin And Tissue Of Groin For Inflamed Sweat Glands With Simple Or Int… 24 13 $9,040.05 $9,040.05 $245.54 $8,873.71 $4,972.03 2026-03-12
29009931 CDM — 13 13 $5,565.55 $5,565.55 $3,061.05 $5,463.14 $4,953.34 2026-03-12
29001935 CDM — 13 13 $5,559.00 $5,559.00 $3,057.45 $6,114.90 $4,947.51 2026-03-12
29000062 CDM — 13 13 $5,559.00 $5,559.00 $3,057.45 $6,114.90 $4,947.51 2026-03-12
28119 HCPCS Removal Of Heel Bone Spur 24 13 $8,966.05 $8,966.05 $310.27 $8,801.07 $4,931.33 2026-03-12
29000593 CDM — 13 13 $5,513.25 $5,513.25 $3,032.29 $6,064.58 $4,906.79 2026-03-12
29002234 CDM — 13 13 $5,512.50 $5,512.50 $3,031.88 $5,411.07 $4,906.13 2026-03-12
2000109 CDM — 13 13 $5,498.55 $5,498.55 $3,024.20 $5,397.38 $4,893.71 2026-03-12
29000175 CDM — 13 13 $5,480.55 $5,480.55 $3,014.30 $5,379.71 $4,877.69 2026-03-12
29001131 CDM — 13 13 $5,395.50 $5,395.50 $2,967.53 $5,296.22 $4,802.00 2026-03-12
29001133 CDM — 13 13 $5,395.50 $5,395.50 $2,967.53 $5,296.22 $4,802.00 2026-03-12
49525 HCPCS Repair Of Sliding Groin Hernia 24 13 $8,715.60 $8,715.60 $332.89 $8,555.23 $4,793.58 2026-03-12
81009004 CDM — 3 3 $5,282.15 $5,282.15 $1,320.54 $5,018.04 $4,753.94 2026-03-12
2000108 CDM — 13 13 $5,337.75 $5,337.75 $2,935.76 $5,239.54 $4,750.60 2026-03-12
29009511 CDM — 13 13 $5,303.95 $5,303.95 $2,917.17 $5,834.35 $4,720.52 2026-03-12
29009510 CDM — 13 13 $5,303.95 $5,303.95 $2,917.17 $5,834.35 $4,720.52 2026-03-12
27676 HCPCS Repair Of Dislocated Lower Leg Tendons By Incision Or Partial Removal Of Lower L… 24 13 $8,482.90 $8,482.90 $361.11 $8,326.81 $4,665.60 2026-03-12
27659 HCPCS Secondary Repair Of Tendon On Back Of Leg 24 13 $8,482.90 $8,482.90 $279.81 $8,326.81 $4,665.60 2026-03-12
23333 HCPCS Removal Of Foreign Body Of Shoulder Joint, Accessed Beneath The Tissue Or Muscle 24 13 $8,430.00 $8,430.00 $284.48 $8,274.89 $4,636.50 2026-03-12
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